Geoffrey D. Peterson, N.P.; Decision and Order, 49266-49268 [2016-17722]
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Federal Register / Vol. 81, No. 144 / Wednesday, July 27, 2016 / Notices
notice of investigation. Extensions of
time for submitting responses to the
complaint and the notice of
investigation will not be granted unless
good cause therefor is shown.
Failure of the respondent to file a
timely response to each allegation in the
complaint and in this notice may be
deemed to constitute a waiver of the
right to appear and contest the
allegations of the complaint and this
notice, and to authorize the
administrative law judge and the
Commission, without further notice to
the respondent, to find the facts to be as
alleged in the complaint and this notice
and to enter an initial determination
and a final determination containing
such findings, and may result in the
issuance of an exclusion order or a cease
and desist order or both directed against
the respondent.
Authority: The authority for institution of
this investigation is contained in section 337
of the Tariff Act of 1930, as amended, and
in section 210.10 of the Commission’s Rules
of Practice and Procedure, 19 CFR 210.10
(2016).
By order of the Commission.
Issued: July 22, 2016.
Lisa R. Barton,
Secretary to the Commission.
[FR Doc. 2016–17745 Filed 7–26–16; 8:45 am]
BILLING CODE 7020–02–P
DEPARTMENT OF JUSTICE
Drug Enforcement Administration
Geoffrey D. Peterson, N.P.; Decision
and Order
sradovich on DSK3GMQ082PROD with NOTICES
On April 14, 2015, the Deputy
Assistant Administrator, Office of
Diversion Control, Drug Enforcement
Administration, issued an Order to
Show Cause to Geoffrey D. Peterson,
N.P. (hereinafter, Registrant), of Hixson,
Tennessee. The Show Cause Order
proposed the revocation of Registrant’s
DEA Certificate of Registration
MP3330545,1 pursuant to which he is
authorized to dispense controlled
substances in schedules II through V, as
a mid-level practitioner, and the denial
1 While Government also alleges that Registrant
holds an additional registration (MP1971731) and
seeks its revocation as well, in its Request for Final
Agency Action, the Government acknowledges that
this registration had expired shortly before the
issuance of the Show Cause Order. To ensure that
Registrant did not file a renewal application for this
registration, I have taken official notice of
Registrant’s registration record with the Agency.
See 5 U.S.C. 556(e). That record shows that
Registrant allowed this registration to expire and
did not file an application to renew it whether
timely or not. Accordingly, I find that this
proceeding is moot insofar as it seeks the revocation
of this registration.
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of any applications on two grounds. GX
1, at 1.
First, the Show Cause Order alleged
that effective January 27, 2015, the
Tennessee Nursing Board had
summarily suspended Registrant’s nurse
practitioner license. Id. at 2. The Order
thus alleged that Registrant is currently
without authority to dispense controlled
substances in the State in which he is
registered with the Agency and
therefore, his registration is subject to
revocation. Id. (citing 21 U.S.C. 802(21),
823(f), 824(a)(3)).
Second, the Show Cause Order
alleged that Registrant materially
falsified his October 7, 2014 application
for the above registration. Id. (citing 21
U.S.C. 824(a)(1)). More specifically, the
Show Cause Order alleged that on
February 17, 2014, Registrant was
arrested by local authorities and charged
with the ‘‘unlawful possession of
marijuana.’’ Id. The Order then alleged
that the charge was still pending at the
time Registrant submitted his renewal
application, and that ‘‘[o]n this
application, [he] did not answer ‘yes’ to
the . . . liability question: ‘Has the
applicant ever been convicted of a crime
in connection with controlled
substance(s) under state or federal law,
or is any action pending?’ ’’ Id. The
Government thus alleged that Registrant
violated 21 U.S.C. 824(a)(1).2
The Show Cause Order also notified
Registrant of his right to request a
hearing on the allegations or to submit
a written statement while waiving his
right to a hearing, the procedure for
electing either option, and the
consequence of failing to elect either
option. Id. at 2–3 (citing 21 CFR
1301.43, 1301.46). On April 23, 2015,
the Show Cause Order was personally
served on Registrant by a DEA Diversion
Investigator. GX 3.
On April 7, 2016, the Government
forwarded a Request for Final Agency
Action. Therein, the Government
represented that neither Registrant ‘‘nor
anyone representing him has requested
a hearing or sent any other
correspondence to DEA.’’ Req. for Final
Agency Action, at 7. Based on the
Government’s representation, I find that
30 days have now passed since the
Show Cause Order was served on
Registrant and that he has neither
2 While the Government contends that Registrant
violated section 824(a)(1), this provision is simply
a grant of authority to the Attorney General to
revoke or suspend a registration and does not itself
impose a substantive rule of conduct. Rather, the
rule of conduct is imposed by 21 U.S.C. 843(a)(4)(A)
(‘‘It shall be unlawful for any person knowingly or
intentionally . . . to furnish false or fraudulent
material information in, or omit any material
information from, any application . . . filed under
this subchapter[.]’’).
