Richard Mabry - Medical Error

"Your chairman said you'd give us as much time as we need."

Anna glanced pointedly at her watch. "Well, have a seat and let's get to it. What do you need from me?"

The man lowered himself into the chair, his expression slightly disapproving. His partner followed suit. "We have some things we need for you to clear up."

"Could I see those credentials again?" Anna said. "Both of you."

They obliged, laying the open wallets on the desk. Anna pulled a slip of notepaper toward her and began copying the information, occasionally glancing up from her writing to match the names and faces on the IDs with the people sitting across from her. The spokesman was Special Agent John Hale, a chunky, middle-aged man wearing an off-the-rack suit that did nothing to disguise his ample middle. Anna thought he looked more like a seedy private eye than an officer of the law.

The woman, the silent half of the pair so far, was Special Agent Carolyn Kramer, a woman who reminded Anna of a California surfer, complete with perfect tan and faultlessly styled short blonde hair. The resemblance stopped there, though. Kramer's eyes gleamed with a combination of intelligence and determination that told Anna she'd better not underestimate the woman. Kramer wore a stylish pantsuit that had probably cost more than Anna made in a week. How could a DEA agent have money for an outfit like that?

Anna handed the badge wallets back to Hale and Kramer."All right, how can I help you?"

Hale pulled a small notebook from his inside coat pocket and flipped through the pages. "Doctor, recently you've been writing a large number of Vicodin prescriptions, all of them for an excessive amount of the drug. Can you explain that?"

"I don't know what you mean," Anna said. "I'm pretty sure I haven't written any more Vicodin 'scripts than usual, and I certainly haven't changed my prescribing practices."

Hale nodded, stone-faced. "What are those practices?"

"I prescribe Vicodin for postoperative pain in many of my patients, but always in carefully controlled amounts, usually thirty pills at a time. By the time they've exhausted that first prescription, I can generally put them on a non-narcotic pain reliever. It's rare that I refill a Vicodin 'script."

Apparently, it was Kramer's turn in the tag-team match. She picked up a thick leather folder from the floor beside her chair, unzipped it, and extracted a sheaf of papers held together by a wide rubber band. "Would you care to comment on these?" Her soft alto was a marked contrast to Hale's gruffbaritone.

Anna's eyes went to the clock on her desk. "Will this take much longer? I really have things I need to do."

Kramer seemed not to hear. She held out the bundle of papers.

"Okay, let me have a look." Anna recognized the top one in the stack as a prescription written on a form from the faculty clinic. She pulled it free and studied it. The patient's name didn't stir any memory, but that wasn't unusual. She might see twenty or thirty people in a day. The prescription read:

VICODIN TABS

DISP. [#100]

SIG: 1 TAB Q 4 H PRN PAIN

At the bottom of the page, three refills were authorized. The DEA number had been written into the appropriate blank on the lower right-hand corner.

Anna squinted, closed her eyes, then looked again. There was no doubt about it. The DEA number was hers. And the name scrawled across the bottom read: Anna McIntyre, M.D.

"Can you explain this?" Kramer asked.

A familiar vibration against her hip stopped Anna before she could reply. She pulled her pager free and looked at the display. The call was from the medical center, but she didn't recognize the number. Not the operating room. Not the clinic. She relaxed a bit when she saw there was no "911" entry after the number. If this was about the autopsy, she'd have to miss it.

Hale picked up the questioning as though there had been no interruption. "What can you tell us about all these prescriptions for Vicodin?"

"I suppose the most important thing I can tell you is that I didn't write them." She rifled through the stack, paying attention only to the signature at the bottom of each sheet. "None of these are mine."

"That's your number and name, right?" Kramer said.

"Right. But that's not my signature. It's not even close."

"Can you explain how someone else could be writing prescriptions on your pads using your DEA number?" Hale asked.

"I have no idea." Anna made no attempt to keep the bitterness out of her words. "Sorry, I've just lost a patient, and I'm not in the best of moods. Can't we wind this up? I didn't write these 'scripts, and I don't know who did."

Obviously, Hale didn't want to let the matter go. "You're sure there's nothing you want to tell us?"

"What would I have to tell you? I said I don't know anything about this."

Kramer spoke, apparently filling the role of good cop. "Take a guess. Help us out here."

Anna felt her jaw muscles clench. These people were relentless. She had to give them something, or this would never end."I really don't know. I mean, we've got an established routine, and all the doctors here are pretty careful."

Kramer pulled a silver ballpoint from the leather folder and twirled it between her fingers. "Why don't you walk us through that routine?"

Anna wanted to follow up on Hatley's autopsy, talk with her department chair about today's events, eventually sit down and try to relax. She was drained. The agents, on the other hand, seemed to have unlimited time and energy.

"Doctor?" Kramer's voice held no hint of irritation. Patient, understanding, all the time in the world. Just two women chatting.

"Sorry." Anna tried to organize her thoughts. "The prescription pads in the clinic are kept in a drawer in each treatment room. That way they're out of sight, although I guess if someone knew where to look, he could latch onto one when no one was in the room." She looked at the agents. Kramer simply nodded. Hale scowled. "Hey, we know it's not perfect, but that's the way we have to do it. Otherwise, we'd waste all of our time hunting for a pad."

"And do you ever forget and leave the pads sitting out when you've finished writing a prescription?" Kramer asked.

"Sure. Especially when we're in a hurry." Anna's cheeks burned.

Hale turned a page in his notebook and frowned. "How about your DEA number?"

"You'll notice those aren't printed on the forms. Each of us has to fill in our number."

"Maybe someone else had access to your number. Do nurses ever write the prescriptions for you?" This came from Kramer. Anna felt as though she was watching a tennis match, going back and forth between the two agents.

"When we have a nurse in the room with us, yes, she'll write the prescription. I don't know what the other doctors do, but I sign the prescriptions after she writes them. And I add the DEA number to the narcotic 'scripts myself."

The questioning went on for another half hour. Anna's throat was dry, her eyes burned, and she felt rivulets of sweat coursing between her shoulder blades. Finally, she'd had enough. "Look, am I being charged with something? Because if I am, I'm not saying another word without a lawyer."

Hale replaced his notebook in his pocket. Kramer picked up her folder and purse. They let the silence hang for a moment more before exchanging glances, then standing.

"Right now, we're simply investigating, Doctor," Hale said."You may be hearing from the Texas Department of Public Safety and the Dallas Police as well. Also, since your DEA number and identity have been compromised, I'd advise you not to prescribe any controlled substances for now. You'll receive formal notification in writing tomorrow about applying for a new permit."

The agents walked out, leaving Anna with her hands pressed to her throbbing temples.