Humberto A. Florian, M.D.; Decision and Order, 52203-52205 [2021-20246]
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Federal Register / Vol. 86, No. 179 / Monday, September 20, 2021 / Notices
responses Applicant provided in her
North Carolina-based registration
application were not ‘‘predictably
capable of affecting, that is, had a
natural tendency to affect, the official
decision’’ of DEA given Applicant’s
unrebutted record evidence of the input
and instructions she said she received
during her meeting with the DEA
investigative team on January 31, 2019.
The Government has the burden of
proof in this proceeding. 21 CFR
1301.44. For the above-stated reasons, I
find that the Government has failed to
meet its burden. The record evidence
does not include clear, unequivocal, and
convincing evidence that Applicant
materially falsified her North Carolinabased registration application. 21 U.S.C.
824(a)(1); Frank Joseph Stirlacci, M.D.,
85 FR 45,229 (2020). Accordingly, I am
dismissing the OSC.
However, as explained supra section
II.B., Applicant is not currently
‘‘authorized to dispense controlled
substances under the laws of the State’’
of North Carolina, I have no statutory
authority to grant Applicant’s North
Carolina-based registration application.
21 U.S.C. 823(f); 21 U.S.C. 802(21);
supra section II.B.
California, the state in which [he is]
registered with DEA.’’ Id. at 2 (citing 21
U.S.C. 824(a)(3)).
Specifically, the OSC alleged that the
Medical Board of California, Department
of Consumer Affairs (hereinafter, the
Board) issued a Decision on November
21, 2018, to revoke Registrant’s medical
license. Id. at 2. On December 21, 2018,
the Board issued an Order denying
Registrant’s Petition for Reconsideration
of the Decision and Registrant’s medical
license was revoked. Id. The California
Medical Board revoked Registrant’s
medical license following its findings,
inter alia, that Registrant was grossly
negligent, committed repeated negligent
acts, failed to maintain accurate and
adequate medical records, and violated
the California Medical Practice Act. Id.
The OSC notified Registrant of the
right to request a hearing on the
allegations or to submit a written
statement, while waiving the right to a
hearing, the procedures for electing each
option, and the consequences for failing
to elect either option. Id. (citing 21 CFR
1301.43). The OSC also notified
Registrant of the opportunity to submit
a corrective action plan. Id. at 3 (citing
21 U.S.C. 824(c)(2)(C)).
Order
Pursuant to 28 CFR 0.100(b) and the
authority vested in me by 21 U.S.C.
823(f) and 824(a), I hereby dismiss the
Order to Show Cause issued to Lisa Mae
Jones, N.P. Further, pursuant to 28 CFR
0.100(b) and the authority vested in me
by 21 U.S.C. 823(f), in conjunction with
21 U.S.C. 802(21), I deny Application
No. W19018692M. This Order is
effective October 20, 2021.
Adequacy of Service
In a Declaration, dated August 11,
2021, a Diversion Investigator
(hereinafter, the DI) assigned to the
Riverside District Office, Los Angeles
Field Division, attempted to contact
Registrant, including at his registered
address in Anaheim, California, ‘‘to
determine if he would voluntarily
surrender his [DEA registration] in light
of his lack of state authority to prescribe
controlled substances.’’ Request for
Final Agency Action (hereinafter,
RFAA), Exhibit (hereinafter, RFAAX) 3
(DI’s Declaration), at 1–2. The DI stated
that a receptionist at the registered
address said that ‘‘[Registrant] had
retired, but [the] office still forwarded
mail to him.’’ Id. at 2. Following the
issuance of the OSC, the DI traveled
with another DI on April 2, 2021, to
‘‘the last known residence’’ of Registrant
to attempt to serve Registrant with the
OSC, but service was unsuccessful as
‘‘no one appeared to be at the residence
at that time.’’ Id. On April 12, 2021, the
Riverside District Office, Los Angeles
Field Division mailed a copy of the OSC
to Registrant’s last know residence via
first-class mail and the mailing was not
returned as undeliverable. Id. On May
14, 2021, the Los Angeles Field Division
mailed a copy of the OSC to Registrant’s
registered address via first-class mail
with return receipt requested, to which
the DEA received ‘‘an unsigned return
receipt on May 24, 2021, indicating that
Anne Milgram,
Administrator.
