Disciplinary Actions against
Jan D. Silberstein, M.D.
Stephen Barrett, M.D.
Jan Silberstein, M.D., was disciplined by the Connecticut Department of Public Health in 2000 and 2003 and surrendered his license in 2004. In 2000, after he had specialized in otolaryngology (ear, nose, and throat treatment), he entered into a consent agreement that concerned his surgical treatment of several patients that the Department considered "departures from the standard of care in diagnosis and treatment." The agreement noted that Silberstein had, for many years, been diagnosed and treated for bipolar disorder and that an investigation of his hospital work had concluded that many of his patient records were inadequate. The consent order permanently banned him from doing otolaryngic surgery, placed him on probation for three years, required him to continue psychiatric care, and called for monitoring of his patient records. In 2003, he signed another consent order (shown below), which noted that he had violated his probation by inappropriately treating patients with hydrogen peroxide and chelation therapy and by prescribing and selling Brava devices (a questionable breast-enlargement device). The consent order required a civil penalty of $2,000 and compliance with the previous order. In 2004, he voluntarily surrendered his medical license.
STATE OF CONNECTICUT
DEPARTMENT OF PUBLIC HEALTH
BUREAU OF HEALTHCARE SYSTEMS
In re: Jan David Silberstein, M.D.
Petition No. 2000-0209-001-024
WHEREAS, Jan David Silberstein, M.D. of East Hartford, Connecticut (hereinafter "respondent") has been issued license number 026007 to practice as a physician and surgeon by the Department of Public Health (hereinafter "the Department") pursuant to Chapter 370 of the General Statutes of Connecticut, as amended; and,
WHEREAS, the Department alleges and respondent admits that:
1. In a period from February to April of 2002, respondent violated his Consent Order by prescribing and selling a breast enhancement device known as a Brava device. Respondent did not violate the Consent Order deliberately. Respondent ceased immediately when the Department informed him of his violation.
2. For a period of approximately ten months in 1999 and 2000, before he entered into the current Consent Order, respondent provided hydrogen peroxide and EDTA chelation therapy to numerous patients. None of the patients had a diagnosis of acute lead toxicity. Respondent's conduct violated the standard of care in one or more of the following ways:
- he used EDTA chelation for conditions other than acute lead toxicity;
- he used hydrogen peroxide therapy to treat back pain, diabetes, or vascular diseases;
- he informed his patients that EDTA is an experimental medication for cardiovascular pathologies but did not follow an FDA approved protocol for experimental medications;
- he failed to make an adequate intake examination upon the commencement of his care for one or more patients;
- he failed to provide adequate nutritional supplements to replace minerals chelated by the EDTA;
- he failed to perform adequate blood analysis and monitoring during the course of therapy;
- his treatment of cardiovascular disease was beyond his training.
3. The above described facts constitute grounds for disciplinary action pursuant to the General Statutes of Connecticut, §20-13c(4).
WHEREAS, respondent, in consideration of this Consent Order, has chosen not to contest this matter and agrees that for purposes of this or any future proceedings before the Connecticut Medical Examining Board (hereinafter "the Board"), this Consent Order shall have the same effect as if proven and ordered after a full hearing held pursuant to §§19a-l0, 19a-14, and 20-13c of the General Statutes of Connecticut.
NOW THEREFORE, pursuant to §§ 19a-14, 19a-17, and 20-13c of the General Statutes of Connecticut, respondent hereby stipulates and agrees to the following:
1. Respondent waives his right to a hearing on the merits of this matter.
2. Respondent shall pay a civil penalty of Two Thousand dollars ($2,000) by certified or cashier's check payable to "Treasurer, State of Connecticut." The check shall reference the Petition Number on the face of the check, and shall be payable thirty days prior to the end of his probation.
3. Respondent's license is reprimanded.
4. Respondent's license shall be on probation until August 15, 2004 under the following terms and conditions:
- Respondent shall participate in regularly scheduled therapy at his own expense with a licensed psychiatrist or psychologist pre-approved by the Department (hereinafter "therapist").
(1) Respondent shall provide a copy of this Consent Order to his therapist.
(2) Respondent's therapist shall furnish written confirmation to the Department of his or her engagement in that capacity and receipt of a copy of this Consent Order within fifteen (15) days of the effective date of this Consent Order.
(3) If the therapist determines that therapy is no longer necessary, that a reduction in frequency of therapy sessions is warranted, or that respondent should be transferred to another therapist, the therapist shall advise the Department, and the Department shall pre-approve said termination of therapy, reduction in frequency of therapy sessions, and/or respondent's transfer to another therapist.
