Federal Register / Vol. 86, No. 142 / Wednesday, July 28, 2021 / Notices 40641 

1RFAAX 12 is the DEA Assistant Administrator’s 

letter to Respondent, dated January 29, 2019, 

rejecting her proposed CAP. 

2 In addition, the RFAA represents that 

‘‘Respondent acknowledged service of a copy of the 

. . . [OSC] in a telephone conversation with [a] 

DEA Diversion Investigator.’’ RFAA, at 3 (citing 

RFAAX 9 (Declaration of Diversion Investigator 

(hereinafter, DI), dated October 1, 2018), at 2). 

3Respondent’s Written Statement is dated 

September 21, 2018. It appears that Respondent 

transmitted her proposed CAP along with her 

Written Statement. The OSC is dated August 24, 

2018; therefore, Respondent’s submissions are 

Continued 

authorities to regain his medical license, 

including at least three months of 

practice under a preceptorship and the 

completion of forty hours of continuing 

medical education. See Response to the 

OSC, Ex. 12, 13. However, it is difficult 

to determine the amount of deterrence 

these consequences will have on 

Respondent due to the fact that he 

deflected responsibility for the 

underlying conduct. 

Finally, Respondent submitted dozens 

of letters from former patients, 

colleagues, and community members 

regarding his aptitude as a physician 

and compassionate nature. Response to 

the OSC, Ex. 14. While these character 

references do not diminish 

Respondent’s bad acts, I find the letters 

to be personal and sincere in their 

written form. They can be of limited 

weight in this proceeding, however, 

because I have limited ability to assess 

the actual credibility of the references 

given their written form. See Michael S. 

Moore, M.D., 76 FR 45,867, 45,873 

(2011) (evaluating the weight to be 

attached to letters provided by the 

respondent’s hospital administrators 

and peers in light of the fact that the 

authors were not subjected to the rigors 

of cross examination). They also were 

not written for the purposes of 

recommending that Respondent be 

granted a controlled substances 

registration, and, therefore, they offer 

little value in assessing the 

Respondent’s suitability to discharge the 

duties of a DEA registrant. Further, 

absent Respondent’s unequivocal 

acceptance of responsibility, what little 

value the letters might have offered me 

in evaluating my ability to trust 

Respondent is nullified by the fact that 

he himself has not shown me that he 

can be so entrusted. 

As discussed above, to receive a 

registration when grounds for denial 

exist, a respondent must convince the 

Administrator that his acceptance of 

responsibility and remorse are 

sufficiently credible to demonstrate that 

the misconduct will not recur and that 

he can be entrusted with a registration. 

Having reviewed the record in its 

entirety, I find that Respondent has not 

met this burden. Although Respondent 

did take some responsibility for his 

actions through his guilty plea and 

settlement agreement with the United 

States and the State of Tennessee, his 

acceptance of responsibility was not 

unequivocal. Respondent’s 

minimization and deflection of 

responsibility for his criminal conduct 

raises concern that he would perhaps 

also be willing to circumvent CSA 

requirements that he deemed 

‘‘technical’’ to the detriment of its 

effective implementation. I am also 

concerned that granting his registration 

absent a full acceptance of 

responsibility for his criminal actions 

would send the message to the 

registered community that they could 

violate so-called ‘‘technical’’ provisions 

of the CSA or its regulations without 

serious consequence. Unless and until 

Respondent is willing to credibly accept 

full responsibility for his unlawful 

conduct, I find that I cannot entrust him 

with a controlled substances 

registration. Accordingly, I will order 

the Agency to deny Respondent’s 

application for a certificate of 

registration. 

Order 

Pursuant to 28 CFR 0.100(b) and the 

authority vested in me by 21 U.S.C. 823, 

I hereby order that the pending 

application for a Certificate of 

Registration, Control Number 

W18085586C, submitted by William 

Ralph Kincaid, M.D., is denied. This 

Order is effective August 27, 2021. 

Anne Milgram, 

Administrator. 

[FR Doc. 2021–16004 Filed 7–27–21; 8:45 am] 

BILLING CODE 4410–09–P 

DEPARTMENT OF JUSTICE 

Drug Enforcement Administration 

Erica N. Grant, M.D.; Decision and 

Order 

I. Introduction 

On August 24, 2018, the Assistant 

Administrator, Diversion Control 

Division, Drug Enforcement 

Administration (hereinafter, DEA or 

Government), issued an Order to Show 

Cause (hereinafter, OSC) to Erica N. 

Grant, M.D. (hereinafter, Respondent) of 

Irving, Texas. OSC, at 1. The OSC 

proposed the revocation of 

Respondent’s Certificate of Registration 

No. FG2374053 for three reasons. Id. 

First, it alleged that Respondent was 

‘‘convicted of a felony under State law 

relating to a controlled substance.’’ Id. 

(citing 21 U.S.C. 824(a)(2)). Second, it 

alleged that it was ‘‘inconsistent with 

the public interest’’ for Respondent to 

maintain her registration. OSC, at 1 

(citing 21 U.S.C. 824(a)(4) in 

conjunction with 21 U.S.C. 823(f)). 

Third, the OSC alleged that Respondent 

‘‘materially falsified the application’’ for 

renewal of her registration. OSC, at 1 

(citing 21 U.S.C. 824(a)(1)). 

Specifically, the OSC alleged that 

Respondent’s ‘‘no contest’’ plea to a 

second-degree felony in Texas, 

‘‘Attempting to Possess a Controlled 

Substance by Fraud in violation of 

Texas Health and Safety Code 

§ 481.129,’’ ‘‘is a conviction providing a 

sufficient basis for the revocation’’ of 

her registration. OSC, at 2, 3. Further, 

the OSC alleged that, ‘‘[t]o determine 

what is in the ‘public interest,’ DEA 

considers, among other things, the 

registrant’s ‘conviction record under 

Federal or State laws relating to the 

manufacture, distribution, or dispensing 

of controlled substances.’ ’’ Id. at 2. 

Finally, according to the OSC, ‘‘DEA 

may revoke a registrant’s DEA . . . 

[registration] upon a finding that the 

registrant materially falsified any 

application filed pursuant to, or 

required by, the Controlled Substances 

Act’’ (hereinafter, CSA), such as by a 

‘‘failure to report . . . [an] arrest for a 

controlled substance felony.’’ Id. at 2, 3. 

The OSC notified Respondent of the 

right to request a hearing on the 

allegations or to submit a written 

statement, while waiving the right to a 

hearing, the procedures for electing each 

option, and the consequences for failing 

to elect either option. Id. at 3 (citing 21 

CFR 1301.43). The OSC also notified 

Respondent of the opportunity to 

submit a corrective action plan. OSC, at 

3–4 (citing 21 U.S.C. 824(c)(2)(C)). 

By transmittal dated September 21, 

2018, Respondent waived her right to a 

hearing and filed a written statement 

and a proposed Corrective Action Plan. 

Request for Final Agency Action 

(hereinafter, RFAA) Exhibit (hereinafter, 

collectively, RFAAX) 10 (Respondent’s 

Hearing Waiver and Written Statement 

in Response to the OSC (hereinafter, 

Written Statement)) and RFAAX 11 

(Respondent’s Request for Corrective 

Action Plan (hereinafter, CAP)).1

Respondent’s written statement 

explicitly references her receipt of the 

OSC.2 RFAAX 10, at 1. 

Based on all of the evidence in the 

record, I find that the Government’s 

service of the OSC was legally 

sufficient. In addition, also based on all 

of the evidence in the record, I find that 

Respondent timely filed her Written 

Statement and proposed CAP.3


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clearly timely regardless of when Respondent 

received service of the OSC. 21 CFR 1301.43. 

4Respondent also submitted the Agreed Order for 

the record. RFAAX 11. 

5The RFAA cites Factor Three in support of the 

OSC allegation that Respondent’s continued 

registration is inconsistent with the public interest. 

RFAA, at 5; 21 U.S.C. 824(a)(4) in conjunction with 

21 U.S.C. 823(f)(3). 

6The Deferred Adjudication Order lists the 

offense as ‘‘Obstruction Controlled Substance Fraud 

Drug 1/2.’’ RFAAX 5, at 1. Under ‘‘Statute for 

Offense,’’ the document shows ‘‘481.29 Penal 

Code.’’ Id. The latter entry appears to be a 

scrivener’s error for section 481.129 of the Texas 

Health and Safety Code. See RFAA, at 3. 

The Government forwarded its RFAA, 

along with the evidentiary record, to 

this office on August 27, 2019. 

I issue this Decision and Order based 

on the Government’s submission, which 

includes Respondent’s Written 

Statement and proposed CAP, and is the 

entire record before me. 21 CFR 

1301.43(e). 

II. Findings of Fact 

A. Respondent’s DEA Controlled 

Substance Registration 

Respondent is the holder of DEA 

Certificate of Registration No. 

FG2374053 at the registered address of 

665 W LBJ Freeway, Suite 217, Irving, 

TX 75063 and a separate ‘‘mail-to’’ 

address. RFAAX 2 (Certification of 

Registration History, dated November 

23, 2018), at 1. Pursuant to this 

registration, Respondent is authorized to 

dispense controlled substances in 

schedules II through V as a practitioner. 

Id. Respondent’s registration expired on 

September 30, 2019, and is in an ‘‘active 

pending status.’’ Id. 

B. The Investigation of Respondent 

According to the DI assigned to this 

matter, the Texas Medical Board 

(hereinafter, TMB) notified him that 

Respondent was the subject of an 

Agreed Order Upon Formal Filing, In 

the Matter of the License of Erica Nicole 

Grant, M.D., License No. N–4438 (Before 

the TMB) dated March 2, 2018 

(hereinafter, Agreed Order). RFAAX 9, 

at 1 (referencing RFAAX 3).4 His 

investigation ensued and included 

obtaining copies of the Agreed Order 

and documents from the 195th Judicial 

District Court of Dallas County, Texas 

related to Respondent’s nolo contendere 

plea. RFAAX 9, at 2. 