[FR Doc. 2021–20241 Filed 9–17–21; 8:45 am]
BILLING CODE 4410–09–P
DEPARTMENT OF JUSTICE
Drug Enforcement Administration
Humberto A. Florian, M.D.; Decision
and Order
On March 24, 2021, the Assistant
Administrator, Diversion Control
Division, Drug Enforcement
Administration (hereinafter,
Government), issued an Order to Show
Cause (hereinafter, OSC) to Humberto A.
Florian, M.D. (hereinafter, Registrant) of
Anaheim, California. OSC, at 1. The
OSC proposed the revocation of
Registrant’s Certificate of Registration
No. FF0235451. Id. It alleged that
Registrant is ‘‘without authority to
handle controlled substances in
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52203
the [OSC] had been delivered.’’ Id.; see
also RFAAX 3, Appendix (hereinafter,
App.) B. Finally, on May 20, 2021, the
DI sent a copy of the [OSC] to Registrant
via his registered email address and did
not receive any error message that
indicated that the email was not
delivered. RFAAX 3, at 2.; see also
RFAAX 3, App. C (copy of email). The
DI also stated that a review of the email
system showed that the email had been
delivered. RFAAX 3, at 2. The DI
concluded that, ‘‘[t]o date, neither
[Registrant] nor any attorney
representing [Registrant] has requested a
hearing. Neither has [Registrant] nor any
attorney for [Registrant] submitted a
written statement.’’ Id. at 3.
The Government forwarded its RFAA,
along with the evidentiary record, to
this office on August 12, 2021. In its
RFAA, the Government represents that
‘‘[Registrant] has not submitted a timely
request for a hearing in this matter.’’
RFAA, at 1. The Government ‘‘seeks to
revoke the [DEA registration] of
[Registrant] because he lacks authority
to handle controlled substances in the
State of California, the state where he is
registered with DEA.’’ Id.
Based on the DI’s Declaration, the
Government’s written representations,
and my review of the record, I find that
the Government accomplished service
of the OSC on Registrant on or before
May 20, 2021. I also find that more than
thirty days have now passed since the
Government accomplished service of
the OSC. Further, based on the DI’s
Declaration and the Government’s
written representations, I find that
neither Registrant, nor anyone
purporting to represent the Registrant,
requested a hearing, submitted a written
statement while waiving Registrant’s
right to a hearing, or submitted a
corrective action plan. Accordingly, I
find that Registrant has waived the right
to a hearing and the right to submit a
written statement and corrective action
plan. 21 CFR 1301.43(d) and 21 U.S.C.
824(c)(2)(C). I, therefore, issue this
Decision and Order based on the record
submitted by the Government, which
constitutes the entire record before me.
21 CFR 1301.43(e).
Findings of Fact
Registrant’s DEA Registration
Registrant is the holder of DEA
Certificate of Registration No.
FF0235451 at the registered address of
2090 S Euclid St. Ste. 104, Anaheim, CA
92802. RFAAX 1 (DEA Certificate of
Registration). Pursuant to this
registration, Registrant is authorized to
dispense controlled substances in
schedules III through V as a practitioner.
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Id. Registrant’s registration expires on
September 30, 2021. Id.
The Status of Registrant’s State License
On June 22, 2018, Administrative Law
Judge Abraham M. Levy of the Office of
Administrative Hearings, State of
California (hereinafter, CA ALJ), issued
a Proposed Decision (hereinafter, CA
ALJ Decision). RFAAX 3, App. A, at 17
and 30. According to the CA ALJ
Decision, Registrant ‘‘committed gross
negligence and repeated negligent acts,
he failed to maintain adequate and
accurate records relating to his
treatment of Patient A, and he, in turn,
violated the Medical Practice Act.’’ Id.
at 18. The CA ALJ Decision summarizes
that Registrant ‘‘saw Patient A five times
between March 2014 and July 2014,
ordered a chest x-ray and a lab work-up,
and despite abnormal findings on the xray indicating further follow-up was
needed, [Registrant] failed to follow up
on the x-ray findings or clinically assess
Patient A’s lung condition.’’ Id. at 17.
