Disgraced, Dishonest Los Angeles Psychiatrist William T. Vicary Surrenders Medical License

July 10, 2019

On June 30 2019, Los Angeles psychiatrist William T. Vicary, surrendered his medical license to the Medical Board of California.   

According the Board’s Order, Dr. Vicary committed gross negligence and excessive prescribing in his treatment of seven patients and committed repeated negligent acts, prescribing without an appropriate exam, and inadequate record keeping for the same seven patients plus an eighth.     

The Order contains 11 pages of details about Vicary’s treatment, including the following:

• Vicary met with Patient “G.I.”, a male undercover officer, in April 2015. Though the visit was for approximately 11 minutes, Vicary wrote in his chart that he spent 30 minutes with the patient. G.I. reported that he had borrowed Adderall from a friend in the past and confirmed that he would be taking Adderall to help him study. Vicary prescribed Adderall and G.I. paid $200 cash for the visit.” 

         The Order states that at no point did Vicary obtain a meaningful medical history, check the patient’s vital signs, or possible substance abuse history, despite the patient admitting to him that he’d obtained the drug illegally for non-medical reasons.   

• Patient “E.S.” was a female undercover officer who was first seen by Vicary on June 5, 2015. E.S. told him she was taking Xanax 2 mg. a day and Ambien 10 mg every night, and had recently moved from Las Vegas. E.S. reported that the medications were ‘to balance her out’ but she did not describe any symptoms that needed balancing, nor did Vicary inquire. E.S. gave Vicary the name of a doctor who had allegedly been prescribing to her but he never obtained a release of information from her in order to verify her history and treatment. He never stated that he would not prescribe to her without verification of an ongoing need and prior treatment. He diagnosed her with “stress/anxiety and insomnia” and prescribed the two drugs to her. 

         E.S.’s last visit to Vicary was July 30, 2015. The meeting lasted seven minutes but Vicary’s notes state it was 30 minutes. Vicary did not obtain any information to justify continuing to prescribed Ambien and Xanax to E.S. nor did he inquire about adverse effects. He wrote prescriptions for the two drugs, doubling the Ambien supply from 30 to 60 tablets. 

• Patient “T.Z.” was an undercover officer who was seen by Vicary on June 11, 2015. T.Z. reported that he used to take Adderall to stay up at night for his work. He asked Vicary for Adderall so he could stay up at night. Vicary did not take any history or vitals, but diagnosed T.Z. with ‘excessive daytime sleepiness’ [and] prescribed Adderall 20 mg. #60. 

• Patient “M.L.” was another male undercover officer that was seen by Vicary on December 18, 2015. M.L., who reported his age as 61, reported consuming 10 alcoholic drinks per week and using drugs “socially.” M.L. requested medication to help him stay up at night and also reported taking a friend’s Adderall.

         Despite M.L.’s reported age, Vicary failed to obtain a meaningful cardiovascular history or perform an EKG and, with no medical records, diagnosed M.L. with “shift work fatique” and prescribed Adderall with no compelling medical reason to do so. 

         Vicary additionally did not inquire about M.L.’s substance abuse history, despite the information of excessive alcohol use and social drug use M.L. had written on the patient history form.

• Patient “S.K.” was a 50-year-old male who began treating with Vicary about 2004 and who died on November 30, 2014 from an accidental overdose. Vicary received letters from S.K.’s medical insurance companies on many occasions stating that S.K. was receiving a large number of prescriptions from multiple providers. Vicary began prescribing dangerous controlled substances before ever recording a single patient visit and acknowledged he was seeing S.K. informally and prescribing controlled substances without doing an examination and obtaining a history. 

• “I.V.” was a long-time patient who first began treating with Vicary in 1988 when she was thirty-three years old, for problems with anger and acting out. It is not clear how he arrived at a diagnosis of anxiety and depression, as his recorded history for I.V. is minimal. In September 1992, he began prescribing I.V. lithium without ordering premedication lab studies. (Lithium can be toxic in higher dosage; its prescribing requires continual monitoring of liver function.) Over the years, Vickery continued to prescribe I.V. combinations of the antidepressant Prozac, lithium, and the antidepressant Elavil, as well as other controlled substances, such as the tranquilizer Ambien, the benzodiazepine Klonopin, the stimulant Ritalin, and the painkiller Vicodin.   

