Notice: This opinion is subject to correction before publication in the PACIFIC REPORTER. 

Readers are requested to bring errors to the attention of the Clerk of the Appellate Courts, 

303 K Street, Anchorage, Alaska 99501, phone (907) 264-0608, fax (907) 264-0878, email 

corrections@akcourts.us. 

THE SUPREME COURT OF THE STATE OF ALASKA 

DAVID M. ODOM, M.D., 

Appellant, 

v. 

STATE OF ALASKA, DIVISION 

OF CORPORATIONS, BUSINESS 

& PROFESSIONAL LICENSING, 

Appellee. 

) 

) Supreme Court No. S-16151 

Superior Court No. 3AN-14-08082 CI 

O P I N I O N 

No. 7220 – February 9, 2018 

) 

) 

) 

) 

) 

) 

) 

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Appeal from the Superior Court of the State of Alaska, Third 

Judicial District, Anchorage, Kevin M. Saxby, Judge. 

Appearances: Lee Holen, Anchorage, for Appellant. 

Robert C. Auth, Assistant Attorney General, Anchorage, and 

Jahna Lindemuth, Attorney General, Juneau, for Appellee. 

Before: Stowers, Chief Justice, Winfree, Maassen, Bolger, 

and Carney, Justices. 

MAASSEN, Justice. 

I. INTRODUCTION 

The state professional licensing division brought an accusation of 

professional misconduct against a doctor, alleging that he acted incompetently when he 

prescribed phentermine and thyroid hormone for one of his patients. The division sought 

disciplinary sanctions against the doctor. Following a hearing, an administrative law 
 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

judge issued a proposed decision concluding that the division had failed to show that the 

doctor’s conduct fell below the standard of care in his field of practice and that no 

disciplinary sanctions were warranted. But the Medical Board instead adopted as its 

decision the proposal for action submitted by the division and revoked the doctor’s 

medical license. 

On appeal to the superior court, the case was remanded to the Board for 

consideration of the doctor’s own late-filed proposal for action. The Board reaffirmed 

its decision to revoke the doctor’s medical license, and the superior court affirmed that 

decision. 

The doctor appeals to this court. Because the Medical Board’s decision to 

revoke the doctor’s medical license is not supported by substantial evidence, we reverse 

the superior court’s affirmance of that decision. 

II. FACTS AND PROCEEDINGS 

David Odom is a bariatric physician1 who has been licensed to practice in 

Alaska since 1974. His Fairbanks practice focused on anti-aging, weight loss treatment, 

and natural hormone replacement therapy. He is certified by the American Board of 

Medical Specialties in anesthesiology and by the American Academy of Anti-Aging and 

1 Bariatrics is a branch of medicine that deals with the causes, prevention, 

and treatment of obesity. Bariatrics, THE SLOANE-DORLUND ANNOTATED MEDICALLEGAL DICTIONARY (1987). 

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Regenerative Medicine,2 and he has been admitted to practice in six states besides 

Alaska. The disciplinary action in this case is his first. 

A. Dr. Odom’s Treatment Of S.Q.3 

In April 2007 Dr. Odom began seeing S.Q. for weight loss treatment and 

hormone evaluation. He noted at her first appointment that she had an “irregularly 

irregular” heartbeat; she reported that in 2002 she had been diagnosed with peripartum 

cardiomyopathy, though it was currently asymptomatic. Cardiomyopathy is a disease 

of the heart muscle that can lead to sudden cardiac arrest and death;4 peripartum 

cardiomyopathy by definition begins during thefinal month ofpregnancy or within a few 

months after giving birth.5 

Dr. Odom recorded his initial impressions: thyroid deficiency, hormone 

imbalance, cardiomyopathy, and obesity. S.Q. signed an informed consent form for 

weight loss treatment and another for hormone supplement therapy. Dr. Odom 

scheduled weekly appointments for S.Q. from April through June 2007, continuing 

monthly into September, so he could monitor her progress. 

2 Dr. Odom is not board-certified in bariatrics, but the Medical Board does 

not require physicians to be board-certified in the fields in which they specialize. See 

AlaskaStateMedicalBoard, Practicing aSpecialtywithout beingBoard-Certified in that 

Specialty (Jan. 24.2008), http://www.commerce.alaska.gov/web/portals/5/pub/MED_ 

Guide_Speciality_Practice.pdf. 

3 We use the patient’s initials to protect her privacy. 

4 Cardiomyopathy, STEDMAN’S MEDICAL DICTIONARY (28th ed. 2006). 

5 Cardiomyopathy, peripartum, STEDMAN’SMEDICALDICTIONARY (28th ed. 

2006); see also Peripartum cardiomyopathy, AMERICAN HEART ASSOCIATION. 

http://www.heart.org/HEARTORG/Conditions/More/Cardiomyopathy/ 

Peripartum-Cardiomyopathy-PPCM_UCM_476261_Article.jsp. (last updated Sept. 30, 

2016). 

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The obesity treatment plan included a prescription for phentermine, a 

central nervous system stimulant that suppresses appetite.6 Dr. Odom also prescribed a 

natural thyroid hormone drug — Armour Thyroid7 — for hypothyroidism.8 He 

instructed S.Q. to start the thyroid drug at a dose of 120 milligrams daily, increasing to 

180 milligrams after two weeks and 240 milligrams after four weeks; after that she could 

adjust the dosage herself based on her symptoms. 

At S.Q.’s September 14, 2007 visit — her last to Dr. Odom’s clinic — she 

was found to have lost 33 pounds, dropping below the weight considered clinically 

obese. She reported, however, that she had experienced jitteriness while taking a 

240 milligramdose of Armour Thyroid, so Dr. Odomreduced the dose to 180 milligrams 

a day. S.Q. appears to have stopped taking both medications soon afterward; she last 

filled her phentermine and Armour Thyroid prescriptions on September 10, when she 

received a thirty day supply of each, and some pills were never used. 

A month later S.Q. visited her cardiologist, who reported that she “has had 

a remarkable year and with careful adjustment of her diet, successfully lost 30 pounds.” 

In early 2008, according to her husband, she “looked better and happier than she had in 

6 Phentermine was once commonly prescribed in combination with 

fenfluramine as an appetite suppressant called fen-phen; fen-phen was withdrawn from 

the market following reports that connected its use with certain types of heart disease. 

See In re Diet Drugs (Phentermine/Fenfluramine/Dexfenfluramine) Prod. Liab. Litig., 

582 F.3d 524, 529 (3d Cir. 2009). Phentermine remains an FDA-approved drug. 

7 Armour Thyroid contains two thyroid hormones, levothyroxine and 

liothyronine, as well as several inactive ingredients. 