According to the CA ALJ Decision
summary, ‘‘[o]n August 14, 2014,
Patient A died from respiratory failure
and interstitial lung disease due to
Chronic Obstructive Pulmonary Disease
(COPD), pulmonary hypertension, and
small cell lung cancer.’’ Id. Further,
according to the ALJ Decision,
‘‘[Registrant] failed to present any
evidence of rehabilitation, or evidence
showing he is amenable to probation, to
justify placing him on probation.’’ Id. at
18. The CA ALJ Decision concluded that
‘‘public protection requires that
[Registrant’s] license be revoked.’’ Id.
On July 31, 2018, the Board issued an
Order of Non-Adoption of Proposed
Decision, which ordered that the ALJ
Decision was not adopted and that a
panel of the Board would decide the
case upon the record. Id. at 16. On
November 21, 2018, the Board issued a
Decision after Non-Adoption
(hereinafter, Board Decision). Id. at 2
and 15. The Board Decision
incorporated the factual findings of the
CA ALJ. Id. at 2–4. The Board Decision
ordered that Registrant’s medical license
be revoked effective December 21, 2018.
Id. at 15. On December 21, 2018, the
Board issued an Order Denying Petition
for Reconsideration that denied the
Petition filed by Registrant for the
reconsideration of the Board Decision.
Id. at 1.
According to California’s online
records, of which I take official notice,
Registrant’s license is still revoked.1
1 Under the Administrative Procedure Act, an
agency ‘‘may take official notice of facts at any stage
in a proceeding—even in the final decision.’’
United States Department of Justice, Attorney
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Jkt 253001
Medical Board of California License
Verification, https://www.mbc.ca.gov/
License-Verification (last visited date of
signature of this Order). California’s
online records show that Registrant’s
medical license remains revoked and
that Registrant is not authorized in
California to practice medicine. Id.
Accordingly, I find that Registrant is
not licensed to engage in the practice of
medicine in California, the state in
which Registrant is registered with the
DEA.
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 (hereinafter, CSA)
‘‘upon a finding that the registrant . . .
has had his State license or registration
suspended . . . [or] revoked . . . by
competent State authority and is no
longer authorized by State law to engage
in the . . . dispensing of controlled
substances.’’ With respect to a
practitioner, the 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, M.D., 76 FR 71,371
(2011), pet. for rev. denied, 481 F. App’x
826 (4th Cir. 2012); Frederick Marsh
Blanton, M.D., 43 FR 27,616, 27,617
(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 . . .
General’s Manual on the Administrative Procedure
Act 80 (1947) (Wm. W. Gaunt & Sons, Inc., Reprint
1979). Pursuant to 5 U.S.C. 556(e), ‘‘[w]hen an
agency decision rests on official notice of a material
fact not appearing in the evidence in the record, a
party is entitled, on timely request, to an
opportunity to show the contrary.’’ Accordingly,
Registrant may dispute my finding by filing a
properly supported motion for reconsideration of
finding of fact within fifteen calendar days of the
date of this Order. Any such motion and response
shall be filed and served by email to the other party
and to Office of the Administrator, Drug
Enforcement Administration at
dea.addo.attorneys@dea.usdoj.gov.
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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 CSA,
the 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. See, e.g.,
James L. Hooper, 76 FR at 71,371–72;
Sheran Arden Yeates, M.D., 71 FR
39,130, 39,131 (2006); Dominick A.
Ricci, M.D., 58 FR 51,104, 51,105 (1993);
Bobby Watts, M.D., 53 FR 11,919, 11,920
(1988); Frederick Marsh Blanton, 43 FR
at 27,617.
According to California statute,
‘‘dispense’’ means ‘‘to deliver a
controlled substance to an ultimate user
or research subject by or pursuant to the
lawful order of a practitioner, including
the prescribing, furnishing, packaging,
labeling, or compounding necessary to
prepare the substance for that delivery.’’
