Robert A. Smith, M.D.; Revocation of Registration, 24629-24631 [05-9244]
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Federal Register / Vol. 70, No. 89 / Tuesday, May 10, 2005 / Notices
substances, as required by 21 U.S.C.
827(a)(1) and 21 CFR 1304.11; and
failure to preserve DEA order forms, as
required by 21 CFR 1305.13.
Pursuant to an April 20, 2004,
Stipulation and Order with DOPL, Dr.
Poulter’s state license to handle
controlled substances and his dental
license were revoked. However, the
revocation orders were stayed as to both
licenses and he was placed on probation
for a term of five years. He was again
ordered to abstain from personal use of
controlled substances and his
Anesthesia Permit was restricted to
certain enumerated drugs.
Pursuant to 21 U.S.C. 824(a)(2), the
Deputy Administrator may revoke a
DEA Certificate of Registration and deny
any pending applications for such a
certificate upon a finding that the
registrant has been convicted of a felony
related to controlled substances under
state or Federal law. The Deputy
Administrator finds Dr. Poulter has been
convicted of a state felony relating to
controlled substances and that
revocation of his registration is
appropriate under 21 U.S.C. 824(a)(2).
Additionally, the Deputy
Administrator may revoke a DEA
Certificate of Registration and deny any
pending applications for such certificate
if she determines that the issuance of
such registration would be inconsistent
with the public interest, as determined
pursuant to 21 U.S.C. 823(a)(4) and
823(f). Section 823(f) requires the
following factors be considered:
(1) The recommendation of the
appropriate state licensing board or
professional disciplinary authority.
(2) The applicant’s experience in
dispensing, or conducting research with
respect to controlled substances.
(3) The applicant’s conviction record
under Federal or State law relating to
the manufacture, distribution, or
dispensing of controlled substances.
(4) Compliance with applicable State,
Federal, or local laws relating to
controlled substances.
(5) Such other conduct which may
threaten the public health or safety.
As a threshold matter, it should be
noted that the factors specified in
section 823(f) are to be considered in the
disjunctive: The Deputy Administrator
may properly rely on any one or a
combination of the factors, and give
each factor the weight she deems
appropriate, in determining whether a
registration should be revoked or
denied. See Henry J. Schwarz, Jr., M.D.,
54 FR 16,422 (1989).
With regard to the public interest
factors of 21 U.S.C. 823(f), as to factor
one, recommendation of the state
licensing board/disciplinary authority,
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16:17 May 09, 2005
Jkt 205001
it is noted that the Utah DOPL took
disciplinary action against Dr. Poulter.
However, it allowed his state dental
license and Anesthesia Permit to
continue in a probationary status, with
certain enumerated conditions.
Accordingly, to the extent that Utah has
allowed Dr. Poulter to continue
practicing dentistry and handle some
controlled substances, that weighs in
favor of continued registration with
DEA. However, ‘‘inasmuch as State
licensure is a necessary but not
sufficient condition for a DEA
registration * * * this factor is not
dispositive.’’ See Edson W. Redard,
M.D., 65 FR 30616, 30619.
Regarding factors two, three, four and
five, the conduct and actions discussed
earlier which resulted in his felony and
misdemeanor convictions are all
relevant and adverse to Dr. Poulter.
While the controlled substances were
apparently being diverted for personal
use and not for others, the record
reflects that simple opportunities and
leniency were extended Dr. Poulter by
the state criminal justice system and
Utah’s licensing authorities. He had an
excellent chance to address his
substance abuse problems with minimal
personal and professional impact.
Nevertheless, despite crystal clear
notice of the consequences of violating
the Plea in Abeyance Agreement and the
benefits of a rehabilitative and
monitoring program for impaired
professionals, Dr. Poulter threw away
the opportunities afforded him.
Instead of getting his personal and
professional life back on track, he chose
to resume abusing controlled substances
and whle doing so, endangered the
public by operating a motor vehicle
while under the influence of drugs.
Through his inability to refrain from
criminal and self-abusive behavior, Dr.
Poulter has demonstrated poor
judgment, questionable character and an
inability to comply with the
responsibilities of a DEA registrant.
