Probation for Benicia osteopath
By Donna Beth Weilenman
A Benicia osteopathic physician who has been under investigation for over-prescribing drugs and not conducting proper examinations has been put on five years’ probation by the state’s Osteopathic Medical Board.
The decision, effective Sept. 30, was signed by Dr. Geraldine O’Shea, president of the panel, confirming a ruling July 30 by Administrative Law Judge Ruth S. Astle, who ordered the revocation of Dr. Dickie Lynn Hill’s license, but simultaneously stayed that revocation to place Hill on probation instead.
Hill has been ordered to comply with 14 probationary conditions, which includes paying the board $61,907.08 for costs incurred in investigating and enforcing the case filed against him, according to Astle’s decision.
He also must surrender his Drug Enforcement Administration permit and reapply for a more restricted DEA permit, although he will be allowed to prescribe and administer a limited number of drugs under California law.
The board’s order requires him to maintain proper records of all controlled substances he prescribes and dispenses.
He must take several courses, including pharmacology, medical records keeping, a medical ethics course and an extensive clinical training program with a possible examination administered by the board.
He has been ordered complete quarterly reports assuring he is complying with all conditions of his probation, complying with the board’s surveillance program, appearing before the board for interviews and obeying all laws and rules governing the practice of medicine in California.
He must notify the board should he decide to leave California to live or practice elsewhere or if his travel takes him out of the state more than 30 days, and he can’t practice medicine at home.
Hill must surrender his license if he is unable to meet the probationary terms, and should he violate those terms, the board may revoke the probation and could revoke his license as well.
Calls to Hill’s office at 231 First St. were not returned, but in 2009 interviews, he denied accusations that he kept inadequate records and didn’t take patients’ histories, and said while completing forms for the Department of Transportation, “I wasn’t doing anything dishonest…that was a mistake.”
He said at the time that if he lost his license, “this would be a huge hole in this community. I take care of the poor; I take care of the uninsured.”
Accusations by Dr. Donald J. Krpan, executive director of the Osteopathic Medical Board, stem from a 10-year investigation of Hill’s record keeping and prescriptions written for three patients.
Krpan accused Hill of unprofessional conduct through gross negligence and incompetence related to excessive prescribing drugs to a patient without performing a medical examination.
One of Hill’s patients whose case was cited was a man identified as W.W. who was 33 in 1999, when he first saw Hill and complained of lower back pain and muscle strain.
Krpan said Hill failed to keep and maintain appropriate and legible medical records, had no complete history on the patient, but prescribed Oxycontin and Methadone in ever-increasing amounts without documenting medical reasons for the increases.
Krpan also said Hill had falsely represented to the DOT that W.W. was not taking narcotic or habit-forming drugs, or had a spinal injury, disease or chronic low back pain, which Krpan called “blatant dishonesty” and “an extreme departure from the standard of care.”
He continued, “The record keeping by respondent (Hill) is so poor that it is impossible to tell if he was appropriately controlling the patient’s pain.”
Krpan investigated the cases of two other patients. One, a woman identified as J.M. who was 27 when first visiting Hill in 1991, complained of headaches. “At no time did (Hill) actually evaluate the patient with any objective study or examination for her chief complaint,” he said. Hill’s handwritten notes “are illegible and inadequate.”
Hill prescribed Oxycontin, OxyIR, fentanyl patches and Vicodin, all opioids, Krpan said. Later Hill added Topamax, an anticonvulsant that is defined as a dangerous drug, Strattera, used to control attention deficit hyperactivity disorder, and drugs associated with hormone replacement therapy, which Krpan said the doctor did without conducting examinations or documenting reasons for the prescriptions.
The third patient, identified as J.B., who was 31 when she started seeing Hill in 2002, complained of low back pain. Hill’s records for her “are random and generally illegible,” Krpan said, and during an interview with the medical board, even Hill could not decipher some of his own writing.
Hill treated her with increasing amounts of Vicodin. He also prescribed Xanax, a drug used to treat anxiety disorders and panic attacks, which Hill said he used to “smooth the transition” between opioid doses. Krpan said there was “no reasonable medical or scientific basis to support its use in this manner,” and its combination with an opioid could cause “significant altered mental status.”
Two other doctors testified along with Krpan. Dr. Kenneth Han, an osteopath, and Kasha Amirdelfan, a interventional pain medicine practitioner, said Hill’s records were “abysmal and impossible to follow,” and that the overall care of the three patients “constituted gross negligence.”
Astle’s summary wasn’t entirely negative, noting improvements in the way Hill conducted his practice.
She said Hill has changed his office practices since the board launched its investigation. “He now has all his patient records typed, and uses AIT Laboratories to perform tests as part of a comprehensive approach to monitoring patient compliance,” she wrote.
She also wrote that four patients testified before the board, including a Contra Costa County deputy sheriff, who spoke favorably of Hill’s treatment.
The deputy praised Hill’s care that reduced his severe pain from an ankle injury. Another patient said Hill gave him satisfactory care for his chronic lower back pain. A third continues to see Hill for “intractable pain,” and a fourth told the board Hill saved his life through a full body scan.
Hill supplied the board with letters from patients and colleagues who described him as dedicated, caring and intelligent.
Supporters also defended him Aug. 6, 2009, during a town hall meeting at Benicia Veterans Hall, a two-hour event during which one said, “He gives us hope.”
Astle wrote that Hill “has demonstrated that he wants to change his practice and comply with the requirements of the Board. However, he needs significant further education and monitoring to insure that the public is protected. It would not be against the public interest to allow (Hill) to continue to be licensed under the probationary terms and conditions set forth in the order.”
Hill began his career as a respiratory care therapist, and received his doctor of osteopathy degree from the Oklahoma College of Osteopathic Medicine at Oklahoma State University in 1982. He interned at the U.S. Naval Hospital in San Diego from 1982 to 1983, and was board certified in April 1994. He has been in private practice since 1985, with special skills in offshore medical emergencies.