PA: Attorney General: Johnstown doctor charged with drug delivery resulting in death

The Tribune-Democrat News –

The defendant was trusted by his community to use his position as a physician to save lives, but instead he stands charged for prescribing his patient a fatal cocktail of drugs despite knowing of and enabling her history of drug abuse

A Johnstown doctor was charged Friday with felony drug delivery resulting in death in connection with the 2018 overdose death of a patient.

Dr. Richard J. Green, whose office is located at 213 Vine St. in downtown Johnstown, is accused by the Pennsylvania Office of Attorney General of overprescribing narcotics to his patients. A prosecution expert alleged that “unreasonable and reckless prescribing” by Green caused the overdose death of patient Sherri Istvan.

Green, 64, of Windber, was arraigned Friday by District Judge Frederick S. Creany, of Ebensburg, and was released after he posted 10% of $20,000 cash bond, court records indicate. He is being represented by Johnstown attorney Art McQuillan.

“Dr. Green is a well-respected physician in the Johnstown area,” McQuillan said Friday. “We didn’t pick this fight, but we will be ready for it.”

Agents Matthew Massaro and Albert J. Rivardo III from the Office of Attorney General laid out their case against Green in a three-page affidavit of probable cause filed Friday. They said they began receiving complaints about Green’s overprescribing of narcotics in 2017.

The agents wrote that they interviewed several former patients of Green’s, who all allegedly reported that Green’s usual practice was to conduct very brief medical examinations, ask simple questions about the patients’ ailments and then provide prescriptions for one-month supplies of narcotics without doing any further examinations or tests. The patients reported that the entire process typically took five to 10 minutes, according to the affidavit.

One of the former patients the agents interviewed was a man identified in the affidavit as “J.M.,” who allegedly said that he attributed the 2018 overdose death of his girlfriend, Istvan, to overprescription of narcotics by Green.

J.M. told the agents that, at his first appointment with Green, he told the doctor he had knee and rotator cuff pain, and Green asked, “What do you need?” He said he asked for and received a prescription for 90 Percocet tablets per month, which was later increased to 120 tablets, then 150. He reported that, whenever he asked Green to increase the amount of Percocet he received monthly, the doctor always replied, “Sure.”

J.M.’s and Istvan’s monthly examinations typically lasted 60 to 90 seconds, J.M. told the agents, adding that Green didn’t drug-test either of them or discuss the risks of drug dependency.

J.M. said that he and Istvan went to an appointment with Green on May 24, 2018, to get their prescriptions, which they filled at a Johnstown pharmacy. He said that they then went to a motel, where they crushed and snorted some of the Percocet and Xanax they’d been prescribed; Istvan also consumed the Seroquel she’d been prescribed. This was their usual practice, J.M. said, according to the affidavit.

Several days later, J.M. said, he found Istvan dead in the motel room. An obituary published in The Tribune-Democrat gives the date of her death as May 27, 2018, while the affidavit gives it as May 28. A toxicology test indicated that the cause of her death was acute alprazolam, oxycodone and quetiapine toxicity, according to the affidavit; those are the generic names for Xanax, Percocet and Seroquel, respectively.

According to the affidavit, J.M. told the agents that he had felt Green was prescribing too many Xanax to Istvan; he claimed he’d warned the doctor that Istvan was “out of control,” asked him six or seven times to stop giving her Xanax and questioned him about the amount of Seroquel he was prescribing her.

The prosecution’s expert, Dr. Stephen Thomas, reviewed copies of Istvan’s patient file and medical records that were seized when a search warrant was executed on March 12. He concluded that Istvan overdosed and was hospitalized five times from 2013 to 2017 and that the primary drugs involved in four of those overdoses were those prescribed by Green; the fifth, on April 21, 2016, involved heroin.

Thomas alleged that Green ignored Istvan’s “exceedingly high-risk” behavior when he continued to prescribe narcotics to her after her overdoses.

“The defendant was trusted by his community to use his position as a physician to save lives, but instead he stands charged for prescribing his patient a fatal cocktail of drugs despite knowing of and enabling her history of drug abuse,” Attorney General Josh Shapiro said in a press release Friday. “Communities across Pennsylvania are being ravaged by the opioid crisis that is being fueled by people like Dr. Green. My office will continue to hold individuals accountable who recklessly put the lives of others at risk for profit, wherever those individuals are found.”

In addition to the charge of drug delivery resulting in death, Green faces a misdemeanor charge of involuntary manslaughter, also stemming from Istvan’s death. He is also charged with prescribing controlled substances to Istvan “not in good faith” and “not in accordance with the treatment principles accepted by a responsible segment of the medical profession,” an alleged violation of the Controlled Substance, Drug, Device and Cosmetic Act.

Also, he is charged with a violation of the “provider prohibited acts” section of Pennsylvania Crimes Code Title 62. According to the agents, the narcotics prescriptions Green issued for Istvan after her 2016 heroin overdose were “below accepted treatment standards and/or unneeded by the patient” and therefore constituted Medicaid fraud.

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