A St. Marys podiatrist is facing felony charges related to his opioid prescription practices following a grand jury investigation.
As a result of the investigation, David G. Sanderson, 59, is charged with 15 felony counts of unlawfully prescribing opioid-based pain medications.
According to a report from the Forty-Sixth Statewide Investigating Grand Jury attached to the affidavit of probable cause, the Grand Jury “learned that between Jan. 1, 2019 and April 3, 2020, Sanderson prescribed controlled substances to multiple patients that were not prescribed in accordance with the treatment principles accepted by a responsible segment of the podiatric medical community. Indeed, on some occasions, the prescriptions were written for treatment of medical conditions that were completely unrelated to the practice of podiatry.”
Joseph Spencer, a licensed pharmacist at the Brockway Drug Company, appeared and testified before the Grand Jury, stating that in July 2019, he filed a complaint with the Pennsylvania Office of Attorney General related to the prescribing practices of Sanderson, regarding two of Sanderson’s patients.
Spencer testified that he “was concerned about the large amount of opioid prescriptions” Sanderson was writing for one of his patients. Additionally, Spencer said that on July 3, 2019, another one of Sanderson’s patients came into the pharmacy with a prescription for Oxycodone written by Sanderson. Spencer became concerned after he checked the Prescription Drug Monitoring Program database and discovered the patient “had not taken an opioid medication for quite some time and was opiate ‘naive.’
“Spencer explained that if an opiate ‘naive’ individual takes a high dosage of opioids, that person could suffer fatal respiratory depression,” the report continued.
Spencer also told the Grand Jury that “Sanderson was prescribing more opioids than any other podiatrist in the area and it appeared as if Sanderson did not know what he was doing.”
The Grand Jury also heard testimony from Narcotics Agent Fred Myers of the OAG Bureau of Narcotics Investigation and Drug Control, who is assigned to the Drug Diversion Unit.
Myers informed the Grand Jury that in December 2019, he received a tip from the Borough of Emporium Police Department that two individuals may be selling prescription pills. An investigation did not uncover any evidence to substantiate the allegation, though it did lead investigators “to discover Sanderson’s controlled substances prescribing practices were unlawful.”
During his investigation, Myers talked to numerous pharmacists who expressed concerns about Sanderson’s prescribing practices. For example, it was uncovered that Sanderson had been writing prescriptions for benzodiazepines as well as opioids to one patient, with a 270 Morphine Milligram Equivalent (MME) per day. Additionally, Myers uncovered a pattern of Sanderson prescribing opioids for non-podiatry related conditions such as fibromyalgia, neck and back issues.
On April 1, 2020, Myers learned that another patient who Sanderson prescribed opioids with a 95 MME per day had later died from a drug overdose.
Myers told the Grand Jury “that based upon his prior experience and knowledge of the guidelines from the Centers for Disease Control (CDC) and United States Food and Drug Administration (FDA), the prescribing of opioids and benzodiazepines at the same time could cause drug overdoses.”
He said FDA guidelines use the MME figure to identify the strength of the medication prescribed, and that CDC guidelines recommend 50 MME per day as the maximum.
The criminal complaint stated that Myers found 16 patients of Sanderson’s who were receiving more than the recommended amount of pain medication, and prepared a search warrant.
The search warrant was executed at Sanderson’s Chestnut Street office in St. Marys on April 3, 2020. After Myers identified himself as a police officer and informed Sanderson he had a search warrant, Sanderson allegedly replied, “Oh yes, I expected this.”
During an interview, Sanderson said he was familiar with the online prescription database and knew he was required to check it before issuing an opiate prescription, though he was not checking it as he should “because he is busy and that he just glanced at it.”
When asked to clarify his statement, Sanderson said “he tries but does not always check it as it is hard and he is very busy,” adding that “if he did, in fact, review the PDMP database, he would note it in the patient’s record.”
According to the report, when Myers asked Sanderson if he prescribed in excess of 50 MME per day, Sanderson replied “Maybe a little.” After being asked a second time, Sanderson “hung his head and his eyes started to water” and he stated “Look, I have done a bad thing here.”
Sanderson also later admitted that he understood that his patients were addicted to the medication that he was prescribing.
When Myers asked Sanderson “if he thought that he had been acting in accordance with the treatment principles accepted by a responsible segment of the medical community,” Sanderson replied “Well no, but I will change and I am sorry.”
After reviewing patient files, it was found that a large percentage of prescriptions were written by Sanderson without the required PDMP check.
The Grand Jury also heard testimony from several of Sanderson’s former patients, including a woman who was prescribed both 20 mg Oxycodone and 30 mg Oxycodone with the instructions that the pills be taken four times per day. The woman said she subsequently became addicted to the medications and “if she ran out of the pills, she did whatever she had to do in order to find more.”
Sanderson allegedly never advised the patient of the dangers involved in taking prescription opiates, nor did he inquire as to whether she had trouble with addiction. Although he discussed weaning her off the pills, he never did so as he had to surrender his license.
Dr. Thomas Pfennigwerth, a licensed podiatrist who operates his own practice in Seneca, testified before the Grand Jury that in regards to the 15 of the 16 patient files reviewed during the investigation, “there was no responsible segment of the podiatric medical profession that would find that Sanderson’s prescribing practices for opioids and benzodiazepines were acceptable under any circumstances.”
Sanderson was arraigned Wednesday before District Judge Mark Jacob and his bail was set at $100,000. A preliminary hearing for the case is set for Aug. 3.