Psychiatrist Mark Kosins placed on 36 months probation for negligence; patient ended up in ICU

May 22, 2009

The Medical Board of California revoked psychiatrist Mark S. Kosins’ license for unprofessional conduct including gross negligence, repeated negligent acts, incompetence and the commission of acts of dishonest or corruption substantially related to the practice of medicine.  The revocation was stayed and he was placed on 35 months probation with conditions.  The Board’s document states that Kosins “committed gross negligence” in his treatment of a 68-year-patient suffering from depression in that he prescribed multiple drugs known to increase the risk of crisis in persons with high blood pressure and abnormal heart muscle activity—both of which this patient suffered from.  Additionally, he failed to provide written informed consent to the patient about the possible interactions and/or consequences of taking a number of these drugs—including multiple antidepressants and a stimulant—concurrently.  These failures resulted in the patient being incubated in intensive care on mechanical ventilation, due to symptoms considered to be a result of interactions between drugs prescribed by Kosins, resulting in serotonin syndrome (a rare but potentially fatal complication of taking SSRI antidepressants alone or in combination with other antidepressants).  Conditions of Kosins’ probation include successful completion of a prescribing practices course, a medical record keeping course and a clinical assessment and training program, among other things.  In 1986, Kosins was placed on a stayed suspension by the California Medical Board for failing to file a report for bizarre behavior by a psychologist over whom he had some business control.  This behavior involved questionable contact with several teenage boys who, among other things, the psychologist had sit on his lap during therapy sessions.