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`IN THE UNITED STATES DISTRICT COURT
`FOR THE SOUTHERN DISTRICT OF TEXAS
`HOUSTON DIVISION
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`COMPLAINT FOR DECLARATORY AND INJUNCTIVE RELIEF, DAMAGES, AND
`DEMAND FOR JURY TRIAL
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`BLUE MINT PHARMCO LLC and JONA
`RUSHIN, R.PH.,
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` Plaintiffs,
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`v.
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`TEXAS STATE BOARD OF PHARMACY
`(“Board”); JULIE SPIER, R.PH., in her official
`capacity and individually; LORI HENKE,
`PHARM.D., in her official capacity and
`individually; RICK FERNANDEZ, R.PH., in his
`official capacity and individually; DONNIE
`LEWIS, R.PH., in his official capacity and
`individually; JENNY DOWNING YOAKUM,
`R.PH., in her official capacity and individually;
`DANIEL GUERRERO, in his official capacity
`and individually; BRADLEY MILLER, PH.T.R.,
`in his official capacity and individually; DONNA
`MONTEMAYOR, P.PH., in her official capacity
`and individually; IAN SHAW, in his official
`capacity and individually; SUZETTE TIJERINA,
`R.PH., in her official capacity and individually;
`RICK TISCH, in his official capacity and
`individually; and TIM TUCKER, R.Ph. in his
`official capacity and individually,
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` Defendants.
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` Civil Action No. 22-561
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`Case 4:22-cv-00561 Document 1 Filed on 02/21/22 in TXSD Page 2 of 18
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`Plaintiffs Blue Mint Pharmco, LLC and Jona Rushin. R.Ph. (“Plaintiffs”) respectfully
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`allege as follows in support of this Complaint for declaratory judgment, preliminary and
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`permanent injunction, and compensatory damages pursuant to 42 U.S.C. § 1983, and demand for
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`jury trial against defendants the Texas State Board of Pharmacy (“Board”), Julie Spier, R.Ph.,
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`Lori Henke, Pharm.D., Rick Fernandez, R.Ph., Donnie Lewis, R.Ph., Jenny Downing Yoakum,
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`R. Ph., Daniel Guerrero, Bradley Miller, Ph.T.R., Donna Montemayor, R.Ph., Ian Shaw, Suzette
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`Tijerina, R.Ph., and Rick Tisch (collectively, “Defendants”).
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`I.
`INTRODUCTION
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`Plaintiffs bring this action under 42 U.S.C. §§ 1981,1983, and the Fourteenth
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`1.
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`Amendment to the United States Constitution to end the pervasive and continuing violations of
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`their constitutional rights by the Defendants, including the Board and its members acting in their
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`official capacity and individually. Plaintiffs seek, among other relief, declaratory judgment that
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`Defendants’ unlawful administration of disciplinary proceedings denied Plaintiffs procedural and
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`substantive due process guaranteed by the Fourteenth Amendment, and that Defendants racially
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`discriminate in their regulation of pharmacists and pharmacies licensed in the State of Texas in
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`violation of the Equal Protection Clause of the United States Constitution. Plaintiffs further seek
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`injunctive relief enjoining Defendants from continuing violations of Plaintiffs’ rights and
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`compensatory damages.
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`Case 4:22-cv-00561 Document 1 Filed on 02/21/22 in TXSD Page 3 of 18
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`II.
`THE PARTIES
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`Plaintiff Blue Mint Pharmco LLC (“Blue Mint”) is a limited liability company
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`2.
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`organized and existing under the laws of the State of Texas. Blue Mint owns Blue Mint
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`Pharmacy (“Pharmacy”), which holds an active Texas Pharmacy License. The Pharmacy
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`provides services in a predominantly low-income, African American community in and around
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`Houston, Texas. Blue Mint is an African American owned business. At all times relevant to this
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`Complaint, Blue Mint has constitutionally protected liberty and property interests in its
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`pharmacy license and economic well-being.
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`3.
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`Plaintiff Jona Rushin, R.Ph. (“Rushin”) is an African American pharmacist
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`licensed in the State of Texas. At all times relevant to this Complaint, Rushin has constitutionally
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`protected liberty and property interests in her pharmacist license and economic well-being.
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`4.
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`Defendant Texas State Board of Pharmacy (“Board”) is a state regulatory body
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`that licenses and disciplines pharmacists and pharmacies.
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`5.
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`6.
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`7.
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`8.
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`9.
