Adopting the recommendation of an administrative law judge, the Drug Enforcement Administration revoked the registration of a Stamford, Connecticut, physician for improper recordkeeping and prescribing related to patients and his own family members (Ajay S. Ahuja, 84 Fed. Reg. 5479, Feb. 21, 2019).

The physician, Ajay S. Ahuja, also lost a DATA waiver authorization that allowed him to dispense or prescribe Schedule III through V controlled drugs for use in maintenance or detoxification treatment.

The charging order to show cause alleged violations of four of the factors in the Controlled Substances Act (at 21 U.S.C. § 824(a)(4)) that are relevant in determining whether continued registration is in the public interest. The ALJ found that the government did not prove two of the allegations but did establish two others relating to improper recordkeeping and improper prescribing practices.

The proceedings began with a DEA investigation in 2014. In 2016, a parallel civil case was filed against Ahuja in a federal district court.

Improper Prescribing and Failure to Accept Responsibility

The ALJ found the doctor’s prescribing practices failing with respect to public patients and with respect to prescriptions for himself and his family members. Alleged violations included overlapping prescriptions to several patients and issuing prescriptions without any documentation or bases for the prescriptions in the patents’ medical records. Also, DEA investigators had found that Ahuja dispensed controlled drugs directly to patients in his office without documentation.

A DEA expert testified that these drug were dispensed for other-than-legitimate medical purposes and outside the course of professional practice. Moreover, such actions fell below the standard of care in the state of Connecticut.

In a registration revocation action, after the government presents a prima facie case for revocation, the respondent has the burden of producing sufficient mitigating evidence to show why he or she should be entrusted with a DEA registration. To rebut the government's case, the respondent must both accept responsibility for the illicit actions and demonstrate that he or she will not engage in future misconduct (see Patrick W. Stodola, M.D., 74 Fed. Reg. 20727, 20734-35 [2009]).

A respondent may accept responsibility by providing evidence of remorse, efforts at rehabilitation, and recognition of the severity of the misconduct. An expression of remorse includes acknowledgment of wrongdoing. Acceptance of responsibility and remedial measures are assessed in the context of the egregiousness of the violations and the DEA’s interest in deterring similar misconduct by the respondent in the future as well as on the part of others.

In the current matter, the ALJ agreed with the government that the record contained no evidence that Ahuja had accepted responsibility for the misconduct at issue in the proceedings and that failure to do so was fatal to his cause. While Ahuja admitted many of the allegations against him, he failed to fully accept responsibility for the most egregious aspects of his actions, according to the decision. For example, Ahuja failed to acknowledge that his prescribing and dispensing practices fell below the standard of care in the state of Connecticut. Furthermore, he refused to admit that the prescriptions that he dispensed to himself, his family, and his patients were issued or dispensed for other-than-legitimate medical purposes and outside the course of professional practice, despite being provided the opportunity to do so.

Even the corrective action plan proposed by Ahuja under 21 U.S.C. §824(c)(2)C effectively acknowledged the occurrence of numerous violations without his actually accepting responsibility for the actions, the ALJ found.

The deciding official, and Acting DEA Administrator, Uttam Dhillon, ordered the revocation of Ahuja’s basic practitioner registration and the related DATA waiver identification number and further ordered denial of any pending application to renew or modify his existing registration, effective Feb. 10.