82 FR 49665 - Harinder Takyar, M.D.; Decision and Order

DEPARTMENT OF JUSTICE
Drug Enforcement Administration

Federal Register Volume 82, Issue 206 (October 26, 2017)

Page Range		49665-49668
FR Document		2017-23338
Federal Register, Volume 82 Issue 206 (Thursday, October 26, 2017)
[Federal Register Volume 82, Number 206 (Thursday, October 26, 2017)]
[Notices]
[Pages 49665-49668]
From the Federal Register Online  [www.thefederalregister.org]
[FR Doc No: 2017-23338]


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DEPARTMENT OF JUSTICE

Drug Enforcement Administration


Harinder Takyar, M.D.; Decision and Order

    On January 24, 2017, the Assistant Administrator, Diversion Control 
Division, Drug Enforcement Administration (hereinafter, DEA or 
Government), issued an Order to Show Cause to Harinder Takyar, M.D. 
(hereinafter, Respondent) of Mesa, Arizona. GX 4. The Show Cause Order 
proposed the revocation of Respondent's Certificate of Registration on 
the grounds that Respondent does ``not have authority to handle 
controlled substances in the State of Arizona,'' the State in which he 
is registered, and that Respondent's ``registration would be 
inconsistent with the public interest.'' GX 4, at 1 (citing 21 U.S.C. 
823(f), 824(a)(3) and (4)).
    As to the Agency's jurisdiction, the Show Cause Order alleged that 
Respondent holds DEA Certificate of Registration No. BT9321150 which 
authorizes him to dispense controlled substances in schedules II 
through V as a practitioner at the registered address of 9341 East 
McKellips Road, Mesa, Arizona 85207. GX 4, at 1. See also GX 1 
(Controlled Substance Registration Certificate) (including ``Reform 
Physicians'') and GX 2, at 1 (Certification of Registration History) 
(9341 E McKellips Road, Mesa, AZ 85207-8520). The Show Cause Order 
alleged that this registration expires on November 30, 2019. GX 4, at 
1. See also GX 2, at 1.
    As the first substantive ground for the proceeding, the Show Cause 
Order alleged that Respondent is ``currently without authority to 
handle controlled substances in Arizona.'' GX 4, at 1. It alleged that, 
on December 21, 2016, Respondent ``entered into an Interim Consent 
Agreement for Practice Restriction with the Arizona Medical Board'' 
which ``prohibited [Respondent] from engaging in the practice of 
medicine in the State of Arizona . . . until he applies to the 
Executive Director and receives permission to do so.'' GX 4, at 1 and 
GX 3, at 5 (Interim Consent Agreement For Practice Restriction), 
respectively. The Show Cause Order alleged that Respondent was ``still 
currently prohibited from practicing medicine in the state in which . . 
. [he is] registered with the DEA . . . [and] therefore, the DEA must 
revoke . . . [his] DEA . . . [registration] based upon . . . [his] lack 
of authority to handle controlled substances in the State of Arizona.'' 
GX 4, at 2 (citing 21 U.S.C. 802(21), 823(f), and 824(a)(3)).
    As the second substantive ground for the proceeding, the Show Cause 
Order alleged that the Arizona Attorney General's Office and the Pinal 
County (Arizona) Task Force ``initiated an investigation of . . . 
[Respondent's] medical practice after receiving information from a 
cooperating source that . . . [he] routinely prescribed large 
quantities of oxycodone, a Schedule II controlled substance, without 
performing an examination.'' GX 4, at 2. After summarizing two law 
enforcement officers' undercover visits to Respondent's medical 
practice, the Show Cause Order alleged that, concerning the first 
undercover officer, Respondent prescribed schedule II and IV controlled 
substances ``after conducting only a cursory medical examination[, or 
no physical examination but falsely documenting a full physical exam] . 
. . without inquiring about whether the agent experienced 
sleeplessness, anxiety, or panic[, and without] . . . properly 
execut[ing] . . . a prescription . . . as required by 21 CFR 1306.05(a) 
by not listing the full address of the patient on the face of the 
prescription . . . [or] maintain[ing] an adequate patient chart.'' GX 
4, at 2-3.
    Concerning the second undercover officer, the Show Cause Order 
alleged that Respondent prescribed a schedule II controlled substance 
the first time ``despite the agent informing . . . [Respondent] that he 
felt no pain during . . . [Respondent's] brief examination of him . . . 
[, and a second time without] conduct[ing] a physical exam . . . and 
falsely documenting a full physical

