Doctors Name: Peter Edward Droubay
License Number: 27705
License Status:  Current - (Dues Paid)
Accusation Filed
Public Reprimand


City of Record: Davis
Region: Sacramento
License issued on: 08/06/1974
Licensing Boards: Medical
Specialties : Internal Medicine

Gender: Male

Accusations and Infractions or Causes for Discipline:  Failure To Maintain Adequate Records
Unprofessional Conduct
Repeated Negligent Acts
Excessive Treatment or Prescribing
Gross Negligence
Prescribing Without Medical Exam
Sexual Misconduct

Date of Last MBC Action: 06/13/2019

Repeat Offender:  Yes
Ongoing Discipline:  Yes
Out of State Discipline:  No
No Medical Board Activity:  

_____________________________________________________________________________________________________
Medical Board Documents, News Articles, Court Documents, Etc.

+Decision 2/25/2016
Accusation 6/13/2019
Interim Suspension Order 5/07/2020
+Accusation 6/05/2020
 

______________________________________________________________________________________________________

Additional Information (Medical School, Dated Actions, Excerpts from Disciplinary Actions, Notes) UNIVERSITY OF MINNESOTA MEDICAL SCHOOL
Excerpt from Accusation dated 6/19/2015:

FIRST CAUSE FOR DISCIPLINE
(Gross Negligence in the lack of proper history & physical exam for patient L.L.)

20. Respondent Peter Edward Droubay, M.D. is subject to disciplinary action under section 2234, subdivision (b) of the Code in that Respondent failed to do a proper history and physical of patient L.L. upon her admission to Courtyard Skilled Nursing Facility (SNF). The circumstances are as follows:

21. On or about March 8, 2014, patient L.L., a 54-year old woman, fell at her niece's house while in the bathroom, and presented at U.C. Davis Emergency Department. Treating physician, Dr. J. N., who cared for patient L.L., filed a complaint with the Medical Board, on March 13, 2014, alleging that Respondent was inappropriately or excessively prescribing pain medication to patient L.L.

22. On or about December 10, 2013, patient L.L., had an earlier fall, while walking to her bathroom using her walker. She was diagnosed with a left humerus comminuted fracture (left shoulder). As her fracture was not displaced her physicians did not recommend surgical intervention. Instead, on December 14, 2013, patient L.L. was transferred to Courtyard SNF for treatment and rehabilitation of her left shoulder. Her care was supervised at this facility by Respondent, who was also the facility director, until March 3, 2014 when she was discharged.

23. On December 16, 2013, the patient was seen by Respondent as part of the formal admission to Comiyard SNF for pain management and rehabilitation of her shoulder fracture. In the two prior days, patient L.L. had been seen by a physician assistant (M.K.) and another physician (Dr. F.) Patient L.L.'s admission medications included the following: Zoloft 150 mg., once a day; Buspar 10 mg., BID (twice a day) for depression and anxiety; Melatonin 3 mg., PO (by mouth) QHS (at bedtime) for insomnia; Klonopin 0.5 mg, twice daily for anxiety; Flexeril 10 mg q (daily) 8 hr prn (when necessary), for anxiety; and Methocarbamol 500 mg, 1 tab PO (by mouth) TID (three times daily), for muscle spasms. For pain, patient L.L. was taking Norco 10/325 mg., 1-2 tab q (daily) 4 hr prn (when necessary) and Oxycodone 5 mg., 102 tab q 3 hours prn. However, at the December 16, 2013 visit Respondent discontinued the Oxycodone prn and substituted Dilaudid 8mg. po q 6 hour. There was no documentation of the Oxycodone being ineffective or the patient showing intolerance to it. Respondent failed to document why he made the change in pain medication.

24. On December 20, 2013, Respondent saw patient L.L. crying in pain. The patient had pain with any slight movement despite using 8 mg. of Dilaudid prn and Norco prn. Respondent prescribed the additional pain medication of Oxycontin 40 mg. po q 12 hours, left the Dilaudid 8 mg., but instructed daily every 3 hours for breakthrough pain rather than every 6 hours, and left the Norco continued as before.

25. On December 28, 2013, patient L.L. was sick, and was recorded as wheezing on examination by Respondent and the patient continued to have much pain in the left arm. Respondent prescribed Augmentin 876 mg. bid for Acute Bronchitis. Respondent documented no review of pain medication effectiveness since the changes from December 20, 2013, nor were any changes made to the patient's pain medication.

