Under an agreement with state officials, Dr. Frank Li will be suspended from practicing medicine for at least another year and will subsequently face a range of other limitations and oversight of his work.

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A prominent Seattle-area pain doctor will face a lifetime of restrictions under a new agreement with health regulators, bringing to an end a sweeping investigation that closely examined the deaths of more than a dozen patients around the state.

Under the agreement with Dr. Frank Li, he will remain suspended from practicing medicine for at least another year and will subsequently face a range of other limitations, including a requirement that he only prescribe controlled substances when patients are in acute pain. And in those cases, Li will only be allowed to prescribe up to seven-day quantities.

Li was the medical director and sole shareholder of Seattle Pain Centers. The company’s eight clinics across the state were shuttered after the Washington Medical Commission suspended his license in 2016.

Micah Matthews, deputy executive director at the Washington Medical Commission, said the resolution ends the case before it would go to a full hearing, which could have resulted in a dismissed case or the full revocation of Li’s license. Li will have to petition to get his license back after his yearlong suspension ends, Matthews said.

“We’re pleased with the order and how we feel it will protect patients,” Matthews said.

Under the agreement, Li doesn’t admit to wrongdoing. His attorney, Tom Fain, said in an email Friday that opioid use in pain care is a complex matter and that Li did his best to treat legitimate pain patients.

“The goal of the compromise was to allow Dr. Li to return to a productive practice of medicine in a manner that the Commission feels provides quality care for citizens of our state,” Fain said.

After working as a board-certified pain-management specialist in California, Li established his Seattle-area pain practice in 2008 and quickly added satellite offices around the state. Officials said he went on to hire some practitioners with pain-management experience but also hired others without training or expertise.

Li has said he had “a mission to make quality pain care accessible.” But, by 2013, officials were scrutinizing his work. The state Department of Labor and Industries denied Li’s application to prescribe drugs for the workers’-compensation program amid concerns about prescribing practices and the death of a patient. A lab Li operated was also barred from billing the state’s Medicaid program in 2015 amid suspicions of fraud related to unnecessary urine screens.

Investigators with the state Attorney General’s Office delivered to the Medical Commission a wide-ranging report in 2015 that detailed concerns about Seattle Pain Centers. It included details on the deaths of 18 patients over five years and suggestions that many more patients may have been harmed, according to documents.

It took more than a year before the Medical Commission suspended Li’s license.

Li’s pain center clinics — in Seattle, Renton, Everett, Tacoma, Olympia, Spokane, Poulsbo and Vancouver– served thousands of patients, and the abrupt closure of his clinics left some patients scrambling to find other care. Hundreds of those patients sought help in emergency rooms, and other pain offices reported being inundated with patients.

One former patient committed suicide, leaving messages describing his back pain and the difficulty of getting help after the clinics were closed.

The final agreement details 16 patients who died with acute drug intoxication as a cause or a contributing cause of death. The agreement says the medical records of those patients “reveal a pattern of substandard medical care,” such as opioid-centric treatment plans at the patient’s initial visit, failures to adequately review patient medical histories, and failures to consider or address risk factors.

Along with his suspension and lifetime restrictions on his ability to prescribe, Li faces a lifetime prohibition from hiring or directing anyone to prescribe opioids and a 10-year prohibition from owning or leading a pain-management practice, among other limitations. He also must submit to practice reviews by the Medical Commission.

The federal Drug Enforcement Administration has also revoked Li’s privileges.

 

March 30 update: This story has been updated to add comment from Li’s attorney.