Psychiatrist James M. Gilbert, Prescribing Tied to Three Overdose Deaths

August 20, 2018

On July 24, 2018 the Oklahoma State Board of Medical Licensure issued a complaint against psychiatrist James M. Gilbert.

The Board opened its investigation of Dr. Gilbert based on a report it received from another medical practitioner who reported that a patient arrived for an appointment in an impaired state: disheveled, having difficulty walking, and with slurred speech. The practitioner checked the PMP and found that the patient was receiving prescriptions for multiple controlled substances from Dr. Gilbert.

A subpoena was issued to Dr. Gilbert for nine patient files. The Board obtained them had them reviewed by an expert. Subsequently, the Board’s investigator received Medical Examiner reports on three overdose deaths associated with Dr. Gilbert. The Board also sent these for expert review.

The expert found the following trends throughout the records obtained: lack of documentation of safety assessments for suicide risk; lack of documentation to support the drugs prescribed; repeated incidents of lost medications, requests for early refills, and DUI arrests which were ignored or addressed in a superficial manner; lack of treatment plans, no consistent mental status exams, and failures to response to adverse effects of prescribed medications; very large amounts of pain management controlled substances and opioids being prescribed in both number and dosage amount prescribed by a psychiatrist, rather than management specialist; frequent failure to document informed consent and little evidence of tapering patients off drugs when the desired effect was not achieved; and little to no use of urine drug screens even when dosages were very high or there was evidence of diversion or abuse.

The aforementioned Medical Examiner’s reports listed the probable causes of death: patient M.T.C., combined drug toxicity; patient C.T.C., methadone toxicity; and patient R.F.C., mixed drug toxicity.

The Board has charged Dr. Gilbert with indiscriminate or excessive prescribing or controlled or narcotic drugs; prescribing, dispensing, or administering of controlled substances in excess of the amount considered good medical practice; and prescribing or administering a drug or treatment without sufficient examination and the establishment of a valid physician-patient relationship, among other things.

From 1999 to 2013, psychiatric drug prescriptions increased 117%, resulting in a 240% increase in death rates.

Source: State of Oklahoma, ex rel. Oklahoma State Board of Medical Licensure v. James Melvin Gilbert, M.D., license no. MD 9487, Verified Complaint, Case No. 17-02-5429, Filed July 24, 2018.