Outraged by Shegog



I am outraged at the outlandish display of political correctness by the Virginia Board of Medicine in its decision to only suspend Dr. J.Howard Shegog's medical license. Based on the detailed account of the events leading up to this hearing, and accurate portrayal of the so-called "trial," coupled with the fact that a member of my family sat through the entire three days of hearings and waited until the early hours of Sunday morning when this ludicrous sentence was announced, I feel qualified to write this letter. In addition, I personally knew the young man who was "mistreated" by this doctor.

I call on Gov. Mark Warner and gubernatorial candidates Jerry Kilgore and Tim Kaine to order an investigation into the rationale that prompted the board to render such an inane decision. Shegog's own witness questioned his failure to read the charts or do examinations before prescribing the drugs vested upon these innocents by this "really caring, sweet family, church-goer."

I find Donnie R. Tuck's May 10 letter ("Shegog is a dedicated doctor") somewhat telling. He got a free consultation from a guy outside of church, who could not or would not spend time with a paying patient to find out the real cause for the patient's need of medication.

Somewhere we Americans have come to accept mediocrity as the norm. Well, it is no longer the norm when nine patients treated by this guy turn up dead.

I urge all concerned Virginians and the Daily Press to impress upon the above-noted state officials and candidates to put a stop to this carnage now. The young man who I knew and loved so well, along with the other eight decedents, deserve no less from us, the living.





Doctors testify about internist Witnesses vary in their opinions of Dr. J. Howard Shegog, who is accused of overprescribing drugs.


May 7, 2005 WILLIAMSBURG - Two pain management specialists offered different assessments Friday of Dr. J. Howard Shegog's care of his patients: One said the suspended physician's care was "laudable and commendable," and the other said it "did not conform to the standards of medical care in Virginia."

Discussing the case of a 46-year-old man, Dr. Martin Ton said that although Shegog wasn't "technically" authorized to wean the patient from methadone, no harm befell the patient.

"Technically, this is a violation," Ton said. "He did a nice thing that got himself in trouble."

Ton, who practices in Virginia Beach, testified as a defense witness in the second day of a hearing about Shegog conducted by eight members of the Virginia Board of Medicine.

The Newport News internist's license was suspended by the board in March. It had concluded that Shegog constituted a "substantial danger to the public health and safety," after the November death of a 30-year-old patient who died of a prescription drug overdose.

The board is hearing evidence surrounding the care of 34 patients, nine of whom died. Ton said that though Shegog lacked sufficient documentation in medical files to justify treatment of many of the patients, he didn't violate medical standards of care.

In the case of a Shegog patient identified as "Patient D" - a 40-year-old woman who died of a drug overdose Aug. 12, 2000 - Ton "lamented the sparse, frugal documentation" that he found in reviewing the woman's file.

Ton said that over three months, he spent 25 hours discussing with Shegog his treatment of patients. Shegog "likes to spend more time with them than document," Ton said.

State documents show that the woman was treated by Shegog on Aug. 10, two days before she died. Ton said Shegog walked a "fine, thin line" in treating the woman, who had a history of substance abuse and drug addiction. "Dr. Shegog felt she should have treatment of pain," Ton said.

But Dr. Virgil A. Balint, who reviewed 12 cases, testified for the prosecution that Shegog should have noticed drug-seeking behavior in some of his patients. One patient, he noted, was getting narcotic medication from another doctor. "It's a clear indication that this was a double-dipping case," Balint said.

In other cases, Shegog failed to perform basic examinations to justify the doses of narcotic painkillers that he was prescribing, Balint said. Reviewing the case of "Patient H," Balint said he would have done more investigating into the patient's statements of shoulder pain. A note in the patient's chart read that she had been seen by a specialist who said the pain wasn't musculoskeletal.

Balint said he saw no indications that Shegog tried to pinpoint the nature of the pain.

"The typical symptoms are nowhere in the chart," he said, but Shegog still prescribed narcotic painkillers to the woman.

In reviewing the records of the 30-year-old man who died of a drug overdose in November, Balint noted that the patient told Shegog in a Nov. 9 office visit that he had taken one of his friend's 40-milligram OxyContin tablets and that it provided him good relief for seven to eight hours.

"This should have been a red flag: that the patient was asking for a specific drug and that he got the drug from somewhere else," Balint said.

The patient died Nov. 10. The cause of his death was "acute combined toxicity with OxyContin and Alprazolam," according to state documents.

Other witnesses for Shegog testified about his character and abilities.

