Healthcare Inspection – Alleged Inappropriate Prescribing of Controlled Substances and Alleged Abuse of Authority, Tomah VA Medical Center, Tomah, Wisconsin

This inspection was originally administratively closed in March 2014 because we could make no conclusive finding of inappropriate prescription practices. We previously released the report pursuant to the Freedom of Information Act. Because of continuing public interest, we are now publishing the report. OIG conducted a review to assess the validity of multiple allegations of misprescribing and diversion of opioid drugs and a physician’s abuse of administrative and clinical authority at the Tomah VA Medical Center, Tomah, WI (facility). We did not substantiate the majority of allegations made in the various complaints that OIG received. Although the allegations dealing with general overuse of narcotics at the facility may have had some merit, they do not constitute proof of wrongdoing. We did not find any conclusive evidence affirming criminal activity, gross clinical incompetence or negligence, or administrative practices that were illegal or violated personnel policies. We briefed the facility and VISN director and brought several suggestions to their attention to improve communication between staff and clinicians concerning opioid prescription practices, assist with the treatment of patients who have complex pain management issues, and evaluate and monitor facility and provider opioid prescribing practices. Please note that we identified an error on page 8, in the sixth line of paragraph two, the morphine equivalents per unique patient range is listed incorrectly. The correct range is 8,989 to 63,184.