These Pain Clinics Vanished, Leaving Patients Without Medical Records. Now Their Medicine is Running

Lisa Duvall watched in horror as the prescription bottle slipped out of her hand and tiny blue painkillers scattered over her kitchen floor. For 30 minutes, she scoured the floor on her hands and knees, trying not to panic.

Duvall had to find every single pill, but not just because her four dogs would gobble up anything she left on the floor. This medicine was the last of a dwindling supply that dulls the throbbing, burning pain in her spine.

The pills run out in two-and-a-half weeks. Duvall has no idea how to get more.

“Then I won’t be able to do even ordinary things, like grocery shopping, because the pain will be too much,” Duvall said. "I hate to say it, because I don't like taking them, but without them I am not functional to any degree."

Duvall, 63, a retiree who lives outside of Memphis, has for years taken opioid painkillers to treat fibromyalgia and severe arthritis. Until recently, Duvall’s medicine were prescribed by doctors at Comprehensive Pain Specialists, or CPS, a giant Tennessee pain management company with dozens of clinics across eight states.

But CPS abruptly closed its clinics this summer, leaving tens of thousands of patients scrambling for a new source of medication before their prescriptions run out. And for countless patients like Duvall, this search has been almost impossible because CPS never released their medical records, making it unlikely that any other doctor will be comfortable prescribing them more opioids.

CPS recently hired a new company to process medical records from ex-patients, but it is unclear if patients will get their records before many prescriptions run out at the end of this month.

'They just can't do this to people'

Over the past three weeks, The Tennessean has spoken with five former CPS patients who say they have been unable to obtain their medical records since the clinics closed. Together, they describe an impenetrable web of forwarded phone calls, unreturned messages and automated responses, always ending with the same result – no medical records.

The cause of the medical record breakdown, at least in part, is a falling out between CPS and another company hired to process records after the clinics closed. Now, it appears no one is left to help ex-patients.

“In order to go to another pain management clinic – which I have to do – I have to have all my records," Duvall said. "They just can’t do this to people."

Former patients being stranded without medical records is just one of the lingering challenges from the closure of CPS, which shut clinics with little warning to customers or employees on July 31. CPS treated more than 48,000 people a month, and many of those ex-patients are now looking for new prescriptions in a state that has becoming increasingly suspicious of chronic pain patients and opioid prescriptions.

Some pain management experts worry the industry doesn’t have enough capacity to absorb the patients CPS left behind, and desperate patients who can't find a new source of prescription opioids may resort to heroin, which is a similar drug but far more addicting and dangerous.

Additionally, John Davis, the former CPS chief executive officer, is being prosecuted for allegations of health care fraud. Federal officials are also conducting a separate, civil investigation into the company’s financial operations.

But neither of these investigations will have as much immediate impact as inaccessible medical records, which will cut off medicine to some former CPS patients. One of those patients is Gina Brown, 54, who lives in rural Tennessee, and uses opioid painkillers to manage lingering pain from a crushed pelvis suffered in a car accident decades ago.

Brown said she first learned her CPS clinic was closing through a news report in mid-July. She filed paperwork asking for her medical records before the clinics closed later that month. Since then, she has received no records and the company hasn't returned her calls.

Brown's medication runs out at the end of the month. To stretch the prescription, she has begun cutting the pills in half.

“I have a 95-year-old grandmother and a 75-year-old mother who I help take care of, and this has put so much pressure on me that it is almost unbearable sometimes," Brown said. "(CPS) did a terrible thing to their patients by not giving them any advanced notice."

Patients in other states left stranded

The medical record problem reaches beyond Tennessee, too. Melissa Robinson, 43, who formerly worked at a CPS clinic in the small town of McComb, Mississippi, said she has talked with several former patients who have been unable to obtain new prescriptions. She has also been called by three local doctors who want to treat an ex-patient but can't obtain their records.

“We were the only full-time pain management clinic in McComb,” Robinson said. “You either have to go 70 miles one way or 70 miles another way to get to another one in a bigger city, and a lot of places are already filled up ... so it’s a big deal that doctors around here can’t get records from our clinic.”

Some former CPS patients, including Duvall, were told their requests for medical records were automatically forwarded to another company, Data File, that was supposed to release the documents on CPS's behalf.

Duvall said she communicated with Data File about her medical records for several weeks before the company said in late-August that it was no longer working with CPS. Data File gave her a phone number for the CPS legal department, but no one has answered her calls. All voicemail boxes are full.

“They didn’t say a lot about what was happening,” Duvall said, describing her final phone call with Data File. “But they were pretty upfront about us being stuck in the middle.”

Data File was hired by CPS earlier this year to ensure that someone would handle patients records "after CPS was gone," so any falling out between the two companies will be devastating to ex-patients stuck in limbo, a former CPS official said, speaking on the condition of anonymity to discuss internal company operations.

The official did not know why Data File was no longer working with CPS.

He said it was no surprise that record requests sent to the CPS legal department were left unanswered because the lawyer no longer works there.

“The legal department no longer exists,” the official said with a heavy sigh. "This situation sure has screwed a bunch of people.”

CPS did not respond to multiple requests for comment for this story. Dr. Peter Kroll, currently CEO of the company, did not respond to messages left at his home. State Sen. Steve Dickerson, a founder of the company, also did not respond to requests for comment. Data File, based in Kansas City, declined to comment.

On Thursday, CPS replaced its website with a web portal designed exclusively for ex-patients to request medical records. Each patient is charged a $25 processing fee, but records are supposed to be provided within seven days.

That web portal is operated by a newly hired company, ABT Medical, which claims it is now processing requests in a matter of hours, said CEO Stephen Manske. Manske said CPS hired ABT after their prior medical records system broke down.

“They turned to us to solve this problem and said, ‘We need something done immediately,’" Manske said. "And we said, ‘Yeah, no kidding.’”

https://www.tennessean.com/story/news/health/2018/09/13/comprehensive-pain-specialists-clinics-medical-records/1225914002/