Psychiatrist David A. Ruben reprimanded for prescribing violations

March 1, 2011

On January 31, 2011, the Medical Board of California issued a letter of Public Reprimand on psychiatrist David Alan Ruben, based on disciplinary action taken against him by the Arizona Medical Board. 

The Arizona board placed Ruben on one year probation in April 2009 for unprofessional conduct regarding his prescribing of narcotics to a patient with chronic pain, such as continuing to prescribe Oxycontin and Oxycodone even after he’d discovered the patient tested positive for cocaine and non-prescribed methadone. 

Ruben continued to prescribed them even after the patient had successfully completed inpatient opioid detoxification. 

Following this action, the Arizona Board, in May 2010,  issued a public censure of Ruben, restricting him from prescribing and any opioid drugs for a period of one year.  He was additionally placed on probation with terms and conditions for two years. 

According to the Board’s order, Ruben deviated from the standard of care with twelve patients to whom he prescribed controlled substances and other dangerous drugs without doing one or more of the following: conducting evaluations; ordering lab studies; obtaining past medical records; obtaining a history of alcohol or substance abuse or a past psychiatric history or performing a functional assessment to support the diagnosis and prescription. 

In one particular case, Ruben diagnosed an 18-year-old girl with ADHD and prescribed her Adderall.  She had presented to him complaining of moodiness and irritability.  There was no documentation of the prescription in the patient’s record. 

He subsequently provided the patient with “frequent, early and escalated doses” of Adderall without documenting any rationale for doing so.  There was no documentation in the patient’s record that Ruben investigated the patient’s rationale for seeking early refills.  The further prescribed her Prozac, Cymbalta, lorazepam and Zoloft without documenting a rationale for the prescriptions or whether he discussed the risks and benefits of the these drugs. 

There was also no evidence in the record that he ordered any laboratory tests to support the continued prescribing of Adderall or to determine if the patient was taking the drug as prescribed and/or any illicit substances. 

Source: Public Reprimand RE: Physician's and Surgeon's Certificate Number G-44789, Medical Board of California Case Number 16-2009-198492 and Order for Decree of Censure, Practice Restriction, Probation and Consent to Same in the Matter of David A. Ruben, M.D., Holder of License No. 11382 For the Practice of Allopathic Medicine in the State of Arizona, Case Nos. MD-09-013A, MD-09-0250A, MD-09-0926A, MD-09-1263A and MD-10-0100A, Before the Arizona Medical Board.