Vancouver nurse practitioner Kelly Bell prescribed more than $1.5 million worth of OxyContin in a six-month span in 2008 — months before federal agents raided the Payette Clinic, according to court documents filed Friday.
The scope of Bell’s prescribing and her interactions with OxyContin manufacturer Purdue Pharma were included in an unredacted complaint against Purdue filed by Attorney General Bob Ferguson. In September, Ferguson filed a lawsuit against the drug manufacturer — accusing Purdue of fueling the opioid epidemic in the state — but details from the company’s internal documents were sealed. Purdue claimed the information was a trade secret. A King County Superior Court judge recently unsealed the documents.
“These newly unsealed details further illustrate the mechanics of Purdue’s massive deception,” Ferguson said in a news release. “Purdue ignored warning signs and their own studies while targeting high-prescribing doctors in Washington state. It’s time they are held accountable for the devastation this epidemic has caused.”
Among the targeted high-prescribing providers is Bell, according to court documents. Bell held an advanced nurse practitioner license — under which she was able to prescribe narcotic pain medication — until Nov. 28, when she surrendered the license following an investigation by the Washington Department of Health. She still holds a registered nurse license in the state, but it’s unclear whether she’s currently practicing.
According to the court documents, Purdue aggressively targeted Bell with materials designed to persuade her to prescribe opioids for pain. Internal notes also indicate Bell accepted Purdue’s concept of “pseudoaddiction.” The company used the term to explain patient behaviors — including illicit drug use and deception — that may occur when the patient’s pain is untreated, according to court documents.
The court documents cite Purdue notes from an Oct. 1, 2008, sales call with Bell where the sales representative asked Bell what she would do in a hypothetical situation where a patient was using more of a medication than prescribed.
Bell, according to court documents, said she would “treat the pain” and explained that “the most common reason for this pseudoaddictive behavior is under-treatment.”
“In short, Ms. Bell would respond to the abuse of opioids by prescribing more opioids,” the court documents state.
The court documents also allege that Purdue’s education efforts “successfully primed” Bell to reject opioid prescribing recommendations set by the state. Bell told Purdue sales representatives she didn’t believe the guidelines had any foundation in science, according to court documents.
The result of all of these efforts, the state argues, was “huge amounts of opioids pumped into Ms. Bell’s patients and the Vancouver community.”
A Dec. 8, 2008, internal Purdue study showed that in the previous six months, Bell had written $1,565,670 worth of OxyContin prescriptions. She had written so many prescriptions that insurance companies began to deny authorizations for the drugs, according to court documents.
Still, Purdue continued to call Bell and promote its products until the state Nursing Care Quality Assurance Commission filed a statement of charges against Bell in April 2009 for prescribing “extremely high doses of opioids,” according to court documents.
Bell could not be reached for comment Friday.
Firm denies allegations
In addition to fueling the opioid epidemic in Washington, the lawsuit claims Purdue operated a “massive deceptive marketing campaign” to convince providers and the public that its drugs were effective for treating chronic pain and carried a low risk of addiction.
After the lawsuit was filed in September, Purdue officials issued a statement saying they “vigorously deny these allegations and look forward to the opportunity to present our defense.”
Bell is one of several providers mentioned by name in the lawsuit. The newly filed court documents highlight interactions between Purdue and three physicians and two nurse practitioners, including Bell.
One of the physicians, Dr. Frank Li, owned and operated Seattle Pain Centers, which had a clinic in Vancouver. The clinics closed last summer after state health officials suspended Li.
