CRJ Pharmacy, Inc. and YPM Total Care Pharmacy, Inc.; Revocation of Registrations, 30846-30849 [E7-10624]

Agencies

• Drug Enforcement Administration
• Department of Justice

[Federal Register Volume 72, Number 106 (Monday, June 4, 2007)]
[Notices]
[Pages 30846-30849]
From the Federal Register Online via the Government Printing Office [www.gpo.gov]
[FR Doc No: E7-10624]


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DEPARTMENT OF JUSTICE

Drug Enforcement Administration

[Docket No. 07-19]


CRJ Pharmacy, Inc. and YPM Total Care Pharmacy, Inc.; Revocation 
of Registrations

    This is a consolidated proceeding involving two pharmacies under 
common ownership. On February 2, 2007, I issued an Order to Show Cause 
and Immediate Suspension of DEA Certificates of Registration, 
BC9458539, issued to CRJ Pharmacy, Inc., and BY9713276, issued to YPM 
Total Care Pharmacy, both of Lakeland, Florida. I immediately suspended 
each Respondent's registration based on my preliminary finding that 
they had ``diverted and continue to divert massive amounts of 
controlled substances in violation'' of federal law ``thereby creating 
an imminent danger to public health or safety.'' Show Cause Order at 5. 
The Show Cause Order further sought the revocation of each Respondent's 
registration on the ground that its continued registration would be 
``inconsistent with the public interest.'' Id. at 1 (citing 21 U.S.C. 
823(f) & 824(a)(4)).
    With respect to CRJ Pharmacy, the Show Cause Order alleged that it 
was the fourteenth largest retail purchaser of hydrocodone-combination 
products in the State of Florida, and that ``[f]rom January through 
November 2006, CRJ purchased 1,416,320 dosage units of brand name and 
generic hydrocodone combination products,'' a schedule III controlled 
substance. Id. The Show Cause Order further alleged that on March 30, 
2006, DEA investigators had inspected CRJ and determined that it filled 
controlled substance orders placed through a Web site, 
yourpainmanagement.com; that the orders were for persons throughout the 
United States; and that the orders were authorized by only two 
physicians. Id. at 2. According to the allegations, one of the 
physicians was licensed to practice only in Florida; the other was 
licensed only in Minnesota. Id.
    The Show Cause Order further alleged that on January 22, 2007, DEA 
investigators executed an administrative search warrant at CRJ and 
obtained records showing that between July 3, 2006, and January 22, 
2007, CRJ had ``filled approximately 19,223 controlled substance drug 
orders and shipped them to customers throughout the United States.'' 
Id. The Show Cause Order also alleged that these prescriptions were 
authorized by physicians located in Texas, Wisconsin, Puerto Rico, New 
York, California, Kansas, and Florida, for persons who did not reside 
in the same States as the physicians, that the prescriptions were 
disproportionately for ``one or two types of highly addictive and 
abused controlled substances,'' that ``CRJ filled large quantities of 
prescriptions per day, per physician,'' and thus CRJ knew or should 
have known that the prescriptions it dispensed ``were not issued `for a 
legitimate medical purpose by an individual practitioner acting in the 
usual course of his professional practice.' '' Id. at 4 (quoting 21 CFR 
1306.04(a)).
    The Show Cause Order alleged that CRJ's owner, Mr. Chris Larson, 
had admitted to investigators that he owned bestrxcare.com. Id. at 2. 
According to the Show Cause Order, Mr. Larson told investigators that 
persons seeking controlled substances completed an on-line 
questionnaire and then faxed their medical records to bestrxcare.com, 
where they were scanned into a database for review by either a 
physician or a physician's assistant (PA). Id. Mr. Larson allegedly 
told investigators that if the records were ``ok,'' a physician or a PA 
would then consult with the customer by telephone. Id. According to the 
Show Cause Order, after the customer had paid the Web site and the 
phone consultation was completed, a ``prescription'' was issued which 
CRJ then downloaded from the Internet and dispensed. Id.
    The Show Cause Order further alleged that a physician employed by 
Larson had admitted to investigators that Larson was using his DEA 
``license for pain pills.'' Id. at 3. According to the Show Cause 
Order, the physician further admitted that ``he does not speak with any 
of the Internet customers or their primary care physicians,'' and that 
he ``does not diagnose the Internet customers or provide after care 
services for the Internet customers.'' Id.
    With respect to YPM, the Show Cause Order alleged that it was 
dispensing controlled substances that were ordered through another Web 
site, yourpainmanagment.com, which was also owned by Larson. Id. at 4. 
The Show Cause Order alleged that on August 17, 2005, Larson stated to 
DEA investigators that a person could order controlled substances for 
pain management through this Web site by completing a form on which 
they provided their name, address, billing information, general 
biographic details and medical complaint. Id. Larson allegedly also 
told investigators that the customers would then fax their medical 
records to the Web site where they were then reviewed by a PA; if the 
records appeared ``in order,'' either a physician or the PA would 
conduct a telephone consultation with the customer. Id. The Show Cause 
Order further alleged that during this interview, one of Larson's 
employees told DEA investigators that the Web site does not order 
further testing of its customers and does not contact the physicians 
named on the customers' medical records. Id.
    The Show Cause Order also alleged that from May 2006 through 
November 2006, YPM had purchased 841,800 units of hydrocodone-
combination products. Id. Relatedly, the Show Cause Order alleged that 
YPM records showed that it had dispensed 17,336 controlled substance 
orders to internet customers throughout the United States and that

