[Federal Register Volume 81, Number 96 (Wednesday, May 18, 2016)]
[Notices]
[Pages 31310-31341]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2016-11550]



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Vol. 81

Wednesday,

No. 96

May 18, 2016

Part II





Department of Justice





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Drug Enforcement Administration





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Superior Pharmacy I and Superior Pharmacy II; Decision and Order; 
Notice

  Federal Register / Vol. 81 , No. 96 / Wednesday, May 18, 2016 / 
Notices  

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DEPARTMENT OF JUSTICE

Drug Enforcement Administration

[Docket Nos. 15-6 and 15-7]


Superior Pharmacy I and Superior Pharmacy II Decision and Order

    This is a consolidated proceeding involving two pharmacies located 
in Tampa, Florida with common ownership. On October 8, 2014, the Deputy 
Assistant Administrator, Office of Diversion Control, Drug Enforcement 
Administration issued an Order to Show Cause to Superior Pharmacy, 
L.L.C. (hereinafter, Superior II), which proposed the revocation of its 
DEA Certificate of Registration BS9699731, pursuant to which it is 
authorized to dispense controlled substances in schedules II through V 
as a retail pharmacy, at the registered location of 5416 Town `N' 
Country Blvd. ALJ Ex. 1, at 1 (No. 15-7). The next day, the Deputy 
Assistant Administrator issued an Order to Show Cause to Superior 
Pharmacy, L.L.C. (hereinafter, Superior I), which proposed the 
revocation of its DEA Certificate of Registration BS9255274, pursuant 
to which it is authorized to dispense controlled substances in 
schedules II through V as a retail pharmacy, at the registered location 
of 3007 W. Cypress Street, Suite 1. ALJ Ex. 1, at 1 (No. 15-6).
    As grounds for the proposed actions (which also included the denial 
of any pending applications), the Show Cause Orders alleged that each 
pharmacy's ``continued registration is inconsistent with the public 
interest, as that term is defined in 21 U.S.C. 823(f).'' Id.; see also 
ALJ Ex. 1, at 1 (No. 15-7); 21 U.S.C. 824(a)(4). Specifically, with 
respect to each pharmacy, the Orders alleged that their ``pharmacists 
repeatedly failed to exercise their corresponding responsibility to 
ensure that controlled substances they dispensed were dispensed 
pursuant to prescriptions issued for legitimate medical purposes by 
practitioners acting within the usual course of their professional 
practice'' and that their ``pharmacists ignored readily identifiable 
red flags that [the] controlled substances prescribed were being 
diverted and dispensed despite unresolved red flags.'' ALJ Ex. 1, at 1 
(No. 15-6); ALJ Ex. 1, at 1 (No. 15-7) (both citing 21 CFR 1306.04(a); 
Holiday CVS. L.L.C., d/b/a CVS Pharmacy Nos. 219 and 5195, 77 FR 62315, 
62319 (2012)).
    The Show Cause Orders further alleged that each pharmacy's 
``pharmacists dispensed controlled substances when they knew or should 
have known that the prescriptions were not issued in the usual course 
of professional practice or for a legitimate medical purpose, including 
circumstances where the pharmacist knew or should have known that the 
controlled substances were abused and/or diverted by the customer.'' 
ALJ Ex. 1, at 2 (No. 15-6); ALJ Ex. 1, at 2 (No. 15-7). Each Show Cause 
Order then listed various red flags which each Respondent's pharmacists 
allegedly failed to resolve before dispensing prescriptions, including: 
(1) ``Multiple individuals presenting prescriptions for the same drugs 
in the same quantities from the same doctor''; (2) ``individuals 
presenting prescriptions for controlled substances known to be highly 
abused, such as oxycodone and hydromorphone''; (3) ``individuals paying 
. . . for controlled substances with cash''; \1\ and (4) ``individuals 
residing long distances from the pharmacy.'' ALJ Ex. 1, at 2 (No. 15-
6); ALJ Ex. 1, at 2 (No. 15-7). Each Show Cause Order then set forth 
allegations of specific instances in which Respondents' pharmacists 
dispensed oxycodone 30 mg or hydromorphone 8 mg without resolving 
various red flags presented by the patients and/or the prescriptions; 
the Order further alleged that several of these prescriptions were 
facially invalid because they lacked the patient's address. ALJ Ex 1, 
at 2 (No. 15-6); ALJ Ex. 1, at 2 (No. 15-7).
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    \1\ With respect to Superior I, the Show Cause Order stated the 
red flag as ``individuals paying high prices for prescriptions for 
controlled substances with cash.'' ALJ 1, at 2 (No. 15-6).
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    Each Show Cause Order further alleged that Respondents' pharmacists 
dispensed hydromorphone, notwithstanding that the ``dosage amounts . . 
. if taken as directed, far exceeded the recommended dosages of 
hydromorphone that should be taken on a daily basis.'' ALJ Ex. 1, at 2 
(No. 15-6); ALJ Ex. 1, at 3 (No. 15-7). The Superior I Order also 
alleged that its pharmacists dispensed prescriptions, which were 
written by the same doctor on the same day, for ``large and 
substantially similar quantities of'' oxycodone 30 mg, ``to two 
customers . . . both of whom resided at the same address,'' in a town 
``located approximately [449 miles] from'' the pharmacy. ALJ Ex. 1, at 
2 (No. 15-6). Likewise, the Superior II order alleged that its 
``pharmacists dispensed large and substantially similar quantities of 
hydromorphone and oxycodone to two individuals with the same last name 
who received their prescriptions on the same day from doctors at the 
same clinic.'' ALJ Ex. 1, at 3 (No. 15-7).
    In addition, the Superior I Order alleged that the pharmacy 
``failed to create and maintain accurate [schedule II order forms] in 
violation of 21 U.S.C. 842(a)(5),'' and that ``[a]t least two [of its] 
pharmacists . . . shared a private key (password) for digitally 
signing'' controlled substances orders, ``in violation of 21 CFR 
1311.30(a), (c), and (e).'' ALJ Ex. 1, at 3-4 (No. 15-6). Finally, the 
Superior I Order alleged that a DEA audit for the period of May 2, 2011 
through February 4, 2013 found, inter alia, that the pharmacy was short 
15,560 dosage units (du) of oxycodone 30 mg; 11,951 du of hydromorphone 
8 mg; 946 du of hydromorphone 4 mg; and 864 du of methadone 10 mg. Id. 
at 4.
    The Superior II Order alleged that it had also failed to maintain 
accurate schedule II order forms and had failed to retain copy three of 
these forms as required by DEA regulations. ALJ Ex. 1, at 3 (No. 15-7) 
(citing 21 CFR 1305.13(a) & (e); id. Sec.  1305.17(a); 21 U.S.C. 
827(b)). The Order further alleged that the pharmacy failed to create 
records of the quantity and date received for orders it placed using 
the Controlled Substances Ordering System (CSOS) and that it ``also 
failed to electronically archive and link these records to the original 
order.'' Id. at 4. Finally, the Superior II Order alleged that a DEA 
audit for the period of July 31, 2012 through February 4, 2013 found, 
inter alia, that the pharmacy had overages of 2,576 du of hydromorphone 
8 mg; 1,189 du of oxycodone 30; and 896 du of methadone 10 mg.
    The Show Cause Order issued to Superior I was served on October 17, 
2014, and the Show Cause Order issued to Superior II was served on 
October 16, 2014. See ALJ Ex. 3 (No. 15-6); ALJ Ex. 4 (No. 15-7). On 
November 14, 2014, each pharmacy, through its counsel, requested a 
hearing on the allegations. See ALJ Ex. 2 (No. 15-6); ALJ Ex. 3 (No. 
15-7). Each matter was placed on the docket of the Office of 
Administrative Law Judges and assigned to Administrative Law Judge 
(ALJ) Christopher B. McNeil.

The Prehearing Motions and Rulings

    On December 3, 2014, the ALJ issued an Order for Prehearing 
Statements and Setting the Matter for Hearing (hereinafter, Prehearing 
Order) in each case. See ALJ Ex. 5 (No. 15-6); ALJ Ex. 6 (No. 15-7). In 
each Prehearing Order, the ALJ directed the Government to file its Pre-
hearing Statement no later than 2 p.m. on December 22, 2014, and each 
Respondent to file its Prehearing Statement no later than 2 p.m. on 
January 5, 2015. ALJ Ex. 5, at 1 (No. 15-

[[Page 31311]]

6); ALJ Ex. 6, at 1 (No. 15-7). The Orders also directed the parties to 
``[p]rovide the names and current addresses of all witnesses whose 
testimony is to be presented,'' and that ``[i]f the Respondent's 
corporate representative intends to testify, the representative must be 
listed, and a summary of anticipated testimony as described below must 
be provided.'' ALJ Ex. 5, at 2 (No. 15-6); ALJ Ex. 6, at 2 (No. 15-7). 
The ALJ's Orders provided the following instruction regarding the 
summaries of testimony:

    Provide a brief summary of the testimony of each witness, with 
counsel for the Government to indicate clearly each and every act, 
omission or occurrence upon which it relies in seeking to revoke the 
Respondent's Certificate of Registration, and counsel for Respondent 
to indicate clearly each and every matter as to which Respondent 
intends to introduce evidence in opposition. The summaries are to 
state what the testimony will be, rather than merely listing the 
areas to be covered. The parties are reminded that testimony not 
disclosed in the prehearing statements or pursuant to subsequent 
rulings is likely to be excluded at the hearing.

ALJ Ex. 5, at 2 (No. 15-6); ALJ Ex. 6, at 2 (No. 15-7).

    The ALJ's Orders also provided that ``[a]ny requests for 
subpoena[s] are to be filed by 2:00 p.m. E.S.T. on January 12, 2015,'' 
and that ``[s]ubpoena requests that do not comply with these 
instructions will be returned to the requestor without further 
action.'' \2\ ALJ Ex. 5, at 4 (No. 15-6); ALJ Ex. 6, at 4 (No. 15-7). 
The ALJ's Orders further provided that ``[w]henever a party seeks to 
file any document, motion, exhibit or otherwise communicate in writing 
with the Administrative Law Judge, the party must provide a true copy 
of the same to the opposing party, using the contact information shown 
in the Certificate of Service below . . . [and] [t]he party making such 
a filing shall include a `Certificate of Service' stating that a true 
copy of the submission has been provided to the opposing party, and 
shall specify the means by which'' this was accomplished. ALJ Ex. 5, at 
5-6 (No. 15-6); ALJ Ex. 6, at 5-6 (No. 15-7).
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    \2\ The Order further required that ``[a]ny motion to quash a 
subpoena must be filed within three working days of receipt of the 
subpoena request and must be served on the opposing party.'' ALJ Ex. 
5, at 4-5 (No. 15-6); ALJ Ex. 6, at 4-5 (No. 15-7).
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    Finally, the ALJ's Orders directed the parties to file their 
proposed exhibits with his Office no later than 2:00 p.m. on January 
12, 2015; it also directed that a copy of the exhibits be served on the 
opposing party. ALJ Ex. 5, at 2 (No. 15-6); ALJ Ex. 6, at 2 (No. 15-7). 
The ALJ's Orders further directed that ``[w]hen any party seeks to . . 
. present proposed exhibits,'' the party must ``timely provid[e] the 
OALJ with a facsimile copy'' and ``must mail hard copy filings 
sufficiently in advance of the due date to assure timely receipt by the 
hearing clerk'' as well as ``that documents are to be filed in 
triplicate.'' ALJ Ex. 5, at 5-6 (No. 15-6); ALJ Ex. 6, at 5-6 (No. 15-
7).
    In his Orders, the ALJ also noted that the cases appeared to 
``involve common questions of law or fact'' and thus directed the 
parties to address whether they should be consolidated. ALJ Ex. 5, at 3 
(No. 15-6); ALJ Ex. 6, at 3 (No. 15-7). Thereafter, the Government 
moved to consolidate the cases (as well as two other cases). Respondent 
opposed the Government's motion.
    On December 22, 2014, the Government filed its Prehearing 
Statements with respect to each pharmacy. In each of these, the 
Government disclosed that it intended to elicit testimony from an 
expert regarding his review of ``numerous controlled substance 
prescriptions filled by Respondent that contained one or more red flags 
for diversion which Respondent never resolved.'' ALJ Ex. 6, at 3 (No. 
15-6); ALJ Ex. 8, at 3-4 (No. 15-7). The Government then identified the 
same set of seven red flags. ALJ Ex. 6, at 3 (No. 15-6); ALJ Ex. 8, at 
3-4 (No. 15-7). With respect to both pharmacies, the Government then 
set forth the expert's proposed testimony regarding various oxycodone 
30 mg prescriptions and the red flags they presented, as well as his 
proposed testimony regarding the pharmacy's dispensing of large 
quantities of hydromorphone and the red flags they presented. ALJ Ex. 
6, at 4 (No. 15-6); ALJ Ex. 8, at 3-4 (No. 15-7). And with respect to 
Superior I, the Government also disclosed that the expert ``will also 
testify about a customer who willingly purchased a prescription for 
oxycodone . . . that costs 37% more than the same prescription four 
months earlier,'' and ``that this fact, combined with the fact that the 
prescription was facially invalid [as it contained] no patient address 
constituted a red flag for diversion.'' ALJ Ex. 6, at 5 (No. 15-6).
    The Government then noticed both Respondents that its expert ``will 
testify that the facts surrounding the prescriptions listed above 
constituted red flags for diversion and that there is no evidence that 
any of the red flags were resolved prior to distributing the controlled 
substances to the customers.'' Id. at 3 (No. 15-6). Finally, it noticed 
Respondents that its expert ``will testify that . . . Respondent[s'] 
pharmacists failed to exercise their corresponding responsibility to 
ensure that prescriptions for controlled substances were issued for a 
legitimate medical purpose in the usual course of professional 
practice.'' ALJ Ex. 6, at 3 (No. 15-6); ALJ Ex. 8, at 3-4 (No. 15-7).
    On January 5, 2015, each Respondent filed a ``Motion to Compel'' 
and a ``Motion for Enlargement of Time to File . . . Pre-hearing 
Statement,'' as well as a Prehearing Statement. ALJ Exs. 9, 10, 11 (No. 
15-6); ALJ Exs. 9, 10, 12 (No. 15-7). In their Motions to Compel, each 
Respondent noted that on February 4, 2013, DEA had executed an 
Administrative Inspection Warrant at it and sought an Order from the 
ALJ requiring the Government to disclose the documents and testimony 
submitted by DEA Investigators to the Federal Magistrate Judge in 
obtaining the Warrants. ALJ Ex. 10, at 2 (No.15-6); ALJ Ex 10, at 2 
(No. 15-7). Each Respondent's Motion to Compel also sought to require 
the Government to: (1) Provide ``full and complete copies of all 
computer data seized . . . during the execution of the'' warrant; (2) 
identify ``all DEA personnel involved in the preparation and execution 
of the [warrant] and the subsequent review and analysis of the 
information, records, and data seized''; and (3) provide ``reports of, 
and the substance of, any statements made to DEA investigators by 
[Respondent's] staff.'' ALJ Ex. 10, at 5 (No.15-6); ALJ Ex 10, at 5 
(No. 15-7).
    Each Respondent also sought an extension of the time to file its 
Prehearing Statement to the end of March 2015 and sought to reschedule 
the hearing ``to no sooner than June 2015.'' ALJ Ex. 11, at 3 (No. 15-
6); ALJ Ex. 9 (No. 15-7). As support for the motions, Respondents 
argued that since the execution of the warrants, the Government had 20 
months to review the records, and that ``[d]uring this time, the 
information was not available to Respondent.'' ALJ Ex. 11, at 3 (No. 
15-6); ALJ Ex. 9, at 3 (No. 15-7). Respondents further argued ``[w]hile 
a portion of the seized information, most notably the prescriptions, 
was provided to Respondent[s] in electronic format, the sheer volume of 
information coupled with the unreasonably short deadlines surrounding 
the holiday season make analysis of the information by [it] 
impossible.'' ALJ Ex. 11, at 3 (No. 15-6); ALJ Ex. 9, at 3 (No. 15-7). 
Respondents further argued that ``due process requires, and good cause 
exists, for a significant'' extension of the time to file the 
Prehearing Statements and ``to prepare for a lengthy hearing in'' these

[[Page 31312]]

matters. ALJ Ex. 11, at 3 (No. 15-6); ALJ Ex. 9, at 3 (No. 15-7).
    The Government opposed these motions. With respect to the Motions 
to Compel, the Government argued that in its Prehearing Statements, it 
had provided a summary of the testimony it intended to elicit as well 
as a list of the exhibits it intended to offer; the Government also 
noted that several weeks earlier, it had met with one of Respondents' 
counsels and that at no time then or since its motion, had Respondents' 
counsel ``communicate[d] a need for, or request[ed] any'' of the 
information it sought through the motions. ALJ Ex. 16, at 3 (No. 15-7). 
The Government further argued that it had fully complied with its 
disclosure obligations, and that to the extent Respondents were seeking 
discovery, `` `[t]here is . . . no general right to discovery under 
either the APA or DEA regulations, but rather only a limited right to 
receive in advance of the hearing the documentary evidence and 
summaries of the testimony which the Government intends to rely upon.' 
'' ALJ Ex. 16, at 4 (No. 15-7) (quoting Roy E. Berkowitz, 74 FR 36758, 
36760 (2009)). Finally, the Government argued that to the extent 
Respondents were asserting that they had a right to receive these 
materials as a matter of due process, ``Respondent[s] ha[d] not even 
articulated how the requested materials might be relevant to this 
proceeding.'' ALJ Ex. 16, at 5 (No. 15-7).
    Each Respondent filed a Reply to [the] Government's Response to 
Motion to Compel. ALJ Ex. 27 (No. 15-6); ALJ Ex.18 (No. 15-7). Therein, 
Respondents contended that they were entitled to the documents as a 
matter of due process because the Government had represented that one 
of its proposed witnesses (a Diversion Investigator) would testify 
regarding his/her interviews with Respondents' staff and that they 
would be prejudiced if the Government did not provide the ``same.'' ALJ 
Ex. 27, at 2 (No. 15-6); ALJ Ex. 18, at 2 (No. 15-7). Respondents 
further asserted that the ``information is essential,'' because the 
Government intended to put on evidence that the prescriptions raised 
red flags and that ``Respondent[s] fail[ed] to exercise [their] 
corresponding responsibility to resolve the `red flag[s],' '' and the 
Government ``has not identified one patient or doctor related to the 
prescriptions allegedly containing unresolved red flags.'' ALJ Ex. 27, 
at 2 (No. 15-6); ALJ Ex. 18, at 2 (No. 15-7).
    The Government also opposed Respondents' Motions for Enlargement of 
Time. ALJ Ex. 16, at 6 (No. 15-7). The Government argued that the Show 
Cause Orders and Prehearing Statements had ``specifically outlined'' 
the allegations, ``as well as the approximate number of documents it 
intend[ed] to introduce into evidence.'' Id. The Government further 
argued that it was ``patently specious'' for Respondents ``[t]o 
characterize this matter as something much more voluminous and 
complicated than what it is and, as a result, argue that further delay 
is necessary.'' Id. The Government also contended that to the extent 
Respondents were seeking an extension to review records and 
prescriptions beyond those referenced in the Show Cause Orders and its 
Prehearing Statements, those documents were not ``material to the 
allegation that he [sic] unlawfully dispensed to customers identified 
in the OTSC and Government's Prehearing Statement.'' Id. at 6-7.
    On January 5, 2015, the ALJ denied Respondents' Motions for 
Enlargement. ALJ Ex. 11, at 3 (No. 15-7); ALJ Ex. 12, at 4 (No. 15-6). 
The ALJ specifically noted ``that since at least October 16, 2014, 
Respondent[s] ha[ve] been informed of the nature of the charges 
presented in the Order to Show Cause,'' and that in their motions, 
Respondents had acknowledged that the Government had provided them with 
the prescriptions. ALJ Ex. 11, at 3 (No. 15-7); ALJ Ex. 12, at 3 (No. 
15-6). The ALJ explained that neither Respondent had ``established that 
it has been prevented from evaluating those prescriptions identified in 
the Order to Show Cause [or] that it has been prevented from preparing 
its prehearing statement.'' ALJ Ex. 11, at 3 (No. 15-7); ALJ Ex. 12, at 
3 (No. 15-6). The ALJ also explained that Respondents had known since 
the issuance of his Prehearing Orders that they were required ``to 
object to any term of that Order by not later than December 10, 2014,'' 
and that they failed to object to the orders until the day their 
Prehearing Statements were due. ALJ Ex. 11, at 3 (No. 15-7); ALJ Ex. 
12, at 3 (No. 15-6). The ALJ thus concluded that:

    I am compelled to consider the nature of the allegations, which 
if proved suggest Respondent[s'] ability to fill controlled 
substance prescriptions would be inconsistent with the public 
interest. I am further compelled to consider Respondent[s'] own role 
in attempting to delay th[ese] proceeding[s], given that [they] 
failed to timely object to the deadlines set forth in the Order[s]. 
I am further compelled to consider fairness to all parties, and the 
convenience of witnesses now identified by the Government in its 
timely prehearing statement[s]. I am further compelled to consider 
the need for orderly and prompt administration of justice. All of 
these considerations compel my finding that good cause has not been 
shown for either enlarging the time for Respondent[s] to file 
[their] prehearing statement[s], or for continuing the hearing now 
set to being on January 27, 2015.

ALJ Ex. 11, at 3 (No. 15-7); ALJ Ex. 12, at 3 (No. 15-6).

    The same day (according to OALJ date stamps), each Respondent filed 
its Prehearing Statement. ALJ Ex. 9 (No. 15-6); ALJ Ex. 12 (No. 15-7). 
Each Respondent proposed as witnesses ``[a]ny and all patients whose 
prescriptions were seized . . . pursuant to the Administrative 
Inspection Warrant executed [on] February 4, 2013 or whose 
prescriptions for controlled substances were dispensed between January 
1, 2011 and February 4, 2013.'' ALJ Ex. 9, at 3 (No. 15-6); ALJ Ex. 12, 
at 3 (No. 15-7). Respondent Superior I further attached a list of 2,355 
purported patients, ALJ Ex. 9, at Attachment A (No. 15-6); and 
Respondent Superior II attached a list of 2,253 purported patients. ALJ 
Ex. 12, at Attachment A (No. 15-7). As for the required summary of 
anticipated testimony, each Respondent proposed that:

    These patients will each be asked to provide testimony regarding 
their medical history, injuries and related pathology, interactions 
with treating physicians and dispensing pharmacists, effectiveness 
of the prescribed controlled substances, continuity of treatment, 
their reasons for patronage of Superior Pharmacy, LLC . . . such 
other testimony relevant to the Government's allegation that any of 
these prescriptions raised `red flags' which should have caused 
pharmacists to refuse to dispense the prescribed controlled 
substances.

ALJ Ex. 9, at 4 (No. 15-6); ALJ Ex. 12, at 4 (No. 15-7).

    Respondents further proposed as witnesses ``[a]ny and all 
physicians who issued the prescriptions seized . . . pursuant to the 
Administrative Inspection Warrant[s] . . . or whose prescriptions for 
controlled substances were dispensed at [them] between January 1, 2011 
and February 4, 2013,'' as well as ``[a]ny and all physicians who 
issued prescriptions for controlled substances to the patients 
identified . . . above after February 4, 2013.'' ALJ Ex. 9, at 3 (No. 
15-6); ALJ Ex. 12, at 3 (No. 15-7). Each Respondent attached a list of 
several hundred physicians who had purportedly issued the controlled 
substance prescriptions dispensed by them. ALJ Ex. 9, at Attachment B 
(No. 15-6); ALJ Ex. 12, at Attachment B (No. 15-7). As for the 
anticipated testimony of the physicians, Respondents represented that:

    These physicians will confirm they performed adequate and 
appropriate physical examinations of the patients to whom they

[[Page 31313]]

issued prescriptions for controlled substances, communication with 
the dispensing pharmacies regarding such prescriptions, the 
reasonableness and necessity of the prescriptions to control the 
pain or other complaints of their patients as required by the 
standard of care and Florida statutes.

ALJ Ex. 9, at 4 (No. 15-6); ALJ Ex. 12, at 4 (No. 15-7).

    Next, Respondents proposed as witnesses ``[a]ny and all pharmacists 
who dispensed prescriptions for controlled substances to the patients 
identified . . . above after February 4, 2013.'' ALJ Ex. 9, at 3 (No. 
15-6); ALJ Ex. 12, at 3 (No. 15-7) (emphasis added). As for their 
anticipated testimony, Respondents represented that ``[t]hese 
pharmacists will describe the information they obtained from the 
patients, physicians and other sources in order to resolve `red flags,' 
if any, raised by the described prescriptions for controlled 
substances.'' ALJ Ex. 9, at 5 (No. 15-6); ALJ Ex. 12, at 5 (No. 15-7). 
Respondent did not, however, provide the names of any of the 
pharmacists. ALJ Ex. 9, at 3 (No. 15-6); ALJ Ex. 12, at 3 (No. 15-7).
    Respondents also proposed as a witness Mr. Sam Badawi, a pharmacist 
and attorney. ALJ Ex. 9, at 3 (No. 15-6); ALJ Ex. 12, at 3 (No. 15-7). 
As for Mr. Badawi's anticipated testimony, Respondents represented that 
he:

will testify regarding his qualifications as an expert in the field 
of pharmacy and the legal and ethical responsibilities of the 
pharmacists dispensing prescriptions at [each Respondent], the 
procedures used at [each Respondent] to consider and resolve `red 
flags,' inventory, ordering and CSOS compliance issues. Mr. Badawi 
will further testify that he had reviewed the prescriptions at 
issue, the relevant inventory and ordering records and prepared 
summaries of the prescription dispensing activity at [each pharmacy] 
during 2011 and 2012, and identified significant errors in the 
inventory performed by the DEA.

ALJ Ex. 9, at 6 (No. 15-6); ALJ Ex. 12, at 6 (No. 15-7).

    Respondents further proposed as a witness Mr. Jack Crowley of Gates 
Healthcare Associates. Respondents represented that Mr. Crowley:

will testify regarding his knowledge and experience in the 
investigation, preparation and execution of Administrative 
Inspection Warrants and the subsequent investigation required. [He] 
will testify regarding errors in the audits performed by the agents/
investigators involved in the investigation of [Respondents]. [He] 
reviewed the prescriptions, inventory and CSOS records of 
[Respondents]. [He] will further testify regarding [Respondents'] 
procedure[s] for resolving potential `red flag' issues and 
compliance with recordkeeping requirements related to inventory 
records, DEA-222 order forms and CSOS issues.

ALJ Ex. 9, at 5 (No. 15-6); ALJ Ex. 12, at 5 (No. 15-7).\3\
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    \3\ Respondents also proposed as witnesses each person ``who 
participated in the preparation of the application for the 
Administrative Inspection Warrant[s],'' as well as each person ``who 
participated in the execution of the Administrative Inspection 
Warrant[s].'' ALJ Ex. 9, at 3-4 (No. 15-6); ALJ Ex. 12, at 3-4 (No. 
15-7).

    On January 9, 2012, each Respondent filed a motion to enlarge the 
time for filing its proposed exhibits or to alternatively provide its 
proposed exhibits electronically, as well as a motion to enlarge the 
time to file its requests for subpoenas. ALJ Ex. 22 (No. 15-6); ALJ Ex. 
23 (No. 15-7). In its motion, Superior I explained that its 
``Prehearing Statement identifies four categories of proposed exhibits 
which consist of 23,032 documents,'' of which ``20,925 pages represent 
the documents seized, and provided to Respondent electronically, by the 
DEA.'' ALJ Ex. 22, at 2 (No. 15-6). Superior I explained that to comply 
with the ALJ's Pre-hearing Order, which required that three copies of 
each exhibit be filed with the OALJ and one copy be filed with opposing 
counsel, this would require more than 92,000 pages and ``approximately 
nineteen standard boxes of paper, which is approximately 950 pounds.'' 
Id. Superior I further explained that because of the volume of copying 
needed to comply with the Pre-hearing Order, the documents would have 
to be sent ``to a third party for reproduction'' and ``the reproduction 
cannot be completed in the allotted time.'' Id. at 3. As for its 
subpoena requests, Superior I contended that the ALJ's Prehearing Order 
was ambiguous ``as to whether the requests and completed subpoenas are 
to be filed in triplicate with the Hearing Clerk,'' and because it was 
seeking to subpoena 2,861 witnesses, it ``cannot complete the . . . 
requests . . . with the completed subpoenas using the required template 
in the allotted time.'' Id.
    Superior II made similar assertions to Superior I, noting that its 
proposed exhibits ``consist of 32,123 documents,'' of which ``30,441 
pages represent the documents seized, and provided to [it] 
electronically, by the DEA,'' and that to comply with the ALJ's 
Prehearing Order, it would have to provide more than 128,000 pages of 
documents, and require ``approximately 1,300 pounds'' of paper. ALJ Ex. 
23, at 2 (No. 15-7). As did Superior I, Superior II asserted that it 
would have to use a third-party to perform the necessary copying, which 
could not ``be completed in the allotted time.'' Id. at 3. Superior II 
also asserted that it could not complete the 2,549 subpoena requests 
for its proposed witnesses on time. Id.
    On January 12, 2015, each Respondent submitted a letter (dated Jan. 
9) to the Hearing Clerk along with thumb drives which contained ``the 
images of each of the exhibits in [its] Prehearing Statement.'' ALJ Ex. 
24 (No. 15-6); ALJ Ex. 24 (No. 15-7). Each Respondent's letter also 
advised that the paper copies of the subpoena requests would be hand 
delivered on Monday, January 12, 2015, and on that date, the ALJ 
``received more than 3,000 written requests for the issuance of 
subpoenas in the[] two cases.'' Tr. 18; see also ALJ Ex. 24 (No. 15-6); 
ALJ Ex. 24 (No. 15-7). According to the ALJ, neither Respondent 
provided ``a certificate of service establishing that [they] ha[d] 
provided the Government with a true copy of these requests.'' Tr. 18.
    The same day, the ALJ's Law Clerk sent a letter under his own 
signature to each Respondent's Counsel noting that the OALJ had 
received the thumb drives. ALJ Ex. 28 (No. 15-6); ALJ Ex. 28 (No. 15-
7). The Law Clerk then explained that he was returning the thumb drives 
to each Respondent's counsel because ``[t]he submission of the thumb 
drive does not adhere to the'' ALJ's Prehearing Order of December 3, 
2014. ALJ Ex. 28 (No. 15-6); ALJ Ex. 28 (No. 15-7).
    On January 12, the ALJ denied each Respondent's Motion to Compel. 
The ALJ noted that in the case of Edge Pharmacy (Docket No. 15-3), the 
respondent had sought to compel the disclosure of much of the same 
material as sought by Superiors I and II. ALJ Ex. 29, at 4 (No. 15-6); 
ALJ Ex. 29, at 4 (No. 15-7). The ALJ further noted that in Edge, the 
Chief Administrative Law Judge (CALJ) had denied the motion of the 
respondent on the ground that it did ``not comport with the narrowly-
focused grant of authority in 21 CFR 1316.52(d),'' and that the 
respondent did ``not seek to compel . . . the class of documents 
discoverable under the [Administrative Procedure Act] or subject to 
inspection under DEA regulations.'' ALJ Ex. 29, at 4 (No. 15-6); ALJ 
Ex. 29, at 4 (No. 15-7). As for the reports and the substance of any 
statements made by Respondents' staff to the Agency's Investigators, 
the ALJ also found that the CALJ's reasoning applied to these 
materials. ALJ Ex. 29, at 4 (No. 15-6); ALJ Ex. 29, at 4 (No. 15-7). 
The ALJ thus concluded that each Respondent had failed to establish its 
entitlement to the documents. ALJ Ex. 29, at 4 (No. 15-6); ALJ Ex. 29, 
at 4 (No. 15-7).

