Karel will receive a hearing before the Board on July 13, and according to the recommendations from the original hearing the state presented evidence Karel inappropriately prescribed large amounts of controlled substances to 10 individuals listed only by number, consisting of failure to perform or document performing adequate diagnostic work-ups, a lack of individualized treatment planning to treat patients suffering from various pain complaints, and failure to perform or document performing adequate patient histories and physical examinations to the extent that patients’ safety was put at risk.
The report goes on to say in the cases of patient 9, who was listed as an employee of Dr. Karel’s, and patient 16, Karel issued prescriptions for controlled substances without documenting those prescriptions in the patients’ charts.
“Furthermore, Dr. Karel admitted during his testimony that a former practice where he worked from 2007 through May 2009 ‘is a true pill mill.’” the report read.
Several of the patients involved in the case were from his former practice.
“Dr. Karel also offered evidence that he refuses to accept about one-third of the patients who come to him due to problems with those patients, and dismisses about one-third of the patients he sees once he discovers they are problematic,” the report says. “It is good that Dr. Karel does that, but (Board expert) Dr. (Theodore) Parran offered persuasive testimony that there is also a downside to that situation. The numbers mean that about 50 percent of the patients who come to Dr. Karel’s practice are addicts. Dr. Parran testified that addicts talk with each other and ‘flock’ to a practice that prescribes large amounts of controlled substances with relatively little evaluation.”
In response to the recommended revocation, Karel’s attorney James M. McGovern said, “This case presents a classic example of what can happen when someone is in the wrong place at the wrong time. Here, the wrong place is a medical practice providing care and treatment to chronic pain patients in southeastern Ohio; and the wrong time is in the wake of the October 2010 issuance of the Ohio Drug Abuse Task Force ‘Final Report,’ which prompted Gov. (John) Kasich to place extreme pressure upon the Board to help clean up prescription drug abuse/diversion problem facing Ohio, and more specifically southeastern Ohio, by getting rid of physicians who prescribe the types of drugs that are typically abused/diverted.”
The response by McGovern says the prescriptions were issued for legitimate medical purposes and that Karel looks forward to addressing the Board on July 13.
“He hopes that the Board will keep an open mind regarding the evidence presented at hearing, consider all the mitigating factors and conclude that a sanction less severe than the permanent revocation of his Ohio license is more appropriate based upon the conduct at issue,” McGovern wrote in his filing.
The Medical Board will decide the action to be taken in Karel’s case at the meeting at 1 p.m. July 13.
FRANK LEWIS may be reached at (740) 353-3101, ext. 232, or firstname.lastname@example.org.