26. On January 3, 2014, Respondent again saw patient L.L. who was complaining of increased right shoulder pain. In addition, the patient was asking for a steroid shot, sleep medication and/or a pain patch. The medical records also indicate that patient L.L. was anxious and was asking to increase the Klonopin to twice daily. Respondent increased the Klonopin to 0.5 mg. po (mouth) q (daily)8 hours. He also started the patient on Duragesic/Fentanyl 25 mcg./hour Patch q 3 days for pain control and Ambien 10 mg. q hs for insomnia. The patient was previously on Melatonin for insomnia.

27. On January 10, 2014, Respondent again saw patient L.L. and he recorded that the pain on the patient's left fracture side was better with the Fentanyl patch. However, the patient had right shoulder/lateral deltoid pain and was requesting a steroid shot which was given. The . plan was to continue the Fentanyl patch and prn Norco 10/325. Respondent did not comment on - any of the other prescribed pain medications including the Oxycontin and Dilaudid.

28. On February 3, 2014, Respondent saw patient L.L. in bed resting. The patient complained that she did not sleep well due to pain in left shoulder and hip. Her left arm was in a sling and was tender. Respondent ordered the medications continued as before. This was Respondent's last recorded visit with the patient and she was discharged a month later, on March 3, 2014, to her niece's home.

29. On March 8, 2014, at the time of the patient's second fall, she was on the following pain medications: Two short acting pain medications consisting of Dilaudid 8mg q (daily) 8 hr prn and Norco 10/325 1-2 tabs q (daily) 6 hours prn, and two long acting pain medications consisting of Fentanyl 25 meg. q (daily) 3 days and Oxycontin 40 mg. bid (twice daily) addition, patient L.L. was also taking the following medications, many with sedating affects [sic]: Flexeril and Methocarbamol to relax the muscles, Klonopin for anxiety, and Melatonin and Ambien for insomnia.

30. The U.C. Davis Emergency Department nurse, noted upon admission on March 8, 2014, that patient L.L. had her Fentanyl patch on the left side of her chest. The patient was x-rayed and no new fractures were noted. The patient was admitted to the Family Practice Group for medication management and then discharged to the Courtyard SNF. At discharge from U.C. Davis, the patient was still taking Oxycontin, Norco and Methocarbamol, but the prescriptions for Dilaudid, Fentanyl and Flexeril were discontinued.

31. Respondent failed to document the characteristics and reason for continued pain at each visit. Respondent failed to write a full SOAP recommendation on the admitting visit and subsequent visits. Respondent failed to obtain the prior pain treatment plan at his admission evaluation. This information would have told him that the severe pain was due to fall and fracture. Respondent reported that the patient was crying and in pain which required medication changes on several visits, yet Respondent failed to document the exacerbating or relieving systems tied to the pain medication given, nor was patient monitored and/or warned about any side-effects. Respondent failed to evaluate the shoulder x-ray to see if the cause of the patient's pain was displacement or to see if any other reason existed for continued pain through a three month period when the fracture should have healed. Respondent failed to explore whether the patient's crying and pain had a psychological component, including possible drug seeking behavior, grief or worsening depression. All of these failures collectively and separately constitute an extreme departure from the standard of care in violation of section 2234, subdivision (b) of the Code.

SECOND CAUSE FOR DISCIPLINE
(Gross Negligence in the treatment plan for patient L.L.)

32. Complainant hereby incorporates paragraphs 20 through 31 of the instant Accusation as though fully set forth herein.

33. Respondent Peter Edward Droubay, M.D. is subject to disciplinary action under section 2234, subdivision (b) of the Code in that Respondent failed to do follow through on a treatment plan of patient L.L. during her stay at Courtyard SNF and after her discharge. Respondent failed to appropriately manage patient L.L.'s pain by referring the patient out to the following consultants: a pain management clinic, a psychologist/psychiatrist for the psychological etiology of uncontrolled pain, for cognitive or behavioral therapy, and/or for complementary and alternative therapies. Respondent also failed to document the risks and benefits of using multiple narcotic and sedative medications at discharge and wrote no discharge summary nor a discharge medication summary. All of these failures collectively and separately constitute an extreme departure from the standard of care in violation of section 2234, subdivision (b) of the Code.

