[Federal Register Volume 71, Number 164 (Thursday, August 24, 2006)]
[Notices]
[Pages 50097-50099]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: E6-14050]


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DEPARTMENT OF JUSTICE

Drug Enforcement Administration


Peter A. Ahles, M.D.; Revocation of Registration

    On August 15, 2005, I, the Deputy Administrator of the Drug 
Enforcement Administration, issued an Order to Show Cause and further 
ordered the immediate suspension of DEA Certificate of Registration, 
AA0092558, issued to Peter A. Ahles, M.D. (Respondent), of Anaheim, 
California. The Show Cause Order proposed to revoke Respondent's 
registration as a practitioner and to deny any pending applications for 
renewal or modification of the registration, on the ground that 
Respondent's continued registration would be inconsistent with the 
public interest. See 21 U.S.C. 823(f) and 824(a)(4). The Show Cause 
Order also immediately suspended Respondent's registration based on my 
preliminary finding that his continued registration ``would constitute 
an immediate danger to the public health and safety because of the 
substantial likelihood that [he would] continue to acquire large 
amounts of narcotic controlled substances and * * * illegally 
distribute these narcotic controlled substances to potential abusers 
and other unauthorized persons in exchange for cash.'' Show Cause Order 
at 3.
    The Show Cause Order specifically alleged that based on a review of 
transaction reports filed by DEA registrants, Respondent, during the 
period March 2004 to March 2005, had received ``nearly 570,000 tablets 
of Schedule III hydrocodone and codeine tablets, most of which were 
packaged in 500 and 1000 count bottles.'' Id. at 1-2. The Show Cause 
Order alleged that ``[t]hese are excessive amounts of narcotics to be 
legitimately dispensed or administered from a single practitioner's 
office in a one-year period.'' Id. The Show Cause Order further alleged 
that in the thirteen month period ending in April 2005, Respondent 
``had purchased over one million dosage units of Schedule II through V 
controlled substances, [which were] predominately narcotic tablets.'' 
Id. at 2.
    The Show Cause Order also alleged that on three occasions during 
May 2005, a DEA Special Agent and a cooperating source (CS) had visited 
Respondent's office and made undercover buys of hydrocodone, a Schedule 
III controlled substance. Id. The Show Cause Order alleged that on two 
occasions, the Special Agent observed the CS pay Respondent $500 in 
cash and receive a plastic bag containing approximately 500 tablets of 
hydrocodone. Id. The Show Cause Order alleged that on the other 
occasion, the Special Agent observed the CS pay Respondent $600 and 
receive a plastic bag containing 500 tablets of Norco, another 
hydrocodone product. Id. The Show Cause Order further alleged that 
Respondent made each of the dispensings without asking the CS for his 
medical complaint, taking a medical history, or conducting a physical 
examination. The Show Cause Order thus alleged that the distributions 
were made ``without any legitimate medical purpose and [were] not in 
the course of legitimate medical practice'' and violated 21 U.S.C. 
841(a)(1). Id.
    Finally, the Show Cause Order alleged that Respondent had, in 
submitting his DEA renewal application, answered

[[Page 50098]]

``No'' the question whether his state license had ever been revoked, 
suspended, or placed on probation. Id. The Show Cause Order alleged 
that the Medical Board of California had, in fact, placed Respondent's 
state license on probation three different times and that Respondent 
had thus ``materially falsified [his] application for registration in 
violation of 21 U.S.C. 843(a)(4)(A).'' Id. at 2-3. Based on evidence in 
the investigative file supporting the above allegations, I further made 
the preliminary finding that Respondent had ``grossly avoided [his] 
responsibilities as a registrant and [had] been responsible for the 
actual diversion of controlled substances into other than legitimate 
channels in violation of 21 U.S.C. 841(a)(1).'' \1\
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    \1\ The Show Cause Order also notified Respondent of his right 
to a hearing and the procedure for requesting one.
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    On August 16, 2005, a DEA Diversion Investigator (DI) personally 
served the Show Cause Order on Respondent. Since that time, neither 
Respondent, nor anyone purporting to represent him, has responded. 
Because (1) more than thirty days have passed since Respondent's 
receipt of the Show Cause Order, and (2) no request for a hearing has 
been received, I conclude that Respondent has waived his right to a 
hearing. See 21 CFR 1309.53(c). I therefore enter this final order 
without a hearing based on information contained in the investigative 
file.

