3 N.J. Doctors Lose Jobs; 16 Offices Probed After Statewide Alert For Deadly Drug

Three doctors have now lost their jobs after 16 New Jersey doctors' offices were investigated, and a statewide alert was issued for a painkiller that officials say caused at least one death.

The Board of Medical Examiners found, among other things, that the three engaged in the indiscriminate prescribing of Subsys, a powerful, oral spray painkiller approved only for use in certain cancer patients, according to releases from the Attorney General's Office.

A Warren County physician was among the latest to lose his license amid allegations he indiscriminately prescribed the oral spray drug – an opioid approximately 50 times more powerful than heroin and 100 times more powerful than morphine – outside its federally approved use.

Dr. Kenneth P. Sun, who practices pain management medicine in Phillipsburg, agreed this week to the temporary suspension of his license amid allegations he engaged in professional misconduct and gross negligence by indiscriminately prescribing Subsys, according to an OAG release.

The OAG said Sun allegedly prescribed Subsys to several non-cancer patients despite the drug's associated risks of addiction, overdose and death.

“These are extremely potent drugs approved only for use in cancer patients who have built up a tolerance for them. Doctors who prescribe Subsys or other TIRF medications for any other use, as we allege Dr. Sun did, face immediate disciplinary action,” Attorney General Christopher S. Porrino said in the release.

Sun’s “off-label” prescription of Subsys to non-cancer patients “jeopardized his patients’ welfare in reckless or willful disregard of the drug’s unequivocal and well-established risks and flouted the rules for prescribing it," according to the release.

“Dr. Sun’s alleged actions demonstrate a serious lapse in judgment and a profound indifference to his patients’ health; conduct that calls into question his fitness to practice medicine,” said Steve Lee, director of the Division of Consumer Affairs.

If proven, Sun’s indiscriminate prescribing of Subsys would "demonstrate a clear and imminent danger" to the public and provide the board with grounds to suspend or permanently revoke his license, according to the state’s allegations.

The sanctions come weeks after investigators with the Division of Consumer Affairs inspected patient records at six doctors’ offices statewide and subpoenaed patient records from 10 others in connection with an investigation for off-label prescribing of the medication.

Read more: 16 N.J. Doctors' Offices Investigated As Statewide Alert For Deadly Drug Issued

Inspections and investigations of the off-label prescribing of Subsys will continue, authorities said.

A Middlesex County doctor who was convicted in October for engaging in sophisticated fraud and money laundering schemes in connection with his practices also was stripped of his medical license, according to the Attorney General's Office.

Dr. Manoj Patharkar, 45, who owns Pain Management Associates of Central Jersey in Edison and Prospect Pain Management in Passaic, is forever barred from practicing medicine in New Jersey. The board found, among other things, that Patharkar engaged in “gross malpractice” that endangered the health, safety and welfare of his patients, according to the release.

In October, the board also temporarily suspended the license of Dr. Vivienne Matalon, a Cherry Hill family physician accused of indiscriminately prescribing a powerful spray form of the painkiller fentanyl to three patients, one of whom died. Her license will remain suspended until the allegations against her are resolved.

In revoking Patharkar’s license, the board cited his criminal conviction last month for engaging in sophisticated fraud and money laundering scheme, hiding approximately $3.6 million in income from his medical practices to evade taxes. He was also convicted for using money from the schemes to pay illegal kickbacks to other professionals for patient referrals to his practices.

The state issued the public alert after filing an action against Matalon who allegedly prescribed the drug to a non-cancer patient who later died from “adverse effect of drugs.”

Porrino and the Division of Consumer Affairs warned the public about the "grave risks" involved in using the potent prescription painkiller Subsys for anything other than its approved use, according to the Office of Attorney General.

Prescribing Subsys for anything other than its approved use, a practice known as “off-label” prescribing, carries an increased risk of misuse, abuse, addiction, overdose and death, authorities said.

Subsys is the brand name of one of six fentanyl medications that instantly deliver the drug through the oral membranes. Subsys is a spray version of fentanyl, which is typically administered under the user’s tongue. Fentanyl is the drug officials say was involved in the overdose death of the legendary musician Prince earlier this year.

The medicine is not intended for use in opioid-non-tolerant patients because life- threatening respiratory depression and death could occur at any dose in patients not taking chronic opioids.

Fentanyl generally is a powerful synthetic opioid painkiller that is similar to morphine but is 50 to 100 times more potent. Recently, fentanyl has increased in popularity as a recreational drug, diverted from its legal use as a Schedule II pain medication, and is often either used by itself or in connection with heroin.

Fentanyl, in both diverted and illegal analog forms, now results in thousands of overdose deaths every year nationally, according to the release.

Patients who believe they were prescribed Susbys in violation of the FDA restrictions should contact the Division of Consumer Affairs at 1-800-242-5846 (toll-free within New Jersey) or 973-504- 6200.

Patch file photo