http://df7s0hkt8o8r9.cloudfront.net/media/english/pdf/sanctions/HGPYEEB6791ADB174AE4803122015.pdf
Here's the report. Bold is my emphasis. Youtube videos of referenced procedures.
A course participant initiated a Foley catheterization on Patient A,
discussed in more detail below in Paragraph 6(a). When the course participant
was unable to successfully catheterize the patient, Dr. Hagmann took over the
procedure, changing the catheterization tubing.
ii. A course participant performed a Foley catheterization on Patient B.
iii. Patient C was administered a FAST I sternal intraosseous infusion. After
making an incision down to the periosteum, Dr. Hagmann or a course participant
removed the device with needle drivers, and according to Patient C, called for
course participants who had never sutured a live person to use the opportunity
to get some practice. Subsequently, when several of the course participants
began suturing, Dr. Hagmann left the area, claiming that he could not bear to
watch.
View: https://www.youtube.com/watch?v=PLslYBT1a3w
During an OEMS/PCC course conducted in the United Kingdom in or about July
attended by United States citizens who were medical students and / or members of
the military, course participants performed the following invasive procedures on one
another, as follows:
i. Patient D performed a Foley catheterization on Patient E.
Subsequently, Dr. Hagmann informed Patient D that he would receive
ketamine (C-III), followed by "a procedure.” Individual 1, a uniformed services
university student acting as the DMI OEMS course coordinator who was present,
stated that, subsequent to the administration of ketamine and midazolam (C-IV),
Page 5
Statement of Particulars - John Henry Hagmann, MD.
Page 3
C.
Patient D was catheterized by Patient E, followed by an intravenous ("IV")
insertion by course participants. Individual 1 stated that Patient D was not told,
prior to receiving ketamine and rnidazolam, what procedure would be
performed, so that the effects of medication(s) on his post-procedure recollection
could subsequently be assessed.
During an OEMS/PCC course held at a uniformed services medical university in
Maryland in or about 2012, Dr. Hagmann conducted one or more "shock labs,” which
involved Withdrawing blood from medical students, monitoring them for hypovolemia,
and then auto-transfusing their blood back to them.
d.
During an OEMS/PCC course held from approximately July 13-20, 2013 at Dr.
Hagmann's training facility in Pink Hill, North Carolina, his 20-acre property, course
participants performed invasive procedures on one another, as follows:
i. After watching a video on Foley catherization, course participants were
encouraged to "practice" on one another. When the course participants appeared
hesitant, Dr. Hagmann volunteered to be the first "subject," and' made
demeaning remarks to the men in the group for not volunteering. Subsequently,
one female was catheterized and the four males in the group were catheterized,
some of them twice.
View: https://www.youtube.com/watch?v=OsOiTf2A36E
ii. Individual 2, the first course participant chosen by Dr. Hagmann t0
catheterize a male patient, later stated that she performed the procedure without
adequate instruction. Individual 2 further stated that she thought Dr. Hagrnann
intentionally Withheld the necessary instruction because previously, she had been
critical of the live tissue training portion of the course, and he was “trying to
Page 6
Statement of Particulars - John Henry Hagmann, MD.
Page 4
embarrass [her]” in retaliation for the criticism.
2. Dr. Hagmann may have violated Sections 54.1-2915.A(3), (8), (11), (12), (13), (16),
(17) and (18); 54.1-33IB.A and 54.1-3408.A-B of the Code and 18 VAC 85-20-29.A(1) of the
Regulations, in that, in the absence of proper training and supervision, and absent medicinal or
therapeutic purposes within the course of his professional practice, he dispensed controlled
substances to and instructed, authorized or allowed course participants, who were not licensed
by the Virginia Department of Health Professions, to administer to or inject each other or
themselves with ketamine; midazolarn; lorazepam (C-IV); lidocaine (C-VI); benzocaine(C-VI),'
heparin (C-VI); Diamox (C-VI); prednisone (C-VI); dexamethazone (CW) and Viagra (C-VI).
Further, Dr. Hagmann directed, authorized or allowed course participants to engage in
"ketamine labs,” “alcohol labs” or “studies,” and "cognition labs,” which involved the dosing
of ketamine (a disassociative anesthetic) and consumption of alcohol, at times in combination or
in quick succession, so that he could assess the effects of these substances on their cognition.
