Attorney General Christopher S. Porrino and the Division of Consumer Affairs today announced that a Burlington County family physician has been temporarily suspended from practice amid allegations he prescribed hundreds of opioid pain pills – up to 720 pills a month - to patients without physically examining them or documenting a legitimate need for the drugs.
Dr. Moishe Starkman, who practiced family medicine in Bordentown, allegedly prescribed massive quantities of Fentanyl and Oxycodone and other controlled dangerous substances (“CDS”) without a legitimate purpose to five patients he saw between 2012 and 2017, including one who fatally overdosed two months after his last visit.
Starkman agreed to the temporary suspension of his license pending a hearing on the allegations against him, under the terms of a Consent Order with the state Board of Medical Examiners (“the Board.”)
According to the State’s Complaint, Starkman prescribed the CDS to patients for a variety of medical conditions he diagnosed without performing physical exams or conducting diagnostic tests. He routinely prescribed hundreds of opioid pills to patients - even to those who showed signs they may have been addicted to the drugs or were diverting them for illegal use, according to the Complaint.
“We allege that instead of providing legitimate medical care to his patients, Dr. Starkman simply wrote them prescription after prescription for highly addictive drugs without so much as taking their temperature,” said Attorney General Porrino. “The scant patient records this physician kept provide no valid reason for his patients to be on powerful painkillers, let alone in such high quantities and for such long periods of time, we allege. This kind of reckless prescribing flies in the face of our efforts to combat the opioid epidemic and we will not stand for it.”
The State alleges that Starkman prescribed the highly-addictive opioid medications and other narcotics to his patients for years without documenting treatment plans for pain management or opioid use; without assessing the efficacy of the narcotics he prescribed; and without making reasonable efforts to prescribe alternative medications or treatments to alleviate pain or decrease the dosages of the controlled substances.
As a family practitioner, Starkman also failed to keep adequate progress notes on his patients and failed to treat them for medical issues not related to their pain, the Complaint alleges.
The five patients are identified in the Complaint by their initials, including H.H., a 22-year-old male who died from a drug overdose in May 2015, two months after his last visit with Starkman.
According to the Complaint, patient records show that H.H. was 19 when he first visited Starkman in July 2012 with complaints of “lower back pain.” At that time H.H. listed an array of medications he was currently taking, including a muscle relaxer; an anti-anxiety drug; a drug to treat attention deficit disorder, a drug to treat insomnia, and “recently finished pain medication from wisdom teeth removal.” Without conducting a physical exam or diagnostic testing to determine the cause of H.H.’s pain, Starkman prescribed a muscle relaxer to him that day, and then began prescribing opioids to him the following month.
Over the next three years, Starkman prescribed Xanax and up to 240 opioid pain pills a month to H.H. while failing to establish and reevaluate treatment plans and reassess the use and dosage of the narcotics prescribed, as required by law, the State alleges.
According to the Complaint, on one visit during December 2014, Starkman continued to prescribe H.H. Oxycontin, despite noting that H.H. was “slurring and falling asleep” during the visit. The following month, when H.H. visited the office because he was “sick” and “ran out of all meds early again,” Starkman wrote him a prescription for a higher dosage of Oxycodone. And on H.H.’s final visit on March 16, 2015, Starkman prescribed him 120 pills of Oxycodone, despite noting that three days earlier H.H. had been discharged from a mental health and addiction treatment facility in Vermont where he had spent a week as an inpatient for anxiety and panic attacks.
With regard to the four other patients, the Complaint alleges, among other things, that Starkman:
* Prescribed T.A., a 29-year-old female, six different prescriptions for 120 pills of Oxycodone that amounted to 720 pills in a thirty-day period, which, if ingested as prescribed, would equal one pill for every hour of the day.
* Kept only one progress note in the 19 months he treated T.A. and conducted only one drug screen on her, which came back negative for all tested substances, even the prescribed opioid.
* Prescribed 600-720 Oxycodone pills each month to C.D., a 41-year-old female, with no physical exams, no treatment plan, no progress notes, and no documentation in her patient file except copies of prescriptions.
* Continued to prescribe large quantities of opioids to C.D. despite receiving a warning letter from her insurance provider that she had filled 18 prescription drug claims at four different pharmacies, and another letter from the provider warning that C.D. had met her threshold of opioid use for a 120-day period.
* Prescribed up to 360 pills of Oxycodone a month and up to 120 pills of Xanax a month to J.T., a 42-year-old male, with no physical examination, detailed history, review of prior treatment history, or diagnostic testing.
* Continued to prescribe large numbers of pills to J.T. despite the fact that the patient’s urine drug screens consistently tested positive for cocaine; a Prescription Monitoring Program report indicated he had filled CDS prescriptions issued by seven different physicians within a one-year-period; and despite receiving warnings from another patient that J.T. was “selling your scripts on the street” and “using someone else’s pee to pass your drug screen.”
* Prescribed opioids in large dosages and quantities to G.A. for almost four years despite the fact that the patient reported no change in his pain levels, and that his urine drug screens tested positive for marijuana.
Under the terms of the Consent Order throughout the period of suspension Starkman may not enter the premises of his former medical practice at any time when patients may be present, and is precluded from managing, overseeing supervising or influencing the practice of medicine or the provision of healthcare activities, including testifying as an expert witness in the state of New Jersey.
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