July 15, 2014

Ellington Psychiatrist Fined By The DEA Is Reprimanded By Med Board

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An Ellington psychiatrist who has already been fined $60,000 by state and federal officials for mishandling a drug called Suboxone was reprimanded Tuesday for the same violations by the state Medical Examining Board.

State and U.S. Drug Enforcement Administration records show that Dr. Erum Shahab had violated regulations in 2012 relating to the storage, documentation and dispensing of the drug, which is prescribed to heroin and prescription pill addicts because it suppresses withdrawal symptoms and cravings.

In October 2012, Shahab agreed to pay a $40,000 to the DEA, which said in a settlement agreement that she failed to properly document and maintain purchasing and dispensing records for Suboxone. The DEA also said she failed to conduct a biennial inventory of controlled substances and unlawfully possessed Suboxone outside of the scope of her license to dispense the drug.

A separate agreement Shahab reached in December 2012 with the state Department of Consumer Protection shows that Connecticut fined her $20,000 and placed her registration to prescribe controlled substances on probation for two years. DEA and the consumer protection department referred their case against Shahab to the state Department of Public Health in 2012.

DPH Staff Attorney David Tilles said these were some of the largest fines he has seen imposed by DEA and consumer protection in the more than 15 years he has been with the state agency. He said the manufacturer of Suboxone used to provide the drug directly to doctors such as Shahab, and investigators found that she did not adequately control her inventory of the drug.

“It was really sloppy,’’ he told the board.

Suboxone is now prescribed by doctors through pharmacies, rather than being dispensed directly to patients, and Shahab’s office procedures have been improved, Tilles said.

“She has no controlled substances in her office,’’ Katherine Callahan, a Hartford attorney representing Shahab, told the board.

Tilles said only a reprimand was sought because DPH did not want to duplicate the fines already imposed on Shahab and because it had no evidence to prove any lapses in the standard of care for her patients.

In an unrelated matter, Shahab made news in May when an analysis by Reuters showed that she had billed for 8,518 drug tests for 43 Medicare patients in 2012. Reuters reported that her billing averaged 198 drug tests per patient and was the highest level of any Medicare provider in 2012.

In other business Tuesday, the medical examining board fined an Old Saybrook doctor $4,000 for administering anesthesia to the wrong eye of a patient who was about to undergo cataract surgery.

The fine was approved as part of a consent order Dr. Lora Ann Stephens agreed to in connection with the July 16, 2013 incident. The incident occurred at an outpatient eye surgery facility in Waterford, and the center submitted a corrective action plan, which was accepted by the state Department of Public Health.

DPH records show that Stephens, who is employed by Norwich Anesthesia Associates at William W. Backus Hospital in Norwich, has since taken courses on patient safety. Stephens could not be reached for comment Tuesday.

Also Tuesday, the board also reprimanded Dr. Rudy Andriani, a Greenwich urologist, for prescribing controlled substances to himself, his wife, son and an employee without adequate documentation and outside of a proper doctor-patient relationship, according to the consent order Andriani signed.

The state investigation began when a drug wholesaler reported to the DEA that Andriani had been buying increasing quantities of controlled substances, the consent order said. For a year in 2012-2013, records show, Andriani nightly prescribed himself Alprazolam, which is commonly used to treat anxiety and panic disorder, and Triazolam, which is used to treat insomnia.

He occasionally prescribed himself Adderall, which is used to treat Attention Deficit Hyperactivity Disorder, and the sleeping pill Ambien, records show. Between June 2012 and April 2013, Andriani prescribed Alprazolam for his wife, and on one occasion when his son was away at college, he prescribed the son Adderall, records show.

Four times between August 2012 and September 2013, Andriani prescribed a 30-day supply of Adderall for an employee of his office who was not his patient, records show. Andriani could not be reached for comment Tuesday.

Tilles told the board that DPH did not ask the members to fine Andriani because he is not practicing medicine now and is not likely to practice again. Tilles also pointed out that Andriani has voluntarily surrendered his state registration to prescribe drugs.

While Tilles said Andriani’s action were “improper,” he added, “There wasn’t any evidence that he was enabling addiction for himself or his wife.”

In other business, the board voted unanimously to add a short period for public comment at its meetings at the urging of member Jean Rexford, who said it would help provide more transparency about the board’s actions.

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