Washington Physician loses medical license over opioid deaths, loan impropriety

(The Center Square) – A physician in Washington state has been barred from future practice for her alleged substandard care that contributed to the opioid-related deaths of a husband and wife, and in the death of a third patient from whom she had received a personal loan.

The license of Dr. Irene K. Kimura, a primary care family physician in Moses Lake, was permanently revoked by the Washington Medical Commission in a July 18 order that cited allegations of unprofessional conduct.

The 41-page order followed a May 8 hearing before the commission with legal counsel from the state Attorney General’s office. Kimura, 62, was represented at the hearing by Garth Dano, a private attorney from Moses Lake and former Grant County prosecutor.

A request to Dano on whether Kimura may appeal the commission’s findings was not immediately returned.

In revoking Kimura’s license, the review panel considered the “gravity of (her) conduct” involving the three patients, their vulnerability, and Kimura’s alleged dishonesty, lack of remorse, failure to take responsibility, and a prior disciplinary record.

Kimura was initially licensed in June 1992 and has 31 years’ experience as a doctor. The commission initially restricted her from prescribing controlled substances in November 2021.

Among the commission’s findings:

From July 21, 2017 to Sept. 3, 2017, Kimura treated a 56-year-old male, identified only as Patient A, who had non-alcoholic liver cirrhosis complicated by a nervous system disorder, kidney stones, chronic back pain caused by a fall and other medical conditions.

During his initial visit, the patient claimed some of his pain medication had been lost on a recent trip. Despite her lack of information from prior records, Kimura allegedly prescribed him 360 tablets of the opioid oxycodone at 5 milligrams each – the highest level he had been prescribed over the past year.

The WMC said Kimura failed to review the patient’s prescription monitoring profile, which noted he had filled opioid prescriptions from six different providers in the previous month and that he already had a 58-day supply of opioids available during his initial visit to Kimura. At the time, she also prescribed two other medications, which – based on his health conditions – put him at risk for over-sedation, confusion, and memory deficits. Kimura later prescribed an extended-release morphine formulation and an early refill of oxycodone.

Two days after the prescription was filled, on Sept. 3, 2017, the patient was found dead. The death was attributed to “mixed drug toxicity.”

Kimura also treated Patient A’s wife between September 2017 and February 2020. The woman had been her husband’s caregiver, but she also cited medical conditions that included shoulder, back, and knee pain, hypertension, obesity, insomnia, gynecological disorders, and bipolar disorder with thoughts of suicide.

Early in 2017, the woman, then in her early 50s, reportedly admitted to another physician that she had an opioid addition and used narcotics for emotional needs unrelated to pain management. That physician would not prescribe her stronger narcotics.

But Kimura allegedly began prescribing opioids to the woman in January 2018 without obtaining medical records from previous providers, and did not discuss the risks of opioid treatment until April 2019, over a year later. She also lacked notes regarding over two dozen emergency room visits made by the woman that were deemed “overt drug-seeking behavior.”

The patient’s last prescription was filled on Feb. 19, 2020. She was found dead six days later. A coroner’s report ruled the death as accidental from the combined effects of oxycodone and four other prescription drugs.

The medical commission said both husband and wife repeatedly demonstrated “drug-seeking behavior” and Kimura should not have trusted their ability to self-limit opioids. She also failed to adequately research their prior medical and drug use histories or inform other local healthcare providers.

The WMC also referenced Kimura’s care of Patient C, who was about 57 years old when treatment began in 2008 and continued into 2020. During that time, she prescribed opioid medication to the man, who had a below-the-knee amputation of his right leg, arthritic-like joint disease in his left foot and ankle, chronic back pain, and other complex body pain. He was also diagnosed with coronary artery and pulmonary diseases and depression.

Authorities said Kimura did not lower Patient C’s medication levels until 2017, when new opioid prescription guidelines and insurance limitations took effect. But the WMC said her prescribing practices continued to allow early refills even as the man experienced depression and memory issues which posed a risk that he might overdose. In August 2021, she prescribed fentanyl patches despite an obligation to “wean medications that placed Patient C at harm …” while also failing to adequately manage the patient on his other medical conditions.

Around 2013, Kimura was experiencing personal financial difficulties and asked the patient for a loan. He agreed, and she reportedly borrowed approximately $25,000, repaying him in part with cash and samples of Abilify, an antipsychotic drug.

In May 2022, Patient C died from pulmonary disease and other complications. At the time, Kimura still owed him money and had stopped making payments in approximately November 2020.

“For a physician, the Respondent’s behavior regarding Patient C was shocking,” the medical commission order stated. “Adding insult to injury, the Respondent did not even pay back the money … and had stopped making any payments by the time of Patient C’s death.”

Such behavior violated “good morals, honesty, and justice” and raised concerns that Kimura might use her professional position as a physician to harm members of the public, the order stated.

The WMC also alleged that Kimura failed to accurately document all three patients’ clinic visits and failed to provide naloxone, commonly called Narcan, to mitigate possible opioid-related overdose deaths.

In separate proceedings in Grant County Superior Court, Kimura unsuccessfully challenged a 2010 state order which placed her on probation at the time, and she was sued in 2009 for alleged negligence following the death of a Moses Lake woman in April 2007. That case was later settled out of court. In other court filings, she faced two collections liens from the state Department of Labor and Industries for unpaid wages and two unpaid debts between 2015 and 2019.