(4) The therapist shall submit reports monthly for the duration of probation, which shall address, but not necessarily be limited to, respondent's ability to practice medicine and surgery safely and competently. Said reports shall continue until the therapist determines that therapy is no longer necessary or the period of probation has terminated.
(5) The therapist shall immediately notify the Department in writing if the therapist believes respondent's continued practice poses a danger to the public, or if respondent discontinues therapy and/or terminates his or her services,
(6) Respondent shall comply with all prescription orders of his treating psychiatrist, if any, and all referrals to group therapy, if any.
- Respondent shall obtain at his own expense, the services of a physician, preapproved by the Department (hereinafter "supervisor"), to conduct a quarterly random review of fifteen percent (15%) or twenty of respondent's patient records, whichever is the larger number. In the event respondent has twenty (20) or fewer patients, the supervisor shall review all of respondent's patient records. After the first year of probation, the review shall be quarterly for the remainder of the probation.
(1) Respondent's supervisor shall meet with him not less than once every quarter of the probationary period.
(2) The supervisor shall have the right to monitor respondent's practice by any other reasonable means which he or she deems appropriate. Respondent shall fully cooperate with the supervisor in providing such monitoring.
(3) Respondent shall be responsible for providing written supervisor reports directly to the Department quarterly for the entire probationary period. Such supervisor's reports shall include documentation of dates and duration of meetings with respondent, number and a general description of the patient records and patient medication orders and prescriptions reviewed, additional monitoring techniques utilized, and statement that respondent is practicing with reasonable skill and safety and in conformity with the provisions of paragraph 4(b) (4) below. The supervisor shall also state whether respondent has limited his practice, and the advertising of his practice, to the procedures stipulated in Appendix A of his September 18, 2000 Consent Order.
(4) Respondent's patient records shall meet applicable standards of record keeping. In addition, respondent's patient records shall be prepared contemporaneously with the care of the patient, shall be signed by respondent and shall be prepared in an uneraseable medium. Every patient file will contain an appropriate patient medical history form signed by the patient. Every patient file will contain a statement of the risks, side effects, and known statistical likelihood of success of the procedure to be used, and a statement from the patient that he/she understands the aforesaid materials. Each patient file shall also contain the following:
(a) The name and address of the patient's primary care physician, if applicable. Respondent shall forward a copy of his records to said primary care physician, unless his chart contains a signed request from the patient that he not send the records to his/her primary care physician.
(b) One or more color photographs of the patient's presenting condition.
(c) A written fee agreement signed by the patient for uninsured treatment.
- Within the final six months of the probationary period, respondent shall, at his own expense, undergo a psychiatric and/or psychological evaluation, by a psychiatrist and/or psychologist pre-approved by the Department (hereinafter "the evaluator(s)"), who shall not be any practitioner who has served as respondent's therapist. Respondent shall fully cooperate with all requests made by the evaluator(s). Respondent hereby agrees that the evaluation report(s) shall be provided by the evaluator(s) directly to the Department. The evaluator(s) shall conclude that respondent can safely practice as a physician and surgeon without having any restrictions on his license, except the restrictions in paragraph 2 above. If the evaluator(s) reach(es) any other conclusion, such finding shall constitute a violation of this Consent Order. The Department may provide the evaluator with a copy of the Consent Order and additional information including, but not limited to, prior psychiatric evaluations of respondent, reports received by the Drug Control Division of the Department of Consumer Protection, the monitoring file including all therapist and employer reports and any reports received from the police or any other authority.
- During the period of probation, respondent shall successfully complete sixteen hours of course work, pre-approved by the Department, in the specialty subject of his practice.
5. All correspondence and reports are to be addressed to:
Bonnie Pinkerton, Nurse Consultant
Department of Public Health
Division of Health Systems Regulation
410 Capitol Avenue, MS #12HSR
P.O. Box 340308
Hartford, CT 06134-0308
6. All reports required by the terms of this Consent Order shall be due according to a schedule to be established by the Department of Public Health.
7. Respondent shall comply with all state and federal statutes and regulations applicable to his licensure.
8. Respondent shall pay all costs necessary to comply with this Consent Order.
9. Any alleged violation of any provision of this Consent Order may result in the following procedures at the discretion of the Department:
- The Department shall notify respondent in writing by first-class mail that the term(s) of this Consent Order have been violated, provided that no prior written consent for deviation from said term(s) has been granted.
- Said notification shall include the acts or omission(s) which violate the term(s) of this Consent Order.
