Small-town NC doctor reprimanded after patient dies of drug overdose
A family medicine doctor was disciplined by the North Carolina Medical Board this month after one of his patients died of an accidental overdose involving “multiple illicit drugs,” including fentanyl and heroin, according to the board.
Dr. Steven Wallace Ferguson, of Powellsville, had prescribed the chronic pain patient 90 milligrams of oxycodone a day — a high dose that requires close monitoring by providers. The patient had a past history of cocaine use, according to the medical board, and was also taking the stimulant Vyvanse and the benzodiazepine Clonazepam, both prescribed by her psychiatrist.
Ferguson did not perform regular urine drug screens that could have detected illicit drug use, and he prescribed the high-dose pain medication despite the patient having opioid dependence, the medical board’s April 17 order states.
The physician failed to perform a thorough history, exam or testing on the patient before prescribing opioids, or note the cause of her chronic pain, according to the board’s order. She died January 5, 2024.
Although Ferguson said he had a controlled medication agreement with the patient, routinely performed required drug screens and reviewed the North Carolina Controlled Substances Reporting System at each visit, none of those claims were supported by her medical record, the board’s order states.
Ferguson could not be reached for comment. The phone number listed for Eastern Carolina Family Practice, where Ferguson practiced, is not in service. Emails sent to Ferguson’s personal email addresses were not returned.
Powellsville is a small town in Bertie County, in eastern North Carolina. It has just under 180 residents.
The board found irregularities in Ferguson’s opioid prescribing to at least three other patients.
Ferguson prescribed 120 milligrams of oxycodone per day to two patients — one for chronic pain and partial quadriplegia following an accident, and another for ankle and shoulder pain. He prescribed a third patient 240 milligrams of morphine a day — 60 milligrams every four hours — for chronic back, hip and knee pain.
In all three cases, Ferguson failed to follow the standard of care, including taking thorough histories, performing exams and documenting required urine drug screenings, the board’s review of patient medical records found.
Ferguson also did not discuss or prescribe the opioid overdose-reversing drug naloxone with the patient on morphine despite her high-dose use, the board found.
Nonopioid therapies are preferred and often as effective as opioids for chronic pain, according to the Centers for Disease Control’s opioid prescribing guidelines. Higher opioid doses present greater risks to patients, including fatal respiratory depression, overdose and addiction.
About 6 million Americans had opioid use disorder — a problematic pattern of opioid use that significantly impairs or distresses a patient — as of 2022, according to the CDC.
The medical board issued a formal reprimand against Ferguson and ordered him to complete continuing education on safe opioid prescribing within six months.
Ferguson was first issued a North Carolina medical license in 1993 and is also currently licensed to practice medicine in California and Virginia. He graduated from medical school at Case Western Reserve University in 1986 and completed his general practice residency at Mercy Catholic Medical Center in Pennsylvania.