By Michael Howell
Florence Doctor Chris Arthur Christensen was arrested without incident at his home last Wednesday on two counts of negligent homicide, nine counts of criminal endangerment, 388 counts of criminal distribution of dangerous drugs (opiate and non-opiate), and one count of possession of dangerous drugs. If found guilty of all the charges, Christensen is facing a maximum sentence of up to 388 life sentences, plus 135 years, and a total fine of up to $20 million.
Dr. Christensen operated Big Creek Family Medicine, a family practice and urgent care clinic in Florence, until his medical license was revoked following the serving of a search warrant on his office and home on April 1, 2014 by a Tactical Diversion Squad consisting of federal, state and local law enforcement personnel. His medical license was revoked on April 7, 2014 and he entered into a stipulation agreement in which he “acknowledged some unprofessional conduct.” He was subsequently authorized to return to practice with “some restrictions on his ability to treat patients and to prescribe controlled substances.” The Drug Enforcement Administration (DEA) revoked his license to prescribe controlled substances and did not reinstate it.
Based on the evidence obtained in that search, and further investigation and interviews over the last 18 months, County Attorney Bill Fulbright on Wednesday filed an affidavit with the court stating the allegations and asking the court to keep it sealed until the arrest warrant had been served. The motion was granted.
In an unusual move, Fulbright and Barbara Roach, the DEA’s Special Agent in Charge, held a press conference the same day Christensen was arrested. Fulbright said that some member of the press had been to his office asking about the case every day since the search warrant was served and that the Sheriff’s Office was also receiving regular inquiries. He said that the filing had been sealed until the warrant was served to protect both the rights of the accused and the state’s rights. He said it was “out of fairness to the defendant, insuring that he would be fully advised of his right to remain silent and to legal counsel before he might be confronted with questions from the media or public.” He said it was also to avoid potential flight of the accused.
DEA Special Agent in Charge Barbara Roach said that a Tactical Diversion Squad was opened in the area a couple of years ago including Ravalli County Sheriff’s Office detectives, DEA agents, and members of the HIDTA task force. The Anti-Drug Abuse Act of 1988 and the ONDCP Reauthorization Act of 1998 authorized the Director of the Office of National Drug Control Policy (ONDCP) to designate areas within the United States which exhibit serious drug trafficking problems and harmfully impact other areas of the country as High Intensity Drug Trafficking Areas (HIDTA). The HIDTA Program provides additional federal resources to those areas to help eliminate or reduce drug trafficking and its harmful consequences. Law enforcement organizations within HIDTA assess drug trafficking problems and design specific initiatives to reduce or eliminate the production, manufacture, transportation, distribution and chronic use of illegal drugs and money laundering.
Roach said that the investigation of Dr. Christensen began in response to numerous complaints from area doctors and pharmacists related to his “excessive distribution of controlled substances.” She said Dr. Christensen was treating drug addicts outside the course of his professional practice and that two overdose deaths had been uncovered in which he was the prescribing doctor. She said his patients came from 10 different states including Wyoming, North Dakota, Idaho, Oregon, Washington, Ohio, California, New Mexico and Nevada, as well as Montana. She said that within Montana his patients came from 62 different towns.
Roach said that Dr. Christensen’s prescription records were compared to seven other doctors in similar sized towns and similar practices and found that Christensen was out-prescribing the other doctors in several controlled substances.
“As a matter of fact,” she said, “he was out-perscribing all seven of them combined.”
Roach said it was the first criminal prosecution of its kind in the state of Montana.
Fulbright said that he was aware that two attempts by an individual associated with the defendant to disseminate disinformation to the media occurred this summer.
“I encourage caution in this area,” said Fulbright. He said accurate information was available through the court and through his office.
Roach said that she has seen doctors charged like this federally but that states have rarely taken the lead. She said she was encouraged by this action and a recent action in Colorado and hoped it marked a trend.
“They are drug traffickers, just with white coats,” said Roach.
Asked how they picked nine patients out of 4,718 patient files to press charges against, Fulbright said that it was not practicable to file thousands of complaints, “so we found what seemed to be representative of all the patients.”
The charging affidavit states that the Task Force arrived at several conclusions after analyzing the evidence. They found that Christensen was writing prescriptions in quantities that have no accepted therapeutic benefit and writing them for medications that were disproportionate to the nature of the patient’s injury or condition. They found he was writing multiple prescriptions to be filled in sequence for the same medication at the same time. They claim he directed patients to specific pharmacies and referred to medications by their street name and referred to the street prices.
Another conclusion was that Christensen would offer a “menu” of medications and allow the patient to select the prescription. They said he would often prescribe an anti-anxiety medication after a patient expressed concerns regarding opiate addiction. They claim he rarely requested medical records for new patients and rarely requested diagnostic testing such as x-ray or MRI imaging. They claim he routinely failed to take into consideration reports of patient addiction, including those that were made by his own staff. They claim his files were generally not maintained, organized or updated and that he executed pain contracts with many of his patients, but did not hold his patients to the terms of the contract. They claim he was never authorized by the DEA to run a narcotic treatment program, but was operating in this capacity and did not follow the guidelines outlined in the Model Policy on the Use of Opioid Analgesics in Treating Chronic Pain.
