Notice2021-19194
Uvienome Linda Sakor, N.P.; Decision and Order
Primary source
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Published
September 7, 2021
Issuing agencies
Justice DepartmentDrug Enforcement Administration
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<title>Federal Register, Volume 86 Issue 170 (Tuesday, September 7, 2021)</title>
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[Federal Register Volume 86, Number 170 (Tuesday, September 7, 2021)]
[Notices]
[Pages 50173-50180]
From the Federal Register Online via the Government Publishing Office [<a href="http://www.gpo.gov">www.gpo.gov</a>]
[FR Doc No: 2021-19194]
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DEPARTMENT OF JUSTICE
Drug Enforcement Administration
Uvienome Linda Sakor, N.P.; Decision and Order
I. Introduction
On June 19, 2019, the Assistant Administrator, Diversion Control
Division, Drug Enforcement Administration (hereinafter, DEA or
Government), issued an Order to Show Cause (hereinafter, OSC) to
Uvienome Sakor, N.P., also known as Uvienome Linda Sakor, N.P.,
(hereinafter, Respondent) of Douglasville, Georgia. OSC, at 1. The OSC
proposed the revocation of Respondent's Certificate of Registration No.
MS1972101, the denial of any pending applications for renewal or
modification of that registration, and the denial of any applications
for additional DEA registrations for two reasons. Id. First, it alleged
that Respondent ``materially falsified multiple renewal applications .
. . filed with the DEA.'' Id. (citing 21 U.S.C. 824(a)(1)). Second, it
alleged that Respondent ``pled guilty to a felony relating to
controlled substances.'' OSC, at 1 (citing 21 U.S.C. 824(a)(2)).
Specifically, the OSC alleged that Respondent entered a guilty plea
in Georgia Superior Court to one count of Forgery in the First Degree
``for attempting to fill a forged controlled substance prescription.''
OSC, at 2. This OSC allegation acknowledged that, under Georgia's First
Offender Act, Respondent was discharged from probation, was exonerated
of any criminal purpose, and is not considered to have a criminal
conviction. Id.
Second, the OSC alleged that Respondent entered into a Consent
Order with the Georgia Board of Nursing (hereinafter, GBN) for her
failure to report her Forgery guilty plea as required by Georgia
statute. Id. It also alleged that the Consent Order placed Respondent
on probation for two years. Id.
Third, the OSC alleged that Respondent submitted three materially
false registration renewal applications after her guilty plea because
she did not respond affirmatively to the first Liability question. Id.
at 2-3. Similarly, the OSC alleged that Respondent submitted two
materially false registration renewal applications after the beginning
of the Consent Order's probationary period because she did not respond
affirmatively to the third Liability question. Id. at 3.
Fourth, the OSC alleged that Respondent's guilty plea to the state
Forgery charge implicates 21 U.S.C. 824(a)(2). Id.
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 4 (citing 21
CFR 1301.43). The OSC also notified Respondent of the opportunity to
submit a corrective action plan. OSC, at 4-5 (citing 21 U.S.C.
824(c)(2)(C)).
The Government forwarded its Request for Final Agency Action
(hereinafter, RFAA), along with the evidentiary record, to this office
on September 5, 2019. Attached to the RFAA is the Declaration of a DEA
Diversion Investigator (hereinafter, DI) that is signed and sworn to
under penalty of perjury. RFAA Exhibit (hereinafter, RFAAX) 6
(Declaration of Diversion Investigator, dated September 5, 2019
(hereinafter, DI Declaration)). The DI Declaration states that the DI
``personally served'' the OSC on Respondent at her registered location
on June 24, 2019. Id. at 3. I credit the DI's sworn statement.
Respondent waived her right to a hearing and filed a written
statement. RFAAX 3 (Respondent's Written Statement, dated July 17, 2019
(hereinafter, Written Statement)), at 1. Her Written Statement
explicitly references the OSC. Id.
Based on all of the evidence in the record, I find that the
Government's service of the OSC was legally sufficient. In addition,
based on all of the evidence in the record, I find that Respondent
timely filed her Written Statement. 21 CFR 1301.43.
I issue this Decision and Order based on the Government's
submission, which includes the Written Statement, 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.
MS1972101 at the registered address of 6559 Church St., Douglasville,
GA 30134-1885. RFAAX 1 (Certification of Registration History, dated
September 4, 2019), at 1. Pursuant to this registration, Respondent is
authorized to dispense controlled substances in schedules III through V
as a MLP-nurse practitioner.\1\ Id. Respondent's registration expired
on February 28, 2021, and is in an ``active pending status.'' Id.
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\1\ MLP means Mid-Level Practitioner. 21 CFR 1300.01(b).
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B. The Investigation of Respondent
According to the DI assigned to this matter, ``a large number of
prescriptions that had been issued by . . . [Respondent] had been
filled'' at a pharmacy the DI was investigating, and Respondent is the
sister of the pharmacy's owner. RFAAX 6, at 1. The DI Declaration
states that Respondent ``previously had been convicted of a felony
involving forgery and that her nursing license had been placed on
probation.'' Id. According to the DI Declaration, the DI's
investigation included obtaining certified copies of records of the
Superior Court of Douglas County and of the GBN. Id. at 2; see also
infra section II.C.
C. The Government's Case
The Government's case includes five exhibits, one of which is the
Written Statement.
The first exhibit is the Certification of Registration History.
RFAAX 1. According to that Certification, Respondent submitted to the
Agency registration renewal applications on December 31, 2011, February
25, 2015, and January 5, 2018. Id. at 1. On each of the three
submissions, the Certification of Registration History states,
Respondent answered ``No'' to whether she ``has . . . ever been
convicted of a crime in connection with controlled substance(s) under
state or federal law, . . . or any such action pending.'' Id. at 1-2,
4, 7, 10. Further, on each of the three submissions, according to the
Certification of Registration History, Respondent answered ``No'' to
whether she ``has
[[Page 50174]]
. . . ever surrendered (for cause) or had a state professional license
or controlled substance registration revoked, suspended, denied,
restricted, or placed on probation, or is any such action pending.''
Id. at 2, 4, 7, 10.
