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Thursday, Nov. 1, 2012 04:57 pm

Jail doctor in good standing despite deaths

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Dr. Stephen Cullinan was fined $10,000 in August but is still licensed to practice medicine.
What’s a leg worth?

Ten thousand dollars, at least in the eyes of the Illinois Department of Financial and Professional Regulation, which in August fined Dr. Stephen Austin Cullinan of Peoria that amount for not properly treating an ankle fracture suffered by an inmate in the Macoupin County jail in Carlinville.

Instead of sending Jason Waggener to an orthopedist, as recommended by an emergency room physician when Waggener broke his ankle and suffered a head injury after a seizure, Cullinan ordered him back to jail, according to documents filed by Waggener’s lawyers in a federal lawsuit, one of more than a dozen cases in which the doctor has been accused of killing or seriously harming patients through poor care. Over the course of several days, Waggener became delusional, took off his splint and walked around until, finally, he suffered a compound fracture to his lower leg that resulted in amputation.

That was in the summer of 2007. On Aug. 14 of this year, the department charged with licensing and disciplining physicians and protecting the public from bad doctors finally acted. The $10,000 fine came 18 months after Waggener settled his lawsuit against Cullinan and Macoupin County, with the county’s insurer paying more than $337,000 to a convicted sex offender. Cullinan (or his insurer) paid at least $130,000.

If history is any indication, it will be many more months, if not years, before the department figures out what a life is worth.

Five months after Waggener lost his leg, Maurice Burris died an agonizing death after his perforated ulcer went untreated in the Sangamon County jail in December, 2007. Cullinan, or his insurer, paid $737,500 nearly a year ago to settle a federal lawsuit.

Sangamon County found another jailhouse doctor shortly after Burris’ demise and paid $60,000 to settle its portion of the lawsuit filed by the son of the deceased. Shortly after the case was settled nearly a year ago, Cullinan left the Peoria company called Health Professionals, Ltd. that provides health care in more than 100 jails throughout the Midwest. The Illinois Department of Financial and Professional Regulation was promptly informed of the settlement but has taken no action against Cullinan nearly a year after the case was settled.

The Burris and Waggener cases do not stand in isolation. In 2009, Cullinan was fined $10,000 by authorities in Michigan who found that he had withheld psychotropic drugs from mentally ill inmates without consulting the prescribing physician. Cullinan had difficulty recalling the case one year later when a lawyer in a Wisconsin lawsuit asked him about it during a deposition taken in a lawsuit filed by relatives of a county jail inmate with a history of heart trouble who died from a heart attack after he didn’t receive prescribed medication. Cullinan was not a defendant in the case that ended with a $1 million jury verdict against the county.

“There is a thing in the state of Michigan,” Cullinan told a plaintiff’s attorney. “I don’t have the particulars of it.”

During the same deposition, Cullinan also testified that he’d never had a licensing problem in the dozen states in which he held a license to practice medicine. But court files show that Cullinan has often been accused of providing poor care.

A federal appeals court judge last year blasted Cullinan for denying prescribed Xanax to John P. King, an inmate who died in a Wisconsin jail in 2007, wondering openly from the bench why the doctor wasn’t sued for malpractice; attorneys for the dead man’s family instead sued La Crosse County in a civil rights action.

“What Cullinan did does seem like pretty serious malpractice,” the judge said. “You have a drug where reducing the dosage can have serious side effects. You have a doctor that knows this fellow has a prescription from the veterans hospital and he cuts it down drastically. And he does this without calling the veterans hospital to ask why this fellow has this large prescription. That sounds really bad.”

During the same hearing, a second judge called it “shocking” that Cullinan, whose office was in Peoria, was making treatment decisions for inmates 300 miles away.

“He’s obviously not dispensing advice with any information,” the judge said.

Michael Devanie, attorney for King’s widow, said that he tried adding Cullinan and his company as defendants after discovering an “unwritten policy” of taking inmates off Xanax and similar drugs, but the judge in the case would not allow it.

“I would not want a person like that practicing medicine in my state,” Devanie said. “He seems like a really dangerous person.”

Cullinan is a defendant in more than eight pending federal lawsuits. The family of Robert Awalt sued last year after Awalt, an epileptic, was denied anti-seizure medication and subsequently died after suffering seizures in the Grundy County jail. The mother of Patrick McCann sued last year after her son, who had suffered severe burns over 40 percent of his body in a house fire, was transferred from a burn unit to the Ogle County jail, where Cullinan substituted methadone for an opiate painkiller. McCann, who had bipolar disorder, was taking psychotropic drugs that can be lethal when combined with methadone, according to the lawsuit.