A former colleague of Shegog, Dr. Vaughan H. Howard, said he always held Shegog in high regard. Howard, an emergency room physician at Mary Immaculate Hospital, said he worked with Shegog for most of the 20 years that Howard had been at the hospital. He was flabbergasted about allegations that Shegog mismanaged the care of patients, he said.

"I have never seen that in my interaction with Dr. Shegog," he said.

The hearing resumes at 8 a.m. today at the Williamsburg Marriott. Testimony is expected to wrap up during the day before the board begins its deliberations of the allegations against Shegog.







Doctor's career remains in limbo He's still suspended, but parents of son who died angered by vague ruling



May 9, 2005 WILLIAMSBURG - Crisply dressed, unbent and silent after a three-day hearing, Dr. J. Howard Shegog faced weary members of the state Board of Medicine in the wee hours of yesterday morning and learned that his decades-long medical career still hangs in limbo.

Shegog closed his Newport News medical practice in March when his license was suspended by an emergency order after the death of a chronic pain patient. But his bid to return to work under strict conditions failed yesterday after a grueling and emotional hearing that examined dozens of charges and events preceding the deaths of nine patients over a four-year period.

The proceedings ended at 2 a.m. with a decision that Shegog's license will remain suspended. He can apply for reinstatement in September, the board concluded, but there were no conditions offered by the medical board that would make a return to practice possible.

Board members, including board president Dr. Thomas B. Leecost, of Richmond, declined to comment.

The vague decision left both the doctor and alleged victims of his care grappling for closure.

"Obviously, we're very disappointed," William Devine, one of Shegog's four lawyers, said as he guided the doctor, his wife and family friends out of a Williamsburg conference center where the hearing was held.

Shegog, 65, who is also under federal investigation in connection with his pain practice and is a past president of the Old Dominion Medical Association, did not testify.

Devine had argued that Shegog was being held to an unfair standard of care given the uncertainty of guidelines associated with the care of chronic pain patients. They repre- sented "a thin sliver" of Shegog's respected practice, said Devine, who will appeal the decision.

But the mother of one of Shegog's patients, a man who died from a toxic reaction to drugs prescribed for him by Shegog, bitterly criticized the board for not revoking Shegog's license.

"How many more people have to die?" she said. "I'm just sick, sick to death of the system. He'll just wait a while and get his license back."

The woman was unidentified when she testified and she asked reporters not to publicly identify her. She said she was stunned when board member the Rev. Alvin Edwards, the only nonmedical member of the eight-person panel hearing the case, asked her if her divorce may have contributed to her 30-year-old son's drug addiction.

"My God. That happened when Michael was 3. What could this man be thinking?" said the woman, who sat with her equally distraught former husband through much of the hearing.

On the witness stand, the woman said that she found pill bottles and prescriptions indicating that Shegog had prescribed large doses of drugs for her son, the day before his death. He had a long history of drug problems, she said, and had been treated at a clinic in Richmond.

Within hours of her son's death, she called Shegog and accused him of murder, she testified.

Medical records examined by the board showed that Shegog had issued the man large doses of drugs on his initial visit with five refills but had no clear documentation of the man's health history or drug use.

But Devine, in the case of the woman's son and other deaths, said there was no evidence that Shegog's care was directly linked to any of the patients' deaths.

Instead, he said Shegog was a compassionate and respected physician. Underlying his care was a vast underprescribed population of legitimate chronic pain patients who cannot receive care because of physician fears of disciplinary action and criminal investigation.

Devine questioned one board expert who outlined the need for strict criteria, detailed patient histories and patient contracts in prescribing opiates for pain patients. Yet the witness, a Northern Virginia pain specialist, refused to treat the severest cases.

"That's an ivory-tower practice," Devine said.

Shegog "was the only barrier between [the patients most in need] and the street," Devine said. "That's what the evidence and the reality showed."

Longtime medical professionals on the Peninsula testified that Shegog was a respected, loving physician whom they had known for 20 years or more; but none of them had a firsthand knowledge of Shegog's medical records and treatment plans.

Virginia is one of the country's hot spots for illegal use of OxyContin and other addictive pain medications. Federal investigators are carrying out several investigations of Virginia doctors known for prescribing the drugs.

Much of Shegog's hearing was monitored by federal drug and criminal investigators. Testimony and various hearing documents indicate that Shegog has been under state or federal investigation since the mid-1990s.