[[Page 49666]]

exam.'' GX 4, at 4. The Show Cause Order concluded that Respondent 
``unlawfully prescribed controlled substances to undercover law 
enforcement officers for other than a legitimate medical purpose and 
outside the usual course of professional practice'' in violation of 
Federal and State law, and violated Arizona medical practice standards 
when he ``failed to maintain appropriate patient records that supported 
the prescribing of controlled substances and . . . failed to conduct an 
appropriate physical examination, or establish a . . . doctor-patient 
relationship before prescribing a controlled substance.'' GX 4, at 2 
(citing 21 CFR 1306.04(a), Ariz. Rev. Stat. Sec.  32-1401.27(e), (j), 
(q), and (SS), and Ariz. Rev. Stat. Sec.  32-901(15)).
    The Show Cause Order notified Respondent of his right to request a 
hearing on the allegations or to submit a written statement while 
waiving his right to a hearing, the procedures for electing each 
option, and the consequences for failing to elect either option. GX 4, 
at 5 (citing 21 CFR 1301.43). The Show Cause Order also notified 
Respondent of the opportunity to submit a Corrective Action Plan. GX 4, 
at 5 (citing 21 U.S.C. 824(c)(2)(C)).
    By letter dated February 22, 2017, Respondent, by his counsel, 
asked the Administrative Law Judge for ``an extension of 30 days within 
which to file a written request for hearing concerning the Order to 
Show Cause.'' GX 5. The letter alleged that ``good cause'' supported 
the request because Respondent's counsel ``has only recently been 
retained,'' the ``discovery concerning the listed allegations is 
voluminous,'' and counsel ``needed [time] to gather necessary 
information concerning the allegations . . . and more effectively 
complete the request for hearing letter.'' Id. By Order dated March 1, 
2017, the Chief Administrative Law Judge, John J. Mulrooney, II, 
granted an ``enlargement of the time allotted to request a hearing . . 
. to the extent (but only to the extent) that, if the Respondent elects 
to request a hearing, he must do so no later than March 17, 2017.'' GX 
6, at 2 (Order Granting in Part the Respondent's Request for an 
Extension of the Time to File a Request for Hearing).
    By Motion dated March 27, 2017, the Government requested that 
further proceedings be terminated because ``[a]s of the date of this 
filing, Respondent has not notified this tribunal or Government counsel 
of any request for hearing.'' GX 7, at 2 (Government's Motion for 
Termination of Proceedings). By Order dated April 3, 2017, the 
Presiding Judge issued an Order Terminating Proceedings, finding that 
``no request for a hearing was filed.'' GX 8 (Order Terminating 
Proceedings).
    I find that the Government's service of the Show Cause Order on 
Respondent was legally sufficient, that the Respondent did not timely 
request a hearing, and that Respondent has waived his right to a 
hearing and his right to submit a written statement. 21 CFR 1301.43(d). 
I therefore issue this Decision and Order based on the record submitted 
by the Government. 21 CFR 1301.43(e).

Findings of Fact

Respondent's DEA Registration

    Respondent currently holds DEA practitioner registration BT9321150 
authorizing him to dispense controlled substances in schedules II 
through V at the address of Reform Physicians, 9341 E McKellips Road, 
Mesa, AZ 85207-8520. GX 1. This registration expires on November 30, 
2019. Id.