[[Page 30847]]

98 percent of the orders were authorized by three physicians. Id. The 
Show Cause Order further alleged that two of these physicians were 
licensed to practice medicine in Florida; moreover, between June 1, 
2006, and January 19, 2007, the third physician, who was licensed in 
Minnesota, had authorized 15,050 orders. Id. The Show Cause Order thus 
alleged that YPM ``knew or should have known that the `prescriptions' 
[it] dispensed were not issued `for a legitimate medical purpose by an 
individual practitioner acting in the usual course of his professional 
practice''' and violated federal law. Id. at 4 (quoting 21 CFR 
1306.04(a)).
    On February 5, 2007, both CRJ and YPM were served with the Order to 
Show Cause and Immediate Suspension of Registrations. On February 22, 
2007, both Respondents, who were represented by the same counsel, 
requested a hearing on the allegations. The matters were assigned to 
Administrative Law Judge (ALJ) Mary Ellen Bittner.
    On March 12, 2007, the Government moved for summary disposition. 
The basis for the Government's motion was that Respondents had closed 
their businesses on February 12, 2007, and had ``transferred all 
prescription records, inventory, and required DEA records to other DEA 
registrants.'' Gov. Mot. for Summ. Disp. at 1. The Government's motion 
further asserted that on February 27, 2007, Respondent CRJ had 
surrendered its Florida Board of Pharmacy License to the Florida Board 
of Pharmacy. Id. The Government further asserted that Respondent YPM 
had ``signified its intent to surrender its Florida Board of Pharmacy 
License in its letter to DEA dated February 22, 2007.'' Id. at 2. The 
Government thus asserted that both ``Respondents are currently without 
authority under Florida law to dispense controlled substances'' and 
therefore are not entitled to maintain their DEA registrations. Id.
    In support of its motion, the Government attached copies of letters 
from both YPM (dated Feb. 27, 2007) and CRJ (dated Feb. 28, 2007) to 
the DEA Miami Office; each letter advised that the pharmacy had closed, 
that it was in the process of surrendering its state license, and 
sought permission to act as a one-time wholesaler to sell the 
controlled substances (which apparently were still in their possession) 
to another pharmacy. See Appendices I & II to Gov. Mot. The Government 
also attached a copy of the letter from CRJ to the Florida Board of 
Pharmacy, by which it surrendered its state license. See Appendix III 
to Gov. Mot. The Government's submission did not, however, include a 
similar letter from YPM.
    Respondent did not oppose this motion. Response to Gov. Motion for 
Summ. Disp. at 1. However, on March 16, 2007, the Government had also 
filed a motion to supplement the motion for summary disposition. The 
Government based its motion on my decision in William R. Lockridge, 
M.D., 71 FR 77,791 (2006). In Lockridge, I reviewed the propriety of an 
immediate suspension in a case in which the Respondent's registration 
had expired, in part, because of the collateral consequences which 
attached with the issuance of the suspension. The Government thus moved 
to submit several affidavits of DEA investigators to support ``the 
basis for the immediate suspensions.'' Gov. Mot. to Supp. at 1.
    Thereafter, on March 19, 2007, the ALJ afforded Respondents the 
