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Margaret Linnell admits to stealing narcotics from her veterinary practice, shooting up on them, and then administering saline solution to pets instead of the drugs for pain control, to cover her tracks. Somehow after all this, the State of Maine lets her keep her license, and when she breaks this agreement by using another doctor's prescription number to get controlled drugs, she still keeps her license.
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STATE OF MAINE BOARD OF VETERINARY MEDICINE
IN RE: Margaret M. Linnell, D.V.M. ) CONSENT Complaint No. 2009-VET-6052 ) AGREEMENT
This document is a Consent Agreement concerning disciplinary action against
the license of Margaret M. Linnell, D.M.V to practice veterinary medicine in the State of
Maine. The parties to the Consent Agreement are: Margaret M. Linnell, D.V.M.
("Dr. Linnell"); the State of Maine Board of Veterinary Medicine ("Board"); and the Maine
Office of Attorney General rAttorney General"). The Consent Agreement is entered
into pursuant to 10 M.R.S.A. 8003(5-A)(A)(5) and (C).
FACTS
1. Dr. Linnell holds a license to practice veterinary medicine in the State of
Maine. She is the owner operator of South Berwick Veterinary Hospital, a veterinary
clinic located in South Berwick, ME.
2. On December 16,2009, the Board received a complaint ("Complaint")
against Dr. Linnell's license from Thomas E. Avery ("Mr. Avery'). the Board investigator.
The Complaint alleges, among other things, that Dr. Linnell admitted that she had
diverted and abused liquid Hydrocodone, Valium and Tramadol tablets, and Alprazolam
from her veterinary practice from late 2008 through July 2009 to both Mr. Avery and a
U.S. Drug Enforcement Administration ('"DEA") agent on November 17, 2009.
In addition, Dr. Linnell admitted that she also had diverted and abused liquid morphine
and replaced it with sterile water to conceal the diversion from her staff. The Complaint
further alleges that Dr. Linnell admitted to a history of abuse of prescription opiates and
alcohol and that she had undergone substance abuse rehabilitation eighteen (18) years
before.
3. Dr. Linnell voluntarily surrendered her DEA registration to the DEA agent
on November 17, 2009. As a result, Dr. Linnell is no longer permitted to store, order,
prescribe, dispense or administer controlled substances.
4. On March 1, 2010, the DEA seized all controlled substances from
Dr. Linnell's practice as a result of reports from Dr. Linnell's employees, including the
other licensed veterinarian, that Dr. Linnell had administered controlled substances to
animals on at least two (2) separate occasions since she surrendered her DEA
registration. In addition, the other licensed veterinarian employed at Dr. linnell's
practice voluntarily agreed to restrict her DEA registration rights with respect to
controlled substances to prescribing only in order to avoid any responsibility for
controlled substances at Dr. Linnell's practice. There is no evidence or allegation of any
illegal or unethical practice by the other licensed veterinarian.
5. In her response to the Complaint dated January 2, 2010, Dr. Linnell
admits that she suffered a substance abuse relapse in the late fall of 2008 through July
2009 spurred by a series of serious personal losses. In July 2009, Dr. Linnell voluntarily
admitted herself into an in-patient substance abuse rehabilitation treatment program.
Dr. Linnell also states that upon completion of the substance abuse rehabilitation
treatment program, she placed all controlled substances and Tramadol, which is not a
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controlled substance, in the offICe safe and had the lock changed so that she does not
have the combination but rather must rely on employees at the practice to open the
safe.
6. Pursuant to 32 M.R.S.A. 4864(4), the Board may impose discipline for
the "chronic or habitual use of drugs."
7. Pursuant to 10 M.R.S.A. 8003(5-A)(A){2), the commission of any gross
negligence, incompetence, and/or misconduct by a licensee while engaged in the
practice of veterinary medicine is subject to discipline by the Board.
8. The parties have agreed to resolve the Complaint through the Consent
Agreement.
COVENANTS
In order to resolve fully the Complaint against Or. Linnell's license to practice
veterinary medicine without further legal proceedings, it is agreed to by the parties that:
1. Dr. Linnell admits that she engaged in the chronic andlor habitual use of
drugs while licensed as a veterinarian;
2. Dr. Linnell admits that she committed misconduct by diverting and abusing
prescription medications and controlled substances from her veterinary practice;
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3. Dr. Linnell agrees that her license to practice veterinary medicine will be
subject to a period of probation for a minimum of five (5) years during which Dr. Linnell
agrees that:
A. Practice Management Plan
Dr. Linnell will develop a written plan ('"Practice Management Plan")
describing in detail how she intends to conduct a veterinary practice as both the
owner and a practicing veterinarian in the absence of a valid DEA registration.
