BEFORE THE MEDICAL BOARD OF CALIFORNIA

DEPARTMENT OF CONSUMER AFFAIRS STATE OF CALIFORNIA

In the Matter of the Accusation Against: ) ) ) )

DONOVAN JOHN ANDERSON, M.D. ) ) ) )

Physician's and Surgeon's ) Certificate No. G48061 )

) Respondent. )

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File No. 16-2010-208984

DECISION

The attached Proposed Decision and Disciplinary Order is hereby adopted as the Decision and Order of the Medical Board of California, Department of Consumer Affairs, State of California.

This Decision shall become effective at 5:00 p.m. on July l, 2011

IT IS SO ORDERED June l, 2011

MEDICAL BOARD OF CALIFORNIA

By:~ Shelton Duruisseau, Ph.D., Chair Panel A

BEFORE THE MEDICAL BOARD OF CALIFORNIA

DEPARTMENT OF CONSUMER AFFAIRS STATE OF CALIFORNIA

In the Matter of the Accusation Against:

DONOVAN JOHN ANDERSON, M.D.,

Physician and Surgeon's Certificate No. G48061,

Respondent.

Case No. 16-2010-208984

OAHNo. 2011010786

PROPOSED DECISION

Administrative Law Judge Ruth S. Astle, State of California, Office of Administrative Hearings, heard this matter in Oakland, California on April 7, 2011.

Jane Zack Simon, Deputy Attorney General, represented complainant.

Respondent Donovan John Anderson, M.D. was present and represented by Gregory Abrams, Attorney at Law.

Submission of the matter was deferred to April 15, 2011 for further evidence, which was received, marked for the record and considered. The matter was submitted on April 15, 2011.

FACTUAL FINDINGS

1. Complainant Linda K. Whitney made this accusation in her official capacity as the Executive Director of the Medical Board of California (Board).

2. On July 2, 1982, Physician and Surgeon's Certificate No. G48061 was issued by the Board to Donovan John Anderson, M.D. (respondent). Respondent's certificate is renewed and current, and will expire on November 30, 2011.

Respondent has been the subject of prior disciplinary action. On April 16, 2004, a Public Letter of Reprimand was issued. This action was based on a letter of reprimand issued by the Arizona Medical Board in January 2004, relating to respondent's failure to obtain an adequate history and failure to adequately examine and evaluate a patient. He was

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ordered to comply with terms and conditions as a condition of the Public Letter of Reprimand being issued.

In January 2007, the Board filed an Accusation related to respondent's improper disposal of confidential patient records. Respondent entered into a Stipulation for Public Reprimand conditioned upon completion of a medical record keeping course, submission of a written protocol for maintaining, preserving, storing, destroying and disposing of patient medical records and payment of an administrative fine.

On July 10, 2008, another Accusation was filed, followed by a First and a Second Amended Accusation, based on respondent's care and treatment of a patient in California as well as based on another Arizona letter of reprimand issued in June 2009 based on respondent's failure to perform an adequate history and physical and assessment of an emergency room patient and failure to maintain adequate medical records. Following a hearing, it was determined that respondent demonstrated one act of simple negligence in his failure to order a CT scan for a head injury (not a basis for discipline) but that there was cause for discipline based on the June 2009 Arizona letter of reprimand. In a decision effective October 29, 2009, respondent was placed on probation for a period of five years with terms and conditions including a Clinical Training Program and an ethics course, which respondent completed. Respondent is currently on probation pursuant to the October 2009 Decision.

3. On August 11, 2010, the Arizona Medial Board issued Findings of Fact, Conclusions of Law and Order under which respondent was issued another letter of reprimand, and placed on probation for one year with a requirement that he obtain Continuing Medical Education in medial record keeping and management of diabetes. The Arizona discipline was based on findings regarding respondent's treatment of a diabetic patient from 2001-2009. It was determined that over a period of years respondent failed to perform adequate laboratory monitoring, failed to refer the patient for yearly retinopathy evaluation, failed to perform a yearly foot examination, and failed to conduct appropriate initial and interval lab work when prescribing mediation.

4. Respondent's conduct and the action of the Arizona Medial Board constitute unprofessional conduct within the meaning of the law and conduct subject to discipline within the meaning of the law. Arizona has terminated respondent's probation as completed as of March 4, 2011.

