Washington state psychiatrist restricted for excessive prescribing; cited for same in 2006

July 15, 2008

The Washington State Department of Health issued an Ex Parte Order of Summary Restriction on psychiatrist Patrick K. Chau. The Department’s Medical Quality Assurance Commission concluded that Dr. Chau presents an immediate danger to the public health, safety or welfare if allowed to continue to practice unrestricted and thus ordered that he is restricted from prescribing benzodiazepines, thyroid medications or stimulant drugs. The Department’s Findings of Fact states that in April 2007, Dr. Chau prescribed to a patient the benzodiazepine Xanax at a “highly addictive” dose; prescribed “an unduly high starting dose” of the amphetamine drug Adderall and “an extremely high, potentially toxic” dose of a hormone supplement, demonstrating treatment below the standard of care. The patient in question developed symptoms of hyperthyroidism including “bugged out” eyes but Dr. Chau dismissed these as unrelated to the medications and doses he’d prescribed. Shortly thereafter, the patient’s symptoms worsened to include severe nausea, vomiting, confusion, difficulty breathing, profuse sweating and racing heartbeat. The patient called Dr. Chau to advise that she was going to the hospital but Dr. Chau dissuaded her, instructing her to discontinue one of the drugs he’d prescribed. This did not correct her condition. Though Dr. Chau insisted her symptoms could not be due to the drugs and doses he’d prescribed, the patient went to the emergency room some days later, where she was diagnosed with hyperthyroidism (excessively high thyroid activity) and iatrogenic (caused by the practitioner) thyrotoxicosis (a disease condition due to overactive thyroid). Dr. Chau has continued to refuse to acknowledge that the patient suffered from hypothyroidism or that the condition was caused by his over prescribing of hormone supplement. The Department’s Order states that Dr. Chau’s “prescribing practices reflect a fundamental lack of understanding of appropriate polypharmaceutical practices (use or prescribing of multiple psychoactive drugs).” Dr. Chau was disciplined in September 2006, for violating the standard of care by excessively dosing five patients with thyroid supplement and Adderall. He was ordered at that time to “institute and continuously implement appropriate prescribing practices for…thyroid medications.” The Department’s current investigation found he had failed to do this with the above-mentioned patient, as well as other patients, according to pharmacy profiles reviewed by the Commission.¹