Paul E. Pilgram, M.D.; Decision and Order, 11058-11060 [2017-03223]
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11058
Federal Register / Vol. 82, No. 32 / Friday, February 17, 2017 / Notices
Findings of Fact
Registrant is the holder of DEA
Certificate of Registration No.
BD3577965, pursuant to which he is
authorized to dispense controlled
substances in schedules II through V, as
a practitioner, at the registered address
of Women’s Pavilion of South
Mississippi, 6524 U.S. Highway 98,
Hattiesburg, Mississippi. GX 1
(Certificate of Registration). His
registration does not expire until June
30, 2017. Id.
On July 8, 2016, Registrant voluntarily
surrendered his medical license to the
Mississippi State Board of Medical
Licensure (Medical Board), stating in a
letter to the Board’s President that he
was relinquishing his right to practice
medicine. GX 3, at 2. On July 13, 2016,
the Medical Board issued a
memorandum to various governmental
and private entities informing them that
Registrant had voluntarily surrendered
his medical license effective July 12,
2016. Id. at 3. As Registrant neither
responded to the Show Cause Order nor
submitted any evidence to show that his
state license has been reinstated, I find
that he does not possess authority to
dispense controlled substances in
Mississippi, the State in which he is
registered with the DEA.
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Discussion
Pursuant to 21 U.S.C. 824(a)(3), the
Attorney General is authorized to
suspend or revoke a registration issued
under section 823 of the Controlled
Substances Act (CSA), ‘‘upon a finding
that the registrant . . . has had his State
license . . . suspended [or] revoked
. . . by competent State authority and is
no longer authorized by State law to
engage in the . . . dispensing of
controlled substances.’’ DEA has also
long held that the possession of
authority to dispense controlled
substances under the laws of the State
in which a practitioner engages in
professional practice is a fundamental
condition for obtaining and maintaining
a practitioner’s registration. See, e.g.,
James L. Hooper, 76 FR 71371 (2011),
pet. for rev. denied, 481 Fed. Appx. 826
(4th Cir. 2012); Frederick Marsh
Blanton, 43 FR 27616 (1978). Thus, the
Agency has further held that ‘‘ ‘the
controlling question is not whether a
practitioner’s license to practice
medicine in the state is suspended or
revoked; rather[,] it is whether the
Respondent is currently authorized to
handle controlled substances in the
[S]tate.’ ’’ Hooper, 76 FR at 71371
(quoting Anne Lazar Thorn, 62 FR
12847, 12848 (1997)).
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This rule derives from the text of two
provisions of the CSA. First, Congress
defined ‘‘the term ‘practitioner’ [to]
mean[ ] a . . . physician . . . or other
person 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). Second, in setting the
requirements for obtaining a
practitioner’s registration, Congress
directed that ‘‘[t]he Attorney General
shall register practitioners . . . if the
applicant is authorized to dispense . . .
controlled substances under the laws of
the State in which he practices.’’ 21
U.S.C. 823(f). Because Congress has
clearly mandated that a practitioner
possess state authority in order to be
deemed a practitioner under the Act,
DEA has held repeatedly that revocation
of a practitioner’s registration is the
appropriate sanction whenever he is no
longer authorized to dispense controlled
substances under the laws of the State
in which he practices medicine. See,
e.g., Hooper, 76 FR at 71371; Sheran
Arden Yeates, M.D., 71 FR 39130, 39131
(2006); Dominick A. Ricci, 58 FR 51104,
51105 (1993); Bobby Watts, 53 FR
11919, 11920 (1988); Blanton, 43 FR at
27616.
By virtue of the surrender of his
medical license, Registrant currently
lacks authority to dispense controlled
substances in Mississippi, the State in
which he holds his DEA registration,
and 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. 824(a), as well as 28 CFR
0.100(b), I order that DEA Certificate of
Registration BD3577965, issued to Lee
B. Drake, M.D., be, and it hereby is,
revoked. Pursuant to the authority
vested in me by 21 U.S.C. 823(f), as well
as 28 CFR 0.100(b), I further order that
any pending application of Lee B.
Drake, M.D., to renew or modify his
registration, be, and it hereby is, denied.
This Order is effective March 20, 2017.
Dated: February 9, 2017.
Chuck Rosenberg,
Acting Administrator.