The Investigations of Respondent and the Status of Respondent's State 
Licenses

    On December 21, 2016, Respondent and the Executive Director of the 
Arizona Medical Board (hereinafter, ``Board'') signed an ``Interim 
Consent Agreement for Practice Restriction.'' GX 3. Pursuant to the 
Interim Consent Agreement for Practice Restriction, Respondent elected 
to relinquish all rights to a hearing and to appeal, and agreed not to 
dispute, but did not concede, its allegations. GX 3, at 6, 4, 
respectively. It contained the allegations that Respondent ``deviated 
from the standard of care'' for one patient by ``failing to 
substantiate and justify a reason for prescribing opioids to . . . 
her[,] to acknowledge and deal with aberrant behavior manifested by 
frequent Emergency Room . . . visits usually for overdoses and 
documentation [sic] cocaine use[,] . . . to utilize urine drug 
screens[,] . . . to access [the patient's] Controlled Substance 
Prescription Monitoring Program (``CSPMP'') profile to monitor [the 
patient's] prescription medication use[, and] . . . by performing 
trigger point injections without identifying physical trigger points on 
examination, usually with a concomitant IM injection of Toradol.'' GX 
3, at 2. The Interim Consent Agreement for Practice Restriction 
contained the allegation that this patient ``experienced actual harm as 
Respondent caused or contributed to her abuse and apparent addiction of 
controlled substances.'' Id.
    The Interim Consent Agreement for Practice Restriction also 
contained allegations that Respondent deviated from the standard of 
care for another patient ``by failing to substantiate and justify a 
reason for prescribing opioids to . . . [her], failing to monitor his 
opioid prescribing, failing to access the CSPMP, and failing to utilize 
urine drug screens.'' GX 3, at 3. Those allegations included that 
Respondent ``failed to identify aberrant behavior including frequent ER 
visits, and claims of lost or stolen medications and requests for early 
refills.'' Id. According to the allegations, Respondent's patient 
``experienced actual harm in that Respondent either created an 
addictive state or contributed to a pre-existing addictive state.'' Id.
    The Interim Consent Agreement for Practice Restriction contained 
allegations concerning a third patient of Respondent's. Those 
allegations included that ``Respondent deviated from the standard of 
care for . . . [the patient] by failing to identify a source of pain 
for . . . [him], and failing to demonstrate that the prescribing of 
opioids met the goals of reduction of pain and improvement of 
function.'' Id. Additional allegations concerning the third patient 
were that ``Respondent failed to monitor his opioid prescribing, failed 
to access the CSPMP and failed to utilize urine drug screens until 
April of 2016.'' Id. According to the allegations, Respondent's patient 
``experienced actual harm in that Respondent ignored abnormal urine 
drug screens and aberrant behavior,'' and faced the ``potential for 
harm'' due to ``inappropriate medication prescribing, including side 
effects such as sedation, gastrointestinal dysfunction, cognitive 
impairment, respiratory depression, insomnia and addiction.'' GX 3, at 
3-4.
    The Interim Consent Agreement for Practice Restriction explicitly 
stated that Respondent agreed not to dispute its allegations ``[f]or 
the purposes of entering this Interim Consent Agreement and for these 
purposes only.'' GX 3, at 4. It also stated that Respondent did ``not 
concede these allegations and this Interim Consent Agreement is not 
intended for use in any subsequent proceeding, either civil or 
criminal, as evidence of any kind.'' Id.
    The Interim Consent Agreement for Practice Restriction's Interim 
Order prohibited Respondent from engaging in the practice of medicine 
in the State of Arizona ``until he applies to the Executive Director 
and receives permission to do so.'' GX 3, at 5 (citing A.R.S. Sec.  32-
1401(22)). The Interim Order stated that Respondent may request release 
and/or modification of the Interim Consent Agreement for

[[Page 49667]]