Cal. Health & Safety Code § 11010
(West, current with urgency legislation
through Ch. 115 of 2021 Reg. Sess).
Further, a ‘‘practitioner’’ means a person
‘‘licensed, registered, or otherwise
permitted, to distribute, dispense,
conduct research with respect to, or
administer, a controlled substance in
the course of professional practice or
research in this state.’’ Id. at § 11026(c).
Because Registrant is not currently
licensed as a physician, or otherwise
licensed in California, he is not
authorized to dispense controlled
substances in California.
Here, the undisputed evidence in the
record is that Registrant currently lacks
authority to practice medicine in
California. As already discussed, a
physician must be a licensed
practitioner to dispense a controlled
substance in California. Thus, because
Registrant lacks authority to practice
medicine in California and, therefore, is
not authorized to handle controlled
substances in California, Registrant is
not eligible to maintain a DEA
registration. Accordingly, I will order
that Registrant’s DEA registration be
revoked.
Order
Pursuant to 28 CFR 0.100(b) and the
authority vested in me by 21 U.S.C.
824(a), I hereby revoke DEA Certificate
of Registration No. FF0235451 issued to
Humberto A. Florian, M.D. Further,
pursuant to 28 CFR 0.100(b) and the
authority vested in me by 21 U.S.C.
823(f), I hereby deny any pending
application of Humberto A. Florian to
renew or modify this registration, as
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well as any other pending application of
Humberto A. Florian, for additional
registration in California. This Order is
effective October 20, 2021.
Anne Milgram,
Administrator.
[FR Doc. 2021–20246 Filed 9–17–21; 8:45 am]
BILLING CODE 4410–09–P
DEPARTMENT OF JUSTICE
Drug Enforcement Administration
Steven P. French, M.D.; Decision and
Order
On February 11, 2021, the Assistant
Administrator, Diversion Control
Division, Drug Enforcement
Administration (hereinafter,
Government), issued an Order to Show
Cause (hereinafter, OSC) to Steven P.
French, M.D. (hereinafter, Registrant) of
Jackson, Wyoming. OSC, at 1. The OSC
proposed the revocation of Registrant’s
Certificate of Registration No.
FF5659505. Id. It alleged that Registrant
is ‘‘without authority to handle
controlled substances in Wyoming, the
state in which [he is] registered with
DEA.’’ Id. at 2 (citing 21 U.S.C.
824(a)(3)).
Specifically, the OSC alleged that the
Wyoming Board of Medicine
(hereinafter, the Board) issued a
Findings of Fact, Conclusions of Law,
and Order on April 17, 2020. Id. at 1.
According to the OSC, the Board
accepted Registrant’s voluntary
relinquishment of his Wyoming medical
license following its finding, inter alia,
that Registrant was convicted of driving
under the influence. Id. at 1–2. The
Board further found that during
Registrant’s arrest for driving under the
influence, Wyoming authorities
‘‘discovered in [Registrant’s] possession
a prescription bottle of lorazepam 0.5
mg pills belonging to one of [his]
patients, but with one pill missing.’’ Id.
at 2.
The OSC notified Registrant of the
right to request a hearing on the
allegations or to submit a written
statement, while waiving the right to a
hearing, the procedures for electing each
option, and the consequences for failing
to elect either option. Id. (citing 21 CFR
1301.43). The OSC also notified
Registrant of the opportunity to submit
a corrective action plan. Id. at 3 (citing
21 U.S.C. 824(c)(2)(C)).
Adequacy of Service
In a Declaration, dated July 21, 2021,
a Diversion Investigator (hereinafter, the
DI) assigned to the Cheyenne Resident
Office of the Denver Field Division,
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stated that on September 21, 2020, prior
to the issuance of the OSC, he had
communicated via email with Registrant
regarding Registrant’s DEA registration.