THIRD CAUSE FOR DISCIPLINE
(Gross Negligence in poly-pharmacy/excessive prescribing of sedating drugs to patient L.L.)

34. Complainant hereby incorporates paragraphs 20 through 31 of the instant Accusation as though fully set forth herein.

35. Respondent Peter Edward Droubay, M.D. is subject to disciplinary action under section 2234, subdivision (b) of the Code in that Respondent failed to consider the side effects of excessive prescribing and/or poly-pharmacy of multiple narcotics, muscle relaxants and mood altering medications and sedative medications both before and after the discharge of patient L.L. from Courtyard SNF. Respondent failed to discontinue certain categories of medications once new medications in the same category were introduced, such as limiting the patient to one short acting pain medication and one long acting medication, along with one muscle relaxer. All of these failures collectively and separately constitute an extreme departure from the standard of care in violation of section 2234, subdivision (b) of the Code.

Excerpt from Decision dated 11/14/2015:

DISCIPLINARY ORDER

IT IS HEREBY ORDERED that Physician's and Surgeon's Certificate No. G 27705 issued to Respondent Peter Edward Droubay, M.D. (Respondent) is publically reprimanded pursuant to Business and Professions Code section 2227, as more specifically set forth below.

1. PUBLIC REPRIMAND. Respondent is publically reprimanded as follows:

On June I9, 20I5, an Accusation was filed against you alleging gross negligence under Business and Professions Code (Code) section 2334, subdivision (b) as follows: In the care of patient L.L., during her stay at Courtyard SNF, you failed to conduct a full and proper history and physical, you also failed to document the risks and benefits of using multiple narcotic and sedative medications at discharge, and you failed to consider the side effects of excessive prescribing and/or poly-pharmacy of multiple narcotics, muscle relaxants, and mood altering medications, and sedative medications, both before and after the discharge of patient L.L. from Courtyard SNF. All of these failures collectively and separately constitute an extreme departure from the standard of care. This public reprimand pursuant to Code section 2227 is issued to you with the expectation that such conduct will not be repeated.

Excerpt from Accusation dated 6/13/2019:

FIRST CAUSE FOR DISCIPLINE
(Sexual Abuse and Misconduct)

Respondent, Peter Edward Droubay, M.D., is subject to disciplinary action under sections 2227, 2234, and 726, of the Code, in that he committed an act or acts of sexual abuse and misconduct with Patients A, B, and C. The facts are as follows:

Patient A:

8. On or about June 24, 2016, Respondent was working as the Medical Director at Courtyard Healthcare Skilled Nursing Facility (Courtyard) in Davis, California. Patient A, a forty (40) year old female, was admitted to Courtyard after being administered too much medication regarding her chronic stiff person syndrome (a rare neurological disorder and autoimmune disease, characterized by fluctuating muscle rigidity in the trunk and limbs).

9. On or about June 27, 2016, Respondent performed an initial examination on Patient A in her bedroom. During the examination, Respondent reached into Patient A's gown with his bare hand and "shook" Patient A's left breast for approximately ten (10) seconds. Respondent then shook Patient A's right breast for approximately ten (10) seconds. During the examination, Respondent never palpitated Patient A's breasts, which would have been consistent with a breast examination. Respondent briefly used a stethoscope to listen to Patient A's heart and lung function, before concluding the examination and leaving the room.

10. Prior to the breast examination, Respondent failed to retain a chaperone and/or discuss the option of retaining a chaperone with Patient A. Moreover, due to Patient A's status as a short-term patient at Courtyard, a breast examination was unnecessary as part of her admission physical.

11. Following Respondent's examination of her, Patient A felt that she had been inappropriately examined and immediately called her mother. Patient A's mother arrived at Courtyard shortly after, and confronted Respondent. Respondent came to Patient A's room and attempted to apologize for a "miscommunication." Respondent stated that he was checking Patient A's lymph nodes, or words to that effect, despite the fact that he had placed his hands directly on Patient A's breasts, in a manner inconsistent with a lymph node examination.

12. On or about July 1, 2016, a Courtyard Social Worker met with Respondent to discuss the June 2016, incident with Patient A. During the conversation, it was requested that Respondent have a nurse or other medical practitioner present, during future physical examinations. Respondent agreed to this proposal.

Patient B:

13. On or about July 20, 2016, Patient B, a seventy-four (74) year old female, was admitted to Courtyard for rehabilitation, following an injury to her leg.