Practice Restriction in writing accompanied by ``information 
demonstrating that he is safe to practice medicine, including having 
successfully completed a competency evaluation at a facility approved 
by the Board or its staff.'' GX 3, at 5. Among other things, the 
Interim Order also stated that it is not a ``final decision by the 
Board,'' is ``subject to further consideration,'' and ``[o]nce the 
investigation is complete, it will be promptly provided to the Board 
for its review and appropriate action.'' Id. The Interim Consent 
Agreement for Practice Restriction was ``effective on the date signed 
by the Board's Executive Director,'' December 21, 2016. GX 3, at 5, 8-
9. Respondent entered into the Interim Consent Agreement for Practice 
Restriction voluntarily. GX 3, at 6. He understood that ``any violation 
of this Interim Consent Agreement constitutes unprofessional conduct 
under A.R.S. Sec.  32-1401(27)(r).'' GX 3, at 8.
    On May 9, 2017, the DEA Diversion Investigator assigned to the 
investigation of Respondent's medical practice (hereinafter, DI) signed 
a Declaration. GX 9. According to that Declaration, the DI 
``confirmed'' with the Senior Investigator for the Board that ``the 
current prohibition on . . . [Respondent's] practice of medicine also 
includes a prohibition on his authorization to handle controlled 
substances.'' GX 9, at 2. Further, as of April 24, 2017, the 
Declaration stated that the Board's Senior Investigator informed the DI 
that Respondent ``remains prohibited from practicing medicine in 
Arizona, pending revocation proceedings currently before the Board.'' 
Id.
    As found above, Respondent waived his right to a hearing and to 
submit a written statement while waiving his right to a hearing 
concerning the Show Cause Order. Accordingly, there is no evidence to 
refute the allegations of the Show Cause Order. I, therefore, find that 
Respondent currently is prohibited from engaging in the practice of 
medicine, and currently is without authority to dispense controlled 
substances, in Arizona, the State in which he is registered.

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 Fed. Appx. 826 
(4th Cir. 2012); Bourne Pharmacy, Inc., 72 FR 18,273, 18,274 (2007) 
(``Under the Controlled Substances Act . . . , it is irrelevant that 
Respondent's state registration is being held in escrow pending state 
proceedings. Under the Act, a practitioner must be currently authorized 
to handle controlled substances in `the jurisdiction in which [it] 
practices' in order to maintain its DEA registration.''); Anne Lazar 
Thorn, M.D., 62 FR 12,847, 12, 848 (1997) (The ``controlling question'' 
is ``whether the Respondent is currently authorized to handle 
controlled substances in the state.''); Frederick Marsh Blanton, M.D., 
43 FR 27,616 (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. 801(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., Hooper, supra, 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, 53 FR 11,919, 11,920 (1988); Thorn, supra, 62 FR at 12,848; 
Blanton, supra, 43 FR at 27,616.
    Under Arizona law, a ``doctor of medicine'' is a ``natural person 
holding a license, registration or permit to practice medicine pursuant 
to this chapter.'' A.R.S. Sec.  32-1401(10) (2017). See also A.R.S. 
Sec.  32-1401(21) (2017) (A ``physician'' is a ``doctor of medicine who 
is licensed pursuant to this chapter.'') The ``practice of medicine'' 
means ``the diagnosis, the treatment or the correction of or the 
attempt or the claim to be able to diagnose, treat or correct any and 
all human diseases . . . by any means, method, devices or 
instrumentalities . . . .'' A.R.S. Sec.  32-1401(22) (2017). 
``Medicine'' means ``allopathic medicine as practiced by the recipient 
of a degree of doctor of medicine.'' A.R.S. Sec.  32-1401(19) (2017). 
``Restrict'' means ``taking a disciplinary action that alters the 
physician's practice or professional activities if the board determines 
that there is evidence that the physician is or may be medically 
incompetent or guilty of unprofessional conduct.'' A.R.S. Sec.  32-
1401(23) (2017). Further, a physician who ``wishes to dispense a 
controlled substance . . . shall be currently licensed to practice 
medicine in Arizona.'' Arizona Medical Board Licensure, R4-16-301 
(2017). ``Dispense,'' under Arizona law, means ``the delivery by a 
doctor of medicine of a prescription drug or device to a patient . . . 
and includes the prescribing, administering, packaging, labeling and 
security necessary to prepare and safeguard the drug or device for 
delivery.'' A.R.S. Sec.  32-1401(9) (2017).
    In this case, the Arizona Medical Board and Respondent entered into 
an ``Interim Consent Agreement for Practice Restriction'' which 
prohibits Respondent from engaging in the practice of medicine in the 
State of Arizona ``until he applies to the Executive Director and 
receives permission to do so.'' GX 3, at 5 (citing A.R.S. Sec.  32-
1401(22)). Further, the unrefuted DI Declaration stated that ``the 
current prohibition on . . . [Respondent's] practice of medicine also 
includes a prohibition on his authorization to handle controlled 
substances.'' GX 9, at 2. Consequently, Respondent is not currently 
authorized to handle controlled substances in the State of Arizona, the 
State in which he is registered and, therefore, he is not entitled to 
maintain his DEA registration. Thorn, supra; Blanton, supra. 
Accordingly, I will order that his registration be revoked and that any 
pending application for the renewal or modification of his registration 
be denied. 21 U.S.C. 824(a)(3).