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`Defendant Julie Spier, R.Ph. (“Spier”) is a member of the Board.
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`Defendant Lori Henke, Pharm.D. (“Henke”) is a member of the Board.
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`Defendant Rick Fernandez, R.Ph. (“Fernandez”) is a member of the Board.
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`Defendant Donnie Lewis, R.Ph. (“Lewis”) is a member of the Board.
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`Defendant Jenny Downing Yoakum, R.Ph. (“Yoakum”) is a member of the
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`10.
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`Defendant Daniel Guerrero (“Guerrero”) is a member of the Board.
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`Board.
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`Case 4:22-cv-00561 Document 1 Filed on 02/21/22 in TXSD Page 4 of 18
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`11.
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`12.
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`13.
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`14.
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`15.
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`16.
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`Defendant Bradley A. Miller, Ph.T.R. (“Miller”) is a member of the Board.
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`Defendant Donna Montemayor, R.Ph. (“Montemayor”) is a member of the Board.
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`Defendant Ian Shaw (“Shaw”) is a member of the Board.
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`Defendant Suzette Tijerina, R.Ph. (“Tijerina”) is a member of the Board.
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`Defendant Rick Tisch (“Tisch”) is a member of the Board.
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`III.
`JURISDICTION AND VENUE
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`This Court has subject matter jurisdiction over the federal claims under 28 U.S.C
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`§§ 1331 and 1342, as this action arises under the Fourteenth Amendment to the United States
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`Constitution and is brought to redress the deprivation, under color of state law, of rights,
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`privileges, and immunities secured by the United States Constitution. This Court is further
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`authorized to grant the requested relief pursuant to 28 U.S.C. §§ 2201, 2202, and 42 U.S.C. §
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`1983.
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`17.
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`Venue is proper in the Southern District of Texas under 28 U.S.C. § 1391 on the
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`provisions of 28 U.S.C. § 1391 because the events giving rise to Plaintiffs’ claims occurred in
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`the Southern District of Texas.
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`IV.
`BACKGROUND ALLEGATIONS
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`Prescription Drug Abuse and Texas Health & Safety Code § 481.0761
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`18.
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`In 2017, the Texas State Legislature passed HB 2561 that amended Health and
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`A.
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`Safety Code § 481.0761 and expanded the Board’s authority to monitor and regulate
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`prescriptions for controlled substances.
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`19.
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`Specifically, the amendment added, among other provisions, Tex. Health &
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`Safety Code § 481.0761(h), which directed the Board to
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`identify prescribing practices that may be potentially harmful and patient
`prescription patterns that may suggest drug diversion or drug abuse. The board
`shall determine the conduct that constitutes a potentially harmful prescribing
`pattern or practice and develop indicators for levels of prescriber or patient
`activity that suggest a potentially harmful prescription pattern or practice may be
`occurring or drug diversion or drug abuse may be occurring.
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`20.
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`Based on the indicators listed above, the Board was authorized to develop
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`“guidelines identifying behavior suggesting a patient is obtaining controlled substances that
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`indicate drug diversion or drug abuse is occurring.” Tex. Health & Safety Code § 481.0761(j).
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`21.
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`Tex. Health & Safety Code § 481.0761(k) further provides that the “guidelines
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`may be based on the frequency of prescriptions issued to and filled by the patient, the types of
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`controlled substances prescribed, and the number of prescribers who prescribe controlled
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`substances to the patient.”
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`22.
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`HB 2561 also imposed a duty on a pharmacist who observes the indicators above
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`with respect to a patient to access the patient’s prescription history before dispensing opioids,
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`benzodiazepines, barbiturates, or carisoprodol. Tex. Health & Safety Code §§ 481.0761(j) and
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`481.0764(a). A pharmacist’s failure to comply with the statute is grounds for disciplinary action
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`by the Board. Tex. Health & Safety Code § 481.0764(d).
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`23.
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`A patient’s prescription history is accessed through an electronic database known
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`as the Texas Prescription Monitoring Program (“PMP”), which is maintained by the Board. In
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`addition to a patient’s prescription history, the PMP assigns a “PMP score” to a particular
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`patient, representing the patient’s risk of overdose.
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`B.
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`The Board’s Red Flag Factors
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`24.
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`In response, the Board promulgated new rules relating to the professional
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`responsibilities of pharmacists that purported to comply with the directives of Tex. Health &
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`Safety Code §§ 481.0761 and 481.0764.
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`25.
