Las Vegas pain doctor faces charges tied to fetanyl, Medicare fraud [Las Vegas Review-Journal]

A Las Vegas pain management doctor indicted in Southern California on charges of giving adulterated fentanyl to patients and scheming to defraud Medicare will go before the Nevada medical board to defend his license in December.

Dr. David James Smith, who is licensed and has practiced in both states, was indicted by a federal grand jury on charges that also include over-prescribing fentanyl and other opioids.

“We are supposed to be able to trust our doctors with our lives,” Randy Grossman, the U.S. attorney for the Southern District of California, said in a news release.

The federal charges against Smith include conspiracy, conspiracy to manufacture and distribute controlled substances, healthcare fraud, false claims and adulteration of fentanyl. He was indicted in December 2022. At the time, authorities said he was 62 years old and lived in Rancho Santa Fe.

John J. Rice, a former federal prosecutor defending Smith in the criminal case, said Smith was just trying to help his patients.

“We’re convinced that Dr. Smith did nothing illegal here,” Rice said. “He services a very difficult pool of patients, many of them suffering from intractable pain for years and years” and who benefited under his care.

Nevada board actions

In June of last year, prior to the indictment, the Nevada Board of Medical Examiners, which licenses doctors in the state, accused Smith of failing to disclose California medical board investigations and discipline against him. Smith denied the allegations in his response filed with the Nevada board, noting that the California Superior Court had set aside the disciplinary action taken against him.

Smith specializes in intrathecal pain pumps surgically placed in a patient’s stomach, with two catheters placed in the spine, according to the criminal indictment. Pain medication is pumped directly into the spine.

The indictment states that Smith and his office manager compounded fentanyl citrate, a salt form of the drug, into vials at the physician’s San Diego Comprehensive Pain Management Center, according to the indictment. The compounding practice was grossly improper, it states, and may have contaminated the drug.

The indictment accuses Smith of prescribing excessive amounts of fentanyl and unnecessary oral opioids, as well as installing pain pumps that were not yet needed by patients. He is accused of having fraudulent reimbursements submitted to Medicare in connection with these practices, court records show.

Rice noted that the indictment does not accuse Smith of diversion of any controlled substance, where a drug is distributed for reasons other than its intended use, which is typically why criminal charges are brought against pain doctors. He said there was “no intent to ever defraud Medicare.”

There are no current restrictions on Smith’s license to practice medicine in Nevada, said Deonne Contine, general counsel for Nevada’s medical board. A hearing on the board’s complaint is scheduled for Dec. 7.

Trouble with medical boards

The California medical board in 2020 placed Smith on probation for gross negligence, incompetence and unprofessional conduct, among other claims, in the treatment of five patients, court and board documents show. Conditions of probation included keeping detailed records of controlled substances along with further assessment and training.

The disciplinary action was overturned in January 2022 by the Superior Court of California on the basis that all of the testimony of the doctor’s expert witness was excluded from consideration, according to court documents Smith submitted to the Nevada medical board.

The California medical board then refiled its complaint against Smith, placing him on probation until October 2027, according to court and board records, with the restriction that he not provide treatment with the intrathecal pain pump.

Two weeks ago, former patient Barbara Peters, 80, picked up her medical records from Smith, who continues to see patients. The Las Vegan said she was switching doctors because her insurance company would not pay for a procedure at the surgical center used by Smith.

Peters was shocked to learn of the indictment from her new doctor and figures there are other patients who are unaware of the charges.

Contact Mary Hynes at mhynes@reviewjournal.com. Follow @MaryHynes1 on Twitter. Hynes is a member of the Review-Journal’s investigative team, focusing on reporting that holds leaders and agencies accountable and exposes wrongdoing.

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