14. On or about July 22, 2016, Patient B was sleeping in her room, when she was awakened by Respondent massaging her breasts. This was the first encounter between Patient B and Respondent. After some time, Patient B, stated, "What are you doing? Who are you?" or words to that effect. Respondent gave Patient B his business card, then turned and walked out of the room.

15. Prior to this meeting, Respondent never spoke with Patient B, nor received consent for the breast examination. Additionally, Respondent failed to retain a chaperone and/or discuss the option of retaining a chaperone with Patient B. Moreover, due to Patient B's status as a short-term patient at Courtyard, a breast examination was unnecessary as part of her admission physical.

16. On or about July 25, 2016, Courtyard's Executive Director and Director of Nursing met with Respondent to discuss the June 2016, and July 2016, incidents with Patient A and Patient B. During the conversation, Respondent was ordered to have a nurse or other medical practitioner present during future physical examinations. The conversation was then memorialized and signed by the parties. On or about August 12, 2016, the aforementioned parties signed a "Clarification of the July 25, 2016, discussion with Dr. Droubay," which reiterated Respondent's requirement to have a nurse or other medical practitioner present for all physical examinations. Respondent was additionally ordered to meet with Courtyard's administrator and/or Courtyard's Director of Nursing, daily, upon his arrival at the facility, to discuss residents who needed to be seen that day and who would be assisting him.

17. On or about March 27, 2017, a Davis Police Department Detective met with Respondent regarding the July 2016, incident with Patient B. During his conversation with the detective, Respondent stated that he changed the way he conducted examinations with female patients, and since the incident, he always has a female employee in the room during an examination of a female patient.

Patient C:

18. On or about August 4, 2017, Patient C, a sixty-seven (67) year old female, was admitted to Stollwood Convalescent Hospital (Stollwood) in Woodland, California. While staying at Stollwood, Patient C became reacquainted with Respondent, who was working as the Medical Director at the facility. Prior to 2017, Respondent was Patient C's physician from approximately the late 1970's to early 1990's.

19. During the course of Patient C's interactions with Respondent, between August 4, 2017, and October 7, 2017, Respondent exhibited increasingly inappropriate behavior. During a physician-patient visit, Respondent conducted an examination of Patient C. At the end of the visit, Respondent initiated a hug with Patient C. Patient C attempted to pull away from the hug, but Respondent continued to hold her tighter. Respondent then kissed Patient C on her cheek.

20. Sometime later, Respondent interacted with Patient C while she was located in the Stollwood common area. Respondent approached Patient C, as she was sitting in her wheelchair, and they engaged in a short, casual conversation. Respondent then hugged Patient C and kissed her on the lips with an open mouth, which lasted for several seconds.

21. On or about October 7, 2017, Respondent performed a medical examination on Patient C, while in her room. Respondent conducted a breast examination of Patient C, in which he reached under her shirt and felt her nipples for a few seconds. Prior to the breast examination, Respondent failed to provide Patient C with the option of having a chaperone present.

22. During the examination, Patient C stated that she was experiencing symptoms consistent with urinary tract infection, or words to that effect. Respondent performed a pelvic examination on Patient C, without first providing Patient C the option of electing to have a chaperone present. While Respondent was alone with Patient C, Respondent removed Patient C's sweatpants. He then inserted an ungloved finger into Patient C's vagina for several seconds.

SECOND CAUSE FOR DISCIPLINE
(Gross Negligence)

23. Respondent is further subject to disciplinary action under section 2234, subdivision (b), of the Code, in that Respondent committed gross negligence in his care and treatment of Patients A, B, and C, as more particularly alleged in paragraphs 7 through 22, and those paragraphs are incorporated by reference as if fully set forth herein.

24. Respondent committed the following acts of gross negligence during the care and treatment of Patient C:

a.) Respondent hugged and kissed Patient C with an open mouth; and

b.) Respondent digitally penetrated Patient C's vagina, with an ungloved hand, during a pelvic examination.

THIRD CAUSE FOR DISCIPLINE
(Repeated Negligent Acts)

25. Respondent is further subject to disciplinary action under section 2234, subdivision (c), of the Code, in that Respondent committed repeated negligent acts in his care and treatment of Patients A, B, and C, as more particularly alleged in paragraphs 7 through 24, and those paragraphs are incorporated by reference as if fully set forth therein.

