The surgeon is alleged to have inaccurately described a Nov. 28 operation at Cody’s West Park Hospital as an “emergency;” that misrepresentation, suggests the board’s written order on the matter, was an attempt to have the nearly $28,600 procedure covered by the Montana man’s insurance.
After the spinal surgery, Schneider is further alleged to have prescribed the man several different drugs for the pain — including a pain patch that’s not supposed to be used to treat post-operation pain.
The man was discharged from West Park Hospital on Dec. 1 and died at his Yellowstone County, Mont., home that night, the board’s order says.
The county coroner’s office concluded that a mix of four different drugs — all of which depress the respiratory system and were given to the man at Schneider’s direction — likely caused the man’s death.
The state board found that Schneider’s prescription of the pain patch, “in direct contradiction” of the medication’s warning label, placed the patient at “imminent risk” of the fatal depression of his respiratory system.
Kevin Bohnenblust, the executive director of the Wyoming Board of Medicine, said in an interview Wednesday that the temporary suspension of Schneider’s license “acts as an injunction and a placeholder” until the the board formally charges him and a contested case hearing is held.
Schneider is presumed to be innocent of the allegations and the case against him must be proven by “clear and convincing evidence” — a lesser standard than the “beyond a reasonable doubt” used in criminal cases — before any permanent punishment could be levied by the board of medicine, Bohnenblust said.
However, the board found at its Saturday meeting that, to protect the public welfare, Schneider’s license should be suspended until the matter is resolved.
The board’s vote came after a presentation by Bohnenblust, the board’s investigator Connie Schepp and two members of the board who conducted interviews, Dr. James Anderson and Ray Johnson, PA-C.
Schneider was not represented.
“It is astounding to me that any agency can suspend someone’s license without giving them an opportunity to be heard,” said Cody attorney Laurence Stinson, who has represented Schneider in other matters. Stinson said Wednesday that he first heard of the matter after being contacted by media on Tuesday.
A number listed for Schneider at Northern Rockies Neuro-Spine in Cody was disconnected on Wednesday, and a woman at the Billings office said he was not available. A message left there was not immediately returned.
Schneider will have the chance to defend himself at a contested case hearing if he chooses. Such a hearing could be held at the board of medicine’s mid-April meeting, or a matter can be resolved by a negotiated settlement at any point, Bohnenblust said.
Bohnenblust said the board deals with roughly one license suspension each year.
“We take it very seriously, because this is a major disruption, not only for the physician, but also for the community,” he said.
The temporary suspension bars Schneider from practicing medicine in the state, including at Powell Valley Hospital and West Park Hospital.
Some surgeries by Schneider were scheduled for Monday and were cancelled, said Powell Valley Healthcare interim CEO Mike Lieb.
In an emailed statement, West Park spokesman Joel Hunt said Schneider had been “an active member in good standing of the hospital medical staff since December 1998” and that the hospital “has no comment on the proceedings before the Board of Medicine.”
The Montana patient had been seeing other doctors for back pain at various times during November, according to the board of medicine’s findings.
On Nov. 15, one of Schneider’s employees called the man’s insurer and asked if they would cover medical services provided by Schneider, the order says; the insurance company, Billings-based E.B.M.S., told Schneider’s office that the man’s coverage was limited to only his regular caregivers. The insurance plan did, however, cover emergency surgeries by any doctor.
Early on Nov. 28, the man called Schneider, complaining of incontinence and leg pain.
Schneider said in his notes that the man had a “neurosurgical urgency/emergency” that “require(s) surgery today” and proceeded to operate that afternoon. That diagnosis, which the board described as alleging “dramatic changes” to the man’s condition from the week before, came despite ordering no new MRI images.
Schneider’s notes say he tried getting in touch with the man’s primary physicians on the day of the surgery and couldn’t get them to call him back; those physicians, however, had no record of Schneider ever contacting them, according to the board.
In addition to wrongly prescribing a pain patch that can dangerously depress the respiratory system of post-operative patients, Schneider also failed to put enough protections in place to monitor the patient’s oxygen levels — which had been low at West Park, the board said.
The man returned home on Jan. 1, and his wife found him dead in the living room the next morning.
Schneider reportedly told investigators that the man had refused home oxygen, but the board said that wasn’t noted in hospital records.
On Jan. 4, Schneider filed a $28,596 claim with E.B.M.S.
The matter came to the board’s attention about a week after the Montana man died, Bohnenblust said. He declined to say who provided the initial information to the board or the age of the patient.
This is the second controversy alleged to involve Schneider in as many months. In early December, a Cody surgeon, Dr. Jimmie Biles, filed a lawsuit accusing Schneider and his wife Michelle of having been behind a mass mailing sent to thousands of Big Horn Basin households in late 2010. That mailing made several false accusations against Biles, including a reportedly bogus claim that he was being investigated by the Wyoming Board of Medicine.
The Schneiders have until Feb. 22 to file their response to Biles’ suit. Stinson indicated that they’ll be filing a counterclaim.
Stinson has suggested in court filings that an Indiana woman, Lisa S. Fallon, acted alone in sending the flyers. Fallon has admitted to sending the documents, but says they weren’t defamatory and that she worked with no one else.
A pretrial conference, in which a trial date will be set, is scheduled to be held today (Thursday) in Biles’ separate suit against Fallon.