One of the major issues we recently wrote about in the context of nursing homes and elder care has been the use of chemical restraints on residents. A problem has been the misuse and overuse of these medications, as well as the oscillating back and forth between different types of medications, including ones that were never even prescribed.
In a recent case, a psychiatrist’s license has been suspended indefinitely by the Illinois Medical Board for his prescribing a certain antipsychotic medication to his patients. Dr. Michael J. Reinstein used the antipsychotic drug called clozapine on what the Chicago Tribune reports as more than 50% of his patients at nursing homes and mental health facilities. This drug is “known as a risky drug of last resort,” and was associated with the deaths of three patients under Reinstein’s case. The drug has also reportedly been at the center of shady kickback deals between the drug’s maker and doctors, and Dr. Reinstein’s case is no different. Dr. Reinstein has been accused of using the drug in exchange for $350,000 in bribes from the drug’s manufacturer, Teva Pharmaceuticals, over the course of seven years, in spite of the fact that he could employ other medications or treatment methods for his patients, and in spite of the danger the drug poses to the health, well-being, and ultimately lives of patients. Reinstein also allegedly received other gifts from the company, including free travel, a fishing trip, boat cruise, and dinners, as well as sporting event tickets. This indefinite license suspension by the medical board was the culmination of a years-long investigation by the Chicago Tribune and ProPublica.
Clozapine has a reputation for diminishing a person’s immune system by decreasing white blood cell count, as well as causing seizures and heart inflammation (also known as myocarditis), plus an overall serious blood condition. For the elderly in particular, there is a greater risk of death with the use of clozapine. Furthermore, dizziness or lightheadedness can also be side effects of the drug. According to the Tribune, Reinstein gave out more clozapine prescriptions in the year 2007 than all providers in the state of Texas combined. One of his patients died in 1999 at 50 years old with “more than five times the toxic level of clozapine in his blood,” while a 54 year old died from a double dose of clozapine in 2007, and a 27 year old died in 2003 as a result of a dangerously accelerated increase in her clozapine dose by Resinstein.
Earlier this year, Teva Pharmaceuticals already settled with the U.S. and Illinois governments for approximately $27.6 million over the alleged bribes to Reinstein to prescribe clozapine. As far as Reinstein is concerned, the federal government has also sued him in federal district court for civil penalties arising from over 140,000 false claims for reimbursement from both Medicare and Medicaid. This is tied to the Teva settlement given that Teva’s actions related to their bribing of him to prescribe the drug to beneficiaries of Medicare and Medicaid. Such false claims are widespread across the healthcare industry, as providers seek to fraudulently take more from the federal or state governments than they are entitled to under rules.
For those under the care or with loved ones under the care of a psychiatrist or any other professional, including at nursing homes, it is important to be sure that the medical provider is not abusing the use of antipsychotic medications and other chemicals such that they endanger a patient’s life.
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