[[Page 31314]]

    The same day, in the Superior I matter, the Government submitted 
its request for the issuance of subpoenas for four witnesses, and in 
the Superior II matter, the Government submitted its request for the 
issuance of subpoenas for five witnesses, all of whom had been 
previously identified in the respective Prehearing Statement.\4\ ALJ 
Ex. 25, at 1-2 (No. 15-6); ALJ Ex. 25, at 1-2 (No. 15-7). The 
Government also submitted its proposed exhibits in each matter. Docket 
Sheet, at 2 (No. 15-6); Docket Sheet, at 2 (No. 15-7).
---------------------------------------------------------------------------

    \4\ The Government also served a copy of both subpoena requests 
on each Respondent. ALJ Ex. 25, at 2 (No. 15-6); ALJ Ex. 25, at 2 
(No. 15-7).
---------------------------------------------------------------------------

The Government's Motions To Consolidate

    On January 13, 2015, the Government moved to consolidate the cases, 
along with a third matter (Jet Pharmacy). ALJ Ex. 31 (No. 15-6); ALJ 
Ex. 31 (No. 15-7). In its motions, the Government argued that there 
were common issues of law and fact with respect to the pharmacies, 
noting that it intended to call the same expert in each of the cases 
and each Respondent had stated that it intended to call the same two 
experts. ALJ Ex. 31, at 2-3 (No. 15-6); ALJ Ex. 31, at 2-3 (No. 15-7). 
The Government further argued that the expert's testimony would 
``account for the bulk of the Government's and likely the Respondents' 
cases in terms of length of testimony,'' and that consolidation would 
``result in a tremendous conservation of time and resources by allowing 
the Government to present its expert's testimony in one proceeding 
rather than in three separate proceedings.'' ALJ Ex. 31, at 5 (No. 15-
6); ALJ Ex. 31, at 5 (No. 15-7).
    The Government also argued that, although ``each of the Respondent 
pharmacies is a separate business entity, there are also strong 
indications of common ownership, management, and/or control between the 
Respondents,'' and that Superior I and II ``are both owned and operated 
by Victor Obi-Anadiume.'' \5\ ALJ Ex. 31, at 3 (No. 15-6); ALJ Ex. 31, 
at 3 (No. 15-7). As support for this assertion, the Government attached 
to its motions various documents it obtained from the Florida 
Department of Heath showing that Victor Obi owned both Superior I and 
II. The Government thus maintained that consolidation was warranted 
``because the conduct of one Respondent may be imputed to other 
Respondents if it can be shown that the same individuals responsible 
for misconduct at one pharmacy also managed and/or controlled other 
pharmacies.'' ALJ Ex. 31, at 5 (No. 15-6); ALJ Ex. 31, at 5 (No. 15-7).
---------------------------------------------------------------------------

    \5\ Mr. Obi-Anadiume is also referred to as Mr. Obi throughout 
this decision.
---------------------------------------------------------------------------

    Each Respondent filed identical oppositions to the Government's 
motions. See ALJ Ex. 30 (No. 15-6); ALJ Ex. 32 (No. 15-7). Therein, 
Respondents argued that ``it is not . . . sufficient for two (2) 
actions to have a common defendant or one common issue of law'' and 
that ``other considerations are necessary such as whether maintaining 
separate actions would lead to inconsistent rulings on similar issues 
of fact and law and to ensure that the same standard is applied to the 
determination of such issues as they arise in each case.'' ALJ Ex. 30, 
at 3-4 (No. 15-6); ALJ Ex. 32, at 3-4 (No. 15-7) (citation omitted). 
Respondents also argued that consolidation of the cases ``may cause 
unnecessary confusion for the fact finder and prejudice to the 
parties.'' ALJ Ex. 30, at 4 (No. 15-6); ALJ Ex. 32, at 4 (No. 15-7) 
(citation omitted).
    Respondents then maintained that ``because each prescription 
represents a different pattern of facts, it appears there is no 
overlapping factual issue between the two matters,'' and ``[a]s such, 
there is no risk of inconsistent results'' which would support 
consolidation. ALJ Ex. 30, at 5 (No. 15-6); ALJ Ex. 32, at 5 (No. 15-
7). Respondents further maintained that ``there is a high risk that one 
defendant could be prejudiced by evidence relating to another 
defendant.'' ALJ Ex. 30, at 5 (No. 15-6); ALJ Ex. 32, at 5 (No. 15-7). 
Respondents also asserted that consolidation would not promote judicial 
economy ``[b]ecause of the large number . . . and limited overlap of'' 
the witnesses and because ``the time necessary to complete the hearing 
as to both parties could exceed ninety (90) days.'' ALJ Ex. 30, at 6 
(No. 15-6); ALJ Ex. 32, at 6 (No. 15-7).
    On January 15, 2015, each Respondent filed a further pleading, 
which appear to be identical, on the issue of consolidation. ALJ Ex. 40 
(No. 15-6); ALJ Ex. 40 (No. 15-7). In addition to the arguments they 
previously raised, Respondents contended that ``[t]o the extent the 
government seeks to rely on a single expert to prove its case in all 
three matters, it heightens the risk of confusion or attempts to 
conflate issues between three distinct defendants.'' ALJ Ex. 40, at 6 
(No. 15-6); ALJ Ex. 40, at 6 (No. 15-7). They also argued that 
``although Respondent[s] share Mr. Obi as a common owner, [he] is not 
responsible for the day-to-day operations or the implementation of 
policies and procedures at these separate businesses'' as each pharmacy 
had a ``different pharmacy manager[ ].'' ALJ Ex. 40, at 7 (No. 15-6); 
ALJ Ex. 40, at 7 (No. 15-7). Respondents further contended that ``Mr. 
Obi did not dispense medication or otherwise process prescriptions at 
these pharmacies during all relevant time periods described in the 
Orders to Show Cause.'' ALJ Ex. 40, at 7 (No. 15-6); ALJ Ex. 40, at 7 
(No. 15-7).
    On January 21, 2015, the ALJ granted the Government's motions with 
respect to Superior I and Superior II. ALJ Ex. 1 (No. 15-6 & 15-7). The 
ALJ specifically found that ``the Government ha[d] demonstrated the 
presence of common questions of law and fact with respect to Superior I 
and Superior II, and ha[d] shown the need to take steps to avoid 
unnecessary cost or delay.'' Id. at 7. More specifically, the ALJ found 
that the Show Cause Orders ``set forth substantially similar factual 
claims'' in that ``pharmacists at both pharmacies dispensed controlled 
substances under conditions where the pharmacists knew or should have 
known that the controlled substances were being either diverted or 
abused by those who received the substances.'' Id. The ALJ further 
found that ``[i]n both cases, the [Government] alleged the pharmacists 
filled prescriptions notwithstanding red flags relating to the unusual 
distance the patients traveled to have their prescriptions filled, and 
notwithstanding red flags relating to evidence that the patients were 
filling multiple prescriptions which bore no address for the 
patients.'' Id.
    The ALJ also rejected Respondents' contention that there was ``a 
substantial risk of prejudice to Respondents in either case.'' Id. at 
8. The ALJ specifically found that ``the prospect of hearing from the 
fact and expert witnesses in both cases will reduce the risk of 
inconsistencies like those that could arise through separate 
hearings.'' Id. The ALJ also ``expressly rejected'' Respondent's 
contention that there was a heightened ``risk of confusion'' because 
the Government intended to use the same expert to prove its case, 
explaining that ``[o]ne expert can easily address the conduct 
attributed to pharmacists working at these two pharmacies.'' Id. 
Finally, the ALJ reasoned that ``[g]iven there is at least some showing 
of common ownership, the Government should be, and will be, permitted 
to advance its theory that `the conduct of one Respondent may be 
imputed to [the] other Respondent[ ] if it can be shown that the same 
individuals responsible for misconduct at one pharmacy also managed 
and/or controlled other pharmacies.''' Id. (citation omitted). The ALJ 
thus ordered that the cases against Superior I and

[[Page 31315]]

Superior II be consolidated under Docket No. 15-6. Id.

The Government's Motions in Limine

    On January 15, 2015, the Government also filed a Motion in Limine 
in each matter. Therein, the Government argued that Respondents had 
failed to comply with the ALJ's Pre-hearing Orders in that they failed 
to provide adequate summaries of the testimony of their proposed 
witnesses. With respect to Mr. Badawi, Respondents' proposed expert in 
pharmacy practice, the Government argued that Respondents' Prehearing 
Statements ``state[d] no facts or conclusions which, if proven, would 
rebut any allegations that the Government has made in its OTSC[s] or 
Prehearing statement[s].'' ALJ Ex. 36, at 4 (No. 15-6); ALJ Ex. 36, at 
4-5 (No. 15-7). The Government specifically argued that while 
``Respondent[s] state[d] that Mr. Badawi ha[d] `prepared summaries' of 
prescription activity and identified `errors' in DEA inventory[,] 
[they] fail[ ] to disclose what those summaries entail or what errors 
have been discovered.'' ALJ Ex. 36, at 4-5 (No. 15-6); ALJ Ex. 36, at 5 
(No. 15-7). The Government further argued that Respondents had ``also 
failed to identify a single `procedure used at [the pharmacies] to 
consider and resolve alleged `red flags,' inventory, ordering and 
CSO[S] compliance issues.'' ALJ Ex. 36, at 5 (No. 15-6); ALJ Ex. 36, at 
5 (No. 15-7). The Government also argued that ``notably absent from 
[the] Prehearing Statement[s] is any notice that Mr. Badawi will opine 
that any of the prescriptions identified in the [Show Cause Orders] and 
the Government's Prehearing Statement[s] were issued in compliance with 
federal or state law.'' ALJ Ex. 36, at 5 (No. 15-6); ALJ Ex. 36, at 5 
(No. 15-7).
    As for Respondents' disclosures pertaining to the testimony of Mr. 
Crowley, the Government argued that ``no facts [were] proffered to give 
[it] any notice regarding [his] conclusions regarding audit errors, or 
the basis for those conclusions, should they exist.'' ALJ Ex. 36, at 5 
(No. 15-6); ALJ Ex. 36, at 5 (No. 15-7). The Government also argued 
that while Respondents proposed that this witness would testify 
regarding their procedures for resolving red flags and complying with 
other requirements, Respondent had not ``offer[ed] a single fact or 
detail to describe, identify, or explain that procedure.'' ALJ Ex. 36, 
at 5 (No. 15-6); ALJ Ex. 36, at 5 (No. 15-7). The Government further 
contended that it is unclear whether this witness's proposed testimony 
would discuss the procedures in place during the period of the alleged 
misconduct or as to procedures subsequently instituted. ALJ Ex. 36, at 
6 (No. 15-6); ALJ Ex. 36, at 6 (No. 15-7). Finally, the Government 
argued that Respondents' disclosure was ``void of any detail about the 
information [this witness] reviewed to form his opinions about the DEA 
audits or the procedures Respondents employed at their pharmacy.'' ALJ 
Ex. 36, at 6 (No. 15-6); ALJ Ex. 36, at 6 (No. 15-7).
    Addressing Respondents' proposed taking of the testimony of the 
numerous patients who filled controlled substance prescriptions at 
Respondents, the Government maintained that Respondents' disclosure 
``constitute[d] a wholesale failure to describe `each and every matter 
as to which [they] intend[ed] to introduce evidence in opposition,' '' 
as required by the ALJ's Pre-hearing Order. ALJ Ex. 36, at 6 (No. 15-
6); ALJ Ex. 36, at 6 (No. 15-7). As for the physicians who wrote the 
prescriptions, the Government argued that the disclosures were 
inadequate because ``Respondent[s] merely indicate[ ] that these 
unknown individuals will testify regarding `communication[s] with the 
dispensing pharmacists regarding such prescriptions,'' and ``no facts 
about any such communications are revealed.'' \6\ ALJ Ex. 36, at 6 (No. 
15-6); ALJ Ex. 36, at 6 (No. 15-7).
---------------------------------------------------------------------------

    \6\ Respondents did, however, disclose the names of the 
physicians as part of their Prehearing Statements. Respondents also 
stated that they intended to elicit testimony from the physicians 
``confirm[ing] [that] they performed adequate and appropriate 
physical examinations of the patients,'' as well as testimony as to 
``the reasonableness and necessity of the prescriptions to control 
the pain or other complaints of their patients as required by the 
standard of care and Florida statutes.'' ALJ Ex. 9, at 4 (No. 15-6); 
ALJ Ex. 12, at 4 (No. 15-7).
---------------------------------------------------------------------------

    The Government also contended that testimony and documentation 
regarding prescriptions which it did not intend to offer into evidence 
was irrelevant. ALJ Ex. 36, at 8 (No. 15-6) ALJ Ex. 36, at 8 (No. 15-
7). Finally, with respect to the physicians who issued prescriptions 
filled by Respondents after February 4, 2013 and the pharmacists who 
filled the prescriptions, the Government argued that Respondent had not 
even identified these persons and that their proposed testimony was 
``stated only in general terms [and] lack[ed] conclusions.'' ALJ Ex. 
36, at 7 (No. 15-6); ALJ Ex. 36, at 7 (No. 15-7).
    In its motion, the Government also addressed Respondents' use of a 
thumb drive to provide its exhibits. ALJ Ex. 36, at 3 (No. 15-6); ALJ 
Ex. 39, at 3 (No. 15-7). According to the Government, the thumb drive 
contained ``hundreds of different files, which contain, collectively, 
thousands of pages of documents,'' of which only one file, which 
``consist[ed] of 1490 pages,'' ``appeared to be marked for 
identification.'' ALJ Ex. 36, at 3-4 (No. 15-6); ALJ Ex. ALJ Ex. 36, at 
3-4 (No. 15-7). The Government further stated that the other files were 
``neither marked for identification nor paginated.'' ALJ Ex. 36, at 4 
(No. 15-6); ALJ Ex. 36, at 4 (No. 15-7). The Government argued that 
Respondents' submission of their proposed documentary evidence did not 
``comply with the ALJ's order in terms of labeling and form.'' ALJ Ex. 
36, at 8 (No. 15-6); ALJ Ex. 36, at 8 (No. 15-7). The Government also 
argued that because ``none of [Respondents'] summarized testimony 
reference[d] any particular documents or page, [it was] unable to 
ascertain whether any of the documents . . . would be relevant to [the] 
proceeding.'' ALJ Ex. 36, at 9 (No. 15-6); ALJ Ex. 36, at 9 (No. 15-7).
    On January 21, 2015, each Respondent filed a Response to the 
Government's Motion; as with Respondents' other filings, the Responses 
appear to be identical. Compare ALJ Ex. 53 (No. 15-6) with Response to 
Government's Motion In Limine (No. 15-7) (hereinafter, Superior II 
Response to Motion in Limine).\7\ Therein, Respondents argued that the 
Government's Motions were ``completely devoid of intellectual 
integrity'' because the Government's Prehearing Statement ``fail[ed] to 
specifically identify a single prescription or patient and only 
generally refers to areas of discussion of its witnesses,'' including 
the proposed testimony of its expert witness. ALJ Ex. 53, at 2 (No. 15-
6); Superior II Response to Motion in Limine, at 2. Respondents also 
argued that ``[t]he Government's Prehearing Statement only identifies 
two patients by their initials and only one by the alleged city of 
residence.'' ALJ Ex. 53, at 3 (No. 15-6); Superior II Response to 
Motion in Limine, at 3.\8\ Respondents thus contended that the 
Government provided an ``inadequate description of the testimony 
concerning specific patients and prescriptions,'' and that they were 
``placed under extreme prejudice in [their] preparation for this 
expedited hearing.'' ALJ Ex. 53, at 3 (No.

[[Page 31316]]

15-6); Superior II Response to Motion in Limine, at 3. Respondents also 
disputed the Government's contention that their argument should be 
rejected because during a December meeting with Government Counsel, 
they did not ask for additional information regarding the patients' 
names. ALJ Ex. 53, at 3 (No. 15-6); Superior II Response to Motion in 
Limine, at 3.
---------------------------------------------------------------------------

    \7\ While this filing is part of the record, it was not assigned 
an ALJ Exhibit Number and is not included on the list of ALJ 
Exhibits in the Superior II matter.
    \8\ While this was true with respect to Superior I, the 
Government's Prehearing Statement in Superior II identified each of 
the patients whose prescriptions were at issue by their initials, 
and with respect to 13 of the patients, either the Prehearing 
Statement or the Show Cause Order identified the patient's city of 
residence. ALJ Ex. 1, at 2-3 (No. 15-7); ALJ Ex. 6, at 4-6 (No. 15-
7).
---------------------------------------------------------------------------

    Respondents further took issue with the Government's contention 
(with respect to both pharmacies) that only a small number of the 
thousands of persons listed in their Prehearing Statements were 
actually identified as patients. ALJ Ex. 53, at 2 (No. 15-6); Superior 
II Response to Motion in Limine, at 2. According to each Respondent, it 
listed all of the ``patients whose prescriptions were dispensed and 
doctors who generated the prescriptions [that were] filled at the 
pharmacy during the relevant time period,'' because at the time it 
filed its Prehearing Statement, the Government was ``the only party . . 
. to know which patients, doctors, and pharmacists are material and 
relevant to the allegations they chose to include in the'' Show Cause 
Order. ALJ Ex. 53, at 3 (No. 15-6); Superior II Response to Motion in 
Limine, at 3. Respondents thus contend that ``the potential exclusion 
of material and relevant witnesses as requested by the Government . . . 
would be arbitrary, capricious, and an abuse of discretion.'' ALJ Ex. 
53, at 3-4 (No. 15-6); Superior II Response to Motion in Limine, at 3-
4.
    As for the Government's contention that Respondents had failed to 
disclose the proposed testimony of the patients, doctors and 
pharmacists with adequate specificity, Respondents argued that 
``without the identification of the prescriptions and/or patients at 
issue (as defined by the OSC), a specific summary of each and every 
potentially relevant witness is impossible within the timeframe 
provided.'' ALJ Ex. 53, at 6 (No. 15-6); Superior II Response to Motion 
in Limine, at 6. Continuing, Respondents argued that ``[t]he witnesses 
will confirm their interaction with the pharmacists in resolving `red 
flags' and verify the prescriptions were issued for a legitimate 
medical purpose in the usual course of professional practice.'' ALJ Ex. 
53, at 6 (No. 15-6); Superior II Response to Motion in Limine, at 6. 
Notably, Respondents did not maintain that the pharmacists would 
testify that they resolved red flags.
    As for the Government's attempt to bar the testimony of Mssrs. 
Badawi and Crowley, Respondents argued that they ``ha[d] summarized 
[their] testimony to the same extent that the Government summarized its 
proposed testimony.'' ALJ Ex. 53, at 5 (No. 15-6); Superior II Response 
to Motion in Limine, at 5. Respondents appeared to argue that they 
could not offer more detail as to the testimony of these witnesses 
because they were ``without notice of what specific facts and opinions 
[would] be offered in the Government's prima facie case as the 
Government chose to not disclose specifics.'' ALJ Ex. 53, at 6 (No. 15-
6); Superior II Response to Motion in Limine, at 6.
    As for the Government's attempt to bar their proposed documentary 
evidence, Respondents argued that they were ``prejudiced by the 
Government's inadequate Prehearing Statement which forced Respondent[s] 
to incorporate and include all potential documents and witnesses from 
the relevant time period.'' ALJ Ex. 53, at 4 (No. 15-6); Superior II 
Response to Motion in Limine, at 4. Respondents further maintained that 
``[t]his prejudice would have only been exasperated [sic] by the costs 
associated with production of multiple sets of paper copies of the 
voluminous records.'' ALJ Ex. 53, at 4 (No. 15-6); Superior II Response 
to Motion in Limine, at 4. Respondents asserted that the electronic 
files were organized in four separate folders, and the folder which 
included the documents seized pursuant to the Administrative Inspection 
Warrant, was simply ``a mirror copy, in the exact form, of the digital 
files dumped on Respondent by the DEA at the time of service of the 
Order to Show Cause.'' ALJ Ex. 53, at 4 (No. 15-6); Superior II 
Response to Motion in Limine, at 4. Respondents stated that they had no 
way of knowing whether folder three ``represent[ed] all documents 
seized and/or reviewed by the Government''; they further argued that 
``the Government made no attempt to label and/or organize the material 
provided.'' ALJ Ex. 53, at 4 (No. 15-6); Superior II Response to Motion 
in Limine, at 4.
    Concluding, Respondents argued that the Government had nearly two 
years to review the documents and that between February 4, 2013 (the 
date the AIWs were served) and the dates of service of the Show Cause 
Orders), ``Respondent[s] had no access to these records.'' ALJ Ex. 53, 
at 5 (No. 15-6); Superior II Response to Motion in Limine, at 5. 
Respondents thus argued that to exclude their ``proposed testimony and 
exhibits, based exclusively on circumstances created by the Government, 
would be an extreme abuse of discretion.'' ALJ Ex. 53, at 6 (No. 15-6); 
Superior II Response to Motion in Limine, at 6.
    On January 27, 2015, the ALJ conducted the initial day of the 
hearing during which he addressed the Government's Motions in 
Limine.\9\ With respect to the proposed testimony of the more than 
5,000 patients who filled their prescriptions at Respondents, the ALJ 
granted the Government's Motions for two reasons. First, he found that 
Respondents had failed to comply with his Prehearing Order because they 
had ``not described with sufficient detail the testimony of the 
proposed witnesses.'' ALJ Ex. 7, at 3 (No. 15-6/15-7) (Journal Entry 
and Order From Initial Day of Hearing). Second, he found that the 
proposed testimony of the patients ``would not constitute relevant 
evidence, given the nature of the charges appearing in the Orders to 
Show Cause, as elaborated upon by the Government's Prehearing 
Statements. Id.
---------------------------------------------------------------------------

    \9\ While the ALJ termed this day as the initial day of the 
hearing, he did not take any evidence. Tr. 1-36.
---------------------------------------------------------------------------

    As for the proposed testimony of the physicians, the ALJ found that 
Respondents' Pre-hearing Statement did ``not sufficiently identify the 
anticipated testimony of the witnesses, nor . . . make a sufficient 
showing that their testimony would constitute relevant evidence.'' Id. 
The ALJ further held that this ruling applied to both those physicians 
who filled the prescriptions before February 4, 2013, as well as after 
that date. Id. at 3-4. As to the latter category of physicians, the ALJ 
barred their testimony based on the additional reason that Respondents 
had not ``timely identif[ied] by name the proposed witnesses,'' as 
again required by his Prehearing Order. Id. at 4. And the ALJ further 
barred Respondents from offering the testimony of ``any pharmacists 
referred to but not identified in [their] prehearing statements.'' Id.
    The ALJ also granted the Government's motion to exclude the 
testimony of Mssrs. Badawi and Crowley. As for Mr. Badawi, the ALJ 
found that Respondent had not complied with his Prehearing Order 
because ``[u]nlike the articulation of specific red flags provided by 
the Government in its description of testimony for its expert, the 
Respondents' Prehearing Statements do not reveal the substance of this 
testimony, but instead presented only a list of areas to be 
discussed.'' Id. at 5. As for Respondents' representation that Mr. 
Badawi would also testify about errors he identified ``in the inventory 
performed by the DEA,'' the ALJ found that Respondents failed to 
``articulat[e]

[[Page 31317]]

the nature of these errors'' and there was ``[in]sufficient information 
regarding the timeframe used by Mr. Badawi to permit a determination 
that the testimony would be relevant.'' Id.
    As for Mr. Crowley's proposed testimony regarding errors in the DEA 
audit, the ALJ found that Respondents ``fail[ed] to articulate what 
those errors were.'' Id. And as for his proposed testimony ``regarding 
procedures used by the pharmacies for resolving red flags and for 
complying with DEA recordkeeping requirements,'' the ALJ explained that 
he could not ``discern from the summary of [his] testimony whether [it] 
concerns the practices of the pharmacies at the time of the execution 
of the administrative warrants, at times before then, or at the present 
time.'' Id. at 5-6. Finding that Respondents had ``failed to comply 
with the prehearing order[s]'' and had also ``failed to establish that 
[his] proposed testimony would be relevant,'' the ALJ barred Mr. 
Crowley's testimony. Id. at 6.
    The ALJ also addressed the Government's contention that 
Respondents' documentary evidence should be excluded. In his Order, the 
ALJ explained that in his Prehearing Orders he had directed the parties 
to exchange their exhibits on or before January 12, 2015, and that the 
``failure to timely do so would result in the exclusion of the 
documents.'' Id. at 4. According to the ALJ, ``[o]n both January 9 and 
. . . 12, a representative of Mr. Sisco's office contacted a member of 
my staff, inquiring whether Respondents [could] submit documents by 
using electronic files; . . . on both occasions my staff member advised 
that only hard copies and facsimiles would be accepted.'' Id. The ALJ 
explained that on January 12, he directed his staff to return the flash 
drives which Respondents' counsel had sent to his office, and that as 
of the date of the hearing, Respondents still had not filed their 
proposed exhibits with his office. Id. at 4-5. The ALJ then explained 
that he had ``considered the Government's report of the contents of 
what presumably was on'' the flash drives, as well as Respondents' 
explanation as set forth in their Responses to the Government's 
Motions, and found that good cause existed to grant the motions and bar 
Respondents from introducing their proposed exhibits. Id. at 5. The 
ALJ, however, provided Respondents' counsel with the opportunity to 
submit its proposed exhibits as a proffer, provided it did so no later 
than February 10, 2015, and provided his Office with an original and 
two copies, as well as a copy to the Government. Id.
    Subsequently, on February 3, 2015, the Government filed a ``Notice 
of Objections to Respondent's Exhibits.'' ALJ Ex. 15 (Nos. 15-6 and 15-
17). Therein, the Government noted that it had received eight binders 
of evidence totaling nearly 4,300 pages, of which five binders appeared 
to be related to Superior I and three binders Superior II. Id. at 2. 
While the Government contended that it was unclear whether the 
Respondents were offering the exhibits as a proffer or as evidence to 
be admitted in the proceeding, it then explained that even if the 
exhibits were offered as a proffer, they should not be included in the 
record because Respondent had not made an offer of proof as required by 
21 CFR 1316.60. Id. The Government further noted that none of the 
documents were ``self-authenticating'' and many of them, which included 
patient medical records, ``appear to come from sources other than the 
Respondents.'' Id. at 3.
    At the first day of the evidentiary phase of the hearing, the ALJ 
addressed the Government's objection. Tr. 54. After re-affirming his 
earlier ruling which barred Respondents from introducing any 
documentary evidence, the ALJ then turned to the Government's 
contention that Respondents had not complied with 21 CFR 1316.60. On 
the issue of whether Respondents had made an adequate offer of proof, 
the ALJ asked one of Respondents' counsel if he was ``correct in 
understanding that the Respondent[s'] Pre-hearing Statements and the 
premises that [he] articulated during the initial day of hearing in 
support of receiving these exhibits should, taken together, be regarded 
as containing the statement of the substance of the evidence which you 
would have accompany the excluded documents?'' Tr. 58. Respondents' 
counsel answered ``[y]es.'' Id. While the ALJ had also noted that ``an 
offer of proof shall be part of the record only if a proper foundation 
has been laid for its admission,'' id. at 57, the ALJ did not ask 
Respondents' counsel to lay a foundation for any of the exhibits. Id. 
at 57-69. After noting that he received only a single copy of the 
proffered exhibits (vice the three copies required by his Prehearing 
Order), the ALJ ordered Respondents to provide two additional copies of 
the proffered exhibits prior to 5 p.m. that day; he further advised 
that if the copies were not filed, he would return the proffered 
exhibits to Respondents. Id. at 69. Subsequently, Respondents filed the 
additional copies of the exhibits, and the exhibits were forwarded as a 
proffer.

