Michigan Medical Board Fines Psychiatrist Dale DMello over Prescribing Practices; Four Patients Died of Drug Toxicity

July 20, 2023

On May 3, 2023, the Michigan Board of Medicine fined psychiatrist Dale D’Mello $750 for prescribing more than three-days’ worth of a controlled substances to a patient without first checking the state’s automated prescription drug monitoring system (MAPS), and for departing from or failing to conform to minimal standards of acceptable medical practice.

The Board’s document states that four of eight of D’Mello’s patients, whose files were reviewed by the Board’s expert, had died of drug toxicity.

As part of an investigation into D’Mello’s prescribing practices, the Michigan Department of Licensing & Regulatory Affairs (LARA) subpoenaed medical records from D’Mello. LARA also obtained the death certificates and MAPS records for patients Jane Doe 1, Jane Doe 2, John Doe 1, and John Doe 2, the patients who died due to drug toxicity.

An expert reviewed the medical files of and documents for patients Jane Doe 1, Jane Doe 2, Jane Doe 3, Jane Doe 4, Jane Doe 5, Jane Doe 6, John Doe 1, John Doe 2, and John Doe 3 and made the following general observations:

a. D’Mello failed to adequately document symptoms in patients with a substance abuse disorder.

b. D’Mello failed to refer substance abuse disorder patients struggling with sobriety for inpatient care or other treatment.

c. D’Mello failed to document his rationale for prescribing short-acting Xanax when longer acting medications would be the preferred medical practice.

d. D’Mello failed to document his rationale for continuing to prescribe controlled substances after irregular drug screens were obtained.

Expert’s Patient-Specific Observations of D’Mello’s Practice

Patient Jane Doe 1:

a. D’Mello failed to refer Jane Doe 1 for a more intensive level of substance abuse treatment prior to her expiring from a drug overdose.

b. D’Mello made a late documentation entry five months after the office visit and after he’d received the subpoena for records from the State of Michigan.

c. D’Mello failed to document his rationale for failing to see Jane Doe 1 for six weeks after first prescribing her Suboxone and for failing to see her for twelve weeks after the second prescription for Suboxone.

d. D’Mello failed to document his rationale for not reevaluating Jane Doe 1 in a timely manner after she demonstrated her inability to abstain from un-prescribed controlled substances.

e. D’Mello failed to document his rationale for stopping his prescribing of diazepam and clonazepam and starting to prescribe alprazolam at Jane Doe 1’s request.

f. D’Mello failed to document recognition of potential red flags for drug abuse and diversion such as irregular drug screens, asking for early refills, and missed appointments.

Patient Jane Doe 2:

g. D’Mello failed to check MAPS as required by law.

Patient Jane Doe 3:

h. D’Mello failed to document his rationale for increasing dosages of controlled substances.

i. D’Mello failed to document any analysis or discussion concerning irregular drug screen results.

j. D’Mello failed to acknowledge that another prescriber was issuing controlled substance prescriptions to Jane Doe 3.

k. D’Mello failed to document cocaine use disorder in the medical record despite the patient disclosing it in a patient intake form from 2015.

l. D’Mello failed to document his rationale for prescribing a stimulant and a sedative concurrently.

m. D’Mello failed to document Jane Doe 3’s high overdose risk scores and include them in a treatment plan.

Patient Jane Doe 4:

n. D’Mello failed to document his rationale for increasing dosages of controlled substances.

o. D’Mello failed to document his analysis of irregular drug screen results.

p. D’Mello failed to document his rationale for issuing a supply of 90 tablets of alprazolam 2mg at one time. This amount could encourage abuse or diversion.

Patient Jane Doe 6:

q. D’Mello failed to document notes regarding another prescriber that was issuing opioids.

r. D’Mello failed to document his rationale for increasing the dosages of prescribed controlled substances.

s. D’Mello failed to document his analysis or discussions regarding irregular drug screen results.

Patient John Doe 2:

t. D’Mello failed to document his analysis or discussions regarding irregular drug screens.

Patient John Doe 3:

u. D’Mello failed to document his rationale for increasing the dosages of prescribed controlled substances.

v. D’Mello failed to document analysis or discussion regarding irregular drug screen results.

w. D’Mello failed to obtain drug screens from 2015 through 2017 despite issuing multiple controlled

substances concurrently.

Source: Consent Order in the Matter of Dale D’Mello, M.D., license no. 43-01-039175, file no. 43-21-000246, Michigan Dept. of Licensing & Regulatory Affairs, Bureau of Professional Licensing, Board of Medicine, Disciplinary Subcommittee, May 3, 2023