On January 13, 2013, the Pennsylvania Department of State suspended the license of Massachusetts psychiatrist Joseph Dambrauskas based on disciplinary action that was taken against him by the licensing authority of another state.
May 31, 2013
State fines psychiatrist Anil Nalluri $10K following criminal conviction
On March 21, 2013 the Pennsylvania Department of State ordered psychiatrist Anil Choudary Nalluri to pay a penalty of $10,000 because he was convicted of a misdemeanor relating to the practice of a health profession.
Nalluri, who practices in Ohio, was convicted in that state of worker’s compensation in December 2012.
State of Florida prohibits psychiatrist James Yelton Rossello from treating female patients
On April 19, 2013, the Florida Board of Medicine permanently restricted the license of psychiatrist James Yelton Rossello; he may not examine or treat female patients.
On April 8, 2011, the Florida Department of Health issued an administrative complaint against Rossello, which stated that between November 2009 and August 2010, while employed by Corrections Corporation of America, working at the Hernando County Jail, providing mental health treatment to patients incarcerated at Hernando County Jail, he committed or attempted to commit sexual misconduct on four different female patients.
Florida psychiatrist Mohammed Saleh fined over controlled substances
On April 24, 2013, the Florida Board of Medicine imposed a $5,000 fine on psychiatrist Mohammed Saleh and placed his license on probation for one year with terms and conditions.
The Board’s document states that Saleh was convicted November 21, 2011 in the state of Nevada of conspiracy to commit unlawful dispensing of controlled substances.
Nevada’s criminal charges against him indicate that he was dispensing controlled substances without a valid controlled substances license issued by the Nevada State Board of Pharmacy.
Additionally, Saleh failed to update his Florida practitioner profile in a timely manner to reflect his criminal conviction.
He also failed to report his conviction to the Florida Board within 30 days, as required.
Wisconsin psychiatrist Michael Panzer reprimanded over prescribing
On April 24, 2013, the Wisconsin Medical Examining Board reprimanded psychiatrist Michael Panzer.
The Board’s documents states that between September 26, 2007 and February 19, 2009, Panzer treated a patient for anxiety, severe depression and constant suicidal ideation.
When the patient came into his care, she was already taking Adderall, alprazolam (a tranquilizer) and quetiapine (an antipsychotic drug), which had been prescribed by previous psychiatrists.
To this, Panzer added modafinil (a stimulant used in the treatment of daytime sleepiness) and duloxetine (an antidepressant) though his progress notes did not routinely document what medications the patient was on or at what dosages, nor did he consult any of her other physicians (she suffered with physical health problems as well) to verify what drugs she might also have been taking or what the interactions might have been with the ones he was prescribing.
Psychiatrist Ronald Kurlander fined over controlled substances
On December 18, 2012, psychiatrist Ronald H. Kurlander entered into a settlement agreement with the Florida Board of Medicine in which he was reprimanded and fined $15,828. The Board charged Kurlander with prescribing controlled substances to two individuals who were not his patients and for whom he did not, among other things, conduct medical or psychiatric examinations; did not render diagnoses; did not establish justification for prescribing the drugs and did not keep patient records.
State issues negligence complaint against “stem cell” psychiatrist William Rader
On March 22, 2013, the Medical Board of California issued an Accusation against psychiatrist William C. Rader, alleging gross negligence, repeated negligent acts, false and/or misleading advertising, disseminating false or misleading statements, dishonesty or corruption, general unprofessional conduct and violation of the state medical practice act.
These charges all regard Rader’s treatment of four patients with fetal stem cell therapy; recommending they undergo such therapy when there is no medical evidence that such therapy could benefit the patients; failing to properly evaluate patients prior to recommending the therapy and failing to provide concise, understandable and accurate information regarding the potential risks and benefits of the therapy.
Additionally, Rader is charged with maintaining two websites and published a book which contain statements that “it is well established that fetal stem cell therapy has no negative side effects.” The website contain other false and/or misleading statements.
