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Tuesday, Sep. 2, 2014

Oldenberg's license revoked

Thursday, October 14, 2010

(Photo)
Dr. Denise Oldenberg during the 10 hour hearing that ended with her medical license being revoked.
The Arkansas State Medical Board has found Dr. Denise Oldenberg guilty of five violations including over-prescribing medications and gross negligence.

Following a 10 hour hearing in Little Rock on Sept. 8, the board took strong action, the following day, to penalize Oldenberg, including revoking her license to practice medicine in Arkansas.

"This has been a reoccurring issue," said Board Chairman Dr. Trent Pierce. "She has put us in this position. Our charge is to protect citizens of Arkansas."

(Photo)
Oldenberg looks on as Dr. Gary Moffitt, an expert witness for the state, tells the state medical board his review of patient records found Oldenberg engaged in a pattern of over-prescribing drugs and poor documentation of patient treatment. The medical board reprimanded Oldenberg, fined her, suspended and revoked her license to practice medicine in Arkansas.
Oldenberg, who has practiced in Fulton, Sharp and Izard counties for 22 years, is a family practitioner who specializes in treating patients with chronic pain problems. She has, six times, faced disciplinary action for over-prescribing narcotic pain medications and failing to properly monitor her patients.

In 2008, while facing disciplinary action, Oldenberg agreed to submit monthly reports on controlled substances she had prescribed as part of a program to monitor her practice.

In May of this year, an Emergency Order was filed suspending Oldenberg's license to practice after the medical board alleged that Oldenberg had violated the 2008 Agreed Order.

In June, Oldenberg's license was restored after an agreement that she would not prescribe any schedule 2 narcotic drugs until the new charges against her were heard by the board.

"As board's exhibit one, a listing of schedule 2 drug prescriptions prescribed by Dr. Oldenberg for patient B-H," said Attorney Bill Trice as he began presenting the case against Oldenberg.

Trice introduced the medical and prescription records of 33 of Dr. Oldenberg's patients.

Later, Dr. Gary Moffitt, a Springdale physician who reviewed the medical records board investigators collected, discussed findings he called "problematic."

According to Moffitt, Oldenberg repeatedly diagnosed patients with chronic pain syndrome and other pain related ailments, without medical tests or records to back up the diagnoses.

Then, according to Moffitt, Oldenberg began prescribing large amounts of narcotic medications and injections, while compiling few records to document that she was carefully managing the patients' cases.

"Do you view that Doctor Oldenberg prescribed excessive amounts of controlled substances for this patient?" Trice asked Moffitt.

"Yes, sir," Moffitt replied.

"Did you find that the doctor failed to maintain proper records in the treatment of the patient?" asked Trice.

"Yes, sir," Moffitt replied.

That was a typical exchange as Moffitt was questioned about his examination of Oldenberg's patient records.

Moffitt cited several instances of patients receiving prescriptions for thousands of doses of schedule 2 drugs over a period of months.

One patient received prescriptions for six narcotic drugs amounting to 9,000 doses over a year and a half, an average of 17 pills a day.

"Put this amount of medication together, taken for a year and a half, this is problematic," said Moffitt.

Another patient was prescribed 14,280 doses of four medications over a five month period while another patient was given prescriptions for amphetamine diet pills for 17 months, even though the patient was not overweight and the state places a six month limit on the dispensing of the pills.

Another expert witness, orthopedic surgeon, Dr. John Wilson, told the board that records indicate Oldenberg had been giving patients steroid injections into a lower spine joint without proper equipment and with a needle too short to reach the intended area.

Finally, Jim Myatt, a state pharmaceutical inspector, discussed his findings that Oldenberg had failed to list all of the drugs she had prescribed to patients in monthly reports required by the 2008 consent order.

Myatt also revealed he had found evidence that Oldenberg wrote two prescriptions for schedule 2 drugs in July, which were filled in Louisiana. The prescriptions were an apparent violation of the order that Oldenberg not dispense any schedule 2 medicines until charges pending against her were resolved.

"These are forms to patients," Dr. Oldenberg told the board. "In a sense, there is counseling. There is monitoring."

Oldenberg, who appeared before the board without an attorney, began her defense by passing out blank forms, eductional material on exercise and nutrition, and charts she uses to determine a patient's pain scale as she evaluates his or her progress.

Board members quickly asked why Oldenberg had not supplied medical forms that patients had actually filled out.

"The board wanted these records," said board member Dr. Joseph Beck. "They are important to your case. Why didn't we get them?"

"I didn't realize they were needed," Oldenberg replied. "I thought the hearing was to defend myself and my licence."