8 Hypothyroidism is the “[d]iminished production of thyroid hormone, 

leading to clinicalmanifestations ofthyroid insufficiency.” Hypothyroidism, STEDMAN’S 

MEDICAL DICTIONARY (28th ed. 2006). 

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a long time.” But on March 6, 2008, about six months after she had stopped seeing 

Dr. Odom, she suffered cardiac failure and died. 

B. The Licensing Division’s Investigation 

In 2009 S.Q.’s husband filed a complaint with the State of Alaska Division 

of Corporations, Business, and Professional Licensing, suggesting a link between 

Dr. Odom’s treatment of S.Q. and her death. The Division launched an investigation and 

sent S.Q.’s medical records to Dr. Patrick Nolan for review. Dr. Nolan, an 

endocrinologist,9

 concluded that it was inappropriate for Dr. Odom to have prescribed 

phentermine given S.Q.’s cardiomyopathy; that Dr. Odom had prescribed “too much 

thyroid” hormone; and that Dr. Odom had inappropriately prescribed thyroid hormone 

“for weight loss.” Dr. Nolan also opined that the “excess thyroid [hormone] and 

phentermine could have contributed to [S.Q.’s] death.” 

Dr. Odom challenged these conclusions, asserting that Dr. Nolan, as an 

endocrinologist, had a starkly different view of weight loss and natural hormone 

replacement therapy than doctors who, like Dr. Odom, practice anti-aging and bariatric 

medicine. Dr. Nolan responded by declaring Dr. Odom’s practice “dangerous” 

and “clearly . . . a threat to the public’s well being,” though his explanation was terse; he 

said in his supplemental report, “I simply refuse to argue with [Dr. Odom’s approach to 

treatment] as clearly the evidence is in favor of modern endocrinology and against Dr. 

Odom.” 

In April 2012 the Division filed an accusation alleging that Dr. Odom had 

provided substandard care by failing “to conduct an adequate examination of S.Q.,” 

9 Endocrinology is the “science and medical specialty concerned with the 

internal or hormonal secretions and their physiologic and pathologic relations.” 

Endocrinology, STEDMAN’S MEDICAL DICTIONARY (28th ed. 2006). 

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prescribing “phentermine to a patient with an established diagnosis of cardiomyopathy,” 

and prescribing “excess thyroid hormone” in combination with phentermine “for weight 

loss.” The Division did not contend that Dr. Odom’s treatment caused S.Q.’s death; in 

this appeal the Division, through its attorney at oral argument, agreed “absolutely” that 

there was no causal connection.10 

C. The Administrative Proceedings 

An administrative law judge (ALJ) held an evidentiary hearing on the 

Division’s accusation over four days in October and November 2012. The Division 

presented the testimony of S.Q.’s husband, her mother, the Division investigator, and 

Dr. Nolan, who testified as an expert. Dr. Odom testified on his own behalf and also 

presented the expert testimony of Dr. David Bryman, a bariatric physician, and Dr. Neal 

Rouzier, an emergency medicine, family practice, and anti-aging physician. 

The ALJ issued a proposed decision in April 2014. He concluded that the 

Division had failed to prove “that Dr. Odom’s examination was below the standard of 

care”; had failed to prove “that to prescribe phentermine to S.Q. was below the standard 

of care”; and had failed to prove “that Dr. Odom prescribed thyroid hormone as a weight 

loss treatment, or that the dosages he prescribed were excessive and fell below the 

standard of care.” The ALJ therefore concluded that no disciplinary sanction was 

warranted. 

10 According to the administrative law judge, “[t]estimony at the hearing 

established that the medication prescribed by Dr. Odom would have long since been 

eliminated from [S.Q.’s] system, and she had been treated by her cardiologist on several 

occasions since her last visit to Dr. Odom some six months before her death.” The Board 

did not modify this finding, and the Division does not challenge it. 

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D. The Parties’ Proposals For Action And The Medical Board’s Decision 

As permitted by AS 44.64.060(e),11 the Division submitted a proposal for 

action in May 2014 that disputed the ALJ’s findings and recommended that the Medical 

Board impose disciplinary sanctions. The Division argued that Dr. Odom’s practice fell 

below the standard of care when he prescribed phentermine to a patient with 

cardiomyopathy and when he prescribed “four times the recommended dosage” of 

thyroid hormone to S.Q. for “supposed hypothyroidism, when her thyroid levels were 

in fact normal.” The Division asserted that its proposed conclusions, though contrary to 

those of the ALJ, could be reached “based on the evidence contained in the [ALJ’s] 

proposed decision (including the product literature), and the Board’s own medical 

expertise.” 

The Medical Board was scheduled to meet to decide Dr. Odom’s case in 

June 2014, and it received the ALJ’s proposed decision and the Division’s proposal for 

action beforehand. A problem with the mail prevented Dr. Odom from filing his own 

proposal for action, and though he tardily filed an opposition to the Division’s proposal, 

the Medical Board did not review it. 

At its June meeting the Medical Board discussed Dr. Odom’s case in 

executive session; the members then voted unanimously, on the record, to “reject the 

11 “[W]ithin 30 days after the proposed decision is served, a party may file 

with the agency a proposal for action . . . [recommending that the agency] do one or 

more of the following: (1) adopt the proposed decision as the final agency decision; 

(2) return the case to the administrative law judge to take additional evidence or make 

additional findings . . . ; (3) exercise its discretion by revising the proposed . . . sanction 

. . . and adopt the proposed decision as revised; (4) in writing, reject, modify, or amend 

a factual finding in the proposed decision . . . ; [or] (5) in writing, reject, modify, or 

amend an interpretation or application in the proposed decision of a statute or regulation 

directly governing the agency’s actions . . . .” AS 44.64.060(e). 

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proposed decision by the ALJ and, instead, adopt the Division’s Proposal for Action” as 

its final agency decision. As a sanction, the Medical Board ordered “the revocation of 

Dr. David Odom’s Alaska medical license.” 

E. Dr. Odom’s Appeal To The Superior Court And Remand 

Dr. Odomappealed theMedical Board’s decision to thesuperior court. The 

court held that substantial evidence supported the Board’s factual and disciplinary 

findings, but it found a violation of Dr. Odom’s due process rights in the Board’s failure 

to consider his late-filed opposition to the Division’s proposal for action; the superior 

court therefore vacated the Board’s decision and remanded the matter to the Board for 

reconsideration. 

