qbird
material girl
Reged: 09/02/02
Posts: 909
Loc: USA
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Here is a report that was on last night on the news. I don't know if anyone caught it.
Last modified: 09:39 PM CDT on Friday, June 13, 2003
DA vows thorough study of doctor's files
Authorities seek links to deaths; physician has denied wrongdoing
06/14/2003
By HOLLY BECKA and SELWYN CRAWFORD / The Dallas Morning News
The medical file of a patient who died more than 10 months ago lay on the kitchen table at the doctor's Lakewood home, according to court records released Friday.
It was among the personal items and medical records seized Tuesday as authorities looked for evidence this week in their expanding investigation into a South Dallas medical clinic and its primary physician.
Dr. Daniel Maynard has been linked in court records to 11 deaths during the last three years. Relatives of a 12th possible victim who died in 1995 of a mixed drug overdose say they also have been talking to investigators.
Dr. Maynard has not been charged with a crime, and his lawyer insists that he has done nothing wrong.
On Friday, Dallas County District Attorney Bill Hill promised an exhaustive investigation.
"We will review every patient file to see if any other of Dr. Maynard's patients died as a result of a drug overdose," he said.
The patient file of 29-year-old Christopher Baty, who died in August of cardiovascular disease and painkiller toxicity, was among the medical records seized from Dr. Maynard's home.
Diane Gifford, Mr. Baty's older sister, said her family would not discuss the case out of respect for their father, Jack, who discovered Mr. Baty's body.
"This is hard for my dad, and this just brings all that pain up again," Mrs. Gifford said. "My brother was only 29 years old when he died. That's a young age to lose a son."
Investigators raided Dr. Maynard's clinic, home, bank and a nearby pharmacy on Tuesday to see whether his prescription-writing practices contributed to any patients' deaths.
An affidavit describes Dr. Maynard, 57, as prescribing narcotics without a valid medical purpose and defrauding the state Medicare and Medicaid systems by charging for medical services that were never performed.
The state has since frozen his Medicaid reimbursements, and Dr. Maynard remains the subject of an ongoing investigation.
Mr. Hill said Friday that decisions that could limit Dr. Maynard's ability to prescribe narcotics and receive Medicare reimbursements could come next week.
"The licensing authorities are working expeditiously to determine whether Dr. Maynard's licenses should be suspended or revoked," he said.
A victim's sister
Patricia Bland of Illinois contends Dr. Maynard is at fault in her brother's death.
Bill Bryan, 44, a former schoolteacher from Grand Prairie, died in August 1995. His autopsy report lists Dr. Maynard as the last physician to treat Mr. Bryan.
Results of Mr. Bryan's autopsy show he had taken several drugs, including the painkiller Hydrocodone, Diazepam, also known as Valium, the muscle relaxant Carisoprodol and cocaine. His sister says she has talked to a district attorney's investigator and a Dallas police narcotics officer about him.
Ms. Bland said her brother was a star high school athlete, a coach and in "perfect health" until he hurt his back in an auto accident in 1989 or 1990.
A friend of her brother's told Mr. Bryan that he went to Dr. Maynard because he could "go in there and get any kind of medication" he wanted and that Mr. Bryan should see him.
It wasn't long, she said, before Mr. Bryan was hooked on pain medication. By the time he died, Ms. Bland said, her brother was often so high that he slurred his words during their frequent telephone conversations.
Mr. Bryan's widow could not be reached for comment. Ms. Bland said that she no longer speaks to her former sister-in-law because of a dispute that grew out of her brother's death.
Ms. Bland said the relationship between her brother and Dr. Maynard went beyond that of patient-doctor. She said that several times when she spoke to her brother, he told her he was either heading out or returning from playing golf with Dr. Maynard or hanging out with him. She said her brother's response to her questioning of Dr. Maynard's prescriptions was odd.
"He said, 'Oh, Danny knows what he's doing. I trust him.' I said, 'Danny?' " Ms. Bland said, adding that she was surprised her brother was on a first-name basis with his physician.
Several items seized
During the raid this week, investigators seized patients' files, records of prescriptions, computers, invoices, Drug Enforcement Administration audit records, billing records and insurance documents from the physician's office and the pharmacy.
At Dr. Maynard's home, investigators carted off the doctor's "statement" to the Dallas police regarding two women, along with a Medicaid newsletter and a sign-in sheet for his clinic. The items were found with other medical files on the kitchen table, records show.
Investigators seized a Texas State Board of Medical Examiners file from a bar in the kitchen, a controlled substance log and various records in a bag on the kitchen floor and documents that had been shredded.
They also found two files that investigators listed as "Texas Board of Medical Examiners investigation letter lawsuit documentation" in the family room and a medical periodical about reducing drug-related errors.