Request for Final Agency Action
(hereinafter, RFAA), Exhibit
(hereinafter, RFAAX) 3 (DI’s
Declaration), at 1. The DI stated that the
following day, ‘‘[Registrant] responded
to the email [the DI] had sent him and
indicated that he had moved to Alaska
and that for any future communications
[the DI] should contact him via email.’’
Id.; see also RFAAX 3, Appendix
(hereinafter, App.) A (email exchange
with Registrant). On February 12, 2021,
the DI sent a copy of the OSC to
Registrant via email. Id. at 1. The DI
stated that later that day, Registrant
‘‘responded to [the] email and indicated
that he received a copy of the [OSC].’’
Id. at 1–2; see also RFAAX 3, App. B
(email from Registrant). The DI stated
that, as of July 21, 2021, ‘‘DEA has not
received any correspondence from
[Registrant] or any attorney acting on his
behalf concerning the [OSC].’’ RFAAX
3, at 2.
The Government forwarded its RFAA,
along with the evidentiary record, to me
on August 10, 2021. In its RFAA, the
Government represents that
‘‘[Registrant] has not submitted a timely
request for a hearing in this matter.’’
RFAA, at 1. The Government seeks to
revoke Registrant’s DEA registration
because ‘‘[Registrant] lacks authority to
handle controlled substances in the
State of Wyoming, the state where he is
registered with DEA.’’ Id.
Based on the DI’s Declaration, the
Government’s written representations,
and my review of the record, I find that
the Government accomplished service
of the OSC on Registrant on February
12, 2021. I also find that more than
thirty days have now passed since the
Government accomplished service of
the OSC. Further, based on the DI’s
Declaration and the Government’s
written representations, I find that
neither Registrant, nor anyone
purporting to represent the Registrant,
requested a hearing, submitted a written
statement while waiving Registrant’s
right to a hearing, or submitted a
corrective action plan. Accordingly, I
find that Registrant has waived the right
to a hearing and the right to submit a
written statement and corrective action
plan. 21 CFR 1301.43(d) and 21 U.S.C.
824(c)(2)(C). I, therefore, issue this
Decision and Order based on the record
submitted by the Government, which
constitutes the entire record before me.
21 CFR 1301.43(e).
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52205
Findings of Fact
Registrant’s DEA Registration
Registrant is the holder of DEA
Certificate of Registration No.
FF5659505 at the registered address of
6605 N Snake River Woods Dr., Jackson,
WY 83001. RFAAX 1 (Certificate of
Registration). Pursuant to this
registration, Registrant is authorized to
dispense controlled substances in
schedules II through V as a practitioner.
Id. Registrant’s registration expires on
September 30, 2021. Id.
The Status of Registrant’s State License
On January 16, 2020, Registrant
submitted a letter to the Board
informing it that he was voluntarily
relinquishing his Wyoming medical
license. RFAAX 3, App. C, at 19. On
March 19, 2020, a member of the Board
petitioned the Board to accept
Registrant’s voluntary relinquishment of
his Wyoming Physician License. Id. at
13. On April 17, 2020, the Board issued
its Findings of Fact, Conclusions of
Law, and Order Accepting Voluntary
Relinquishment of the Wyoming
Physician License of Steven P. French,
M.D., Wyoming Physician License No.
3068A (hereinafter, Board Order). Id. at
1.
According to the Board Order, in
September 2018, Registrant’s clinical
privileges were permanently revoked by
Crook County Medical Services District
in Sundance, Wyoming based upon an
incident in August 2018 where
Registrant was allegedly intoxicated and
exhibited ‘‘disruptive, abusive, and
threatening behavior’’ at the hospital
while he was off-duty. Id. at 3. When
the Wyoming Medicine Board opened a
complaint on the matter, Registrant
denied any inappropriate behavior and
‘‘asserted that he had unilaterally
resigned his clinical privileges as
opposed to them being revoked.’’ Id. On
July 2, 2019, while the first complaint
was still pending, Registrant applied to
renew his Wyoming medical license and
indicated on his application that he
‘‘was convicted of driving under the
influence on November 26, 2018, related
to an arrest incident that occurred on
July 12, 2018.’’ Id.
