Wendy Fillhardt went to see Dr. Pragya B. Gupta at Advanced Pain Treatment Center in Edgewood for back pain in 2021.
“I was told that he was a good doctor,” she said. “I was encouraged to go there. So I finally gave in and went.”
She said she’s not a fan of going to the doctor or being on medication, but eventually she just couldn’t take the pain. She was at a dead end.
“I was working full time when I went there,” she said. “And it just went downhill from the moment I went. Now I’m fully disabled.”
Fillhardt is one of several people who reached out to LINK nky to tell their stories of Gupta, the clinic and his office manager, Donnie Jay Thomas (also known as Donald J. Thomas and DJ Thomas), after seeing a story published in June. Gupta said in court filings he considered Thomas a medical assistant because he had personally trained him.
Thomas still works at the clinic, according to a registration document with the Kentucky Board of Medical Licensure dated May 22, 2023. He is listed as a “clerical staff.” That document lists ownership of the clinic as having been transferred from Gupta to Dr. Zeeshan Tayeb.
That June LINK story outlined the Kentucky Board of Medical Licensure’s June 2023 agreement with Gupta that the doctor’s license to practice medicine was restricted indefinitely in Kentucky and that he could not practice medicine in Kentucky unless otherwise stated by the board. This was based on a consultant’s opinion that Gupta allowed Thomas to perform medical procedures without proper certification. Those procedures included administering anesthesia, according to Fillhardt’s complaint, and placing IVs, according to interviews LINK nky has conducted.
Fillhardt is the one who filed the complaint that led to the board’s decision.
“I went there to get better,” she said. “And I’m not. I’m worse.”
Gupta’s attorney said in court filings that Fillhardt signed consent forms acknowledging there are no guaranteed results for the procedures she underwent. But Fillhardt – and others who spoke to LINK nky – described a clinic overrun with patients, a doctor who did not like to be questioned, and an office manager who performed certain medical procedures without the legal ability to do so.
The law – or, more specifically, what the law does not say – is at the heart of this story.
Kenton County Commonwealth’s Attorney Rob Sanders confirmed that he launched an investigation into the clinic after seeing the LINK nky story and reviewing the board’s investigation.
“The board had never contacted me about Dr. Gupta, and frankly I didn’t realize he existed until I read about it on your website,” Sanders said.
While Sanders didn’t elaborate on specifics because it is an active investigation, he did say there are multiple complainants and that what he received from the medical board “is not everything that has been alleged against the doctor.”
At a state and even a national level, the stories these former patients and employees shared with LINK highlight a medical system that can be difficult to navigate – along with laws and regulations that change from state to state, making patients’ ability to understand the full scope of their provider’s history a challenge.
Sanders expressed frustration with the communication between the medical board and local law enforcement. He said his office was not contacted after the board’s decision about Gupta’s license in Kentucky came down.
The patient and families we spoke to said they found out about Gupta the way many people find a health care provider – through word of mouth.
But only after seeing what happened inside the clinic did they – and two former employees – realize they had more questions than answers.
What are the laws and regulations surrounding pain clinics in Kentucky? How easy is it to find out whether the people treating patients at these clinics are licensed to do so or operating within the law? What recourse do patients have when they feel they have been wronged?
‘The law is not clear’
Each state in the U.S. has a board that oversees doctors’ licenses and, when necessary, discipline. In Kentucky, that board is called the Kentucky Board of Medical Licensure.
The structure and composition of a medical board varies from state to state, according to Jacqueline Landess’ report State Medical Boards, Licensure, and Discipline in the United States, published in the National Library of Medicine.
“Today,” Landess writes, “state medical boards are usually responsible for a variety of functions, with the main function being the detection and discipline of unprofessional and unethical conduct by physicians and other medical professionals.”
The board oversees licensure and not criminal conduct, so if Gupta were to be criminally charged, that would have to be done through the courts.
That has not happened, but Judd Uhl, who is representing Gupta, Thomas and Advanced Pain Treatment Center in the case Fillhardt brought against them, said he isn’t sure what the criminal charges would be.
He also said he could not allow Gupta to sit down for an interview because of the ongoing litigation.
“The law is not clear about what is considered a medical assistant,” Uhl said. That, coupled with the fact that he said Fillhardt wasn’t injured, means Gupta didn’t do anything wrong criminally as it relates to this case specifically, he said.
