The mother of 32-year-old Adam Emmott, who died last year from a prescription drug overdose in Forest Knolls, has filed a wrongful death lawsuit in Marin County Superior Court against her son’s physician, Wendi Joiner.
A former Coastal Health Alliance family practitioner, Dr. Joiner lost her license with the Medical Board of California in November following a 2014 drunk driving arrest and 2015 conviction. The ensuing investigation conducted by the state medical board revealed 33 false prescriptions she had written to a fictitious name later traced to her fiancé.
At the time of her arrest, Dr. Joiner registered a blood-alcohol concentration of over twice the legal limit and was found with three handles of whiskey, a whipped cream dispenser charged with nitrous oxide—which is inhaled to produce a quick but strong high—two dozen nitrous oxide cartridges and over 100 pills. She pleaded no contest to six misdemeanor charges in April.
Almost exactly a year later, Dr. Joiner was arrested for possession of codeine, hydrocodone, amphetamine, carisoprodol, fentanyl and morphine, and later pleaded not guilty to four felony and two misdemeanor counts.
Dr. Joiner, a 40-year-old Nicasio resident, could not be reached for comment.
In her suit, Adam’s mother, Kris Teplin, a retired nurse, alleges that Dr. Joiner had been aware since at least 2012 that her son was an opiate addict. She claims that Dr. Joiner pledged not to prescribe Adam opiate medications after learning that he was supplying her with fake M.R.I. reports, but that she continued to prescribe them anyway.
Ms. Teplin declined to speak with the Light about the details of her suit or about Adam’s death.
When Adam was found deceased at his mother’s home on Jan. 11, 2015, there were eight controlled substances in his blood, including a large amount of fentanyl, a synthetic opiate more potent than morphine.
Summarizing medical records, the coroner’s report said Adam had “reported ‘the specialist’ preferred Fentanyl to Methadone for his type of chronic pain,” which stemmed from neck and back pain related to a 2001 vehicle accident and was exacerbated by minor work-related injuries.
Toxicology tests revealed that his blood also contained amounts of Xanax and carisoprodol, a muscle relaxant. Bottles for both were found with him at the time of his death and were prescribed by Dr. Joiner.
Adam’s father, Jim Emmott, believes that two days before Adam died, Dr. Joiner had prescribed him a “basket-full of opiates.” He said Adam had at least four appointments at the alliance clinic in Bolinas during the year prior to his death, and that Dr. Joiner was the only doctor there whom he saw.
“I’m not saying that Adam didn’t cause his own death,” said Mr. Emmott, who has worked in construction in West Marin since 1980. “I told him many times that this was a slow suicide and it would lead to his own death. But I can’t help but think that even though, metaphorically, he pulled the trigger, I have to say that Wendi put the bullet in the gun.”
Adam’s death is part of a troubling string of prescription drug overdoses in Marin, where public health officials and social service workers say prescription drug abuse is an epidemic. “Unfortunately, this is not an isolated incident,” said Matt Willis, the county’s public health officer. “The fact that our own prescribers themselves are caught up in this shows just how powerful a hold these drugs can have over our communities.”
For Adam, the large amounts of prescriptions he was able to obtain fueled his addictive habits and, on a few occasions, led to trouble. In his late 20s, he was caught in a police sting operation in which he supplied 100 oxycodone pills to an undercover officer and was arrested outside Good Earth Natural Foods in Fairfax.
That incident, along with other run-ins with the law and several stints in rehab, left Adam eager to work for his father, who agreed to employ him on construction jobs. Mr. Emmott recalled that Adam was proud of his work, often taking pictures of finished construction jobs and posting them on his Facebook page.
“I wanted to engage him,” Mr. Emmott said. “I wanted to create a space where, through a longer period of time, he could get to weigh the two lifestyles.”
But the powerful hold of opioids and other drugs was too strong for Adam, and he relapsed several times before the end of his life. Even so, friends and family remember him as an intelligent and social person who just got caught up in a battle that was too tough to win.
“If you walked down the road with Adam, it was like walking down the road with royalty,” Mr. Emmott said. “Everybody he saw, they’d shake his hand. He was super, super, super social.”