Dr. Linnell must submit the Practice Management Plan to the Board for prior
approval by the Board Complaint Committee within thirty (30) days of the date
upon which Dr. Linnell signs the Consent Agreement.
At a minimum, the Practice Management Plan must address how:
1. Dr. Linnell intends to conduct a veterinary practice in the absence of a
valid DEA registration, which is required for her to store. order,
prescribe, dispense and/or administer the controlled substances
necessary for the care of patients in the normal course of a veterinary
medicine practice. Specifically, the Practice Management Plan must:
a. identify what, if any, surgelies Dr. Linnell intends to perform and
how she intends to perform them, including a detailed protocol for
the use of anesthesia; and
b. describe how Dr. Linnell intends to treat and manage patient pain.
both chronic and acute;
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2. Dr. Linnell intends to care for patients in need of controlled substances
in emergency situations, including how clients will be made aware of
any periods when emergency services for their animals are
unavailable; and
3. Dr. Linnell intends to track and account for the use of all other
prescription medications and substances stored, ordered I prescribed J
dispensed andlor administered in her practice, which are not controlled
substances but which have the potential for abuse, such as Tramadol
or its brand names and generic equivalents;
B. Client Notification
Dr. Linnell agrees that during the frve-year probationary period she will
notify her clients of the limitations on her veterinarian practice by, at a minimum:
1. Posting a written notice ("Notice") on the main entry door describing
what aspects of veterinary medicine she may practice. The Notice
must be submitted to the Board for prior approval by the Board
Complaint Committee no later than thirty (30) days from the date upon
which Dr. Linnell signs the Consent Agreement;
2. Providing a copy of the Notice to each client at the time of the first
appointment after the onset of the probationary period and upon the
clienfs request at any subsequent time; and
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3. Providing an oral explanation describing what aspects of veterinary
medicine Dr. Linnell may practice at the time an appointment is
requested for a service which Dr. Linnell is not permitted to perform;
C. Abstinence Maintenance and Monitoring
Dr. Linnell agrees to abstain completely from the use of Prohibited
Substances.1 In furtherance of which, Dr. Linnell agrees to:
1. Provide the name(s), addressees) and telephone number(s) of her
primary care physician(s), dentist(s), and any other physician(s) or
healthcare provider(s) from whom Dr. Linnell in receives healthcare
andlor treatment to the Board at the time she submits the signed
Consent Agreement. Dr. Linnell agrees that she will notify the Board in
writing of any change in her healthcare provider(s) within five (5)
business days.
1 Prohibited Substances" as used throughout the Consent Agreement shall be defined to mean: Fentanyl; Hydrocodone; Percocet; Vicodin; Vicoprofin; DameTOI; Pentobarbital; Valium; benzodiazepines; barbiturates; opiates; alcohol; cocaine; mood, consciousness or mind-altering substances, whether illicit or not; Tramadol and its brand name and generic equivalents; and all drugs which are dispensed to or prescribed for Dr. Linnen by anyone other than a treating physician knowledgeable of her history of substance abuse, unless the circumstances constitute a genuine medical emergency.
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Dr. Linnell shall execute any and all releases necessary for the Board
to have access to any medical and/or mental health treatment records
related to the prescription of or treatment for any of the Prohibited
Substances; and
2. Provide a written list of all medications currently prescribed for her,
identifying the prescribing healthcare provider, to the Board at the time
she submits the signed Consent Agreement. Dr. Linnell agrees to
notify the Board in writing of any change in her in prescribed
medications within five (5) business days. Dr. Linnell further agrees
that the prescribing healthcare provider will notify the Board both by
telephone and in writing within forty-eight (48) hours, or as soon
thereafter as possible, jf any controlled drug is dispensed to or
prescribed for Dr. linnell. This notice shall be followed by a written
summary of all pertinent circumstances to be submitted to the Board
no later than five (5) business days;
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3. Dr. Linnell agrees to provide a written substance abuse monitoring
plan ("Substance Abuse Monitoring Plan") from her primary healthcare
provider by which he, she or a qualified designee agrees to:
a. Administer observed random drug-screening tests to Dr. Linnell for
all of the above-listed Prohibited Substances not less than two (2)
times per month. The healthcare provider shall also agree to
forward copies of all test results to the Board within seventy-two
(72) hours and to notify the Board within twenty-four (24) hours, or
as soon thereafter as is reasonably feasible, of receipt of any
positive result for any Prohibited Substance for which Dr. Linnell
does not have a valid prescription from a licensed healthcare
provider;
b. Submit written reports on a quarterly basis to the Board
addressing: Dr. Linnell's current physical and mental conditions;
any medications prescribed to Dr. Linnell; Dr. Linnell's compliance
with abstinence and testing requirements; and whether there is any
evidence of a change in Dr. Linnell's affect or presentation
indicating the use of a Prohibited SUbstance;
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4. Dr. Linnell agrees to submit a structured substance abuse plan
("Substance Abuse Plan") to the Board within thirty (30) days of the date
upon which Dr. Linnell signs the Consent Agreement. The Substance
Abuse Plan shall be designed to reinforce Dr. Linnell's abstinence and
shall include at a minimum:
a. Participation in individual and/or group counseling with a licensed
mental health or substance abuse clinician. Dr. Linnell agrees to
submit the name(s), address(es). and telephone number(s) of any
individuals with whom she engages in substance abuse counseling.
