Arizona Medical Board - azmd.gov€¦ · 2. MD-15-0217A, DALTON R. CARPENTER, M.D., LIC. #32356 Dr. Gillard summarized that Dr. Carpenter was invited for a Formal Interview in February

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

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DRAFT MINUTES FOR REGULAR SESSION MEETING

Held on Wednesday, December 6, 2017 9535 E. Doubletree Ranch Road • Scottsdale, Arizona

Board Members James M. Gillard, M.D., M.S., F.A.C.E.P., F.A.A.E.M., Chair

R. Screven Farmer, M.D., Vice-Chair Jodi A. Bain, Esq., Secretary

Bruce A. Bethancourt, M.D., F.A.C.P. Teresa L. Connolly, D.N.P., R.N., N.E.A.-B.C.

Gary R. Figge, M.D. Pamela E. Jones

Lois E. Krahn, M.D. Edward G. Paul, M.D. Wanda J. Salter, R.N.

Wednesday, December 6, 2017 GENERAL BUSINESS

A. CALL TO ORDER Dr. Gillard called the meeting to order at 8:02 a.m.

B. ROLL CALL The following Board members were present: Dr. Gillard, Ms. Bain, Dr. Farmer, Dr. Bethancourt, Dr. Connolly, Dr. Figge, Ms. Jones, Dr. Krahn, Dr. Paul and Ms. Salter. ALSO PRESENT Present among Board staff include: Carrie Smith, AAG; Anne Froedge, AAG; Beth Campbell, AAG; Patricia E. McSorley, Executive Director; Kristina Fredericksen, Deputy Director; William Wolf, M.D., Chief Medical Consultant; Andrea Cisneros, Staff Investigational Review Committee (“SIRC”) Coordinator; Raquel Rivera, Investigations Manager; Mary Bober, Board Operations Manager; and Michelle Robles, Board Coordinator.

C. PUBLIC STATEMENTS REGARDING MATTERS LISTED ON THE AGENDA Individuals who addressed the Board during the Public Statements portion of the meeting appear beneath the matter(s) referenced.

D. EXECUTIVE DIRECTOR’S REPORT • Update on Agency Relocation

Ms. McSorley reported that the Agency will be moving on January 5-6, 2018 and that the IT department has been working and preparing for setup in the new building. This upcoming Tuesday there will be a ribbon cutting ceremony.

• Update on recent Joint Officers Meetings

http://www.azmd.gov/

Draft Minutes for the December 6, 2017 AMB Regular Session Meeting Page 2 of 22

Ms. McSorley reported that the next meeting is scheduled for December 14, 2018.

• Update on Physicians Health Program Committee and status of RFP through State Procurement Office Ms. McSorley reported that once the bid is closed the Board will be provided an update.

E. CHAIR’S REPORT No report was given.

F. LEGAL ADVISOR’S REPORT • Update on Case # 16A-37896-MDX

Ms. Smith reported that the Board did require the physician to provide regular status reports and that the most current report is available for the Board’s review.

G. REVIEW, DISCUSSION AND POSSIBLE RECOMMENDATION REGARDING BOARD’S POLICY FOR REIMBURSEMENT FOR PER DIEM COMPENSATION AND EXPENSES Ms. McSorley reported that the Auditor General’s Office had reviewed agency reimbursement, and a report had been provided for the Board’s review. Ms. McSorley informed the Board that the Board’s policy meets ADOA’s requirements.

H. REVIEW, DISCUSSION AND POSSIBLE ACTION REGARDING LEGISLATIVE PROPOSAL FOR EXPEDITED LICENSURE PURSUANT TO HB 2502, SESSION LAW 2016, CHAPTER 137 Ms. McSorley reported that the mandate is for the Board to establish an expedited licensing process. Board staff has worked towards implementing the temporary license and the Board’s full medical license process has become more expeditious. Ms. McSorley informed the Board of 78 day total timeframe it generally takes to obtain the required licensure documents and that once they are received it takes about 7 to 8 Board processing days to issue the license, where previously it took 28 days to issue a license.

Ms. McSorley informed the Board that she has prepared a letter for Senator Barto and Representative Carter explaining that the Board’s current processes meet the requirements of the mandate and requested that the Board allow her to send the letter.

MOTION: Dr. Krahn moved for the Board to approve the Executive Director’s recommendation to inform the legislature that the requirement for expedited licensure is satisfied by the Board’s current processes. SECOND: Dr. Farmer. VOTE: 10-yay, 0-nay, 0-abstain, 0-recuse, 0-absent. MOTION PASSED.

