Two Orange County doctors in hot water with the California Medical Board over deaths tied to their methods of prescribing dangerous drugs have essentially lost their licenses to practice medicine.
Anaheim family medicine Dr. Clyde M. Ikuta surrendered his medical license effective last Thursday, according to the board.
Santa Ana's Thomas S. Powers, whose matter before the board we previously covered ("Dr. Thomas S. Powers' History of Poor Record Keeping Catches Up with Him"), had his license suspended effective Jan. 17 for owing thousands of dollars in unpaid state taxes.
Ikuta and his Mission Viejo lawyer Garrett S. Gregor signed the Medical Board of California Stipulated Surrender of License and Order, which includes evidence accusing the doctor of unprofessional conduct, gross negligence, repeated negligent acts and incompetence.
That is because of Ikuta's treatment of a 42-year-old male opiate addict and intermittent heroin abuser as well as two male heroin addicts, ages 25 and 32. The younger of the two men died of an overdose.
In that case, the patient identified by the board as P.G. came to see Ikuta in August 2010 due to knee and feet pain. The doctor did document that P.G. had a history of heroin use beginning at age 22 and had used the previous year, but Ikuta did not note any other drug or alcohol use by the patient nor specifics about the reported pain, including which knee was hurting, medical board investigators found.
P.G. was prescribed methadone, but Ikuta did not follow state protocols when it comes to approving the drug for an addict, according to the board, which notes the doctor refilled that prescription while adding in Clonidine, a dangerous drug used to lower blood pressure, three weeks later but, again, did not perform adequate record keeping of the visit. The same was true two weeks later, the board states, when P.G. was prescribed more methadone and BuSpar, an anti-anxiety medication.
Before the month was out, on Sept. 30, 2010, P.G. was back for a script for more methadone as well as Klonopin, a very powerful anti-seizure and panic-attack medication. "On this visit, the patient was noted to have continuing complaints in the feet, legs and back, especially in the early morning," reads the medical board exhibit. "No physical examination was documented in the chart; however, during his interview, [Ikuta] stated he 'probably' did one, but didn't document it because he was lazy."
Twice the following October, P.G. would receive refills for methadone and Klonopin—without those visits being adequately documented by Ikuta—and on Nov. 2, 2010, which was five days after the patient's previous visit, he claimed his medications had been stolen so he received prescriptions for more from the doctor who, again, failed to properly document the visit.
Two days later, Ikuta gave P.G. a disability form for the county Social Services Agency stating the patient had been diagnosed with ADHD since he was child, but the doctor could produce no documentation for the medical board showing that a psychological evaluation had ever been done to reach such a conclusion. Ikuta "stated during his interview that he would not have performed an evaluation for this condition as he believed the patient because the patient was active in the room."
There were prescription refills—and poor record keeping—on Nov. 10, Dec. 2 (with the dangerous anti-depressant Effexor XR added to the methadone and Klonopin mix) and Dec. 22 of 2010 as well as Jan. 11, Feb. 2 and Feb. 18 (with a new disability form to cover the next five months) of 2011. A month later, on March 24, 2011, the patient told Ikuta that he wanted to decrease his daily methadone intake, but the doctor instead increased the dosage, according to the medical board. P.G. was back a week later to say he lost his drugs, so Ikuta cut another prescription. The patient received refills for the next two months.
On May 12, 2011, two days after his last visit with Ikuta, P.G. died of an accidental overdose, according to the medical board.
The 32-year-old man, identified as A.F., followed a similar treatment routine beginning Sept. 4, 2007. Over the next several years, this would include repeated prescriptions (and poor record keeping) of mostly methadone and Klonopin, an addition of Clonidine and the patient claiming to have had meds lost or stolen and receiving new scripts within days of previous ones being filled. These visits continued through Aug. 8, 2012.
The 42-year-old patient, C.T., began receiving repeated scripts for methadone and Clonidine after his first visit with Ikuta on Aug. 14, 2011, and when asked by the board investigators why he did not document a physical exam for an Oct. 5, 2011, appointment, the doctor replied, "Because I'm lazy." Two months later, besides methadone, Ikuta included amoxicillin on the script because C.T. complained of having a cavity. Ikuta conceded to board investigators, "No, I am not a dentist."
The poorly documented treatment of the patient and repeated script giving continued through a May 16, 2012, emergency room visit, when St. Jude's Medical Center doctors treating back spasms wrote C.T. prescriptions for Toradol and Soma, which are pain relievers. The next day, C.T. received his regular methadone and Clonidine scripts but Ikuta added Klonopin to the mix. When the patient asked why, the doctor replied it was a sleep aid.
Ikuta confessed to the board investigators he did not know C.T. had been to the hospital the day before.
C.T. was back at emergency that May 26, and on May 29 he received from Ikuta his regular scripts plus even more Klonopin than had been prescribed before. Again, Ikuta confided he did not know his patient had been to the emergency room twice in two weeks. But Ikuta did know about those trips by the time of a June 2012 visit, when he did mention the pain relievers while prescribing more methadone and Klonopin.
A month later, C.T. went to the Coast Plaza Hospital emergency room due to acute paralysis.
Ikuta will have to reapply with the medical board if he wants to get his license back.
If you like this story, consider signing up for our email newsletters.
SHOW ME HOW
You have successfully signed up for your selected newsletter(s) - please keep an eye on your mailbox, we're movin' in!
As for Dr. Powers, the Sept. 2, 2016, complaint by Kimberly Kirchmeyer, the Medical Board of California executive director, alleged that poor record keeping may have contributed to the physician over-prescribing addictive drugs to four patients, including one who died.
Kirchmeyer recommended suspension or revocation proceedings begin for the medical license of Powers, who specialized in anti-aging and preventive medicine, cosmetic medicine, stress management, pain management, addiction recovery, weight management and regenerative medicine at Open Care Medical Clinic in Santa Ana.
But the suspension that became effective this month was not due to medical record keeping but a violation of California Revenue and Taxation Code section 7063, according to the board. The code requires a state license/certificate/registration be suspended of anyone who has outstanding tax obligations due to the Franchise Tax Board or the State Board of Equalization and appears on either the FTB or BOE's certified lists of top 500 tax delinquencies over $100,000.
If Thomas wants the suspension lifted, the Newport Coast resident has 90 days to clear the tax matter up, according to the medical board.