26. Respondent committed the following repeated negligent acts during the care and treatment of Patient A:

a.) Respondent performed an unnecessary breast examination on Patient A, as part of a new patient physical assessment, without relevant symptoms to warrant such an examination; and

b.) Prior to performing a breast examination on Patient A, Respondent failed to offer to have a chaperone present and/or performed a breast examination without a chaperone present.

27. Respondent committed the following repeated negligent acts during the care and treatment of Patient B:

a.) Respondent performed an unnecessary breast examination on Patient B, as part of a new patient physical assessment, without relevant symptoms to warrant such an examination; and

b.) Prior to performing a breast examination on Patient B, Respondent failed to offer to have a chaperone present and/or performed a breast examination without a chaperone present.

28. Respondent committed the following repeated negligent acts during the care and treatment of Patient C:

a.) Respondent hugged and kissed Patient C with an open mouth;

b.) Prior to performing a breast examination on Patient C, Respondent failed to offer to have a chaperone present and/or performed a pelvic examination without a chaperone present.

c.) Respondent digitally penetrated Patient C's vagina, with an ungloved hand; and

d.) Prior to performing a pelvic examination on Patient C, Respondent failed to offer to have a chaperone present and/or performed a pelvic examination without a chaperone present.

FOURTH CAUSE FOR DISCIPLINE
(General Unprofessional Conduct)

30. Respondent Peter Edward Droubay, M.D. is further subject to disciplinary action under sections 2227 and 2234, of the Code, in that he has engaged in conduct which breaches the rules or ethical code of the medical profession, or conduct which is unbecoming to a member in good standing of the medical profession, and which demonstrates an unfitness to practice medicine, as more particularly alleged in paragraphs 7 through 28, above, which are hereby incorporated by reference and realleged as if fully set forth herein.


DISCIPLINARY CONSIDERATIONS

31. To determine the degree of discipline, if any, to be imposed on Respondent Peter Edward Droubay, M.D., Complainant alleges that in a prior disciplinary action entitled, "In the Matter of the Accusation Against Peter Edward Droubay, M.D." before the Medical Board of California, in Case Number 800-2014-003735, effective March 25, 2016, Respondent was publicly reprimanded for gross negligence and failure to maintain adequate and accurate medical records, in the care and treatment of a patient. That decision is now final and is incorporated by reference as if fully set forth herein.

Excerpt from Accusation dated 6/05/2020:

FIRST CAUSE FOR DISCIPLINE
(Gross Negligence)

41. Respondent's license is subject to disciplinary action under Section 2234, subdivision (b), of the Code, in that he committed gross negligence during the care and treatment of Patients A, B, C, and D. The circumstances are as follows:

Patient A

42. On or about December 12, 2013, Patient A was first seen by Respondent, following back surgery for spinal abscess. Patient A had a history of uterine cancer, chronic abdominal pain, anxiety and depression.

43. Between on or about November 29, 2013, and July 10, 2018, Respondent prescribed Patient A high amounts of hydrocodone bitartrate - acetaminophen (up to 240 tablets per month of 325 milligram/10 milligram doses), morphine sulfate (60 milligram doses up to approximately 90 doses per month), and methadone hydrochloride (10 milligram doses, up to 360 tablets per month). Throughout Respondent's care and treatment of Patient A, Respondent routinely prescribed opioids at high levels, which resulted in Patient A having a morphine milligram equivalent greater than 1,000.

44. On or about January 27, 2015, Patient A's urine drug test results revealed use of hydrocodone, methadone, and morphine. The detected morphine could not be matched to any of Patient A's prescriptions. Furthermore, the test results revealed 22,314 micrograms of morphine of analysis per gram of creatinine, with a cutoff for a positive test of 50 nanograms of analyte per milliliter of urine. Although Patient A appeared to be in violation of a pain agreement that she previously signed (on or about December 12, 2013), there is nothing in Respondent's records to indicate that he addressed with Patient A the high levels of morphine detected from her urine drug test.

45. On or about June 13, 2019, Respondent participated in an interview, as part of the Board's investigation. During the interview, Respondent incorrectly converted morphine millimeter equivalents regarding methadone. He additionally was not aware that as a dose of methadone is increased, it becomes exponentially more dangerous, and the multiplier increases.