I. UPDATE ON DEPARTMENT OF HEALTH SERVICES (DHS) RULES, R9-10-120 AND CURRENT RULEMAKING PROCESS RELATED TO OPIOID PRESCRIBING AND UPDATE ON GOVERNOR’S COUNCIL TO ADDRESS OPIOID CRISIS Sheila Sjolander, DHS Assistant Director, Prevention Services and Kathy McCanna, Branch Chief, DHS Licensing Services provided a presentation to the Board regarding Governor Ducey’s State of Emergency declaration due to an opioid epidemic and the subsequent mandates DHS must implement. These mandates includes developing guidelines to educate providers on responsible prescribing, provide training to local law enforcement agencies on proper protocols for administering naloxone in overdose situations and to provide a report on findings and recommendations. DHS has also initiated emergency rulemaking for opioid prescribing and


treatment practices for licensed Health Care Institutions. The presentation included an update on the goals, recommendations and performance measures of the Opioid Action Plan. Dr. Farmer spoke in favor of DHS’s efforts and presentation. Dr. Farmer commented on the lack of information being relayed to practicing physicians and discussed utilizing the Board’s Newsletter to help bridge that education gap. Dr. Farmer noted the emphasis on treatment is necessary and having forms of treatment available for patients who are affected by this Executive Order and the opioid epidemic.

J. APPROVAL OF MINUTES MOTION: Dr. Connolly moved to approve the September 14, 2017 Special Teleconference; including Executive Session and the October 3-4, 2017 Regular Session; including Executive Session. SECOND: Dr. Paul. VOTE: 10-yay, 0-nay, 0-abstain, 0-recuse, 0-absent. MOTION PASSED.

LEGAL MATTERS K. REVIEW, CONSIDERATION AND POSSIBLE ACTION ON PROPOSED

BOARD ORDER ARISING FROM ADMINISTRATIVE LAW JUDGE’S (“ALJ”) RECOMMENDED DECISION

1. MD-15-0916A, SUSAN D. SCARLA, M.D., LIC. #13951 Dr. Scarla was not present. Dr. Gillard summarized that the ALJ found clear and convincing evidence of multiple deviations including inadequate medical records, inappropriate prescribing to family members, violation of a Board Order and a danger to public safety. The State requests that the Board to accept the recommendation of revocation with the deletion of Findings of Fact number 57. MOTION: Ms. Bain moved to adopt the ALJ's recommended Findings of Fact as modified by the State. SECOND: Dr. Bethancourt. Ms. Smith, on behalf of the State, clarified the State’s request to delete Findings of Fact #57 stated that the ALJ found clear and convincing evidence that the Respondent had engaged in unprofessional conduct pursuant to A.R.S. §§ 32-1401(27)(e)(j)(q)(t)(dd)(jj) and (ss). The State requested that the Board adopt the Findings of Fact, as modified, Conclusions of Law and the Order for Revocation. ROLL CALL: Roll call vote was taken and the following Board members voted in favor of the motion: Dr. Gillard, Ms. Bain, Dr. Bethancourt, Dr. Connolly, Dr. Figge, Ms. Jones, Dr. Krahn, Dr. Paul and Ms. Salter. The following Board member was absent: Dr. Farmer. VOTE: 9-yay, 0-nay, 0-abstain, 0-recuse, 1-absent. MOTION PASSED. MOTION: Ms. Salter moved to adopt the ALJ's recommended Conclusions of Law. SECOND: Ms. Jones. ROLL CALL: Roll call vote was taken and the following Board members voted in favor of the motion: Dr. Gillard, Dr. Bethancourt, Dr. Connolly, Dr. Figge, Ms. Jones, Dr. Krahn, Dr. Paul and Ms. Salter. The following Board member abstained: Ms. Bain. The following Board member was absent: Dr. Farmer. VOTE: 8-yay, 0-nay, 1-abstain, 0-recuse, 1-absent. MOTION PASSED.


MOTION: Dr. Figge moved to adopt the ALJ's recommended Order for license revocation. SECOND: Dr. Krahn. ROLL CALL: Roll call vote was taken and the following Board members voted in favor of the motion: Dr. Gillard, Ms. Bain, Dr. Bethancourt, Dr. Connolly, Dr. Figge, Ms. Jones, Dr. Krahn, Dr. Paul and Ms. Salter. The following Board member was absent: Dr. Farmer. VOTE: 9-yay, 0-nay, 0-abstain, 0-recuse, 1-absent. MOTION PASSED.