None of these labs or studies was approved by an Institutional Review Board ("IRB").
Specifically:
a. In or about 2012, during the OEMS course(s) conducted at the uniformed services
university in Maryland, students participated in a "ketamine lab,” wherein they were
injected with ketamine in order to observe its effects.
View: https://www.youtube.com/watch?v=O3skZlcsiSY
b. In or about July 2012 during the OEMS/FCC course in the United Kingdom:
i. Several course participants received morphine (C-II) or ketamine
injections, administered by Dr. Hagmann or one of the course participants. ii.
After receiving ketamine, rnidazolam and IV fluid, Patient D was
catheterized, as detailed above in Paragraph 1(b)(ii).
Page 7
Statement of Particulars - John Henry Hagmann, MD.
Page 5
C.
In or about July 2013, at the OEMS/PCC course in Partlow, Virginia, as part of a
"cognition lab,” course participants were asked to complete cognition tests prior to and
after consuming approximately eight (8) ounces of bourbon in a span of approximately
20-30 minutes. According to Patient C, this lab was “ part of training.” Patient C further
stated that, subsequently, participants were permitted or encouraged to "chase" the
bourbon with beer.
View: https://www.youtube.com/watch?v=DWLXzyYj8Tw
d.
In or about July 2013, at the OEMS/PCC course in Pink Hill, North Carolina:
i. As part of a"'cognition lab,” course participants were asked to complete
cognition tests prior to and after consuming approximately eight (8) ounces of 80-
proof rum Within approximately ten minutes. Two participants each drank an
additional approximate four (4) ounces of rum.
ii. Approximately one hour or less after consuming rum as part of the
“cognition lab,” several course participants were injected with ketamine to allow
them to feel the effects. Regarding four participants who consumed alcohol (rum)
and received ketamine injections:
0 Patient F experienced a negative reaction to the ketamine and began
crying. Lorazepam was administered in an effort to calm her down.
Subsequently, despite the fact that Dr. Hagmann was the only licensed
health care provider present, he did not monitor Patient F’s condition or
offer follow-up care. Instead, Individual 2 cared for Patient F by placing
her in the recovery position.
0 Patient G became nauseous almost immediately after receiving ketamine
(having consumed approximately twelve (12) ounces of rum within the
Page 8
Statement of Particulars - John Henry Hagmann, MD.
Page 6
6.
iii.
previous hour) and began vomiting. Dr. Hagmann and-another course
participant, who was inebriated, discussed performing a penile nerve
block on Patient G. Individual 2 twice informed Dr. Hagmann and the
other 'course participant that she did not think it was appropriate for him
to perform a penile nerve block on Patient G, who was incapable of giving
informed consent. Subsequently, two other course participants
approached Individual 2 and stated that they had not agreed with the
proposed procedure, and Patient G later stated that he was glad that
Patient 2 had interceded on his behalf.
View: https://www.youtube.com/watch?v=lCZq-LEcrjA
Patient H, who received ketamine after consuming rum, underwent a
penile nerve block while intoxicated.
Patient W received three (3) doses of ketarnine. Despite the fact that Dr.
Hagmann was the only licensed health care provider present, he did not
monitor this patient's condition or offer follow-up care. Rather, Patient W
asked Individual 2 to stay up with him before retiring at approximately
3:45 am.
Subsequent to the incident with Patient G, on that same evening, Dr.
Hagmann volunteered himself for a penile nerve block, which course participants
performed on him.
In or about July 2013, at the Mission Performance at High Altitude (“MPHA”) course
in Leadville, Colorado, conducted at a high altitude location in rented huts:
i.
As part of a “cognition lab” conducted on or about the evening of July 11,
2013, in which cognition was being studied at various altitudes, participants, who
Page 9
Statement of Particulars - John Henry Hagmann, MD.
Page '7
f.
were described by Patient C as “pressured” into participation, performed the
same or similar cognition tests prior to and after consuming quantities of
bourbon, as had the participants in the Virginia and North Carolina alcohol
"labs."
