Suspended doctor seeks legal help, hasn't released records

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http://www.andersonsc.com/and/news/article/0,1886,AND_8203_3102033,00.html
By Heidi C. Williams
Independent-Mail
August 10, 2004


WALHALLA -
A Seneca physician who had his medical license suspended last month following a series of drunk and disorderly conduct arrests applied Monday for a public defender to represent him in General Sessions Court.

Although he made the application in person at the county courthouse, Antonio Felipe Amaya has yet to make available the medical records his patients need to continue their treatment elsewhere. And now the state board of medical examiners is saying it is powerless to seize those records or deliver them to patients.

Dr. Amaya had his medical license suspended last month, following a series of arrests, the last of which landed him in jail on charges of criminal domestic violence and discharging a firearm while under the influence. Oconee County sheriff's deputies say he was shooting an AK-47 semi-automatic machine gun, drunk in the backyard of his Hartwell Lake area home.

His application for indigent defense was tendered Monday, according to clerk of court records. Foreclosure proceedings already are under way on his Stonehaven Way home.

Since his arrest June 25, Dr. Amaya's practice - the New Hope Neurological Clinic - has been closed, although some patients report the office was open for about two days so they could get copies of their medical records.

No formal notice was issued that the office would be open those days, however, and now the Eagles Nest Drive professional building is locked.

"All we can do is try and encourage the physician and his staff to assist patients in gaining access to their records," said Jim Knight, a spokesman for the state board of medical examiners. "We have not had that assistance or cooperation in this case."

Research by the Anderson Independent-Mail found that Dr. Amaya had been reported to the state board of medical examiners at least three times in the past three years.

The state board of medical examiners does not discuss complaints against a doctor unless formal action is taken, Mr. Knight said, and only the letter to the clinic owner prompted action by the board. Dr. Amaya received a public reprimand, was fined and required to take anger management classes.

South Carolina has a history of lax oversight when it concerns its doctors, according to officials from Public Citizen, a national watchdog group that runs the Web site www.questionabledoctors.org..

The group annually ranks state medical boards' serious disciplinary actions, and for the past three years South Carolina has hovered in the bottom 10 states, based on a three-year average. Last year, of the state's 10,140 physicians, only 33 received serious disciplinary actions, the group reports.

Medical boards are supposed to track complaints against doctors so that the public is protected, said Sidney Wolfe, director of Public Citizen's health research group.

"When medical boards aren't carrying out orders, they are protecting doctors instead of protecting patients," Dr. Wolfe said. Although a national database of complaints against physicians exists, it is not available to the public nor to practicing physicians, he said.

"It's a secret," Dr. Wolfe said, one that is perpetuated by a piece of federal legislation: the national Health Quality Improvement Act of 1986. "It robs patients of finding out about their doctors."

State legislation apparently is what's preventing local patients from gaining access to records at Dr. Amaya's office. The South Carolina Physicians Patient Records Act does not specifically address what to do when a physician abandons his office, Mr. Knight of the medical examiners board said.

Although the board, which is overseen by the state Department of Labor, Licensing and Regulation, has the authority to suspend and revoke a physician's license, it has no such authority to deliver medical records to patients, Mr. Knight said.

Said Mr. Knight of Dr. Amaya's patients: "They're caught in the middle, here."




Doctor gone, but questions remain

http://www.andersonsc.com/and/news/article/0,1886,AND_8203_3095561,00.html

Despite years of complaints, an Upstate doctor lost his medical license only last month. Now he is nowhere to be found, and his prescriptions are being linked to several deaths

By Heidi C. Williams
Oconee-Pickens Bureau
August 7, 2004

SENECA - The professional building at 115-C Eagles Nest Drive is missing almost all evidence that a doctor's office once operated there.

Pieces of double-sided tape are all that remain where signs for the New Hope Neurological Clinic once hung. A piece of paper in one window reads "No narcotics or controlled substances are kept in this office."

The space once housed the practice of Antonio Felipe Amaya. A licensed neuropathologist, he specialized in the diagnosis and treatment of diseases of the brain and nervous system.

For weeks the office phone has been disconnected, and calls to Dr. Amaya's Stonehaven Way home also go unanswered. Court documents show that foreclosure proceedings have been initiated there.

Since his practice closed its doors, at least one of Dr. Amaya's patients has committed suicide. In the months and years while he was practicing, Oconee County's coroner traced several overdose deaths to prescriptions Dr. Amaya signed. And red flags were raised before his resignation from a local hospital years ago.

All those things are leading some to speculate whether larger problems are at play, not only in Dr. Amaya's practice, but in the medical community at large.

"I hate to say this, but this is an indictment of all our doctors," said Pickens County coroner and retired surgeon James Mahanes.

He responded to the July 12 suicide of a Central man who had been under the care of Dr. Amaya.

What few medical records he had of the Pickens County man gave him little information, other than that he was taking a variety of medications, including narcotics and antidepressants. Those medications ran out five days before the man shot himself with a 22-mm rifle.