At a special meeting, the Medical Board “decided not to re-open the 

evidence in this case as is its prerogative,” and it reaffirmed its decision to revoke 

Dr. Odom’s license. In November 2015 the superior court issued an order affirming the 

Board’s decision. 

Dr. Odom appealed to this court. 

III. STANDARDS OF REVIEW 

When a superior court acts as an intermediate court of appeals reviewing 

an administrative or agency decision, we independently review the merits of the 

administrative decision,12 giving no deference to the superior court’s decision.13 We 

review the agency’s factual findings to determine whether they are supported by 

12 Jurgens v. City of North Pole, 153 P.3d 321, 325 (Alaska 2007). 

13 State, Dep’t of Revenue v. Merriouns, 894 P.2d 623, 625 (Alaska 1995) 

(citing Handley v. State, Dep’t of Revenue, 838 P.2d 1231, 1233 (Alaska 1992)). 

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substantial evidence.14 Substantial evidence is “such relevant evidence as a reasonable 

mind might accept as adequate to support a conclusion.”15 “The substantial evidence test 

is highly deferential, but we still review the entire record to ensure that the evidence 

detracting from the agency’s decision is not dramatically disproportionate to the 

evidence supporting it such that we cannot ‘conscientiously’ find the evidence 

supporting the decision to be ‘substantial.’ ”16 The substantial evidence standard 

“reflects the prudence of deferring to a state professional board’s special competence in 

recognizing violations of professional standards.”17 “But we will not uphold the 

imposition of reputationally and economically damaging professional sanctions based 

14 Jurgens, 153 P.3d at 325 (citing Lindhag v. State, Dep’t of Nat. Res., 123 

P.3d 948, 952 (Alaska 2005); Fields v. Kodiak City Council, 628 P.2d 927, 932 (Alaska 

1981)). 

15 Storrs v. State Med. Bd., 664 P.2d 547, 554 (Alaska 1983) (citing Keiner 

v. City of Anchorage, 378 P.2d 406, 411 (Alaska 1963)). 

16 Shea v. State, Dep’t of Admin., Div. of Ret. & Benefits, 267 P.3d 624, 634 

n.40 (Alaska 2011) (emphasis in original). “[A] court may [not] displace the Board’s 

choice between two fairly conflicting views, even though the court would justifiably 

have made a different choice had the matter been before it de novo. But under the 

substantial evidence test, a reviewing court is not barred from setting aside a Board 

decision when it cannot conscientiously find that the evidence supporting that decision 

is substantial, when viewed in the light that the record in its entirety furnishes, including 

the body of evidence opposed to the Board’s view.” Id. (quoting Universal Camera 

Corp. v. Nat’l Labor Relations Bd., 340 U.S. 474, 488 (1951)). 

17 State, Dep’t of Commerce, Cmty. & Econ. Dev., Div. of Corps., Bus. & 

Prof’l Licensing v. Wold, 278 P.3d 266, 273 (Alaska 2012). 

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on evidence that would not permit a reasonable mind to reach the conclusion in 

question.”18 

“We review questions of law, including the appropriate standard of proof, 

using our independent judgment.”19 We review the agency’s selection of a particular 

disciplinary sanction for abuse of discretion.20 

IV. DISCUSSION 

AlaskaStatute08.64.326(a)(8)(A)authorizestheMedicalBoardtosanction 

a doctor if the Board finds after a hearing that the doctor “has demonstrated professional 

incompetence.”21 “Professionalincompetence”isdefinedbyregulationtomean “lacking 

sufficient knowledge, skills, or professional judgment in that field of practice in which 

the physician . . . concerned engages, to a degree likely to endanger the health of his or 

18 Id. (citing Wendte v. State, Bd. of Real Estate Appraisers, 70 P.3d 1089, 

1091 (Alaska 2003)). 

19 Jurgens, 153 P.3d at 325-26 (citing Romulus v. Anchorage Sch. Dist., 

910 P.2d 610, 615 n.3, 618-19 (Alaska 1996)). 

20 See AS 08.64.331(a) (identifying sanctions that the Medical Board “may” 

impose under various circumstances); AS 44.62.570(b) (identifying judicial inquiry on 

appeal as limited to the questions of jurisdiction, “whether there was a fair hearing,” and 

“whether there was a prejudicial abuse of discretion”); see also, e.g., Colo. Real Estate 

Comm’n v. Hanegan, 947 P.2d 933, 936 (Colo. 1997) (en banc) (“The imposition of 

sanctions is a discretionary function which, if within the statutory authority of an agency, 

must not be overturned unless that discretion is abused.”); Wasfi v. Dep’t of Pub. Health, 

761 A.2d 257, 267 (Conn. App. 2000) (“If the penalty meted out is within the limits 

prescribed by law, the matter lies within the exercise of the [agency’s] discretion and 

cannot be successfully challenged unless the discretion has been abused.” (alteration in 

original) (quoting Gibson v. Conn. Med. Examining Bd., 104 A.2d 890, 895 (Conn. 

1954))). 

21 See also AS 08.64.101(3). 

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her patients.”22 Sanctions for professional incompetence may range from a letter of 

reprimand or required educationto revocation ofamedical license.23 The Administrative 

Procedure Act provides that “if an accusation has been filed under AS 44.62.360” (to 

determine whether a license “should be revoked, suspended, limited, or conditioned”), 

the accusing authority “has the burden of proof by a preponderance of the evidence” 

unless “applicable law” requires otherwise. We assume for purposes of this discussion 

that the preponderance of the evidence standard applies.24 

Dr. Odom challenges the Medical Board’s decision to revoke his license 

as lacking substantial evidence in support of it. His argument targets the Board’s two 

underlying findings: (1) that prescribing phentermine to S.Q. was below the standard of 

care because of her cardiomyopathy, and (2) that prescribing thyroid hormone to S.Q. 

was below the standard of care because the dosage prescribed was excessive and it 

should not have been given in combination with phentermine. We agree that the Board’s 

decision lacks sufficient support in the evidence. 

22 12 Alaska Administrative Code (AAC) 40.970 (2017). 

23 AS 08.64.331(a). 

24 Our opinion, when first published, applied a clear and convincing evidence 

tandard, citing the due process analysis of Nguyen v. State, Dep’t of Health Med. 

uality Assurance Comm’n, 29 P.3d 689, 696 (Wash. 2001). On the Division’s petition 

or rehearing we conclude that this case does not require us to decide whether a standard 

igher than preponderance of the evidence is constitutionally mandated in professional 

censing proceedings. 

