Disciplinary Action against Stephen B. Edelson, M.D. (2004)
In April 2004, the Georgia State Board of Medical Examiners reprimanded Stephen B. Edelson, M.D., fined him $1,000, and placed him on 3 years' probation after concluding that he had been inappropriately self-medicating and had become addicted to benzodiazepine sleeping pills. Documents in the case indicate that from January 2000 through about half of 2001, he had (a) written rescriptions for himself, (b) used another doctor's name to obtain prescriptions by telephone, and (c) written prescriptions in the name of employees for his own use. The board also concluded that he had had failed to keep adequate records. In October 2004, Edelson announced that he was retiring and closing his practice because dealing with regulatory actions and malpractice suits had "taken a tremendous toll" on him and his family. For background information, click here.
BEFORE THE COMPOSITE STATE BOARD OF MEDICAL EXAMINERS
STATE OF GEORGIA
IN THE MATTER OF:
STEPHEN EDELSON, M.D.
DOCKET NO. 10020064
PUBLIC CONSENT ORDER
By agreement of the Composite State Board of Medical Examiners and Stephen Edelson, M.D.. Respondent, the following disposition of this matter is entered pursuant to O.C.G.A. § 5013-13 (a) (4).
FINDINGS OF FACT
Respondent is licensed to practice medicine in the State of Georgia and was licensed at all times relevant to the matters stated herein.
In April of 1995. Respondent entered in to a Consent Order with the Board in which Respondent admitted to improper prescribing and inadequate record keeping. Said Consent Order placed Respondent's license on probation subject to terms and conditions. On January 14, 1998. the Board entered an Order terminating said probation.
On or about May 8, 2002. Respondent was served with an Order for Mental and Physical Evaluation based upon information received by the Board that Respondent had been self-prescribing and had an addiction to benzodiazepines, a sleep medication. In July of 2002,
Respondent underwent a mental and physical evaluation at Piedmont Psychiatric Clinic. In a report dated July 25,2002. Piedmont Psychiatric Clinic noted that Respondent had engaged in self-prescribing and in the past had had an addiction problem. The report recommended that certain safeguards be set up to ensure that Respondent no longer prescribes for himself or his family and to ensure his remission from substance abuse.
During the period of time from January of 2000 through October of 2001. Respondent engaged in a practice of self-diagnosis, self-treatment and self-prescribing of medications. The prescription records indicate that Respondent prescribed medications for himself by writing prescriptions for himself" by calling in prescriptions for himself in the name of another physician without permission of that physician and by writing prescriptions in the name of employees for his own use. In the course of this self-treatment, Respondent did not document any physical examination, clinical or radiographic data to support his diagnoses or treatment.
Respondent has submitted information to the Board indicating that he has not prescribed for himself or for his family since May of 2001.
Respondent's treatment of himself has been evaluated by a Board appointed consultant who concluded that Respondent's treatment departed from and failed to conform to the minimal standards of acceptable and prevailing medical practice in the following ways:
Minimum standards of care would require Respondent to document in a patient's medical records the appropriate history, physical exam, treatment, diagnostic test results, and response to treatment. Respondent did not prepare or maintain any medical records for his own treatment.
Respondent's prescribing of controlled medications for his self- use was in violation of Board Rule 360-3-.02(2) and his failure to keep adequate records of such prescription practice was in violation of Board Rule 360-3-.02(7).
CONCLUSIONS OF LAW
Respondent's condition and/or prior conduct constitute sufficient grounds for the imposition of sanctions upon Respondent's license to practice medicine in the State of Georgia under O.C.G.A. CHS 1and 34 T. 43) as amended. Respondent hereby waives any further conclusions of law with respect to the above-styled matter.
The Composite State Board of Medical Examiners, having considered the particular facts and circumstances of this case, hereby orders, and Respondent hereby agrees. to the following terms of discipline:
Beginning on the effective date of this Consent Order, Respondent's license shall be placed on probation for a period of three (3) years) subject to the following terms and conditions:
(a) TRIPLICATE PRESCRIPTIONS. Respondent shall utilize a triplicate prescriptions system for all controlled substances prescribed by him. Each prescription written by Respondent for controlled substances shall be for a patient for whom a patient chart has been created by Respondent and shall be recorded in said chart. Furthermore, each prescription for such a controlled substance written by Respondent shall be sequentially numbered and the copies distributed as follows: original to patient. one copy to the Board, and one copy to the patient's chart. Respondent shall not begin renumbering when he reaches 1000, but shall continue to number sequentially. The copies for the Board shall be mailed or delivered to the Board by Respondent once per quarter. A copy of Respondent's dispensing records shall be provided to the Board upon request for all controlled substances dispensed by him or on his order. Two (2) years from the effective date of this Consent Order, Respondent may petition for removal or modification of this triplicate prescription requirement.