Each state also has a website where the public can look up the status of a doctor’s medical license. There is something called a National Practitioner Data Bank (NPDB), which allows certain state agencies to query its database to determine whether providers have faced disciplinary action in other states. But, Landess writes in her report, that database is not available to the public.
“The NPDB was created, in part, to prevent physicians from traveling across state lines to practice when their license has been suspended or revoked in another state,” Landess said in her report. “However, states are inconsistent when deciding how to respond to claims or even disciplinary actions arising in other states.”
If a patient wants to know whether his doctor has been disciplined in another state, he must check the licensure verification for that physician in each state separately. A simple Google search most likely will not produce information about a physician’s disciplinary record, unless a news story has been written that would come up in a search.
ProPublica did compile a list of links to recent board actions in each state, which can be found at projects.propublica.org/graphics/investigating-doctors.
LINK nky has verified that Gupta is licensed to practice medicine in California, Ohio and Connecticut. While Gupta’s license has been restricted in Kentucky and he agreed not to practice medicine in Kentucky, it is still technically active.
So, while the consultant who worked with the Kentucky Board of Medical Licensure ahead of its June agreement with Gupta determined that Thomas practicing medicine under Gupta’s supervision posed “an immediate threat to the safety and health of citizens of Kentucky” – and that the board and Gupta agreed that he “shall not perform any act which would constitute the practice of medicine … in the Commonwealth of Kentucky” – Gupta is free to practice medicine in any other state where he is licensed.
On Aug. 8, the Kentucky medical board revised its restrictions on Dr. Gupta to let him practice in the Paducah and Hopkinsville offices of Pain Management Centers of America. Gupta would be practicing under the supervision of a board-certified anesthesiologist, Dr. Laxmaiah Manchikanti, according to state records.
As for Thomas, the board that oversees Gupta does not have jurisdiction over any discipline because, according to Donald A. Balasa, CEO and house legal counsel for the American Association of Medical Assistants, licensure for medical assistants does not exist under Kentucky law.
In his response to the medical board’s decision, Gupta admitted that Thomas is not licensed to perform medical procedures. But, he said, “Donnie J. Thomas is a trained medical assistant. I have trained him since 2002.” But Gupta did not admit guilt in the agreement with the board.
However, Balasa told LINK, the Kentucky Medical Practice Act states that only licensed physicians are permitted legally to practice medicine.
“There are exceptions,” he said. “Mr. Thomas does not fall into any of those exceptions. Therefore, given the facts of this case, it is likely that Mr. Thomas was practicing medicine without a license.”
Thomas served time in federal prison after he pled guilty to embezzling money from a Cincinnati pain clinic in 2012. Other than that, he has not been found to be in violation of the law related to his work in medical facilities.
While Thomas could be charged for practicing medicine without a license, Balasa said, the state medical board has no jurisdiction over medical assistants.
“That would likely require an indictment and an action in court,” Balasa wrote in an email to LINK nky. “I don’t believe it could be addressed within the disciplinary authority of the KY Medical Board because, once again, the Medical Board has no direct supervision over Mr. Thomas as it did with Dr. Gupta.”
But Thomas’ lawyer, Steve Megerle, told LINK nky that there is no basis for criminal charges, in part because everything Thomas did was under Gupta’s direct supervision.
“At no time was Ms. Fillhardt’s safety as a patient ever in jeopardy under the care of Dr. Gupta or below the standard of care, either by Dr. Gupta or any of his staff,” Megerle said in a statement.
Megerle went on to say that the fact that the attorney who filed Fillhardt’s complaint is also on the Kentucky Board of Medical Licensure is an ethics violation. That attorney, Kristin Turner, is also Fillhardt’s niece. Turner declined to comment for this story.
“Once this frivolous lawsuit is dismissed, Mr. Thomas intends to request the executive branch ethics commission and the bar association to investigative whether an attorney can use their position on the medical licensure board to solicit clients for medical malpractice lawsuits at the same time,” Megerle said.
‘He was dressing up like he was playing doctor’
The patients and family members LINK nky spoke to for this story said that because their care was being overseen by a medical doctor, they assumed anyone performing medical procedures on them or their loved ones was licensed or legally trained to do so.
Uhl contends in a May response to Fillhardt’s complaint that because Gupta oversaw everything Thomas did, that means Thomas was legally trained. But the consultant who worked with the medical board in its investigation into Fillhardt’s complaint disagreed.
