OVERDOSE VICTIM'S MOTHER BLAMES DOCTOR FOR DEATH
A Redding woman whose son died of a painkiller overdose waited outside a full courtroom Wednesday while a Redding physician pleaded innocent to charges of murdering three patients who died of suspected overdoses.
Stephanie Navo said the name of her son, Christopher D. Navo of Redding, should be added to the list of people who died because of prescriptions written by Dr. Frank Fisher at his Westside Walk-In Clinic in Anderson.
Navo said her 20-year-old son died at their home in May of an oxycodone overdose after getting the prescription narcotic illegally on the street.
Fisher has not been charged in connection with Navo's death and authorities have said they don't believe Navo was a patient of the Harvard Medical School graduate.
I can't be 100 percent sure of anything, but I believe that he is responsible, said Navo, a Redding schoolteacher. I don't want to accuse wrongly.
In additions to pleading innocent to three counts of murder each, Fisher, Redding pharmacist Stephen Miller, 49, and his wife, Madeline Miller, 44, also pleaded innocent in Shasta County Superior Court to two dozen charges of drug dealing and Medi-Cal fraud.
The well-attended court appearance had a more restricted atmosphere than past hearings. For the sake of impartiality, Judge James Ruggiero banned from the courtroom Guilty of Caring T-shirts and buttons worn by Fisher fans. Some supporters cloaked their pro-Fisher shirts under coats before going through the metal detector.
Deputy marshals warned the crowd some carrying newsletters by Fisher supporters that waves or gestures at the defendants are against the law. Onlookers were turned away once the 70-seat courtroom filled to capacity.
Fisher and the Millers who have appeared in court twice since being arrested and jailed Feb.18 wore leg shackles for the first time at Wednesday's hearing. Shackles are routinely used in certain cases, county Marshal Dennis Boatner said.
In his first court appearance on behalf of Fisher, veteran San Francisco attorney Patrick Hallinan told the judge that the leg chains were demeaning for his peace-loving client. Ruggiero said he will address the issue of shackles at the trio's next court appearance March 19.
Ruggiero ruled that a sealed portion of court documents be unsealed solely for court appointed attorney Rhonda Hixon, who represents Stephen Miller, owner of Shasta Pharmacy on Westside Road in Redding. Redding attorney Eric Berg is representing Madeline Miller, who worked at the pharmacy.
Hixon said she needed to look at the names of more than 3,200 Medi-Cal patients of Fisher and clients of the Millers to determine if she had a conflict of interest in representing Stephen Miller.
After the hearing, Hallinan chided state authorities before a cluster of cameras from various Northern California television stations. State Deputy Attorney General Gary Binkerd, who is prosecuting the case, walked away from the media horde and declined to comment. Hallinan said the attorney general's office would never have the audacity to make such charges in San Francisco. They did so in Redding, he said, because they wrongly expected to deal with a lot of rednecks and hicks and get away with it.
When the attorney general's office offered Fisher a plea bargain last year in a different case involving Medi-Cal fraud charges, the physician turned it down, Hallinan said. That angered state authorities and prompted them to file more charges, he said.
Prosecutor Blinkerd has said his office offered the settlement when Fisher only faced charges of $2,500 in fraud. That offer was taken off the table when we learned that his practice was at fault for other and much more serious complaints, Binkerd said Monday. Hallinan said the fact that state authorities are investigating suspected overdose deaths this year and in the past two years to determine if they are linked to Fisher and the Millers shows the weakness of the initial charges.
It's an eloquent commentary on how good their primary case is. Not so good, said Hallinan, the older brother of San Francisco District Attorney Terence Hallinan. He said the allegations of $2 million in Medi-Cal fraud were garbage and called the murder charges ludicrous.
Fisher's father, retired Berkeley elementary school teacher Frank Fisher Sr., listened quietly to Navo as she said that the physician may have been compassionate, but should not have prescribed such excessive amounts of potent painkillers.
Navo said her son was not a longtime user of oxycodone or a pain patient when he died of a painkiller overdose, which was ruled an accident.
Prescribing strictly regulated drugs to pain patients whom others had refused to treat is risky, but essential because untreated pain is a major cause of suicides, Hallinan said. It takes a lot of guts for a doctor to do that, he said.
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AFTER FURTHER REVIEW : DR. FRANK FISHER
This article submitted by Dan M. on 4/5/99.
[Having tossed in my 2-cents' worth last week, in support of this man, I want to explain a 180-degree swing in my opinion. Too many good pain-management doctors--and the pharmacists who dispense the prescriptions they write--are being wrongly punished or intimidated.]
By now, many have heard of Dr. Frank Fisher, who was arrested in Shasta County, California, on February 19th. He has been charged with three counts of murder, 24 counts of drug-pushing and many counts of fraudulent Medi-Cal billing. He ran the Westwood Walk-In Clinic, where he had treated over a thousand patients for pain over the last few years.
Many--hundreds--of his patients were legitimate chronic-pain sufferers, who, sadly, were denied proper medicines by other physicians.
