Muskogee doctor disciplined after string of patient opioid overdoses
A Muskogee physician will be banned from prescribing opioids and other potentially dangerous drugs after a string of his patients died of overdoses.
Scott Gregory Lilly, an oncologist who treated chronic pain patients at Cardiac Clinic of Muskogee, also will have to pay a $20,000 fine, serve a six-month suspension from practicing medicine and seek state approval before taking any new job in medicine.
Lilly said he hasn't practiced medicine since the U.S. Drug Enforcement Agency visited the clinic in 2015, but would like to do so again.
Since 2010, 14 of Lilly's patients died of overdoses, according to a complaint filed with the Oklahoma State Board of Medical Licensure and Supervision.
The state presented evidence about seven deaths, but the board eliminated two cases from consideration: a patient who didn't fill Lilly's prescription before his or her death, and another whose toxicology report showed methamphetamine as well as opioids. None of the patients in the complaint were identified.
The board didn't judge whether Lilly was responsible for any patient's death, but determined he prescribed excessive amounts of opioids and was negligent in the care he provided.
Betty Baugh, of Muskogee, said she wasn't satisfied with the board's decision and would like to see criminal charges filed. She attended the hearing Friday morning, but wasn't allowed to speak. Her son, Jamie Orman Jr., died in September 2011 after receiving pills from Lilly. Orman's case wasn't included in the evidence the state presented.
Orman, who died at 45, had injured his hip several years earlier and found the clinic where Lilly worked in the phone book, Baugh said. Lilly prescribed 600 milligrams of morphine daily, as well as oxycodone and other drugs, she said.
Recommendations released by the U.S. Centers for Disease Control and Prevention earlier this year caution doctors when prescribing any dose higher than 90 milligrams of morphine per day.
The drugs didn't help, Baugh said, and Orman's mobility declined. At the time, she didn't know that his prescriptions could be a problem. It was only after his death that she began looking up his prescriptions online and found they could have been dangerous because of his history of lung problems, she said.
“He got to where he could not walk hardly at all,” she said. “(Lilly) wasn't doctoring his hip. He was just giving him more pain pills.”
Law enforcement didn't order an autopsy in Orman's case, but Baugh doesn't doubt Lilly's prescriptions contributed.
“He killed him. That's all you can say,” she said.
Lilly said his practices didn't lead to any deaths. Patients took more pills than he intended when prescribing them, either because they didn't remember the information he gave them or because they had mental health conditions and wanted to die, Lilly said.
He emphasized he was trying to help patients with intractable pain.
“Any time you do anything or don't do anything as a physician, there are going to be issues,” he said. “I think there are a couple patients that intentionally overdosed that I should have been more mindful of their psychiatric conditions.”
Assistant Attorney General Jason Seay pressed the board to revoke Lilly's license. Lilly's failure to monitor his patients' opioid use directly contributed to their deaths, he said, and the board should send a message to other doctors.
“The fact is: People die every day throughout this country because of the prescribing practices you see here,” he said.
Lilly's attorney, Vicki Behenna, said the doctor received little training about how to prescribe opioids safely, and had difficulty refusing to prescribe pills for patients in pain. He could practice oncology without danger to the public, she said.
“To persecute physicians who were trying to treat chronic pain is not the message to send,” she said.
The board also met Thursday, and suspended the license of Dr. Leslie Ann Masters for one year. One of Masters' patients died during liposuction, and another developed an infection after receiving an injection of fat filler in her face. Masters wasn't trained to sedate patients or perform liposuction.
The board also voted to continue suspending the license of Dr. Cynthia Carol Almond, who pleaded guilty to manufacturing methamphetamine, and to allow a respiratory care practitioner to surrender her license due to alleged substance abuse.
According to a report with the Oklahoma State Board of Medical Licensure and Supervision, the patients whose deaths the state alleged were linked to Lilly’s prescribing were:
JG, who died on March 26, 2010. Toxicology reports found a combination of morphine, hydrocodone, oxycodone, hydromorphone and alprazolam, an anti-anxiety drug. His records showed a history of substance misuse.
GC, who died on Dec. 17, 2011. Toxicology reports found a high level of fentanyl. GC already was receiving fentanyl, oxycodone and alprazolam, but Lilly didn’t perform a drug screening before adding Dilaudid, another opioid, to the mix.
CO, who died Dec. 20, 2011. Toxicology reports found oxycodone and two anti-anxiety drugs. When CO last saw Lilly on Dec. 9, 2011, the doctor prescribed 180 long-acting oxycodone pills and 240 fast-acting oxycodone pills.
SA, who died March 17, 2012. Toxicology reports found a dangerously high level of morphine. CO also received potentially risky prescriptions from other physicians.
RT, who died May 11, 2012. Toxicology reports found fentanyl, morphine, oxycodone and two anti-anxiety drugs, among other medications. Two days before dying, RT filled prescriptions from Lilly for oxycodone, morphine, a muscle relaxant and an anti-anxiety medication. Lilly wasn’t prescribing fentanyl at the time of RT’s death.