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 
BT9321150 issued to

[[Page 49668]]

Harinder Takyar, M.D., be, and it hereby is, revoked. I further order 
that any pending application of Harinder Takyar, M.D., to renew or 
modify this registration, as well as any other pending application by 
him for registration in the State of Arizona, be, and it hereby is, 
denied. This order is effective November 27, 2017.

    Dated: October 18, 2017.
Robert W. Patterson,
Acting Administrator.
[FR Doc. 2017-23338 Filed 10-25-17; 8:45 am]
BILLING CODE 4410-09-P
Federal Register / Vol. 82, No. 206 / Thursday, October 26, 2017 / Notices 49665

person licensed, registered or otherwise in the Commonwealth of Massachusetts As the first substantive ground for the
permitted, by . . . the jurisdiction in be denied. proceeding, the Show Cause Order
which he practices . . . to distribute, alleged that Respondent is ‘‘currently
Order
dispense, [or] administer . . . a without authority to handle controlled
controlled substance in the course of Pursuant to the authority vested in me substances in Arizona.’’ GX 4, at 1. It
professional practice.’’ 21 U.S.C. by 21 U.S.C. 824(a), as well as 28 CFR alleged that, on December 21, 2016,
802(21). Second, in setting the 0.100(b), I order that DEA Certificate of Respondent ‘‘entered into an Interim
requirements for obtaining a Registration No. BC6966381 issued to Consent Agreement for Practice
practitioner’s registration, Congress Yoon Choi, M.D., be, and it hereby is, Restriction with the Arizona Medical
directed that ‘‘[t]he Attorney General revoked. Pursuant to the authority Board’’ which ‘‘prohibited [Respondent]
shall register practitioners . . . if the vested in me by 21 U.S.C. 823(f), I from engaging in the practice of
applicant is authorized to dispense . . . further order that any application of medicine in the State of Arizona . . .
controlled substances under the laws of Yoon Choi, M.D., to renew or modify until he applies to the Executive
the State in which he practices.’’ 21 this registration, or for any other Director and receives permission to do
U.S.C. 823(f). Because Congress has registration in the Commonwealth of so.’’ GX 4, at 1 and GX 3, at 5 (Interim
clearly mandated that a physician Massachusetts, be, and it hereby is, Consent Agreement For Practice
denied. This Order is effective Restriction), respectively. The Show
possess state authority in order to be
November 27, 2017. Cause Order alleged that Respondent
deemed a practitioner under the Act,
was ‘‘still currently prohibited from
DEA has held that revocation of a Dated: October 17, 2017.
practicing medicine in the state in
practitioner’s registration is the Robert W. Patterson, which . . . [he is] registered with the
appropriate sanction whenever he is no Acting Administrator. DEA . . . [and] therefore, the DEA must
longer authorized to dispense controlled [FR Doc. 2017–23329 Filed 10–25–17; 8:45 am] revoke . . . [his] DEA . . . [registration]
substances under the laws of the State BILLING CODE 4410–09–P based upon . . . [his] lack of authority
in which he practices medicine. See, to handle controlled substances in the
e.g., Calvin Ramsey, 76 FR 20034, 20036 State of Arizona.’’ GX 4, at 2 (citing 21
(2011); Sheran Arden Yeates, M.D., 71 DEPARTMENT OF JUSTICE U.S.C. 802(21), 823(f), and 824(a)(3)).
FR 39130, 39131 (2006); Dominick A. As the second substantive ground for
Ricci, 58 FR 51104, 51105 (1993); Bobby Drug Enforcement Administration the proceeding, the Show Cause Order
Watts, 53 FR 11919, 11920 (1988); see alleged that the Arizona Attorney
also Hooper v. Holder, 481 Fed. Appx. Harinder Takyar, M.D.; Decision and General’s Office and the Pinal County
at 828. Order (Arizona) Task Force ‘‘initiated an
As a consequence of the Board’s Final On January 24, 2017, the Assistant investigation of . . . [Respondent’s]