         Vicary saw I.V. on April 15, 2011, at which time he added a diagnosis of musculoskeletal pain. He continued the prescription for Vicodin, with no quantity noted and also prescribed the antidepressant Zoloft daily, the antipsychotic Geodon at bedtime, the anti-epilepic drug Neurontin at bedtime, Elavil at bedtime, the antipsychotic Seroquel at bedtime, and Klonopin during the day and at bedtime.  

The Board’s Order enumerates the ways in which Vicary violated the standard of care in his treatment of the eight patients, including:

• “Prescribed medications with a high potential for abuse without a good faith examination and medical need…”

• “Failed to take a valid history and diagnose a medical condition for the controlled substances were provided.” 

• “Failed to warn the patient about the dangers of chronic amphetamine use, including driving while under the influence.” 

• “Record keeping failed to identify the controlled substances prescribed, quantities, or refills, justifications for medications, and/or reasoning behind starting, stopping, or increasing medication.” 

• “Failed to coordinate lethal amounts of medications with other prescribers of lethal amounts of medications.” 

• “Failed to obtain information to support his diagnoses and treatment.”  

• “Prescribed lithium without any monitoring."

• “Prescribed opioid medications without any history or examination of alleged injury of site of pain.” 

• “Did not provide to the patient the black box warning for Adderall regarding sudden death.” 

• “Failed to record the number of…pills or the number of refills prescribed.”  

• “Failed to provide suggestions regarding non-pharmacological treatments of chronic pain or insomnia.”  

Pattern of negligence

On June 29, 2012, the Board placed Vicary on 35 months’ probation, stemming from similar allegations regarding a patient identified as “L.C.”

Vicary had worked with L.C. at a clinical counseling center. In 2002, L.C. approached him for help with personal issues. Vicary initially provided advice and medication to L.C. as a courtesy and later began accepting payment for services. An undated note refers to L.C. having symptoms of depression, anxiety, and insomnia. Vicary’s chart contains only 32 progress notes for L.C. over an eight-year period.

Vicary never obtained a patient history nor did he conducted an initial physical examination or subsequent examinations before repeatedly prescribing dangerous drugs.

Further, he did not document L.C.’s complaints, his objective vital and symptomatic signs, or his treatment of prescriptions.

Around 2007, Vicary began serving as a supervisor for L.C. in L.C.’s work as a psychological assistant. He failed to separate his roles as L.C.’s supervisor and his treating psychiatrist.  

Disgraced forensic psychiatrist

On April 10, 1998, the Board placed Vicary’s license on probation for three years for gross negligence, falsifying medical documentation, and dishonesty, relative to his conduct as a defense expert in high-profile murder trial.

On May 1990, Vicary was a Beverly Hills psychiatrist specializing in forensic psychiatry. He had, at that time, who had at that time performed psychiatric evaluations in approximately 1,000 homicide cases and testified in approximately 100 homicide cases. 

In May 1990, Vicary was engaged by defense attorney Leslie Abramson, to serve as both treating and forensic psychiatrist for her client, Erik Menendez, who with his brother Lyle, had been accused of murdering their parents. They were tried twice, the first trial ending in a hung jury. At the second trial, both brothers were convicted and sentenced to life in prison without the possibility of parole.  

In November 1993, shortly before Vicary’s testimony in the first trial he and Abramson met and reviewed his interview notes page by page. Abramson became upset by what she perceived as information potentially damaging to her client’s defense. 

Vicary rewrote approximately 10 pages of his clinical notes, deleting the passages which Abramson objected to.

“He rewrote this notes in such a way that they closely resembled the original notes and would not appear suspicious,” the Board’s 1998 Order states. “His purpose in rewriting the notes was twofold: first, to conceal or destroy statements made by Erik Menendez that were contained in the original notes and, second, to conceal the fact that the original notes had been rewritten.”

After he’d rewritten the notes, he destroyed the originals. 

The change might never have been detected except that in April 1996, during the penalty phase of the second trial, Abramson inadvertently provided Dr. Park Dietz, the prosecution’s psychiatric expert a copy of the original notes. When Dietz was done with them, he provided them to the prosecuting attorney, who compared them to the edited notes which were originally provided, and found that they had been altered.

Source: Decision in the Matter of the Accusation Against William Tice Vicary, M.D., Physician’s and Surgeon’s Certificate No. G 30952, Case No. 800-2014-009420, Medical Board of California, March 6, 2019; Accusation (Vicary, Case No. 02-2008-194534, Medical Board of CA), September 1, 2011; and Decision and Order (Vicary, Case No. 17-96-62136, Medical Board of CA), March 11, 1998.