Dr. Fisher appears to have prescribed narcotics--especially high-dose pills of OxyContin--to almost every patient he treated. He SEEMS to have worked out an arrangement with a pharmacy 10 miles from his office, where patients could get their medicine without even minimal proper review by the pharmacists. (A kickback scheme, between doctor and pharmacy, is also a formal allegation).
After scouring the Web, and discounting the Drug-War-disinformed nonsense as best I can... I'm sad to say that the Harvard-educated Dr. Fisher is--at least--irresponsible. It seems that he saw 10-12 patients an hour. It appears that a few of these patients--opiod-naive--overdosed, stopped breathing--and died.
I oppose the existence of the DEA and our self-destructive Drug War. But even if these entities and the laws at their disposal did not exist--it WOULD NOT CHANGE the weighty responsibilities of a doctor who is treating patients-in-pain. The reality that many hundreds of Dr. Fisher's surviving patients are now untreated--and probably blacklisted from obtaining good treatment--does not mitigate Fisher's apparent malpractice.
Perhaps, some at this forum might think that the better-educated (often, self-educated) sufferers among us would be comfortable with Dr. Fisher. I'll risk this guess: I don't think so. Not even those who may know, precisely, which opiates and adjunctive medicines they need.
They would be stunned and offended by a doctor who did not review their written records and imaging material. They would be disgusted with a doctor who was not trying to gain full and accurate understanding of their--no doubt complex--condition.
The smart doctor and smart patient cultivate a relationship of understanding and mutual respect. A good patient would be outraged if a doctor pushed aside their chart and said:
"Here's a prescription for 200 OxyContin, 80 milligrams. Take a few as needed. Come back in three or four weeks, when you need more." I suspect that a phone call, and letter to a licensing board would follow this charade.
I realize that the alleged misbehavior of Fisher is at the opposite extreme of the experiences of most of us. Many of us are sick of having the severity and chronicity of our pain minimized or denied by physicians. But I believe that Dr. Fisher has handed the Drug Warriors a hammer no wise enemy of our needs could have fashioned. The repercussions may extend far beyond California. It likely will make it harder for us to obtain the changes-in-law needed to assure that we can obtain proper treatment.
[I cling to the frail hope that someone will correct me. You will tell me, convincingly, that the media have completely misrepresented this man's conduct. Not just in the drug-ignorance of reporters and editors of the Sacramento Bee and San Jose Mercury News--but in the material facts of the doctor's case.]
US CA: Overdose Victim's Mother Blames Doctor For Death
Newshawk: Kim Levin
Pubdate: Pubdate: March 11, 1999
Source: Redding Record Searchlight (CA)
Copyright: Redding Record Searchlight - E.W. Scripps
Author: Anne Hart
OVERDOSE VICTIM'S MOTHER BLAMES DOCTOR FOR DEATH
A Redding woman whose son died of a painkiller overdose waited outside a full courtroom Wednesday while a Redding physician pleaded innocent to charges of murdering three patients who died of suspected overdoses.
Stephanie Navo said the name of her son, Christopher D. Navo of Redding, should be added to the list of people who died because of prescriptions written by Dr. Frank Fisher at his Westside Walk-In Clinic in Anderson.
Navo said her 20-year-old son died at their home in May of an oxycodone overdose after getting the prescription narcotic illegally on the street.
Fisher has not been charged in connection with Navo's death and authorities have said they don't believe Navo was a patient of the Harvard Medical School graduate.
I can't be 100 percent sure of anything, but I believe that he is responsible, said Navo, a Redding schoolteacher. I don't want to accuse wrongly.
In additions to pleading innocent to three counts of murder each, Fisher, Redding pharmacist Stephen Miller, 49, and his wife, Madeline Miller, 44, also pleaded innocent in Shasta County Superior Court to two dozen charges of drug dealing and Medi-Cal fraud.
The well-attended court appearance had a more restricted atmosphere than past hearings. For the sake of impartiality, Judge James Ruggiero banned from the courtroom Guilty of Caring T-shirts and buttons worn by Fisher fans. Some supporters cloaked their pro-Fisher shirts under coats before going through the metal detector.
Deputy marshals warned the crowd some carrying newsletters by Fisher supporters that waves or gestures at the defendants are against the law. Onlookers were turned away once the 70-seat courtroom filled to capacity.
Fisher and the Millers who have appeared in court twice since being arrested and jailed Feb.18 wore leg shackles for the first time at Wednesday's hearing. Shackles are routinely used in certain cases, county Marshal Dennis Boatner said.
In his first court appearance on behalf of Fisher, veteran San Francisco attorney Patrick Hallinan told the judge that the leg chains were demeaning for his peace-loving client. Ruggiero said he will address the issue of shackles at the trio's next court appearance March 19.
Ruggiero ruled that a sealed portion of court documents be unsealed solely for court appointed attorney Rhonda Hixon, who represents Stephen Miller, owner of Shasta Pharmacy on Westside Road in Redding. Redding attorney Eric Berg is representing Madeline Miller, who worked at the pharmacy.
Hixon said she needed to look at the names of more than 3,200 Medi-Cal patients of Fisher and clients of the Millers to determine if she had a conflict of interest in representing Stephen Miller.
