The Arkansas State Medical Board suspended a Harrison doctor’s medical license last June, for the third time in four years, after multiple complaints that the doctor overprescribed opioids and had serious mental health issues, an examination of his file reveals.
A board hearing has been postponed until Dr. James Hawk undergoes an evaluation for competency to practice medicine. But his attorney said Hawk, who recently was working as a laborer for Tyson Foods, could not afford the evaluation.
“Until he does that, we’re sort of in limbo,” said the medical board’s attorney, Kevin O’Dwyer of Little Rock. “I don’t know what the evaluation is going to say.”
He said Hawk was sent to a prescribing course and was ordered to be monitored by the Arkansas Medical Foundation, which provides treatment for health care workers.
Hawk’s problems began more than 20 years ago, in California, where he was first licensed to practice medicine. In Arkansas, however, the Medical Board gave Hawk chance after chance to rectify problems ranging from excessive prescribing of controlled substances to failing to keep proper records to failing to take medication to treat his mental illness.
A psychiatrist who performed a limited review of Hawk’s personal medical record, Dr. Brian T. Hyatt of Springdale, told the board that Hawk’s failure to take stabilizing drugs was “suggestive of an utter indifference to the potential consequences his untreated mental illness could cause his patients and therefore represents gross negligence.”
Dr. Judy McDonald of Royal (Garland County), criticized the board for not doing more to stop Hawk, especially in light of the nation’s opioid epidemic.
“I can’t believe how our medical board has apparently gone out of their way to get him a slap on the wrist time and time again,” she told Arkansas Business.
Hawk, who worked in family practice, pediatrics, urgent care and pain management, has surrendered his Drug Enforcement Administration permit, which allowed him to prescribe controlled substances.
Bruce B. Tidwell, the Little Rock lawyer representing Hawk, declined to allow a reporter to interview Hawk because of the pending action before the board. Tidwell said that the last time he talked to Hawk, before Christmas, Hawk had been working at a Tyson Foods plant in Berryville “as a laborer position to kind of pay his bills.” An operator at the Tyson plant said last week that Hawk wasn’t working there.
Tidwell also said his client had been trying to raise $15,000-$17,000 to pay for the evaluation. “With him being out of practice, it’s hard to come up with the funds,” Tidwell said.
Hawk’s current license suspension came after accusations that he overprescribed painkillers to 16 patients, but Tidwell said Hawk maintains he didn’t do anything wrong. “His position is that he has some patients with some some pretty severe issues up there,” Tidwell said. “It was not overprescribing. It was authorized. It was what they needed at the time.”
That’s not how it looked to Dr. McDonald, who told Arkansas Business that she worked 10 days in Hawk’s clinic in 2016 as a fill-in physician while he was under an emergency suspension order. The amount of pain medication Hawk was prescribing was overwhelming, she said.
“This was not family medicine,” she said. “This is just a … drug mill. I had never seen such incredibly high doses of narcotics being prescribed and in such combinations,” she said.
McDonald, a board-certified obstetrician-gynecologist, said she wrote more narcotics prescriptions while at Hawk’s clinic than she had in her previous 30 years in medicine. “Most of the patients that I saw were on the maximum dosage of whatever they were on,” she said. “They would be so high that they just boggled my mind.”
Employees Blamed
McDonald filled in for Hawk during his second suspension from practice. In the first order, Hawk was accused of overprescribing in February 2014 to six patients.
Hawk blamed former employees of his clinic for stealing his prescription pads and forging his name on prescriptions. The suspension was lifted two months later, followed by a hearing in October 2014 at which a Harrison police detective testified that Hawk’s employees were being investigated for criminal forgery. The complaint against Hawk was dismissed.
Five women who had worked for Hawk were subsequently charged with felonies in Boone County Circuit Court. Three of them were acquitted of all charges in December 2015, and charges against a fourth woman were dismissed in 2016. The fifth former employee pleaded guilty to misdemeanors in 2015.
The four women who weren’t convicted then sued Hawk and his then-wife, Kim Hawk, who was the clinic’s office manager. The women said in their lawsuit, filed in Boone County Circuit Court, that the Hawks intentionally gave false and misleading statements to law enforcement officers so James Hawk wouldn’t face repercussions from the medical board. The Hawks denied the allegations in their court filing.
The attorney for the plaintiffs dismissed the case against the Hawks in November. The plaintiffs, however, can refile the case within a year.
California Problems
Hawk graduated from Loma Linda University School of Medicine in California in 1991. He did his residency in surgery at Loma Linda University Medical Center from 1991 to 1994. He said on his application for an Arkansas medical license that he didn’t complete the surgery program.
“During surgical residency, I was asked to do things that seemed unethical,” Hawk wrote in his October 1998 application.
He said some of the attending physicians weren’t seeing patients on a daily basis, as they should have. And when he complained about it, those attendings were offended, he wrote.