46. Respondent's care and treatment of Patient A was grossly negligent in the following respects:

a. Respondent failed to recognize and/or address with Patient A that she tested positive for morphine during her February 23, 2015 urine toxicology screen;

b. Respondent prescribed Patient A the morphine milligram equivalent greater than 1,000 throughout the duration of 2017 and 2018; and

c. Respondent failed to properly calculate the correct dosages of morphine for Patient A, during that timeframe.

Patient B

47. On or about July 23, 2009, Patient B was first seen by Respondent. Between August 15, 2013, and July 2, 2018, Respondent prescribed to Patient B high amounts of a variety of prescription drugs. Specifically, Respondent prescribed carisoprodol (up to 60 tablets per month of 325 milligram doses, clonazepam (up to 60 tablets per month of 1 milligram doses), hydrocodone bitartrate-acetaminophen (up to 180 tablets per month of 325 millgram/10 milligram doses), to up to 30 capsules per month of 15 milligram doses), clonazepam (up to 60 tablets per month of 1 milligram doses), and oxycodone HCL (up to 180 tablets per month of 325 milligram/10 milligram doses). During this time period, Respondent routinely prescribed opioids in conjunction with benzodiazepines and Soma.

48. During Respondent's care and treatment of Patient B, he became aware that Patient B had been arrested and jailed for alcohol related crimes. Additionally, Respondent became aware that Patient B was obtaining narcotics from co-workers. Respondent failed to modify or discontinue Patient B's narcotic regiment, and/or otherwise address the issue.

49. On or about June 17, 2013, Patient B's urine drug test results revealed use of hydrocodone, norhydrocodone, oxycodone, noroxycodone, oxymorphone, temazepam, and oxazepam. However, at that time, Patient B was only prescribed Lidoderm, Norco, Soma, and temazepam. Although Patient B appeared to be in violation of a previously signed pain agreement, there is nothing in Respondent's records to indicate that he planned to modify or discontinue Patient B's narcotic regiment, and/or otherwise address the issue. On or about March 26, 2018, a urine toxicology test showed positive results for oxycodone and oxymorphone-which were not being prescribed to him. Respondent subsequently failed to address, modify, or discontinue Patient B's prescription regimen.

50. Respondent's care and treatment of Patient B was grossly negligent in the following respects:

a. Respondent failed to address or modify or discontinue Patient B's prescription regimen after a June 17, 2013, urine toxicology test showed positive results for oxycodone and oxymorphone-which were not being prescribed to him, and negative for Soma-which was being prescribed to him;

b. Respondent failed to address or modify or discontinue Patient B's prescription regimen after a March 26, 2018, urine toxicology test showed positive results for oxycodone and oxymorphone-which were not being prescribed to him;

c. Respondent continued to prescribe narcotics to Patient B after becoming aware that he had been obtaining other narcotics from outside sources; and

d. Respondent continued to prescribe narcotics to Patient B after becoming aware that I6 Patient B had been arrested for issues relating to drug and/or alcohol abuse.

Patient C

51. On or about May 10, 2000, Patient C was first seen by Respondent. Patient C was a female smoker with a history of back problems, intravenous drug use, bipolar disorder, and hepatitis

C. Patient C was under the care of a psychiatrist with Yolo County, however, she was additionally seeing Respondent for her pain management needs.

52. On or about May 10, 2013, Patient C signed a pain agreement with Respondent.

53. Between on or about August 21, 2013, and July 23, 2018, Respondent prescribed to Patient C high amounts of a variety of prescription drugs. Specifically, Respondent prescribed hydrocodone bitartrate - acetaminophen (up to 180 tablets per month of 325 millgram/10 milligram tablets doses), alprazolam (up to 60 tablets per month of0.5 milligram doses), lorazepam (up to 30 tablets per month of 1 milligram doses), oxycodone HCL - acetaminophen (up to 40 tablets per month of 325 millgram I 10 milligram doses), hydromorphone HCL (up to 60 tablets per month of 4 milligram tablets doses), lyrica (up to 90 tablets per month of 50 milligram doses), temazepam (up to 30 tablets per month of 30 milligram doses), tramadol HCL (up to 30 tablets per month of 50 milligram doses), and buprenoprphine-naloxone (up to 60 tablets per month of 8 milligram 12 milligram doses). During this time, Respondent routinely prescribed opioids in conjunction with benzodiazepines.

