State health officials have permanently revoked the license of a Maple Valley osteopathic physician for not completing required training and continuing to prescribe controlled drugs after being told not to do so.
The Board of Osteopathic Medicine and Surgery and the Washington State Department of Health initially suspended the license of Dale E. Alsager in August of 2008. He was prohibited from prescribing Schedule II and III controlled substances. Alsager didn’t complete mandatory training and continued to prescribe Schedule III controlled substances while prohibited from the previous order. Officials said he also did not cooperate in the investigation of a more recent complaint.
A message left at Alsager’s office was not returned. The answering machine stated that August is the clinic’s “month off” for the summer.
Alsager’s Osteopathic Physician and Surgeon’s license was issued in August of 1995. He opened the Country Doctor Clinic in Maple Valley in 1996, at the age of 52.
On Sept. 14 of 2005, Alsager prescribed the strongest dose of Duragesic patch (which contains a potent Schedule II opioid) available, along with oxycodone and Valium, for a 24-year-old patient who lacked sufficient documented opioid tolerance. The patient died the following day from acute intoxication from the drugs. Alsager’s management of seven chronic care patients showed a pattern of substandard care for pain management and other areas. He also prescribed opiates and benzodiazepines to patients with an existing high risk for abuse. His license was suspended in 2008. The charges show he also did not adjust a medication regime of a patient, despite reports and other signs that the patient was physically abusing his wife. The documents state he also prescribed excessive opiate doses at the beginning of treatment and excessively increased the doses during follow-up visits.
Alsager failed to address that the patient who overdosed was related to four of the other patients in question, and that two others were dating.
According to the statement of charges: “These relationships between chronic pain patients who were receiving controlled substance prescriptions should have lead to considerations regarding possible medical sharing, diversion, and the loss of objectivity and separation in decision making.”
In January of 2013, the charges claim Alsager prescribed Axiron (testosterone), a Schedule II substance, to himself and 12 patients from December 2011 to August 2012. He also prescribed a Schedule III weight loss and appetite suppressant to patients from 2007-10.
The newest charges claim Alsager began violating the order by issuing Schedule III on Sept. 17, 2008, and continued through at least Feb. 15, 2013.
His license was “summarily suspended” on Sept. 20, 2013.
The clinic’s webpage addresses the 2008 license suspension, saying, among other things, that, “Dr. Alsager’s practice was targeted” and that the “Department of Health focused on seven patients all of whom have well documented chronic pain conditions and who required daily doses of pain medications exceeding the Interagency Group proposed guidelines.” The website adds that, “Dr. Alsager had no opportunity to defend himself in the public eye.”
