[Federal Register Volume 61, Number 23 (Friday, February 2, 1996)]
[Notices]
[Pages 3946-3948]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 96-2170]
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DEPARTMENT OF JUSTICE
Drug Enforcement Administration
[Docket No. 95-39]
Edward L.C. Broomes, M.D.; Revocation of Registration
On March 27, 1995, the Deputy Assistant Administrator, Office of
Diversion Control, Drug Enforcement Administration (DEA), issued an
Order to Show Cause to Edward L.C. Broomes, M.D., (Respondent) of East
Chicago, Indiana, notifying him of an opportunity to show cause as to
why DEA should not revoke his DEA Certificate of Registration,
AB2703925, under 21 U.S.C. 824(a)(4), and deny any pending applications
for renewal of such registration as a practitioner under 21 U.S.C.
823(f). Specifically, the Order to Show Cause alleged that:
1. Information provided to DEA and the Indiana State Police by
several confidential informants indicates that since 1989, [the
Respondent has] written prescriptions for controlled substances to
numerous individuals for other than legitimate medical purposes.
These informants stated that a group headed by a James Marshall
regularly drives to East Chicago, Indiana, from Pennsylvania,
provides names to [the Respondent] and/or [his] employees to be used
on prescriptions, obtains the prescriptions from [his] medical
office, fills the prescriptions at specific pharmacies in Gary,
Indiana, and sells the controlled substances in Pennsylvania. The
informants identified the drugs obtained as Desoxyn and Percocet,
both Schedule II controlled substances. The informants also
identified some of the names used by James Marshall in this scheme
as Houston Abbott, David Abbott, Michael Johnson, Jason Brown,
Beverly Abbott, and Patricia Armstrong.
2. [The Respondent] continued to write prescriptions for
controlled substances in the names of at least two (2) individuals,
Sean Abbott and James Quisenberry, for several years after their
deaths.
3. Review of triplicate prescription records maintained by the
State of Indiana indicates that between September 1989 and April
1994, [the Respondent] wrote prescriptions totalling over 6,600
dosage units of Schedule II controlled substances to the six (6)
individuals identified by the informants. Many of these individuals
obtained prescriptions for Desoxyn at least once a month for a
period of over three (3) years.
4. [The Respondent] prescribed Desoxyn and Percocet on a regular
basis to at least one (1) drug-addicted individual.
5. On December 22, 1992, eight (8) prescriptions issued by [the
Respondent] were filled at a Gary, Indiana, drug store. Each of the
prescriptions was for 400 dosage units of Dilaudid. None of the
prescriptions contained a date of issue as required by 21 CFR
1306.05.
6. Many prescriptions written by [the Respondent] listed
nonexistent addresses for the patients. For example, none of the
addresses provided on the eight (8) prescriptions listed in the
preceding paragraph was in existence as of October 1994. In
addition, between January 1, 1993 and July 31, 1993, [the
Respondent] wrote at least sixteen (16) prescriptions for controlled
substances, including Percocet and Desoxyn, for James Marshall. The
address provided on each of the prescriptions, 4930 Alden in East
Chicago, Indiana, does not exist. Information provided by a
confidential informant and corroborated by the Pennsylvania Bureau
of Motor Vehicles indicates that James Marshall is a resident of
Aliquippa, Pennsylvania.
7. On October 4, 1994, investigators executed a federal search
warrant at [the Respondent's] office. The following violations were
noted:
a. [The Respondent] had presigned controlled substance
prescriptions for James Marshall in violation of 21 CFR 1306.05(a).
b. Patient files indicated that [the Respondent had] maintained
narcotic addicts on methadone without obtaining a separate
registration in violation of 21 CFR 1301.22.
c. Patient files revealed that [the Respondent had] prescribed
Desoxyn, a Schedule II controlled substance, to treat obesity, in
violation of Indiana law.
On May 30, 1995, the Respondent filed a reply to the show cause
order, but he did not indicate whether he was requesting a hearing. On
May 31, 1995, the Hearing Clerk sent a letter to the Respondent,
advising him that he had until June 14, 1995, to request a hearing, and
on June 30, 1995, Chief Judge Mary Ellen Bittner issued an order
terminating proceedings before her, noting that the Respondent had
failed to request a hearing by that date. Accordingly, the Deputy
Administrator now enters his final order in this matter pursuant to 21
CFR 1301.54(e) and 1301.57, without a hearing and based on the
investigative file and the written Reply submitted by the Respondent.
