Month: September 2015

How to shave months off the time it takes to conclude an appeal – Part I

Posted on September 30, 2015 by - Appellate

In a prior post, I discussed the time it takes, from start to finish, to conclude an appeal, and it can be a lengthy process. Today I will discuss the many opportunities a skilled appeals lawyer may seize to expedite an appeal, saving a client much time and therefore some expense.

For the purpose of this discussion, I will assume the role the appellant taking an appeal to the Oregon Court of Appeals. I do this for two reasons. First, the Oregon Court of Appeals is the busiest appellate court in Oregon and, second, the appellant is responsible for most of the work on appeal, and is therefore afforded the greatest number of opportunities to expedite the appeal. Some of the same opportunities will apply equally well, however, to the respondent on appeal.

The opportunities to expedite an appeal in the Oregon Court of Appeals, are as follows:

Entry of the judgment

This first opportunity to save time presents itself before the appeal is even filed. Although there are exceptions (not discussed here), most appeals are taken from a “judgment,” after it is “entered” in the registry. It is surprising, however, how long the parties and the trial court might take to prepare, negotiate, litigate, sign, file, and enter the judgment. In some cases, by nudging this process along, months can be saved by having the judgment prepared, signed, filed, and entered promptly, so that you can file your notice of appeal quickly after your loss in the trial court.

Filing the appeal

An appellant is allowed sufficient time, often 30 days (but not always), to prepare and file a notice of appeal, but there is no requirement to wait that long. By filing the notice of appeal early, you trigger the next event, and can easily shave three weeks off the time it takes to eventually conclude the appeal.

Preparation and filing of the trial court’s transcript of proceedings

After the notice of appeal is filed, the Court of Appeals will assign a court-approved transcriptionist, to convert the audio recording into a transcript of the trial court proceedings. Once the transcriptionist is notified by the Court of Appeals that he or she has been assigned the work, the transcriptionist will then contact the lawyer for the appellant, to provide an estimate of the cost, and to request pre-payment. At the same time, the transcriptionist will add this new assignment to his or her backlog of work, usually in the order received. If the transcriptionist needs more time, the transcriptionist can file his or her own motion in the Court of Appeals seeking an extension of time, and such motions are routinely granted by the Court. As you might guess, it may take several months or longer before the transcript is prepared and filed, especially if nobody is paying attention.

It is not necessary, however, to accept as fate this slow process. If your circumstances require otherwise, months can be saved by having the transcript prepared as soon as you know you will be appealing. Just be sure that you choose a court-certified transcriptionist and that you include his or her name in your notice of appeal, and further explain in your notice of appeal that the transcribing work is done, or already underway. This way, the Transcript Coordinator will know to assign the work to the transcriptionist you have already hired. In those cases where I want to save even more time, I will call a list of court-certified transcriptionists that I maintain in my office, to determine which transcriptionist is most available, and how soon he or she can get the work done.

Correction of the transcript

After the transcript is served and filed, there is a short period of time (14 days) to file a motion in the trial court to correct any errors in the transcript, and there are always errors in a transcript. Most of the time, however, the errors are insignificant. It is my practice never to file a motion to correct a transcript merely to fix typographical errors, misspellings, or other insignificant errors, if I can simply correct the error on appeal but using editorial insertions or references to other evidence, unless the typographical error, misspelling, or other thing goes to the heart of something that is important or dispositive on appeal.

If there is a risk of confusion on a key issue, or the error changes and important fact that you need on appeal, by all means, file the motion to correct the transcript. But remember, although the 14 day period to correct a transcript is short, the motion you file in the trial court may take a month, or several months, to resolve, before your appeal is back on track.

By avoiding an unnecessary motion to correct a transcript, you will save a month or more, not to mention the expense of the work. And remember, you cannot file your opening brief on appeal until the transcript is filed and “settled.” Settling the transcript requires the expiration of the 14 period to correct the transcript or, if a motion to correct has been filed, the entry of an order by the trial court correcting the transcript.

