The Kentucky Board of Medical Licensure has indefinitely restricted the license of a doctor who practices in London after it found that he was self-prescribing medications and maintaining inadequate patient medical records.
Dr. Munawar Siddiqi, whose London practice is called Kentucky Spine and Pain Care, cannot prescribe controlled substances until he completes the terms of an agreed order filed Monday.
Siddiqi, who lives in Jessamine County, has been licensed in Kentucky since 2004. At one time, he managed a pain management clinic at St. Joseph London.
Siddiqi can continue to see patients, said Richard Plymale, the Lexington attorney who represented the doctor before the licensure board.
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“Many of his patients are elderly patients who can be treated with other drugs and other pain medications that are not controlled,” Plymale said.
“He has a reputation as one of the most conservative doctors who treat pain patients, and other doctors refer patients to him on a daily basis,” Plymale said. “He is a good and honorable doctor who serves his patients and the London community extremely well.”
In 2014, the Cabinet for Health and Family Services received a complaint from a person who indicated that her mother was selling medications prescribed by Siddiqi. The cabinet began an investigation.
During an interview with a board investigator in May 2016, Siddiqi admitted to “prescribing cheratussin cough syrup to himself on two occasions,” board records say.
“He stated that he did not realize it was a controlled substance,” the records say. “He denied having any dependency issues with medications.”
The following month, Siddiqi denied any improper prescribing. Nevertheless, a board consultant found problems with Siddiqi’s medical records of patients.
“I thought Dr. Siddiqi’s medical records from St. Joseph were of good quality, history was concise, reasoning was clear,” the consultant wrote.
However, “the records from Dr. Siddiqi’s private practice are of a completely different quality. It is often hard to determine what medications the patient was on when they arrived vs. when they left. …Sentences were often incomplete or made no sense…. Typically, the treatment plan was very scanty or there was no clear logic.”
“More troubling,” the consultant continued, “was repeated failure to act upon inappropriate drug screens. Any physician can miss an abnormal result occasionally. Typically, however, (in records kept by Siddiqi) the abnormality would be noted but no action would be taken. In the case of Patient A, the patient had three inappropriate urine drug screens, admitted to smoking marijuana but opioids were still continued.”
In one chart, the board consultant said Siddiqi’s prescribing “constituted an imminent threat to patient safety,” the board records say.
The consultant said “the deterioration in the quality of the notes in the patient charts suggested possible impairment” by Siddiqi.
Plymale said Siddiqi was testing several software programs while shifting to electronic records.
“He went through several systems, and during that time, his records were probably not what they are today,” Plymale said. “No patient was harmed.”
The board said within 20 days of the filing of the agreed order, Siddiqi is to arrange and schedule all necessary evaluations to determine whether he requires treatment for any condition which may impair or adversely affect his ability to practice medicine.
He is also directed to enroll in a seminar on upkeep of medical records.
He must also successfully complete a Vanderbilt University Health Center in Nashville course on prescribing controlled drugs.
Plymale said Siddiqi has already completed some required training.
Siddiqi was also directed to pay $1,312.50 for the cost of the investigation.