In light of the foregoing, the Deputy
Administrator finds that Dr. Poulter’s
registration would be inconsistent with
the public interest, as that term is used
in 21 U.S.C. 823(f) and 824(a)(4).
Accordingly, the Deputy
Administrator of the Drug Enforcement
Administration, pursuant to the
authority vested in her by 21 U.S.C. 823
and 824 and 28 CFR 0.100(b) and 0.104,
hereby orders that DEA Certificate of
Registration BP7418177, previously
issued to John S. Poulter, D.D.C., be, and
it hereby is, revoked. The Deputy
Administrator further orders that any
pending applications for renewal or
modification of such registration be, and
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Sfmt 4703
24629
they hereby are, denied. This order is
effective June 9, 2005.
Dated: May 2, 2005.
Michele M. Leonhart,
Deputy Administrator.
[FR Doc. 05–9248 Filed 5–9–05; 8:45 am]
BILLING CODE 4410–09–M
DEPARTMENT OF JUSTICE
Drug Enforcement Administration
Robert A. Smith, M.D.; Revocation of
Registration
On September 29, 2004, the Deputy
Administrator, Drug Enforcement
Administration (DEA), issued an Order
to Show Cause/Immediate Suspension
of Registration to Robert A. Smith, M.D.
(Dr. Smith) who was notified of an
opportunity to show cause as to why
DEA should not revoke his DEA
Certificate of Registration AS2502284
under 21 U.S.C. 824(a)(4) and deny any
pending applications for renewal or
modification of that registration under
21 U.S.C. 823(f). Dr. Smith was further
notified that his registration was being
immediately suspended under 21 U.S.C.
824(d) as an imminent danger to the
public health and safety.
The Order to Show Cause alleged in
relevant part, that Dr. Smith diverted
controlled substances for a substantial
time by knowingly issuing fraudulent
prescriptions to individuals, without a
bona fide doctor-patient relationship or
legitimate medical purpose. The Order
to Show Cause also notified Dr. Smith
that should not request for a hearing be
filed within 30 days, his hearing right
would be deemed waived.
On October 20, 2004, a DEA
investigator personally served the Order
to Show Cause/Immediate Suspension
of Registration on Dr. Smith’s attorney
at Respondent’s medical office in
Philadelphia, Pennsylvania. Since that
date, DEA has not received a request for
a hearing or any other reply from Dr.
Smith or anyone purporting to represent
him in this matter.
Therefore, the Deputy Administrator
of DEA, finding that (1) thirty days
having passed since personal delivery of
the Order to Show Cause/Immediate
Suspension of Registration to the
registrant and (2) no request for hearing
having been received, concludes that Dr.
Smith is deemed to have waived his
hearing right. See David W. Linder, 67
FR 12579 (2002). After considering
material from the investigative file in
this matter, the Deputy Administrator
now enters her final order without a
hearing pursuant to 21 CFR 1301.43(d)
and (e) and 1301.46.
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Federal Register / Vol. 70, No. 89 / Tuesday, May 10, 2005 / Notices
The Deputy Administrator finds that
Dr. Smith is registered with DEA as a
practitioner under Certificate of
Registration AS2502284 with a
registered location at 1420 Locust Street,
Suite 200, Philadelphia, Pennsylvania.
In May 2003, DEA began investigating
Dr. Smith as a result of complaints from
area pharmacies that were encountering
large numbers of young, seemingly
healthy individuals, filling prescriptions
issued by Dr. Smith for OxyContin and
Percocet, both schedule II controlled
substances. These individuals paid cash
for their prescriptions and appeared to
be traveling long distances to have them
prescribed and filled.
On June 27, 2003, Independence Blue
Cross (IBC) insurance investigators
interviewed IBC beneficiary ‘‘H.B.’’
regarding prescriptions for OcyContin,
Percocet and Methadone which had
been issued by Dr. Smith under her
name and insurance data. H.B. had
never seen or heard of Dr. Smith and
had no medical conditions warranting
the prescriptions. It was also established
that H.B.’s son’s father, ‘‘M.P.,’’ was a
heroin addict and that M.P.’s sister,
‘‘L.P.,’’ who also had a history of
narcotic’s abuse, worked for Dr. Smith
as his office assistant.
