AG: Suspend Dover psychiatrist who bartered drugs for guns

A Dover psychiatrist whose license has been on probation off and on for 15 years for sexual offenses and other violations is still seeing patients, despite a recent complaint by the Department of Justice that says he gave a handgun and switchblade to a patient and ingested that patient's prescribed stimulants.

Gregory Villabona has been under investigation by the Attorney General's Office since 2016, an office spokesman said. According to the AG's recent complaints filed with the Department of State, Villabona continued to prescribe oxycodone to one patient, even after law enforcement officials notified him that the patient had been receiving narcotics from multiple prescribers and was court-ordered to participate in a substance abuse treatment program.

The patient later died of a heroin overdose.

Six other patients received pain medication without regular monitoring, treatment plans or record keeping, the most recent complaint said.

State records show that Villabona's Delaware medical license has been on probation off and on since 2003 stemming from sexual offenses with two minors and consensual sex with a former adult patient that "exploited the doctor-patient privilege," along with probation violations.

On Thursday, the same day The News Journal posted a story online chronicling Villabona's troubles, the AG's Office asked Secretary of State Jeff Bullock to order an emergency suspension of Villabona's controlled substances registration based on the "imminent danger he poses to public health."

That amended complaint contained several new allegations. Among them: Villabona has been known to "barter" medical services for guns and yard work.

The AG also asked Bullock Thursday to immediately suspend Villabona's medical license, but no details on that complaint were available. Medical license investigations – unlike most other professional license investigations – are confidential under state law until formal action is taken.

Villabona, who has declined to comment to The News Journal, has until Monday morning to provide a response to the petitions. Bullock is expected to rule on them Monday.

The psychiatrist's attorney, Andre Beauregard, did not respond to a request for comment Friday.

Last week, AG spokesman Carl Kanefsky told The News Journal that the office's previous complaint, filed against Villabona in September, did not meet the "threshold" to warrant an emergency suspension of his license. At the time, Kanefsky noted that an amended complaint was in the works, but provided no timeline. He added that the investigation has involved "voluminous records and multiple witnesses."

Villabona is the only licensed mental health professional in Delaware barred from treating minors, according to Department of State spokesman Doug Denison.

Citing Villabona's disciplinary record, the state of Maryland's medical board refused to license him in 2009 based on "immoral" and "unprofessional conduct in the practice of medicine," according to Maryland records.

Twice before, the Delaware AG's office recommended that the Delaware medical board temporarily suspend Villabona's license; the board instead gave him probation both times and continued to allow him to treat patients, state records show.

Through the State Department, members of the Delaware Board of Medical Licensure and Discipline declined to comment for this story.

Earlier last week, Beauregard declined to comment on the bulk of accusations against his client. He criticized the DOJ for "embellishments" in its investigation but would not be more specific.

"Sometimes their investigations aren't as thorough as they should be," the Dover lawyer explained.

The public complaint against Villabona's medical license dates to 2013, when State Department investigators began looking into it. It took three years for the complaint to be forwarded to the AG's Office for further investigation. All the while, Villabona continued to see patients.

Without commenting on Villabona's specific case, Denison, of the State Department, said it is not uncommon for department investigations to span many months or even years before they are turned over to state prosecutors. He noted that an initial complaint can spark other complaints that might broaden the scope of an investigation.

Last year, another complaint came in against Villabona's controlled substance registration.

One of the more serious allegations to emerge from that complaint dates to a 2014 patient appointment. Aware that several law enforcement officers had just arrived at his office, Villabona handed a patient a 9 mm handgun and switchblade from his desk drawer and the patient took them home, according to the complaint. The patient, who was being treated for anxiety and pain management, returned the weapons to Villabona one month later, the complaint said.

That same patient, who is identified only as Patient D2, said he routinely provided Villabona with "most or all of his methylphenidate prescription" that the psychiatrist had prescribed for him, according to the DOJ complaint. Methylphenidate, also known as Ritalin, is typically used to treat Attention Deficit Hyperactivity Disorder.

Villabona "sometimes paid Patient D2 for the pills and sometimes he did not," the complaint said. "On several occasions, Patient D2 observed [Villabona] ingest the Methylphenidate pills."

Villabona denies providing weapons to the patient or taking his pills, Beauregard said.

Doctors avoid punishment

Nationwide, physician-dominated medical boards have been criticized for going easy on their peers accused of sexual misconduct.

In 2016, the nonprofit public watchdog group Public Citizen published a study analyzing sexual misconduct records in the National Practitioner Data Bank from 2003 to 2013. Researchers found that most of the physicians reported for sexual misconduct by hospitals, medical societies and malpractice insurers were never disciplined by their state medical boards.

