[Federal Register Volume 59, Number 28 (Thursday, February 10, 1994)]
[Unknown Section]
[Page 0]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 94-3026]


[[Page Unknown]]

[Federal Register: February 10, 1994]


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DEPARTMENT OF JUSTICE
[Docket No. 92-36]

 

Jerry Neil Rand, M.D.; Denial of Application

    On February 13, 1992, the Deputy Assistant Administrator, Office of 
Diversion Control, Drug Enforcement Administration (DEA), issued an 
Order to Show Cause to Jerry Neil Rand, M.D. (Respondent), of San 
Diego, California, proposing to deny his application for registration 
as a practitioner on grounds that his registration would be 
inconsistent with the public interest, as set forth in 21 U.S.C. 
823(f). The Order to Show Cause alleged that from at least mid-1986 
Respondent self-administered hypnotic sedatives and pain medication; on 
November 21, 1987, Respondent was arrested for the illegal possession 
of Schedule III and IV controlled substances in Orange County, 
California; in May 1988, the Medical Board of California filed a 
complaint against the Respondent alleging that he was intoxicated while 
attending a patient, that he failed to supervise his physician 
assistants by pre-signing prescriptions, and that he engaged in 
unprofessional conduct in the treatment of five patients; and the 
Medical Board of California (Medical Board), on September 18, 1989, 
entered a stipulated decision and order which revoked the Respondent's 
medical license, and then stayed that order and placed him on five 
years probation.
    Respondent, through counsel, filed a request for hearing on the 
issues raised by the Order to Show Cause, and the matter was docketed 
before Administrative Law Judge Mary Ellen Bittner. Following 
prehearing procedures, a hearing was held in San Diego, California on 
June 25, 1992. On July 7, 1993, in her opinion and recommended ruling, 
findings of fact, conclusions of law, and decision, the administrative 
law judge recommended that the Respondent's application for a DEA 
Certificate of Registration be granted subject to certain restrictions.
    No exceptions to Judge Bittner's opinion were filed by either 
party. On August 9, 1993, the administrative law judge transmitted the 
record to the Administrator.
    The Acting Administrator has carefully considered the entire record 
in this matter and, pursuant to 21 CFR 1316.67, hereby issues his final 
order in this matter based upon findings of fact and conclusions of law 
as hereinafter set forth.
    The administrative law judge found that the Respondent is a 
licensed physician in the State of California, under probation from the 
Medical Board. He graduated from the Chicago Medical School in 1972 and 
specialized in emergency medicine at hospitals in Illinois and 
California. In 1984, the Respondent opened an urgent care center in 
Orange County, California, which he operated until his entry into a 
drug rehabilitation program in April 1988.
    The administrative law judge found that the Respondent sent a 
letter to the DEA in February 1990, advising that he had voluntarily 
terminated his previous DEA registration. Subsequently, in July 1990, 
Respondent submitted an application for a new DEA Certificate of 
Registration.
    During the hearing, the Government presented evidence that over a 
period of several years, from at least mid-1986, the Respondent was 
accused of self-administering hypnotic sedatives and pain medications, 
including a daily dose of 40 to 50 mg. of Valium, a Schedule IV 
controlled substance; that the Respondent entered three separate 
substance abuse treatment facilities in August, October, and November 
of 1987, where he was diagnosed as drug dependent; that on November 21, 
1987, Respondent was arrested in Orange County, California for illegal 
possession of controlled substances for his own use, including 
Dolophine, a Schedule II controlled substance, Anexsia, Fiorinal and 
Fioricet, Schedule III controlled substances, and Darvon, a Schedule IV 
controlled substance, which resulted in a State court issuing a 
temporary restraining order prohibiting the Respondent from practicing 
medicine; that on September 18, 1989, the Medical Board issued a 
stipulated decision and order which revoked Respondent's medical 
license, stayed the revocation, and placed the Respondent on five years 
probation; that the Respondent's ex-girlfriend had told a Medical Board 
investigator that Respondent had abused Demerol, a Schedule II 
controlled substance, in his home, that he had telephoned local 
pharmacies for controlled substance deliveries to his home or office, 
and that he had abused barbiturates; that an employee of the Respondent 
told an investigator that Demerol was routinely missing from office 
stock, and that the Respondent kept unsecured controlled substance 
samples in his desk; and that a State audit of the Respondent's office 