54. During his care and treatment of Patient C, Respondent failed to perform a yearly urine toxicology screen on Patient C. Additionally, during Respondent's care and treatment of Patient C, Respondent failed to check Patient C's CURES report yearly, and/or failed to document checking Patient C's CURES report.

55. Respondent's care and treatment of Patient C was grossly negligent in the following respects:

a. Respondent failed to check Patient C's urine toxicology screen over the course of multiple visits; and

b. Respondent failed to document and/or run and review a CURES report on Patient C during the entire period of his care and treatment of her.

Patient D

56. On or about March 24, 1999, Patient D was first seen by Respondent. Patient D was a female patient with a history of chronic pain, narcolepsy, anxiety and bipolar disorder.

57. Between on or about August 8, 2013, and July 24, 2018, Respondent prescribed to Patient D high amounts of a variety of prescription drugs. Specifically, Respondent prescribed hydrocodone bitartrate-acetaminophen (up to 240 tablets per month of500 milligram 15 milligram doses), clorazepate dipotassium (up to 30 tablets per month of 15 milligram doses), modafinil (up to 120 tablets per month of 200 milligram doses, zolpidem tartrate (up to 10 tablets per month of 10 milligram doses), lorazepam (up to 90 tablets per month of 0.5 milligrams doses), temazepam (up to 30 tablets per month of 30 milligram doses), methylphenidate HCL (up to 30 tablets per month of27 milligram doses), and amphetamine salts (up to 60 tablets per month of 20 milligram doses). During this time, Respondent routinely prescribed opioids in conjunction with stimulants and benzodiazepines.

58. During his care and treatment of Patient D, Respondent was unaware of the criteria for the diagnosis of narcolepsy; however, he nonetheless diagnosed Patient D with narcolepsy, and performed ongoing treatment of Patient D's narcolepsy, without referring Patient D to, and/or consulting an outside expert.

59. Respondent's care and treatment of Patient D was grossly negligent in the following respects:

a. Respondent assumed treatment for Patient D's bipolar disorder with suicidal ideation, which should have been treated by a psychiatrist; and

b. Respondent improperly diagnosed and treated Patient D for difficult to control narcolepsy.

SECOND CAUSE FOR DISCIPLINE
(Repeated Negligent Acts)

60. Respondent's license is further subject to disciplinary action under Section 2234, subdivision (c), of the Code, in that Respondent committed repeated negligent acts in his care and treatment of Patients A, B, C, and D, as more particularly alleged in paragraphs 41 through 59, and those paragraphs are incorporated by reference as if fully set forth therein.

61. Respondent's care and treatment of Patient B, Patient C, and Patient D, was repeatedly negligent in the following respects:

a. Respondent improperly prescribed high dosages of controlled substances and prescribed a potentially dangerous combination of benzodiazipines, [sic] Soma, and narcotics to Patient B.

b. Respondent improperly prescribed high dosages of controlled substances and prescribed a potentially dangerous combination of sedatives, stimulants, and narcotics to Patient C.

c. Respondent improperly prescribed high dosages of controlled substances and prescribed a potentially dangerous combination of sedatives, stimulants, and narcotics to Patient D.

 THIRD CAUSE FOR DISCIPLINE
(Failure to Maintain Adequate and Accurate Records)

62. Respondent's license is further subject to disciplinary action under Section 2266, of the Code, in that he failed to maintain adequate and accurate medical records relating to his care and treatment of Patients A, B, C, and D, as more fully described in paragraphs 41 through 61, above, and those paragraphs are incorporated by reference as if fully set forth herein.

FOURTH CAUSE FOR DISCIPLINE
(Excessive Prescribing)

63. Respondent's license is further subject to disciplinary action under Section 725 of the Code, in that he has engaged in excessive prescribing, as more particularly alleged in paragraphs 41 through 62, above, which are hereby incorporated by reference and re-alleged as if fully set forth herein. 
 

DISCIPLINARY CONSIDERATIONS

64. To determine the degree of discipline, if any, to be imposed on Respondent Peter Edward Droubay, M.D., Complainant alleges that in a prior disciplinary action entitled, "In the Matter of the Accusation Against Peter Edward Droubay, M.D." before the Medical Board of California, in Case Number 800-2014-003735, effective March 25, 2016, Respondent was publicly reprimanded for gross negligence and failure to maintain adequate and accurate medical records, in the care and treatment of a patient. That decision is now final and is incorporated by reference as if fully set forth herein

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