That same year, an Atlanta Journal-Constitution investigation documented widespread sexual abuse by doctors across the country – such as OB-GYNs raping patients and anesthesiologists groping sedated patients – yet fragmented medical oversight.

The AJC graded each state on how well it protects patients against sexually abusive doctors. Delaware received a 91 out of 100. The newspaper highlighted the Villabona case as an exception.

The full scope of the problem is unknown, the newspaper noted, since many misconduct investigations are conducted in secret. Patients are often reluctant to challenge authority or they feel that their concerns won't be taken seriously due to a history of mental illness.

Recently, Beauregard questioned the credibility of Villabona's accusers.

"You're dealing with people who are disabled or who have some sort of mental illness," he said. "You just can't take their word for it."

Paul Hofmann, president of the California-based Hofmann Healthcare Group, said it is relatively common for one state to deny a medical license to a doctor while another state approves it based on the same disciplinary record. Not every state professional board conducts a thorough background check, he said. Some states are more focused on filling staffing shortages, he said.

Delaware, like other states, is struggling with a psychiatrist shortage.

"It is just so lamentable that the state medical boards are not more consistent and effective in making sure these vulnerable patients are not placed at risk," said Hofmann, who has testified as an expert witness in cases that involve sexual assault or harassment by clinicians.

"They have a duty to reduce preventable harm."

After Lewes pediatrician Earl Bradley was convicted in 2011 of raping nearly 100 patients, including babies, the First State's insular medical establishment enacted sweeping reforms.

In an interview last year, David Mangler, director of Delaware's Division of Professional Regulation, credited a coordinated effort on the part of law enforcement, the medical community and the general public in identifying doctors' abhorrent behavior.

From 2010 to 2017, the average number of complaints filed against licensed physicians with the state division nearly doubled to 264 compared to each of the seven years prior.

In the wake of the landmark Bradley case, the medical board hasn't received any complaints about doctors' inappropriate sexual behavior with children, Mangler said. Post-Bradley, the board revoked the licenses of three Delaware doctors for inappropriate sexual conduct with adults.

'No credible evidence'

After graduating from Universidad Central del Caribe Medical School in Puerto Rico, Villabona completed a one-year residency in family medicine at Christiana Care Health System, followed by three years of residency training at Delaware State Hospital, according to state records.

A 1996 News Journal article listed Villabona as a $190,000-a-year staff psychiatrist at Connections CSP, a Wilmington mental health nonprofit. He also was on staff at the state-operated Sussex Mental Health Clinic in Georgetown.

Villabona's license troubles began in 2002, when he pleaded guilty to a third-degree sex offense on a female minor, a felony, and a fourth-degree sex offense on a female minor, a misdemeanor, in the Circuit Court for Queen Anne's County, Maryland.

Villabona's nieces had accused him of molesting them from 1978 to 1983 when they were both under 12 years old and Villabona was in his 30s, according to court and state records.

The alleged abuse stopped nearly a decade before Villabona became licensed in Delaware in 1992.

Villabona had faced a maximum of 11 years in prison in that case, but he received probation before judgment as part of a plea deal, which meant that he was spared a conviction on his record and he wasn't required to register as a sex offender. Rather, he was ordered to undergo an evaluation by a sexual disorder unit and to have no unsupervised contact with anyone under age 18 while on probation for five years.

Prosecutors also agreed to dismiss 28 criminal counts against Villabona, according to state records.

Following the publicity surrounding the Maryland case, the state of Delaware terminated Villabona's employment contract. Then-Delaware Deputy Attorney General Gregory Smith initially asked the state medical board to temporarily suspend Villabona's license in January of 2003, state records show. The board refused, opting to schedule a hearing.

At the hearing, Villabona's attorney argued that his client was not guilty of "dishonorable or unethical conduct" under state statute, and warned that any sanctions against Villabona would harm patients.

Explaining that there was "no credible evidence" that Villabona had committed sexual misconduct against a child or patient since his graduation from medical school, the hearing panel noted that "a significant number of his patients think very highly of him both as a person and as a physician," state records show.

The panel also unanimously agreed that Villabona was not mentally ill or incompetent. Previous evaluations found no evidence of a sexual disorder or psychiatric disorder other than depression related to numerous "stressors" in his life, according to state records.

While concluding that it was "unlikely" that Villabona would commit similar transgressions in the future, his "behavior has harmed the public in a general sense," the panel ruled.

In the end, Delaware's medical board, with approval from the AG's office, placed Villabona's license on probation to run concurrently with his five-year criminal probation in Maryland.

Under the disciplinary order, Villabona was prohibited from seeing minor patients without an adult present and was required to be supervised by a physician and disclose his "admitted sexual crimes" to his patients.

