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State suspends Utah doctor's license over meds

Published July 9, 2014 12:15 pm

Health • Two newborns had to be monitored for withdrawal symptoms, state says.
This is an archived article that was published on sltrib.com in 2014, and information in the article may be outdated. It is provided only for personal research purposes and may not be reprinted.

A Utah doctor had his license suspended Tuesday for allegedly prescribing medication without properly assessing three of his patients.

Paul M. Gahlinger prescribed Suboxone, which treats opioid dependence, to two pregnant women and a man during 2012 and 2013 without properly evaluating them, according to the Utah Division of Occupational and Professional Licensing (DOPL).

Gahlinger prescribed the drug through Medicruiser, a business he operated with the help of an assistant, who is not licensed under any profession in Utah.

"She is not required to have a professional license, and few people in this position have one," Gahlinger told The Salt Lake Tribune in an e-mail. He contends that the "finding of facts" DOPL listed in its reason for suspending his license are false, that the investigators did not contact him and that they "did not request the medical records of the patients, which would have shown proper care."

According to DOPL, Gahlinger's medical practice has led to two newborns having to be monitored for withdrawal symptoms. The division issued an emergency order Tuesday suspending Gahlinger's license.

In the division's first case of concern, a woman gave birth at Vernal's Ashley Regional Medical Center in October, where the staff learned that she had been taking Suboxone from Gahlinger since April 2013. Her baby was monitored for withdrawal symptoms, due to her use of the drug, according to DOPL.

Both Gahlinger and his assistant "knew [she] was pregnant, but they would do very little physical monitoring of [her] condition and did not communicate with [her] OBGyn," according to DOPL. Gahlinger would sometimes Skype with the patient, but most of the time, the pregnant woman did not see him.

Then in December, another woman who was prescribed Suboxone gave birth at the Vernal hospital, and her baby was monitored for withdrawal symptoms, as well.

But Gahlinger contends that Suboxone is "strongly supported by the medical standards during pregnancy," and is safer than the previously recommended treatment with methadone, and certainly better than relapse.

"We counseled each of our pregnant patients on the use of Suboxone and the [effect] on the baby, and worked closely with them to reduce the dose to the minimal," Gahlinger said. "We also were in close communication with the OB physician managing the pregnancy."

Gahlinger claims that "the outcomes of these cases were very good, with the OB physician recommending to the patient to continue our Suboxone management."

Since June 2012, DOPL also alleges that Gahlinger prescribed Suboxone to a man suffering from obesity, high blood pressure and constant pain. But Gahlinger did not physically monitor the man prior to having his assistant call in the prescription, according to DOPL.

The man did not meet Gahlinger personally, but did see him over Skype, at times, the DOPL report adds.

The division found that Gahlinger "did not conduct a proper patient assessment to establish the diagnosis of opiate addiction, document the patient's use of other substances or evaluate the patient's level of physical, psychological and social functioning and impairment."

But as far as Gahlinger is concerned, DOPL evidently based its findings "on hearsay, which is frankly outrageous and a gross miscarriage of justice… I am simply incredulous that DOPL would take such unprofessional, and perhaps even illegal, action without a proper investigation, beginning with the examination of the medical records."

Gahlinger has been licensed in Utah since 1997. He can request a hearing in the next three weeks to dispute the allegations.

He still holds licenses in California and with the American Board of Preventive Medicine.

mmcfall@sltrib.com

Twitter: @mikeypanda