(b) PRESCRIPTION LOG. Respondent shall personally maintain for inspection a contemporaneous log (separate from his clinical records or the clinical records of other health care providers) of all controlled substances and dangerous drugs prescribed. administered. dispensed, or ordered by him. The prescription log shall include the date, patient name, drug, strength, quantity, and refill status, on a form approved by the Board. The prescription log shall also include the diagnosis and the reasons for prescribing, administering, dispensing. or ordering each drug. The Board shall be authorized to inspect Respondent's prescription log. Respondent's prescription log fails to comply with the requirements of this consent order, the Board is authorized to summarily suspend Respondent's license, pending a hearing. Two (2) years from the effective date of this Consent Order, Respondent may petition for removal or modification of this prescription-logging requirement for all controlled substances.
(c) RECORD KEEPING. Prior to prescribing, administering, ordering or dispensing any controlled substance, Respondent shall detail fully the examination performed and diagnosis reached in the particular patient's tile. Respondent shall specifically record all physical data of the patient. and detail the exact nature of Respondent's evaluation of the patient. In addition to this requirement. Respondent agrees to comply with all record keeping requirements of the Board.
(d) USE OF PHYSICIAN'S ASSISTANT OR NURSE PRACTITIONER. If Respondent employs a physician's assistant and/or nurse practitioner in his practice, Respondent shall not utilize the physician's assistant and/or nurse practitioner to perform tasks which are otherwise prohibited by the terms of this Consent Order> or otherwise utilize the services of the physician's assistant and/or nurse practitioner in such a way as to circumvent any restriction, term or condition outlined herein. Respondent expressly agrees to disclose this consent order to any physician's assistant or nurse practitioner with whom Respondent employs or associates.
(e) TREATMENT. Respondent shall remain in treatment of therapists acceptable to the Board. Respondent shall authorize the release of ll treatment records.
(f) SUPERVISION AND MONITORING. Respondent shall designate an acceptable supervising physician who will supervise Respondent's work. Said supervising physical shall be a Board approved on site supervisor who works in Respondent's office or shall be a Board approved physician who will perform on site supervision of Respondent's practice twice a month for two hours per on site visit. Respondent shall also designate an acceptable monitoring physician who is trained in addictionology and who win monitor any medications Respondent is prescribed. Respondent shall provide a copy of this Consent Order to both physicians. Such physicians shall sign a statement to be submitted in conjunction with the Consent Order as evidence of having read and understood the Consent Order and having agreed to serve as Respondent's supervising and monitoring physicians. Respondent shall obtain prior written Board approval through the Medical Director for any change in the monitoring or supervising physician.
(g) QUARTERLY REPORTS. Respondent shall submit or cause to be submitted quarterly reports from his supervising and monitoring physicians regarding his performance and mental/physical condition by March 31, June 30, September 30 and December 31, including a report on any medication being prescribed to Respondent. Failure to submit or have such reports submitted in a timely manner shall be considered a violation of this Consent Order. It is expected that said supervising and monitoring physicians shall be in communication with each other and will immediately report any change in Respondent's condition which would render Respondent unable to practice with reasonable skill and safety to patients. By executing this Consent Order, Respondent specifically agrees that his monitoring and supervising physicians (or any other facility where Respondent obtains medical treatment) may report on Respondent's condition, notwithstanding any privilege provided by state or federal law.
(h) RANDOM DRUG/ALCOHOL SCREENS. The Board or its representative or Respondent's supervising or monitoring physician shall have the authority at any time to order Respondent to undergo random witnessed and immediate drug/alcohol urine, biological fluid or blood screen analysis at Respondent's expense. Proper chain of custody shall be maintained and positive results shall be confirmed by such means as may be required to ensure the validity of such screening.
(i) INSPECTIONS/INTERVIEWS. During the probationary period, the Medical Director or another Board representative shall periodically review and inspect Respondent's records. The representative is authorized to review and inspect these records at any reasonable time and as often as the representative deems necessary. The Respondent shall have the right to be present during such inspection of records and the patients' privacy and confidentiality rights shall be maintained. The Respondent shall be available, upon reasonable notice, for personal interviews with the Medical Coordinator or other representative of the Board. Failure of the Respondent to be reasonably available for inspection of his records or for personal interviews with a Board representative shall be considered a violation of this Consent Order.
(j) RESIDENCY OUTSIDE GEORGIA. In the event Respondent should leave Georgia to reside or practice outside Georgia for periods longer than thirty (30) consecutive days, Respondent shall notify the Board in writing of the dates of departure and return. periods of residency or practice outside Georgia as well as periods when respondent is not actively engaged in the 'practice of medicine or is on inactive licensure status will not apply to the reduction of Respondent's probationary period. except as authorized by the Board. Respondent shall advise the Board of any change in address of record or employment status.