L. RESCIND REFERRAL TO FORMAL HEARING AND ACCEPT PROPOSED

CONSENT AGREEMENT 1. MD-17-0399A, BRIAN E. MCCARTHY, M.D., LIC. #40004

Dr. Gillard summarized that Dr. McCarthy has a signed Consent Agreement with the Connecticut Board that limits his ability to practice. There was no unprofessional conduct in this case. AAG Froedge, on behalf of the State, informed the Board that Dr. McCarthy stated that he had not planned to return to Arizona and thought that his license would expire. He has since signed a Consent Agreement for a Practice Limitation and when his license is due for renewal he plans to let it expire. The State is requesting approval of the Consent Agreement. MOTION: Ms. Salter moved to rescind the referral to Formal Hearing and accept the proposed Consent Agreement for Practice Limitation. SECOND: Dr. Krahn. ROLL CALL: Roll call vote was taken and the following Board members voted in favor of the motion: Dr. Gillard, Ms. Bain, Dr. Bethancourt, Dr. Connolly, Dr. Figge, Ms. Jones, Dr. Krahn, Dr. Paul and Ms. Salter. The following Board member was absent: Dr. Farmer. VOTE: 9-yay, 0-nay, 0-abstain, 0-recuse, 1-absent. MOTION PASSED.

2. MD-15-0217A, DALTON R. CARPENTER, M.D., LIC. #32356

Dr. Gillard summarized that Dr. Carpenter was invited for a Formal Interview in February which he did not appear for and the case was referred for Formal Hearing. The initial recommendation by Board staff was to issue an Advisory Letter and the Board felt there were multiple deviations from the standard of care and recommended the issuance of a Letter of Reprimand. The physician has since signed a Consent Agreement for a Letter of Reprimand. AAG Smith, on behalf of the State, requested that the Board adopt the proposed Consent Agreement. MOTION: Dr. Paul moved to rescind the referral to Formal Hearing and accept the Proposed Consent Agreement for a Letter of Reprimand. SECOND: Dr. Krahn. ROLL CALL: Roll call vote was taken and the following Board members voted in favor of the motion: Dr. Gillard, Dr. Bethancourt, Dr. Connolly, Dr. Figge, Ms. Jones, Dr. Krahn, Dr. Paul and Ms. Salter. The following Board member abstained: Ms. Bain. The following Board member was absent: Dr. Farmer. VOTE: 8-yay, 0-nay, 1-abstain, 0-recuse, 1-absent. MOTION PASSED.

3. MD-16-0013A, I. ARTHUR SCHECHET, M.D., LIC. #11097


Dr. Gillard summarized that Dr. Schechet was sanctioned by the Michigan Medical Board and Board staff recommended issuance of a Letter of Reprimand. AAG Smith, on behalf of the State, stated that the physician requested inactivation of his license in 2002 and since Arizona statute prohibits a physician from practicing on an inactive license. AAG Smith explained that the Letter of Reprimand will resolve the pending investigation allowing the physician to cancel his license. The State requested that the Board adopt the Consent Agreement. MOTION: Dr. Krahn moved to rescind the referral to Formal Hearing and accept the Proposed Consent Agreement for a Letter of Reprimand. SECOND: Dr. Bethancourt. ROLL CALL: Roll call vote was taken and the following Board members voted in favor of the motion: Dr. Gillard, Ms. Bain, Dr. Bethancourt, Dr. Connolly, Dr. Figge, Ms. Jones, Dr. Krahn, Dr. Paul and Ms. Salter. The following Board member was absent: Dr. Farmer. VOTE: 9-yay, 0-nay, 0-abstain, 0-recuse, 1-absent. MOTION PASSED.