Patient C stated that, as part of a "ketamine lab” conducted late in the
evening on or about ]uly 12, 2013, Patient 1, a Dutch military commando
attending the course, was administered a micro-dose of ketarnine in order to
"demonstrate the intoxicating effects of the drug," or words to that effect.
iii. In or about the late evening of July 12, 2013, ketamine and midazolam
were administered to Patient K to demonstrate, according to Patient C, the
“calming effects of adding midazolam to micro-dose ketamine, and also to show
the suggestibility of a patient dosed With this combination of drugs” (also
witnessed by Individual 4). Prior to receiving the ketamine and midazolam,
Patient K had expressed reservations about undergoing a tibial intraosseous
infusion, which was known to be painful, but after receiving the medications, he
was "easily manipulated into accepting the procedure," according to Patient C.
Although the procedure was not performed, the administration for the purpose
of the infusion was.
In or abOut July 2013 at the MPHA course in Partlow, Virginia and / or Leadville,
Colorado, Dr. Hagrnann dispensed or administered Diamox, prednisone and
dexamethazone for “working at altitude" testing and Viagra for "aerobic performance at
altitude” testing to Patients] - T as follows:
0 Patients] and K - Diamox and Viagra
Page 10
Statement of Particulars - John Henry Hagmann, MD.
Page 8
' Patients L, O, P and S ~Diamox
' Patients M and N - prednisone or dexamethazone and Diamox
0 Patients Q and R - prednisone or dexamethazone, Diamox and Viagra
1' Patient T - prednisone and Diamox
g. In or about July 2013, as shown in a DMI training video provided to the
Department of Health Professions’ investigator in or about July 2014, Dr. Hagmann
authorized or allowed Individual 5 to administer Heparin to Patient 1 and subsequently
Withdraw blood from the patient.
h. Dr. Hagmann's July 2013 medication and dispensing logs for ketamine,
lorazepam and midazolam indicate that he transferred these medications from Gig
Harbor, Washington to Partlow, Virginia and dispensed or administered these
medications to Patients F, K, R, U, V and W, or dispensed and instructed course
participants, who were not licensed health care practitioners, to administer these
medications to themselves or each other, as follows:
Date Patient Medication/dosage administered
7/ 7/ 13 Patient F 0.5 mg/ .25 ml lorazepaln
7/ 8/ 13 Patient U 3mg/ 0.6 ml midazolam
7/10/13 Patient K 1 ml ketamine; ng/ 0.4 ml midazolam
7/ 10/ 13 Patient R 2 ml ketamjne
7/18/13 Patient F _ 0.25 ml ketamine
7/ 18/ 13 Patient U 1 ml ketamine
7/ 18/ 13 Patient V 1 n1] ketamine
7/ 18/ 13 Patient W 1.25 ml ketamine
3. Dr. Hagmann may have violated Sections 54.1-2915.A(17) and (18) and 541-3304
of the Code in that, in or about July 2012 and July 2013, he dispensed, as detailed in Paragraph
2, C-III and C-IV controlled substances (ketarnine, midazolam and lorazepam) to
patients/ individuals without being licensed by the Board of Pharmacy, as required by Section
Page 11
Statement of Particulars - John Henry Hagmann, MD.
Page 9
541-3302 of the Code.
4. Dr. Hagmann may have violated Sections 54.1-2915.A (17) and (18) and 54.1-
3404.D of the Code in that he failed to maintain a dispensing log for morphine administered to
DMI course participants, despite the fact that his drug invoices indicate that he purchased 50
units of injectable morphine sulfate on or about July 1, 2013 and an additional 50 units on or
about November 7, 2013. Further, Dr. Hagmann admitted to the DHP investigator that he uses
morphine in a course offered to participants from the Department of Energy and Individual 3
stated that at least one student was administered morphine during the July 2012 OEMS/PCC
course in the United Kingdom (as detailed in Paragraph 2(b)(i)). Further, Dr. Hagmann failed
to maintain a dispensing log for the "high altitude” medications he dispensed to patients in
Virginia and/ or Colorado in or about July 2013, as detailed in Paragraph 2(f).
5. Dr. Hagmann may have violated Section 54.1-2915.A(3), (13) and (16) of the Code
in that he failed to obtain adequate or appropriate consent from Patients F, G, H and W, who
Were purported to have “consented” to the administration of ketamine and benzodiazepines
While under the influence of alcohol, as detailed in Paragraph 2(d).
