Doctor Prescribed Opioids Without Cause In Fatal OD: Authorities

A Burlington County family physician has been temporarily suspended from practice amid allegations he prescribed hundreds of opioid pain pills to patients without a legitimate purpose, including to one person who died of an overdose, authorities announced. The pills included large amounts of Fentanyl and Oxycodone, among other controlled dangerous substances, Attorney General Christopher S. Porrino and the Division of Consumer Affairs announced on Monday.

Dr. Moishe Starkman, who practiced family medicine in Bordentown, is accused of prescribing up to 720 pills a month to five patients over the last five years. The prescriptions were for medical conditions he diagnosed them with without physically examining them, conducting diagnostic tests or documenting a legitimate need for the drugs, according to the complaint filed in the case on Aug. 25.

Starkman even prescribed pills to people who showed signs they may have been addicted to the drugs or were diverting them for illegal use, according to the complaint.

Starkman’s attorney wasn’t immediately available for comment on Monday.

In one instance, a 22-year-old man identified in the complaint as “H.H.” died of a drug overdose in May of 2015, two months after his last visit with Starkman, according to the complaint.

“H.H.” was 19 the first time he visited Starkman with complaints of back pain in July of 2012, according to the complaint. At that time, “H.H.” listed an array of medications he was currently taking, including a muscle relaxer; an anti-anxiety drug; a drug to treat attention deficit disorder, a drug to treat insomnia, and “recently finished pain medication from wisdom teeth removal.”

Starkman prescribed a muscle relaxer that day without conducting a physical exam or diagnostic to discover what caused the pain, according to the complaint. The following month, he began prescribing opioids to “H.H.”

Over the next three years, Starkman prescribed Xanax and up to 240 opioid pain pills a month to “H.H.” However, he never established and reevaluated treatment plans, nor did he reassess the use and dosage of the narcotics prescribed, as required by law, according to the complaint.

In fact, during one visit in December of 2014, Starkman continued to prescribe Oxycontin to “H.H.,” even though the patient was slurring his speech and falling asleep during the visit, according to the complaint. The following month, when H.H. visited the office because he was “sick” and “ran out of all meds early again,” Starkman wrote him a prescription for a higher dosage of Oxycodone.

At one point, “H.H.” spent a week in a mental health and addiction treatment facility in Vermont for anxiety and panic attacks. Three days after he was released, he visited Starkman, and was prescribed 120 pills of Oxycodone. Starkman made note of the time “H.H.” spent in the Vermont facility during the March 16, 2015 appointment, according to the complaint. “H.H.” died two months later.

This anecdote falls in line with state allegations that Starkman prescribed the highly-addictive opioid medications and other narcotics to his patients for years without documenting treatment plans for pain management or opioid use. He also failed to assess the effects of the narcotics he prescribed; and didn’t make any reasonable efforts to prescribe alternative medications or treatments to alleviate pain or decrease the dosages of the controlled substances.

He also failed to keep adequate progress notes on his patients and failed to treat them for medical issues not related to their pain, according to the complaint.

With regard to the four other patients, Starkman is accused of:

• Prescribing T.A., a 29-year-old female, six different prescriptions for 120 pills of Oxycodone that amounted to 720 pills in a thirty-day period, which, if ingested as prescribed, would equal one pill for every hour of the day. He kept only one progress note in the 19 months he treated T.A. and conducted only one drug screen on her, which came back negative for all tested substances, even the prescribed opioid;

• Prescribing 600-720 Oxycodone pills each month to C.D., a 41-year-old female, with no physical exams, no treatment plan, no progress notes, and no documentation in her patient file except copies of prescriptions. He continued to prescribe large quantities of opioids to C.D. despite receiving a warning letter from her insurance provider that she had filled 18 prescription drug claims at four different pharmacies, and another letter from the provider warning that C.D. had met her threshold of opioid use for a 120-day period;

• Prescribing up to 360 pills of Oxycodone a month and up to 120 pills of Xanax a month to J.T., a 42-year-old male, with no physical examination, detailed history, review of prior treatment history, or diagnostic testing. He continued to prescribe large numbers of pills to J.T. despite the fact that the patient’s urine drug screens consistently tested positive for cocaine; a Prescription Monitoring Program report indicated he had filled CDS prescriptions issued by seven different physicians within a one-year-period; and despite receiving warnings from another patient that J.T. was “selling your scripts on the street” and “using someone else’s pee to pass your drug screen;” and

• Prescribing opioids in large dosages and quantities to G.A. for almost four years despite the fact that the patient reported no change in his pain levels, and that his urine drug screens tested positive for marijuana.

His license has been suspended pending a hearing under the terms of a Consent Order with the state Board of Medical Examiners. During his suspension, Starkman isn’t permitted to visit his former medical practice at any time when patients may be present, and he may not manage, supervise, oversee or influence the practice of medicine or the provision of healthcare activities, including testifying as an expert witness in the state of New Jersey.

Patch file photo