Preparation and filing of the opening brief on appeal

Although you are allowed 49 days from the settling of the transcript to file your opening brief, there is no requirement that you wait 49 days to file your opening brief. If you have followed my recommendations above, you will have obtained the transcript early, which means you can prepare your opening brief early too, and then file it soon (within days) after the transcript has settled. Once the opening brief is filed, the next deadline is triggered, for the other side to file its answering brief.

Preparation and filing of the reply brief on appeal

In many appeals, the appellant is permitted to file a reply brief. Other times, a reply brief may be optional, by leave (permission) of the Court of Appeals. Obviously, you cannot prepare the reply brief until you have the answering brief in hand, but if you know the answering brief is coming, you can reserve time on your calendar to do the work immediately, in order to get the reply brief filed early too. By planning ahead, you can save a month or longer in getting the reply brief filed.

Conclusion

The work itemized above is necessary for a basic appeal in the Oregon Court of Appeals. As you can see from the above discussion, it is possible to shave significant time off an appeal. It is not always easy to do, however. Your appeals lawyer will need to be both experienced and proactive. Expediting an appeal may be counter intuitive, as we have all become accustomed to waiting for deadlines, and following the prescribed or expected path. But in the right case, expediting an appeal can be highly desirable, and it will almost always save money under the theory that the longer litigation lasts, the more it will cost.

In a future post, I will discuss other time consuming events that may, but do not always, present themselves on appeal. By anticipating these additional time consuming events, still more time may be shaved off the time it takes to conclude an appeal, from start to finish.

Should I waive my right to a hearing with the Oregon State Board of Nursing?

Posted on September 28, 2015 by - Licensure

The answer to this common question is that most of the time nurses will eventually waive their right to a hearing before the Oregon Board of Nursing, as part of a larger settlement agreement. This does not mean, however, that your decision to settle your case should be made lightly, or without the advice of skilled Oregon licensure counsel.

The decision to waive your right to a hearing is one of the more important decisions you will make. If professional discipline is imposed, it will have lasting consequences. Your right to a hearing is your safety net against an unfair resolution. Your right to a hearing preserves your opportunity to have your case decided by an neutral and independent Administrative law Judge (ALJ). And finally, because both sides generally prefer to avoid a hearing, your right to a hearing is also one of your bargaining chips.

This point is key: waiving your right to a hearing is part of a settlement, but you should not waive any of your rights until you and your Oregon licensure lawyer are satisfied that you have reached a fair settlement. If you are facing an investigation by the Oregon Board of Nursing, consult an Oregon licensure lawyer immediately.

Do I need a nursing Board lawyer to review my stipulated order of reprimand?

Posted on September 25, 2015 by - Licensure

The answer to this question is “yes,” you need a nursing board lawyer, usually called a “licensure lawyer,” to review a proposed stipulated order of remand. If there is an exception to this answer, I am unaware of it.

First a bit of background. Reprimands exist on the low end of the range of professional sanctions that are available to any licensing Board, including the Oregon State Board of Nursing. Reprimands may be offered, for example, by the Board of Nursing as a quick resolution to a complaint involving a relatively small digression by the nurse, providing what may appear at first glance as an easy way out for both the Board of he Nursing and the nurse. It is precisely because reprimands exist on the low end of the range of sanctions, that reprimands are sometimes viewed as an easy settlement. It is a mistake, however, to treat reprimands so lightly.

Consider these three consequences of a reprimand:

  • Although a reprimand exists on the low end of the range of sanctions, a reprimand is nonetheless a form of professional sanction or discipline, and it is a public record. For most licensees, a reprimand will be included in your profile listed on your Board’s licensing verification page (e.g., the Board’s website). This is true of the Oregon State Board of Nursing, and also the Oregon Medical Board and the Oregon Board of Pharmacy.
  • Because a reprimand is a form of professional sanction or discipline, it is almost always necessary to report the reprimand to any other states in which you are also licensed, which will prompt another investigation – and maybe mirror-image discipline – by those states.
  • A reprimand also counts as disciplinary history against you, which means that if another complaint is filed with the Oregon State Board of Nursing, the nurse will have “disciplinary history” the next time, which is not desirable.