opportunity to respond to the Government's motion by April 2, 2007. 
Subsequently, on March 22, 2007, the ALJ granted the Government's 
motion for summary disposition to the extent it sought the revocation 
of Respondents' DEA registrations on the ground that CRJ and YPM were 
without authority under Florida law to handle controlled substances and 
therefore were not entitled to maintain their DEA registrations. ALJ 
Dec. at 3. The ALJ thus recommended that Respondents' registrations be 
revoked. Id.
    The ALJ also granted the Government's motion to supplement its 
original motion for summary disposition and submit into the record the 
two affidavits. The ALJ, however, also afforded Respondents the 
opportunity to submit additional documents including affidavits.\1\
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    \1\ The ALJ did not, however, rule on the Government's 
alternative basis for summary disposition.
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    On April 2, 2007, Respondents filed their response which vigorously 
opposed the Government's motion. Respondents contended that there is 
``no dispute'' that they ``can no longer hold DEA registrations.'' 
Response at 3. Respondents maintained, however, that the Government's 
reliance on Lockridge was misplaced because in there, a full hearing 
had been held and ``[m]ootness was implicated only when the 
respondent's registration expired after the hearing.'' Id. at 4.
    Respondents further argued that ``[t]he Government itself has 
claimed that this case is moot and therefore no hearing should be 
held,'' and that this precludes a ``ruling on the immediate suspension 
as the Government seeks.'' Id. Respondents also contended that because 
of the collateral consequences that attach with the issuance of an 
immediate suspension, ``to the extent the Deputy Administrator seeks to 
uphold the suspension, CRJ and YPM have a right to a hearing.'' Id. 
Respondents thus maintained that granting the Government's supplemental 
motion would ``violate [their] hearing rights'' because the 
Government's affidavits are ``conclusory'' and cannot support the 
``factual findings'' sought by the Government. Id. at 4-5 (citing 21 
CFR 1316.41). Finally, Respondent contended that Lockridge ``does not, 
and cannot, hold that a decision on the merits may issue after a 
summary disposition.'' Id. at 5. Respondents did not, however, submit 
any affidavits of their own.
    Neither party filed exceptions to the ALJ's decision. Thereafter, 
the ALJ forwarded the record to me for final agency action. Having 
considered the record as a whole, I hereby issue this final order. I 
adopt the ALJ's recommendation that each Respondent's registration be 
revoked on the ground that it no longer has authority to handle 
controlled substances in the State of Florida and thus is not entitled 
to hold a DEA registration in that State. I further conclude that my 
decision in Lockridge is not controlling and that the issue of the 
validity of the immediate suspensions is now moot because each 
Respondent has surrendered its Florida pharmacy license and closed its 
business. Moreover, neither the Government nor Respondents have pointed 
to any non-speculative collateral consequence which a ruling on the 
merits of the immediate suspension order would resolve. I make the 
following findings.

