A weight-loss/pain-management/medical marijuana doctor, who resides in Dana Point and has practiced in spas and clinics all over Orange County and Southern California, has surrendered his license to practice medicine in California.
The Medical Board of California had placed Dr. Richard Berton Mantell's license on probation last year for 13 causes for discipline, including unprofessional conduct, false representations, dishonesty or corruption and violations of the Medical Practice Act.
The license surrender agreement, which was signed by Mantell and his attorney Peter Osinoff on June 12 and became effective last Friday, gave "mental illness effecting competency" as the grounds for the action.
One condition of the physician's license probation was that he undergo an intense neuropsychological examination, which showed Mantell "experienced significant decline in the areas of perceptual reasoning, processing speed and overall IQ," according to a report to the medical board, which was informed the 63-year-old scored in the "mildly to moderately impaired range" in his demographic group.
"Respondent's test results demonstrated severe impairment regarding perceptual reasoning and mental spatial organization" and his"neuropsychological impairments precluded him from being able to safely practice medicine," concluded the evaluation that was presented to the medical board on Feb. 21.
The first cause cited in a recommendation to revoke probation was Mantell failing to successfully complete a clinical training program, which had been a condition the board imposed when his license was placed on probation. Mantell's probation was tied to poor treatment of pain patients, including some who were drug addicts when they received prescriptions for powerful, addictive medications.
For a knee-pain sufferer who tested positive for methamphetamine use, Mantell kept poor records, violated established protocols and failed to properly supervise the patient's care and treatment, the board found. The board knocked Mantell for similar treatment of a back-pain sufferer, who admitted during his treatment that he was an opiod addict. The doctor prescribed methadone, as the patient requested, without taking a proper medical history or without any discussion about drug and alcohol use, concluded the board, which further found Mantell did not possess the government registration required for detoxification treatment nor did he establish a treatment plan nor did he inform the patient of the increased risks of overdose or even death on methadone.
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Poor record keeping in that case was also cited, as it was for a third patient, who was also being treated for knee pain. That patient was already under three prescriptions filled in the Los Angeles area when he saw Mantell, who would write him scripts for powerful drugs and repeatedly re-filled them when the patient claimed another doctor stole the meds. A fourth patient, this one with leg pain and on insulin for diabetes, also got prescriptions filled and re-filled by claiming police confiscated his prescribed drugs. At one point, that patient was receiving the equivalent of 11 Norco pills a day.
There is no indication the doctor knew that a fifth patient, who was being treated for jaw pain, was already on oral opiods and a morphine pump when he prescribed her more powerful meds, found the board, which also cited Mantell's shoddy records. She came up with excuses including her meds were missing when her car got towed with them inside, her daughter going to prison for stealing her prescribed drugs and that she was very depressed after being taken off the morphine pump before Mantell obliged her wishes for more meds. Similar allegations accompanied Mantell's treatment of a man with back and knee pain and another with bruised ribs. The treatment off all these patients, the board concluded, constituted "gross negligence."
In December 2012, board investigators sent an undercover agent posing as a patient to discuss weight-loss options with Mantell, who did not ask for her medical history, whether she was a smoker and what medications she was currently taking. She was told about the importance of exercise and was prescribed phentermine, a dangerous stimulant and appetite suppressant that is normally given only to the very obese, and only with very close supervision by a physician. Four months after that appointment, the patient/agent made an unannounced visit to Mantell's office to receive her medical records. His signature was no where on the chart notes she was given, but when the board asked for the same documents a month later, Mantell's signature was there with "12/10/12" scrawled next to his John Hancock. The board believes he actually signed it three days after the undercover's visit. His care for the undercover was also extremely lacking, according to the board, which concluded that with all the patients cited Mantell was guilty of repeated negligent acts.
Another cause for discipline was Mantell being recruited to supervise the non-physician owner of a Corona medical clinic, where the doctor received a salary from the owner but did not hire/fire staff, set work schedules, sign paychecks, conduct job training or performance evaulation or hold any ownership interest in the business. The owner had been referred to Mantell's clinic by medical marijuana patients.