[Column] When Poor Management of Medical Narcotics Becomes a Serious Crime... Defense Strategies to Protect a Doctor's License

Recently, tension has been running high at private clinics that frequently handle psychotropic drugs. This is because the Ministry of Food and Drug Safety analyzes big data from the Narcotics Information Management System (NIMS) to select hospitals and clinics that prescribe unusually large amounts of propofol, dietamine (an appetite suppressant), and the like, or that show inventory discrepancies, and then conducts intensive, planned investigations into medical narcotics jointly with the police and health authorities.

In the past, even when staff members' simple NIMS reporting omissions or poor inventory management were caught, cases were often concluded with relatively light fines or administrative dispositions. However, as drug crimes have emerged as a serious problem in our society, investigative agencies now view hospitals' poor management not as negligence but through the lens of a serious crime—a violation of the Narcotics Control Act aimed at illegal diversion.

Above all, one must be cautious about the revised Medical Service Act, which took effect in November 2023. In the past, a doctor's license was revoked if one received a suspended prison sentence for a violation of the Narcotics Control Act, but now the disposition standards have been significantly strengthened, with newly added grounds for disqualification including even a "suspended imposition of a sentence of imprisonment or heavier," which did not exist under the old law.

Furthermore, the disqualification period restricting re-issuance after license revocation has also been greatly extended: in the case of an actual prison term, five years must pass after completion of the sentence, and in the case of a suspended sentence, two years must pass after the suspension period elapses. Therefore, if one is brought to trial for a violation of the Narcotics Control Act and receives a guilty verdict as described above, not only is the license immediately revoked, but it also leads to the fatal consequence of being unable to return to the medical field for a long time.

When one becomes the target of such an investigation, the first crisis one faces is the problem of NIMS inventory discrepancies and reporting omissions. In a busy medical environment, it often happens that staff fail to report disposal amounts in time due to error, or that the remaining inventory quantity differs from the ledger by just 1 to 2 mg. Investigative agencies may suspect this to be deliberate manipulation for profit-driven illegal diversion or private self-administration.

Therefore, the hospital must clearly demonstrate that this was administrative negligence rather than intent. Mobilizing all available evidence—CCTV footage of the dispensary and operating room, handwritten disposal ledgers, and staff statements about the process of disposing of leftover ampoules—to objectively explain that there was no room for an illegal purpose is the starting point of the defense.

Along with inventory management problems, another issue that investigative agencies relentlessly dig into is over-prescription of medicines. The approach is to frame it as if the director indiscriminately issued prescriptions while knowing that a patient was so-called "doctor shopping" to abuse diet pills or sleep anesthetics. At this point, one must avoid making statements that hastily admit the charges out of panic during the investigation.

It is important to logically argue and support, from a clinical-medical perspective, that the prescription was a normal medical practice based on the medical records—considering the severity of the symptoms the patient complained of at the time, the treatment purpose, and the appropriate dosage according to clinical guidelines.

The moment to be most careful about throughout handling all these issues is a surprise search and seizure. Acts by flustered medical staff or employees who, unable to withstand the pressure, make unfavorable statements or arbitrarily modify charts and data can be regarded as destruction of evidence and even carry the risk of the investigation being converted into a detention investigation. In particular, arbitrary modification of medical records itself constitutes a separate crime of violating the Medical Service Act.

Therefore, one must accurately confirm the scope of the items subject to seizure listed in the warrant and respond cautiously. Medical narcotics cases require both the medical expertise to decipher complex medical charts and the criminal expertise to respond to intensive, planned investigations. If you have become the target of an investigative agency or face a surprise search and seizure, you must exercise your right to defense systematically with the assistance of a legal expert from the early stages of the investigation to protect your precious hospital and license.

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