Desperation and death after Seattle Pain Centers close: ‘The whitecoats don’t care’

http://www.seattletimes.com/seattle-news/health/the-whitecoats-dont-care-one-mans-desperation-and-death-when-pain-clinics-close/

A 58-year-old former patient of Seattle Pain Centers committed suicide last month, leaving notes claiming he could find no help for his chronic pain after the chain of clinics closed in July following state sanctions.

JoNel AlecciaBy JoNel Aleccia
Seattle Times health reporter

Two days before he shot himself in the head, Denny Peck called 911 and said he couldn’t stand the pain.

Peck, 58, told the fire-department dispatcher that he had been a patient of Seattle Pain Centers, a chain of Washington clinics, until it closed abruptly in July amid allegations of improper oversight and patient deaths.

“They’ve been shut down by the government,” Peck said in the Sept. 15 call, which was punctuated by sharp cries and grunts.
Find help

Seattle Pain Centers’ former patients should seek advice from their primary-care providers and insurance plans about finding a new source of pain management, officials said.

Call the Washington Recovery Helpline at 1-866-789-1511, or visit www. warecoveryhelpline.org

Or call the Washington Suicide Prevention Life Line at 1-800-273-8255.

Washington State Department of Health

“And, anyways, I got severe back pain and everything. I took the last of my pills and I’m going through some serious withdrawal symptoms. I got the crawling skin and everything else. Can you guys help or not?”

But the woman on the phone said she couldn’t give Peck any drugs, only a trip to the hospital, which he declined. In the weeks before he called 911, Peck’s family said he contacted primary-care doctors and went to emergency rooms. The family doesn’t know all the details, but Peck said he couldn’t get the pain pills he needed.

On Sept. 17, just after 10 a.m., Thurston County sheriff’s deputies were summoned by the worried manager of Peck’s mobile-home park outside Yelm. They found Peck in bed, two guns in his lap and bullet wounds on both sides of his head, according to the deputy’s report.

“Can’t sleep, can’t eat, can’t do anything,” said a handwritten note left nearby, “And all the whitecoats don’t care at all.”
Denny Peck, 58, of Yelm, killed himself on Sept. 17, two months after the abrupt closure of Seattle Pain Centers cut off his supply of pain medications. (Courtesy of Lorraine Peck)
Part of this note was read by Lorraine Peck at the memorial service for her son, Denny Peck, who killed himself Sept. (Ken Lambert/The Seattle Times)

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Denny Peck, 58, of Yelm, killed himself on Sept. 17, two months after the abrupt closure of Seattle Pain Centers cut off his supply of pain medications. (Courtesy of Lorraine Peck)

The death of Peck — an easygoing Seattle native who was injured 26 years ago in a commercial-fishing accident — is the only fatality reported among former Seattle Pain Centers patients since the clinics closed, state health and Medicaid officials said. Many factors can contribute to suicide, but the case provides a window into the desperation some pain patients feel.

“Every time someone takes their life, it’s a tragic loss for their family and the community,” Dr. Kathy Lofy, the Washington state health officer, said in an email.

“We know that many people struggle with pain, both physical and emotional. We want people to know that it can get better and that there are people and resources that can help. If anyone feels helpless or desperate, we hope they will reach out for help and that people surrounding them will take action.”

About 8,000 patients were prescribed opiates by Seattle Pain Centers this year, part of an estimated 25,000 seen at eight clinic sites since 2008. The sites closed days after state regulators suspended the medical license of former director Dr. Frank Li, saying he failed to properly monitor Medicaid patients, possibly contributing to at least 18 deaths since 2010.

Li, who has denied the allegations, has not been charged with a crime.

A hearing before members of the state Medical Commission is set for April.
“Left in a lurch”

Government documents showed that state officials were warned in 2015 about overdose deaths among Seattle Pain Centers patients. And they were told three years ago that Li had been blocked from prescribing for the state workers’ compensation program.

Some critics complained that state health officials took too long to act. Others said that when they did, there was no plan in place to absorb a huge number of pain patients, including many, like Peck, who were taking very high doses of dangerous opiates or who had complicated medical conditions.