The next exhibit is the OSC, RFAAX 2, and the third exhibit is the
Written Statement, RFAAX 3.
The next exhibit consists of ten documents certified by the ``Clerk
Superior/State Court'' as true and correct copies from case ``10CR00980
State of Georgia vs. Linda U. Sakor.'' \2\ RFAAX 4, at 1; see also
RFAAX 6, at 2. The first document is one page consisting of the
``Petition for Discharge of Defendant (First Offender Act)'' and the
signed ``Order of Discharge,'' dated March 20, 2012. RFAAX 4, at 2. In
this document, a probation officer states that Respondent is ``eligible
for discharge as shown by having fulfilled the term of . . . probation
and upon review of . . . [her] criminal record.'' Id. Below the
probation officer's statement, the Court's signed Order of Discharge
states that (1) Respondent is ``discharged without Court adjudication
of guilt,'' (2) the ``discharge shall completely exonerate . . .
[Respondent] of any criminal purpose,'' (3) the ``discharge shall not
affect any of . . . [Respondent's] civil rights or liberties,'' (4)
Respondent ``shall not be considered to have a criminal conviction,''
and (5) the ``discharge may not be used to disqualify a person in any
application for employment or appointment to office in either the
public or private sector by reason of criminal conviction . . . unless
otherwise provided by law.'' Id.
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\2\ Although the certification for RFAAX 4 references ``Linda U.
Sakor,'' five of the documents in RFAAX 4 refer to ``Uvienome Linda
Sakor,'' three of the documents refer to ``Linda Sakor,'' one
document refers to ``Linda U. Sakor,'' and one document does not
refer to anyone by name. RFAAX 4, at 2 (Linda U. Sakor); id. at 3-26
(Uvienome Linda Sakor); id. at 27-30 (Linda Sakor); id. at 31 (no
name). I find substantial record evidence that all of the documents
in RFAAX 4 pertain to Respondent.
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The second document, consisting of fifteen pages, is the
``Transcript of Proceedings'' of the criminal hearing on November 18,
2010. Id. at 3-17. The Transcript states that Respondent was present
with her attorney ``to enter a negotiated guilty plea.'' Id. at 4.
According to the Assistant District Attorney (hereinafter, ADA),
Respondent changed employers in July of 2008. Early in 2009, the ADA
stated, Respondent presented a prescription for hydrocodone,
purportedly issued by her previous employer, to be filled at a
pharmacy. Id. at 9. The ADA indicated that Respondent had forged the
prescription in the name of her previous employer. Id. at 10. He also
stated that ``[t]here's no evidence that there were any other forged
prescriptions presented'' by Respondent. Id.; see infra section II.E.
Respondent's Public Defender added that Respondent had ``retained the
[prescription] pad after she had left their employ and basically she
wrote prescriptions out for herself which basically she would have to
have gone back to the doctor to get that authorized prior to the time
this was done and that's not the way it was done.'' RFAAX 4, at 13
[emphasis added]; see infra section II.E.
When the Court invited her to speak, Respondent stated that ``nurse
practitioners actually do have the authority and . . . [she has] the
authority, . . . [has] the license to write prescriptions for people in
the State of Georgia as in many other states, and that is part of . . .
[her] job.'' RFAAX 4, at 14-15. She did not mention the controlled
substance schedule parameters, schedules III through V, of her federal
authority to issue controlled substance prescriptions. She finished by
stating that she ``did the wrong thing in writing it for . . .
[her]self.'' Id. at 15. When the Court asked her why she forged the
prescription, she stated that she ``was having severe pain and could
not make it to . . . [her] doctor's office.'' Id. When the Court asked
her, she denied having ``any sort of drug abuse problem.'' Id. The
Transcript ends with the Court imposing the recommended sentence and
treating Respondent as a first offender. Id. at 15-16.
The third document is the one-page Plea Sheet filed on November 18,
2010. Id. at 18. The Plea Sheet shows that Respondent pled guilty to
one count, that she was to undergo substance abuse counseling, that she
was fined $1,000, and that she received a sentence of five years'
probation with the possibility of four years being suspended ``after
completion of 1st year of probation successfully.'' Id.
The fourth document is the one-page Waiver of Rights, dated
November 18, 2010. Id. at 19. This document, signed by Respondent and
her attorney, lists the rights that Respondent waived by pleading
guilty. Id. Over the Court's signature, the document states that
``inquiry has been made of the . . . [Respondent] concerning the rights
listed,'' that the Court is ``satisfied there is an adequate factual
basis to support the guilty plea,'' and that the Court is satisfied
that Respondent ``is acting knowingly, freely and voluntarily and no
promise, threat or force has been used to induce the . . . [Respondent]
to enter this plea.'' Id.
The document comprising the next three pages is the ``First
Offender Treatment Order,'' the ``General Conditions of Probation,''
and the ``Special Conditions of Probation Imposed Pursuant to Code 42-
8-34.1,'' dated November 18, 2010. Id. at 20-22. This document shows
that Respondent ``negotiated'' a guilty plea to one count and was
sentenced to five years, which may be served on probation, and the
payment of a $1,000 fine. Id. at 20-21.
The sixth set of documents concerns the ``Felony Accusation'' about
Respondent. Id. at 23-26. The documents indicate that Respondent pled
guilty to one count of ``Forgery in the First Degree (O.C.G.A. 16-9-
1)'' on November 18, 2010. Id. at 23, 24, and 26. Her attorney and the
ADA signed the fully completed document along with Respondent. Id. at
26.
The next two documents, ``Entry of Appearance; and Notice of Intent
to Engage in Reciprocal Discovery'' and ``Rule 5.2(2) Certificate of
Service of Discovery,'' dated April 24, 2010, show that Respondent was
represented by counsel at the proceedings. Id. at 27-28. These
documents also show two ``unindicted'' case numbers. Id.
The ninth document is the two-page ``Affidavit for Arrest''
concerning Respondent, signed by a Douglas County Magistrate Judge on
March 30, 2010. Id. at 29-30. The first page shows a warrant in the
matter of ``The State of GA vs. [Respondent]'' charging four counts of
Forgery, a Felony in the First Degree, with bail set at $16,000. Id. at
29. The second page of the ``Affidavit for Arrest'' shows a warrant in
the matter of ``The State of GA vs. [Respondent]'' charging one count,
Theft by Taking, a misdemeanor, with bail set at $1,000. Id. at 30.