When told the records could help show she does monitor patients and manage their care, Oldenberg said the forms were in "an external drive" on her computer system.

Oldenberg later said the patient forms were in a box at her office but none had been scanned into her electronic record system since June.

Oldenberg repeatedly told the board it was wrong to issue an emergency order to suspend her license.

"There was no emergency," Oldenberg said. "No one died. No one was harmed."

Oldenberg reminded the board that the Arkansas Pain Management Act, which she helped pass, allows doctors to administer larger than normal doses of narcotics if they help with pain management.

She insisted she has helped hundreds of chronic pain sufferers lead more normal, active lives.

"My patients are happy. Doing well. They have quality of life. I haven't harmed anybody," Oldenberg told the board.

Rev. Ronald Meyers, M.D., an Oklahoma physician who also specializes in pain management, testified on behalf of Oldenberg.

Myers questioned how the board could charge Oldenberg with over-prescribing when it has not set guidelines to help physicians determine what constitutes over-prescribing.

He called Dr. Moffitt a "pill counter" who does not understand that many chronic pain sufferers must take large doses of medications. Instead of how many pills a patient takes, Myers said, "Are they improving?" is what a doctor should look at as patients are evaluated.

More than 40 of Oldenberg's patients attended the board hearing, although many had to wait outside after the hearing room was filled to capacity.

Oldenberg called 10 patients as witnesses. All praised Oldenberg as a caring physician who took them even if they did not have insurance and worked tirelessly to help them manage their pain, when other doctors had failed.

The patients also described being abandoned without needed pain medication since Oldenberg was ordered to stop dispensing schedule 2 narcotics.

"I take only one pain medication," said Tina Crenshaw of Salem. "I'm not a drug addict. I don't sell my pills. I am 48 years old. I don't have a quality of life since you took my doctor away from me."

As for testimony against her, Oldenberg talked of obtaining training in Florida to perform the disputed spinal injections, saying the procedure has greatly relieved pain for many patients.

After initially refusing to discuss the illegal schedule 2 prescriptions written in July, Oldenberg told the board, "The man came a long way. I felt very compassionate. I knew he would not find a doctor there for schedule twos."

Oldenberg complained that nothing happens to surgeons who make mistakes that result in death adding, "Why are doctors who treat pain so persecuted and other doctors are not?"

After board attorney Trice listed the charges against Oldenberg: improper steroid injections, over-prescribing medications, poor record keeping, improper use of amphetamine diet pills, and violating two consent orders issued by the board, Oldenberg was given one last chance to speak.

Rather than apologizing for mistakes and asking for leniency, Oldenberg said she didn't "like to complain" but she has gone through a "nasty divorce," her ex-husband and his friend, Salem Police Chief Albert Roork, have plotted to destroy her, and law enforcement has tried, unsuccessfully, to use confidential informants to catch her doing something illegal.

Her friend and former attorney, Ed Chandler, finally shouted to her, "Denise, you are getting off track."

Oldenberg ended her comments by saying, "I am not guilty as charged... I care about my patients."

As the medical board began discussions, board members expressed compassion for Oldenberg's patients who have had trouble finding new doctors to help them deal with pain and other medical issues.

They also expressed frustration that Oldenberg has continued to wind up before the board despite efforts to work with her and educate her about proper and improper methods of prescribing medications.

"She is not educable with prescription drugs and record keeping hasn't taken either," said chairman Trent Pierce. "This has become a reoccurring issue. With this history, does she have the right to practice in the state of Arkansas?"

After discussing the questionable spinal steroid injections, the board decided to offer Oldenberg a reprimand if she agreed to stop doing the injections.

Initially, Oldenberg was not receptive saying, "It helps people." But she quickly reversed herself and agreed to stop the injections. The board unanimously imposed the sanction.

After a short break, the board decided that, since they had been working for 11 hours, they would recess until Saturday, Oct. 9, to decide other punishment for Oldenberg.

On Saturday, with Oldenberg and 10 supporters on hand, two counts of over-prescribing of medication were the first orders of business.

Board members discussed whether to take Oldenberg's DEA permit, the permit that allows her to write prescriptions for schedule 2 narcotics, or revoke her license to practice.

After considerable debate, the board's decision was to permanently suspend Oldenberg's DEA permit.

A second count led to a vote to suspend her medical license for six months and require Oldenberg to repay the cost of the investigation of her practice, $10,300 to be paid over five years, as well as the DEA permit suspension.

For failing to record and document patient records, Oldenberg was, again, ordered to repay the cost of the investigation.

For violating diet therapy regulations, Oldenberg was given a one year medical license suspension, as well a the DEA revocation and investigation costs.