The ALJ's Ruling on Respondents' Subpoena Requests

    During the January 27 hearing, the ALJ also addressed each 
Respondent's request for subpoenas. Tr. 17-23. As explained above, each 
Respondent submitted requests for an extensive number of subpoenas but 
failed to include with its requests a certificate of service 
establishing that they had provided copies to the Government.
    Asked by the ALJ to address its requests, Respondents' counsel 
asserted that ``the request for subpoenas was copied to [Government 
counsel] timely as to each of the subpoenas.'' Id. at 18. However, when 
asked by the ALJ if it was correct that he did not include a 
certificate of service, Respondents' counsel answered: ``If the Court 
says that that wasn't included then I'll accept that. However, I will 
represent that everything that I provided to the Court has been 
provided to'' Government counsel. Id. at 20. The ALJ then asked the 
Government's counsel if he had been provided with copies of the 
subpoena requests. Id. at 21. Government counsel answered that he had 
received a thumb drive which ``contains so many thousands of pages of 
documents'' that he ``did not look for specific subpoenas.'' Id. 
Subsequently, Respondents' counsel confirmed that he had sent the 
subpoena requests to the Government electronically. Id. at 22.
    The ALJ then explained that in his Prehearing Orders, he had 
advised the parties that subpoena requests that did not comply with his 
instructions would be returned without further action; he also 
explained that Respondents had neither objected to nor sought 
clarification of the Prehearing Orders. Id. at 23. Finding that 
Respondents had not complied with his Prehearing Orders, the ALJ 
announced that he would be returning Respondents' subpoena requests 
without further action. Id. The ALJ did not address whether Respondents 
had made an adequate showing as to relevancy with respect to either the 
patients or the physicians. Id. at 17-23.

Respondents' Motions for a Daubert Hearing and To Exclude the Testimony 
of the Government's Expert

    On January 15, 2015, Respondents also filed motions to exclude the 
testimony of the Government's pharmacy expert Robert Parrado. ALJ Ex. 
41 (No. 15-6); ALJ Ex. 41 (No. 15-7). The basis of Respondents' motions 
was that ``Mr. Parrado's proposed opinions are based on nothing more 
than a cursory review of the written prescriptions to the exclusion of 
all

[[Page 31318]]

other information,'' and that he ``did not apply any reliable 
methodology as mandated'' by Daubert v. Merrell Dow Pharmaceuticals, 
Inc., 509 U.S. 579 (1993), and its progeny. ALJ Ex. 41, at 2 (No. 15-
6); ALJ Ex. 41, at 2 (No. 15-7). Respondents also argued that Mr. 
Parrado was ``not qualified to render any opinions regarding whether 
the physician issuing the prescriptions did so for a legitimate medical 
purpose in the usual course of professional practice.'' ALJ Ex. 41, at 
2 (No. 15-6); ALJ Ex. 41, at 2 (No. 15-7) (both citing Fla. Stat. 
766.102(5) (``person may not give expert testimony concerning the 
prevailing professional standard of care unless the person is a health 
care provider who holds an active and valid license and conducts a 
complete review of the pertinent medical records'').
    Respondents argued that the ALJ was required to perform a 
``gatekeeping'' function in determining whether Mr. Parrado's testimony 
was admissible. ALJ Ex. 41, at 2 (No. 15-6); ALJ Ex. 41, at 2 (No. 15-
7). They further argued that under Daubert, the Government was required 
to show that: (1) Mr. Parrado was qualified to testify as an expert; 
(2) that he used a sufficiently reliable methodology in reaching his 
conclusions; and (3) that his testimony would assist the trier of fact. 
ALJ Ex. 41, at 2 (No. 15-6); ALJ Ex. 41, at 2 (No. 15-7). Respondents 
then suggested that under Daubert, the ALJ was required to consider 
``whether the theory or technique'' used by Mr. Parrado ``has been 
subject to peer review and publication.'' ALJ Ex. 41, at 4 (No. 15-6); 
ALJ Ex. 41, at 4 (No. 15-7). According to Respondents, Mr. Parrado's 
testimony should be excluded as unreliable because ``he failed to 
conduct a thorough investigation and failed to base his proposed 
opinion on any reliable methodology.'' ALJ Ex. 41, at 5(No. 15-6); ALJ 
Ex. 41, at 5 (No. 15-7).
    The Government opposed the motions. Quoting agency precedent, the 
Government argued that where, as here, non-scientific expert testimony 
is at issue, the expert's `` `knowledge and experience' '' may provide 
a sufficient foundation for concluding that his testimony is reliable. 
ALJ Ex. 50, at 3 (quoting Holiday CVS, L.L.C., d/b/a CVS Pharmacy No. 
219 and 5195, 77 FR 63316, 62334 (2012) (quoting Surles ex rel. Johnson 
v. Greyhound Lines, Inc., 474 F.3d 288, 295 (6th Cir. 2007))). The 
Government noted that Mr. Parrado has been a licensed pharmacist for 
more than 40 years and had been ``the recipient of numerous 
professional appointments.'' Id. The Government further argued that at 
the hearing, Respondents would ``have ample opportunity to question 
[him] regarding his knowledge and experience, but . . . to exclude him 
on that basis, prior to trial, is both misguided and premature.'' ALJ 
Ex. 50, at 4. The Government also argued that Respondents provided no 
support for their contention that Mr. Parrado's testimony should be 
excluded because ``he did not interview [the] patients or other 
persons.'' ALJ Ex. 50, at 4.
    The ALJ denied Respondents' motions. The ALJ reasoned that in each 
Show Cause Order and its Prehearing Statements, ``the Government 
identifie[d] red flags or other conditions which, according to the 
Government, triggered a corresponding obligation on the part of 
pharmacies who were presented with a number of prescriptions. The 
thrust of this evidence is [not] dependent upon scientific or technical 
analysis, but upon documentary or testimonial evidence establishing or 
rebutting the claimed corresponding obligation.'' ALJ Ex. 7, at 7 (Nos. 
15-6 and 15-7).
    The ALJ then held that ``[t]he Government ha[d] made a sufficient 
showing to permit Mr. Parrado to appear and give testimony.'' Id. 
Continuing, the ALJ explained that at the hearing, he would allow 
Respondents to question Mr. Parrado as to his qualifications and the 
methodology he used, but that he was not making a ``preclusive ruling 
prior to the time [he] testified.'' Id. The ALJ thus denied 
Respondents' motions to either conduct a separate hearing on the 
admissibility of Mr. Parrado's testimony or to exclude his testimony 
prior to the hearing. Id.

Respondents' Motions for a Continuance

    On January 15, 2015, each Respondent also moved for a continuance. 
ALJ Ex. 42 (No. 15-6); ALJ Ex. 42 (No. 15-7). Respondents sought a 
continuance of the proceeding ``to commence no sooner than June 2015.'' 
See, e.g., ALJ Ex. 42, at 5 (No. 15-6). Respondents asserted that they 
needed the continuance ``to interview and subpoena witnesses,'' and 
that they ``ha[d] timely requested the issuance of numerous subpoenas 
and . . . ha[d] exercised due diligence in this regard.'' Id. at 3. 
Respondents further asserted that ``[d]ue to the short time period 
between the issuance of the order[s] to show cause and the commencement 
of the hearing, and the numerous potential witnesses, [they] will 
undoubtedly be prejudiced by a [sic] the lack of time to adequately 
interview and obtain service on the necessary witnesses.'' Id.
    Respondents argued that ``the Government has had years to prepare 
its case whereas [they have] only been afforded a few months.'' Id. at 
4. Continuing, Respondents contended that the Government ``has had more 
than 20 months to process and analyze the seized information,'' and 
that ``[d]uring this time, the information was not available to 
Respondent.'' Id. at 5. While Respondents then acknowledged that ``a 
portion of the seized information, most notably the prescriptions, was 
provided to [them] in electronic format,'' they then contended that 
``the sheer volume of information coupled with the unreasonably short 
deadlines surrounding the holiday season makes analysis of the 
information . . . impossible.'' Id.
    On January 27, 2015 (during the initial day of the hearing), the 
ALJ denied Respondents' motions.\10\ In so ruling, the ALJ relied on 
his previous ruling that Respondents had ``failed to timely submit 
their request for subpoenas.'' Tr. 30. The ALJ then explained that he 
could not ``reconcile'' Respondents' assertion that they needed more 
time to prepare with the representations made in each of their 
Prehearing Statements that their two proposed experts had ``reviewed 
the prescriptions at issue, the relevant inventory and ordering history 
and prepared summaries of the pharmacies' dispensing activities during 
2011 and 2012.'' Tr. 31; see also ALJ Ex. 9, at 5-6 (No. 15-6); ALJ Ex. 
12, at 5-6 (No. 15-7).\11\ Finally, the ALJ explained that he had:
---------------------------------------------------------------------------

    \10\ The Government did not file a response to this motion.
    \11\ As found above, in their Prehearing Statements, Respondents 
represented that Mr. Badawi would testify about ``the procedures 
used at Superior Pharmacy [I and II] to consider and resolve alleged 
`red flags,' inventory, ordering and CSOS compliance issues. Mr. 
Badawi will further testify that he has reviewed the prescriptions 
at issue, the relevant inventory and ordering records and prepared 
summaries of the prescription dispensing activity at Superior 
Pharmacy [I and II] during 2011 and 2012, and identified significant 
errors in the inventory performed by the DEA.'' ALJ Ex. 9, at 6 (No. 
15-6); ALJ Ex. 12, at 6 (No. 15-7).
     Likewise, Respondents represented that ``Mr. Crowley will 
testify regarding errors in the audits performed by the agent/
investigators of Superior Pharmacy [I and II]. Mr. Crowley reviewed 
the prescriptions, inventory and CSOS records of Superior Pharmacy 
[I and II]. Mr. Crowley will further testify regarding Superior 
Pharmacy[I and II]'s procedure for resolving potential `red flag' 
issues and compliance with recordkeeping requirements related to 
inventory records, DEA-222 order forms and CSOS issues.'' ALJ Ex. 9, 
at 5 (No. 15-6); ALJ Ex. 12, at 5 (No. 15-7).

consider[ed] a variety of factors, including the diligence and good 
faith of the parties seeking the continuance; the grounds for the 
delay; fairness to both parties; the need for orderly administration 
of justice; the length

[[Page 31319]]

of the delay requested; whether other continuances have been 
requested and received; the inconvenience to litigants, witnesses, 
opposing counsel and the Court; and whether the requesting party 
contributed to the circumstances which give rise to the request for 
a continuance and any other relevant factors depending on the facts 
---------------------------------------------------------------------------
of the case.

Tr. 31. The ALJ then found that ``cause has not been shown to delay 
this hearing'' and denied the Respondents' motions. Id.
    With the evidentiary phase of the hearing set to begin on February 
10, 2015, on February 6, 2015, Respondents filed a second Motion for 
Continuance. ALJ Ex. 12, at 1 (No. 15-6/15-7). The basis for the motion 
was that on January 28, 2015, they had retained a third counsel, who 
previously been involved in resolving a matter involving another of Mr. 
Obi's pharmacies. Id. at 2. Citing ``the complexity of the issues in 
these matters,'' Respondents sought a continuance of three weeks to 
allow its additional counsel to prepare for the hearing. Id.
    The same day, the Government objected. ALJ Ex. 19 (Nos. 15-6/15-7). 
It argued that Respondents had been aware of the allegations since 
October 16 and 17, 2014, and that ``neither Respondent has been without 
counsel since'' they were served with the Show Cause Orders, and that 
Superior I had previously retained an additional counsel. Id. at 3. The 
Government further asserted that it was ``both disingenuous and . . . 
legal gamesmanship to suggest that the eleventh hour appearance of a 
co-counsel for Superior II and a second co-counsel for Superior I 
constitute grounds for disrupting a proceeding that'' in its view had 
commenced on January 27, 2015. Id. It then argued that Respondents had 
not demonstrated any hardship that justified a continuance and they 
``ha[d] never timely objected to any'' of the dates set by the ALJ, 
``including the date and location of the hearing which'' had been set 
``more than two months'' earlier. Id. at 4. Finally, the Government 
stated that it was prepared to put on its case and that ``all of [its] 
witnesses are travelling to Arlington, Virginia, and have set aside 
time to participate in this matter.'' Id. The Government thus argued 
that ``any further delay'' would cause it prejudice. Id.
    The ALJ denied Respondents' motion. ALJ Ex. 24, at 2 (Nos. 15-6/15-
7). As with Respondents' previous motions for a continuance, the ALJ 
explained that he had considered various factors and found that ``cause 
has not been shown to delay the hearing.'' Id.

The Evidentiary Hearing and ALJ Decision

    On February 10 and 11, the ALJ conducted the evidentiary phase of 
the hearing at the DEA Hearing Facility in Arlington, Virginia. At the 
hearing, the Government elicited the testimony of four witnesses, 
including its expert witness, Mr. Robert Parrado; the Government also 
introduced various documents into evidence. Consistent with the ALJ's 
order granting the Government's Motions in Limine, Respondents were 
precluded from calling any witnesses and introducing any documentary 
evidence. The ALJ did, however, allow Respondent to submit ten binders 
of documents (totaling nearly 4,300 pages) as a proffer.
    Following the hearing, both parties submitted briefs containing 
proposed findings of fact and conclusions of law (hereinafter, referred 
to as Post-Hearing Brief). On April 9, 2015, the ALJ issued his 
Recommended Decision (hereinafter, cited as R.D.); according to the 
Certificate of Service, on April 10, the ALJ's law clerk sent a copy of 
the Decision to all three of Respondents' counsels by Federal Express.
    In the Recommended Decision, the ALJ relied on the Government's 
evidence with respect to factors two and four to conclude that ``the 
Government has established its prima facie case by at least a 
preponderance of the evidence that Respondents' continued . . . 
registrations would be inconsistent with the public interest.'' R.D. 
87. Further finding that ``Respondents have failed to rebut that case 
through a demonstration of sufficient remediation,'' the ALJ 
recommended that I revoke each Respondent's registration and deny any 
pending applications to renew or modify its registration. Id.
    On May 4, 2015, the ALJ transmitted the record to my Office. On May 
6, 2015, Respondents filed a brief captioned as: Exceptions to the 
Recommended Decision and Request for Removal of the ALJ (hereinafter, 
cited as Resp.' Exceptions). Respondents, however, offered no showing 
of good cause to excuse the untimely filing of their brief. See 
generally id. In response, on May 7, 2015, the Government filed with my 
Office a motion to strike Respondents' Exceptions as untimely or, in 
the alternative, to respond to their Exceptions. See Gov. Motion to 
Supplement the Record, Strike Respondent[s'] Untimely Filed Exceptions 
to the Recommended Decision of the Administrative Law Judge Or, In the 
Alternative, Respond to Exceptions. Because Respondents have not 
demonstrated good cause to excuse the untimely filing of their 
Exceptions, I consider the claims raised therein only if they were 
previously raised in their Post-Hearing Brief.
    Having carefully considered the entire record in this matter and, 
in particular, the claims of error raised by Respondents in their Post-
hearing Brief, I do not adopt the ALJ's findings of fact and 
conclusions of law with respect to the allegations that each 
Respondent's pharmacists violated 21 CFR 1306.04(a) and 1306.05(a). I 
do, however, adopt the ALJ's findings of fact and legal conclusions 
with respect to: (1) The allegations pertaining to the audits conducted 
of each pharmacy, (2) the allegations that Respondents were not 
properly maintaining required records including their schedule II order 
forms, and (3) that for purchases made using the electronic Controlled 
Substance Order System, Superior II was not electronically linking its 
receipt records to its purchase records. I further find that Respondent 
Superior II violated DEA regulations by allowing a non-authorized 
person to place electronic orders using the key assigned to an 
authorized person. I therefore conclude that the Government has made 
out a prima facie case to support revocation of Respondents' 
registrations. And because Respondents have produced no evidence of any 
corrective measures they have undertaken, I will order that their 
registrations be revoked and that any pending applications be denied. 
As ultimate fact finder, I make the following.

Findings of Fact

    The parties stipulated that Respondent Superior I holds DEA 
Certificate of Registration BS9255274, pursuant to which it is 
authorized to dispense controlled substances in schedules II through V 
as a retail pharmacy, at the registered address of 3007 W. Cypress St., 
Suite 1, Tampa, Florida. ALJ Ex. 7, at 2 (Nos. 15-6/15-7).
    The parties stipulated that Respondent Superior II holds DEA 
Certificate of Registration BS9699731, pursuant to which it is 
authorized to dispense controlled substances in schedules II through V 
as a retail pharmacy, at the registered address of 5416 Town `N' 
Country Blvd., Tampa, Florida. Id.

The DEA Investigation

    On February 4, 2013, DEA Investigators executed Administrative 
Inspection Warrants at Respondents Superior I and Superior II. Tr. 370-
71; 471. With respect to Superior I, the Investigators seized the 
original

[[Page 31320]]

prescriptions for its schedule II and III dispensings, as well as its 
schedule II order forms (DEA-Form 222), invoices, and inventory 
records. Id. at 372. At Superior I, a DEA Investigator (who assisted 
the lead Investigator) also conducted an inventory of the controlled 
substances then on hand with the assistance of the pharmacist on duty, 
who verified the count; the Investigator also obtained a copy of an 
inventory taken by Superior I which was dated May 2, 2011. Id. at 373-
78. According to a DI, because the May 2, 2011 inventory ``did not 
include all the drugs that were a part of the audit,'' he asked the 
lead Investigator to contact the pharmacy for additional inventory 
records, and on February 11, 2013, Superior I provided additional 
records which included a ``bi-annual inventory'' and an ``in-house 
inventory.'' Id. at 378-79.
    Likewise, with respect to Superior II, the lead Investigator on the 
warrant testified that she seized the original schedule II 
prescriptions and the pharmacy's purchasing records for the drugs that 
were subject of the audit; the DI also testified she obtained the 
pharmacy's schedule II order forms as well as a perpetual inventory 
maintained by the pharmacy which was dated July 31, 2012. Id. at 472, 
474, 477. The DI also took an inventory of the controlled substances 
then on hand, with the DI witnessing Superior II's pharmacist counting 
of the pills. Id. at 477.
    As part of the investigations, the Government provided various 
schedule II prescriptions which were dispensed by each pharmacy to its 
expert Mr. Robert Parrado, who reviewed them to determine if they were 
dispensed in compliance with the Controlled Substances Act. Mr. Parrado 
testified that he obtained his B.S. in Pharmacy in 1970 from the 
University of Florida College of Pharmacy and that he has held a 
Florida pharmacist's license since 1971. Tr. 122; GX 2, at 1 (No. 15-6/
15-7). Mr. Parrado testified that he has practiced as a pharmacist at 
both community pharmacies as well as hospital pharmacies; he also 
testified that he had been the Pharmacy Department Manager at multiple 
pharmacies, including two pharmacies that he owned for approximately 19 
years. Tr. 124-26; GX 2, at 1-2.
    Mr. Parrado was a member of the Florida Board of Pharmacy from 
January 2001 through February 2009, and had served as both Vice 
Chairman and Chairman of the Board. Tr. 128-29; GX 2, at 3. He is a 
member of the Florida Pharmacy Association, having served as both its 
President and then Chairman of the Board. GX 2, at 3. He is also a 
member of the Hillsborough County Alcohol & Drug Abuse Task Force, the 
National Community Pharmacists Association, and the American Society 
for Pharmacy Law. Id. Finally, he has made numerous presentations on 
the dispensing of controlled substances by pharmacists, id. at 3-7, and 
has testified as an expert witness for both the prosecution and defense 
in criminal and administrative matters. Tr. 133; see also id. at 152 
(answering ``no'' when asked on voir dire if, in criminal matters, he 
has always testified for the Government).
    Asked to explain what the standard of care (in Florida) requires of 
a pharmacist who is presented with a prescription for a controlled 
substance, Mr. Parrado testified:

    You have to ensure that the prescription is appropriate and that 
it's valid. And in doing that he has to look at the prescription. He 
has to understand the nature of the drug, the nature of the disease 
state that they're treating, the appropriateness of the therapy and 
the dosing.
    And then make sure that the prescription was issued under . . . 
the valid circumstances of a physician . . . having written the 
prescription in the course of his practice and that the prescription 
is . . . for [a] legitimate medical purpose.

Id. at 137.

    Asked to explain what a ``red flag'' is as it relates to the 
dispensing of controlled substances, Mr. Parrado then testified that:

    [a] red flag is anything that will cause the pharmacist concern 
as to the validity of that prescription. It could be numerous 
things.
    And a lot of times it's just dependent on the patient presenting 
the prescriptions or the circumstances. Or just looking at the 
prescription itself might raise a red flag . . . and cause you 
concern.

Id. at 138.

    Mr. Parrado then proceeded to identify various red flags, including 
if the prescription was for ``a known drug of abuse'' and if the dosing 
is ``appropriate.'' \12\ Id. Continuing, Mr. Parrado explained that 
after ``mak[ing] sure the dosing is appropriate . . . you look at the 
quantity of tablets'' and ask if it is ``an appropriate therapy for the 
condition . . . [t]hat the physician is treating.'' Id. at 139. Mr. 
Parrado then testified that he looks at what he termed the 
``triangle''--the locations of ``the patient['s] home, the physician's 
office and the pharmacy'' and that ``whenever one of those legs seems 
to get a little bit long I seem to get a little concerned,'' thus 
leading him to ``want to verify why a person would drive a long way to 
[go] to a particular clinic'' and why the person would ``drive a long 
way from that clinic to a pharmacy.'' Id. at 140.
---------------------------------------------------------------------------

    \12\ At this point, Respondents' counsel objected on the ground 
that the testimony was ``outside the scope of the'' Government's 
Prehearing Statements. Tr. 138. However, in its Prehearing 
Statements, the Government notified Respondents that Mr. Parrado 
would identify and discuss ``prescriptions for controlled substances 
which are known to be highly abused'' and ``prescriptions for 
quantities of narcotics that exceeded the recommended daily 
dosages.'' ALJ Ex. 6, at 3 (No. 15-6); ALJ Ex. 7, at 3 (No. 15-7). I 
thus find that the ALJ properly overruled the objection.
---------------------------------------------------------------------------

    Mr. Parrado also identified other red flags to include ``[m]ultiple 
people presenting with identical or very similar prescriptions from the 
same clinic,'' as well as where a person presents prescriptions for 
``cocktails that are known to be abused on the street.'' Id. Mr. 
Parrado then explained that a cocktail ``is a combination of drugs,'' 
which usually includes an ``opioid such as oxycodone or 
hydromorphone,'' ``a benzodiazepine such as Xanax or Valium,'' and ``a 
muscle relaxant such as Soma.'' Id. at 140-41.
    Mr. Parrado further identified as a red flag the circumstance where 
multiple persons present the ``same prescriptions'' from either ``the 
same practitioner'' or ``clinic.'' Id. at 141. Mr. Parrado then 
explained that multiple persons getting the same prescriptions ``from 
the same clinic'' would be a red flag because ``there's supposed to be 
an individualization of therapy whenever a physician is ordering a pain 
medication.'' \13\ Id. Of similar import, Mr. Parrado testified that he 
was familiar with the term ``pattern prescribing,'' which he explained 
was when ``prescriptions com[e] from the same clinic in . . . the same 
drug,'' with the same or ``very similar'' dosing and quantities. Id. at 
142. Reaffirming his earlier testimony, Mr. Parrado explained while 
``there could be a small difference'' in the quantity (i.e., 168 vs. 
180 pills) prescribed, ``[t]hat doesn't

[[Page 31321]]

show me that there's any attempt at individualization of therapy.'' Id.
---------------------------------------------------------------------------

    \13\ Here again, Respondents objected to the testimony, 
asserting that it was ``outside the scope of [Mr. Parrado's] 
testimony'' and that Mr. Parrado was not ``qualified to testify 
about what the standard of care is for . . . a healthcare 
practitioner'' under Florida Statute Sec.  766.102. Tr. 141-42. Of 
note, in its Prehearing Statements, the Government disclosed to 
Respondents that Mr. Parrado would discuss ``prescriptions issued to 
multiple individuals presenting prescriptions for the same drugs in 
the same quantities from the same doctor.'' ALJ Ex. 6, at 3 (No. 15-
6); ALJ Ex. 7, at 3 (No. 15-7). The ALJ overruled the objection. Tr. 
142. Respondent did not, however, explain how it was prejudiced 
because the Government then asked whether a red flag was also 
presented because the prescriptions came from the same clinic. As 
for Respondent's contention that Mr. Parrado was not qualified under 
the Florida Statute to render an opinion on the issue, Florida law 
does not control the scope of permissible testimony in this 
proceeding.
---------------------------------------------------------------------------

    Mr. Parrado then identified two more red flags. The first of these 
is when ``two people in the same household or [with the] same address 
were needing the exact same drugs.'' Id. at 143. While Mr. Parrado 
explained that this could possibly be legitimate, the ``onus of 
verifying that prescription has been seriously moved up a notch.'' Id. 
Mr. Parrado then testified that a red flag is also raised when 
prescriptions are issued to multiple persons with the same last name. 
Id.
    Asked by the Government what steps a pharmacist should take upon 
being presented with a prescription that raises a red flag, Mr. Parrado 
explained:

    At that point the pharmacist--first thing he has to do, he has 
to verify that prescription with the prescriber. Florida law says 
you check with the prescriber.
    Not the prescriber's office, with the prescriber. And then you 
speak with the prescriber and get his opinion.
    You ask him the questions that you feel, you know, address your 
concerns. And then at that point I have to . . . use my professional 
judgment. Did I believe him or not.
    Because a physician who had written a script is always going to 
say, yes they wrote it. But I'm trying to determine if it was 
written for a legitimate medical purpose. So that's why I'm asking 
the questions I'm asking.

Id. at 144.

    Continuing, the Government asked Mr. Parrado if some red flags are 
unresolvable, prompting objections by each Respondent that this 
testimony was beyond the scope of the summary of the testimony 
disclosed by the Government in its Prehearing Statements. Id. at 144-
45. The ALJ overruled the objections \14\ and Mr. Parrado testified:
---------------------------------------------------------------------------

    \14\ This was the first of several objections to the 
Government's elicitation of testimony from its Expert as to whether 
some of prescriptions presented red flags that could not be 
resolved. As Respondents argued, the Government Pre-hearing 
Statements ``do [ ] not anywhere discuss irresolvable red flags. And 
this is a last minute attempt to prejudice the ability of the 
Respondent[s] to put on a case here.'' Tr. 144.
    One of the fundamental tenets of Due Process is that the Agency 
must provide a respondent with notice of those acts which the Agency 
intends to rely on in seeking the revocation of its registration so 
as to provide a full and fair opportunity to challenge the factual 
and legal basis for the Agency's action. See NLRB v. I.W.G., Inc., 
144 F.3d 685, 688-89 (10th Cir. 1998); Pergament United Sales, Inc., 
v. NLRB, 920 F.2d 130, 134 (2d Cir. 1990). See also 5 U.S.C. 554(b) 
(``Persons entitled to notice of an agency hearing shall be timely 
informed of . . . the matters of fact and law asserted.'').
    However, `` `[p]leadings in administrative proceedings are not 
judged by the standards applied to an indictment at common law.' '' 
Citizens State Bank of Marshfield v. FDIC, 751 F.2d 209, 213 (8th 
Cir. 1984) (quoting Aloha Airlines v. Civil Aeronautics Bd., 598 
F.2d 250, 262 (D.C. Cir. 1979)). See also Boston Carrier, Inc. v. 
ICC, 746 F.2d 1555, 1560 (D.C. Cir. 1984) (quoted in Edmund Chein, 
72 FR 6580, 6592 n.21 (2007) (``an agency is not required `to give 
every [Respondent] a complete bill of particulars as to every 
allegation that [he] will confront''). Thus, the failure of the 
Government to disclose an allegation in the Order to Show Cause is 
not dispositive, and an issue can be litigated if the Government 
otherwise timely notifies a respondent of its intent to litigate the 
issue.
    The Agency has thus recognized that ``the parameters of the 
hearing are determined by the prehearing statements.'' Darrell 
Risner, D.M.D., 61 FR 728, 730 (1996). Accordingly, in Risner, the 
Agency held that where the Government has failed to disclose ``in 
its prehearing statements or indicate at any time prior to the 
hearing'' that an issue will be litigated, the issue cannot be the 
basis for a sanction. 61 FR at 730. See also Nicholas A. Sychak, d/
b/a Medicap Pharmacy, 65 FR 75959, 75961 (2000) (noting that the 
function of prehearing statements is to provide Due Process through 
``adequate . . . disclosure of the issues and evidence to be 
submitted in . . . proceedings''); cf. John Stafford Noell, 59 FR 
47359, 47361 (1994) (holding that notice was adequate where 
allegations were not included in the Order to Show Cause but ``were 
set forth in the Government's Prehearing Statement'').
    However, consistent with numerous court decisions, the Agency 
has also held that even where an allegation was not raised in either 
the show cause order or the prehearing statements, the parties may 
nonetheless litigate an issue by consent. Pergament United Sales, 
920 F.2d at 135-37; see also Duane v. Department of Defense, 275 
F.3d 988, 995 (10th Cir. 2002) (discussing Facet Enterprises, Inc., 
v. NLRB, 907 F.2d 963, 974 (10th Cir. 1990); ``we held that 
defendant had constructive notice of an alternate theory of 
liability not described in the formal charge when the agency 
detailed that theory during its opening argument and at other points 
during the hearing and when the defendant's conduct revealed that it 
understood and attempted to defend against that theory''). See also 
Grider Drug #1 & Grider Drug #2, 77 FR 44070, 44077 n.23 (2012) 
(holding that while the Government did not provide adequate notice 
of its intent to litigate an allegation in either the show cause 
order or its prehearing statements, where respondents ``did not 
object that the allegation was beyond the scope of the proceeding 
and that they were denied adequate notice of it'' and ``fully 
litigated the issue,'' the allegation was litigated by consent) 
(citing Citizens State Bank, 751 F.2d at 213; Kuhn v. Civil 
Aeronautics Bd., 183 F.2d 839, 841-42 (D.C. Cir. 1950); and Yellow 
Freight System, Inc., v. Martin, 954 F.2d 353, 358 (6th Cir. 1992)).
    Here, I conclude that the ALJ erred when he overruled 
Respondents' objections to the testimony, as neither the Show Cause 
Orders, nor the Government's Prehearing Statements ever identified 
any prescription as presenting red flags that could not be resolved. 
As the Second Circuit has explained, ``[t]he primary function of 
notice is to afford [a] respondent an opportunity to prepare a 
defense by investigating the basis of the complaint and fashioning 
an explanation that refutes the charge of unlawful behavior.'' 
Pergament United Sales, 920 F.2d at 135 (citation omitted). The 
defense of the allegation that a prescription presented red flags 
that could not be resolved requires entirely different proof, i.e., 
testimony as to why a prescription did not lack a legitimate medical 
purpose, than the defense of the allegation that a pharmacist failed 
to resolve red flags, and Respondents' multiple objections make 
clear that they did not consent to the litigation of the issue. 
Accordingly, the Expert's testimony to this effect cannot be 
considered in determining whether Respondents' pharmacists violated 
their corresponding responsibility under 21 CFR 1306.4(a).

