The Baltimore Sun
March 2, 2006 Thursday FINAL EDITION
TELEGRAPH; Pg. 1A
Long wait for action in death of their son
Assembly considers reform of review board as parents seek
discipline for doctor who prescribed OxyContin
A Sun follow-up
Masking malpractice cases
FRED SCHULTE
SUN REPORTER
Three years after their
teenage son, Michael, died
from taking a prescription
painkiller, George and
Alicia Osgood are still
waiting for the outcome of
a state investigation into
his death.
The couple wants the
Maryland
Board
of
Physicians to discipline the
doctor who prescribed the
strongest dose on the
market
of
the
drug,
OxyContin, to treat the 19year-old's sore throat.
"I can't believe that the
Board of Physicians is not
doing anything about it,"
said George Osgood, a
civil engineer who lives in
Upper Marlboro. "It never
seems to get resolved."
At least 400 complaints,
some accusing doctors of
mistakes
that
gravely
injured
patients,
are
backed up at the medical
board, state records show.
As the General Assembly
considers two bills that
would continue the board
as the licensing agent for
more
than
25,000
physicians,
there
are
conflicting views on how
best to clear the backlog.
The medical board wants
to limit the role of
administrative law judges
and streamline a process
in
which
physicians
determine whether a fellow
doctor has failed to meet
standards of care -proposals opposed by the
state medical society.
It is unclear, however,
whether lawmakers will
decide to make any
changes in the system, or
leave it until next year
when they must renew the
board or let it expire.
A House bill would extend
the board for six years and
require it to come up with a
plan to reduce the backlog
within two years. A Senate
version extends the board
for two years and demands
a strategy to speed up the
process by July 1.
The board says it has a
plan to speed things up,
but needs to hire and train
more
investigators
to
handle
about
1,100
complaints
it
receives
every year. The board
disciplines doctors for 40
types
of
infractions,
including
incompetence
and sex or drug offenses.
"Trying to turn this ship is
going to take time," the
board's executive director,
C. Irving Pinder Jr., told
lawmakers in Annapolis
last week. "We're on the
right track. We've made a
good-faith effort."
The effectiveness of the
effort is difficult to assess.
A series published in The
Sun in December reported
that the time spent to
resolve disciplinary cases
has lengthened to more
than four years -- far longer
than the 18 months
envisioned
when
lawmakers created the
board in 2003.
The conduct of individual
cases is hidden under state
law,
which
makes
complaints about doctors
confidential. The law also
prohibits the medical board
from
discussing
a
complaint.
The Osgood case offers a
rare
look
inside
the
secretive
system.
The
family gave The Sun
access to records of a
malpractice suit and their
complaint to the board
against Bowie internist Carl
J. Slavin -- the doctor they
blame for their son's death.
Slavin
denied
the
allegations in the lawsuit.
He could not be reached
for
comment
despite
numerous attempts by
phone and visits to two
offices. Calls to the lawyer
who represented Slavin in
the lawsuit were not
returned.
The doctor treated Michael
Osgood during Christmas
break from Iowa State
University, which the teen
attended on an academic
scholarship. By Jan. 6,
2003, he couldn't swallow
and had a fever and other
signs of flu, records show.
Slavin has testified that
Osgood was crying from
throat pain but rejected a
number
of
painkillers,
saying he couldn't swallow.
Slavin
prescribed
80
milligrams of OxyContin
every 12 hours. "Because
of the severity of pain he
was having, I felt that that
was [the] dose that he was
going to need," Slavin
testified in a January 2004
deposition. He said he had
the patient's mother fill the
prescription and bring it to
the office, where he
watched as the teen took
the first dose.
Two days later, after Alicia
Osgood couldn't rouse her
son, he was airlifted in a
coma
to
Georgetown
University Hospital. He
died Jan. 12, 2003, from
accidental
"oxycodone
intoxication" after the third
dose, according to the
District
of
Columbia
medical examiner's office.