The tenth and final document is entitled ``Arrest Warrant, County
of Douglas, State of Georgia, Exhibit: A page 1 of 1'' to the Forgery
in the First Degree ``Affidavit for Arrest,'' filed on April 2010.\3\
Id. at 31. The ``Arrest Warrant'' describes four counts of Forgery in
the First Degree. The first count concerns the ``knowing,'' ``with
intent to defraud'' making of a ``certain writing in such a manner that
the writing as made purports to have been made by authority of one . .
. who did not give such authority at another time and did deliver said
writing being a prescription for Hydrocodon [sic] and Phenergan.'' Id.
The other three counts specifically concern the delivery to a pharmacy
of forged prescriptions for Vicodin and Phenergan on September 8, 2009,
Tussionex Pennkinetic on
[[Page 50175]]
November 6, 2009, and Vicodin, Ibuprofin, and Phenergan on November 11,
2009. Id.
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\3\ The day in April is not legible. RFAAX 4, at 31.
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The first page of the next exhibit is the Certification of the GBN,
dated July 23, 2019, concerning its Consent Order with Respondent and
the statement that ``Respondent has met the terms and conditions
outlined in this order.'' RFAAX 5, at 1. The second page is the GBN
letter to Respondent, dated July 20, 2015, advising Respondent that her
``license is unencumbered and free of the conditions imposed by'' the
Consent Order. Id. at 2.
The remaining ten pages of RFAAX 5 is the June 25, 2013 Consent
Order between Respondent and the GBN. Id. at 3-11. The first page of
the Consent Order states that Respondent pled guilty, ``[o]n or about
November 18, 2010,'' to the ``felony criminal offense of Forgery, First
Degree in the Superior Court of Douglas County.'' Id. at 3. It also
states that ``Respondent failed to report her felony conviction to the
Board within ten (10) days of such conviction as required'' by Georgia
statute. Id. Page three of the Consent Order states that, ``[u]pon the
effective date of this Consent Order, the Respondent's license to
practice as a registered professional nurse and authorization to
practice as an advanced practice nurse in the State of Georgia shall be
placed on probation for a period of two (2) years, or until lifted by
the Board.'' Id. at 5. The Consent Order specifies that ``this Consent
Order, once approved and docketed, shall constitute a public record,
evidencing disciplinary action by the Board.'' Id. at 10. The Consent
order was approved on June 20, 2013, and docketed on June 25, 2013. Id.
at 10, 3.
The last exhibit of the RFAA is the DI Declaration. RFAAX 6. In
addition to certifying some of the Government's other exhibits and
providing the origins of the investigation leading to the OSC, as
already discussed, the DI Declaration affirms that Respondent pled
guilty to one felony count ``for attempting to fill a forged controlled
substance prescription'' and ``agreed [with the GBN], among other
things, to be placed on probation for a period of two (2) years.'' Id.
at 2.
D. Respondent's Case
As already discussed, Respondent submitted a timely Written
Statement. Supra section I. In her Written Statement, Respondent stated
that she was responding to the ``material falsification of renewal
applications for . . . [her] DEA license'' by ``writ[ing] a statement
of explanation.'' \4\ RFAAX 3, at 1. Respondent began the explanation
by stating that ``[i]n the year 2008, . . . [she] made a very grave
mistake which . . . [she] will forever regret.'' Id. She elaborated,
stating that she ``wrote a prescription for . . . [her]self in 2008 on
a prescription pad which belonged to . . . [her] collaborating
physician.'' Id. The prescription, according to her Written Statement,
``was for Vicodin which is also known as Hydrocodone 5/500 mg.'' Id.
She ``did this,'' she stated, ``because . . . [she] was in severe
menstrual pain and could not make it to see . . . [her] personal
physician to prescribe this medication for . . . [her].'' Id.
Respondent wrote that she ``presented this prescription to a local
pharmacy who notified the physician . . . [she] worked with, and then
proceeded to notify the local authorities.'' Id. She stated that
``[s]ince then . . . [she has] undergone a lot of emotional stress
regarding the risk . . . [she] placed . . . [her] career in.'' Id.
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\4\ Respondent explicitly ``request[ed] a waiver of a hearing.''
RFAAX 3, at 1.
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According to her Written Statement, she pleaded nolo contendere and
``was sentenced under the first offender act [sic] and upon completion
of . . . [her] one-year probation was noted not to have a felony
conviction.'' Id. ``It was based on this understanding,'' Respondent
wrote, ``that . . . [she] responded to the questions in . . . [her]
subsequent DEA renewal applications.'' Id. Specifically, she admitted
that ``[i]n December of 2011 on . . . [her] DEA renewal application, .
. . [she] responded `No' to liability question 1 with the understanding
that . . . [she] was not guilty of a felony substance control
conviction.'' Id.
Regarding her nursing license, Respondent stated that she
``answered `Yes' on the renewal of . . . [her GBN] license to the
questions regarding a pleading Nolo Contedere [sic] and was then placed
on a two-year probationary period in 2013 which after careful
monitoring was lifted in 2013.'' Id. According to her Written
Statement, she ``underwent psychological evaluation and testing
requested by the . . . [GBN] which concluded that . . . [she] did not
have substance abuse problems and was able to practice safely as a
nurse.'' Id. Regarding the registration renewal applications she
submitted, she admitted that, in 2015 and 2018, she ``answered ``no''
to liability question 2 [sic] with the understanding because at that
time . . . [her] nursing license was no longer under probation.'' \5\
Id.
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\5\ Respondent may have meant to refer to Liability question
``3,'' not ``2.''
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Respondent addressed her three false answers to the first Liability
question on the registration renewal applications she submitted in
December, 2011, February, 2015, and January, 2018, and her two false
answers to the third Liability question on the registration renewal
applications she submitted in 2015 and in 2018. Id. She stated that she
``did not intentionally answer these questions to misrepresent or give
false information for . . . [her] DEA application.'' Id. Respondent
wrote that she ``also renewed . . . [her] Georgia nursing license and
when faced with similar questioning ha[s] answered yes to . . . [her]
Nolo Contendere plea with an explanation of the situation.'' Id. She
did not attach documentary evidence to support this assertion.
