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Oncologist didn’t know he was giving non-approved meds

Copyright © 2014 Albuquerque Journal

The only oncologist in Deming can go back to work after a hearing officer for the New Mexico Medical Board concluded Dr. Mohamed Aswad was unaware he was treating patients with cancer drugs that weren’t approved for use in the U.S.

The medical board on Friday voted to lift Aswad’s emergency suspension after receiving the report of board hearing officer Jennifer G. Anderson.

Anderson concluded that evidence from a hearing she held last week showed Aswad didn’t conceal his use of the drugs and didn’t tell cancer patients they were being treated with foreign-made medications he bought via a toll-free phone number.

But that was because he himself didn’t know, she added.

Anderson’s report said she believes he has learned his lesson.

“Dr. Aswad appears to be less trusting and savvier with respect to suppliers of oncology mediations and supplies, and I genuinely believe that Dr. Aswad will not make the same unwitting mistake in the future,” she added.

Instructions for some of the chemotherapy drugs Aswad purchased from July 2010 to February 2012 were in Turkish. But he testified that he never read them because he already knew how to administer the medications.

“Based on his testimony and lack of any evidence to contrary, I believe Dr. Aswad never intended to subject his patients to risk and that Dr. Aswad thought that he was providing excellent care,” the hearing officer wrote.

Though no evidence was presented that any patients were harmed, “that is cold comfort to the Board given the undisputed risk of harm presented by the administration of non-FDA-approved medications,” Anderson wrote.

“If none of Dr. Aswad’s patients suffered any setbacks in their health or well-being after being infused with the (non-FDA-approved) medications, the lack of harm can only be attributable to good fortune,” her report stated.

An investigator from the U.S. Food and Drug Administration testified on Monday that he didn’t know whether any patients had been harmed, noting that a number had died.

But vials of medications seized by the FDA from Aswad’s Deming office in April 2012 tested positive for the active ingredient used in their U.S. versions. There wasn’t enough of the medication left, however, to ascertain whether the drugs had been diluted, the agent testified.

The board on Nov. 14 issued an emergency suspension of Aswad’s license based in part on his guilty plea last month to a federal misdemeanor charge in which he must forfeit $750,000 and reimburse Medicare, Medicaid and TriCare nearly $1.3 million – the amount he billed the agencies for the drugs.

Anderson concluded Aswad didn’t subject his patients to risk “in pursuit of personal gain” and found no evidence to support the board prosecutor’s original contention that Aswad made $2 million in profit by buying the cheaper foreign versions of the U.S. cancer drugs.

Anderson concluded that, based on the testimony and letters of support from patients and colleagues, “the real risk of harm to the Deming community arises from Dr. Aswad’s inability to practice medicine.”

Deming is an underserved community that has experienced a drop in the number of physicians from 15 to 6, according to testimony in the suspension hearing.

A graduate of the University of Aleppo medical school in Syria, Aswad is the only oncologist in the southern New Mexico city and surrounding areas.

His patients were concerned they would have to travel several hours from home to get treatment if Aswad’s suspension continued, Anderson wrote.

And, she added, there have been no concerns raised about Aswad’s care of patients in the 30 months since the FDA raided his office.

Aswad’s attorney, Molly Schmidt-Nowara, said Friday, “We commend the Medical Board for acting swiftly in doing what we believe was the right thing in this case. Dr. Aswad is an excellent doctor.”

Though he is permitted to treat patients again, Aswad still faces a related disciplinary hearing before the Medical Board.

Anderson, in her report, cautioned the oncologist about his failure to immediately stop working once the board ordered his emergency suspension last month.

Aswad continued practicing medicine and filling or writing prescriptions for patients for three days after learning from his attorney that the board had ordered an immediate suspension of his license.

Schmidt-Nowara told Anderson during Monday’s hearing that she was to blame for giving him legal advice that he could work until he actually received written notice of the suspension by mail. That occurred Nov. 21.

Aswad testified the volume of medications he prescribed in those three days was greater than normal because he was concerned about abandoning his patients who needed refills.