A Laguna Hills psychiatrist surrendered his medical license to settle a California Medical Board case that alleged he negligently prescribed opiates and other medications to three addicts and over-prescribed drugs to a senior woman—all of whom died while in his care.
The board released legal documents Wednesday that showed Dr. Irwin Ira Rosenfeld gave up his license, effective this week, to resolve license revocation proceedings.
A judge in May barred the same doctor from prescribing narcotics pending the outcome of the proceedings.
The dead mentioned in the California Medical Board documents included:
* A 53-year-old man who died in Jan. 26, 2012, from a “mixed drug overdose.” Rosenfeld, who treated the patient from September 2004 until his death, knew than man abused various opiate painkillers, but he prescribed him Xanax, which was one of the drugs named in the autopsy report.
* A 29-year-old man who died on Dec. 31, 2012, from multiple drug toxicities. Rosenfeld had treated him from June 2003 until his death for panic disorder, ADHD, musculoskeletal pain, generalized anxiety disorder and substance abuse issues. The doctor knew in 2003 that the patient abused drugs, alcohol and had illegally distributed amphetamines yet, though 2008, he was prescribed him Gabitril, Adderall, Zoloft, Trileptal, Visaril, Seroquel, Lexapro, Clonazepam, Ambien, Robaxin and Temazepam. The scripts kept coming even during 2007, when Rosenfeld knew the patient was abusing prescription medication while undergoing drug treatment. From March-June '09, Rosefeld wrote the fellow multiple scripts for Tranxene, Meprobamate, Xanax, Clorazepate and Klonopin. On July 27, '09, the patient’s mother called the doctor to say her son was acting crazy and seemed over-medicated. The next day, Rosenfeld prescribed him Valium, Clorazepate, Klonopin, Meprobamate and Seroquel. Through the remainder of the year, he received Rosenfeld scripts for more Clorazepate, Valium, Meprobamate and Benzodiazepines (to counter the Vyvanse). The patient was referred to another doctor in October 2009 for a psychopharmacology evaluation. Noting that in addition to the laundry list of drugs the patient was using medical marijuana for insomnia and drinking alcohol, that doctor suggested inpatient detoxification may be needed. The doctor talked this over with Rosenfeld, who did not follow through with any of the recommendations. That December, the patient was taken to St. Jospeh Hospital’s emergency room for sedative intoxication. What followed into the next year was three doctors, including Rosenfeld, prescribing the patient drugs without knowing he was already getting scripts from the others.
* A 27-year-old man who died on Oct. 12, 2014, of “acute polydrug intoxication.” He was treated by Rosenfeld from June 15, 2012, through his death. The psychiatrist wrote in the medical chart that the patient was abusing heroin, yet he was prescribed Valium despite having a history of abusing a similar drug. Rosenfeld was also negligent for not referring the addict for substance abuse treatment.
* A 73-year-old woman who died Jan. 26, 2013, of gabapentin and memantine intoxication. She had been treated by Rosenfeld from May 2008 through her death for painful bladder syndrome. On May 26, 2009, Rosenfeld prescribed her Xanax and Ambien. On June 8, she reported the Xanax was stolen and was prescribed more. These scripts continued until March 2012, when temazepam was substituted for Ambien, so she continued with that and the Xanax through her death. Rosenfeld was cited for being negligent for prescribing excessive doses of benzodiazepine temazepam and for inappropriate medication, doses and length of prescriptions for someone her age. Concurrent prescribing of tramadol, gabapentin and Risperdal increases impairment, the board noted, adding that Rosenfeld gave no explanation or justification for these scripts.
In addition to those cases, the board cited another involving an 86-year-old man with advanced dementia. His daughter had power of attorney over the patient's finances and Advanced Health Care Directive to make medical decisions for him. She hired two caretakers, a man and a woman, via Craigslist in December 2012. In February 2013, unbeknownst to the daughter, the father signed over financial and healthcare powers or attorney over to the couple, who were relative strangers.
The next month, the caretakers took the elderly man to Rosenfeld to determine the patient's “ability to make a free decision.” The daughter and the patient’s regular psychiatrist were unaware of this. After the examination, and at the request of the male caretaker, the doctor drafted a letter that stated the patient possessed the mental ability to understand the powers of attorney and that the man would be his caretaker.
The state medical board found Rosenfeld negligent because he should have known the patient was being subjected to elder abuse by the caretakers and that, when it came to his mental ability, he was not capable of understanding what was going on as he could not correctly name the day of the week, the year or details about his finances.
The couple subsequently withdrew $5,000 from the patient’s savings account.
Rosenfeld had been on the medical board's radar for years. In 2011, he was placed on five years probation from the board for gross negligence, violating laws regarding dangerous drugs and controlled substances and engaging in unprofessional conduct.