A state medical licensing board has censured a Maine doctor after two of his patients died from medications he prescribed.
Dr. Stephen Doane’s medical license was placed on probation following an investigation by the Maine Board of Licensure in Medicine, which found he was incompetent in treating patients by failing to recognize the hazards of the medications he prescribed.
The censure marks the board’s second time disciplining Doane, an internist and geriatrician.
Doane had a primary care practice at PrimeCare Physicians Biddeford, which is affiliated with Southern Maine Medical Center, but left a year ago, according to a receptionist at the office. Doane began serving as medical director for various skilled medical facilities owned by Genesis Health Care in the 1990s, according to the board’s investigation documents. He works in the Biddeford area, the panel said in a news release.
In May 2012, the licensing board reprimanded and fined Doane in connection with a patient who died from an apparent drug overdose on Jan. 18, 2011. When the patient began seeing Doane, she had already been hospitalized for a previous overdose, the documents show. She also had a history of mental health issues, including suicide attempts, difficulty taking medications as prescribed and breathing problems, according to the documents.
Doane was unaware of those issues because he failed to check her most recent medical records and the state’s prescription monitoring program upon treating her, the documents state. Doane prescribed the patient “a significant amount” of narcotic medications, doubling the dosage and increasing the frequency four days after prescribing her 15 days worth of medication.
Biddeford police later informed the board of concerns about Doane’s prescribing of controlled drugs for eight people, including the patient who had died.
The licensing board reprimanded Doane for unprofessional conduct and fined him $1,185.
Doane signed a consent agreement, which physicians may negotiate with the board rather than proceed to formal hearings. In the document, he agreed to limit his prescribing of controlled medications. The agreement took effect on May 18, 2012.
The second patient died the next day, on May 19, 2012.
The cause of death in that case was intoxication from oxycodone, a prescription narcotic, and cyclobenzaprine, a muscle relaxant, according to the board’s decision and order, which it released Friday. Both drugs are controlled medications.
The second patient came to Doane for treatment in 2003 with multiple diagnoses. He later prescribed her Percocet and a muscle relaxant, among other medications, according to the order.
The patient was treated at the Southern Maine Medical Center emergency room twice for oversedation.
The patient’s death on May 19, 2012, was determined to be accidental.
Dr. James Cardi, an outside physician enlisted by the board to review her treatment, found Doane showed poor judgement and decision-making well outside standard practice. The patient’s illnesses, including emphysema, sleep apnea and chronic bronchitis, put her at risk of breathing complications from medication, he found. Cardi also told the board that Doane failed to take sufficient note of the patient’s previous overdoses and fell short in keeping records of her treatment.
Richard Raskin, vice president of medical affairs for the northeast at Genesis Health Care, told the board he was satisfied with Doane’s clinical care and that Doane was a “significant asset to the residents of Genesis facilities,” according to the order. Doane testified that he now tapers patients who are admitted on narcotics and uses the drugs only when needed.
In addition to determining Doane was incompetent in his treatment and record keeping, the board found he acted unprofessionally by failing to follow up on information about the second patient’s overdoses.
A censure is the highest disciplinary action the board may impose. Licensing restrictions, such as revocations or suspensions, are treated separately.
Doane still has his medical license but was placed on probation. He must have a monitor review all cases in which he prescribes controlled substances for more than one week. He may supervise only one mid-level practitioner and oversee no more than 200 beds in at most two facilities.
Doane was first licensed in Maine in November 1985.
Multiple attempts to contact Doane and Genesis for comment were unsuccessful Friday.