Assistant Attorney General William C. Garrett and several board members returned again and again to Shegog's patient records, which showed little effort to track patient progress, pain levels, pill counts and past drug use.

He prescribed to one patient who lived more than 200 miles away and whom he hadn't seen for months, failed to develop information about possible multiple suppliers for drug-seeking patients, and sometimes allegedly disregarded pleas from other caregivers not to continue prescribing certain drugs to addicted patients.

Catherine Welsh, a nurse who worked with Shegog for several years, described a practice that had become top-heavy with chronic pain sufferers, at times reaching 80 percent of the caseload.

She said disruptions occurred in office practices. At closing time the office would be besieged by patients exhibiting slurred speech, stumbling and other drug-seeking behaviors.

"It was overwhelming," she said, conceding that at times she recovered prescriptions for waiting addicts because, "I was afraid not to."

When confronted by staff, Shegog simply said that he was "comfortable" handling the patients, but medical records showed he has had little training in pain medication.

Welsh said that as conditions worsened, nurses and other staff began seeing the names of patients in the obituary pages.

"When people started dying that was a whole different animal," she said. "We just wanted it to stop."

Shegog, she said, "was a simple man who got confused between compassion and value" of care. "I don't know how it went haywire, but it did."

Unmentioned during the hearing last week were investigations of Shegog's drug-prescribing habits in the mid-1990s. State records show he was brought before the medical board for allegedly overprescribing thousands of dosages of narcotics. The medical board dismissed the case.

That decision came in the same conference center where Shegog's case was heard over the weekend, just a few yards away in another room.

"I don't feel like things progress very fast with the board of medicine," said the mother who'd testified about her son's death.

"I was hoping that my son's death would help keep other parents from having to go through this. Now I don't think so."





Doctors testify about internist


Witnesses vary in their opinions of Dr. J. Howard Shegog, who is accused of overprescribing drugs.



May 7, 2005 WILLIAMSBURG - Two pain management specialists offered different assessments Friday of Dr. J. Howard Shegog's care of his patients: One said the suspended physician's care was "laudable and commendable," and the other said it "did not conform to the standards of medical care in Virginia."

Discussing the case of a 46-year-old man, Dr. Martin Ton said that although Shegog wasn't "technically" authorized to wean the patient from methadone, no harm befell the patient.

"Technically, this is a violation," Ton said. "He did a nice thing that got himself in trouble."

Ton, who practices in Virginia Beach, testified as a defense witness in the second day of a hearing about Shegog conducted by eight members of the Virginia Board of Medicine.

The Newport News internist's license was suspended by the board in March. It had concluded that Shegog constituted a "substantial danger to the public health and safety," after the November death of a 30-year-old patient who died of a prescription drug overdose.

The board is hearing evidence surrounding the care of 34 patients, nine of whom died.

Ton said that though Shegog lacked sufficient documentation in medical files to justify treatment of many of the patients, he didn't violate medical standards of care.

In the case of a Shegog patient identified as "Patient D" - a 40-year-old woman who died of a drug overdose Aug. 12, 2000 - Ton "lamented the sparse, frugal documentation" that he found in reviewing the woman's file.

Ton said that over three months, he spent 25 hours discussing with Shegog his treatment of patients. Shegog "likes to spend more time with them than document," Ton said.

State documents show that the woman was treated by Shegog on Aug. 10, two days before she died. Ton said Shegog walked a "fine, thin line" in treating the woman, who had a history of substance abuse and drug addiction.

"Dr. Shegog felt she should have treatment of pain," Ton said.

But Dr. Virgil A. Balint, who reviewed 12 cases, testified for the prosecution that Shegog should have noticed drug-seeking behavior in some of his patients. One patient, he noted, was getting narcotic medication from another doctor.

"It's a clear indication that this was a double-dipping case," Balint said.

In other cases, Shegog failed to perform basic examinations to justify the doses of narcotic painkillers that he was prescribing, Balint said. Reviewing the case of "Patient H," Balint said he would have done more investigating into the patient's statements of shoulder pain. A note in the patient's chart read that she had been seen by a specialist who said the pain wasn't musculoskeletal.

Balint said he saw no indications that Shegog tried to pinpoint the nature of the pain.

"The typical symptoms are nowhere in the chart," he said, but Shegog still prescribed narcotic painkillers to the woman.

In reviewing the records of the 30-year-old man who died of a drug overdose in November, Balint noted that the patient told Shegog in a Nov. 9 office visit that he had taken one of his friend's 40-milligram OxyContin tablets and that it provided him good relief for seven to eight hours.