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requested a hearing nor submitted a
written statement in lieu of hearing. 21
CFR 1301.43(b) & (c). Accordingly, I
find that Registrant has waived his right
to a hearing or to submit a written
statement and issue this Decision and
Order based on the evidence submitted
by the Government. Id. § 1301.43(d) &
(e). I make the following findings.
Findings
Registrant is the holder of DEA
Certificate of Registration MP3330545,
pursuant to which he is authorized to
dispense controlled substances in
schedules II through V, as a mid-level
practitioner, at the registered address of
Hormone Replacement Specialists, 5550
Highway 153, Suite 103, Hixson,
Tennessee. GX 7, at 1. Registrant
renewed this registration on October 7,
2014, at which time he was required to
answer the following question: ‘‘Has the
applicant ever been convicted of a crime
in connection with controlled
substance(s) under state or federal law,
or been excluded or directed to be
excluded from participation in a
medicare or state health care program,
or any [sic] such action pending?’’ GX
6. Registrant entered ‘‘N’’ for no. Id.
On February 17, 2014, Registrant was
arrested by a member of the Sequatchie
County Sheriff’s Department and
charged with felony possession of
marijuana, an offense under Tenn. Code
Ann. § 39–17–415. GX 5, at 1, 3, 6.
According to a March 31, 2015 letter
from the Clerk of the General Sessions
Court of Sequatchie County, criminal
charges were pending against Registrant
‘‘as of October 31, 2014.’’ GX 8. The
Clerk’s letter further states that the
‘‘[c]harges were expunged on 11/21/
2014.’’ Id.
Registrant was also previously
licensed by the Tennessee Board of
Nursing (Board) as an advanced practice
nurse (APN) and held a Certificate of
Fitness to prescribe. GX 4, at 2.
However, on January 27, 2015, the
Board ordered the summary suspension
of Registrant’s advance practice nurse
license and Certificate of Fitness to
Prescribe. Id. at 7. The Board based its
order on findings which included that
on December 19, 2014, a search warrant
was executed at Registrant’s residence
during which the search team found
‘‘prefilled syringes of morphine, vials of
morphine, shopping bags full of used
needles, a bottle of prednisone, and a
bottle of animal morphine,’’ and that
‘‘[t]he syringes of morphine are of
unknown origin with no identifying
prescription information.’’ Id. at 3. The
search team also found a pipe
containing marijuana residue. Id.
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The Board also based its order on
findings that from April 1, 2013 through
March 31, 2014, Registrant was ‘‘a top
50 prescriber in Tennessee based on
morphine equivalents,’’ and that in a
letter to the Board, he had stated that
‘‘he had no intention of curbing his
prescribing practices.’’ Id. at 4. The
Board further found that on January 12,
2015, Registrant had ‘‘obstructed a
Department of Health investigation’’
into his activities at a pain clinic, by
‘‘refus[ing] to allow access to [the] clinic
or to cooperate in any fashion, leaving
the Department unable to verify the
conditions of the clinic or obtain patient
charts to determine whether [he] has a
supervising physician or a medical
director at the pain clinic.’’ Id.
Based on these and other findings, the
Board found that Registrant ‘‘[i]s unfit or
incompetent by reason of negligence,
habits or other cause’’; ‘‘[i]s guilty of
unprofessional conduct’’; and ‘‘[h]as
violated or attempted to violate, directly
or indirectly, or assisted in or abetted
the violation of or conspired to violate
any provision of this chapter or any
lawful order of the board.’’ Id. at 6.
(citing Tenn. Code Ann. § 63–7–
115(a)(1)). The Board then explained
that Registrant’s ‘‘impaired judgment
combined with the high amount of
controlled substances he prescribes . . .
create[s] an extreme and untenable
danger to his patients and the public of
Tennessee’’ and his ‘‘actions constitute
a serious and immediate danger to the
public’s health, safety and welfare and
require emergency action by this
Board.’’ Id.
Subsequently, on May 6, 2015,
Registrant entered into an Agreed Order
with the Board, which the latter
approved on August 6, 2015 and which
suspended his APN license and his
Certificate of Fitness to prescribe.3 GX
10, at 8. The Order also imposed
numerous conditions, including that he
voluntarily surrender his DEA
registrations within 10 days of the
Board’s ratification of the Order. Id. at
10.