C. The Government’s Case 

The Government’s case includes nine 

exhibits. The content of some of those 

exhibits is also attached to Respondent’s 

Written Statement. RFAA, at 6–7; infra 

Section II.D. 

The DI Declaration certifies the 

authenticity of RFAA Exhibits 2 through 

8. RFAAX 9, at 2. The DI Declaration, 

signed and attested to be ‘‘true and 

correct’’ under penalty of perjury, 

further states that DI interviewed 

Respondent ‘‘at her offices in Irving, 

Texas’’ on June 1, 2018. Id. at 2. 

According to the DI Declaration, ‘‘In that 

interview, . . . [Respondent] admitted 

that she had diverted multiple 

controlled substances from numerous 

patients at Parkland Hospital in Dallas, 

Texas.’’ Id. The DI Declaration also 

states that Respondent ‘‘admitted she 

diverted Dilaudid, Morphine, Versed, 

and Fentanyl.’’ Id. 

The Government submitted a twopage document entitled, ‘‘Affidavit for 

Arrest Warrant or Capias,’’ of the Dallas 

County Hospital District Police 

Department, dated April 5, 2016 

(hereinafter, Arrest Warrant Affidavit).5

RFAAX 6. According to the Arrest 

Warrant Affidavit, the Parkland Health 

and Hospital System Director of 

Pharmacy contacted the Drug Diversion 

Control Officer about ‘‘an issue 

developed in Anesthesia at Parkland 

Hospital . . . in which . . . 

[Respondent] . . . was drug screened 

. . . and sent to a rehabilitation facility 

at an unidentified location.’’ Id. at 1. 

Subsequently, according to the Arrest 

Warrant Affidavit, relevant records 

about ‘‘all controlled substances 

removed from any Pyxis within the 

hospital’’ by Respondent between 

November 23, 2015, and February 18, 

2016, were reviewed and compared 

with Respondent’s documented entries. 

Id. This review led to the discovery of 

one ‘‘discrepancy/diversion.’’ Id. 

According to the Arrest Warrant 

Affidavit, Respondent removed one 

hydromorphone 1 mg/1 mL syringe 

from a Pyxis located in the Labor & 

Delivery Alcove for a patient. Id. 

According to the patient’s anesthesia 

records, however, the hydromorphone 

was not administered to the patient, 

‘‘nor was a procedure opened requiring 

the Hydromorphone’’ for that patient. 

Id. Further, ‘‘[a]n additional review of 

the Pyxis in Anesthesia and Labor & 

Delivery, between . . . [February 6, 

2016, and February 17, 2016,] disclosed 

that no employee in Anesthesia, to 

include . . . [Respondent,] returned or 

wasted through Pyxis Hydromorphone 

removed from the Pyxis in Anesthesia 

and Labor and Delivery’’ for that 

patient. Id. at 1–2. The Arrest Warrant 

Affidavit states that ‘‘there was no 

Anesthesia event for this patient’’ on 

February 6, 2016. Id. at 2. The Arrest 

Warrant Affidavit concludes that, 

‘‘[b]ased upon the documentation,’’ 

Respondent ‘‘did not administer the 

Hydromorphone to . . . [the patient], 

but fraudulently obtained the controlled 

substance, by stating that the controlled 

substance would be administered to 

. . . [the patient].’’ Id. The Arrest 

Warrant Affidavit shows that a Dallas 

County, Texas Magistrate determined, 

based on her examination of the Arrest 

Warrant Affidavit, that probable cause 

existed for the issuance of an arrest 

warrant for Respondent. Id. 

The Government submitted 

Respondent’s Arraignment Sheet dated 

April 7, 2016. RFAAX 7, at 1. According 

to this document, Respondent was 

arraigned on two charges of ‘‘Fraud Del 

CS/Prescription Sch II.’’ Id. It also 

shows that bond was set at $2,500 for 

each charge. Id. 

The Government also submitted 

Respondent’s Judicial Confession, The 

State of Texas v. Erica Nicole Grant, No. 

F1644784 (195th Judicial District Court, 

Dallas County, Texas May 26, 2017) 

(hereinafter, Judicial Confession). 

RFAAX 4. The Judicial Confession 

memorializes Respondent’s admission 

that, ‘‘on or about the 6th day of 

February, 2016, in Dallas County, 

Texas,’’ she ‘‘did intentionally and 

knowingly possess and attempt to 

possess a controlled substance, namely: 

Hydromorphone, by misrepresentation, 

fraud, forgery, deception and 

subterfuge.’’ Id. at 1. Respondent’s 

signed statement concludes with these 

words: ‘‘I further judicially confess that 

I committed the offense with which I 

stand charged exactly as alleged in the 

indictment in this cause.’’ Id. In 

addition to Respondent, her attorney, 

the Assistant District attorney, the 

Deputy District Clerk, and the Presiding 

Judge signed this document. Id. 

The Government submitted the Order 

of Deferred Adjudication, The State of 

Texas v. Erica Nicole Grant, No. F– 

1644784–N (195th Judicial District 

Court, Dallas County, Texas May 26, 

2017) (hereinafter, Deferred 

Adjudication Order), RFAAX 5, at 1. 

According to this seven-page exhibit, 

the Deferred Adjudication Order was 

entered for a second-degree felony, 

‘‘Obstruction Controlled Substance 

Fraud Drug 1/2,’’ on May 26, 2017.6 Id. 

It shows that Respondent pled nolo 

contendere to an Information, that 

adjudication of guilt was deferred, and 

that Respondent was placed on 

community supervision for two years. 

Id. According to the document, 

Respondent ‘‘appeared in person with 

Counsel.’’ Id. The other pages of this 

exhibit are the ‘‘Conditions of 

Community Supervision’’ (three pages), 

the ‘‘Court’s Admonishment on Right to 

Order of Nondisclosure’’ (one page), and 


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7RFAAX 8 is a more legible version of the first 

page of the attachment to RFAAX 2. According to 

RFAAX 2 and RFAAX 8, the registration renewal 

application ‘‘Submission Date’’ is August 11, 2016. 

RFAAX 2, at 2; RFAAX 8, at 1. According to the 

Certification of Registration History, the ‘‘last 

approved renewal of this DEA registration was on 

August 15, 2016.’’ RFAAX 2, at 1. 

8See also, regarding ‘‘from at least 80 patients,’’ 

RFAAX 6, at 1 (‘‘Based on . . . [the Parkland Health 

& Hospital System Director of Pharmacy’s] 

information, the Pyxis (CareFusion) Records in 

reference to all controlled substances removed from 

any Pyxis within the hospital by . . . [Respondent], 

between 11/23/2015 and 02/18/2016, were 

reviewed, and all removals were compared to the 

entries . . . [Respondent] documented in each 

patient’s Anesthesia Record. The following 

discrepancies/diversions were discovered: Drug— 

Hydromorphone 1 mg/1 mL: (Schedule II).’’) and, 

regarding ‘‘for her own use,’’ RFAAX 3, at 3–4 and 

RFAAX 11, at 11–12 (specifying TMB’s Conclusions 

of Law that the Board is authorized to take 

disciplinary action against Respondent ‘‘based on 

Respondent’s inability to practice medicine with 

reasonable skill and safety to patients because of 

. . . (C) excessive use of drugs, narcotics, 

chemicals, or another substance, or (D) a mental or 

physical condition’’ and ‘‘Respondent’s use of 

alcohol or drugs in an intemperate manner that, in 

the opinion of the Board, could endanger the lives 

of patients,’’ while not including a finding 

specifying that Respondent ingested any of the 

controlled substances she admitted diverting). 

RFAAX 3, at 2–3 and RFAAX 11, at 10–11. 

9Respondent attached the Agreed Order to her 

proposed CAP. RFAAX 11, at 9–23; infra. 

the ‘‘Judgment/Certificate of 

Thumbprint’’ (one page). Id. at 3–7. 

The Government put into the record 

the registration renewal application that 

Respondent submitted on August 11, 

2016.7 RFAAX 8, at 1. According to 

RFAAX 8, Respondent answered ‘‘N’’ 

(meaning ‘‘no’’) to whether she had 

‘‘ever been convicted of a crime in 

connection with controlled substance(s) 

under state or federal law . . ., or any 

such action pending.’’ RFAAX 8, at 1. 

According to the Government, the fact 

that DEA did not rely on Respondent’s 

‘‘N’’ response does not make that 

response ‘‘immaterial’’ under past 

Agency decisions’ interpretations of 21 

U.S.C. 824(a)(1) and the Supreme 

Court’s definition of ‘‘material’’ in 

Kungys v. United States, 485 U.S. 759, 

770 (1988). RFAA, at 5–6. 

The Government also submitted a 

copy of the Agreed Order. RFAAX 3; see 

also infra Section II.D. According to the 

RFAA’s ‘‘Statement of Undisputed 

Material Facts,’’ the Government argues 

that, ‘‘[b]etween November 2015 and 

February 2016, Respondent withdrew 

medications, including controlled 

substances[,] from at least 80 patients 

from the Parkland Hospital Pyxis 

System’’ and ‘‘[d]uring that time, 

Respondent diverted controlled 

substances, including Dilaudid, 

Morphine, Versed, and Fentanyl for her 

own use.’’ RFAA, at 2 (citing RFAAX 3 

and RFAAX 9). The Government does 

not provide a page cite to RFAAX 3 for 

this citation in its RFAA and I do not 

see all of the asserted statements in 

RFAAX 3. The RFAA contains no other 

reference to RFAAX 3 and includes no 

other document from the TMB. The DI 

Declaration, RFAAX 9, states that 

Respondent ‘‘admitted that she had 

diverted multiple controlled substances 

from numerous patents at Parkland 

Hospital in Dallas, Texas’’ and that 

Respondent ‘‘admitted she diverted 

Dilaudid, Morphine, Versed, and 

Fentanyl.’’ RFAAX 9, at 2. Accordingly, 

I find that two portions of the 

Government-proposed statements of 

undisputed material facts, that 

Respondent withdrew controlled 

substances ‘‘from at least 80 patients’’ 

and ‘‘for her own use,’’ are not 

supported by the evidence the RFAA 

cites, or by substantial record evidence.8

D. Respondent’s Case 

As already discussed, Respondent 

submitted a timely Written Statement 

and proposed CAP. Supra section I. In 

her Written Statement, Respondent 

stated that she is an anesthesiologist 

whose ‘‘entire practice and . . . ability 

to make a living . . . as a single parent 

with a son in college and caregiver for 

. . . [her] 79 year-old mother and 

disabled sister is dependent on . . . 

