Fatal fentanyl overdose caused by Kansas doctor, suit says. This is his third suit.

Bobby Ray Jordan didn’t know that his wife’s 2014 death might have been caused by a legal prescription medication until law enforcement agents came around last year asking questions about Overland Park doctor Steven Simon, according to a new lawsuit.

The coroner’s report had suggested she overdosed on illegal drugs, but after talking to the agents Jordan learned that it might have been Subsys, an opioid-based fentanyl spray produced by a pharmaceutical company that was paying Simon hundreds of thousands of dollars in speaking fees to promote it.

The U.S. Food and Drug Administration approved Subsys in 2012 for cancer pain. Its manufacturer, Arizona-based Insys Therapeutics, is the focus of a federal criminal case that alleges the company’s executives used the speaking fees to pay kickbacks to doctors who wrote lots of Subsys prescriptions, including for “off-label” uses other than cancer pain.

The Star reported last year that Simon was Kansas’ top-paid pharmaceutical industry speaker from 2013 to 2015, taking in more than $1 million in travel expenses and speaking fees. More than $200,000 of that came from Insys to promote Subsys and he was also the state’s top prescriber of the medication within the Medicare Part D program.

Simon was already the focus of two other lawsuits in Johnson County brought by former patients who alleged damages caused by improper Subsys prescribing. Jordan, from Tonganoxie, filed his suit last month in Leavenworth County.

Jordan’s suit says Simon treated his wife for back pain starting in 2013 until her death in January 2014.

As with the plaintiffs in the other two lawsuits, Carey Ballou and James “Mike” Whitham, Simon quickly stepped her up to higher, more expensive doses of Subsys, something federal prosecutors say Insys actively encouraged in order to maximize profits. Lawsuits in other states have faulted the company’s marketing and sales tactics for contributing to overdose deaths.

Simon would also “create fully executed, pre-signed prescriptions for patients to refill Subsys” without actually seeing the patients. According to the suit he did this because he was frequently out of the office traveling to paid speaking gigs for pharmaceutical companies.

According to the suit, the county coroner told Jordan his wife died of “fentanyl intoxication with contribution from underlying diseases,” but the coroner inaccurately said that his wife’s medical records showed no source of prescription fentanyl and therefore she must have gotten it illegally.

Jordan didn’t know that Subsys was a fentanyl product and Simon had never told him or his wife that Subsys was only approved for cancer patients, that he was being paid to promote it, or that it could be fatal.

“In fact, Mr. Jordan did not learn of any potential wrongdoing by any of the Defendants until, in 2017, he was approached by law enforcement agents inquiring about Dr. Simon’s treatment of his wife,” the lawsuit states.

Frontier Forensics, the company that handles autopsies for Leavenworth County, is not a party to the suit. The Star has requested more information from the company about Doris Jordan’s medical records.

“We would just be speculating at this point, but it would appear that Subsys was a newer drug, I suppose and as a result of that perhaps they did not recognize it as a fentanyl-based drug,” said David Helms, one of Jordan’s attorneys. “Alternatively, perhaps they did not see all of her pharmaceutical records. We don’t know at this time.”

Reached by phone Monday, Jordan said he would defer to his attorneys rather than commenting on the case. But he said his wife never had cancer, to his knowledge.

Simon’s lawyer, James Wyrsch, said he did not want to comment on pending litigation.

In an interview with the Star last year, before the suits were filed, Simon said that his prescribing was entirely based on what he thought was best for his patients, not what companies paid him.

The two Johnson County suits were filed in September, about a month after FBI agents served a search warrant for patient records at Simon’s clinic, The Pain Management Institute of Mid-America Physiatrists.

Simon has not been criminally charged. The FBI, while confirming they were at the clinic, has not said whether Simon is under investigation or whether the visit was related to the wider criminal case against Insys. But in a financial disclosure filing last year Insys said it had received a subpoena from the U.S. Attorney’s Office in Kansas.

Simon no longer works at the clinic, which has since moved and changed its name.

The suits against Simon also name as defendants one of his nurses, several opioid distributors, Insys, the Insys sales representative who worked with Simon, and three Insys executives, including the company’s billionaire founder, John Kapoor.

Kapoor was added to the suit after he was indicted in the federal criminal case in October. He’s pleaded not guilty.

Earlier this month Kapoor’s lawyers asked the judge handling the Johnson County suits, Paul Gurney, to put them on hold until the criminal case is resolved. Gurney has not yet ruled on that motion.

This story was originally published February 20, 2018 at 9:32 AM with the headline "Fatal fentanyl overdose caused by Kansas doctor, suit says. This is his third suit.."