"This should have been a red flag: that the patient was asking for a specific drug and that he got the drug from somewhere else," Balint said.

The patient died Nov. 10. The cause of his death was "acute combined toxicity with OxyContin and Alprazolam," according to state documents.

Other witnesses for Shegog testified about his character and abilities.

A former colleague of Shegog, Dr. Vaughan H. Howard, said he always held Shegog in high regard. Howard, an emergency room physician at Mary Immaculate Hospital, said he worked with Shegog for most of the 20 years that Howard had been at the hospital. He was flabbergasted about allegations that Shegog mismanaged the care of patients, he said.

"I have never seen that in my interaction with Dr. Shegog," he said.

The hearing resumes at 8 a.m. today at the Williamsburg Marriott. Testimony is expected to wrap up during the day before the board begins its deliberations of the allegations against Shegog.





Paper trail of accusations follows local doctor



3/26/05 - Dr. James Howard Shegog is a deacon at the First Baptist Church in Hampton and a member of the Virginia War Museum Foundation's Board of Trustees.

He's a Vietnam War veteran and a retired Army colonel. He raised two children, one of whom grew up to become a major in the military and the other a university professor. He even helped raise the son of a friend after his friend died.

Shegog, whose privileges at Mary Immaculate Hospital stretch back 20 years, has earned praise for his compassionate care from relatives of deceased loved ones who mentioned him in obituaries.

Yet Shegog, a 65-year-old York County resident, finds himself at the center of controversy. His medical license was suspended this month following a meeting of the state Board of Medicine. The board suspended his license pending a May hearing in connection with the death of a patient who died of an overdose of OxyContin and Xanax, drugs the board says were prescribed by Shegog. Medicine Board documents do not identify patients.

Shegog has declined to comment.

News of the suspension led many people to call and write the Daily Press to express concern over Shegog's treatment of their friends and relatives.

In fact, Shegog was sued four times by relatives of former patients, court documents show. In each case, Shegog's treatment of patients was called into question. He prevailed in one case, was dropped as a defendant in another, has one case pending, and lost one in 2004 but has appealed the case to the Virginia Supreme Court.

When suspending Shegog's license, the state board said "the continued practice of Dr. Shegog constitutes a substantial danger to the public health and safety."

The suspension order also stated that Shegog met with board members to discuss "alleged substandard medical treatment" of 34 patients from about 1992 to 2004.

Shegog, who received his medical degree from Ohio State University, worked as an Army doctor, serving at Fort Monroe from 1981 to 1989, according to a Web site affiliated with Baylor University, from which Shegog received a degree.

From 1989 to 1991, he served as deputy commander of clinical services at Fort Eustis Army Base before entering private practice in Newport News in 1991.

Within a year, he began treating a patient for back pain who later told Shegog she was addicted to Vicodin, according to allegations outlined in the Virginia Board of Medicine report.

For nine years, Shegog continued to practice medicine in the area after he first appeared before the state Board of Medicine on allegations of "indiscriminately and excessively prescribing" drugs.

Those charges were dismissed without explanation in early 1997. The Virginia Board of Medicine does not explain its rulings.

Howard Shegog isn't the only member of his family to run into problems with a medical board.

His brother, Don Shegog, had his medical license in Kentucky placed on probation in 1999 after a Kentucky Board of Medicine inquiry into allegations that he was over-prescribing medications to 23 patients, according to Kentucky Board of Medicine documents.

Don Shegog told a Kentucky medical investigator that he "sometimes has too big of a heart and has a difficult time saying no to patients when they request medication because they are in pain or upset," according to Kentucky Board of Medicine documents.

Don Shegog, who lives in the Cincinnati area, is also on probation by the Ohio Board of Medicine for failing to notify the agency of the Kentucky investigation. He could not be reached for comment on Friday.

In Virginia, court and Board of Medicine documents state that Howard Shegog was "grossly careless in diagnosing patients and prescribing drugs" that included OxyContin, Xanax, Vicodin and Percocet. He was writing prescriptions even as patients said they were addicted to drugs, and he noted in records that he suspected they were right, according to state Board of Medicine documents.

In 1998, Shegog began prescribing OxyContin to David C. Terry, a patient recovering from back surgery, according to a lawsuit filed in 2003 in Richmond Circuit Court. Shegog, a number of other Virginia doctors and Purdue Pharma, the manufacturer of OxyContin, were being sued by Terry and other plaintiffs who claimed they became addicted to the pain-killing drug.

