Pubdate: Wed, 24 Feb 1999
Source: Redding Record Searchlight (CA)
Copyright: Redding Record Searchlight - E.W. Scripps
Contact:  http://www.redding.com/
Forum: http://www.redding.com/disc2_frm.htm
Author:  Jim Schultz

THEY HAD CONCERNS ABOUT PRESCRIPTIONS

North state pharmacists said Tuesday that they often refused to fill some
prescriptions written by Dr. Frank Fisher because they feared the dosages
and quantities were excessive.

Bob Harrel, pharmacist at Safeway Food & Drug in Anderson, said he began
refusing to honor all Fisher’s prescriptions three years ago.

“I thought his (controlled substances) prescriptions were inappropriate for
the (walk-in practice) he had”, Harrel said.

Although Harrel said he has refused before to fill prescriptions during his
32 years as a pharmacist, he had never before issued such a blanket
prohibition against any one physician.

Harrel said he wasn’t surprised by Fisher’s arrest last week at his Anderson
clinic for allegedly over-prescribing drugs that may have led to the deaths
of three people.

“I felt it would come,” he said “I just didn’t know when.”

Some of Fisher’s supporters believe he is being railroaded because he has
recommended medicinal marijuana to some patients.  But north state
pharmacists interviewed Tuesday said Fisher caused them serious concerns.

“It got to the point where it was ridiculous,” said an established Anderson
pharmacist who requested anonymity for fear of retribution.

He said Redding resident Fisher, 45, would sometimes prescribe as many as
1,000 tablets of a drug to patients when the average quantity was 24.

“Give me a break,” he said “I have never before seen any (prescriptions)
that were so flagrant.”

So, he said, he closely inspected the need for such drugs when patients
brought in prescriptions written by the doctor and refused to fill them if
the illness did not warrant the requested dosages.

“My license is too valuable” to jeopardize, he said.

“We did turn a lot of people away.”

The decision whether to fill the prescriptions was made on a case-by-case
basis and through consultations with the patients and Fisher, he added.

Frank Hatanaka, pharmacist at Rite Aid Pharmacies in Anderson, said he would
also decide whether to fill Fisher’s prescriptions based on each request.
Some to the quantity and strength of the pills were “a little bit high” and
he would not provide them.

Hatanaka said he had few problems with Fisher’s drug prescriptions up until
a few years ago.

Daryl Odegard, pharmacist at Owens Pharmacy next door to Fisher’s clinic,
said “just about everybody” ran into the same problem when it came to the
doctor’s prescriptions.

“He was unique in that way,” he said.

Still, he does not want to make any assumptions about Fisher’s innocence or
guilt.

“We try to stay clear of that,” he said, adding that he was surprised by the
doctor’s recent arrest.

Fisher, a 1981 Harvard Medical School graduate who was licensed to practice
medicine in California in 1982, was arrested Thursday at his Westwood
Walk-In Clinic.

Also arrested were Stephen and Madeline Miller, owners of Shasta Pharmacy in
Redding.  The trio is being charged with three counts murder each and 24
counts of Medi-Cal fraud and drug-related offenses.

Investigators accuse Fisher and the Millers of unnecessarily prescribing and
furnishing drugs to make money off Medi-Cal.

Authorities allege prescriptions written by Fisher and dispensed by the
Millers resulted in the 1998 deaths of Tamara Stevens, 38 of Anderson,
Rebecca Mae Williams, 34, of Cottonwood and Bruce Johanssen Jr., 19, of
Redding.

The state’s two-year investigation was partially triggered by reports of
increases in overdoses at Redding-area emergency rooms and tips from
pharmacies and patients about the volume of oxycodone, a highly additive
narcotic, and other controlled drugs prescribed by Fisher.

Mike Arnold, executive director of the Shasta-Trinity County Medical
Society, said Tuesday that about 90 of the society’s 200 physicians met
Monday with state and federal representatives at Mercy Medical Center in
Redding to discuss how best to cope with treating Fisher’s many patients,
some of whom have become addicted to the drugs he prescribed.

“We’re asking them to help” with the heavy workload, he said.

Although several doctors agreed to see some of Fisher’s patients, many
voiced apprehension because they are not trained or allowed to prescribe
treatments for detoxification under existing laws, Arnold said.

Also, he said some don’t want to expose themselves to possible liability or
be further burdened by strict government record-keeping requirements.

Still, the society and its members want to work with government and law
enforcement agencies to try to adequately treat the patients and resolve
what he termed a community crisis, Arnold said.

The society, which has established a hot line to try to find doctors for
Fisher’s patients, has been inundated with calls, he said.

It was originally believed that between 3000 and 5000 patients would need
assistance, but medical officials now say that number may be higher.  “We
have had calls from as far away as Sacramento,” Arnold said.

The number is 247-7784.

Dr. Ann Murphy, medical director of the Shasta Community Health Center in
Redding, said Tuesday that Monday’s meeting did not go as well as she had
hoped.

“We did not get a whole-hearted sense of support from the different
agencies,” she said.

Those agencies represented during the meeting were the federal Drug
Enforcement Administration, the State Board of Pharmacy and the state
attorney general’s office, she said.

Murphy said a relaxation some state and federal laws is needed so doctors
can help Fisher’s patients kick their drug habits.

“They want assurances that they won’t be prosecuted if they diagnose and
treat patients for their drug dependence,” she said.

But, she said, she and the doctors were not encouraged by the responses they
received from the agency representatives.

“There were a lot of mixed messages,” she said.  “It could have been more
encouraging.  But we’ll have to take a big breath, evaluate each patient,
and then do the right thing by them.”

Ironically, Fisher worked for the Shasta Community Health Center in the
early 1990’s, but Murphy said he only worked there a few months before
leaving.

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