Psychiatrist Priscilla Sheldon-Cost charged with narcotics offenses

An addiction rehabilitation psychiatrist with a history of treatment for alcohol and drug abuse was among those charged Wednesday with manufacturing and distributing the drug Ecstasy at a Towson home.

Dr. Priscilla W. Sheldon-Cost, 51, and her boyfriend, Thomas Ronald Joyave, 52, of the 700 block of Walker Ave. are both charged with five counts of narcotics offenses, including manufacturing and possessing drugs with the intent to distribute them, Baltimore County police said. Vincent Mark Ricker, 24, of the 7700 block of Fairgreen Road faces the same charges.

Sheldon-Cost previously worked at Baltimore Behavioral Health, a rehabilitation center for addicts in West Baltimore, while undergoing addiction treatment herself, under the supervision of the state Board of Physicians, according to board documents.

The board suspended her license indefinitely in 2012 after she violated probation by submitting drug-testing samples and psychiatric evaluation reports late and failing to notify the board that her employer suspended her clinical privileges. The board had imposed addiction treatment and drug-testing requirements upon Sheldon-Cost since 2004.

Police, county fire and U.S. Drug Enforcement Administration crews raided the home of Sheldon-Cost and Joyave about 10 a.m. Wednesday, police said. Police said the raid and investigation indicates drugs were manufactured in the home. Police declined to comment further.

Residents described the community as tightly-knit, and were surprised by the arrests. Neighbor Rachel Plank, 21-year-old Towson University student, said she’d seen the occupants of the Walker Ave. house on occasion. They seemed nice, she said.

Plank said she was surprised Wednesday at about 11 a.m. when she left for work and saw police cars at the end of the street and several officers standing in a circle.

Both Sheldon-Cost, a 1995 graduate of the Johns Hopkins School of Medicine, and Joyave were released from Baltimore County Detention Center on Thursday, — Sheldon-Cost on $30,000 bail and Joyave on $20,000 bail. Ricker was still being held there Thursday, according to online court records.

Sheldon-Cost did not respond to a request for comment. Joyave could not be reached for comment, and no lawyer was listed in court records for any of the three charged. No one answered the door at the Walker Ave. address Thursday evening.

Sheldon-Cost entered a physician rehabilitation program offered by MedChi, the state’s medical society, in May 2002. The month before, she had been suspended from a position at Levindale Hebrew Geriatric Center and resigned. The Mount Washington hospital for elderly psychiatric and rehabilitative patients had expressed concerns about her “physical and mental condition,” according to board documents.

In connection with her suspension and resignation from Levindale, she entered a nondisciplinary disposition agreement with the board in February 2004 that stipulated she abstain from the use of alcohol. Later that year, she entered a board-monitored physician rehabilitation program.

Officials with LifeBridge Health, which owns Levindale, could not be reached for comment.

Sheldon-Cost began volunteering, and later working part time, at Baltimore Behavioral Health in 2005 and continued until leaving in April 2007 to care for her ailing mother, according to board documents. Two months after she left, she tested positive for Tramadol, a painkiller similar to opiates, and told a board investigator the drugs were left over from a legitimate prescription she received after a skating injury.

She resumed working part time at BBH in September 2007 while under a rehabilitation agreement with the physicians board that required an individualized rehabilitation plan and undergoing regular random drug testing.

After she tested positive for alcohol in a December 2008 urine test, the board charged her with “unprofessional conduct in the practice of medicine” in 2009. Under a public consent order with the board settling those charges in March 2010, she was placed on probation for five years, according to board documents.

She was among multiple doctors at BBH who had faced board discipline at the time, a 2010 Baltimore Sun investigation found. Sheldon-Cost told The Sun in November 2010 that the facility often hired doctors with histories of drug and alcohol problems in an “effort to give people a chance.”

The Sun investigation found various problems in the clinic, including unusually high Medicaid billings, six-figure salaries paid to family members who controlled the nonprofit company, and drug use among patients staying in unregulated rental homes that the clinic operated.

BBH filed for bankruptcy in 2012 and is now owned by JR Health Care Associates. Officials with the company referred questions about Sheldon-Cost to DLA Piper attorney Mark Friedman, bankruptcy trustee for BBH’s previous owners. Friedman could not be reached for comment.

The physicians board suspended Sheldon-Cost’s medical license in September 2012 when officials found she violated terms of her probation, including failing to check in to learn when she was ordered to take random drug tests, submitting three drug samples late, submitting psychiatric reports late and failing to notify the board when her employer suspended her clinical privileges.

