Pain clinic doctor practiced for years after first death complaint
TAMPA — Dana Kittler turned to the Florida Board of Medicine after her 26-year-old son overdosed on painkillers in 2009. She blamed a Pinellas Park doctor who, according to state records, had prescribed him 3,360 oxycodone pills in the year before his death.
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But Dr. Edward Neil Feldman’s patients kept dying of overdoses and a grieving mother found no peace.
“They didn’t do anything about Dr. Feldman,” said Kittler, a pharmacy technician now living in Tennessee. “Not at all.”
Three times in the past three years, a Board of Medicine panel has accused Feldman of malpractice, charging that he prescribed excessive, unjustified quantities of oxycodone and other medicines to patients he didn’t adequately screen, examine, treat, or drug counsel.
He still has his state medical license. He still has a federal Drug Enforcement Agency license to prescribe controlled substances.
He could still be on the job, except for a federal judge’s temporary order to stay home and steer clear of doctoring while awaiting trial in an alleged $6 million drug conspiracy.
One of his attorneys, Warren Pearson of Tallahassee, said he has seen no evidence that Feldman directly caused the death of Kittler’s son.
Libor Mark Kittler of Seminole died March 6, 2009, when Feldman was 69. The mother filed a complaint Dec. 6, 2010, when Feldman was 71. This year, the doctor turns 76, and the complaint continues to grow old.
Department of Health spokesman Ryan Ash said the agency is preparing to forward the complaint and two others to the state Division of Administrative Hearings for a final hearing.
Feldman signed a settlement agreement in two state cases, including Kittler’s, in April, neither admitting nor denying guilt, but accepting a $40,000 fine and agreeing to sanctions, including enrollment in a drug prescribing course at the University of Florida.
However, as the full Board of Medicine was set to vote on the agreement, Pearson withdrew it.
“It’s in negotiations,” Pearson said. “We’re having a back and forth with the Department of Health regarding his case.”
In the meantime, records reviewed by the Tampa Bay Times show that at least 16 other people in possession of Feldman prescriptions have died of overdoses since the death of Kittler, who came to the United States from the Czech Republic with his family as a boy.
Three deaths from 2010 and 2011 landed in a Dec. 10 federal grand jury indictment, unsealed last week, that accuses Feldman of dispensing drugs outside the usual course of professional practice for reasons that weren’t medically legitimate.
He and his wife both face charges of drug conspiracy and money laundering, but the doctor could spend the rest of his life in prison if he is found to have caused the deaths of patients identified only by the initials “J.M,” “R.G.” and “S.W.”
Under a 2014 Supreme Court ruling that arose from a heroin dealer’s appeal, Burrage vs. United States, the government would have to prove that without the Feldman-prescribed drugs, the deaths would not have occurred.
It’s sometimes a steep threshold because abusers might combine different drugs from multiple sources, tainting toxicology studies. For many of Feldman’s patients, the cause of death was “multidrug toxicity.”
Prosecutors can make a case that a drug cocktail caused a death, but only if dangerous elements of the cocktail were all dispensed by the same doctor.
In the case of Kittler, the Pinellas-Pasco medical examiner found methadone, oxycodone and Xanax. Public records in the case do not explain the source of the methadone.
Health officials allege in an administrative complaint that Feldman prescribed oxycodone and Xanax unnecessarily even as he recommended that Kittler enter an in-patient drug rehabilitation program.
His mother knew he abused drugs but assumed they came from the street, not doctors, she said. She could tell when he was high. She would kick him out of the house to keep him from being around his young nephew.
It stunned her, after the death, to see how much oxycodone her son had been prescribed, she said. She knows now he was doctor shopping. She opened the bills later. But she saw a list of a half a year’s worth of pills, she said, and many were from Feldman.
“His prescription, I gave that prescription to police, those detectives that came to my house,” she said. “That prescription was written for oxycodone, 30 milligrams, 240 pills. Can you picture that?”
Amid federal charges in the other cases, the DEA asked Feldman to relinquish his license. He has not yet done so, DEA spokeswoman Mia Rowe said this week.
The agency is aware that Magistrate Judge Anthony Porcelli made abstention from medicine a condition of Feldman’s pretrial release. He was released on an unsecured bond, in part because the government had tied up the family’s real property by announcing it might be forfeited.
The U.S. Attorney’s Office, which filed charges based on a DEA investigation, seeks forfeiture of the couple’s Ballast Point home and a clinic on Park Boulevard.
Feldman, at various times, had offices in Tampa, St. Petersburg and Pinellas Park.
Kittler’s mother recalls the sea of emotions that nearly propelled her to visit a clinic and confront the doctor in person.
“Once, I called and I was pretty cold and mean and nasty,” she said. “But I didn’t get to talk to the doctor. They didn’t put him on the phone.
“I was asking if they know the doctor was prescribing oxycodone and other narcotics to young kids like my son. I told them my son died because of Dr. Feldman.”
He is not criminally charged in Kittler’s death. He faces possible licensing sanctions.
The Board of Medicine, whose members are appointed by Gov. Rick Scott, operates under the Department of Health, which regulates and licenses health professions.
In disciplinary actions, the department acts as prosecutor and the board serves as an independent, quasijudicial arbiter, deciding if a professional has violated the law and determining punishment.
Asked if Department of Health cases normally take this long, Feldman’s attorney declined to answer.
“I’m not going to criticize the department, as a former employee and somebody opposite them in the current case,” Pearson said.
