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Last updated: Fri. Mar. 29, 2013 - 12:58 pm EDT

Pain doctor placed on probation, can practice

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INDIANAPOLIS — Dr. William Hedrick of Fort Wayne avoided strong sanctions from the Indiana Medical Licensing Board late Thursday when the panel placed him on probation for two years after finding three violations related to his pain clinic practice.

The group said he breached standard of care in at least one case, failed in properly supervising his employees, and overused steroid injections in the spine.

The board cleared Hedrick of three other counts.

In comparison, he and the state attorney general’s office earlier had agreed to a failed settlement that would have suspended his license for two years.

He had been placed on emergency suspension and can practice again as soon as the board’s final order is signed. Hedrick must follow a number of probation-related requirements.

Hedrick was visibly relieved at the conclusion of the hearing but declined to comment.

“We are certainly satisfied with the board’s decision. The board listened to all the evidence and considered it,” said Hedrick’s attorney, Stacy Cook. “The suspension will be lifted, and he will be able to practice again.”

Hedrick testified earlier in the day that there were a “few isolated cases where the result was not good” but that after further review of the process and the charts, he didn’t feel he was culpable.

“I can’t control the actions of every individual,” Hedrick said.

The state filed a complaint against him in December accusing him of incompetence. Deputy Attorney General Jessica Krug said he ignored clear evidence of addiction to and diversion of controlled substances.

Hedrick is founder and president of the Centers for Pain Relief, which is based in Fort Wayne and had more than a dozen other locations in northern Indiana when he was initially charged. The number of locations has now dropped to six.

The case largely centered on opioid therapy – or the chronic use of strong painkillers or steroids to control pain through injections or prescriptions.

During the hearing, the attorney general’s office detailed the treatment of seven patients at Hedrick’s clinic who later died. But Hedrick’s defense argued that the state had not connected the deaths to the treatment – a contention that at least one board member agreed with.

“I don’t think any of those people that died were his fault. Absolutely not,” Worthe Holt said.

But Holt and others pointed to lackluster supervision on Hedrick’s part, including inadequate training and oversight for employees and lack of implementation of protocols.

Cook argued that Hedrick could not be held accountable for actions taken by employees he supervised, particularly nurse practitioners or physician assistants. But Krug disagreed.

“Can patient safety be delegated? Tasks were delegated and all responsibilities for negative consequences were absolved,” she said.

The board struggled with the concept during discussion, noting that everyone involved in the treatment has his or her own medical or nursing license.

Earlier in the day the panel heard expert testimony on complicated medical charts.

Dr. Hary Ailinani, a doctor who used to work with Hedrick at Centers for Pain Relief, testified that he resigned after he became uncomfortable with certain practices and lack of oversight. He talked generally about different types of spinal injections, the quantity of prescriptions for strong opioid narcotics and a lack of continuity of care.

On cross-examination, Ailinani admitted he now runs a competing pain management company against Hedrick with multiple doctors who also left his practice.

Lawsuits are ongoing between those doctors and Hedrick related to a non-compete clause and defamation.

The defense questioned an expert pathologist who disagreed with several Allen County coroner reports that found that patients of Centers for Pain Relief had died of multiple drug toxicity.

Dr. E. Allen Griggs pointed out that several of the findings were made without the aid of an autopsy. He agreed that one was related to multiple drug toxicity but disagreed on others.

For instance, in one, he found the primary cause of death was a heroin overdose. In others, he found the drug levels in the person’s system were not high enough to be fatal. In a third, he found the death was primarily related to heart disease, with drug toxicity only a contributing factor.

A pain management expert testified that Hedrick and the clinic did not provide substandard care, offering only a few critical comments on a nurse practitioner who still works for Hedrick.

Included in Hedrick’s probation requirements are an evaluation by the Center for Personalized Education for Physicians; limits on how many physician aides he can supervise at one time; chart reviews by an independent expert; and regulations on spinal injections.

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