On August 27, 2010, the Texas Medical Board and James Edward Stevens, D.O., entered into an agreed order (shown below) under which he must pay a $3,000 administrative penalty and, within one year, complete 24 hours of continuing medical education that include eight hours in immunology, eight hours in endocrinology and eight hours in medical recordkeeping. The agreed order settled charges that he had prescribed nontherapeutic (inappropriate) supplements and drugs and had failed to obtain proper consent for long-term use of steroid drugs for a patient with fibromyalgia and chronic fatigue.
Since 2005, Stevens has practiced in the Dallas office of Fibromyalgia & Fatigue Centers (FFC), a chain of 16 clinics that specializes in treating fibromyalgia and chronic fatigue syndrome. The FFC Web site states that its doctors “diagnose and treat the underlying causes” and take a “big picture approach” that includes “mitochondrial enhancement,” “hormone balancing,” and treatment of “underlying viral infections” with “minimally necessary medications and supplements to assure absence of symptoms.” The agreed order did not specify which of the drugs and supplements used by Stevens that the Texas board considered “nontherapeutic” However, a printed FFC “IM/IV Order Sheet” lists more than 20 types of questionable intravenous therapy.
Stevens, who is also licensed in Florida, has also had trouble there. In 2007, the licensing authorities obtained a judgment of $2,121.51 for failing to pay a required annual assessment from 2002 through 2006. In June 2010, the Florida Board of Medicine ordered him to pay the judgment, reprimanded him, and fined him an additional $1,000.
LICENSE NO. E-8937
IN THE MATTER OF THE
JAMES EDWARD STEVENS, D.O.
TEXAS MEDICAL BOARD
Filed August 27, 2010.
On the 27 day of August, 2010, came on to be heard before the Texas Medical Board (the “Board”), duly in session, the matter of the license of James Edward Stevens, D.O. (“Respondent”).
On April 26, 2010, Respondent appeared in person, with counsel James R. Nelson, at an Informal Show Compliance Proceeding and Settlement Conference in response to a letter of invitation from the staff of the Board. The Board’s representatives were Allan Shulkin, M.D., , member of the Board, and Ruthie Burrus, a member of a District Review Committee. Amy E. McNamara represented Board Staff.
Board Staff charged that Respondent’s care and treatment of a patient for Fibromyalgia and Chronic Fatigue Syndrome (“CFS”) fell below the standard of care. Specifically, Board Staff charged that Respondent nontherapeutically prescribed drugs and other supplements for Fibromyalgia and CFS and failed to order preventative tests necessary to screen for side effects. Further, Board Staff charged that Respondent failed to obtain proper informed consent for the chronic use of steroids.
Respondent has not previously been the subject of disciplinary action by the Board.
Upon the recommendation of the Board’s representatives and with the consent of Respondent, the Board makes the following Findings and Conclusions of Law and enters this Agreed Order.
The Board finds the following:
1. General Findings:
- Respondent received all notice required by law. All jurisdictional requirements have been satisfied. Respondent waives any defect in notice and any further right to notice or hearing under the Medical Practice Act, Title 3, Subtitle B, Texas Occupations Code (the” Act”) or the Rules of the Board.
- Respondent currently holds Texas Medical License No. E-8937. Respondent was originally issued this license to practice medicine in Texas on August 27, 1977. Respondent is also licensed to practice medicine in Florida.
- Respondent’s training is family practice, emergency medicine, and cardiac anesthesiology. Respondent concentrates his practice in the treatment of patients with Fibromyalgia and CFS. Respondent is board certified by the American Academy of Osteopathic Specialists, a member board of the American Board of Medical Specialties.
- Respondent is 62 years of age.
2. Specific Panel Findings:
- Respondent treated the patient from 2006 through 2009 for Fibromyalgia and CFS. Over the course of treatment, Respondent ordered thorough lab testing.
- Respondent treated the patient with T3, Cortisol, Pregnenolone, Hydrocortisone, Doxy, Diflucan, Valtrex, Cipro, Zithromax, Flagyl, Ambien, Trazadone, Lexapro, supplemental IV infusions, and other supplements.