Villabona appealed that decision to Kent County Superior Court, which sided with the board in April of 2004, according to court records. Villabona then appealed to Delaware Supreme Court, which affirmed the Superior Court's decision four months later. The appeals delayed the board's order from taking effect for nearly a year.

In 2005, Villabona successfully petitioned the Maryland Circuit Court and the Delaware medical board for early termination of his probation. Delaware's medical board took him off probation but continued to mandate that Villabona treat minors only with adult supervision and notify patients of his record, state records show.

That same year, Villabona allegedly treated a 17-year-old psychiatric patient whose mother couldn't attend an emergency appointment, according to state records. A receptionist told investigators that she found Villabona seated in an "inappropriate position" on an ottoman pushed against a sofa where the patient was laying with her underwear visible to the receptionist.

Villabona told a Dover Police detective that he was only in the room for 15 seconds; the patient claimed that she had been alone with him for at least 20 minutes. He also challenged the credibility of three of his employees, his former psychiatric patients who testified for the state.

The patient denied any inappropriate contact with Villabona and no criminal charges were ever filed, according to state records.

The following year, in 2006, Villabona lost a medical malpractice lawsuit and was ordered to pay $200,000 to a former 22-year-old female patient who claimed that he had sex with her in a car in 2002. The patient, a sexual abuse survivor, began seeing Villabona for depression, according to the lawsuit filed in Superior Court.

After several visits, the patient accused Villabona of taking her to a Dover sports bar, where he bought her several rounds of drinks even though she was on antidepressants prescribed by him. He then drove her back to his office where he had sex with her in the parking lot, the plaintiff's lawyer, Bruce Hudson, said at the time.

In court, Villabona denied having sex with his client. Under revised disciplinary guidelines adopted after Bradley's 2011 conviction, a doctor who has sex with a current patient faces a minimum six-month license suspension and may be prevented from practicing medicine indefinitely. Felony sex offenses also result in licenses being revoked.

But Villabona was never convicted of a felony and his infractions predate the Bradley reforms.

His disciplinary record, available for free at the Division of Professional Regulation's online license verification portal, provides documentation on the medical board's two disciplinary orders in 2003 and 2007 and a 2008 consent agreement. After Villabona lost the civil lawsuit, the DOJ recommended that the medical board move for an emergency suspension of his license, according to state records. Again, the board refused.

Under the consent agreement, Villabona was permanently banned from treating anyone except male patients over age 18. His license is still on probation.

The national Medicare website, Medicare.gov, lists Villabona as accepting Medicare patients and says he is affiliated with Bayhealth Kent General Hospital. But a Bayhealth spokeswoman said Villabona does not have hospital privileges.

As part of the AG's Thursday petition against Villabona, Deputy Attorney General Stacey Stewart alleged that many of his patient files were missing required notice forms about his sexual offenses – in violation of the medical board's order.

In at least one case, the complaint said, Villabona used a substitute form not approved by the medical board stating that he was "falsely accused of the criminal charges and incorrectly stating that the board found no evidence of guilt."

The petition also accuses the psychiatrist of ignoring red flags raised by law enforcement and other pain doctors about patients' painkiller addictions. After a patient's family member told Villabona in 2016 that the patient intended to commit suicide, the next day Villabona prescribed Dilaudid, an opiate painkiller, to the patient, the complaint said. Several months later, Villabona prescribed a cocktail of stimulants and tranquilizers to the patient after he reported using LSD.

Investigators also discovered two handguns in a safe in Villabona's office that weren't registered to him; he claimed that the guns came from patients concerned with harming themselves.

They found expired antidepressants and antipsychotics in an unsecured cabinet in Villabona's office and observed "medical devices mixed in among over-the-counter medications, alcohol, insecticide, rodenticide and hazardous waste." Several drugs were registered to an "office account," including testosterone and benzodiazepines, in violation of Uniform Controlled Substance Act Regulations, according to the petition.

In a highly publicized case earlier this year, former Olympic team doctor Larry Nassar was sentenced to 40 to 195 years in prison for molesting young gymnasts and other athletes. Despite widespread coverage of that scandal, Hofmann, the healthcare consultant, considers it "wishful thinking" to assume that medical licensing boards will overhaul their practices.

Physicians are entitled to a degree of confidentiality in disciplinary matters to protect their reputation against baseless accusations, he said. But patients also rely on hospitals and state licensing officials to properly vet healthcare professionals.

"The level of vigilance and the amount of analysis and intervention are all still lacking," he said.

Contact Margie Fishman at (302) 324-2882, on Twitter @MargieTrende or mfishman@delawareonline.com.

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