5. Respondent is licensed in both California and Arizona. He lives in Arizona and practices medicine in an area along the California/ Arizona border along the Colorado River. He works as a primary care physician. He has given up working in the emergency room as a result of an audit by the Department of Health Services. He is not working as many hours and has the weekends off. Respondent successfully completed a 40-hour PACE program of intensive training specifically designed for him in Emergency and Family Medicine as of October 1, 2010. He completed the PACE program after the matters that occuned that led to the present Arizona discipline. Respondent submitted a letter of

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reference from Edward T. Paget, M.D. Dr. Paget finds respondent to be a compassionate and honest person and recommends him without reservation. Respondent has taken the PACE Medical Recording Keeping Course three times. The last time was this year. He has converted his practice to electronic medical records and plans to update his use to "meaningful use of medical records 1." While respondent does have a history of disciplinary action beginning in 2004, he has made a concerted effort to improve his practices. He has met all the terms and conditions of his latest probationary order. It would not be against the public interest to allow respondent to continue practicing under terms and conditions of probation.

LEGAL CONCLUSIONS

1. By reason of the matters set forth in Findings 2, 3 and 4, cause for disciplinary action exists pursuant to Business and Professions Code sections 2305 and 141, subdivision (a) (Discipline Imposed by Another State).

2. The matters set forth in Finding 5 have been considered in making the following order.

ORDER .

Certificate No. 048061 issued to respondent Donovan John Anderson, M.D., is revoked. However, revocation is stayed and respondent is placed on probation for three (3) years upon the following terms and conditions2

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1. Monitoring - Practice

Within 30 calendar days of the effective date of this Decision, respondent shall submit to the Board or its designee for prior approval as a practice monitor, the name and qualifications of one or more licensed physicians and surgeons whose licenses are valid and in good standing, and who are preferably American Board of Medical Specialties (ABMS) certified. A monitor shall have no prior or current business or personal relationship with respondent, or other relationship that could reasonably be expected to compromise the ability of the monitor to render fair and unbiased reports to the Board, including but not limited to any form of bartering, shall be in respondent's field of practice, and must agree to serve as respondent's monitor. Respondent shall pay all monitoring costs.

The Board or its designee shall provide the approved monitor with copies of this Decision and Accusation, and a proposed monitoring plan. Within 15 calendar days of receipt of the Decision, Accusation, and proposed monitoring plan, the monitor shall submit

1 This is a term of art used to describe a specific form of medical records.

2 This disciplinary order shall supersede any present disciplinary order.

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a signed statement that the monitor has read the Decision(s) and Accusation(s), fully understands the role of a monitor, and agrees or disagrees with the proposed monitoring plan. If the monitor disagrees with the proposed monitoring plan, the monitor shall submit a revised monitoring plan with the signed statement.

Within 60 calendar days of the effective date of this Decision, and continuing throughout probation, respondent's practice shall be monitored by the approved monitor. Respondent shall make all records available for immediate inspection and copying on the premises by the monitor at all times during business hours and shall retain the records for the entire term of probation.

The monitor shall submit a quarterly written report to the Board or its designee which includes an evaluation of respondent's performance, indicating whether respondent's practices are within the standards of practice of medicine or billing, or both, and whether respondent is practicing medicine safely, billing appropriately or both. It shall be the sole responsibility of respondent to ensure that the monitor submits the quarterly written rep01is to the Board or its designee within 10 calendar days after the end of the preceding quarter.

If the monitor resigns or is no longer available, respondent shall, within 5 calendar days of such resignation or unavailability, submit to the Board or its designee, for prior approval, the name and qualifications of a replacement monitor who will be assuming that responsibility within 15 calendar days. If respondent fails to obtain approval of a replacement monitor within 60 days of the resignation or unavailability of the monitor, respondent shall be suspended from the practice of medicine until a replacement monitor is approved and prepared to assume immediate monitoring responsibility. Respondent shall cease the practice of medicine within 3 calendar days after being so notified by the Board or designee.

In lieu of a monitor, respondent may participate in a professional enhancement program equivalent to the one offered by the Physician Assessment and Clinical Education Program at the University of California, San Diego School of Medicine, that includes, at minimum, quarterly chart review, semi-annual practice assessment, and semi-annual review of professional growth and education. Respondent shall participate in the professional enhancement program at respondent's expense during the term of probation.

Failure to maintain all records, or to make all appropriate records available for immediate inspection and copying on the premises, or to comply with this condition as outlined above is a violation of probation.

