Sales Reps Ignored Gross Negligence of Practice in Tennessee Pain Clinics

Michelle Rosenker

July 19, 2019

Today’s opioid crisis is unlike any other public health crisis the state of Tennessee has ever seen before. Thousands of people die each year in Tennessee from opioid related overdoses, never mind those who lose their lives to complications caused by opioid addiction. In fact, approximately 1,776 people died of opioid overdose in Tennessee in 2017, making it the seventh top cause of death in the state. Influenza and pneumonia, kidney disease and failure, and suicide round out the rest of the top 10. 

The opioid overdose death rate in the state is much higher than the national average, mostly due to the malpractice of prescribing professionals such as Dr. Abdelrahman Mohamed.

Mohamed, the owner of  Hamblen Neuroscience Center, is known as the “drive-through doctor” of Morristown because of his uncontrolled and downright careless prescription of pain medications, particularly Opana ER. Countless residents of local and nearby communities would regularly visit Dr. Mohamed, and his office would even see large waves of out-of-state customers knocking at his doors. From 2007 to 2017, Dr. Mohamed continued to negligently prescribe prescription painkillers like Opana — and with the help of this particular drug’s sales representatives.

How Sales Reps for Opana Fueled Tennessee’s Opioid Crisis

As Dr. Mohamed kept on with writing out numerous prescriptions for Opana, pharmacists in the area refused to fill the prescriptions because of the sheer amount that were being requested. For these pharmacists, something didn’t seem right. 

Nothing about Dr. Mohamed’s practices seemed right to anyone, really, including the 60 prescriptions that were prewritten each day, the lines of people that would overflow into the parking lot, and the visible handfuls of cash customers carried when entering the office. Customers knew exactly why they sought out Dr. Mohamed, as they knew that he wouldn’t ask any questions or pry into their business when requesting painkillers. It was a practice that everyone seemed to know about as being a corrupt pill mill — except the for the sales reps for Endo, the company behind Opana. 

 Opana ER is an opioid-based medication that is designed to treat physical pain. Patients do not need to keep taking Opana throughout the day, as ER stands for extended-release, meaning that it keeps working over time. When this medication is taken as prescribed, it can be hugely beneficial in treating pain in those who suffer from chronic pain, pain due to cancer, or pain following a surgical procedure. However, when it is abused, it can be habit-forming and lead to death. Unfortunately, these sales reps were not focused on the dangers of their medication and the inability of their  “top writer” to carefully and responsibly prescribe this medication. Instead, they turned a blind eye to what was occurring at Dr. Mohamed’s office despite visiting the facility more than 45 times a year. In fact, when Dr. Mohamed was struggling for local pharmacists to fill his prescriptions written for his customers, a sales rep for Endo worked to address this problem. According to reports, one rep stated in an email that “he (Mohamed) is having a hard time getting Opana for his current patients and now switching them over to other medications” in an effort to continue to push this medication. 

Sales reps for Endo routinely visited Dr. Mohamed’s facility in Tennessee for a decade. During 2007 and 2014 alone, Dr. Mohamed prescribed more than half a million Opana pills to customers (604, 379 to be exact). Within that period of time, in 2011, the Eastern Tennessee sales district had prescribed more Opana ER than any other district in the country. That same year, Endo raked in just shy of $385 million in nationwide sales of Opana ER. 

Tennessee Attorney General Files a Lawsuit

The Attorney General’s office of Tennessee has filed a lawsuit against Endo stating that their “sales representatives and district managers observed and ignored red flags for abuse or diversion of opioids.” This lawsuit has recently gone public as the Knoxville News Sentinel insisted that the public be made aware of those behind the deadly opioid crisis in their communities. In it, Endo is described as falsely promoting Opana ER by stating that it is “abuse-resistant” despite being aware that it is not. Endo is also accused of ignoring communication from people warning of these prescribing malpractices. Court documents even go as far as to show communication from a district sales rep voicing concerns for a Tennessee-based pill mill selling Opana ER to a sales executive who simply brushed off those very concerns.

Last year, a very similar lawsuit was filed against Purdue Pharma, one of the largest pharmaceutical companies in the country, due to their negligence surrounding their top-selling drug, OxyContin. To date, Endo has still yet to file a response to the lawsuit served to them by the Tennessee Attorney General’s office.

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