The Deputy Administrator finds that the Respondent is licensed to
practice medicine in Indiana, and he has a Certificate of Registration
with the DEA as a practitioner in Schedules II through V. The
Respondent's registered location is the Lakeside Medical Clinic in East
Chicago, Indiana. In February 1992, an investigation was initiated by
the Indiana State Police because the Respondent had purportedly
authorized an unusually large number of Schedule II controlled
substance prescriptions according to information provided by the
Indiana Health and Professions Bureau. DEA was asked to assist in this
investigation, and it was found that the Respondent had issued
prescriptions for Schedule II substances as late as April 1991, to an
individual who had died on December 9, 1988. In his Reply, the
Respondent wrote: ``Attention has been drawn to the fact that two of my
patients were receiving prescriptions of Ritalin although they had been
dead for some time. I did not know of the demise until reading of it in
the letter.''
On October 5, 1994, a federal search warrant was executed at the
Lakeside Medical Clinic, and presigned controlled substance
prescriptions were found. Further, patient files indicated that the
Respondent had maintained narcotic addicts on methadone, even though he
was not registered to participate in such a program.
Further, two of the clinic's employees, as well as the Respondent,
were interviewed during the search of the Respondent's clinic. The
interviewing officer noted that the Respondent sometimes talked about
matters unrelated to his questioning. Further, he was concerned when
the Respondent appeared to fall asleep during the interview, although
the Respondent assured him that he wished to continue, and the
interview lasted only approximately one hour. The Respondent stated
that during 1994 he had been in the hospital in January, August, and
September, when he had remained for about 10 or 11 days. Further, the
Respondent admitted to prescribing controlled substances to a known
drug addict, stating that he
[[Page 3947]]
would rather have her obtain such substances from him than from someone
``on the street.'' The Respondent also admitted that he had prescribed
Desoxyn for appetite control. Desoxyn is a brand name for a product
containing methamphetamine, a Schedule II controlled substance, and
according to the Physicians' Desk Reference, if it is prescribed for
treatment of obesity, it should be used on a short-term basis. Yet a
survey of the Respondent's prescriptions revealed that he had issued
prescriptions for Desoxyn to individuals for a period of time in excess
of three years.
A colleague of the Respondent's (Colleague), whose medical license
was then under probation in Indiana and who was under the Respondent's
supervision, was also interviewed. He stated that patients were taken
into the Respondent's office when he could hardly walk, and that it was
unknown what type of examination, if any, was conducted on these
patients. in the Colleague's opinion, the Respondent was no longer
competent to practice medicine and was a danger to his patients.
Another of the Respondent's employees was interviewed, and she
stated that a box of approximately 40 patient records were segregated
in the file room, and office personnel referred to these files as the
``druggie files.'' She stated that these patients came to the clinic
solely to get controlled substance prescriptions, specifically Schedule
II controlled substance prescriptions, for which they paid an
additional fee. The investigator interviewed another of the
Respondent's employees who corroborated this information. This second
employee also reported that the clinic had had several thefts of entire
stock bottles of controlled substances, which were in the clinic to
dispense to patients. However, these thefts had not been reported to
DEA, State, or local police.
Subsequently, investigators interviewed cooperating individuals who
had received controlled substance prescriptions from the Respondent.
Two such individuals reported that on several occasions they had been
given prescriptions for Schedule II substances of their choice, and
that no physical examinations had been conducted. After filling these
prescriptions, they had given the substances to James Marshall, who
paid them for their participation in his scheme. The individuals were
told by Mr. Marshall that he sold these controlled substances to
individuals in another State. On one occasions, an individual assisting
Mr. Marshall was told to choose a local address from the telephone book
in the Respondent's office and to give that address for the
prescription. Following up on this information, investigators noted
that in numerous instances the addresses appearing on the multiple
prescription forms signed by the Respondent for Schedule II controlled
substances, when investigated, did not exist. The Respondent did not
address these allegations in his Reply.
In his Reply, the Respondent wrote that he was 81 years old, and
that he generally denied the allegations in the show cause order.
Although he described in general his treatment practices, the
Respondent did not factually refute specific allegations in the order.
He disputed the evidence providing a numerical analysis of his
prescribing practices, but he did not rebut the specific allegations
concerning the conduct by James Marshall or his associates. He merely
denied that such conduct could occur, given his general office
procedures. He did not deny (1) prescribing Desoxyn to treat obesity,
(2) having pre-signed controlled substance prescriptions for James
Marshall in his clinic, or (3) prescribing methadone to narcotic
addicted patients.