Seventeen of the 20 pills
remained, records show.
Slavin
said
he
was
"devastated and cried for
like three days" after
hearing of the teen's death,
according to his deposition,
in which he defended his
care.
The board was notified
three times of Osgood's
death, but when its review
began
cannot
be
determined from available
records.
Dr. Charles A. Read, a
lung specialist who treated
Osgood at Georgetown
University Hospital, told
The Sun that he filed a
written complaint shortly
after the patient was
admitted.
"I reported my concerns,"
said Read, adding that
OxyContin "seemed like a
strange prescription to give
to a kid." He said that more
than three years later, he
hasn't heard from the
board.
In September 2003, a state
agency
that
initially
processes all malpractice
claims sent the medical
board a copy of the one the
family had filed the month
before, records show. In
May 2004, a month before
they settled the suit, the
Osgoods filed a complaint
with the medical board
arguing
that
it
was
"blatantly wrong" for Slavin
to prescribe the potent
OxyContin.
"It is difficult to kill a healthy
19 year old. Dr. Slavin did
so by ignoring all of the
standards and information
for prescribing OxyContin,
including the known risk of
fatal respiratory depression
when
administered
to
patients not previously
exposed to opioids," their
complaint stated.
The Osgoods' lawsuit was
settled for $950,000 in
June 2004. In settling,
Slavin "expressly denied"
any fault or liability.
That month, lawyers for the
Osgoods complied with a
subpoena from the medical
board requesting records
of the legal case. In
October 2004, George
Osgood testified before a
state
commission
on
medical malpractice. Since
then, he has been told
repeatedly
by
medical
board staffers that the
matter is stuck in peer
review.
That process has long
been controversial. Until
2003, it was run by
MedChi, the Maryland
State Medical Association,
which was criticized for
taking too long to complete
reviews. The 2003 law put
the system out for bid, and
it now is run by the
Delmarva
Foundation,
based in Easton.
The law requires that
doctors accused of poor
care be reviewed by two
physicians
in
their
specialty.
Should
they
disagree, a third reviewer
can be brought in. About
half the backlog is due to
such cases, according to
Pinder.
The board wants the
Assembly to amend the
law so it could use one
reviewer, as many states
do.
"You really don't need a
peer review on a lot of
those cases," said Ray W.
Huff, one of five consumers
on the 21-member board.
But Sen. Andrew P. Harris,
a practicing physician and
member of the Education,
Health and Environmental
Affairs Committee, said two
reviewers are needed to
ensure fairness.
MedChi opposes cutting
the
number
of
peer
reviewers. The doctors
group, which has about
7,200
members,
also
opposes restricting the use
of
administrative
law
judges to hear cases,
according to its lobbyist,
Joseph A. Schwartz III.
Using judges guarantees
their
independence,
a
"critical factor when a
doctor's license is on the
line," he contended in
prepared testimony.
Harris, a Johns Hopkins
anesthesiologist,
said
doctors should be entitled
to "due process" from an
"impartial" third party.
There's little dispute that
the board needs to hire
investigators. In recent
years, they have routinely
juggled 50 or more cases
at once, twice what the
board
considers
the
optimum.
Pinder argues that the
starting pay of about
$33,000 has been too low
to attract and retain staff.
The
board
has
10
investigators and wants to
hire five more.
But in last week's hearing,
Pinder could not explain to
lawmakers'
satisfaction
why the board can't take
steps to raise salaries. His
lack of response on that
and on a firm date to
resolve
the
backlog
seemed to exasperate
Sen. Paula C. Hollinger,
the
Baltimore
County
Democrat who chairs the
health
committee
and
sponsored the Senate bill.
fred.schulte@baltsun.com
GRAPHIC:
Photo(s)
George
and
Alicia Osgood hold a photo
of their son, Michael, 19,
who died in 2003 after
taking
OxyContin
prescribed for his sore
throat.
ANDRÉ
F.
CHUNG
:
SUN
PHOTOGRAPHER