The Kentucky Board of Medical Licensure launched an investigation Monday into the "prescribing practices" of a doctor at a walk-in pain management clinic on North Broadway in Lexington.
Doug Wilson, an investigator with the board, said the investigation stems from numerous grievances about Lexington Algiatry, a small office tucked into the corner of an L-shaped shopping center directly across from Whitaker Bank Ballpark.
The grievances describe suspected inappropriate prescriptions of controlled substances that were written by Dr. Najam Azmat, Wilson told the Herald-Leader.
Wilson said the complaints came from other physicians who questioned the high number of prescriptions that their patients have received from the clinic. Residents also have complained about the high number of visitors who seem to be from out of the county or from other states, Wilson said.
Azmat did not immediately return messages for comment.
As of Monday, no criminal charges had been filed. It's unclear whether any law enforcement agencies were investigating the pain clinic.
Lexington police spokeswoman Sherelle Roberts said local officers were not investigating Lexington Algiatry, but "we are aware that other law enforcement agencies are investigating so-called pill mills around town, and if the Lexington Division of Police is contacted by these agencies, we'll assist in any way necessary."
Representatives of the regional bureau of the U.S. Drug Enforcement Agency and Kentucky Attorney General's Office declined to comment, citing policies that prevent them from confirming open investigations.
Wilson spent more than an hour at the clinic Monday morning. He emerged with stacks of medical records, which he said would be submitted to a consultant "to see if there is appropriate practice going on here."
If any wrongdoing is found, consequences could range from a letter of reprimand to revocation of Azmat's medical license, Wilson said.
The clinic was operating while Wilson investigated. A Herald-Leader reporter observed license plates from Boyd, Carter, Gallatin, Knox, Laurel and Rowan counties. There also were cars in the parking lot from Ohio and Tennessee.
Most of those cars carried two or three people. Drivers would drop off people at the clinic, then park in the back lot and wait for them to return.
Warren Gold is the only person listed on documents filed with the city. Gold was arrested last year in Tampa, Fla., for operating a clinic that prescribed pain pills without a license, according to documents obtained by the Herald-Leader.
The building, which is shared by hair stylists, a barber, a travel agent and a chiropractor, is owned by Virginia Haynes of Lexington.
Haynes said Lexington Algiatry was leased to Gold, whose address is in Tampa. She said that her husband, Harold Haynes, rented the space to Gold in May, a few weeks before Harold Haynes died.
"They indicated that they were a wellness clinic. My husband thought they were going to do physical therapy, exercise, that sort of thing," Haynes said. "He was not aware of what kind of medicine they were going to practice."
'Up and disappeared'
The Kentucky Board of Medical Licensure began looking into Azmat's prescribing practices earlier this year because of complaints about an abnormally high amount of patient traffic.
Last week, the Herald-Leader observed patients gathering in a breezeway outside and a constant stream of people going in and out of the clinic throughout the day. At one point about lunchtime Thursday, a line extended out the door.
"We have a lot of people walking through our parking lot, and we have had trouble with a lot of people parking in our parking lot," said Nancy Marks, who works at the North Lexington Veterinary Clinic next door.
Neighbors also said they are concerned about the security guards that are present at Lexington Algiatry.
A sign near the front door tells patients to have a copy of an MRI "less than two years old" in hand when coming to see the doctor, and to have three months' pharmacy history and previous physician notes.
Azmat's name appears on patient documents downloaded from the clinic's Web site. But officials at the clinic would not confirm whether he is there.
Lloyd Vest, general counsel for the medical board, said Azmat, whose specialty is vascular surgery, is licensed in Kentucky but had not registered the address of his practice, which is required under the Kentucky Revised Statutes.
Medical board records say Azmat is practicing in Georgia, where he was sued by a former nurse and by the federal government under the Federal False Claims Act.
Azmat and Satilla Regional Medical Center, the hospital where he worked, are listed as defendants in a whistleblower lawsuit filed in 2007 in federal court in Georgia. A former nurse, Lana Rogers, accused the hospital of covering up Azmat's negligence and high morbidity rate, including multiple injuries and one patient who died in his care. The federal government later joined the lawsuit.
Azmat and the hospital have denied those claims.
In 2010, Azmat worked at a short-lived pain clinic called Lebanon Medical Solutions in Lebanon, Ky., according to an article published by the Lebanon Enterprise.
That pain clinic closed just days before police planned to investigate it, Lebanon police Chief Wally Brady said.
"We had a specialized unit that was ... getting ready to do a criminal investigation on them, and they just up and disappeared one night," he said.
Brady said he did not know where the doctor had gone.
'Like an epidemic'
A local business license for Lexington Algiatry was approved on April 1, according to records filed with the Lexington-Fayette Urban County Government, which list Gold as the owner of the business. The application was approved less than four months after Gold was arrested in Tampa, Fla., on charges of operating a pain clinic without a permit, according to documents filed in Hillsborough County Criminal Court. According to articles in the St. Petersburg Times, Gold previously owned the Habana Spine and Medical Clinic in Tampa, from which doctors prescribed pain pills to patients, many of whom were from out of state. Gold operated the clinic without a permit, and authorities shut it down — the same situation he ran into in two other Florida towns, according to the article.
In September, Gold pleaded no contest to the charge in Florida, meaning he did not dispute the facts but did not admit guilt, according to court documents from the Hillsborough County, Fla., clerk of courts. He was sentenced to six months probation and $277 in fines and fees, and he was told he was not allowed to operate a pain management clinic, the records said.
Dale Sisco, the attorney who represented him in that case, said that restriction applied only to Hillsborough County, Fla., and it did not specify about owning clinics in other areas. Sisco said he no longer represents Gold.
A listed number for Gold rang through to a fax machine.
Gold's wife, Aigoul Gold, is listed on Lexington Algiatry LLC's articles of organization, which is filed with the Kentucky Secretary of State's office. Aigoul Gold signed on behalf of Diverse Medical Solutions LLC, the organizer and registered agent of Lexington Algiatry LLC.
Aigoul Gold paid her husband's bond when he was arrested in Florida, according to documents.
It's not clear when Warren Gold and Azmat went into business together. As recently as 2007, Azmat was working as a vascular surgeon in Georgia.
Authorities have long expressed a great deal of concern about a so-called pill pipeline that has closely linked Kentucky to other states, including Florida and Georgia where laws governing pain clinics have not been as strict.
Fly-by-night pain clinics, which had mostly been thought to be a problem in Eastern Kentucky, are now spreading across the state.
"We're starting to see them pop up in Louisville, too," said Wilson, the board of medical licensure investigator.
Many of those clinics are owned by someone other than the doctor working there, and the doctor writing prescriptions specializes in something other than pain management, Wilson said.
"It's almost like an epidemic of pain-management clinics opening," he said. "The drug enforcement and the medical board and the law enforcement — we're all looking at these things now, trying to get control of it."