[FR Doc. 2017–03222 Filed 2–16–17; 8:45 am]
DEPARTMENT OF JUSTICE
Drug Enforcement Administration
Paul E. Pilgram, M.D.; Decision and
Order
On November 29, 2016, the Assistant
Administrator, Diversion Control
Division, Drug Enforcement
Administration (DEA), issued an Order
to Show Cause to Paul E. Pilgram,1 M.D.
(Registrant), of West Jordan, Utah. The
Show Cause Order proposed the
revocation of Registrant’s DEA
Certificate of Registration, on the ground
that he does not have authority to
handle controlled substances in Utah,
the State in which he is registered with
the Agency. Show Cause Order, at 1
(citing 21 U.S.C. 824(a)(3)).
As the jurisdictional basis for the
proceeding, the Show Cause Order
alleged that Registrant is registered as a
practitioner in schedules II through V
under DEA registration No. AP1393038,
at the registered address of 1561 West
7000 South, Suite 200, West Jordan,
Utah. Id. The Order alleged that
Registrant’s registration does not expire
until March 31, 2017. Id.
The Show Cause Order then alleged
that on October 17, 2016, the State of
Utah revoked Registrant’s authority to
prescribe and administer controlled
substances and that he is ‘‘without
authority to handle controlled
substances in . . . the [S]tate in which
[he is] registered with the’’ Agency. Id.
The Order then asserted that as a
consequence of the loss of his state
authority, ‘‘DEA must revoke’’ his
registration. Id. (citing 21 U.S.C.
802(21), 823(f) and 824(a)(3)). The Show
Cause Order also notified Registrant of
his right to request a hearing on the
allegations, or to submit a written
statement in lieu of a hearing, the
procedure for electing either option, and
the consequence for failing to do elect
either option. Id. at 2 (citing 21 CFR
1301.43). The Order further notified
Registrant of his right to submit a
corrective action plan. Id. at 2–3 (citing
21 U.S.C. 824(c)(2)(C)).
On December 6, 2016, a Diversion
Investigator (DI) from the DEA Salt Lake
City District Office effected service by
hand-delivery of a copy of the Show
Cause Order to Registrant at his
registered address of 1561 West 7000
South, Suite 200, West Jordan, Utah. GX
2, at 1–2 (Declaration of Diversion
Investigator). According to the
Government, since the date of service of
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1 Registrant’s name in the Order to Show Cause
is spelled ‘‘Pilgrim’’; however, all other documents
in the record, including Registrant’s Certificate of
Registration, use the correct spelling (Pilgram).
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the Show Cause Order, the Agency ‘‘has
not received a request for hearing or any
other reply from’’ Registrant. Request for
Final Agency Action (RFFA), at 2.
On January 10, 2017, the Government
forwarded this matter to my Office for
final agency action along with an
evidentiary record. RFFA, at 1. Based
upon the Government’s representation
and my review of the record, I find that
more than 30 days have now passed
since the date of service of the Show
Cause Order, and that neither
Registrant, nor anyone purporting to
represent him, has requested a hearing
or submitted a written statement in lieu
of a hearing. I therefore find that
Registrant has waived his right to a
hearing or to submit a written statement
in lieu of a hearing, and issue this
Decision and Order based on relevant
evidence contained in the record
submitted by the Government. 21 CFR
1301.43(d) & (e). I make the following
findings of fact. Id. § 1301.43(e).
Findings of Fact
Registrant is the holder of Certificate
of Registration AP1393038, pursuant to
which he is authorized to dispense
controlled substances in schedules II
through V as a practitioner, at the
registered address of 1561 West 7000
South, Suite 200, West Jordan, Utah. GX
2. His registration does not expire until
March 31, 2017. Id.
On October 17, 2016, the Utah
Division of Occupational and
Professional Licensing, Department of
Commerce (the Division), issued an
order revoking Registrant’s license to
prescribe and administer controlled
substances in the State. GX 3, at 2.
Therein, the Division adopted the
recommended order of the Utah
Physicians Licensing Board (Physician’s
Board), which the latter issued
following a hearing it held on August
24–25, 2016 at which Registrant was
represented by counsel. Id. at 5.
