Physician Suspended After 15 Deaths Linked to Pain Meds

September 26, 2012

September 26, 2012 — The state of Kentucky has told a family physician to stop practicing medicine until it resolves charges against him involving the deaths of 15 patients for whom he prescribed pain medications. Of the 15 patients, 14 died of drug overdose.

On Monday, the Kentucky Board of Licensure suspended the license of Gary Shearer, MD, saying in an emergency order that there was "probable cause" to believe that his practice of medicine endangered his patients and the public alike. The board based its action in part on a study by a pain-medicine consultant of another 15 patients — not those who died — who were treated by Dr. Shearer for pain.

That consultant, Saroj Dubal, MD, wrote in a letter to the board that Dr. Shearer failed to provide proper follow-up care in 10 of the 15 cases that she examined. These patients, Dr. Dubal said, continued to receive prescriptions for pain medications despite urine tests that revealed both prescribed and unprescribed drugs, including some illicit ones, in their bloodstream. Also unheeded, Dr. Dubal said, were reports from the Kentucky All Schedule Prescription Electronic Reporting (KASPER) system showing that several patients filled overlapping pain-med prescriptions from Dr. Shearer and other clinicians at pharmacies.

According to Dr. Dubal, Dr. Shearer blamed an employee for failing to bring red-flag urine tests and KASPER reports to his attention. Dr. Dubal concluded that it was still ultimately Dr. Shearer's responsibility "to follow up on these serious issues."

Dr. Dubal said that Dr. Shearer struck her as a "caring physician" who acted properly when he initially prescribed pain meds for the patients in question. "The follow-up care needs more close attention to prevent gross negligence," she wrote. "I feel these issues can be addressed by educating the physician about proper follow-up."

Earlier this month, Dr. Shearer applied with the state medical board to operate a physician-owned pain-management clinic. The application indicated that he had completed a review course in controlled-substance management, according to the board.

Physician Denies Wrongdoing, Says Attorney

The deaths of the 15 patients under Dr. Shearer's care occurred from 2009 to 2011. The individuals ranged in age from 29 to 59 years. At least 7 of the overdose deaths were attributed in whole or part to oxycodone. A search of KASPER showed that Dr. Shearer was one of the top 5 prescribers of oxycodone in central and eastern Kentucky, according to the emergency order issued by the Kentucky medical board. All 14 of the patients who overdosed had medications prescribed by Dr. Shearer in their system, the board said.

The 1 patient who did not overdose died of "multiple blunt force injuries." Oxycodone and acetaminophen pills were in the patient's pocket at the time.

A government investigation of several overdose deaths triggered a raid by the Federal Bureau of Investigation on Dr. Shearer's office in Florence, Kentucky, a suburb of Cincinnati, Ohio, on April 17. Agents seized all of his patient charts and 313 presigned but otherwise blank prescriptions.

The Kentucky medical board gave Dr. Shearer 10 working days to request an emergency hearing on his license suspension.

Robert Sanders Jr, an attorney representing Dr. Shearer, did not respond to a request for an interview with Medscape Medical News. However, an article in the Cincinnati Enquirer quoted Sanders as saying that his client denied any wrongdoing.

"Nobody has ever died as a result of taking drugs prescribed by Dr. Shearer as they were prescribed by Dr. Shearer," Sanders told the newspaper.

Sanders said the physician's legal team investigated several of the overdose deaths and determined that heroin was the culprit in most of them, according to the Cincinnati Enquirer. A physician cannot be held responsible for a patient mixing legal and illegal drugs, or not taking legal drugs as prescribed, Sanders contended.

"Unless the doctor goes home with every patient, I don't know how they are supposed to control that," Sanders was quoted as saying. "Show me a single case where any patient died as a result of taking drugs as prescribed by Dr. Shearer, and I will go out and help you string him up."