There is a medical condition called pseudobulbar affect, or PBA. It’s technically a rare nervous system disorder that causes people to laugh and/or cry uncontrollably. The Mayo Clinic says it is often brought on by brain injuries or strokes, or by neurological diseases, like Alzheimer’s or Parkinson’s. There are only about 200,000 cases a year.
Nuedexta, manufactured by Avanir Pharmaceuticals, is supposed to be used in the treatment of PBA. However, a CNN investigation found “repeated examples where state regulators discovered doctors had prescribed Nuedexta to dementia patients, purportedly for PBA, when it was actually being used to control unruly behaviors.” About 500 or so doctors collected speakers’ fees for promoting the drug – a common practice in the pharmaceutical industry. However, in this case, at least a dozen of the top paid speakers have been disciplined by their state medical boards for “the harmful treatment of nursing home residents and ‘grossly negligent acts’ involving the inappropriate prescribing of dangerous and addictive drugs – resulting in probation, suspension, fines and revoked licenses.”
Avanir Pharmaceuticals paid problem doctors – doctors who had their licenses revoked, who had criminal convictions– almost $14 million dollars to promote a drug for an off-label use that led to the abuse and neglect of elderly nursing home residents.
This is not an isolated incident in the pharmaceutical industry
We wish we could say that Avanir was a rogue company, but it would be a lie. Earlier this year, John Kapoor, the CEO of Insys Pharmaceuticals, was indicted for a bribery and kickback scheme involving doctors and pharmacists around the country. Briefly, Insys paid doctors to prescribe their fentanyl spray, Subsys, to treat chronic pain. As a result, dozens of people sustained injuries, and at least one death has been attributed to the drug. The numbers are not fully in as to how many people became addicted to the opioid drug as a result of prolonged use.
In 2015, Daiichi Sankyo agreed to pay “$39 million to the U.S. government and state Medicaid programs to settle claims it paid doctors kickbacks to prescribe its drugs.” The company manufactures Benicar, a hypertension drug that can cause gastro-intestinal problems such as sprue-like enteropathy, a condition which mimics Celiac disease. GlaxoSmithKline and Teva Pharmaceutical Industries have also settled cases regarding kickbacks and bribery; in fact, it led to GSK to stop the practice of paying speakers’ fees altogether.
Chemically restraining nursing home residents is a common form of abuse
Using Nuedexta as a means of control is a form of nursing home abuse. For years, nursing homes throughout the country have gotten away with using antipsychotics as a means to control dementia patients, despite the increased “risk for heart failure, infections and death” when such drugs are used improperly. Using a drug for an off-label use – whether it is Nuedexta or something else – is dangerous.
You should know that under the Nursing Home Reform Act of 1987, chemical restraints can only be used in the context of protecting a resident from doing harm to him or herself, or another resident. The type of restraint must be approved and monitored by a doctor. Failure to comply with these guidelines puts the facility in violation of federal law. The practice of using chemical restraints is also prohibited in Arizona. Per the Arizona Department of Health Services, nursing home residents have the right to “Be free from chemical and physical restraints that are not used to treat medical symptoms but for the purpose of discipline or staff convenience.”
At Plattner Verderame, P.C., we protect the rights of nursing home residents who have been neglected or abused. If you have questions about our services, or need to speak with one of our lawyers in Phoenix, please call 602-783-8793, or contact us to schedule a free consultation.