Lack of Records, Over-Prescribing Catch Up with Dr. Omid Vesal

The medical license of an OC internal medicine physician has been placed on probation for four years due to negligence, repeated negligent acts, dishonesty, unprofessional conduct, keeping poor records and prescribing medications without prior examinations, documented needs or proven positive outcomes for three patients, according to state documents.

The order for Dr. Omid Vesal, who resides in Anaheim Hills and has an office in Irvine, became effective at 5 p.m. on Nov. 9, according to the Medical Board of California. Facts of the case were acknowledged as true by Vesal and his lawyer John D. Bishop, with their signatures Aug. 21 and 22 respectively to an acceptance letter from the state board.

“S.A.,” a 32-year-old male patient the physician treated from Jan. 2, 2012, through July 31, 2015, was given 138 prescriptions for controlled substances, according to the evidence submitted by medical board investigators. Vesal prescribed 150 of about 195 tablets that S.A. obtained over 13 days in November 2013.

Most scripts for S.A.—who complained at various appointments with Vesal of chronic arm, head and low back pain from a motor vehicle accident and resulting surgery, a twisted knee, insomnia, anxiety, chest pain, rapid breathing, elbow pain, fatigue, dizziness and headaches—were for painkillers that typically have the brand names Vicodin, Norco and Xodol, which the patient got filled at various pharmacies multiple times during the same weeks. He also got prescriptions over the months of seeing Vesal for alprazolam, a panic disorder medication commonly marketed as Xanax; the painkillers suboxone and buprenorphine (common brand names: Buprenex, Butrans and Probuphine); and amphetamine/dextroamphetamine, an ADHD/narcolepsy treatment.

The 13-day November 2013 run ended on the 13th of that month. Two days later, S.A. was back before Vesal complaining of back and arm pain, insomnia and anxiety, leading to prescriptions that would be filled for Acet, a combination of acetaminophen, codeine and caffeine used to treat mild to moderate pain. However, Vesal has no record of that script and some of his notes regarding several appointments with S.A. are not legible or incomplete, board investigators found. More troubling is “a gap in care” reflected in records (or lack thereof) from Nov. 15, 2013, through March 1, 2014, the medical board concluded.

The treatment of S.A., according to the board, reflected gross negligence due to: the lack of a justifiable treatment plan and ongoing monitoring of the patient; unprofessional conduct for the sheer number of prescriptions written to one patient over a relatively short period of time; inadequate exams; lack of patient imaging; lack of documentation about having discussed the specific risks from controlled substances and treatment plan goals; and inadequate pain score documentation, among many other factors.

It was a pattern repeated with a second patient, identified as 33-year-old female “A.B.,” who’d gone to Vesal from Sept. 14, 2013, through Feb. 12, 2016, due to neck and back pain, migraine headaches, anxiety, ADHD and depression. As they had done with S.A., board investigators charted the frequency of prescriptions from Vesal that A.B. got filled for controlled substances. For many of the same reasons cited for the treatment of S.A., Vesal practiced gross negligence when it came to A.B., the board found.

Patient “C.B.,” a 32-year-old man who complained of anxiety, chronic neck and back spasm/pain and ADHD, also produced a laundry list of filled prescriptions from Vesal for controlled substances, which on average local pharmacies filled three times a month between Jan. 2, 2012, and July 31, 2015. Again, for pretty much the same reasons, the treatment of C.B. displayed gross negligence, according to the board, which also dinged Vesal for repeated negligent acts.

The board also cited dishonesty because Vesal, upon learning he was under investigation for his treatment of S.A., A.B. and C.B., sent a May 30, 2016, letter to the California Department of Consumer Affairs Division of Investigation that essentially stated it is the job of his Irvine staff to do all the things the medical board found the doctor did not do, as required under his license.

During Vesal’s probationary period, he has been ordered by the board to: maintain adequate controlled substances records and have them monitored; complete medical education, prescribing practices, medical record keeping and professional ethics course; finish a clinical competence assessment program; have his practice monitored; notify hospitals and clinics where he has privileges of his probationary status, obey all laws; and provide quarterly updates about his progress.

Failure to adhere to the conditions could cause license revocation procedures to kick in, according to state officials.

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