Therein, the parties agreed to a variety
of factual findings pertinent to his
prescribing of controlled substances.
These included that during 2011, he had
worked at a Chattanooga-based clinic
(Superior One Medical Clinic) and
‘‘wrote prescriptions for schedule II
controlled substances with no medical
necessity or supporting documentation
as to the condition which would
warrant such prescribing.’’ Id. at 3. As
for his prescribing at Holistic Health
3 I take official notice of the Agreed Order and
have made it a part of the record. See 5 U.S.C.
556(e).
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and Primary Care (a pain clinic in
Hixson, TN which was owned by his
father), the Board reviewed 10 patients
charts maintained by him ‘‘from March
2012 to December 2013’’ and found that
it reflected treatment ‘‘with controlled
substances in amounts and/or durations
not medically necessary, advisable, or
justified.’’ Id. The Board also found that
‘‘he typically prescribed opioids in
amounts not medically necessary,’’ that
he ‘‘does not utilize alternative
treatments . . . for his pain
management patients and neglected to
establish a treatment plan . . . other
than the continuation of controlled
substances,’’ and that while he had
patients provide urine drug tests, he
‘‘often failed to address inconsistent
results.’’ Id. at 3–4.
Registrant also stipulated to the
findings of the Summary Suspension
Order regarding the various controlled
substances and paraphernalia found
during the execution of a search warrant
at his residence, the findings that he
was a Top 50 prescriber of morphine
equivalents and had told the Board that
he did not intend to curb his
prescribing, and the findings related to
his obstruction of the Department of
Health’s investigation of his father’s
pain clinic.4
Discussion
Registrant’s Lack of State Authority
Pursuant to 21 U.S.C. 824(a)(3), ‘‘[a]
registration . . . to . . . dispense a
controlled substance . . . may be
suspended or revoked by the Attorney
General upon a finding that the
registrant . . . has had his State license
or registration suspended, revoked, or
denied by competent State authority
and is no longer authorized by State law
to engage in the . . . dispensing of
controlled substances.’’ This Agency has
further held that notwithstanding that
this provision grants the Agency
authority to suspend or revoke a
registration, other provisions of the
Controlled Substances Act ‘‘make plain
that a practitioner can neither obtain nor
maintain a DEA registration unless the
practitioner currently has authority
under state law to handle controlled
substances.’’ James L. Hooper, 76 FR
71371, 71372 (2011), pet. for rev.
denied, Hooper v. Holder, 481 F. App’x
826 (4th Cir. 2012). See also Frederick
Marsh Blanton, M.D., 43 FR 27616,
27617 (1978) (‘‘State authorization to
4 Registrant also stipulated to findings that he had
abused animals and his 88-years old father, who
was listed as his supervising physician, as well as
that he had ‘‘obstructed attempts by three
independent agencies to determine the welfare of’’
his father. Agreed Order, at 4–7.
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49267
dispense or otherwise handle controlled
substances is a prerequisite to the
issuance and maintenance of a Federal
controlled substances registration.’’).
These provisions include section
102(21), which defines the term
‘‘practitioner’’ to ‘‘mean[ ] a physician
. . . licensed, registered, or otherwise
permitted, by . . . the jurisdiction in
which he practices . . . to distribute,
dispense, [or] administer . . . a
controlled substance in the course of
professional practice,’’ 21 U.S.C.
802(21), as well as section 303(f), which
directs that ‘‘[t]he Attorney General
shall register practitioners . . . to
dispense . . . controlled substances
. . . if the applicant is authorized to
dispense . . . controlled substances
under the laws of the State in which he
practices.’’ Id. § 823(f). As the Supreme
Court has explained, ‘‘[i]n the case of a
physician, this scheme contemplates
that he is authorized by the State to
practice medicine and to dispense drugs
in connection with his professional
practice.’’ United States v. Moore, 423
U.S. 122, 140–41 (1975).
Here, it undisputed that the
Tennessee Board of Nursing has
suspended Registrant’s advance practice
nursing license and his Certificate of
Fitness to prescribe. I therefore find that
Registrant is without authority to
dispense controlled substances in
Tennessee, the State in which he is
registered. Because Registrant no longer
meets the CSA’s prerequisite for
maintaining a practitioner’s registration,
I will order that his existing registration
be revoked.
Material Falsification
Pursuant to section 304(a)(1), the
Attorney General is also authorized to
suspend or revoke a registration ‘‘upon
a finding that the registrant . . . has
materially falsified any application filed
pursuant to or required by this
subchapter.’’ 21 U.S.C. 824(a)(1). Based
on Registrant’s failure to disclose his
arrest for marijuana possession on his
October 7, 2014 application, the
Government contends that he materially
falsified the application when he
answered ‘‘N’’ or no to the question:
‘‘Has the applicant ever been convicted
of a crime in connection with controlled
substance(s) under state or federal law,
or been excluded or directed to be
excluded from participation in a
medicare or state health care program,
or any [sic] such action pending?’’ GX
6.