2. Notification

Prior to engaging in the practice of medicine the respondent shall provide a true copy of this Decision and Accusation to the Chief of Staff or the Chief Executive Officer at every hospital where privileges or membership are extended to respondent, at any other facility where respondent engages in the practice of medicine, including all physician and locum tenens registries or other similar agencies, and to the Chief Executive Officer at every

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insurance carrier which extends malpractice insurance coverage to respondent. Respondent shall submit proof of compliance to the Board or its designee within 15 calendar days.

This condition shall apply to any change(s) in hospitals, other facilities or insurance carrier.

3. Supervision of Physician Assistants

During probation, respondent is prohibited from supervising physician assistants.

4. Obey All Laws

Respondent shall obey all federal, state and local laws, all rules governing the practice of medicine in California and remain in full compliance with any court ordered criminal probation, payments, and other orders.

5. Quarterly Declarations

Respondent shall submit quarterly declarations under penalty of perjury on forms provided by the Board, stating whether there has been compliance with all the condi'tions of probation.

Respondent shall submit quarterly declarations not later than 10 calendar days after the end of the preceding quarter.

6. Probation Unit Compliance

Respondent shall comply with the Board's probation unit. Respondent shall, at all times, keep the Board informed of respondent's business and residence addresses. Changes of such addresses shall be immediately communicated in writing to the Board or its designee.

Under no circumstances shall a post office box serve as an address of record, except as allowed by Business and Professions Code section 2021, subdivision (b ).

Respondent shall not engage in the practice of medicine in respondent's place of residence. Respondent shall maintain a current and renewed California physician's and surgeon's license.

Respondent shall immediately inform the Board or its designee, in writing, of travel to any areas outside the jurisdiction of California which lasts, or is contemplated to last, more than thirty (30) calendar days.

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7. Interview with the Board or its Designee

Respondent shall be available in person for interviews either at respondent's place of business or at the probation unit office, with the Board or its designee upon request at various intervals and either with or without prior notice throughout the term of probation.

8. Residing or Practicing Out-of-State

In the event respondent should leave the State of California to reside or to practice respondent shall notify the Board or its designee in writing 30 calendar days prior to the dates of departure and return. Non-practice is defined as any period of time exceeding thirty calendar days in which respondent is not engaging in any activities defined in sections 2051 and 2052 of the Business and Professions Code.

All time spent in an intensive training program outside the State of California which has been approved by the Board or its designee shall be considered as time spent in the practice of medicine within the State. A Board-ordered suspension of practice shall not be considered as a period of non-practice. Periods of temporary or permanent residence or practice outside California will not apply to the reduction of the probationary term. Periods of temporary or permanent residence or practice outside California will relieve respondent of the responsibility to comply with the probationary terms and conditions with the exception of this condition and the following terms and conditions of probation: Obey All Laws; and Probation Unit Compliance ..

Respondent's license shall be automatically cancelled ifrespondent's periods of temporary or permanent residence or practice outside California totals two years. However, respondent's license shall not be cancelled as long as respondent is residing and practicing medicine in another state of the United States and is on active probation with the medical licensing authority of that state, in which case the two year period shall begin on the date probation is completed or terminated in that state.

Any respondent disciplined under Business and Professions Code sections 141, subdivision (a) or 2305 (another state discipline) may petition for modification or termination of penalty: if at least one year has elapsed from the effective date of the California discipline.

9. Failure to Practice Medicine - California Resident

In the event respondent resides in the State of California and for any reason respondent stops practicing medicine in California, respondent shall notify the Board or its designee in writing within 30 calendar days prior to the dates of non-practice and return to practice. Any period of non-practice within California, as defined in this condition, will not apply to the reduction of the probationary term and does not relieve respondent of the responsibility to comply with the terms and conditions of probation. Non-practice is defined as any period ohime exceeding thi1iy calendar days in which respondent is not engaging in any activities defined in sections 2051 and 2052 of the Business and Professions Code.

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All time spent in an intensive training program which has been approved by the Board or its designee shall be considered time spent in the practice of medicine. For purposes of this condition, non-practice due to a Board-ordered suspension or in compliance with any other condition of probation, shall not be considered a period of non-practice.

Respondent's license shall be automatically cancelle? irresp~:mdent resides in California and for a total of two years, fails to engage in California in any of the activities described in Business and Professions Code sections 2051 and 2052.