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A. The Medical Board’s Decision Does Not Support License Revocation. 

We begin by explaining why the Medical Board’s decisional document 

does not support its conclusion regardless of how we view the evidence of Dr. Odom’s 

treatment of S.Q. We note parenthetically that the Medical Board’s adoption of the 

Division’s proposal as its final decision was clearly not what the Division had 

anticipated; the Division had proposed that the Board amend the ALJ’s decision in some 

particulars, and the only sanctions it discussed were a license suspension or alternatively 

“a fine, reprimand, probation, education, and permanent restriction on respondent’s 

practice, including a prohibition against prescribing phentermine and thyroid hormone 

to patients.” 

The Board’s procedure was also irregular. The law requires that the Board 

support the revocation of a medical license with a written decision and “a brief and 

concise statement of the grounds and reasons for the action.”25 The decisional document 

of any administrative body, “done carefully and in good faith, serves several salutary 

purposes,” such as “facilitat[ing] judicial review by demonstrating those factors which 

were considered” and “tend[ing] to ensure careful and reasoned administrative 

deliberation.”26 An ALJ’s proposed decision is usually in a form that will serve these 

purposes, if it is adopted by the Board.27 And AS 44.64.060(e) sets out other options if 

25 AS 08.64.340; see also Peninsula Mktg. Ass’n v. State, 817 P.2d 917, 922 

(Alaska 1991) (observing that “agency decisions, in exercise of their adjudicative 

powers, must be accompanied by written findings and a decisional document” (quoting 

Messerli v. Dep’t of Nat. Res., State of Alaska, 768 P.2d 1112, 1118 (Alaska 1989))). 

26 Se. Alaska Conservation Council, Inc. v. State, 665 P.2d 544, 549 (Alaska 

1983), superseded by statute on other grounds, Ch. 86, § 1, SLA 2009. 

27 See, e.g., In re Bartling, OAH No. 12-0221-MED at 13 (July 19, 2013) 

(continued...) 

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the Board declines to adopt the ALJ’s proposed decision, including returning the case 

to the ALJ for further proceedings, changing the ALJ’s recommended disposition, and 

rejecting,modifying, or amending theALJ’s factual findings (“by specifying theaffected 

finding and identifying the testimony and other evidence relied on by the agency for the 

rejection, modification, or amendment of the finding”).28 The Medical Board’s “nonadoption options”do not expressly contemplateacceptingoneparty’sproposal for action 

as the Board’s decision, as the Board did here; that may work sometimes, but on the 

other hand the proposal for action may well be, as it was here, a piece of party advocacy 

rather than an ostensibly impartial decisional document that clearly sets out the Board’s 

rationale and helps facilitate judicial review. 

The document that became the Board’s final decision in this matter thus 

contains no findings of its own but asserts that its conclusion can be reached “based on 

theevidencecontained in the[ALJ’s]proposeddecision(includingtheproduct literature), 

and the Board’s own medical expertise.” But the document also suggests specific 

amendments to the ALJ’s decision and invites the Board to enlist the assistance of the 

attorney general’s office in making revisions. While a member of the public who has both 

the Division’s proposal for action and the ALJ’s recommended decision in hand could 

thus — perhaps — stitch together a single decisional document with a coherent narrative, 

27(...continued) 

(adopting proposed decision); In re Ilardi, OAH No. 10-0114-MED at 10 (Oct. 28, 2010) 

(same). 

28 The Medical Board could also prepare its own decision, as in In re Emery, 

OAH No. 07-0169-MED (Jan. 30, 2009). See also State, Div. of Corps., Bus. & Prof’l 

Licensing, Alaska Bd. of Nursing v. Platt, 169 P.3d 595, 598 (Alaska 2007) (reviewing 

Board of Nursing decision adopting hearing officer’s findings of fact and conclusions 

of law but adding its own different analysis). 

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it is not at all clear that the document’s factual findings would lead to its conclusion. And 

the Board’s decision on remand, after considering Dr. Odom’s late-filed proposal for 

action, adds no explanation other than the conclusory statement that its earlier decision, 

as embodied in the Division’s proposal for action, was supported by substantial evidence. 

Most importantly, the document that became the Board’s final decision 

expressly states that “[i]mposing a suspension on Dr. Odom’s license would be consistent 

with prior Board decisions involving inappropriate prescribing by physicians” (emphasis 

added) and supports this statement with a discussion of relevant legal authorities. The 

Board, however, revoked Dr. Odom’s license instead, based not on any written 

explanation but presumably on its discussion in executive session. By statute, the 

Medical Board must be “consistent in the application of disciplinary sanctions,” and “[a] 

significant departure from earlier decisions of the board involving similar situations must 

be explained in findings of fact or orders made by the board.”29 In professional 

incompetence cases, the Medical Board has generally “directed its efforts to imposing 

appropriate limits on [the doctor’s] practice or to seeking to upgrade [the doctor’s] 

performance.”30 This approach is reflected in the Division’s proposal in this case that the 

Board, to be consistent with its precedent, impose a suspension or consider lighter 

sanctions as alternatives. 

License revocations, in contrast, are more likely to follow revocations in 

other states or convictions for crimes such as fraud, felony drug offenses, or sex 

29 AS 08.64.331(f). 

30 In re Kohler, OAH No. 10-0635-MED at 51-52 (June 7, 2011) (identifying 

the specific area in which a doctor was incompetent and restricting him from practicing 

in the area of his incompetence). 

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offenses.31 We have also affirmed a license revocation based on “a pattern of 

inadequacy,”32 but this case involves only Dr. Odom’s treatment of S.Q.; the Division did 

not allege or pursue a claim that Dr. Odom acted incompetently in any cases besides this 

one. And given the Division’s further concession that Dr. Odom’s treatment of S.Q. had 

no causal connection to her death, there is no reason apparent in the Board’s decisional 

document why S.Q.’s case alone would warrant a sanction that is inconsistent with the 

Board’s precedent. 

Weconcludethat theBoard’s final decision fails to comply with its statutory 

duty to “be consistent in the application of disciplinary sanctions” or explain the 

inconsistency,33 and it therefore does not support the sanction imposed. 

B.	 The Medical Board’s Conclusion That Dr. Odom’s Prescription Of 

Phentermine To S.Q. Was Below The Standard Of Care In His Field Of 

Practice Is Not Supported By Substantial Evidence. 

