The Associated Press
Psychiatrist suspended over prescriptions
November 11, 2003

A psychiatrist who had two patients die of drug overdoses while they were undergoing a controversial treatment for pain has had her license indefinitely suspended.

The state medical board on Monday suspended Anne-Francis Nicol’s license to practice medicine.

Nicol, whose privileges to prescribe narcotic painkillers were suspended in June 2002, had given the patients who died a narcotic-like painkiller and an anti-anxiety drug. The Woonsocket Call reports the board’s administrator said the drugs prescribed, Darvon and Doxetein, were not a violation of the prior order, but said Nicol failed to properly document the medical evaluations on which she based the prescriptions.

“The manner in which these patients were treated medically by Dr. Nicol falls far below the minimum acceptable standard of care,” the state Board of Medical Licensure and Discipline wrote in an order signed Monday by Dr. Patricia Nolan, director of the state Department of Health.

Nicol, 63, is under indictment on criminal charges of first-degree arson for which she is scheduled to go to trial in Superior Court at the end of the month. The charges stem from a 2002 incident in Woonsocket following an argument with her landlady and are not related to the investigation by the Board of Medical Licensure and Discipline.

An aggravating factor in Nicol’s suspension, said licensing board administrator Dr. Robert Crausman, was her failure to comply in a timely fashion with prior orders of the board to obtain an evaluation of her medical skills after she was placed on probation on June 12, 2002.

The board placed Nicol on probation after determining she had been improperly prescribing Oxycontin, Vicodin and other powerful, addictive painkillers in the morphine family of drugs.

The board had also ordered Nicol to undergo a clinical skills evaluation within a year of the order. The board said she missed the deadline, but the evaluation she did get found a number of deficiencies.

Crausman said that the most troubling findings by the board involved Nicol’s alleged prescribing of Darvon and Doxetein in concert with the practice known as prolotherapy.

Crausman said the prolotherapy, which he said is not accepted by the medical mainstream, calls for injecting toxic agents into muscle tissue to relieve pain.

It’s impossible to know what Nicol was injecting into her patients because her notes weren’t always specific, Crausman said. Sometimes they indicated the substance was lidocaine, a topical anesthetic, or a saline solution. Other times the notes merely indicated she was using “the usual substance.”

Responding in a written statement, Nicol’s lawyer blamed her client’s performance on the clinical evaluation on stress associated with her pending arson trial and the death of her former boss.

The lawyer said Nicol did complete the evaluation on time, and said the doctor contends that prolotherapy is an accepted treatment in use since 1934 “with excellent results in the treatment of pain.” She said the substances she has injected are nontoxic, including glucose, Novocain and vitamin B12.