San Franscisco psychiatrist Karin Hastik placed on probation for numerous departures from standard of care
June 14, 2010
On May 19, 2010, the Medical Board of California revoked psychiatrist Karen L. Hastik’s license for Gross Negligence/Repeated Negligence, Prescribing without Prior Examination/Medical Indication and Inadequate Medical Records. Revocation however was stayed and she was placed on probation for five years with numerous terms and conditions.
Hastik began treating “D.L.,” a 43-year-old female patient, in March 2000 for purposes of medication management but kept no medication log for the patient. Hastik took the patient off of two drugs she was on and started instead on Paxil (an antidepressant) and Valium (tranquilizer) without consulting D.L.’s previous psychiatrist concerning her response to the prior treatment regimen.
Hastik maintained D.L. on this combination for four years, during which she saw the patient about once a year and filled prescriptions or changed dosages through telephone messages or occasional calls. At no time in the four years did she perform any physical examinations or laboratory testing.
Hastik tapered the patient off of Paxil and put her on Celexa but neglected to document a medical rationale for this.
Hastik diagnosed the patient with “cyclothymia” (in label which desribes symptoms similar to what is labeled "bipolar disorder" but milder in intensity) without documenting the basis for such diagnosis; Hastik neglected to consult the patient’s family members or primary care physician.
Hastik neglected to conduct physical examinations, testing, proper evaluation or consultation; neglected to conduct an appropriate medical workup, as required prior to initiating lithium treatment; failed monitor lithium levels when treatment was instituted. One week later, the patient began experience severe nausea, vomiting, diarrhea, ataxia, disorientation, tremors, cramping, headaches and suicidal ideation. Hastik never considered that the side effects could have been caused by lithium toxicity.
The terms of probation include the monitoring of her practice by an approved licensed physician or professional enhancement program for the duration of her probation; Hastik must present a copy of the Board’s Decision and Accusation to the Chief of Staff or Chief Executive Officer at every hospital where she has privileges or otherwise practices, as well as to the Chief Executive Officer of any and all malpractice insurance carriers under with which she is covered.
NOTE: While not necessarily applicable to the foregoing, it it interesting to note Hastik received more than $73,000 in funding from pharmaceutical maker Eli Lilly & Co. in 2009 for conducting "educational" programs for healthcare professionals (basically this means making presentations in which she promoted Lilly drugs to other doctors). Such funding data was not disclosed by Lilly until 2009.
Source: Decision In the Matter of the Accusation Against Karin Leslie Hastik, M.D., Physician and Surgeon License No. A 60374, File No. 12-2006-172817, Before the Medical Board of California, April 19, 2010 and Eli Lilly Faculty Registry (disclosure of monies paid to physicians by the company), First-Fourth Quarter 2009, URL: http://www.lillyfacultyregistry.com/Pages/lilly-registry-report.aspx
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