ANDERSON — The Indiana Attorney General's office is investigating the deaths of 31 people as part of a probe of the Madison County Community Health Center, according to documents obtained by The Herald Bulletin.
The 31 people had been patients of Dr. Frank Campbell, the former medical director of the health center, 1547 Ohio Ave., according to a court affidavit obtained by the newspaper.
Twenty-three of the patients had lived in Madison County, and the others lived in central Indiana counties including Delaware, Hamilton, Marion and Tipton counties. Their ages ranged between 22 and 58. All of the deaths were drug-related and occurred from 2009 to 2013.
The affidavit was filed last year by Indiana's Medicaid Fraud Control Unit in Madison Circuit Court 1. Based on the affidavit, the state obtained a search warrant in September and retrieved Campbell's records from the health center and its satellite offices in Elwood and Alexandria.
The Herald Bulletin requested the court documents under Indiana's open records law. The newspaper received the documents last week.
According to the affidavit, Campbell's name was on 45,895 prescriptions written between Jan. 1, 2009, and March 11, 2013. During that time, he prescribed 3,664,879 pills for 3,553 patients.
The state is investigating whether Campbell defrauded Medicaid. The state's fraud unit investigator, Damon Grove, wrote, "I strongly suspect that he is requiring his patients to submit to unnecessary office visits and, possibly, unnecessary procedures."
Grove, who has been with the fraud unit for 10 years, also wrote "that since January 1, 2009, 31 of Dr. Campbell's patients who had been receiving controlled substances from him died from drug-related deaths."
Grove wrote, "Some of those patients may not have seen Dr. Campbell for some time before their deaths."
The Herald Bulletin attempted to reach families of the deceased. Six families said their deceased relatives had been treated at the health center, although some said the patients had also visited other clinics or physicians.
The health center, whose chief executive officer is Anthony J. Malone, serves the area's uninsured and under-insured. Physician services at the center are typically reimbursed through Medicaid.
The Medicaid fraud unit based its affidavit on a list of patients who obtained controlled substances, such as hydrocodone or methadone, prescribed by Campbell. That list was matched against death records at the Indiana State Department of Health.
As part of the affidavit, investigators described the center's operations based on interviews with three unnamed "concerned citizens" and a confidential informant.
One of those citizens, a former health center employee, said the health center had "become a pill mill that attracts and creates addicts due to the action of Dr. Campbell and Mr. Anthony Malone."
The U.S. Drug Enforcement Administration also conducted surveillance of the health center and Campbell in early 2013.
In addition, the fraud unit filed subpoenas seeking death certificates at the county level. The Herald Bulletin obtained those subpoenas and death certificates under Indiana's open records law.
In examining the death certificates, the newspaper found that most of the causes of death were overdoses involved with mixing controlled substances, many involving pain-reducing opioids.
The health center is currently embroiled in legal battles. Much of the controversy is based on the use of prescription pads pre-signed by Campbell and used primarily by physician assistants. By law, prescriptions are to be signed and dated upon the day of an examination.
In early 2013, one of the physicians at the health center took Campbell's pre-signed prescriptions to the Drug Enforcement Administration offices in Indianapolis. On May 10, DEA agents interviewed Campbell and he surrendered his license to prescribe controlled substances. He is seeking reinstatement of the license this week before the Indiana Medical Licensing Board; the next hearing is Wednesday in Indianapolis. That hearing is also to determine if he faces disciplinary action.
Campbell has acknowledged he pre-signed pads that were used by physician assistants at the center.
In a June 19, 2013, affidavit presented to the licensing board, Campbell wrote, “I provided the physician assistants with pre-signed prescription blanks to facilitate patient care because the Center operates at both Anderson and Elwood locations. Also I treat patients off-site through our school-based behavioral health programs. Because I reviewed patient charts daily, I believed that providing Physician Assistants with pre-signed prescriptions was within the scope of my supervisory authority."
He added, "Nevertheless, I am now aware that both federal and Indiana regulations require that prescriptions must be dated as of, and signed on, the same day they are issued.”
Malone was asked to comment about The Herald Bulletin's findings. In one email response, he wrote, "I agree that there is a huge problem of opioid use in Madison County and (it) did not start with the Health Center. In fact we are planning a high level public discussion on the subject, which is part of the Health Center's advocacy responsibility."
In a separate email sent through a consultant, Shawn Neal of Anderson Creative Solutions, Malone responded, "As a non-clinical staff, I cannot make any comments that would have legal implications. Also, to assert any comments that could be misinterpreted by any of the regulating entities could create serious fines. Also, I would hope that careful attention would be given to prescribers at emergency rooms and other facilities that prescribed to these patients. It is my understanding that some of these patients have not been seen at the Center in many months and years."
Mixed drug overdoses
Last year, the Indiana Attorney General's Office issued two subpoenas, one to Madison County Coroner Marian Dunnichay and the other to the Madison County Health Department. The subpoenas sought coroner reports and death certificates. The names of treating physicians are not on the records.
The Herald Bulletin delivered an open records request to the county agencies and received the subpoenas and death certificates.
The subpoena issued to the county coroner sought records for seven people. Of those, The Herald Bulletin found:
— Patsy Jo Jackson was 58 when she died from a morphine overdose in December 2012, according to the death certificate. She had been treated at the health center about a year before her death, said her widower, John Jackson. She was treated for pain from arthritis, but her doctor at the center, Campbell, had not prescribed morphine for her, Jackson said.
— Courtina Jones died at the age of 36 from a mixed drug intoxication of morphine and dextromethorphan, which is generally used to treat colds. A former family member, living in Anderson, said she had been a patient at the health center. She died in November 2010.
— Elizabeth Callahan, 57, died Sept. 1, 2012, of a mixed drug intoxication and alcohol intoxication; the drugs involved were the pain reliever methadone and the sedative clonazepam, according to the death certificate. Her widower, Donald Callahan, confirmed that she had been a patient at the health center. However, he said that his wife had received morphine about a day before her death from then-Saint John's Medical Center.
The other subpoena, issued in June to the county health department, was also examined by The Herald Bulletin. The newspaper found:
— Shannon Blizzard, 23, died Feb. 8, 2010. About a year before her death from a self-induced methadone overdose, Blizzard’s mother, Telisa Bradley, went to the health center and asked doctors to stop prescribing narcotics to Blizzard.
“I told them to red-flag it because I didn’t know what else to do,” Bradley told The Herald Bulletin. The health center complied with the request, but Blizzard continued abusing drugs, her mother said.
— Thomas House, 40, died on May 8, 2010, from hydrocodone intoxication. His stepmother, Elizabeth House, said he was a patient at the health center and had seen several doctors. More than one of the doctors prescribed pain medication to him, according to his stepmother. She said House was taking several pain medications at that same time.
— Michael W. Lockridge Sr., 44, who died of mixed drug intoxication in 2011, had been a patient at the health center where he received prescriptions to handle diabetes and pulmonary disease. The day before he died, Lockridge obtained a prescription for morphine from a doctor's office and not at the health center, his fiancee told the newspaper.
Contact Scott L. Miley at (765) 648-4230 or Ken de la Bastide at (765) 640-4863.