On July 9, 2003, IBC investigators
interviewed ‘‘C.P.,’’ who was L.P.’s
sister. IBC’s records reflected that on
May 10, 2003, Dr. Smith issued
prescriptions for Percocet and
Alprazolam (Xanax), a schedule IV
controlled substance, using C.P.’s name
and policy, which were then paid for by
insurance company. Investigators
determined C.P. had never met or been
examined by Dr. Smith, that she did not
receive the prescriptions written in her
name and had no medical conditions
warranting them.
On November 6, 2003, DEA Diversion
Investigators responded to the Lombard
Apothecary in Philadelphia to interview
‘‘D.N.,’’ who had attempted to fill a
prescription for Oxycontin issued by Dr.
Smith using D.N.’s mother’s name and
insurance. D.N. admitted that her
mother had no knowledge of the
prescription and was a patient of Dr.
Smith. D.N. had asked Dr. Smith to
issue her fraudulent prescriptions, as
she had no medical insurance of her
own. He also had written her a
prescription for Oxycontin, using her
brother’s name and insurance data. D.N.
then used the Oxycontin to feed her
personal narcotics addiction.
On November 26, 2003, ‘‘J.S.’’ was
interviewed by local law enforcement
authorities, with DEA Division
Investigators present. She admitted
receiving seven to ten prescriptions for
Oxycontin from Dr. Smith, per visit, on
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16:17 May 09, 2005
Jkt 205001
a weekly basis. These prescriptions
would be written in J.S.’s name, as well
as her father’s and fiancée’s names. She
paid $65.00 per visit and an additional
$100.00, each time, to ensure Dr. Smith
would continue providing her
fraudulent prescriptions. Additionally,
Dr. Smith would ask J.S. for sexual
favors during her office visits. While she
personally declined to fulfill his
requests, as a substitute, she paid
another woman $100.00 to perform a
sexual act upon Dr. Smith. J.S. also
reported that Dr. Smith’s office
assistant, L.P., had provided her blank
prescriptions in return for $40.00 and
Oxycontin pills.
Dr. Smith also wrote prescriptions for
‘‘A.D.,’’ who had heard of Respondent’s
‘‘street’’ reputation for providing
controlled substance prescriptions. A.D.
was first seen by Dr. Smith in February
2003 and the only examination involved
measuring A.D.’s blood pressure. In
March and April 2003, Dr. Smith issued
prescriptions for Oxycontin and
Percocet, using both A.D.’s and his
wife’s names. In February 2004, Dr.
Smith also wrote ten prescriptions for
A.D. using A.D.’s name, his wife’s name
and a friend’s name.
On February 22, 2004, ‘‘S.K.’’ was
found, apparently unresponsive, by her
mother-in-law, who called 911. S.K.
died of a drug overdose and few weeks
later S K.’s mother-in-laws contacted
DEA Diversion Investigators and
advised that S.K. had been addicted to
narcotics and Dr. Smith was the source
of her prescriptions. The Philadelphia
Medical Examiner’s Office provided
DEA investigors 31 prescription bottles
recovered from S.K.’s residence. All of
their labels indicated they were
prescribed by Dr. Smith and the
majority was for schedule II and IV
controlled substances.
On May 20, 2004, a confidential
Source (CS) was provided $400.00 to
purchase fraudulent prescriptions
written by Dr. Smith. The CS used that
money to obtain twelve separate
prescriptions from an individual who,
inturn, had received them from Dr.
Smith.
On May 27, 2004, Diversion
Investigator’s interviewed ‘‘J.G.’’ who,
for six or eight months, had been seeing
Dr. Smith on a weekly basis. J.G. would
give Dr. Smith a list of fictitious names
and types of controlled substances he
desired and Dr. Smith would issue three
prescriptions under each name, usually
for Perocet, OxyContin and Xanax. Dr.
Smith issued between nine and fifteen
fraudulent prescriptions for controlled
substances per visit and received
$100.00 for each set of three
prescriptions. J.G. then sold the
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Fmt 4703
Sfmt 4703
prescriptions to a third party who, in
turn, sold the drugs on the street. Dr.
Smith was aware of and knowingly
participated in this scheme.
