Missouri Valley, Iowa-based Robert Cunard, MD, entered into a settlement agreement on Feb. 15 with the Iowa Board of Medicine, resulting in the indefinite suspension of his license to practice medicine in the state of Iowa, the Missouri Valley Times reports.
Here are six things to know:
1. The board previously alleged Dr. Cunard failed to provide appropriate pain management care. On May 19, 2017, the former family medicine physician entered into a stipulated order with the medical board, agreeing not to prescribe controlled substances with the exception of testosterone and to patients in residential hospice and nursing home settings until the issue is resolved.
2. On July 20, 2017, the board filed a statement of charges against Dr. Cunard, alleging "he willfully or repeatedly violated the laws and rules governing the practice of medicine in Iowa when he failed to provide appropriate medical care and pain management to several patients in Missouri Valley between 2011 and 2017, resulting in serious harm to patients and the public." Dr. Cunard was then placed on administrative leave from CHI Health Missouri Valley (Iowa) and his patients were notified he could no longer prescribe controlled substances.
3. The Iowa Medical Board’s investigation alleged Dr. Cunard indiscriminately prescribed controlled substances to several patients, including large quantities of potentially lethal medications, while failing to appropriately assess and document the patients' need for chronic opioid therapy. The statement also alleges several of Dr. Cunard’s patients experienced motor vehicle accidents and frequent falls, and Dr. Cunard did not address substance abuse as the cause of those incidents.
Other allegations include:
- Failure to appropriately document appropriate utilization of the Iowa Prescription Monitoring Program for patients receiving chronic opioid therapy.
- Failure to utilize drug screening for patients receiving chronic opioid therapy and to document efforts to address urine drug screens that were negative for prescribed medications.
- Routinely providing early refills to patients despite evidence of abuse, misuse, or diversion.
- Prescribing methadone to patients despite the fact that they were participating in a structured opioid treatment program.
- Prescribing an exceptionally high volume of pseudoephedrine, which is frequently abused in combination with other stimulants, opioids, or benzodiazepines and is used as a raw material for methamphetamine.
4. The Iowa Board of Medicine issued Dr. Cunard a citation and warning and ordered him to pay a $5,000 civil penalty at the settlement. The board also permanently prohibited Dr. Cunard from prescribing, administering or dispensing controlled substances for chronic pain treatment.
5. If Dr. Cunard seeks to reinstate his Iowa medical license, he must first successfully completed a board-approved comprehensive clinical competency evaluation, professional ethics program and medical recordkeeping course. He must also appear before the board.
6. If the board decides to reinstate Dr. Cunard's medical license in the future, he will be placed on indefinite probation subject to board monitoring, including prescribing audits, a board-approved practice monitoring plan and a worksite monitor.
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