Know Pain Clinic on Harper Road in Beckley has suspended patient treatment again.

A recording advises patients to call the clinic from 9 a.m. to 4 p.m. weekdays through Nov. 20 to obtain their medical records.

However, several patients contacted The Register-Herald to report they were unsuccessful in obtaining their records from the clinic.

The recording advises patients to call 304-252-2100, extension 306, to have their records faxed, mailed or available for pick-up.

Patients who want additional information on obtaining their records may contact clinic attorney John Miesner at 304-343-2600.

Under West Virginia law, patients may be charged up to 75 cents per page for copying medical records. But it is illegal for providers to charge a fee to search for or retrieve the records, according to West Virginia Board of Medicine Executive Director Robert Knittle.

According to Gary Hartsog, owner of local records company Alpha Records Management, records management businesses are not permitted under federal law to release medical records to anyone other than the business or individual with whom they are contracted.

Citing security protocol, Hartsog declined to verify whether Alpha manages Know Pain Clinic patient records.

He added that Alpha policy is to work with contracted clinics, even in cases of bankruptcy, to ensure that patients have access to their medical records.

"If indeed we have somebody's records and there's a bankruptcy, I'm sure we can work something out," Hartsog said. "We're not going to try to hold somebody's medical records hostage."ù

Miesner said Friday the clinic has not filed for bankruptcy.

- - -

The most recent closing of the clinic marks the second time this year the clinic has closed its doors.

According to the recording, the clinic does not have a supervising physician.

The most recent physician working at the clinic, Dr. Munawar Siddiqi, left on Oct. 16.

It is illegal for physicians' assistants to dispense medication without a supervising physician.

In August, Dr. Narciso Rodriguez-Cayro left the clinic, reporting he resigned because he had not been paid for nine weeks of work.

Rodriguez-Cayro also said clinic administrators failed to pay his malpractice insurance and reported different income figures on the physician's W-2 statements, and to the state Labor Board, from April 1, 2008 to March 31, 2009.

The West Virginia Board of Medicine is expected to decide by January whether it will file charges against Rodriguez-Cayro.

Clinic officials reported Rodriguez-Cayro unethically ended the physician-client relationship at Know Pain by leaving the clinic and that he violated state law when prescribing medications.

The WVBOM complaint alleges Rodriguez-Cayro wrote too many prescriptions for patients.

In his response to the complaint, Rodriguez-Cayro stated he left due to breach of contract by clinic administrator Danette Farrel and the owner, Dr. Cecil Graham.

Rodriguez-Cayro said he believed patients would continue to receive care after his departure because Farrel had informed him during a discussion on his absent paycheck that he would be replaced immediately if he stopped working.

In the document, Rodriguez-Cayro also stated Graham was listed as the supervising physician for three physicians' assistants at the WVBOM Web site on July 30, 2009.

Rodriguez-Cayro denied violating state law when prescribing medications.

Rodriguez-Cayro added the number of prescriptions were proportionate to the number of patients, that they were written in "good faith," were "medically necessary" and were "written after other forms of treatment had been considered."ù

According to the document, two employees had allegedly forged prescriptions in the past to obtain the narcotic Percocet and had been reported by clinic officials to WVBOM.

The doctor does not have any other malpractice or disciplinary cases on file.