10. Completion of Probation

Respondent shall comply with all financial obligations (e.g., cost recovery, restitution, probation costs) not later than 120 calendar days prior to the completion of probation. Upon successful completion of probation, respondent's certificate shall be fully restored.

11. Violation of Probation

Failure to fully comply with any term or condition of probation is a violation of probation. If respondent violates probation in any respect, the Board, after giving respondent notice and the opportunity to be heard, may revoke probation and carry out the disdplinary order that was stayed. If an Accusation, or Petition to Revoke Probation, or an Interim Suspension Order is filed against respondent during probation, the Board shall have continuing jurisdiction until the matter is final, and the period of probation shall be extended until the matter is final.

12. License Surrender

Following the effective date of this Decision, if respondent ceases practicing due to retirement, health reasons or is otherwise unable to satisfy the terms and conditions of probation, respondent may request the voluntary surrender of respondent's license. The Board reserves the right to evaluate respondent's request and to exercise its discretion whether or not to grant the request, or to take any other action deemed appropriate and reasonable under the circumstances. Upon formal acceptance of the surrender, respondent shall within 15 calendar days deliver respondent's wallet and wall certificate to the Board or its designee and respondent shall no longer practice medicine. Respondent will no longer be subject to the terms and conditions of probation and the surrender of respondent's license shall be deemed disciplinary action. If respondent re-applies for a medical license, the application shall be treated as a petition for reinstatement of a revoked certificate.

13. Probation Monitoring Costs

Respondent shall pay the costs associated with probation monitoring each and every year of probation, as designated by the Board, which may be adjusted on an annual basis. Such costs shall be payable to the Medical Board of California and delivered to the Board or

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its designee no later than January 31 of each calendar year. Failure to pay costs within 30 calendar days of the due date is a violation of probation.

DATED: ~ 2.5/ l..6!frl

RUTHS. ASTLE Administrative Law Judge Office of Administrative Hearings

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1 EDMUND G. BROWN JR. Attorney General of California

2 JOSE R. GUERRERO Supervising Deputy Attorney General

3 JANE ZACK SIMON Deputy Attorney General

4 State Bar No. 116564 455 Golden Gate A venue, Suite 11000

5 San Francisco, CA 94102-7004 Telephone: (415) 703-5544

6 Fax: (415) 703-5480 E-mail: Janezack.simon@doj.ca.gov

7 Attorneys.for Complainant Medical Board of Cal?fornia

FILED STATE OF CALIFORNIA

MEDICAL BOARD J: CALIFORNIA SACRAME~TO QG~b.£ "'L ~ r20J.!.. BY: ,:;rt;vf~-A.-f'. ANALYST

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BEFORE THE MEDICAL BOARD OF CALIFORNIA

DEPARTMENT OF CONSUMER AFFAIRS STATE OF CALIFORNIA

13 In the Matter of the Accusation Against:

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DONOVAN JOHN ANDERSON, M.D. 8700 Hwy 95 P.O. Box 5878 Mohave Valley, AZ 86440

Physician's and Surgeon's 17 Certificate No. G48061

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21 The Complainant alleges:

Respondent.

Case No. 16-2010-208984

ACCUSATION

22 1. Complainant Linda K. Whitney is the Executive DirectOr of the Medical

23 Board of California, Department of Consumer Affairs, and brings this Accusation solely in her

24 official capacity.

25 2. On July 2, 1982, Physician's and Surgeon's Certificate

26 No. G48061 was issued by the Medical Board of California to Donovan John Anderson, M.D.

27 ("respondent.") The certificate is renewed and current, with an expiration date of November 30,

28 2011. The certificate has been the subject of prior disciplinary actions as follows: On April 16,

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Accusation (16-2010-208984)

2004 a Decision became effective which read: Public Letter of Reprimand. On January 4, 2007

2 an Accusation was filed and on September 19, 2007 respondent entered into a settlement

3 agreement under which a Public Reprimand was ordered subject to respondent's compliance with

4 conditions; respondent complied with the terms and conditions of the settlement agreement and

5 on March 25, 2008 a Public Reprimand was issued. On July 10, 2008 another Accusation was

6 filed, followed by First and Second Amended Accusations; on October 29, 2009 a Decision

7 became effective which read Revoked, Stayed, Five Years Probation with Terms and Conditions.