Notably, the Government does not
argue that Registrant has been convicted
of the unlawful possession of marijuana,
let alone that he had been convicted of
the offense prior to submitting his
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application on October 7, 2014. Indeed,
the only evidence it offers relevant to
whether Registrant has been convicted
of a controlled substance offense is the
state court clerk’s letter stating that
Registrant ‘‘did have criminal charges
pending against him . . . as of October
31, 2014’’ and that the ‘‘[c]harges were
expunged’’ several weeks later.
The clerk’s letter does not, however,
even identify what charges were
pending against Registrant at the time.
Moreover, the Government does not rely
on the line of cases holding that a
deferred adjudication of an offense
falling under 21 U.S.C. 824(a)(2) which
ultimately results in dismissal of the
charge is still a conviction for purposes
of the Controlled Substances Act and
that the failure to disclose such
conviction on a subsequent application
is a material falsification. See Hoxie v.
DEA, 419 F.3d 477, 481(6th Cir. 2005)
(upholding Agency’s finding that
practitioner committed material
falsification when he failed to disclose
a controlled substance conviction which
was expunged). See also Pamela
Monterosso, 73 FR 11146, 11148 (2008)
(citing David A. Hoxie, 69 FR 51477,
51478 (1994); Eric A. Baum, 53 FR
47272, 42274 (1988)); see also Kimberly
Maloney, 76 FR 60922, 60922 (2011);
Mark De La Lama, 76 FR 20011, 20013–
14, 20019–20 (2011).
Instead, the Government argues that
Registrant materially falsified his
application because ‘‘the new
application required that [Registrant]
disclose this arrest because the
application asked: ‘Has the applicant
ever been convicted of a crime in
connection with controlled substance(s)
or is any action pending?’ ’’ Request for
Final Agency Action, at 5–6. The
question does not, however, require the
disclosure of an arrest. Rather, it
requires the disclosure of ‘‘any action
pending,’’ and while this is reasonably
read to include a criminal prosecution
for a controlled substance offense which
is ongoing at the time an application is
submitted, the Government’s evidence
establishes only that charges were
pending 24 days after Registrant
submitted his application and not on
the date he submitted his application.
While it may be that the marijuana
possession charge was pending on
October 7, 2014 and was expunged
pursuant to a deferred adjudication,
which under Agency precedent
constitutes a conviction even where the
conviction is later expunged, the
Government did not produce any
evidence establishing that this was the
basis for the expungement of the charge.
Accordingly, I find that the
Government has failed to provide
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substantial evidence to support its
contention that Registrant materially
falsified his application. Nonetheless,
because Registrant no longer holds
authority under Tennessee law to
dispense controlled substances, he is
not entitled to maintain his registration.
Accordingly, I will order that his
registration be revoked.
Order
Pursuant to the authority vested in me
by 21 U.S.C. 823(f) and 824(a), as well
as 28 CFR 0.100(b), I order that DEA
Certificate of Registration MP3330545
issued to Geoffrey D. Peterson, N.P., be,
and it hereby is, revoked. I further order
that any application of Geoffrey D.
Peterson to renew or modify the above
registration be, and it hereby is, denied.
This Order is effective immediately.5
Dated: July 19, 2016.
Chuck Rosenberg,
Acting Administrator.
[FR Doc. 2016–17722 Filed 7–26–16; 8:45 am]
BILLING CODE 4410–09–P
DEPARTMENT OF LABOR
Occupational Safety and Health
Administration
[Docket No. OSHA–2013–0016]
Nemko-CCL, Inc.: Grant of Expansion
of Recognition
Occupational Safety and Health
Administration (OSHA), Labor.
ACTION: Notice.
AGENCY:
In this notice, OSHA
announces its final decision to expand
the scope of recognition for Nemko-CCL,
Inc., as a Nationally Recognized Testing
Laboratory (NRTL).
DATES: The expansion of the scope of
recognition becomes effective on July
27, 2016.
FOR FURTHER INFORMATION CONTACT:
Information regarding this notice is
available from the following sources:
Press inquiries: Contact Mr. Frank
Meilinger, Director, OSHA Office of
Communications, U.S. Department of
Labor, 200 Constitution Avenue NW.,
Room N–3647, Washington, DC 20210;
telephone: (202) 693–1999; email:
meilinger.francis2@dol.gov.