Decision and Order, Respondent is not Administrator, Diversion Control medical practice after receiving
currently authorized to dispense Division, Drug Enforcement information from a cooperating source
controlled substances in Massachusetts, Administration (hereinafter, DEA or that . . . [he] routinely prescribed large
the State in which he is registered. Government), issued an Order to Show quantities of oxycodone, a Schedule II
controlled substance, without
Because the CSA makes clear that the Cause to Harinder Takyar, M.D.
performing an examination.’’ GX 4, at 2.
possession of authority to dispense (hereinafter, Respondent) of Mesa,
After summarizing two law enforcement
controlled substances under the laws of Arizona. GX 4. The Show Cause Order
officers’ undercover visits to
the State in which a practitioner engages proposed the revocation of
Respondent’s medical practice, the
in professional practice is a Respondent’s Certificate of Registration
Show Cause Order alleged that,
fundamental condition for both on the grounds that Respondent does
concerning the first undercover officer,
obtaining and maintaining a ‘‘not have authority to handle controlled
Respondent prescribed schedule II and
practitioner’s registration, it is of no substances in the State of Arizona,’’ the
IV controlled substances ‘‘after
consequence that the Board’s Order State in which he is registered, and that
conducting only a cursory medical
provided that he may petition to stay Respondent’s ‘‘registration would be examination[, or no physical
the suspension upon meeting certain inconsistent with the public interest.’’ examination but falsely documenting a
conditions. Cf. Hooper v. Holder, 481 F. GX 4, at 1 (citing 21 U.S.C. 823(f), full physical exam] . . . without
App’x at 828 (upholding revocation of a 824(a)(3) and (4)). inquiring about whether the agent
physician’s registration as based on a As to the Agency’s jurisdiction, the experienced sleeplessness, anxiety, or
reasonable interpretation of the CSA, Show Cause Order alleged that panic[, and without] . . . properly
notwithstanding that the physician’s Respondent holds DEA Certificate of execut[ing] . . . a prescription . . . as
medical license was subject to a Registration No. BT9321150 which required by 21 CFR 1306.05(a) by not
suspension of known duration); see also authorizes him to dispense controlled listing the full address of the patient on
James L. Hooper, 76 FR 71371, 71371– substances in schedules II through V as the face of the prescription . . . [or]
72 (2011).6 As of this date, Respondent a practitioner at the registered address maintain[ing] an adequate patient
is not currently authorized to dispense of 9341 East McKellips Road, Mesa, chart.’’ GX 4, at 2–3.
controlled substances in Massachusetts, Arizona 85207. GX 4, at 1. See also GX Concerning the second undercover
and therefore, he is not entitled to 1 (Controlled Substance Registration officer, the Show Cause Order alleged
maintain his registration in that State. Certificate) (including ‘‘Reform that Respondent prescribed a schedule
ethrower on DSK3G9T082PROD with NOTICES

Accordingly, I will order that his Physicians’’) and GX 2, at 1 II controlled substance the first time
registration be revoked and that any (Certification of Registration History) ‘‘despite the agent informing . . .
pending application to renew his (9341 E McKellips Road, Mesa, AZ [Respondent] that he felt no pain during
registration, or for any other registration 85207–8520). The Show Cause Order . . . [Respondent’s] brief examination of
alleged that this registration expires on him . . . [, and a second time without]
6 By contrast, Respondent’s suspension is of November 30, 2019. GX 4, at 1. See also conduct[ing] a physical exam . . . and
unknown duration. GX 2, at 1. falsely documenting a full physical