“From then on they highlighted my every mistake,” Hawk said. “At the end of my third year, they requested that I change my ways or go elsewhere. I chose to leave. I chose to discontinue surgical residency rather than become a dishonest surgeon.”
Dr. Donald Halverson, a director of the San Bernardino Medical Group in California, who worked with Hawk for three years, wrote a letter of support for Hawk in 1998. Hawk, he wrote, “is a deeply religious man with sound personal values and morals above reproach.”
But not all his colleagues were so enthusiastic.
Dr. H.E. Heidinger, director at the University of California, Riverside, told the Arkansas State Medical Board in 1998 that Hawk would not be recommended for a medical staff reappointment to the Campus Health Center at the university. “The ‘chemistry’ between some, but not all, of the professional colleagues and Dr. Hawk was not what is desired,” Heidinger wrote. “I do not feel that these problems should prohibit him from obtaining a license to practice medicine in your state, however it would limit our ability to reemploy him.”
Hawk also was the subject of his first medical board action while he practiced in California, although it wasn’t filed until after he had applied for a license in Arkansas.
The Medical Board of California filed a complaint against Hawk in March 1999 concerning a “manic episode” he experienced while working at the San Bernardino Medical Group in June 1998.
The board’s filing didn’t provide many details about what had happened, but Hawk spent four days at a behavioral medical center. Hawk’s psychiatrist reported Hawk to the board in July 1998, alleging Hawk was not able to treat patients safely at that time. Hawk received treatment between June and September 1998 and was then cleared to return to work.
The board’s complaint said Hawk was suffering from a “treatable mental illness,” but he could practice safely if he followed a program of medication and therapy under the care and supervision of a psychiatrist.
The California board revoked Hawk’s medical license but stayed that action with a 15-year probation. The terms of probation called for Hawk to continue his psychiatric treatment.
In April 1999, the Arkansas Medical Board awarded Hawk a temporary permit to practice medicine for a year on the condition that he continue his psychiatric treatment.
After a year with no problems, according to his medical board filing, the board gave Hawk a license.
A month later, in May 2000, Hawk surrendered his California medical license.
The Complaints Begin
Complaints that Hawk was overprescribing opioids date back to at least 2008. That’s when Tammy King of Harrison complained to the Arkansas Medical Board about Hawk’s treatment of her 24-year-old son, who battled prescription drug addiction, depression and anxiety.
The young man’s name was redacted in the nearly 1,000-page file that the medical board released to Arkansas Business under the state Freedom of Information Act.
King said her son walked into Hawk’s office and left with four prescriptions, including one for 90 hydrocodone tablets. “And 48 hours later they were all gone,” she said in her letter to the medical board. She said she wasn’t sure if her son ingested all the pills or sold them.
In his response, Hawk said King’s son manipulated him and his staff to get the prescriptions. “In no way did he indicate that he had a prescription drug problem,” Hawk said. “I am not a drug dispensing doctor and regret that Tammy has categorized me as one.”
The board voted to investigate the complaint. It found in 2009 that it couldn’t prove gross negligence or malpractice and no action was taken, closing the case.
A 2017 complaint by Bill Witty of Harrison also suggested that some of the opioids Hawk prescribed were being resold. Witty said he believes that Hawk was the source of the drugs that killed his 24-year-old daughter, Jillian Grace Witty-Lewis, in 2015, but Hawk responded that he had never treated Witty-Lewis and had no information regarding her death.
Other complaints were filed in the interim.
‘A Public Health Menace’
In 2013, the Arkansas State Medical Board received a complaint that Hawk prescribed an excessive amount of controlled substances and failed to keep proper records for monitoring those patients.
The board issued an emergency order of suspension against Hawk in February 2014, which was lifted after the Harrison police confirmed that it was investigating office staff members.
However, Dr. J. Carlos Roman of Little Rock, who was on the board’s Pain Management Review Committee, had concerns about Hawk’s practice.
“The sheer volumes of narcotics, coming from Dr. Hawk’s prescription pads, pose a public health menace,” Roman wrote in a March 8, 2014, letter to the board. “Dr. Hawk would also appear to suffer from some psychiatric problems as seen from his prior suspension of his California medical License in 1999 and reports of his medical non-compliance.”
Hawk’s shifting of the blame to “a host” of office employees did not satisfy Roman.
“The amount of financial theft, narcotics prescribed, and potential insurance fraud alluded to in the police reports demonstrate a physician who has lost control over his medical practice, his business practice, and his prescription pad,” Roman said. “Dr. Hawk shows a wanton and/or willful misconduct showing an utter indifference to the consequence that may result.”
The board dismissed the suspension order in October 2014. Soon allegations tied to Hawk’s mental illness surfaced.