Lauren said she worked at Gupta’s office for three weeks in 2021 before realizing she wanted no part of the clinic’s operations. She had only completed one semester of nursing school before being hired at the clinic on the spot during her interview.
LINK agreed to use only Lauren’s first name because she said she felt manipulated into performing tasks she was unqualified to do at Advanced Pain Treatment Center and doesn’t want it to affect her future employment.
“(Thomas is) back there just suited in his little bonnet and surgical mask and scrubs,” Lauren said. “My thing about working in a medical facility is, you can go buy a pair of scrubs at Walmart, you can buy a scrub cap at Walmart. Anybody can dress up like they’re gonna play doctor. And that’s what I feel like this guy was doing every day. He was dressing up like he was playing doctor.”
Lauren told LINK she observed things at the clinic right away that she knew were not OK.
“I witnessed DJ putting anesthetics in someone,” she said. “Usually I was kept out of the room because I’m guessing they didn’t want me to see things happening that shouldn’t have been happening.”
Fillhardt said in her complaint that, on multiple occasions, Thomas was the one who administered anesthesia to her at the clinic.
“He would ask Dr. Gupta how much to administer and then measure out and give the doses by IV,” the complaint says.
In a response to Fillhardt’s complaint, Uhl, Gupta’s attorney, wrote that the medical board had never issued an opinion that precluded a medical assistant from “participating in a procedure involving moderate sedation/analgesia.” Analgesia is a medication that relieves pain.
The response does not specifically say whether the law addresses the administration of IVs or anesthesia or that Thomas did or did not place or administer medication through an IV. That, Balasa said, is the key.
Even in accredited medical assisting programs, Balasa told LINK nky, IV theory and technique are not taught.
As of the date of publication of this story, neither Gupta nor Thomas has been criminally charged. But charges may be coming soon, depending on the results of Commonwealth’s Attorney Rob Sanders’ investigation into the clinic.
“You don’t do this to people,” Fillhardt said. “What does DJ have that is making people overlook that he harmed somebody? That he is not being held accountable for his actions? Not only for what he did to me, but to how many other people?”
Joanetta Wilson, whose mother, Joan, saw Gupta in 2019 for pain after contracting shingles, said she felt equally as helpless.
Medical records the Wilson family shared with LINK show that, during a routine epidural at the clinic, Joan Wilson experienced a pneumothorax, which is a collapsed lung that can be caused by injury to the lung.
Health care providers use lumbar epidural steroid injections as a pain relief option for certain causes of chronic back pain, according to the Cleveland Clinic. During the procedure, doctors inject an anti-inflammatory medication into the epidural space around the spinal nerves.
The needle, intended to help relieve Joan Wilson’s pain, instead punctured her lung. The situation was exacerbated because she had the chronic lung condition COPD.
While Gupta’s attorney, Uhl, said that Gupta oversaw all procedures Thomas was involved with, Joanetta Wilson said that when her mother was wheeled out of the procedure room at the clinic after the procedure, struggling to breathe, she was accompanied by a man and two women who were not Gupta. She said they came toward her from the left, and Gupta came from the other direction.
“Attorneys talked to my dad and said, ‘Well, if she had died, you’d have a case,’ ” she said of her mother, Joan Wilson. “That’s what they told him. Or another one told him, ‘For $100,000, I can take the case. Not saying you’re going to win.’ I mean, it wasn’t that my dad wanted money. My dad just wanted Dr. Gupta to pay. He doesn’t want him to hurt anyone else.”
While Joan Wilson’s family said she was an active person before the procedure – driving, going to gamble with her friends – afterward, she was never the same.
“She ended up bedridden,” Joanetta Wilson said.
Joan Wilson died in October 2020 after having gone downhill in the time since her procedure at Advanced Pain Treatment Centers, her family said.
While her death was not directly attributed to the epidural that punctured her lung, Charlie Wilson, Joan Wilson’s husband of 57 years, said he will always wonder.
“I like to think – and maybe I’m wrong, but I don’t think I am – that this doctor had a whole lot to do with her leaving,” Charlie Wilson said. “He stuck a needle in her lung. I’m not saying he killed her, but I’m saying he had a whole lot to do with it.”
Because he doesn’t have hundreds of thousands of dollars to bring legal action against Gupta – and was told by several attorneys he might not get that money back even if he did – he said speaking publicly about his story was the least he could do.
