Authorities are investigating the medical records of a Chicago-area pediatrician who died by suicide after finding a note that raised questions over his vaccination practices, sheriff’s deputies said.

Dr. Van Koinis died in September, but the Cook County Sheriff’s Office said that when investigating his death, there were “record keeping issues” that made it unclear which patients received vaccinations and which did not.

Investigators also found evidence to suggest that Koinis did not vaccinate children at parents’ requests, the sheriff’s office said in a statement.

“He was well known for being someone who was into homeopathic medicine, and from what we have determined, it was well known that people opposed to vaccination could go to him,” Sheriff Tom Dart told the Chicago Tribune.

Investigators believe parents would use falsified records so their children could attend schools that would otherwise require all students to be vaccinated, Dart told WBBM-TV.

It’s unclear how widespread the practice was, but Dart told the news outlets that Koinis may have been falsifying the records for up to 10 years.

Koinis had been licensed to practice medicine in Illinois since 1991, the sheriff’s office said. He primarily served patients from Chicago’s southwest side and nearby suburbs.

Stories of hope:

Illinois law requires that all students be vaccinated and have records of those vaccinations, except for those exempt due to medical conditions and religious objections, according to the Tribune.

Some parents whose children were treated by Koinis told local media that the doctor reliably vaccinated their children.

“He never hesitated to give vaccinations. He never hesitated at all,” Tatiana Rudolph, a mother of two who saw Koinis, told WBBM-TV. “If they needed them for school, they were getting them.”

However, others expressed concerns.

“I was just there for the checkup and he actually ended up telling me that my son didn’t need the vaccines that the school had said,” Mary Mullaney told the TV station. She said her son’s school later contacted her about his vaccination record, and they returned to Koinis to get the vaccinations.

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