On June 1, 17 and 19, 2004, a CS
visited Dr. Smith’s medical office. On
each occasion, he obtained fraudulent
prescriptions for Xanax, OxyContin and
Percocet, paying Dr. Smith $500.00 for
fiften prescriptions, written under five
different fraudulent identities.
On June 29, 2004, Diversion
Investigators were contacted by Family
Meds, a mail order pharmacy in
Connecticut. On June 22, 2004, the
pharmacy received five prescriptions for
controlled substances written by Dr.
Smith for ‘‘M. B.’’ Family Meds had
contacted Dr. Smith, who verified
issuing the prescriptions. However, the
pharmacy ultimately refused to fill them
and verified that on June 6, 2004, M. B.
had filled identical prescriptions issued
by Dr. Smith at another pharmacy.
A review of reports from the
Pennsylvania Attorney General’s Office,
Bureau of Narcotics Investigation and
Drug Control showed that from January
14, 2002, to April 30, 2004, Dr. Smith
issued over 6,500 prescriptions for
schedule II narcotic controlled
substances. These prescriptions
constituted a significant portion of the
total schedule II prescriptions filled in
the Philadelphia and New Jersey area.
Pursuant to 21 U.S.C. 823(f) and
824(a)(4), the Deputy Administrator may
revoke a DEA Certificate of Registration
and deny any pending applications for
renewal of such registration, if she
determines that the continued
registration would be inconsistent with
the public interest. Section 823(f)
requires that the following factors be
considered in determining the public
interest:
(1) The recommendation of the
appropriate state licensing board or
professional disciplinary authority.
(2) The applicant’s experience in
dispensing, or conducting research with
respect to controlled substances.
(3) The applicant’s conviction record
under federal or state laws relating to
the manufacture, distribution, or
dispensing of controlled substances.
(4) Compliance with applicable state,
federal, or local laws relating to
controlled substances.
(5) Such other conduct which may
threaten the public health or safety.
These factors are considered in the
disjunctive; the Deputy Administrator
may rely on any one or a combination
of factors and may give each factor the
weight she deems appropriate in
determining whether a registration
should be revoked or an application for
E:\FR\FM\10MYN1.SGM
10MYN1
Federal Register / Vol. 70, No. 89 / Tuesday, May 10, 2005 / Notices
registration denied. See Henry J.
Schwartz, Jr., M.D., 54 FR 16422 (1989).
As to factor one, the recommendation
of the appropriate state licensing board
or professional disciplinary authority,
there is no evidence in the investigative
file that the State of Pennsylvania has
yet taken adverse action against Dr.
Smith’s medical license. However,
‘‘inasmuch as State licensure is a
necessary but not sufficient condition
for a DEA registration * * * this factor
is not dispositive.’’ See Edson W.
Redard, M.D., 65 FR 30616, 30619
(2000).
With regard to factors two and four,
Respondent’s experience in handling
controlled substances and his
compliance with applicable controlled
substance laws, the investigative file
contains overwhelming evidence that
Dr. Smith unlawfully prescribed and
diverted controlled substances over an
extensive period of time. He knowingly
prescribed controlled substances to
individuals without bona fide doctorpatient relationships and issued
fraudulent prescriptions destined to
feed the recipient’s personal addiction
or to be sold on the street. He did so in
a calculated manner, for financial gain,
violating multiple state and federal laws
and abysmally failing to meet the
rudimentary responsibilities of a
physician and registrant. Thus, factors
two and four weigh in favor of a finding
that continued registration would be
inconsistent with the public interest.
Factor three, the applicant’s
conviction record under federal or state
laws relating to the manufacture,
distribution, or dispensing of controlled
substances, is not relevant for
consideration, as there is no evidence
Dr. Smith has yet been convicted of nay
crime related to controlled substances.
However, it is noted the investigation
has been provided to Federal authorities
for possible initiation of criminal
charges.
With respect to factor five, other
conduct that may threaten the public
health and safety, Respondent’s actions
discussed above are also relevant under
this factor. The Deputy Administrator is
particularly troubled by Dr. Smith’s
efforts to enrich himself at the expense
of the public health and safety. Not only
has a large quantity of controlled
substances been diverted over an
extensive period of time as a result of
this illegal activities, at least one patient
has died of a drug overdose after taking
medications prescribed by Dr. Smith.