Respondent's Written Statement states that she ``prescribe[s]
medications to patients in . . . [her] role as a nurse practitioner''
and that she has practiced as a nurse, and then a nurse practitioner,
``for the past 25 years.'' Id. Respondent stated that she ``cannot
emphasize how sorry . . . [she] is that . . . [she has] placed
[her]self in such a position.'' Id. at 2. She stated that she is a
mother of two and a wife, that she has ``worked hard throughout . . .
[her] life to have a successful career which . . . [she] placed in
jeopardy,'' and that she is ``an upstanding member of . . . [her]
community and church and [has] never abused any medications.'' Id. The
Written Statement characterizes the ``circumstances'' as her
``unwittingly submit[ting] the wrong responses on . . . [her] renewal
applications,'' and, ``instead of a complete revocation'' of her
registration, ``appeal[s]'' for ``a period of either probation or
suspension with monitoring and the ability to reapply or renew'' her
registration. Id.
I find substantial record evidence that Respondent admitted, in her
Written Statement, to writing a prescription for herself in 2008 on a
prescription pad belonging to her collaborating physician. Id. at 1.
This wrongdoing by Respondent is not set out in the Government's case.
While the Government's case presents evidence of one negotiated guilty
plea by Respondent arising from events in 2009, I find substantial
record evidence that the Written Statement references ``a very grave
mistake'' of forgery by Respondent in 2008. Compare RFAAX 4, 3-16 and
id. at 29-31 with RFAAX 3, at 1; see also RFAAX 5, at 1 (referring to
Respondent's ``plea of guilty to the felony criminal offense of
Forgery, First Degree in the Superior Court of Douglas County . . .
pertain[ing] to her forging prescriptions in 2009 for pain medication
for her own use''). I further
[[Page 50176]]
find, based on substantial record evidence, that the ``Affidavit for
Arrest'' and the ``Arrest Warrant'' state that Respondent presented
four forged prescriptions for filling in 2009, the year after
Respondent's 2008 ``very grave mistake'' forgery admission described in
her Written Statement. RFAAX 4, at 29-31. I find substantial record
evidence that one of the instances described in the Arrest Warrant
corresponds to the facts underlying Respondent's negotiated guilty plea
according to the Transcript of that plea. Id. at 9.
There is substantial fact congruity between the evidence submitted
by the Government and Respondent's Written Statement. The glaring
exceptions to this substantial fact congruity are the number of
controlled substance prescription forgeries the evidence indicates and
the number of times Respondent pled to forging a controlled substance
prescription.
Regarding the number of controlled substance prescription forgeries
the evidence indicates, there are significant differences between the
Written Statement's description of the forgery Respondent states took
place in 2008, and the forgery underlying her 2009 guilty plea
documented in the Government's evidence along with the alleged
forgeries described in the Arrest Warrant. These significant
differences lead me to conclude that they describe two different
forgeries. For example, in its description of the four purported self-
prescribed controlled substance prescriptions, the Arrest Warrant
differentiates between brand names and generic names for controlled
substances. See, e.g., RFAAX 4, at 31 (Arrest Warrant description of
four purported self-prescribed controlled substance prescriptions for
``hydrocodone,'' ``Vicodin,'' ``Tussionex Pennkinetic,'' and
``Vicodin''). The Written Statement states that the forged prescription
she wrote for herself in 2008 ``was for Vicodin which is also known as
Hydrocodone 5/500 mg.'' RFAAX 3, at 1. The Transcript of Respondent's
guilty plea, on the other hand, describes the forged prescription of
2009 to have been for ``hydrocodone.'' RFAAX 4, at 7. While the Written
Statement explains that ``Vicodin is also known as Hydrocodone,'' this
is in direct contrast to the record evidence in the Arrest Warrant that
provides the precise name of the controlled substance entered on the
purportedly forged prescriptions. Accordingly, in this context, I find
that ``Vicodin,'' not ``hydrocodone,'' is a noteworthy departure and
points to two different forgeries.
By way of further example, according to the Written Statement,
Respondent wrote the Vicodin prescription for herself in 2008 ``on a
prescription pad which belonged to . . . [her] collaborating
physician'' and she ``presented this prescription to a local pharmacy
who notified the physician . . . [she] worked with and then proceeded
to notify the local authorities.'' RFAAX 3, at 1. According to the
Transcript of her 2009 guilty plea, by contrast, the prosecutor stated
that Respondent left the employ of a medical practice in 2008 to work
for another medical practice. RFAAX 4, at 9. Several months after that
job change, he stated, Respondent presented a forged hydrocodone
prescription written on a pad that belonged to the previous employer.
Id. at 9-10. The pharmacy contacted Respondent's new employer and then
the previous employer who ``informed them that he did not write or
authorize this prescription.'' Id. at 10. The previous medical practice
notified law enforcement. Id. Neither Respondent nor her Public
Defender corrected any part of these prosecutor statements. Instead,
the Public Defender added that Respondent had retained the prescription
pad from the former employer and forged the prescription while at the
subsequent employment. Id. at 11. I find that the differences between
the Written Statement and the guilty plea Transcript on these critical
points are too significant to result from faulty memory. I further find
that the absence of any correction of those differences by Respondent
or her Public Defender during the guilty plea proceeding means that the
2008 forgery described in the Written Statement and the forgery to
which Respondent pled guilty in 2009 are not the same. Consequently, I
find that the Written Statement describes a different forgery than the
forgery to which Respondent pled guilty and the forgeries alleged in
the Arrest Warrant. RFAAX 4, at 31. I consider the fact that the 2009
guilty plea for forging a controlled substance in the Government's
evidence was not an isolated incident in determining the appropriate
sanction.\6\ Infra section IV.
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\6\ Although I find this fact relevant to my determination of a
sanction, there is more than enough record evidence without it to
support revocation as a sanction based on the Government's prima
facie case.
