IN AND BEFORE THE OKLAHOMA STATE BOARD OF MEDICAL LICENSURE AND SUPERVISION

STATEOFOKLAHOMA FilE[[) STATE OF OKLAHOMA, ex ref. ) OKLAHOMASTATEBOARD ) OF MEDICAL LICENSURE ) AND SUPERVISION, )

Plaintiff,

v.

JAMES LAWRENCE FLECKENSTEIN, M.D., LICENSE NO. MD 23288,

Defendant.

) ) ) ) ) ) ) ) )

JUN 0 7 2018

Case No. 16-12-5409

AMENDED VERIFIED COMPLAINT

The State of Oklahoma, ex rei. Oklahoma State Board of Medical Licensure and Supervision ("Board"), for its Complaint against James Lawrence Fleckenstein, M.D. ("Defendant") alleges and states as follows:

I. JURISDICTION

1. This Board has jurisdiction over the subject matter and is a duly authorized agency of the State of Oklahoma empowered to license and oversee the activities of physicians and surgeons in the State of Oklahoma. 59 O.S. § 480, et seq. and Okla. Admin. Code §§ 435:5-1-1 et seq., 435:10-4-2.

2. This action is authorized by 59 O.S. § 503 and Okla. Admin. Code § 435:3-3-4 et seq.

3. In Oklahoma, Defendant holds medical license no. 23288, issued March 27, 2003. Defendant also holds licenses in Florida, Minnesota, Texas and Wyoming.

4. The acts and omissions complained of herein were made while Defendant was acting as a physician pursuant to the medical license conferred upon him by the State of Oklahoma. Such acts and omissions occurred within the physical territory of the State of Oklahoma.

II. ALLEGATIONS OF UNPROFESSIONAL CONDUCT

5. On December 6, 2016, this agency received information from the Oklahoma Bureau of Narcotics (OBN) that Defendant was prescribing numerous Controlled Dangerous Substances ("CDS") to his wife LOL. Defendant and LOL were married August 27, 2014. LOL retained her maiden name.

Page 1 of 5 Amended Verified Complaint; 16- 12-5409 James Lawrence Fleckenstein, MD 23288

6. A check of prescribing records shows that between July, 1, 2013 and October 21, 2016, Defendant wrote approximately sixty-five (65) prescriptions for CDS to LOL. Additionally, there were two (2) CDS prescriptions written to VOL (LOL's twin), and five (5) CDS presctiptions written for TYL. This is a total of 72 CDS prescriptions in approximately three (3) years and four (4) months.

7. Of these 72 prescriptions, there were 28 CDS-IV totaling 790 tabs (1 Alprazolam lmg #20, 1 Alprazolam 2mg #30, 5 Clonazepam 1mg #120, 1 Diazepam lOmg #20, and 20 Zolpidem lOmg #600). There were 2 COS-Ill totaling 120 tabs (2 Hydrocodone 10mg #120). It should be noted Hydrocodone was a CDS-III at the time the prescriptions were written; it is now a CDS-II. There were 42 CDS-II totaling 3,027 tabs (2 Hydromorphone 4mg #100, 1 Meperidine 100mg #10, 3 Oxycodone 10mg #280, 30 Oxycodone 30mg #2103, and 6 Oxycodone ER 40mg #534). This totals 3,937 CDS dosages .

Interview of Defendant

8. On January 5, 2017, Defendant was interviewed by Board Investigator Lane. During this interview, Defendant admitted he had authorized all of the prescriptions listed in the prescribing records. He admitted the majority of the prescriptions written to his wife LOL were for his personal use. Defendant also admitted there were no medical records for patients LOL, VOL, and TYL.

9. Defendant stated TYL was a friend of his wife LOL. Defendant admitted that he wrote CDS prescriptions to TYL, who filled them and returned them to the Defendant, and he then used them for his own personal use. Defendant stated TYL agreed to fill prescriptions under her (TYL) name thinking they were for use by LOL.

10. Defendant admitted to a long history of substance abuse. Defendant stated that in the early 1990's he had "a clu·onic dependence upon alcohol and marijuana, and intermittent abuse of other drugs." Defendant stated he attended in-patient treatment at COPAC in Mississippi for six (6) months during this time. Defendant stated he applied for licensure in Oklahoma in 2003. Defendant disclosed his history information and was granted an unrestricted Oklahoma medical license.

11. Defendant stated he began drinking in 2004 after being sober for approximately 12 years. Defendant advised that after his continued use of alcohol for a few years, he voluntarily signed a contract with the Oklahoma Health Professional's Program ("OHPP") on October 18, 2007. He was released from this contract on October 18, 2012 after five (5) years of sobriety.

12. Defendant advised that he had back surgeries in April2013 and January 2015. Defendant stated he was prescribed opiate pain medication as a result of these surgeries. Defendant admitted after receiving these opiate pain medications he began to fraudulently prescribe CDS to LOL for his own use.

13. Defendant stated that sometime around June 2016, a pharmacist refused to fill any more of his CDS prescriptions for LOL. Defendant advised at this point he knew he had a

Page 2 of 5 Amended Verified Complaint; 16-1 2-5409 James Lawrence Fleckenstein, MD 23288

problem and needed help. Defendant stated that he then contacted Dr. Y and told him he was addicted to opioids. Dr. Y sta1ted Defendant on a Suboxone program. Defendant stated he has not taken any other opioids since that time.