The exact degree of suffering and
costs, both social and economic,
stemming from Dr. Smith’s activities
will never be known. Suffice it to say,
his unprofessional and criminal conduct
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16:17 May 09, 2005
Jkt 205001
has resulted in the diversion of large
quantities of controlled substances in
the Philadelphia area for a lengthy
period of time, with correspondingly
severe consequences for public health
and safety.
In sum, Dr. Smith’s cavalier disregard
for the law and abandonment of his
responsibilities as a physician and
registrant cannot be tolerated. They
weigh, irresistibly, in favor of a finding
that continued registration would not be
in the public interest.
Accordingly, the Deputy
Administrator of the Drug Enforcement
Administration,pursuant to the
authority vested in her by 21 U.S.C. and
28 CFR 0.100(b), and 0.104, hereby
orders the DEA Certificate of
Registration AS2502284, issued to
Robert A. Smith, M.D., be, and it hereby
is, revoked. The Deputy Administrator
further orders that any pending
applications for renewal or modification
of such registration be, and they hereby
are, denied. This order is effective June
9, 2005.
Dated: May 2, 2005.
Michele M. Leonhart,
Deputy Administrator.
[FR Doc. 05–9244 Filed 5–9–05; 8:45 am]
BILLING CODE 4410–09–M
DEPARTMENT OF LABOR
Office of the Secretary
Combating Exploitive Child Labor
Through Education in Guyana
May 10, 2005.
Bureau of International Labor
Affairs, Department of Labor.
Announcement Type: New. Notice of
Availability of Funds and Solicitation
for Cooperative Agreement
Applications.
Funding Opportunity Number: SGA
05–02.
Catalog of Federal Domestic
Assistance (CFDA) Number: Not
applicable.
AGENCY:
Key Dates: Deadline for
Submission of Application is July 11,
2005.
SUMMARY: The U.S. Department of
Labor, Bureau of International Labor
Affairs, will award up to U.S. $2 million
through one or more cooperative
agreements to an organization or
organizations to improve access to and
quality of education programs as a
means to combat exploitive child labor
in Guyana. Projects funded under this
solicitation will provide educational
and training opportunities to children as
a means of removing and/or preventing
DATES:
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Frm 00134
Fmt 4703
Sfmt 4703
24631
them from engaging in exploitive work
or the worst forms of child labor. The
activities funded will complement and
expand upon existing projects and
programs to improve basic education in
the country. Applications must respond
to the entire Statement of Work outlined
in this solicitation. In Guyana, activities
under these cooperative agreements will
provide the direct delivery of quality
basic education to working children and
those at risk of entering work, and will
result in their enrollment, persistence,
and completion of an education or
training program.
I. Funding Opportunity Description
The U.S. Department of Labor
(USDOL), Bureau of International Labor
Affairs (ILAB), announces the
availability of funds to be awarded by
cooperative agreement to one or more
qualifying organizations for the purpose
of expanding access to and quality of
basic education and strengthening
government and civil society’s capacity
to address the education needs of
working children and those at risk of
entering in work in Guyana. The overall
purpose of USDOL’s Child Labor
Education Initiative, as consistently
enunciated in USDOL appropriations
FY 2000 through FY 2005, is to work
toward the elimination of the worst
forms of child labor through the
provision of basic education.
Accordingly, entities applying under
this solicitation must develop and
implement strategies for the prevention
and withdrawal of children from the
worst forms of child labor, consistent
with this purpose. ILAB is authorized to
award and administer this program by
the Consolidated Appropriations Act,
2005, Public Law 108–447, 118 Stat.
2809 (2004). The cooperative agreement
or cooperative agreements awarded
under this initiative will be managed by
ILAB’s International Child Labor
Program (ICLP) to assure achievement of
the stated goals. Applicants are
encouraged to be creative in proposing
cost-effective interventions that will
have a demonstrable impact in
promoting school attendance and
completion in the geographical areas
where children are engaged in or are
most at risk of working in the worst
forms of child labor.