6. Dr. Hagmann may have violated Section 54.1-2915.A(3), (12), (13), (16), (18) and
(19) of the Code and 18 VAC 85-20-29(3) and 18 VAC 85-20-100 of the Regulations, in that, from
approximately July 5-8, 2013, he exploited, for personal gain and sexual gratification, Patients A
and B, participants in his Partlow, Virginia DMI OEMS/PCC course, as follows:
a. After a course participant had difficulty passing a catheter through Patient A, Dr.
Hagmann changed the tubing type or size and catheterized the patient. Later that day,
Dr. Hagmann approached the patient and recommended a "private" prostate exam to
determine a physical reason for the difficulty. At approximately 10:30 pm. that evening,-
Page 12
Statement of Particulars - John Henry Hagmann, MD.
Page 10
Dr. Hagmann conducted a detailed physical examination of Patient A's penis, testicles
and rectum, and the patient later stated to a uniformed services university investigating
officer that the rectal exam “took longer than expected and made me feel
uncomfortable," adding that Dr. Hagmann later asked if the patient "wanted to perform
a digital rectal exam" on him.
b. Patient B was catheterized by another course participant, during which Dr.
Hagmann noticed that the patient was uncircumcised. Subsequently, on or about the
evening of July 8, 2013, after all other course participants had left the Partlow, Virginia
premises, while consuming beer with Patient B, Dr. Hagmann "boastIed]”about his
proficiency with rectal exams and drove with Patient B to the warehouse on the
property to practice "additional procedures." At the warehOuse, Patient B, at Dr.
Hagmann's request, performed a "femoral gas” on after which he requested that
Patient B perform a focused pelvic trauma examination, including a penile and rectal
examination, stating that he would talk Patient B through it.
View: https://www.youtube.com/watch?v=Sx9NC5j8yew
This examination was
videotaped, according to Dr. Hagmann, for future training purposes; however, Patient B
stated that the video has not been requested for course material. Further, while they
both continued to consume beer, Dr. Hagmarm questioned Patient B about the effect his
uncircumcised. penis had on masturbation and sexual intercourse and asked to
photograph the patient's penis during various stages of manipulation of the foreskin,
purportedly to use as a "training tool.” Patient B, who stated that he was inebriated and
felt that he could not refuse Dr. Hagmann’s request, acquiesced and allowed him to
examine, manipulate and photograph his penis.
Here's the report. Bold is my emphasis. Youtube videos of referenced procedures.
A course participant initiated a Foley catheterization on Patient A,
discussed in more detail below in Paragraph 6(a). When the course participant
was unable to successfully catheterize the patient, Dr. Hagmann took over the
procedure, changing the catheterization tubing.
ii. A course participant performed a Foley catheterization on Patient B.
iii. Patient C was administered a FAST I sternal intraosseous infusion. After
making an incision down to the periosteum, Dr. Hagmann or a course participant
removed the device with needle drivers, and according to Patient C, called for
course participants who had never sutured a live person to use the opportunity
to get some practice. Subsequently, when several of the course participants
began suturing, Dr. Hagmann left the area, claiming that he could not bear to
watch.
View: https://www.youtube.com/watch?v=PLslYBT1a3w
During an OEMS/PCC course conducted in the United Kingdom in or about July
attended by United States citizens who were medical students and / or members of
the military, course participants performed the following invasive procedures on one
another, as follows:
i. Patient D performed a Foley catheterization on Patient E.
Subsequently, Dr. Hagmann informed Patient D that he would receive
ketamine (C-III), followed by "a procedure.” Individual 1, a uniformed services
university student acting as the DMI OEMS course coordinator who was present,
stated that, subsequent to the administration of ketamine and midazolam (C-IV),
Page 5
Statement of Particulars - John Henry Hagmann, MD.
Page 3
C.
Patient D was catheterized by Patient E, followed by an intravenous ("IV")
insertion by course participants. Individual 1 stated that Patient D was not told,
prior to receiving ketamine and rnidazolam, what procedure would be
performed, so that the effects of medication(s) on his post-procedure recollection
could subsequently be assessed.
During an OEMS/PCC course held at a uniformed services medical university in
Maryland in or about 2012, Dr. Hagmann conducted one or more "shock labs,” which
involved Withdrawing blood from medical students, monitoring them for hypovolemia,
and then auto-transfusing their blood back to them.
d.
During an OEMS/PCC course held from approximately July 13-20, 2013 at Dr.
