In his message in the Louisiana State Board of Dentistry’s Winter 2010 Bulletin, retiring board President Barry Ogden said in the third paragraph from the bottom of page 4 of the bulletin: “Every time a licensee gets sanctioned they always explain it as the board was on a witch hunt… or they are power hungry…. This is all bogus, and I ask you whether your would sign a consent decree if you thought we were wrong? I don’t think so.”
It’s pretty obvious why: The board holds the life or death power over dentists’ livelihoods. They can, on a whim, render years of costly education useless, destroying careers in the process.
LouisianaVoice has shown in previous posts how the Louisiana State Board of Dentistry has run roughshod over dentists. We have revealed board actions ranging from levying draconian fines for minor board rules infractions to initiating devastating reprisals against whistleblowers and those who otherwise resist its strong-arm tactics.
But in examining the case of Slidell dentist Dr. Kenneth O. Starling, it becomes even more evident that the Dentistry Board for decades has operated a white collar extortion scheme that rivals any protections racket run by mobsters in New York, New Jersey or elsewhere.
Strong accusation? Indeed. But what’s more, the board has been allowed to do this at will, unabated and unrestrained by those who appoint the board members. And that would be whoever happens to occupy the governor’s office.
Due process? Fugetaboutit. Innocent until proven guilty? Not even an option. Burden of proof? Don’t want it, don’t need it, can’t use it.
To be sure, some of Dr. Starling’s troubles were of his own making. He had a drinking problem that first placed him in the board’s crosshairs. He freely admits that and has never made an issue of it.
But then, as it often does, the board smelled not alcohol, but blood.
And, like any other rapacious animal, sensing weakness on the part of its prey, it moved in for the kill.
In early 2010, he was called before the board for his “habitual indulgence of the use of drugs, narcotics, and intoxicating liquors” in violation of state statutes and for failing to notify the board of three driving while intoxicated convictions.
The statute was a catch-all one and while it could be interpreted that he was simultaneously abusing narcotics and/or other drugs, he insists he was not. The term “habitual indulgence,” however, seemed accurate enough in light of three DWIs. “I did abuse alcohol and I did receive three DWIs,” he said in a recent interview with LouisianaVoice. “I own them and I acknowledge that fact.”
On March 5, 2010, Starling signed a consent decree in which he agreed to “reimburse the board costs” of $350 and to pay a fine of $8,000 to the board. In addition, a five-year suspension of his dental license was stayed (waived) in favor of a five-year probationary period provided he satisfactorily completed an approved rehabilitation program.
A third major stipulation of the consent decree was that Starling would surrender “all controlled dangerous substance prescribing privileges.” That meant just what it said: he could not prescribe medications during the five years he was on probation.
So, with the consent decree signed, his $8,000 fine paid, and his DEA card (his only authority to issue prescriptions) cancelled for five years, he shuttled off to his new residence for six months at the Palmetto Addiction Recovery Center 200 miles away in Rayville in Richland Parish in Northeast Louisiana. http://www.palmettocenter.com/
And that’s when his real problems began.
During his exile in Palmetto, three other dentists rotated with each other to fill in for Starling. The three on occasion prescribed pain medication like Vicodin and Lortab to patients.
Those were perfectly legal because it was they, not Starling, who issued the prescriptions.
Except because they were written on prescription pads from his dentist office, the pharmacies filling the prescriptions, instead of looking at the signature on the prescriptions, looked at the letterhead on the pads and entered Starling’s name as the prescribing dentist. That information was entered into a data bank used by pharmacists as a deterrent to doctor shopping by those addicted to pain killers.
And that’s where Camp Morrison entered the picture and things got unbelievably complicated for Starling at the hands of a Board of Dentistry that had already long been drunk on power.
Morrison was a private investigator who was issued eight contracts by the Board of Dentistry totaling more than $1.46 million. Even more puzzling was how Morrison, a private contractor, warranted free office space in the board’s suite of offices on the 26th floor of One Canal Place in New Orleans—for which the board pays $4,700 in monthly rent.
Beginning with a $45,000 contract in 1997, all but one of his contracts were of three-year durations. His final contract, for $110,000, was for only 10 months, from September 1, 2012 through June 30, 2013. https://wwwcfprd.doa.louisiana.gov/latrac/contracts/expiredSearchResults.cfm?view=A
Out of the blue and based on an “investigation” by Morrison, Starling was accused by the board of dispensing prescription narcotics against the terms of his probation.