State makes unannounced visit to Indiana psych facility on reports of understaffing
PLYMOUTH — Indiana Department of Child Services officials report that they found inadequate staffing levels for children at the psychiatric facility Michiana Behavioral Health on March 20, following up on issues raised by former employees about understaffing.
The former employees alleged that the understaffing at the Plymouth facility caused risks for patients and staff.
But the facility’s CEO disagrees with the assessment from state licensing officials and argues that nurses should be counted in staffing ratios.
DCS still has questions it’s trying to resolve about issues such as the use of medications and behavior plans for the children.
The Tribune recently obtained a letter from DCS that spells out what the agency found on the unannounced visit March 20, along with CEO Bryan Lett’s written response on April 29.
As The Tribune reported on April 7, a group of former nurses and mental health technicians have been holding weekly protests near the facility since mid-March. They continue to do so.
In written and verbal statements to The Tribune, they’ve claimed that one worker often would supervise 15, 20 or more children at a time. But state licensing reviews hadn’t shown that over the past five years.
Lett had told The Tribune the group’s claims were false.
Lett said that an average of 50 children and adolescents and seven adult patients were lodged there in February. The youths come from 15 Indiana counties, including St. Joseph, and from Michigan.
DCS reports that it interviewed several staff and residents and made observations on its visit.
What letters from DCS and Lett don’t address is whether or not children have acted out sexually at the facility, an issue that former staff had raised, including Dominique Smith, who quit her job as a mental health technician last year and is spearheading the group that’s raising concerns. She alleged that sexual activity is occurring because of lack of staff and their inability to supervise children closely enough.
Meanwhile, the Indiana Division of Mental Health and Addiction expects to file a letter soon on what auditors found on their visit the week of March 25, a spokeswoman said.
The Joint Commission, the nonprofit organization that accredits the facility, also did an on-site survey April 9 and 10 to look into complaints it had received about the facility. So far, spokesman Bret Coons said, the commission hasn’t required Michiana Behavioral to make any improvements as a result.
Also, one of the former nurses in The Tribune story April 7 has filed a lawsuit against Michiana Behavioral and against Lett, alleging that she was wrongfully terminated and that Lett slandered her by telling other employees that she was fired for falsifying medical records and lying to a doctor.
That nurse, who asked to only be named by her initials, DC, since she said was seeking another job, said she was fired after an incident where she sought to put a young boy under the facility’s own policy of “sexual acting out precautions.”
Staffing levels
State code requires that, in a child psychiatric facility like this, there must be one direct-care staff member for every four children while the children are awake.
On March 20, DCS found four mental health technicians who were supervising two living units and one nurse on duty, plus other staff that couldn’t be included in the ratios. There were 29 children lodged in the units, though Lett notes that there was one less by the day’s end.
DCS wrote that the facility was including nurses in the staff-child ratios, pointing out that nurses aren’t typically part of that ratio because they have duties other than direct care of the children. Even if they were included, the letter said, there still wasn’t enough staff. DCS pointed out “confusion” over which staff can be included in that ratio.
Lett cited a state statute and argued that it isn’t clear which staff are “responsible for daily direct care and supervision of children” — nor, he wrote, does it preclude nurses from that. He argued that his nurses do direct care and should be counted in child-staff ratios.
A follow-up letter from Michiana Behavioral’s attorney said three nurses were on duty, providing what it saw as 10 direct-care staff for 29 kids.
Lett wrote that the ratio that DCS observed was only true from 8:30 to 9:30 p.m. And since 8:30 p.m. is bed time, he wrote, that met the state’s ratios. (Indiana code calls for a staff-child ratio of 1:12 when the children are asleep.) Time cards and security cameras back that up, he wrote.
To avoid any more gaps in child-staff ratios, Lett wrote that the facility has revised its schedules for mental health technicians so that they work solid, 3-to-11 p.m. shifts. Also, he wrote that the facility reviewed its process for scheduling staff when other staff are sick, on vacation or otherwise absent — and would retrain its staff on this process.