Meanwhile, Janice Houston, a Dallas police spokeswoman, said there is no internal investigation into the officers who worked off-duty security at Dr. Maynard's clinic.
"We don't have any indication that our officers were involved in any way," Ms. Houston said.
She said that several officers had worked security there and that they were hired for tasks such as theft and crime prevention.
"If we had reason to suspect that our officers were involved, action would have been taken. If any officer suspects criminal activity, we would hope that they would take the appropriate action.
"Because of the investigation and some of the things that are involved, I'm not going to go into a lot of detail about anything else."
Staff writer Tanya Eiserer contributed to this report.
DallasNews.com
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Take thy beak from out my heart, and take thy form from off my door!" E.A. Poe
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Sky_Queen
Fly Girl
Reged: 12/03/02
Posts: 1983
Loc: Texas
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Thanks for posting this article Cindy, I've been following it in the local news. The doctor has not been charged yet. The people this doctor was helping were very sick people, including one woman that had Lupus.
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oldnavy170
Board Addict
Reged: 05/12/03
Posts: 357
Loc: New York
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The patient file of 29-year-old Christopher Baty, who died in August of cardiovascular disease and painkiller toxicity
How much medicine do you think it would take to cause painkiller toxicity? I was just wondering because sometimes when I have alot of pain I will take up to 6 hydrocodone in one day.
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qbird
material girl
Reged: 09/02/02
Posts: 909
Loc: USA
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When they did this report last night, they interviewed the husband of a woman that died of liver problems due to high amounts of narcotics that she was taking. He showed a big box full of the stuff. What was amazing is that at this doctor's clinic they had a line of people waiting at the door for the clinic to open. He supposedly would give them anything they wanted according to the woman's husband. Several patients denied this, but I found it odd that all those people would be standing in line outside of the clinic.
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Take thy beak from out my heart, and take thy form from off my door!" E.A. Poe
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LumbarSpasm
Silent Chaos
Reged: 05/07/02
Posts: 1538
Loc: USA
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Liver toxicity was probably related to the APAP and not the actual opioid.
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LumbarSpasm
Or just a pain in the butt?!
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Pickledoo
Old Hand

Reged: 09/20/02
Posts: 427
Loc: New England
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Hmmmm.....the cocaine wouldn't have ANYTHING to do with it!!!???!!! Noooooo certainly not!
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Jeremiah
Agape GrandParent
Reged: 07/14/02
Posts: 705
Loc: U.S.A.
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Wow!
This Docs office is located in the poorest part of East Dallas.
There is another 'Clinic' I heard about on Martin Luther King Blvd. that gives out scripts for amphetimines. They line up before dawn the same way.Its first come first serve,too.
J.
(No,I dont know where it is)
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I can't see me lovin nobody but you,for all my life
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Anglwink
Veteran

Reged: 04/29/03
Posts: 610
Loc: East coast
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I agree with you on the cocaine being the main cause, especially with the cardiovascular disease!!!
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"Believe"
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Jeremiah
Agape GrandParent
Reged: 07/14/02
Posts: 705
Loc: U.S.A.
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Quote:
How much medicine do you think it would take to cause painkiller toxicity? I was just wondering because sometimes when I have alot of pain I will take up to 6 hydrocodone in one day.
This depends on quite a few factors,but the 'norm' is try not to go over 4g (4000mg) a day of tylenol(APAP). For example,if you take 6 tabs of 10/500 per day,your APAP would be 3g daily which is under the accepted toxicity level.
The other factors are whether you have a gallbladder which detoxifies meds first then sent to the liver for further breakdown. If you dont have a GB,the liver takes over this function solely.
Another factor is whether you take statin drugs(cholesterol) or drink alcohol(ETOH).Both these are known detriments for the liver and may cause abnormal liver enzymes within the organ.APAP added to the equation can cause deterioration of the liver quicker.
Hope this helps!
J.
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I can't see me lovin nobody but you,for all my life
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oldnavy170
Board Addict
Reged: 05/12/03
Posts: 357
Loc: New York
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Thank you for the information. Yes I do still have my Gallbladder so that is a good thing. If I do plan on having a few drinks(not often) I try not to take any pain meds or at least take them real early.
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heli
Newbie
Reged: 04/19/03
Posts: 26
Loc: Rocky Mountains
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I read a lot of your posts, Lumbar, and feel you're a good person to ask my question: With all to the bad publicity about hydro, how do you ask your doc to lower your apap levels? I'm on 10/500, but would like to have 10/325. I agree that it's the apap that does the damage. Not the opioid.
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rex
Enthusiast
Reged: 01/29/03
Posts: 219
Loc: U.S.