The Physician’s Board found that
Registrant ‘‘did not [ ] meet the standard
of care of the profession for pain
management patients’’ and failed to
follow the Model Policy for the Use of
Controlled Substances for the Treatment
of Pain (2004) in his treatment of nine
patients. As support for its finding, the
Board specifically cited: (1) ‘‘[t]he
inadequacy of the documented
evaluation of the patients,’’ (2) ‘‘[t]he
failure to obtain or document informed
consent as to major risks of the high
opioid regimes,’’ (3) ‘‘[t]he perfunctory
consideration or enforcement of
agreements for treatment,’’ (4) ‘‘[t]he
improperly low level of consultation
with other health and mental
professionals [sic]),’’ and (5) ‘‘[t]he
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failure to maintain accurate and
complete medical records.’’ Id. at 6–7.
The Board further found that Registrant
‘‘failed to demonstrate a legitimate
medical purpose for his prescribing
practices, [that] there was an absence of
sound clinical judgment on [his] part
. . . and the pattern of prescribing
practices was not based on clear
documentation of unrelieved pain.’’ Id.
at 7. The Board then made detailed
findings with respect to nine patients.
Id. at 8–26.
The Physician’s Board thus concluded
that Registrant had engaged in
unprofessional conduct:
11059
also https://secure.utah.gov/llv/search/
index.html. I therefore find that
Registrant is without authority to
dispense controlled substances under
the laws of Utah, the State in which he
holds his registration.
Discussion
Pursuant to 21 U.S.C. 824(a)(3), the
Attorney General is authorized to
suspend or revoke a registration issued
under section 823 of the Controlled
Substances Act (CSA), ‘‘upon a finding
that the registrant . . . has had his State
license . . . suspended [or] revoked
. . . by competent State authority and is
no longer authorized by State law to
by failing, as a prescribing practitioner, to
engage in the . . . dispensing of
follow the Model Policy for the Use of
controlled substances.’’ Moreover, DEA
Controlled Substances for the Treatment of
has long held that the possession of
Pain, 2004 [ ], in [his]evaluation of the
patient, obtaining or documenting informed
authority to dispense controlled
consent, giving more than perfunctory
substances under the laws of the State
consideration to, or enforcement of,
in which a practitioner engages in
agreements for treatment, conducting
professional practice is a fundamental
periodic reviews, consultation with other
medical specialists, maintaining accurate and condition for obtaining and maintaining
a practitioner’s registration. See, e.g.,
complete medical records, and complying
James L. Hooper, 76 FR 71371 (2011),
with the state laws referenced in [its]
conclusions.
pet. for rev. denied, 481 Fed. Appx. 826
(4th Cir. 2012); Frederick Marsh
Id. at 27 (citing Utah Admin. Code r.
Blanton, 43 FR 27616 (1978).
156–1–501(6)).2 The Board further
This rule derives from the text of two
concluded that ‘‘[t]he prescribing of
provisions of the CSA. First, Congress
controlled substances by [Registrant] on
defined ‘‘the term ‘practitioner’ [to]
too many occasions did not have a
mean[ ] a . . . physician . . . or other
legitimate medical purpose, did not
person licensed, registered or otherwise
show sound clinical judgment and was
permitted, by . . . the jurisdiction in
not based on clear documentation of
which he practices . . . to distribute,
unrelieved pain.’’ Id. at 28.3
dispense, [or] administer . . . a
The Board thus recommended that
controlled substance in the course of
Registrant’s state ‘‘license to prescribe
professional practice.’’ 21 U.S.C.
and administer controlled substances
802(21). Second, in setting the
. . . be revoked.’’ Id. at 29. On October
requirements for obtaining a
17, 2016, the Division adopted the
practitioner’s registration, Congress
Board’s factual findings, legal
directed that ‘‘[t]he Attorney General
conclusions and recommended order
shall register practitioners . . . if the
‘‘in its entirety.’’ Id. at 2, 4. According
applicant is authorized to dispense . . .
to the online records of the Utah
controlled substances under the laws of
Division of Occupational and
the State in which he practices.’’ 21
Professional Licensing of which I take
U.S.C. 823(f). Because Congress has
official notice, Registrant’s controlled
substance license remains revoked as of clearly mandated that a practitioner
the date of this Decision and Order. 4 See possess state authority in order to be
deemed a practitioner under the Act,
2 As for Registrant’s conduct after the Board
DEA has held repeatedly that revocation
adopted its 2013 Model Policy on the Use of
of a practitioner’s registration is the
Opioids Analgesics in the Treatment of Chronic
appropriate sanction whenever he is no
Pain, the Board also found that he engaged in
longer authorized to dispense controlled
unprofessional conduct. GX 3, at 28 (citing Utah
substances under the laws of the State
Admin. Code r. 156–1–501(7)).