Extra attention
The DCS letter also raises questions about staffing in cases of “special precautions,” which, per Michiana Behavioral’s policies, is “when a child has a severe behavioral incident requiring one-on-one supervision as a result of being a danger to themselves or others.”
Former staff had raised specific issues about its policies for “sexual acting out precautions” when children have been known to act out sexually. Among other things, former staff said, the policy requires staff to have a “line of sight” on the child at bedtime, but they stressed to The Tribune that it’s difficult to keep up with that when they are understaffed.
Both situations involve calling on extra staff to supervise the child, and the DCS letter states, “It is reported by staff that attempting to secure relief staff is sometimes challenging.”
In response, Lett again points DCS to Michiana Behavioral’s efforts to fill gaps when staff are absent.
Ages and genders
The DCS letter pointed out how children of “varying ages and genders” were found on the units.
It also reported that each living unit may house no more than 15 children but that, on March 20, one unit had 19 children while the other one had 10.
Lett responded that that was because the facility aims to keep children together and adolescents together for programming during the day, although it uses the combined bed capacity for sleeping arrangements.
“Generally, adolescents are roomed together,” Lett wrote.
DCS reviewers found a child in what appeared to be a “time out room,” though DCS perceived that to be “seclusion” since a staff member used his body to keep the child from leaving. DCS suggested that the staff be retrained on the difference between the two — so that it’s reported correctly.
Lett agreed to retrain the staff on this.
Psychotropic drugs
There are some concerns that DCS is still trying to resolve. Specifically:
Were psychotropic drugs used to subdue children whose behavior needed to be restrained? These are known as “chemical restraints.” DCS doesn’t generally allow drugs to be used to restrain a child’s behavior, the DCS letter states. Such drugs may only be given via a “stat” order by the prescribing physician for a one-time emergency basis when a child is agitated or after developing a “behavior management plan” for the specific child that first seeks to use less restrictive methods, the DCS letter states.
Were psychotropic drugs ordered for children without a behavior management plan? And if so, were the drugs ordered as part of a chemical restraint?
When asked about both issues, DCS spokeswoman Stephanie McFarland said, “It’s unclear, so we’re trying to assess that.” In other words, she said, DCS continues to ask questions of Michiana Behavioral.
The DCS letter states that four children lacked a behavior management plan.
But Lett countered that such plans are incorporated into the child’s “master treatment plans” so that all staff are aware of what triggers a child to be aggressive and the options for controlling the child’s behavior. He provided DCS with the plans for the four children.
He also wrote that mandatory trainings for all staff would cover the use of “chemical restraints” and behavior plans.In her follow-up letter, Michiana Behavioral’s attorney wrote that the facility didn’t give drugs in violation of DCS rules. Nor, she wrote, does it believe its policies on chemical restraint conflict with the state’s policies.
Source: Joe Dits, “Staff ratios under review; Michiana Behavioral Health facility CEO disagrees with DCS report,” South Bend Tribune, May 18, 2013.
May 27, 2013
Psychiatrist William Ellien sentenced to 30 months prison for prescribing violations
Former Savannah psychiatrist William George Ellien on Thursday was sentenced to 30 months in federal prison for prescribing unlawful addictive drugs to patients.
Federal prosecutors said Ellien exchanged prescriptions for highly addictive drugs for sex with former patients, some of whom he met in strip clubs, between 2009 and 2012.
Ellien, 57, also must serve a three-year supervised release term after completing his custody sentence and must perform 40 hours of community service in the first year after his release from prison, U.S. District Judge William T. Moore Jr. ruled.
The judge said Ellien does not have the ability to pay a fine.
Moore noted that Ellien has surrendered his Drug Enforcement Administration license to prescribe drugs, as well as his medical license, but ordered Ellien to surrender any other medical licenses he still holds.
Moore imposed a three-year supervised release term instead of the five years available under sentencing guideline.
“He has lost his right to practice medicine. He has lost his job,” Moore said.
Ellien, wearing a gray-striped jail suit, told Moore, “I deserve incarceration as punishment. … I’m aghast by my conduct.
