[Federal Register: November 29, 2002 (Volume 67, Number 230)]
[Notices]
[Page 71196-71198]
From the Federal Register Online via GPO Access [wais.access.gpo.gov]
[DOCID:fr29no02-123]
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DEPARTMENT OF JUSTICE
Drug Enforcement Administration
Christopher E. Castle, M.D., Revocation of Registration
On March 14, 2002, the Deputy Assistant Administrator, Office of
[[Page 71197]]
Diversion Control, Drug Enforcement Administration (DEA), issued an
Order to Show Cause, Immediate Suspension of Registration, to
Christopher E. Castle, M.D. (Dr. Castle) of Seymour, Tennessee,
notifying him of an opportunity to show cause as to why DEA should not
revoke his DEA Certificate of Registration, BC1157076 under 21 U.S.C.
824(a), and deny any pending applications for renewal or modification
of that registration. The order also notified Dr. Castle that should no
request for a hearing be filed within 30 days, his hearing right would
be deemed waived.
The Order to Show Cause was sent by certified mail to Dr. Castle at
his registered location in Seymour, Tennessee. It was also delivered by
DEA Investigators to Dr. Castle and his legal counsel on March 19,
2002, at the Blount County Jail in Maryville, Tennessee, where Dr.
Castle was incarcerated.
DEA has not received a request for hearing or any other reply from
Dr. Castle or anyone purporting to represent him in this matter.
Therefore, the Deputy Administrator, finding that (1) 30 days have
passed since the receipt of the Order to Show Cause, and (2) no request
for a hearing having been received, concludes that Dr. Castle is deemed
to have waived his hearing right. After considering material from the
investigative file in this matter, the Deputy Administrator now enters
his final order without a hearing pursuant to 21 CFR 1301.43(d) and (e)
and 1301.46.
On November 4, 1987, Dr. Castle obtained DEA Certificate of
Registration Number BC1157076, as a practitioner in Schedules II
through V. That registration remained valid until August 31, 2002.
Pursuant to 21 CFR 1301.36(i), the Deputy Administrator will extend the
registration for purposes of this revocation proceeding. On June 3,
2001, the Sevierville (Tennessee) Sheriff's Department arrested an
individual referred herein as ``RS,'' and charged him with various
offenses related to the possession of controlled substances with intent
to distribute. At the time of his arrest, ``RS'' was in possession of
controlled substances from prescriptions that were issued by Dr.
Castle. During a subsequent interview of ``RS'' by the Sevierville
Sheriff's Department he informed law enforcement authorities that
during his association with Dr. Castle, and in exchange for controlled
substance prescriptions, he along with his spouse provided personal
services to Dr. Castle, including installation of cabinets and repair
of a garage door. ``RS'' further informed law enforcement authorities
that on numerous occasions, he and his spouse were able to obtain from
Dr. Castle prescriptions for any controlled substance they desired, in
exchange for cash. Included among the drugs that Dr. Castle authorized
for the couple in exchange for cash were Adderall and OxyContin, both
highly abused Schedule II controlled substances. A subsequent
investigation by DEA revealed that ``RS'' sold controlled substances to
other individuals from prescriptions issued by Dr. Castle.
``RS'' also informed law enforcement authorities that while
visiting Dr. Castle's home on a prior occasion, he observed several of
Dr. Castle's blank prescription pads unsecured in various parts of Dr.
Castle's home, as well as prescriptions vials for controlled substances
in the names of other individuals. ``RS'' also recounted one instance
where Dr. Castle provided to him OxyContin tablets for his personal
use, and for controlled substances in the names of other individuals.
``RS''also recounted one instance where Dr. Castle provided to him
OxyContin tablets for his personal use, and for no legitimate medical
purpose. ``RS'' further informed law enforcement authorities that he
informed Dr. Castle of his June 3, 2001 arrest on drug possession
charges. Nevertheless, a subsequent review by DEA of prescription
information regarding ``RS'' revealed that between January and August
2001, Dr. Castle issued prescriptions totaling 900 dosage units of
OxyContin 40mg., and 90 dosage units of OxyContin 80mg. Dr. Castle
continued issuing controlled substance prescriptions for ``RS'' up
until October 3, 2001, despite Dr. Castle's knowledge of his drug
arrest.