The Board opened an additional
complaint concerning the arrest
incident. Id. The Board Order states that
Registrant was arrested for a DUI at a gas
station, and ‘‘[d]uring the arrest, sheriff
deputies also located a prescription
bottle of [l]orazepam 0.5 mg for 30 pills,
of which one pill was missing.’’ Id. at
4. Further, ‘‘[t]he label indicated the
prescription was written by [Registrant]
for one of his patients’’ and ‘‘[i]t was
determined that the prescription was
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[Federal Register Volume 86, Number 179 (Monday, September 20, 2021)]
[Notices]
[Pages 52203-52205]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2021-20246]
-----------------------------------------------------------------------
DEPARTMENT OF JUSTICE
Drug Enforcement Administration
Humberto A. Florian, M.D.; Decision and Order
On March 24, 2021, the Assistant Administrator, Diversion Control
Division, Drug Enforcement Administration (hereinafter, Government),
issued an Order to Show Cause (hereinafter, OSC) to Humberto A.
Florian, M.D. (hereinafter, Registrant) of Anaheim, California. OSC, at
1. The OSC proposed the revocation of Registrant's Certificate of
Registration No. FF0235451. Id. It alleged that Registrant is ``without
authority to handle controlled substances in California, the state in
which [he is] registered with DEA.'' Id. at 2 (citing 21 U.S.C.
824(a)(3)).
Specifically, the OSC alleged that the Medical Board of California,
Department of Consumer Affairs (hereinafter, the Board) issued a
Decision on November 21, 2018, to revoke Registrant's medical license.
Id. at 2. On December 21, 2018, the Board issued an Order denying
Registrant's Petition for Reconsideration of the Decision and
Registrant's medical license was revoked. Id. The California Medical
Board revoked Registrant's medical license following its findings,
inter alia, that Registrant was grossly negligent, committed repeated
negligent acts, failed to maintain accurate and adequate medical
records, and violated the California Medical Practice Act. Id.
The OSC notified Registrant of the right to request a hearing on
the allegations or to submit a written statement, while waiving the
right to a hearing, the procedures for electing each option, and the
consequences for failing to elect either option. Id. (citing 21 CFR
1301.43). The OSC also notified Registrant of the opportunity to submit
a corrective action plan. Id. at 3 (citing 21 U.S.C. 824(c)(2)(C)).
Adequacy of Service
In a Declaration, dated August 11, 2021, a Diversion Investigator
(hereinafter, the DI) assigned to the Riverside District Office, Los
Angeles Field Division, attempted to contact Registrant, including at
his registered address in Anaheim, California, ``to determine if he
would voluntarily surrender his [DEA registration] in light of his lack
of state authority to prescribe controlled substances.'' Request for
Final Agency Action (hereinafter, RFAA), Exhibit (hereinafter, RFAAX) 3
(DI's Declaration), at 1-2. The DI stated that a receptionist at the
registered address said that ``[Registrant] had retired, but [the]
office still forwarded mail to him.'' Id. at 2. Following the issuance
of the OSC, the DI traveled with another DI on April 2, 2021, to ``the
last known residence'' of Registrant to attempt to serve Registrant
with the OSC, but service was unsuccessful as ``no one appeared to be
at the residence at that time.'' Id. On April 12, 2021, the Riverside
District Office, Los Angeles Field Division mailed a copy of the OSC to
Registrant's last know residence via first-class mail and the mailing
was not returned as undeliverable. Id. On May 14, 2021, the Los Angeles
Field Division mailed a copy of the OSC to Registrant's registered
address via first-class mail with return receipt requested, to which
the DEA received ``an unsigned return receipt on May 24, 2021,
indicating that the [OSC] had been delivered.'' Id.; see also RFAAX 3,
Appendix (hereinafter, App.) B. Finally, on May 20, 2021, the DI sent a
copy of the [OSC] to Registrant via his registered email address and
did not receive any error message that indicated that the email was not
delivered. RFAAX 3, at 2.; see also RFAAX 3, App. C (copy of email).