According to the lawsuit, Terry was not provided warnings associated with taking OxyContin and his family said "he became sick" from taking the drug in 2001. He was hospitalized, and the lawsuit says Shegog continued to prescribe his patient OxyContin even after his hospital stay.

Terry died July 19, 2001. His family contends that his death is associated with his OxyContin use, though an official cause of death is not listed in court documents.

In 2004, the case was moved to Newport News, the city where Terry lived. A Newport News Circuit Court judge then ruled that any claim against Howard Shegog should be filed as a separate malpractice claim, separate from the allegations against the pharmaceutical company.

By the time the Terry case was filed, Howard Shegog had already won a malpractice suit in the case of a 71-year-old woman who died in 1996. He had also been named as a defendant in another malpractice suit. In that case, the daughter of an 81-year-old woman filed suit after her mother died in a Hampton nursing home of complications from a blood clot in her leg in 1997 after leg surgery, according to Hampton Circuit Court documents. The jury awarded $300,000 and found Howard Shegog liable for the woman's wrongful death.

In a letter to the court, the woman's lawyer stated that Shegog has called himself a specialist in internal medicine. According to the American Board of Internal Medicine, Shegog is not certified in internal medicine. This certification isn't a requirement to practice medicine. But it is meant to demonstrate to the public that the doctor has completed an approved program, has been evaluated, and has taken an extensive examination assessing knowledge, experience and patient care, according to the American Board of Internal Medicine.

In a recent pending case, a Hampton woman is suing Howard Shegog and Mary Immaculate Hospital for $1.65 million, alleging that he gave her husband lethal doses of a drug in 2002, causing his death. A jury trial for that case has been scheduled for September.

Former Christopher Newport University President Anthony Santoro, who served with Shegog on the board of the Virginia War Museum Foundation, said Shegog was thoughtful, gracious and deliberate at board meetings.

Santoro, whose wife plays bridge with Shegog's wife, remembers Shegog as a good listener who could make a "pithy remark that nobody has thought of."

Shegog, who was meticulous in his dress and appearance, has integrity, Santoro said.

"That's the Howard Shegog I'm familiar with," he said. "He's a very articulate man and a very gentlemanly man. I just don't know a negative word about him. He's just a kind-sounding and softly spoken man and appears to show a great interest in what you're saying to him."





Newport News physician investigated in patient deaths



3/22/95 RICHMOND, Va. (AP) - The state Board of Medicine said Tuesday it has suspended the license of a Newport News physician pending a hearing regarding allegations that he overprescribed narcotics for his patients, including nine who died in his care.

In its order suspending Dr. Howard Shegog, an internal medicine specialist, the board focused on the death of one patient, alleging that Shegog excessively prescribed antidepressant Zanax and narcotics Percocet and OxyContin after failing to perform a proper examination or create a proper treatment plan.

The patient died in November, and the medical examiner found that the toxic combination of OxyContin and Zanax caused his death, according to the order.

Shegog, 65, met with a board committee in the fall to discuss allegations of substandard medical treatment of 34 patients from 1992 to 2004, including nine who died. The panel voted unanimously to refer Shegog's case to a formal administrative hearing in May, said Karen Perrine, the board's deputy executive director for discipline.

Also Online
State Board of Medicine Web site
http://www.dhp.virginia.gov/enforcement/cdecision/boardresults.asp?board=1

A message left Tuesday at a telephone listing for Shegog was not immediately returned and his attorney, Bill Devine, declined to comment on the allegations.

In documents filed in the board's case against Shegog, the board detailed his treatment of several patients, alleging that he failed to properly examine, treat and monitor them and "prescribed narcotics outside of a physician/patient relationship."

At least five deaths of Shegog's patients were linked to drug use. Two were listed as suicides, one of them involving a drug overdose, according to the documents.

In several cases, Shegog continued to prescribe Vicodin ES and other narcotics to patients who were admitted addicts without assessing their drug intake to ensure they weren't abusing the drugs, the investigation found.

A three-day hearing is scheduled to begin May 5, Perrine said.

Similar allegations of overprescibing drugs were filed against Shegog in 1996, but those charges were dismissed after a hearing in 1997. Records from that proceeding aren't public, Perrine said.





Dr. Shegog Charged



3/20/05 - A Peninsula doctor is under investigation in the deaths of nine patients. The license of Dr. J. Howard Shegog, an internist for 20 years at Mary Immaculate Hospital in Newport News, has been suspended amid allegations he carelessly prescribed heavy doses of narcotics to patients.