Hopefully, the above analysis is sufficient to establish the seriousness of a reprimand, and why it is a good idea to have any proposed settlement reviewed by an experienced nursing board lawyer before accepting a reprimand in order to settle a Board of Nursing complaint, used as an example above.

Two cases that make the point

I was retained by nurses earlier this year, shortly after they had received proposed reprimands from Oregon Board of Nursing, offered as a settlement to conclude the case. In both case, the reprimands were worded in a way that could be interpreted to include far worse conduct than the underlying facts warranted. This fact alone was reason to reject the reprimands. Additionally, there were extenuating circumstances in each case that caused me to recommend to each of the nurses they not accept any form of reprimand to settle their cases. Both nurses accepted my recommendations, which prompted me to explain my advice to the Board of Nursing and to request that the Board of Nursing issue letters of concern only. The Board of Nursing agreed, and recently closed both files without disciplining the nurses (a letter of concern is not discipline).

One last point

If legal advice from a nursing board lawyer is necessary before accepting a “lowly” reprimand, you will certainly want to consult a nursing board lawyer whenever you receive notice of any proposed disciplinary sanction from the Oregon Board of Nursing (the same is true for the Oregon Medical Board and the Oregon Board of Pharmacy).

Above and beyond a reprimand, the range of sanctions available to the Board of Nursing include having your license to practice nursing temporarily suspended, indefinitely suspended, or permanently suspended; or having your license to practice nursing revoked. Sanctions may further include monetary fines, continuing education, recurrent training, the imposition of a mentor and monitoring, and periods of probation. One or more sanctions, in combination, may be proposed by the Board of Nursing, as the Board sees fit.

In sum, if you are being investigated by the Oregon Board of Nursing, a nursing board lawyer should be involved from the start, and should certainly review any proposed settlements. Although I have written these comments using the Oregon Board of Nursing as an example, the same is true of investigations involving the Oregon Medical Board and the Oregon Board of Pharmacy; a lawyer should always be involved.

Oregon State Board of Nursing complaints: A common question

Posted on September 23, 2015 by - Licensure

What should I do when my employer files a complaint with the Oregon State Board of Nursing?

As you will see from this discussion, it pays to obtain competent licensure counsel and take early action. In four cases this year, I was hired soon after the nurse (my client) was informed that his or her hospital intended to file a complaint with the Oregon State Board of Nursing (OSBN).

In the first two cases, the hospital made its decision and terminated the nurse all in the span of a few days. The process was essentially a well-orchestrated and documented exit interview, leaving little for us to do, other than wait for the expected notice from the Oregon State Board of Nursing that the compliant had been received, and start our defense then.

In the third and fourth cases, however, the hospital provided the nurse with 14 days advance notice of the hospital’s plan to file a complaint with the Oregon State Board of Nursing. In these two cases, the hospital was required by a labor contract to allow the nurse 14 days to provide an “optional response,” which allowed us to start our work immediately, with the hospital.

What happened in the four cases?

The first two cases were fully resolved in the nurse’s favor. At the conclusion of both interviews, the investigators for the Board of Nursing evidently agreed with the nurse, not the hospital, and the Board of Nursing took no action.

In the third case, the hospital withdrew its threat of termination and of filing a complaint with the Oregon State Board of Nursing. The hospital also made internal changes as a result of the nurse’s response (our response) to the hospital’s threat of termination and filing a complaint with the Board of Nursing. This was an excellent result for the nurse and the Board of Nursing was never involved, as a complaint was never filed.

