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The Montana State Board of Medical Examiners continued with the prosecution of Helena physician Mark Ibsen yesterday with an appeal hearing in which Ibsen is seeking to reverse the decision by a panel that concluded he should be sanctioned for over prescribing narcotic pain medications.

Ibsen describes it as “the fight of his career.”

The process began March 15, 2013 with a complaint from one of Ibsen’s former employees, Sarah Damm, who Ibsen fired Feb. 15, 2013.

The 20 foot by 20 foot hearing room couldn’t accommodate all Ibsen’s supporters, more than 20 at one point. Several people had to observe the proceedings from the hallway, some who squeezed inside the hearing room sat on the floor.

The room size wasn’t the only snag in the proceedings, which are expected to take three days. Also in dispute was two boxes of document evidence and the two sides were at odds over some witnesses added late.

The paper evidence was bundled in two groups -- one around 800 pages and a second crate with 2,800 pages. The two sides couldn’t agree whether or not the larger “pile” was even submitted.

The state’s attorney, Michael Manning, wanted the larger group of papers excluded as evidence in the proceedings, saying that he and the expert witnesses had not had opportunity to review it.

Ibsen’s attorney, however, said he had submitted the larger group of documents in a timely fashion to the Board of Medical Examiners’ compliance specialist LaVelle Potter.

According to Ibsen’s attorney, John Doubek, the first group of documents was rejected by Potter.

“She told us she had concerns receiving that many records,” Doubek said, “and being able to forward those to her screening panel She told us her concerns related to the amount of prescriptions for pain medications.

“So we pared that down,” Doubek continued. “The pared down records are accurate and they relate to the issues Mrs. Potter told us about.”

But, Doubek said, the scope of the issues has expanded and the larger group of documents is necessary to prove Ibsen’s dedication to providing quality care to his patients.

Fanning, however, disputed Doubek’s account, as it seemed to call into question Potter’s character and job performance.

“I have studiously tried to avoid bringing this up because it’s so terribly unseemly,” he said. “Mrs. Potter says that didn’t happen. She didn’t have the larger stack and reject it, it’s her practice to just submit everything… She doesn’t limit people on their defense nor does she make a determination on what’s relevant to their defense. She scans it and sends it to the screening panel and they deal with it.”

The dispute over the two “piles” of documents will likely result in a delay in the final day of the proceedings, according to the hearing officer, David Scrimm.

“We’re in a pretty tough spot. I am troubled by the lack of real disclosure of these documents,” Scrimm said. “Now we have a whole bunch more documents that no one (except Ibsen’s attorney) has reviewed.”

Because the expert witnesses have not reviewed the larger group of documents, Scrimm decided to delay the testimony of experts, set for the third day, until a “later date.”

“If I exclude them (the documents),” Scrimm said, "We’re not seeing the whole picture.”

Also at issue was the fact that the case had “evolved” over time and new allegations were added to the case.

The crux of the case was and still is “over-prescribing narcotics,” Fanning said, but also at issue are allegations that Ibsen’s patient records were “substandard” and that he failed to “properly tend to patients with very complex medical issues.”

Scrimm decided to continue the hearing process to allow the state’s and Ibsen’s witnesses to testify. Ibsen’s attorney is expected to complete his presentation of witnesses Wednesday.

Outside of the hearing many of Ibsen’s patients were eager to express their support for him.

“I’ve been a patient of his off and on for 25 years,” said Byron Taylor. “I’ve had knee and back problems… several surgeries on my knees.”

Taylor worked for 22 years in the maintenance department at St. Peter’s Hospital in Helena and a decade before that for the railroad. Over his years working, Taylor said, “you just kind of wear things out.

“I’m here to support him because he’s one of the few doctors that really tries to find out what kind of a person you are and what your problems are. He takes the extra time. With most doctors you’re out in 15 minutes. With him it’s more likely to be an hour and a half.”

Taylor said he tries to avoid taking any medication.

“If you prescribe 10 narcotics to me there will be nine left because I’ll take only what I absolutely need," he said.

Taylor said, Ibsen’s intent is “to improve your quality of life, how you feel about yourself.”

Doctors who are part of the modern “medical machine” lose contact with patients, he said.

“Doctor Ibsen embraces the old style,” Taylor said.

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Terence Corrigan can be reached at terence.corrigan@helenair.com

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