1. Background and Program Scope
A. USDOL Support of Global
Elimination of Exploitive Child Labor
The International Labor Organization
(ILO) estimated that 211 million
children ages 5 to 14 were working
around the world in 2000. Full-time
child workers are generally unable to
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Agencies
[Federal Register Volume 70, Number 89 (Tuesday, May 10, 2005)]
[Notices]
[Pages 24629-24631]
From the Federal Register Online via the Government Printing Office [www.gpo.gov]
[FR Doc No: 05-9244]
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DEPARTMENT OF JUSTICE
Drug Enforcement Administration
Robert A. Smith, M.D.; Revocation of Registration
On September 29, 2004, the Deputy Administrator, Drug Enforcement
Administration (DEA), issued an Order to Show Cause/Immediate
Suspension of Registration to Robert A. Smith, M.D. (Dr. Smith) who was
notified of an opportunity to show cause as to why DEA should not
revoke his DEA Certificate of Registration AS2502284 under 21 U.S.C.
824(a)(4) and deny any pending applications for renewal or modification
of that registration under 21 U.S.C. 823(f). Dr. Smith was further
notified that his registration was being immediately suspended under 21
U.S.C. 824(d) as an imminent danger to the public health and safety.
The Order to Show Cause alleged in relevant part, that Dr. Smith
diverted controlled substances for a substantial time by knowingly
issuing fraudulent prescriptions to individuals, without a bona fide
doctor-patient relationship or legitimate medical purpose. The Order to
Show Cause also notified Dr. Smith that should not request for a
hearing be filed within 30 days, his hearing right would be deemed
waived.
On October 20, 2004, a DEA investigator personally served the Order
to Show Cause/Immediate Suspension of Registration on Dr. Smith's
attorney at Respondent's medical office in Philadelphia, Pennsylvania.
Since that date, DEA has not received a request for a hearing or any
other reply from Dr. Smith or anyone purporting to represent him in
this matter.
Therefore, the Deputy Administrator of DEA, finding that (1) thirty
days having passed since personal delivery of the Order to Show Cause/
Immediate Suspension of Registration to the registrant and (2) no
request for hearing having been received, concludes that Dr. Smith is
deemed to have waived his hearing right. See David W. Linder, 67 FR
12579 (2002). After considering material from the investigative file in
this matter, the Deputy Administrator now enters her final order
without a hearing pursuant to 21 CFR 1301.43(d) and (e) and 1301.46.
[[Page 24630]]
The Deputy Administrator finds that Dr. Smith is registered with
DEA as a practitioner under Certificate of Registration AS2502284 with
a registered location at 1420 Locust Street, Suite 200, Philadelphia,
Pennsylvania. In May 2003, DEA began investigating Dr. Smith as a
result of complaints from area pharmacies that were encountering large
numbers of young, seemingly healthy individuals, filling prescriptions
issued by Dr. Smith for OxyContin and Percocet, both schedule II
controlled substances. These individuals paid cash for their
prescriptions and appeared to be traveling long distances to have them
prescribed and filled.
On June 27, 2003, Independence Blue Cross (IBC) insurance
investigators interviewed IBC beneficiary ``H.B.'' regarding
prescriptions for OcyContin, Percocet and Methadone which had been
issued by Dr. Smith under her name and insurance data. H.B. had never
seen or heard of Dr. Smith and had no medical conditions warranting the
prescriptions. It was also established that H.B.'s son's father,
``M.P.,'' was a heroin addict and that M.P.'s sister, ``L.P.,'' who
also had a history of narcotic's abuse, worked for Dr. Smith as his
office assistant.
On July 9, 2003, IBC investigators interviewed ``C.P.,'' who was
L.P.'s sister. IBC's records reflected that on May 10, 2003, Dr. Smith
issued prescriptions for Percocet and Alprazolam (Xanax), a schedule IV
controlled substance, using C.P.'s name and policy, which were then
paid for by insurance company. Investigators determined C.P. had never
met or been examined by Dr. Smith, that she did not receive the
prescriptions written in her name and had no medical conditions
warranting them.
On November 6, 2003, DEA Diversion Investigators responded to the
Lombard Apothecary in Philadelphia to interview ``D.N.,'' who had
attempted to fill a prescription for Oxycontin issued by Dr. Smith
using D.N.'s mother's name and insurance. D.N. admitted that her mother
had no knowledge of the prescription and was a patient of Dr. Smith.
