HARVARD - A local doctor's medical license has been revoked after a state panel found he committed malpractice, engaged in fraud, and violated the law governing controlled substances. But the former physician's lawyer says his client could apply to get his license back in four years.
Lee Dunn, who represents Rimas Maurukas of Groton, said Maurukas would have to prove to the state medical board that he was eligible to return to practice.
"He's going to have to show - as anyone else who has been punished by the board - that his clinical competence is the same," Dunn said last week.
Dunn said he was not certain whether Maurukas would seek to practice again. The 54-year-old former internist and pulmonary specialist is "looking for work," the lawyer said.
Maurukas could not be reached for comment. The ruling against him has shocked some in the small town of Harvard, where he had one of two medical offices.
But Judith McAvoy of Walpole, whose 44-year-old husband, Scott, died in 2006 while under Maurukas's care, said she thought Maurukas "got what he deserved."
"What goes around comes around," she said.
Findings by the state Board of Registration in Medicine describe Maurukas's treatment of 13 patients, two of whom died. The findings do not say he caused the deaths.
"There was no allegation made or proven that these two patients died as a result of anything Dr. Maurukas did or didn't do," said Dunn.
Dunn said Maurukas agreed to the findings, gave up his license voluntarily, and has not been criminally or civilly charged with breaking the law. "The question was, was he up to snuff - and I'm using that term purposely - in the issue of pain care," Dunn said.
The findings, in a brief made public in December, show a pattern of Maurukas prescribing high doses of narcotics and often postdating prescriptions, sometimes without documenting the patients' medical conditions or requesting objective data to support his diagnoses. The brief also states that, while some of the patients had a history of drug addiction, Maurukas did not always refer them to substance abuse specialists.
The brief describes Maurukas's care of 11 of the patients as "substandard."
In one case, Maurukas - knowing that a patient was working full-time at one job - submitted a disability application for him to a federal agency where he had another job, the brief says.
Maurukas has his supporters.
William Cory, a former patient and the landlord at Maurukas's Harvard practice in the Appleworks strip mall, described him as having "good insights."
After other medical practitioners said Cory had lung cancer, he said, Maurukas diagnosed it as sarcoidosis, a disease in which tiny lumps of cells can cause inflammation of the lungs and other organs. Maurukas prescribed prednisone, a drug that helped control the condition, Cory said.
"He was very observant," Cory said. "He was a terrific doctor, and I think they might have made a mistake taking his license away."
Russell Aims, spokesman for the medical board, said the revocation came after a two-year investigation involving "mountains of evidence."
Maurukas, who also shared a practice with another doctor at New England Baptist Hospital and was affiliated with Nashoba Valley Medical Center and Deaconess-Glover Hospital, was suspended from all the facilities several times between April 2001 and August 2005 "for failure to complete medical records," according to the brief.
In one case, a patient identified only as E.E. complained of back pain, but Maurukas did not include a physical exam in the record; he prescribed high doses of narcotics, including OxyContin, Percocet, Dilaudid, Klonopin, and Duragesic. After E.E. tested positive for heroin, Maurukas continued treating the 30-year-old man with narcotics.
On Aug. 25, 2004, Maurukas added methadone to E.E.'s regimen. Four days later, E.E. was admitted to Beth Israel Deaconess Hospital. He died that day of cardiac arrest and liver failure, according to his death certificate.
Dunn said that "there is a difference of opinion" about whether patients with substance abuse problems should receive high doses of narcotics as part of their care.
"Some places would say probably the best thing to do would have been to continue to treat the patient but refer him to an addiction specialist," Dunn said.
A consult for another patient, identified as C.E., stated that he "did not have a good physical explanation for his symptoms, and there was no significant abnormality at all," the brief says.
Less than two weeks later, in August 2004, Maurukas submitted a disability application to the US Department of Labor on behalf of C.E., who was approximately 34 years old, stating that he "was unable to perform the duties of his job" because of his medical condition; Maurukas "was aware that while on disability from his job as an accountant, Patient C.E. was working full-time as an electrician," the brief says.
Dunn said he argued that the medical board should exclude that finding, denying it happened "the way they put it." But it is true, Dunn said, that Maurukas postdated prescriptions for narcotics, as happened with Scott McAvoy.
Judith McAvoy, a nurse, said the drugs helped ease the pain after her husband was involved in a car accident in Ayer, but that he was "overmedicated."
On March 20, 2006, McAvoy had his last appointment with Maurukas, the brief says. Four days later, McAvoy died of hypertensive heart disease, according to his death certificate.
After his death, Judith McAvoy said, she discovered three prescriptions for her husband postdated for the next month, April.
"I don't think it was appropriate," she said. She said she and her 18-year-old daughter are still grieving the loss of "a great guy, a wonderful father."
Maurukas signed a voluntary agreement not to practice medicine on Dec. 15, 2006.
Cory said "a lot of people were shocked" when Maurukas's license was revoked a year later.
Maurukas was "very upset," Cory said, but "was confident he'd get it back."
Connie Paige can be reached at cpaige@globe.com.
