- Illinois medical board suspends license of Chicago psychiatrist in clozapine case
Illinois agency suspends Chicago psychiatrist’s license, citing illegal payments from drugmaker
For years, Dr. Michael Reinstein was a prolific prescriber of a dangerous antipsychotic drug in nursing homes and mental health facilities, giving it to more than 50 percent of the patients under his care.
The psychiatrist’s prescriptions of clozapine, known as a risky drug of last resort, were linked to three patients’ deaths and triggered federal accusations of kickbacks and fraud.
Chicago psychiatrist suspended
Michael J. Reinstein
Now, the Illinois medical board has indefinitely suspended Reinstein’s license, saying he received $350,000 in illegal payments from the drug’s maker while disregarding its life-threatening effects and alternative treatments. Clozapine can cause seizures, a decrease in white blood cells, inflammation of the heart wall and increased risk of death in elderly patients.
The disciplinary action comes more than four years after a joint investigation by the Tribune and ProPublica focused attention on Reinstein’s prescribing habits.
The action against Reinstein, dated Friday, ended a two-year legal fight with the Illinois Department of Financial and Professional Regulation over his use of clozapine. His license will be suspended for at least three years.
“It is the mission of the department to protect every Illinois resident who consults with a health care professional, particularly vulnerable senior citizens in nursing homes,” said Dr. Brian Zachariah, chief medical coordinator for IDFPR. “Dr. Reinstein’s actions, and his failure to adequately explain those actions to the department, led to last week’s suspension.”
Reinstein, who has denied wrongdoing, is seeking an injunction in Cook County Circuit Court to stop the action, said his attorney, Michael Goldberg. In every case, Reinstein stands by the medications as medically necessary, Goldberg said.
“He’s very knowledgeable about the medications he prescribes and lectures about them,” Goldberg said.
This doctor should NEVER get his license back! @Olderwiser he did spend a little more time with the patients then 30 seconds but not much more and yes, they stood in line, like cattle, waiting to be seen. I pray that with the recent passing of an amazing man, Robin Williams, that more attention…
In its decision and other case documents, IDFPR says Reinstein issued prescriptions of generic clozapine in exchange for annual $50,000 consulting agreements from Teva Pharmaceuticals, maker of generic clozapine, and its subsidiary IVAX from 2003 to 2009.
The documents also detail other expensive gifts from the drugmaker: free travel to the corporate headquarters in Miami in 2004, a fishing trip and dinners with guests, a boat cruise in 2005 and several tickets to sporting events for the doctor and others.
The benefits flowed until fall 2009, when Reinstein asked Teva to halt the consulting agreements after the Tribune scrutinized his prescribing habits.
In March, Teva agreed to pay $27.6 million to settle federal and state claims that the company paid Reinstein for prescribing the drug.
A federal lawsuit against Reinstein filed in 2012 remains pending in U.S. District Court in Chicago. Authorities say Reinstein submitted more than 140,000 false Medicare and Medicaid claims, and the lawsuit seeks civil penalties for each.
Based in a strip mall office in Chicago’s Uptown neighborhood, Reinstein served as a psychiatric medical director at 13 nursing facilities, according to the Tribune-ProPublica report. In 2007, Reinstein issued more prescriptions for clozapine than all doctors in Texas combined, the investigation found.
In written statements, Reinstein strongly defended his reliance on clozapine, saying the medication was underprescribed and was the most effective in its class for schizophrenic patients.
Reporters uncovered autopsy and court records showing that three patients under Reinstein’s care died of clozapine intoxication.
One was Alvin Essary, a 50-year-old patient at Somerset Place nursing home. When he died in 1999, medical records showed he had more than five times the toxic level of clozapine in his blood. Essary’s family sued Reinstein for negligence, claiming the doctor should not have prescribed multiple medications to a patient with one kidney. The lawsuit settled for $85,000.
In 2003, Wendy Cureton died at age 27. Reinstein had increased her dose of clozapine twice as fast as the recommended pace, the Tribune and ProPublica found. A team of medical staff under Reinstein’s supervision later mixed the drug with sedatives, despite warnings on the label against doing so. Reinstein then increased her dose of another antipsychotic drug. Days later, she collapsed and later died.
Odell Spruell was 54 and living on a psychiatric ward in 2007 when Reinstein doubled his longtime, stable dose of clozapine, records show. Spruell, a former steel mill worker, became lethargic, sleeping for long periods and drooling. Within three weeks of the increased dose, he died of clozapine intoxication, an autopsy found.