Radha V. Bachman, a health care lawyer for the firm Carlton Fields Jorden Burt isn’t involved in Feldman’s cases.
Speaking generally, she said delays sometimes work in favor of doctors who are in the wrong, allowing them to continue to practice.
Bachman speculated that the Department of Health might be allowing federal authorities to take the lead, yielding to agencies with greater investigative powers and resources.
“Whatever happens with regard to that case could put his license in jeopardy, baseline, aside from the fact that there’s a complaint.”
Times news researcher John Martin and staff writers Jimmy Geurts and Michael Auslen contributed to this report.
Filed under: General Problems
You can put an addict in rehab over and over, but until THEY hit THIER rock bottom and THEY WANT to clean up and be sober, rehab is a waste of time. He would have just checked himself out as often as she put him in. The only way he MIGHT have gotten cleaned up is if SHE had him arrested for some criminal act such as stealing money or whatever from the family and then he could have been sent to a jail rehab, much like what finally cleaned up Robert Downey,Jr, remember how many times he violated his various paroles (some running concurrently??) for substance abuse??? I remember it was E! News or Court TV showing one of his hearings where he stated “Its like I’m putting a gun in my mouth and I like the taste of the metal” A judge finally sentenced him to a rehab jail to serve all his sentences at one time and get cleaned up. He finally got IT there. I’ve always been a fan of his and since he cleaned up, he has been nothing but phenonmenal!!, but HE had to want it and HE has to maintain it. While a sad tragedy, her son sounds like he had a mental illness along with addiction disease…something else was going on in that home, in his head, instead of rehab, he should have done a stint in a mental health facility for a proper diagnosis and treatment as a minor while she still had a say in his healthcare.
And how can you fake an MRI??? When I have had one done, The radiology pictures are all digitally sent to my doctor and if I go to another doctor, he pulls them up on the computer or if not available, my doctor’s office has sent a CD to the specialist of my MRI via a courier or faxed a copy of the written radiologists report to the specialist.
Case-in-point…..
A drug abuser will go to lengths to devalue and defraud the pain community.
Perhaps she should have put him in rehab….
People get hung up on the#of pills rather than the strength. Obviously this mother knew of the problem but what about rehab? What about the fact he was not following a doctor’s order? He chose to deceive and all the ones with chronic pain should be under treated? My pill count looks high because I must have two prescriptions and two copays because they don’t make the tablet strength I need so two tablets twice a day isn’t excessive. The DEA must not punish doctors for patients that do not follow the instructions on the pill bottle. Should a doctor have to say look both ways before crossing the street?
[…] https://www.pharmaciststeve.com/?p=9405#comment-8732 […]
It was the methadone part of his multi-drug use that tragically killed Mr. Kittler. And apparently his ignorance of how methadone works. Pain patients take methadone just like it was any other pain pill (I know I did), but it’s not the same. Methadone stays in your system a lot longer than opioids like Oxy and should always be used with a lot of care.
And to all the pain patients who don’t understand that, after they take all the drug addicts away, they’ll be coming for you next, well, don’t say you weren’t warned.
This is disgusting! First off. 240 oxycodone 30’s is not over prescribing. Insurance companies cover more pills than this! When my mom was middle aged and her pain syndrome and pain issues were in full swing?
She was prescribed. Oxycontin 80mgs 90 a month, Roxicodone 30mg 240 a month She as also given 60-2 mg Xanax a day, plus a Soma at night before bed. Mother took all as prescribed, and she didn’t die. In fact, she was doing fine. She is now 67 years old. I was also prescribed, 90-80mgs on Oxycontin monthly,120 roxi 30 4 a month,60 methadone 10’s a month, 60 Xanax 2 mgs tabs and Cymbalta, I didn’t die either and now 55 yrs old.
Now days.. most doctors would be afraid to prescribe this. Our pain was controlled very well and we were both very functional. and yes.. NOW.. we’ve been reduced and not always functional.
The only reason I am stating this? Is to prove a point. If doses are taken as prescribed,, do NOT drink alcohol, and most patients will do fine.. Of course they these people weren’t put on all these doses over night. It was slowing titrated..
Now.. if a person was to get all this? and then seek other doctors, get more medications? and then take illegal drugs? YES! They will most likely die!
It’s a shame that many long term patients, who were given a dose that kept them functional doesn’t exist like this anymore because of idiots like this woman’s kid’s mental disease, if that’s what you want to call it? It say just a damn greedy addict.
If a parent obviously knows that her kid is abusing drugs? No matter what age.. Parents have to know what is going on with such different habits and personality changes., they turn a blind’s eye on it? Then their precious child dies? The parent is at fault in my opinion for NOT setting up an intervention to help their loved one to stop taking medicines they don’t need! Especially a mother! They usually love their child more than their own life!
In cases as this news article? I would think that the mother is most likely a drunk or an addict herself, and this is why such tragedies happen.
The doctor should Not have to take ALL blame. The SOAAP test for induction of patients, for mental evaluation? Doctors can be fooled! If Fake MRI’s were present at that particular time of this 26 yr old’s death. The PDMP wasn’t in place at that time, so how could a doctor be a fault?
The Damn, DEA try to Take all his possessions? Not fair!! See how all this is out of hand in 2015? The DEA are thieves and want steal all a doctor has worked for his entire life! But then.. The DEA only slaps the hands of pharmacists for over filling.. Makes NO sense!