LA PUSH — A state medical panel of doctors and members of the public has sanctioned a physician assistant who worked on the Quileute Tribe’s La Push reservation for five months in 2015, determining he asked a tribal clinic female patient for sex in return for opioid medication.
Thomas L. Hughes, whose age and city of residence were unavailable Monday, had his license suspended April 10 for at least five years by the panel and was assessed at $1,000 fine by the state Medical Quality Assurance Commission.
Hughes had already been sanctioned Jan. 8, 2015 for overprescribing medications.
Hughes, who was deployed by the U.S. Coast Guard in 2009-2010, worked at the Quileute Tribal Clinic from Sept. 1, 2015-Dec. 1, 2015.
He also worked at the Clallam Bay Medical Clinic, Forks Community Hospital and the Bogachiel Clinic, which he resigned from Sept. 1, 2015. He also worked at the Republic Medical Clinic in Ferry County.
Hughes engaged in general medical practice, which included prescribing opioid medications to patients.
He violated 14 state laws and sections of the Washington Administrative code, according to the commission’s 29-page April 10 ruling.
The commission determined Hughes committed moral turpitude and sexual misconduct toward the Quileute clinic patient while he was employed at the Quileute Tribal Clinic, according to the ruling announced April 25 in a statement by the state Department of Health.
Hughes touched the woman’s thighs and asked her to perform a sex act in return for medication or sex for medication, according to the ruling.
He also prescribed Tramadol, an opioid-type medication, that “was not justified under the circumstances,” according to the report.
He was terminated from the clinic after the woman reported the incident to the tribe’s domestic violence-sexual abuse prevention program.
The panel also found Hughes engaged in sexual misconduct toward a second female patient while he was employed at the Republic Medical Clinic in Ferry County on July 1, 2016.
He pressed his crotch against the woman while he was marking a steroid injection site on her shoulder, according to the ruling.
Ferry County Public Hospital District 1, which runs the clinic, terminated Hughes on July 15, 2016 after determining the the complaint was similar to two previous patient complaints that officials there had discussed with him, according to the report.
Previous issues also had arisen with Hughes, according to the ruling.
It was alleged he had failed to meet chronic pain management rules in treating two patients by prescribing potent opioids and benzodiazepines together, failed to document the need for high doses of opioids and kept poor records.
In a Jan. 8, 2015 stipulation with state health authorities, he had agreed to measures including completing four hours of continuing medical education on the commission’s website on pain management rules and prescribing opioids for chronic, non-cancer pain.
A year later, in January 2016, a state Department of Health investigator reviewed Hughes’ practices under the stipulation.
The investigator obtained eight patient records from January 2015 through Augusts 2015, discovering Hughes “failed to comply with the 2015 stipulation,” according to the April 10 report.
His record keeping was so lax that Hughes did not know if the patients were receiving opioid medication from several treatment providers and did not conduct screening tests with the patients.
When he did conduct tests, he did not act on results, such as when a patient’s urine test showed the presence of THC.
Hughes also prescribed potent opioid pain medications combined with benzodiazepines, increasing the risk of respiratory depression, accidental overdose and death to patients who were tobacco users who had compromised respiratory systems.
Hughes must be evaluated by a commission-appointed evaluator before he can apply for re-instatement of his license, according to the ruling.
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Senior Staff Writer Paul Gottlieb can be reached at 360-452-2345, ext. 55650, or at pgottlieb@ peninsuladailynews.com.