- Respondent violated the standard of care by treating the patient with nontherapeutic drugs and supplements.
- Although Respondent discussed guidelines, risks, benefits, alternatives, and goals regarding the use of low-dose steroids, monitored the use of low-dose steroids by the patient, and obtained verbal informed consents for all treatments, the written consent form used by Respondent failed to specifically address the possible risks associated with long-term steroid use. In this case, the patient was on hydrocortisone for over two years.
In determining the appropriate sanctions in this matter, the Panel considered that Respondent has cooperated in the investigation of the allegations related to this Agreed Order. Respondent’s cooperation, through consent to this Agreed Order, pursuant to the provisions of Section 164.002 the Act, will save money and resources for the State of Texas. To avoid further investigation, hearings, and the expense and inconvenience of litigation, Respondent agrees to the entry of this Agreed Order and to comply with its terms and conditions.
CONCLUSIONS OF LAW
Based on the above Findings, the Board concludes that:
1. The Board has jurisdiction over the subject matter and Respondent pursuant to the Act.
2. Section 164.0S1(a)(6) of the Act authorizes the Board to take disciplinary action against Respondent based on Respondent’s failure to practice medicine in an acceptable professional manner consistent with public health and welfare; and as further defined by Board Rules 190.8(1): (D) – failure to safeguard against potential complications; (K) – prescription or administration of a drug in a manner that is not in compliance with Chapter 200.3 of this title (relating to Standards for Physicians Practicing Complementary and Alternative Medicine), specifically, Board Rules: 200.3(1)(b) and (d); 200.3(2)(b); 200.3(3)(b)(i) and (iii); 200.3(S)(e) and 200.3(6).
3. Sections 164.0S2(a)(S) and 164.0S3(a)(S) of the Act authorizes the Board to take disciplinary action against Respondent based on Respondent prescribing or administering a drug or treatment that is nontherapeutic in nature or nontherapeutic in the manner the drug or treatment is administered or prescribed.
4. Sections I 64.0S2(a)(S) and 164.0S3(a)(6) of the Act authorizes the Board to take disciplinary action against Respondent based on Respondent prescribing, administering, or dispensing in a manner inconsistent with public health and welfare, dangerous drugs as defined by Chapter 483, Health and Safety Code; or controlled substances scheduled in Chapter 481 Health and Safety Code; or controlled substances scheduled in the Comprehensive Drug Abuse Prevention and Control Act of 1970, (21 U.S.C. 3801 et seq.).
5. Section 164.001 of the Act authorizes the Board to impose a range of disciplinary actions against a person for violation of the Act or a Board rule.
6. Section 164.002(a) of the Act authorizes the Board to resolve and make a disposition of this matter through an Agreed Order.
7. Section 164.002( d) of the Act provides that this Agreed Order is a settlement agreement under the Texas Rules of Evidence for purposes of civil litigation.
Based on the above Findings of Fact and Conclusions of Law, the Board ORDERS that Respondent shall be subject to the following terms and conditions:
1. Within one year from the date of the entry of this Order, Respondent shall obtain, in person only, and in addition to any continuing medical education (“CME”) required for licensure renewal, 24 hours of CME approved for Category I credits by the American Medical Association divided as follows: 8 hours of CME in the subject of immunology; 8 hours of CME in the subject of endocrinology; and 8 hours in the subject of medical recordkeeping. The CME shall be approved in writing in advance by the Compliance Division of the Board. To obtain approval for the course, Respondent shall submit in writing to the Compliance Division of the Board information on the course, to include at least a reasonably detailed description of the course content and faculty, as well as the course location and dates of instruction. Respondent shall submit documentation of attendance and successful completion of this requirement to the Compliance Division of the Board on or before the expiration of the time limit set forth for completion of the course.
