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The suit alleges that he did not use adequate care in prescribing drugs.
Published Sep. 22, 2009

Mark G. Kantzler, a Tampa Bay doctor who was disciplined by the state after allegations he inappropriately prescribed controlled substances to six patients, is facing a malpractice suit in the death of a 28-year-old patient who died of an overdose.

Darlene Brosious, as personal representative of her son's estate, sued last month. The case alleges that son Carl Reagle, died because Kantzler prescribed excessive quantities of various drugs and failed to meet standards of care required by state law.

"I'm not guilty," said Kantzler, 56, an osteopathic physician who works in Clearwater.

Unfortunately, doctors are blamed in cases where patients are responsible, added Kantzler, who said he didn't want to say anything more without his lawyer's advice.

"I don't want anything misconstrued or taken out of context," said Kantzler, who also has offices in Hillsborough and Pasco counties, records show.

Brosious' case was filed around the time Kantzler settled another suit alleging his negligence led to the death of John Neckerauer, a 52-year-old Largo man. Court records do not detail the settlement amount, but Kantzler's state health records show a $210,000 liability settlement for that case. They also show a $700,000 liability settlement in 2003.

Brosious' complaint, also filed against Kantzler's business, West Coast Personal Injury & Family Medicine in Madeira Beach, says that Kantzler, who saw Reagle from January 2006 through February 2007, prescribed multiple drugs, including oxycodone, Xanax, Soma, Valium, and Viagra.

It alleges that Kantzler prescribed excessive doses and quantities of drugs, failed to monitor the level of drugs he prescribed, increased medications rather than decreasing them and failed to conduct follow-up exams or screen Reagle for dependency.

"Based upon the evidence and expert testimony I have developed, he was negligent in the way he treated Mr. Reagle," Brosious' attorney, Robert Heyman, said. "He was an otherwise healthy 28-year-old who complained of back pain."

The St. Petersburg lawyer said that, at Reagle's age, the doctor should have explored other methods of treating his pain, such as physical therapy and referrals to other specialists to deal with the actual cause of the pain.

"The protocol is not to put him on a powerful multi-drug cocktail," Heyman said. "When you put somebody on that type of a strong medical cocktail, you need to make sure you don't create an addict."

Reagle, who lived near Seminole, died Feb. 10, 2007. Toxicology tests detected oxycodoneand Xanax, as well as alcohol, Pinellas-Pasco Medical Examiner records show.

An investigative report from the Medical Examiner's Office said that records from Kantzler's office showed that Reagle was diagnosed with back pain, back spasms and panic disorder.

Kantzler's records also say that on Feb. 8, 2007, Reagle was prescribed oxycodone, Oxydose, Valium, Viagra and Xanax,

Reagle was "known to abuse prescription medications and smoke marijuana," said the medical examiner's investigation report.

Reagle had been arrested on several drug charges, including introducing contraband into a detention facility, in 1996 and 2006, according to state and county records. He received court-ordered probation for marijuana and Valium possession charges in connection with the July 1996 arrest, and for cocaine and marijuana possession charges in connection with the September and December 2006 arrests, records show.

Kantzler has had a brush with the law as well. In December 2006, he was arrested and charged with driving under the influence. He pleaded no contest, was adjudicated guilty and received court-ordered probation and other penalties, records show.

The doctor has also been disciplined twice by state regulators.

His first tracks back to 1991, when his license was suspended temporarily for allegedly having a problem with a prescription drug.

Kantzler received drug treatment and rehabilitation from 1989 through 1990, according to a complaint presented to the state Board of Osteopathic Medical Examiners.

In May 1991, his drug screens showed positive for a drug called Nubain, chemically related to oxymorphone, an addictive substance, records show. Based on that information, the case said, he was unable to practice medicine with reasonable skill and safety. Kantzler was fined $2,500 and reprimanded.

The doctor's more recent case came before the state Board of Osteopathic Medicine in November 2007.

The state Department of Health said it investigated Kantzler after it received information from the state Agency for Health Care Administration's bureau of Medicaid Program Integrity that alleged that Kantzler was "violating the standard of care and he was excessively or inappropriately prescribing controlled substances to multiple Medicaid recipients/patients."

The Department of Health filed the complaint, which detailed allegations about the treatment of six patients. The complaint said, that among other things, Kantzler failed to document physical exams and medical tests, obtain adequate medical histories and monitor patients' health conditions. One patient, identified only as J.N., died of multidrug toxicity Oct. 3, 2006, the same date that John Neckerauer died.

The complaint said that Kantzler prescribed controlled substances to the patients "without medical justification, in quantities that endangered the patents' health, or were not in the best interest of the patients and in a manner not in the course of the osteopathic physician's professional practice."

The board approved a settlement agreement that took effect January 2008. Kantzler, who neither admitted nor denied the allegations, was fined $18,000 and ordered to pay $19,500 in administrative costs. He was also placed on three years of administrative probation, said Eulinda Smith, a Department of Health spokeswoman.

Times researcher Caryn Baird contributed to this report. Lorri Helfand can be reached at (727) 445-4155.