“People come to this person for help, and instead of getting help, they’re met with deadly consequences. If the allegations are true, he is Dr. Death, no doubt about it.” — Mike Register, Clayton County Police Chief

By CCHR International
January 22, 2016

Psychiatrist Narendra Nagareddy from Jonesboro, Georgia, referred to by police as “Dr. Death,” was arrested after 36 of his patients died, with at least 12 killed by overdose on prescription drugs.[1] Nagareddy is a top state prescriber of several highly addictive benzodiazepines, such as Xanax, and antipsychotics, including clozapine, a drug so potentially dangerous it requires doctors and pharmacists to register with a program that monitors the drug’s use.[2] His arrest prompts calls for greater oversight of psychiatrists with high prescription practices, a request made by Citizens Commission on Human Rights International to Georgia state legislators in October 2015 in relation to psychiatrists affiliated with a chain of behavioral centers.

Nagareddy was held at his office on January 14, 2016 following a raid by Drug Enforcement Administration (DEA) agents, while nearly 40 federal and local agents raided his offices. He was later arrested. Clayton County Police Chief Mike Register said the psychiatrist has had “a multitude of overdoses and overdose deaths” in recent years. “People come to this person for help, and instead of getting help, they’re met with deadly consequences,” Register added. “If the allegations are true, he is Dr. Death, no doubt about it.”[3]

Register also made the observation: “The guy may call himself a doctor, but if the allegations are true, I call him a drug dealer.”[4]

In 2013, Nagareddy wrote 19,766 prescriptions, including refills, for 833 patients under Medicare.

According to ProPublica records from Medicare alone, in 2013, Nagareddy wrote 19,766 prescriptions, including refills, for 833 patients under Medicare Part D with a retail cost of $1.53 million.[5]

His top eight prescribed drugs and number of prescriptions included the highly addictive benzodiazepines: alprazolam (generic of Xanax, 1,534 prescriptions), clonazepam (generic of Klonopin, 1,281) and lorazepam (generic of Ativan, 795); the antipsychotics risperidone (generic of Risperdal, 1,334), clozapine (generic of Clozaril, 1,270), olanzapine (generic of Zyprexa, 1,127) and quetiapine fumarate (generic of Seroquel, 774), and the antidepressant fluoxetine HCL (generic of Prozac, 777).[6]

For the state of Georgia, Nagareddy was the top prescriber of alprazolam[7] and clozapine,[8] the second highest prescriber of olanzapine,[9] fourth highest prescriber of risperidone[10] and third highest prescriber of the generic of Prozac.[11]

Among other top state prescribers of these and other psychotropic drugs are psychiatrists affiliated with behavioral facilities owned by Universal Health Services (UHS). Nagareddy is not associated with UHS. But fifteen psychiatrists affiliated with UHS behavioral facilities in Georgia had prescription retail costs under Medicare Part D of $10.8 million, with one psychiatrist from Atlanta totaling $1.5 million in prescription costs for 17,782 prescriptions. That psychiatrist was the top state prescriber of two stimulants, generics of Adderall and Vyvanse. He was also the fifth highest prescriber of alprazolam and top prescriber of Suboxone, used to treat opiate addiction. Nagareddy was the eleventh highest state prescriber of Suboxone[12] and top state prescriber of alprazolam.

Another UHS affiliated psychiatrist had $2.9 million in prescription retail costs for 23,750 prescriptions to 1,545 patients and was the top state prescriber of six antipsychotics, one of which—olanzapine—Nagareddy ranked second. Nagareddy ranked as the No. 4 prescriber of risperidone.[13]

Independent of Nagareddy, Georgia also had five psychiatrists among the top five national prescribers of antidepressants and antipsychotics.

Citizens Commission on Human Rights called on state regulators and law enforcement agencies in 2015 to provide greater oversight of UHS behavioral facilities, in part, because in analyzing a sample of 45 psychiatrists affiliated with UHS facilities in six states there was a similarity in the types of psychotropic drugs prescribed. For example:

• 42 psychiatrists prescribed the generic of Seroquel
• 33 prescribed the generic of Risperdal
• 25 prescribed Abilify (patented antipsychotic)

A former healthcare fraud investigator advised CCHR to report high prescribers of psychotropic drugs, alleging this could be a potential red flag for abuse and fraud. Anyone with such information can report this to CCHR.

References:

[1] “Georgia doctor arrested after 36 patients die, at least 12 from overdose on prescribed meds,” New York Daily News, 16 Jan 2016, nydailynews.com/news/national/georgia-doctor-arrested-36-patients-die-article-1.2498832

[2] http://www.nlm.nih.gov/medlineplus/druginfo/meds/a691001.html; http://www.drugs.com/pro/clozapine.html

[3] “Georgia doctor arrested after 36 patients die, at least 12 from overdose on prescribed meds,” New York Daily News, 16 Jan 2016, nydailynews.com/news/national/georgia-doctor-arrested-36-patients-die-article-1.2498832

[4] “Psychiatrist arrested in raid charged with woman’s death,” WSB TV Atlanta, 15 Jan 2016, http://www.wsbtv.com/news/news/local/psychiatrist-arrest-raid-charged-womans-death/np582/

[5] https://projects.propublica.org/checkup/providers/1598859498

[6] https://projects.propublica.org/checkup/providers/1598859498

[7] https://projects.propublica.org/checkup/drugs/3282/states/georgia

[8] https://projects.propublica.org/checkup/drugs/4085/states/georgia

[9] https://projects.propublica.org/checkup/drugs/6872/states/georgia

[10] https://projects.propublica.org/checkup/drugs/4101/states/georgia

[11] https://projects.propublica.org/checkup/drugs/1615/states/georgia

[12] https://projects.propublica.org/checkup/drugs/2017/states/georgia

[13] https://projects.propublica.org/checkup/drugs/4101/states/georgia