Findings

    On April 21, 2006, Respondent YPM Total Care Pharmacy, Inc., was 
issued DEA Certificate of Registration, BY9713276, as a retail 
pharmacy, with an expiration date of May 31, 2009. On some date not 
specified in the record, Respondent CRJ Pharmacy, Inc., was issued DEA 
Certificate of Registration, BC9458539, with an expiration date of 
August 31, 2008.
    On February 7, 2007, DEA investigators served both YPM Total Care 
Pharmacy, Inc., and CRJ Pharmacy, Inc., with the above described Order 
to Show Cause and Immediate Suspension of Registration. Shortly 
thereafter, on February 12, 2007, YPM closed its pharmacy. Moreover, on 
February 26, 2007, YPM transferred its prescription records to another 
DEA registrant, and

[[Page 30848]]

on February 28, 2007, YPM transferred its records and inventory of 
controlled substances (with the Agency's approval) to that registrant. 
YPM subsequently surrendered its Florida Pharmacy License. I take 
official notice of the online records of the Florida Department of 
Health which confirm that YPM Total Care Pharmacy has closed.\2\
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    \2\ Under the Administrative Procedure Act (APA), an agency 
``may take official notice of facts at any stage in a proceeding-
even in the final decision.'' U.S. Dept. of Justice, Attorney 
General's Manual on the Administrative Procedure Act 80 (1947) (Wm. 
W. Gaunt & Sons, Inc., Reprint 1979). In accordance with the APA and 
DEA's regulations, Respondent is ``entitled on timely request, to an 
opportunity to show to the contrary.'' 5 U.S.C. 556(e); see also 21 
CFR 1316.59(e). Respondent can dispute these facts by filing a 
properly supported motion for reconsideration within fifteen days of 
service of this order, which shall begin on the date this order is 
mailed.
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    According to the record, on February 12, 2007, CRJ Pharmacy, Inc., 
also closed its pharmacy. On February 26, 2007, CJR transferred its 
prescription records to another DEA registrant, and on February 28, 
2007, transferred its records and inventory of controlled substances to 
that registrant. CJR subsequently surrendered its Florida Pharmacy 
License. I also take official notice of the online records of the 
Florida Department of Health which confirm that CRJ Pharmacy has 
closed.