8 Respondent is currently on probation pursuant to the terms of the October 2009 Decision.

9 .JURISDICTION

10 3. This Accusation is brought before the Medical Board of California 1,

11 (hereinafter the "Board") under the authority of the following sections of the California Business

12 and Professions Code (hereinafter "Code'?) and/or other relevant statutory enactment:

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A. Section 2227 of the Code provides in part that the Board may

revoke, suspend for a period not to exceed one year, or place on probation, the license of

any licensee who has been found guilty under the Medical Practice Act, and may recover

the costs of probation monitoring.

B. Section 2305 of the Code provides, in part, that the revocation,

18 suspension, or other discipline, restriction or limitation imposed by another state upon a

19 license to practice medicine issued by that state, that would have been grounds for

20 discipline in California under the Medical Practice Act, constitutes grounds for discipline

21 for unprofessional conduct.

22 I I I

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27 1• The term "Board" means the Medical Board of Califomia;"Division of Medical

Quality" shall also be deemed to refer to the Board.

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C. Section 141 of the Code provides:

"(a) For any licensee holding a license issued by a board under the jurisdiction of a department, a disciplinary action taken by another state, by any agency of the federal government, or by another country for any act substantially related to the practice regulated by the California license, may be a ground for disciplinary action by the respective state licensing board. A certified copy of the record of the disciplinary action taken against the licensee by another state, an agency of the federal government, or another country shall be conclusive evidence of the events related therein.

"(b) Nothing in this section shall preclude a board from applying a specific statutory provision in the licensing act administered by the board that provides for discipline based upon a disciplinary action taken against the licensee by another state, an agency of the federal government, or another country."

FIRST CAUSE FOR DISCIPLINE

(Discipline, Restriction, or Limitation Imposed by Another State)

4. Respondent has been licensed in California since 1982. He lives in Arizona

and practices medicine in both Arizona and California, in an area along the Colorado River. He

works as an emergency room physician and as a family practitioner.

5. Respondent's past disciplinary history in both California and Arizona is

significant. In April 2004, the Medical Board of California issued a Public Letter of Reprimand

based on a letter of reprimand issued by the Arizona Medical Board in January 2004, relating to

respondent's failure to obtain an adequate history and failure to adequately examine and evaluate

a patient. In January 2007, the Board filed another Accusation against respondent, again based on

an Arizona letter ofreprimand. The 2007 Accusation related to respondent's improper disposal

of confidential patient records. Respondent entered into a Stipulation for Public Reprimand

conditioned upon completion of a medical record keeping course, submission of a written

protocol for maintaining, preserving, storing, destroying and disposing of patient medical records

and payment of an administrative fine. In July 2008, another California disciplinary action was

filed, based on respondent's care and treatment of a patient in California as well on another

Arizona letter ofreprimand issued in June 2009 based on respondent's failure to perform an

adequate history and physical and assessment of an emergency room patient and failure to

maintain adequate medical records. Following a hearing, it was determined that respondent

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Accusation (! 6-2010-208984)

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demonstrated one act of simple negligence in his failure to order a CT scan for a head injury

patient (not a basis for discipline) but that there was cause for discipline based on the June 2009

Arizona letter ofreprimand. In a Decision effective October 29, 2009, respondent's license was

revoked, stayed, subject to 5 years probation. Terms and conditions of the probation include

completion of a Clinical Training Program and an ethics course.

6. On August 11, 2010, the Arizona Medical Board issued Findings of Fact,

Conclusions of Law and Order under which respondent was issued yet another letter of

reprimand, and placed on probation for one year with a requirement that he obtain CME in

medical record keeping and management of diabetes. The Arizona discipline was based on

findings regarding respondent's treatment of a diabetic patient from 2001-2009. It was

determined that over a period of years respondent failed to perform adequate laboratory

monitoring, failed to refer the patient for yearly retinopathy evaluation, failed to perform a yearly

foot examination, and failed to conduct appropriate initial and interval lab work when prescribing

medication. A copy of the Findings of Fact, Conclusions of Law and Order issued by the Arizona

Medical Board is attached as Exhibit A.

7. Respondent's conduct and the action of the Arizona Medical Board as set

forth in paragraph 6, above, constitute unprofessional conduct within the meaning of section 2305

and conduct subject to discipline within the meaning of section 141 (a).