    Well anytime that there is a red flag my job is to resolve that 
red flag. And at that point I'm having to use my professional 
judgment when I'm weighing all the different factors that are 
causing me concern.
    If I cannot resolve all these things that are bothering me, at 
that point that becomes unresolvable and I cannot fill that 
prescription.

Id. at 145-46. See also id. at 361 (agreeing that a pharmacist's 
education, experience and training inform his/her professional 
judgment).

    The Government then asked Mr. Parrado if a retail pharmacist would 
document his/her resolution of a red flag ``somewhere?'' Id. at 146. 
Mr. Parrado answered: ``Absolutely. Anytime you have a concern with 
appropriateness of therapy, you always do what you have to do to 
resolve it and then you document it on the prescription.'' Id. Asked by 
the Government if the resolution of a red flag ``would be documented on 
the prescription itself,'' Mr. Parrado answered: ``Yes. Unless you have 
another form of doing that I don't know about, but the standard of 
practice has always been you document it on the prescription.'' Id.
    On Respondent's voir dire, Mr. Parrado was asked whether ``the 
manner in which a pharmacist documents their [sic] efforts to resolve 
red flags is not mandated by any statute, regulations or guidance 
document?'' Id. at 154. Mr. Parrado answered: ``The pharmacist has a 
duty to verify that's done. And when he's done that he needs to 
document it. Because if you haven't documented it you haven't done 
it.'' Id. Upon further questioning by Respondents, Mr. Parrado 
acknowledged that neither the Florida Statutes nor the Florida 
Administrative Code state where the pharmacist has to document his/her 
resolution of a red flag. Id. at 156.
    On further voir dire by Respondents, Mr. Parrado testified that his 
opinions were not based on conversations he had with the pharmacists at 
Respondents, or any statements of the pharmacists provided to him by 
DEA. Id. at 158. He also testified that his opinions were not based on 
any statements made by the patients, or the prescribers. Id. at 158-

[[Page 31322]]

59.\15\ Over Respondents' objections,\16\ Mr. Parrado was accepted as 
an expert. Id. at 165.
---------------------------------------------------------------------------

    \15\ Regarding whether his opinions were based on the 
presentations on red flags made by the former head of the Agency's 
Office of Diversion Control, Mr. Parrado acknowledged that he has 
seen these presentations on two occasions. Tr. 159. However, Mr. 
Parrado stated that the presentations ``reinforced'' his existing 
opinions on red flags. Id. at 160. As for the presentations he had 
previously given, Mr. Parrado acknowledged that he no longer 
considers a patient's asking for a drug by brand name to be a red 
flag. Id. at 161-62.
    When asked whether his opinions were based on information in the 
DEA Pharmacist's Manual, Mr. Parrado answered ``yes'', and when 
asked if he disagreed with anything in the Manual as it relates to 
red flags and their resolution, answered ``no.'' Id. at 163.
    \16\ The basis of Respondents' objection to Mr. Parrado being 
accepted as an expert was that he ``is a practicing pharmacist. He's 
experienced in retail pharmacy but qualification as an expert, 
there's no need.'' Tr. 165. Given Mr. Parrado's extensive years of 
practice as a retail pharmacist; his years as a member of the 
Florida Board of Pharmacy, which includes service as both Vice 
Chairman and Chairman; his involvement in the Florida Pharmacy 
Association which includes his service in leadership positions; his 
membership in other professional associations; and his numerous 
presentations; the ALJ properly overruled Respondents' objection.
---------------------------------------------------------------------------

    Mr. Parrado then testified that he was retained to ``review the 
prescriptions.'' Id. at 166. He also acknowledged having ``reviewed 
some patient records'' and ``a patient profile,'' before clarifying 
that ``the main thing [he] relied on was the prescriptions and those 
partial patient records.'' \17\ Id.
---------------------------------------------------------------------------

    \17\ On cross-examination, Mr. Parrado testified that he had 
review only one patient profile ``a couple of weeks'' before the 
hearing. Tr. 232.
---------------------------------------------------------------------------

The Superior I Prescriptions

    The Government then proceeded to question Mr. Parrado regarding the 
25 prescriptions contained in Government Exhibit 3 (No. 15-6). Id. at 
167. Each of the prescriptions was issued by a physician at the 24th 
Century Medical Center, which, according to the prescriptions, was 
located at 7747 W. Hillsborough Avenue in Tampa. GX 3. Sixteen of the 
prescriptions were issued on August 5, 2011 for oxycodone 30 and were 
filled by Superior I on the same day. See id. at 1-16; Tr. 169. 
Moreover, 13 of these 16 prescriptions were written by the same 
physician (Dr. C.), with the remaining three written by another 
physician (Dr. R.). GX 3, at 1-16.
    Each page of this exhibit contains two images; one showing the 
front of the prescriptions; the other showing the back. See generally 
GX 3. With respect to the first page of the exhibit, Mr. Parrado 
testified that the bottom image was the back of the prescription. Tr. 
169. He explained that when a pharmacy fills a prescription, its 
computer generates labels, one of which goes on the prescription bottle 
and the other goes on the prescription. Id. Mr. Parrado then explained 
that the number following the letters ``RX'' on the label was the 
prescription number and that the number is generated sequentially by 
the pharmacy's ``computer as prescriptions are being filled.'' Id. at 
170-71. However, Mr. Parrado subsequently testified that ``[d]epending 
on the computer format they have, some will generate a number with the 
first number being different . . . depending on the schedule of the 
drug.'' Id. at 174.
    The Government then asked Mr. Parrado whether there were ``any red 
flags associated with'' the 16 prescriptions, which were filled on 
August 5, 2011. Id. at 178. Mr. Parrado testified that the 
prescriptions presented multiple red flags:

    Well first thing I would see was the drug, [o]xycodone, 30 
milligrams. Then I would see that they're all coming from the same 
clinic. They're all for the same strength written by the same 
physician on the same day.
    So there's multiple patients coming from the same clinic. Which 
was one of my concerns earlier. Multiple people presenting from the 
same clinic with a like or similar prescription.
    These are definitely alike in similar prescriptions. So that 
would be my first red flag.
    Then the next red flag I would have looked at was the dosing. 
The appropriateness of therapy. A red flag I would have to resolve 
at this point was knowing that 80 milligrams a day of [o]xycodone is 
a lethal dose to an opioid na[iuml]ve patient. These are much higher 
than 80 milligrams a day dosing.
    I would have to verify--I'd have to feel good about the fact 
that the patient had been on this drug therapy and established to 
this dose. Would have been the first thing.
    Then the next thing I would have looked at would have been the 
patient[']s address. How far he drove to get there.
    Then another thing I would have looked at was what . . . did he 
pay for it with cash. And how much did he pay. How much is he 
willing to pay for.\18\
---------------------------------------------------------------------------

    \18\ At this point, Mr. Parrado testified that ``in that time 
period,'' oxycodone cost from $.33 to $1.00 per tablet, at which 
point Respondents' counsel objected to the testimony, asserting that 
it was outside the scope of the Government's Prehearing Statements 
and that there was no foundation for Mr. Parrado's testimony. Tr. 
179. While the Government's Prehearing Statement did not disclose 
the precise prices he testified to, the Government did disclose that 
Mr. Parrado would ``identify and discuss . . . prescriptions for 
individuals playing [sic] high prices . . . for controlled 
substances with cash.'' ALJ Ex. 6, at 3 (No. 15-6). Moreover, the 
label attached to the back of each of the prescriptions contains 
data as to both the price to the patient and the cost of the 
prescription and the prescriptions were provided to Respondents 
prior to the hearing. The labels suggest that Mr. Parrado's 
testimony as to the cost per tablet was accurate. See, e.g., 
generally GX 3 (No. 15-6).
    As to the issue of foundation, Mr. Parrado testified that ``I 
know the pharmacy I was working in at that time [was] paying about 
$.33 a pill for [o]xycodone.'' Tr. 182. He then added that the 
average price charged to a patient ``may have gotten to a $1.00.'' 
Id. On cross-examination, Mr. Parrado further testified that his 
knowledge of pricing was not based on his having called individual 
pharmacies, but rather his ``general knowledge of what the market 
place was.'' Tr. 242.

---------------------------------------------------------------------------
Id. at 178-79.

    Mr. Parrado further testified that each of the 16 prescriptions was 
paid for in cash. Id. at 181. Asked whether based on his experience and 
knowledge of retail pharmacy practice, the prices being charged by 
Respondent for these prescriptions ``were considered high prices for 
oxycodone,'' Mr. Parrado answered ``[v]ery.'' Id. at 182. Mr. Parrado 
subsequently explained that ``these prices are very, very high'' and 
that this would be an additional red flag. Id.at 183. As the evidence 
shows, 13 of the patients paid $784 or more for their prescriptions, 
and five of the patients paid $952 or more. GX 3, at 1-16.
    The Government then questioned Mr. Parrado regarding the red flags 
presented by the relative location of the patients to the prescriber 
and Superior I. With respect to the prescriptions reproduced at pages 
one (112 oxycodone 30 to M.L.) and nine (224 oxycodone 30 to V.P.), 
both patients' addresses were listed as being in Spring Hill, 
Florida.\19\ See id. at 1, 9. According to Mr. Parrado, Spring Hill is 
located 45 to 50 miles from Superior I.\20\ Tr. 185. Mr. Parrado then 
explained that ``[t]here

[[Page 31323]]

are many pharmacies between Spring Hill and Tampa.'' Id.
---------------------------------------------------------------------------

    \19\ See also GX 3, at 2 (Rx for 160 oxycodone 30 to J.R.).
    \20\ Here again, Respondents objected to Mr. Parrado's 
testimony, arguing that the Government's Prehearing Statement did 
not disclose that he was ``going to be offering testimony with 
regard to the distances between locations or the relative locations 
of these patients and the pharmacy.'' Tr. 184. Respondents further 
argued that they had ``prepared to cross examine the person who [the 
Government] said would testify to that. It was the intelligence 
analyst. It is not Mr. Parrado.'' Id.
    It is correct that the Government did not disclose in its 
Prehearing Statement for Superior I that Mr. Parrado would 
specifically testify about the distances between Superior I and the 
towns of Spring Hill (as well as New Port Richey and others). It 
also true that in its Prehearing Statement, the Government indicated 
that it intended to call a different witness (an intelligence 
analyst) to testify about a chart she created showing the large 
number of Superior I's patients who lived long distances from the 
pharmacy. However, the Government also disclosed that it intended to 
ask the ALJ to take official notice of the approximate mileage 
between Superior I and the various municipalities where the patients 
lived. Moreover, the distances between Superior I and the towns of 
Spring Hill and New Port Richey are disputable only to the extent 
one argues over the precise addresses used to ascertain that 
distance or the route taken. I thus conclude that Respondent cannot 
show how it was prejudiced by the ALJ's overruling of its objection.
---------------------------------------------------------------------------

    Regarding the prescriptions reproduced at page four (168 oxycodone 
30 S.M.) and 16 (224 oxycodone 30 for S.A.), Mr. Parrado testified that 
both patients gave addresses in New Port Richey. Id. He then testified 
that New Port Richey is ``[a]bout 40 miles north of Tampa.'' Id. Mr. 
Parrado then noted that patient addresses for other prescriptions 
included Bradenton (40-45 miles south and west of Tampa), id. at 186; 
Port Richey (which is next to New Port Richey), id. at 187; Ocala (90-
100 miles north of Tampa), id. at 188; Gainesville (130 miles north of 
Tampa), id.; High Springs (``probably a 150 miles'' from Tampa), id. at 
188-89; Jacksonville (200 miles north and east of Tampa), id. at 189-
90; Alachua (140-150 miles from Tampa); id. at 190; Middleburg 
(``[c]lose to Jacksonville'' and ``about 200 miles'' from Tampa); id. 
at 191; and Uvalda, Georgia (``probably . . . close to 300 miles'' from 
Tampa). Id. at 192.
    Next, the Mr. Parrado testified that each of the 16 prescriptions 
was ``facially invalid'' because the prescribing physician did not 
include the patient's address. Id. Mr. Parrado explained that under 
Florida law ``at the time \21\ . . . the patient name and address had 
to be on the front of the prescription.'' Id. While Mr. Parrado 
testified that a missing address is a red flag, he acknowledged that 
the pharmacist could resolve it by adding in the patient's address. Id. 
Asked by the Government whether it appeared that Superior I's 
pharmacists had resolved this red flag with respect to the 
prescriptions reproduced at pages one and four of GX 3, Mr. Parrado 
acknowledged that it appeared that they had done so as evidenced by the 
``computer generated sticker[s] that the pharmacist[s] put'' on the 
prescriptions. Id. at 193. However, Mr. Parrado then explained that it 
``would have been [the pharmacist's] duty'' to verify that the address 
on the sticker ``was accurate.'' Id.
---------------------------------------------------------------------------

    \21\ While Mr. Parrado referred to Florida law ``at the time,'' 
Florida law still requires that the face of a controlled substance 
prescription contain ``[t]he full name and address of the person for 
whom . . . the controlled substance is dispensed.'' Fla. Sta. Sec.  
893.04(c)(1)(2015).
---------------------------------------------------------------------------

    The Government then asked Mr. Parrado about the prescriptions found 
at pages 11 (RX#452161), 12 (RX#452160), 14 (RX#452156), 15 
(RX#452155), and 16 (RX#452159). Tr. 194-95. Of note, these 
prescriptions were issued to patients who reported their addresses 
respectively as being in High Springs, Alachua, Middleburg, Florida; 
Uvalda, Georgia; and New Port Richey, Florida. See GX 3, at 11-12, 14-
16. Specifically, the Government asked whether ``the fact that these 
numbers are so close together, looking at these prescriptions 
collectively, does that raise any additional red flags for you?'' Tr. 
195. After the ALJ overruled Respondent's objection that the testimony 
was outside the scope of the Prehearing Statement, Mr. Parrado 
answered:

    Yes. Yes, it would have caught my attention that we had people 
coming from long distances and places that were close together, 
coming to get these prescriptions.
    What I don't see on there is, you know, it looks like the 
[patient address] sticker was put on the front to resolve the red 
flag. It doesn't tell me how they resolved the red flag.

Id.

    The Government then asked Mr. Parrado about the prescriptions 
reproduced at pages 13 (RX#452157) and 14 (RX#452156); these 
prescriptions listed the patient's addresses as being in Jacksonville 
(J.M.) and Middleburg, Florida (B.M.). Id. at 196; GX 3, at 13-14. 
According to Mr. Parrado, these ``two prescriptions were filled 
sequentially for people from Middleburg and Jacksonville, which are 
both very close to each other.'' Tr. 196. Continuing, Mr. Parrado 
opined: ``So they could have travelled together to come there.'' \22\ 
Id. Mr. Parrado further observed that these patients had the same last 
name. Id. at 197.
---------------------------------------------------------------------------

    \22\ Here again, Respondent objected to the testimony as ``rank 
speculation'' for which there was ``no foundation.'' Tr. 196. He 
also argued that it was beyond scope of the Government's Prehearing 
Statement. Id. The ALJ overruled the objection.
    As for Respondent's objection on the ground that the testimony 
was ``rank speculation,'' given that Mr. Parrado testified and the 
prescriptions show that: (1) These two patients had the same last 
name, (2) provided addresses which suggested that they lived near 
each other, and (3) their prescriptions bore sequential prescription 
numbers, Mr. Parrado's testimony was a permissible inference. In any 
event, even if the patients did not travel together, each of these 
prescriptions presented red flags.
    Moreover, even acknowledging that the Government did not 
disclose that Mr. Parrado would testify that these two persons could 
have travelled to Superior together, the Government nonetheless 
disclosed that it intended to elicit testimony regarding 
Respondent's filling of multiple prescriptions for patients who 
travelled long distances to obtain their prescriptions. ALJ Ex. 1, 
at 2-3 (No. 15-6); ALJ Ex 7, at 3-5 (No. 15-6). See also supra note 
12 (collecting cases).
---------------------------------------------------------------------------

    Next, the Government asked Mr. Parrado about the prescriptions 
reproduced at pages 14 and 15. Of note, the latter prescription was 
issued to a patient (C.M.), who provided an address in Uvalda, Georgia 
and who has the same last name as that of the patients discussed in the 
preceding paragraph. See GX 3, at 15. Mr. Parrado again opined that he 
believed these persons travelled together to obtain the prescriptions. 
Tr. 198. Asked by the Government--over the overruled objection of 
Respondent--whether the red flags presented by these were resolvable, 
Mr. Parrado explained:

    These are the kinds of prescriptions that would cause me not to 
be able to resolve that--this many red flags together. The long 
distance, the same name, the like, similar drugs, thousands of 
dollars involved here, in cash, would cause me . . . concern.
    It's not, in my practice, it's not been--the average customer 
doesn't come into the pharmacy with $1,000 in their pocket. You 
know, it's average you tell the person they have a $20 copay they 
get upset.
    For these process [sic] to be charged, you know, it's just--
that's a red flag that I would have a hard time resolving.\23\
---------------------------------------------------------------------------

    \23\ Here too, Respondent objected that Mr. Parrado ``ha[d] no 
idea what people who come into a pharmacy have in their pocket or 
they don't.'' Tr. 199-200. Respondent thus contended that Mr. 
Parrado's testimony was speculation and was outside the scope of the 
Prehearing Statement. Id. at 200. The ALJ stated that he noted the 
objection and that he did not need Respondent to tell him ``what 
should be or should not be allowed in this hearing.'' Id. The ALJ 
then explained that he had made his ruling and instructed the 
Government to ask its next question. Id.
    I agree with Respondent that this testimony was speculative 
because the patients could well have paid for their prescriptions 
with credit cards. However, the prescriptions list their respective 
prices as $833 (RX 452157), $952 (RX452156), and $833 (RX452155). 
GX3, at 13-15. Regardless of the method of payment used to purchase 
them, Mr. Parrado testified that the cost of the prescriptions was 
also a red flag.

Id. at 199. Asked the same question with respect to the prescriptions 
reproduced at pages 13 and 14, Mr. Parrado testified: ``It would be the 
same answer. It's the same situation.'' \24\ Id. at 200.
---------------------------------------------------------------------------

    \24\ This prompted the same objection by Respondent and the same 
ruling. Tr. 200.

    The Government then asked Mr. Parrado whether, with respect to the 
16 oxycodone 30 prescriptions (GX 3, at 1-16), which were issued and 
filled on August 5, 2011, there was any evidence, other than the 
placement of the address stickers, that the red flags they presented 
``were resolved?'' Tr. 200. Mr. Parrado testified: ``[t]here is no 
documentation to that effect on any of these prescriptions.'' Id. 
Following up, the Government asked Mr. Parrado if he had seen any 
evidence ``that any of the red flags [other than the missing addresses] 
---------------------------------------------------------------------------
were even investigated?'' Id. at 201. Mr. Parrado replied:

    In some of the partial medical records I looked at, there wasn't 
any evidence of any conversations between the clinics and the

[[Page 31324]]

pharmacist.\25\ Also, this is one of the things I got out of the 
partial medical records, that there wasn't any evidence that they 
had even talked with the pharmacy. And there was nothing here being 
documented either.
---------------------------------------------------------------------------

    \25\ On cross-examination, Mr. Parrado testified that he had 
been given the partial medical records after the New Year's holiday. 
Tr. 357-58.

---------------------------------------------------------------------------
Id.

    Mr. Parrado then opined that it ``would be outside the standard of 
care for a pharmacist to fill these without having resolved the red 
flags before dispensing.'' Id. Asked to opine on whether, based on the 
prescriptions and records he reviewed, the pharmacists ``exercise[d] 
their corresponding responsibility to ensure that a prescription for a 
controlled substance was issued for [a] legitimate medical purpose,'' 
Mr. Parrado answered: ``[n]ot that I can tell from the records shown to 
me.'' Id. at 201-02.
    The Government then questioned Mr. Parrado about the remaining 
prescriptions in its Exhibit 3. These included a prescription for 240 
oxycodone 30 issued on December 10, 2011 to J.M.; as with the other 
prescriptions, the prescriber had not written the patient's address on 
the prescription but the prescription contained a small sticker listing 
J.M.'s address as Lenoir, Tennessee. GX 3, at 22 (No. 15-6). Asked if 
the prescription raised any red flags, Mr. Parrado noted J.M.'s address 
and explained that his ``first concern'' was the ``person coming from 
Tennessee.'' Tr. 202. Mr. Parrado identified additional red flags 
presented by the prescriptions, including the physician's failure to 
include the patient address on the prescription, that the quantity of 
240 pills was a ``very high dose'' for oxycodone 30, that the 
prescription came ``from the same clinic,'' and that it cost $1,155. 
Id. Mr. Parrado then explained that ``[t]hose are all red flags that I 
could not have resolved.'' Id.
    However, when asked by the Government if he could tell who filled 
the prescription, Mr. Parrado testified that the prescription bore the 
initials ``CD,'' thus indicating ``the pharmacist responsible'' for the 
script; he then added that ``there's a scribble on the front from 
somebody that canceled the prescription.'' Id. at 203. Moreover, the 
prescription has two diagonal lines drawn through it, along with a 
circle with the letter ``C'' in bold, and while there is a copy of the 
dispensing label attached to the back, see GX 3, at 22, the Government 
offered no further evidence to clarify whether the prescription was 
actually dispensed.
    Next, the Government asked Mr. Parrado whether the prescriptions 
(reproduced at GX 3, at 17-18), which are dated August 6, 2011 and bear 
sequential prescription numbers presented any red flags. Both of these 
prescriptions were issued by Dr. S.A.H., a physician at the same 24th 
Century Medical Center in Tampa, to two persons (E.P. and R.B.) for 150 
and 140 tablets respectively of oxycodone 30. GX 3, at 17-18. Here too, 
the front of each prescription lacked the patient's address. See id. 
However, each prescription bore a sticker listing the patient's 
address, and the stickers indicated that E.P. and R.B. lived at the 
same street address in Milton, Florida. See id.
    Asked by the Government whether the prescriptions presented any red 
flags, Mr. Parrado identified the patients' addresses and added that 
``Milton, Florida is way in the [w]estern panhandle of Florida. It's 
well over 400 miles'' to the pharmacy. Tr. 204.\26\ Mr. Parrado noted 
that ``both of them seem to have the same address.'' Id. However, he 
then testified that the driver's license that was in R.B.'s ``partial 
medical records'' listed his address as being in a different city 
(Pace, Florida) than Milton. Id. at 205. Mr. Parrado explained that the 
disparity between the address on the prescription and the address on 
the driver's license ``caused me concern that they weren't looking very 
closely.'' Id. at 205-06.
---------------------------------------------------------------------------

    \26\ Respondent's counsel objected that the testimony was 
outside the scope of the Government's Prehearing Statement and was 
rank speculation. Tr. 204-5. The ALJ overruled the objection. Id. at 
205. Here again, the Show Cause Order specifically alleged that 
``[o]n August 6, 2011, one or more Superior I pharmacists dispensed 
large and substantially similar quantities of thirty milligram 
tablets of oxycodone to two customers, E.P. and R.B., both of whom 
resided at the same address in Milton, Florida, which is located 
approximately four hundred and forty nine miles (449) from Superior 
I's location.'' ALJ Ex. 1, at 2 (No. 15-6). While this alone 
provided adequate notice, the Government's Prehearing Statement 
further advised that ``Mr. Parrado will further testify that, on 
August 6, 2011, Respondent dispensed large quantities of thirty 
milligram oxycodone to two individuals, E.P. and R.B., who resided 
at the same address in a city located more than 440 miles . . . from 
Respondent's pharmacy.'' ALJ EX. 7, at 4 (No. 15-6). The ALJ thus 
properly overruled the objection.
---------------------------------------------------------------------------

    After noting that E.P.'s prescription cost $562 and R.B.'s 
prescription cost $525, Mr. Parrado testified that ``two people from 
one address paying over $1,000 would be a red flag from somebody coming 
. . . from 400 miles away.'' Id. at 206. He further noted that both 
prescriptions were written by the same physician and were for the same 
drug and in essentially the same quantities. Id. Mr. Parrado then 
testified that he had seen ``no documentation anywhere'' that Superior 
I's pharmacist resolved the red flags, including in the ``partial 
medical records,'' which contained ``no evidence that there was any 
conversation between the pharmacy and the physician['s] office.'' Id. 
at 206-07.
    Next, the Government asked Mr. Parrado about a prescription issued 
by Dr. V.S. (also of the 24th Century Medical Center) and dispensed on 
December 2, 2011 to B.W., for 200 tablets of Dilaudid (hydromorphone) 8 
mg. See GX 3, at 21; Tr. 207. Here again, the prescription lacked the 
handwritten patient's address but contained a sticker which listed 
B.W.'s address as being in Fort Ogden, Florida. GX 3, at 21.
    Asked if the prescription presented any red flags, Mr. Parrado 
testified that there were multiple red flags, including that ``it's a 
very, very potent drug'' and that the quantity was for 200 pills. Tr. 
208. Continuing, Mr. Parrado testified that:

    I have never seen a prescription in my 41 years as a pharmacist 
for a quantity like that of . . . Dilaudid 8 milligrams as being 
dosed at every . . . three to four hours.
    Which would be six to eight times a day. So 48 to 72 milligrams 
. . . would be the daily dose for a drug that the recommended upper 
dose be probably 24 milligrams.
    So it's a much higher dose then [sic] what I have ever seen as a 
pharmacist. And that would have caused me serious concern that I had 
to resolve before I could do anything, period.
    The fact that they came a long way, again, from Fort Ogden, from 
that same clinic that I'm seeing all these prescriptions from, would 
cause me not to be able to resolve that red flag.

Id. at 208-09.

    Mr. Parrado was then asked whether a prescription (GX 3, at 19) for 
196 Dilaudid 8 mg issued by Dr. P.C. and dispensed on December 1, 2011 
to R.L. (Largo, Fl.) also presented red flags. Tr. 209. Mr. Parrado 
testified that the quantity and dosing raised the ``exact same 
concern'' as the dosing was ``well outside the recommended upper dosage 
of that drug.'' Id. Continuing, he explained: ``And I don't see 
anything where that was resolved to establish that the patient had 
developed a tolerance to that drug to avoid the respiratory depression 
that would have been inherent at that dose.'' Id.
    Asked whether R.L.'s address in Largo was also a red flag (here 
too, the patient's address had not been written on the prescription but 
had been added by a sticker), Mr. Parrado testified that the distance 
was 20 to 25 miles. Id. at 209-10. While he acknowledged that this was 
not ``a very long distance,'' he

[[Page 31325]]

explained that ``the fact that there's so many coming from outside the 
area just starts compounding the fact that this is almost . . . like a 
destination clinic or destination pharmacy where people know to go 
there.'' Id. at 210. Mr. Parrado then testified that he found no 
evidence that Superior I's pharmacist attempted to resolve the red 
flags.
    As for the prescription (GX 3, at 20), which was issued by Dr. R. 
(also of 24th Century) to C.L. for 224 Dilaudid 8 mg on December 1, 
2011 and filled the same day, Mr. Parrado again found the quantity to 
be a red flag, testifying that this would be ``a lethal dose to an 
opioid na[iuml]ve patient.'' Tr. 211. He then explained that ``there's 
nothing here to show that the patient has developed a tolerance to this 
drug.'' Id.\27\ As for the prescription (GX 3, at 23), which was issued 
by Dr. V.S. (of the same clinic) to M.A. for 224 Dilaudid 8 mg on 
December 2, 2011 and filled the same day, Mr. Parrado testified that 
the ``very high dose'' was a red flag and that there was no evidence 
that the patient had developed tolerance to the drug. Tr. 212.
---------------------------------------------------------------------------

    \27\ In response to the Government's question whether the fact 
that these two prescriptions were presented the same day raised 
``[a]ny additional red flags,'' Mr. Parrado testified that 
``[t]hat's another pattern prescribing red flag. To me.'' Tr. 211-
12. I conclude, however, that two prescriptions do not establish 
pattern prescribing.
---------------------------------------------------------------------------

    Concluding its direct examination of Mr. Parrado regarding the 
Superior I prescriptions, the Government asked if he had an opinion as 
to whether the pharmacists who dispensed the prescriptions knew or had 
reason to know that they were issued without a valid doctor-patient 
relationship. Tr. 220-21. After the ALJ overruled Respondent's 
objection,\28\ Mr. Parrado explained:
---------------------------------------------------------------------------

    \28\ Respondent objected on the ground that ``[t]here's no 
opinion summarized anywhere in the Government's [P]re-hearing 
[S]tatement . . . that relates to whether or not . . . the 
pharmacist knew or should have known that those prescriptions were 
issued. And it's outside his area of expertise. It's nothing but 
rank speculation.'' Tr. 221.
    Even assuming that the first ground for objection was that the 
Government did not provide notice that it intended to ask whether 
the pharmacists knew or should have known that the prescriptions 
were issued without a valid doctor-patient relationship, in its 
Prehearing Statement, the Government advised that Mr. Parrado ``will 
testify that, based on his expertise, training, and experience, and 
based on his review of the evidence summarized above, Respondent's 
pharmacists failed to exercise their corresponding responsibility to 
ensure that prescriptions for controlled substances were issued for 
a legitimate medical purpose in the usual course of professional 
practice.'' ALJ Ex. 7, at 5. Asking whether the prescriptions ``were 
issued without a valid-doctor patient relationship'' is just another 
way of asking whether the prescriptions ``were issued for a 
legitimate medical purpose in the usual course of professional 
practice,'' as a physician must establish and maintain a valid 
doctor-patient relationship to act in the usual course of practice 
and to issue a prescription for a legitimate medical purpose.
    Nor was it beyond Mr. Parrado's expertise to opine on whether 
the prescriptions were issued outside of a valid doctor-patient 
relationship. See United States v. Hayes, 595 F.2d 258, 261 & n.6 
(5th Cir. 1979) (``[A] pharmacist can know that prescriptions are 
issued for no legitimate medical purpose without his needing to know 
anything about medical science.''). Indeed, pharmacists are expected 
to review the patient record and each prescription for therapeutic 
appropriateness and identify, inter alia, over-utilization, 
incorrect drug dosage, and clinical abuse/misuse. Fla. Admin Code 
r.64B16-27.810(1). A pharmacist is obviously required to be able to 
determine when a prescription calls for the dispensing of such 
potent narcotics as oxycodone or Dilaudid in quantities that far 
exceed recommended upper dosages and would be lethal in an opioid 
na[iuml]ve patient, let alone when a patient presents such other red 
flags of abuse or diversion, such as travelling long distances to 
obtain narcotics.