Emergency Order Issued
Sherri King, who was Hawk’s clinic nurse, notified the board on July 25, 2016, that Hawk wasn’t “acting right.” He was not writing legible prescriptions and had put the wrong patient’s name on a prescription.
She also reported that Hawk had tried to ride his bicycle about 35 miles to Branson, Missouri, for a family counseling session. His staff found him miles from his house and “very tired and exhausted,” she said.
Hawk was taken to Mercy Hospital in Rogers and then rushed to a behavioral hospital in Little Rock.
As a result, the board issued an emergency order of suspension in July 2016, alleging Hawk presented a danger to the public health, safety and welfare of the citizens of Arkansas.
McDonald was working for a company that provided temporary physicians when she learned of an emergency opening in Harrison. A solo practitioner there was in the hospital and was desperate to have someone cover his clinic, she said. She said she was told that Hawk’s practice would be basic family medicine.
“I felt sorry for him because I had been in solo practice,” McDonald said. “When you don’t have good call coverage, it gets to be a problem.”
Within just a few days of starting to practice at Hawk’s clinic, McDonald said, she knew something was wrong. Every patient she saw was seeking a refill of narcotics.
She said she complained to her company, which got her out of the job, and to the medical board.
Meanwhile, the medical board was continuing to investigate Hawk.
Hawk’s medical file from his six-day inpatient stay “seems to confirm a diagnosis of Bipolar 1 disorder,” Hyatt said in a September 2016 letter to the board.
“Of particular concern, it is noted in the chart that Dr. Hawk intimated to his wife that he felt he had the ‘psychiatrist fooled,’ reportedly stating ‘I’m a physician. I know what they are looking for,’” Hyatt wrote.
Hawk also allegedly indicated to his wife that he wasn’t going to take prescribed mood-stabilizing medication, because it made him feel “sluggish” and “groggy,” Hyatt said.
Hyatt worried that Hawk’s indifference to his mental illness represented “gross negligence.”
In October 2016, the board converted Hawk’s suspension order to a consent order after Hawk said he would complete continuing medical education courses in boundaries and prescribing within one year. He also said he would enter into a monitoring contract with the Arkansas Medical Foundation.
‘Severe Mental Instability’
In a matter of months, however, more problems arose.
In March 2017, Kim Hawk informed the medical board that she was filing for a divorce. She wanted board members to know several things about her husband, including that he used an escort service in 2016 and had used a website to solicit prostitutes.
She included records that she said supported her allegations.
In April 2017, she sent another letter to the board saying that she had covered up the “severe mental instability problems” of her husband.
“I am at fault for telling the staff not to say anything but it has come to a point that it needs to stop,” she said, and offered to take a polygraph.
“When Dr. Hawk is taking his medication he can be a good doctor and be kind to his staff, and his patients love him,” Kim Hawk said. “The major problem causing harm to his practice as a physician and to himself is his mental health. He has chosen not to take his medication on a consistent basis.”
Amy Embry became the executive director of the Arkansas State Medical Board in October, replacing Karen Whatley, who went work in the Arkansas governor’s office as the director of legislative affairs.
Embry began working at the medical board in September 2014 as the administrative services manager in charge of human resources, budget and accounting. She was named interim executive director of the agency in August, after Whatley left to work in the Arkansas governor’s office. Embry became the executive director in October.
She received a bachelor’s from Florida State University and a master’s degree in public administration from the University of Arkansas at Little Rock.
Between 2002 and 2014, Embry worked for the Arkansas Department of Finance & Administration.
She said that without his medication, Hawk often instructed his staff to improvise “by attending to matters that only the doctor should legally and ethically perform.”
The divorce was final last February, ending a marriage that had lasted about five years.
Meanwhile, the board continued to investigate Hawk’s prescribing habits.
An examination by the medical board’s Pain Management Review Committee looked at more than a dozen patient records and found that many showed signs of “quite excessive amounts of medications,” a committee member said in a May 2018 letter.
The majority of the patients were using a combination of opiate, benzodiazepine and carisoprodol. “The combination is often referred to as the ‘holy trinity’ due to the extreme euphoric effect it produces in patients,” the letter said. “While some patients may have a true need for these medications separately, the combination of the three is extremely dangerous and typically not recommended.”
About half of the patients the committee reviewed were prescribed that combination.
The committee member found that “the prescribing in many charts reviewed would be viewed as excessive and/or dangerous.”
In June 2018, the board issued its third emergency order of suspension against Hawk over the allegations that he overprescribed controlled medication for 16 patients and failed to keep records about the reasons for the prescriptions.
In October, the board agreed to hold Hawk’s suspension hearing after he completes a physician assessment evaluation to see if Hawk could be rehabilitated.
“Now … will he get his license back and will he ever practice medicine again?” said O’Dwyer, the board’s attorney. “I have no idea.”