Hagmann's training facility in Pink Hill, North Carolina, his 20-acre property, course
participants performed invasive procedures on one another, as follows:
i. After watching a video on Foley catherization, course participants were
encouraged to "practice" on one another. When the course participants appeared
hesitant, Dr. Hagmann volunteered to be the first "subject," and' made
demeaning remarks to the men in the group for not volunteering. Subsequently,
one female was catheterized and the four males in the group were catheterized,
some of them twice.
View: https://www.youtube.com/watch?v=OsOiTf2A36E
ii. Individual 2, the first course participant chosen by Dr. Hagmann t0
catheterize a male patient, later stated that she performed the procedure without
adequate instruction. Individual 2 further stated that she thought Dr. Hagrnann
intentionally Withheld the necessary instruction because previously, she had been
critical of the live tissue training portion of the course, and he was “trying to
Page 6
Statement of Particulars - John Henry Hagmann, MD.
Page 4
embarrass [her]” in retaliation for the criticism.
2. Dr. Hagmann may have violated Sections 54.1-2915.A(3), (8), (11), (12), (13), (16),
(17) and (18); 54.1-33IB.A and 54.1-3408.A-B of the Code and 18 VAC 85-20-29.A(1) of the
Regulations, in that, in the absence of proper training and supervision, and absent medicinal or
therapeutic purposes within the course of his professional practice, he dispensed controlled
substances to and instructed, authorized or allowed course participants, who were not licensed
by the Virginia Department of Health Professions, to administer to or inject each other or
themselves with ketamine; midazolarn; lorazepam (C-IV); lidocaine (C-VI); benzocaine(C-VI),'
heparin (C-VI); Diamox (C-VI); prednisone (C-VI); dexamethazone (CW) and Viagra (C-VI).
Further, Dr. Hagmann directed, authorized or allowed course participants to engage in
"ketamine labs,” “alcohol labs” or “studies,” and "cognition labs,” which involved the dosing
of ketamine (a disassociative anesthetic) and consumption of alcohol, at times in combination or
in quick succession, so that he could assess the effects of these substances on their cognition.
None of these labs or studies was approved by an Institutional Review Board ("IRB").
Specifically:
a. In or about 2012, during the OEMS course(s) conducted at the uniformed services
university in Maryland, students participated in a "ketamine lab,” wherein they were
injected with ketamine in order to observe its effects.
View: https://www.youtube.com/watch?v=O3skZlcsiSY
b. In or about July 2012 during the OEMS/FCC course in the United Kingdom:
i. Several course participants received morphine (C-II) or ketamine
injections, administered by Dr. Hagmann or one of the course participants. ii.
After receiving ketamine, rnidazolam and IV fluid, Patient D was
catheterized, as detailed above in Paragraph 1(b)(ii).
Page 7
Statement of Particulars - John Henry Hagmann, MD.
Page 5
C.
In or about July 2013, at the OEMS/PCC course in Partlow, Virginia, as part of a
"cognition lab,” course participants were asked to complete cognition tests prior to and
after consuming approximately eight (8) ounces of bourbon in a span of approximately
20-30 minutes. According to Patient C, this lab was “ part of training.” Patient C further
stated that, subsequently, participants were permitted or encouraged to "chase" the
bourbon with beer.
View: https://www.youtube.com/watch?v=DWLXzyYj8Tw
d.
In or about July 2013, at the OEMS/PCC course in Pink Hill, North Carolina:
i. As part of a"'cognition lab,” course participants were asked to complete
cognition tests prior to and after consuming approximately eight (8) ounces of 80-
proof rum Within approximately ten minutes. Two participants each drank an
additional approximate four (4) ounces of rum.
ii. Approximately one hour or less after consuming rum as part of the
“cognition lab,” several course participants were injected with ketamine to allow
them to feel the effects. Regarding four participants who consumed alcohol (rum)
and received ketamine injections:
0 Patient F experienced a negative reaction to the ketamine and began
crying. Lorazepam was administered in an effort to calm her down.
Subsequently, despite the fact that Dr. Hagmann was the only licensed
health care provider present, he did not monitor Patient F’s condition or
offer follow-up care. Instead, Individual 2 cared for Patient F by placing
her in the recovery position.