General and technical information:
Contact Kevin Robinson, Director,
Office of Technical Programs and
SUMMARY:
5 Based on the findings of the Tennessee Board,
I find that the public interest necessitates that this
Order be effective immediately. 21 CFR 1316.67. I
further note that as of this date, Registrant has failed
to surrender his DEA registration as required by the
Board.
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Coordination Activities, Directorate of
Technical Support and Emergency
Management, Occupational Safety and
Health Administration, U.S. Department
of Labor, 200 Constitution Avenue NW.,
Room N–3655, Washington, DC 20210;
telephone: (202) 693–2110; email:
robinson.kevin@dol.gov. OSHA’s Web
page includes information about the
NRTL Program (see https://
www.osha.gov/dts/otpca/nrtl/
index.html).
SUPPLEMENTARY INFORMATION:
I. Notice of Final Decision
OSHA hereby gives notice of the
expansion of the scope of recognition of
Nemko-CCL, Inc. (CCL), as an NRTL.
CCL’s expansion covers the addition of
two recognized testing and certification
sites and twenty-two additional test
standards to their NRTL scope of
recognition.
OSHA recognition of an NRTL
signifies that the organization meets the
requirements in Section 1910.7 of Title
29, Code of Federal Regulations (29 CFR
1910.7). Recognition is an
acknowledgment that the organization
can perform independent safety testing
and certification of the specific products
covered within its scope of recognition
and is not a delegation or grant of
government authority. As a result of
recognition, employers may use
products properly approved by the
NRTL to meet OSHA standards that
require testing and certification.
The Agency processes applications by
an NRTL for initial recognition, or for
expansion or renewal of this
recognition, following requirements in
Appendix A to 29 CFR 1910.7. This
appendix requires that the Agency
publish two notices in the Federal
Register in processing an application. In
the first notice, OSHA announces the
application and provides its preliminary
finding and, in the second notice, the
Agency provides its final decision on
the application. These notices set forth
the NRTL’s scope of recognition or
modifications of that scope. OSHA
maintains an informational Web page
for each NRTL that details its scope of
recognition. These pages are available
from the Agency’s Web site at https://
www.osha.gov/dts/otpca/nrtl/
index.html.
CCL submitted two applications,
dated January 28, 2015 (OSHA–2013–
0016–0008) and January 26, 2016
(OSHA–2013–0016–0011), to expand its
recognition to include the addition of
two recognized testing and certification
sites located at: Nemko USA, Inc., 2210
Faraday Avenue, Suite 150, Carlsbad,
California 92008; and Nemko Canada,
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Agencies
[Federal Register Volume 81, Number 144 (Wednesday, July 27, 2016)]
[Notices]
[Pages 49266-49268]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2016-17722]
Drug Enforcement Administration
Geoffrey D. Peterson, N.P.; Decision and Order
On April 14, 2015, the Deputy Assistant Administrator, Office of
Diversion Control, Drug Enforcement Administration, issued an Order to
Show Cause to Geoffrey D. Peterson, N.P. (hereinafter, Registrant), of
Hixson, Tennessee. The Show Cause Order proposed the revocation of
Registrant's DEA Certificate of Registration MP3330545,\1\ pursuant to
which he is authorized to dispense controlled substances in schedules
II through V, as a mid-level practitioner, and the denial of any
applications on two grounds. GX 1, at 1.
---------------------------------------------------------------------------
\1\ While Government also alleges that Registrant holds an
additional registration (MP1971731) and seeks its revocation as
well, in its Request for Final Agency Action, the Government
acknowledges that this registration had expired shortly before the
issuance of the Show Cause Order. To ensure that Registrant did not
file a renewal application for this registration, I have taken
official notice of Registrant's registration record with the Agency.
See 5 U.S.C. 556(e). That record shows that Registrant allowed this
registration to expire and did not file an application to renew it
whether timely or not. Accordingly, I find that this proceeding is
moot insofar as it seeks the revocation of this registration.
---------------------------------------------------------------------------
First, the Show Cause Order alleged that effective January 27,
2015, the Tennessee Nursing Board had summarily suspended Registrant's
nurse practitioner license. Id. at 2. The Order thus alleged that
Registrant is currently without authority to dispense controlled
substances in the State in which he is registered with the Agency and
therefore, his registration is subject to revocation. Id. (citing 21
U.S.C. 802(21), 823(f), 824(a)(3)).
Second, the Show Cause Order alleged that Registrant materially
falsified his October 7, 2014 application for the above registration.
