A physician assistant has permanently surrendered his license to practice in the state of Washington after being accused of failing to provide adequate care to prisoners at the Washington State Penitentiary in Walla Walla .
Richard T. Oliver was accused of failing to evaluate and treat potentially life-threatening illnesses, such as malignant melanoma.
He also failed to completely assess or follow up on the management of chronic medical illnesses, such as diabetes, according to allegations in state documents.
The Washington Medical Commission and Oliver reached an agreement for him to voluntarily surrender his license. No further action was found to be needed to protect the public.
Oliver is retired and has no plans to return to practice, according to the agreed order. He had been licensed as a physician assistant since 2012.
The medical commission considered eight cases in its statement of charges of unprofessional conduct that resulted in the agreed order. It alleged:
▪ An inmate asked in May 2019 for the removal of a skin lesion on his back that was cracking, bleeding and painful.
Oliver diagnosed the issue as a noncancerous skin condition, seborrheic keratosis, without documenting factors that could be used to determine if it was a potentially life threatening form of skin cancer. That included the color, whether or not it was symmetrical, and whether or not its borders were regular.
Oliver did not refer the inmate to a dermatologist, although he saw the patient twice more for other medical conditions in August.
In September, Oliver did a biopsy of the lesion, which came back positive for malignant melanoma.
More than a month later a nurse saw the inmate and noticed the biopsy stitches had not been removed.
It was not until another physician assistant saw the inmate in April 2020, more than 10 months after the inmate first showed Oliver the lesion, that the second physician assistant ordered surgery to remove the cancer.
▪ A second inmate who reported a large skin lesion on his back to Oliver in March 2021 did not receive a biopsy until another physician assistant did one a month later, even though there were warning signs it could be melanoma and a family history of skin cancer.
▪ An inmate was short of breath and had swelling caused by fluid trapped in tissue in March 2021.
Oliver failed to conduct a pulmonary examination or order a chest X-ray. Three months later the inmate was transferred to an emergency room with a slowed heart and possible heart attack.
▪ An inmate with a fast resting heart rate complained of dizziness in March 2021, but Oliver did not consider whether the dizziness could be caused by a heart problem or obtain a cardiology consultation.
▪ Questions were raised about the care of four inmates with diabetes, each with indications of very high blood sugars over two to three months.
Oliver was accused in one of those cases of failing to discuss treatment options, failing to offer medication for high cholesterol and failing to followup.
In another of the diabetes patients, the dosage of a medication that can raise blood potassium and cause potentially life-threatening cardiac arrhythmia was doubled, but Oliver did not assess blood potassium.
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