---------------------------------------------------------------------------
Regarding the number of forgery pleas, the Written Statement
describes a 2008 nolo contendere plea for forging a controlled
substance prescription. RFAAX 3, at 1. The conviction described in the
Government's evidence is a 2009 guilty plea for forging a controlled
substance prescription on February 5, 2009. RFAAX 4, at 3-16; see also
RFAAX 5, at 1 (referring to Respondent's ``plea of guilty to the felony
criminal offense of Forgery, First Degree in the Superior Court of
Douglas County . . . pertain[ing] to her forging prescriptions in 2009
for pain medication for her own use''). I need not sort out whether
there were two pleas or one plea because the OSC alleges one felony
conviction and because I am carrying out the provisions of 21 U.S.C.
824 regarding that felony conviction alleged in the OSC. 28 CFR
0.100(b). Whether Respondent pled nolo contendere to a violation in
2008 is not an issue presented by the OSC, is not before me for
adjudication, and, therefore, I shall not resolve it.
E. Allegation That Respondent Has Been Convicted of a Felony Related to
a Controlled Substance (21 U.S.C. 824(a)(2))
I find that there is substantial record evidence that Respondent,
after leaving employment at a medical practice, retained a prescription
pad of a doctor in that medical practice. Id. at 13 (statement of
Respondent's attorney). I find that there is substantial record
evidence that Respondent used the prescription pad after leaving that
employment to ``wr[i]te prescriptions out for herself'' without
authorization of the doctor to whom the prescription pad belonged. Id.
(statement of Respondent's attorney). I find that there is substantial
record evidence that Respondent ``would have to have gone back to the
doctor to get that [prescription] authorized prior to the time this was
done and that's not the way it was done.'' Id. (statement of
Respondent's attorney).
I find that there is substantial record evidence that Respondent
presented for filling a controlled substance (hydrocodone) prescription
on February 5, 2009, that this prescription purported to be issued by a
doctor at her former employment, and that this prescription was one of
the unauthorized prescriptions Respondent wrote for herself on the
prescription pad of a doctor at her former employment. Id. at 9.
I find that there is substantial record evidence that the
pharmacist investigated this prescription. Id. at 10. I find that there
is substantial record evidence that the doctor for whom Respondent had
previously worked stated that he neither wrote nor authorized the
prescription, that this doctor notified his practice, and that the
practice notified law enforcement. Id. I find that there is substantial
record evidence that the prosecutor at Respondent's sentencing stated
that
[[Page 50177]]
``[t]here's no evidence that there were any other forged prescriptions
presented by . . . [Respondent].'' Id. I find that there is substantial
record evidence that Respondent's attorney stated that Respondent
``retained the [prescription] pad after she had left . . . [her prior
medical office employer's] employ and basically she wrote prescriptions
out for herself.'' Id. at 13. I further find that the ``Arrest
Warrant'' for Respondent describes four allegations of Forgery in the
First Degree, including presenting those forged prescriptions to a
pharmacy for filling, spanning February 5, 2009, through November 11,
2009. Id. at 31. I credit the statement of Respondent's attorney and
the items addressed in the ``Arrest Warrant'' for Respondent. I
conclude that the statement of Respondent's attorney, that Respondent
``wrote prescriptions for herself,'' was made to ensure that all of
Respondent's alleged criminality was subsumed in her guilty plea. Id.
at 13. Given, among other reasons, that the statement of Respondent's
attorney implicated Respondent in criminality in addition to the one
instance to which she pled guilty through a ``negotiated plea,'' I
credit the statement of Respondent's attorney, which I consider in my
determination of Respondent's appropriate sanction. Id. at 10; supra
section II.C.
Based on substantial record evidence, I find that Respondent
entered a negotiated guilty plea to Forgery in the First Degree, Ga.
Code Ann. 16-9-1, a Georgia felony, and that the Court accepted her
guilty plea on November 18, 2010. RFAAX 4, at 3-5, 9, 20, 26
(hydrocodone prescription); see also RFAAX 5, at 3 (``forging
prescriptions''). I find that there is substantial record evidence that
the facts underlying Respondent's First-Degree Felony conviction
include her having forged and presented for filling a controlled
substance, hydrocodone, prescription for herself, and that the Court
ordered Respondent discharged under the Georgia Probation for First-
Offenders Act. RFAAX 4, at 9-10; id. at 2.
F. Allegation That Respondent Materially Falsified Registration Renewal
Applications (21 U.S.C. 824(a)(1))
I find clear, unequivocal, and convincing evidence that, on
November 18, 2010, the Honorable William H. McClain, Superior Court
Judge of Douglas County, Georgia, found that Respondent pled guilty to
one count of Forgery in the First Degree under Georgia law, ``freely
and voluntarily, with a full knowledge, understanding in waiver of her
rights, there's a factual basis, and no promises, threats or force has
been used to induce'' her plea. Id. at 13; see also id. at 4-9. I find
clear, unequivocal, and convincing record evidence that the facts
underlying the Georgia felony to which Respondent pled guilty are that
she forged and presented for filling a controlled substance
(hydrocodone) prescription made out to herself on prescription paper
belonging to a former physician employer. Id. at 9-10, 13. I find
clear, unequivocal, and convincing record evidence that Judge McClain
accepted her guilty plea, imposed sentence, and treated Respondent as a
first offender on November 18, 2010. Id. at 15-16; see also id. at 20-
22. I find clear, unequivocal, and convincing record evidence that, on
November 18, 2010, when Judge McClain asked her before imposing
sentence if ``there [is] anything that . . . [she] would like to say,''
Respondent replied that she would ``[j]ust . . . enlighten people that
nurse practitioners actually do have the authority and . . . [she]
do[es] have the authority, . . . the license to write prescriptions for
people in the State of Georgia as in many other states, and that is
part of . . . [her] job.'' Id. at 14-15. I find clear, unequivocal, and
convincing record evidence that Respondent also stated that she ``did
the wrong thing in writing it for [her]self.'' Id. at 15. I find clear,
unequivocal, and convincing record evidence that, when Judge McClain
asked her whether she had ``any sort of drug abuse problem,''
Respondent answered, ``No, I do not.'' Id.