Board officials did not return calls for comment and did not respond to emailed questions Thursday.

Court records show Sheldon-Cost was arrested twice in 2002.

In May, she was charged with theft and malicious destruction of property. Both charges were not prosecuted. A statement of charges in that case provided by the Howard County state’s attorney’s office show Sheldon had been arrested for shoplifting at the Lord and Taylor store at The Mall in Columbia, after an employee said she had attempted to leave the store with three sterling silver necklaces and five sterling silver bracelets she hadn’t paid for.

In July 2002, she was charged with two counts of theft in another case. Court records show she was not prosecuted on the first count, and pleaded guilty on the second count, theft of items worth less than $500. She received one year of supervised probation before judgment, which in Maryland does not count as a conviction.

Details of that case were unavailable. Howard County District Court officials said the case file has been destroyed because it’s more than three years old.

Source: Scott Dance and Nayana Davis, “Psychiatrist among those charged in Towson drug raid,” The Baltimore Sun, June 26, 2014.

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Psychiatrist Harold Smith gives up license following history of drug-related disciplinary actions

On June 18, 2014 the Florida Board of Medicine accepted Florida psychiatrist’s Harold Edward Smith’s voluntary relinquishment of his medical license.

Per the terms of the agreement, Smith may never again apply for a physician’s license in Florida. This follows his history of at least four medical license suspensions or revocations by three states and by the U.S. Drug Enforcement Aadministration and several narcotic drug use relapses of his own.

Most recently, an administrative complaint was filed against him by the Florida Department of Health alleging he drugged to death a hospitalized patient of his. The medical examiner’s autopsy report stated she died from drug intoxication involving the very same drugs Smith was prescribing to her. Despite obvious symptoms of prolonged drowsiness, Smith raised her dosage twice before a hospital worker found her dead on the floor.

State of Florida FINALLY takes action on psychiatrist with history of ampthetamine abuse

On June 18, 2014 the Florida Board of Medicine accepted Florida psychiatrist’s David G. Malen’s voluntary relinquishment of his medical license.

Per the terms of the agreement Malen may never again apply for a physician’s license in Florida.

The Florida Department of Health initiated its case against Malen in 2007.

The administrative complaint which resulted in Malen giving up his license, contained information about Malen’s “history of taking ‘extraordinary’ doses of amphetamines with extreme difficulties resulting from the drugs, including depression, suicide attempts and psychosis,” as well as his continued use of and addiction to the substance.

The Department of Health’s document further contains information about Malen’s submission to the state’s Professionals Resource Network (“PRN,” a program for impaird physicians) in 2008. This resulted in Malen undergoing several psychiatric evaluations between 2008 and 2011, all of which found him impaired, yet it appears that the state continued to allow him to practice.

You read that correctly: Malen’s drug addiction was a well-documented concern since 2007, yet his license was free and clear from 2007 to June 2014.

Convicted psychiatrist seeks to avoid prison; will be sentenced Dec. 7

His lawyer is asking that an 82-year-old New City psychiatrist who admitted in June to illegally distributing prescription drugs be sentenced to a fine and community service rather than prison time.

Aristide Esser faces up to 20 years in federal prison when he is sentenced Dec. 7 by Judge Kenneth M. Karas in U.S. District Court in White Plains.

John E. Finnegan, a lawyer for Esser, said in a sentencing memorandum filed Friday that the psychiatrist had a distinguished career before it was derailed in 2011 by at least four incidents where Esser illegally prescribed Seconal, a sedative, to cooperating witnesses. Esser’s conduct, Finnegan said, was illegal but did not fit the pattern of recent arrests of doctors, many of whom are accused of operating so-called “pill mills.”

“He was not engaged in ‘drug dealing’ in the traditional sense of the term, involving large-scale distribution for profit,” Finnegan wrote in court papers, before writing that some of Esser’s prescriptions resulted from patients’ “skillful manipulations and persistence.”

Prosecutors, meanwhile, have said that Esser told the cooperating witness that he would “gladly medicate” the witness’s friends, should they also need prescriptions.

Prosecutors have said that Esser’s 2011 conduct is just the latest in a string of incidents regarding Esser’s alleged overprescription of drugs to patients. Esser was previously ordered to stop prescribing opiates after a 2001 investigation by the state Department of Health, which accused him of giving opiates to substance abusers without proper evaluation or monitoring, according to court papers.