In response to the above information, in August 2001, the Tennessee
Bureau of Investigation (TBI), the United States Department of Health
and Human Services (HHS), and the Sevierville Sheriff's Department
initiated investigation of Dr. Castle's medical practice. During a
surveillance of Dr. Castle's office, law enforcement agents observed a
high volume of persons entering in, and exiting the office for the
purpose of obtaining prescriptions. These office visits typically
lasted five minutes or less, and some of these individuals had been
identified by local law enforcement agents as having prior drug related
convictions and/or under investigation for illegal drug violations.
On October 3, 2001, the State of Tennessee, Department of Health
(Department of Health) issued to Dr. Castle a Notice of Charges and
Memorandum of Assessment of Civil Penalty. In the Notice of Charges,
the Department of Health alleged, among other things, that with respect
to its review of Dr. Castle's treatment of eleven patients, Dr. Castle
issued prescriptions for controlled substances months before actually
examining a patient, and that Dr. Castle dispensed, prescribed, or
otherwise distributed controlled substances outside of Dr. Castle's
professional practice, and not in good faith to relieve pain or
suffering. Specifically, the Department of Health alleged Dr. Castle's
improper prescribing with respect to patients referred herein as ``DE''
and his spouse ``JE.''
The Notice of Charges further proposed that Dr. Castle pay civil
penalties in the amount of $16,500, and that the State Board of
Medicine make a determination as to whether Dr. Castle's medical
license be suspended, revoked or otherwise disciplined. That matter is
currently pending resolution.
On October 19, 2001, a search warrant was executed at Dr. Castle's
office by agents from TBI, HHS, the Tennessee Valley Authority, and the
Sevierville County Drug Task Force. During the execution of the
warrant, agents seized several patient files, and interviewed an
employee of Dr. Castle's office. Dr. Castle's employee confirmed that
several of Dr. Castle's patients obtained controlled substance
prescriptions in exchange for cash.
On October 19, 2001, Special Agents from HHS, as well as TBI and
DEA investigators interviewed a former medical assistant/laboratory
technician employed by Dr. Castle's office. The individual informed law
enforcement personnel that one occasion, when Dr. Castle was absent
from his office in August 2001, Dr. Castle authorized his staff to fill
in names, dates, and quantities of controlled substances prescribed on
pre-signed prescriptions. These prescriptions were not dated on, or
signed on the day when issued as required by 21 CFR 1306.05.
On November 14, 2001, Special Agents from HHS, TBI and the
Tennessee Office of Inspector General interviewed another individual
herein referred to as ``CLF,'' a former patient as well as a personal
acquaintance of Dr. Castle. ``CLF'' informed law enforcement personnel
that over a period of several months, Dr. Castle routinely prescribed
Adderall in ``CLF's'' name, and had her return portions of the filled
prescription to Dr. Castle for his personal use. ``CLF'' further
informed that Dr. Castle never performed a physical examination before
writing prescriptions in her name, and that Dr. Castle frequently
[[Page 71198]]
issued prescriptions while dining with her in a local restaurant.
In December 2001, Dr. Castle was named as a defendant in a
$2,500,000 civil lawsuit filed in Sevier County Circuit Court by a
former employee of Dr. Castle's medical practice. The suit alleged in
part that Dr. Castle provided pain medications to his former employee
when she was sixteen years old, prescribed pain medications while she
was pregnant, and contributed to her addiction until the time she left
Dr. Castle's employ at the age of twenty-one. The suit further alleges
that Dr. Castle's actions contributed to the December 6, 2000, overdose
on pain medications by the employee, which eventually led her to seek
detoxification the following week. That matter is also pending
resolution.
On January 10, 2002, DEA investigators conducted surveys of three
pharmacies where several of Dr. Castle's patients had prescriptions
filled: the pharmacies were Jabo's Pharmacy located in Newport,
Tennessee; Murphy's Sav-Mor Pharmacy located in Jefferson City,
Tennessee; and Mugford's Pharmacy located in Knoxville, Tennessee. The
surveys revealed, that following the issuance to Dr. Castle of the
Notice of Charges, as well as the execution of a search warrant at Dr.
Castle's office, Dr. Castle continued to issue numerous Schedule II
through IV controlled substance prescriptions for ``DE'' and ``JE.'' As
noted above in paragraph six, the Department of Health alleged Dr.