[her] ability to provide a balanced 

anesthetic to patients which is not 

limited to, but includes controlled 

substances.’’ RFAAX 10, at 1. She 

admitted that ‘‘diversion of controlled 

substances occurred as stated from 

November 2015 through February 11, 

2016’’ and characterized it as a 

‘‘complete lack of judgment.’’ Id. Her 

Written Statement places the diversion 

in the context of her contemporaneous 

personal life experiences ‘‘never . . . as 

an excuse’’ but ‘‘rather [as] an 

explanation for which I have always 

taken 100% responsibility.’’ Id. 

Respondent, ‘‘[i]n accepting 

responsibility,’’ has ‘‘done everything in 

. . . [her] power to correct . . . [her] 

actions and 31 months later, . . . 

continue[s] to work hard at maintaining 

sobriety and gain the trust of those . . . 

lost, including the public.’’ Id. She 

wrote, ‘‘I accept sole responsibility and 

I have taken actions to become sober 

and healthy and continue to do such.’’ 

Id. at 2. Stating that this is her ‘‘first 

offense,’’ she added that she is ‘‘working 

diligently for it to never occur again’’ 

and asked for the opportunity ‘‘to 

continue to demonstrate’’ that she ‘‘ha[s] 

been rehabilitated and will always put 

the trust of the public first and 

foremost.’’ Id. at 2–3. 

Respondent’s Written Statement 

includes a list, consisting of about half 

of a single-spaced page, describing the 

‘‘course of action’’ she has taken ‘‘since 

February 11, 2016,’’ to ‘‘maintain[ ] 

sobriety and a healthy lifestyle.’’ Id. at 

3. She stated that her ‘‘course of action’’ 

includes inpatient and outpatient 

rehabilitation, participation in 

Alcoholics Anonymous or Caduceus 

meetings three times a week, bimonthly 

sessions with a therapist, weekly 

random drug testing beginning in 

October 2016, as-needed sessions with 

an Addiction Specialist, and a personal 

spirituality program. Id. I find a matter 

of concern about Respondent’s candor 

based on my review of this section of 

Respondent’s Written Statement and the 

Agreed Order. In her Written Statement, 

Respondent wrote ‘‘[NO incidents]’’ 

after stating that her course of action 

includes ‘‘[w]eekly random drug testing 

beginning October 2016 under voluntary 

agreement with . . . [TMB] with 

continuation under final order March, 

2018.’’ Id. The Agreed Order states, in 

the section entitled ‘‘Specific Panel 

Findings,’’ that ‘‘Respondent voluntarily 

submitted to interim drug testing with 

the . . . [TMB]; however, she has had 

four missed calls and one late drug 

screen. She has not tested positive for 

any substances.’’ RFAAX 3, at 3 and 

RFAAX 11, at 11. It appears that 

Respondent’s ‘‘[NO incidents]’’ 

representation is addressing the 

situation after the Agreed Order went 

into effect and that the ‘‘Specific Panel 

Findings’’ of the Agreed Order is 

describing the situation leading up to 

creation of the ‘‘Agreed Order.’’ The 

matter of concern to me, thus, is 

Respondent’s candor in this proceeding 

because she presented facts showing 

herself in a positive light and did not 

present related facts showing herself in 

an unfavorable light. Had Respondent 

requested and participated in a hearing, 

she would have been able to address my 

concern about her candor. She chose, as 

she is entitled under the regulations, to 

waive her opportunity for a hearing and 

to submit the Written Statement instead. 

RFAAX 10, at 1, 2; 21 CFR 1301.43. As 

the regulation notes, ‘‘Such statement, if 

admissible, shall be made a part of the 

record and shall be considered in light 

of the lack of opportunity for crossexamination in determining the weight 

to be attached to matters of fact asserted 

therein.’’ 21 CFR 1301.43(c). 

About another half page, single 

spaced, of the Written Statement lists 

conditions to which the Agreed Order 

subjects Respondent.9 RFAAX 10, at 3. 

I interpret Respondent’s intent for 

including those conditions after the 

‘‘course of action’’ list was to highlight 


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10RFAAX 11, at 9–23 is the same document that 

the Government submitted at RFAAX 3. 

11The page from the 2006 Edition of the DEA 

‘‘Practitioner’s Manual’’ includes the text of the first 

Liability question. RFAAX 11, at 3. According to 

the 2006 Edition, that question asks ‘‘Has the 

applicant ever been convicted of a crime in 

connection with controlled substances under state 

or federal law’’? Id. Based on this version of the first 

Liability question, Respondent ‘‘disputes’’ the OSC 

allegations that she was ‘‘convicted’’ of a crime in 

connection with controlled substances. Id. at 1–2 

(citing id. at 3). Instead, she stated, she pled nolo 

contendere, ‘‘received deferred adjudication 

probation,’’ ‘‘was released a year early from 

probation’’ on May 29, 2018, and, therefore, ‘‘the 

case is dismissed as a non-conviction.’’ RFAAX 10, 

at 2. 

12This is not surprising given that the 

Government submitted its RFAA less than two 

years after the date the Agreed Order was entered. 

RFAA, at 6. 

13 I find that Respondent’s admission that she 

treated herself with controlled substances does not 

necessarily mean that she admitted to ingesting the 

controlled substances she diverted. RFAAX 3, at 2 

and RFAAX 11, at 10. 

additional steps she agreed to follow for 

up to ten years. Id. 

In her CAP, Respondent proposed that 

‘‘the requirements outlined in the Texas 

Medical Board Public Order #18–270 

[the Agreed Order] . . . be accepted as 

an action plan and proceedings to 

revoke her DEA . . . [registration] be 

discontinued effective immediately.’’ 

RFAAX 11, at 1, citing id. at 9–23.10

Respondent represented that she has 

been ‘‘compliant with the actions’’ 

required by the Agreed Order and that 

she will report ‘‘immediately’’ to DEA 

the suspension of her medical license 

resulting from a violation of the Agreed 

Order. 

Attached to Respondent’s proposed 

CAP are (1) one page from the 2006 

Edition of the DEA ‘‘Practitioner’s 

Manual’’ entitled ‘‘Form–224a Renewal 

Application for Registration,’’ id. at 3; 

(2) the Deferred Adjudication Order, id. 

at 4–5; (3) Conditions of Community 

Supervision, The State of Texas v. Erica 

Nicole Grant, No. F–1644784–N (195th 

Judicial District Court, Dallas County, 

Texas May 26, 2017), id. at 6–7; (4) 

Order Dismissing Proceedings and 

Granting Early Discharge From 

Community Supervision Following 

Deferred Adjudication, The State of 

Texas v. Erica Nicole Grant, No. 

F1644784N (195th JDC, Dallas County, 

Texas May 29, 2018) (hereinafter, Order 

Dismissing Proceedings and Granting 

Early Discharge), id. at 8; and (5) the 

Agreed Order, id. at 9–23. The Deferred 

Adjudication Order, the Conditions of 

Community Supervision, and the 

Agreed Order are also part of the 

Government’s case.11 Supra section II.C. 

The Order Dismissing Proceedings 

and Granting Early Discharge states that 

Respondent ‘‘satisfactorily fulfilled’’ all 

conditions of community supervision 

and that ‘‘the best interests of society 

and . . . [Respondent] will be served by 

granting the early discharge from 

community supervision and dismissing 

the proceedings.’’ RFAAX 11, at 8. The 

Order Dismissing Proceedings and 

Granting Early Discharge terminates the 

‘‘period of supervision’’ about a year 

early, discharges Respondent from 

community supervision, and dismisses 

‘‘all proceedings in this cause’’ against 

Respondent. Id. 

The Agreed Order between 

Respondent and the TMB was signed 

and entered by the TMB presiding 

officer on March 2, 2018. RFAAX 3, at 

15 and RFAAX 11, at 23. According to 

the Agreed Order’s ‘‘Mitigating Factor’’ 

section, ‘‘Respondent neither admits nor 

denies the information given above.’’ 

RFAAX 3, at 3 and RFAAX 11, at 11. 

The ‘‘Specific Panel Findings’’ section is 

‘‘above’’ the ‘‘Mitigating Factor’’ section 

and, thus, I find that Respondent neither 

admitted nor denied the TMB’s General 

and Specific Panel Findings. RFAAX 3, 

at 3 and RFAAX 11, at 11. I also find, 

though, that Respondent ‘‘agree[d] to the 

entry of th[e] Agreed Order,’’ and agreed 

‘‘to comply with its terms and 

conditions’’ to ‘‘avoid further 

investigation, hearings, and the expense 

and inconvenience of litigation.’’ 

RFAAX 3, at 3 and RFAAX 11, at 11. 

The terms of the Agreed Order subject 

Respondent to multiple conditions for 

ten years. RFAAX 3, at 5 and RFAAX 

11, at 13. Respondent’s noncompliance 

with, or violation of, specified Agreed 

Order conditions could lead to the 

immediate suspension of her medical 

license. RFAAX 3, at 5–6, 8 and RFAAX 

11, at 13–14, 16. The Agreed Order 

affords Respondent the opportunity to 

seek amendment or termination of the 

conditions after two years following the 

date of the Agreed Order’s entry and 

once a year thereafter. RFAAX 3, at 13 

and RFAAX 11, at 21. There is no 

evidence in the record that Respondent 

availed herself of the opportunity to 

seek amendment or termination of the 

Agreed Order’s conditions.12

The TMB’s ‘‘Specific Panel Findings,’’ 

which are matters that Respondent 

‘‘neither admits nor denies,’’ contain 

five paragraphs. RFAAX 3, at 2–3 and 

RFAAX 11, at 10–11; see also supra. 