0 Patient G became nauseous almost immediately after receiving ketamine
(having consumed approximately twelve (12) ounces of rum within the
Page 8
Statement of Particulars - John Henry Hagmann, MD.
Page 6
6.
iii.
previous hour) and began vomiting. Dr. Hagmann and-another course
participant, who was inebriated, discussed performing a penile nerve
block on Patient G. Individual 2 twice informed Dr. Hagmann and the
other 'course participant that she did not think it was appropriate for him
to perform a penile nerve block on Patient G, who was incapable of giving
informed consent. Subsequently, two other course participants
approached Individual 2 and stated that they had not agreed with the
proposed procedure, and Patient G later stated that he was glad that
Patient 2 had interceded on his behalf.
View: https://www.youtube.com/watch?v=lCZq-LEcrjA
Patient H, who received ketamine after consuming rum, underwent a
penile nerve block while intoxicated.
Patient W received three (3) doses of ketarnine. Despite the fact that Dr.
Hagmann was the only licensed health care provider present, he did not
monitor this patient's condition or offer follow-up care. Rather, Patient W
asked Individual 2 to stay up with him before retiring at approximately
3:45 am.
Subsequent to the incident with Patient G, on that same evening, Dr.
Hagmann volunteered himself for a penile nerve block, which course participants
performed on him.
In or about July 2013, at the Mission Performance at High Altitude (“MPHA”) course
in Leadville, Colorado, conducted at a high altitude location in rented huts:
i.
As part of a “cognition lab” conducted on or about the evening of July 11,
2013, in which cognition was being studied at various altitudes, participants, who
Page 9
Statement of Particulars - John Henry Hagmann, MD.
Page '7
f.
were described by Patient C as “pressured” into participation, performed the
same or similar cognition tests prior to and after consuming quantities of
bourbon, as had the participants in the Virginia and North Carolina alcohol
"labs."
Patient C stated that, as part of a "ketamine lab” conducted late in the
evening on or about ]uly 12, 2013, Patient 1, a Dutch military commando
attending the course, was administered a micro-dose of ketarnine in order to
"demonstrate the intoxicating effects of the drug," or words to that effect.
iii. In or about the late evening of July 12, 2013, ketamine and midazolam
were administered to Patient K to demonstrate, according to Patient C, the
“calming effects of adding midazolam to micro-dose ketamine, and also to show
the suggestibility of a patient dosed With this combination of drugs” (also
witnessed by Individual 4). Prior to receiving the ketamine and midazolam,
Patient K had expressed reservations about undergoing a tibial intraosseous
infusion, which was known to be painful, but after receiving the medications, he
was "easily manipulated into accepting the procedure," according to Patient C.
Although the procedure was not performed, the administration for the purpose
of the infusion was.
In or abOut July 2013 at the MPHA course in Partlow, Virginia and / or Leadville,
Colorado, Dr. Hagrnann dispensed or administered Diamox, prednisone and
dexamethazone for “working at altitude" testing and Viagra for "aerobic performance at
altitude” testing to Patients] - T as follows:
0 Patients] and K - Diamox and Viagra
Page 10
Statement of Particulars - John Henry Hagmann, MD.
Page 8
' Patients L, O, P and S ~Diamox
' Patients M and N - prednisone or dexamethazone and Diamox
0 Patients Q and R - prednisone or dexamethazone, Diamox and Viagra
1' Patient T - prednisone and Diamox
g. In or about July 2013, as shown in a DMI training video provided to the
Department of Health Professions’ investigator in or about July 2014, Dr. Hagmann
authorized or allowed Individual 5 to administer Heparin to Patient 1 and subsequently
Withdraw blood from the patient.
h. Dr. Hagmann's July 2013 medication and dispensing logs for ketamine,
lorazepam and midazolam indicate that he transferred these medications from Gig
Harbor, Washington to Partlow, Virginia and dispensed or administered these
medications to Patients F, K, R, U, V and W, or dispensed and instructed course
participants, who were not licensed health care practitioners, to administer these
medications to themselves or each other, as follows:
Date Patient Medication/dosage administered
7/ 7/ 13 Patient F 0.5 mg/ .25 ml lorazepaln
7/ 8/ 13 Patient U 3mg/ 0.6 ml midazolam
7/10/13 Patient K 1 ml ketamine; ng/ 0.4 ml midazolam
7/ 10/ 13 Patient R 2 ml ketamjne
7/18/13 Patient F _ 0.25 ml ketamine
7/ 18/ 13 Patient U 1 ml ketamine
7/ 18/ 13 Patient V 1 n1] ketamine
7/ 18/ 13 Patient W 1.25 ml ketamine
3. Dr. Hagmann may have violated Sections 54.1-2915.A(17) and (18) and 541-3304
of the Code in that, in or about July 2012 and July 2013, he dispensed, as detailed in Paragraph
2, C-III and C-IV controlled substances (ketarnine, midazolam and lorazepam) to
patients/ individuals without being licensed by the Board of Pharmacy, as required by Section
Page 11
Statement of Particulars - John Henry Hagmann, MD.