After the hearing, Hallinan chided state authorities before a cluster of cameras from various Northern California television stations. State Deputy Attorney General Gary Binkerd, who is prosecuting the case, walked away from the media horde and declined to comment. Hallinan said the attorney general's office would never have the audacity to make such charges in San Francisco. They did so in Redding, he said, because they wrongly expected to deal with a lot of rednecks and hicks and get away with it.
When the attorney general's office offered Fisher a plea bargain last year in a different case involving Medi-Cal fraud charges, the physician turned it down, Hallinan said. That angered state authorities and prompted them to file more charges, he said.
Prosecutor Blinkerd has said his office offered the settlement when Fisher only faced charges of $2,500 in fraud. That offer was taken off the table when we learned that his practice was at fault for other and much more serious complaints, Binkerd said Monday. Hallinan said the fact that state authorities are investigating suspected overdose deaths this year and in the past two years to determine if they are linked to Fisher and the Millers shows the weakness of the initial charges.
It's an eloquent commentary on how good their primary case is. Not so good, said Hallinan, the older brother of San Francisco District Attorney Terence Hallinan. He said the allegations of $2 million in Medi-Cal fraud were garbage and called the murder charges ludicrous.
Fisher's father, retired Berkeley elementary school teacher Frank Fisher Sr., listened quietly to Navo as she said that the physician may have been compassionate, but should not have prescribed such excessive amounts of potent painkillers.
Navo said her son was not a longtime user of oxycodone or a pain patient when he died of a painkiller overdose, which was ruled an accident.
Prescribing strictly regulated drugs to pain patients whom others had refused to treat is risky, but essential because untreated pain is a major cause of suicides, Hallinan said. It takes a lot of guts for a doctor to do that, he said.
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Shasta County Physician, Two Pharmacy Operators Arrested for Felony Medi-Cal Fraud
Fatal drug overdoses linked to Medi-Cal fraud case
February 18, 1999
99-021-a
FOR IMMEDIATE RELEASE
(SACRAMENTO) -Attorney General Bill Lockyer today announced the arrest of Dr. Frank Fisher and pharmacy owners Stephen and Madeline Miller, all of Shasta County, on three counts of murder and other charges involving improper narcotic drug prescriptions that resulted in more than $2 million in Medi-Cal fraud.
The felony criminal charges allege that the Anderson-area physician and pharmacy operators provided the controlled narcotic oxycodone to patients unnecessarily and in potentially lethal doses at high cost to taxpayers. The 27-count complaint was the latest to be filed against the physician. In May 1998, Dr. Fisher was charged with submitting false Medi-Cal claims involving over-prescription of drugs. The earlier complaint has been pending in Shasta County Superior Court.
"We have moved to shut down a medical practice and pharmacy kickback scheme that our investigators found fraudulently billing the state Medi-Cal program over $2 million," Lockyer said. "We are prosecuting what was in fact a highly sophisticated drug-dealing operation. By taking this action, we are shutting down suppliers of a highly addictive drug that has been improperly allowed to saturate the community."
Lockyer said Redding-area emergency rooms have reported increased numbers of patients seeking treatment for drug overdoses. There have been links of these patients to Dr. Fisher and the over-prescribing and over-dispensing scheme. With the supply of prescription narcotics shut down, local physicians are bracing to see more patients with drug addiction problems. Local physicians have asked patients who were receiving treatment for legitimate pain conditions to consult another personal physician or contact the Shasta Trinity Medical Society hotline at (530) 247-7784.
The lawsuit charges Dr. Fisher with prescribing Schedule II and Schedule III controlled drugs without providing good faith medical examinations and without need or medical justification. Investigators found the physician to be running a patient mill with patient examinations typically being cursory at best and lasting no more than a few minutes. Investigators also found that the doctor orchestrated higher billings by changing his status from a "fee-for-service" to "Rural Health Clinic" provider, raising his Medi-Cal reimbursement receipts from approximately $17 to $50 per patient visit.
The felony complaint also alleges that the physician pursued an illegal kickback and referral scheme that directed business to Shasta Pharmacy, owned and operated by the Millers. The scheme facilitated improper drug billings to the Medi-Cal program totaling more than $1 million.
According to 1998 federal Drug Enforcement Administration data, Shasta Pharmacy became the nation's top wholesale buyer of the physician-prescribed drug oxycodone in the state and 10th largest purchaser in the nation. The allegedly improper billings boosted the couple's average monthly income from $52,000 to approximately $250,000. The alleged scheme by the physician and pharmacy resulted in the prescribing, dispensing and furnishing of over 1.5 million milligrams of oxycodone.
According to medical experts, oxycodone is a potent and highly addictive narcotic commonly prescribed to patients suffering from extreme pain associated with end-stage cancer and who generally have developed tolerances to other painkillers.
The murder charges stem from the deaths of Rebecca Mae Williams on August 6, 1998; Bruce Johannsen, Jr. on July 8, 1998, and Tamara Stevens on September 10, 1998. The victims, former patients of Dr. Fisher, were found with lethal doses of oxycodone.