    There's no documentation that I saw that there was any 
conversation with a physician determining that. Because at these 
doses there would had to have been conversation determining 
tolerance. There would have been conversation determining medical 
need at this dosing.
    So at that point I would have had a question in my mind, as a 
pharmacist filling or being presented with this prescription, that 
there may have been . . . not a very good valid patient-doctor 
relationship going on at that point in time.

Id. at 221-22.

    On cross-examination, Mr. Parrado acknowledged that he could not 
offer an opinion as to whether any of the patients, whose prescriptions 
were provided in GX 3, were opioid na[iuml]ve. Tr. 235-36. Asked 
whether it was true that he had no knowledge as to the procedures used 
at Superior I to revolve red flags, Mr. Parrado answered that 
``[n]othing that was documented on the prescriptions showed that 
anything had been done.'' Id. at 237. After acknowledging that 
``there's nothing that mandates where [documentation] has to be,'' he 
also acknowledged that if the resolution of the red flags was 
documented someplace other than on the prescription itself, the 
documentation wasn't provided to him, and thus he does not know whether 
it exists or not. Id. at 237-38.
    While Mr. Parrado testified that he knew one of the pharmacists who 
worked at Superior I, he stated that he had not spoken with her about 
any of the prescriptions. Id. at 246. Nor has he discussed with any of 
Superior I's pharmacists the policies or procedures the pharmacy had in 
place from January 1, 2011 through February 4, 2013, or currently has 
in place, for identifying diversion and for documenting the resolution 
of red flags. Id. at 246-47.
    Mr. Parrado further testified that he asked DEA ``for complete 
profiles on all these patients'' but was told to look at only the 
prescriptions. Id. at 247. He then testified that he believed the 
Agency had the profiles because he had seen some of them in the DEA's 
office. Id.
    Mr. Parrado testified that he had not consulted with any other 
pharmacists in forming his opinions. Id. at 248. He also testified that 
he did not speak with any of the prescribers of the 25 prescriptions or 
with the patients who received them. Id. at 249. He then testified that 
he did not know what training or experience the prescribers had. Id. at 
250.
    Asked by Respondent whether, based on the materials provided to him 
by DEA, he knew if Superior I's pharmacists had called the prescribers 
``to discuss any issues related to the patients or the prescriptions,'' 
Mr. Parrado answered that ``did not see anything to that effect.'' Id. 
at 251. He then testified that if ``[i]t wasn't documented[,] [i]n my 
mind, they didn't do it.'' Id. However, Mr. Parrado acknowledged that 
he did not know if this was documented other than on the prescriptions. 
Id. at 252.
    Mr. Parrado did not know whether Superior I kept a paper file which 
included medical records on their patients. Id. at 254. He also did not 
know if Superior I's pharmacists obtained copies of MRIs, X-Rays and CT 
scans. Id. He then testified that:

    In the partial patient records that I did receive, there was 
evidence of some MRIs. What struck me was that these MRIs were old 
and not ordered by the physician who was writing these 
prescriptions, which would have been a red flag to me. Some of these 
MRIs were two/three years old. They were ordered by someone else.
    There were some . . . MRIs, reports didn't even have a referring 
prescription on it. That would have concerned me as a pharmacist 
filling that prescription.

Id. at 254-55.

    Respondent then asked Mr. Parrado if, based on the information 
provided to him, he was ``aware that the pharmacists were obtaining 
copies of radiographic studies [and] reports of radiographic studies?'' 
Id. at 255. Mr. Parrado answered:

    No, I didn't say I saw it in the pharmacy records. I saw it in 
the medical records. If the pharmacist would have had access to 
that, that would have presented another red flag in the fact that 
that was an old record ordered by someone else. That would have 
raised the bar there if you will.

Id. Mr. Parrado then explained that he did not know the source of the 
medical records.\29\ Id.
---------------------------------------------------------------------------

    \29\ Subsequently, the lead Investigator testified that the 
medical records had been obtained pursuant to a subpoena issue to 
the 24th Century Clinic and had been provided to Mr. Parrado by 
Government Counsel. Tr. 578, 589-90.


[[Page 31326]]


---------------------------------------------------------------------------

    Mr. Parrado acknowledged patients become dependent and develop 
tolerance to opioid analgesics and that there is no upper limit as to 
the quantity or dose that can be prescribed. Id. at 260. He also 
acknowledged that he did not know if any of the patients who received 
the prescriptions in GX 3 worked in Tampa. Id. He also conceded that 
the patients ``were seeing the physicians regularly over a good period 
of time.'' Id.
    Continuing, Mr. Parrado acknowledged that there is an expressway 
which runs from Spring Hill to Tampa, and that people may commute from 
the former to the latter for work. Id. at 261. Mr. Parrado testified 
that this red flag would have been resolvable if the question had been 
asked and answered. Id. at 262.
    Next, Mr. Parrado testified that a pharmacist can add an address to 
a prescription if ``you've checked with the physician and gotten the 
correct thing and that matches what the patient is telling you.'' Id. 
at 263. He then acknowledged that he did not attempt to determine if 
any of the prescriptions in GX 3 were necessary for the treatment of 
chronic or recurring disease. Id. at 264.
    On re-direct, Mr. Parrado was asked whether the one patient profile 
he was provided with was for P.D. (GX 3, at 24) and whether the profile 
showed that there was a gap in care. Tr. 268. Asked to describe what 
was on the document, Mr. Parrado testified that:

    [t]there was a list of dates for Mr. P.D. that showed the dates 
he had prescriptions filled for this drug and there was a gap of two 
months in there which, as a pharmacist, anybody that stops taking 
opioids or if I don't know he's continued taking opioids, at that 
point I can't fill a further prescription till I've established 
that.
    He could have been in jail. He could have been in a rehab unit. 
It is well-documented that patients that have gone into these 
things, gone back in the community and accessed a prescription at 
the old dosage they were on would kill them and it has killed them.

Id. at 269-70.\30\ Asked by the Government whether when he reviewed 
this document, he saw any indication that red flags had been resolved 
or explained, Mr. Parrado answered ``no.'' Id. at 271.
---------------------------------------------------------------------------

    \30\ At this point, Respondent objected, arguing that if Mr. 
Parrado was going to talk about this document, the Government should 
be required to ``produce the document so that we can see what it is 
that he's talking about. You know, he's talking about some amorphous 
document.'' Tr. 270. He also argued that the testimony was outside 
the scope of either cross examination or the Prehearing statement. 
Id. While the ALJ disagreed that it was outside the scope, he 
explained that because there was ``no document in front of him'' and 
he was ``relying on the frailties of human memory,'' he was not 
going to give this testimony ``a whole lot of weight.'' Id. at 271.

    Questioned by the ALJ as to where he would document the red flags 
presented by a prescription, Mr. Parrado testified that: ``I would have 
identified the red flags that concerned me when the prescription was 
presented. I would have noted that on the back and I would have noted 
what I did to resolve each one of those if there was more than one.'' 
Id. at 273. Mr. Parrado added that ``you scribble on the back and/or 
you write on a piece of paper and staple it to that prescription.'' Id.
    The ALJ then asked Mr. Parrado if, in his ``experience working with 
other pharmacists, . . . they have other ways of making records . . . 
to keep track of the red flags and how they've been resolved?'' Id. at 
274. Mr. Parrado answered: ``[n]ot in the 43 years I've been a 
pharmacist.'' Id.
    On further re-cross, Respondent asked Mr. Parrado: ``Not all 
pharmacists document in the same way that you do, do they?'' Id. Mr. 
Parrado answered: ``[a]s a Board of Pharmacy member, I would have 
expected them when they came before the Board to show me that 
documentation. It was always on the prescription. It's always on that 
prescription record somehow.'' Id. Noting that Mr. Parrado had not been 
on the Board of Pharmacy for some time, Respondent then asked if he had 
``ever seen in your 43 years[,] pharmacists document the same 
information in different ways?'' Id. at 275. Mr. Parrado answered: 
``I've seen them document in different ways but always on the 
prescription.'' Id.

The Superior II Prescriptions

    With respect to the Superior II prescriptions, Mr. Parrado 
testified that he reviewed them in the same manner as he did the 
Superior I prescriptions. Id. at 277. He then proceeded to identify 
various red flags presented by the prescriptions.
    The first of these was a prescription issued by Dr. H.V.D. (also of 
the 24th Century Medical Center) to J.T. of Fort Meyers, Florida, for 
280 oxycodone 30. GX 3, at 1-2 (No. 15-7). Here again, the patient's 
address was left blank and the address was provided by a sticker, which 
was affixed to the front of the prescription. Id. at 1. Mr. Parrado 
testified that prescription presented the following red flags: The drug 
having ``a high potential for abuse''; the ``very large quantity'' and 
``the dosing at a very high rate, well above . . . 80 milligrams a 
day''; the ``patient travelling from Fort Meyers, which is . . . 150 
miles or so from Tampa''; and the patient paying $1,260 cash for the 
drugs. Tr. 277-78.\31\ Mr. Parrado then testified ``there was nothing 
on the prescription to show me that these things had been discussed.'' 
Id. at 279.
---------------------------------------------------------------------------

    \31\ Respondent objected to Mr. Parrado's testimony as to the 
price, asserting it was beyond the scope of the Pre-hearing 
Statement because it did not specifically identify ``the pricing 
issue'' as being one of the red flags associated with the 
prescription. Tr. 278. The Government did, however, identify that it 
intended to elicit testimony on the issue of ``individuals playing 
[sic] high prices for prescriptions . . . with cash.'' ALJ Ex. 7, at 
3 (No. 15-7).
---------------------------------------------------------------------------

    The second prescription was issued on December 2, 2011 by Dr. R. 
(the same Dr. R. of 24th Century), to R.B. of Milton, Florida (the same 
R.B. discussed in the Superior I findings) for 168 oxycodone 30. GX 3, 
at 3-4 (No. 15-7). Here again, the patient's address was left blank and 
the address was provided by a sticker, which was affixed to the front 
of the prescription. Id. at 3. After Mr. Parrado identified R.B. as 
being one the persons who filled a prescription at Superior I which 
presented red flags, the Government asked him to also look at the 
prescriptions reproduced at pages 5-6 of the exhibit. The latter 
prescription was also issued on December 2, 2011 by Dr. V.S. (also of 
24th Century) to E.P., who again used R.B.'s address as her address; 
the prescription was also for 168 oxycodone 30. Id. at 5-6. Of further 
note, R.B.'s and E.P.'s prescriptions had sequential RX numbers. Id.
    Asked if these prescriptions presented any red flags, Mr. Parrado 
testified that ``[t]hese were the same two patients that had gotten 
prescriptions filled at the other pharmacy, both with the same Milton, 
Florida address, both paying $924 in cash, travelling a long way, very 
high dosing, all the same concerns I had with the previous 
prescriptions.'' Tr. 280-81. He also observed that the prescriptions 
``were filled consecutively'' and that the dispensing labels show that 
the same pharmacist (M.F.) filled the prescriptions, and that these 
circumstances would have caused him concern. Id. at 282-83. And Mr. 
Parrado further testified that he saw no evidence that the pharmacist 
attempted to resolve the red flags. Id. at 283.
    The next prescription was issued on September 18, 2012 by Dr. V.S. 
(the same Dr. V.S. who had worked at 24th Century) to L.P. of 
Jacksonville, for 168 oxycodone 30. GX 3, at 7-8. Mr. Parrado testified 
that the prescription presented multiple red flags including ``the 
drug,'' the ``very high quantity,'' that the patient was ``coming from 
Jacksonville . . . over 200 miles'' from Tampa, and that the patient 
was ``paying $1,344 in

[[Page 31327]]

cash.'' Tr. 284. Mr. Parrado then testified that there was ``nothing 
documented'' regarding the pharmacist's attempt to resolve the red 
flags. Id.
    After Respondent ``object[ed] to the repetitive nature of this,'' 
the ALJ asked Mr. Parrado if he had found ``the same kinds of red 
flags'' throughout the Exhibit. Id. at 285. Mr. Parrado answered 
``[y]es.'' Id. The ALJ then asked Mr. Parrado if he had also found that 
``the failure to resolve the red flags is documented on the documents 
there?'' Id. Mr. Parrado answered ``[y]es.'' However, after the ALJ 
asserted that ``[t]hat seems to address all of Exhibit 3,'' the 
Government advised the ALJ that there were ``some differences.'' Id.
    The Government then questioned Mr. Parrado about two prescriptions 
which were issued on May 22, 2102 by Dr. C. (also of 24th Century) to 
L.B. of Dover, Florida, which the latter filled the same day. GX 3, at 
11-14. The prescriptions were for 168 oxycodone 30 and 84 Dilaudid 8 
mg. See id. Asked by the Government whether the combination of these 
two drugs raised a red flag, Mr. Parrado testified that ``that's a 
major red flag in that you have two immediate use opioids being 
dispensed at the same time. The practice is never to dispense two 
immediate use opioids at once, at the same time for the same patient.'' 
Id. at 286. Mr. Parrado then testified that both of the drugs were 
immediate release, and upon being asked if there was a way to resolve 
this red flag, Respondent objected to the testimony, arguing that it 
was beyond the scope of the Government's Prehearing Statement. Id. at 
287.
    The ALJ overruled the objection, explaining that ``I'd like to 
know.'' \32\ Id. Mr. Parrado then testified that he could not resolve 
the red flag, and that while it was proper therapy to prescribe a 
``long-acting opioid, like OxyContin'' and an immediate release drug 
``such as hydromorphone for breakthrough,'' using ``two immediate use 
opioids[,] [y]ou just don't do that.'' Id. Here again, Respondent 
objected on the ground that the opinion was beyond the scope of Mr. 
Parrado's expertise because he is not a physician. Id. at 287-88. The 
ALJ overruled the objection. Id. at 288.
---------------------------------------------------------------------------

    \32\ As discussed above, the Government failed to provide 
Respondent with constitutionally adequate notice on this issue. See, 
e.g., Pergament United Sales, 920 F.2d at 135 (``The primary 
function of notice is to afford [a] respondent an opportunity to 
prepare a defense by investigating the basis of the complaint and 
fashioning an explanation that refutes the charge of unlawful 
behavior.'').
---------------------------------------------------------------------------

    On May 22, 2012, Respondent filled prescriptions for 168 oxycodone 
30 and 56 Dilaudid 8 issued by Dr. S.A.H. (of 24th Century) to V.B., 
who has the same last name and lived in the same town as L.B.\33\ GX 3, 
at 15-18. Asked whether ``seeing these prescriptions together,'' there 
were ``additional red flags,'' Mr. Parrado testified that ``the fact 
that two people from essentially the same address were coming together 
with the same last name for the same drugs which were two immediate use 
opioids from the same clinic . . . I would have found that 
unresolvable.'' Tr. 289-90. Mr. Parrado then testified that he found no 
evidence that the red flags were resolved. Id. at 290.
---------------------------------------------------------------------------

    \33\ Mr. Parrado noted that while the prescriptions for L.B. and 
V.B. indicated that they lived on different streets, they had the 
same house number. Tr. 288. While Mr. Parrado then suggested that 
``may have been just a typo,'' id., the Government offered no 
further evidence to corroborate this testimony.
---------------------------------------------------------------------------

    On October 22, 2012, Dr. V.S. (who, according to the prescription 
was then working at the MD Plus Clinic in Lakeland), issued a 
prescription for 168 oxycodone 30 to J.P., whose address (which again 
was not written on the prescription) was in Ft. Walton Beach, Florida; 
Respondent filled the prescription the same day. GX 3, at 19-20. Upon 
being asked ``what kind of route J.P. [would have] follow[ed] if he 
came from home, went to the doctor's office in Lakeland and then went 
to Tampa'' to fill the prescription, Respondent objected on the ground 
that the testimony would be speculative because Dr. V.S. could legally 
prescribe at any place in the State. Tr. 293-94. After the ALJ 
overruled the objection, Mr. Parrado testified that while he did not 
``know the exact route [J.P.] took . . . the triangle between . . . the 
three places is very large [and] would have to be resolved.'' Id.
    On October 23, 2012, Dr. V.S. (of the MD Plus Clinic) issued a 
prescription to K.B. of Jacksonville, for 168 oxycodone 30; Respondent 
filled the prescription on November 7, 2012. GX 3, at 21-22. On October 
22, 2012, Dr. R.R. (of the 24th Century Medical Center) issued a 
prescription to R.B. of Milton for 168 oxycodone 30; Respondent filled 
the prescription on November 1, 2012. Id. at 23-24. Mr. Parrado 
testified that both prescriptions presented the same red flags that he 
had previously discussed. Tr. 295-96.
    On November 5, 2012, Dr. H.D. (of the 24th Century Medical Center) 
issued a prescription to J.S. of Panama City Beach, for 180 oxycodone 
30; Respondent filled 120 tablets of the prescription the same day. GX 
3, at 25-26. Asked where Panama City Beach is in relation to Tampa, Mr. 
Parrado testified that it is located in the ``extreme western part of 
the Florida panhandle'' and 450 miles from Tampa. Tr. 297.
    Notably, the prescription contains a handwritten notation: ``120 
per pat'' with the rest of the word obscured by the address sticker, 
below which is the date and time. GX 3, at 25. According to Mr. 
Parrado, ``this was the only form of any kind of notation or 
documentation I saw on any of the records showing that they did 
document at one point and the only thing they documented was that they 
shorted the person pills.'' \34\ Tr. 298. Mr. Parrado further noted 
while the address on prescription listed Panama City Beach as J.S.'s 
town of residence, the sticker attached to the prescription, as well as 
the dispensing label, listed her town of residence as Port Charlotte, 
which is in the ``opposite direction'' from Tampa. Id.
---------------------------------------------------------------------------

    \34\ Mr. Parrado further testified that it is common practice to 
make a note on the prescription when pharmacist does not provide a 
patient with the entire quantity of the prescription. Id. at 299.
---------------------------------------------------------------------------

    On November 5, 2012, Dr. R.R. (24th Century) issued a prescription 
to A.R. for 180 oxycodone 30; Respondent filled the prescription the 
same day. GX 3, at 27-28. While the prescription lists the patient's 
address as Lawtey, Florida, both the address sticker attached to the 
prescription and the dispensing label list A.R.'s address as in 
Gainesville, Florida. Id. Over Respondent's objection (on grounds of no 
notice), Mr. Parrado testified that this was an additional red flag and 
the ``difference . . . should have been documented.'' Tr. 300-01.
    On April 23, 2012, Dr. S.A.H. (24th Century) issued a prescription 
to T.P. of St. Augustine, Florida for 180 oxycodone 30; Respondent 
filled the prescription the same day. GX 3, at 29-30. Noting that Saint 
Augustine is located ``just below Jacksonville'' in ``the upper 
northeast corner of Florida,'' Mr. Parrado testified that ``the 
distance'' between T.P.'s residence and Respondent was a red flag. Tr. 
301-02.
    Also on April 23, 2012, Dr. P.C. (24th Century) issued a 
prescription to A.W. of Mayo, Florida, for 200 oxycodone 30; Respondent 
filled the prescription the same day. GX 3, at 31-32. Mr. Parrado 
testified that Mayo is located 150 to 200 miles from Tampa and that 
this was a red flag ``along with all the other things,'' including 
``the drug and the price paid,'' which was $1,400. Tr. 302-03; GX 3, at 
32.
    On April 23, 2012, Dr. P.C. issued a prescription to D.T. of 
Gainesville for 190 oxycodone 30; Respondent filled the prescription 
the same day. GX 3, at

[[Page 31328]]

33-34. Also on April 23, Dr. S.A.H. issued a prescription to J.S. of 
Tallahassee for 168 oxycodone 30; Respondent filled the prescription 
the same day. Id. at 35-36. Mr. Parrado testified that neither 
prescription raised ``any additional red flags'' beyond those he had 
previously discussed. Tr. 303. However, on further questioning, he 
testified that Tallahassee is 250 to 260 miles from Tampa.\35\ Id. at 
303-04.
---------------------------------------------------------------------------

    \35\ Respondent objected to Mr. Parrado's testimony regarding 
the distances from Mayo to Tampa and Tallahassee to Tampa on the 
ground that this testimony was not disclosed in advance of the 
hearing. Tr. 302-03. In its Pre-Hearing Statement, the Government 
did disclose that Mr. Parrado ``will . . . testify regarding large 
quantities of oxycodone distributed by Respondent on April 23, 2012, 
to at least twelve persons . . . and four of them (T.P., A.W., D.T., 
and J.S.) resided more 100 miles from Respondent's pharmacy.'' ALJ 
Ex. 7, at 5 (No. 15-7). Respondent thus had notice that the distance 
between it and the residences of the patients would be at issue even 
if the Government did not disclose that Mr. Parrado would testify as 
to the precise distances.
---------------------------------------------------------------------------

    On November 2, 2012, Dr. R.R. issued a prescription for 112 
Dilaudid 8 mg to T.N., which Respondent filled the same day. GX 3, at 
37-38. Of note, while the prescription as prepared by Dr. R.R. listed 
T.N.'s address as being in Port Salerno, Florida, both the address 
sticker placed on the front of the prescription and the dispensing 
label listed an address in Gainesville. See id. Mr. Parrado testified 
that this was a red flag, as was the high dose of the prescription (32 
mg per day), which was ``above the 24 milligram upper dose 
recommendation.'' Tr. 304.
    The final prescription in the exhibit was issued on November 5, 
2012 by Dr. H.D. to K.P. of Spring Hill for 140 Dilaudid 8 mg. GX 3, at 
39-40. Asked the same question as with previous prescription (``How 
about the drug and the amount?''), Mr. Parrado testified: ``[t]he 
answer will be the same.'' Tr. 304. Thereafter, the Government moved 
Exhibit 3 into evidence in the Superior II matter, and the ALJ admitted 
the exhibit. Id. at 305.
    The Government then moved to admit into evidence its Exhibits 4 and 
14. Id. The former is a compilation of 25 additional prescriptions for 
oxycodone 30 and Dilaudid 8 mg, which was offered to show additional 
instances in which patients presented the ``red flag of long distance'' 
between their residence, the prescriber, and Superior II. Id.; see also 
GX 4 (No. 15-7). The latter is a collection of MapQuest maps and 
printouts showing the distances between the patient's residence, the 
prescriber, and Superior II. Id.; see also GX 14 (No. 15-7). Both 
exhibits were admitted over Respondent's objection.\36\ Tr. 305-06.
---------------------------------------------------------------------------

    \36\ With respect to the MapQuest printouts, Respondent did not 
object based on authenticity, but rather on lack of foundation, 
arguing that ``there are ways to set parameters to avoid highways, 
to take the shortest route, to take the fastest route.'' Tr. 307. 
The objection is not without some merit. However, given the 
distances of the patients from the prescribers and Superior, any 
differences in mileage or driving time which would be caused by 
choosing between these two parameters is not significant enough to 
be material.
---------------------------------------------------------------------------

    As for the prescriptions in GX 4, Mr. Parrado testified that they 
all presented the red flag of the patients travelling long distances. 
Tr. 308. He further testified that he used Google to ``get an 
approximation of the mileage'' for those cities for which he did not 
know the exact mileage. Id. at 310.
    Asked by the Government whether he had seen any evidence that 
Superior II's pharmacists attempted to resolve the red flags presented 
by the prescriptions in both its Exhibits 3 and 4, Mr. Parrado 
testified that ``[t]he only documentation I saw was that shortage of 
tablets. That's the only thing I saw documented anywhere.'' Tr. 312. 
With respect to these prescriptions, Mr. Parrado then testified that he 
did not ``see any evidence'' that the dispensing pharmacist had 
complied with his/her corresponding responsibility to ensure that 
prescriptions were issued for a legitimate medical purpose. Id.
    The Government concluded its direct examination of Mr. Parrado, 
asking him--over Respondent's objection--whether the pharmacists, who 
filled the prescriptions in GXs 3 and 4, ``knew or had reason to know 
that the prescriptions were being issued without a valid doctor/patient 
relationship?'' Id. at 313-14. Mr. Parrado answered:

    All these red flags would have caused me concern to where I had 
to call that physician to verify all these things.
    And at that point I would have to use my professional judgment 
and whether or not even though possibly faced with what could 
ostensibly be a valid prescription I should know or either knew or 
should have known that these were being used . . . for not a 
legitimate medical purpose, just based on all the red flags that are 
present.
    So even if the doctor had told me, yes, he did fill it, I would 
still, I still would not have filled them.

Id. at 314-15.

    On cross-examination, Mr. Parrado adhered to his earlier testimony 
that if the resolution of a red flag was not documented on the 
prescription, ``it wasn't done.'' Id. at 316. While Parrado 
acknowledged that he did not know whether Florida law requires that 
this be documented on the prescription, he testified that ``[i]t's been 
standard practice since I've been practicing for 43 years.'' Id. He 
further acknowledged that DEA does not require that the resolution of a 
red flag be documented on the face of the prescription. Id. at 318. And 
he also acknowledged that in rendering an opinion as to whether another 
pharmacist had properly exercised his professional judgment in deciding 
to dispense a controlled substance, it is important to understand the 
circumstances, including whether the pharmacist has a history with the 
prescriber of the prescription. Id. at 321.
    Asked by Respondent whether he ``wouldn't think twice about'' a 
prescription he received from a reputable prescriber which was missing 
the patient's address, Mr. Parrado testified that ``I would do 
something to address that and fix it.'' Id. Asked if he would then go 
into his pharmacy software and use the information to put an address 
label on the prescription and that this would not cause him ``to be 
concerned about diversion,'' Mr. Parrado answered: ``Not if I knew the 
patient. And there's always a circumstance where it [the prescription] 
could be good.'' Id. at 321-22.
    When then asked whether ``one of those circumstances would be if 
you knew the prescribing practitioner and . . . . [his] practice[] and 
. . . protocols and . . . knew that when you called them [he] answered 
your questions about the diagnoses and the reasons for things,'' the 
ALJ, without any objection by the Government, stated that he would not 
allow Mr. Parrado to answer the question because there was ``no 
evidence that the Respondent, through any of its pharmacists, did 
that.'' Id. at 322. Even after Respondent argued that it was a 
hypothetical question and that Mr. Parrado ``was proffered as an 
expert'' and had testified that he had asked for additional information 
from DEA and been denied it, the ALJ adhered to his ruling. Id. at 322-
23.
    However, Mr. Parrado subsequently agreed with Respondent that in 
trying to determine whether a red flag had been resolved, it is 
``important to know what the pharmacist knew about'' the patient. Id. 
at 324. Mr. Parrado testified that he had asked for the patient 
profiles for the Superior II patients and that the Government told him 
not to look at those. Id. at 324-25. Mr. Parrado then acknowledged that 
a patient profile would show the complete history of prescriptions 
filled by the pharmacy in the period for which it was run and would 
show whether the patient was also receiving non-controlled drugs. Id. 
325. He also acknowledged that the patient profile would be important 
in

[[Page 31329]]

determining whether the patient was opioid na[iuml]ve or tolerant. Id.
    Mr. Parrado then testified that he was given some ``partial medical 
records,'' and that these showed that ``these people were on multiple 
controlled substances [and] not just the prescriptions that were given 
to me.'' Id. He then added that there were ``multiple people from the 
same address getting the exact same cocktails of these drugs.'' \37\ 
Id. at 325-26.
---------------------------------------------------------------------------

    \37\ No evidence established what the cocktails were, let alone 
the strength and dosing of the drugs.
---------------------------------------------------------------------------

    Asked if his opinions were based on these medical records, Mr. 
Parrado testified that the medical records did not form his opinions 
but ``just reinforced'' them, because he did not ``see any 
documentation of conversations between the pharmacy and the clinic'' 
and the records ``showed on a lot of these patients the cocktails.'' 
Id. at 326. After Mr. Parrado testified that the medical records were 
those ``of the prescribing physician,'' Respondent attempted to ask if 
he knew whether a physician is supposed to note a conversation with the 
pharmacist in the chart. Id. The ALJ barred the question, even in the 
absence of an objection of the Government, reasoning that there was no 
evidence that any of Superior II's pharmacists had called the 
prescriber. Id. at 327.
    Mr. Parrado then acknowledged that there is ``no upper limit on the 
amount of an opioid that a patient can develop a tolerance to'' and 
that there is no federal limit on the quantity of a drug that can be 
prescribed. Id. He further testified that whether a prescription is 
medically necessary is patient specific and depends on such factors as 
tolerance, the condition causing the pain, and the duration, intensity 
and frequency of the pain. Id. at 330.
    Asked whether it was per se unlawful to fill an oxycodone 30 
prescription, Mr. Parrado testified that ``I would have to evaluate 
each prescription individually and know that . . . that patient had 
developed that tolerance . . . before I fill it.'' Id. at 331. Then 
asked whether ``[o]xycodone 30 standing alone is not an indicator that 
a prescription'' lacks a legitimate medical purpose, Mr. Parrado 
answered: ``Well, it's the leading drug of abuse on the street. So that 
is the first potential for a red flag.'' Id.
    Mr. Parrado acknowledged that patients have the right to pay for 
their prescriptions in cash and that in some States, the law requires a 
pharmacy to allow a patient to pay in cash. Id. at 332. Mr. Parrado 
then testified that it is ``not so much the paying cash, it's the 
quantity of cash that raised the red flag to me.'' Id.
    While Mr. Parrado agreed that physicians may use a particular drug 
as their default option in treating a patient such as in prescribing a 
cholesterol-lowering medication, he disagreed that this practice also 
applies to pain management. Id. at 333. As he explained: ``how you 
treat diabetes, blood pressure, . . . cholesterol therapy, those are 
relatively standard therapies. But not in pain, pain has to be 
individualized, starting low and going slow as you reach the proper 
limit'' of dosing. Id. Respondent then asked if the fact that a 
prescriber tends to prescribe one drug over another for pain patients 
``is not necessarily indicative of diversion, is it?'' Id. at 334. Mr. 
Parrado answered: ``It becomes a cause for concern when it's always the 
number one known drug of abuse on the streets. That's where it becomes 
a concern. And in oxycodone and Percocet, there's a very low dose, it's 
only five milligrams, whereas . . . oxycodone 30 presents a different 
issue.'' Id.
    Asked if when he verified the identity of a person filling a 
prescription, he would place a photocopy of the patient's 
identification on the prescription, Mr. Parrado acknowledged that ``[a] 
lot of times we did,'' or we had ``another page with it,'' or we 
``scanned it into our computer where it showed up as part of that 
patient's profile.'' Id. at 336. When, however, Respondent asked Mr. 
Parrado if ``it would be appropriate for certain types of verifications 
and resolving of red flags to keep, say for example, a photo ID in an 
electronic file of a pharmacy, particularly in the age of computers,'' 
the ALJ intervened--again, in absence of an objection by the 
Government--and disallowed the question, explaining that ``whether it's 
appropriate or not, there is nothing before me that suggests that that 
was kept.'' Id. at 337.
    Mr. Parrado subsequently agreed with Respondent that ``not every 
failure to catch a red flag is intentional'' and that pharmacists can 
make mistakes. Id. at 337-38. While he agreed that a pharmacist may 
make mistakes in dispensing drugs, he then explained:

    The question is that it doesn't happen over and over and over 
and over, which was my concern in this case and the records I was 
looking at. Could a person come from a long distance once? Sure. 
Does it happen every day from a long distance multiple times? No.