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`Pursuant to 22 Tex. Admin. Code § 291.29(f),
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`A pharmacist shall not dispense a prescription drug if the pharmacist knows or
`should know the prescription drug order is fraudulent or forged. A pharmacists
`shall make every reasonable effort to prevent inappropriate dispensing due to
`fraudulent, forged, invalid, or medically inappropriate prescriptions in violation of
`a pharmacist’s corresponding
`responsibility. . . .
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`The section further enumerates a list of nineteen dispensing patterns, known as
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`26.
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`the “Red Flag Factors,” that the Board deemed relevant to preventing nontherapeutic dispensing
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`of controlled substances. Id. An evaluation of the Red Flag Factors was to be considered based
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`on the totality of the circumstances rather than on any single factor. Id.
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`27.
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`The factors most relevant to the Complaint include:
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`(1) the pharmacy dispenses a reasonably discernible pattern of substantially
`identical prescriptions for the same controlled substances, potentially paired
`with other drugs, to numerous persons, indicating a lack of individual drug
`therapy in prescriptions issued by the practitioner;
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`(2) the pharmacy operates with a reasonably discernible pattern of overall low
`prescription dispensing volume, maintaining relatively consistent 1:1 ratio of
`controlled substances to dangerous drugs and/or over-the-counter products
`dispensed as prescriptions;
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`(3) Prescriptions by a prescriber presented to the pharmacy are routinely for
`controlled substances commonly known to be abused drugs, including
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`opioids, benzodiazepines, muscle relaxants, psychostimulants, and/or cough
`syrups containing codeine, or any combination of these drugs;
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`(4) . . .
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`(5) Prescriptions for controlled substances are commonly for the highest strength
`of the drug and/or for large quantities (e.g., monthly supply), indicating a lack
`of individual drug therapy prescriptions issued by the practitioner; . . .
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`Id.
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`28. While the Board purports the Red Flag Factors to be a balancing test based on the
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`circumstances presented, the Red Flag Factors are applied as a bright line rule based on statistical
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`thresholds.
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`29.
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`For example, a pharmacist can be found in violation of the first factor where the
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`pharmacist dispenses controlled substances in a discernable pattern, regardless of whether the
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`prescription was valid or whether the prescription was reasonable and medically necessary.
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`30.
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`Accordingly, the Red Flag Factors require pharmacists to additionally fall within
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`the arbitrary prescription limits assigned by the Board, even if the pharmacist complies with Tex.
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`Health & Safety Code § 481.0764(a) and accesses the patient’s PMP history prior to dispensing
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`controlled substances.
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`C.
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`Discriminatory Impact of the Board’s Red Flag Factors
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`31.
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`The Red Flag Factors provide no safe harbors for pharmacists who comply with
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`their corresponding duties despite being statistical outliers.
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`32.
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`The Board’s strict application of the Red Flag Factors further disproportionately
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`affects pharmacies and pharmacists operating in low-income and minority communities.
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`33.
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`Based on the Board’s published disciplinary orders, between 2018 through
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`February 1, 2022, the Board discipline approximately two dozen pharmacies and pharmacists
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`based on the Red Flag Factors.
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`34.
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`In particular, the licensees were disciplined for dispensing controlled substances
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`in a pattern that the Board considered to demonstrate lack of professional judgment in that the
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`licensee should have known, based on the Red Flag Factors, that the prescriptions were invalid.
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`35.
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`The Board made no inquiries into whether the prescriptions were valid, whether
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`patients were harmed, or whether the prescriber actually wrote the prescription in the majority of
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`the cases. The discipline was solely on the grounds that the Board believed the prescriptions
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`were invalid because the licensee’s prescription data fell outside of the boundaries acceptable to
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`the Board.
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`36.
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`The overwhelming majority of licensees who were disciplined between 2018
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`through February 1, 2022 were operating in and around Houston, Texas, and in low-income
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`communities with predominantly minority populations.
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`37.
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`According to data provided by the Texas Department of State Health Services, in
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`2014, white pharmacists accounted for 51.1% of all pharmacists licensed in Texas, while African
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`American and Latino pharmacists accounted for 14.9% and 10.4%, respectively.1
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`38.
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`Yet, nearly all of the enforcement actions brought by the Board for violations
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`pursuant to the Red Flag Factors have been against minority pharmacists and minority-owned
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`1 Health Professions Resource Center, Trends, Distribution, and Demographics – Pharmacist
`2014, Tex. Dept. of State Health Services (March 2015)
`[https://www.dshs.texas.gov/chs/hprc/publications/2014/2014PharmFactSheet.pdf]
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`pharmacies serving neighborhoods overwhelming populated by racial minorities.