2. Respondent shall pay an administrative penalty in the amount of $3000 within 60 days of the date of the entry of this Order. The administrative penalty shall be paid in a single payment by cashier’s check or money order payable to the Texas Medical Board and shall be submitted to the Board for routing so as to be remitted to the Comptroller of Texas for deposit in the general revenue fund. Respondent’s failure to pay the administrative penalty as ordered shall constitute grounds for further disciplinary action by the Board, and may result in a referral by the Executive Director of the Board for collection by the Office of the Attorney General.
3. The time period of this Order shall be extended for any period of time that: (a) Respondent subsequently practices exclusively outside the State of Texas; (b) Respondent’s license is subsequently cancelled for nonpayment of licensure fees; (c) this Order is stayed or enjoined by Court Order; or (d) for any period of time longer than 60 consecutive days that Respondent does not actively practice medicine. If Respondent leaves Texas to practice elsewhere or ceases active practice for more than 60 consecutive days, Respondent shall immediately notify the Board in writing. Upon Respondent’s return to active practice or return to practice in Texas, Respondent shall notify the Board in writing. When the period of extension ends, Respondent shall be required to comply with the terms of this Order for the period of time remaining on the Order. Respondent shall pay all fees for reinstatement or renewal of a license covering the period of extension or tolling.
4. Respondent shall comply with all the provisions of the Act and other statutes regulating the Respondent’s practice.
5. Respondent shall fully cooperate with the Board and the Board staff, including Board attorneys, investigators, compliance officers, consultants, and other employees or agents of the Board in any way involved in investigation, review, or monitoring associated with Respondent’s compliance with this Order. Failure to fully cooperate shall constitute a violation of this order and a basis for disciplinary action against Respondent pursuant to the Act.
6. Respondent shall inform the Board in writing of any change of Respondent’s office or mailing address within 10 days of the address change. This information shall be submitted to the Registration Department and the Compliance Department of the Board. Failure to provide such information in a timely manner shall constitute a basis for disciplinary action by the Board against Respondent pursuant to the Act. Respondent agrees that 10 days notice of a Probationer Show Compliance Proceeding to address any allegation of noncompliance of this Agreed Order is adequate and reasonable notice prior to the initiation of formal disciplinary action. Respondent waives the 30-day notice requirement provided by § 164.003(b )(2) of the Medical Practice Act and agrees to 10 days notice, as provided in 22 Texas Administrative Code §187.44(4).
7. Any violation of the terms, conditions, or requirements of this Order by Respondent shall constitute unprofessional conduct likely to deceive or defraud the public, or to injure the public, and shall constitute a basis for disciplinary action by the Board against Respondent pursuant to the Act.
8. Respondent shall be permitted to supervise and delegate prescriptive authority to physician assistants and advanced practice nurses and to supervise surgical assistants.
9. This Order shall automatically terminate upon Respondent’s submission of sufficient evidence to the Compliance Division of the Board that Respondent successfully completed the requirements ordered in Ordering Paragraph No. 1 and Ordering Paragraph No. 2.
RESPONDENT WAIVES ANY FURTHER HEARINGS OR APPEALS TO THE BOARD OR TO ANY COURT IN REGARD TO ALL TERMS AND CONDITIONS OF THIS AGREED ORDER. RESPONDENT AGREES THAT THIS IS A FINAL ORDER.
THIS ORDER IS A PUBLIC RECORD.
I, JAMES EDWARD STEVENS, D.O., HAVE READ AND UNDERSTAND THE FOREGOING AGREED ORDER. I UNDERSTAND THAT BY SIGNING, I WAIVE CERTAIN RIGHTS. I SIGN IT VOLUNTARILY. I UNDERSTAND THIS AGREED ORDER CONTAINS THE ENTIRE AGREEMENT AND THERE IS NO OTHER AGREEMENT OF ANY KIND, VERBAL, WRITTEN OR OTHERWISE.
DATED: July 14, 2010.
JAMES EDWARD STEVENS, D.O.
SIGNED AND ENTERED by the presiding officer of the Texas Medical Board on this 27 day of August, 2010.
Irvin E, Zeitler, Jr., D.O., President
Texas Medical Board
This page was posted on December 7, 2010.