Castle's improper prescribing with respect to patients ``DE'' and his
spouse ``JE.'' DEA's investigation revealed that between October 15,
2001 to January 12, 2002, these individuals had their prescriptions
filled at different pharmacies including each of the above pharmacies.
DEA's review of prescriptions authorized by Dr. Castle, and
obtained from Murphy's Sav-Mor Pharmacy revealed a Dandridge, Tennessee
home address for ``DE'' and ``JE.'' Yet, a review of written
prescriptions filled by ``DE'' and ``JE'' at Mugford's Pharmacy
revealed a Knoxville, Tennessee home address for the couple. These
addresses were not included on the prescriptions that were issued by
Dr. Castle, and were added to the prescriptions by someone other than
Dr. Castle. A subsequent investigation by DEA revealed that Dr. Castle
failed to list addresses on prescriptions issued to ``DE'' and ``JE,''
as well as numerous prescriptions issued to other patients, as required
by 21 CFR 1306.05(a).
On February 11, 2002, Special Agents from HHS, TBI and the
Tennessee Office of Inspector General interviewed an individual herein
referred to as ``JS.'' ``JS'' informed law enforcement officials that
he had a long-term history of narcotic abuse and had purchased
OxyContin from ``RS'' (referenced in paragraphs two through four
above). ``JS'' further informed that Dr. Castle wrote prescriptions for
OxyContin and Adderall for him in the name of the wife of ``JS.''
``JS'' further informed law enforcement personnel that his wife had
never been to Dr. Castle's office, and was not aware that Dr. Castle
issued prescriptions in her name for ``JS.'' ``JS'' also informed that
Dr. Castle created fictitious patient information in the name of his
wife. Law enforcement personnel from the above agencies later conducted
an interview of the wife of ``JS'' and she confirmed that she had never
received any controlled substance prescriptions from Dr. Castle, nor
had she ever visited Dr. Castle's office.
The investigation of Dr. Castle's practice also revealed that on or
around September 6, 2001, ``JS'' requested that Dr. Castle send to him
a prescription for OxyContin in his wife's name. Several days later,
``JS'' found the requested prescription in his mail box in his wife's
name, which had been mailed from Dr. Castle's office and signed by Dr.
Castle. DEA's investigation further revealed that between November and
December 2001, Dr. Castle issued several Schedule II controlled
substance prescriptions for ``JS'' in his wife's name.
On February 21, 2002, the Sevier County Street Crimes Unit executed
a search warrant at Dr. Castle's medical practice. During the execution
of the warrant, law enforcement officers recovered from Dr. Castle's
person several syringes, including some that had been used. The
syringes contained Adderall.
In November 2001, Dr. Castle was indicted in the United States
District Court, Eastern District of Tennessee, on one count of
possession of child pornography. However, after posting a $50,000 bond,
Dr. Castle was granted pretrial release on November 7, 2001. As a
condition of Dr. Castle's release, Dr. Castle was ordered not to
download child pornography from Dr. Castle's personal computer, carry a
firearm, or engage in the personal use of drugs. Nevertheless, an
investigation by the Tennessee Office of Inspector General revealed
that Dr. Castle continued to download child pornography in violation of
a condition set by Dr. Castle's pretrial release. As a result, on
February 26, 2002, the court ordered the revocation of Dr. Castle's
bond, and further ordered Dr. Castle detained until Dr. Castle's May 7,
2002, trial on a charge of possession of child pornography.
In view of the foregoing, and pursuant to 21 U.S.C. 824(d), I find
that Christopher E. Castle, M.D. has been responsible for the diversion
of large quantities of controlled substances into other than legitimate
medical channels. It is my conclusion that Dr. Castle has committed
such acts as would render his continued registration inconsistent with
the public interest. 21 U.S.C. 824(a)(4). Accordingly, the Deputy
Administrator of the Drug Enforcement Administration, pursuant to the
authority vested in him by 21 U.S.C. 823 and 824 and 28 CFR 0.100(b)
and 0.104, hereby orders that DEA Certificate of Registration
BC1157076, issued to Christopher E. Castle, M.D. be, and it hereby is,
revoked. The Deputy Administrator further orders that any pending
applications for renewal or modifications of such registration be, and
they hereby are, denied. This order is effective December 30, 2002.
Dated: November 12, 2002.
John B. Brown, III,
Deputy Administrator.
[FR Doc. 02-30255 Filed 11-27-02; 8:45 am]
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