Id. at 338.

    Turning more specifically to the prescriptions filled by Superior 
II, Mr. Parrado reiterated that he did not interview any of the 
patients or prescribers, as well as that DEA did not provide him with 
any statements made by the patients or information about the patients' 
conditions. Id. at 339. Asked whether it would be appropriate for a 
pharmacist, who knew the address placed on the prescription by the 
prescriber was incorrect, to verify the patient's address and place a 
sticker on the prescription with the correct address, Mr. Parrado 
answered: ``I would want to document that I had . . . addressed that 
question . . . and then put [the sticker] on there.'' Id. at 341. He 
then maintained that while the stickers were placed on the 
prescriptions, he did not know that the pharmacists had verified the 
patients' addresses. Id. Asked whether it is appropriate for a 
pharmacist to add the address to the prescription when the physician 
did not include it, Mr. Parrado testified: ``[a]fter consultation with 
the physician.'' Id. at 342. When then asked if a DEA letter addressing 
the prescribing of schedule II drugs ``says that,'' Mr. Parrado 
testified that Florida law (Chapter 893) ``says that you verify with 
the prescriber,'' before acknowledging that a DEA letter ``does not say 
that.'' Id.
    Mr. Parrado agreed with Respondent that it would be permissible for 
a physician to prescribe pain medicine to ``two people who share a 
residence'' and who ``have chronic pain due to a car accident.'' Id. at 
343-44. Asked whether ``if the prescriptions were legitimate, it would 
be permissible for a pharmacy to fill'' them, Mr. Parrado answered that 
it would be as long as the pharmacist had resolved the red flag and 
documented it. Id. at 344.
    As for the ``partial medical files'' he reviewed, Mr. Parrado could 
not answer as to how many of them were for Superior II's patients. Id. 
at 344. As for why he was provided with partial and not the full files, 
Mr. Parrado explained that it was his understanding that the files 
``came from the Respondent to DEA who sent them to me.'' Id. at 345.
    Mr. Parrado acknowledged that as long as a prescriber is registered 
within a State, he can prescribe from anywhere in the State. Id. at 
346. He then acknowledged that he had not looked into whether any of 
the prescribers had issued the prescriptions from locations other than 
where they were registered. Id. at 347.
    Regarding the prescription issued to J.S. for 180 oxycodone 30 but 
which was only filled for 120 tablets, see GX 3, at 25, Mr. Parrado 
acknowledged that a pharmacist can change the quantity in consultation 
with the prescriber. Tr. 347. As for the prescription issued to T.N. 
for Dilaudid which listed her address as Port Salerno but the address

[[Page 31330]]

and dispensing labels listed her address as Gainesville, GX 3, at 37-
38; Mr. Parrado agreed that the prescription did not present the red 
flag of a different address when it was presented to the pharmacy and 
that the sole red flag was the distance.\38\ Tr. 352. He then agreed 
that ``it is not a red flag for a pharmacist to affix the correct 
address to a prescription that contains an incorrect address,'' before 
adding that he ``would have documented'' his reason for ``changing the 
address.'' Id. at 353. However, on re-direct regarding the same 
exhibit, Mr. Parrado testified that if a patient presents a 
prescription which lists a different address for the patient from that 
in the pharmacy's records, this needs to be investigated and there was 
no evidence that the disparity was investigated. Id. at 362.
---------------------------------------------------------------------------

    \38\ Contrary to the question, Mr. Parrado had earlier 
identified the dosage as a red flag. Tr. 304.
---------------------------------------------------------------------------

    After Mr. Parrado noted that some of the partial medical records 
contained an opioid contract that required the patient to fill the 
prescriptions at one pharmacy, that being Respondent, he then 
acknowledged ``that there are a number of experts who believe that the 
one doctor, one pharmacy, one patient is the best way to prevent 
diversion when it comes to pain management.'' Id. at 355. And he agreed 
that ``[a]s long as everybody's doing their obligations,'' this 
approach is in ``the best interests of the patient.'' Id. He also 
acknowledged that Florida law requires the use of a pain management 
contract, and that the contract is supposed to identify where the 
prescriptions will be filled. Id. at 356.

Evidence Regarding the Audits and Recordkeeping Allegations

    Next to testify for the Government was a Diversion Investigator 
(DI) who participated in the execution of the Administrative Inspection 
Warrant at Superior I. Id. at 370-71. The DI testified that at the time 
of the hearing, he had been a Diversion Investigator for more than five 
years and that he had conducted approximately 130 pharmacy inspections. 
Id. at 368-69. He also testified that he had received training in how 
to conduct controlled substance audits as part of his training to 
become a DI. Id. at 390.
    According to the DI, ``we collected original prescriptions,'' as 
well as DEA 222s (schedule II order forms), invoices and inventory 
records. Id. at 372. He also ``conducted the closing inventory'' and 
``helped package the documents and all controlled substance related 
records.'' \39\ Id. The DI testified that he conducted an audit of 
Superior I's handling of controlled substances and prepared a 
computation chart. Tr. 373; see also GX 4 (No. 15-6).
---------------------------------------------------------------------------

    \39\ Asked whether he had any knowledge as to whether Superior 
I's computer records were electronically copied, the DI testified 
that while he did not handle that, he believed that digital evidence 
was collected. Tr. 372.
---------------------------------------------------------------------------

    With respect to the closing inventory, the DI testified that this 
involved a count of the drugs the pharmacy had on hand at the time of 
the inspection and that he was assisted by the pharmacist in performing 
the closing inventory. Id. at 373-74. He also testified that he used 
the pharmacy's ``bi-annual [sic] inventory'' which was dated May 2, 
2011 (beginning of business),\40\ and used this as the beginning date 
of the audit. Id. at 374-75. As for the closing inventory, the DI 
testified that he counted the drugs on hand ``with the pharmacist,'' 
and that the pharmacist attested to the accuracy of the inventory. Id. 
at 376. The DI further testified that after the warrant was executed, 
he requested additional records through the lead Investigator because 
``the bi-annual [sic] inventory'' which was provided by Superior I when 
the warrant was executed ``did not include all the drugs that were a 
part of the audit.'' Id. at 378. On February 11, 2013, the DI received 
additional inventories which included ``the bi-annual [sic] inventory 
and . . . an in-house inventory conducted by the'' pharmacy. Id. at 
379.
---------------------------------------------------------------------------

    \40\ The DI subsequently explained he used the inventory which 
must be taken every two years (i.e., the biennial), ``which is 
required . . . per regulation 1304.11.'' Tr. 374.
---------------------------------------------------------------------------

    The DI then explained that in conducting the audit he reviewed the 
purchase records, ``the distribution transfers,'' ``any returns,'' and 
``any disposition records'' which included the actual prescriptions.'' 
Id. at 378, 410. Subsequently, with respect to the prescriptions, he 
supervised a team which computed the dispensings, which were counted on 
a monthly basis. Id. at 412-13. The DI also explained that each of the 
team members was a DI, and as such, had been trained in how to conduct 
an audit. Id. at 414.
    According to the DI, ``we use whatever we have as well . . . to 
make cross checks and to verify that there are no inconsistencies.'' 
Id. at 378. Still later, the DI explained that he personally cross-
checked some of the monthly dispensing totals. Id. at 412.
    The DI testified that his audit found that Superior I had shortages 
of multiple drugs. Id. at 380-382. The most significant of these were 
the shortages of 15,560 dosage units (du) of oxycodone 30 mg and 11,951 
du of hydromorphone 8 mg. GX 4 (No. 15-6). In addition, the audit found 
that Superior had shortages of 946 du of hydromorphone 4 mg, 864 du of 
methadone 10 mg, 474 dosage units of morphine sulfate 100 mg ER, and 
447 du of morphine sulfate 30 mg ER.\41\ Id.
---------------------------------------------------------------------------

    \41\ The audit also found an overage of 159 du of morphine 
sulfate 60 mg ER. GX 4 (No. 15-6).
---------------------------------------------------------------------------

    The DI also testified regarding the manner in which Superior I kept 
its Schedule II order forms (DEA 222). According to the DI, one of the 
order forms (GX 5, at 2) should not have been used because the 
pharmacist had lined out the National Drug Code (NDC) number for the 
drug being ordered and added a new NDC number. Tr. 383-84; see also id. 
at 386. The DI testified that according to 21 CFR 1305.15(a)(2), ``any 
alteration or any erasure or change of description should be a cause 
for a DEA 222 form not to be used.'' Id. at 383. The Government then 
asked the DI whether a second order form (GX5, at 3) was filled out 
properly. Id. at 384. The DI answered ``[n]o,'' and explained that 
``the information in regard to the number of package[s] receive [sic] . 
. . was omitted.'' Id.
    On cross-examination regarding the altered order form (GX 5, at 2), 
the DI conceded that according to the regulation, the manufacturer 
should not have filled the order. Tr. 387. Then asked whether there was 
``any problem with the pharmacy having corrected the Form 222, or is 
the problem that the manufacturer filled the order,'' the DI explained 
that ``the regulation says any alteration, any erasure, and that should 
not be used.'' Id. at 387-88. When then asked if it is unlawful to make 
a mistake on the form, the DI testified ``[t]he regulation is clear on 
how to use DEA 222 forms. And [the] DEA 222 form[] states that it 
should not be filled.'' Id. at 388.
    On cross-examination regarding the audit, Respondent's counsel 
asked the DI if there were any spreadsheets that showed how the DEA 
222s were counted and how the dispensings were counted. Tr. 393. The DI 
answered: ``No, I don't have that at this time, sir.'' Id. Then asked 
whether he had ever had such documents ``at any time,'' the DI 
answered: ``I do not recall at this time if I have this or not.'' Id.
    Respondent's counsel then represented that when DEA provided 
Respondent with the CDs (which contained the records obtained from 
them) after the Order to Show Cause was served, the CDs included ``some 
scratch papers.'' Tr. 393. Counsel then

[[Page 31331]]

asked the DI if he ``recall[ed] working out some scratch papers where 
you may have done the math?'' Id. at 393-94. Counsel also advised the 
ALJ that he had copies if it would refresh the DI's recollection. Id. 
at 394. After the DI answered that he did ``not recall this,'' 
Respondent's counsel asked the DI if it would ``refresh [his] 
recollection if [he] looked at the notes?'' Id. The ALJ then 
intervened, stating: ``Documentation, even if it does, this 
documentation is not going to be allowed.'' Id. When Respondent's 
Counsel then argued that ``it's just for impeachment,'' the ALJ 
explained that while Respondent's Counsel could impeach the witness, he 
could not use documents which he did not provide ``ahead of time'' and 
that he had ``an obligation to provide [the documents] as part of the 
response to the Pre-hearing Statement.'' Id. at 394-95.
    Respondent's counsel then asserted that the documents were ``not 
intended to be used as an exhibit'' but ``merely to check the math.'' 
Id. at 395. He further asserted that when he went ``through the DEA 
222s on the [m]orphine [s]ulphate tabs and add them up, all the ones 
that were were returned . . . by the Government, I get to a number of 
7,200. And what I'm trying to figure out is whether or not there are 
any supporting documents where we can see your math to see if you got 
it correct.'' Id. After the Government objected that Respondent's 
counsel was testifying and the ALJ expressed his agreement with the 
Government, Respondents' counsel stated that he wanted to present the 
222s to the DI and ``walk through the math together and see if Your 
Honor comes to the same number that they [sic] do.'' Id. at 396. The 
ALJ ruled that because Respondent's counsel ``didn't [timely] present 
the 222s as evidence,'' he would not allow the question. Id.
    Then asked whether he did his calculations ``by hand'' or by 
creating a spreadsheet, the DI testified that he could not recall what 
procedure he used because he did the audit two years earlier. Id. at 
396-97. Asked if he used only the hard copy 222s or also used the 
electronic order records, the DI testified that he ``used all the DEA 
222s that were there[] and there were some CSOS'' (electronic orders) 
as well. Id. at 397. The DI subsequently explained that the electronic 
orders were printed out and that he used the paper copy of these. Id. 
at 401. Then asked whether he did anything to control for math errors, 
the DI testified that he ``reviewed [his] counts on many occasions'' 
and ``did some cross checks'' with ``other documents provided by the 
pharmacy.'' Id. at 402. The DI also testified that he cross-checked 
Respondent's purchases by using ARCOS data,\42\ but because some 
distributors report only every quarter, he could only check 
approximately 95 percent of the purchase data. Id. at 402-04.
---------------------------------------------------------------------------

    \42\ See 21 CFR 1304.33 (setting forth ARCOS reporting 
obligations imposed on manufacturers and distributors).
---------------------------------------------------------------------------

    The Government called another DI, who testified regarding the 
execution of the AIW at Superior II and the subsequent audit of its 
handling of controlled substances. Id. at 469, 471. The DI testified 
that she delivered the warrant to the pharmacy manager and did a 
closing inventory. Id. at 471. She then asked for the purchasing 
records and the hard copy controlled substance prescriptions. Id. at 
472. The DI testified that she was familiar with patient profiles and 
that no patient profiles were obtained during the execution of the 
warrant. Id. at 473.
    The Government then asked the DI about a number of Superior II's 
schedule II order forms. Id. at 473-74. Regarding the orders forms in 
GX 6 (No. 15-07), the DI testified that the forms were not filled out 
properly, as ``[t]hey are missing the number of packages received and 
date received on some of the lines on each form.'' Id. at 474. With 
respect to the first form in the exhibit, which had two line entries, 
each for 12 packages of 100 count of oxycodone 30, she identified line 
two as not being properly completed, apparently because it did not list 
the number of packages received and the date received. Id.
    Turning to the second form, she also identified the second line of 
the form as not being properly completed, apparently because it did not 
list the number of packages received and the date received. Id. 
However, the first two forms have the same serial number, thus 
establishing that one of them is a duplicate. Compare GX 6, at 1, with 
id. at 2.
    As for the next four forms, the DI testified that each was a copy 
and not the original and was thus a violation. Tr. 474-75; see also id. 
at 521. With respect to several of the remaining forms in the exhibit, 
she identified that for several of the line items there was no notation 
that ``no packages [were] received or date received.'' Id. at 475; see 
also id. at 476.
    However, on cross-examination, the DI testified that she relied on 
the entries on the forms maintained by Respondent and did not verify 
whether every line on the 222s had been actually shipped by the 
distributors. Id. at 518. While the DI acknowledged that sometimes 
distributors don't ship an entire order at once, she then testified 
that ``after 60 days, the 222 is invalid'' and the purchaser ``should 
go back and put a zero and the date they put the zero'' on the form. 
Id. at 520. However, when asked where, in the Pharmacist's Manual, it 
instructs registrants to do this, the DI answered: ``I couldn't tell 
you which page. But it does say they have to complete the 222 forms.'' 
Id. When then asked where in the regulation it says that, the DI stated 
that she did not ``know the specific quotation.'' Id.
    Moving back to the audit, the DI testified that ``we asked for 
purchasing records \43\ and dispensing records, and that the hardcopy 
original prescriptions \44\ were used as the dispensing record.'' Id. 
at 477. As the starting point of the audit, the DI testified that she 
``asked when their last physical count was. And we used the July 31st, 
2012. And the pharmacist got the numbers from their perpetual 
inventory.'' Id. On cross-examination, the DI reiterated her earlier 
testimony that she ``did not ask for perpetual inventory numbers. I 
asked for an actual physical count of those seven drugs.'' Id. at 491. 
She then explained that Superior II's employees ``told me that they 
take physical counts very frequently'' and that she ``asked them when 
their most recent one was that was at least six months'' old, ``[a]nd 
these were the numbers I was given.'' Id. at 491-92. As for the closing 
inventory, the DI testified that the pharmacist ``counted the pills, 
and I witnessed.'' Id. at 477.
---------------------------------------------------------------------------

    \43\ On cross-examination, the DI testified that she used both 
the paper and electronic 222 forms in doing the audit. Tr. 504. She 
also testified that ``[w]e always ask if there's been any theft or 
loss, returns, or if they have any outdated drugs.'' Id. She then 
testified that she specifically recalled asking a pharmacist for 
these records. Id. at 505.
    \44\ The DI testified that she asked for the hard copy Schedule 
II prescriptions for the period of January 1, 2011 through October 
31, 2011, and from December 1, 2012 to the date of the warrant, 
February 4, 2013. Tr. 515. She also testified that ``I asked for 
specific date ranges, because there had been a notice of inspection 
prior to the admin. inspection warrant. So I asked for different 
date ranges.'' Id. at 514. The DI then explained that she did not 
participate in the prior inspection. Id.
---------------------------------------------------------------------------

    According to the DI, the audit found that Superior II was short 40 
du of hydromorphone 4 mg and had an overage of 2,576 du of 
hydromorphone 8 mg. Id. at 479. As for the other drugs, the audit found 
overages of 1,189 du of oxycodone 30 mg, 896 du of methadone 10 mg, 674 
du of morphine sulfate 30 mg, 563 du of morphine sulfate 60 mg, and 426 
du of morphine sulfate 100 mg. GX 12. According to the DI, ``[a]n 
overage indicates that all records either

[[Page 31332]]

were not maintained or not provided.'' Tr. 480.\45\
---------------------------------------------------------------------------

    \45\ Respondent objected to the admission of the computation 
chart, arguing that the opening inventory was based on Superior II's 
perpetual inventory, which it is not lawfully required to maintain. 
Tr. 483. The ALJ overruled the objection. Id. While there is no 
requirement to maintain a perpetual inventory, there is no 
requirement that the Government use only an actual hand counted 
inventory in establishing the quantities on hand on the beginning 
date of the audit period. Indeed, at times, a pharmacy is entirely 
missing the required inventory and the DIs use zero as the opening 
inventory.
     Most significantly, Respondent ignores that the DI testified 
multiple times that she asked for an actual physical count which was 
at least six months old and used what Superior II gave her.
---------------------------------------------------------------------------

    On cross-examination, the DI testified that she did not do any 
interviews and was not present during any interviews. Id. at 485. She 
further testified that she did not notify Superior II of the audit 
results and did not know whether another DI had done so. Id. at 486. 
She also testified that she did not do any further investigation into 
Superior II other than to review the records that were obtained and to 
complete the audit. Id. at 487.
    On further cross, the DI testified that in performing the audit, 
she did not compare the 222 forms she obtained from Superior II with 
those its suppliers provided to the Agency.\46\ Id. at 501. She also 
testified that she could not recall if she obtained ARCOS data to 
verify whether the documents obtained pursuant to the warrant contained 
``accurate information,'' explaining that ``[w]hen we conduct [an] 
audit, it is the registrant's responsibility to provide all 
documents.'' Id. at 502. Subsequently, the lead investigator on the 
matter testified that she did not instruct anyone working on the 
investigation to ``consult ARCOS'' or to look at either the paper or 
electronic 222 forms that had been sent to the Agency.\47\ Id. at 583.
---------------------------------------------------------------------------

    \46\ Pursuant to 21 CFR 1305.13(d), ``[t]he supplier must retain 
Copy 1 of the DEA Form 222 for [its] files and forward Copy 2 to the 
Special Agent in Charge . . . in the area in which the supplier is 
located.''
    \47\ The evidence also showed that only the DI and the lead DI 
``handled the prescription records and the 222s.'' Id. at 584.
---------------------------------------------------------------------------

    The DI further testified that she kept track of the serial numbers 
on the 222s by spreading them out on a desk but did not ``make a 
document.'' Id. at 505. Respondent's counsel then asked her if she had 
considered several orders which he identified by drug, quantity, date, 
and the order form number. Id. The DI responded to these questions 
stating that if the record was provided, it was considered. Id. at 505-
08.
    Subsequently, the DI acknowledged that pharmacy personnel filling a 
prescription could make an error when counting the pills. Id. at 512. 
She then identified another DI who was involved in calculating the 
dispensing totals for the audit, as well as the pharmacy's receipts. 
Id. at 513.
    The Government's final witness was a DI from the Tampa office with 
19 years of experience as such, who was the lead investigator in the 
Superior II matter. Id. at 539-40; 558. She testified that on November 
30, 2012, she participated in a Notice of Inspection at Superior II, 
which she explained involved ``go[ing] on-site and advis[ing] the 
registrant that we're going to be doing an audit of their controlled 
substance records.'' Id. at 541. She further testified that during the 
Notice of Inspection issued to Superior II, ``[w]e obtained records, 
purchase records, and dispensing records which consisted of the 
prescriptions.'' Id.
    The DI testified that she was not present at Superior II when the 
AIW was executed. Id. at 542. However, she did review the records 
seized from Superior II to include its purchases and dispensing 
records. Id. at 543. She also testified that no patient profiles were 
taken during the November 30 inspection and that when she reviewed the 
records obtained from Superior II pursuant to the AIW, she did not see 
any patient profiles. Id. at 544. Subsequently, she testified that the 
records she told Mr. Parrado that he could not review were the records 
she obtained from the State's Prescription Drug Monitoring Program. Id. 
at 546-48. And later, on cross-examination, she clarified that Mr. 
Parrado did not get the PDMP records. Id. at 559. She also testified 
that she did not provide the ``partial medical records'' to Mr. 
Parrado, id. at 577, and that the records were provided by Government 
Counsel.\48\ Id. at 578.
---------------------------------------------------------------------------

    \48\ Later, on re-direct, the Government asked the DI if she had 
``ever subpoenaed any medical records from any clinics owned by Mr. 
Obi-Anaduime?'' Tr. 589-90. The DI testified that ``[o]n the same 
day of the administrative inspection warrant, we issued subpoenas 
for the clinic, 21st [sic] Century.'' Id.
---------------------------------------------------------------------------

    Thereafter, the DI acknowledged that various notations made on the 
Superior II order forms were her initials and that she did not keep a 
clean copy of the documents. Id. at 549. According to the DI, when she 
reviews records, she ``will usually initial it in some way or the other 
just to let me know that I did review that record.'' Id. She testified 
that the 222s that were returned to Respondent had her initials on 
them. Id. at 550.
    Turning to Superior's II ordering of controlled substances using 
the Controlled Substances Order System (CSOS), the DI testified that 
during the November 30, 2012 inspection, she met with a pharmacist (Mr. 
Majed) and asked to see its primary records for the receipt of 
controlled substances. Id. at 551. According to the DI, Mr. Majed 
stated ``that once he gets the orders he inputs it into the system[,] . 
. . places the order[,] . . . then . . . prints out'' the form, and 
upon receipt of ``the product, he jots it down where it says packages 
shipped and packages and dates shipped. So I said this is your receipt. 
After you receive them manually,'' at which point Respondent 
objected.\49\ Id. at 551-52. After the ALJ overruled the objection, the 
DI testified that when she asked Mr. Majed what he did once he received 
product, Mr. Majed said that ``he notates [the receipt of product] on 
this paper form'' and that he did not go back into the CSOS and enter 
the receipt because ``he wasn't aware that he had to do that.'' Id. at 
554. She then asked Mr. Majed if the paper records were the ``primary 
records'' and was told ``yes.'' The DI then testified that these were 
the records she used for the audit. Id.
---------------------------------------------------------------------------

    \49\ Respondent objected on the grounds of hearsay and the lack 
of notice. As for the latter objection, this was based on the 
Government having been ``aware of [Mr. Majed's] participation in 
this and [it] gave us no notice in [its] pre-hearing statement that 
[it] intended to have this witness testify about things that he 
said.'' Tr. 552. Respondent did, however, have notice of the issue 
through the Government's disclosure of the DI's testimony. ALJ Ex. 
6, at 6-7 (No. 15-7) (``She will testify that Respondent, as a 
purchaser of controlled substances via [the CSOS], failed to create 
an accurate record of the quantity of controlled substances received 
and the date received. She will testify that Respondent failed to 
electronically archive and link these records to the original order, 
as required by the . . . [r]egulations.''). As for Respondent's 
objection that the testimony was hearsay, hearsay is admissible in 
these proceedings and Respondent made no argument as to why the 
testimony was unreliable.
---------------------------------------------------------------------------

    Continuing, the Government asked the DI whether a printout of an 
electronic 222 form complied with DEA regulations. Id. at 555. 
According to the DI, the document ``should have been linked'' and was 
the ``supplier's copy'' and not the ``purchaser's copy.'' Id. at 556. 
The DI further explained that ``[y]ou see where it says packages 
shipped? He's not the supplier. He's the purchaser. So that should be 
packages received and date received. What he's showing me here is the 
supplier's copy.'' Id. Moreover, to the DI's knowledge, this record was 
not included in any database. Id.
    The DI further explained that in order for a person to use the 
CSOS, the person has to have a pass key. Id. at 556-57. However, while 
Mr. Majed represented that he had a key, the DI subsequently determined 
that he did not, and that only Mr. Obi (the owner) and another

[[Page 31333]]

pharmacist (Ms. Minozzi) had pass keys. Id. at 557-58.
    On cross-examination, the DI acknowledged that because she had the 
PDMP records she could determine whether the patients were opioid 
tolerant or opioid na[iuml]ve. Id. at 559-60. The DI did not, however, 
use that information. Id. at 560.
    The DI further testified that electronic 222 forms found in 
Government Exhibit 7 were obtained during the AIW, when she was not 
present. Id. at 563. When then asked whether her testimony regarding 
the statements made by Mr. Majed were based on her personal knowledge, 
the DI testified that they were made during the notice of inspection. 
Id.
    The DI also testified that Mr. Majed told her that the handwritten 
notations on printouts of the electronic 222 forms were of the packages 
that the pharmacy had actually received and the date received. Id. at 
567. The DI testified that if Superior II pharmacists had correctly 
documented their receipts of drugs, ``they would have printed out the 
receipt and the receipt date'' on a different form and not used the 
supplier's copy. Id. The DI then testified that the receipt record must 
be electronically linked to the same record that the pharmacy used to 
place the order. Id. at 569.
    Respondent's counsel further attempted to ask the DI if she had 
investigated if Superior II had stopped ordering oxycodone after the 
AIW. Id. at 574. While the Government objected that the question was 
outside the scope, the ALJ initially overruled the objection. Id. 
However, after Respondent re-asked the question with only an immaterial 
change in wording, the ALJ barred the question, on the ground that 
Respondent had not acknowledged any misconduct in its Pre-hearing 
Statement. Id. at 575-77.
    Before the Government rested, it requested a ruling from the ALJ 
clarifying whether Respondents would be allowed to call any witnesses. 
Id. at 594. After the ALJ stated that he agreed with the Government's 
understanding that Respondents would not be allowed to call any 
witnesses, Superior II's counsel stated that he intended to call a 
witness. Id.
    Asked by the ALJ to provide ``the legal basis for . . . Superior II 
to produce any witnesses, given [his] prior orders,'' Superior II's 
counsel stated that ``we have noticed witnesses in the Pre-hearing 
Statement,'' including Mr. Obi-Anadiume. Id. at 595. Again asked to 
explain the legal basis for calling any witnesses, Superior II's 
counsel argued that in its Prehearing Statement, it notified the 
Government that it intended to call ``any and all witnesses identified 
in the Government's Pre-hearing Statement.'' Id. at 597. As to the 
issues that Mr. Obi would testify to, Superior II's counsel argued that 
``the summary of [his] testimony'' was ``covered sufficiently'' by the 
Government in its Prehearing Statement and that ``the Government has no 
prejudice with respect to this.'' Id. at 597-98. Superior II's counsel 
then asserted that because Government counsel had represented in its 
Prehearing Statement that it intended to call Mr. Obi and had 
subpoenaed him, he should be allowed to testify. Id. Superior II's 
counsel further argued that under section 555 of the Administrative 
Procedure Act, Mr. Obi was an interested person who had the right to 
participate in the proceeding, and that ``fundamental fairness'' 
required that he be allowed to testify. Id. at 598-602.
    After Superior II's counsel represented that he was making the same 
motion with respect to Superior I, the ALJ asked if he was relying on 
the Government's Prehearing Statements as his proffer. Id. at 604. 
Superior II's counsel advised that there was one additional matter that 
went beyond the scope of the proposed testimony--``the acceptance of 
responsibility and corrective action.'' Id. at 604. Superior II's 
counsel further represented that he had ``submitted written information 
to [Government Counsel] with language of proposed acceptance of 
responsibility and with specific corrective actions that have already 
been taken, and those that are being taken and those that will be taken 
in the future.'' Id. at 605.
    The ALJ denied the motion, noting that the proffer ``clearly . . . 
exceed[ed] what the Government presented in its Pre-hearing 
Statement.'' Id. at 606. Continuing, the ALJ stated:

    With all due respect to your colleagues, I think these were well 
informed lawyers making strategic decisions to keep as little 
information in the Pre-hearing Statements as possible. And I think 
it ill-served the course of justice and makes this proceeding a much 
more difficult process merely because of a strategic decision to 
keep me in the dark.
    I'm not attributing that to you at all. And I don't expect a 
response, nor will I care to hear a response with respect to that. 
I've already given Mr. Sisco the opportunity to explain why the 
record is as it is in documents that I've received from Respondents.
    And that record will stand, I will address that at another time 
in another forum. But from what you've told me, I don't see a legal 
justification for allowing the Respondent to, in either case . . . 
present testimony.

