News and Tribune

Floyd County

June 22, 2010

New Albany doctor indicted on fraud, illegal drug distribution

Father of Clark County man blames doctor for son’s death

> SOUTHERN INDIANA — James “Jamie” Armburgey went for an appointment to the Pain Management Center of Southern Indiana in New Albany on May 27, 2009. The next day, according to his family, the 43-year-old from Marysville, passed out at his girlfriend’s house in Henryville. He was pronounced dead two days later.

“I have proof that [the doctor] had him on six different prescriptions. He was on OxyContin and different drugs. He went for his appointment, and they increased his dosage 100 percent from what he was taking for pain,” his father, Arthur, said. “He went to his girlfriend’s home and he passed out and fell out of a car. He was unconscious, and he never regained consciousness until he died.”

Amburgey had six drugs prescribed to him by his doctor at the Pain Management Center. He had prescriptions to take more than 500 pills per month. Medicare paid $4,808 in five months for Amburgey’s prescriptions with him paying more than $2,000, according to his records.

The Kentucky medical examiner’s final diagnosis report lists Amburgey’s cause of death as “multiple substance intoxication” with an enlarged heart as a possible contributing factor.

The report states Amburgey had Xanax, Lortab, Vicodin, Oxycodone metabolite, OxyContin and Percodan in his system at time of death. According to records his father kept, those were drugs Amburgey had been prescribed.

“The doctor should have known that six different drugs was too much for one human,” he said.

Now the medical doctor who owns the Pain Management Center along State Street in New Albany — along with offices in Bloomington and Indianapolis — has been indicted by a federal grand jury with health care fraud, health care fraud resulting in serious bodily injury and 11 counts of unlawful drug distribution.

The indictment alleges that Kamal Tiwari, 58, required patients to undergo injection procedures, such as facet blocks, trigger point injections, radio frequency ablations and epidurals, that were not for legitimate medical purposes as a condition of receiving narcotic controlled substances.

The indictment lists 16 patients that the U.S. Attorney for the Southern District of Indiana alleges were drug-dependent and were prescribed controlled substances in such dosage frequencies as part of a scheme to convince them to submit to unwanted and unnecessary medical procedures.

The indictment also alleges that Tiwari defrauded health care benefit programs such as Medicare, Indiana Medicaid and Anthem Blue Cross Blue Shield. Those three companies alone paid Tiwari $21,617,687.

“The allegations in this matter go well beyond the health care billing fraud we usually see. In this situation, a physician not only used patients as pawns for profit, but actually compromised the health of some of Indiana’s most vulnerable citizens,” said Lamont Pugh III, special agent in charge of Office of the Inspector General’s Chicago region.

Tiwari’s attorney, Steve Romines, said he entered a not guilty plea and looks forward to taking the case to trial.

“There are no specific tests you can run for chronic pain,” Romines said. “You have to rely on some of what patients tell you. [Tiwari] treated everyone in an attempt to help them.”

Arthur Amburgey believes Tiwari never tried to ensure his son was taking what was prescribed. He knows his son was dealing pills, but he was never required to take a urine test in the several months he had been a patient at the center.

“The one time I went there, the people in there, you could tell they were not there for legal drugs,” he said.

Tiwari was arrested Thursday in Bloomington without incident.

According to assistant U.S. attorneys Winfield D. Ong, Bradley P. Shepard and Shelese Woods — who are handling the case for the government — Tiwari faces a maximum of 10 or 20 year in prison on each of the 15 charges he faces and fines as much as $1 million for each count of drug distribution.

“Prescription drug abuse is a serious problem in Indiana, made worse by physicians who abuse their position of trust by overprescribing addictive painkillers to patients who may well be addicts,” Indiana Attorney General Greg Zoeller said.

Tiwari has been the subject of two complaints from the Medical Licensing Board of Indiana. He was accused in 2007 of reusing syringes at a Bloomington hospital, putting hundreds of people at risk of intravenous diseases.

Tiwari can still practice medicine in Indiana, but his license to write prescriptions has been suspended.

Romines said the Pain Management Center in New Albany will continue to operate under different leadership.

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