Id. (citing 21 U.S.C. 824(a)(1)). More specifically, the Show Cause
Order alleged that on February 17, 2014, Registrant was arrested by
local authorities and charged with the ``unlawful possession of
marijuana.'' Id. The Order then alleged that the charge was still
pending at the time Registrant submitted his renewal application, and
that ``[o]n this application, [he] did not answer `yes' to the . . .
liability question: `Has the applicant ever been convicted of a crime
in connection with controlled substance(s) under state or federal law,
or is any action pending?' '' Id. The Government thus alleged that
Registrant violated 21 U.S.C. 824(a)(1).\2\
---------------------------------------------------------------------------
\2\ While the Government contends that Registrant violated
section 824(a)(1), this provision is simply a grant of authority to
the Attorney General to revoke or suspend a registration and does
not itself impose a substantive rule of conduct. Rather, the rule of
conduct is imposed by 21 U.S.C. 843(a)(4)(A) (``It shall be unlawful
for any person knowingly or intentionally . . . to furnish false or
fraudulent material information in, or omit any material information
from, any application . . . filed under this subchapter[.]'').
---------------------------------------------------------------------------
The Show Cause Order also notified Registrant of his right to
request a hearing on the allegations or to submit a written statement
while waiving his right to a hearing, the procedure for electing either
option, and the consequence of failing to elect either option. Id. at
2-3 (citing 21 CFR 1301.43, 1301.46). On April 23, 2015, the Show Cause
Order was personally served on Registrant by a DEA Diversion
Investigator. GX 3.
On April 7, 2016, the Government forwarded a Request for Final
Agency Action. Therein, the Government represented that neither
Registrant ``nor anyone representing him has requested a hearing or
sent any other correspondence to DEA.'' Req. for Final Agency Action,
at 7. Based on the Government's representation, I find that 30 days
have now passed since the Show Cause Order was served on Registrant and
that he has neither requested a hearing nor submitted a written
statement in lieu of hearing. 21 CFR 1301.43(b) & (c). Accordingly, I
find that Registrant has waived his right to a hearing or to submit a
written statement and issue this Decision and Order based on the
evidence submitted by the Government. Id. Sec. 1301.43(d) & (e). I
make the following findings.
Findings
Registrant is the holder of DEA Certificate of Registration
MP3330545, pursuant to which he is authorized to dispense controlled
substances in schedules II through V, as a mid-level practitioner, at
the registered address of Hormone Replacement Specialists, 5550 Highway
153, Suite 103, Hixson, Tennessee. GX 7, at 1. Registrant renewed this
registration on October 7, 2014, at which time he was required to
answer the following question: ``Has the applicant ever been convicted
of a crime in connection with controlled substance(s) under state or
federal law, or been excluded or directed to be excluded from
participation in a medicare or state health care program, or any [sic]
such action pending?'' GX 6. Registrant entered ``N'' for no. Id.
On February 17, 2014, Registrant was arrested by a member of the
Sequatchie County Sheriff's Department and charged with felony
possession of marijuana, an offense under Tenn. Code Ann. Sec. 39-17-
415. GX 5, at 1, 3, 6. According to a March 31, 2015 letter from the
Clerk of the General Sessions Court of Sequatchie County, criminal
charges were pending against Registrant ``as of October 31, 2014.'' GX
8. The Clerk's letter further states that the ``[c]harges were expunged
on 11/21/2014.'' Id.
Registrant was also previously licensed by the Tennessee Board of
Nursing (Board) as an advanced practice nurse (APN) and held a
Certificate of Fitness to prescribe. GX 4, at 2. However, on January
27, 2015, the Board ordered the summary suspension of Registrant's
advance practice nurse license and Certificate of Fitness to Prescribe.
Id. at 7. The Board based its order on findings which included that on
December 19, 2014, a search warrant was executed at Registrant's
residence during which the search team found ``prefilled syringes of
morphine, vials of morphine, shopping bags full of used needles, a
bottle of prednisone, and a bottle of animal morphine,'' and that
``[t]he syringes of morphine are of unknown origin with no identifying
prescription information.'' Id. at 3. The search team also found a pipe
containing marijuana residue. Id.
[[Page 49267]]
The Board also based its order on findings that from April 1, 2013
through March 31, 2014, Registrant was ``a top 50 prescriber in
Tennessee based on morphine equivalents,'' and that in a letter to the
Board, he had stated that ``he had no intention of curbing his
prescribing practices.'' Id. at 4. The Board further found that on
January 12, 2015, Registrant had ``obstructed a Department of Health
investigation'' into his activities at a pain clinic, by ``refus[ing]
to allow access to [the] clinic or to cooperate in any fashion, leaving
the Department unable to verify the conditions of the clinic or obtain
patient charts to determine whether [he] has a supervising physician or
a medical director at the pain clinic.'' Id.
