NORMAN J CLEMENT RPH., DDS, NORMAN L.CLEMENT PHARM-TECH, MALACHI F. MACKANDAL PHARMD, BELINDA BROWN-PARKER, IN THE SPIRIT OF JOSEPH SOLVO ESQ., IN THE SPIRIT OF REV. C.T. VIVIAN, JELANI ZIMBABWE CLEMENT, BS., MBA., IN THE SPIRIT OF THE HON. PATRICE LUMUMBA, IN THE SPIRIT OF ERLIN CLEMENT SR., WALTER F. WRENN III., MD., JULIE KILLINGWORTH, WILLIE GUINYARD BS., JOSEPH WEBSTER MD., MBA, BEVERLY C. PRINCE MD., FACS., RICHARD KAUL, MD., LEROY BAYLOR, JAY K. JOSHI MD., MBA, ADRIENNE EDMUNDSON, ESTER HYATT PH.D., WALTER L. SMITH BS., IN THE SPIRIT OF BRAHM FISHER ESQ., MICHELE ALEXANDER MD., CUDJOE WILDING BS, MARTIN NDJOU, BS., RPH., IN THE SPIRIT OF DEBRA LYNN SHEPHERD, BERES E. MUSCHETT, STRATEGIC ADVISORS
“My people are destroyed
from the lack of knowledge
Because you have rejected knowledge,
I will also reject you ”
“ignorance can support irresponsibility and irresponsibility is not forgiven”
On February 17 2021 I was arrested and incarcerated. Instead of waiting until I was in Pennsylvania, the warrant was served in NJ. As a result, I had to be extradited to Pennsylvania causing me to be incarcerated at Camden County Jail for 7 days.
Then spend another 14 hours in a Philadelphia jail. As a condition of bail, I had to surrender my medical license DEA license, and passport. I also had to sign a paper that I would not practice medicine anymore. I was charged among other things with Drug Delivery Resulting In Death and involuntary manslaughter.
I am a black physician. At the time of my arrest, I had practiced medicine in West Philadelphia for 42 years.
I was 80 years old. I was what is referred to as a solo practitioner. The article regarding your press conference implied that somehow after 42 years of an unblemished medical practice
I had disregarded the unwritten rule of first to do no harm and caused the death of one of my patients.
This accusation would be totally out of character for me if anyone would review my record.
I graduated from Cheyney University in 1969 with a 3.75 GPA while being married with 3 children and holding down a full-time job at the United States Postal Service in Philadelphia Pennsylvania.
I entered Jefferson Medical School in 1970 and graduated in 1974. Again married with 5 children. While a student at Jefferson I was class president for 2 and a half years.
I did an Internship and Residency at Mercy Catholic Medical Center and after serving as the ER physician for 1 month entered private practice in August 1977. I chose to practice in the neighborhood
I grew up in as I felt obligated to serve my community. Over the years I have held many positions both professionally and privately. I received an award from the Chapel Of The Four Chaplains.
PRESIDENT OF THE LOCAL MEDICAL SOCIETY
I was the president of our local medical society the Medical Society Of Eastern Pennsylvania an affiliate of the National Medical Association. I served as a board trustee of the National Medical Association for 6 years.
At the time of my arrest, I was president of the Keystone State Medical Society a position I held for 11 years.
In 2004 I was the National President of the Jefferson Medical School Alumni Association. Professionally I was the medical director of Inpatient detox at Misericordia Hospital for 5 years.
At the time of my arrest, I was the medical director of 2 out-patient drug and alcohol treatment centers, a position I held for 14 years.
It is implied in the referral that I attempted to defraud Keystone First Insurance Company. Keystone First Insurance Company is an offshoot of Keystone Mercy Insurance Company.
Before there was a Keystone Mercy there was Cedar Management Insurance Company a brainchild of Edward McLaughlin M. D. the head of surgery at Misericordia Hospital. I was a member of that group as my office was in the pavilion.
Keystone Mercy was formed and Theodore Whitney and Dr. Toomey made up the initial provider list.
We formed the nucleus as all physicians who participated in Keystone Mercy had to have admitting privileges at Mercy Catholic Medical Center or a contract with a physician who had to admit privileges.
I was a physician member of Keystone Mercy for many years. As one of the original physician members, why would I attempt to defraud the company I helped start?
MY PRIVATE PRACTICE TREATED PATIENTS WITH HIGH BLOOD PRESSURE, DIABETES, AND OPIATE ADDICTION DISORDERS
In my private practice in addition to patients with high blood pressure and diabetes, I treated opiate-addicted individuals with Suboxone, something I had done for 11 years.
I had a unique record of retaining 60 percent of my patients for more than 6 years.
A review of my treatment method shows that in addition to Suboxone, most of my patients also received a benzodiazepine.
Unfortunately, this combination has received a bad name and has been associated with the deadly triad opiate, benzodiazepine, and Soma.
This negative association while popular has no clinical trials indicating a contraindication but has been put forth by some with nothing to back them up except observational data.
Observational data is not clinical data and cannot be applied to a select population of those who died from a drug overdose.
Certainly, these individuals did not take the medications as prescribed.
My 11 years of experience, knowledge, and understanding of prescribing an opiate with a benzodiazepine while not a clinical trial is evidence enough to prove that the combination of an opiate and a benzodiazepine taken as prescribed is perfectly safe.
It is my belief that my high rate of retention is a direct result of my prescribing this combination.
In addition, recent medical data shows that the combination of an opiate with an antidepressant is more common at autopsy than the combination of an opiate and a benzodiazepine.