The Medical Board’s decisional document is legally insufficient not only 

with regard to its choice of sanction, but also in its conclusion that Dr. Odom acted 

incompetently. One of the reasons the Board gave for adopting the Division’s position 

was that it was “unprofessional, incompetent, and below the standard of care for 

Dr. Odom to prescribe phentermine to a patient with known cardiomyopathy.” This 

31 ALASKA MEDICAL BOARD, SUMMARY OF BOARD ACTIONS - 1997 TO 

PRESENT (Feb. 9, 2017), https://www.commerce.alaska.gov/web/portals/5/pub/ 

MED_1997_to_2017_Board_Action_Summary.pdf. 

32 Storrs v. State Med. Bd., 664 P.2d 547, 555-56 (Alaska 1983) (finding a 

“pattern of inadequacy” based on five cases over five years in which a doctor 

demonstrated an inability to foresee common complications, obtain consultations for 

developing complications, and apply diagnostic and corrective measures once 

complications arose). 

33 AS 08.64.331(f). 

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conclusion relied primarily on the testimony of Dr. Nolan, bolstered by product literature 

and a reference book. But we conclude that this evidence is insufficient to support the 

Board’s finding of incompetence. 

Dr. Nolan, the Division’s only medical witness, testified that he was board 

certified in internal medicine and endocrinology.34 He testified that his practice usually 

involves patients who have diabetes or some kind of thyroid disease; many of his diabetic 

patients “have weight problems,” but he does not use any drug therapy specifically for 

weight loss. Indeed, when asked by the Division at the outset of its investigation whether 

he “perform[ed] the type of practice which is in dispute in this matter,” he answered “No,” 

explaining that he did not prescribe the medicines at issue. He testified at the hearing that 

he has not prescribed phentermine “in many years” because he found it to be ineffective 

“in the long run” and because “it’s very controversial.” 

Dr. Nolan nonetheless did not review any recent studies of phentermine 

before forming his opinions in the case and, despite his role as an expert witness, admitted 

that he “ha[d]n’t researched it out that carefully.” He testified that he had reviewed the 

“package insert”; the online entry for phentermine in the Physician’s Desk Reference, 

which contains the same manufacturer-provided information as the package insert; and 

Lexicomp’s Drug Information Handbook, which he described as a more reliable 

sourcebook prepared by the American Pharmacists’ Association. He described the 

package insert as contraindicating the use of phentermine for patients with “cardiac 

34 Dr. Nolan described internal medicine as including “a whole list of . . . 

different subspecialities: pulmonary disease, cardiology,gastrointestinal,rheumatology, 

dermatology,endocrinology,”and hedefined endocrinology as the“studyofendocrines, 

. . . which are the ductless glands in your body: the pituitary, the thyroid, the adrenal, 

outlet cells in the pancreas, parathyroid, things like that.” See also Endocrinology, 

STEDMAN’S MEDICAL DICTIONARY (28th ed. 2006). 

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disease,” and he testified that contraindications in package inserts are clear statements to 

physicians not to prescribe a drug under the given circumstances. He also testified that 

the Drug Information Handbook contains a “severe warning” against the use of 

“stimulants . . . in patients with . . . cardiomyopathy.” Dr. Nolan admitted, however, that 

“the package insert [for a drug] may or may not be totally reliable” and that a physician 

should not rely solely upon the Drug Information Handbook either. But he also testified 

that he had asked seven cardiologists whether they would “consider using phentermine 

in a patient with known cardiomyopathy,” and they all answered, “Absolutely not.” He 

concluded that Dr. Odom should not have prescribed phentermine to treat S.Q.’s obesity 

because of her history of cardiomyopathy, and that doing so was below the standard of 

care. 

The manufacturer’s literature for phentermine clearly states that the drug is 

contraindicated for patients with cardiovascular disease, though whether that includes 

S.Q.’s asymptomatic peripartum cardiomyopathy is a debatable issue, one that the ALJ 

noted but did not decide.35 The Division argued for a broad interpretation of the 

contraindications and warnings as applying to all kinds of heart diseases and conditions, 

and the Board ostensibly adopted that interpretation. But we need not consider this issue 

ourselves; regardless of whether phentermine’s manufacturer intended cardiomyopathy 

to be among the listed contraindications, the evidence disproportionately supports a 

conclusion that the contraindications do not establish a relevant standard of care, and 

35 Dr. Nolan testifiedthat cardiomyopathy isaformofcardiovascular disease. 

Both of Dr. Odom’s experts testified that S.Q.’s condition, peripartum cardiomyopathy, 

is a disease of the heart muscle rather than the vascular system, is thus not a 

cardiovascular disease, and is not among phentermine’s listed contraindications. 

-17- 7220
 
 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

furthermore that Dr. Odom’s prescription of phentermine to S.Q. was within the standard 

of care for physicians who practice in his field. 

Dr. Bryman, one of Dr. Odom’s expert witnesses, is a physician licensed in 

Alaska and several other states who practices primarily in bariatrics. He has served on 

the American Board of Bariatric Medicine and is active in the American Society of 

Bariatric Physicians. He testified that he is “very familiar” with phentermine; he has 

prescribed it in his practice for over 20 years, has lectured on the drug, and has defended 

other physicians’ use of the drug. As the ALJ summarized Dr. Bryman’s testimony, 

“phentermine is routinely prescribed for anorectic [appetite-suppressant] purposes by 

bariatric physicians nationwide.” 

Dr. Bryman also addressed phentermine’s contraindications. He strongly 

supported Dr. Odom’s view that contraindications on drug labels generally are not 

binding on physicians and do not establish a standard of care,36 and that the product 

literatureon phentermineinparticular was outdatedand misleading. Whiledisputing that 

cardiomyopathy is a cardiovascular disease, he discussed several studies indicating that 

phentermine did not cause the adverse cardiovascular effects the product literature warns 

about. Both Dr. Bryman and Dr. Rouzier, Dr. Odom’s other expert witness, testified that 

phentermine’scontraindications and warnings regardingits usewithcardiacpatients were 

36 The ALJ cited several federal cases in support of this proposition. See 

Planned Parenthood Sw. Ohio Region v. Dewine, 696 F.3d 490, 496 n.4 (6th Cir. 2012) 

(“The FDA regulates the marketing and distribution of drugs by manufacturers, not the 

practices of physicians in treating patients.”); Weaver v. Reagan, 886 F.2d 194, 198 

(8th Cir. 1989) (“FDA approved indications were not intended to limit or interfere with 

the practice of medicine nor to preclude physicians from using their best judgment in the 

interest of the patient.”); id. (“Once a product has been approved for marketing, a 

physician may prescribe it for uses or in treatment regimens or patient populations that 

are not included in approved labeling.” (quoting 12 FDA DRUG BULLETIN 1, at 4-5 

(1982), http://www.circare.org/fda/fdadrugbulletin_041982.pdf)). 