Based on these and other findings, the Board found that Registrant
``[i]s unfit or incompetent by reason of negligence, habits or other
cause''; ``[i]s guilty of unprofessional conduct''; and ``[h]as
violated or attempted to violate, directly or indirectly, or assisted
in or abetted the violation of or conspired to violate any provision of
this chapter or any lawful order of the board.'' Id. at 6. (citing
Tenn. Code Ann. Sec. 63-7-115(a)(1)). The Board then explained that
Registrant's ``impaired judgment combined with the high amount of
controlled substances he prescribes . . . create[s] an extreme and
untenable danger to his patients and the public of Tennessee'' and his
``actions constitute a serious and immediate danger to the public's
health, safety and welfare and require emergency action by this
Board.'' Id.
Subsequently, on May 6, 2015, Registrant entered into an Agreed
Order with the Board, which the latter approved on August 6, 2015 and
which suspended his APN license and his Certificate of Fitness to
prescribe.\3\ GX 10, at 8. The Order also imposed numerous conditions,
including that he voluntarily surrender his DEA registrations within 10
days of the Board's ratification of the Order. Id. at 10.
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\3\ I take official notice of the Agreed Order and have made it
a part of the record. See 5 U.S.C. 556(e).
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Therein, the parties agreed to a variety of factual findings
pertinent to his prescribing of controlled substances. These included
that during 2011, he had worked at a Chattanooga-based clinic (Superior
One Medical Clinic) and ``wrote prescriptions for schedule II
controlled substances with no medical necessity or supporting
documentation as to the condition which would warrant such
prescribing.'' Id. at 3. As for his prescribing at Holistic Health and
Primary Care (a pain clinic in Hixson, TN which was owned by his
father), the Board reviewed 10 patients charts maintained by him ``from
March 2012 to December 2013'' and found that it reflected treatment
``with controlled substances in amounts and/or durations not medically
necessary, advisable, or justified.'' Id. The Board also found that
``he typically prescribed opioids in amounts not medically necessary,''
that he ``does not utilize alternative treatments . . . for his pain
management patients and neglected to establish a treatment plan . . .
other than the continuation of controlled substances,'' and that while
he had patients provide urine drug tests, he ``often failed to address
inconsistent results.'' Id. at 3-4.
Registrant also stipulated to the findings of the Summary
Suspension Order regarding the various controlled substances and
paraphernalia found during the execution of a search warrant at his
residence, the findings that he was a Top 50 prescriber of morphine
equivalents and had told the Board that he did not intend to curb his
prescribing, and the findings related to his obstruction of the
Department of Health's investigation of his father's pain clinic.\4\
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\4\ Registrant also stipulated to findings that he had abused
animals and his 88-years old father, who was listed as his
supervising physician, as well as that he had ``obstructed attempts
by three independent agencies to determine the welfare of'' his
father. Agreed Order, at 4-7.
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Discussion
Registrant's Lack of State Authority
Pursuant to 21 U.S.C. 824(a)(3), ``[a] registration . . . to . . .
dispense a controlled substance . . . may be suspended or revoked by
the Attorney General upon a finding that the registrant . . . has had
his State license or registration suspended, revoked, or denied by
competent State authority and is no longer authorized by State law to
engage in the . . . dispensing of controlled substances.'' This Agency
has further held that notwithstanding that this provision grants the
Agency authority to suspend or revoke a registration, other provisions
of the Controlled Substances Act ``make plain that a practitioner can
neither obtain nor maintain a DEA registration unless the practitioner
currently has authority under state law to handle controlled
substances.'' James L. Hooper, 76 FR 71371, 71372 (2011), pet. for rev.
denied, Hooper v. Holder, 481 F. App'x 826 (4th Cir. 2012). See also
Frederick Marsh Blanton, M.D., 43 FR 27616, 27617 (1978) (``State
authorization to dispense or otherwise handle controlled substances is
a prerequisite to the issuance and maintenance of a Federal controlled
substances registration.'').
These provisions include section 102(21), which defines the term
``practitioner'' to ``mean[ ] a physician . . . licensed, registered,
or otherwise permitted, by . . . the jurisdiction in which he practices
. . . to distribute, dispense, [or] administer . . . a controlled
substance in the course of professional practice,'' 21 U.S.C. 802(21),
as well as section 303(f), which directs that ``[t]he Attorney General
shall register practitioners . . . to dispense . . . controlled
substances . . . if the applicant is authorized to dispense . . .
controlled substances under the laws of the State in which he
practices.'' Id. Sec. 823(f). As the Supreme Court has explained,
``[i]n the case of a physician, this scheme contemplates that he is
authorized by the State to practice medicine and to dispense drugs in
connection with his professional practice.'' United States v. Moore,
423 U.S. 122, 140-41 (1975).
Here, it undisputed that the Tennessee Board of Nursing has
suspended Registrant's advance practice nursing license and his
Certificate of Fitness to prescribe. I therefore find that Registrant
is without authority to dispense controlled substances in Tennessee,
the State in which he is registered. Because Registrant no longer meets
the CSA's prerequisite for maintaining a practitioner's registration, I
will order that his existing registration be revoked.
