A proposed law could reduce accidental deaths and suicides from prescription painkillers.
Supporters of the controversial measure include two San Diegans who were featured in an NBC 7 Investigates story about prescription drug overdoses. Those residents are flying to the state Capitol to testify Monday on behalf of the legislation.
More than 1,000 Californians die every year from accidental or purposeful abuse of controlled substances. Those victims include Kristin Greene, a Lakeside resident who killed herself in November, 2013, with a toxic cocktail of painkillers and sedatives.
Documents obtained by NBC 7 Investigates reveal that Kristin had obtained more than 60 prescriptions from nine medical professionals and several pharmacies in the five years before her death.
Her story — and her family’s effort to prevent more prescription drug deaths — was the focus of an NBC 7 Investigates report in February.
Kristin’s sister, Lisa Bond, said Kristin might still be alive if doctors were required to check the state’s narcotics database, called CURES (the Controlled Substance Utilization Review and Evaluation System), before they prescribe controlled substances for new patients.
Senate Bill 482, authored by State Senator Ricardo Lara, of Bell Gardens, would require doctors to use the CURES database or be subject to discipline.
Bond and her husband are flying to Sacramento Sunday to prepare for Monday’s Senate committee hearing on the proposed law. They’ll be joined at the Capitol hearing by Clark Smith, M.D., a San Diego psychiatrist and addiction expert who also supports the mandatory use of the CURES database.
“I think if CURES were used on a regular basis, we would see tremendous progress in cutting back prescription drug dependence,” Smith told NBC 7 Investigates.
Supporters say it will prevent “doctor shopping” by drug addicted patients, like Kristin.
Her sister said if one of Kristin’s doctors had refused to write her a prescription, Kristin might have sought help for her addiction.
“Maybe at that point she would have said, ‘Hey, listen, I have a problem. I need to get in rehab again,’” said Bond. “Because she can’t get the drug. What’s she going to do? She needs to take care of that situation. Maybe then she would reach out and say, ‘I need to get rehab’, or anything. But she wouldn’t be able to get all those drugs.”
The California Narcotics Officers’ Association, the California College and University Police Chiefs Association and several consumer groups, including Consumer Watchdog, also support SB 482.
Opponents include CVS Health and Rite Aid stores and the California Medical Association (CMA).
The CMA says “the premature and overly-broad mandatory check” required by the proposed law would “negatively impact patient care” and “will discourage even appropriate prescribing of controlled substances.”
The CMA advocates a more “balanced” approach to the problem of prescription drug abuse: “This bill doesn’t achieve that balance and patients with legitimate medical (needs) will be the ones who are disproportionately impacted.”
The science may be sketchy, but medical “experts” like Gary Ordog keep litigation alive and kicking.
Gary Ordog was trained in emergency medicine. He spent the first 17 years of his career patching up knife and gunshot wounds at Martin Luther King/Drew Medical Center in the tough Compton neighborhood of Los Angeles. Then he found a more lucrative specialty. For $9,800 up front (plus $975 an hour) Dr. Ordog appears as an expert witness in lawsuits to testify that mold can cause a terrifying array of diseases, from lung cancer to cirrhosis of the liver. Mold “is a major, devastating part of my patients’ lives,” says Ordog, a portly British Columbia native who says he’s treated thousands of people for mold exposure at his clinic in a strip mall in the Los Angeles suburb of Santa Clarita. “It destroys their health, their homes and all of their possessions.”
The American College of Occupational & Environmental Medicine and the federal Institute of Medicine say there’s no evidence for such claims. The vice president of Ordog’s own professional association, the American College of Medical Toxicology, agrees. “Mold exposure does not cause significant disease,” says Paul Wax, a practicing toxicologist in Phoenix who isn’t involved in litigation.