- Respondent shall be allowed fifteen (15) days from the date of the mailing of notification required in paragraph 9.a. above to demonstrate to the satisfaction of the Department that he has complied with the terms of this Consent Order or, in the alternative, that he has cured the violation in question.
- If respondent does not demonstrate compliance or cure the violation by the limited fifteen (15) day date certain contained in the notification of violation to the satisfaction of the Department, he shall be entitled to a hearing before the Board which shall make a final determination of the disciplinary action to be taken.
- Evidence presented to the Board by either the Department or respondent in any such hearing shall be limited to the alleged violation(s) of the term(s) of this Consent Order.
10. In the event respondent violates any term of this Consent Order, respondent agrees immediately to refrain from practicing as a physician and surgeon, upon request by the Department, with notice to the Board, for a period not to exceed 45 days. During that time period, respondent further agrees to cooperate with the Department in its investigation of the violation and to submit to and complete a medical, psychiatric and/or psychological evaluation, if requested to do so by the Department; and, that the results of the evaluation shall be submitted directly to the Department. Respondent further agrees that failure to cooperate with the Department in its investigation during said 45 day period shall constitute grounds for the Department to seek a summary suspension of respondent's license. In any such summary action, respondent stipulates that his failure to cooperate with the Department's investigation shall constitute an admission that his conduct constitutes a clear and immediate danger as required pursuant to the General Statutes of Connecticut, sections 4- 182( c) and 19a-17( c).
11. In the event respondent violates any term of this Consent Order, said violation may also constitute grounds for the Department to seek a summary suspension of his license before the Board.
12. In the event respondent is not employed as a physician and surgeon for periods of thirty (30) consecutive days or longer, or is employed as a physician and surgeon less than twenty (20) hours per week, or is employed outside of the State of Connecticut, respondent shall notify the Department in writing. Such periods of time shall not be counted in reducing the probationary period covered by this Consent Order.
13. Legal notice shall be sufficient if sent to respondent's last known address of record reported to the Licensure and Registration Section of the Division of Health Systems Regulation of the Department.
14. This Consent Order is effective on the first day of the month immediately following the date this Consent Order is accepted and ordered by the Board.
15. Respondent agrees that this Consent Order shall be deemed a public document, and the Department's allegations as contained in this Consent Order shall be deemed true in any subsequent proceeding before the Board in which his compliance with this Consent Order or with §20-13c of the General Statutes of Connecticut, as amended, is at issue. Further, respondent understands this document is a reportable event to the National Practitioner Data Bank and will appear on his physician profile pursuant to Connecticut General Statutes 20-13j.
16. Any extension of time or grace period for reporting granted by the Department shall not be a waiver or preclude the Department from taking action at a later time. The Department shall not be required to grant future extensions of time or grace periods.
17. This Consent Order and terms set forth herein are not subject to reconsideration, collateral attack or judicial review under any form or in any forum. Further, this Order is not subject to appeal or review under the provisions of Chapters 54 or 368a of the General Statutes of Connecticut, provided that this stipulation shall not deprive respondent of any rights that he may have under the laws of the State of Connecticut or of the United States.
18. This Consent Order is a revocable offer of settlement which may be modified by mutual agreement or withdrawn by the Department at any time prior to its being executed by the last signatory.
19. Respondent permits a representative of the Legal Office of the Bureau of Healthcare Systems to present this Consent Order and the factual basis for this Consent Order to the Board. Respondent understands that the Board has complete and final discretion as to whether this executed Consent Order is approved or accepted.
20. Respondent understands and agrees that he is responsible for satisfying all of the terms of this Consent Order during vacations and other periods in which he is away from his residence.
21. Respondent has consulted with an attorney prior to signing this document.
I, Jan David Silberstein, M.D., have read the above Consent Order, and I stipulate and agree to the terms as set forth therein. I further declare the execution of this Consent Order to be my free act and deed.
Jan David Silberstein, M.D.
Subscribed and sworn to before me this 30th day of May 2003.
Commissioner of Superior Court
The above Consent Order having been presented to the duly appointed agent of the
Commissioner of the Department of Public Health on the 3rd day of
June 2003, it is hereby accepted.
Stanley K. Peck, Director, Legal Office
Bureau of Health care Systems
The above Consent Order having been presented to the duly appointed agent of the CMAB
on the 17th day of June 2003, it is hereby ordered and accepted.
Dennis G. O’Neill, M.D.
Connecticut Medical Examining Board
This page was posted on October 31, 2014