Dr. Linnell also agrees that she will ensure that her mental health
and/or substance abuse clinician(s) submit written reports addressing
her current physical and mental conditions, compliance with
counseling, and any evidence of a change in Dr. Linnell's affect or
presentation indicating the use of a Prohibited Substance to the Board
on a quarterly basis. Dr. Linnell shall execute any and all releases
necessary for the Board or its designee to obtain access to her
substance abuse counseling treatment records;
b. Attendance at Alcoholics or Narcotics Anonymous or other such
substance abuse support groups. Dr. Linnell agrees to submit
evidence satisfactory to the Board verifying her attendance at and
participation in an established, recognized substance abuse support
group to the Board on a quarterly basis. The verifying documentation
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must be issued by an identified third-party, who is both satisfactory to
the Board and available for the Board to contact for independent
corroboration;
D. Restoration of DEA Registration
If Dr. Linnell's DEA registration is restored, in whole or in part, such that
she is permitted to store, order, prescribe, dispense and/or administer controlled
substances as part of her veterinary medicine practice, Dr. Linnell must submit a
detailed protocol by which the use of controlled substances rControlied
Substance Protocol") will be monitored and safeguarded from abuse and
diversion. The Controlled Substance Protocol must be submitted to and
approved by the Board before Dr. Linnell exercises any privileges pursuant to the
restored DEA registration.
E. Right of Inspection
Dr. Linnell's practice premises, drug inventory logs, patient records drug
purchase orders and inventory history records will be made available for
inspection by Mr. Avery, the Board Complaint Officer, or any Board designee at
any time during business operation hours without any advance notice;
F. Reporting Requirements
Dr. Linnell will appear in person before the Board at its September 2010
meeting and at subsequent meetings thereafter specified by the Board, not less
than twice per calendar year, to report to the Board as to her practice
performance and her compliance with the Consent Agreement;
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G. Change of Circumstances
If Dr. Linnell changes her profession, relocates her residence or her
practice, or changes her work or home telephone numbers, she shall provide
notice to the Board within ten (10) days of such occurrence(s); and
H. Termination of Probation
Termination of Dr. Linnell's probation status will rest solely in the
discretion of the Board and will be determined based upon Dr. Linnell's progress
and compliance with respect to aU of the terms of the Consent Agreement;
4. Dr. Linnell agrees that any reliable evidence of use of any Prohibited
Substance without a valid prescription at any time in the future, whether in Maine or
elsewhere, shall constitute a violation of the Consent Agreement, for which her license
may be immediately and indefinitely suspended until such time as an adjudicatory
hearing may be scheduled before the Board;
5. Dr. Linnell shall bear all costs incurred in performance of the Consent
Agreement If a violation(s) of the Consent Agreement is proven to have occurred, the
Board may reqUire Dr. Unnell to reimburse the Board for all costs and attorney's fees
incurred in proving such violation regardless of any sanctions imposed for the actual
violation{s);
6. The Attorney General and the Board agree that no further agency or iegal
action will be taken against Dr. Linnell's veterinarian medicine license based on the
facts described herein, except in the event that Dr. Linnell does not comply fully with the
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terms of the Consent Agreement Any violation of the Consent Agreement will be an
additional ground for discipline before the Board:
7. The Consent Agreement is not subject to appeal;
8. The Consent Agreement is not subject to amendment except by written
agreement of all parties;
9. The Consent Agreement is a public document within the meaning of
1 M.R.S.A. 402 et ~.;
10. Dr. Linnell understands that the execution of the Consent Agreement is
completely voluntary and that she has the right to consult with an attorney before
signing the Consent Agreement; and
11. Dr. Linnell understands that her signature indicates that she has read and
understands the Consent Agreement and that she enters into it of her own free will.
Dated: -7-t-1--'(s'-t-'