PRAYER

WHEREFORE, the complainant requests that a hearing be held on the matters

herein alleged, and that following the hearing, the Board issue a decision:

1. Revoking or suspending Physician's and Surgeon's Certificate Number

G48061 heretofore issued to respondent Donovan John Anderson, M.D.;

2. Revoking, suspending or denying approval of the respondent's authority to

supervise physician assistants;

3. Ordering respondent, if placed on probation, to pay the costs probation

monitoring; and

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4. Taking such other and further action as the Board deems necessary and

proper.

DATED: October 27, 2010.

LINDA K. WHITNEY Executive Director Medical Board of C fornia Department of Co sumer Affairs State of California

Complainant

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Accusation ( 16-20 I 0-208984)

Exhibit A

1 BEFORE THE ARIZONA MEDICAL BOARD

2 In the Matter of

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DONOVAN ANDERSON, M.D.

Holder of License No. 13491 For the Practice of Allopathic Medicine In the State of Arizona.

Board Case No. MD-09-1540A

FINDINGS OF FACT, CONCLUSIONS OF LAW AND ORDER

(Decree of Censure and Probation)

· The Arizona Medical Board ("Board") considered this matter at its public meeting

on June 9, 2010. Donovan Anderson, M.D., ("Respondent") appeared before the Board

for a formal interview pursuant to the authority vested in the Board by A.RS. § 32-

1451 (H). The Board voted to issue Findings of Fact, Conclusions of Law and Order after

due consideration of the facts and law applicable to this matter.

· FINDINGS OF FACT

13 1. The Board is the duly constituted authority for the regulation and control of the

14 practice of allopathic medicine in the State of Arizona.

15 2. Respondent is the holder of License No. 13491 for the practice of allopathic medicine

16 in the State of Arizona.

17 3. The Board initiated case number MD-09-1540A after receiving a complaint regarding

18 Respondent's care and treatment of a 40 year-old female patient ("AR") alleging

19 inappropriate care and treatment of a diabetic patient.

20 4. AR established care with Respondent in 2001. Her medical problems included

21 diabetes and obesity. In 2005, AR was prescribed Norco for left leg pain and referred to an

22 orthopedist, a gynecologist for dysmenorrhea, and an ophthalmologist. She was seen

23 frequently by Respondent and given further prescriptions for Norco. Electronic Medical

24 Record (EMR) documentation included notions from prior progress notes and charting was

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1 5. In 2006, AR reported back and knee pain, and she was treated with Norco. Medication

2 information was duplicated in each successive progress note. AR reported chest pain and

3 numbness to the first through third digits of her left hand and a limited exam was

4 performed. AR was referred to a cardiologist. In 2007, AR was treated for GERD and

5 received pain medication, but was a "no show" for follow up and did not have an A 1 c done

6 as recommended.

7 6. In 2008, AR requested follow up of her diabetes and requested a medication change.

s· Respondent documented that AR was doing well and included the usual medication notes.

9 AR was treated for pain and no labs were ordered. Respondent's progress notes included

10 multiple duplications from prior notes, including the Plan.

11 7. AR was seen multiple times in 2009 and EMR progress notes included duplications

12 from prior notes, sparse exam findings, prescriptions for pain medication and referrals.

13 Labs ordered by a GI consultant were done in August 2009 and showed a glucose level of

14 235. One month later, AR was hospitalized in Nevada with chest pain. Her admission labs

15 showed a glucose level of 312. She was treated for bronchitis and saw Respondent tn

16 follow up. No labs were ordered. Respondent subsequently provided AR with a discharge

1 7 letter, reporting that he was no longer treating pain patients. AR later established care with

18 another provider and an A 1 c was drawn in October 2009 that was found to be 8.9. The

19 new provider referred AR to an endocrinologist for her uncontrolled diabetes.

2 O 8. The Medical Consultant.(MC) identified multiple deviations from the standard of care

21 and found that Respondent's EMR notes were inadequate in that they often did not

2 2 include physical exam findings addressing patient concerns, and multiple duplications

2 3 form prior EMR progress notes were included in successive notes.

2 4 9. Respondent claimed that AR was noncompliant with multiple cancelled appointments

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1 and there was documented evidence of her not taking medications as directed by multiple

2 doctors. He referred AR to another doctor because he had be.en treating her for ten years

3 without much success. Respondent also claimed that this was not really a case about

4 diabetes management, but was, instead, about extortion from a patient who wanted ,

5 narcotics. At the Formal Interview Respondent did concede that he "dropped the ball on

6 this case."

7 1 O. The standard of care requires a physician to perform lab monitoring of diabetic

8 patients.