At this point it time, the fourth case is too new to my office to predict or know the outcome, but as you can see, these cases are defensible. In the first three cases, the hospital was mistaken, and the nurse had it right.

What you need to know

All four cases involved a complicated mix of practice issues, legal issues, management issues, and sometimes “personalities.” In all four cases, the hospital was acting through its Human Resources Department (HR), which, if you do not know, is essentially an in-house legal department comprised of management and lawyers. When HR is involved, it may mean that a small team of individuals has already organized and is working against you. If this scenario sounds familiar, you are advised to hire competent licensure counsel immediately. The nurse is often right and taking early action works!

I want to appeal – How long will it take?

Posted on September 21, 2015 by - Appellate

Good question. Appeals are a slow process, with flurries of activity followed by periods of inactivity.

The typical progression of an appeal in the Oregon Court of Appeals

If you are the appellant taking an appeal to the Oregon Court of Appeals, the flurries of activity include the following:

  • preparation and filing of the notice of appeal
  • preparation and filing of a cost bond (or cash deposit) into the trial court
  • preparation and filing of a supersedeas bond, or “stay bond,” to stop execution of the trial court’s judgment
  • preparation and filing of the trial court’s transcript of proceedings
  • correction of the transcript, if necessary
  • preparation and filing of the opening brief on appeal
  • preparation and filing of the reply brief on appeal
  • preparation and attendance at oral argument.

The work itemized above is necessary for basic appeals, and it will take about a year for both parties complete all that is to be done.

Occasionally, other work may be necessary. For example, there may be a cross-appeal, requiring another round of briefing. Or there may be two appeals, that the parties will want to consolidate, by filing a motion to consolidate, and then waiting for a ruling from the Court of Appeals. Or it may be discovered that the trial court is missing part of the record, making it necessary for the Court of Appeals to “remand” (return) the case to trial court so that the parties and the trial court may correct the record. Or there may be a jurisdictional issue that will interrupt the flow of work while parties brief the issue and the Court of Appeals decides the issue. Or it may be necessary to file part of the record under seal, in order to protect the privacy of minors or patients. All of this will take additional time. One of these issues may take two-to-three months to resolve. If two or more of these issues are present, an appeal may take an additional six months to conclude. In the end, an appeal having moderate complexity may consume 1-1/2 years before the briefing is complete and the case is waiting to be argued to the Court of Appeals.

How long to oral argument?

After so much work, the next question often asked is, how long before oral argument? I checked my last three cases and found that oral argument was heard, on average, six months after the briefing was complete. One case took five months from the completion of the briefing to oral argument, the second case took nine months, and the third case took four months. The delay in getting to oral argument is a function of the Court of Appeals’ backlog of cases. As you can see, an appeal having moderate complexity may consume 1-1/2 years to complete the briefing, and take another six months to get to oral argument, two years total.

How long before the Court of Appeals decides my appeal?

The next question is often, how long before the Court of Appeals will decide my case? The answer may surprise you. If you are the appellant, you do not want a quick decision, because cases on appeal can be lost quickly – in one to two months – while winning takes time. If you are the appellant, winning takes time because the Court of Appeals must write and publish a decision reversing the lower trial court, a time-consuming process. For this reason, when I represent the appellant, I am always pleased when two or more months have passed and nothing is heard from the Court of Appeals. I am even more pleased when the Court of Appeals’ decision has been pending four months or longer. The court may still deny your appeal, but at least the time-to-decision suggests that the denial was not easily decided. In my experience, the longer the Court of Appeals takes to reach a decision, the better the odds of a favorable result.

How long overall?

As you can now see, appeals are a slow process, comprised of flurries of activity followed by periods of inactivity. The numerous periods of activity are spent waiting on the other side, or waiting on the Court. A basic appeal might take 1-1/2 years from start to finish, before the case is argued and decided, while a more complicated appeal, requiring “motion practice” to resolve one or more issues, may take 2-1/2 years from start to finish, before the case is argued and decided.