On the count of violating the 2008 consent order by failing to list all drugs she had prescribed, Oldenberg was given the toughest penalty possible, the permanent revocation of her license to practice.

As the day began, chairman Trent Pierce told the board the penalties it decides act as peer pressure on other doctors to follow the rules. He added, Oldenberg had challenged the board's authority by "flagrantly thumbing her nose at us."

On the count of violating the 2010 consent agreement not to write narcotic prescriptions, Oldenberg was given another license revocation.

The board issued separate penalties on each count because, in the case of a court appeal, a judge could dismiss some penalties while keeping others in place.

"I will send her the order," said board attorney Trice, after the penalties were decided.

Oldenberg has 30 days in which to file a notice of appeal to a court in Little Rock or Sharp County, since Oldenberg's current office is in Cherokee Village.

The hearing ended with the board using most of the punishment options available to it.

The board issued a reprimand, suspended Oldenberg's DEA license, issued a fine, suspended her license for 18 months and, finally, permanently revoked her medical license.

While Oldenberg has the right to, some day, seek a new license, the board indicated it hoped it had sent a strong message so that future boards would uphold its decision that Oldenberg should not practice medicine again in Arkansas.

At one point during the board's deliberations, Oldenberg asked to speak but was denied. After the meeting ended, she quietly left the hearing room without comment.


Comments
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I find it interesting when a person is quick to condemn a physician when he/she has not had his/her life directly affected by the actions of that physician. I also find it interesting when one sits in judgment of another person as a means of refusing to accept responsibility for his/her own actions or acts of omission.

Whether or not we like it Opiates have a long track record in mitigating and/or eliminating pain in a safe and extremely effective manner when used appropriately. In spite of what one might think or read somewhere, this is the only family of drugs that is capable of providing adequate pain control.

The Arkansas State Medical Board called upon the testimony of a "so called" expert witness to assess the prescription usage of Dr. Oldenberg. Dr. Gary Moffitt, a Springdale physician was obviously coerced into providing answers to questions posed by Mr. William H. Trice, III, attorney for the board. Dr. Moffitt's answers were indicative of an individual who is pharmaceutically naive and apparently opiate illiterate. If either of these two gentlemen is ever presented with serious pain issues; I would be more than happy to count out the number of Tylenol drops that should be administerd to relieve his discomfort.

Perhaps Dr. Oldenberg should have been more contrite during her hearing, but after enduring the witch hunt that has been orchestrated by Mr. Trice and Dr. Pierce, it's understandable that she would be reticent to present such a picture of herself. Dr. Oldenberg is a tough ex Marine Officer and it's quite understandable that contrition would not come easily.

Rev. Ronald Meyers, M.D., an Oklahoma physician quite correctly pointed out that the Arkansas State Medical Board had toatlly abdicated its responsibility in failing to institute guidelines for physicians to follow in order to stay within the parameters of what would be considered proper for controlled substances. It might be surprising to anyone who might read this post , including Dr. Moffitt, Dr. Pierce, and Mr. Trice, to learn that their is NO MAXIMUM DOSE described in the literature of schecule II narcotic drugs or Opiates as I have referred to them above as they are used in chronic pain. Doses are contingent upon the severity of an individual's pain and the duration of time that has elapsed since the onset of that person's therapy.

It is high time that the Arkansas State Medical Board seek help from experts in pain management to set up definitive prescribing guidlines for physicians to use. Sending investigators into the field to purposely trap prescribers is a complete waste of time and counter productive to resolving the real problems that physicians and their patients face on a daily basis. Patients continue to suffer when a board of incompetent peers sit in judgement of a practitioner rather than pursue a proactive approach that deals with the problems of those who find themselves helpless while reaching out for relief!

Hipocrisy is ubiquitous among those who have been charged with the responsibility of protecting us from bad medicine. The question I have is: who is responsible for protecting us from the Arkansas State Board of Medicine?

