From the Lexington Herald Leader -
Regulators have barred an Eastern Kentucky doctor from prescribing drugs over concerns that included his alleged failure to guard against patients illegally selling pills he prescribed to them.
The Kentucky Board of Medical Licensure cited “risky prescribing patterns” by the doctor, Madhan Mohan, in an order released Tuesday.
The board said two of Mohan’s patients died of drug overdoses in 2018 soon after getting prescriptions for opioid drugs.
Mohan, whose specialty is internal medicine, has been licensed in Kentucky since 1993. He practices at the Pine Mountain Clinic in Pineville, according to information from the board and online directories, though the order listed a Knoxville address for him.
The licensure board’s order said it received concerns about Mohan’s prescribing from other doctors and from police.
The inspector general’s office at the state Cabinet for Health and Family Services reviewed information on Mohan’s prescriptions and noted several potential problems, according to the licensure board.
Those included the combinations of drugs Mohan was prescribing for people, with some getting four or more controlled substances.
It also appeared that between December 2018 and December 2019, Mohan hadn’t used the state’s monitoring system to check patients’ records of getting prescriptions, according to the board order.
The system helps prevent people from getting multiple prescriptions from different doctors.
In the summer of 2020, a consultant reviewed files on 18 of Mohan’s patients and concluded that he fell short of acceptable medical practices, demonstrating a pattern which would be deemed to be gross negligence, incompetence, ignorance or malpractice under the circumstances, the board said in its order.
The review indicated Mohan was deficient in treating drug addiction and chronic pain; in safe prescribing of opioids, which are pain drugs; and in preventing patients from diverting the drugs they received, the order said.
Proper treatment would have involved using urine drug tests to check if patients were taking their prescriptions properly, as well as providing adequate counseling and referring patients to specialists to treat pain and substance abuse, the consultant said.
The consultant said a particular concern was Mohan’s “apparent trend” of treating drug addiction, opioid use disorder and chronic pain with short-acting narcotics for long periods of time.
In one case, Mohan impeded a patient from getting substance-abuse treatment with Suboxone, a drug used in treating opioid dependence, and instead convinced him to keep getting drugs from Mohan’s clinic, according to the consultant’s report.
And Mohan continued prescribing pain and anti-anxiety drugs to patients who reportedly were selling the drugs illegally, the report said.
Mohan’s attorney said in a response that the doctor agreed he could be more vigilant about the danger of his patients diverting drugs to illegal sales and more aggressive in using drug screens and counting patients pills to guard against that.
Mohan pledged to begin using measures such as drug screens to try to make sure patients were taking pills as prescribed and not selling them.
However, he also said he disagreed with the consultant’s findings about his alleged shortcomings. Mohan’s attorney, Joshua D. Johnson, said Mohan, who has provided care for patients in Bell County for many years, had no comment beyond the board’s order.
The order bars Mohan from prescribing or dispensing controlled substances for an indefinite period and requires him to reimburse the board’s costs of $24,893 for the case, according to the order. Mohan also must undergo a clinical skills assessment.
The licensure board won’t consider a request to restore his prescribing privileges until it has received the assessment and, if recommended, an educational or remediation plan for Mohan, the order said.