State of Arizona censures psychiatrist David A. Ruben over prescribing practices, etc.

March 14, 2011

On May 21, 2010, the Arizona Medical Board issued a public censure of psychiatrist David A. Ruben and restricted 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.  He 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.

In April 2009, the Board placed Ruben on one year probation 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 and continued to prescribed them even after the patient had successfully completed inpatient opioid detoxification.

Source: 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.