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I take 10/325s and I have also wondered what the long-term hazards are of this (I take 3 to 6 per day). I think the PDR says not to exceed 60 mg hydro per day (I'm going by memory here, so I may be wrong). I am going to ask the doc on my next consult.
Heli - I know you did not direct your question to me - but to tell you my experience - the only time I ordered hydro from an OP (NWW) I told them that I wanted 10/325 and they said OK. I have been prescribed hydro many times by my PCP and ENT doctor, and EVERY SINGLE TIME it is 5/500. That seems to be the standard for "moderate" pain, but I don't know.
Too bad we can't get 10/0. I've always wondered if they put the APAP in it to keep people from abusing it. From what I read, it seems like if you abuse it (for the hydrocodone) you die (from the APAP).
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snakey
Member
Reged: 05/20/03
Posts: 108
Loc: cally
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I mean look what else was in his blood,valium,muscle relaxer,cocaine I am not judging him but hell I got nervous reading that.What would be the limit for hydro anyone really know that one I am sure alot of us would appreciate it,I too take 6 sometimes 8 on a real bad day,and yes it would be nice if they just gave the hydro,and yes my tolerance is up hence the 8 a day really sucks,but if I did not take those I would be eating a whole bottle of tylenol in one day so I thoughtI was doing ok. I don't know now.anybody?
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LumbarSpasm
Silent Chaos
Reged: 05/07/02
Posts: 1538
Loc: USA
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Heli, I am not sure how to get your doctor to change the hydro/apap ratio. Around here, I don't think doctors even know about the 10/325's.
I'd think mentioning it to your doctor would be predicated on how much you have been prescribed and for how long.
If you are to take 1 or 2 tablets 4 times a day, and are taking 5-8 tabs daily, then I think you could validly bring up the APAP issue. Just say you read about a drug that had the same amount of hydrocodone and a lower amount of APAP in each pill and could you try it?
You might also consider SAM-E or milk thistle or some of the other thinks available to help your liver detox from the APAP.
I do not believe hydrocodone itself has a limit... it is the APAP that it is combined with that would determine a safe limit.
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LumbarSpasm
Or just a pain in the butt?!
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quincy
Board Addict

Reged: 11/07/02
Posts: 333
Loc: pacific northwest
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This guy died because of mixing too many drugs, and he was also taking cocaine. If he had cardiac problems, then cocaine puts too much stress on your heart. Benzos can kill you too. I don't know about hydro though. Heroin,definetly. I think its the APAP we need to worry about since there is no ceiling level for certain opiates. This is just another case of harassment, a stupid lawsuit or legal charge because some moron misused his meds. If you have a generous doctor, then don't abuse it!! Be responsible and quit ruining it for the rest of us. There are so many of us who can't even get 20 hydros for a month, and this guy is doing cocaine with his normal meds. He was a mess. Now I don't know about the doctor, but it is common practice when doctors and patients know each other socially for them to get a little extra care. I don't know about the lines out the door for this guy. It seems like if that were the case, he would have been busted long before someone died. I just can't beleive they raid doctors offices like some crack house!!
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Sky_Queen
Fly Girl
Reged: 12/03/02
Posts: 1983
Loc: Texas
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They suspended Dr. Maynard's license yesterday.
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Jeremiah
Agape GrandParent
Reged: 07/14/02
Posts: 705
Loc: U.S.A.
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Yep,they shut him down. Seems once a Doc hits the media around these parts,they hang on to the story,follow up and updates on the news and in the paper.
J.
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I can't see me lovin nobody but you,for all my life
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qbird
material girl
Reged: 09/02/02
Posts: 909
Loc: USA
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Thanks for letting me know. I was curious if there was going to be any consequences for his actions. I am surprised his practice was open for any length of time because of his bad practices.
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Take thy beak from out my heart, and take thy form from off my door!" E.A. Poe
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heli
Newbie
Reged: 04/19/03
Posts: 26
Loc: Rocky Mountains
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Thank you, Rex, for your reply! I think I'll talk to my OP and tell the doc that I don't want all of that tylenol. I have 10/500. I'd like it lowered to 10/325.
The media is a crazy place, don't you think? I'm glad we all have this board so that we can discuss our own truths with one another.
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heli
Newbie
Reged: 04/19/03
Posts: 26
Loc: Rocky Mountains
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Thanks, Lumbar! I will try your suggestion. And the natural herb liver detox plan is a great idea. Do you detox while still taking hydro or do you take a break from the hydro in order to detox?
I'm getting off subject here. Feel free to PM me.
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Stacy
Enthusiast
Reged: 11/15/02
Posts: 245
Loc: USA
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Quote:
Heli, I am not sure how to get your doctor to change the hydro/apap ratio. Around here, I don't think doctors even know about the 10/325's.