3 Under the Division’s rules, ‘‘unprofessional
conduct’’ includes: ‘‘failing, as a prescribing
practitioner, to follow the ‘Model Policy for the Use
of Controlled Substances for the Treatment of Pain,’
2004, established by the Federation of State Medical
Boards,’’ and ‘‘failing, as a prescribing practitioner,
to follow the ‘Model Policy on the Use of Opioid
Analgesics in the Treatment of Chronic Pain,’ July
2013, adopted by the Federation of State Medical
Boards.’’ Utah Admin. Code r. 156–1–501(6) and (7)
(2016).
4 In accordance with the Administrative
Procedure Act (APA), an agency ‘‘may take official
notice of facts at any stage in a proceeding—even
PO 00000
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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). To allow Respondent the opportunity to
refute the facts of which I take official notice,
Respondent may file a motion for reconsideration
within 15 calendar days of the date of service of this
Order which shall commence on the date this Order
is mailed.
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Federal Register / Vol. 82, No. 32 / Friday, February 17, 2017 / Notices
in which he practices medicine. See,
e.g., Hooper, 76 FR at 71371–72; Sheran
Arden Yeates, M.D., 71 FR 39130, 39131
(2006); Dominick A. Ricci, 58 FR 51104,
51105 (1993); Bobby Watts, 53 FR
11919, 11920 (1988); Blanton, 43 FR at
27616.
Because Registrant currently lacks
authority to handle controlled
substances in Utah, the State in which
he holds his DEA registration, 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. 824(a), as well as 28 CFR
0.100(b), I order that DEA Certificate of
Registration AP1393038, issued to Paul
E. Pilgram, M.D., be, and it hereby is,
revoked. Pursuant to the authority
vested in me by 21 U.S.C. 823(f), as well
as 28 CFR 0.100(b), I further order that
any pending application of Paul E.
Pilgram, M.D., to renew or modify this
registration, be, and it hereby is, denied.
This Order is effective immediately.5
Dated: February 9, 2017.
Chuck Rosenberg,
Acting Administrator.
[FR Doc. 2017–03223 Filed 2–16–17; 8:45 am]
BILLING CODE 4410–09–P
DEPARTMENT OF JUSTICE
Federal Bureau of Investigation
[OMB Number 1110–0005]
Agency Information Collection
Activities; Proposed eCollection
eComments Requested; Extension
Without Change, of a Currently
Approved Collection; Age, Sex, Race,
and Ethnicity of Persons Arrested
Under 18 Years of Age; Age, Sex Race,
and Ethnicity of Persons Arrested 18
Years of Age and Over
Federal Bureau of
Investigation, Department of Justice.
AGENCY:
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5 Based on the extensive findings of the Utah
Division of Occupational and Professional
Licensing, I find that the public interest necessitates
that this Order be effective immediately. 21 CFR
1316.67.
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17:38 Feb 16, 2017
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ACTION:
60-Day notice.
The Department of Justice
(DOJ), Federal Bureau of Investigation
(FBI), Criminal Justice Information
Services Division (CJIS), will be
submitting the following information
collection request to the Office of
Management and Budget (OMB) for
review and approval in accordance with
the Paperwork Reduction Act of 1995.
DATES: Comments are encouraged and
will be accepted for 60 days until April
18, 2017.
FOR FURTHER INFORMATION CONTACT: All
comments, suggestions, or questions
regarding additional information, to
include obtaining a copy of the
proposed information collection
instrument with instructions, should be
directed to Mrs. Amy C. Blasher, Unit
Chief, Federal Bureau of Investigation,
Criminal Information Services Division,
Module E–3, 1000 Custer Hollow Road,
Clarksburg, West Virginia 26306;
facsimile (304) 625–3566.
