A longtime Tri-City physician has been charged with unprofessional conduct by the state’s medical licensing agency for allegedly providing substandard care to three patients at a Richland nursing home.

The state Medical Quality Assurance Commission has been investigating complaints against Dr. Frank E. Cole for several years stemming from his care of three patients at Life Care Center of Richland.

All three patients died while they were patients of Cole’s, but the state does not claim he caused their deaths.

Three of the complaints resulted in noncriminal charges of unprofessional conduct being filed in February. A fourth complaint submitted in October is under investigation, saidMichael Farrell, staff attorney for the commission.

And Richard Rogers of Kennewick told the Herald on Thursday that he had sent a complaint to the commission the day before, alleging Cole failed to diagnose his wife’s lung cancer in the summer of 1997. She died in March 1999.

Rogers’ complaint would be the fifth against Cole, but is not connected to his work at Life Care Center of Richland.

Cole’s attorney, Chris Mertens of Kennewick, said Cole plans to vigorously defend himself against the charges.

“”We don’t believe the allegations are well-founded,”” Mertens said. “”These are all very sad cases. These patients were all in the end stages of their lives. Dr. Cole believes he provided appropriate and compassionate care to the patients.””

Representatives of Life Care Centers of America, the company operating the Richland nursing home, did not respond to messages left by the Herald on Thursday.

Commission documents summarize three incidents from 2005 to 2007 in which Cole is alleged to have provided substandard care to patients, who are described only as Patients A, B and C.

— Patient A was a 50-year-old woman with multiple medical problems, including diabetes, congestive heart failure, a history of stroke, epilepsy, asthma, anemia, end-stage renal disease requiring dialysis and chronic pain. She had an above-the-knee leg amputation in June 2007.

She entered Life Care Center of Richland in February 2007, and was placed under Cole’s care as the center’s medical director, documents said.

The commission alleges Cole failed to appropriately manage Patient A’s pain and prescribed her medications that could destabilize the levels of the methadone she was taking for pain.

“”Respondent should have consulted with a pain management specialist or someone more knowledgeable in pain management,”” the charging documents said.

The documents said the patient was in severe pain and refused dialysis Aug. 4, 2007. She died three days later, but the documents do not allege Cole played a role in her death.

— Patient B was a 25-year-old woman who was in a persistent vegetative state after a stroke, and was under Cole’s care at the nursing home. She also was in renal failure requiring dialysis, and had a feeding tube and tracheostomy — a surgically created hole in the front of her neck for breathing.

The patient was admitted to Kadlec Regional Medical Center in October 2005 with a fever, and was discharged back to the nursing home Nov. 8, 2005, with a doctor’s orders for how to care for the tracheostomy.

The commission alleges Cole failed to follow those orders and the patient’s tracheostomy tube became plugged. Several hours after arriving at the nursing home, she was taken back to Kadlec not breathing and without a pulse.

Patient B was pronounced dead shortly after being re-admitted to the hospital, documents said.

— Patient C was a 58-year-old woman at Life Care Center of Richland who was admitted to Kadlec on June 7, 2005, with an infection. She was treated in telephone consultation with Cole, but died the next day of methicillin-resistant staphylococcus aureus, or MRSA, with a pancreatic pseudocyst at the center of the infection.

According to the National Institute of Health website, a pancreatic pseudocyst is a fluid-filled sac in the abdomen, which also may contain tissue from the pancreas, pancreatic enzymes and blood. They most often develop after sudden, severe swelling of the pancreas.

Patient C died June 8, 2005. In this case, the commission alleges that Cole committed unprofessional conduct by failing to dictate a history and physical report until July 13 – more than a month after her death — and that the report lacked necessary elements.

Cole has until April 22 to formally respond to the charges.

Cole also has been sued twice for wrongful deaths stemming from care of two patients other than those in the commission’s charges.

Mertens said a jury found Cole had not been negligent in a 2007 case in Benton County involving a patient named Helen Baucum, who was alleged to have died from injuries sustained at Life Care Center of Richland in April 2002.

And a family who sued Cole and Life Care Center of Kennewick in 2010 over the death of patient Paul Nelson, who died as a result of ulcers, infections and multi-organ failures in 2007, ultimately dropped their claims against Cole.