Discussion

    Under the Controlled Substances Act, a practitioner must be 
currently authorized to handle controlled substances in ``the 
jurisdiction in which [it] practices'' in order to maintain its DEA 
registration. See 21 U.S.C. 802(21) (``[t]he term `practitioner' means 
a * * * pharmacy * * * licensed, registered, or otherwise permitted, by 
* * * the jurisdiction in which [it] practices * * * to * * * dispense 
a controlled substance in the course of professional practice''). See 
also id. section 823(f) (``The Attorney General shall register 
practitioners * * * if the applicant is authorized to dispense * * * 
controlled substances under the laws of the State in which [it] 
practices.''). As numerous agency orders have held, ``a registrant may 
not hold a DEA registration if it is without authority under the laws 
of the state in which it does business.'' Bourne Pharmacy, Inc., 72 FR 
18273, 18274 (2007) (quoting Oakland Medical Pharmacy, 71 FR 50100, 
50102 (2006)). Accord Rx Network of South Florida, LLC, 69 FR 62,093 
(2004); Wingfield Drugs, Inc., 52 FR 27,070 (1987).
    Each Respondent having surrendered its State license, neither now 
disputes ``that summary disposition and revocation are appropriate.'' 
Response to Gov. Mot. to Supplement at 3. Respondents do, however, 
object to the Government's submission of the two affidavits and my 
ruling on the merits of the immediate suspension.
    Respondents assert that Lockridge is distinguishable because there, 
a full evidentiary hearing had been held, and here, no such hearing has 
been held. Respondents further argue that the validity of the immediate 
suspensions is now a moot issue although they contend--inconsistently--
that they are entitled to a hearing ``before bearing the adverse 
collateral consequences'' that would arise were I to issue a ruling 
upholding the immediate suspension orders.
    I conclude that Lockridge is not controlling and that the issue of 
the validity of the immediate suspensions in this case is now moot. It 
is fundamental that the issuance of an immediate suspension imposes a 
deprivation of a property interest which gives rise to the protections 
of the Due Process Clause. See, e.g., FDIC v. Mallen, 486 U.S. 230, 240 
(1988). Subsequent events may nonetheless make clear that there is no 
longer a live controversy between the parties even when the Government 
has yet to provide the constitutionally required process. Cf. City News 
and Novelty, Inc., v. City of Waukesha, 531 U.S. 278 (2001).
    In Lockridge, I held that the proceeding was not moot 
notwithstanding that the practitioner had allowed his registration to 
expire following the hearing and there was no existing registration to 
act upon. In so holding, I relied on several factors. These included 
the collateral consequences that attached with the issuance of the 
immediate suspension, in particular the harm to the practitioner's 
reputation, and the additional disability imposed by the Agency's 
requirement to report the suspension on any subsequent application for 
a DEA registration.
    I also noted that the practitioner had not moved to dismiss the 
proceeding on mootness grounds and that he had submitted no evidence 
showing that he ``intend[ed] to permanently cease the practice of 
medicine.'' 71 FR at 77797. I thus concluded that Respondent might 
apply for a new registration and seek to engage in the same practices 
which had prompted the immediate suspension. Thus, it was not `` 
`absolutely clear that [the practitioner's] allegedly wrongful behavior 
could not reasonably be expected to recur.' '' Id. (quoting Friends of 
the Earth, Inc., v. Laidlaw Env. Servs., Inc., 528 U.S. 167, 189 (2000) 
(other quotations and citations omitted)).\3\
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    \3\ I also noted the extensive resources committed by both 
parties in litigating the case and the potential prejudice to the 
public interest were I to dismiss the proceeding without making 
findings.
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    Here, by contrast, the record establishes that each Respondent has 
not only surrendered its State license, but has also gone out of 
business. Moreover, in contrast to the registrant in Lockridge, each 
Respondent has not only engaged in affirmative acts showing that it was 
ending its business activities, it has also expressly communicated 
these facts to the Agency. Relatedly, neither Respondent opposes the 
revocation of its registration nor seeks to litigate the validity of 
the suspension orders.
    Finally, neither Respondent has asserted that it plans to re-enter 
the business of pharmacy at some future date. The speculative 
possibility that either Respondent will seek a new registration at some 
point in the future is not enough to conclude that sufficient 
collateral consequences exist to render the issue of the suspension 
orders' validity a live dispute. See, e.g., City News, 531 U.S. at 285; 
Spencer v. Kemna, 523 U.S. 1, 16 (1998). Indeed, were either Respondent 
to apply for a new registration in the future, it would nonetheless be 
required to disclose on its application the revocation being ordered 
below. Under these circumstances, the suspension orders impose on 
Respondents no additional consequence beyond what they will be required 
to disclose because of the revocations of their registrations.\4\ 
Accordingly, the issue is now moot.
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    \4\ Finally, in this proceeding, the Government apparently did 
not place under seal the controlled substances possessed by either 
Respondent at the time of the suspensions. See 21 U.S.C. 824(f). 
Accordingly, title to the controlled substances is not a collateral 
issue which would be resolved in this proceeding.
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Order

    Pursuant to the authority vested in me by 21 U.S.C. 824, as well as 
28 CFR 0.100(b) & 0.104, I hereby order that DEA Certificate of 
Registration, BC9458539, issued to CRJ Pharmacy, Inc., and DEA 
Certificate of Registration, BY9713276, issued to YPM Total Care 
Pharmacy, Inc., be, and they hereby are, revoked. I further order that 
pending applications for renewal or modification of either registration 
be, and they hereby are, denied. This order is effective July 5, 2007.


[[Page 30849]]


    Dated: May 21, 2007.
Michele M. Leonhart,
Deputy Administrator.
 [FR Doc. E7-10624 Filed 6-1-07; 8:45 am]
BILLING CODE 4410-09-P