Tell your doc the pharmacist said something to you.
Back after the 10/325 had been out a while when I went to pick up my last refil the pharmacist told me about the 10/325. I had been on the 10/500 for about 1 year then and she said for me to ask my doc about it when I went back to see him. That was when all the stuff about Tylenol and the liver was coming out.
Call the pharmacist and ask the pharmacist how much Tylenol is too much to take when you are taking pain meds on a regular basis. Then play dumb and say you are worried about the amount of Tylenol and you wish there was something with a lower Tylenol amount. And....the pharmacist will explain to you that there is one that only has 325mg of Tylenol. 
Then you can tell you doc about the "news" your pharmacist told you.
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LumbarSpasm
Silent Chaos
Reged: 05/07/02
Posts: 1538
Loc: USA
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You can take the suppliments at the same time. No need to stop the hydro.
And long term use of hydro/APAP can precipitate hearing loss. I am not sure if more APAP increases the risk or if it is just the combination.
What? I didn't hear that...
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LumbarSpasm
Or just a pain in the butt?!
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Sky_Queen
Fly Girl
Reged: 12/03/02
Posts: 1983
Loc: Texas
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This was in the Dallas Morning News this morning:
Doctor, pharmacist are sued over deaths
South Dallas practitioner, nearby druggist accused of causing overdoses
07/02/2003
By TERRI LANGFORD and HOLLY BECKA / The Dallas Morning News
A South Dallas doctor targeted in an ongoing criminal investigation faces five lawsuits accusing him of negligently causing patients' overdose deaths.
The neighboring pharmacist, Cliff Griggs, is named in four of the suits, which allege that he and Dr. Daniel Maynard conspired to provide medically unnecessary and improper medications "in order to profit from their ongoing use" by patients.
Lawyers for families of five deceased patients of Dr. Maynard filed the suits late Monday evening, the deadline for filing under an existing law that puts fewer limits on possible damages.
Neither Dr. Maynard, whose medical license was temporarily suspended last month, nor Mr. Griggs could be reached to comment Tuesday. Dr. Maynard's lawyer, Jim Rolfe, did not return a call Tuesday. In the past, he has said his client has done nothing wrong.
Dallas attorney Kay Van Wey filed four lawsuits in county court on behalf of the families of Maynard patients Cecil and Harold Armitage, Mildred Janis and Leonard Neal.
Ms. Janis and Mr. Neal do not appear to be among the 13 patients whose deaths were previously disclosed in court records by law enforcement and the Texas State Board of Medical Examiners.
A search warrant affidavit describes Dr. Maynard, 57, as prescribing narcotics without a valid medical purpose and defrauding the Medicare and Medicaid systems by charging for medical services that were never performed.
District Attorney Bill Hill declined to say whether the doctor's treatment of Ms. Janis, who died in May 1996, and Mr. Neal, who died in September 1998, was part of the investigation.
Ms. Van Wey said she was unsure whether her clients had been contacted by law enforcement authorities but added that they were willing to cooperate.
Ms. Van Wey said she included the pharmacist in the lawsuits because Mr. Griggs had an "ownership interest" in the Mancuso Pharmacy, which is next door to the Maynard clinic, and because the pharmacy filled most of Dr. Maynard's prescriptions.
"There's no way on God's green earth that he could ... not know what was going on right underneath his nose," Ms. Van Wey said.
Dallas lawyer Linda Turley filed a lawsuit in state district court on behalf of the father of Christopher Baty, another Maynard patient.
The 28-year-old Dallas man, who went to Dr. Maynard after an old back injury flared up, died in August 2002.
"The family is anxious to get to the bottom of this and find out why this happened," Ms. Turley said.
Ms. Van Wey said that although Ms. Janis died in 1996, her relatives had just "put two and two together" about Dr. Maynard's possible role in the woman's death after the June 10 raid on his clinic.
The lawsuit on behalf of Mr. Baty, who died in August 2002, says that "negligence, carelessness and unskillfullness were a proximate cause of Christopher Baty's injuries and death."
The suits also allege that Mr. Neal and the two Armitage brothers died from mixed drug overdoses related to "numerous medically unnecessary or inappropriate" medications prescribed by Dr. Maynard. Most of their prescriptions were filled at the Mancuso Pharmacy, the lawsuits say.
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heli
Newbie
Reged: 04/19/03
Posts: 26
Loc: Rocky Mountains
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Stacy, your news on how to get the change in hydro/apap ratio is worthy news, indeed! I will use that on my next consult. Thank you very much! 
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heli
Newbie
Reged: 04/19/03
Posts: 26
Loc: Rocky Mountains
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Huh?
Thanks again, Lumbar!
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