The state board that oversees Iowa physicians has reinstated the license of a doctor who was previously sanctioned for alleged “gross malpractice” in connection with patient deaths caused by drug overdoses.
In 2017, the Iowa Board of Medicine charged Dr. Robert Cunard of Missouri Valley with inappropriate prescribing, ineffective pain management, and unethical behavior that contributed to the deaths of an unspecified number of patients due to drug overdoses.
According to the board, Cunard “prescribed large quantities of potentially lethal medications to numerous patients” between 2011 and 2017, and continued to prescribe those drugs to patients who demonstrated signs of drug abuse or diversion to others.
The board also accused Cunard of prescribing sedatives and painkillers to certain patients at the same time, “putting them at an increased risk of harm, including unintentional death.”
Furthermore, the board alleged that Cunard prescribed methadone and Suboxone to patients attempting to recover from drug addiction despite the fact that he lacked a federal permit to do so.
Cunard was sued by the parents of Stephen Cathcart, 31, who allegedly died of a painkiller overdose in 2014. Cathcart’s family claimed Cunard had prescribed him oxycodone, gabapentin, and clonazepam despite his documented history of suicidal ideation and drug abuse.
In 2018, the civil complaint was settled out of court, and the Board of Medicine suspended Cunard’s license indefinitely and assessed a $5,000 financial penalty. At the time, the board noted that if it ever chose to reinstate Cunard’s Iowa license, it would be placed on probation, resulting in board surveillance of his practice, including prescription audits.
In September 2019, the Nebraska Department of Health and Human Services granted Cunard a license to perform medicine and surgery in Nebraska, subject to probation. In a letter to Cunard, the department noted that “the reason for offering you a probationary license is the suspension of your license by the Iowa Board of Medicine.”
According to state payroll records, Cunard was also hired as a physician by Nebraska’s Department of Corrections Services in 2019.
In July 2022, Nebraska’s Board of Medicine decided 7-0 to refuse Cunard’s request for early termination of his probationary period. Cunard’s probationary period expired in October 2023, and two months later, in December 2023, the board voted 8-0 to deny Cunard’s request to remove undisclosed “limitations” on his license that remained in effect.
In deciding to reinstate Cunard’s Iowa medical license, the Iowa Board of Medicine upheld its previous order prohibiting Cunard from prescribing or dispensing controlled drugs for the treatment of chronic pain, save when working with patients in nursing homes and hospice.
However, the board added that because Cunard had “already completed probation and monitoring in the state of Nebraska,” it will not impose any extra obligations along similar lines.