-- Posted by DumBass on Thu, Oct 14, 2010, at 12:36 PM

What gives? Can Oldenburg supporters not see there is a problem. 2008 over-prescribing narcotics and poor record keeping. 2009 same old same old. 2010 33 people with such huge amounts of narcotics prescribed that the State Board is forced to do something to stop the irresponsibility. She put herself in this situation by thumbing her nose at Medical Practice Laws, laws she herself helped write. No one could have known the guidelines any better and yet she choose to flaunt them. Even though she called herself a physician specializing in pain management no where will you find that she was a board certified specialist in this area or any other for that matter. She's a family physician qualified for family medicine. There are people in this area who were stumbling around, slurring their words in public and praising her because they no longer had to buy marijuana for pain relief -- "She'll give me anything I want." This is the pain management doctor you are defending? There is no defense for poor medical practice and there certainly is no defense for malpractice. I have not heard of any of her patients seeking a new physician to handle their care; main reason being that they can't get the medications they want. They will not go to a pain management clinic with a "real" pain management specialist because (whine whine) "He'll take away my drugs. I'll die without them." According to Dr. Oldenburg no one has been harmed and no one is dead so we can conclude you won't die if you don't get the drugs she was so willing to supply -- so many drugs; so many people; so little time with so much to do. The excuse was "a nasty divorce." If her estranged husband really had information concerning patient's names, conditions and what was being used to treat them then Dr. Oldenburg should have more charges levied. HIPPA rules and regulations state patients are to expect complete confidentiality of their records and their person. If he knew about patients through conversations around the dinner table then she violated HIPPA laws and could be fined in federal court and spend time in prison for each offense. 33 charts would be a lot of fines at $10,000 to $30,000 a pop, not to mention the jail time. If the patients want to take a proactive approach their time would be better spent in seeking help from a pain management clinic than taking trips to court in Little Rock and writing to the Governor. I can't speak for the Governor, however, I would guess he will be on the side of law and order and will see his main duty as protection of people who obviously do not have the judgment to protect themselves. I am proud to know that Arkansas is taking a stand against this type of negligent medical practice. The Board is to be commended for a quick, though and quality investigation. May they continue to work on major practice problems such as this. Let Arkansas be a leader in holding untrained negligent physicians accountable for their actions whether through commission or omission.

-- Posted by reflections on Thu, Oct 14, 2010, at 10:59 PM

Until you have lived with chronic pain, it's very difficult to judge what you would do. The first thing most drs. will say is "I don't prescribe narcotics" - that is before you tell them your problem ... it is 2010 folks, wake up! Drs. have the means to help folks in pain, yet they choose not to because of this sort of thing ...(I guess?) I suppose everyone should walk around with a morphine drip to control pain? (except you couldn't get a prescription for that either). What would you have a person do? - seriously, all you people who have not lived with pain day in and day out? This is [not] my physician and I [don't] take narcotics, however, unless you are in chronic pain ... I applaud her for trying to help people.

-- Posted by jchdhh2 on Fri, Oct 15, 2010, at 6:54 AM

Denise, Please remember who loves you and that you are in our prayers.

Your Christian Family

-- Posted by Momoffourtoo on Fri, Oct 15, 2010, at 3:12 PM

Physicians do prescribe Schedule II drugs every day. The ones who prescribe within State law and standard of medical practice do not have problems with the Arkansas Licensing Board and you never hear on the "street" go to Dr. xxxx, she/he will give me anything I want. There is a difference between those who truly have chronic pain and need pain management and those who are drug seekers. Ask any hospital ER about those type of drug seekers coming into the emergency rooms time after time after time wanting something for pain and then walk out if Toradol (a very effective non-narcotic pain medication) is offered. The revocation of her license was not done out of hate; for her or anyone else. It was done because of irresponsibility, poor to no accountability and huge doses of medications that should be used sparingly and only for severe pain. There are many very good pain management clinics out there and I have yet to hear of any of her patients seeking help through legimate means.

-- Posted by reflections on Wed, Oct 20, 2010, at 8:17 AM

It is not easy to find a Pain Mangement Doctor that will take Medicaid as i have or that will do anything besides Steroid injections which i cannot have because i have Glaucome which was caused from Steroid injections i had been given in the past.I still believe Arkansas would better benefit from some control over the refusal to Medicaid/Medicare patients.@ Reflections if someone is discussing what goes on in there ER they to are violating HIPPA laws.If they want GP`s to stop treating pain than make the Pain Mangement Doctors more accessible to everyone!!!!I agree there are those that abuse drugs but there are those of us that need help and cannot get it and your referance to Torradol i am allergic to it but if i tell a Doctor that are they going to assume i am just seeking "drugs"? Of course they are.It`s an absolute no win situation until the Medical Board makes changes that will actually help people.I would love to go to a pain clinic when you find one that will actually help me and take my insurance let me know.Until then don`t assume it`s so easy to get in to one.

-- Posted by Ridiculous on Fri, Oct 22, 2010, at 11:21 AM

I used to see Dr.Ronald Meyers he is a great Doctor but the Medical Board has caused him problems in the past also.I don`t believe they have been able to find anything against him to date.Just another Dr. they have singled out because they dont approve of how his practice is handled. I know some Doctors absolutely should lose there license but they still have them than there are others they just wont leave alone.

-- Posted by Ridiculous on Fri, Oct 22, 2010, at 11:27 AM


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