That hasn’t stopped Ordog from serving as an expert witness in, by his estimate, hundreds of lawsuits by people alleging they were injured by mold and mycotoxins. The Insurance Information Institute estimates that $3 billion in mold claims were paid out in 2002, the most recent year for which detailed statistics are available. Most states have responded by passing laws allowing insurance companies to exclude mold from coverage, so plaintiff lawyers now target landlords, condominium associations and school districts instead. “I’ve got seven or eight cases set for trial between now and June,” says William Slaughter, a defense lawyer in Ventura, Calif.
Four years after a groundbreaking $32 million verdict in Texas, mold litigation has fallen into a familiar pattern. Like previous suits over silicone breast implants, electromagnetic radiation and the anti-nausea drug Bendectin, it is being kept alive by a handful of experts who are willing to contradict mainstream scientists to say that mold can make otherwise healthy people sick.
There’s no question that mold can cause asthma, sinusitis and other breathing problems. But that’s not what experts like Ordog are saying. They’re diagnosing more serious conditions–such as cancer, immune-system disorders and memory loss–that have been linked to specific mycotoxins. And if they find any traces of them in a plaintiff’s home, workplace or school–bingo. But there are no reliable tests to show that a person has been exposed to a specific mold or mycotoxin, much less how long that exposure lasted or how much of a substance he absorbed. “I certainly believe these poisons make people sick, but I can’t make that connection,” says David Straus, a researcher at Texas Tech University’s medical school whose testimony has helped plaintiffs win three mold lawsuits.
Some medical experts are old hands at tort claims. Texas mold expert Andrew Campbell previously testified in silicone breast implant cases. Nachman Brautbar of Los Angeles has worked on everything from breast implants and welding fumes to the chromium contamination in the Erin Brockovich case (his Web site features a testimonial from the film’s namesake).
Only 30 mold lawsuits alleging personal injury have gone to a verdict in the U.S., by the estimate of Los Angeles attorney Stephen Henning, and the defense won more than half. But with an expert supporting their claims, plaintiffs can often extract a lucrative settlement simply by surviving defense motions to dismiss.
Ordog’s testimony helped a California couple win a $2.4 million settlement in 2003 over the death of their infant son from pulmonary hemorrhage linked to Stachybotrys chartarum, or “black mold.” The CDC in 2000 repudiated reports linking Stachybotrys to infant pulmonary hemorrhage, but the defendants weren’t willing to risk putting a case involving a dead child in front of a jury.
A defense lawyer once calculated Ordog’s annual take from expert witness fees and his busy toxicology clinic at more than $3 million. Ordog laughs at that figure–”I wish” is all he’ll say–but he has acknowledged earning more than $10,000 a day for testimony and travel time. Such figures are grating to defense attorneys, who say Ordog shouldn’t even be allowed to testify. The state of California sought to revoke his license in 2003, alleging that in several cases he misdiagnosed patients as having toxic poisoning. Ordog says no hearings have been held and that his license was renewed last year.
But his say-so has been challenged. A California judge once said Ordog “lacks credibility completely” after he testified that he was chief toxicologist at Henry Mayo Newhall Memorial Hospital in Santa Clarita, which has no such department; that he’d published “hundreds” of scholarly articles, when a search of the PubMed database turns up fewer than 70, almost all of them dealing with gunshot wounds and trauma; and that former President Bill Clinton called him personally to run a special mold commission for the Environmental Protection Agency, even though an EPA spokesman says the agency’s authority doesn’t include indoor air quality. Ordog “is completely abusing the system,” says James Robie, a defense lawyer with Robie & Matthai in Los Angeles who has cross-examined Ordog several times. “He is possibly the most dishonest man I have ever met.”