Additional Information

14. Defendant completed "Application for Renewal" of his Oklahoma License on February 18, 2014, January 9, 2015 and January 26, 2016. On each of these applications, Defendant answered "NO" on question F: "Have you been addicted to or abused any drug or chemical substance including alcohol?"

15. Defendant received a comprehensive assessment at Vanderbilt in Nashvi lle, Tetmessee on February 20 and 21, 2017. Defendant received a diagnosis of: (1) Opiate Use Disorder, (2) Alcohol and Cocaine Use Disorder, and (3) Clu·onic Pain Disorder.

16. On March 26, 2018, Defendant plead guilty in Tulsa County District Court to one misdemeanor count of Possession of Controlled Dangerous Substance by Registrant by Fraud/Forgery in violation of 63 O.S. § 2-402. In exchange for that plea of guilty he received a two (2) year deferred sentence.

III. VIOLATIONS

17. Based on the foregoing, Defendant is guilty of unprofessional conduct as follows:

a.

b.

c.

d.

e.

f.

g.

Page 3 of5

Procuring, aiding or abetting a criminal operation, in violation of 59 O.S. § 509(1).

Habitual intemperance or the habitual use of habit-forming drugs, in violation of 59 O.S. § 509(4) and Okla. Admin. Code§ 435:10-7-4(3).

Conviction or confession to a crime involving violation of the anti-narcotic or prohibition laws and regulations of the federal government, or the laws of this state, in violation of 59 O.S. § 509(7)(a), (b), 63 O.S. § 2-406(A)(3), and Okla. Admin. Code§§ 435:10-7-4(27), 475:25-1-3(b), (c), 475:30-1-3(a), (d).

Dishonorable or immoral conduct which is likely to deceive, defraud or harm the public, in violation of 59 O.S. § 509(8) and Okla. Admin. Code§ 435:10-7-4(11).

The commission of any act which is a violation of the criminal laws of any state when such act is cmmected with the physician's practice of medicine, in violation of 59 O.S. § 509(9).

The writing of fa lse or fictitious prescriptions for any drugs or narcotics declared by the laws of this state to be controlled or narcotic drugs, in violation of 59 O.S. § 509(11) and Okla. Admin. Code§ 435:10-7-4(27).

Prescribing or administering a drug or treatment without sufficient examination and establislunent of a valid physician patient relationship, in violation of 59 O.S. § 509(12).

Amended Verified Complaint; 16-12-5409 James Lawrence Fleckenstein, MD 23288

h. The inability to practice medicine with reasonable skill and safety to patients by reason age, illness, drunkenness, excessive use of drugs, narcotics, chemicals, or any other type of material or as a result of any mental or physical condition, in violation of 59 O.S. § 509(15) and Okla. Admin. Code§ 435:10-7-4(40);

1. Prescribing, dispensing or administering of controlled substances or narcotic drugs in excess of the amount considered good medical practice, or prescribing, dispensing or administering controlled substances or narcotic drugs without medical need in accordance with published standards, in violation of 59 O.S. § 509(16) and Okla. Admin. Code§ 435:10-7-4(1), (2), (6), (24).

J. Adequate medical records to support diagnosis, procedure, treatment or prescribed medications must be produced and maintained, in violation of 59 O.S. § 509(20) and Okla. Admin. Code§ 435: 10-7-4(41).

k. Prescribing any regulated substance in Schedule I through V, as defined by the Unifonn Controlled Dangerous Substances Act, for the physician's personal use, in violation ofOkla. Admin. Code§ 435:10-7-4(5), (26).

I. Fraud or misrepresentation in applying for or procuring a medical license or in cormection with applying for or procuring periodic reregistration of a medical license, in violation of Okla. Admin. Code§ 435:10-7-4(8).

m. Using a false, fraudulent or deceptive statement in a document cormected with the practice of medicine and surgery, in violation of Okla. Admin. Code § 435:10-7-4(19).

IV. CONCLUSION

Given the foregoing, the undersigned respectfully requests the Board conduct a hearing, and, upon proof of the allegations contained herein, impose such disciplinary action as authorized by law, up to and including suspension or revocation and any other appropriate action with respect to the Defendant's professional license, including an assessment of costs and attorney's fees incurTed in this action as provided by law.

Page 4 of5

Respectfully submitted,

Jo ph Ashbaker, OBA No. 19395 Rachel A. Rogers, OBA No. 31206 Assistant Attorneys General OKLAHOMA STATE BOARD OF MEDICAL

L ICENSURE AND SUPERVISION

101 NE 51 51 Street Oklahoma City, OK 73105 (405) 962-1400 ( 405) 962-1499 -Facsimile

Amended Verified Complaint; 16-1 2-5409 James Lawrence Fleckenstein, MD 23288

VERIFICATION

I, Jana Lane, under penalty of pe1jury, under the laws of the State of Oklahoma, state as follows:

1. I have read the above Complaint regarding Defendant, James Lawrence Fleckenstein,

M.D.; and

2. The factual statements contained therein are true and correct to the best of my knowledge

and belief.

an Lane, Investigator AHOMA STATE BOARD OF M EDICAL

LICENSURE AND SUPERVISION

Page 5 of5

Date: _ a-=---:ta-----=- o'----"'5_-..... .....::...;;-=o --'--41 g~---

()tAo.homll.LkLL~~, Ol( County, State of Execut101

Amended Verified Complaint; 16- 12-5409 James Lawrence Fleckenstein, MD 23288