[Federal Register Volume 60, Number 86 (Thursday, May 4, 1995)]
[Notices]
[Pages 22076-22078]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 95-10927]



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DEPARTMENT OF JUSTICE
[Docket No. 93-56]


Michael G. Sargent, M.D.; Revocation of Registration

    On June 2, 1993, the Deputy Assistant Administrator (then 
Director), Office of [[Page 22077]] Diversion Control, Drug Enforcement 
Administration (DEA), issued an Order to Show Cause to Michael G. 
Sargent, M.D. of Katy, Texas (Respondent), proposing to revoke his DEA 
Certificate of Registration, AS2512374, as a practitioner and deny any 
pending application for registration as a practitioner. The statutory 
basis for the Order to Show Cause was that Respondent's continued 
registration as a practitioner would be inconsistent with the public 
interest as that term is used in 21 U.S.C. 823(f) and 824(a)(4).
    Respondent, through counsel, requested a hearing on the issues 
raised in the Order to Show Cause, and the matter was docketed before 
Administrative Law Judge Mary Ellen Bittner. Following prehearing 
procedures, a hearing was held on January 5 and 6, 1994, in Houston, 
Texas. On August 25, 1994, the administrative law judge issued her 
opinion and recommended ruling, findings of fact, conclusions of law 
and decision recommending that Respondent's registration be revoked. 
Respondent filed exceptions to the opinion on September 19, 1994.
    On October 13, 1994, the administrative law judge transmitted the 
record of the proceeding to the Deputy Administrator. After a careful 
consideration of the record in its entirety, the Deputy Administrator 
enters his final order in this matter, in accordance with 21 CFR 
1316.67, based on findings of fact and conclusions of law as set forth 
herein.
    The administrative law judge found that, in July 1991, DEA 
investigators in Houston, Texas, received an anonymous complaint that 
Respondent was prescribing controlled substances to individuals without 
a legitimate medical purpose. As a result, DEA investigators conducted 
prescription surveys of pharmacies located near Respondent's office. 
These surveys established that Respondent was prescribing Tylenol #3 
with codeine, a Schedule III controlled substance, in conjunction with 
Valium, a Schedule IV controlled substance.
    Judge Bittner further found that, on five separate occasions from 
August 16, 1991 through April 16, 1992, Respondent prescribed 
combinations of Tylenol #3 with codeine and Valium to two undercover 
agents without a legitimate medical purpose and not in the usual course 
of professional medical practice. Respondent failed to conduct and 
record an appropriate patient history and failed to conduct a physical 
examination of either agent prior to prescribing this combination of 
controlled substances.
    The administrative law judge considered testimony from the 
Government's expert medical witness who concluded that Respondent was 
not acting within the normal course of his professional practice when 
these prescriptions were issued. Conversely, Respondent's expert 
medical witness concluded that Respondent issued the prescription at 
issue for a legitimate medical need and in the normal course of 
professional practice, and, at worse may have exercised poor judgment 
with respect to prescribing Tylenol with codeine.
    Pursuant to 21 U.S.C. 823(f) and 824(a)(4), the Deputy 
Administrator may revoke a DEA Certificate of Registration and deny any 
application for such registration, if he determines that continued 
registration would be inconsistent with the public interest. Section 
823(f) requires that the following factors be considered:
    ``(1) The recommendation of the appropriate State licensing board 
or professional disciplinary authority.
    (2) The [registrant's] experience in dispensing or conducting 
research with respect to controlled substances.
    (3) The [registrant's] conviction record under Federal or State 
laws relating to the manufacture, distribution, or dispensing of 
controlled substances.
    (4) Compliance with applicable State, Federal, or local laws 
relating to controlled substances.
    (5) Such other conduct which may threaten the public health and 
safety.''
    The Deputy Administrator may properly rely on any one or a 
combination of these factors, and give each factor the weight he deems 
appropriate in determining whether a registration should be revoked or 
