Dr. Pain

Pacific Pain Care’s Dr. Steven Mangar, who is facing 37 felony charges, continues practicing in his Salinas office, pictured.

Inside Dr. Steven Mangar’s dimly lit office space in Salinas, a half dozen people sit in the waiting room on a recent afternoon, paging through magazines. His schedule is packed with back-to-back patients, as he is one of just 11 pain management specialists in Monterey County. But that could soon change.

On June 23, the state Attorney General’s Office will ask a Monterey County Superior Court judge, on behalf of the California Medical Board, to suspend Mangar’s medical license while his criminal case is underway.

Mangar was charged in May with 37 felonies that allege he was part of a $500,000 insurance fraud scheme. He is believed to have billed insurance companies for services patients never had, says Deputy District Attorney Amy Patterson. His office manager, Maria Aloha Eclavea, is also charged with 23 felonies on suspicion of committing fraud.

J.A. Hernandez, Eclavea’s attorney, says it wasn’t fraud, but perhaps “poor record-keeping.” Mangar’s attorneys, Susan Chapman and Frank Dice, declined to comment.

Mangar’s case stems from a two-year investigation by local, state and federal authorities. Beyond insurance fraud, Mangar is accused of overprescribing opiates to patients, leading to addiction and overdoses. There are at least 25 victims of overprescription identified in the criminal complaint.

“Patients would go to see him and would get worse,” Patterson says. “He would overprescribe narcotics without a medical evaluation.”

At least four patients died while in Mangar’s care, according to documents filed by the medical board.

In 2013, Mangar prescribed hydrocodone, sold under brand names like Vicodin, the most. He was responsible for 967 prescriptions or refills, making him the No. 2 prescriber of hydrocodone among California specialists, according to a database maintained by ProPublica.

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Mangar continues practicing medicine, but prosecutors and the medical board say the severity of the accusations should put a stop to it, at least until proven not guilty.

He has denied all allegations against him, and at least one of his patients, Kerry Wright, stands by him, despite the criminal proceedings. She’s had numerous surgeries, including back and brain operations, and says she uses oxycodone to deal with chronic pain.

“I’ll have pain the rest of my life, but now I am happy, I function and I am not addicted,” Wright says. “He saved my life.” Without Mangar, Wright says she would have to travel to San Jose or San Francisco to see a specialist.

Editor's note: On Thursday, June 23, there was no decision made on whether Dr. Mangar's medical license should be suspended. An evidentiary hearing will be held on the matter will be held July 19. 

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(3) comments

Richard Clark

Jim and Tony both make passionate and compelling comments about the current state of our health care system in general and, specifically, the need for people with chronic pain to be able to find some relief. Having to deal with doctor's offices, insurance companies and government agencies and all the accompanying paperwork can often be difficult and confusing and at times it can be a nightmare. And no one should ever have to suffer from serious pain because they have nowhere to turn, and while also having to navigate through this complex system.
But neither of these topics have anything to do with the issue at hand. Namely, the question of whether or not a physician has repeatedly and knowingly violated the Medical Practices Act under various sections of the Business and Professions Code. And that is what the courts will decide.
In the mean time you might be interested in doing a little homework about Dr. Mangar, as I have done. I am including a website at the bottom which will give you some idea of the scope and severity of the allegations brought by the State Attorney General's office. In this document you'll read terms like "gross negligence", "repeated negligent acts", "incompetence"and "unprofessional conduct", all stemming from the allegations that Dr. Mangar repeatedly "failed to develop a treatment plan with objectives, to periodically review the effectiveness of the prescribed treatment or to consider alternatives when the patient failed to improve." And that he "…failed to respond to evidence that the patient's condition was not benefitting and was actually worsening…" And that he "…failed to obtain appropriate medicine consultations despite signs that the patient was abusing some medications…" And that he "…prescribed controlled substances to a patient without an appropriate medical examination." And that he "…created medical records which stated that the patient was seen by him when in fact there was no face-to-face encounter." And that he"…failed to perform, or performed an inadequate, risk evaluation and mitigation strategy in a patient who presented with indications of past substance abuse." Here is the website (copy and paste) for those who would like to read more. It is available on the Medical Board of California's website and is a matter of public record. It also includes information about six of Dr. Mangar's patients, three of whom died while under his care. And there is apparently a fourth. I can only hope that his license is revoked before there is a fifth. My only question is why it has taken this long.
http://www2.mbc.ca.gov/BreezePDL/document.aspx?path=%5cDIDOCS%5c20160114%5cDMRAAAFC17%5c&did=AAAFC160115003452736.DID&licenseType=A&licenseNumber=65476#page=1

Tony Esparza

Dr. Mangar should be aloud to continue practicing medicine while this case is still pending. What the fools at the DA don't know is that patients who have been on long term opiates cannot be suddenly withdrawn from their medications otherwise they will become very sick. At the very least Dr. Mangar should be given enough time to move his patients to other pain management doctors. Honestly I think Dr. Mangar is being falsely accused simply because he's a Pain Doctor. If you suffer from severe chronic pain like I do these pain doctors are the difference between life and death. I really hope Dr. Mangar is found innocent.

Jim Hodges

The service that this Doctor provides is essential in our community. Do you know why there are so few pain management clinics in our area? My theory is that so many people other than the doctor are attempting to practice medicine. The DEA, Medicare, local zealots in the DA'S office looking for that boost in their career. Pencil pushing headline seeking goobers.
Yep, how many of these individuals had their residency completed at Stanford and the major portion of their medical education including anesthesiology and pain management completed there as well.How are these people entitled to an opinion of this Doctor's practice.
And as the fraud goes, have you tried to fill any insurance paperwork lately? The biggest problem from what I understand is that Dr. Mangar has prescribed meds that are more expensive than the insurance companies want to pay for, especially Medicare. So you have to fill out reams of requests and track which are approved, which are denied, which are lost in a system designed to delay and avoid and not pay, all the while your patient can't get out of bed to make a cup of coffee because their prescription has not been approved by a system made to serve itself.
This Doctor and man has filled a vital need in our community and deserves much more than a trial on the nightly news ( an attaboy for law enforcement and public safety by our deeply concerned local , state and federal government.) and the local rags that pass for print media. Although I normally hold the Weekly and ProPublica in higher regard than what they have shown in this case.
This is not a "Pill Mill" / This clinic is not a place for junkies "doc" shopping for hands full of OXY./ This is not a dirty doc ripping off the system to line his pockets.

These are people with end of life pain issues, these are people that have severe and chronic pain issues, these are people that no one else wants anything to do with because they have complicated, high risk issues that involve narcotics to offer them any sort of normality in their lives. This clinic is needed to help patients that have real pain that compassionate marijuana won't help. It is also an other example of a health care system that has too many cooks in the kitchen.
I hope that no one else is in a position that hey can't stand ,walk or even wipe themselves after using the toilet because they are in so much pain but we do need to treat the ones of us so unlucky that we can't live normally without pain management.
Give this guy a break and get off the band wagon. Do not accept the press releases from Dean Flippos office as gospel. Above all pass on the DEA opinion on anything other than if it's day or night. Please Coast Weekly and ProPublica renew my faith.
If he's guilty well, F#@$ it, I'm wrong but why hasn't his license been suspended, possibly they have a higher burden of proof.
Maybe we should talk with former Public Defender Jim Edgar about the Monterey County DA's office attitude on public service and fair play in the courtroom

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