Mother wants son's doctors to be punished

In the nearly three years since her son's death from a drug overdose, Carolyn Aviles has fought to get someone to punish his doctors.

Joseph Valdez died April 24, 2007, the same day a pain clinic doctor prescribed the addictive drugs Soma, Xanax and oxycodone. He was 32.

Now, the state Department of Health has brought charges against physician Gerard Romain, who gave Valdez the prescriptions. The department filed an administrative complaint charging Romain with failure to practice medicine in accordance with the level of care required by law, inappropriately prescribing drugs and failing to keep legible medical records in connection with his treatment of Valdez.

After Valdez died, nurses found in his pockets a receipt from the Kenaday Medical Clinic, an empty Soma bottle and a Xanax bottle with a few pills.

All three of the prescribed drugs were ruled as contributing to his death, along with unprescribed methadone.

The day before his death, Valdez was released from St. Joseph's Hospital, where he had been treated for 19 days after an overdose of Xanax.

Aviles had tried for years to stop doctors from prescribing drugs to her addicted son. She said physicians shared the blame for his death; in particular, she wanted Romain to face discipline.

"I knew in my heart that this doctor needed to take responsibility for what he did," she said.

Aviles said the health department's complaint against Romain is validation of her quest.

Romain, who is not permitted to practice medicine, could not be reached.

Not for lack of trying

Valdez was one of 191 people in Hillsborough County whose deaths were caused, at least in part, by prescription drug overdoses in 2007 - a 60 percent jump over 2006 and nearly three times the number in 2003, according to the Florida Medical Examiners Commission.

In a 2008 story, The Tampa Tribune and TBO.com chronicled Valdez's struggles with addiction, his efforts to persuade doctors to prescribe drugs and his family's efforts to get him treatment.

Using medical records obtained with Aviles' help, the story also detailed how physicians continued to give Valdez prescriptions in spite of his history of overdoses.

Tampa lawyer Dale Sisco, who was representing the Kenaday clinic, said then that doctors "have a duty to treat their patients for pain." He said Kenaday doctors followed a protocol to identify drug abusers, but insisted doctors cannot be blamed when they are fooled by addicts.

Four days after the story was published, the health department wrote Aviles saying it wanted to review her son's medical treatment "to determine if his healthcare practitioner has violated any of the laws or rules regulating" the medical profession.

Aviles said it was the first time anyone wanted to review the case.

She and her husband, Jose, said they had called every federal, state and local law enforcement agency they could think of and consulted attorneys.

"There needed to be some kind of justice," Carolyn Aviles said. Health department officials "were the only ones that actually stepped up to the plate."

The department declined to bring charges against another of Valdez's doctors about whom the Avileses complained.

But health officials investigated Romain, who was in disciplinary proceedings over charges he improperly prescribed the painkiller hydrocodone over the Internet to a California man who died of an overdose in June 2006.

Sisco said last week that the California medical examiner and a Florida health department expert testified at Romain's disciplinary hearing that the man's overdose was not attributable to the drugs Romain prescribed.

Still, Romain was ordered in December 2008 to pay a $20,000 fine and $37,300 in costs. He was directed to complete courses in medical records, and laws and rules for doctors. He was placed on probation and ordered to perform 100 hours of community service.

Doctor disciplined

Romain was not allowed to practice except under the supervision of a board-certified physician. For a year, he was prohibited from prescribing any Schedule II or III drugs, which include oxycodone and methadone.

In January, the Florida health department filed charges alleging Romain failed to pay the fine and costs and didn't appear before the agency's probation committee.

Among the possible disciplines Romain faces are the permanent revocation or suspension of his license. His license now is deemed delinquent and he is not permitted to practice medicine, health department spokeswoman Eulinda Smith said.

According to the complaint in the Valdez case, Romain failed to perform a complete assessment and a physical examination on April 24, 2007. He also is accused of failing to obtain Valdez's complete medical history and to seek a consultation regarding his treatment.

The complaint cites Romain for prescribing drugs to Valdez when he had a history of overdoses and for increasing the medication without noting the justification.

"There has to be consequences for these doctors that are giving out these medications (that are) killing our children," Aviles said. "Hopefully, he will get what's due him."