9 11. Respondent deviated from the standard of care by failing to perform appropriate

10 diabetic lab monitoring of AR.

11 12. The standard of care for a diabetic patient requires a physician to refer the patient for

12 yearly ophthalmology examinations to assess for diabetic retinopathy.

13. 13. Respondent deviated from the standard of care by failing to assure that AR was

14 referred and underwent yearly diabetic retinopathy evaluation.

15 14. The standard of care requires a physician to perform a comprehensive yearly foot

16 exam on a diabetic patient.

1 7 15. Respondent deviated from the standard of care by failing to perform yearly

18 comprehensive foot exams on AR.

19 16. The standard of care requires a physician to conduct appropriate initial labs or lab

2 o monitoring when prescribing diabetic medications.

21 17. Respondent deviated from the standard of care by prescribing diabetic medications

22 without appropriate initial labs or lab monitoring.

23 18. Respondent's deviations from the standard of care may have contributed to the

2 4 worsening of A R's diabetic control and development of findings suggestive of diabetic

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3 CONCLUSIONS OF LAW

4 1. The Arizona Medical Board possesses jurisdiction over the subject matter

5 hereof and over Respondent.

6 2. The Board has received substantial evidence supporting the Findings of

7 Fact described above and said findings constitute unprofessional conduct or other

8 grounds for the Board to take disciplinary action.

9 3. The conduct and circumstances described above constitute unprofessional

10 conduct pursuant to A.R.S. § 32-140i(27)(e) ("(f)ailing or refusing to maintain adequate

11 records on a patient") and § 32-1401 (27)(q) ("[a]ny conduct that is or might be harmful or

12 dangerous to the health of the patient or the public.")

13 ORDER

14 Based upon the foregoing Findings of Fact and Conclusions of Law,

15 IT IS HEREBY ORDERED:

16 1. Respondent is issued a Letter of Reprimand.

1 7 2. Respondent is place on ·probation for one year with the following terms and

18 conditions:

19 a. Within six months of the effective date of this Order, Respondent shall

2 O obtain 15-20 hours of Board staff preapproved Category I CME in the

21 medical recordkeeping, and obtain 15-20 hours of Board staff pre-

2 2 approved Category I CME in an intensive course for the management

2 3 of diabetes. The CME shall be in addition to the hours required for the

2 4 biennial renewal of medical licensure. The Probation shall terminate

2 5 upon successful completion of the CME.

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b. Respondent shall obey all state, federal and local laws, all rules

governing the practice of medicine in Arizona, and remain in full

compliance with any court ordered criminal probation, payments and

other orders.

c. In the event Respondent should leave Arizona to reside or practice

outside the State or for any reason should Respondent stop practicing

medicine in Arizona, Respondent shall notify the Executive Director in

writing within ten days of departure and return or the dates of non­

practice within Arizona. Non-practice is defined as any period of time

exceeding thirty days during which Respondent is not engaging in the

practice of medicine. Periods of temporary or permanent residence

or practice outside Arizona or of non-practice within Arizona, will not

apply to the reduction of the probationary period.

15 3. The Board retains jurisdiction and may initiate new action based upon any

16 violation of this Order.

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18 RIGHT TO PETITION FOR REHEARING OR REVIEW

19 Respondent is hereby notified that he has the right to petition for a rehearing or

2 0 review. The petition for rehearing or review must be filed with the Board's Executive

21 Director within thirty (30) days after service of this Order. A.R.S. § 41-1092.09(8). The

2 2 petition for rehearing or review must set forth legally sufficient reasons for granting a

23 rehearing or review. A.A.C. R4-16-103. Service of this order is effective five (5) days

24 after date of mailing. A.R.S. § 41-1092.09(C). If a petition for rehearing or review is not

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filed, the Board's Order becomes effective thirty-five (35) days after it is mailed to

Respondent.

Respondent is further notified that the filing of a motion for rehearing or review is

required to preserve any rights of appeal to the Superior Court.

~UC-u S ( , ~/13 ;>

THE ARIZONA MEDICAL BOARD

~i~aS.$ Executive Director

ORIGINAL of the ~ay of k=~~~~~<2:2~.!:.8:::::._ with:

Arizona Medical Board 9545 East Doubletree Ranch Road Scottsdale, Arizona 85258

Scott Holde Holden & Armer, P.C.

J

6101 S. Rural Rd. Suite 118 Tempe, AZ 85283 (Attorney for espondent)

6