In my next post, I will discuss the several opportunities a lawyer can exploit to expedite an appeal, saving much time, and some expense.

 

The VA’s transition-to-practice program for new Registered Nurses

Posted on September 16, 2015 by - Licensure

If you are a new Registered Nurse hired by the Veteran’s Hospital Administration (or “VA”), you are entitled to be trained under the VA’s Transition-to-Practice Program. If you are not familiar with this program, I direct your attention to VHA Directive 2011-039, also known as the “VHA Registered Nurses (RN) Transition-to-Practice Program.”

Without the Transition-to-Practice program, new nurses experience a high failure rate

According to this VHA Directive, the Transition-to-Practice program is applicable to “all levels of RNs with 1 year or less of experience.” See VHA Directive, 1. The Transition-to-Practice program was developed to address industry-wide turnover rates as high a 60%. See VHA Directive, 1. The VHA Directive describes the high turnover within the VHA, as follows:

“c. Among the total RN population within VHA, new graduate RNs have the highest turnover rates. In Fiscal Year 2007, the 12-month turnover costs for a cohort of 291 new RNs totaled $2.52 million. From analysis of those initial figures, ONS determined that the turnover rate for new RNs was a significant issue for VHA. This prompted ONS to develop a program to address these critical issues.”

See VHA Directive, 1.

The Transition-to-Practice Program works; new nurse failure rates reduced to zero

The VHA Transition-to-Practice pilot program was immediately successful; it “resulted in a 100 percent RN retention rate (zero regrettable losses) and all findings indicate the program was successful and ultimately proved beneficial to every facility in the pilot.” See VHA Directive, 2.

What you need to know

If you are a new Registered Nurse, with a year or less experience as an RN (prior nursing experience with a lower level of licensure doesn’t count), be sure this program is fully in place at the start of your employment. Otherwise, you risk a failure rate as high as 60 percent. Be aware that not all VA hospitals have the program, which is likely if you are the first new RN hired since 2011, the year the transition program was mandated. And be on the lookout for a transition program that may exist in name, but be deficient in substance. Whatever the circumstances, don’t miss out. The program is mandatory as of November 28, 2011, the date of the VHA Directive :

“[i]t is VHA policy that VHA facilities establish a structured development transition program for all levels of entry RNs utilizing the flexible VHA 12-month RN Transition-to-Practice Program.”

See VHA Directive, 2.

Relevant conduct under the federal sentencing guidelines is criminal conduct

Posted on September 12, 2015 by - Appellate, DEA Prosecutions

U.S. v. Chube II, 538 F3d 693 (7th Cir. 2008)

I was the appellate lawyer lawyer for Drs. David and Randall Chube on appeal to the Seventh Circuit Court of Appeals in the case of US v. Chube II, 538 F3d 693 (7th Cir. 2008). At the time of sentencing in that case, both the DEA attorney (the federal prosecutor) and the “PSR writer” (the author of the Pre-sentence Investigation Report) seemingly counted every prescription for controlled substances, whether it was criminal or not, as relevant conduct when applying the federal sentencing guidelines, and the District Court (trial court) sentenced accordingly, which greatly increased the length of sentence for each physician – five years for Dr. Randall Chube, and fifteen years for Dr. David Chube.

On appeal, the Seventh Circuit Court of Appeals found that the District Court relied upon insufficient evidence to prove the relevant conduct was criminal conduct. Both physicians sentences were vacated and the case was remanded back down to the District Court for re-sentencing. A short while later, the trial court released both physicians from prison pending re-sentencing, and both physicians served substantially shorter sentences when relevant conduct was determined correctly. That was seven years ago.