Starling said it would have been impossible for him to issue prescriptions with no DEA identification card, so he said he asked Morrison how he got his information. “He said, ‘I had a hunch and I looked it up,’” he quoted Morrison as replying.
The only problem with that is that Morrison, who has no DEA credentials, had no legal authority to access the data bank. “He had to have accessed the information by obtaining someone’s DEA card,” Starling said. “That’s a flagrant violation of the Computer Fraud and Abuse Act, a federal offense. He also ran me through the DEA data base and the FBI data base.
“He had a hunch and he looked up information that was not only illegal, but inaccurate as well,” he said. “I have never had any prescription drug issues.”
In Massachusetts, a doctor named Bharani Padmanabhan has filed a lawsuit against the Massachusetts Attorney General in federal court for “illegally trawling through the state prescription drug monitoring program.”
Besides the prescriptions written by the three substitute dentists—verified in at least one case by a March 18, 2010, letter from a Walgreens pharmacist—six of the 10 prescriptions Morrison accused Starling of writing illegally were actually written prior to Starling’s surrender of his DEA card at the end of October 2009.
So it turns out that six prescriptions were written legally while Starling still held his DEA card and the remaining four in question were written by substitute dentists working to keep his office open while he was in rehab.
Starling, of course, did what anyone in his position would do. He fired off a letter to Morrison. “Since my voluntary surrender of my DEA license, I have neither written, nor authorized to be written, nor called in, any prescriptions for controlled substances,” he wrote.
Besides including a copy of the letter from the Walgreens pharmacist, he named the substitute dentists who wrote prescriptions for each of the patients cited by.
“I was under the understanding that without a DEA license, no prescriptions could be filled under my old DEA number,” he wrote.
And here’s where things really got dicey.
On Nov. 5, 2013, the Board of Dentistry sent Starling a letter inviting him to a December 6 conference of the board’s Disciplinary Committee “relative to your request for reconsideration of adverse sanctions.”
Those sanctions proposed an additional fine of $20,000, plus $850 in costs to cover Morrison’s error-laden “investigation.” Among the erroneous allegations was the claim that Starling wrote a prescription for 300 tablets of Hydrocodone when in reality, it was for a much weaker dosage of 300 mls. (about 60 teaspoons) of the medication in liquid form.
That Dec. 6 conference was attended by committee Chairman Blackwood, Drs. David Melancon and Wilton Guillory, Jr., and independent counsel Arthur Hickham, Jr.
The minutes of that meeting read, in part:
“The Disciplinary Committee of the Louisiana State Board of Dentistry finds that the application for reconsideration of an adverse sanctions filed by Dr. Kenneth Starling does have substantial merit.” (Emphasis added.)
In a separate letter to the Board of Dentistry, Starling enclosed copies of patient records that showed signatures of substitute dentists on the dates on which Morrison accused him of writing the prescriptions. “I did not see any patients during the dates I was incarcerated in St. Tammany (Parish) or in treatment at Palmetto treatment center and no prescriptions were written by me during this time.
“I ask that the Board take all of this into consideration and I humbly ask for a reconsideration of sanctions imposed in relation to the second consent decree.”
And it was that last sentence, however, that spelled doom for Starling at that Dec. 6 committee meeting. A “reconsideration of sanctions” would necessarily mean a rescission of the $20,000 fine and the $850 in costs.
And the board was having none of that.
With the Dentistry Board, money trumps justice. Every time.
The very next day, on Dec. 7, the full board met and besides approving pay raises and per diem payments and other expenses to themselves, and despite the Disciplinary Committee’s decision that Starling’s application had “substantial merit,” voted unanimously to deny Starling’s application for reconsideration.
Starling was called in and Blackwood pushed the newest consent decree toward him and instructed him to sign it.
So, even though the Disciplinary Committee recommended consideration of Starling’s application, the full board not only denied the application on the following day, but also had the consent decree already drawn up, obviously in advance of the board’s decision.
It was a kangaroo court and the fix was in.
The consent decree not only called for him to pay $20,850 in fines and costs, but to again surrender his DEA card, attend AA meetings, enter into group therapy, undergo addiction counseling, re-enter Palmetto, and to agree to five years’ probation.
Starling balked and Blackwood, he said, spat “Sign the G—d—m consent decree.”
Realizing that Blackw00d and the board held all the cards, Starling signed.
Justice, or more accurately, the board’s idea of justice, was served and the Starling’s bank account was $20,850 lighter.
And the citizens of Louisiana were safer, thanks to the diligence—and greed—of the State Board of Dentistry.