The TMB’s first specific panel finding is 

that ‘‘Respondent admitted that she 

diverted drugs through the Pyxis system 

that should have gone to patients’’ and 

that ‘‘[t]hese violations impacted patient 

care and involved lying to patients and 

her employer.’’ RFAAX 3, at 2 and 

RFAAX 11, at 10. The second TMB 

specific panel finding is that 

‘‘Respondent admitted that she has 

struggled with addiction and substance 

abuse.’’ RFAAX 3, at 2 and RFAAX 11, 

at 10. The third TMB specific panel 

finding is that ‘‘Respondent was 

suspended from her position at 

Parkland Hospital after a peer review 

action’’ and that ‘‘[t[his suspension was 

related to her diversion of controlled 

substances and her substance abuse 

issues.’’ RFAAX 3, at 2 and RFAAX 11, 

at 10. The fourth TMB specific panel 

finding is that ‘‘Respondent admitted 

that she treated herself with controlled 

substances.’’ 13 RFAAX 3, at 2 and 

RFAAX 11, at 10. The last TMB specific 

panel finding is that ‘‘Respondent 

voluntarily submitted to interim drug 

testing with the Board,’’ that ‘‘she has 

had four missed calls and one late drug 

screen,’’ and that ‘‘[s]he has not tested 

positive for any substances.’’ RFAAX 3, 

at 3 and RFAAX 11, at 11. 

The Agreed Order’s ‘‘Conclusions of 

Law’’ suggest that the TMB concluded 

that it had nine bases for disciplining 

Respondent ‘‘[b]ased on the above 

[General and Specific Panel] Findings.’’ 

RFAAX 3, at 3 and RFAAX 11, at 11. 

First, the TMB concluded that 

Respondent committed an act 

prohibited under Texas statute, Texas 

Occupations Code Annotated § 164.052 

(2018). RFAAX 3, at 3 and RFAAX 11, 

at 11. Second, the TMB concluded that 

Respondent violated TMB rules 

requiring the maintenance of adequate 

medical records. RFAAX 3, at 3 and 

RFAAX 11, at 11. Third, the TMB 

concluded that Respondent was unable 

to practice medicine with reasonable 

skill and safety to patients because of 

excessive use of drugs, narcotics, 

chemicals, or other substance, or a 

mental or physical condition. RFAAX 3, 

at 3 and RFAAX 11, at 11. Fourth, the 

TMB concluded that Respondent failed 

to practice medicine in an acceptable 

professional manner consistent with 

public health and welfare due to 

negligence in performing medical 

services, failing to use proper diligence 

in her professional practice, failing to 

safeguard against potential 

complications, and inappropriate 

prescription of dangerous drugs or 

controlled substances to herself, family 

members, or others in which there is a 

close personal relationship. RFAAX 3, 

at 3–4 and RFAAX 11, at 11–12. 

Fifth, the TMB concluded that 

Respondent’s use of alcohol or drugs in 

an intemperate manner could endanger 

the lives of patients. RFAAX 3, at 4 and 

RFAAX 11, at 12. Sixth, the TMB 

concluded that Respondent’s 

unprofessional or dishonorable conduct 

likely to deceive or defraud the public 


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14The CSA defines ‘‘dispense’’ to mean ‘‘to 

deliver a controlled substance to an ultimate user 

. . . by, or pursuant to the lawful order of, a 

practitioner, including the prescribing and 

administering of a controlled substance.’’ 21 U.S.C. 

802(10). 

15According to Respondent’s Written Statement, 

‘‘The diversion of controlled substances occurred as 

stated from November 2015 through February 11, 

2016.’’ RFAAX 10, at 1. The meaning of ‘‘as stated’’ 

might refer to the allegations of the OSC, but since 

it is not clear, I am not making a finding about the 

meaning of the phrase. 

16Respondent’s reference to ‘‘the facts’’ appears 

to refer to the OSC’s ‘‘summary of the matters of fact 

and law at issue.’’ OSC, at 1. 

or injure the public included providing 

medically unnecessary services, 

submitting a billing statement to a 

patient or a third-party payor that she 

should have known was improper, and 

violating state law concerning insurance 

fraud and concerning prescribing or 

administering without a valid medical 

purpose. RFAAX 3, at 4 and RFAAX 11, 

at 12. Seventh, the TMB concluded that 

Respondent prescribed or administered 

a drug or treatment that was 

nontherapeutic in nature, or that was 

nontherapeutic in the manner 

administered or prescribed. RFAAX 3, 

at 4 and RFAAX 11, at 12. Eighth, the 

TMB concluded that Respondent 

prescribed, administered, or dispensed 

dangerous drugs or controlled 

substances in a manner inconsistent 

with public health and welfare. RFAAX 

3, at 4 and RFAAX 11, at 12. Ninth, the 

TMB concluded that Respondent’s 

improper billing practices violated 

Texas law. RFAAX 3, at 4 and RFAAX 

11, at 12. 

There is substantial congruity 

between the evidence submitted by the 

Government and Respondent’s 

evidence. I now address the OSC’s 

allegations in the order in which they 

appear in the OSC. 

E. Allegation That Respondent Has Been 

Convicted of a Felony Related to a 

Controlled Substance (21 U.S.C. 

824(a)(2)) 

Based on substantial record evidence, 

including the evidence that both the 

Government and Respondent submitted, 

I find that Respondent pled nolo 

contendere to a second-degree Texas 

felony relating to a controlled substance, 

hydromorphone, and that adjudication 

of her guilt was deferred. See, e.g., 

RFAAX 4, at 1 (hydromorphone); 

RFAAX 5, at 1 (controlled substance); 

RFAAX 11, at 4 (controlled substance); 

id. at 8 (‘‘CS’’ and ‘‘Sch II’’). 

F. Allegation That Respondent’s 

Registration Is Inconsistent With the 

Public Interest (21 U.S.C. 824(a)(4) and 

823(f)) 

The section of the Government’s 

RFAA addressing the 21 U.S.C. 824(a)(4) 

public interest basis for revocation of 

Respondent’s registration focuses 

exclusively on Factor Three, 21 U.S.C. 

823(f)(3): Respondent’s ‘‘conviction 

record under Federal or State laws 

relating to the . . . dispensing of 

controlled substances.’’ 14 RFAA, at 5. 

The Government argues that 

Respondent’s nolo contendere plea to a 

second-degree controlled substance 

felony under Texas law justifies 

revocation of Respondent’s registration. 

Id. 

As already discussed, I find that 

Respondent pled nolo contendere to a 

second-degree Texas felony relating to a 

controlled substance, hydromorphone, 

and that adjudication of her guilt was 

deferred. Supra section II.E. More 

specifically, I find substantial record 

evidence that Respondent pled as 

follows: ‘‘on or about the 6th day of 

February, 2016, in Dallas County, Texas, 

I did intentionally and knowingly 

possess and attempt to possess a 

controlled substance, namely, 

HYDROMORPHONE, by 

misrepresentation, fraud, forgery, 

deception and subterfuge.’’ RFAAX 4, at 

1. Further, I find substantial record 

evidence based on the above findings 

and the unrefuted Affidavit for Arrest 

Warrant or Capias that Respondent did 

not return or waste the hydromorphone. 

RFAAX 6, at 1–2. I do not find 

substantial record evidence about what 

Respondent did with the 

hydromorphone that she pled to 

fraudulently possessing or attempting to 

possess. 

While the Government focused 

exclusively on Factor Three, the OSC’s 

allegations based on 21 U.S.C. 824(a)(4) 

and 823(f) are broader. Accordingly, I 

am analyzing, making findings of fact 

about, and drawing conclusions of law 

based on the entire text of 21 U.S.C. 

823(f). 

I find substantial record evidence that 

Respondent admitted that she engaged 

in the ‘‘diversion of controlled 

substances’’ ‘‘from November 2015 

through February 11, 2016.’’ 15 RFAAX 

11, at 1; RFAAX 10, at 1. I find 

substantial record evidence that 

Respondent, ‘‘[w]hile making such an 

admission of diversion, . . . denie[d] all 

the above [OSC] charges against her as 

described in the Waiver of Hearing letter 

dated September 21, 2018.’’ RFAAX 11, 

at 1. I find substantial record evidence 

that Respondent characterized as 

‘‘unfortunate’’ the legal action taken by 

‘‘Parkland Hospital, the affiliate hospital 

where the diversion occurred,’’ and 

stated that the legal action was taken 

‘‘unbeknownst and at the disapproval of 

the committee that led to a series of 

events as outlined in the facts.’’ 16

RFAAX 10, at 1. 

I find substantial record evidence that 

Respondent’s Written Statement 

disputes the OSC’s material falsification 

and felony conviction charges on the 

basis of the Texas ‘‘deferred 

adjudication probation,’’ and states that, 

‘‘[i]n summary, I do not deny nor have 

I ever in the past the unfortunate course 

of actions I decided to take by diverting 

controlled substances.’’ Id. at 2. I find 

substantial record evidence that her 

Written Statement further states that, ‘‘I 

accept sole responsibility and I have 

taken actions to become sober and 

healthy and continue to do such.’’ Id. I 

find substantial record evidence that 

Respondent’s Written Statement asks 

that she be ‘‘allow[ed] . . . to continue 

to demonstrate that . . . [she has] been 

rehabilitated and will always put the 

trust of the public first and foremost.’’ 

Id. at 2–3. I find substantial record 

evidence that the Written Statement 

represents that ‘‘this is . . . 

[Respondent’s] first offense and . . . 