Justin Ray Sparlin, an Army veteran who says he has post-traumatic stress syndrome, sued Cullinan last year alleging improper treatment for mental illness in the LaSalle County jail in Illinois. Although two psychiatrists hired for his criminal case diagnosed mental illness, Cullinan prescribed a 20-day supply of a drug used to treat heart problems, high blood pressure and migraines, according to Sparlin’s lawyers. After more than a year in the county jail, Sparlin was sent to the Stateville Correctional Center, where psychiatrists immediately prescribed drugs for depression and schizophrenia, according to the lawsuit.

Robin Pedersen Craft sued Cullinan in July, claiming that she was deprived lithium while being held in the Lee County jail last year. In her lawsuit, Craft says that she didn’t get her lithium after Cullinan told her that she didn’t deserve her drugs. When jailers finally started giving her lithium after six days in custody, she began vomiting, urinating on herself and eating her own feces. Nonetheless, Cullinan did not examine her again or otherwise monitor her before she was taken to a hospital after a week of obvious medical distress, according to the lawsuit. She was diagnosed with renal failure and lithium toxicity, according to court documents.

Also in July, the family of Dale Dakota sued Cullinan alleging that the doctor’s poor care caused Dakota’s death in a Michigan jail in 2011. Dakota had a history of heart problems and was acting weak and lethargic. He had a rash down his neck, and an eye was swollen. When jailers called Cullinan, he told them to keep an eye on Dakota and call back the next day. Three hours later, jailers again called Cullinan to report that Dakota had fallen and hit his head. He could not stand or grasp anything.

“Dr. Cullinan did not believe that Mr. Dakota’s medication would cause such a reaction and he stated that Mr. Dakota was acting up,” lawyers for Dakota’s family wrote in the lawsuit.

Once again, Cullinan told jailers to keep an eye on Dakota but otherwise ordered no treatment, according to the lawsuit. Two hours later, jailers called Cullinan for a third time, reporting that blood from an unknown source was smeared on the walls of Dakota’s cell. Still, Cullinan did not send Dakota to a hospital and he ultimately died. In court papers, the plaintiff says that delay in treatment led to the death of Dakota, who suffered from an intercranial hematoma, sepsis and an inflammation to the lining of his heart.

Cullinan’s legal history dates to at least 2004, when Anthony Snyder, a 36-year-old  inmate at a southern Illinois jail, died from pneumonia, a death that the coroner in the case said was “100 percent preventable.”  In the subsequent lawsuit, which was settled with terms confidential, Snyder’s family said that Cullinan told an incoherent Snyder that he was faking symptoms on the same day he was rushed to a hospital.

Deaths and lawsuits and settlements have had no effect on Cullinan’s ability to practice medicine. What the public is allowed to know about doctors varies between states, and websites of licensing bodies in most states where Cullinan is licensed contain no mention of lawsuit settlements and discipline that was invoked in Illinois and Michigan.

States are supposed to be informed of settlements and discipline regardless of jurisdiction via the Federation of State Medical Boards. However, the public isn’t granted access to the federation’s database. In Cullinan’s case, what the public is allowed to know isn’t necessarily the full picture. The federation, which charges $9.95 for a disciplinary report, says that Illinois fined and reprimanded Cullinan in August for “conduct likely to deceive or defraud or harm the public.” In fact, Cullinan’s failure to treat a fractured ankle resulted in Waggener, a sex offender, losing his lower leg and collecting a six-figure settlement.

Why is Cullinan still allowed to practice medicine in Illinois?

“I’m not going to answer that question,” says Sue Hofer, spokeswoman for the Department of Financial and Professional Regulation. “We do not discuss individual cases.”

In Waggener’s case, the matter was resolved through an “informal conference.” According to the consent order, Cullinan and state regulators talked about Waggener’s treatment and Cullinan “provided information regarding changes in his clinical practice and his plans for the future.” Hofer said that the department can provide no further details. Malpractice settlements and deaths do not necessarily trigger discipline, she said.

“If a state takes disciplinary action we will take similar action,” Hofer said. “If we have a physician and a complaint is filed with us, we of course can take action to investigate to determine if there was a violation of the act. Even if a patient dies, that may not be a result of something that the doctor could have done differently. There are risks in treating patients.”

Roger Clayton, a Peoria attorney who represented Cullinan at the informal conference, confirmed that he is representing the doctor in the state investigation into the death of Burris from a perforated ulcer. He declined any further comment.

Burris has been dead for nearly five years. Hofer could not say how long the investigation might take.

“Every case takes its own time,” Hofer said. 

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