The DI also stated that a review of the email system showed that the
email had been delivered. RFAAX 3, at 2. The DI concluded that, ``[t]o
date, neither [Registrant] nor any attorney representing [Registrant]
has requested a hearing. Neither has [Registrant] nor any attorney for
[Registrant] submitted a written statement.'' Id. at 3.
The Government forwarded its RFAA, along with the evidentiary
record, to this office on August 12, 2021. In its RFAA, the Government
represents that ``[Registrant] has not submitted a timely request for a
hearing in this matter.'' RFAA, at 1. The Government ``seeks to revoke
the [DEA registration] of [Registrant] because he lacks authority to
handle controlled substances in the State of California, the state
where he is registered with DEA.'' Id.
Based on the DI's Declaration, the Government's written
representations, and my review of the record, I find that the
Government accomplished service of the OSC on Registrant on or before
May 20, 2021. I also find that more than thirty days have now passed
since the Government accomplished service of the OSC. Further, based on
the DI's Declaration and the Government's written representations, I
find that neither Registrant, nor anyone purporting to represent the
Registrant, requested a hearing, submitted a written statement while
waiving Registrant's right to a hearing, or submitted a corrective
action plan. Accordingly, I find that Registrant has waived the right
to a hearing and the right to submit a written statement and corrective
action plan. 21 CFR 1301.43(d) and 21 U.S.C. 824(c)(2)(C). I,
therefore, issue this Decision and Order based on the record submitted
by the Government, which constitutes the entire record before me. 21
CFR 1301.43(e).
Findings of Fact
Registrant's DEA Registration
Registrant is the holder of DEA Certificate of Registration No.
FF0235451 at the registered address of 2090 S Euclid St. Ste. 104,
Anaheim, CA 92802. RFAAX 1 (DEA Certificate of Registration). Pursuant
to this registration, Registrant is authorized to dispense controlled
substances in schedules III through V as a practitioner.
[[Page 52204]]
Id. Registrant's registration expires on September 30, 2021. Id.
The Status of Registrant's State License
On June 22, 2018, Administrative Law Judge Abraham M. Levy of the
Office of Administrative Hearings, State of California (hereinafter, CA
ALJ), issued a Proposed Decision (hereinafter, CA ALJ Decision). RFAAX
3, App. A, at 17 and 30. According to the CA ALJ Decision, Registrant
``committed gross negligence and repeated negligent acts, he failed to
maintain adequate and accurate records relating to his treatment of
Patient A, and he, in turn, violated the Medical Practice Act.'' Id. at
18. The CA ALJ Decision summarizes that Registrant ``saw Patient A five
times between March 2014 and July 2014, ordered a chest x-ray and a lab
work-up, and despite abnormal findings on the x-ray indicating further
follow-up was needed, [Registrant] failed to follow up on the x-ray
findings or clinically assess Patient A's lung condition.'' Id. at 17.
According to the CA ALJ Decision summary, ``[o]n August 14, 2014,
Patient A died from respiratory failure and interstitial lung disease
due to Chronic Obstructive Pulmonary Disease (COPD), pulmonary
hypertension, and small cell lung cancer.'' Id. Further, according to
the ALJ Decision, ``[Registrant] failed to present any evidence of
rehabilitation, or evidence showing he is amenable to probation, to
justify placing him on probation.'' Id. at 18. The CA ALJ Decision
concluded that ``public protection requires that [Registrant's] license
be revoked.'' Id.
On July 31, 2018, the Board issued an Order of Non-Adoption of
Proposed Decision, which ordered that the ALJ Decision was not adopted
and that a panel of the Board would decide the case upon the record.
Id. at 16. On November 21, 2018, the Board issued a Decision after Non-
Adoption (hereinafter, Board Decision). Id. at 2 and 15. The Board
Decision incorporated the factual findings of the CA ALJ. Id. at 2-4.
The Board Decision ordered that Registrant's medical license be revoked
effective December 21, 2018. Id. at 15. On December 21, 2018, the Board
issued an Order Denying Petition for Reconsideration that denied the
Petition filed by Registrant for the reconsideration of the Board
Decision. Id. at 1.