[she] is working diligently for it to never 

occur again.’’ Id. at 3. 

I find there is substantial record 

evidence that Respondent admitted that 

she ‘‘had diverted multiple controlled 

substances from numerous patients at 

Parkland Hospital in Dallas, Texas.’’ 

RFAAX 9, at 2. I find there is substantial 

record evidence that Respondent 

admitted that she ‘‘diverted Dilaudid, 

Morphine, Versed, and Fentanyl.’’ Id. 

I find there is substantial record 

evidence that Respondent and the TMB 

entered into an Agreed Order that was 

signed and entered by the TMB 

presiding officer on March 2, 2018. 

RFAAX 3, at 15 and RFAAX 11, at 23. 

I find substantial record evidence that 

Respondent neither admitted nor denied 

the TMB’s General and Specific Panel 

Findings. RFAAX 3, at 3 and RFAAX 

11, at 11. I find substantial record 

evidence that Respondent ‘‘agree[d] to 

the entry of th[e] Agreed Order,’’ and 

agreed ‘‘to comply with its terms and 

conditions’’ to ‘‘avoid further 

investigation, hearings, and the expense 

and inconvenience of litigation.’’ 

RFAAX 3, at 3 and RFAAX 11, at 11. I 

find substantial record evidence that the 

terms of the Agreed Order subject 

Respondent to multiple conditions for 

up to ten years, that Respondent’s 

noncompliance with, or violation of, 

specified Agreed Order conditions 

could lead to the immediate suspension 

of her medical license, and that the 

Agreed Order affords Respondent the 


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17Respondent submitted evidence about the exact 

wording of the first Liability question. RFAAX 11, 

at 3. I find clear, unequivocal, and convincing 

record evidence that Respondent’s proffered 

evidence, from 2006, is out-of-date and obsolete 

and, therefore, irrelevant to this adjudication. Id., 

compare with RFAAX 2, at 2; RFAAX 8, at 1. 

opportunity to seek amendment or 

termination of the conditions after two 

years following the date of the Agreed 

Order’s entry and once a year thereafter. 

RFAAX 3, at 5–13 and RFAAX 11, at 

13–21. 

I find substantial record evidence that 

the TMB found that ‘‘Respondent 

admitted that she diverted drugs 

through the Pyxis system that should 

have gone to patients’’ and that ‘‘[t]hese 

violations impacted patient care and 

involved lying to patients and her 

employer.’’ RFAAX 3, at 2 and RFAAX 

11, at 10. I find substantial record 

evidence that the TMB found that 

‘‘Respondent admitted that she has 

struggled with addiction and substance 

abuse.’’ RFAAX 3, at 2 and RFAAX 11, 

at 10. I find substantial record evidence 

that the TMB found that ‘‘Respondent 

was suspended from her position at 

Parkland Hospital after a peer review 

action’’ and that ‘‘[t[his suspension was 

related to her diversion of controlled 

substances and her substance abuse 

issues.’’ RFAAX 3, at 2 and RFAAX 11, 

at 10. I find substantial record evidence 

that the TMB found that ‘‘Respondent 

admitted that she treated herself with 

controlled substances.’’ RFAAX 3, at 2 

and RFAAX 11, at 10. I find substantial 

record evidence that the TMB found 

that ‘‘Respondent voluntarily submitted 

to interim drug testing with the Board,’’ 

that ‘‘she has had four missed calls and 

one late drug screen,’’ and that ‘‘[s]he 

has not tested positive for any 

substances.’’ RFAAX 3, at 3 and RFAAX 

11, at 11. 

I find substantial record evidence that 

the TMB concluded that it had multiple 

bases under Texas law for disciplining 

Respondent, including her failure to 

maintain adequate medical records; her 

inability to practice medicine with 

reasonable skill and safety to patients 

because of excessive substance use or a 

mental or physical condition; her failure 

to practice medicine in an acceptable 

professional manner consistent with 

public health and welfare due to, among 

other things, her negligence, improper 

diligence, not safeguarding against 

potential complications, and 

inappropriate prescription of dangerous 

drugs or controlled substances; her use 

of alcohol or drugs in an intemperate 

manner that could endanger the lives of 

patients; and her unprofessional or 

dishonorable conduct likely to deceive 

or defraud the public or injure the 

public including prescribing or 

administering a controlled substance 

without a valid medical purpose (Tex. 

Health & Safety Code § 481.071(a). 

RFAAX 3, at 3–4 and RFAAX 11, at 11– 

12. 

G. Allegation That Respondent 

Materially Falsified a Renewal 

Application (21 U.S.C. 824(a)(1)) 

I find clear, unequivocal, and 

convincing record evidence that, on 

April 7, 2016, Respondent was 

arraigned on charges that she violated a 

second-degree Texas felony involving a 

controlled substance. RFAAX 7, at 1; see 

also RFAAX 6, at 1–2. I find clear, 

unequivocal, and convincing record 

evidence that Respondent answered 

‘‘N’’ to the first Liability question on the 

registration renewal application that she 

submitted on or about August 11, 2016. 

RFAAX 2, at 2 and RFAAX 8, at 1. I find 

clear, unequivocal, and convincing 

record evidence that the text of the first 

Liability question on the registration 

renewal application that Respondent 

submitted on or about August 11, 2016, 

asked whether Respondent had ‘‘ever 

been convicted of a crime in connection 

with controlled substance(s) under state 

or federal law . . . or any such action 

pending.’’ 17 RFAAX 2, at 2 and RFAAX 

8, at 1. I find clear, unequivocal, and 

convincing record evidence that the 

date of Respondent’s Judicial 

Confession is May 26, 2017. RFAAX 4, 

at 1. Accordingly, I find clear, 

unequivocal, and convincing record 

evidence that Respondent’s ‘‘N’’ 

response to the first Liability question 

on the registration renewal application 

that she submitted on or about August 

11, 2016, was false because, on April 7, 

2016, Respondent was arraigned on 

charges that she violated a seconddegree Texas felony involving a 

controlled substance. 

III. Discussion 

A. The Controlled Substances Act 

Under the CSA, ‘‘[a] registration . . . 

to . . . distribute[ ] or dispense a 

controlled substance . . . may be 

suspended or revoked by the Attorney 

General upon a finding that the 

registrant—(1) has materially falsified 

any application filed pursuant to or 

required by this subchapter or 

subchapter II; (2) has been convicted of 

a felony under . . . any . . . law of the 

United States, or of any State, relating 

to any substance defined in this 

subchapter as a controlled substance; 

. . . [or] (4) has committed such acts as 

would render his registration under 

section 823 of this title inconsistent 

with the public interest as determined 

by such section.’’ 21 U.S.C. 824(a). The 

OSC alleges these three bases for 

revocation of Respondent’s registration: 

violations of 21 U.S.C. 824(a)(1), (2), and 

(4). 

B. Allegation That Respondent 

Materially Falsified an Application (21 

U.S.C. 824(a)(1)) 

As already discussed, I find clear, 

unequivocal, and convincing evidence 

that Respondent submitted a registration 

renewal application containing a false 

answer to the first Liability question. 

Supra section II.G. My finding about 

Respondent’s submission of a false 

answer involves Respondent’s 

arraignment on charges that she violated 

a second-degree, controlled-substance 

related Texas felony about four months 

before her submission of the registration 

renewal application. Id. Respondent’s 

false submission, therefore, implicates 

Factor Four, Respondent’s 

‘‘[c]ompliance with applicable State, 

Federal, or local laws relating to 

controlled substances.’’ 21 U.S.C. 

823(f)(4). Respondent’s false response to 

the first Liability question directly 

implicated my statutorily-mandated 

analysis and my decision by depriving 

me of legally relevant facts when I 

evaluated Respondent’s registration 

renewal application. RFAAX 2, at 1; see 

also Frank Joseph Stirlacci, M.D., 85 FR 

45,229, 45,235 (2020). Accordingly, I 

find, based on the CSA and the analysis 

underlying multiple Supreme Court 

decisions explaining ‘‘materiality,’’ that 

the falsity Respondent submitted was 

material. Frank Joseph Stirlacci, M.D., 

85 FR at 45,235. 

Respondent’s Written Statement 

argues that her nolo contendere plea to 

a second-degree Texas felony is ‘‘not a 

conviction,’’ because ‘‘it is a deferred 

adjudication probation that was 

completed May 29, 2018 and is 

therefore discharged as a nonconviction.’’ RFAAX 10, at 2. She 

posited that, ‘‘It is not considered a 

conviction under Texas law.’’ Id. There 

are two reasons why I disagree with 

Respondent’s arguments. 

First, the Agency established over 

thirty years ago, and reiterated as 

recently as about ten years ago, that a 

deferred adjudication is ‘‘still a 

‘conviction’ within the meaning of the 

. . . [CSA] even if the proceedings are 

later dismissed.’’ Kimberly Maloney, 

N.P., 76 FR 60,922, 60,922 (2011). In 

reaching this conclusion, the Agency 

explained that, ‘‘[a]ny other 

interpretation would mean that the 

conviction could only be considered 

between its date and the date of its 

subsequent dismissal.’’ Id., citing Edson 


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W. Redard, M.D., 65 FR 30,616, 30,618 

(2000). 

Second, Respondent’s Written 

Statement arguments do not account for 

the fact, as I already found, that the first 

Liability question on the registration 

renewal application that she submitted 

asked whether she had ‘‘ever been 

convicted of a crime in connection with 

controlled substance(s) under state or 

federal law . . . or any such action 

pending’’ [emphasis added]. RFAAX 2, 

at 2; RFAAX 8, at 1; see also supra 

section II.G. I already found that 

Respondent submitted her registration 

renewal application on or about August 

11, 2016, that she was arraigned on 

charges that she violated a seconddegree Texas felony involving a 

controlled substance on April 7, 2016, 

and that she pled guilty on May 26, 

2017. Supra section II.G. As such, 

Respondent had already been arraigned, 

meaning there was an ‘‘action pending,’’ 

when she submitted her registration 

renewal application on or about August 

11, 2016. Her ‘‘N’’ response to the first 

Liability question on that renewal 

application, therefore, was false, 

because there was already a seconddegree Texas controlled-substance 

related felony action pending. 