I find clear, unequivocal, and convincing record evidence that,
after her felony guilty plea and sentencing on November 18, 2010,
Respondent submitted registration renewal applications to the Agency on
December 31, 2011, on February 25, 2015, and on January 5, 2018. RFAAX
1, at 1-10; see also RFAAX 3, at 1-2. I find clear, unequivocal, and
convincing record evidence that, on those three registration renewal
applications, Respondent answered ``no'' to the first Liability
question that 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?'' RFAAX 1, at 1-2, 4, 7, 10. I find
clear, unequivocal, and convincing record evidence that Respondent
admitted in her Written Statement that she answered ``no'' to this
liability question ``in . . . [her] subsequent DEA renewal
applications.'' RFAAX 3, at 1. I find clear, unequivocal, and
convincing record evidence that Respondent stated that she provided
this negative answer in ``December of 2011 . . . with the understanding
that . . . [she] was not guilty of a felony substance control
conviction.'' Id.
I find clear, unequivocal, and convincing record evidence that, on
June 25, 2013, the GBN placed Respondent's Georgia Nurse Practitioner
license on probation for two years due to her ``fail[ure] to report her
felony conviction to the . . . [GBN] within ten (10) days of such
conviction.'' RFAAX 5, at 3-11, citing Ga. Code Ann. 43-1-27.\7\ I find
clear, unequivocal, and convincing record evidence that, after the GBN
placed her nurse practitioner license on probation on June 25, 2013,
Respondent submitted registration renewal applications to the Agency on
February 25, 2015 and on January 5, 2018. RFAAX 1, at 1-10; see also
RFAAX 3, at 1-2. I find clear, unequivocal, and convincing record
evidence that, on those two registration renewal applications,
Respondent answered ``no'' to the third Liability question that asked
whether she had ``ever surrendered (for cause) or had a state
professional license or controlled substance registration revoked,
suspended, denied, restricted, or placed on probation, or is any such
action pending.'' RFAAX 1, at 1-2, 4, 7, 10. I find clear, unequivocal,
and convincing record evidence that Respondent admitted in her Written
Statement that she answered ``no'' to this liability question in 2015
and in 2018. RFAAX 3, at 1. I find clear, unequivocal, and convincing
record evidence that Respondent stated that she provided these two
negative answers ``with the understanding because at that time . . .
[her] nursing license was no longer under probation.'' Id.
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\7\ ``Any licensed individual who is convicted under the laws of
this state, the United States, or any other state, territory, or
country of a felony as defined in paragraph (3) of subsection (a) of
Code Section 43-1-19 shall be required to notify the appropriate
licensing authority of the conviction within ten days of the
conviction. The failure of a licensed individual to notify the
appropriate licensing authority of a conviction shall be considered
grounds for revocation of his or her license, permit, registration,
certification, or other authorization to conduct a licensed
profession.''
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III. Discussion
A. The Controlled Substances Act
Under the Controlled Substances Act (hereinafter, 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
[[Page 50178]]
subchapter II; [or] (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,'' among
other reasons. 21 U.S.C. 824(a). The OSC alleged material falsification
and felony conviction as the proposed bases for revocation of
Respondent's registration. 21 U.S.C. 824(a)(1) and (2).
B. Allegation That Respondent Materially Falsified an Application (21
U.S.C. 824(a)(1))
As already discussed, I find clear, unequivocal, and convincing
record evidence that Respondent submitted to the Agency three
registration renewal applications containing a false answer to the
first Liability question. Supra section II.F. Also, as already
discussed, I find clear, unequivocal, and convincing record evidence
that Respondent submitted to the Agency two registration renewal
applications containing a false answer to the third Liability question.
Id. My findings that Respondent submitted these false answers to the
Agency stem from Respondent's conviction for violating a Georgia First-
Degree Felony when she forged and presented for filling a controlled
substance prescription for herself. Id.; infra section III.C. Further,
my fact findings directly implicate three of the factors I am
statutorily mandated to consider as I act on applications for
registration: The applicant's experience in dispensing controlled
substances, the applicant's conviction record under Federal or State
laws relating to the dispensing of controlled substances, and other
conduct which may threaten the public health and safety. 21 U.S.C.
823(f)(2), (3), and (5). Thus, Respondent's false responses on three
registration renewal applications directly implicated my statutorily-
mandated analyses and decisions by depriving me of legally relevant
facts when I evaluated those three registration renewal applications of
Respondent. RFAAX 1, at 1-11; see also Frank Joseph Stirlacci, M.D., 85
FR 45,229, 45,235 (2020). Accordingly, I find, based on the CSA and the
analyses underlying multiple Supreme Court decisions explaining
``materiality,'' that the five false Liability question responses
Respondent submitted to the Agency in the three registration renewal
applications at issue were material, and that the five false responses
are grounds for the suspension or revocation of her registration. 21
U.S.C. 824(a)(1); see Frank Joseph Stirlacci, M.D., 85 FR 45,235.
According to the Written Statement, Respondent ``responded `No' to
liability question 1 with the understanding that . . . [she] was not
guilty of a felony substance control conviction.'' RFAAX 3, at 1. Due
to the clear, unequivocal, and convincing record evidence, I do not
credit this portion of Respondent's Written Statement.\8\ See, e.g.,
RFAAX 4, at 9 and RFAAX 5, at 3; see also infra section III.C.
---------------------------------------------------------------------------
\8\ If Respondent intended to argue that her negotiated guilty
plea in 2010 and her treatment as a first offender mean that she was
not convicted of a First-Degree Felony, I reject her argument. The
Agency established over thirty years ago, and recently reiterated,
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 W. Redard, M.D., 65 FR 30,616, 30,618
(2000)). The same reasoning applies to treatment as a first
offender. I also note that the GBN Consent Order exists because
Respondent ``failed to report her felony conviction to the Board
within ten (10) days of such conviction as required by O.C.G.A.
Sec. 43-1-27.'' RFAAX 5, at 3.
---------------------------------------------------------------------------
Respondent's Written Statement also states that she ``answered `No'
'' to the third Liability question ``with the understanding because at
that time . . . [her] nursing license was no longer under probation.''
