Derby Pain Clinic Medical Director Fined $7,500 By Med Board

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The medical director of a pain clinic in Derby was reprimanded and fined $7,500 on Tuesday by the state Medical Examining Board for writing prescriptions for patients based on assessments of their appearance or behavior conducted by unlicensed medical assistants.

Dr. Mark Thimineur, medical director of the privately run Comprehensive Pain & Headache Treatment Centers, LLC, housed at Griffin Hospital, signed a consent order on June 1 agreeing to the punishment. In the order, he did not contest the findings by the board and the state Department of Public Health.

The consent order states that from 2011 to the present, Thimineur failed to meet the standard of care when treating one or more patients for chronic pain. It said he wrote prescriptions for patients based on assessments by unlicensed medical assistants of the patients’ physical appearance, behavior, pain levels or lab test results.

David Tilles, a DPH staff attorney, told the board that the health department is satisfied that Thimineur has made changes at the clinic and halted such use of the medical assistants.

Last week, C-HIT reported that Thimineur and Heather Alfonso, a nurse practitioner at the center, were among the top high-volume Medicare prescribers of Schedule II narcotic drugs in Connecticut in 2013, accounting for $9 million of the $40 million spent by Medicare on such drugs. The controlled substances, including opioids such as OxyContin, have a high potential for addiction and abuse.

Alfonso’s prescribing habits attracted scrutiny earlier this year, when a probe by the Drug Control Division of the Department of Consumer Protection led her to surrender her state and federal licenses to prescribe controlled substances.

William Gerrish, DPH’s spokesman, said Tuesday that the health department has an ongoing investigation into Alfonso’s advanced practice registered nurse (APRN) license. A person who answered the phone at the clinic last week said Alfonso no longer worked there.

In a related case in June 2014, Alfonso was fined $2,000 by the Board of Examiners of Nursing for failing to personally examine patients and relying on the assessments of an unlicensed medical assistant while authorizing renewals of opioids.

DPH records show the agency launched its investigation of Thimineur in April 2013 when it was investigating a separate complaint against the center’s APRN, who Gerrish confirmed was Alfonso.

Thimineur was the third-highest Medicare Schedule II drug prescriber among pain medicine specialists in the state in 2012, a February story by C-HIT disclosed, based on Medicare data. The recently released 2013 data shows he was the 10th highest prescriber statewide, with the sixth-highest billing to Medicare for the potent narcotic drugs.

In an unrelated case Tuesday, the board reprimanded and fined a Norwalk sports medicine doctor $3,000 for grabbing the face of a patient at Milford Hospital and telling the patient to “snap out of it,” records show.

The board also placed the medical license of Dr. Stuart Steinman, who is employed by WestSports Medicine in Norwalk, on probation for six months so that he can complete coursework in professional ethics and the management of patients with behavioral health problems. Steinman has already completed a course in anger management, medical board records show.

DPH began an investigation in October when it received a report from Milford Hospital about Steinman’s inappropriate conduct while treating a patient in August who was in police custody in the emergency department, board records show.

The patient was requesting medication for withdrawal symptoms when Steinman grabbed the patient’s face, said the patient would only receive Tylenol and told the person to “snap out of it,’’ records show.

The hospital said Steinman was asked to leave the hospital and not return to work pending an investigation. Steinman voluntarily resigned and the hospital submitted a corrective action plan, which was approved by DPH.

By signing a consent order with the medical board on April 25, Steinman agreed to the punishment and did not dispute DPH’s findings.

In other business Tuesday, the board reprimanded and fined Dr. Kenneth Abriola of Darien $2,500 for permitting unlicensed medical assistants to provide medication injections to patients in 2013 and 2014, medical board records show.

DPH launched its investigation into Abriola, whose internal medicine practice is in Glastonbury, when two former medical assistants contacted DPH to say that Abriola had permitted or directed medical assistants to give the injections, records show.

On May 6, Abriola signed a consent order agreeing to the fine and reprimand and agreeing not to contest the findings.

His attorney, David Haught, said Abriola was not aware of the regulation that barred medical assistants from giving injections. He changed his practice as soon as he found out about it, Haught said.

“He had no knowledge that medical assistants could not do that,’’ Haught said. “It wasn’t clandestine at all. He’s one of the good guys.”

3 thoughts on “Derby Pain Clinic Medical Director Fined $7,500 By Med Board

  1. Sometimes the DPH goes to far because the people that need pain meds cant get them. It’s like a witch hunt . My meds been cut to the point that they don’t help and they want to cut them even more . Long story?

  2. Witch hunt? Due to the illegal sales, people who really need the help and opioids being the only pain medicine that helps many people with severe previous surgical problems and other medical problems that can’t be helped with Tylenol etc etc we are the ones that are suffering now because of the illegal usage seems everyone is coming down on our pain clinics telling them they can’t prescribe long term etc and what are we to do. Every doctor now is afraid they’ll lose their license if they help or continue to help us that have real medical problems and have been patients for many years THIS never mentioned by the media , or even thought of by our people who run our state or the government it’s as if we do not exist or to me that they just don’t care what will become of us when the doctor tells us they can no longer treat us and we can’t any longer find any doctor because they are too afraid. So we go thru some pretty heavy physical withdrawals and no one cares and we have to go to the hospital. Many are seriously ill and have legit reasons for treatment and again just left to our sickness and pain.
    I never heard of. Pain mgmt clinics just letting people go, I thought it was their responsibility to professionally detox those patients. Something is very wrong here, very wrong. Again there are people that are very ill and need treatment just to function daily.
    Shame on those who forget about us especially the ones that truly need the help to get on with our life shame especially on the media

  3. Accurate , Sad . I am a retired Pharmacist . Going back to the late 90s , we as as professionals started to worry about the shear volume of Oxys we were dispensing . The DC division of the DCP consistently just said that if the prescriptions were legitimate there was nothing they could do about it .Back then we had no way of seeing a patients chart except if it were in the same chain , you had to call other pharmacies if you were suspicious , etc . Forgeries ” doctor shopping ” street value kept increasing . etc it was pandemic . The restrictions that should have been in place a decade ago was swept away by sales reps , of manufactures these potent medications .MDs got lavish rewards depending on how many scrips they wrote ,etc . Soon just about every physician , regardless of speciality were writing prescriptions for Oxys !! Now 2 decades later it’s ” suddenly ” a problem ?? Who gets hurt ?? The patients who really need them !! Even so , they become entangled with ” Pain Management Clinics that you have to go every month .They count your meds , take a urine . Talk to the PA/MD for maybe 5 minutes .Maybe 5 minutes !! Make another appointment . Then you call if there should be a situation that warrants a change in an appointment . And they won’t renew your RX .. worse ,the clinic calls the patient to notify you that THEY need to reschedule you due to a CV outbreak .Worse yet , they cancel you based on a weather forecast !! Gee , people still need their meds ?? Oh but our staff can’t get in ??!Can’t ? More like Dónt ..Don’t want to come in ..Well , can you at least give me enough to get me to the next appointment that YOU CANCELLED , not by me , I’ll be there . Doctor’s , or any health care worker for that matter , using a weather forecast for an excuse to NOT to work is no reason to let those suffer and withold meds .
    The extremes of regulations placed upon this medication is absurd . Why not just make oxycodone a schedule one drug ?? The way it’s regulated now just hurts those that need it and dramatically increases the street value .