Not much has changed

I was recently retained to assist defense counsel with the sentencing of a physician in a state located within the Fifth Circuit Court of Appeals, and it seems not much has changed. Like in the Chube case, both the DEA attorney and the PSR writer make the mistake of seemingly counting every prescription for a controlled substance as relevant conduct, without first establishing that the relevant conduct was criminal conduct, when applying the sentencing guidelines. If the District Court adopts these computations by the PSR writer and the DEA attorney at the time of sentencing, the District Court will commit reversible legal error just as the District Court did in US v. Chube II, 538 F3d 693 (7th Cir. 2008).

Prescribing without a legitimate medical purpose

The civil standard of care and the criminal conviction standard are two distinct legal standards, yet these two legal standards are often substituted, confused, and/or conflated, by the DEA’s drug diversion investigators, the DEA’s attorneys, the federal prosecutors, the prosecution’s medical experts, and the PSR writer, during the investigation, the trial and at sentencing. Most often, the civil and criminal standards are conflated through the misapplication of the rule against prescribing without a legitimate medical purpose, discussed on the criminal violations page and elsewhere on this website. Unfortunately for physicians, when the criminal conviction standard is conflated with the civil standard of care, the criminal conviction standard is lowered, making numerous criminal convictions easier to win, and the relevant conduct necessary to further lengthen a sentence, easier to find. The burden is upon defense counsel and the courts to keep these two distinct legal standards separate.

Never forget that relevant conduct is criminal conduct

A violation of the civil standard of care (which may amount to professional negligence or medical malpractice) is not, without more, a drug crime. In other words, a physician may commit malpractice when prescribing controlled substances, but that does not mean the physician committed a crime. Never forget that relevant conduct is criminal conduct. Because a violation of the civil standard of care when writing a prescription for a controlled substance is not, without more, criminal conduct, it is not properly considered relevant conduct for purposes of sentencing. More is required. See U.S. v. Chube II, 538 F3d 693 (7th Cir. 2008). By using an incorrect legal standard to determine which prescriptions are criminal, and therefore relevant conduct when applying the federal sentencing guidelines, a District Court will commit reversible legal error at the time of sentencing. It is incumbent upon defense counsel to preserve this legal error for appeal.

 

How to obtain good results in tough licensure cases: Four examples

Posted on September 9, 2015 by - Licensure

When facing a Board investigation, it is common among practitioners to fear the loss of their license, or the imposition of substantial restrictions upon their practice. Today I will discuss four such cases, involving two physicians, a pharmacist, and a nurse. In one of the cases, the practitioner went so far as to surrender his license, hoping to make it all go away. In all four cases, however, the practitioner prevailed, with the board imposing no discipline whatsoever.

The physician practicing under an evolving standard of care

In the first example, a physician was getting good results for all his patients, and he had no bad outcomes. The standard of care, however, was both disputed and evolving, and the physician had provided his patients with what appeared to be a lot of treatment, and it was the amount of treatment that prompted a complaint to the Medical Board. The case was resolved successfully after the Medical Board came to understand the perspective of several experts, the evolving standard of care, and the above average results that this physician obtained for his patients. In sum, the physician’s knowledge and thoughtful presentation, supported by expert opinion, literature, and good patient outcomes, carried the day. This case was closed without any discipline.

The physician treating chronic pain with narcotics

In the second example, a physician was treating chronic pain with narcotics in a small practice setting. This is a difficult medical practice in the best of settings, given the nature of the patient population, and the scrutiny imposed by state and federal regulators, including the Board of Medicine and the Drug Enforcement Administration (DEA). The physician’s charting was good, however, and, with the assistance of an expert to provide an objective assessment, the physician’s charting was organized into a comprehensive and detailed written report. Small discrepancies were spotted, self-corrected immediately, and disclosed to the Board of Medicine, leaving nothing for the Board to do. The physician’s presentation was persuasive, and the case was closed without any discipline.