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based on 50-year-old research on amphetamines, a chemically related but fundamentally 

different compound with much different effects, and that thedrug’s literaturehadnot been 

updated despite new studies showing that “phentermine does not have any of those 

properties that . . . amphetamines [have].” Dr. Bryman testified that the FDA had recently 

approved a new drug containing phentermine based on studies that showed no adverse 

cardiovascular effects at all. He testified that about 30% of his own patients had some 

form of heart disease and were referred to him by their cardiologists, and that he 

prescribed phentermine to patients with cardiomyopathy. 

Dr. Bryman noted that S.Q.’s medical records showed no increase in her 

heart rate or blood pressure while she was on phentermine, and that in fact, because of her 

obesity and cardiomyopathy, she was “a perfect patient for” the drug. He concluded 

“with certainty that [Dr. Odom] practiced to the standard of care like a reasonable doctor 

would treat a patient and not allow her to continue her obesity and worsen her condition. 

So he intervened appropriately, in my opinion, and she got better.” Dr. Rouzier, too, 

testified adamantly that the best treatment for S.Q.’s obesity was weight loss and that 

phentermine was a safe and effective way to promote it. 

The ALJ who presided over the evidentiary hearing noted that the Division 

“did not call S.Q.’s treating cardiologist, or any other cardiologist, as a witness, and it did 

not admit into evidence any studies of phentermine to support the allegations of the 

accusation.” The ALJ contrasted the Division’s expert witness, Dr. Nolan, who “has little 

clinical experiencewith phentermine,”with Dr. Odom’s expertwitness, Dr. Bryman, who 

had “substantial clinical experience with phentermine, including the use of phentermine 

for patients referred by cardiologists.” The ALJ concluded that “the Division has not 

shown by a preponderance of the evidence that it was below the standard of care to 

prescribe phentermine to S.Q.” We agree with this conclusion. The evidence detracting 

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from the Board’s decision is dramatically disproportionate to the evidence in support of 

it, meaning that we cannot conscientiously say that the supporting evidence is 

substantial.37 

Finally, the Division’s proposal for action — the Board’s final decision — 

cited an earlier Medical Board decision in support of the proposition that a doctor’s 

prescription contrary to manufacturer-provided contraindications can show a breach of 

the standard of care. In re Bartling dealt in part with a claim that a doctor had prescribed 

an opioid to a patient who was not opioid tolerant, “contrary to FDA warnings” listed on 

the product’s packaging.38 The Board concluded that the patient actually was opioid 

tolerant and therefore there was no violation of the standard of care.39 But the Board 

noted the testimony of two experts that “the warning was a guide, and that in some cases 

it is medically appropriate to prescribe [the drug] to a patient who is not opioid tolerant” 

despite the warnings.40 And the Board in Bartling did not have to address issues like 

those in this case about whether more recent research and clinical experience undermined 

the credibility of the product literature. Bartling does not support the Board’s decision 

in this case.41 

37 See Shea v. State, Dep’t of Admin., Div. of Ret. & Benefits, 267 P.3d 624, 

634 n.40 (Alaska 2011). 

38 OAH No. 12-0221-MED at 9 (July 19, 2013). 

39 Id. at 10. 

40 Id. 

41 The Board’s decision also cites cases from other jurisdictions in which 

doctors were found to have inappropriately prescribed phentermine to patients with 

cardiac problems. Zac v. Riffel, 115 P.3d 165, 170 (Kan. App. 2005) (expert testified 

that phentermine should not have been prescribed to a patient with left ventricular 

(continued...) 

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C.	 The Medical Board’s Conclusion That Dr. Odom’s Prescription Of 

Thyroid Hormone Fell Below The Standard Of Care In His Field Of 

Practice Was Not Supported By Substantial Evidence. 

TheMedical Board alsoadoptedasitsfinaldecisiontheDivision’s argument 

that Dr. Odom’s conduct was “unprofessional, incompetent, and below the standard of 

care” when he prescribed thyroid hormone to S.Q. The Board apparently accepted the 

ALJ’s relevant factual findings: that Dr. Odom prescribed Armour Thyroid in late June 

2007 with a beginning dosage of 120 milligrams a day, increasing to 180 milligrams after 

two weeks and 240 milligrams after four weeks, and that he decreased it to 180 

milligrams in September after S.Q. reported jitteriness on the 240-milligram dose. While 

the ALJ found no breach of the standard of care in this chronology, the Board reached 

two much different conclusions: (1) that Dr. Odom prescribed an excessive dosage of 

thyroid hormone, and (2) that it was inappropriate to prescribe thyroid hormone along 

with phentermine given the risks associated with using the two drugs in combination. Dr. 

Odom argues that these findings are not supported by substantial evidence, and again we 

agree with him. 

TheMedical Board adopted theDivision’s argument that S.Q. “received too 

much thyroid too soon” because “the product literature state[s] that for hypothyroidism, 

the usual starting dose [of Armour Thyroid] was 30mg, with increments of only 15mg 

every 2 to 3 weeks,” whereas S.Q. started with 120 milligrams and reached 240 

41(...continued) 

dysfunction); Fletcher v. Pa. Prop. & Cas. Ins. Guar. Ass’n, 27 A.3d 299, 302 (Pa. 

Cmmw. 2011) (malpractice damages awarded, in part, because phentermine was 

inappropriately prescribed to a patient with coronary artery disease); Ancier v. State, 

Dep’t of Health, 166 P.3d 829, 834 (Wash. App. 2007) (doctor inappropriately 

prescribed180,000 medications, including phentermine,overtheinternet;experttestified 

that phentermine is dangerous for patients with cardiovascular disease). None of these 

cases address S.Q.’s particular malady, asymptomatic peripartum cardiomyopathy. 

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milligrams five weeks later. The Board’s decision is supported by the testimony of 

Dr. Nolan, who did not prescribe Armour Thyroid in his own practice but opined that Dr. 

Odom prescribed too much of it, basing his opinion on what he read in the Drug 

Information Handbook and the manufacturer’s literature. Dr. Nolan testified that the 

Drug Information Handbook says the “recommended adult dosage” of Armour Thyroid 

is “[f]ifteen to 30 milligrams initially.” 