After considering, analyzing, and 

evaluating Respondent’s arguments, I 

find clear, convincing, and unequivocal 

record evidence and conclude that 

Respondent materially falsified the 

registration renewal application she 

submitted on or about August 11, 2016. 

Accordingly, I find that there is clear, 

convincing, and unequivocal evidence 

in the record supporting revocation of 

Respondent’s registration based on her 

having ‘‘materially falsified any 

application filed pursuant to or required 

by this subchapter or subchapter II.’’ 21 

U.S.C. 824(a)(1). 

C. Allegation That Respondent Has 

Been Convicted of a Felony Relating to 

Any Controlled Substance (21 U.S.C. 

824(a)(2)) 

As already discussed, I find, based on 

substantial record evidence, including 

evidence that both the Government and 

Respondent submitted, that Respondent 

pled nolo contendere to a second-degree 

Texas felony relating to a controlled 

substance, hydromorphone, and that 

adjudication of her guilt was deferred. 

Supra section II.E.; see also section II.F. 

I find substantial record evidence that 

the second-degree Texas felony to 

which Respondent pled is section 

481.129 of the Texas Health and Safety 

Code. RFAAX 4, at 1; see also RFAA, at 

2. Chapter 481 is the Texas Controlled 

Substances Act. Every offense in the 

version of subchapter 129 of the Texas 

Controlled Substances Act in effect 

when Respondent pled nolo contendere 

in which the word ‘‘fraud’’ appears 

concerns controlled substances. See, 

e.g., Tex. Health and Safety Code 

§§ 481.129(a)(5)(A), (B), and (C). 

481.129(a)(6), and 481.129(a-1) (2017). 

Respondent’s ‘‘Judicial Confession’’ 

states that she ‘‘did intentionally and 

knowingly possess and attempt to 

possess a controlled substance, namely: 

HYDROMORPHONE, by 

misrepresentation, fraud, forgery, 

deception and subterfuge.’’ RFAAX 4, at 

1. Texas Health and Safety Code 

§ 481.129(a)(5)(A) states that a ‘‘person 

commits an offense if the person 

knowingly . . . possesses, obtains, or 

attempts to possess or obtain a 

controlled substance or an increased 

quantity of a controlled substance . . . 

by misrepresentation, fraud, forgery, 

deception, or subterfuge.’’ Tex. Health 

and Safety Code §§ 481.129(a)(5)(A) 

(2017). Accordingly, I find substantial 

record evidence that Respondent pled 

nolo contendere to a Texas felony 

relating to a controlled substance, Tex. 

Health and Safety Code 

§§ 481.129(a)(5)(A) (2017). 21 U.S.C. 

824(a)(2). 

I note the record evidence showing 

that, pursuant to deferred adjudication, 

the proceedings against Respondent 

were dismissed and Respondent was 

discharged early from community 

supervision. RFAAX 11, at 8. As already 

discussed, though, under prior Agency 

decisions, an Order dismissing 

proceedings following deferred 

adjudication does not change the fact 

that Respondent pled nolo contendere 

to a second-degree Texas felony. Supra 

section III.B. Accordingly, I find that 

there is substantial evidence in the 

record supporting revocation of 

Respondent’s registration based on her 

Texas second-degree controlled 

substance-related felony conviction. 21 

U.S.C. 824(a)(2). 

D. Allegation That Respondent’s 

Registration Is Inconsistent With the 

Public Interest (21 U.S.C. 824(a)(4) and 

823(f)) 

As already discussed, the CSA 

provides for the revocation or 

suspension of a registration to distribute 

or dispense a controlled substance 

‘‘upon a finding that the registrant . . . 

has committed such acts as would 

render his registration under section 823 

of this title inconsistent with the public 

interest as determined by such section.’’ 

21 U.S.C. 824(a)(4). In the case of a 

‘‘practitioner,’’ which is defined in 21 

U.S.C. 802(21) to include a ‘‘physician,’’ 

Congress directed consideration of the 

following factors in making the public 

interest determination: 

(1) The recommendation of the appropriate 

State licensing board or professional 

disciplinary authority. 

(2) The applicant’s experience in 

dispensing . . . controlled substances. 

(3) The applicant’s conviction record under 

Federal or State laws relating to the . . . 

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. 

21 U.S.C. 823(f). These factors are 

considered in the disjunctive. Robert A. 

Leslie, M.D., 68 FR 15,227, 15,230 

(2003). 

According to Agency decisions, I 

‘‘may rely on any one or a combination 

of factors and may give each factor the 

weight [I] deem[ ] appropriate in 

determining whether’’ to revoke a 

registration. Id.; see also Jones Total 

Health Care Pharmacy, LLC v. Drug 

Enf’t Admin., 881 F.3d 823, 830 (11th 

Cir. 2018) (citing Akhtar-Zaidi v. Drug 

Enf’t Admin., 841 F.3d 707, 711 (6th Cir. 

2016)); MacKay v. Drug Enf’t Admin., 

664 F.3d 808, 816 (10th Cir. 2011); 

Volkman v. U.S. Drug Enf’t Admin., 567 

F.3d 215, 222 (6th Cir. 2009); Hoxie v. 

Drug Enf’t Admin., 419 F.3d 477, 482 

(6th Cir. 2005). Moreover, while I am 

required to consider each of the factors, 

I ‘‘need not make explicit findings as to 

each one.’’ MacKay, 664 F.3d at 816 

(quoting Volkman, 567 F.3d at 222); see 

also Akhtar-Zaidi, 841 F.3d at 711; 

Hoxie, 419 F.3d at 482. ‘‘In short, . . . 

the Agency is not required to 

mechanically count up the factors and 

determine how many favor the 

Government and how many favor the 

registrant. Rather, it is an inquiry which 

focuses on protecting the public 

interest; what matters is the seriousness 

of the registrant’s misconduct.’’ Jayam 

Krishna-Iyer, M.D., 74 FR 459, 462 

(2009). Accordingly, as appellate courts 

have recognized, findings under a single 

factor are sufficient to support the 

revocation of a registration. MacKay, 

664 F.3d at 821. 

In this matter, the Government’s 

RFAA addresses Factor Three. RFAA, at 

5; see also supra section II.F.; infra. In 

addition to Factor Three, I consider all 

of the public interest factors that are 

relevant to the record evidence. 21 

U.S.C. 823(f). 

1. Factor One—Recommendation of the 

Appropriate State Licensing Board 

Factor One calls for consideration of 

the ‘‘recommendation of the appropriate 

state licensing board or professional 


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18The John O. Dimowo, M.D. Agency decision 

stands for the proposition that ‘‘[a]lthough statutory 

analysis [of the CSA] may not definitively settle 

. . . [the breadth of the cognizable state 

‘recommendation’ referenced in Factor One], the 

most impartial and reasonable course of action is 

to continue to take into consideration all actions 

indicating a recommendation from an appropriate 

state.’’ 85 FR at 15,810. 

disciplinary authority’’ in the public 

interest determination. 21 U.S.C. 

823(f)(1). The record evidence does not 

include a direct recommendation to the 

Agency from the TMB about 

Respondent’s continued registration. 

As already discussed, both the 

Government and Respondent submitted 

the Agreed Order for the record. Supra 

sections II.C. and II.D. There is some 

congruence between the matters 

addressed in the Agreed Order and the 

OSC allegations, such as Respondent’s 

diversion of controlled substances. See, 

e.g., OSC, at 2; RFAAX 3, at 2–4; 

RFAAX 11, at 10–12. The Agreed Order 

states that the TMB found multiple 

bases under Texas law for disciplining 

Respondent. RFAAX 3, at 3–5 and 

RFAAX 11, at 11–13; see also supra 

section II.D. It subjects Respondent to 

multiple conditions for up to ten years. 

RFAAX 3, at 5–13 and RFAAX 11, at 

13–21; see also supra section II.D. 

While the Agreed Order is not a direct 

recommendation for purposes of Factor 

One, it does indicate a possible response 

to some of the allegations and evidence 

before me. John O. Dimowo, M.D., 85 FR 

15,800, 15,810 (2020).18 I apply the 

same analysis and reach the same 

conclusion here given the differences 

between the allegations and evidence 

set out in the Agreed Order and the 

allegations and evidence before me. In 

sum, while the fact that the Agreed 

Order conditioned Respondent’s 

medical license, as opposed to revoking 

or suspending it, is not dispositive of 

the public interest inquiry in this case 

and is minimized due to the differences 

in the charges underlying the Agreed 

Order and the OSC charges I am 

adjudicating, I consider the fact that the 

TMB conditioned Respondent’s medical 

license, as opposed to revoking or 

suspending it, and I give that aspect of 

the Agreed Order minimal weight in 

Respondent’s favor. 

2. Factors Two and/or Four—The 

Respondent’s Experience in Dispensing 

Controlled Substances and Compliance 

With Applicable Laws Related to 

Controlled Substances 

As already discussed, there is 

substantial record evidence of 

Respondent’s negative controlled 

substance dispensing and noncompliance with applicable laws related 

to controlled substances. See, e.g., supra 

section II.F. For example, I already 

found that Respondent, herself, 

admitted that she engaged in the 

‘‘diversion of controlled substances’’ 

‘‘from November 2015 through February 

11, 2016.’’ Id.; cf. id. (referencing the 

Agreed Order and Respondent’s 

decision not to admit or deny the TMB’s 

General and Specific Panel Findings). I 

further found that Respondent, herself, 

admitted ‘‘the unfortunate course of 

action . . . [she] decided to take by 

diverting controlled substances.’’ Id. 