had determined that he could only account for nine of fifty-six DEA 
Schedule II order forms that he had received in 1986.
    Respondent testified at the hearing that he did not believe that 
all of the Government's evidence was factually correct. He maintained 
that the Anexsia found by the Orange County police was prescribed by an 
orthopedist, and the other noted substances were office samples. He 
also disagreed with his ex-girlfriend's representation, and asserted 
that she was a Demerol abuser, and in fact that he was allergic to 
Demerol. Regarding his office practice, he admitted that he had pre-
signed prescriptions for his physician assistants, but was not sure 
what happened to his DEA Schedule II order forms.
    The administrative law judge found that in May 1988, the Medical 
Board filed an accusation alleging that the Respondent had been 
arrested in 1987; had been diagnosed as drug dependent; that as a 
result of his usage of controlled substances or dangerous drugs he had 
``become a danger to himself, other persons or the public, or has 
impaired his ability to practice his profession safely''; had treated a 
patient while intoxicated; and failed to adequately supervise physician 
assistants by signing blank prescription forms. A supplemental 
accusation, filed in June 1988, and amended in March 1989, alleged that 
between 1985 and 1986, the Respondent provided incompetent and grossly 
negligent medical care to five patients.
    The administrative law judge found that the Respondent admitted the 
substantive allegations of the accusations when he entered into a 
stipulated decision and order with the Medical Board. The order, 
effective September 25, 1989, revoked Respondent's medical license, 
stayed the revocation and placed Respondent of five years probation. 
The order further required, inter alia, that the Respondent enter a 
drug rehabilitation program, an refrain from practicing medicine until 
the Medical Board and the drug rehabilitation program concluded that it 
would be safe for him to reenter the practice of medicine.
    The Respondent testified that he suffered a back injury in 1984, 
and received a regimen of treatment which included traction and various 
controlled substances. In 1986, he had spinal fusion surgery and was 
continued on pain medications and anti-depressants. He testified that 
various physicians and psychiatrists prescribed controlled substances 
for pain, and he would frequently overdose, which included the night of 
his arrest by Orange County police. The Respondent testified that he 
entered a methadone treatment center in 1987, which did not help; was 
subsequently hospitalized for three weeks, where he only received more 
pain medication; and then entered a three week drug abuse 
rehabilitation program at Saint Joseph's Hospital in April 1988.
    Witnesses for the Respondent, including a chemical dependency 
counselor, a psychiatrist, and physicians testified that after 
Respondent left St. Joseph's Hospital, he attended an inpatient drug 
rehabilitation program at Rancho L'Abri for two-and-a-half months, 
where he received detoxification treatment and therapy; he then moved 
to Alternative Solutions, a halfway house type of recovery center, 
where he resided for approximately two years. The witnesses agreed that 
the Respondent had embraced the recovery program, had made steady 
progress, was aware of the negative impact of drugs, and had abstained 
from drugs. Various letters from other individuals also attested to the 
Respondent's attendance in recovery programs.
    Witnesses also testified as to the Respondent's continuing 
participation in the Medical Board Diversion Program in which he 
attends mandated twice weekly counseling, and submits to random visits 
from compliance officers and urine screenings. The Respondent testified 
that for the 18 months following his stay at the halfway house, he was 
employed in a clinic where he engaged in general practice and addiction 
medicine.
    The Administrator may deny an application for registration if he 
determines that such registration would be inconsistent with the public 
interest. Pursuant to 21 U.S.C. 823(f), ``[i]n determining the public 
interest, the following factors shall be considered:
    (1) The recommendation of the appropriate State licensing board or 
professional disciplinary authority.
    (2) The applicant's experience in dispensing, or conducting 
research with respect to controlled substances.
    (3) The applicant's conviction record under Federal or State laws 
relating to the manufacture, distribution, or dispensing of controlled 
substances.
    (4) Compliance with applicable State, Federal, or local laws 
relating to controlled substances.
    (5) Such other conduct which may threaten the public health and 
safety.''
    It is well established that these factors are to be considered in 