M. REVIEW, DISCUSSION AND POSSIBLE ACTION ON PROPOSED CONSENT

AGREEMENT (MD-15-1130A, MD-16-1121A, MD-15-0710A, MD-15-1190A) AND RESCIND REFERRAL TO FORMAL HEARING (MD-15-0710A, MD-15-1190A)

1. MD-15-1130A, MD-16-1121A, MD-15-0710A, MD-15-1190A, KIUP A. KIM, M.D., LIC. #42708 Counsel Scott King, Esq. was present on behalf of the physician. Dr. Gillard summarized that this case is based on possible unnecessary venous procedures poor medical records on three patients. The physician has completed PACE however was found to be weak in some parts of general surgery. The physician has signed a Consent Agreement of a Letter of Reprimand, Probation that includes chart reviews. AAG Smith, on behalf of the State, requested that the Board rescind the referral to formal hearing and adopt the proposed Consent Agreement. Mr. King requested that the Board adopt the proposed Consent Agreement. MOTION: Dr. Figge moved to accept the Proposed Consent Agreement in all four cases for a Letter of Reprimand and Two Year Probation requiring CME in recordkeeping and ethics, a practice proctor to oversee patient and procedure selection, and periodic chart reviews. Once the licensee has complied with the terms of Probation, he must petition the Board to request termination SECOND: Ms. Bain. ROLL CALL: Roll call vote was taken and the following Board members voted in favor of the motion: Dr. Gillard, Ms. Bain, Dr. Bethancourt, Dr. Connolly, Dr. Figge, Ms. Jones, Dr. Krahn, Dr. Paul and Ms. Salter. The following Board member was absent: Dr. Farmer. VOTE: 9-yay, 0-nay, 0-abstain, 0-recuse, 1-absent. MOTION PASSED. MOTION: Ms. Bain moved to rescind referral to Formal Hearing. SECOND: Ms. Jones. VOTE: 9-yay, 0-nay, 0-abstain, 0-recuse, 1-absent. MOTION PASSED.


N. REVIEW, DISCUSSION AND POSSIBLE ACTION REGARDING SUMMARY ACTION

1. MD-17-0137A, JEFF CRAWFORD, M.D., LIC. #18695 Dr. Crawford was not present. Dr. Gillard summarized that the initial recommendation was for a Letter of Reprimand and Probation by Board staff for inappropriate prescribing. Board staff cited poor compliance with Board requests, failure to provide reasoning for opiate prescriptions and poor legible records. Board staff requested that the physician’s practice be restricted and that he be prohibited from prescribing controlled substances pending the outcome of a formal hearing or formal interview. AAG Smith clarified that if the license is summarily suspended the case will be referred to the Office of Administrative Hearing (“OAH”) automatically and if the case is summarily restricted the Board can move for the case be referred to OAH. AAG Smith clarified the process of OAH and subsequent timeline for the case to move forward. MOTION: Dr. Paul moved to summarily restrict Dr. Crawford's Arizona medical license based on the finding that the public health, safety, or welfare imperatively requires emergency action by the Board. The matter shall be referred to the Office of Administrative Hearings for a Formal Hearing. Dr. Crawford shall be prohibited from prescribing controlled substances in any setting pending the outcome of a Formal Hearing. SECOND: Dr. Krahn. ROLL CALL: Roll call vote was taken and the following Board members voted in favor of the motion: Dr. Gillard, Ms. Bain, Dr. Bethancourt, Dr. Connolly, Dr. Figge, Ms. Jones, Dr. Krahn, Dr. Paul and Ms. Salter. The following Board member abstained: Dr. Farmer. VOTE: 9-yay, 0-nay, 1-abstain, 0-recuse, 0-absent. MOTION PASSED.

2. MD-16-0589A, JOHN J. SEARS, M.D., LIC. #27392

Dr. Sears was present with Counsel Scott Hergenroethner, Esq. Board staff summarized that the Board initiated the case after receiving a complaint regarding Dr. Sears’ care and treatment of CP alleging failure to properly treat and for overprescribing. Prescriptions for benzodiazepine and amphetamines were given, and over five years of the Dr. Sears continued to prescribe medication to the patient while averaging less than three appointments per year. Refills for narcotics were given without face to face assessment. The Board’s Medical Consultant (“MC”) found that the standard of care for the prescribing of opiates in chronic pain was not met in several areas including a failure to refer the patient to a pain specialist. Dr. Sears did not appropriately consider or evaluate CP for opiate abuse or misuse when he exhibited multiple warning signs and that Dr. Sears made no attempts to contact CP’s other healthcare providers or attempts to contact the family. The case was sent back for further investigation to review three additional charts. In all three charts refills were given without follow up, creating a precedent that the physician did not have to see a patient unless there was a problem. Board staff recommended a Letter of Reprimand, continuing medical education (“CME”) in opioid prescribing with an Interim Practice Restriction prohibiting Dr. Sears from prescribing controlled substances pending a formal hearing or formal interview. Dr. Sears was offered an Interim Practice Restriction however, through counsel; Dr. Sears