D.N. had asked Dr. Smith to issue her fraudulent prescriptions, as she
had no medical insurance of her own. He also had written her a
prescription for Oxycontin, using her brother's name and insurance
data. D.N. then used the Oxycontin to feed her personal narcotics
addiction.
On November 26, 2003, ``J.S.'' was interviewed by local law
enforcement authorities, with DEA Division Investigators present. She
admitted receiving seven to ten prescriptions for Oxycontin from Dr.
Smith, per visit, on a weekly basis. These prescriptions would be
written in J.S.'s name, as well as her father's and fiancée's names.
She paid $65.00 per visit and an additional $100.00, each time, to
ensure Dr. Smith would continue providing her fraudulent prescriptions.
Additionally, Dr. Smith would ask J.S. for sexual favors during her
office visits. While she personally declined to fulfill his requests,
as a substitute, she paid another woman $100.00 to perform a sexual act
upon Dr. Smith. J.S. also reported that Dr. Smith's office assistant,
L.P., had provided her blank prescriptions in return for $40.00 and
Oxycontin pills.
Dr. Smith also wrote prescriptions for ``A.D.,'' who had heard of
Respondent's ``street'' reputation for providing controlled substance
prescriptions. A.D. was first seen by Dr. Smith in February 2003 and
the only examination involved measuring A.D.'s blood pressure. In March
and April 2003, Dr. Smith issued prescriptions for Oxycontin and
Percocet, using both A.D.'s and his wife's names. In February 2004, Dr.
Smith also wrote ten prescriptions for A.D. using A.D.'s name, his
wife's name and a friend's name.
On February 22, 2004, ``S.K.'' was found, apparently unresponsive,
by her mother-in-law, who called 911. S.K. died of a drug overdose and
few weeks later S K.'s mother-in-laws contacted DEA Diversion
Investigators and advised that S.K. had been addicted to narcotics and
Dr. Smith was the source of her prescriptions. The Philadelphia Medical
Examiner's Office provided DEA investigors 31 prescription bottles
recovered from S.K.'s residence. All of their labels indicated they
were prescribed by Dr. Smith and the majority was for schedule II and
IV controlled substances.
On May 20, 2004, a confidential Source (CS) was provided $400.00 to
purchase fraudulent prescriptions written by Dr. Smith. The CS used
that money to obtain twelve separate prescriptions from an individual
who, inturn, had received them from Dr. Smith.
On May 27, 2004, Diversion Investigator's interviewed ``J.G.'' who,
for six or eight months, had been seeing Dr. Smith on a weekly basis.
J.G. would give Dr. Smith a list of fictitious names and types of
controlled substances he desired and Dr. Smith would issue three
prescriptions under each name, usually for Perocet, OxyContin and
Xanax. Dr. Smith issued between nine and fifteen fraudulent
prescriptions for controlled substances per visit and received $100.00
for each set of three prescriptions. J.G. then sold the prescriptions
to a third party who, in turn, sold the drugs on the street. Dr. Smith
was aware of and knowingly participated in this scheme.
On June 1, 17 and 19, 2004, a CS visited Dr. Smith's medical
office. On each occasion, he obtained fraudulent prescriptions for
Xanax, OxyContin and Percocet, paying Dr. Smith $500.00 for fiften
prescriptions, written under five different fraudulent identities.
On June 29, 2004, Diversion Investigators were contacted by Family
Meds, a mail order pharmacy in Connecticut. On June 22, 2004, the
pharmacy received five prescriptions for controlled substances written
by Dr. Smith for ``M. B.'' Family Meds had contacted Dr. Smith, who
verified issuing the prescriptions. However, the pharmacy ultimately
refused to fill them and verified that on June 6, 2004, M. B. had
filled identical prescriptions issued by Dr. Smith at another pharmacy.
A review of reports from the Pennsylvania Attorney General's
Office, Bureau of Narcotics Investigation and Drug Control showed that
from January 14, 2002, to April 30, 2004, Dr. Smith issued over 6,500
prescriptions for schedule II narcotic controlled substances. These
prescriptions constituted a significant portion of the total schedule
II prescriptions filled in the Philadelphia and New Jersey area.