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`39.
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`Accordingly, the Board’s enforcement of the Red Flag Factors not only
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`disproportionately affect minority pharmacists and minority-owned pharmacies, but also
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`communities with predominantly minority populations, as those communities were deprived of
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`medically necessary services.
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`D.
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`The Board’s Discriminatory Intent
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`40.
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`The Board adopted the Red Flag Factors in order to target and discriminate
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`against minority pharmacists and minority-owned pharmacies.
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`41.
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`The Board also discriminates in its enforcement of violations under the Red Flag
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`Factors.
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`42. While the Red Flag Factors may address concerns with prescription drug abuse,
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`the factors were purposely developed to single out minority pharmacists providing legitimate
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`services in minority communities and their patients, whose medical needs may result in the
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`prescription patterns the Board arbitrarily deemed to be cause for discipline.
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`43. Moreover, the Board purposely provided no safe harbor provisions for
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`pharmacists or pharmacies whose prescription patterns may violate the Red Flag Factors but are
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`nonetheless valid.
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`44.
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`Under the color of the law, the Board granted itself authority to determine the
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`validity, or invalidity, of prescriptions for controlled substances based on a pharmacist’s
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`statistical output, and to discipline that pharmacist according to its arbitrary determinations.
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`45.
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`The Board further used this authority to racially discriminate Plaintiffs and deny
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`Plaintiffs equal protection of law by initiating disciplinary proceedings against Plaintiffs for
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`violations pursuant to the Red Flag Factors.
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`E.
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`The Board’s Disciplinary Action Against Plaintiffs
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`46.
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`On or about November 19, 2020, the Board issued a Statement of Allegations to
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`Plaintiffs, alleging that, from April 20, 2019 through April 20, 2020 and April 21, 2020 through
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`July 27, 2020, Plaintiffs dispensed prescriptions for controlled substances that demonstrate a lack
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`of professional judgment and neglect of a pharmacist’s corresponding responsibility in
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`dispensing controlled substances in that Plaintiffs knew or should have known the prescriptions
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`were invalid.
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`47.
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`The Board alleged on information and belief that Plaintiffs dispensed
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`prescriptions for controlled substances to patients in discernable patterns that rendered the
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`prescriptions invalid, and that Plaintiffs demonstrated a lack of professional judgment in filling
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`those prescriptions. In support of its allegations, the Board cited to Plaintiffs’ PMP history. The
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`Board did not allege any patient complaints or harm resulting from Plaintiff’s prescription
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`practices, nor did the Board allege any misconduct on the part of the prescriber.
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`48.
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`Indeed, as of the time of filing this Complaint, the prescribers identified in the
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`Board’s allegations against Plaintiffs have not been subject to any discipline relating to their
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`prescription practices.
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`49.
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`On or about March 2, 2021, an informal settlement conference (“ISC”) was held
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`to resolve the disciplinary action prior to the commencement of formal proceedings. Plaintiffs
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`retained the services of an expert witness who testified at the ISC. The expert reviewed the
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`Plaintiffs’ prescription data for the period between April 2019 and April 2020, as well as
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`conducted an interview with Rushin. At the ISC, the expert testified that, in his expert opinion,
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`Plaintiffs exercised sound professional judgment in prescribing controlled substances, ensured
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`proper patient safety, and complied with the strict procedures when filling controlled
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`prescriptions, including accessing the PMP history of patients.
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`50.
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`Despite the expert witness’ findings, the Board filed formal charges against
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`Plaintiffs on or about August 9, 2021.
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`51.
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`At about the same time the formal charges were filed against Plaintiffs, the Board
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`issued Plaintiffs’ expert witness a Statement of Allegations, charging him with violating Board’s
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`rules and the Texas Controlled Substances Act (“TSCA”) when he accessed the PMP without
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`proper authorization in connection with the expert witness services he provided to Plaintiffs. The
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`expert’s access to the PMP was entirely legal and proper.
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`52.
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`Following the ISC proceeding in the expert witness’ disciplinary matter, the
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`expert was informed that his participation in Plaintiffs’ administrative action as an expert witness
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`may adversely affect his own disciplinary action before the Board. The threat was contained in
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`words to the effect that, if the expert witness stayed under the Board’s radar, his disciplinary
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`matter may be resolved favorably.
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`53.
