ROCKINGHAM, N.C. (WBTV) – James McKeithan didn’t realize his brother Charles was hooked on prescription opioid pills until months before his death.
Charles McKeithan had been on a long-term dose of powerful opioids, including hydrocodone, since at least 2012. He had a bad fall working as a supervisor for the railroad and badly hurt his back and foot.
By 2016, James McKeithan said, he was worried about his brother.
“As the year went on, I’d see more and more of it. He was taking it by the hand full,” James McKeithan said of Charles' use of prescription opioid pills. “I begged him and begged him and begged him ‘Charles, you’ve got to get off this stuff.’ But it was too late. He was hooked on it too bad.”
Charles McKeithan died in October 2016. The cause of death listed on his death certificate is heart failure.
There’s nothing linking his death to years of opioid use.
In fact, there’s relatively little in his medical records at all, according to a WBTV review of Charles McKeithans' that his brother obtained from the hospital system that now owns Charles' former doctor’s practice.
The medical and pharmacy records do show that Charles was prescribed thousands of prescription opioid pills by Dr. Fred McQueen, a doctor in Hamlet.
According to the records, Charles would visit the office once every other month. There’s not much in the records about the visits. James McKeithan said that’s because they weren’t substantive.
“Bring him up here, he’d walk in there, sign the register, they’d hand him the drug and go home,” James McKeithan said of his brother’s visits to get his prescription refilled.
McQueen entered into a consent order with the N.C. Medical Board in 2018 over his failure to properly monitor patients to whom he was prescribing opioids, among other things, the board’s records show.
The order, entered in December 2018, came as the result of an audit of five patient records.
According to the order, the board found that three of the five patients were “not treated appropriately for chronic paid, and appropriate pharmacovigilance was not employed while treating the patients.”
The audit also found McQueen kept inadequate records for all five patients, among other findings, according to the board documents.
But, ultimately, the board issued McQueen a public letter of concern and allowed him to continue practicing, provided he followed the screening and monitoring protocols of the health system that bought his practice and that he attend continuing education.
Under the terms of the consent order, McQueen is also subject to continued monitoring and review by the board but records of that ongoing monitoring are not public, a board spokeswoman said. There is no public record showing how or whether McQueen has upheld the terms of the order.
James McKeithan filed his complaint with the medical board at the suggestion of a special agent with the N.C. State Bureau of Investigation, who investigated Charles' death but ultimately determined there was not enough evidence for criminal charges.
The medical board wrote McKeithan back that they wouldn’t investigate McKeithan’s complaint because of the 2018 consent order.
“The issues noted in your complaint were resolved via a December 2018 Consent Order for matters previously reviewed by the Board,” they wrote.
But the SBI agent that investigated McKeithan’s case confirmed the board did not review Charles McKeithan’s medical records.
It remains unclear why the medical board would not examine Charles McKeithan’s medical record to determine whether the issues were similar to what they found in the previous five-patient audit of McQueen’s patients.
“They wouldn’t even give me an interview,” James McKeithan said. “You know, I tried to explain it to them and they said ‘well, we already disciplined him.’ Already disciplined him.”
Jean Brinkley, a spokeswoman for the medical board, declined to be interviewed for this story but sent an emailed statement.
“It’s just been the Board’s experience that five cases is generally enough to give insight into practice patterns and overall safety of care. In a case where the primary concern is treatment of chronic pain, the Board would select a representative sample of chronic pain patients to give insight into the licensee’s management of chronic pain,” Brinkley said. “In the case you are interested in, all five of the cases came back below accepted standards of care. When this is the case, there generally is no imperative to continue confirming substandard practice with the addition of additional patient records.”
“The Board does not have any evidence of additional substandard practice or unprofessional conduct.”
McQueen, through a spokesperson, declined to comment.
James McKeithan said he will continue pushing for more oversight from the medical board.
“I found out the medical board is just a board. Nobody monitors them and they’re supposed to monitor doctors when they have problems with them,” he said.