In an interview at a luxurious Santa Clarita restaurant Ordog says he’s the victim of a smear campaign. The state’s complaint to revoke his license, he says, was “payback from Alcoa” after his testimony helped secure a multimillion-dollar verdict against it. (The November 2000 judgment was against Alcoa Paving Co., a now-defunct firm unrelated to the aluminum maker.) Ordog also says the “evidence is overwhelming for our position,” citing 28,000 articles supporting the idea that mycotoxins can cause disease. A PubMed search finds 28,540 articles containing the word “mycotoxin,” but experts say there are no reliable studies showing that mold can cause anything more than asthma and similar breathing difficulties (see box, p. 101).
Ordog isn’t the only mold expert with credibility issues. Texas authorities are seeking to revoke Andrew Campbell’s medical license, alleging a pattern of misdiagnosing patients with occupational or mold-related illnesses, overbilling and excessive testing. A family-practice specialist by training who runs the Medical Center for Immune, Environmental & Toxic Disorders in Spring, Tex., Campbell blames insurers for his problems. “My patients have signed affidavits saying they were happy with my care,” he says.
How does this go on? Junk science was supposedly banished from the courtroom in the 1993 Supreme Court decision Daubert v. Merrell Dow Pharmaceuticals, involving since-debunked claims that Bendectin causes birth defects. Under Daubert, judges must exclude witnesses who rely on implausible theories or poor methodology. But Daubert applies only in federal courts.
Many state courts use the looser standard of “general acceptance,” which can be met by convening a group of like-minded experts and publishing their papers in a sympathetic journal. Those papers fail to use double-blind methods to strip out possible researcher bias, and most rely on self-reported mold exposure by patients, many of whom are involved in mold lawsuits. Bolstered by articles in such journals as Archives of Environmental Healthand the Scientific World Journal, plaintiff experts can mount an expensive fight against defense lawyers who are trying to get them dismissed. Because Ordog’s opinions cover a wide range of medical disciplines from toxicology to cancer, “You end up hiring docs in all areas of medicine to disqualify him,” says Michael O’Neill, a Los Angeles defense lawyer.
As the epidemiological evidence against mold claims mount, lawyers and experts are changing tactics. Steven Goldman, a lawyer in New York City, has filed 400 or so lawsuits in the city on behalf of apartment dwellers and employees who believe mold made them sick. He deliberately avoids using the word “mold,” however, referring instead to “dangerous and hazardous conditions.” That gets him around the mold exclusions in many insurance policies–and gives his experts room to pursue other theories of disease linked to the same underlying complaint about neglected water leaks.
“What’s the next mold? Bacteria!” Goldman says excitedly. “And I’m the only one who knows it.” Still, it won’t be long before the experts catch up. (LINK) — 4/11/2005
SCV doctor indicted on alleged health care fraud
A Valencia doctor was recently indicted by a federal grand jury on nine counts of health care fraud after allegedly scamming Medicare to the tune of $2.5 million over six years, according to a Thursday U.S. Department of Justice news release.
Gary J. Ordog, 60, billed Medicare up to $6.5 million for services that were not provided to Medicare patients, at times billing for decease patients, according to the news release. These accusations allegedly occurred from January 2009 to Febuary 2015.
According to the federal indictment, Medicare only reimbursed $2.5 million of his claims.
Ordog would see a patient for evaluation and would then submit false claims to Medicare for reimbursement several years later, the news release said. His patients, sent to him from various referrals, were supposedly suffering from illnesses associated from exposure to mold and other toxic substances, according to the federal indictment.
Some of claims included bills that were for patients who died after the claims were submitted, the news release states.
According to public documents posted online by the Medical Board of California, Ordog’s medical license was suspended for 90 days in 2006 and he was placed on seven years of probation following accusations of gross negligence and dishonesty.
Among the documents was a stipulation that prohibited him from serving as a medical expert witness or medical consultant for legal matters.
In September 2013, his seven-year probation was extended another 18 months. He completed his probation in March this year, said California Medical Board spokeswoman Cassandra Hockenson.
Ordog was indicted by a federal grand jury on March 27, the Department of Justice news release said, but it was unsealed Thursday. (LINK) — 4/16/2015
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