“If there’s something I can do to keep him from hurting someone else, I’d like to be able to do it,” Charlie Wilson said. “If this little conversation we’re having will help someone else, God love ’em.”
Former employee Lauren said she had the same reasoning for speaking to LINK about what she saw in the office.
And the things that made her uneasy didn’t stop with Thomas.
“Once, I couldn’t get an IV in,” she said. “And I have a rule: I try twice, and after that I ask for assistance.”
So she asked Gupta for help.
“He came in, didn’t wash his hands, didn’t clean the area with antiseptic, didn’t put gloves on,” Lauren said. “He just put the needle in the patient’s arm.”
Another time, Lauren said she saw Gupta drop sterile gloves on the floor. Instead of throwing them away and getting new ones, he picked them up and put them on.
When she asked if he wanted clean gloves, she said he told her, “I don’t need you to tell me how to do my job.”
She started documenting what she saw in text messages to her boyfriend and mother. She also took photos of sheets stained with iodine and blood.
“They had me inject local anesthetics yesterday unsupervised which is very much not OK,” she said in one text message to her boyfriend. “And when I said something about it I was again told to do what is asked of me and I shouldn’t question the doctor because he knows what he’s doing.”
More laws, safeguards in place
Laws surrounding pain clinics have changed drastically in the United States in the last 20 years, and Kentucky is no exception.
A 2012 law established standards for pain clinics, defining them as a facility where a majority of patients receive treatment for pain.
It requires that all pain management facilities register with the Kentucky Board of Medical Licensure, and physicians who prescribe controlled drugs to patients are required to complete special training in pain management.
That registration is required annually, and if a new or different physician obtains ownership of the facility, they must file an amended registration with the board.
The registration update for Advanced Pain Treatment Centers filed on May 22, 2023 to change the owner from Gupta to Tayeb occurred 10 days before Gupta’s medical license was officially stripped in the state of Kentucky.
Kentucky also passed a law in 2017 that limits the number of prescription painkillers that health providers can prescribe.
Another safeguard is the KASPER system.
“Created in 1999, KASPER is used to track all prescriptions for a controlled substance for an individual patient,” according to Kentucky Comeback, a coalition the Kentucky Chamber created to transform the state’s approach to addiction and criminal justice. “The system allows for real-time tracking, and 2012 legislation requires health care providers to obtain a KASPER report on a patient to determine whether a patient already has a prescription from another provider before writing a prescription for certain controlled drugs.”
But the current Kentucky laws – or, more specifically, the ones that don’t exist – are exactly the point, Gupta’s attorney Uhl said in his May response to the complaint Fillhardt filed.
“In the event that this Board would like to directly control the activities of medical assistants in Kentucky,” Uhl wrote, “proposing statutory legislation on this subject or issuing a prospective administrative regulation on this topic … are more appropriate vehicles than retrospective punishment of Dr. Gupta when there has been no violation of Kentucky law or breach of the applicable standard of care.”
But Jennifer Jasper-Lucas, who worked at Gupta’s clinic in 2012, spoke to LINK about several state laws she believes were broken when she worked at the clinic.
She spoke about the KASPER system and how what she called its incorrect usage in the clinic was one of the red flags she noticed right away. Sometimes Gupta filled the reports out for patients, and sometimes he didn’t, she said.
She also noticed that, even though Gupta originally told her he primarily did procedures to relieve pain, the office dealt with a lot of prescriptions.
“I just started noticing that, on clinic days, we had a lot of patients in the waiting room,” Jasper-Lucas said. “And they didn’t seem to mind waiting. Because they wanted their meds.”
Beyond that, behavior that should be flagged, Jasper-Lucas said, is if a patient calls and asks if a prescription can be called in without actually seeing the doctor, which allows them to avoid a urine test.
“So there were those patients who wouldn’t come in, and Dr. Gupta would go ahead and give them a prescription,” Jasper-Lucas said. “And when I mentioned that to him, I basically was told, ‘I’m the doctor, I know what I’m doing.’ And I’m like, ‘It’s not your choice. It’s the law.’”
The red flags, Jasper-Lucas said, were increasing in number.
“We had family members of patients who would call and say, ‘I think my spouse is addicted,’ ” Jasper-Lucas said. “I would always document all of that and have a conversation with Dr. Gupta about those things. But as far as I know, none of those ever resulted in him firing a patient.”
