The Oklahoma Attorney General has charged an Oklahoma doctor with five counts of second degree murder after many of her patients died of drug overdose.
Investigators say that Dr. Regan Nichols, an osteopathic physician, prescribed "horrifyingly excessive" quantities of painkillers, muscle relaxers, and anti-anxiety medications in combinations that proved lethal for ten of her patients in a span of four years. She is charged with murder in five of those cases.
A probable cause affidavit describes the five overdose deaths for which Nichols is accused of being responsible:
- March 24, 2010 - Dr. Nichols prescribed a patient hydrocodone (narcotic painkiller), alprazolam (anti-anxiety medication), and carisoprodol (muscle relaxer) in a quantity totaling 450 pills. The patient died of acute drug toxicity six days later. One expert who reviewed the Nichols's actions and the patient's death said there was "no need for the quantity or combination" of the prescribed drugs, and another called the prescription "the holy trinity in the drug addict's terminology."
- February 12, 2012 - Dr. Nichols prescribed 240 pills of oxycodone and alprazolam to a patient whom she had not given a full examination to in more than three years. Between the patient's first visit to Dr. Nichols and her death, the doctor had prescribed her Norco (hydrocodone), Soma (carisoprodol), and Xanax (alprazolam). The patient died five days after getting her final alprazolam prescription filled. The doctors who reviewed the case seemed stunned that she hadn't died earlier, saying that one full examination in four years was insufficient to establish a valid patient-doctor relationship and to determine whether or not the patient had a legitimate medical need for the types and quantities of drugs prescribed.
- November 21, 2012 - Dr. Nichols prescribed 510 pills of hydrocodone, alprazolam, and carisoprodol to a patient who filled the prescriptions and died of acute drug toxicity the same day. Doctors reviewing the case called the combination and quantity of drugs "irrational," and noted that the patient's son--who lived at the same house as his mother--was also a patient of Dr. Nichols and was also prescribed the same "holy trinity" drug cocktail.
- August 1, 2013 - Dr. Nichols prescribed 360 pills of oxycodone and carisoprodol to a diabetic patient who died of drug overdose three days later. The affidavit said that Dr. Nichols discharged the patient from the hospital a week prior to her death with instructions to continue her "regular" prescriptions of carisoprodol and oxycodone and also added a prescription of hydrocodone--despite the patient testing positive for amphetamines in the hospital. Doctors reviewing the case noted the patient's diagnoses of bipolar disorder and seizures, and said that the woman should never have been discharged in the first place, but rather transferred to a psychiatric hospital or a drug treatment unit.
- October 8, 2013 - Dr. Nichols prescribed 270 pills of oxycodone and diazepam (Valium) to a patient with Hepatitis C who would not have been able to
metabolize the oxycodone well. The patient died of acute drug toxicity a little over two weeks later. Doctors reviewing the file called the prescriptions
"way, way out of line" and her care "egregious."
Investigators say at least five more patients died of drug overdose while under the "care" of Dr. Nichols between January 1, 2010, and October 7, 2014. They say she prescribed more than 3 million dosage units of controlled substances during that time.
In September 2015, the Oklahoma State Board of Osteopathic Examiners stripped her of the ability to prescribe controlled substances for 5 years, and she voluntarily surrendered her credentials.
Now, as a result of the criminal investigation, she is charged with five counts of second degree murder for perpetrating "an act imminently dangerous to another person and evincing a depraved mind, regardless of human life."
Each act of second degree murder is punishable by 10 years to life in prison.