According to California's online records, of which I take official
notice, Registrant's license is still revoked.\1\ Medical Board of
California License Verification, https://www.mbc.ca.gov/License-Verification (last visited date of signature of this Order).
California's online records show that Registrant's medical license
remains revoked and that Registrant is not authorized in California to
practice medicine. Id.
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\1\ Under the Administrative Procedure Act, an agency ``may take
official notice of facts at any stage in a proceeding--even in the
final decision.'' United States Department of Justice, Attorney
General's Manual on the Administrative Procedure Act 80 (1947) (Wm.
W. Gaunt & Sons, Inc., Reprint 1979). Pursuant to 5 U.S.C. 556(e),
``[w]hen an agency decision rests on official notice of a material
fact not appearing in the evidence in the record, a party is
entitled, on timely request, to an opportunity to show the
contrary.'' Accordingly, Registrant may dispute my finding by filing
a properly supported motion for reconsideration of finding of fact
within fifteen calendar days of the date of this Order. Any such
motion and response shall be filed and served by email to the other
party and to Office of the Administrator, Drug Enforcement
Administration at [email protected].
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Accordingly, I find that Registrant is not licensed to engage in
the practice of medicine in California, the state in which Registrant
is registered with the DEA.
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 (hereinafter, CSA) ``upon a finding that the
registrant . . . has had his State license or registration suspended .
. . [or] revoked . . . by competent State authority and is no longer
authorized by State law to engage in the . . . dispensing of controlled
substances.'' With respect to a practitioner, the 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,
M.D., 76 FR 71,371 (2011), pet. for rev. denied, 481 F. App'x 826 (4th
Cir. 2012); Frederick Marsh Blanton, M.D., 43 FR 27,616, 27,617 (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 CSA, the 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. See, e.g., James L. Hooper, 76
FR at 71,371-72; Sheran Arden Yeates, M.D., 71 FR 39,130, 39,131
(2006); Dominick A. Ricci, M.D., 58 FR 51,104, 51,105 (1993); Bobby
Watts, M.D., 53 FR 11,919, 11,920 (1988); Frederick Marsh Blanton, 43
FR at 27,617.
According to California statute, ``dispense'' means ``to deliver a
controlled substance to an ultimate user or research subject by or
pursuant to the lawful order of a practitioner, including the
prescribing, furnishing, packaging, labeling, or compounding necessary
to prepare the substance for that delivery.'' Cal. Health & Safety Code
Sec. 11010 (West, current with urgency legislation through Ch. 115 of
2021 Reg. Sess). Further, a ``practitioner'' means a person ``licensed,
registered, or otherwise permitted, to distribute, dispense, conduct
research with respect to, or administer, a controlled substance in the
course of professional practice or research in this state.'' Id. at
Sec. 11026(c). Because Registrant is not currently licensed as a
physician, or otherwise licensed in California, he is not authorized to
dispense controlled substances in California.
Here, the undisputed evidence in the record is that Registrant
currently lacks authority to practice medicine in California. As
already discussed, a physician must be a licensed practitioner to
dispense a controlled substance in California. Thus, because Registrant
lacks authority to practice medicine in California and, therefore, is
not authorized to handle controlled substances in California,
Registrant is not eligible to maintain a DEA registration. Accordingly,
I will order that Registrant's DEA registration be revoked.
Order
Pursuant to 28 CFR 0.100(b) and the authority vested in me by 21
U.S.C. 824(a), I hereby revoke DEA Certificate of Registration No.
FF0235451 issued to Humberto A. Florian, M.D. Further, pursuant to 28
CFR 0.100(b) and the authority vested in me by 21 U.S.C. 823(f), I
hereby deny any pending application of Humberto A. Florian to renew or
modify this registration, as
[[Page 52205]]
well as any other pending application of Humberto A. Florian, for
additional registration in California. This Order is effective October
20, 2021.
Anne Milgram,
Administrator.
[FR Doc. 2021-20246 Filed 9-17-21; 8:45 am]
BILLING CODE 4410-09-P