the disjunctive, i.e., the Administrator may properly rely on any one 
or a combination of factors, and give each factor the weight he deems 
appropriate. Henry J. Schwarz, Jr., M.D., Docket No. 88-42, 54 FR 16422 
(1989).
    The administrative law judge concluded that the first, fourth, and 
fifth factors were relevant and found that as to the first factor, the 
Respondent's medical license is restricted by a five year probation; 
that as to factor four, the Respondent unlawfully obtained and abused 
controlled substances; and that as to factor five, the Medical Board 
findings regarding his treatment of patients were pertinent.
    Judge Bittner further found that as a result of his personal abuse 
of controlled substances, the Respondent abrogated his professional 
responsibilities as a physician and his responsibilities as a DEA 
registrant; that he was hospitalized three times for substance abuse; 
voluntarily surrendered his previous DEA registration; and had his 
State medical license placed on probation for a period of five years. 
The administrative law judge concluded that there is a lawful basis for 
denying the Respondent's application.
    The administrative law judge also found that the Respondent has 
demonstrated his current fitness to possess a DEA registration, insofar 
as his substance abuse began as a result of a chronic pain condition 
generated by a back injury; that the Respondent admitted his drug abuse 
and indicated remorse for past misconduct; that the Respondent 
presented credible evidence of appropriate medical and rehabilitative 
treatment; and that he had not used drugs for over three years 
preceding the hearing, and was committed to a drug-free lifestyle.
    The administrative law judge found that several witnesses credibly 
testified that the Respondent was committed to his recovery. The 
administrative law judge further credited the Respondent's stated 
intent to establish an addictionology medical practice and his 
contention that he needed controlled substance authority to be 
effective in this field. Judge Bittner found that the Respondent is 
unlikely to abuse controlled substances in the future or otherwise 
abuse the privileges of a DEA registrant.
    As a result, the administrative law judge recommended that the 
Administrator grant the Respondent's application for a DEA registration 
subject to certain restrictions. These restrictions included provisions 
that the Respondent be limited to prescribing controlled substances, 
except in a hospital setting where he would be allowed to administer 
controlled substances; that he not possess or store any controlled 
substances in his office or home (other than those lawfully prescribed 
by another practitioner); that he not dispense, other than by 
prescription, any controlled substance from his office or home; that he 
not write any controlled substance prescriptions for himself, or any 
family member; that he not obtain for his own use any controlled 
substances, except on written prescription by another practitioner; 
that he notify the DEA on each occasion he acquires a controlled 
substance by prescription; that he submit quarterly to the DEA for a 
period of two years a log of all controlled substance prescriptions he 
issues; and finally that he complete an appropriate continuing medical 
education course, approved by the Medical Board, in the proper handling 
of controlled substances.
    The Acting Administrator concurs with the administrative law 
judge's findings of fact and conclusions of law, except as herein 
noted. The Acting Administrator disagrees with the administrative law 
judge's finding that the Respondent is unlikely to abuse controlled 
substances or the privileges of a registrant in the future. The Acting 
Administrator concludes that the Respondent's rehabilitative efforts, 
although laudable, are not sufficiently complete to ensure that he will 
not again succumb to the pressures of abusing controlled substances. 
The Acting Administrator does not adopt the administrative law judge's 
conclusion that the Respondent's registration, even with certain 
restrictions in place, would be in the public interest. The Acting 
Administrator declines to adopt the administrative law judge's decision 
and recommendation that the Respondent's application be granted. 
Accordingly, the Acting Administrator finds that the registration of 
the Respondent would not be in the public interest at this time.
    The Acting Administrator of the Drug Enforcement Administration, 
pursuant to the authority vested in him by 21 U.S.C. 823 and 824 and 28 
CFR 0.100(b), hereby orders that the application for a DEA Certificate 
of Registration of Jerry Neil Rand, M.D., be, and it hereby is, denied. 
This order is effective February 10, 1994.

    Dated: February 4, 1994.
Stephen H. Greene,
Acting Administrator of Drug Enforcement.
[FR Doc. 94-3026 Filed 2-9-94; 8:45 am]
BILLING CODE 4410--09-M