I also found that the Government 

submitted substantial evidence that 

Respondent admitted, to the DI, 

diverting multiple controlled substances 

from numerous patients at Parkland 

Hospital. Id. I further found substantial 

record evidence that Respondent also 

admitted to the DI that she ‘‘diverted 

Dilaudid, Morphine, Versed, and 

Fentanyl.’’ Id. 

In addition, I already found 

substantial record evidence that the 

TMB’s findings included that 

‘‘Respondent admitted that she diverted 

drugs through the Pyxis system that 

should have gone to patients,’’ 

‘‘Respondent admitted that she has 

struggled with addiction and substance 

abuse,’’ ‘‘Respondent was suspended 

from her position at Parkland Hospital 

after a peer review action’’ and ‘‘[t[his 

suspension was related to her diversion 

of controlled substances and her 

substance abuse issues,’’ ‘‘Respondent 

admitted that she treated herself with 

controlled substances,’’ and 

‘‘Respondent voluntarily submitted to 

interim drug testing with the Board,’’ 

that ‘‘she has had four missed calls and 

one late drug screen,’’ and that ‘‘[s]he 

has not tested positive for any 

substances.’’ Id. 

I also found substantial record 

evidence that the TMB concluded that 

it had multiple bases under Texas law 

for disciplining Respondent. Id. The 

multiple bases for disciplining 

Respondent under Texas law included 

her prescribing or administering a 

controlled substance without a valid 

medical purpose. Id. 

I find that these matters directly 

implicate Factors Two and/or Four and 

strongly weigh against Respondent. 

3. Factor Three—The Respondent’s 

Conviction Record Under State Laws 

Relating to the Manufacture, 

Distribution, or Dispensing of 

Controlled Substances 

I already found that Respondent was 

convicted under Texas law of a seconddegree felony relating to a controlled 

substance. Supra section II.E. and 

section III.C. (concerning 21 U.S.C. 

824(a)(2)). Concerning Factor Three and 

the OSC charge under 21 U.S.C. 

824(a)(4), in conjunction with 21 U.S.C. 

823(f)(3), the Government’s RFAA 

argues that ‘‘revocation is justified by 

. . . [Respondent’s] State conviction 

record relating to [the] manufacture, 

distribution, or dispensing of controlled 

substances as evidenced by her nolo 

contendere plea to a second-degree 

controlled substance felony in Texas.’’ 

RFAA, at 5. The RFAA cites RFAAX 4 

and RFAAX 5 to support this statement. 

Id. In its next sentence, the RFAA states 

that ‘‘Respondent pled nolo contendere 

to intentionally and knowingly 

possessing and attempting to possess a 

controlled substance, hydromorphone, 

by misrepresentation, fraud, forgery, 

deception, and subterfuge.’’ Id. Again, 

the RFAA cites RFAAX 4 and RFAAX 

5 as support for this statement. Id. It 

also cites 21 U.S.C. 823(f)(3) and 21 

U.S.C. 824(a)(4), reconfirming that this 

portion of the RFAA is addressing the 

public interest basis for revocation. 

After a ‘‘see also’’ signal, the 

Government cited generally to three 

Agency decisions. Id. 

The first decision involves a nolo 

contendere plea, a deferred entry of 

judgment, and the subsequent dismissal 

of proceedings. Edson W. Redard, M.D., 

65 FR 30,616 (2000), cited supra section 

III.B. As already discussed, that decision 

states that the Agency ‘‘has consistently 

held that a plea of nolo contendere 

constitutes a ‘conviction’ within the 

meaning of 21 U.S.C. 824(a)(2).’’ Id. at 

30,618. Concerning Factor Three, the 

decision has one sentence in a onesentence paragraph: ‘‘As previously 

discussed, factor three is relevant since 

the Deputy Administrator finds that 

Respondent was convicted of a felony 

offense relating to controlled 

substances.’’ Id. at 30,619. The 

decision’s ‘‘previous discussion’’ was 

that the doctor had pled nolo 

contendere to one count of obtaining 

and attempting to obtain hydrocodone 

by fraud. Id. at 30,617. The decision 

does not elaborate on its one-sentence 

Factor Three conclusion. 

The second and third Agency 

decisions that the Government cited to 

support its argument that Factor Three 

is relevant are Jana Marjenhoff, D.O., 80 

FR 29,067 (2015) and David D. Miller, 

M.D., 60 FR 54,511 (1995). RFAA, at 5. 

According to Jana Marjenhoff, D.O., 

‘‘[r]egarding Factor Three, the record in 

this case does not contain evidence that 

the Respondent has been convicted of 

(or even charged with) a crime related 

to any of the controlled substance 

activities designated under this 

provision in the CSA.’’ 80 FR at 29,089 

[footnote omitted]. This sentence does 


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not appear to support the Government’s 

Factor Three argument. 

Regarding David D. Miller, M.D., the 

decision explains that the doctor pled 

nolo contendere in state court to the 

unlawful distribution of marijuana and 

concluded that this plea ‘‘established a 

prima facie case under factor three.’’ 60 

FR at 54,512 [emphasis added]. I agree 

with this conclusion. 21 U.S.C. 

823(f)(3). I note that, according to the 

record evidence before me in this 

matter, Respondent pled to a seconddegree State felony ‘‘possession’’ charge, 

not to a charge about ‘‘the manufacture, 

distribution, or dispensing of controlled 

substances.’’ Id.; see also RFAAX 4, at 

1 (memorializing Respondent’s Judicial 

Confession that she ‘‘did intentionally 

and knowingly possess and attempt to 

possess a controlled substance, namely: 

HYDROMORPHONE, by 

misrepresentation, fraud, forgery, 

deception and subterfuge’’). 

For all of these reasons, I conclude 

that the record before me contains no 

evidence, or contains insufficiently 

developed evidence, to support my 

crediting the Government’s Factor 

Three-related argument. Accordingly, I 

do not find record evidence that fits the 

‘‘manufacture, distribution, or 

dispensing of controlled substances’’ 

criteria of Factor Three. 

4. Factor Five—Such Other Conduct 

Which May Threaten the Public Health 

and Safety 

As already discussed, the record 

contains substantial evidence, 

submitted both by the Government and 

by Respondent, about Respondent’s 

conduct which may threaten the public 

health and safety. See, e.g., supra 

section II.F. First, according to the 

‘‘Specific Panel Findings’’ of the Agreed 

Order, the TMB found that 

Respondent’s diversion of drugs through 

the Pyxis system ‘‘impacted patient care 

and involved lying to patients and her 

employer.’’ RFAAX 3, at 2 and RFAAX 

11, at 10. 

Second, based on all of its Findings 

and the correlation of its Findings with 

legal requirements, the TMB concluded 

that there were multiple ways that 

Respondent’s conduct may threaten the 

public health and safety. RFAAX 3, at 

3–4 and RFAAX 11, at 11–12. It 

concluded that Respondent was unable 

to ‘‘practice medicine with reasonable 

skill and safety to patients,’’ because of 

excessive substance use or a mental or 

physical condition. RFAAX 3, at 3 and 

RFAAX 11, at 11. The TMB concluded 

that Respondent had failed to ‘‘practice 

medicine in an acceptable professional 

manner consistent with public health 

and welfare’’ due to, among other 

things, her negligence in performing 

medical services, improper diligence in 

her professional practice, her failure to 

safeguard against potential 

complications, and her inappropriate 

prescription of dangerous drugs or 

controlled substances. RFAAX 3, at 3– 

4 and RFAAX 11, at 11–12. The TMB 

also concluded that ‘‘Respondent’s use 

of alcohol or drugs in an intemperate 

manner . . . could endanger the lives of 

patients.’’ RFAAX 3, at 4 and RFAAX 

11, at 12. Further, the TMB concluded 

that Respondent engaged in 

‘‘unprofessional or dishonorable 

conduct that is likely to deceive or 

defraud the public or injure the public.’’ 

RFAAX 3, at 4 and RFAAX 11, at 12. 

I find that these matters directly 

implicate Factor Five and strongly 

weigh against Respondent. 

5. Summary of Factors One, Two, Three, 

Four, and Five 

As I found above, the Agreed Order is 

not a direct recommendation for 

purposes of Factor One, but it does 

indicate a possible response to some of 

the allegations and evidence before me. 

Supra section III.D.1. While the fact that 

the Agreed Order conditioned 

Respondent’s medical license, as 

opposed to revoking or suspending it, is 

not dispositive of the public interest 

inquiry in this case and is minimized 

due to the differences in the charges 

underlying the Agreed Order and the 

OSC charges, I consider the fact that the 

TMB conditioned Respondent’s medical 

license, as opposed to revoking or 

suspending it, and I give that aspect of 

the Agreed Order minimal weight in 

Respondent’s favor. Id. 

Regarding Factors Two and Four, I 

find substantial record evidence, 

including from Respondent’s 

admissions, of her negative controlled 

substance dispensing experience, her 

diversion of controlled substances, and 

her noncompliance with applicable 

laws relating to controlled substances. 

See, e.g., supra section II.F. and section 

III.D.2. I give this record evidence 

significant weight against Respondent. 

Regarding Factor Three, I find no 

relevant record evidence. 

Regarding Factor Five, I find 

substantial record evidence that 

Respondent engaged in conduct which 

may threaten the public health and 

safety. Supra, e.g., section II.F. and 

section III.D.4. I give this record 

evidence significant weight against 

Respondent. 

Accordingly, I conclude that it would 

be ‘‘inconsistent with the public 

interest’’ for Respondent to retain her 

registration due to the significant record 

evidence implicating Factor Two, Factor 

Four, and Factor Five, despite the 

record evidence implicating Factor One, 

and regardless of the lack of record 

evidence implicating Factor Three. 21 

U.S.C. 824(a)(4) and 21 U.S.C. 823(f); 

see Wesley Pope, 82 FR 14,944, 14,985 

(2017). 