But the Drug Information Handbook and the manufacturer’s literature both 

use the word “recommended” only in conjunction with pediatric dosages, which range 

from 15 milligrams to “over 90” milligrams. The manufacturer’s literature does state that 

the “usual starting dose” is 15 to 30 milligrams, to be scaled up by 15 milligrams every 

few weeks. And the manufacturer’s literature and the Handbook agree that “[m]ost 

patients require 60 to 120 mg/day.” But neither the manufacturer’s literature nor the 

Handbook supports the Board’s necessary extrapolation: that S.Q. was among “most 

patients” for whom the “usual starting dose” was the only medically appropriate one, and 

that prescribing dosages other than the usual ones was necessarily unsafe or below the 

standard of care. 

Aside from the dosages listed in the Drug Information Handbook and the 

manufacturer’s literature, the only evidence of a proper dosage at the hearing came from 

Dr. Odom and his expert witness, Dr. Rouzier, who regularly teaches courses in hormone 

replacement for “various medicalacademies”including theAmericanAcademyofFamily 

Physicians. Dr. Odom testified that the “average” adult dosage is 4 grains 

(240 milligrams) per day. Dr. Rouzier testified that the “standard” dosage is between 

2 and 4 grains (120 to 240 milligrams) per day. Dr. Rouzier also testified that S.Q.’s 

dosages — from 120 milligrams to 240 milligrams then back down to 180 milligrams per 

day — were “very appropriate” and “within the range of what’s standard and available 

. . . for us to prescribe.” According to Dr. Rouzier, S.Q.’s dosage even at its highest “was 

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a standard, middle-of-the-range, middle-run dose. Not too high, not too low.” He also 

testified that the drug manufacturer makes 4 grain, 5 grain, and 6 grain tablets; the 

manufacturer’s literature and the Drug Information Handbook confirm that 4 grain and 

5 grain tablets (240 and 300 milligrams) are available, which runs counter to the Medical 

Board’s conclusion that S.Q.’s lower dosages were necessarily “excessive.” 

Dr. Rouzier’s and Dr. Odom’s estimates of “standard” dosages are indeed 

higher than what the Drug Information Handbook lists as usual maintenance doses 

(“[u]sually 60-120 mg/day”), but every patient cannot be the usual patient.42 The 

manufacturer’s literature adds, “The dosage of thyroid hormones . . . must in every case 

be individualized according to patient response and laboratory findings.” Dr. Rouzier 

testified accordingly that some patients achieve the best results from taking significantly 

higher doses of thyroid hormone than those prescribed to S.Q. According to Dr. Rouzier, 

S.Q.’s dosages were within the safe range. 

The Division presented some evidence about the risks of excessive thyroid 

hormone. The manufacturer’s literature notes that “[e]xcessive doses of thyroid result in 

a hypermetabolic state,” essentially inducing hyperthyroidism.43 Dr. Nolan testified that 

too much thyroid hormone can eventually lead to atrial fibrillation and bone loss, and 

Dr. Rouzier testified that extremely high doses could lead to “palpitations [and] 

tachycardia.” But Dr. Rouzier also testified that if a patient starts seeing side effects like 

42 Dr. Rouzier explained that “normal” simply refers to “an average of the 

population” rather than what might be best for a particular patient. And Dr. Bryman 

explained that “normal” can differ between patients at a healthy weight and those who 

are obese, just as “normal” will differ between pediatric and geriatric patients. 

43 Hyperthyroidism is “[a]n abnormality of the thyroid gland in which 

secretion of thyroid hormone is usually increased and no longer under regulatory control 

ofhypothalamic-pituitary centers.” Hyperthyroidism, STEDMAN’SMEDICALDICTIONARY 

(28th ed. 2006). 

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jitteriness (as S.Q. did), the dosage can simply be scaled back, and the drug’s effect will 

dissipate in less than 24 hours. This is consistent with the manufacturer’s literature, 

which suggests that overdoses of Armour Thyroid be treated by simply reducing or 

temporarily discontinuing the usual dosage. And the Division failed to establish how 

much thyroid hormone is too much.44 Again, we cannot conscientiously say that the 

Medical Board’s finding that Dr. Odom prescribed an excessive dosage of Armour 

Thyroid is supported by substantial evidence. 

Similarly unsupported is the Board’s conclusion that S.Q. “received too 

much thyroid hormone too soon.” There was little evidence on this issue presented at the 

hearing. In Dr. Nolan’s rebuttal testimony he referred to the dosage as being “excessive 

to start with,” apparently by referencing only the “usual dosages” entry in the Drug 

Information Handbook. But again, there is no basis in the record for inferring that a 

physician breaches the standard of care unless he treats every patient as the “usual” 

patient. Given the strong contrary testimony of Dr. Odom and Dr. Rouzier, we conclude 

that substantial evidence does not support the Board’s finding that a starting dosage 

differing from those listed in the Drug Information Handbook indicated a breach of the 

standard of care. 

The Medical Board also accepted the Division’s argument that it was unsafe 

for Dr. Odom to combine thyroid hormone and phentermine when prescribing for S.Q. 

In support of this argument the Division cited only the product literature for Armour 

Thyroid, which reads in part, “Larger doses may produce serious or even life-threatening 

44 Dr. Nolan testified that in his experience, “most people [taking] around 3 

or 4 grains [180 to 240 milligrams] of dessicated thyroid per day will have perturbation 

of thyroid function, which is not desirable.” But Dr. Nolan also admitted that he never 

prescribes Armour Thyroid, and that he believes the use of Armour Thyroid to be 

“substandard and unconventional.” He testified that practitioners in the field of 

endocrinology have sought to remove Armour Thyroid from the market. 

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manifestations of toxicity, particularly when given in association with sympathomimetic 

amines [e.g., phentermine] such as those used for their anorectic effects.” But this 

warning is explicitly directed toward the drug’s use “[i]n euthyroid patients,” meaning 

patients with normal thyroid gland function.45 Whether S.Q. had normal thyroid gland 

function was another disputed issue. Dr. Nolan testified that she did, based on laboratory 

tests showing thyroid levels within the normal range. The ALJ’s recommended decision, 

however, described the symptoms that led Dr. Odom to his clinical diagnosis of 

hypothyroidism and noted the dispute between physicians who rely on lab tests to 

determine normal thyroid function and those who “subscribe to an alternative view, 

accepted by many clinicians in their field of practice, to the effect that normal laboratory 

findings simply reflect the thyroid hormone levels found in the population generally, 

rather than the levels that will result in optimal functioning.” But this dispute was 

ultimately irrelevant, because, as the ALJ concluded, “the Division’s accusation did not 

allege that Dr. Odom misdiagnosed hypothyroidism,” but rather that, assuming S.Q. had 

hypothyroidism, he prescribed too much thyroid hormone to treat it. 

