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'Disturbing pattern.' Medical board restricts prescribing by Lexington doctor.

Lexington Herald-Leader - 11/19/2021

Nov. 19—A state medical board has barred a Lexington doctor from prescribing drugs after a consultant found shortcomings in her practice.

The consultant said Dr. Carolyn V. Smith had not done adequate examinations in some cases before prescribing powerful painkillers for patients and that she prescribed high quantities of drugs with little or no monitoring to see if people were misusing them.

"There is a disturbing pattern that emerges in reviewing these charts," the consultant said in a report to the KentuckyBoard of Medical Licensure.

The board issued an emergency order Wednesday restricting Smith from prescribing or dispensing controlled substances.

The order said attempts to locate Smith to respond to the consultant's report were unsuccessful, and that on Nov. 15 her office on Eastway Drive in Lexington appeared to be unoccupied.

A woman who answered the telephone Thursday at a number listed for Smith's practice with the licensure board said Smith was working but unavailable. Smith did not return the call.

State records say Smith was licensed to practice in Kentucky in 1995, spending time at Fort Knox and the University of Louisville. Her specialty is urology.

The Kentucky Cabinet for Health and Family Services received an anonymous complaint in April 2020 with concerns about her prescribing.

An initial review identified potential problems, including that Smith "far exceeded" the average amount of opioid pain drugs prescribed by similar doctors, as well as statewide.

The board asked a consultant to review files on a small sample of Smith's patients.

Smith told the board she followed all guidelines and that it had been her habit to reduce the use of controlled substances to a minimum, and to use alternate medications when possible.

Smith said many of her patients would say they couldn't continue providing for their families without help to deal with painful, longstanding physical conditions.

However, the consultant to the licensure board raised a number of concerns about Smith.

They included that Smith's work to take patient histories was inadequate in some cases; that she hadn't used imaging tests to diagnose patients' conditions; that she hadn't referred patients to other specialists who might be able to help; that she had prescribed combinations of drugs that could be dangerous; and that there was no evidence Smith had used drug screens to try to make sure patients were not misusing the drugs.

Smith seemed to have a mentality "to enable these patients of their continued dependence of these potent drugs," the consultant wrote.

The drugs Smith was prescribing were highly addictive and likely to be sold or abused, the consultant said.

The consultant said Smith's work had fallen short of acceptable practices in Kentucky and represented a danger to patients and the public.

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