RFAAX 3, at 1. I do not credit this portion of Respondent's Written
Statement because the third Liability question asks whether the
applicant ``ever . . . had a state professional license . . . placed on
probation.'' RFAAX 1, at 4; id. at 10 [emphasis added].
C. Allegation That Respondent Has Been Convicted of a Felony Related to
Any Controlled Substance (21 U.S.C. 824(a)(2))
As already discussed, I find substantial record evidence that
Respondent entered a negotiated guilty plea to Forgery in the First
Degree, Ga. Code Ann. 16-9-1, a Georgia felony, on November 18,
2010.\9\ Supra section II.E. I also find substantial record evidence
that the facts underlying Respondent's First-Degree Felony conviction
include her having forged a controlled substance prescription for
herself. Id.
---------------------------------------------------------------------------
\9\ ``A person commits the offense of forgery in the first
degree when with intent to defraud he knowingly makes, alters, or
possesses any writing in a fictitious name or in such manner that
the writing as made or altered purports to have been made by another
person, at another time, with different provisions, or by authority
of one who did not give such authority and utters or delivers such
writing.'' Ga. Code Ann. Sec. 16-9-1 (West, Westlaw effective to
June 30, 2012).
---------------------------------------------------------------------------
Based on the facts I found in this matter, I conclude that
Respondent has been convicted of a felony under a State law relating to
a controlled substance. 21 U.S.C. 824(a)(2). First, to state the
obvious, the state of Georgia used its First-Degree Felony Forgery
statute to prosecute and convict Respondent of forging a controlled
substance prescription even though that Georgia statute does not
include the phrase ``controlled substance'' in its text. See n.9.
Georgia's choice of this forgery statute shows that Respondent was
convicted of a felony under a state law relating to any controlled
substance. 21 U.S.C. 824(a)(2).
Second, according to the Supreme Court, the phrase ``in relation
to'' is interpreted expansively, and means ``with reference to'' or
``as regards.'' Smith v. United States, 508 U.S. 223, 237 (1993). The
Smith decision involved an offer to trade an automatic weapon for
cocaine. 508 U.S. at 225. The decision addressed the question of
whether the exchange of a firearm for cocaine constitutes using a
firearm ``during and in relation to . . . [a] drug trafficking crime''
within the meaning of 18 U.S.C. 924(c)(1). Id. The Supreme Court's
analysis cited prior Supreme Court and appellate court decisions
interpreting the phrase ``in relation to'' and concluding that the
phrase should be interpreted expansively. Id. at 237; see, e.g.,
District of Columbia v. Greater Washington Board of Trade, 506 U.S.
125, 129 (1992) (``We have repeatedly stated that a law `relate[s] to'
a covered employee benefit plan . . . `if it has a connection with or
reference to such a plan.' . . . This reading is true to the ordinary
meaning of `relate to' . . . and thus gives effect to the `deliberately
expansive' language chosen by Congress.''); United States v. Harris,
959 F.2d 246, 261 (D.C. Cir. 1992) (per curiam) (``The only limitation
is that the guns be used ``in relation'' to the drug trafficking crime
involved, which we think requires no more than the guns facilitate the
predicate offense in some way.''); United States v. Phelps, 877 F.2d 28
(9th Cir. 1989) (concluding that the situation was ``unusual'' and not
covered, the court stated that ``the phrase `in relation to' is
broad'').
The Supreme Court also cited a dictionary definition in its
analysis. 508 U.S. at 237-38. It stated that ``[a]ccording to
Webster's, `in relation to' means `with reference to' or `as regards.'
'' Id. at 237. It concluded, thus, that the phrase ``in relation to,''
at a minimum, ``clarifies that the firearm must have some purpose or
effect with respect to the drug trafficking crime; its presence or
involvement cannot be the result of accident or coincidence.'' Id. at
238. The Court also stated that ``the gun at least must `facilitate[e],
or ha[ve] the
[[Page 50179]]
potential of facilitating,' the drug trafficking offense.'' Id.
Applying its analysis to the facts before it, the Court concluded that
the use of the firearm ``meets any reasonable construction'' of ``in
relation to'' because the gun was ``an integral part of the
transaction.'' Id. I apply these conclusions of the Supreme Court as I
analyze the record evidence before me.
According to the facts I already found, Respondent used the
prescription pad of a doctor at her former place of employment to write
a schedule II controlled substance prescription for herself. RFAAX 4,
at 9-10 and 13. My found facts also include that Respondent's
registration did not have schedule II authority. RFAAX 1, at 1. As
such, for Respondent to have any chance of obtaining a schedule II
controlled substance from a pharmacy by her efforts alone, she had to
present a prescription written on the prescription pad of, and
purportedly signed by, a registrant with schedule II authority. As my
found facts show, Respondent had already absconded with the
prescription pad of a doctor at her former place of employment and used
that prescription pad to prescribe a schedule II controlled substance
for herself, including forging the name of the registrant to whom the
prescription pad belonged. RFAAX 4, at 9-10 and 13. Under my found
facts, therefore, the use of the forged prescription was ``an integral
part of the transaction.'' Smith v. United States, 508 U.S. at 238.
Based on the Supreme Court's explanation of ``in relation to,'' I
conclude that Respondent's Georgia felony forgery conviction was ``with
reference to'' and ``as regards'' a controlled substance and,
accordingly, I also conclude that Respondent's felony forgery
conviction satisfies the terms of 21 U.S.C. 824(a)(2).
Third, prior Agency decisions have applied the felony conviction
provision of 21 U.S.C. 824(a)(2) to circumstances similar to those in
this matter. See, e.g., Samuel S. Jackson, D.D.S., 72 FR 23,848, 23,852
(2007) (conspiracy to be an accessory after the fact); Clark G.
Triftshauser, M.D., 67 FR 71,202, 71,203 (2002) (criminal possession of
a forged instrument); Charles A. Buscema, M.D., 59 FR 42,857, 42,858
(1994) (First-Degree Felony conviction for falsifying business records
about the dispensing of controlled substances, but ultimately not
finding for revocation); Lambert N. DePompei, M.D., 49 FR 37,862,
37,863 (1984) (possession of false or forged prescriptions are ``all
felony convictions relating to controlled substances''); Ontario Drugs,
Inc., Fullerton-Kedzie Pharmacy, Inc., 46 FR 16,004, 16,005 (1981)
(theft and forgery of controlled substance prescriptions).