The two patients who died of drug overdoses were 43-year-old Missoula resident Kara Philbrick-Lenker and 33-year-old Missoula resident Gregg Griffin.
The affidavit alleges that on March 13, 2013, Philbrick-Lenker met with Dr. Christensen for thirty minutes. Her chief complaints were a recently injured wrist and a pre-existing back injury from 1987. In the visit Christensen diagnosed her wrist as being broken by palpitation and without assistance of any other diagnostic equipment. The affidavit alleges that Christensen conducted no other examinations, tests, or evaluations, requested no prior medical records, did not consult with the MPDR, and failed to contact Eric Ravitz, DO, a physician at Blue Mountain Clinic, who was Philbrick-Lenker’s longtime treating primary care physician.
Dr. Ravitz had prescribed Fentanyl, Diazepam and Lyrica for Philbrick-Lenker’s condition and on March 7, 2013 he refused to change her prescription to Methadone because she had previously overdosed on the drug and was combining alcohol consumption with her prescription medication, consistent with her known alcoholism.
During her first and only visit with Christensen, she was prescribed Methadone and Dilaudid. Three days later she died from an overdose of her medications. The state alleges that Christensen distributed Methadone and Dilaudid to her outside the course of a professional practice and that the criminal negligence resulted in her death.
According to the affidavit, Griffin’s primary care physician from 2009 through January 2012 was Elena Furrow, MD, a family physician in Lolo. Dr. Furrow prescribed Suboxone for longstanding drug addiction issues, Propranolol HCL and Clonazepam for anxiety and Doxepin for insomnia and got concurrence from another doctor for the treatment plan.
Griffin had obtained a medical marijuana card through Dr. Christensen in 2008 and in a chart note on a visit to Christensen in 2009 it was noted that Dr. Furrow was his primary care physician. It is alleged that, despite knowing this, Christensen signed a medical marijuana card for Griffin in 2012 certifying Griffin was his patient and that he had primary care responsibilities and that he had done a full assessment of the patient’s medical history and current condition.
In February of 2012, Christensen met with Griffin and noted in his medical file that Griffin could no longer afford Suboxone, and that he had not abused medications for years. He changed Griffin’s treatment plan from addiction to pain management and prescribed Methadone. The affidavit alleges that Christensen never obtained Griffin’s medical records from Dr. Furrow, or consulted with her regarding the change in treatment plan.
Nonetheless, the affidavit alleges, Dr. Christensen prescribed Alpazolam and Clonazepam on Feb. 17, 2012; Methadone on Feb. 22; Methadone on March 2; Alprazolam and Clonazepam on March 20; and Methadone on March 30. Two days later, on April 2, Griffin was pronounced dead at his residence of a mixed toxicity drug overdose. Blood tests showed high levels of Methadone, Alprazolam and Doxepin.
The charging affidavits include nine counts of felony criminal endangerment. One of those patients was alleged to have been prescribed large amounts of Methadone and Morphine Sulphate. The nurse who treated the patient for drug addiction and withdrawal symptoms after she left Christensen’s care stated in an interview that the amount of Methadone and Morphine Sulphate prescribed by Christensen would not have been therapeutic and that Christensen is nothing more than “a licensed drug dealer.”
Another patient who began seeing Christensen after his previous physician had refused to provide him with any more narcotic medication described Christensen as “the best drug dealer he ever had.”
Some of the patients admitted diverting the drugs being prescribed to them to other people. One of them admitted to authorities that he was a drug dealer and obtained drugs from Christensen to sell in the Bakken oil fields. He called the amount of drugs he was receiving from Christensen “obscene.” He said he sold the Dilaudid pills for $25 each and got between $50 and $80 for each Oxycodone.
Christensen ended up hiring another patient as a licensed addiction counselor. The patient was prescribed large amounts of Methadone and Dilaudid over the course of a few years while working for Christensen. When asked why he was employed by Christensen, the patient replied that it was “to cover [the defendant’s ass” and noted that “weeding out [patients] is not part of [the defendant’s] philosophy… He believes that everyone can decide what’s best for themselves.”
The patient stated that at one point the DEA attempted to contact him and that he brought it to the attention of the defendant. He said the defendant stated, “the DEA can’t do anything to me.”
As of Monday, August 31, Christensen remained in custody at the Ravalli County detention center and was scheduled for an arraignment hearing on Tuesday. Bail was set by District Judge James Haynes at $200,000. In 2005, Christensen was indicted in U.S. District Court in Idaho on eighteen counts of distribution of controlled substances outside the course of a professional practice and without a legitimate medical purpose. He was acquitted of the charges on February 3, 2010.