"It doesn't make any sense," Dr. Mahanes said. "When somebody is so directly prescribing things that are deadly in their own right, and then when you're without it you need it so bad that you do something desperate, that's the real horror."



Pattern of erratic behavior

Dr. Amaya had his medical license suspended by the state last month. He was arrested four times between Jan. 1, 2003, and June 25, and the most recent arrest came after Oconee County sheriff's deputies say Dr. Amaya was found shooting an AK-47 semi-automatic gun in the back yard of his Hartwell Lake-area home, heavily intoxicated.

According to the order, that erratic behavior is what led the state Board of Medical Examiners to suspend Dr. Amaya's license on July 26. The South Carolina Bureau of Drug Control revoked his ability to prescribe medicines the next day, and the federal government followed.

Although a hearing still must be held to determine whether his medical license will be revoked permanently, it is the first time Dr. Amaya has been prevented from treating patients since he secured his state medical license in December 1999.

But records and information suggest the state Board of Medical Examiners - the sanctioning body for all medical professionals in South Carolina - had been made aware of other concerns about Dr. Amaya years before they took action against him last month, including:

In 2001, Dr. Amaya was reported to the state after administrators at Oconee Memorial Hospital reported their concerns about his practice of mixing drugs and a lack of support for his clinical findings.

In 2002, Oconee County's coroner, after noticing a pattern of overdose deaths where Dr. Amaya was the prescribing physician, reported him to a state investigator.

In 2003, the state placed him on probation for an accusatory letter he wrote to the owner of several Louisiana clinics, accusing her of extortion.

Central resident Mary Steele says in light of those past problems, her question, and the question shared by many of her friends, is: "What took so long?"

Mrs. Steele's longtime friend committed suicide on July 12. His name has been withheld at the request of his family.

The week before he died, he had been taking between 240 mg and 270 mg of Roxicodone - a heavily controlled narcotic - a day, Mrs. Steele said. Bottles of methadone - a drug used to treat heroin addicts - along with morphine sulphate and Valium, also had been prescribed to him.

Five days after the man's last pill was gone, he shot himself in the chest with the rifle that had been hanging on the wall of Mrs. Steele's home.

For almost 11 months, Mrs. Steele's friend said he was being treated for fibromyalgia and heat stroke by Dr. Amaya.

But when the man's prescriptions ran out in early July, Dr. Amaya was still in jail. Mrs. Steele said she wondered why her friend was prescribed the drugs to begin with.

He had a history of depression and of drinking too much, but he had been sober for three years, she said. When his drugs dried up, he started drinking again.

Mrs. Steele is among the friends and family members who said that they have since written to the state Board of Medical Examiners and filed formal complaints about the role that they believe Dr. Amaya played in the July 12 suicide.

"As soon as he ran out of medicine, he started drinking again," Mrs. Steele explained. "He just lost hope, I think." Shortly after her friend's death, Mrs. Steele said she drove to Dr. Amaya's house.

"I sat in the driveway for about 10 minutes," she recalled. The grass appeared to be overgrown, and no lights were on inside. "I just said, 'I want the law to take care of this SOB.' So I left."



Lots of drugs, little paperwork

Attempts to contact Dr. Amaya through his home, office and past legal counsel were unsuccessful last week. The Oconee County Sheriff's Department also does not know where Dr. Amaya has gone.

His supporters, patients who defend his medical practice, are quick to say he is the only doctor who ever diagnosed their painful conditions. They say he was mild-mannered and professional.

They are reluctant be named, however, saying people perceive them as drug addicts, not chronic pain patients.

"He listens to us. He sees our pain, and he got us out of pain," said one Westminster woman who had been seeing Dr. Amaya for nearly three years. She was being treated for arthritis, degenerative disc disease and a herniated back.

"I have admiration for the man," a Walhalla man diagnosed with lyme disease said. "He figured out something that's been wrong with me for 30 years."

But questions regarding his medical practices have lingered since 2001, when Dr. Amaya resigned from the staff of Oconee Memorial Hospital.

According to internal documents obtained by the Anderson Independent- Mail, Dr. Amaya had been placed on hospital probation for a variety of issues uncovered by a "quality improvement committee." According to a letter addressed to Dr. Amaya, that committee recommended he attend counseling based on:

- his "polypharmacy practices," or mixing drugs to treat a single condition

- failing to document and support clinical findings and treatment plans

- questionable management of chronic pain

- his diagnosis of movement disorders and lyme disease.


The hospital confirmed the validity of those documents late last week, saying the review was part of a process that all provisional doctors go through before determining whether they qualify for full, medical staff membership.

Dr. Amaya resigned April 25, 2001, but because of the probationary nature of his clinical privileges, hospital officials said their findings were turned over to the state board of medical examiners.

By law, the state board is not permitted to discuss complaints against a doctor, spokesman Jim Knight said last week, therefore it is unclear what, if any, measures the state was taking to monitor Dr. Amaya's medical activity from that point on.



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