(k) DISCLOSURE. In addition to other disclosures required by this Consent Order, Respondent shall supply a copy of this Consent Order. once approved and docketed, and within ten (10) days from receipt of the docketed copy by Respondent, to each hospital or other institution in Georgia where Respondent maintains staff privileges of any kind, and to any person with whom Respondent is associated in practice, including other physicians or physician's assistants or to any person or entity for whom Respondent is employed as a physician in the State of Georgia. Respondent shall also be required to disclose the existence of and provide a copy of this Consent Order to such individuals or entities in connection with any future application for institutional appointment, associated practice, utilization of a physician's assistant, or employment as a physician in the State of Georgia while this Consent Order is in effect. By executing this Consent Order, Respondent specifically consents to any such individuals or entities reporting to the Board information which would affect Respondent's ability to practice medicine with reasonable skill and safety to patients. notwithstanding any privilege provided by state or federal law.
(l) ABIDE BY ALL LAWS. Respondent shall abide by all State and Federal laws regulating the practice of medicine or relating to drugs, the Rules and Regulations of the Composite State Board of Medical Examiners, the terms of any order issued by another lawful licensing authority or consent agreement entered between Respondent and another lawful licensing authority and the terms of this Consent Order. If Respondent shall fail to abide by such laws, rules, terms or orders, or if it should appear from monitoring reports submitted to the Board that Respondent is otherwise unable to practice medicine with reasonable skill and safety to patients. Respondent's license shall be subject to further discipline, including revocation, upon substantiation thereof after notice and hearing. and if revoked the Board in its discretion may determine that the license should be permanently revoked and not subject to reinstatement. Should ;mother lawful licensing authority or court of competent jurisdiction enter an order revoking Respondent's license or revoking Respondent's probationary status while Respondent is subject to this Consent Order, Respondent's Georgia license shall stand automaticallysuspended. effective on the date of such action, pending proceedings for revocation or other action by the Georgia Board.
(m) TERMINATION OF PROBATION. Respondent shall not be eligible to petition for termination of probation for a period of three years from the docketing of this Consent Order. At such time, Respondent may petition for termination only by certifying under oath before a notary public that Respondent has complied with all conditions of probation and by providing documentation supporting discharge from probation, including. but not limited to, written statements from Respondent's monitoring and supervising physicians indicating that said monitoring and supervising physicians agree with the termination of probation. The Composite State Board of Medical Examiners shall review and evaluate the practice of Respondent prior to lifting the probation. At such time, should the Board determine that reasonable cause exists for maintaining Respondent's license on a probationary status, the Board shall notify Respondent of its intent to extend the probationary period, and Respondent may respond to such notice in writing or request an appearance before the Board as in a noncontested case. lf no reasonable cause exists to maintain Respondent's medical license on a probationary status, the Board shall be authorized. but is not required to terminate probation. In any event, this Consent Order shall remain in effect pending a final determination by the Board and notification that the probationary period has terminated.
In addition to any other sanction contained herein, this Consent Order shall constitute a PUBLIC REPRIMAND by the Board to Respondent in connection with the conduct alleged.
In addition to and in conjunction with any other condition imposed by this Consent Order, Respondent shall pay a fine to the Board in the amount of $1000.00, payable by certified check or money order to the Composite State Board of Medical Examiners within thirty (30) days after the effective date of this Order. Failure to pay the entire amount of the fine by the 30th day shall be considered a violation of this Order and shall result in further sanctioning of Respondent's license, including revocation, upon substantiation.
Respondent acknowledges that he has read this Consent Order and that he understands the contents of the Consent Order. Respondent understands that he has the right to a hearing in this matter, and Respondent freely, knowingly and voluntarily waives such right by entering into this Consent Order. Respondent understands that this Consent Order will not become effective until approved. and docketed by the Composite State Board of Medical Examiners. Respondent further understands and agrees that a representative of the Department of Law may be present during the presentation of this Consent Order and that the Board shall have the authority to review the investigative file and all relevant evidence in considering this Consent Order. Respondent further understands that this Consent Order, once approved, shall constitute a public record. which may be disseminated as a disciplinary action of the Board. However. if this Consent Order is not approved, it shall not constitute an admission against interest in this proceeding, or prejudice the right of the Board to adjudicate this matter. Respondent consents to the terms of discipline contained herein.
Approved this 1st day of April, 2004.
COMPOSITE STATE BOARD
OF MEDICAL EXAMINERS
BY: GRACE B. DAVIS, M.D., M.P.H.
STEPHEN B. EDELSON, M.D.
Sworn to and subscribed
before me this 15 day
of March, 2004.