Citing the death of two patients from drug overdoses along with “substandard medical decision-making and judgment” and “irresponsible and substandard prescribing of controlled substances,” the Montana Board of Medical Examiners indefinitely suspended the medical license of Dr. Chris Christensen of Florence after a hearing Monday.
Christensen’s medical practice, Big Creek Family Medicine and Urgent Care in Florence, was raided by Ravalli County and federal authorities, including DEA agents, last Monday. They were serving a search warrant following a two-year investigation into the doctor’s prescription-writing practices.
No criminal charges have been filed in the case.
The medical board, which conducted its own investigation into the doctor, released a number of facts regarding Christensen to support its decision.
Among them was a finding that two of Christensen’s patients in Montana, for whom he prescribed methadone, have died from drug overdoses. The board also found that Christensen’s practice was on a cash-only basis and that he improperly acquired prescription medications intended for patients, including controlled substances, and then kept and distributed the drugs at his clinic.
They also found that Christensen resorted to fraud, misrepresentation or deception in the examination, treatment and billing of patients.
On Jan. 16, the Montana Board of Pharmacy filed a complaint against Christensen, alleging that some of his patients had filed complaints against a pharmacist on the grounds that the pharmacist refused to fill prescriptions issued by Christensen.
The Board of Pharmacy dismissed the patients’ complaints against the pharmacist, finding that the pharmacist had properly exercised his professional judgment to refuse to fill prescriptions for controlled substances. The pharmacist’s professional opinion was that the prescriptions had not been issued in the course of a legitimate or reputable professional practice.
The Board of Pharmacy then issued its complaint against Christensen, and the Board of Medical Examiners launched an investigation into the Board of Pharmacy’s allegations.
On April 3, two days after Christensen’s offices were raided by authorities, the board’s investigator released her report.
The board convened a special panel Monday to make a decision on Christensen’s medical license, and he took part in the discussion by telephone, accompanied by his lawyer. The board summarily suspended his license, effective indefinitely.
In defending its decision, the board made a number of facts from the investigation public.
The report was prepared by Michael L. Fanning, a special assistant attorney general with the Department of Labor and Industry’s Office of Legal Services. Christensen’s suspension order was signed by Dr. Anna Earl, presiding officer of the Montana Board of Medical Examiners.
The report states:
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“The Screening Panel finds that the public health, safety and/or welfare imperatively requires emergency action in this matter.”
The report also states that Christensen’s medical charts demonstrate irresponsible and substandard prescribing of controlled substances, and that his prescriptions were written and timed so as to permit the patient to acquire excess pills over the number needed for the dosage for a given time period.
“Dr. Christensen prescribed dangerous combinations and quantities of drugs which are known to decrease respiration, posing a risk of death to the patient,” the report states. “In such cases, Dr. Christensen failed to properly counsel patients on the risks of these drug combinations and quantities and failed to adequately monitor the patients’ use of these drugs. The patient records document not only high doses of methadone, but also these same patients were simultaneously prescribed Xanax, Soma and hydrocodone in excessive doses and quantities.”
The board’s investigator also examined records from the Montana Prescription Drug Registry as part of her investigation. She found that Christensen prescribed one chronic pain patient 8,900 methadone tables in a 133-day period, or roughly 67 tablets per day.
In another 14-month period, Christensen prescribed that same patient 19,508 methadone tablets, or more than 45 tablets per day for more than one year. The patient would commonly use 1,000 tablets, a 30-day prescription, in as little as 13 days.
She also found that unusually large doses of controlled substances caused some pharmacists to resist or refuse to fill Christensen’s prescription orders.
The report states that Christensen’s medical practice was marked by substandard medical decision-making and judgment, often not performing evaluations on patients complaining of pain and simply prescribing unusually high doses of narcotics. Christensen is alleged to have issued a false statement in connection with a medical marijuana card in 2013.
The report states that Christensen’s charting and medical records are often illegible and are substandard, and that he failed to document even routine physical examinations and proper histories.
“Dr. Christensen wrote a prescription to a chronic pain patient for 300 Dilaudid 4 mg tablets and then remarked to the patient, ‘This is $3,000 worth of Ds,’ ” the report states. “The patient reported surprise that her doctor used the street name for Dilaudid and was aware of the price of diverted Dilaudid on the street.”
The fact that Christensen accepted only cash also raised suspicions.
“Cash-based pain clinics that do not accept private insurance or government-funded health care are recognized by law enforcement and medical professionals to attract patients seeking to abuse or divert controlled substances,” the report states.
The investigator also found that Christensen left blank prescription pads lying around the clinic, and that one chronic pain patient admitted to stealing one. Christensen also possessed an unsecured bag of hundreds of assorted tablets and capsules.
Christensen was acquitted by an Idaho jury in 2010 on charges of illegal distribution of controlled substances. Another case was brought against him in 2007 alleging that he prescribed methadone and Xanax that resulted in the death of a patient, but the charges were dismissed by an Idaho district court judge.
Christensen has 20 days to appeal his suspension.