IV. Sanction 

Where, as here, the Government 

presented three, independent bases for 

the revocation of Respondent’s 

registration, and Respondent did not 

present evidence rebutting any of the 

three bases, it is then up to Respondent 

‘‘to assure the Administrator’’ that she 

‘‘can be entrusted with the 

responsibilit[ies] that accompany 

registration.’’ White v. Drug Enf’t 

Admin., 626 F. App’x 493, 496 (5th Cir. 

2015); see also Jones Total Health Care 

Pharmacy, LLC v. Drug Enf’t Admin., 

881 F.3d 823, 830 (11th Cir. 2018) 

(quoting Akhtar-Zaidi v. Drug Enf’t 

Admin., 841 F.3d 707, 711 (6th Cir. 

2016)); MacKay v. Drug Enf’t Admin., 

664 F.3d 808, 816 (10th Cir. 2011) 

(quoting Volkman v. Drug Enf’t Admin., 

567 F.3d 215, 222 (6th Cir. 2009) 

quoting Hoxie v. Drug Enf’t Admin., 419 

F.3d 477, 482 (6th Cir. 2005)). As the 

Fifth Circuit also stated, ‘‘[s]uch 

evidence includes acceptance of 

responsibility and a demonstration that 

the . . . [Respondent] ‘will not engage 

in future misconduct.’ ’’ White v. Drug 

Enf’t Admin., 626 F. App’x at 496; see 

also Pharmacy Doctors Enterprises, Inc. 

v. Drug Enf’t Admin., 789 F. App’x, 724, 

733 (2019) (citing Jones Total Health 

Care Pharmacy, LLC v. Drug Enf’t 

Admin., 881 F.3d at 831 (citing MacKay 

v. Drug Enf’t Admin., 664 F.3d at 820 

(noting that past performance is the best 

predictor of future performance and, 

when a registrant has ‘‘failed to comply 

with . . . [her] responsibilities in the 

past, it makes sense for the agency to 

consider whether . . . [she] will change 

. . . [her] behavior in the future’’) and 

Alra Labs., Inc. v. Drug Enf’t Admin., 54 

F.3d 450, 452 (7th Cir. 1995) (‘‘An 

agency rationally may conclude that 

past performance is the best predictor of 

future performance.’’))). 

The Agency has decided that the 

egregiousness and extent of misconduct 

are significant factors in determining the 

appropriate sanction. Garrett Howard 

Smith, M.D., 83 FR 18,882, 18,910 

(2018) (collecting cases); Samuel 

Mintlow, M.D., 80 FR at 3652 

(‘‘Obviously, the egregiousness and 

extent of a registrant’s misconduct are 

significant factors in determining the 

appropriate sanction.’’). The Agency has 

also considered the need to deter similar 

acts in the future by Respondent and by 

the community of registrants. Garrett 


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19 I do not consider remedial measures when a 

Respondent does not unequivocally accept 

responsibility. As discussed, the scope of 

Respondent’s presentation of remedial efforts was 

limited and, therefore, unpersuasive and not 

reassuring. 

Howard Smith, M.D., 83 FR at 18,910; 

Samuel Mintlow, M.D., 80 FR at 3652. 

In terms of egregiousness, the 

violations that the substantial record 

evidence shows Respondent committed 

go to the heart of the CSA: Not 

complying with the closed regulatory 

system devised to ‘‘prevent the 

diversion of drugs from legitimate to 

illicit channels’’ and not prescribing 

controlled substances in compliance 

with the applicable standard of care and 

in the usual course of professional 

practice. Gonzales v. Raich, 545 U.S. at 

13–14, 27. 

Respondent’s submissions address her 

acceptance of responsibility. RFAAX 10 

and RFAAX 11. According to her 

Written Statement, she has ‘‘always 

taken 100% responsibility’’ for her 

diversion of controlled substances.’’ 

RFAAX 10, at 1. It also states that she 

does ‘‘not deny nor . . . [has she] ever 

in the past the unfortunate course of 

actions . . . [she] decided to take by 

diverting controlled substances.’’ Id. at 

2. Her Written Statement continues with 

her ‘‘accept[ing] sole responsibility and 

. . . [stating that she has] taken actions 

to become sober and healthy and 

continue[s] to do such.’’ Id. 

Respondent’s choice to submit a 

Written Statement, instead of taking 

advantage of her right to a hearing, 

means that she cannot answer questions 

about her acceptance of responsibility. 

The several areas of concern I have 

about her acceptance of responsibility, 

therefore, remain unresolved. First, 

Respondent’s statements accepting 

responsibility are expressed only in the 

general terms of diverting controlled 

substances. Id. at 1, 2. Second, she does 

not accept responsibility for all of the 

OSC’s founded allegations. Instead, she 

is explicit in her ‘‘deni[al of] all the 

above charges against her,’’ meaning, at 

least, the OSC charges that she was 

convicted of a felony relating to a 

controlled substance and that she 

materially falsified her registration 

renewal application. RFAAX 11, at 1. 

Third, she does not address, let alone 

accept responsibility for, the conduct 

the TMB found as a basis for 

disciplining Respondent. RFAAX 3, at 

3–5 and RFAAX 11, at 11–13. 

Consequently, Respondent’s 

acceptance of responsibility is not broad 

enough to encompass all of the Agency’s 

charges against her. RFAAX 3, at 3–5 

and RFAAX 11, at 1, 11–13. As such, it 

is not unequivocal, as the Agency 

requires. Jeffrey Stein, M.D., 84 FR 

46,968, 46,972–73 (2019) (unequivocal 

acceptance of responsibility); Jayam 

Krishna-Iyer, M.D., 74 FR 459, 463 

(2009) (collecting cases). These 

deficiencies are concerning as they may 

mean that Respondent is not ready and/ 

or willing to appreciate (1) the full 

extent of her misconduct and the (2) 

breadth of the harm her misconduct 

caused. I am also left wondering what 

Respondent learned from her 

misconduct, and whether Respondent 

has the resources to avoid committing 

the misconduct again. 

For example, Respondent’s statements 

accepting responsibility connect this 

acceptance with a violation of ‘‘the oath 

. . . [she] took as a physician and 

trusted public figure.’’ RFAAX 10, at 1. 

This, of course, is good and appropriate, 

and it ties into her statements that she 

has ‘‘done everything in . . . [her] 

power to correct . . . [her] actions,’’ and 

that ‘‘she continue[s] to work hard at 

maintaining sobriety and gain[ing] the 

trust of those that . . . [she has] lost, 

including the public.’’ Id. Her 

acceptance of responsibility does not 

appear to extend beyond the impact of 

her misconduct on herself, her sobriety, 

and the public’s perception of her 

trustworthiness. For example, she 

focuses on herself as she characterizes 

as ‘‘unfortunate’’ Parkland Hospital’s 

taking legal action concerning her 

diversion of controlled substances. 

RFAAX 10, at 1; supra section II.F. She 

does not mention, let alone 

unequivocally accept responsibility for, 

potentially endangering the lives of the 

Hospital’s patients. RFAAX 3, at 3–4 

and RFAAX 11, at 11–12. By way of 

further example, she does not 

acknowledge that her misconduct, not 

complying with the closed regulatory 

system devised to ‘‘prevent the 

diversion of drugs from legitimate to 

illicit channels,’’ goes to the heart of the 

CSA. Gonzales v. Raich, 545 U.S. at 13– 

14, 27. Her stated ‘‘hard work’’ goes to 

‘‘maintaining sobriety and gain[ing] the 

trust of those that . . . [she has] lost, 

including the public,’’ but not, 

apparently, also to regaining the trust of 

the Agency whose statutory 

responsibilities include determining 

who may be entrusted with the 

responsibilities of a controlled 

substance registration. 

For all of the above reasons, it is not 

reasonable for me, at this time, to trust 

that Respondent will comply with all 

controlled-substance related legal 

requirements in the future.19 Alra Labs., 

Inc. v. Drug Enf’t Admin., 54 F.3d at 452 

(‘‘An agency rationally may conclude 

that past performance is the best 

predictor of future performance.’’). 

Accordingly, I shall order that 

Respondent’s registration be revoked 

and that all pending applications to 

renew or modify Respondent’s 

registration, and any pending 

application for a new registration in 

Texas, be denied. 

Order 

Pursuant to 28 CFR 0.100(b) and the 

authority vested in me by 21 U.S.C. 

824(a) and 21 U.S.C. 823(f), I hereby 

revoke DEA Certificate of Registration 

No. FG2374053 issued to Erica N. Grant, 

M.D. Pursuant to 28 CFR 0.100(b) and 

the authority vested in me by 21 U.S.C. 

824(a) and 21 U.S.C. 823(f), I further 

hereby deny any pending application of 

Erica N. Grant, M.D., to renew or modify 

this registration, as well as any other 

pending application of Erica N. Grant, 

M.D. for registration in Texas. This 

Order is effective August 27, 2021. 

Anne Milgram, 

Administrator. 

[FR Doc. 2021–16003 Filed 7–27–21; 8:45 am] 

BILLING CODE 4410–09–P 

DEPARTMENT OF JUSTICE 

[OMB Number 1121–0277] 

Agency Information Collection 

Activities; Proposed Collection and 

Comments Requested; Reinstatement 

With Change of Previously Approved 

Collection #1121–0277: OJJDP’s 

National Training and Technical 

Assistance Center (NTTAC) Feedback 

Form Package 

AGENCY: Office of Juvenile Justice and 

Delinquency Prevention (OJJDP), 

Department of Justice. 

ACTION: 60-Day notice. 

SUMMARY: The Office of Juvenile Justice 

and Delinquency Prevention, 

Department of Justice (DOJ), will be 

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review and approval in accordance with 

the Paperwork Reduction Act of 1995. 

DATES: Comments are encouraged and 

will be accepted for 60 days until 

September 27, 2021. 

FOR FURTHER INFORMATION CONTACT: If 

you have comments, especially on the 

estimated public burden or associated 

response time, suggestions, or need a 

copy of the proposed information 

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or additional information, please 

contact Jill Molter, Web Content 

Manager, OJJDP’s NTTAC COR at 202– 

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