Colleagues and former patients of Dr. Joiner have likewise praised her as a skilled doctor and good person. No one seems to have been aware of her apparent struggles with alcohol and prescription drugs. “She seemed like a smart, pro-active physician willing to listen and help,” Elizabeth Barnett told the Light last month. “I’m very sorry and sad about this for her. And for others, too, of course.”
Dr. Joiner provided infant, adult and emergency care at Coastal Health Alliance clinics from November 2012 to January 2015, when she left to join Marin Community Clinics and was promoted to medical director for the San Rafael campus last July. Before the promotion in April, she served a 30-day jail sentence for her prior D.U.I. conviction.
The Light reported last month that neither the chief executive officer of Marin Community Clinics, Linda Tavaszi, nor the executive director of the Coastal Health Alliance, Steve Siegel, were aware of Dr. Joiner’s substance abuse problems and prescribing practices.
But Mr. Emmott has since called that ignorance into question. The medical board’s report states that another physician at the Coastal Health Alliance contacted the patient to whom Dr. Joiner had been writing false prescriptions and “notified him that he could no longer obtain prescriptions for controlled substances through their facility.” Mr. Emmott said a doctor calling another doctor’s patient with that kind of message is unprecedented. “This idea that no one knew anything is absolutely untrue,” he said. “That’s the thing that’s bothered me with it.”
The alliance’s medical director at the time, Dr. Mike Witte, did not respond to requests for comment.
Mr. Siegel declined to comment on whether other physicians at the alliance knew about the false prescriptions. “Due to the seriousness and complexity of this issue, I’m not able to provide any supportive information right now,” he said.
Ms. Teplin alleged in her suit that she called Mr. Siegel in 2014 to inform him both about Adam’s false M.R.I. reports and Dr. Joiner’s continued prescribing of opioid drugs. “He told me he would get back to me,” she stated in an unverified note attached to her suit. “He never did.”
For her part, Dr. Tavaszi reiterated this week that the clinic was unaware of any problems until Dr. Joiner notified the chief medical officer about her 2014 D.U.I. arrest. Dr. Tavaszi said she herself first learned of the D.U.I. and the prescription falsification one afternoon in November, when investigators from the medical board arrived “unannounced” at the clinic to inform her that Dr. Joiner’s license had been revoked.
“We’ve never had a situation like this before,” she said. “We were really shocked and saddened, and continue to feel that way. She had been a very good clinician, treating patients—so far as we knew—appropriately.”
The Marin County Sheriff’s Office has declined to comment on whether or not it is investigating Dr. Joiner’s practices. According to law enforcement authorities, similar investigations in California are typically only conducted when multiple deaths from prescription drugs have been tied to a single doctor.
Mark Dale, founder of the Marin County Prescription Drug Abuse Task Force, noted that it is unusual for a doctor to prescribe fentanyl to a known opiate addict. Fentanyl is administered through a time-release patch and, according to the National Institute on Drug Abuse, “is typically used to treat patients with severe pain, or to manage pain after surgery.” It is also given to patients with a high tolerance to opiates.
It is estimated to be “80 times as potent as morphine and hundreds of times more potent than heroin,” according to the Centers for Disease Control.
“Fentanyl is an incredibly powerful drug, often used by late stage cancer patients” said Mr. Dale, who devoted himself to prescription drug advocacy after his own son nearly died of an overdose in 2010. “I’ve never heard from anybody that using fentanyl in place of methadone is the way to go.”
By his count, there have been five deaths related to prescription drugs in Marin since Christmas. Mr. Emmott said he knew five other people who grew up in the San Geronimo Valley and died from prescription drug overdoses in the year-and-a-half prior to Adam’s death. All were around Adam’s age, he said.
Coroner records show 21 drug-related deaths in Marin since January 2015, with seven of these attributed to “acute multiple prescription drug intoxication.”
Dr. Joiner and Ms. Teplin are scheduled for a case management hearing in superior court on May 19. Ms. Teplin filed for an unlimited civil case exceeding $25,000.