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`Due to the Board’s frivolous allegations against the expert, the expert has
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`attempted to resign as a testifying expert for Plaintiffs in the administrative action. The expert is
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`no longer communicating with Plaintiffs despite contractual retention and payment of fees by
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`Plaintiffs.
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`54.
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`As such, the Board has extorted the expert with express or implied promise of
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`leniency if he does not testify in the administrative action. In so doing, Plaintiffs have been
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`deprived of procedural and substantive due process.
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`G.
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`The Board Violated Plaintiffs’ Right to Due Process
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`55.
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`There is no doubt that Plaintiffs have constitutionally protected liberty and
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`property interests associated with their reputation, professional licenses, and economic well-
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`being.
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`56.
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`Thus, the Board must provide Plaintiffs with due process guaranteed by the
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`Fourteenth Amendment to the United States Constitution before depriving them of their rights.
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`57.
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`The Board, acting under the color of law, denied Plaintiffs their right to a fair
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`hearing by preventing Plaintiffs from establishing a legitimate defense to the Board’s allegations.
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`58.
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`As a result of the Board’s unlawful conduct, Plaintiffs are further denied any
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`opportunity to challenge the allegations and findings relating to the PMP, since any expert
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`witness Plaintiffs might retain would similarly face disciplinary actions from the Board.
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`59. Moreover, Plaintiffs have been harmed by the Board’s enforcement of the
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`unlawful disciplinary proceedings.
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`///
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`///
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`///
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`///
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`V.
`FIRST CLAIM FOR RELIEF AGAINST DEFENDANTS FOR VIOLATION OF THE
`FOURTEENTH AMENDMEND AND 42 U.S.C. § 1983
`(Procedural Due Process)
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`Plaintiff realleges paragraphs 1 through 59 of this Complaint as if fully set forth
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`60.
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`below.
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`61.
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` At all times relevant to the Complaint Defendants, individually and in their
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`official capacity, acted under the color of state law in enforcement the Board’s rules and
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`commencing disciplinary action against Plaintiffs.
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`62. While acting under the color of state law, Defendants deprived Plaintiffs of their
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`constitutional right to due process guaranteed by the Fourteenth Amendment to the United States
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`Constitution.
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`63.
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`Plaintiffs have constitutionally protected liberty and property interests associated
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`with their reputation, professional licenses, and economic well-being.
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`64.
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`Thus, Defendants must provide Plaintiffs with notice and a fair hearing before
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`depriving Plaintiffs of their protected rights.
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`65.
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`Defendants denied Plaintiffs procedural due process when it interfered with
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`Plaintiffs’ ability to establish a defense to the Board’s allegations by bringing meritless
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`disciplinary action against Plaintiffs’ expert witness to prevent him from testifying at the
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`administrative hearing.
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`66.
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`Plaintiffs are entitled to declaratory judgment, permanent injunction, and
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`compensatory damages because there is no plain, adequate, or speedy remedy at law to prevent
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`Defendants from continuing violations of Plaintiffs rights.
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`67.
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`Plaintiffs are entitled to attorney’s fees and costs pursuant to 42 U.S.C. § 1988.
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`VI.
`SECOND CLAIM FOR RELIEF AGAINST DEFENDANTS FOR VIOLATION OF THE
`FOURTEENTH AMENDMEND AND 42 U.S.C. § 1983
`(Substantive Due Process)
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`Plaintiff realleges paragraphs 1 through 67 of this Complaint as if fully set forth
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`68.
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`below.
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`69.
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` At all times relevant to the Complaint Defendants, individually and in their
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`official capacity, acted under the color of state law in enforcement the Board’s rules and
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`commencing disciplinary action against Plaintiffs.
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`70. While acting under the color of state law, Defendants deprived Plaintiffs of their
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`constitutional right to due process guaranteed by the Fourteenth Amendment to the United States
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`Constitution.
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`71.
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`Plaintiffs have constitutionally protected liberty and property interests associated
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`with their reputation, professional licenses, and economic well-being.
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`72.
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`Thus, Plaintiffs are guaranteed protection from unreasonable government
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`interference with their protected rights.
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`73.
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`Defendants unreasonably interfered with Plaintiffs’ substantive due process rights
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`when it enacted and enforced the Red Flag Factors against Plaintiffs in an arbitrary and
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`unreasonable manner.
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`74.
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`Defendants further unreasonably interfered with Plaintiffs’ right to establish a
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`defense to the Board’s allegations and are continuing to subject Plaintiffs to unlawful
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`disciplinary proceedings.
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`75.