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Federal Register / Vol. 82, No. 206 / Thursday, October 26, 2017 / Notices 49667

Practice Restriction in writing substances.’’ With respect to a See also A.R.S. § 32–1401(21) (2017) (A
accompanied by ‘‘information practitioner, the DEA has also long held ‘‘physician’’ is a ‘‘doctor of medicine
demonstrating that he is safe to practice that the possession of authority to who is licensed pursuant to this
medicine, including having successfully dispense controlled substances under chapter.’’) The ‘‘practice of medicine’’
completed a competency evaluation at a the laws of the State in which a means ‘‘the diagnosis, the treatment or
facility approved by the Board or its practitioner engages in professional the correction of or the attempt or the
staff.’’ GX 3, at 5. Among other things, practice is a fundamental condition for claim to be able to diagnose, treat or
the Interim Order also stated that it is obtaining and maintaining a correct any and all human diseases . . .
not a ‘‘final decision by the Board,’’ is practitioner’s registration. See, e.g., by any means, method, devices or
‘‘subject to further consideration,’’ and James L. Hooper, M.D., 76 FR 71,371 instrumentalities . . . .’’ A.R.S. § 32–
‘‘[o]nce the investigation is complete, it (2011), pet. for rev. denied, 481 Fed. 1401(22) (2017). ‘‘Medicine’’ means
will be promptly provided to the Board Appx. 826 (4th Cir. 2012); Bourne ‘‘allopathic medicine as practiced by the
for its review and appropriate action.’’ Pharmacy, Inc., 72 FR 18,273, 18,274 recipient of a degree of doctor of
Id. The Interim Consent Agreement for (2007) (‘‘Under the Controlled medicine.’’ A.R.S. § 32–1401(19) (2017).
Practice Restriction was ‘‘effective on Substances Act . . . , it is irrelevant that ‘‘Restrict’’ means ‘‘taking a disciplinary
the date signed by the Board’s Executive Respondent’s state registration is being action that alters the physician’s
Director,’’ December 21, 2016. GX 3, at held in escrow pending state practice or professional activities if the
5, 8–9. Respondent entered into the proceedings. Under the Act, a board determines that there is evidence
Interim Consent Agreement for Practice practitioner must be currently that the physician is or may be
Restriction voluntarily. GX 3, at 6. He authorized to handle controlled medically incompetent or guilty of
understood that ‘‘any violation of this substances in ‘the jurisdiction in which unprofessional conduct.’’ A.R.S. § 32–
Interim Consent Agreement constitutes [it] practices’ in order to maintain its 1401(23) (2017). Further, a physician
unprofessional conduct under A.R.S. DEA registration.’’); Anne Lazar Thorn, who ‘‘wishes to dispense a controlled
§ 32–1401(27)(r).’’ GX 3, at 8. M.D., 62 FR 12,847, 12, 848 (1997) (The substance . . . shall be currently
On May 9, 2017, the DEA Diversion ‘‘controlling question’’ is ‘‘whether the licensed to practice medicine in
Investigator assigned to the Respondent is currently authorized to Arizona.’’ Arizona Medical Board
investigation of Respondent’s medical handle controlled substances in the Licensure, R4–16–301 (2017).
practice (hereinafter, DI) signed a state.’’); Frederick Marsh Blanton, M.D., ‘‘Dispense,’’ under Arizona law, means
Declaration. GX 9. According to that 43 FR 27,616 (1978). ‘‘the delivery by a doctor of medicine of
Declaration, the DI ‘‘confirmed’’ with This rule derives from the text of two a prescription drug or device to a
the Senior Investigator for the Board provisions of the CSA. First, Congress patient . . . and includes the
that ‘‘the current prohibition on . . . defined the term ‘‘practitioner’’ [to] prescribing, administering, packaging,
[Respondent’s] practice of medicine also mean[ ] a . . . physician . . . or other labeling and security necessary to
includes a prohibition on his person licensed, registered, or otherwise prepare and safeguard the drug or
authorization to handle controlled permitted, by . . . the jurisdiction in device for delivery.’’ A.R.S. § 32–
substances.’’ GX 9, at 2. Further, as of which he practices . . . , to distribute, 1401(9) (2017).
April 24, 2017, the Declaration stated dispense, [or] administer . . . a In this case, the Arizona Medical
that the Board’s Senior Investigator controlled substance in the course of Board and Respondent entered into an
informed the DI that Respondent professional practice . . . .’’ 21 U.S.C. ‘‘Interim Consent Agreement for
‘‘remains prohibited from practicing 801(21). Second, in setting the Practice Restriction’’ which prohibits
medicine in Arizona, pending requirements for obtaining a Respondent from engaging in the
revocation proceedings currently before practitioner’s registration, Congress practice of medicine in the State of
the Board.’’ Id. directed that ‘‘[t]he Attorney General Arizona ‘‘until he applies to the
As found above, Respondent waived shall register practitioners . . . if the Executive Director and receives
his right to a hearing and to submit a applicant is authorized to dispense . . . permission to do so.’’ GX 3, at 5 (citing
written statement while waiving his controlled substances under the laws of A.R.S. § 32–1401(22)). Further, the
right to a hearing concerning the Show the State in which he practices.’’ 21 unrefuted DI Declaration stated that
Cause Order. Accordingly, there is no U.S.C. 823(f). Because Congress has ‘‘the current prohibition on . . .
evidence to refute the allegations of the clearly mandated that a practitioner [Respondent’s] practice of medicine also
Show Cause Order. I, therefore, find that possess State authority in order to be includes a prohibition on his
Respondent currently is prohibited from deemed a practitioner under the CSA, authorization to handle controlled
engaging in the practice of medicine, the DEA has held repeatedly that substances.’’ GX 9, at 2. Consequently,
and currently is without authority to revocation of a practitioner’s registration Respondent is not currently authorized
dispense controlled substances, in is the appropriate sanction whenever he to handle controlled substances in the
Arizona, the State in which he is is no longer authorized to dispense State of Arizona, the State in which he
registered. controlled substances under the laws of is registered and, therefore, he is not
the State in which he practices. See, entitled to maintain his DEA
Discussion
e.g., Hooper, supra, 76 FR at 71,371–72; registration. Thorn, supra; Blanton,
Pursuant to 21 U.S.C. 824(a)(3), the Sheran Arden Yeates, M.D., 71 FR supra. Accordingly, I will order that his
Attorney General is authorized to 39,130, 39,131 (2006); Dominick A. registration be revoked and that any
suspend or revoke a registration issued Ricci, M.D., 58 FR 51,104, 51,105 (1993); pending application for the renewal or
under section 823 of the Controlled Bobby Watts, 53 FR 11,919, 11,920 modification of his registration be
ethrower on DSK3G9T082PROD with NOTICES

