'His flank was wide open’: NKY doctor convicted of improperly prescribing to pain patients

A Northern Kentucky doctor faces the possibility of prison after a federal judge in Covington found him guilty of improperly prescribing opioids to chronic pain patients he treated in 2016.

Dr. Michael Fletcher, a pain management and addiction treatment specialist, was convicted Friday of three counts of distribution of a controlled substance – a verdict that followed Fletcher’s six-day bench trial before U.S. District Judge David Bunning.

The 2021 indictment stemmed from Fletcher’s work treating patients at Interventional Pain Specialists in Crestview Hills.

The practice’s owner, Dr. Kendall Hansen, was charged alongside Fletcher and ultimately acquitted at trial. Jurors were unable to reach a verdict on two counts against Hansen, but prosecutors later moved to dismiss those charges.

Fletcher was likewise found not guilty of a conspiracy to distribute controlled substances count, with Bunning pointing to a lack of evidence showing the doctors conspired with one another.

“In fact, they didn’t agree on much,” the judge said, adding that Fletcher’s is not a pill mill case.

Fletcher continued prescribing opioid medications to patients while ignoring warning signs of inappropriate substance use and addiction, according to prosecutors. Those red flags included failed urine drug tests, signs of medications being misused and patient histories of substance use.

Bunning said there was no evidence to suggest that Fletcher even tried to obtain patients’ mental health records, which would’ve outlined drug use issues disqualifying them from opioid treatment.

The judge also pointed to testimony that Fletcher’s face-to-face interactions with patients were minimal, with one patient unaware the doctor left the practice until roughly two years after his departure.

His patients were bad candidates for opioid treatment, prosecutors said, noting seven of them died of overdoses shortly after being prescribed opioids by Fletcher. However, his convictions stem from the treatment of just two patients.

As a voting member of the Kentucky Board of Medical Licensure, Fletcher should’ve known the standards for prescribing opioids, which he even enforced by revoking other doctors’ privileges due to their opioid prescribing habits, prosecutors said.

One employee even warned Fletcher that the number of patients he was treating could draw the attention of regulators, prosecutors said, adding his prescribing history showed that he was sometimes prescribing to upwards of 80 patients per day.

‘His flank was wide open’

However, Fletcher argued that many of his patients were abandoned by their previous pain doctors after those providers shuttered their practices and that Interventional Pain Specialists became inundated with patients as a result.

“I’ve always endeavored to practice medicine as a ministry and a service to others,” said Fletcher, who represented himself at trial and gave his own closing argument.

“My reputation in this town is good,” he added.

In his family medicine practice, Dr. Jeremy Engel relied on Fletcher as a specialist to assist with caring for pain and addiction patients, saying their conditions often improved after seeing Fletcher.

Engel, who’s known Fletcher for 15 years, said the verdict was “chilling” because it places doctors who treat high-risk populations in harm’s way.

“He gets the worst of the worst and the hardest of the hardest,” Engel said of Fletcher’s addiction treatment practice, which he founded after leaving Interventional Pain Specialists.

At the time Fletcher was treating pain patients in 2016, doctors were still grappling with how to manage patients with both chronic pain and addiction, he added.

“We’re just now figuring this stuff out,” Engel said, noting that Fletcher took a lead locally in treating addiction patients at the start of the heroin epidemic.

“Even well-intentioned people, who are imperfect, can be punished,” Engel said. “Mike Fletcher is being punished because his flank was wide open.”

Fletcher, who now lives in Oklahoma, was allowed to remain free on bond pending final sentencing, which is currently scheduled for Dec. 17. He intends to appeal his convictions.

This article originally appeared on Cincinnati Enquirer: 'His flank was wide open’: NKY doctor convicted of improperly prescribing to pain patients