And then one day, in the fall of 2012, Gupta called her into his office.
“I was called into his office, and he told me that he couldn’t afford me anymore,” Jasper-Lucas said.
At this time, Jasper-Lucas’ husband was dying, and she said she suspected the reason Gupta couldn’t afford her anymore as an employee was due to the mounting medical bills.
Gupta told Jasper-Lucas he was having financial problems, she said, and he couldn’t afford to keep her on staff.
Jasper-Lucas said she ended up reporting Gupta to three separate agencies: the Board of Medical Licensure, the U.S. Equal Opportunity Employment Commission and Medicare.
She filed a complaint to the employment commission because, she said, she was routinely required to stay until 7 p.m. while Gupta finished seeing patients because she was on salary. The hourly employees were allowed to leave at 5, she said.
As for Medicare, Jasper-Lucas said at the time, the agency was enticing doctors to use electronic reporting systems by offering them financial incentive.
Gupta was taking the incentive, she said, but he was not properly filling out the forms.
And the Board of Medical Licensure? She submitted that complaint because of all the other things she said she observed.
Because of how long ago she filed the complaints, she does not still have them, and LINK nky was not able to independently verify their submission.
Jasper-Lucas said she was never contacted about the complaints.
As for Lauren, she’s almost done with nursing school.
Fillhardt, whose lawsuit is still making its way through the Kenton County Circuit Court, found out in June that Gupta, Thomas and Advanced Pain Treatment Centers filed a motion to dismiss her claim of fraud.
Fillhardt’s initial attorney withdrew from the case, and a July court appearance was continued to give her time to find a new attorney. Louisville attorneys David Gray and TJ Smith are now representing her and expect to be back in court in October.
As for Charlie Wilson, there are reminders of his Joanie throughout his house.
One of them is a Christmas tree, still displayed and decorated in June.
“Let me tell you about that,” he said. “I put that up several years ago and she said, ‘Charlie, when are you going to take that damn tree down?’ And I said, ‘Joanie, I said we’ll take that tree down together. I said you get your lazy butt up out of that bed and you come and help me. And we’ll both take it down together.’ ”
Charlie Wilson cleared his throat.
“That tree will be there until after I’m gone. Because I will never take it down.”
How do you find a doctor you can trust?
St. Elizabeth Public Relations Manager Guy Karrick told LINK nky that patients should speak with their primary care providers, read online reviews, and talk to others they trust for recommendations.
“A patient should feel comfortable with their provider and should be able to ask questions about treatment plans and alternatives,” Karrick said.
St. Elizabeth, he said, completes a background check as part of the hiring process, which includes an investigation of any actions against the provider in Kentucky or any other state where they have held a license.
The U.S. Department of Health and Human Services, in a 2022 article, compiled a list of things to consider when choosing a doctor.
It advises narrowing down a list of top choices and then learning more about them:
- Is the doctor taking new patients?
- Who will see me if the doctor isn’t available?
- Does the doctor have experience treating my medical conditions?
- How long will it take to get an appointment?
- Is there a doctor or nurse who speaks my preferred language?
Then, the department recommends, think about your experience after your first visit:
- Did the doctor and office staff make you feel comfortable?
- Did the doctor spend enough time with you?
- Did the doctor give you a chance to ask questions?
- Did the doctor listen carefully to you?
- Did the doctor know important information about your medical history?
If the answer to any of those questions after your first visit is “no,” the department advises that you keep looking.
Why do people go to pain clinics?
Most people who go to pain clinics, Karrick said, are seeking relief from their chronic pain, along with improvement in their functionality and quality of life.
But why don’t patients go to their general practitioner for such care?
“It is likely different in every situation,” Karrick said. “Many general practitioners are not comfortable with high doses of pain medication that may be necessary to adequately treat the patient’s pain. With recent litigation against physicians prescribing pain medications, others may be concerned about their license.”
Most patients start by going to their primary care practitioner, he said, but, like many diagnoses, if initial treatments are not helping, additional expertise may be required. That expertise could include other therapies and interventions to offer, along with knowledge of medications that can be utilized.
St. Elizabeth is not affiliated with Advanced Pain Treatment Center and Gupta is not listed on their website as having privileges at the hospital system.
Anyone wishing to find out if a doctor has privileges at St. Elizabeth can search that physician’s name at stelizabeth.com/find-a-doctor.