In its unpublished opinion filed on April 25, 2017, the State of Michigan Court of Appeals (“Michigan Appellate Court”) upheld the order of the Michigan Board of Medicine (“Board”) suspending a doctor’s license to practice medicine for six months and a day, rendering void his license to prescribe controlled substances, and imposing a $20,000 fine, to be paid before he could apply for reinstatement of his medical license, finding that there was no error in the Board ruling that the facts regarding the doctor’s record of prescribing drugs alleged in the complaint, if proven, likely would be sufficient to establish a violation under MCL 333.16221(a) and (b)(i).
The Factual Allegations
The Board had filed a two-count administrative complaint against the doctor alleging negligence and incompetence under MCL 333.16221(a) and (b)(i), respectively, in part on the basis of data the Board obtained from the Michigan Automated Prescriptions System (“MAPS”) indicating that the doctor had prescribed more than 25,000 controlled substances between August 1, 2012 and July 31, 2013.
The Board’s complaint focused on four of the doctor’s patients, referred to as “BS,” “AR,” “CH,” and “KB,” and alleged that in each case the doctor had issued monthly prescriptions for commonly abused controlled substances without offering the patients alternative treatments or monitoring them for abuse or diversion of the drugs. The Board’s investigation into the prescribing habits of the doctor resulted from a complaint filed by the mother of BS after she found BS in possession of a large number of drugs that had been prescribed by the doctor and BS was in a condition that led her to believe that he had overdosed on drugs.
An expert testified during the disciplinary proceeding that he reviewed these four patients’ charts and MAPS reports, and the expert concluded that the doctor’s prescribing practices fell below the standard of care. The doctor countered that the amounts and combinations of medications he prescribed were necessary because his patients all suffered from conditions that caused chronic pain, which was often accompanied by anxiety and difficulty sleeping.
The Administrative Law Judge (“ALJ”) concluded in his proposal for decision (“PFD”) that the Board had established that the doctor violated MCL 333.16221(a) and (b)(i) by failing to consider the use of other treatment modalities or non-narcotic medications for the treatment of pain, failing to consistently monitor for abuse and diversion by utilizing urine drug testing and checking patients’ prescription records with MAPS, and by prescribing an inappropriate combination of medication. The doctor excepted to the PFD; however, the Board’s disciplinary subcommittee accepted the PFD after reviewing the record.
In affirming the Board’s order, the Michigan Appellate Court stated that the Board’s complaint cites the number of prescriptions for each of the named patients, the inappropriate combinations of such drugs, the lack of any record of the patients being given advice about the dangers of the drugs or advice on alternative treatments, and that the patients denied receiving such advice and counsel, all of which together adequately states a claim for violation of the cited laws.
The doctor also challenged the accuracy of the information about which the expert testified but the Michigan Appellate Court stated that just because the doctor disagreed with the expert’s testimony did not render it either untruthful or inadmissible; the conflict was to be resolved by the fact-finder, which is invested with the authority to assess witness credibility and to weigh the evidence presented.
The Michigan Appellate Court affirmed the Board’s Order.
Source: Department of Licensing and Regulatory Affairs v. Abdelbaset Abdelmagid Youssef, M.D., No. 330222
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