SUPPLEMENTARY INFORMATION: Written
comments and suggestions from the
public and affected agencies concerning
the proposed collection of information
are encouraged. Your comments should
address one or more of the following
four points:
—Evaluate whether the proposed
collection of information is necessary
for the proper performance of the
functions of the Federal Bureau of
Investigation, including whether the
information will have practical utility;
—Evaluate the accuracy of the agency’s
estimate of the burden of the
proposed collection of information,
including the validity of the
methodology and assumptions used;
—Evaluate whether and if so how the
quality, utility, and clarity of the
information to be collected can be
enhanced; and
—Minimize the burden of the collection
of information on those who are to
respond, including through the use of
appropriate automated, electronic,
mechanical, or other technological
collection techniques or other forms
of information technology, e.g.,
SUMMARY:
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permitting electronic submission of
responses.
Overview of This Information
Collection
1. Type of Information Collection:
Extension of a currently approved
collection.
2. The Title of the Form/Collection:
Age, Sex, Race, and Ethnicity of Persons
Arrested Under 18 Years of Age; and
Age, Sex, Race, and Ethnicity of Persons
Arrested 18 Years of Age and Over.
3. The agency form number, if any,
and the applicable component of the
Department sponsoring the collection:
The form number is 1–708 and 1–708a.
The applicable component within the
Department of Justice is the Criminal
Justice Information Services Division, in
the Federal Bureau of Investigation.
4. Affected public who will be asked
or required to respond, as well as a brief
abstract:
Primary: City, county, state, tribal and
federal law enforcement agencies.
Abstract: Under Title 28, U.S. Code,
Section 534, Acquisition, Preservation,
and Exchange of Identification Records;
and Appointment of Officials, 1930, this
collection requests the number of arrests
from from city, county, state, tribal, and
federal law enforcement agencies in
order for the FBI UCR Program to serve
as the national clearinghouse for the
collection and dissemination of arrest
data and to publish these statistics in
Crime in the United States.
5. An estimate of the total number of
respondents and the amount of time
estimated for an average respondent to
respond: There are approximately
11,791 law enforcement agency
respondents; calculated estimates
indicate 12 minutes for form 1–708a and
15 minutes for form 1–708 per month.
The total annual burden hours per
respondent is 5 hours and 24 minutes.
Total Annual Hour Burden: 15
minutes + 12 minutes × 12 months =
324 / 60 = 5 hours and 24 minutes.
6. An estimate of the total public
burden (in hours) associated with the
collection: There are approximately
63,671 hours, annual burden, associated
with this information collection.
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]]>Agencies
[Federal Register Volume 82, Number 32 (Friday, February 17, 2017)]
[Notices]
[Pages 11058-11060]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2017-03223]
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DEPARTMENT OF JUSTICE
Drug Enforcement Administration
Paul E. Pilgram, M.D.; Decision and Order
On November 29, 2016, the Assistant Administrator, Diversion
Control Division, Drug Enforcement Administration (DEA), issued an
Order to Show Cause to Paul E. Pilgram,\1\ M.D. (Registrant), of West
Jordan, Utah. The Show Cause Order proposed the revocation of
Registrant's DEA Certificate of Registration, on the ground that he
does not have authority to handle controlled substances in Utah, the
State in which he is registered with the Agency. Show Cause Order, at 1
(citing 21 U.S.C. 824(a)(3)).
---------------------------------------------------------------------------
\1\ Registrant's name in the Order to Show Cause is spelled
``Pilgrim''; however, all other documents in the record, including
Registrant's Certificate of Registration, use the correct spelling
(Pilgram).
---------------------------------------------------------------------------
As the jurisdictional basis for the proceeding, the Show Cause
Order alleged that Registrant is registered as a practitioner in
schedules II through V under DEA registration No. AP1393038, at the
registered address of 1561 West 7000 South, Suite 200, West Jordan,
Utah. Id. The Order alleged that Registrant's registration does not
expire until March 31, 2017. Id.
The Show Cause Order then alleged that on October 17, 2016, the
State of Utah revoked Registrant's authority to prescribe and
administer controlled substances and that he is ``without authority to
handle controlled substances in . . . the [S]tate in which [he is]
registered with the'' Agency. Id. The Order then asserted that as a
consequence of the loss of his state authority, ``DEA must revoke'' his
registration. Id. (citing 21 U.S.C. 802(21), 823(f) and 824(a)(3)). The
Show Cause Order also notified Registrant of his right to request a
hearing on the allegations, or to submit a written statement in lieu of
a hearing, the procedure for electing either option, and the
consequence for failing to do elect either option. Id. at 2 (citing 21
CFR 1301.43). The Order further notified Registrant of his right to
submit a corrective action plan. Id. at 2-3 (citing 21 U.S.C.