Besides the manufacturer’s literature, Dr. Nolan also testified that “excess 

thyroid hormone and [p]hentermine is not a good combination”; “[t]he risks of using 

phentermine with high doses of Armour Thyroid in persons with established 

cardiomyopathy is not a good idea. It’s just too risky.” But Dr. Nolan did not explain 

why the combination was unsafe, nor did his testimony shed light on whether he believes 

phenterminecombinedwith lower doses ofthyroid hormonewouldbewithin thestandard 

of care.46 

45 See Euthyroidism, STEDMAN’S MEDICAL DICTIONARY (28th ed. 2006). 

46 The Board’s decision does not appear to rely on the Drug Information 

Handbook for its findings about the use of thyroid hormone and phentermine in 

(continued...) 

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Finally, both Dr. Rouzier and Dr. Bryman, who were able to testify from 

their own direct experience treating patients in Dr. Odom’s fields of practice, concluded 

that Dr. Odom was acting within the standard of care in prescribing phentermine and 

thyroid hormone to S.Q. Dr. Rouzier testified, “The only thing that helps [obese, 

hypothyroid] patients is weight loss. Get the fat off. . . . How do you do that? 

Phentermine and thyroid.” 

Having reviewed therecord, “wecannot ‘conscientiously’find the evidence 

supporting the [Board’s] decision to be ‘substantial.’ ”47 The record does not support the 

Medical Board’s conclusion that Dr. Odom prescribed excess thyroid hormone to S.Q., 

or that it was unsafe or incompetent to prescribe phentermine in combination with thyroid 

hormone. 

D. The Medical Board’s Decision Must Be Reversed. 

We conclude that the Division failed to prove that Dr. Odom “lack[s] 

sufficient knowledge, skills, or professional judgment in that field of practice in which 

[he] engages.”48 We note that the legislature has expressly warned against “bas[ing] a 

46(...continued) 

combination. The Handbook does not suggest that combining the two drugs is unsafe. 

The Handbook’s section on phentermine advises prescribing physicians to “[a]void 

concomitant use” of phentermine with several drugs but not including thyroid hormone, 

and the Handbook does not include thyroid hormone in the list of drugs for which 

phentermine may increase or decrease the effect or toxicity. Nor does the Handbook’s 

section on thyroid hormone warn against combining it with phentermine. 

47 Shea v. State, Dep’t of Admin., Div. of Ret. & Benefits, 267 P.3d 624, 634 

n.40 (Alaska 2011). 

48 See 12 AAC 40.970 (defining “professional incompetence”). 

The Division argues on appeal that “Dr. Odom’s ‘field of practice’ in this 

context was the prescribing of controlled substances and other drugs and he was not free 

(continued...) 

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finding of professional incompetence solely on the basis that a licensee’s practice is 

unconventional or experimental in the absence of demonstrable physical harm to a 

patient.”49 The Division disclaims any intent to violate this statutory directive, but it is 

hard to overlook the fact that this case, involving no “demonstrable physical harm to a 

patient,”resulted intheBoard excessivelysanctioning therespondent for an approach that 

the evidence showed was commonly taken by physicians in his field of practice.50 We 

concludethat the Medical Board lacked sufficient evidencetosupportits findings and that 

the Medical Board abused its discretion by revoking Dr. Odom’s medical license. 

V. CONCLUSION 

For the foregoing reasons, we REVERSE the superior court’s decision 

affirming the decision of the Medical Board to revoke Dr. Odom’s medical license. 

48(...continued) 

to ignore contraindications or dosage limits merely by claiming that he was a weight loss 

or an antiaging physician.” We reject the argument that “the prescribing of controlled 

substances” is itself a field of practice; this would presumably allow any medical 

professional with prescribing authority to testify about the standard of care for 

prescribing drugs in a specialty of which the witness has no knowledge or practical 

experience. While the applicable definition of incompetence is regulatory rather than 

statutory, it is noteworthy that in the analogous context of medical malpractice cases the 

legislature has mandated that only those experts who practice in the defendant’s “field 

or specialty” are qualified to offer opinions on the standard of care. AS 09.55.540(a)(1). 

It would seem incongruous to require something less when a physician’s license is at 

stake. 

49 AS 08.64.326(a)(8)(A). 

50 As the ALJ properly noted, Dr. Nolan’s opinion was “the view of the 

American Association of Clinical Endocrinologists. Dr. Odom and Dr. Rouzier 

subscribe to an alternative view, accepted by many clinicians in their field of practice.” 

-27- 7220
 
 

 

 

 

 

 

 

 

 

 

 

 

In the Supreme Court of the State of Alaska
 

David M. Odom, M.D.,	

 

 Appellant, 

 v.	 

State of Alaska, Division of 

Corporations,

 Appellee. 

) 

) Supreme Court No. S-16151 

 Order 

Petition for Rehearing 

Date of Order: 2/9/2018 

) 

) 

) 

) 

) 

) 

) 

Trial Court Case # 3AN-14-08082CI 

Before: Stowers, Chief Justice, Winfree, Maassen, Bolger, and Carney, Justices. 

Having considered the petition for rehearing filed by the State of Alaska, Division 

f Corporations, Business & Professional Licensing, the response filed by David M. 

dom, and the supplemental briefing of both parties, 

IT IS ORDERED that the petition is GRANTED as follows: 

o

O

1.	 Opinion No. 7187, issued 8/11/2017 is WITHDRAWN. 

2.	 Opinion No. 7220, is issued on this date in its place. 

3.	 The opinion as modified declines to adopt a “clear and convincing 

evidence” burden of proof for actions to revoke medical licenses; minor 

editing changes reflect this modification. The opinion is otherwise 

unchanged. 

Entered by direction of the court. 

Clerk of the Appellate Courts 

/s/ 

Marilyn May 

cc:	 Supreme Court Justices 

Judge Saxby 

Trial Court Appeals Clerk 

Publishers 
David M. Odom, M.D. v. State of Alaska, Division of Corporations 

Supreme Court No. S-16151 

Order of 2/9/18 

Page Two 

Distribution: 

M. Lee Holen
 

Lee Holen Law Office 


P.O. Box 92330
 

Anchorage AK 995092330
 

Robert Auth
 

Attorney General’s Office 


1031 W 4th Ave Ste 200
 

Anchorage AK 99501