Pursuant to 21 U.S.C. 823(f) and 824(a)(4), the Deputy
Administrator may revoke the Respondent's DEA Certificate of
Registration and deny any pending applications, if he determines that
the continued registration would be inconsistent with the public
interest. Section 823(f) requires that the following factors 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 or
safety.
These factors are to be considered in the disjunctive; the Deputy
Administrator may rely on any one or a combination of factors and may
give each factor the weight he deems appropriate in determining whether
a registration should be revoked or an application for registration
denied. See Henry J. Schwarz, Jr., M.D., Docket No. 88-42, 54 FR 16422
(1989).
In this case, factors two, four, and five are relevant in
determining whether the Respondent's continued registration would be
inconsistent with the public interest. As to factor two, the
Respondent's ``experience in dispensing * * * controlled substances,''
the Deputy Administrator has previously found that a prescription for a
controlled substance ``must be issued for a legitimate medical purpose
by an individual practitioner acting in the usual course of his
professional practice.'' 21 CFR 1306.04(a); see also Harlan J.
Borcherding, D.O, 60 FR 28796, 28798 (1995). Here, the Respondent
issued prescriptions for Schedule II substances to deceased
individuals, showing a blatant disregard for the requirement that
controlled substance prescriptions be issued for a legitimate medical
purpose. Further, the investigative file contains evidence that the
Respondent issued controlled substance prescriptions to individuals
upon their request, to include the substance of their request, without
performing any physical examinations or other clinical tests. He also
accepted additional payment for these prescriptions. The Deputy
Administrator has previously found that prescriptions issued under such
circumstances were not for a legitimate medical purpose. Ibid.
As to factor four, the Respondent's ``[c]ompliance with applicable
State, Federal, or local laws relating to controlled substances,''
Indiana passed a statute in 1988 which made it unlawful to prescribe
controlled substances ``to any person for purposes of weight reduction
or for control in the treatment of obesity.'' See Indiana Code 25-22.5-
2-7. However, the Respondent admitted that he had prescribed Desoxyn, a
Schedule II controlled substance, as part of his treatment for his
obese patients, and the evidence demonstrated that he issued such
prescriptions through 1994. Further, a separate DEA registration is
required to treat drug addicted patients with methadone, but the
Respondent engaged in such treatment without obtaining the required
registration, in violation of the Controlled Substances Act and its
implementing regulations. See 21 U.S.C. 823(g); 21 CFR 1301.22. Also,
the Respondent failed to report to the DEA the theft of large
quantities of controlled substances from his clinic, despite the
requirement to do so. See 21 CFR 1301.76(b). Finally, he kept pre-
signed controlled substance prescription forms prepared for James
Marshall. Such practices violate 21 CFR 1306.05(a), which states in
relevant part:
``(a) All prescriptions for controlled substances shall be dated as
of, and signed on, the day when issued * * * [and] the prescribing
practitioner is responsible in case the prescription
[[Page 3948]]
does not conform in all essential respects to the law and
regulations.''
As to factor five, ``[s]uch other conduct which may threaten the
public health or safety,'' the Deputy Administrator gives some weight
to the Colleague's opinion concerning the danger the Respondent's
practices creates for his patients. Although the Colleague had also
experienced professional difficulties, his observations as to the
Respondent's impaired abilities to treat his patients were corroborated
by other office personnel, by interviewing investigators, and by the
Respondent himself in discussing his health problems in 1994. Such
impairment, coupled with his past prescribing practices, creates doubt
as to the Respondent's ability to comply with DEA regulations in
issuing prescriptions for controlled substances. Also, his failure to
provide any basis for the Deputy Administrator to believe that his
professional practices would be altered in the future, weighs heavily
in favor of revoking the Respondent's DEA Certificate of Registration
at this time.
Accordingly, the Deputy 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) and 0.104, hereby orders that DEA
Certificate of Registration AB2703925, previously issued to Edward L.C.
Broomes, M.D., be, and it hereby is, revoked, and that any pending
applications for renewal of such registration be, and they hereby are,
denied. This order is effective March 4, 1996.
Dated: January 29, 1996.
Stephen H. Greene,
Deputy Administrator.
[FR Doc. 96-2170 Filed 2-1-96; 8:45 am]
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