Material Falsification
Pursuant to section 304(a)(1), the Attorney General is also
authorized to suspend or revoke a registration ``upon a finding that
the registrant . . . has materially falsified any application filed
pursuant to or required by this subchapter.'' 21 U.S.C. 824(a)(1).
Based on Registrant's failure to disclose his arrest for marijuana
possession on his October 7, 2014 application, the Government contends
that he materially falsified the application when he answered ``N'' or
no to the question: ``Has the applicant ever been convicted of a crime
in connection with controlled substance(s) under state or federal law,
or been excluded or directed to be excluded from participation in a
medicare or state health care program, or any [sic] such action
pending?'' GX 6.
Notably, the Government does not argue that Registrant has been
convicted of the unlawful possession of marijuana, let alone that he
had been convicted of the offense prior to submitting his
[[Page 49268]]
application on October 7, 2014. Indeed, the only evidence it offers
relevant to whether Registrant has been convicted of a controlled
substance offense is the state court clerk's letter stating that
Registrant ``did have criminal charges pending against him . . . as of
October 31, 2014'' and that the ``[c]harges were expunged'' several
weeks later.
The clerk's letter does not, however, even identify what charges
were pending against Registrant at the time. Moreover, the Government
does not rely on the line of cases holding that a deferred adjudication
of an offense falling under 21 U.S.C. 824(a)(2) which ultimately
results in dismissal of the charge is still a conviction for purposes
of the Controlled Substances Act and that the failure to disclose such
conviction on a subsequent application is a material falsification. See
Hoxie v. DEA, 419 F.3d 477, 481(6th Cir. 2005) (upholding Agency's
finding that practitioner committed material falsification when he
failed to disclose a controlled substance conviction which was
expunged). See also Pamela Monterosso, 73 FR 11146, 11148 (2008)
(citing David A. Hoxie, 69 FR 51477, 51478 (1994); Eric A. Baum, 53 FR
47272, 42274 (1988)); see also Kimberly Maloney, 76 FR 60922, 60922
(2011); Mark De La Lama, 76 FR 20011, 20013-14, 20019-20 (2011).
Instead, the Government argues that Registrant materially falsified
his application because ``the new application required that
[Registrant] disclose this arrest because the application asked: `Has
the applicant ever been convicted of a crime in connection with
controlled substance(s) or is any action pending?' '' Request for Final
Agency Action, at 5-6. The question does not, however, require the
disclosure of an arrest. Rather, it requires the disclosure of ``any
action pending,'' and while this is reasonably read to include a
criminal prosecution for a controlled substance offense which is
ongoing at the time an application is submitted, the Government's
evidence establishes only that charges were pending 24 days after
Registrant submitted his application and not on the date he submitted
his application. While it may be that the marijuana possession charge
was pending on October 7, 2014 and was expunged pursuant to a deferred
adjudication, which under Agency precedent constitutes a conviction
even where the conviction is later expunged, the Government did not
produce any evidence establishing that this was the basis for the
expungement of the charge.
Accordingly, I find that the Government has failed to provide
substantial evidence to support its contention that Registrant
materially falsified his application. Nonetheless, because Registrant
no longer holds authority under Tennessee law to dispense controlled
substances, he is not entitled to maintain his registration.
Accordingly, I will order that his registration be revoked.
Order
Pursuant to the authority vested in me by 21 U.S.C. 823(f) and
824(a), as well as 28 CFR 0.100(b), I order that DEA Certificate of
Registration MP3330545 issued to Geoffrey D. Peterson, N.P., be, and it
hereby is, revoked. I further order that any application of Geoffrey D.
Peterson to renew or modify the above registration be, and it hereby
is, denied. This Order is effective immediately.\5\
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\5\ Based on the findings of the Tennessee Board, I find that
the public interest necessitates that this Order be effective
immediately. 21 CFR 1316.67. I further note that as of this date,
Registrant has failed to surrender his DEA registration as required
by the Board.
Dated: July 19, 2016.
Chuck Rosenberg,
Acting Administrator.
[FR Doc. 2016-17722 Filed 7-26-16; 8:45 am]
BILLING CODE 4410-09-PDEPARTMENT OF LABOR