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" First do no harm " is no longer in effect as regards medical ethics. We must be

very cautious about taking any pharmaceuticals, even over-the-counter drugs, if

we use any drugs at all. The FDA has not been protecting consumers.

Betsy

 

 

 

A decade ago the Minnesota Board of Medical Practice accused Dr. Faruk Abuzzahab

of a “reckless, if not willful, disregard” for the welfare of 46 patients, 5 of

whom died in his care or shortly afterward. The board suspended his license for

seven months and restricted it for two years after that.

Skip to next paragraph Dr. Faruk Abuzzahab

 

Multimedia Graphic One Doctor’s Story

Graphic Money for Sanctioned Doctors

 

Related A Battle With Depression and Suicidal Tendencies (June 3, 2007)

 

 

But Dr. Abuzzahab, a Minneapolis psychiatrist, is still overseeing the testing

of drugs on patients and is being paid by pharmaceutical companies for the work.

At least a dozen have paid him for research or marketing since he was

disciplined.

Medical ethicists have long argued that doctors who give experimental medicines

should be chosen with care. Indeed, the drug industry’s own guidelines for

clinical trials state, “Investigators are selected based on qualifications,

training, research or clinical expertise in relevant fields.” Yet Dr. Abuzzahab

is far from the only doctor to have been disciplined or criticized by a medical

board but later paid by drug makers.

An analysis of state records by The New York Times found more than 100 such

doctors in Minnesota, at least two with criminal fraud convictions. While

Minnesota is the only state to make its records publicly available, the problem,

experts say, is national.

One of Dr. Abuzzahab’s patients was David Olson, whom the psychiatrist tried

repeatedly to recruit for clinical trials. Drug makers paid Dr. Abuzzahab

thousands of dollars for every patient he recruited. In July 1997, when Mr.

Olson again refused to be a test subject, Dr. Abuzzahab discharged him from the

hospital even though he was suicidal, records show. Mr. Olson committed suicide

two weeks later.

In its disciplinary action against Dr. Abuzzahab, the state medical board

referred to Mr. Olson as Patient No. 46.

“Dr. Abuzzahab failed to appreciate the risks of taking Patient No. 46 off

Clozaril, failed to respond appropriately to the patient’s rapid deterioration

and virtually ignored this patient’s suicidality,” the board found.

In an interview, Dr. Abuzzahab dismissed the findings as “without heft” and said

drug makers were aware of his record. He said he had helped study many of the

most popular drugs in psychiatry, including Paxil, Prozac, Risperdal, Seroquel,

Zoloft and Zyprexa.

The Times’s examination of Minnesota’s trove of records on drug company payments

to doctors found that from 1997 to 2005, at least 103 doctors who had been

disciplined or criticized by the state medical board received a total of $1.7

million from drug makers. The median payment over that period was $1,250; the

largest was $479,000.

The sanctions by the board ranged from reprimands to demands for retraining to

suspension of licenses. Of those 103 doctors, 39 had been penalized for

inappropriate prescribing practices, 21 for substance abuse, 12 for substandard

care and 3 for mismanagement of drug studies. A few cases received national news

media coverage, but drug makers hired the doctors anyway.

The Times included in its analysis any doctor who received drug company payments

within 10 years of being under medical board sanction. At least 38 doctors

received a combined $140,000 while they were still under sanction. Dr. Abuzzahab

received more than $55,000 from 1997 to 2005.

Drug makers refused to comment, said they relied on doctors to report

disciplinary or criminal cases, or said they were considering changing their

hiring systems.

Asked about the Minnesota analysis, the deputy commissioner and chief medical

officer of the Food and Drug Administration, Dr. Janet Woodcock, said the

federal government needed to overhaul regulations governing clinical trials and

the doctors who oversaw them.

“We recognize that we need to modernize the F.D.A. approach in keeping people

safe in clinical trials,” Dr. Woodcock said.

Drug makers are not required to inform the agency when they discover that

investigators are falsifying data, and indeed some have failed to do so in the

past. The F.D.A. plans to require such disclosures, Dr. Woodcock said. The

agency inspects at most 1 percent of all clinical trials, she said.

Karl Uhlendorf, a spokesman for the Pharmaceutical Research and Manufacturers of

America, said the trade group would not comment on The Times’s findings.

The records most likely understate the extent of the problem because they are

incomplete. And the Minnesota Board of Medical Practice disciplines a smaller

share of the state’s doctors than almost any other medical board in the country,

according to rankings by Public Citizen, an advocacy group based in Washington.

Dr. David Rothman, president of the Institute on Medicine as a Profession at

Columbia University, said the Times analysis revealed a national problem.

“There’s no reason to think Minnesota is unique,” Dr. Rothman said.

“Clinical trial investigators must be culled from only the finest physicians in

the country,” he said, “since they work on the frontiers of new knowledge. That

drug makers are scraping the bottom of the medical barrel is an outrage.”

 

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Need to know more? 50% off home delivery of The Times.

Tips To find reference information about the words used in this

article, double-click on any word, phrase or name. A new window will open with a

dictionary definition or encyclopedia entry.

 

Past Coverage

Narcotic Maker Guilty of Deceit Over Marketing (May 11, 2007)

DOCTORS REAPING MILLIONS FOR USE OF ANEMIA DRUGS (May 9, 2007)

Prescription-Writing Law Is Voided (May 1, 2007)

Court Strikes Law Barring Sale of Drug Data (May 1, 2007)

 

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