The state board that oversees Iowa physicians has reinstated the license of a doctor it previously sanctioned for alleged “gross malpractice” related to patient deaths caused by drug overdoses.
In 2017, the Iowa Board of Medicine accused Dr. Robert Cunard of Missouri Valley of inappropriate prescribing, improper pain management and unethical conduct that contributed to the deaths of an unspecified number of patients through drug overdoses.
According to the board, Cunard had “prescribed large quantities of potentially lethal medications to numerous patients” between 2011 and 2017, and continued to prescribe those drugs to patients who had exhibited signs of abusing the drugs or diverting the drugs to others.
Cunard was also alleged to have simultaneously prescribed sedatives and painkillers to certain patients, “placing them at increased risk of harm, including unintentional death,” the board alleged.
In addition, the board alleged Cunard prescribed methadone and Suboxone to patients who were trying to recover from drug addiction, even though he lacked a federal permit to prescribe the drugs in that manner.
Before the board filed those charges, Cunard was sued by the parents of 31-year-old Stephen Cathcart, who allegedly died of a painkiller overdose in 2014. Cathcart’s family alleged Cunard had prescribed Cathcart oxycodone, gabapentin and clonazepam, despite Cathcart’s documented history of suicidal thoughts and drug abuse.
In 2018, the civil lawsuit was settled out of court and the Board of Medicine suspended Cunard’s license for an indefinite period and imposed a civil penalty of $5,000. At the time, the board stated that should it ever choose to reinstate Cunard’s Iowa license. it would be placed on probation that would result in board monitoring of his practice, including audits of his prescriptions.
In September 2019, the Nebraska Department of Health and Human Services issued Cunard a license, subject to probation, to practice medicine and surgery in Nebraska. In a letter to Cunard, the department stated, “The reason for offering you a probationary license is the suspension of your license by the Iowa Board of Medicine.”
Also in 2019, Nebraska’s Department of Correctional Services hired Cunard to work for the department as a physician, according to state payroll records.
In July 2022, Nebraska’s Board of Medicine voted 7-0 to deny Cunard’s application for early termination of his probationary requirements. Cunard’s probationary period ended in October 2023, and two months later, in December 2023, the board voted 8-0 to reject Cunard’s request for removal of unspecified “limitations” on his license that remained in place.
In recently agreeing to reinstate Cunard’s Iowa medical license, the Iowa Board of Medicine kept in place its prior order that bars Cunard from prescribing or administering controlled substances for the treatment of chronic pain except when dealing with patients in nursing homes and hospice.
However, the board stated that because Cunard has “already completed probation and monitoring in the state of Nebraska,” it will be imposing no additional requirements along those lines.
The Iowa Capital Dispatch was unable to reach Cunard for comment.
