Opinion ID: 3153469
Heading Depth: 2
Heading Rank: 6

Heading: Government’s Expert

Text: Dr. Gene Kennedy testified as the government’s expert witness on pain management. Dr. Kennedy stated that it is “impossible” to diagnose a “chronic patient” without (1) reviewing the patient’s medical history and treatment records, and (2) conducting a physical examination. After making the appropriate findings, doctors should create treatment plans for their patients. For patients experiencing pain, a treatment plan may include a referral for physical therapy, occupational therapy, or neurosurgery, in addition to other measures. If prescribing a controlled substance is necessary, the physician must discuss with the patient the risks and benefits of the drug. Dr. Kennedy reviewed the patient files that were relevant to the indictment and concluded that, in each instance, Dr. Azmat did not prescribe the controlled substances for a legitimate medical purpose or in the usual course of professional 16 Case: 14-13703 Date Filed: 11/10/2015 Page: 17 of 60 practice. Based on his review of the records, Dr. Kennedy explained that Dr. Azmat prescribed medication when: (1) patients did not already have controlled substances in their system, which suggested that the patients were lying when they reported that other doctors had prescribed them controlled substances; (2) patients did not present medical records from their previous physicians to verify their injuries and prescription history; (3) patients’ MRIs and physical exams were unremarkable; (4) patients were from out-of-state or obtained their MRIs out-of-state, when patients in extreme pain typically are not capable of traveling great distances; (5) patients self-reported for MRIs, rather than being referred by a doctor; (6) patients were reporting high levels of pain but did not appear to be in distress, further suggesting dishonesty; and (7) patients had state identification cards, rather than drivers’ licenses, which suggested that they had been caught driving under the influence of drugs or alcohol. All of these factors are red flags for doctors, and Dr. Azmat should have been suspicious that the patients were seeking pills. Dr. Kennedy also discussed additional issues with Dr. Azmat’s medical practices. He believed that Dr. Azmat was prescribing too many pills; failed to note or treat obvious problems, such as patients’ alarmingly high blood pressures; and failed to prepare treatment plans. Furthermore, Dr. Kennedy thought it was strange that patients signed a form before seeing Dr. Azmat, stating that they 17 Case: 14-13703 Date Filed: 11/10/2015 Page: 18 of 60 consented to opioid treatment. He believed that the practice suggested that it was a foregone conclusion that opioids would be prescribed. On cross-examination, Dr. Kennedy admitted that doctors do not deny addicts pain medication simply because they are addicts. Addicts who are suffering pain are still entitled to be treated with medications. Dr. Kennedy further conceded that there was no evidence that East Health Center dispensed medications on site.