COMMONWEALTH OF MASSACHUSETTS BOARD OF REGISTRATION IN MEDICINE. MIDDLESEX, ss ‘Adjudicatory Case No. 2020-041 (RM-20.0387), ) In the Matter of ) d FINAL DECISION AND ORDER George Hayao, MD. 5 a ee) roceducal History “The Board initatod this matter by issuing a Statement of Allegations ageinst Respondent on September 25,2020 and referring the matter to the Divison af ‘Administrative Law Appeals (DALA), The DALA Magitate issued a Recommended Decision on July 1,2021 that incorporates the Patios’ June 29,2021 Stipulation, There ‘were no objection to the Recommended Decision. ‘The Board hes reviewed and hereby adopts the Recommended Decision in its (this Final Decision and Onde, imposing the following entirety and incorporates sanction ‘Sanetion ‘The record demonstrates that the Respondent failed to meet the standard of care with respect to three paticnts. Specifically, the Respondent prescribed controlled substances fo two patients, Patients A and B, for many years without conducting any physician examination of them, without communicating with their other providers, and without maintaining medical records for them. The record demonstrates, t00, that the Respondent failed to meet the standard of care with respect toa third patient, Patent C, ‘by presoribing inapproprisie amounts of exycedone, The Bused “Is long, viewed the utmost responsibilty for issuing prescriptions for controlled substances." Accontingly, itis proper for the Board to impose sanction. See Raymond v. Board of Registration in Medicine, 387 Mass 08 (1982); Levy v. Board of Registration in Medicine, 318 Mas. 519 (1979), nusness any physician's inability or failure to discharge” his “grave * Soo he Mater of Bal Hofman, MLD., Boa of Mediine, Adiulicaary Case No, A5-7-0R (Fal Decision and Oedr, November 20, 1985),‘When determining the appropriate sunction in a substandard care case, the Board takes into consideration the degree of deviation from acceptable medical car, the number ‘of acts of negligence, the impact of the physician’s misconduct, end any mitigating circumstances. The facts presented in this matter fall short of those presented in instances where the Board has imposed a revocation or suspension with respect to substandard prescribing practices. In those instances, the substandard preseribing was ‘coupled with falsifying records to conceal the prescribing”, issuing prescriptions to sion- jsorders', or issuing prescriptions in names of patients known to have substance use ‘others to obtain controlled substances for his own use! In cases involving substandard ‘care of two or three patients, the Board has Juding an admonishment? censure’, reprimand,” or imposed a range of sanctions, practice restriction’ In such cases, the Board has sometimes included other diseipine, 2 Senn he Mater of Michel Sevens, MD, Board of Registration in Mein, Adjuaary Cas No. 2010-019 (Content Grd, August 2, 201 oard imposed indefinite supers o be stayed Up ey Into ive yur probation arene nh ater te psn’ mrctespseibig prac a em to he atentn othe fy medal deo. Tn reponse to montortg he medi rector the ‘rican sited medial cords o make it ppoa that he wes aerng narcotics when infact he ‘Eine fo soe penn in hr aot. He ait being overly Soman of ‘eeehng patie odd wot have th sity eo ot Doundar). ‘See nthe Mater of Christopher Oven 1D, Bondo Regist n Mace, Aduery Case No 2017-03 nal Deets snd Orde, Api 25, 218) Boar evoked innate igh to ree bed on ‘Calf dicpine fr presebing controled aubtnces ths piiend and nor-patens own have “stn as rer enn medic roses). "Seen he Mater of tram Zengot LD. Bose of Registro in Mode, Adjuticaory Ce No. (34-DAL.A (lal Deon end Ore, October 0, 2001}oat suspended north ee bse ‘on ising prescriptions inthe names of equals who thn fled he prescriptions fr bin, among ‘er misconduct) Se mike Mater of Mihoet N. Weinstein, MD, Posed of Reistaton ix Main, Adc Case [No 8 9-TK Pata Deon en Orde, Mach 950)oe4 ipod nadine and reqied “Saag ports for ne year fom hes nh which pln vay fled, where pytican ‘ener sabetandard cr to Oro patents and maintained sbsiandard medial rood forthe tid) The ‘ond sated ta he pst scnowledged his emery and demoted commitment to improving his sills by completing i ptr tote inpeston of csiline. 3S tite Mate of Poly Cong 2D Bow ox Repaion Medi, Agusetay Cwe [No ODIEDALA (Pal Decon and Orr, Decor 13, 2000\(Boud imposed conse and required 15 canting poesioal velo es nail esp eee nt neato of raga Sudo to wel ety so Probation Agen, whee» physi ender tard car 00 [ts tnd nile saboandd ecard fr hs patents) Fee nthe Str of Pepa Butera MD, Boat uf Reparation in Meticine, Adjutizaory Caso No ‘2007-025 (Hal Deon an Order, December 17, 2008XBoand imposed arepinan, where physicin ‘rth instances of etbstnded coe completed ah ieral edie review couse and hail wandering [Poss porto he postion of dieing) FSteasa nthe Marr Marc: resdnan, HD, Bosd of Reisraton it Mois, Ajuizwry Case ‘No 2015-052 (Consent Orr, October 2, 2013) @ourd rece physica to specie fie proces ‘whee physician rendered saan eae to thee patients and a pte of prec cal ino gestion‘such as probation, @ required clinical skills assessment or continuing. professional dovelopment (CPD). In light ofthe Respondent's substandard eare with respect to three patients and his failure to maintein adequate medical records with respect to two of the patients, the ‘Board hereby imposes a REPRIMAND. In addition, the Respondent must document his completion af five Rearlapneoved continning rofessional development (CPD) credits in opioid prescribing and five Boand-approved CPD in medical record-keeping. within sixty days of this Final Decision and Order. ‘The Respondent shall provide @ complete copy of this Final Decision and Order, ‘with all exhibits and attachments within ten (10) days by certified mail, return receipt requested, or by hand delivery to the follow hospital, nursing home, clinic, other licensed facility, or municipal, state, or federal facility at which he practices medicine; any in- or out-of-state health maintenance designated entities: any in-or out-of-state ‘organization with whom he has privileges or any other kind of association; any state agency, in- or out-of-state, with which he has a provider contract; any in- or out-ofstate ‘medical employer, whether or not he practices medicine thee; the state licensing boards of all states in which he has any kind of license to practice medicine; the Drug Enforcement Administration — Boston Diversion Group; and the Massachusetts Department of Public Health Drug Control Program. ‘The Respondent shall also pro {his notification to any such designated entities with which he becomes associated for one year within issuance of this Order. The Respondent is further directed to certify to the ‘Bosra within ten (10) days that he has complied with this directive. ‘The Boatd expressly reserves the authority o independently notify, at any time, any of the entities designated hove, or any other affected entity, of any action it has taken. The Respondent has the right to appeal this Final Decision and Order within tity (30) days, pursuant to G.L: &. 30A, $614 and 15, and G.L. c. 112, § 64. Date: December 2, 2021 Julian Robinson, MD. Chair Board of Registration in Modicine his competes to pasion obvetial sree.) The Consent Onder specified that the plyseian had completed nia sil ascesment pia 1 the Boned dcp