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At first, the Richards didn't think much of the mention of Dr. Thornton. Randy had his own doctor, and usually was at home with them on Sundays anyway. And no one at the Spark Foundation, it seems, knew that by the time Dr. Howard Thornton stepped foot into the group's residential homes, he was already the subject of complaints to the California Medical Board. Complaints against doctors do not become public information in California unless they make their way to an official Medical Board charge. That process can take years.
Medical records show that Thornton saw Randy Richards several times. On Feb. 8, 1995, the doctor completed a medical history and evaluation of Randy, without ever contacting his parents, who, as conservators, are legally empowered to make decisions for him.
"I've never seen the man," says Maxine. "I've never talked to him. He never wrote me a letter, never sent us a form to fill out."
To see a patient without consent violates what is known in medical circles as the Standard of Care -- that is, a standard by which the propriety of medical decisions is judged. Further-more, some of the information on an evaluation completed by Thornton was just plain wrong. A Department of Social Services evaluation form created by Thornton indicates that Randy, an autistic, mentally retarded man subject to seizures, is able to "care for personal needs," "administer own medications," and "leave facility unassisted."
That assessment hardly describes the man Randy's mother knows. "Randy has to be supervised to brush his teeth, wash his face, and bathe," explains Maxine. "He doesn't know one pill from the other."
In fact, Randy was taken to the hospital a few years before, after swallowing medication that had been set out for another resident of his group home. And in 1980, when Randy's parents became his legal conservators, a physician at Santa Cruz Medical Clinic, where Randy had been a patient since birth, gave this assessment: "Randy is totally disabled and needs close supervision and this condition will be present throughout his life."
A medical history recorded by Thornton in February 1995 is also radically at odds with reality. The history states that:
Randy has had no past abdominal operations. He's had two.
Randy has had no broken bones. But he's broken a collarbone.
The history states that Randy's family was "unobtainable or unknown" -- a suggestion that is particularly irritating to Maxine.
"He never made any attempt to contact me. I was on the board of the foundation, and either my husband or I were in and out of that house twice a week. Why didn't he call me?"
According to the Medical Board's accusation against Thornton, the doctor saw Randy Richards at least 12 times without the knowledge or approval of his parents. Most of the reports from those visits show "no change," and are completed with Thornton's computer-generated signature.
In November, Maxine and Wayne Richards wrote a letter to Thornton officially rescinding any authorization he thought he might have to see Randy. They also called the California Medical Board to complain.
"I don't think I ever gave permission, but I rescinded it anyway," says Maxine. "I wasn't going to support a fraud. Why should they be having to see this guy once a month anyway? I think it was just a way to get money."
Even that didn't stop the doctor. Medical records show Thornton's signature on two reports after the Richards' requested that he not see Randy.
And they were not alone.
Another parent of another Spark resident also was surprised to learn that her son had become a patient of Dr. Thornton.
"I never designated him to be [my son's] doctor," says the mother, who agreed to be interviewed on the condition that she and her son remain anonymous. "I found out that my son was sick, that he [Thornton] had prescribed something, and that the staff had filled it and administered it, and this is all before I ever even knew he was seeing my son as a patient."
Her son is 25 years old and suffers from autism, Tourette's syndrome, hypertension, a seizure disorder, and a host of other ailments. According to the Medical Board's accusation, Thornton saw this resident 19 times between Sept. 18, 1994, and March 5, 1996, and never recorded his vital signs, including blood pressure readings, even though this patient had been diagnosed as suffering from hypertension, i.e., high blood pressure.
At the time, the resident was taking at least four different medications prescribed by other doctors. He had been hospitalized and evaluated repeatedly by specialists at the University of California, San Francisco Medical Center, Stanford University Hospital, and El Camino Hospital for the grand mal seizures he suffered.
Yet Thornton produced a medical information card listing himself as this resident's doctor.
"Thornton never contacted the doctors at UC or Stanford," says the mother. "He's with kids who are acting out and having a hard time; you'd think he'd need to know who the doctors are and need to coordinate with them.
"I told our program director verbally that I don't want him to see my son because what he's doing is not right. I think he's billing Medi-Cal for services that he's providing my son that I don't want."