Findings

    Respondent is the holder of DEA Certificate of Registration No. 
AA0092588, which expired on June 30, 2005. On May 5, 2005, Respondent 
applied for a renewal of his registration and sought authority to 
prescribe Schedule II through V controlled substances including 
Schedule II and III narcotics. On his renewal application, Respondent 
answered ``No'' the question: ``Has the applicant ever surrendered (for 
cause) or had a state professional license or controlled substance 
registration revoked, suspended, denied, restricted, or placed on 
probation?''
    According to the Medical Board of California's records, at the time 
Respondent filed his renewal application, he had been the subject of 
three separate disciplinary proceedings. In each of these cases, the 
California Board placed Respondent on probation.\2\ I also take 
official notice of the records of the California Board which indicate 
that on February 24, 2006, Respondent surrendered his state license.
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    \2\ The proceedings were commenced in June 1975, September 1992, 
and October 1996.
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    The investigative file further establishes that between March 2004 
and April 2005, Respondent purchased over one million dosage units of 
Schedule III through Schedule V controlled substances from ANDA 
Pharmaceuticals. Respondent obtained hydrocodone 7.5 and 10 mg. 
tablets, codeine 4, Stadol (butorphanol tartrate), and 
Phenergan with codeine.
    The investigative file also establishes that in April 2005, a DEA 
Special Agent and a DEA Diversion Investigator debriefed a cooperating 
source (CS). The CS stated that he/she had purchased various controlled 
substances including hydrocodone, Norco, and Xanax from Respondent. 
During the interviews, the CS related that Respondent performed little 
to no medical examination and did not require that the CS give a 
medical reason before selling the drugs to the CS. The CS further 
asserted that Respondent charged $500 cash for 500 pills/tablets of 
controlled substances, but charged $600 for 500 pills/tablets of Norco. 
The CS also stated that Respondent would prescribe any drug including 
Schedule II controlled substances such as Oxycontin to persons he knows 
well. Finally, the CS related that Respondent had few legitimate 
patients and that most of the people he saw visited him to obtain 
prescription drugs either for personal use or to resell the drugs on 
the street.
    The investigative file further establishes that following the 
interviews, a DEA special agent accompanied the CS to Respondent's 
office on three separate dates. On May 12, 2005, the Special Agent 
observed as the CS paid Respondent $500 and received a black plastic 
bag containing approximately 500 hydrocodone tablets. Respondent did 
not perform a physical examination on the CS and did not discuss with 
the CS a medical reason for the dispensing. Moreover, Respondent did 
not give the CS any directions for use of the drugs. The Special Agent 
further observed that Respondent appeared to be under the influence of 
some substance.
    On May 18, 2005, the same Special Agent and the CS returned to 
Respondent's office. On this occasion, the CS paid $600 and received 
from Respondent a black plastic bag containing 500 tablets of Norco. 
While on this occasion Respondent weighed the CS, the CS offered no 
medical complaint and Respondent did not perform a physical exam. 
Respondent also failed to give the CS any directions for use of the 
drugs.
    Finally, on May 19, 2005, the Special Agent and the CS returned to 
Respondent's office. On this occasion, the Special Agent paid 
Respondent $500 and requested 500 hydrocodone tablets. Respondent 
handed the Special Agent a black plastic bag containing approximately 
500 Norco tablets. The Special Agent did not complain of any medical 
symptoms and Respondent did not perform a physical examination.

Discussion

    As pertinent here, Section 304 of the Controlled Substances Act 
(CSA) provides that a registration to:

    Dispense a controlled substance * * * may be suspended or 
revoked * * * upon a finding that the registrant--
    (1) Has materially falsified any application filed pursuant to 
or required by this subchapter or subchapter II of this chapter;
* * * * *
    (3) Has had his State license or registration suspended, 
revoked, or denied by competent State authority and is no longer 
authorized by State law to engage in the * * * distribution, or 
dispensing of controlled substances * * *;
    (4) Has committed such acts as would render his registration 
under section 823 of this title inconsistent with the public 
interest as determined under such section[.]