824(c)(2)(C)).
On December 6, 2016, a Diversion Investigator (DI) from the DEA
Salt Lake City District Office effected service by hand-delivery of a
copy of the Show Cause Order to Registrant at his registered address of
1561 West 7000 South, Suite 200, West Jordan, Utah. GX 2, at 1-2
(Declaration of Diversion Investigator). According to the Government,
since the date of service of
[[Page 11059]]
the Show Cause Order, the Agency ``has not received a request for
hearing or any other reply from'' Registrant. Request for Final Agency
Action (RFFA), at 2.
On January 10, 2017, the Government forwarded this matter to my
Office for final agency action along with an evidentiary record. RFFA,
at 1. Based upon the Government's representation and my review of the
record, I find that more than 30 days have now passed since the date of
service of the Show Cause Order, and that neither Registrant, nor
anyone purporting to represent him, has requested a hearing or
submitted a written statement in lieu of a hearing. I therefore find
that Registrant has waived his right to a hearing or to submit a
written statement in lieu of a hearing, and issue this Decision and
Order based on relevant evidence contained in the record submitted by
the Government. 21 CFR 1301.43(d) & (e). I make the following findings
of fact. Id. Sec. 1301.43(e).
Findings of Fact
Registrant is the holder of Certificate of Registration AP1393038,
pursuant to which he is authorized to dispense controlled substances in
schedules II through V as a practitioner, at the registered address of
1561 West 7000 South, Suite 200, West Jordan, Utah. GX 2. His
registration does not expire until March 31, 2017. Id.
On October 17, 2016, the Utah Division of Occupational and
Professional Licensing, Department of Commerce (the Division), issued
an order revoking Registrant's license to prescribe and administer
controlled substances in the State. GX 3, at 2. Therein, the Division
adopted the recommended order of the Utah Physicians Licensing Board
(Physician's Board), which the latter issued following a hearing it
held on August 24-25, 2016 at which Registrant was represented by
counsel. Id. at 5.
The Physician's Board found that Registrant ``did not [ ] meet the
standard of care of the profession for pain management patients'' and
failed to follow the Model Policy for the Use of Controlled Substances
for the Treatment of Pain (2004) in his treatment of nine patients. As
support for its finding, the Board specifically cited: (1) ``[t]he
inadequacy of the documented evaluation of the patients,'' (2) ``[t]he
failure to obtain or document informed consent as to major risks of the
high opioid regimes,'' (3) ``[t]he perfunctory consideration or
enforcement of agreements for treatment,'' (4) ``[t]he improperly low
level of consultation with other health and mental professionals
[sic]),'' and (5) ``[t]he failure to maintain accurate and complete
medical records.'' Id. at 6-7. The Board further found that Registrant
``failed to demonstrate a legitimate medical purpose for his
prescribing practices, [that] there was an absence of sound clinical
judgment on [his] part . . . and the pattern of prescribing practices
was not based on clear documentation of unrelieved pain.'' Id. at 7.
The Board then made detailed findings with respect to nine patients.
Id. at 8-26.
The Physician's Board thus concluded that Registrant had engaged in
unprofessional conduct:
by failing, as a prescribing practitioner, to follow the Model
Policy for the Use of Controlled Substances for the Treatment of
Pain, 2004 [ ], in [his]evaluation of the patient, obtaining or
documenting informed consent, giving more than perfunctory
consideration to, or enforcement of, agreements for treatment,
conducting periodic reviews, consultation with other medical
specialists, maintaining accurate and complete medical records, and
complying with the state laws referenced in [its] conclusions.
Id. at 27 (citing Utah Admin. Code r. 156-1-501(6)).\2\ The Board
further concluded that ``[t]he prescribing of controlled substances by
[Registrant] on too many occasions did not have a legitimate medical
purpose, did not show sound clinical judgment and was not based on
clear documentation of unrelieved pain.'' Id. at 28.\3\
---------------------------------------------------------------------------
\2\ As for Registrant's conduct after the Board adopted its 2013
Model Policy on the Use of Opioids Analgesics in the Treatment of
Chronic Pain, the Board also found that he engaged in unprofessional
conduct. GX 3, at 28 (citing Utah Admin. Code r. 156-1-501(7)).