“This was such a huge surprise to the entire system,” said Dr. Ray Hsiao, president of the Washington State Medical Association. “This is unprecedented.”

State health-department officials said legal constraints prevented them from warning people about the charges that were coming against Li. Once they were public, Lofy and others reached out immediately to providers and patients.

People are falling through the cracks. It’s just terrible. It’s just tragic.” – Jennifer Hanscom, executive director of the medical association

“When Dr. Li closed his clinics, we developed information and strategies to help patients know how to find help,” health-department spokeswoman Julie Graham said in an email. “We’ve also been working to make sure that health care providers understand how to take on the care of patients with chronic pain issues within the guidelines of the state’s pain rules.”

Still, thousands of former Seattle Pain Centers patients flooded emergency rooms and others reported desperate efforts to find new care. Officials at the state’s largest pain programs scrambled to absorb hundreds of clients.

Officials at the medical association urged their primary-care members to help. In a recent blog post, Hsiao was blunt.

“No matter your opinion on the state’s handling of this situation, one thing is clear: thousands of patients in our communities have been left in a lurch, suddenly and unexpectedly cut off from appropriate treatment for their pain, or opioid medication management.”

But Hsiao said that while some doctors have agreed to help, others have balked.

“They’re saying, I just don’t have the capacity for it,” Hsiao said in an interview. “I’m seeing patients every 15 minutes. How can I give these patients the time?”

Some doctors said they’re skeptical of stepping up after being told to send chronic pain patients to specialists, as recommended in guidelines pioneered by Washington state in 2007 and finalized in 2012.

“For years, primary care physicians have been pushed away from treating chronic pain, threatened with lawsuits and licensure action,” Dr. Russell W. Faria of Auburn said in an email. “I can fairly guarantee that primary care physicians will not be very receptive to this call, to put it mildly.”

The result? “People are falling through the cracks,” said Jennifer Hanscom, executive director of the medical association. “It’s just terrible. It’s just tragic.”
Decades of pain

For Peck, the trouble began in 1990, when he was injured while working on a fishing boat in Juneau, Alaska, crushing several vertebrae.

“He has been in pain ever since,” said Peck’s mother, Lorraine Peck, 86, of Seattle.

The pain haunted Peck, who was raised in Ballard and is remembered by his family as a kind, smart, friendly guy who played the drums, worked as a cook and a welder and ran a limestone plant before signing on to the trawler. He lived on a boat at Seattle’s Fishermen’s Terminal for a time, and always wanted to be near the water.

Peck had two children, a son, Jasen Peck, 35, and a daughter, Amanda Peck, 32.

Amanda Peck said she didn’t remember a time when her dad didn’t hurt.

Denny Peck moved to Yelm five years ago and kept his pain under control with visits every three months to a local Seattle Pain Centers site, according to a clinic bill. At the time of his death, he still owed $131.82 for care, it showed.

Peck was taking high daily doses of opiates, including morphine and oxycodone/acetaminophen, plus powerful muscle relaxants, prescription records showed.

When the clinics closed in July, Peck tried to find a new primary-care provider, as state health officials advised patients to do.

“No doctor would chance losing his license due to new laws, and Denny saw no help from the medical people although he tried and tried,” said Peck’s obituary on the funeral-home website.

Peck’s family said he sought help at the Washington Center for Pain Management, another provider, but his family contends he wasn’t given enough medication. Officials at that center said privacy laws prevented them from confirming whether he had been treated there.

Peck rationed his final pills, his mother said. But then he ran out.

“He was in so much misery,” she said.

When Lorraine Peck talked to her son in the days before he died, she urged him to talk to a pastor with a local church.

“I think he found peace,” she said. “I could not fault him at all. He could see no other way out.”

About three dozen people gathered for a memorial service for Denny Peck on Oct. 15 — the day Seattle was threatened with a big windstorm — to say goodbye.

Stories were shared, as was the letter he left behind.

“I feel sorry 4 all of the people that got kicked out and R still in pain,” Peck wrote. “Find them and help them!! Help them, please, they hurt still.”

Filed under: General Problems