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`Plaintiffs are entitled to declaratory judgment, permanent injunction, and
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`compensatory damages because there is no plain, adequate, or speedy remedy at law to prevent
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`Defendants from continuing violations of Plaintiffs rights.
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`76.
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`Plaintiffs are entitled to attorney’s fees and costs pursuant to 42 U.S.C. § 1988.
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`VII.
`THIRD CLAIM FOR RELIEF AGAINST DEFENDANTS FOR VIOLATION OF THE
`FOURTEENTH AMENDMEND AND 42 U.S.C. §§ 1981 AND 1983
`(Equal Protection)
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`Plaintiff realleges paragraphs 1 through 76 of this Complaint as if fully set forth
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`77.
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`below.
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`78.
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` At all times relevant to the Complaint Defendants, individually and in their
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`official capacity, acted under the color of state law in enforcement the Board’s discriminatory
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`rules against Plaintiffs.
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`79. While acting under the color of state law, Defendants deprived Plaintiffs of their
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`constitutional right to equal protection of law guaranteed by the Fourteenth Amendment to the
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`United States Constitution.
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`80.
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`Plaintiffs belong to a protected minority class that have been subject to disparate
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`treatment by the enactment and enforcement of Defendants’ rules and regulations.
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`81.
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`Defendants enacted the rules and regulations relating to the Red Flag Factors with
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`discriminatory intent. Defendants further enforced those rules against Plaintiffs with
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`Case 4:22-cv-00561 Document 1 Filed on 02/21/22 in TXSD Page 16 of 18
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`discriminatory purpose.
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`82.
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`Plaintiffs are entitled to declaratory judgment, permanent injunction, and
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`compensatory damages because there is no plain, adequate, or speedy remedy at law to prevent
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`Defendants from continuing violations of Plaintiffs rights.
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`83.
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`Plaintiffs are entitled to attorney’s fees and costs pursuant to 42 U.S.C. § 1988.
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`Accordingly, Plaintiffs pray for relief as follows:
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`PRAYER FOR RELIEF
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`A.
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`For declaratory judgment that Defendants’ conduct unlawfully denied Plaintiffs
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`procedural and substantive due process in that Defendants have unreasonably interfered with
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`Plaintiffs’ protected liberty and property interest guaranteed by the Fourteenth Amendment to the
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`United States Constitution;
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`B.
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`For declaratory judgment that Defendants’ enactment and enforcement of the Red
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`Flag Factors violate the Fourteenth Amendment to the United States Constitution;
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`C.
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`For injunctive relief requiring Defendants to cease discriminatory enforcement of
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`its rules and regulations;
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`D.
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`For injunctive relief requiring Defendants to cease continuing violations of
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`Plaintiffs’ rights;
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`For compensatory damages relating to Defendants’ violations of Plaintiffs’ rights;
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`For attorneys’ fees and costs; and
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`All other relief this Court finds appropriate and just.
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`E.
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`F.
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`G.
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`Case 4:22-cv-00561 Document 1 Filed on 02/21/22 in TXSD Page 17 of 18
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`DATED: February 21, 2022
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`Respectfully submitted,
`KHOURI LAW OFFICE, PLLC
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`By:
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`/s/ Michael J. Khouri
`MICHAEL J. KHOURI
`Texas Bar No. 24073809
`California Bar No. 97654
`8150 N. Central Expressway, 10th Floor
`Dallas, Texas 75206
`Phone: (949) 336-2433
`Facsimile: (949) 387-0044
`Email: mkhouri@khourilaw.com
`Attorneys for Plaintiffs,
`BLUE MINT PHARMCO, LLC
`JONA RUSHIN, R.PH.
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`Case 4:22-cv-00561 Document 1 Filed on 02/21/22 in TXSD Page 18 of 18
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`DEMAND FOR JURY TRIAL
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`Plaintiffs demand a jury trial on all the issues so triable.
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`DATED: February 21, 2022
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`Respectfully submitted,
`KHOURI LAW OFFICE, PLLC
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`By:
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`/s/ Michael J. Khouri
`MICHAEL J. KHOURI
`Texas Bar No. 24073809
`California Bar No. 97654
`8150 N. Central Expressway, 10th Floor
`Dallas, Texas 75206
`Phone: (949) 336-2433
`Facsimile: (949) 387-0044
`Email: mkhouri@khourilaw.com
`Attorneys for Plaintiffs,
`BLUE MINT PHARMCO, LLC
`JONA RUSHIN, R.PH.
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