\3\ Under the Division's rules, ``unprofessional conduct''
includes: ``failing, as a prescribing practitioner, to follow the
`Model Policy for the Use of Controlled Substances for the Treatment
of Pain,' 2004, established by the Federation of State Medical
Boards,'' and ``failing, as a prescribing practitioner, to follow
the `Model Policy on the Use of Opioid Analgesics in the Treatment
of Chronic Pain,' July 2013, adopted by the Federation of State
Medical Boards.'' Utah Admin. Code r. 156-1-501(6) and (7) (2016).
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The Board thus recommended that Registrant's state ``license to
prescribe and administer controlled substances . . . be revoked.'' Id.
at 29. On October 17, 2016, the Division adopted the Board's factual
findings, legal conclusions and recommended order ``in its entirety.''
Id. at 2, 4. According to the online records of the Utah Division of
Occupational and Professional Licensing of which I take official
notice, Registrant's controlled substance license remains revoked as of
the date of this Decision and Order. \4\ See also https://secure.utah.gov/llv/search/. I therefore find that Registrant
is without authority to dispense controlled substances under the laws
of Utah, the State in which he holds his registration.
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\4\ In accordance with 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). To allow Respondent the
opportunity to refute the facts of which I take official notice,
Respondent may file a motion for reconsideration within 15 calendar
days of the date of service of this Order which shall commence on
the date this Order is mailed.
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Discussion
Pursuant to 21 U.S.C. 824(a)(3), the Attorney General is authorized
to suspend or revoke a registration issued under section 823 of the
Controlled Substances Act (CSA), ``upon a finding that the registrant .
. . has had his State license . . . suspended [or] revoked . . . by
competent State authority and is no longer authorized by State law to
engage in the . . . dispensing of controlled substances.'' Moreover,
DEA has long held that the possession of authority to dispense
controlled substances under the laws of the State in which a
practitioner engages in professional practice is a fundamental
condition for obtaining and maintaining a practitioner's registration.
See, e.g., James L. Hooper, 76 FR 71371 (2011), pet. for rev. denied,
481 Fed. Appx. 826 (4th Cir. 2012); Frederick Marsh Blanton, 43 FR
27616 (1978).
This rule derives from the text of two provisions of the CSA.
First, Congress defined ``the term `practitioner' [to] mean[ ] a . . .
physician . . . or other person 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). Second, in
setting the requirements for obtaining a practitioner's registration,
Congress directed that ``[t]he Attorney General shall register
practitioners . . . if the applicant is authorized to dispense . . .
controlled substances under the laws of the State in which he
practices.'' 21 U.S.C. 823(f). Because Congress has clearly mandated
that a practitioner possess state authority in order to be deemed a
practitioner under the Act, DEA has held repeatedly that revocation of
a practitioner's registration is the appropriate sanction whenever he
is no longer authorized to dispense controlled substances under the
laws of the State
[[Page 11060]]
in which he practices medicine. See, e.g., Hooper, 76 FR at 71371-72;
Sheran Arden Yeates, M.D., 71 FR 39130, 39131 (2006); Dominick A.
Ricci, 58 FR 51104, 51105 (1993); Bobby Watts, 53 FR 11919, 11920
(1988); Blanton, 43 FR at 27616.
Because Registrant currently lacks authority to handle controlled
substances in Utah, the State in which he holds his DEA registration,
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. 824(a), as well
as 28 CFR 0.100(b), I order that DEA Certificate of Registration
AP1393038, issued to Paul E. Pilgram, M.D., be, and it hereby is,
revoked. Pursuant to the authority vested in me by 21 U.S.C. 823(f), as
well as 28 CFR 0.100(b), I further order that any pending application
of Paul E. Pilgram, M.D., to renew or modify this registration, be, and
it hereby is, denied. This Order is effective immediately.\5\
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\5\ Based on the extensive findings of the Utah Division of
Occupational and Professional Licensing, I find that the public
interest necessitates that this Order be effective immediately. 21
CFR 1316.67.
Dated: February 9, 2017.
Chuck Rosenberg,
Acting Administrator.
[FR Doc. 2017-03223 Filed 2-16-17; 8:45 am]
BILLING CODE 4410-09-P
