Medical Board Inconsistent on Disciplinary Actions

Before being accused of bombing the car of the chairman of the Arkansas State Medical Board, Dr. Randeep Mann of Russellville was accused of over-prescribing medications that led to the deaths of 10 of his patients.

Yet he is still a licensed physician in Arkansas while doctors whose transgressions seem far less serious - having a consensual affair with a patient that led to marriage, for instance - have had their licenses yanked.

Arkansas Business reviewed the board's files on several doctors and found startling inconsistencies in the way doctors are held accountable, a situation that the Arkansas Supreme Court described as "arbitrary and capricious" in one case and which other researchers found to be common across the country.

Since Jan. 31, 2007, the Arkansas State Medical Board has revoked the licenses of 11 doctors. It also issued 39 emergency orders of suspension. The doctors have lost their licenses for using drugs, sexually assaulting patients or over-treating and overbilling patients.

Public Citizen, a nonprofit consumer advocacy organization in Washington, D.C., ranks state medical boards based on how likely they are to take serious disciplinary action against a doctor. In its 2009 report, Arkansas' medical board came in 18th best in the country with 3.61 serious actions taken against every 1,000 doctors between 2006 and 2008.

But even the most aggressive medical board in the country, Alaska's, disciplines fewer than 1 percent of its doctors, said Sidney Wolfe, director of the health research group at Public Citizen.

"We found boards [are] arbitrary and capricious in not handing out punishment," Wolfe said.

Arkansas' Medical Board is composed of 14 members who are appointed by the governor for six-year terms. Eleven members of the board are doctors. The number of people with active doctor's licenses in Arkansas currently stands at 5,763.

The executive director of the board, Peggy Pryor Cryer, referred questions about the board's decisions to the private attorney who has represented the board since 1989, William H. Trice III of Little Rock.

Arkansas Medical Board Chairman Dr. Trent Pierce, the victim of the car bomb attributed to Dr. Mann, didn't return calls for comment, but his office also referred questions to Trice. 

Trice said the board examines every complaint and the circumstances of the alleged wrongdoing. It also reviews the history of the doctor. The board then decides whether the doctor should be removed from serving the public or if other remedies are appropriate, such as sending the physician to a rehabilitation program.

"When looking at what type of punishment, they do try and look at each case individually," he said. "Some of those infractions the board views as very serious, and some of them aren't so serious. And some of them are offenses that the board hopes they can reform the doctor and get him back to where he's safe to practice with the public."

 

Hindsight

In hindsight, the case of Dr. Randeep Singh Mann seems much clearer.

Mann, disciplined for over-prescribing medication, has been linked to the deaths of 10 patients and is facing medical malpractice lawsuits in connection with two of the deaths. He denies the allegations.

But Mann's biggest problems are in U.S. District Court, where has pleaded not guilty to a 10-count indictment that includes a charge of using "a weapon of mass destruction" in connection with the car bombing that injured Pierce. If convicted, Mann could face life in federal prison.

In 2006, the board stripped Mann of his Drug Enforcement Administration permit to prescribe medication. Trice said the board didn't take stronger action because "the allegations in front of the board at that time were that he wasn't prescribing correctly or over-prescribing scheduled medication. You can't prescribe scheduled medication for your patients if you don't have a DEA permit."

And Trice said that Mann made repeated appearances before the board to request his DEA permit be reinstated, but the board continued to deny the request.

Trice said the board felt its 2006 order with Mann was sufficient because it prevented him from prescribing controlled substances, though he still could write prescriptions for blood pressure medications or antibiotics.

By contrast, the board took a much harsher action against Dr. William Collie of Little Rock, who had sex with a patient whom he later married. Trice said the board stripped Collie of his medical license altogether because Collie didn't recognize the boundary issue being violated by having a relationship with a patient.

Collie appealed to the state Supreme Court, which concluded that the board's decision was "arbitrary and capricious." It reduced the penalty to a one-year suspension of Collie's license.

"I don't always understand the workings of the Supreme Court or any court," Trice said. "We have our job. They have theirs."

See also: Mann Retained License Despite Deaths

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