Page 9
541-3302 of the Code.
4. Dr. Hagmann may have violated Sections 54.1-2915.A (17) and (18) and 54.1-
3404.D of the Code in that he failed to maintain a dispensing log for morphine administered to
DMI course participants, despite the fact that his drug invoices indicate that he purchased 50
units of injectable morphine sulfate on or about July 1, 2013 and an additional 50 units on or
about November 7, 2013. Further, Dr. Hagmann admitted to the DHP investigator that he uses
morphine in a course offered to participants from the Department of Energy and Individual 3
stated that at least one student was administered morphine during the July 2012 OEMS/PCC
course in the United Kingdom (as detailed in Paragraph 2(b)(i)). Further, Dr. Hagmann failed
to maintain a dispensing log for the "high altitude” medications he dispensed to patients in
Virginia and/ or Colorado in or about July 2013, as detailed in Paragraph 2(f).
5. Dr. Hagmann may have violated Section 54.1-2915.A(3), (13) and (16) of the Code
in that he failed to obtain adequate or appropriate consent from Patients F, G, H and W, who
Were purported to have “consented” to the administration of ketamine and benzodiazepines
While under the influence of alcohol, as detailed in Paragraph 2(d).
6. Dr. Hagmann may have violated Section 54.1-2915.A(3), (12), (13), (16), (18) and
(19) of the Code and 18 VAC 85-20-29(3) and 18 VAC 85-20-100 of the Regulations, in that, from
approximately July 5-8, 2013, he exploited, for personal gain and sexual gratification, Patients A
and B, participants in his Partlow, Virginia DMI OEMS/PCC course, as follows:
a. After a course participant had difficulty passing a catheter through Patient A, Dr.
Hagmann changed the tubing type or size and catheterized the patient. Later that day,
Dr. Hagmann approached the patient and recommended a "private" prostate exam to
determine a physical reason for the difficulty. At approximately 10:30 pm. that evening,-
Page 12
Statement of Particulars - John Henry Hagmann, MD.
Page 10
Dr. Hagmann conducted a detailed physical examination of Patient A's penis, testicles
and rectum, and the patient later stated to a uniformed services university investigating
officer that the rectal exam “took longer than expected and made me feel
uncomfortable," adding that Dr. Hagmann later asked if the patient "wanted to perform
a digital rectal exam" on him.
b. Patient B was catheterized by another course participant, during which Dr.
Hagmann noticed that the patient was uncircumcised. Subsequently, on or about the
evening of July 8, 2013, after all other course participants had left the Partlow, Virginia
premises, while consuming beer with Patient B, Dr. Hagmann "boastIed]”about his
proficiency with rectal exams and drove with Patient B to the warehouse on the
property to practice "additional procedures." At the warehOuse, Patient B, at Dr.
Hagmann's request, performed a "femoral gas” on after which he requested that
Patient B perform a focused pelvic trauma examination, including a penile and rectal
examination, stating that he would talk Patient B through it.
View: https://www.youtube.com/watch?v=Sx9NC5j8yew
This examination was
videotaped, according to Dr. Hagmann, for future training purposes; however, Patient B
stated that the video has not been requested for course material. Further, while they
both continued to consume beer, Dr. Hagmarm questioned Patient B about the effect his
uncircumcised. penis had on masturbation and sexual intercourse and asked to
photograph the patient's penis during various stages of manipulation of the foreskin,
purportedly to use as a "training tool.” Patient B, who stated that he was inebriated and
felt that he could not refuse Dr. Hagmann’s request, acquiesced and allowed him to
examine, manipulate and photograph his penis.
