State: Boca Raton doctor prescribed ‘large doses’ of Percocet, opioids without exams
A Boca Raton doctor kept “illegible” patient records while failing to document why he prescribed opioids or prescribed monthly increases in pain medication dosages for patients, a Florida Department of Health complaint alleges.
The administrative complaint, which starts the disciplinary process, is the only disciplinary action shown on Dr. John Girard’s online profile for his 36 years as a licensed medical doctor in the state.
Girard’s profile also says he’s certified by the American Board of Internal Medicine for internal medicine and geriatric medicine, but a check of that board’s website says those certifications from 1990 and 1992, respectively, are no longer valid.
Girard’s is accused of shortcomings that involved two of the five patients mentioned in the complaint — and they start and end with his “medical record entries” being “illegible.”
More serious charges accompany that allegation in the sections devoted to three other patients.
Percocet and D.J.
The complaint says “D.J.” saw Girard from May 2019 through June 2021 for chronic left hip and lumbar pain. Another doctor had prescribed D.J. 80 tablets of Percocet, a Schedule II pain drug with oxycodone that is considered to have “a high potential for abuse” as the complaint notes.
On May 19, 2019, nine days after first seeing D.J., Girard increased the prescription to 120 10mg Percocet tablets monthly, one pill every six hours. Girard increased that to 150 10mg tablets monthly, one pill every four to six hours, on June 27, and 180 10mg tablets monthly on Oct. 10.
The complaint says Girard “failed to have or document having, an adequate medical rationale for increasing the quantity of Percocet tablets to Patient D.J. or prescribing a large dose of Percocet to Patient D.J.” Also, Girard, “failed to perform, or document performing, a complete physical examination of Patient D.J., including range of motion, tenderness or spasticity or examination of Patient D.J.’s left hip.”
The complaint also says Girard fell short in monitoring (or documenting monitoring) “D.J.’s compliance with [Girard’s] prescribed treatment plan through the use of urine drug screens or other appropriate method(s).”
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Oxy, Xtampza and S.R.
Another patient, “S.R,.” came to Girard on Aug. 14, 2020, for help with chronic lower back pain that spread down to her legs.
On Aug. 18, Girard prescribed 120 tablets of 30mg oxycodone hydrochloride and 60 tablets of 27mg Xtampza, the name brand version of extended release oxycodone.
“[Girard] failed to have or document having, an adequate medical rationale for prescribing a large dose of opioids to Patient S.R.,” the complaint said.
As with D.J., a lack of appropriate physical exams and abuse monitoring — or, at least, documentation of exams and monitoring — was alleged in the complaint. Also, it said, Girard didn’t refer or record referring S.R. to a specialist, such as a neurologist, rehabilitation specialists, massage therapist, chiropractor or interventional pain medicine physician.
Girard saw S.R. until Jan. 20 of this year.
L.H.’s neck, back, knees and Percocet
The complaint says “L.H.” came to Girard on April 13, 2018, with a history of chronic pain in the neck, back and knees and a prescription from another doctor of 120 10mg Percocet tablets monthly.
In six days, Girard increased that prescription to 120 15mg oxycodone tablets monthly.
The complaint said Girard’s records lacked any examination of L.H.’s problem areas, tracking of L.H’s consumption or reason for the increase in pain medication.
A message that a Miami Herald reporter left at Girard’s office, across the street from Town Center mall, hasn’t been returned yet.
This story was originally published December 13, 2022 at 1:10 PM.