The pharmacist-in-charge discovering and reporting a substantial drug loss

In the third example, the pharmacist-in-charge (PIC) discovered a large drug loss in his pharmacy. Security and protocol had been breached. The pharmacist-in-charge was very proactive, however, quick to discover the problem, quick to verify a pattern of theft, and quick to report the drug loss to the Board of Pharmacy and the DEA. The pharmacist-in-charge also confronted the person responsible for the drug theft and further implemented corrective measures. Although the pharmacist-in-charge worked closely with the Board of Pharmacy, it was the pharmacist-in-charge that lead the effort, an effort that was much appreciated by the Board of Pharmacy. And although the drug theft occurred under his watch, the pharmacist-in-charge promptly fulfilled his role in the state and federal regulatory scheme intended to secure the inventory of controlled substances. The case was closed without any discipline.

The nurse alleged to have exceeded his scope of practice

In the final example, a highly skilled nurse was alleged to have exceeded his scope of practice. The nurse’s advanced education and experience carried the day, however. The Board of Nursing concluded that the nurse in fact had the education, training and experience necessary to refute the allegation that the nurse had exceeded his scope of practice. The Board of Nursing reasoned that whatever dispute there was between the hospital and the nurse, it was an employment matter, not a licensure matter. The case was also closed without any discipline.

What you need to know

In difficult cases it is necessary to take the initiative, to perform the research and analysis necessary to take a lead role to get in front of the case, showing your licensing Board what you are doing, and further offering the conclusion the Board should accept without need of discipline. In the four examples offered above, none of the cases proceeded beyond an interview, and in two of the cases, investigators determined that an interview was not warranted. These examples illustrate the value of early action when defending your medical license.

If a DEA Drug Diversion Agent asks you to sign a waiver or release, just say “no.”

Posted on September 4, 2015 by - DEA Prosecutions, Licensure

If you possess a DEA Registration to prescribe, possess, or dispense controlled substances, you may one day be approached by a DEA Drug Diversion Investigator requesting an interview and asking you to sign a release or waiver of your right to remain silent. Just say “no.”

As my late friend Glen Crick has written,

“if you are told, ‘You have the right to remain silent,’ then remain silent. This warning is only given to someone who is the subject of a criminal investigation. If an investigator tells you that you have the right to remain silent, there is no guesswork involved. You are the subject of a criminal investigation, and there is nothing to be gained, and much to be lost, by talking to an investigator without legal counsel present.”

Two examples of what can go wrong

In one case, a senior physician was duped into writing prescriptions to young, drug seeking “patients.” His clinical assessments and charting were both good, and the drugs prescribed were appropriate and in therapeutic doses. The trouble arose, however, not from his charting, but from the statements he made during his voluntary interview with the Drug Diversion Investigator – he made the big mistake of signing a written release of his rights, and he then sat for an interview. Unfortunately, the mistakes he made during that interview hurt him, and he later pled to one “small count” (small by drug diversion standards) resulting in a sentence of probation, the surrender of his DEA Registration, and the closure of his practice. It was my opinion, however, that without the statements he made during his voluntary interview, his case was entirely defensible.

In another case, a physician made the same mistake of signing a written release of her rights, and she then sat for an interview with two Drug Diversion Investigators without legal counsel present. Before that interview was over, she was further persuaded to surrender her DEA Registration. This physician never faced allegations of criminal wrong doing, but she incurred much legal expense and trouble in an attempt to restore her Registration and medical practice. Although this case was never fully developed, it was my opinion based upon what was known, and what has been learned since, that this physician would not have lost her DEA Registration and there was no reason to surrender it to the DEA investigators in the first place.

What you need to know

In both the of the examples above, the physicians released their rights and agreed to be interviewed by Drug Diversion Investigators. It was my opinion that both cases were fully defensible. The lesson to be learned is that if a DEA Drug Diversion Investigator wants to interview you and asks you to sign a release or waiver of your right to remain silent, don’t do it. Just say “no.” If you are told, “You have the right to remain silent,” then remain silent. Decline all interviews until you have consulted with a lawyer familiar with prescribing issues under state and federal law. Whatever you do, don’t go it alone.