A June 2026 Medical Board of California accusation alleges a physician permitted compounded semaglutide and tirzepatide to be prepared and handled in his medical office under conditions that did not comply with applicable compounding, labeling, documentation, dispensing, and sterile compounding standards and requirements.
Medical Board Details Alleged Compounding, Labeling, and Dispensing Violations
On June 10, 2026, the Medical Board of California filed an accusation seeking disciplinary action against San Diego physician Ronald Scott Cohen, M.D., over allegations involving compounded semaglutide and tirzepatide. The accusation alleges Dr. Cohen permitted a pharmacist to prepare the medications within his medical office. The case highlights physician oversight and prescription drug handling for compounded GLP-1 medications that may be relevant to Med Spa medical weight-loss services.
Accusation Describes Alleged Compounding and Drug Handling Practices
The Medical Board’s June 10, 2026 filing alleges Dr. Ronald Scott Cohen entered into a verbal agreement in early 2023 allowing a licensed pharmacist to compound semaglutide with L-carnitine in a clean room located within his San Diego medical office. The filing alleges the arrangement expanded in November 2023 to include compounded tirzepatide with L-carnitine and continued until June 2025.
The filing also alleges the following case details:
- Compounding: Beginning in early 2023, the filing alleges a pharmacist prepared compounded semaglutide with L-carnitine, and later tirzepatide with L-carnitine, inside the provider’s medical office clean room. Some compounded medications were allegedly left for the provider to administer or dispense, while others were allegedly taken to another location for patients.
- Labeling: Investigators allege the compounded vials initially contained only the drug name, lot number, and expiration date, omitting required patient and prescription information. The filing also alleges syringes used to administer or dispense the medications had no labels, and that vials later displayed “Gram Peptides.”
- Dispensing: Board investigators allege the compounded medications were administered or dispensed without meeting applicable California dispensing and labeling requirements. The filing also alleges the medications were not packaged in child-resistant containers.
The allegations stem from the reported June 2025 inspection of the provider’s medical office by a California State Board of Pharmacy inspector and a November 2025 interview with Medical Board investigators. The filing states the provider discussed the compounding arrangement and his role in the preparation, storage, and handling of the compounded medications.
Source: California Medical Board Accusation
According to the Medical Board’s June 10, 2026 accusation, the filing alleges multiple violations involving the compounding, labeling, dispensing, and handling of dangerous drugs and seeks disciplinary action against the provider’s California physician and surgeon certificate. As of this reporting, the disciplinary matter remains pending before the Medical Board.
Compliance Context From the Medical Board Accusation
The Medical Board’s filing identifies multiple regulatory requirements applicable to sterile compounding and the labeling, dispensing, and handling of compounded prescription medications. The disciplinary action cites provisions of the California Business and Professions Code, the California Code of Regulations, USP Chapter 797, and federal law governing compounded sterile preparations.
The filing alleges concerns involving several compliance areas, including:
- Sterile compounding procedures and cleanroom operations
- Environmental controls and personnel training under USP Chapter 797
- Documentation, quality assurance, and standard operating procedures
- Prescription labeling and beyond-use dating for compounded medications
- Packaging, dispensing, and administration requirements for dangerous drugs
The Medical Board seeks discipline under six alleged causes involving gross negligence, compounding, labeling, dispensing, adulterated drugs, and misbranded drugs. The filing also states that compounded drug vials were labeled with “Gram Peptides” beginning in June 2025. In a separate federal enforcement action, the FDA issued a March 2026 warning letter to Gram Peptides concerning the online marketing of injectable peptide products.
For Med Spa operators offering medications for weight management services, the disciplinary filing highlights regulatory requirements governing sterile compounding, prescription drug handling, labeling, documentation, and physician oversight. California has also proposed AB 1990 addressing compounded GLP-1 sourcing and advertising, while recent federal enforcement has included FDA warning letters involving compounded GLP-1 telehealth marketing.
Practical Implications for Med Spa Operators
- Confirm that GLP-1 medications and other prescription drugs are obtained through lawful suppliers and authorized distribution channels.
- Verify the licensure, regulatory standing, and compliance history of pharmacies, outsourcing facilities, and other medication suppliers before obtaining prescription products.
- Ensure physician oversight responsibilities are clearly defined for prescription medications ordered, stored, dispensed, or administered within the facility.
- Maintain written policies governing prescription drug handling, labeling, documentation, quality assurance, and inventory controls.
- Review policies for compounded prescription medications to confirm they align with applicable state and federal requirements before they are purchased, received, or used within the facility.
What to Watch Next
As of this reporting, the disciplinary matter remains pending before the Medical Board of California. Additional action by the Medical Board or related agencies may also become part of the public record as the case progresses.
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Image Attribution: “California Capitol in Downtown Sacramento, California” by Tszeiler1, via Wikimedia Commons, licensed under CC BY-SA 4.0.