Id.\50\ The ALJ thus denied Respondents' motion. Id. at 606-07.

    \50\ While the ALJ then offered the Government the opportunity 
to respond to the motion, the Government chose not to. Tr. 607.
---------------------------------------------------------------------------

    Superior II's counsel then sought to allow Mr. Obi to testify by 
asking and ``answering the questions [himself] that are posed in the 
Government's Pre-hearing Statement.'' Id. at 608. The ALJ denied the 
request. Id. Superior II's counsel then sought to take an interlocutory 
appeal of the ALJ's ruling. Id. The ALJ denied the motion. Id.
    Explaining that he wanted to understand how the proffer would be 
done, Superior II's counsel then asked the ALJ if he wished for him 
``to proffer what would be said'' by Mr. Obi. Id. at 609. The ALJ 
responded ``no,'' and explained that Superior II's counsel had given 
him the ``substance of what that information would be.'' Id. Superior 
II's counsel then argued that he should be allowed ``to put the full 
proffer . . . on the record.'' Id.
    In response, the ALJ stated that Superior II's counsel had made ``a 
sufficient proffer,'' noting that he had sought to go ``beyond the 
scope of what the Government covered and enter[] into the area of 
acknowledgment and remediation [which] would not be permitted[,] 
[b]ecause you did not disclose it in advance.'' Id. at 610. The ALJ 
then stated that this told him ``the broad parameters'' and that was 
all he needed ``to preserve your client's right.'' Id.
    Superior II's counsel then explained that his ``statements about 
the Government's Pre-hearing statement and the broader subject matters 
[was] not the proffer [and] that the proffer is substantially broader 
[as] it addresses individual patients, because the Government's Pre-
hearing Statement called for those things.'' Id. at 610-11. Superior 
II's counsel then explained that he understood ``that this may be a 
bifurcated issue where there's a notice issue on acceptance of 
responsibility [and] corrective action,'' but ``no notice issue on 
what's in the Government's Pre-hearing statement but [was] still being 
excluded from the record.'' Id. at 611. Superior II's counsel then 
represented that with respect to ``the matter of what is in the 
Government's Pre-hearing Statement . . . Respondent has an extensive 
proffer about that for the record which would address a wide variety of 
things.'' Id. Continuing, Superior II's counsel explained that his 
previous statements were his ``legal argument rather than the factual 
proffer'' and then asked that he ``be

[[Page 31334]]

permitted to actually make the detailed proffer.'' Id. at 611-12.
    The ALJ rejected the request, explaining that ``[y]ou were 
permitted to do so. That's what the Pre-hearing Statement was for.'' 
Id. at 612. Continuing, the ALJ explained that the record now reflected 
Respondent's proffer and ``that the detailed proffer that you're 
describing was appropriate and was not provided to me in a timely 
fashion. And I believe that was a strategic decision of prior 
counsel.'' Id.
    The Government then rested. Id. at 612-13. Thereafter, Superior 
II's counsel sought to call Mr. Obi. Id. at 614. The ALJ denied the 
request for the reasons he had previously explained.

Discussion

    Under the CSA, ``[a] registration pursuant to section 823 of this 
title to manufacture, distribute, or dispense a controlled substance . 
. . may be suspended or revoked by the Attorney General upon a finding 
that the registrant . . . has committed such acts as would render [its] 
registration under section 823 of this title inconsistent with the 
public interest as determined under such section.'' 21 U.S.C. 
824(a)(4). In the case of a retail pharmacy, which is deemed to be a 
practitioner, see id. Sec.  802(21), Congress directed the Attorney 
General to consider the following factors in making the public interest 
determination:

    (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.

Id.

    ``[T]hese factors are . . . considered in the disjunctive.'' Robert 
A. Leslie, M.D., 68 FR 15227, 15230 (2003). It is well settled that I 
``may rely on any one or a combination of factors, and may give each 
factor the weight [I] deem[] appropriate in determining whether'' to 
suspend or revoke an existing registration. Id.; see also MacKay v. 
DEA, 664 F.3d 808, 816 (10th Cir. 2011); Volkman v. DEA, 567 F.3d 215, 
222 (6th Cir. 2009); Hoxie v. DEA, 419 F.3d 477, 482 (6th Cir. 2005). 
Moreover, while I am required to consider each of the factors, I ``need 
not make explicit findings as to each one.'' MacKay, 664 F.3d at 816 
(quoting Volkman, 567 F.3d at 222); see also Hoxie, 419 F.3d at 
482.\51\
---------------------------------------------------------------------------

    \51\ In short, this is not a contest in which score is kept; the 
Agency is not required to mechanically count up the factors and 
determine how many favor the Government and how many favor the 
registrant. Rather, it is an inquiry which focuses on protecting the 
public interest; what matters is the seriousness of the registrant's 
or applicant's misconduct. Jayam Krishna-Iyer, 74 FR 459, 462 
(2009). Accordingly, as the Tenth Circuit has recognized, findings 
under a single factor can support the revocation of a registration. 
MacKay, 664 F.3d at 821. Likewise, findings under a single factor 
can support the denial of an application.
---------------------------------------------------------------------------

    Under the Agency's regulation, ``[a]t any hearing for the 
revocation or suspension of a registration, the Administration shall 
have the burden of proving that the requirements for such revocation or 
suspension pursuant to . . . 21 U.S.C. 824(a) . . . are satisfied.'' 21 
CFR 1301.44(e). In this matter, while I have considered all of the 
factors, the Government's evidence in support of its prima facie case 
is confined to factors two and four.\52\ For reasons explained below, I 
find the Government's evidence insufficient to establish that 
Respondents' pharmacists violated their corresponding responsibility 
when they dispensed the prescriptions at issue. However, I find that 
the Government has established by substantial evidence that Respondents 
have failed to maintain accurate records, as well as other violations, 
and that it has thus established that Respondents have committed acts 
which render their registrations ``inconsistent with the public 
interest.'' 21 U.S.C. 824(a)(4). Because I further find that 
Respondents did not properly disclose in advance of the proceeding 
their proposed evidence as to any remedial measures, I conclude that 
Respondents have not rebutted the Government's prima facie showing. I 
will therefore order that each Respondent's registration be revoked and 
that any pending application be denied.
---------------------------------------------------------------------------

    \52\ As to factor one, there is no evidence that the Florida 
Department of Health has either made a recommendation to the Agency 
with respect to either Respondent, or taken any disciplinary action 
against either Respondent. See 21 U.S.C. 823(f)(1). However, even 
assuming that each Respondent currently possesses authority to 
dispense controlled substances under Florida law and thus meets a 
prerequisite for maintaining its registration, this finding is not 
dispositive of the public interest inquiry. See Mortimer Levin, 57 
FR 8680, 8681 (1992) (``[T]he Controlled Substances Act requires 
that the Administrator . . . make an independent determination [from 
that made by state officials] as to whether the granting of 
controlled substance privileges would be in the public interest.''). 
Accordingly, this factor is not dispositive either for, or against, 
the revocation of each Respondent's registration. Paul Weir 
Battershell, 76 FR 44359, 44366 (2011) (citing Edmund Chein, 72 FR 
6580, 6590 (2007), pet. for rev. denied, Chein v. DEA, 533 F.3d 828 
(D.C. Cir. 2008)).
     As to factor three, I acknowledge that there is no evidence 
that either of the Respondents, or Mr. Obi-Anadiume, or any of the 
Respondents' pharmacists, has been convicted of an offense under 
either federal or Florida law ``relating to the manufacture, 
distribution or dispensing of controlled substances.'' 21 U.S.C. 
823(f)(3). However, there are a number of reasons why even a person 
who has engaged in criminal misconduct may never have been convicted 
of an offense under this factor, let alone prosecuted for one. Dewey 
C. MacKay, 75 FR 49956, 49973 (2010), pet. for rev. denied MacKay v. 
DEA, 664 F.3d 808 (10th Cir. 2011). The Agency has therefore held 
that ``the absence of such a conviction is of considerably less 
consequence in the public interest inquiry'' and is therefore not 
dispositive. Id.
    As to factor five, no evidence was offered with respect to it.
---------------------------------------------------------------------------

Factors Two and Four--The Respondent's Experience in Dispensing 
Controlled Substances and Compliance with Applicable Laws Related to 
Controlled Substances

The Dispensing Allegations

    ``Except as authorized by'' the CSA, it is ``unlawful for any 
person [to] knowingly or intentionally . . . manufacture, distribute, 
or dispense, or possess with intent to manufacture, distribute, or 
dispense, a controlled substance.'' 21 U.S.C. 841(a)(1). Under the Act, 
a pharmacy's registration authorizes it ``to dispense,'' id. Sec.  
823(f), which ``means to deliver a controlled substance to an ultimate 
user . . . by, or pursuant to the lawful order of, a practitioner.'' 
Id. Sec.  802(10).
    The CSA's implementing regulations set forth the standard for a 
lawful controlled substance prescription. 21 CFR 1306.04(a). Under the 
regulation, ``[a] prescription for a controlled substance to be 
effective must be issued for a legitimate medical purpose by an 
individual practitioner acting in the usual course of his professional 
practice.'' Id. Continuing, the regulation provides that:

    [t]he responsibility for the proper prescribing and dispensing 
of controlled substances is upon the prescribing practitioner, but a 
corresponding responsibility rests with the pharmacist who fills the 
prescription. An order purporting to be a prescription issued not in 
the usual course of professional treatment . . . is not a 
prescription within the meaning and intent of section 309 of the Act 
(21 U.S.C. 829) and the person knowingly filling such a purported 
prescription . . . shall be subject to the penalties provided for 
violations of the provisions of law relating to controlled 
substances.\53\
---------------------------------------------------------------------------

    \53\ As the Supreme Court has explained, ``the prescription 
requirement . . . ensures patients use controlled substances under 
the supervision of a doctor so as to prevent addiction and 
recreational abuse. As a corollary, the provision also bars doctors 
from peddling to patients who crave the drugs for those prohibited 
uses.'' Gonzales v. Oregon, 546 U.S. 243, 274 (2006) (citing United 
States v. Moore, 423 U.S. 122, 135, 143 (1975)).


[[Page 31335]]


---------------------------------------------------------------------------

Id. (emphasis added).

    As the Agency has made clear, to prove a violation of the 
corresponding responsibility, the Government must show that the 
pharmacist acted with the requisite degree of scienter. See JM Pharmacy 
Group, Inc., d/b/a Farmacia Nueva and Best Pharma Corp., 80 FR 28667, 
28669 (2015). Thus, the Government can prove a violation by showing 
either: (1) That pharmacist filled a prescription notwithstanding his/
her actual knowledge that the prescription lacked a legitimate medical 
purpose; or (2) that the pharmacist was willfully blind (or 
deliberately ignorant) to the fact that the prescription lacked a 
legitimate medical purpose. See id. at 28671-72. As to establishing 
that a pharmacist acted with ``willful blindness, proof is required 
that: `(1) the defendant must subjectively believe that there is a high 
probability that a fact exists and (2) the defendant must take 
deliberate actions to avoid learning of that fact.'' Id. at 28672 
(quoting Global-Tech Appliances, Inc., v. SEB S.A., 563 U.S. 754, 769 
(2011)).
    Here, the Government makes no claim that any of Respondents' 
pharmacists dispensed the prescriptions having actual knowledge that 
the prescriptions lacked a legitimate medical purpose. Instead, relying 
primarily on Holiday CVS, L.L.C., d/b/a CVS/Pharmacy Nos. 219 and 5195, 
77 FR 62316, 62341 (2012), the Government argues that a pharmacist 
violates the corresponding responsibility rule when he/she dispenses a 
controlled substance prescription ``in the face of a red flag (i.e.[,] 
a circumstance that does or should raise a reasonable suspicion as to 
the validity of a prescription) unless he . . . takes steps to resolve 
the red flag and ensure that the prescription is valid.'' Gov. Post-
Hrng. Br. 16. The Government argues that each Respondent's pharmacists 
violated this regulation by filling oxycodone prescriptions which 
presented various ``red flags'' which were never resolved. Gov. Post-
Hrng. Br. 15-18. Noting that its pharmacy expert gave ``unrefuted 
testimony,'' the Government argues that ``[a]ll of the prescriptions 
discussed by [its Expert] we[re] for highly abused drugs such as 
oxycodone and hydromorphone'' and ``contained one or more of'' some six 
``red flags.'' Id. at 17. It further argues that the Expert ``testified 
that no evidence could be found to show the red flags had been resolved 
prior to dispensing.'' Id.
    As proof for its assertion that the red flags were not resolved, 
the Government points to its Expert's testimony ``that, in the practice 
of pharmacy, a red flag which is resolved must be documented and that 
the documentation should be placed on the prescription itself.'' Id. It 
further notes that the prescriptions contained no notations showing 
that the pharmacists resolved the red flags (with the exception of the 
address stickers that were placed on the prescriptions). It further 
contends that ``[t]o the extent the Respondents may argue that [their] 
practice was to place such documentation elsewhere, that argument flies 
in the face of evidence showing that [the pharmacies] habitually 
corrected `mistakes' related to prescriptions on the prescriptions 
themselves,'' such as the missing patient addresses and the instance in 
which a pharmacist marked on the prescription that it had only been 
partially filled. Id.at 17-18.
    Here, I assume that the red flags with respect to each prescription 
or the convergence of red flags--as there were typically multiple red 
flags associated with each prescription--establishes that the 
pharmacists ``subjectively believed that there was a high probability'' 
that the various prescriptions lacked a legitimate medical purpose.\54\ 
I nonetheless conclude that the Government has failed to put forward 
sufficient evidence to establish that the pharmacists failed to resolve 
the various red flags (i.e., that they deliberately failed to avoid 
learning of the fact that the prescriptions lacked a legitimate medical 
purpose).
---------------------------------------------------------------------------

    \54\ All red flags do not have the same hue, and as the Supreme 
Court's decision in Global-Tech makes plain, proof that a pharmacist 
dispensed a controlled substance prescription without resolving a 
red flag which only created a ``reasonable suspicion'' that the 
prescription lacked a legitimate medical purpose, is not enough to 
establish that a pharmacist acted with the requisite scienter. 
However, where there are multiple red flags, none of which alone 
would establish the requisite scienter, the combination of red flags 
may well create a subjective belief that there is a high probability 
that a prescription lacks a legitimate medical purpose.
---------------------------------------------------------------------------

    As noted above, as proof that the pharmacists failed to resolve the 
red flags, the Government relies solely on the absence of such 
documentation on the prescriptions themselves and the Expert's 
testimony that it is the custom in pharmacy practice to document the 
resolution of a red flag on the prescription. Yet as the Expert 
conceded, no provision of the Controlled Substances Act, DEA 
regulations, Florida law, or the Florida Board of Pharmacy's 
regulations requires that a pharmacist document the resolution of red 
flags on the prescription itself.\55\ While it would be reasonable to 
draw an adverse inference that a pharmacist failed to resolve a red 
flag (or flags) from the failure to document the resolution in any 
manner, the Government offered no evidence that the DIs even asked the 
pharmacists at either Respondent if they documented their resolution of 
red flags, and if so, where they did so.
---------------------------------------------------------------------------

    \55\ While it may be customary in the profession to document the 
resolution of a red flag on the prescription itself, that does not 
make it improper to document the resolution someplace else. 
Moreover, while evidence of a custom certainly has probative value, 
it is not conclusive proof. See Sorrels v. NCL (Bahamas) Ltd., 796 
F.3d 1275, 1282 (11th Cir. 2015) (`` `[E]vidence of custom within a 
particular industry, group, or organization is admissible as bearing 
on the standard of care in determining negligence. Compliance or 
noncompliance with such custom, though not conclusive on the issue 
of negligence, is one of the factors the trier of fact may consider 
in applying the standard of care.' '') (emphasis added) (quoting 
Muncie Aviation Corp. v. Party Doll Fleet, Inc., 519 F.2d 1178, 
1180-81 (5th Cir. 1975)); II Wigmore, Evidence, Sec.  379, at 403 
(Tillers rev. ed. 1983) (explaining that with respect to evidence of 
custom or usage of trade, ``the question is not whether the offered 
instances fully prove the custom alleged, but merely whether they 
are receivable as having probative value'').
---------------------------------------------------------------------------

    Here, a regulation of the Florida Board of Pharmacy (then in 
effect) specifically required that ``[a] patient record system . . . be 
maintained by all pharmacies for patients to whom new or refill 
prescriptions are dispensed'' and that the ``system shall provide for 
the immediate retrieval of information necessary for the dispensing 
pharmacist to identify previously dispensed drugs at the time a new or 
refill prescription is presented for dispensing.'' Fla. Admin. Code 
64B-16-27.800. This rule also required that the pharmacy maintain ``[a] 
list of all new and refill prescriptions obtained by the patient at the 
pharmacy . . . during the two years immediately preceding the most 
recent entry'' and include the ``prescription number, name and strength 
of the drug, the quantity and date received, and the name of the 
prescriber.'' Id. The rule further required that the record include the 
``[p]harmacist['s] comments relevant to the individual's drug therapy, 
including any other information peculiar to the specific patient or 
drug.'' Id. And the rule also required that the pharmacist make ``a 
reasonable effort . . . to obtain from the patient . . . and record any 
known allergies, drug reactions, idiosyncrasies, and chronic conditions 
or disease states of the patient and the identity of any other drugs . 
. . being used by the patient which may relate to prospective drug 
review.'' Id. Finally, the rule required that ``[t]he pharmacist . . . 
record any related information indicated by a licensed health care 
practitioner.'' Id.\56\
---------------------------------------------------------------------------

    \56\ This rule remains in effect today; however, the rule now 
requires that the information be maintained for a period of four 
years preceding the most recent entry.

---------------------------------------------------------------------------

[[Page 31336]]

    Of further note, the Board of Pharmacy's rules require that a 
pharmacist ``review the patient record and each new and refill 
prescription presented for dispensing in order to promote therapeutic 
appropriateness.'' Fla Admin Code r. 64B16-27.810. This rule 
specifically requires that a pharmacist identify such issues as: 
``[o]ver-utilization,'' ``[t]herapeutic duplication,'' ``[d]rug-drug 
interactions,'' ``[i]ncorrect drug dosage,'' and ``[c]linical abuse/
misuse.'' Id.
    On cross-examination, the Expert testified that he asked DEA ``for 
complete profiles on all these patients'' but was told to look at only 
the prescriptions. Tr. 247; see also id. at 324-25 (testimony of Expert 
that he had asked for patient profiles for the Superior II patients and 
was told not look at them, although it was unclear whether he actually 
received them). He further acknowledged that a patient profile would 
show a patient's complete history of the prescriptions filled at the 
pharmacy during the period for which it was run, as well as whether the 
patient was opioid na[iuml]ve or tolerant. Id. at 325. While subsequent 
testimony suggests that the Agency's Investigators did not obtain the 
patient profiles (at least with respect to Superior II) \57\ but only 
state PMP reports, both the Board's regulation and the Expert's 
testimony establish that the patient profiles were relevant evidence in 
assessing whether Respondents' pharmacists had resolved the red flags, 
whether they contained such proof or not.
---------------------------------------------------------------------------

    \57\ With respect to Superior I, a DI testified that he believed 
that digital evidence was collected. Tr. 372.
---------------------------------------------------------------------------

    The Government nonetheless argues that it had no obligation to 
produce the patient profiles and that the Respondents' position would 
force the Government to ``search the entire universe for exculpatory 
evidence.'' Gov. Mot. to Supplement the Record, Strike Respondent's 
Untimely Exceptions, . . . Or, In the Alternative, Respond to 
Exceptions, at 15. It further argues that it is entitled to an adverse 
inference that Respondents' pharmacists did not resolve the various red 
flags because such evidence, if it does exist, is ``under the complete 
control of the Respondent'' and ``not DEA'' and Respondent ``fail[ed] 
to produce'' it. Id. (citing Int'l Union, UAW v. NLRB, 459 F.2d 1329, 
1336 (D.C. Cir. 1972)).
    As for the contention that Respondents' position would force the 
Government to ``search the entire universe for exculpatory evidence,'' 
it does no such thing. Indeed, the Government ignores that its own 
Expert sought to review the patient profiles and that the Board of 
Pharmacy's rules mandate that a pharmacist review the patient's profile 
as part of the prospective drug use review which is required before 
filling a prescription. Unexplained by the Government is why it would 
be improper for pharmacists to document their resolution of a red flag 
in the patient profile given that the Board's rules required (and still 
require) that a pharmacist document his/her ``comments relevant to the 
individual's drug therapy, including any other information peculiar to 
the specific patient or drug,'' as well as ``any related information 
indicated by a licensed health care practitioner'' in that record.
    Of further consequence, the Government produced no evidence 
establishing when the various patients first filled prescriptions at 
Respondents for the drugs in the prescriptions at issue here. 
Unexplained by the Government is why, if the red flags associated with 
a specific patient and prescription had been previously resolved and 
this was documented in the patient profile, the pharmacists were 
nonetheless required to document this on subsequent prescriptions.
    I also reject the Government's contention that it is entitled to an 
adverse inference based on the failure of Respondents to produce any 
evidence showing that they resolved the red flags. Under the adverse 
inference rule, if a party has evidence within its control that ``would 
in fact strengthen [its] case, [it] can be expected to introduce it 
even if it is not subpoenaed.'' Int'l Union, 459 F.2d at 1338. Be that 
as it may, while the patient profiles remained within Respondents' 
control, International Union itself recognizes that ``if a party has 
good reason to believe his opponent has failed to meet [its] burden of 
proof, [it] may find no need to introduce his strong evidence.'' Id.
    Here, the Government has the burden of proof. See 21 CFR 1301.44(d) 
& (e). While it may be that there is nothing in the patient profiles 
which would have been favorable to Respondents, given that the 
Government's Expert acknowledged the relevance of these records and the 
scope of the information required by the Board's rule to be maintained 
in them, requiring the Government to put forward evidence as to whether 
the patient profiles show that the various red flags were not resolved, 
is not fairly described as requiring it ``to search the entire universe 
for exculpatory evidence.'' To the contrary, obtaining and reviewing 
patient profiles would seem to be fundamental to conducting an adequate 
investigation of the dispensing allegations.
    As further support for its contention that the absence of 
documentation on the prescriptions is proof that the red flags were not 
resolved, the Government points to the evidence showing that where the 
physicians failed to include the patients' address, the pharmacists 
placed address stickers on the prescriptions. It also points to a 
single prescription, which was partially filled, and that the 
pharmacist documented this on the face of the prescription.
    Yet Florida law expressly required (and still requires) that a 
patient's address ``appear on the face of the prescription.'' Fla. Sta. 
Ann. Sec.  893.04(c); see also 21 CFR 1306.05(a) (``All prescriptions 
for controlled substances . . . shall bear the full name and address of 
the patient[.]'').\58\ As for the partially filled prescription, a DEA 
regulation requires that the pharmacist ``make a notation of the 
quantity supplied on the face of the written prescription . . . or in 
the electronic prescription record.'' 21 CFR 1306.13(a). By contrast, 
no law or rule requires the documentation of the resolution of a red 
flag to be placed on the prescription itself. Finally, it bears 
repeating that there is no evidence in the record that the 
Investigators even asked Respondents' pharmacists, as a general matter, 
if they resolved red flags presented by controlled substance

[[Page 31337]]

prescriptions, and if so, how they documented having done so.\59\
---------------------------------------------------------------------------

    \58\ Quoting 21 CFR 1306.05(a), the Government suggests that 
prescriptions were ``[d]ispensed in an [i]mproper manner.'' Gov. 
Post-Hrng. Br. 18. The Government then states: ``[a]s evidenced [b]y 
many of the prescriptions themselves for both Superior I and II, 
prescriptions were repeatedly issued absent a patient address.'' Id. 
The Government, however, offers no further explanation as to why 
Respondents violated federal law by filling the prescriptions given 
that they contain address stickers for the patients.
     Of note, the DEA Office of Diversion Control maintains a Web 
page of ``Questions & Answers'' pertaining to prescriptions. See 
http://www.deadiversion.usdoj.gov/faq/prescriptions.htm. One of the 
questions is: ``What changes may a pharmacist make to a prescription 
written for a controlled substance in schedule II?'' Id. at 2. In 
its answer, the Office of Diversion Control noted a conflict between 
its previous policy and a statement made in a 2007 rulemaking 
entitled Issuance of Multiple Prescriptions for Schedule II 
Controlled Substances; the answer further explained that the Agency 
``plans to resolve this matter through a future rulemaking.'' Id. 
The Answer then advised that ``[u]ntil that time, pharmacists are 
instructed to adhere to state regulations or policy regarding those 
changes that a pharmacist may make to a schedule II prescription 
after oral consultation with the prescriber.'' Id. Because the 
Government has produced no evidence that Florida law, the Board of 
Pharmacy's regulations, or the Board's policy prohibited the 
pharmacists from adding the patient's address to the prescriptions, 
I reject the Government's suggestion.
    \59\ The Government also alludes to testimony by its Expert to 
the effect that he was shown partial medical records for the 
patients and that he found no evidence in these records ``that any 
conversation had taken place between the prescriber and the 
Respondents' pharmacist.'' Gov. Post-Hrng. Br. 17 n.10. None of 
these records are in evidence, and thus, there is no evidence 
establishing when the patients first saw the physicians and whether 
there was any communication between the pharmacists and prescribers 
at that time. In any event, there is no evidence in the record 
establishing that a physician has an obligation under the standard 
of care to document phone calls from a pharmacist questioning his 
prescription. Accordingly, I place no weight on this testimony.
---------------------------------------------------------------------------

    Accordingly, I find that the Government's allegations that 
Respondents' pharmacists violated 21 CFR 1306.04(a) and Fla. Stat. Ann. 
Sec.  465.016(1)(s)) when they dispensed controlled substance 
prescriptions without resolving the red flags presented by the 
prescriptions are not supported by substantial evidence.\60\
---------------------------------------------------------------------------

    \60\ As found above, on various occasions, the Government 
elicited testimony from its Expert, over Respondents' objections, to 
the effect that some of the prescriptions presented red flags that 
could not be resolved. While the Government made no argument based 
on this testimony in its Post-hearing Brief, the ALJ made multiple 
findings that several of the prescriptions presented red flags that 
could not be resolved. See R.D. 80-81 (FoF#s 9, 10). Moreover, in 
its Response to Respondent's Exceptions, the Government invokes this 
evidence. See Gov. Response to Resp.'s Exceptions, at 14 
(``Notwithstanding the fact that Mr. Parrado credibly testified that 
he discovered red flags which, in his opinion, were unresolvable . . 
. Respondents are now arguing for a new rule that requires the 
Government to prove a negative.'') (citing Tr. 145-46, 289-90).
    While in the Show Cause Orders, the Government made conclusory 
allegations to the effect that the Respondents' ``pharmacists 
dispensed controlled substances when they knew or should have known 
that the prescriptions were not issued in the usual course of 
professional practice or for a legitimate medical purpose,'' ALJ Ex. 
1, at 2 (No. 15-6), which implies that the red flags could not be 
resolved, the Government never identified a specific prescription in 
either Show Cause Order or any of its Prehearing Statements that 
could not be resolved. As explained previously, while the ALJ 
overruled Respondents' objections, the correct standard is not 
whether the ALJ wanted to know the answer to the Government's 
question, Tr. 287, but whether Respondents knew ``what conduct was 
being alleged and ha[d] a fair opportunity to present [their] 
defense.'' Duane v. DOD, 275 F.3d 988, 995 (10th Cir. 2002) (quoting 
Facet Enters., Inc., v. NLRB, 907 F.2d 963, 972 (10th Cir. 1990). 
See also Pergament United Sales, 920 F.2d at 135 (``Notice does not 
mean a complaint necessarily must state the legal theory upon which 
the General Counsel intends to proceed. Instead notice must inform 
the respondent of the acts forming the basis of the complaint.''); 
see also id. (``The primary function of notice is to afford [a] 
respondent an opportunity to prepare a defense by investigating the 
basis of the complaint and fashioning an explanation that refutes 
the charge of unlawful behavior.'').
     Because the Government never alleged that any of the 
prescriptions could not be resolved, and Respondents objected to 
this line of inquiry, there is no basis for a finding of litigation 
by consent. Accordingly, I do not consider the testimony that the 
some of the prescriptions presented unresolvable red flags.
---------------------------------------------------------------------------

The Audits and Recordkeeping Allegations

    The evidence nonetheless shows that both Respondents violated the 
CSA by failing to maintain and/or properly maintain required records. 
With respect to Superior I, the evidence is particularly egregious, as 
an audit conducted by Agency Investigators found that the pharmacy had 
shortages of 15,560 du of oxycodone 30 mg and 11,951 du of 
hydromorphone 8 mg. In addition, Superior I was short 946 du of 
hydromorphone 4 mg, 864 du of methadone 10 mg, 474 du of morphine 
sulfate 100 mg ER, and 447 du of morphine sulfate 30 mg ER. Thus, 
Superior I was short more than 30,000 du of highly abused controlled 
substances. And while Superior II had only a small shortage of a single 
drug, it had substantial overages in several drugs, including 2,576 du 
of hydromorphone 8 mg and 1,189 du of oxycodone 30 mg.
    ``Recordkeeping is one of the CSA's central features; a 
registrant's accurate and diligent adherence to this obligation is 
absolutely essential to protect against the diversion of controlled 
substances.'' Paul H. Volkman, 73 FR 30630, 30644 (2008); see also Fred 
Samimi, 79 FR 18698, 18712 (2014) (finding where physician ``had 
shortages totaling more than 40,000 dosage units'' of various drugs 
that his ``inability to account for this significant number of dosage 
units creates a grave risk of diversion,'' and that ``even were there 
no other proven violations, the audit results alone are sufficient to . 
. . establish[] that [physician's] registration[] `would be 
inconsistent with the public interest''') (citations omitted).
    During the hearing, Respondents raised various challenges to the 
validity of the audits. With respect to the Superior I audit, 
Respondent's counsel attempted to impeach the DI's result by using a 
document he described as ``scratch paper'' which, according to his 
representation, had been included among the documents returned to 
Respondents on the CD and which listed the DEA 222 forms for Superior 
I's morphine sulfate orders; Respondent's counsel further represented 
that when he added up the orders, he got a number of 7,200 du. Tr. 395.
    I need not decide whether the ALJ erred when he barred Superior I's 
counsel from using this document to impeach the DI, Tr. 394-95, because 
Respondent did not properly preserve the claim of error. Notably, 
Respondent's counsel did not seek to submit the document even as a 
rejected impeachment exhibit, and in its Post-hearing Brief, Respondent 
did not specifically identify this ruling as being in error. Indeed, 
while in its Post-hearing Brief, Superior I proposes as a factual 
finding that it ``proffered Exhibits 3 through 9 including invoices and 
other records that demonstrate errors in the DEA audit which resolve 
the alleged inventory overages,'' Resp. Post-Hrng. Br. 9 (emphasis 
added), with respect to Superior I, the gravamen of the Government's 
audit allegation was that it had shortages of multiple drugs.\61\ 
Moreover, Exhibits 3 through 9, which comprise nearly 1500 pages of 
assorted documents, and which purportedly include relevant records for 
each of the audited drugs, are just that--raw documents, with no 
accompanying explanation or calculations showing why the Government's 
audit results are in error.\62\
---------------------------------------------------------------------------