“I have lost my license. I have left my family destitute . … I’m not a bad person, but I have done wrong.”
Defense attorney George Asinc called the case “highly unusual,” adding he had never seen a man “lose as much as this man lost.”
He urged Moore to allow some leniency in his sentence.
Assistant U.S. Attorney Greg Gilluly called Thursday “a sad day for the defendant and his family.”
He said Eillien would meet women in strip clubs and they ultimately trusted him.
But, Gilluly said, “Some of these women were manipulative — not angels.”
The pre-sentencing investigation by probation officers detailed numerous drug prescriptions by Ellien, in one instance detailing more than nine pages of prescriptions given to one woman.
The prosecutor said there was evidence Ellien engaged in similar conduct in Mississippi before coming to Savannah.
But he also pointed out that Ellien was a lieutenant colonel in the U.S. Army and almost immediately admitted wrongdoing in the case.
Source: Jan Skutch, “Savannah psychiatrist sentenced in drugs-for-sex scheme,” Savannah Morning News, May 23, 2013.
Former patient sues psychiatrist Abdullahi Abdulkarim Mohamed over sexual assaults
MONROE, Mich. (CN) – A psychiatrist told a patient he dreamed of sodomizing her and sexually assaulted her before writing prescriptions for drugs she needed, the patient claims in court.
Mary Shaw sued Dr. Abdullahi Abdulkarim Mohamed and the Progressive Guidance Center of Monroe, in Monroe County Court.
Shaw says in the complaint “that during several office treatment visits between 1/5/12 and 5/31/12, the defendant, Mohamed, sexually assaulted the plaintiff, Shaw, while she was at his office for psychiatric care and treatment.”
She claims that during an office visit on Jan. 5, 2012, “Mohamed spoke to plaintiff about certain dreams he was having about her.
Defendant Mohamed told the plaintiff that he dreamed of engaging in anal sex with her. The discussion lasted for several minutes.
Defendant Mohamed then wrote the mental health prescriptions for this plaintiff.
Thereafter, defendant Mohamed brushed his hands across plaintiff’s breasts. Thereafter, plaintiff left defendant Mohamed’s office.
“During the office visit on or about 02/02/2012, defendant Mohamed again sexually abused the plaintiff. During this visit, defendant Mohamed again told the plaintiff Shaw that he still dreams about having anal sex with her. Moreover, during this medical visit,
defendant Mohamed lifted up the plaintiff’s shirt to view her breasts and inappropriately hugged and kissed the plaintiff Shaw,” according to the complaint.
On subsequent visits, Mohamed touched Shaw’s breasts and “grinded his body against the plaintiff’s body in a sexual fashion,” before writing prescriptions for her psychotropic medications, she says in the complaint.
On her last visit with Mohamed, he “again hugged and kissed the plaintiff. However, while doing so, defendant Mohamed slid one of his hands down into plaintiff’s pants, under her underwear, into the crotch area. Moreover, at the same time, defendant Mohamed slid his other hand up under plaintiff’s bra and fondled her breast. Thereafter, defendant Mohamed wrote the mental health prescriptions and plaintiff left his office,” the complaint states.
It adds: “That when plaintiff Shaw returned to defendant Progressive Guidance Center of Monroe for care and treatment, she was consulted by Dr. Memon, who, among other things, concluded that plaintiff’s mental health prescriptions were highly excessive in
nature and recommended a new prescription regimen.”
Shaw says she reported Mohamed’s sexual assault to the police and but Progressive Guidance Center retained him on its medical staff, “well after he had sexually assaulted several victims, all of whom relied upon him for psychotropic medications and psychiatric
management and all of whom had Medicare and/or Medicaid insurance.”
Shaw seeks $10 million in damages for sexual assault, emotional distress, and false imprisonment.
She is represented by Gregory Rohl, of Novi, Mich.
Source: Jack Bouboushian, “Patient Says Shrink Told Her His Dirty Dreams,” Courthouse News Service, March 4, 2013.
Psych Crime Reporter 