an application for registration denied. Henry J. Schwartz, Jr., M.D. 54 
FR 16422 (1989). In the present case, the administrative law judge 
found that factors two, four and five were relevant in determining 
whether Respondent's registration should be revoked.
    Judge Bittner found that Respondent's prescribing of controlled 
substances to the undercover agents was not for a legitimate medical 
purpose. Further, Respondent did not conduct comprehensive physical 
examinations of the two agents and failed to maintain proper records 
regarding his prescribing of controlled substances.
    The administrative law judge concluded that the record does not 
support Respondent's contentions that the controlled substances he 
prescribed were warranted by, and appropriate for, the medical ailments 
that the investigators presented to him. She further found that the 
record demonstrates Respondent neither conducted anything resembling 
comprehensive physical examinations nor asked probing questions of the 
agents as to their symptoms, the possible causes of these symptoms, or 
alternative treatments for their complaints. See James H. Brown, M.D., 
59 FR 37778 (1994). Respondent additionally was remiss in his 
responsibilities as a DEA registrant by failing to keep appropriate 
patient files on the agents.
    Judge Bittner additionally found that a negative inference is 
warranted where, as in the present case, Respondent did not testify. 
See Raymond A. Carlson, M.D., 53 FR 7425 (1988). The administrative law 
judge concluded that Respondent has not discharged his responsibilities 
as a DEA registrant in the past and there is no indication that he is 
more likely to do so in the future. Judge Bittner recommended that 
Respondents DEA Certificate of Registration be revoked and any pending 
applications for registration as a practitioner be denied.
    Respondent took exception to Judge Bittner's opinion and 
recommendation arguing that there was not sufficient, reliable, 
probative, and substantial evidence to support such recommendation of 
revocation. Respondent further contended that Judge Bitter, in finding 
that 21 U.S.C. 823(f) (2), (4) and (5) were relevant, failed to discuss 
Respondent's threat to the public interest under these factors. 
Respondent additionally argued that the record, as a whole, does not 
support a conclusion that his behavior was egregious, that Judge 
Bittner failed to address the requirements of 21 CFR 1306.04 concerning 
valid prescriptions, that Respondent did not have inadequate 
recordkeeping practices, and that a negative inference was not 
warranted from Respondent's decision not to testify. Respondent further 
objected to the characterization that he did not perform any diagnostic 
tests, and to the administrative law judge's description of the agents' 
visit to Respondent's office on March 23, 1992. Respondent also took 
exception to the use of the testimony given by the Government's expert 
medical witness.
    The Deputy Administrator adopts the opinion and recommended 
decision of the administrative law judge in its entirety. The Deputy 
Administrator concurs with the administrative law judge's finding that 
the Government had met its burden of proof with respect to establishing 
the factors set forth under 21 U.S.C. 823(f) (2), (4) and (5). The 
Deputy Administrator finds that Respondent prescribed controlled 
[[Page 22078]] substances to the undercover agents without legitimate 
medical purpose and not in the usual course of professional medical 
practice. Further, Respondent's recordkeeping practices, medical 
examinations and patient history procedures were extremely deficient. 
Finally, the Deputy Administrator concurs with the administrative law 
judge's finding that a negative inference was warranted from 
Respondent's decision not to testify.
    Accordingly, the Deputy Administrator of the Drug Enforcement 
Administration, pursuant to the authority vested in him by 21 U.S.C. 
823 and 824 and 28 CFR 0.100(b) and 0.104, hereby orders that DEA 
Certificate of Registration, AS2512374, previously issued to Michael G. 
Sargent, M.D, be, and it hereby is, revoked, and any pending 
applications for such registration be, and hereby are, denied. This 
order is effective June 5, 1995.

    Dated: April 28, 1995.
Stephen H. Greene,
Deputy Administrator.
[FR Doc. 95-10927 Filed 5-3-95; 8:45 am]
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