Two area doctors who misused their prescription pads have had their medical licences placed on probation for five years by the Medical Board of California.
Dr. John Chu, who resides in Laguna Niguel and practices emergency medicine at Kaiser Permanente in Huntington Beach, prescribed Ambien without having performed medical evaluations to his mother, two brothers and a doctor in his department.
Dr. Gary Phillip Jacobs, who resides in Long Beach and has worked as a family and internal medicine specialist in Westminster, Whittier, Hawaiian Gardens and Van Nuys, started prescribing Ativan to himself in 2012, although the board did not receive an anonymous tip about it until January 2015.
Chu and his attorney Frederick M. May signed a probation acceptance letter from the medical board on Nov. 9, according to state records.
Jacobs signed his acceptance letter on Nov. 4, but the copy I downloaded from the board's database is missing the signature of his attorney Tracy Green.
Ativan is used to treat seizure disorders, such as epilepsy, and can also be given just before surgery and medical procedures to relieve anxiety. But it is a controlled substance because it can cause paranoid or suicidal thoughts and impair memory, judgment and coordination. Combined with other substances, particularly alcohol, Ativan can slow breathing and possibly lead to death.
While the board's probation order mentions the self prescribing of a controlled substance, it deals more with Jacob's apparent attempts to avoid participating in the state investigation of him. According to the board, he:
* Failed to participate in an interview with the board, which was responding to an anonymous complaint alleging the doctor was self medicating in January 2015.
* Told board investigators, who confronted him at his Los Angeles office in August 2015, that he would give them his lawyer's contact information.
* Twice failed to answer messages from board investigators seeking an interview a month later, so the board subpoenaed him. But the subpoena could not be served on Oct. 19, 21, 27 and 28 of 2015 because Jacobs was not in his office when servers showed up.
* Responded, on Dec. 16, 2015, to a certified letter sent Nov. 15 about him scheduling an interview, saying he would be in contact to do so. But messages an investigator left on Dec. 16, Dec. 28, Jan. 7, 2016, to schedule the interview were not answered.
* Received, on Jan. 13, 2016, a subpoena—hand delivered by the investigator—commanding Jacobs to appear at the Division of Investigation, Health Quality Investigation Unit in Cerritos on that Jan. 27.
* Left, the morning of Jan. 27, 2016, a voice mail with the investigator explaining that he was ill and would not make it to the interview.
* Never responded, as of March 7, 2016, to the investigator's Jan. 27 voice mail about re-scheduling the interview.
The board took into consideration for its discipline Jacobs having received a letter of reprimand on Feb. 7, 1997, for unlawful use or prescribing of dangerous drugs from 1985-95. Because Jacobs enrolled in a board diversion program, he avoided probation or license revocation proceedings back then.
During probation, he cannot use controlled substances and must undergo routine drug tests. Jacobs is also required to complete ethics and prescribing practices courses, notify every hospital or facility where he has privileges of his probationary status, obey all laws and make quarterly reports on his progress.
He cannot practice medicine solo nor supervise physician assistants.
And, this one is key given the new probation report: Jacobs must make himself available to the board for interviews at any time.
Ambien is supposed to be a short-term aid for insomnia, and prescribing it should be done as part of a treatment plan that does not include open-ended use of the medication, according to the state board. That is because Ambien is an addictive, controlled substance, which might shine a light on why a patient identified by the board as J.C. needed so many prescriptions—many with refills—from his brother Chu starting in 2011 and continuing for three years.
Take a look:
J.C. got these scripts without medical evaluations being done by Chu or proper records about the visits being kept, according to the board. The same can be said for:
* Chu's mother, identified as L.C., who got scripts from her son for 30, 10 mg Ambien pills on Jan. 17, Feb. 17, April 30, Oct. 10 (with a refill), Oct. 29, 2012, (with three refills) and Nov. 12 of 2013 and Jan. 7 of 2014.
* A.C., another brother of Chu, who got the same prescriptions on: Nov. 6, 2012, (with three refills) and Jan. 22, March 10 (with three refills), April 19, May 29, July 24 (with three refills) and Nov. 1 of 2013 (with two refills).
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* Chu's fellow Kaiser emergency medicine physician C.L., more of the same on: Sept. 18, 2012, (30 pills with five refills) and 60 pills each on March 17 (three refills), Aug. 13 (two refills) and Aug. 30 (on refill) of 2013.
The treatment of J.C. represents gross negligence, while the scripts for that patient as well as his mother, brother A.C. and Dr. Chu's colleague constitute repeated negligent acts, furnishing drugs without examination, excessive prescribing, violating state drug laws and failure to maintain adequate records, according to board documents.
During his probation, Chu must: maintain adequate records; allow a board designee access to his records and controlled substance inventories; take a continuing medical education class and an ethics course; practice with other doctors and not alone; avoid prescribing drugs to anyone, including family members, who he is forbidden from treating; and he must show the board letters he has sent to family members explaining he cannot see them as a doctor any more.
The state indicates Chu has already met conditions that he complete prescribing practices and medical record keeping courses. But he also must obey all laws and give quarterly updates to the board about his progress in meeting the other conditions. Violating probation could set in motion revocation procedures, and he must let the board know if he decides to surrender his medical license.