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Two Pasadena doctors accused of overprescribing narcotics to patients, face Medical Board sanctions

A building with a sign in front that says "Huntington Memorial Hospital."
Independent Drs. Elisa Cuellar Alvarado and Robert D. Siew have had privileges to see patients at Huntington Hospital in Pasadena.
(Gina Ferazzi / Los Angeles Times)
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Two Pasadena doctors are facing allegations from the California Medical Board that they negligently prescribed painkillers and other potentially dangerous narcotics to patients.

Officials are seeking to revoke or suspend the medical licenses of Dr. Elisa Cuellar Alvarado and Dr. Robert D. Siew, according to two separate accusations filed this year. Both doctors practice internal medicine and are permitted to see patients at Huntington Hospital, according to their bios.

Alvarado and Siew did not respond to phone calls seeking comment Monday. Dorey Huston, a spokesperson for Huntington Health, said the physicians are not employed by the hospital.

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“They are private, independent doctors, who have privileges at our hospital,” Huston said in an email to The Times. “Due to privacy laws, we are unable to comment about matters before the California Medical Board other than to say that we respect the board’s process.”

The Medical Board of California was established to protect patients by licensing doctors and investigating complaints. The board has a long history of going easy on troubled doctors, a Times investigation has found.

Jan. 13, 2022

The allegations against Alvarado, who has been licensed since 2006, stem from two patients she treated in the last seven years. The Medical Board accused her of gross negligence, repeated negligent acts and failing to maintain adequate and accurate medical records, according to a petition the board filed in April.

For a 71-year-old male patient suffering from restless leg syndrome, the board alleged, Alvarado prescribed Tylenol with codeine and roughly 400 milligrams of tramadol per day. The board alleged that this amount is “above the daily maximum dose recommended by the FDA.”

The initial therapies for restless leg syndrome include gabapentinoids, which treat neuropathic pain, and medications that increase dopamine activity in the brain. Medical records did not indicate why she prescribed different medications, according to the allegation.

The board also accused Alvarado of prescribing opiates for years to a middle-aged woman without a plan to manage the continued use of the addictive medication, while also prescribing other powerful drugs without documenting alternative treatment options.

The Medical Board accused Siew of gross negligence related to the care of six patients, repeated negligent acts, excessive prescribing, failing to to maintain adequate and accurate medical records, and failing to review patients’ controlled substance history using a state database before writing them prescriptions, according to a petition filed in January.

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The allegations against Siew, who has been licensed since 1988, stemmed from patients he treated between 2013 and 2022. In one instance, an 88-year-old woman who Siew had prescribed various controlled substances, including hydrocodone, fentanyl, Xanax and Ativan, between 2015 and 2019 had been getting narcotic prescriptions from at least 14 doctors, according to the board’s accusation.

Officials allege Siew did not catch this because there were no records indicating he searched the patient in the Controlled Substance Utilization Review and Evaluation System. The database, known as CURES, is maintained by the state Department of Justice and tracks certain controlled substances dispensed to patients in California. Beginning in October 2018, medical providers were mandated to check the system before prescribing a controlled substance to a patient.

During an interview, Siew told investigators that “he did not think CURES was mandatory (in 2018 or 2019) and that he was not aware that there were multiple prescribers of narcotics to this patient,” according to the board’s allegation.

Like 48 other states, California has an online database that records all the prescriptions issued for potentially habit-forming or abuseable drugs, such as OxyContin and Ritalin.

June 14, 2016

Siew has been affiliated with Huntington Hospital since 1995, and Alvarado has been linked to the hospital since 2008, according to bios posted to the hospital’s website. The doctors also provide consulting services to the Californian, a skilled nursing facility in Pasadena, according to Brandon Bales, the facility’s administrator.

Siew has been the medical director of the nursing home for more than a decade, and Alvarado joined the quality assurance committee in April, Bales said. He added that the Medical Board’s accusations “do not involve any of our patients.”

Investigators with the California Department of Public Health launched an investigation into the nursing home in response to four complaints involving patients falling and a failure by nursing staff to respond to call lights that show requests for help from patients’ rooms. The probe was first reported by the Southern California News Group.

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“We fully cooperated with the inquiry,” Bales said. The state “concluded its review of the complaints last month and determined that there was no harm to any of our residents.”

However, investigators reported that during a May 7 inspection of the facility, nursing staff did not properly respond to a patient’s call light. They also found that staff had failed to “update care plans” after two patients fell and required treatment at a hospital, according to a copy of the report obtained by The Times.

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