PAUL J. HANNAN, M.D., Appellant,
DELAWARE BOARD OF MEDICAL LICENSURE AND DISCIPLINE, Appellee.
A. Parkins, Jr. Superior Court Judge.
is a physician whose license was revoked by the Board of
Medical Practice and Licensure for, in the words of the
Hearing Officer, "enabling a criminal drug gang in
Pennsylvania by providing them with a regular source of
controlled substance prescriptions to be sold on the
street." The physician now seeks a stay of the
revocation of his license pending the results of this appeal.
It is manifest on the face of his application that he has not
alleged any substantial issue to be raised on the appeal.
Therefore, even though the State has stipulated to a stay,
the court will deny it.
Facts The Board summarized the evidence before the
Hearing Officer in part as follows:
Based on the testimony of the State's expert, the hearing
officer found as a matter of fact that Dr. Hannan's
practice of prescribing opioids ignored a number of "red
flags, " that indicate that his patients were seeking
controlled substances for nontherapeutic purposes. Dr. Hannan
requested MRI reports from his patients at the time of their
initial presentation, but made little to no effort to secure
any charting of prior pain management physicians. Dr. Hannan
ignored point-of-care urine screens that indicated patients
may be taking prescriptions, or other opioids, that he was
not prescribing. Dr. Hannan required the execution of a pain
management contract, but did little to enforce the terms of
these agreements. Physical examinations were never performed,
pursuant to the testimony of the patients highlighted in this
hearing, and this is corroborated by the medical records that
include no indication that physical examinations were
performed. Dr. Hannan's medical records hardly ever
included diagnoses, and medications were increased without
documented rationale. Dr. Hannan's files did contain
"short form" and "long form" disclosures
about the risks and benefits of taking controlled substances,
but the hearing officer found these were fill in the blank
forms that weren't filled in, and referenced discussions
of risks and benefits occurring elsewhere without
documentation of any other discussion of the risks and
benefits. The hearing officer found as a matter of fact the
Dr. Hannan engaged in discussions with his patients including
discussions of Dr. Hannan's Nurse Practitioner's
family situation, as well as multiple conversations about Dr.
Hannan being investigated by the DEA. Finally, the hearing
officer found as a matter of fact that on April 22, 2015, Dr.
Hannan was arrested and charged with knowingly and unlawfully
carrying a concealed loaded handgun in his briefcase, a
misdemeanor offense for which he pled guilty, but
successfully completed probation before judgment.
State based its case against Dr. Hannan on his treatment of
eight patients. The court need not detail the evidence
relating to each patient at this point. Suffice it to say,
the Board found that the "record of how these patients
were treated is deplorable." The following are
• Dr. Hannan repeatedly prescribed opioid medications
for patients without documenting any justification for doing
so. He increased dosages even though there was no report of
new symptoms or increase pain, and in at least one case
ordered an increase in dosage even though he recorded that
the patient reported she was doing well.
• Urine drug screens frequently were negative for the
opioids he was prescribing, suggesting that the patient might
be diverting the medication rather than taking it.
• On some occasions Dr. Hannan prescribed Oxymorphone (a
drug with twice the potency of Oxycodone) without any
justification being apparent from his records.
• The Pennsylvania Prescription Monitoring Program
("PMP) record shows that roughly 53 of Dr. Hannan's
patients filled their prescriptions in Pennsylvania
pharmacies. The PMP for one patient illustrates how quickly
and freely he handed out prescriptions for pain killers:
o Initial prescription: 90 Oxycodone (30 mg.) and 56
Oxycodone (15 mg).
o Prescription changed to 84 30mg and 84 15mg. later.
o When patient reported this was "not enough" Dr.
Hannan increased the Oxycodone 30mg tabs from 84 to 160.
o April 11, 2013: Appellant prescribed 160 Oxycodone 30mg
tabs for the patient.
o Six days later (April 17) he prescribed 58 Oxycodone 5mg
tabs for the same patient.
o May 10, 2013: Appellant prescribed 124 Oxycodone 30mg and
62 Oxymorphone 5mg tabs to the patient.
• Many of Dr. Hannan's patients came from out of
state. According to one patient ostensibly living in Elkton,
MD, Dr. Hannan knew that the patient actually resided in
Kentucky and travelled by train to Elkton to obtain
prescription. Another patient estimated that 35 to 40 of Dr.
Hannan's patients resided in Shamokin, Pennsylvania,
which is 115 miles (and roughly a three-hour drive) from
• One patient wore an audio recording/transmitting
device to a visit with Dr. Hannan. The records prior to the
recorded visit show that Dr. Hannan increased the
patient's dosage of Oxycodone even though the patient
advised of a "2" on a pain scale of 0 to 10. The
recording shows that the patient told Dr. Hannan that he sold
half of his prescribed drugs to support his family, and later
told appellant he intended to sell half of the drugs. Dr.
Hannan advised the patient that such activity was a criminal
offense, whereupon the patient told Dr. Hannan he intended to
continue selling the drugs. Nevertheless Dr. Hannan
prescribed 150 tabs of Oxycodone 30mg and 60 tabs of
Methadone 10mg "to prevent withdraw."
Hearing Officer observed that:
The evidence in this case establishes that Dr. Hannan was
enabling a criminal drug gang in Pennsylvania by providing
them with a regular source of controlled substance
prescriptions to be sold on the street.
Board had a similar view of the evidence, concluding:
Dr. Hannan's practices show a clear priority on
money-making at the expense of appropriate patient care.
There is a real concern for public safety.
The court will not agree to the stipulated stay
State and the appellant have stipulated that this court stay
the Board's decision pending the outcome of this appeal.
It is manifest from the papers that the sole purpose of the
stay is to prevent (for the time being at least) Florida
medical authorities from learning the Delaware Board's
revocation of Dr. Hannan's license. Dr. Hannan is now
treating patients for pain management in Florida, which
apparently includes prescription of narcotic pain
medications. The purpose of the motion is to prevent (for the
time being at least) Florida authorities from learning that
his license has been revoked in Delaware. According to his
Appellant continues to practice in the area of pain
management medicine in Tampa, Florida. Without a stay, and
without being afforded his constitutional due process rights,
the discipline will be made public and placed on the National
Practitioner Database. * * * Appellant's patients, for
the most part, suffer from chronic and life-altering pain and
rely upon his practice for obtaining relief from that ...