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54,000 Prescriptions Draw Law's Notice; Clinic Is Raided

A Dallas physician, who is still practicing, averaged about 200 prescriptions per day. The deaths of 11 patients are being investigated.

June 22, 2003|Lisa Falkenberg | Associated Press Writer

DALLAS -- Dr. Daniel Maynard took no appointments. Instead, hundreds of patients would wait for hours in the parking lot in a line that began forming the night before.

"When you've got 300 people ahead of you, you know a production line is what he's doing," said former patient Walter Shearin, 53, who would wait eight to 10 hours to see Maynard and get his prescription for narcotics renewed. "It's a red flag."

Maynard's practice was a red flag to state and federal authorities too. They raided his clinic, home and bank this month, and seized thousands of documents and computer equipment in an investigation into the deaths of 11 patients, several of whom died of drug overdoses or toxic combinations of drugs.

Investigators alleged in court papers that Maynard prescribed narcotics without a valid medical purpose.

No charges have been filed. But the 57-year-old doctor could face manslaughter or criminal negligent homicide charges, investigators said.

The investigation involves far more deaths than similar cases brought recently against doctors in Florida, Georgia and New Mexico, officials said.

The doctor still holds his medical license. But the district attorney's office has asked the federal Drug Enforcement Administration to revoke his license to prescribe narcotics. And the state canceled Medicaid reimbursement payments to the clinic.

The investigation has come as a relief to relatives of patients who died under Maynard's care. But the news was met with shock and frustration by lines of patients who took turns knocking on the locked door of the South Dallas clinic in the days after the raids, waiting to be escorted in.

The doctor has not spoken publicly about the investigation. But his attorney, Jim Rolfe, said Maynard is "completely innocent."

"He did not prescribe anything to anyone that was not medically necessary, medically sound or medically OK to do so," Rolfe said, adding that the number of deaths -- 11 people, ages 29 to 62, over the past three years -- is "really not abnormal" considering the number of patients that Maynard has.

Records show that in 2002, Maynard wrote more prescriptions for the sedative diazepam (also known by the brand name Valium) than any other doctor in Texas. And he wrote the second-most prescriptions for Tylenol with codeine. In all, he wrote 54,748 prescriptions last year, according to the records.

If Maynard worked an average 270 days a year, eight hours a day, that would work out to about 200 prescriptions per day.

"When we say 25 per hour, there's no way you could see the patient and write the prescriptions, much less document the whole situation," said Dale L. Austin, chief operating officer for the Federation of State Medical Boards.

Sandra Blackburn, 47, a teacher, lost her two older brothers after years of pleading with them to stop seeing Maynard.

"I personally believe he's a drug dealer," she said. "He's a legal drug dealer. That's the sad thing."

Her brother Cecil Armitage, 62, died in March, surrounded by dozens of prescription bottles. Court records show Maynard had written him 23 prescriptions for such drugs as the pain reliever and cough suppressant hydrocodone, Viagra, diazepam and cough syrup with codeine.

Blackburn's other brother, Harold Armitage, 52, who suffered from high blood pressure, hepatitis C and kidney failure, was killed in a traffic accident after going to Maynard for pain medication. He had been prescribed such drugs as diazepam, hydrocodone, the muscle relaxant carisoprodol and Viagra, according to court records.

Patients waiting outside Maynard's clinic defended him as a kindhearted doctor who hands out cash to hungry people so that they can buy fried chicken down the street. He has become an institution in a part of town where haggard men ask strangers for bus fare and sirens wail incessantly.

"There's a lot of pain in this neighborhood and this is his specialty, treating pain," said patient Lawrence Stephenson, 58. He said he takes a narcotic for back pain.

Rebecca Martinez said Maynard is "the one who keeps my mom and dad alive."

Dist. Atty. Bill Hill said support from patients is to be expected: "That's where they're getting their dope."

The district attorney and five other agencies, including the FBI and the DEA, began investigating Maynard after complaints by family members of patients who died from drug overdoses. Hill said it could take months to go through the seized evidence to determine whether Maynard, a doctor of osteopathy and a Texas general practitioner since 1973, will face charges.

Meanwhile, Rolfe said the doctor is still seeing patients.

"He's been in the community of South Dallas for 24 years," Rolfe said. "He's going to continue to practice as long as he possibly can."

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