Psychiatrist Reprimanded in 2002 Drug Intoxication Death

I have been wondering if cases similar to this, which result in the death of a patient due to a patient's treatment (and where there is no expected danger of death) should a least be subject to a charge of 'medical' man-slaughter. As seen in this report

A Lakeland psychiatrist brought before the Florida Board of Medicine on Friday after one of his patients died of "multiple drug intoxication" will get a reprimand, pay a $6,000 fine and attend classes intended to prevent similar situations.

The discipline package requires Dr. Charles Dack to complete "Prescribing Controlled Drugs: Critical Issues and Common Pitfalls of Misprescribing" or a board-approved equivalent. He must attend 16 hours of continuing medical education in drug medication and pain-management consultations. And he will pay administrative costs, up to $6,109.33, for investigation and preparation of his case.

He agreed to that discipline in a proposed settlement, negotiated with the Florida Department of Health, that was given to the Board of Medicine. He didn't comment before or after the board agreed to accept the agreement without debating its terms.

Dack, certified in psychiatry with subspecialty certification in addiction psychiatry, hasn't had previous discipline from the board, DOH said.

Dack treated a woman for seven years for depression and back pain. Before her death in March 2002, the state's administrative complaint said, she was on 1,300 milligrams of morphine a day and on 300 milligrams a day of Elavil, an antidepressant that also can be used to treat chronic pain. In addition to those drugs, Dack also prescribed other medicines.

Another psychiatrist recommended in 1997 he change the medication and suggested more conventional pain management.

Dack wrote a letter in which he agreed she might benefit from a pain management program, the state said, but "failed to take steps to make certain patient M.T. sought the help of pain management specialists."

The complaint said Dack failed to properly recognize her dependence and tolerance for controlled substances and didn't properly consider the possibility of her exaggerating her pain level. It said he inappropriately escalated the "quantity and dosage of the prescribed narcotics for patient M.T. without objectively justifying and adequately documenting changes in the patient's condition."

The settlement agreement doesn't require him to admit or deny allegations made against him in the state complaint.