Consequently, my finding that Respondent's Georgia forgery felony
guilty plea satisfies the terms of 21 U.S.C. 824(a)(2) is consistent
with Agency decisions issued in the last forty years.
For all of the above reasons, I conclude that the found facts in
this matter meet the requirements of 21 U.S.C. 824(a)(2). Accordingly,
I find that Respondent has been convicted of a felony related to any
controlled substance. 21 U.S.C. 824(a)(2).
In sum, I find that the record evidence supports two independent
legal bases for the suspension or revocation of Respondent's
registration--(1) five material falsifications in three registration
renewal applications and (2) Respondent's conviction of a felony
related to any controlled substance. 21 U.S.C. 824(a)(1) and (2).
IV. Sanction
Where, as here, the Government presented two, independent bases for
the suspension or revocation of Respondent's registration, and
Respondent did not present evidence rebutting either of the two 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 3630, 3652 (2015)
(``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
Howard Smith, M.D., 83 FR 18,910; Samuel Mintlow, M.D., 80 FR 3652.
In terms of egregiousness, the five instances of material
falsification and the felony conviction go to the heart of the CSA:
Non-compliance 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. 1, 13-14, 27 (2005). These material
falsifications and felony conviction alone support revocation.
Further, the uncontroverted record evidence, including Respondent's
admissions, shows that Respondent's forgery of controlled substance
prescriptions for herself spanned 2008 and 2009. Supra sections II.C.,
II.D., II.E., and II.F. The record evidence includes five instances of
Respondent's founded (including negotiated and admitted) or alleged
forgery of a controlled substance prescription. Id. The admittedly and
allegedly forged, self-prescribed controlled substance prescriptions,
Vicodin/hydrocodone (4) and Tussionex Pennkinetic (1), all include
hydrocodone, a highly abused schedule II controlled substance. Supra
sections II.C., II.D., and II.E. In this regard, I note Respondent's
sworn denials of ``any sort of drug abuse problem.'' Supra sections
II.C. and II.F. I also note, though, that Respondent's current
registration does not authorize her to issue schedule II controlled
substance prescriptions, and that Respondent allegedly forged two,
self-prescribed schedule II controlled substance prescriptions in one
month. Supra sections II.A., II.C., and II.E.
Respondent's submission does not address acceptance of
responsibility. See supra section II.D. Indeed, Respondent does not
even acknowledge the entirety of the OSC's charges against her. Her
Written Statement begins by stating that she is writing it about
``material falsification of renewal
[[Page 50180]]
applications for . . . [her] DEA license.'' RFAAX 3, at 1. At the end
of her Written Statement, Respondent asks for ``a period of either
probation or suspension with monitoring'' ``based on the circumstances
in which . . . [she] unwittingly submitted the wrong responses on . . .
[her] renewal applications.'' Id. at 2. In other words, Respondent does
not even acknowledge that the OSC also proposed the revocation of her
registration based on 21 U.S.C. 824(a)(2).
Further, the focus of her Written Statement is that she ``made a
very grave mistake which . . . [she] will forever regret.'' Id. at 1.
It points out that she has ``undergone a lot of emotional stress
regarding the risk . . . [she] placed . . . [her] career in.'' Id. The
Written Statement, however, does not move beyond the impact her
wrongdoing has on herself and her career. Id. at 1-2. It characterizes
her wrongdoing as ``unwittingly submitting the wrong responses,'' not
as violating the law and betraying the trust of her employer and the
Agency. Id. at 2.
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 admittedly and allegedly forged controlled
substance prescriptions and whether she accepts responsibility for her
wrongdoing. The areas of concern I have about her admitted and alleged
violations include how many times she forged controlled substance
prescriptions for herself, what controlled substances were involved,
why she forged the prescriptions, and what she did with the controlled
substances. The areas of concern I have about acceptance of
responsibility include whether, and for what, Respondent unequivocally
accepts responsibility. In other words, Respondent's recognition of
having made a ``grave mistake'' that placed her career in risk, the
resulting experience of ``a lot of emotional stress,'' and being
``sorry'' that she placed herself ``in such a position'' do not
constitute unequivocal acceptance of responsibility for her wrongdoing.
All of the areas of concern to me remain unresolved.
In sum, the record evidence raises, but does not answer, the extent
and degree of Respondent's wrongdoing and whether Respondent
unequivocally accepts responsibility for it 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. For
example, they may mean that Respondent does not appreciate (1) the full
extent of her wrongdoing and the (2) breadth of the harm her wrongdoing
caused. I am also left wondering what Respondent learned from her
wrongdoing, and whether Respondent has the resources to avoid future
wrongdoing.
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 legal requirements in the future.\10\ 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
Georgia, be denied.
---------------------------------------------------------------------------
\10\ I do not consider remedial measures when a Respondent does
not unequivocally accept responsibility. As discussed, the scope of
Respondent's discussion of remedial efforts was limited and,
therefore, unpersuasive and not reassuring.
---------------------------------------------------------------------------
Order
Pursuant to 28 CFR 0.100(b) and the authority vested in me by 21
U.S.C. 824(a), I hereby revoke DEA Certificate of Registration No.
MS1972101 issued to Uvienome Linda Sakor, N.P. Pursuant to 28 CFR
0.100(b) and the authority vested in me by 21 U.S.C. 824(a) and by 21
U.S.C. 823(f), I further hereby deny any pending application of
Uvienome Linda Sakor, N.P., to renew or modify this registration, as
well as any other pending application of Uvienome Linda Sakor, N.P. for
registration in Georgia. This Order is effective October 7, 2021.
Anne Milgram,
Administrator.
[FR Doc. 2021-19194 Filed 9-3-21; 8:45 am]
BILLING CODE 4410-09-P
</pre></body>
</html>Indexed from Federal Register on September 7, 2021.
This is legal information, not legal advice. Laws vary by jurisdiction and change frequently. Always verify current law with official sources and consult a licensed attorney in your jurisdiction for advice on your specific situation.