I want to go back to the so-called deadly triad. For years Soma came in 2 formulations and was commonly prescribed for patients presenting with back pain.
This was Soma Compound and Soma Compound with Codeine. These drugs along with drugs like Motrin were routinely prescribed by me and thousands of other health care providers.
Sometimes Valium a benzodiazepine was used as a muscle relaxant along with an opiate pain medication.
Why wasn’t this considered a deadly combination?
Could the answer be that hysteria about opiate drug overdoses and an opiate epidemic as well as a false narrative as
to the cause had not been introduced?
The false narrative introduced was that the pharmaceutical companies who manufactured opiate pain medication and the physicians who prescribed them were responsible for the opiate epidemic.
This was further exacerbated by a misinterpretation and application of the 2016 CDC guidelines for prescribing opiate pain medication. Completely ignored was that these guidelines were not laws or rules and that they were for PCP prescribing opiate pain medication for the first time.
As a result of this misapplication and misinterpretation of these guidelines, prior authorization requests were introduced by insurance companies.
Patients with chronic pain had their medication stopped. At the VA a 2017 study showed that 67 percent of those veterans who had their opiate pain medication stopped overdosing and died. 31 percent committed suicide.
GUIDELINES ARE NOT LAW
In the April 24 2019 issue of the New England Journal of Medicine, the CDC published an article on the misapplication of their guidelines. However, this was ignored.
On July 16 2021 the BCS had its meeting to issue new guidelines. It was apparent from this meeting that tremendous harm had been done and that the misinterpretation using 90 MME was the term misused the most.
In addition one member of the committee who advocated for the 90 MME as a threshold had received up to $ 500,000.00 on 1 occasion to serve as an expert witness pushing the false narrative of 90 MME’S.
The first charge against me at my plea agreement hearing uses this same false narrative.
Another charge that of falsifying medical records relies on the fact that I used the diagnosis of metastatic lung cancer.
First, this is on a prior authorization request, not a legal document but one introduced by the insurance company incorrectly misapplying the 2016 CDC guidelines.
Nowhere on the form is there a warning of criminal charges for falsifying that form. Keystone First Insurance Company employed Perform Rx to evaluate the prior authorization forms. Unless there was a dispute between the prescriber and Perform Rx, Perform Rx had the final say.
The insurance company medical directors only got involved if there was a dispute requiring a one on one telephone conversation between the provider and the insurance medical director. This never occurred in any prior authorization involving Ms. Hayes. How then can one be charged with a crime?
In addition, Ms. Hayes had been on the same milligram dose, same quantity, and same combination of medication since 2014 with no adverse events until she took cocaine on May 3, 2019.
Her medication was a continuation of care with no change in her dose or amount and was subject to automatic approval. The fact that she was on these medications 2 years before the 2016 CDC guidelines further disprove the 1st charge against me as well as the 4th charge of reckless endangerment.
If the combination was dangerous why didn’t she have any adverse events until she took cocaine?
The fact that the falsified form was a form generated by the insurance company and not the governing body of the Pennsylvania Medicaid Agency makes the charge of falsifying a medical record mute.
A prior authorization form is not part of her medical record. In addition, it is not Medicaid fraud.
Since I had the exclusive right under the rules of the FDA and CSA to prescribe opiate pain medication no law was broken when I prescribed medication to Ms. Hayes.
THE EXPERT GRIFTERS
I realize that the justice department relies on their expert witnesses to advise them regarding medical issues. A better method would be a medical board review. Had that been done no charges would have been brought against me.
The examiner used by the state only reviewed 34 pages of Ms. Hayes’s medical records a total of 5 visits. I treated Ms. Hayes for more than 20 years.
During that time I did an MRI of her cervical and lumbar spine. I sent her to a specialist for nonsurgical treatment for her pain. Eventually, she had surgery on her lumbar spine. Post-op she developed foot drop and urinary and bowel incontinence and an increase in her pain.
My treatment obligated me to increase her pain medication. She tolerated these increases and had no adverse events until she took cocaine.
Your expert incorrectly implied that the combination of Oxycodone, Morphine Sulfate ER, and cocaine caused the death of Ms. Hayes. Nothing could be further from the truth.
Opiates and cocaine do not act synergistically. Cocaine causes tachycardia and death from a cardiac event and opiates cause bradycardia and a respiratory arrest.
In addition, the National Association Of Medical Examiners makes it clear that the direct cause of death cannot be determined when multiple drugs are found in a deceased system.
That’s why the cause of death is listed as “Accident”. NAME cautions about using Homicide as a cause of death. Surely Drug Delivery Resulting In Death and involuntary manslaughter are forms of Homicide.
At my plea agreement hearing, I observed the prosecutor talking to the daughter of Ms. Hayes.
I know that the involuntary manslaughter charges were allowed to remain as a charge to satisfy the daughter of Ms. Hayes to get her cooperation and assist her in her civil suit against me and the pharmacies that filled her mother’s prescriptions.
The Civil suit was put on hold until the criminal case was resolved. This daughter was not the one present when her mother died. I saw Ms. Hayes on March 1, 2019.
She picked up her medicine on March 2, 2019. She died on March 3, 2019.
What happened to the remaining medication?
The police chief from Ridley Park told me no additional information other than the initial police report was reported.
The missing medication with a street value of more than $4000.00 is unaccounted for. It appears that although NAME believes that medication found at the scene is important when determining the cause of death, your department makes no mention of it.
I believe that a detailed medical review of my medical treatment of Ms. Hayes as well as her complete medical records will exonerate me of all charges. I await your response.
Walter F.Wrenn III M.D
FOR NOW, YOU ARE WITHIN