Substances Act (hereinafter, CSA), (1988); Thorn, supra, 62 FR at 12,848; denied. 21 U.S.C. 824(a)(3).
‘‘upon a finding that the registrant . . . Blanton, supra, 43 FR at 27,616.
has had his State License or registration Under Arizona law, a ‘‘doctor of Order
suspended [or] revoked by competent medicine’’ is a ‘‘natural person holding Pursuant to the authority vested in me
State authority and is no longer a license, registration or permit to by 21 U.S.C. 824(a), as well as 28 CFR
authorized by State law to engage in the practice medicine pursuant to this 0.100(b), I order that DEA Certificate of
. . . dispensing of controlled chapter.’’ A.R.S. § 32–1401(10) (2017). Registration BT9321150 issued to

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Document Created: 2018-10-25 10:12:23
Document Modified: 2018-10-25 10:12:23
Category		Regulatory Information
Collection		Federal Register
sudoc Class		AE 2.7: GS 4.107: AE 2.106:
Publisher		Office of the Federal Register, National Archives and Records Administration
Section		Notices
FR Citation		82 FR 49665
82 FR 49665 - Harinder Takyar, M.D.; Decision and Order

DEPARTMENT OF JUSTICEDrug Enforcement Administration

Federal Register Volume 82, Issue 206 (October 26, 2017)

DEPARTMENT OF JUSTICE
Drug Enforcement Administration