In the sentencing memorandum, Finnegan said Esser grew up in Indonesia during the Japanese occupation in World War II. Esser’s father and uncle were executed by the Japanese. Esser moved to Holland in 1946, before eventually going to medical school and, in 1961, coming to the United States to serve as a research fellow at Yale University. He later moved to Rockland County, where he practiced psychiatry for decades.

Seconal was widely used in the 1960s and 1970s but has been less popular among recreational users in recent years. A parade of famous musicians, artists, writers, and others were said to have used or abused Seconal, including Tennessee Williams, Judy Garland, and Jimi Hendrix. Garland died June 22, 1969, after a suspected Seconal overdose.

Source: Erik Shilling, “New City psychiatrist, 82, seeks to avoid prison in drug case,” The Journal News, November 26, 2012.

US Attorney files fraud lawsuit against Illinois psychiatrist Michael Reinstein

The U.S. Attorney for the Northern District of Illinois filed a federal fraud lawsuit today against a Chicago psychiatrist profiled by ProPublica and the Chicago Tribune in 2009 for his voluminous prescribing of antipsychotic drugs to nursing home patients.

In a news release, the government says that Dr. Michael Reinstein “received illegal kickbacks from pharmaceutical companies and submitted at least 140,000 false claims to Medicare and Medicaid for antipsychotic medications he prescribed for thousands of mentally ill patients in area nursing homes.”
Original Story

In Chicago’s Nursing Homes, a Psychiatrist Delivers High-Risk Meds, Cut-Rate Care

by Christina Jewett, ProPublica, and Sam Roe, Chicago Tribune, Nov. 10, 2009

ProPublica and the Tribune reported in 2009 that Reinstein prescribed more of the risky antipsychotic clozapine to patients in Illinois’ Medicaid program in 2007 than all of the doctors in the Medicaid programs of Texas, Florida and North Carolina.

The government accuses Reinstein of billing Medicare and Medicaid for managing his patients’ medications, “knowing that he did not engage in substantive evaluations of his patients’ medical and psychiatric conditions to properly manage their medications,” the U.S. attorney’s office said in its release. “Instead, he allegedly prescribed medications to his patients based on his receipt of kickbacks from pharmaceutical companies.”

Prosecutors allege that Reinstein’s prescribing decisions were motivated by money and perks from pharmaceutical companies. He allegedly switched patients from one brand of clozapine to another based on money and other enticements he received from a pharmaceutical maker.

Before August 2003, the government alleged, Reinstein prescribed Clozaril, brand name for clozapine made by Novartis, which paid him to promote the drug.

When the drug went off patent in 1998, the lawsuit says, Reinstein resisted attempts to switch his patients to cheaper, generic versions. But when Novartis stopped paying Reinstein in 2003, the lawsuit says, he switched his patients to a generic version made by IVAX Pharamceuticals.

That company had agreed to pay him a consulting fee, pay his nurse to speak on the drug’s behalf and fund a research study at an affiliated institute, according to the lawsuit.

“While generally only four percent of schizophrenia patients who were prescribed antipsychotics received clozapine, during the time Reinstein was allegedly accepting kickbacks from IVAX, more than 50 percent of his patients were prescribed IVAX’s clozapine,” the U.S. Attorney’s office said in its news release. “At one nursing home, Reinstein had 75 percent of the 400 residents on IVAX’s clozapine.”

Ivax paid other perks to Reinstein and his associates, including airfare, entertainment expenses, a fishing trip, a boat cruise and a golf outing, the lawsuit says.

In 2006, Reinstein began switching to clozapine made by a different company but moved some patients back when he received additional perks and funds, the lawsuit says.

In an interview, federal prosecutor Eric Pruitt would not comment on whether his office would pursue criminal charges against Reinstein or whether any legal action would be taken against the pharmaceutical companies that allegedly paid the physician kickbacks.

A call left at the office of Reinstein’s attorney was not immediately returned.

The 2009 investigation by ProPublica and the Tribune showed that Reinstein’s high prescribing had serious consequences for his patients. Autopsy and court records showed that by 2009 at least three patients under Reinstein’s care had died of clozapine intoxication. One of them, a 50-year-old man, had five times the toxic level of clozapine in his blood when he died, according to his medical records.

Reporters determined that, based on his Medicaid prescribing alone, Reinstein he would have to work 21 hours a day, seven days a week to see each of his patients for 10 minutes. Research has found that the typical U.S. psychiatrist sees about 35 patients per week; Reinstein was seeing 60 each day, he wrote in an audit report in 2007.

Source: Charles Ornstein and Tracy Weber, “High-Prescribing Chicago Psychiatrist Faces Federal Fraud Suit,” ProPublica, November 15, 2012.