While Toledo-area physician Dr. Lance Christiansen has declined to speak publicly about his license suspension that followed the deaths of six of his patients reportedly from medication overdoses, information contained in the state Department of Health's recently available files offers some insight into his practice.
Christiansen, 65, tells authorities he has discovered the "true cause and initial treatment" of various painful syndromes, as well as defends himself against allegations he over prescribed drugs, according to the documents.
The longtime south Lewis County physician's responses to an anonymous complaint to the state in February 2003 that he over prescribed narcotics showed that in one case when he learned a patient sought opiates for pain from himself and from another doctor, Christiansen terminated the man as a patient.
In another case, when he was tipped off a female patient may have been selling her prescription drugs on the street, he contacted law enforcement. The next time the woman returned, Christiansen noted he gave her a reduced dosage, and then telephoned police. The woman never returned, according to Christiansen.
With a third patient, the physician said he wasn't comfortable with the level of pain medication she was on, so he referred her to a pain specialist, according to Department of Health documents in the case.
Christiansen, a family practice physician who operated Mount St. Helens Medical Clinics in Toledo, Winlock and Onalaska, is fighting the June 1 emergency suspension of his license.
The Department of Health's Board of Osteopathic Medicine alleges he prescribed excessive quantities of controlled substances and created an unreasonable risk of harm to eight patients by failing to perform physical exams, making unsubstantiated diagnoses, failing to maintain adequate records, and failing to consult with specialists or follow the recommendations of specialists.
In a separate action, on Feb. 9, the state Department of Labor and Industries revoked Christiansen's eligibility to treat or be paid by the agency for injured workers. The action stemmed from a patient death last August, in which a reviewing doctor concluded Christiansen prescribed approximately five times the appropriate "conversion" dosage of methadone. That death is among the six that prompted the license suspension.
The string of deaths of his patients beginning in October 2003 from overdoses include accidental overdoses of methadone, something he reportedly prescribed for pain management, according to authorities. One was labeled a suicide and the others accidental.
The Department of Health has withheld the identities of the patients, but records show both the Lewis and Cowlitz county coroners investigating the cases indicated deaths took place in both areas.
Before his suspension, the state agency had taken corrective action against Christiansen once. In 1998, he allegedly failed to properly place a patient's broken arm for an X-ray, which resulted in the patient needing reconstructive surgery. The state required Christiansen to take a minimum seven hours of continuing education on proper X-ray technique.
Christiansen, who has practiced locally for more than 20 years, is a doctor of osteopathy, as opposed to a doctor of medicine. The two kinds of physicians have many similarities and both can operate family practices. There are about 700 osteopathic doctors licensed in Washington.
The Toledo resident in early February ended about 14 months of fighting criminal charges in Lewis County Superior Court, in which he was accused of threatening to kill his teenage daughter's 17-year-old boyfriend, or former boyfriend. A jury found him not guilty of all charges.
Christiansen, licensed in Washington since September of 1982, graduated from Chicago College of Osteopathic Medicine in 1977, according to the Department of Health's records. He completed his internship while in the U.S. Navy. He was working at a branch clinic for Moffett Field Naval Air Station in California before moving to Washington
Among the documents in the current case is Christiansen's description of his discovery of the "true cause and initial treatment" for conditions of various painful syndromes.
He notes he is writing a journal article on it for publication.
In one section, the investigator wrote that the physician talks about rheumatic fever and streptococcal-A and later shoulder, neck and back pain, and numbness in legs, feet, arms and hands.
"In the last two or three years I've spent a couple of thousand hours, extra, doing anatomical studies, laboratory studies, literature research, and very thorough physical exams and learning more about neuroantonomy, and I've determined a cause for many people's chronic pain," Christiansen is quoted as writing in response to the February 2003 complaint.
"Many of these patient are labeled 'fibromyalgia,' which I don't think is the diagnosis, and many of the patients have erroneous surgery on their cervical and lumbar spines, and also on other parts of their body such as, their shoulders."
About one patient who died, following a history including a fall from a roof, back surgery and chronic pain, the investigator wrote:
"The respondent states these constellations of problems are due to rheumatic fever in his youth."
The man, over time, was prescribed MS Contin, Roxicet, Hydroxyzine, Ambien, Somaa and Prednisone, according to the report, as well as Clonazepam for seizures.
Christiansen wrote he last saw the patient last June. The patient subsequently died from what was determined to be an intentional overdose of morphine and probably Citalopram, according to the case documents.
Christiansen's response to the Lewis County coroner indicated the family doctor was somewhat surprised by the suggestion the overdose was intentional.
"I must say he talked to me a number of times about being in so much pain, having no good future, that he thought about killing himself, but he talked about that from time to time, I didn't feel he was an acute suicide risk, besides we were trying to approach his problems in a logical way."
Christiansen is appealing the license suspension.
His attorney, Don McConnell in Centralia, expects to have prepared an answer to the civil charges by the end of July. A hearing on the allegations would then be scheduled.
Sharyn L. Decker covers law enforcement, local fire departments and the courts for The Chronicle. She may be reached by e-mail at sdecker@chronline.com, or by telephoning 807-8235.
