Secretary of State Announces Suspension of Prescribing Privileges

DOVER – Acting on recommendations from the state’s Controlled Substances Advisory Committee, Secretary of State Jeffrey Bullock has suspended certain prescribing privileges of three Delaware physicians, citing findings that they repeatedly violated Delaware’s Uniform Controlled Substances Act.

In making this determination, Secretary Bullock and the committee considered the conclusions of an administrative hearing officer, who found that Steven Grossinger, Bruce Grossinger and Jason Brajer improperly administered pain medications to a patient with a history of substance abuse. The hearing officer determined that the physicians failed to subject the patient to required drug screenings, failed to properly document pill counts in the patient’s chart, and continued to prescribe controlled substances with knowledge that the patient was addicted.

The physicians currently practice at Grossinger Neuropain Specialists in Wilmington and Eddystone, Pa.

The secretary’s order bars the physicians from prescribing or dispensing Schedule II controlled substances for a period of six months, including medications such as oxycodone, fentanyl, morphine, methadone and amphetamine. The suspensions are accompanied by fines of $3,000 for each physician and will be followed by a three-year probationary period, during which the physicians will submit to quarterly random audits of 10 percent of their patient charts.

The licensure statuses of these physicians have been updated on the Division of Professional Regulation’s online license verification service. Electronic versions of the signed suspension orders can be found here, here and here.


Secretary of State Signs Emergency Rule to Place Requirements on Prescription of Hydrocodone

 **Click here to view the Emergency Order**

(Dover, Del.) Secretary of State Jeffrey Bullock has put into place emergency regulations around any extended-release hydrocodone (Zohydro) that lacks an abuse-deterrent formulation (ADF) feature following recommendations from the Delaware Controlled Substance Advisory Committee. Abuse-deterrent formulation (ADF) features are physical barriers that cause a drug to be ineffective when chewed, crushed, cut, grated, or ground or chemical barriers that can resist extraction of the opioid using common solvents like water.

“The use of this new and dangerous narcotic painkiller known as Zohydro must be monitored closely because the abuse of it can be deadly,” said Secretary Bullock .  “ It carries even higher risks of abuse than other short-acting formulations.”

The regulations require best practices in assessment, prescribing and monitoring of patients for whom the drug has been prescribed.  The restrictions and requirements, in conjunction with the Delaware Prescription Monitoring Program, provide an additional safety net in fulfilling obligations to protect the public.

Because of the potential for accidental overdose, intentional abuse or diversion, and available data and information pertaining to extended-release hydrocodone lacking ADF, Secretary Bullock finds that adoption of these emergency regulations is necessary to address the imminent peril to the public health, safety and welfare of all Delawareans.

Prior to prescribing an extended-release hydrocodone that is manufactured without an ADF, the medical practitioner shall conduct and document a thorough medical evaluation and physical examination as part of the patient’s medical record.

For more information about the Division of Professional Regulation Controlled Substances program visit: http://dpr.delaware.gov/boards/controlledsubstances/index.shtml.

Contact: Tammy Stock at (302) 857-3038 or tamara.stock@delaware.gov. Delaware Department of State, Chief, Community Relations.


Delaware Imposes Three-Year Suspension and $5,000 Fine on Dr. Muhammed Niaz for Unlawful Prescribing Practices

Delaware’s Board of Medical Licensure and Discipline suspended the medical license of Dr. Muhammed Niaz this week for three years and required that he pay a fine of 5,000 dollars for numerous violations of the state’s Medical Practice Act, specifically related to the prescribing of controlled substances.

“Dr. Niaz’s conduct demonstrates a willful disregard for professional responsibility to protect patients and the community from the very serious effects of drug abuse and illegal diversion,” said Secretary of State Jeffrey Bullock.

The Board found that, among other violations, Dr. Niaz’s failure to document medical histories and test results; his failure to develop and follow appropriate treatment plans; his disregard of indications that patients were abusing medication; and basing prescribing decisions in large part on patient requests or representation rather than objective results “constitute such egregious deviation from the standard of care that this level of unprofessional conduct must be met with the appropriate discipline. That is, suspension.”

“When prescribed and used properly, medication can significantly improve the health and quality of life of people who are suffering with severe pain and other ailments,” said Dr. Gregory Adams, Board President. “When a medical professional does not follow proper protocol in prescribing and monitoring the use of medication, however, there can be significant negative impact on the patient and the community.”

The Board also held Dr. Niaz responsible for his lack of oversight of an advanced practice nurse who worked in his office. The nurse practitioner has also been accused of serious violations related to her prescribing practices.

In addition to the suspension and fine, which must be paid within 90 days, Dr. Niaz must complete 12 hours of continuing education related to drug abuse and addiction, the prescribing of controlled substances, and proper supervision practices before the Board will consider lifting the suspension in 2016.


Settlement Reached in Overprescribing Case

Dr. Patrick Titus must meet stringent requirements for treating pain management patients

Secretary of State Jeffrey Bullock has signed an order to accept a consent decree setting forth numerous requirements that Dr. Patrick Titus must satisfy before he is allowed to resume prescribing controlled substances. Dr. Titus’ Controlled Substance Registration was suspended in December 2011 when it was alleged that he had been overprescribing controlled substances and ignoring evidence that some of his pain management patients were abusing or diverting the controlled substances.

Dr. Titus admitted that he needs additional training and education to safely and effectively prescribe controlled substances to chronic pain patients. He also admitted that controls to prevent diversion and abuse of controlled substances were inadequate and may have actually led to abuse.

“This is unfortunately another of an increasing number of cases involving lax prescribing practices that lead to diversion and abuse of potentially dangerous drugs,” said Secretary Bullock. “The effects of prescription drug abuse and diversion can be devastating to individuals, families and communities. It is imperative that physicians strictly adhere to standards for safely prescribing controlled substances.”

Among the terms of the consent agreement, Dr. Titus must fulfill extensive requirements before his registration will be reinstated. These include evidence that his practice is fully equipped to comply with regulations and guidelines set forth by the Delaware Board of Medical Licensure and Discipline, the Federation of State Medical Boards, the American Pain Society and the American Academy of Pain Medicine. Furthermore, Dr. Titus’s staff must undergo training on these regulations and guidelines and appropriate medical record keeping practices. He will be subject to random audits for the next two years.

Dr. Titus must also complete 12 hours of Continuing Medical Education (“CME”), in addition to those regularly required for license renewal (40 hours), on opioid prescription practices, treatment of chronic pain, or other related topics before his suspension will be lifted. For the next two years, Dr. Titus must take 6 additional CME hours on these topics each year.

When treating patients for chronic pain, Dr. Titus must require toxicology screens.  He may not treat any pain management patients longer than six months. Thereafter, he must refer each patient to a recognized pain management physician for re-evaluation.