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.
Despite laws in many states that protect non-smokers from secondhand smoke, exposure remains especially high for children ages 3 to 11, African-Americans, and those who live in poverty or rental housing, according to a recent report. Jessica Hollenbach, the director of asthma programs at the Connecticut Children’s Medical Center, agreed with the report, done by the U.S. Centers for Disease Control and Prevention, and said tobacco is a negative toxin that can make other illnesses worse. Hollenbach studies the relationship between secondhand smoke exposure and asthma in children. She said tobacco is an asthma trigger, and children with asthma often have higher exposure to second-hand smoke. In Connecticut, 13.9 percent of public school students have asthma, according to a state Department of Public Health report released last year.
A Derby nurse practitioner whose prolific prescribing of potent narcotics was the subject of a February story by C-HIT has surrendered her state and federal licenses to prescribe controlled substances and is the subject of an “open investigation” by the state health department, officials said Monday. Heather Alfonso, an advanced practice registered nurse (APRN) at the Comprehensive Pain & Headache Treatment Centers, LLC, in Derby, surrendered her controlled substance registration after a recent probe by the Drug Control Division of the Department of Consumer Protection, a spokeswoman for the department confirmed. “The controlled substance registration of this provider has been turned in,” said the spokeswoman, Claudette Carveth. She said the agency had no further comment. Meanwhile, William Gerrish, a spokesman for the Department of Public Health, said his agency has an ongoing investigation into Alfonso’s APRN license, which is separate from her prescribing registration.
Three Connecticut nursing homes have been cited and fined by the state Department of Public Health for violations, including two instances in which residents were physically injured. Wilton Meadows Health Care Center was fined $1,160 for an incident that took place in May 2014. A resident, whose diagnoses included quadriplegia and Alzheimer’s dementia, suffered a broken arm after a nursing assistant at the Wilton facility moved the resident to a bed using a lift without any assistance, according to DPH. The nursing assistant claimed all the other nursing assistants were busy at the time and unable to help move the resident. When using the lift the nursing assistant was supposed to have help from another staff member, according to the citation.
A Derby nurse practitioner was among the top 10 prescribers nationally of the most potent controlled substances in Medicare’s drug program in 2012 – an anomaly in a state where Medicare records show nurse practitioners rarely prescribe such drugs, which have a high potential for abuse. Heather Alfonso, an advanced practice registered nurse (APRN) at the Comprehensive Pain & Headache Treatment Centers, LLC, wrote out 8,705 prescriptions for opioids and other Schedule II drugs in 2012 – the most prolific prescriber among all Connecticut practitioners, including pain specialists and other physicians, according to Medicare data compiled by ProPublica. She wrote out more prescriptions for the opioid Exalgo than any other Medicare provider in the country, and was the seventh highest prescriber nationally of Oxycontin, writing out more than twice as many prescriptions for that narcotic as the next highest prescriber in Connecticut. She also was the 10th highest prescriber nationally of Avinza, a morphine product. There is no indication that Alfonso’s unusual prescribing frequency drew scrutiny from state or federal officials.
Those who visit a medical spa in Connecticut for Botox, hair transplants or other cosmetic procedures can be assured they will see a licensed medical professional there, which hasn’t always been the case. Previously, consumers complained that med-spa procedures were sometimes performed by unlicensed providers, but a recently enacted state law has placed stricter requirements on the businesses. The law, which took effect Oct. 1, requires all medical spas to employ – either on staff or by contracting for services – a physician, physician assistant or advanced practice registered nurse (APRN). It also mandates that one of those medical professionals perform an initial physical assessment of every med-spa client before any procedure is done.
The state Department of Public Health has fined a New Jersey company $200,000 for operating eight blood collection centers throughout Connecticut without state approval. Dr. Marc Grodman, president of BioReference Laboratories Inc., signed a consent order with DPH Nov. 3 in which he agreed to the fine and five years’ probation on the licenses of three clinical laboratories in Danbury, Greenwich and Westport and a certificate of approval for a blood collection center in Greenwich. In October, BioReference – which bills itself as the third largest chain of full-service clinical diagnostic labs in the U.S. – withdrew all of its pending applications to open blood-drawing centers in Connecticut. On Aug.
The state Department of Public Health has shut down eight blood collection centers because they were operating without a license or certificate. DPH issued a cease and desist order Aug. 29 against BioReference Laboratories Inc. of New Jersey, for operating the unlicensed blood collection centers in Fairfield, Ansonia, Milford, New London, Norwich, Waterbury, Wallingford and North Stonington. The order said that BioReference has a licensed clinical laboratory at 27 Hospital Ave. in Danbury, but that it opened the other labs before receiving a license or certificate to operate them.
Seven Connecticut nursing homes have been fined by the state Department of Public Health in connection with lapses in care, including one sexual assault of a resident by another resident and two cases in which residents died. Other cases involved residents who developed pressure sores, one who sustained a cut on the forehead during a fall and another who left a home and wandered across the street. The Kent Ltd. of Kent, which is owned by Apple Rehab, was fined $1,195 on April 4 in connection with two residents for whom CPR was delayed or stopped without a doctor’s order, records show. On May 5, 2013, there was a delay of nine minutes in starting CPR on an 88-year-old resident while a supervisor was notified and while equipment was gathered, records show.
Four nursing homes have been fined by the state Department of Public Health in connection with incidents in which one resident died, another was verbally abused and several female residents were touched inappropriately by a resident. On March 13, 2014, Ledge Crest Health Care Center in the Kensington section of Berlin was fined $780 in connection with a March 2013 incident involving the resident who died. Records show the resident had chronic constipation and was supposed to be monitored for abdominal discomfort and vomiting. Despite the vomiting and low blood pressure on March 4, 2013, a nurse’s note failed to say whether a doctor had been notified about the change in the resident’s condition and failed to show whether additional blood pressure checks had been done, DPH records said. State records report that six hours later, the resident was admitted to a hospital for gastrointestinal bleeding and sepsis, a life-threatening inflammation prompted by an infection.