Duggal hearing moved to January; doctor maintains his innocence

POULSBO — Dr. Narinder Duggal, accused of medical misconduct, again denied all wrongdoing in a recent Amended Statement of Charges against him.

Duggal is suspended from practicing as a physician until the charges are resolved. His hearing, similar to a trial, before the state Medical Quality Assurance Commission is scheduled to begin Jan. 27 and will take several days.

Messages left at Duggal’s practice and at Duggal’s attorney’s office were not returned. The message at Duggal’s office states it is open to assist in transferring medical records to other doctors.

The state Medical Quality Assurance Commission filed an amended statement in May and suspended Duggal’s license May 2, alleging there was a risk of harm to the public, according to the documents. He was first charged in November 2012.

The charges allege Duggal failed to properly examine patients, overprescribed medication and made sexual advances toward patients. He allegedly failed to research his patients’ medical histories and/or document their history.

Duggal’s practice offers pain management and outpatient drug rehabilitation.

One patient, labeled Patient H, was diagnosed with metastatic ovarian cancer after seeing another doctor. The charges allege Duggal “ignored drug toxicology screen results,” and his electronic medical record-keeping was “virtually impossible to track the patient’s physical condition and progress.”

Patient H, who identified herself as Sara, is a 72-year-old woman from Port Orchard. She first went to Duggal’s practice for headaches after her physician retired in 2009. Sara said when she saw Duggal he wasn't rude, but "wasn't a good one to answer questions."

In late 2011, she began experiencing stomach pain. Sara said Duggal began prescribing her medication to treat an ulcer and ordered an X-ray, but never followed up with her about the results. She said she experienced stomach pain for three or four months until her daughter insisted she go to the emergency room. The doctors at St. Anthony’s in Gig Harbor gave her more tests, and referred her to an oncologist. She said they found cancer cells in her stomach that had originated in her ovaries. She’s had a few rounds of chemotherapy, surgery, and still requires use of an oxygen tank.

In the time she was experiencing stomach pain, Sara said she lost 75 pounds and her weight dropped to 105.

“He had to see that I was losing all this weight, [and] he never said nothing,” Sara said.

Sara is considering filing a civil suit, but needs to find a lawyer who will take on her case, she said.

“I want to see him lose his license, I want to see him pay for my cancer,” Sara said. “If I’d been to a doctor that was paying attention, I wouldn’t be in this situation.”

Kenneth, identified as Patient E in the charges, said he was a drug addict and started seeing Duggal to treat his addiction in 2009. Duggal was licensed to prescribe Suboxone, an opioid dependence medication.

“Suboxone seemed like the drug everyone was talking about, like a miracle drug [that stopped] people from relapsing,” Kenneth, a Bremerton resident, said.

“He seemed like, honestly, like a pretty nice guy at first. He just seemed like one of those doctors who was quick.”

Kenneth said Duggal didn’t examine him but would do a urinalysis and then give Kenneth his prescription.

“In and out, bang-bang,” Kenneth said.

Kenneth admitted to being an addict, and when he hurt his foot on the job at the Puget Sound Naval Shipyard, he was given Vicodin at work. When Kenneth went to see Duggal, he was given another prescription of Percocet, which is a narcotic pain reliever.

“He didn’t check my foot, examine it, he didn’t touch me, he just took my word for it,” Kenneth said. “I kept going to see him. Every appointment I kept saying my foot still hurts, he’d just keep refiling my Percocet.”

“It’s obvious to everybody and their mother that I was strung out on these pills, I was abusing them. The doctor didn’t seem to care.”

Kenneth stopped seeing Duggal in 2010. By then, he was being prescribed seven 40 milligram-pills of oxycodone a day, plus Ativan and Adderall Duggal had prescribed. Kenneth’s father, also a physician, was shocked when he found out the amount of pain medication his son was on. He said that amount of pain killers should be given to people who are terminally ill or are severe burn patients.

“The reason I complained is because he was well known in the community of people that I hung out with, traded pills with, that he was an easy doctor to get prescriptions from, he’d get you whatever you wanted,” Kenneth said.

Kenneth said he lost his house, his job, and contact with the mother of his daughter.

Kenneth has been clean since May 6, 2012 and is seeing another doctor.

“[Duggal] overprescribes patients,” he said. “Pill addiction is very, very dangerous in a lot of young people’s lives today. I just don’t want what happen to me to happen to other people.”

Karen Laberge’s mother was a patient of Duggal’s, and she said Duggal took advantage of her mother’s addictive personality. She said he overprescribed and overcharged her for services, turning her mother into a “zombie.”

Laberge has filed a complaint with the medical commission, but has not been contacted.

Laberge’s mother, Sadie, turns 80 this year and was treated by Duggal for about 10 years. Laberge said her mother has had several surgeries — stomach, shoulder and knee, among them — and went to Duggal for her post-op pain management.

Laberge said she became concerned when she saw the amount of pain medication her mother was taking. She once found a cache of empty pain medication bottles in her mother’s house, and saw four empty Darvocet (an opioid analgesic medication) bottles prescribed in one month. Duggal was also prescribing her Suboxone, the opioid withdrawal medication, at the same time. Laberge confronted Duggal about this, where he allegedly replied, “I know what I’m doing.”

Laberge said she wasn’t allowed at her mother’s appointments after that. She said she has been sent bills for unpaid services, despite her mother’s triple insurance (TRICARE, teacher’s pension and Medicare). Laberge said she was also charged for psychiatric care, despite Duggal not having a psychiatric degree. She said she also found Canadian prescriptions in her mother’s house, for which she said her mother would pay Duggal cash.

Laberge said her mother was a zombie. “I was losing her, I could just tell, her sanity,” she said.

Laberge said she tried several times to get her mother to another doctor, but Sadie would keep returning to Duggal; Laberge said it was because Duggal did not properly monitor Sadie’s narcotic intake.

“From the outside looking in, what I saw what it was doing to my family, that’s what scared me the most,” Laberge said.

“To know you’ll be cut off [from pain meds] is scary for patients, so I think he really abused the elderly for that reason,” she said.

She is considering filing a civil suit against Duggal.

Duggal does have patients who believe he provides a good service. Larry Berg, staff attorney with the medical commission, said the office has received approximately 19 letters of support, which go in his file and may be introduced as evidence.

Janna Hedrick of Lakewood said she had been seeing Duggal for about seven months before his practice closed during the investigation. She was referred to his office by one of his medical assistants, and was told Duggal was a good doctor for pain management. She said she never had any problem with Duggal; he would ask her questions, like how she was feeling, and if she felt anything had changed since their last visit.

“I hope he beats the charges against him,” she said. “It’s hard finding a decent doctor out there.”

A Statement of Charges means the state Department of Health believes there is enough evidence to warrant a hearing. When a complaint regarding a healthcare provider is received, it is reviewed to decide if the incident is a violation of the law, if the public needs protection, and if the Health Department has legal authority to take action, according to the department’s website. If the department determines the allegation might be a violation, and there is legal authority to take action, then it conducts an investigation.

The first complaint was filed on July 22, 2010 and authorized for investigation a week later. The amended statement includes eight different patients with allegations. Berg said there are other cases still being investigated.



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