21 U.S.C. 824(a).

    In this case, I conclude that each of the above provisions provide 
independent grounds for revoking Respondent's registration.
    First, it is clear that Respondent materially falsified his May 5, 
2005 application for renewal of his registration. On that application, 
Respondent was asked whether he had ``ever surrendered (for cause) or 
had a state professional license or controlled substance registration 
revoked, suspended, denied, restricted, or placed on probation?'' 
(emphasis added). Respondent answered ``No,'' notwithstanding that the 
Medical Board of California had placed him on probation on three 
separate occasions. Given that the question specifically asked 
Respondent whether his medical license had ever been ``placed on 
probation,'' it is indisputable that Respondent's answer was a material 
falsification.
    The CSA requires DEA to determine whether the issuance of a 
registration would be consistent with the public interest. See 21 
U.S.C. 823(f). The provision of truthful information on applications is 
absolutely essential to effectuating this statutory purpose. See 21 
U.S.C. 824(a)(1); see also VI Pharmacy, Rushdi Z. Salem, 69 FR 5584, 
5585 (2004); Terrance E. Murphy, M.D., 61 FR 2841, 2845 (1996). As the

[[Page 50099]]

Sixth Circuit recently observed: ``Candor during DEA investigations * * 
* is considered by the DEA to be an important factor when assessing 
whether a physician's registration is consistent with the public 
interest.'' Hoxie v. DEA, 419 F.3d 477, 483 (2005). Our cases 
accordingly hold that ``'falsification cannot be tolerated.''' VI 
Pharmacy, 69 FR at 5585 (quoting Murphy, 61 FR at 2845) (other citation 
omitted). Respondent's failure to truthfully answer the question 
regarding prior state disciplinary actions is thus reason alone to 
revoke his registration.
    Respondent's drug dealing provides an additional ground for 
revoking his registration. Such conduct clearly constitutes acts which 
``render his registration * * * inconsistent with the public 
interest.'' See 21 U.S.C. 824(a)(4). Moreover, while the CSA sets forth 
five factors to be considered in determining the public interest, see 
id. Sec.  823(f), I am ``not required to make findings as to all of the 
factors, and can give each factor the weight [I] determine[] is 
appropriate.'' Hoxie, 419 F.3d at 482; see also Morall v. DEA, 412 F.3d 
165, 173-74 (D.C. Cir. 2005). Where, as here, a registrant has engaged 
in such egregious misconduct as drug dealing, a lengthy analysis of 
each of the factors is unnecessary.
    It is indisputable that Respondent did not comply with applicable 
State and Federal laws ``relating to controlled substances'' and that 
his conduct ``threaten[s] public health and safety.'' 21 U.S.C. 
823(f)(4) and (5). Furthermore, while the investigative file does not 
contain evidence establishing what action the Medical Board of 
California took in response to this investigation, see id. Sec.  
823(f)(1), I have taken official notice of the fact that on February 
24, 2006, Respondent surrendered his California medical license in 
response to the State Board's accusation that Respondent committed 
unprofessional conduct for, inter alia, violating state and federal 
drug laws.\3\ See also id. Sec.  824(a)(3). Thus, it is clear that 
Respondent ``has committed such acts as would render his registration * 
* * inconsistent with the public interest as determined under'' section 
823(f). Id. Sec.  824(a)(4). The revocation of Respondent's 
registration is therefore necessary to protect the public interest.
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    \3\ Although the Show Cause Order did not allege Respondent's 
loss of state authority as a ground for this proceeding, the CSA 
does not authorize DEA ``to maintain a registration if the 
registrant is without state authority to handle controlled 
substances in the state in which he practices.'' Sheran Arden 
Yeates, M.D., 71 FR 39130, 39131 (2006). DEA has consistently 
applied this rule. Id.; see also Dominick A. Ricci, M.D., 58 FR 
51104 (1993); Bobby Watts, M.D., 53 FR 11919 (1988). Because 
Respondent no longer has authority under California law to handle 
controlled substances, he is not entitled to maintain his DEA 
registration and revocation of his registration is warranted for 
this reason as well. Furthermore, an allegation that a practitioner 
has committed acts that render his continued registration 
inconsistent with the public interest incorporates the statutory 
factors of 21 U.S.C. 823(f). See 21 U.S.C. 824(a)(4). The first 
factor requires consideration of ``[t]he recommendation of the 
appropriate State licensing board or professional disciplinary 
authority.'' See id. Sec.  823(f)(1). An allegation brought under 
section 824(a)(4) thus provides adequate notice that a loss of a 
State license may be considered during the proceeding.
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Order

    Accordingly, pursuant to the authority vested in me by 21 U.S.C. 
823(f) and 824(a), as well as 28 CFR 0.100(b) and 0.104, I hereby order 
that DEA Certificate of Registration, AA0092558, issued to Peter A. 
Ahles, M.D., be, and it hereby is, revoked. I further order that any 
pending applications for renewal or modification of such registration 
be, and they hereby are, denied. This order is effective September 25, 
2006.

    Dated: August 15, 2006.
Michele M. Leonhart,
Deputy Administrator.
 [FR Doc. E6-14050 Filed 8-23-06; 8:45 am]
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