Pursuant to 21 U.S.C. 823(f) and 824(a)(4), the Deputy
Administrator may revoke a DEA Certificate of Registration and deny any
pending applications for renewal of such registration, if she
determines that the continued registration would be inconsistent with
the public interest. Section 823(f) requires that the following factors
be considered in determining the public interest:
(1) The recommendation of the appropriate state licensing board or
professional disciplinary authority.
(2) The applicant's experience in dispensing, or conducting
research with respect to controlled substances.
(3) The applicant's conviction record under federal or state laws
relating to the manufacture, distribution, or dispensing of controlled
substances.
(4) Compliance with applicable state, federal, or local laws
relating to controlled substances.
(5) Such other conduct which may threaten the public health or
safety.
These factors are considered in the disjunctive; the Deputy
Administrator may rely on any one or a combination of factors and may
give each factor the weight she deems appropriate in determining
whether a registration should be revoked or an application for
[[Page 24631]]
registration denied. See Henry J. Schwartz, Jr., M.D., 54 FR 16422
(1989).
As to factor one, the recommendation of the appropriate state
licensing board or professional disciplinary authority, there is no
evidence in the investigative file that the State of Pennsylvania has
yet taken adverse action against Dr. Smith's medical license. However,
``inasmuch as State licensure is a necessary but not sufficient
condition for a DEA registration * * * this factor is not
dispositive.'' See Edson W. Redard, M.D., 65 FR 30616, 30619 (2000).
With regard to factors two and four, Respondent's experience in
handling controlled substances and his compliance with applicable
controlled substance laws, the investigative file contains overwhelming
evidence that Dr. Smith unlawfully prescribed and diverted controlled
substances over an extensive period of time. He knowingly prescribed
controlled substances to individuals without bona fide doctor-patient
relationships and issued fraudulent prescriptions destined to feed the
recipient's personal addiction or to be sold on the street. He did so
in a calculated manner, for financial gain, violating multiple state
and federal laws and abysmally failing to meet the rudimentary
responsibilities of a physician and registrant. Thus, factors two and
four weigh in favor of a finding that continued registration would be
inconsistent with the public interest.
Factor three, the applicant's conviction record under federal or
state laws relating to the manufacture, distribution, or dispensing of
controlled substances, is not relevant for consideration, as there is
no evidence Dr. Smith has yet been convicted of nay crime related to
controlled substances. However, it is noted the investigation has been
provided to Federal authorities for possible initiation of criminal
charges.
With respect to factor five, other conduct that may threaten the
public health and safety, Respondent's actions discussed above are also
relevant under this factor. The Deputy Administrator is particularly
troubled by Dr. Smith's efforts to enrich himself at the expense of the
public health and safety. Not only has a large quantity of controlled
substances been diverted over an extensive period of time as a result
of this illegal activities, at least one patient has died of a drug
overdose after taking medications prescribed by Dr. Smith.
The exact degree of suffering and costs, both social and economic,
stemming from Dr. Smith's activities will never be known. Suffice it to
say, his unprofessional and criminal conduct has resulted in the
diversion of large quantities of controlled substances in the
Philadelphia area for a lengthy period of time, with correspondingly
severe consequences for public health and safety.
In sum, Dr. Smith's cavalier disregard for the law and abandonment
of his responsibilities as a physician and registrant cannot be
tolerated. They weigh, irresistibly, in favor of a finding that
continued registration would not be in the public interest.
Accordingly, the Deputy Administrator of the Drug Enforcement
Administration,pursuant to the authority vested in her by 21 U.S.C. and
28 CFR 0.100(b), and 0.104, hereby orders the DEA Certificate of
Registration AS2502284, issued to Robert A. Smith, M.D., be, and it
hereby is, revoked. The Deputy Administrator further orders that any
pending applications for renewal or modification of such registration
be, and they hereby are, denied. This order is effective June 9, 2005.
Dated: May 2, 2005.
Michele M. Leonhart,
Deputy Administrator.
[FR Doc. 05-9244 Filed 5-9-05; 8:45 am]
BILLING CODE 4410-09-M