The State Board of Medicine held an emergency meeting to stop Dr Shegog from treating patients.

"His license has been suspended so he will not be able to practice at the hospital or in his office," said Kelley Daspit of Mary Immaculate Hospital.

Documents obtained from the state allege that Dr. Shegog so carelessly handed out drugs that it led to the deaths of nine patients and hurt more than 30 others.

In one case the state alleges Dr. Shegog had a patient taking Xanax, an anti-anxiety drug, then he added Oxycontin, a strong pain reliever similar to morphine. The next day the patient was found dead at his father's house.

The chief medical examiner ruled it was a high level of those drugs that killed him.

In another case, the state says a patient sent Dr. Shegog at least 21 letters confessing she was addicted to painkillers and that she had been stealing them from her mother-in-law. Dr. Shegog, however, allegedly kept prescribing the woman more and more Vicodin.





Local doctor investigated in 9 deaths



March 19, 2005 - A Newport News Internist who practices at Mary Immaculate Hospital has been suspended from practicing medicine, pending a May administrative hearing before the state Board of Medicine as it probes the doctor's link to the deaths of nine patients in his care.

The allegations against Dr. J. Howard Shegog are similar to allegations leveled against him in 1996, when the Board of Medicine looked into allegations that he over-prescribed medication contrary to "sound medical judgment."

But those charges were dismissed without explanation after a 1997 hearing. The reasons for the dismissals are not public because deliberations of the board are confidential, said William Harp, executive director of the Virginia Board of Medicine.

Harp said that although the board is interested in protecting the public, "you want the doctors to have their due process."

In the recent allegations, in 41 pages of Board of Medicine documents, 65-year-old Shegog is portrayed as a doctor who recklessly and carelessly prescribed heavy doses of narcotics to patients. Wednesday he was suspended from practicing medicine in the state.

Shegog, who has been licensed in Virginia since 1982, did not return messages Friday. Bill Devine, Shegog's attorney, declined to comment about the allegations. Shegog "won't have any comment about them either, I'm confident of that," Devine said.

Shegog has had privileges at Mary Immaculate for 20 years, and his private practice is in the medical pavilion on the hospital's campus, said spokeswoman Kelley Daspit. His privileges at the hospital have been suspended pending the state hearing.

Shegog has been in good standing at the hospital the last two decades, Daspit said.

Of the nine deaths of patients who were under Shegog's care, the most recent was in November. The patient first saw Shegog in August for treatment of anxiety, and Shegog prescribed Xanax, documents say.

On Nov. 9, Shegog prescribed Oxycontin for back spasms and anxiety, documents show. The next day, the patient was found dead at his father's house. The cause of death was listed in a medical examiner's report as "acute combined toxicity with Oxycontin and Alprazolam."

Two other deaths of Shegog's patients were listed as suicides. One of those, in July 2002, was from a drug overdose. At least four other deaths of Shegog's patients were linked to drugs.

In another death, no autopsy was performed. In that case, documents allege, Shegog prescribed drugs to a patient in his care, even though another patient overheard the doctor saying he knew the patient was faking her injuries.

In another case, the documents allege that on Oct. 17, 2000, Shegog prescribed methadone to a woman he had been treating for "post-traumatic migraine headaches." Three days later, she was dead. An autopsy report listed her cause of death as acute methadone poisoning, documents say.

On Aug. 10, 2000, Shegog prescribed drugs to a woman with a history of drug addiction whom he had been treating off and on since the early 1990s. "There are no notations in the medical record of any physical examination, or treatment history since her previous visit with Dr. Shegog on April 2, 1999," documents say.

The woman died of a drug overdose on Aug. 12, 2000, documents say.

Another patient sent 21 letters to Shegog between August 1998 and March 1999 saying she was addicted to medication and needed more Vicodin or other narcotics to sustain her addiction, according to the documents. On multiple occasions, Shegog wrote prescriptions to the patient "knowing that the Vicodin ... was not being used for a therapeutic purpose," documents say.

He also wrote prescriptions for the woman after she told him she had stolen medicine from her mother-in-law to feed her addiction and after a counselor at a detoxification facility asked him not to write a prescription, documents say.

Another patient told a Virginia State Police special agent that he was using Shegog to "detox" himself, documents say.

The documents accuse Shegog of failing to maintain complete and accurate records of drugs sold, administered and dispensed in his practice. All told, Shegog stands accused of mismanaging the care of 34 patients.




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