    \61\ Likewise, even assuming the correctness of Superior I's 
counsel's representation that when he added up the morphine sulfate 
orders, he got ``a number of 7,200,'' Tr. 395, he made no proffer as 
to errors with respect to the audit results for oxycodone 30 mg and 
hydromorphone 8 mg, which found massive shortages.
    \62\ It is noted that Respondents attached, as supplements to 
their untimely filed Exceptions, charts which purport to show audit 
results for both pharmacies which are dramatically different from 
those found by the Government. See Resp. Exceptions, at Appendices A 
& B. Respondents offered no foundation for consideration of the 
charts, and in any event, the charts are not properly considered as 
newly discovered evidence.
     Furthermore, while throughout the proceeding, Respondents have 
argued that their due process rights have been violated because the 
Agency's Lead Investigator ``unlawfully retained'' records seized 
pursuant to the Administrative Inspection Warrants for some 611 
days, Resp. Post-Hrng. Br. 18, Respondents were provided with the 
records on or about the same day they were served with the Show 
Cause Orders, which made specific allegations as to the audits. 
Thus, Respondents had approximately 80 days from the date they were 
informed of the allegations to the date on which they were required 
to file their Prehearing Statements to investigate the allegations 
pertaining to the audits and prepare a defense.
     While Respondents argue that ``[t]he first access [they] had to 
what may or may not be all of the evidence was on the day that DEA 
served its Order to Show Cause,'' Resp. Post-Hrng. Br. 19, they did 
not identify any records that were necessary to complete their 
audits which were not provided to them when their records were 
returned.
---------------------------------------------------------------------------

    Respondent also questioned the validity of the audits on the ground 
that while the DIs could have verified their calculations as to the 
level of Respondents' purchases of the drugs by obtaining data from the 
Agency's ARCOS database, they ``willfully chose to ignore that evidence 
which would have demonstrated the accuracy of the pharmacies' records 
with respect to [their] purchases.'' Id. at 20. Contrary to 
Respondent's understanding, one of the purposes of an audit is to 
determine whether the audited party is maintaining ``a complete and 
accurate

[[Page 31338]]

record of each [controlled] substance . . . received, sold, delivered, 
or otherwise disposed of by him.'' See 21 U.S.C. 827(a)(3); see also 
id. at Sec.  827(a)(1) (requiring registrants to ``make a complete and 
accurate record of all stocks . . . on hand'' when ``first engag[ing] 
in the . . . dispensing of controlled substances, and every second year 
thereafter''). Putting aside that Respondents produced no evidence 
showing discrepancies between the DIs' calculations as to the 
quantities of the drugs received by them and the distributions as 
reported by their suppliers to the ARCOS system, the DIs were entitled 
to rely on the records provided by Respondent in response to the 
warrant. Given that ARCOS data is compiled from distribution reports 
submitted by manufacturers and distributors, and Respondents were not 
required to file reports to ARCOS, see 21 CFR 1304.33(c), the DIs had 
no obligation to cross-check their calculations with ARCOS data.
    Respondent Superior II questioned the validity of the audit 
pertaining to it, on the ground that the DI based her initial inventory 
figures on a perpetual inventory which Respondent is not lawfully 
required to maintain. However, the DI testified multiple times that she 
asked for an actual physical count which was at least six months old 
and used what Superior II gave her. Tr. 491-92. I thus reject 
Respondent's challenge to the findings of the audit of Superior II, 
which establishes that it had overages in several drugs.\63\
---------------------------------------------------------------------------

    \63\ While Superior II also argues that DEA failed to consider 
ARCOS data in auditing it, I reject the argument for the same 
reasons that I rejected the argument with respect to Superior I's.
---------------------------------------------------------------------------

    I thus find that both pharmacies failed to maintain complete and 
accurate records as required by 21 U.S.C. 827(a)(1) & (3). While this 
finding alone supports the conclusion that each pharmacy has committed 
such acts as to render its continued registration ``inconsistent with 
the public interest,'' see 21 U.S.C. 824(a)(4), the scope of the 
shortages of oxycodone 30 mg and hydromorphone 8 mg found during the 
audit of Superior I supports a sanction of revocation. See Samimi, 79 
FR at 18712.
    The Government further alleges that Respondents failed to properly 
complete various schedule II order forms. More specifically, with 
respect to Superior I, the Government's evidence included an Order Form 
for oxycodone 30 on which the National Drug Code was changed. GX 5, at 
1 (No. 15-6). However, while the DI testified that ``any alteration or 
any erasure or change of description'' should result in the form not 
being used,'' the applicable regulation actually states that the order 
``must not be filled if . . . [t]he order shows any alteration, 
erasure, or change of any description.'' 21 CFR 1305.15(a) (emphasis 
added). Thus, the regulation is not fairly read as imposing liability 
on Superior I for changing the National Drug Code.
    The DI also testified that a second order form was not filled out 
properly, because ``information in regard to the number of package[s] 
receive [sic] . . . was omitted.'' Tr. 384. However, the Government 
offered no evidence that any portion of the two orders listed on the 
form were filled. While DEA's regulation states that ``[t]he purchaser 
must record on Copy 3 of the . . . 222 the number of commercial or bulk 
containers on each item and the dates on which the containers are 
received by the purchaser,'' 21 CFR 1305.13(e), the Government points 
to no provision which requires, where no portion of a line entry has 
been filled by the expiration of the 60-day period in which the Order 
Form is valid, id. Sec.  1305.13(b), the purchaser to notate on the 
form that no portion of that entry was received.\64\
---------------------------------------------------------------------------

    \64\ While the purchaser's copy 3 of the form includes columns 
``To Be Filled In By Purchaser'' in which the purchaser lists the 
``No. of Packages Received'' and the ``Date Received'' for each line 
item, see GX 5 (No. 15-6), if no packages of that item have been 
received, then there is no date on which they were received.
---------------------------------------------------------------------------

    The Government made similar claims with respect to Superior II. For 
example, it identified the first two pages of GX 6 (No. 15-7) as 
examples of Order Forms that were not properly completed because the 
second entry on each form did not list the number of packages received 
and the date received. Putting aside that these two documents bear the 
exact same serial number, here again, the Government put forward no 
evidence that any portion of the order listed in the second line item 
was filled. While here too, this DI insisted that ``after 60 days, the 
222 is invalid'' and that Respondent ``should go back and put a zero 
and the date they put the zeros'' on the form, as explained above, the 
regulations do not so require. And while the DI also asserted that the 
Pharmacist's Manual--which does not have the force and effect of law 
anyway--instructs pharmacists to do this, the Manual actually states 
that ``[w]hen the items are received, the pharmacist must document on 
the purchaser's copy (copy three) the actual number of packages 
received and the date received'' and nothing more. DEA, Pharmacist's 
Manual--An Informational Outline of the Controlled Substances Act 23 
(Rev. ed. 2010).
    While the DI further identified other Order Forms in this Exhibit 
which she alleged were not properly completed, she did not identify a 
single instance in which a line item had actually been shipped to 
Respondent and the entry had not been made. Indeed, with respect to the 
Exhibit, the only violations the DI identified were that the forms were 
copies and not the original. Tr. 474-75, 521. Under a DEA regulation, 
``[t]he purchaser must retain Copy 3 of each executed DEA Form 222.'' 
21 CFR 1305.13(a). Standing alone these violations would be of minimal 
consequence.
    The evidence further showed that while Superior II used the 
electronic Controlled Substances Ordering System to purchase controlled 
substances, it did not comply with 21 CFR 1305.22(g). Under this 
provision, ``[w]hen a purchaser receives a shipment, the purchaser must 
create a record of the quantity of each item received and the date 
received. The record must be electronically linked to the original 
order and archived.'' 21 CFR 1305.22(g). The evidence shows that 
Respondent's pharmacists would print out a copy of the electronic order 
form and by hand, notate in the boxes in which the Supplier is to list 
the ``Packages Shipped'' and the ``Date Shipped,'' the number of 
packages received and the date received. See generally GXs 7 & 10; Tr. 
551. According to the DI, when she asked Mr. Majed (one of Superior II 
pharmacists), how he documented the pharmacy's receipt of the drugs, 
the pharmacist explained that he did not go back into the CSOS because 
``he wasn't aware that he had to do that.'' Tr. 554.
    The record thus supports the conclusion that Superior II's receipts 
were not documented electronically and were not linked to the original 
order. Thus, I conclude Superior II violated 21 CFR 1305.22(g) with 
respect to the numerous electronic orders it placed.
    The DI also testified that Mr. Majed represented that he had a key 
which is required under the Agency's regulations for placing electronic 
orders through the CSOS. Tr. 557-58. Under DEA's regulation, a person 
must ``obtain a CSOS digital certificate from the DEA Certification 
Authority to sign electronic orders for controlled substances.'' 21 CFR 
1311.10. However, a person is eligible to obtain a CSOS digital 
certificate only if he/she: (1) is the person who ``signed the most 
recent registration application or renewal application,'' (2) is ``a 
person authorized to sign a registration application,'' or (3) has been 
``granted power of attorney by [the] registrant to sign orders for one 
or more schedules of controlled

[[Page 31339]]

substances.'' Id. DEA's regulations further provide that ``[o]nly the 
certificate holder may access or use his or her digital certificate and 
private key,'' and ``[a] certificate holder must ensure that no one 
else use the private key'' and ``prevent unauthorized use of that 
private key.'' Id. Sec.  1311.30. According to the DI, after her 
conversation with Mr. Majed, she determined that only Mr. Obi, 
Respondent's owner, and Ms. Minozzi, another pharmacist, had been 
issued CSOS keys. Accordingly, I conclude that Respondent violated 21 
CFR 1311.30(a) and (c).
    Accordingly, I conclude that the evidence with respect to factor 
four--Respondents' compliance with applicable laws related to 
controlled substances--establishes that each Respondent ``has committed 
such acts as would render [its] registration . . . inconsistent with 
the public interest.'' 21 U.S.C. 824(a)(4).

Sanction

    Under Agency precedent, where, as here, ``the Government has proved 
that a registrant has committed acts inconsistent with the public 
interest, a registrant must ` ``present sufficient mitigating evidence 
to assure the Administrator that it can be entrusted with the 
responsibility carried by such a registration.'' ' '' Medicine Shoppe-
Jonesborough, 73 FR 364, 387 (2008) (quoting Samuel S. Jackson, 72 FR 
23848, 23853 (2007) (quoting Leo R. Miller, 53 FR 21931, 21932 
(1988))). ``Moreover, because `past performance is the best predictor 
of future performance,' ALRA Labs, Inc. v. DEA, 54 F.3d 450, 452 (7th 
Cir.1995), [DEA] has repeatedly held that where a registrant has 
committed acts inconsistent with the public interest, the registrant 
must accept responsibility for its actions and demonstrate that it will 
not engage in future misconduct.'' Medicine Shoppe, 73 FR at 387; see 
also Jackson, 72 FR at 23853; John H. Kennedy, 71 FR 35705, 35709 
(2006); Prince George Daniels, 60 FR 62884, 62887 (1995). See also 
Hoxie v. DEA, 419 F.3d at 483 (``admitting fault'' is ``properly 
consider[ed]'' by DEA to be an ``important factor[ ]'' in the public 
interest determination).
    While a registrant must accept responsibility and demonstrate that 
it will not engage in future misconduct in order to establish that its 
continued registration is consistent with the public interest, DEA has 
repeatedly held these are not the only factors that are relevant in 
determining the appropriate sanction. See, e.g., Joseph Gaudio, 74 FR 
10083, 10094 (2009); Southwood Pharmaceuticals, Inc., 72 FR 36487, 
36504 (2007). Obviously, the egregiousness and extent of a registrant's 
misconduct are significant factors in determining the appropriate 
sanction. See Jacobo Dreszer, 76 FR 19386, 19387-88 (2011) (explaining 
that a respondent can ``argue that even though the Government has made 
out a prima facie case, his conduct was not so egregious as to warrant 
revocation''); Paul H. Volkman, 73 FR 30630, 30644 (2008); see also 
Paul Weir Battershell, 76 FR 44359, 44369 (2011) (imposing six-month 
suspension, noting that the evidence was not limited to security and 
recordkeeping violations found at first inspection and ``manifested a 
disturbing pattern of indifference on the part of [r]espondent to his 
obligations as a registrant''); Gregory D. Owens, 74 FR 36751, 36757 
n.22 (2009).
    The Agency has also held that `` `[n]either Jackson, nor any other 
agency decision, holds . . . that the Agency cannot consider the 
deterrent value of a sanction in deciding whether a registration should 
be [suspended or] revoked.' '' Gaudio, 74 FR at 10094 (quoting 
Southwood, 72 FR at 36504); see also Robert Raymond Reppy, 76 FR 61154, 
61158 (2011); Michael S. Moore, 76 FR 45867, 45868 (2011). This is so, 
both with respect to the respondent in a particular case and the 
community of registrants. See Gaudio, 74 FR at 10095 (quoting 
Southwood, 71 FR at 36503). Cf. McCarthy v. SEC, 406 F.3d 179, 188-89 
(2d Cir. 2005) (upholding SEC's express adoptions of ``deterrence, both 
specific and general, as a component in analyzing the remedial efficacy 
of sanctions'').
    Here, the record contains no evidence that the principals of either 
Respondent acknowledge its misconduct. So too, the record contains no 
evidence that either Respondent has undertaken any remedial measures.
    Respondents attribute this to the ALJ's ruling barring Mr. Obi 
(Respondents' owner) from testifying. They argue that the ALJ's ruling 
denied them their right to due process and a fair hearing under the 
Administrative Procedure Act. See Resp. Post-Hrng. Br. 23 (citing, 
inter alia, Oshodi v. Holder, 729 F.3d 883, 889 (9th Cir. 2013) (en 
banc); Block v. SEC, 50 F.3d 1078, 1085 (D.C. Cir. 1995); 21 [sic] 
U.S.C. 556). Tallying up the number of each party's objections which 
the ALJ overruled versus those he sustained, as well as the number of 
times the ALJ, sua sponte, instructed a witness not to answer a 
question, they assert that ``[t]his unmistakable pattern reflects the 
[ALJ's] clear bias against Respondents.'' Id. at 27. As additional 
grounds for their contention that the ALJ was biased, they assert that 
he ``refused to require the DEA to obey the order of the Federal 
Magistrate Judge.'' Id. at 34.
    As for their claim of bias, none of their assertions establish 
bias. As found above, while several of the ALJ's rulings on objections 
were erroneous, many of them were not, and some of Respondents' 
objections were clearly lacking in merit. In any event, ``judicial 
rulings alone almost never constitute a valid basis for a bias or 
partiality motion.'' Liteky v. United States, 510 U.S. 540, 555-56 
(1994) (citing United States v. Grinnell Corp., 384 U.S. 563, 583 
(1966)).
    As for the contention that bias is established by the ALJ's refusal 
to require the DI to obey the Federal Magistrate Judge's order, 
Respondents point to no provision of law which grants an Administrative 
Law Judge authority to order the Government to comply with an order of 
a Federal Magistrate Judge.\65\ A Magistrate Judge has authority to 
ensure compliance with his orders, including the power to hold a 
disobeying party in contempt. See 28 U.S.C. 636. Respondents offer no 
explanation for why they did not seek an order compelling the return of 
the documents from the Magistrate Judge who approved the warrant. I 
thus reject Respondents' claim that the ALJ's ruling on Mr. Obi's 
testimony should be rejected on the ground of bias.\66\ Indeed, 
Respondents self-refute their claim of bias when they argue that 
``[t]he real reason that the ALJ refused to let Mr. Obi testify was 
because he felt like Respondents' counsel had not adequately complied 
with the

[[Page 31340]]

disclosure requirements of the ALJ's prehearing order.'' Resp. 
Exceptions, at 24 (emphasis added).
---------------------------------------------------------------------------

    \65\ Respondents do not identify what orders the DI violated. If 
Respondents mean the administrative inspection warrants, the 
language of the warrants only provided for a return of the warrant 
to the court and an accounting of the property seized. Resp.'s Post-
Hrng. Br., at Attachments 1 and 2. The warrants contained no 
provision requiring the return of the seized property, and 
Respondents point to no further orders by the court to return the 
records.
    \66\ Respondents further assert that the ALJ's ``general bias . 
. . finds its roots in'' what they characterize as ``the 
Administrator's public scolding of the ALJ in Clair L. Pettinger, 
M.D., 78 [FR] 61591 (2013), for requiring the DEA to follow the 
procedural rules of the Agency and for his interpretation of the 
law.'' Id. at 35. Not only is Respondents' explanation of Pettinger 
counterfactual (both the pleading burden imposed by the ALJ and his 
interpretation of factor two were inconsistent with agency 
precedent), they cite no authority for their theory. Beyond that, 
Respondents ignore the extensive protections provided to ALJs under 
federal law to ensure decisional independence, including that they 
are not subject to performance appraisals, 5 U.S.C. 4301(2)(D), 
their pay is set by OPM independent of any evaluation by the Agency, 
id. Sec.  5372, and they are subject to discipline only upon a 
showing of good cause by the MSPB. Id. Sec.  3105.
---------------------------------------------------------------------------

    Respondents thus assert that the ALJ erred in barring Mr. Obi from 
testifying because he was an interested person within the meaning of 
the APA. That Mr. Obi is an interested person is hardly disputable. 
However, while an interested person has a right to participate in a 
proceeding, that right is subject to the reasonable procedural rules of 
the Agency and rulings of the ALJ. See, e.g., 5 U.S.C. 556(c) 
(``Subject to published rules of the agency and within its powers, 
employees presiding at hearings may . . . regulate the course of the 
hearing.''); 21 CFR 1316.58(a) (``The presiding officer may direct that 
summaries of the direct testimony of witnesses be prepared in writing 
and served on all parties in advance of the hearing.'').
    Here, in his Orders for Prehearing Statements, which were issued 
more than one month before Respondents' Prehearing Statements were due, 
the ALJ specifically warned Respondents that if their ``corporate 
representative intends to testify, the representative must be listed as 
a witness, and a summary of anticipated testimony as described below 
must be provided.'' ALJ Ex. 5, at 2 (No. 15-6); ALJ Ex. 6, at 2 (No. 
15-7). The Orders for Prehearing Statements also cautioned Respondents 
that their summaries of testimony must ``indicate clearly each and 
every matter as to which Respondent[s] intend[ ] to introduce evidence 
in opposition'' and that ``[t]he summaries are to state what the 
testimony will be rather than merely listing the areas to be covered.'' 
ALJ Ex. 5, at 2 (No. 15-6); ALJ Ex. 6, at 2 (No. 15-7). And finally, 
the Orders for Prehearing Statements further warned ``that testimony 
not disclosed in the prehearing statements or pursuant to subsequent 
rulings is likely to be excluded at the hearing.'' ALJ Ex. 5, at 2 (No. 
15-6); ALJ Ex. 6, at 2 (No. 15-7).
    Respondents thus had fair notice of the steps they were obligated 
to take to present Mr. Obi's testimony. While Respondents represented 
in their Prehearing Statements that they intended to call ``[a]ny and 
all witnesses identified in the Government's Prehearing Statement[s] in 
th[ese] matter[s],'' and the Government identified Mr. Obi as a 
potential witness therein, Respondents entirely failed to provide a 
summary of the testimony they intended to elicit from him. ALJ Ex. 9, 
at 4 (No. 15-6); ALJ Ex. 12, at 4 (No. 15-7).
    While at the hearing Respondents asserted that there would be no 
prejudice to the Government because ``the summary of Mr. Obi's 
testimony'' was ``covered sufficiently'' by the Government in its 
Prehearing Statements, the Government's summary of Mr. Obi's 
anticipated testimony was confined to questioning him about past acts. 
Tr. 597-98; see also ALJ Ex. 7, at 6-7 (No. 15-6); ALJ Ex. 7, at 8-9 
(No. 15-7). Indeed, Respondents' Counsel conceded that he intended to 
elicit testimony from Mr. Obi as to the corrective actions Respondents 
had undertaken and that this raised a notice issue. Id. at 611. 
Moreover, at no point prior to the hearing did Respondents provide 
notice to the Government that any of their proposed witnesses would 
testify regarding any corrective actions undertaken by the 
pharmacies.\67\ See ALJ Ex. 9, at 4-6 (No. 15-6); ALJ Ex. 12, at 4-6 
(No. 15-7). Thus, the ALJ did not abuse his discretion when he barred 
Mr. Obi from testifying.\68\ See Gunderson v. Department of Labor, 601 
F.3d 1013, 1021 (10th Cir. 2010).
---------------------------------------------------------------------------

    \67\ Respondents' reliance on Oshodi is not persuasive. Therein, 
the Ninth Circuit overturned a decision of the Board of Immigration 
Appeals (BIA), which affirmed a decision of an Immigration Judge 
that Oshodi, who was an applicant for asylum, was not credible. 729 
F.3d at 885. Specifically, the court held that the Immigration Judge 
violated the applicant's right to due process ``by cutting off his 
testimony on the event of his alleged past persecution . . . that 
[were] the foundation of his'' claims, and denied his claims 
``solely on the basis of [an] adverse credibility finding.'' Id.
    Respondents also cite to Kerciku v. INS, 314 F.3d 913 (7th Cir. 
2003), asserting that the ALJ violated their rights to due process 
by precluding them from putting on any case. Resp. Post-Hrng. Br. 2. 
In Kericku, the Seventh Circuit vacated a BIA decision which upheld 
an IJ's denial of applications for asylum, faulting the IJ for not 
allowing the applicants ``to make any presentation.'' 314 F.3d at 
918.
    Neither case, however, raised the issue of whether a party could 
be barred from putting on testimony when the party entirely failed 
to comply with an agency rule which requires disclosure of the 
substance of that testimony in advance of the proceeding to prevent 
prejudice. While Respondents also argue that the ALJ did not 
neutrally apply this rule, I have carefully reviewed the parties' 
respective Prehearing Statements, and conclude otherwise.
    \68\ In Hatem M. Ataya, M.D., 81 FR 8221, 8243 (2016), I held 
that while the Agency's case law requires a respondent to 
acknowledge its misconduct and put on evidence of its remedial 
measures to rebut the Government's prima facie case, the Agency's 
cases do not require a respondent ``to admit to the allegations even 
before [it] even has the opportunity to challenge the Government's 
evidence.'' Thus, in Attaya, I held that a respondent's failure to 
acknowledge his misconduct in his prehearing statement could not bar 
him from introducing evidence of his remedial measures. Id. at 8242. 
However, in Attaya, I also held that because the respondent had not 
adequately disclosed ``with sufficient particularity'' his evidence 
of remedial measures, the testimony could nonetheless be barred.
    Here, while Respondents failed to set forth any proposed 
testimony by Mr. Obi on the issue of acceptance of responsibility in 
advance of the hearing, this would not have been a bar to Mr. Obi's 
testimony as to Respondents' corrective measures, had such proposed 
testimony on the latter issue been disclosed in advance of the 
hearing. Just as in federal court, evidence that a respondent had 
undertaken remedial measures is not proof that it has engaged in 
culpable conduct. Cf. Fed. R. Evid. R.407.
     While a respondent retains the right to challenge the 
allegations at the proceeding, when the Government serves a party 
with a show cause order, a respondent should assume that the 
Government has probable cause to support the allegations and a good 
faith basis for seeking the action (revocation or suspension) it 
proposes. A wise respondent conducts its own investigation to 
determine whether the allegations are true, and if they are, to then 
determine what measures are needed to correct the violations or 
offending practices. Thus, while a respondent retains the right to 
challenge the Government's evidence at the hearing, it is still 
properly charged with the obligation to disclose the remedial 
measures it has undertaken as a condition of being able to present 
such evidence at the hearing. Of course, where the Government fails 
to prove an allegation at the hearing, a respondent need not put on 
evidence of any corrective measures relevant to that allegation.
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    Indeed, in their Post-Hearing Brief, Respondents argue that ``Mr. 
Obi's testimony could have been restricted to the issues discussed in 
the DEA's prehearing statement.'' Resp. Post-Hrng. Br. 24. However, as 
explained above, to rebut the Government's prima facie case, 
Respondents bore the burden of producing evidence as to their remedial 
measures. Thus, even if Mr. Obi had testified to those issues 
identified in the Government's Prehearing Statements and acknowledged 
Respondents' misconduct (as to those violations proven on the record), 
Respondents still would have failed to rebut the Government's prima 
facie case. Accordingly, even if it was error to bar Mr. Obi's 
testimony as to the issues discussed in the Government's Prehearing 
Statements, Respondents have not shown prejudice. See Gunderson, 601 
F.3d at 1021 (An ALJ's error in excluding evidence must `` 
`prejudicially affect a substantial right of a party' ''; ``[a]n error 
is prejudicial only `if it can be reasonably concluded that with . . . 
such evidence, there would have been a contrary result.''') (quoting 
Sanjuan v. IBP, Inc., 160 F.3d 1291, 1296 (10th Cir. 1998)); see also 
Air Canada v. Department of Trans., 148 F.3d 1142, 1156 (D.C. Cir. 
1998) (``As incorporated into the APA, the harmless error rule requires 
the party asserting error to demonstrate prejudice from the error.'') 
(citing 5 U.S.C. 706). I thus reject Respondents' contentions with 
respect to the ALJ's ruling which barred Mr. Obi's testimony.\69\
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    \69\ As for Respondents' arguments with respect to the ALJ's 
ruling which precluded them from submitting their documentary 
evidence, see Resps.' Post-Hrng. Br. at 30-32, the ALJ's Prehearing 
Orders were clear enough that the documents had to be submitted in 
hard copy. Moreover, my holding that the Government has failed to 
prove any of the dispensing violations renders moot their 
contentions with respect to those exhibits that were relevant to 
those allegations.
    As for the thousands of pages of exhibits that include records 
of Respondents' purchases and dispensings of the controlled 
substances audited by the Government, because Respondents failed to 
make an adequate proffer as to their audit results prior to the 
hearing, the ALJ did not abuse his discretion in declining to admit 
this evidence.

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[[Page 31341]]

    Because Respondents failed to produce any evidence of remedial 
measures undertaken to address the numerous recordkeeping issues that I 
find proven on the record, I conclude that Respondents have not 
rebutted the Government's prima facie showing they have ``committed 
such acts as [to] render [their] registration[s] inconsistent with the 
public interest.'' 21 U.S.C. 824(a)(4). And based on the substantial 
shortages found at Superior I, which supports the conclusion that it 
has major recordkeeping issues and/or has engaged in diversion, I 
conclude that revocation of its registration is warranted to protect 
the public interest.\70\
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    \70\ Given the size of the shortages, the Agency's deterrence 
interests also support revocation.
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    I acknowledge that Superior II's recordkeeping violations did not 
involve large shortages but rather overages. However, the pharmacy 
nonetheless failed to maintain complete and accurate records as 
required by the CSA, did not properly document its receipts on 
electronic order forms, and allowed an unauthorized person to access 
the electronic ordering system. In addition, the pharmacies have common 
ownership in that they are both owned by Mr. Obi. Thus, while the 
conduct proven with respect to Superior I is more egregious than that 
proved with respect to Superior II, given that Mr. Obi owns and 
controls each pharmacy, I conclude that revocation is warranted with 
respect to Superior II as well.\71\
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    \71\ In numerous cases, DEA has held that where misconduct has 
previously been proved with respect to the owners, officers, or key 
employees of a pharmacy, the Agency can deny an application or 
revoke a registration of a second or subsequent pharmacy where the 
Government shows that such individuals have influence over the 
management or control of the second pharmacy. See, e.g., Lawsons & 
Sons Pharmacy and Fenwick Pharmacy, 48 FR 16140, 16141 (1983); 
Orlando Wholesale, L.L.C., 71 FR 71555, 71557 (2006) (denying 
application noting evidence that ``one of Respondent's managing 
members had previously operated a business which distributed List I 
chemicals without a valid registration''); Cf. 4 OTC, Inc., 77 FR 
35031, 35035 (2012) (denying application for registration as List I 
chemical distributor where evidence showed that a person holding a 
10 percent interest in applicant had been found by Canadian 
regulatory agency to have violated its List I regulations).
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Order

    Pursuant to the authority vested in me by 21 U.S.C. 824(a)(4) and 
823(f), as well as 28 CFR 0.100(b), I order that DEA Certificates of 
Registration BS9255274 and BS9699731 issued to Superior Pharmacy, 
L.L.C., be, and they hereby are, revoked. I further order that any 
application of Superior Pharmacy, L.L.C., to renew or modify either 
registration, be, and it hereby is, denied. This Order is effective 
June 17, 2016.

    Dated: May 7, 2016.
Chuck Rosenberg,
Acting Administrator.
[FR Doc. 2016-11550 Filed 5-17-16; 8:45 am]
BILLING CODE 4410-09-P