expressed a concern for patient transitions and disagreement with the language of the Interim Consent Agreement and declined Board staff’s offer. Mr. Hergenroethner urged the Board not to restrict Dr. Sears’ practice. Dr. Sears has confirmed that any practice restriction of his license will result in termination of his Board certification; if it is removed he will be terminated from employment. Mr. Hergenroethner stated there is not imminent danger to public safety as the investigation has been going on for 19 months. Mr. Hergenroethner stated that the MC’s concern that Dr. Sears has not seen his patients on a regular basis is ambiguous. Dr. Sears stated that he uses appropriate judgement and that he has pain management contracts, queries the CSPMP on a regular basis and does not increase the doses. Mr. Hergenroethner explained that family practitioners in rural areas treat pain management. Mr. Hergenroethner requested that this matter be referred to OAH. Dr. Sears explained that due to his patients’ poor economic status it is difficult to schedule doctor’s office visits on a regular basis. Dr. Sears stated that he is a conscientious physician and requested the Board allow him to continue to prescribe controlled substances. MOTION: Ms. Bain moved for the Board to enter into Executive Session pursuant to A.R.S. § 38-431.03(A)(3). SECOND: Dr. Figge. VOTE: 10-yay, 0-nay, 0-abstain, 0-recuse, 0-absent. MOTION PASSED. The Board entered into Executive Session at 8:46 a.m. The Board returned to Open Session at 9:01 a.m. No legal action was taken by the Board during Executive Session.

MOTION: Dr. Farmer moved to table this matter to allow the physician’s counsel to discuss the matter with the Board’s legal counsel. SECOND: Ms. Bain. VOTE: 10-yay, 0-nay, 0-abstain, 0-recuse, 0-absent. MOTION PASSED. Ms. Smith informed the Board that the request is to appear for a Formal Interview at the February 2018 meeting and within one week from this Board meeting will schedule a Board staff approved an intensive in-person CME course for prescribing controlled substances. Ms. Smith recommended if the Board adopts this request to direct Board staff to conduct reviews of Dr. Sears’ CSPMP report. MOTION: Ms. Bain moved for the Board to enter into Executive Session pursuant to A.R.S. § 38-431.03(A)(3). SECOND: Dr. Farmer VOTE: 10-yay, 0-nay, 0-abstain, 0-recuse, 0-absent. MOTION PASSED. The Board entered into Executive Session at 10:00 a.m. The Board returned to Open Session at 10:03 a.m. No legal action was taken by the Board during Executive Session.

The Board instructed staff to schedule the matter for a formal interview at its upcoming February, 2018 meeting. The Board further instructed staff to perform CSPMP queries in the interim, while the matter is pending Board review.


O. FORMAL INTERVIEWS 1. MD-16-0518A, LARRY C. LEVERETT, M.D., LIC. #19168

Dr. Leverett was present with Counsel Don Anderson, Esq. C.G. addressed the Board during the Public Statements portion of the meeting. Board staff summarized that the Board initiated the case after receiving a complaint regarding Dr. Leverett’s care and treatment of patient CG alleging inadequate postoperative care and treatment. The MC indicated that Dr. Leverett met the standard of care in terms of his pre-operative evaluation and performance of the procedure; however, the MC stated that Dr. Leverett deviated from the standard of care by failing to recognize the severity of the compromised circulation and failing to initiate treatment earlier. Dr. Leverett disagreed with the MC’s concern regarding his post-operative care. Dr. Leverett stated that once he was notified of the presence of puss and infection he referred the patient to the Emergency Room. Dr. Leverett requested that this case be dismissed. During questioning, Dr. Leverett explained that CG received wound care every day by a registered nurse and that no blood work was drawn as there were no signs of sepsis. Dr. Leverett explained in detail how often he saw the patient post operatively and opined in retrospect would not have done anything differently In closing, Mr. Anderson stated that this matter does not rise to the level of disciplinary action. During deliberations, Dr. Krahn commented that the postoperative care was appropriate and that she does not find evidence of unprofessional conduct. MOTION: Dr. Krahn moved to dismiss. SECOND: Ms. Bain. Dr. Farmer commented that it is always difficult when qualified experts have different findings and opinions. VOTE: 10-yay, 0-nay, 0-abstain, 0-recuse, 0-absent. MOTION PASSED.

2. MD-16-0797A, GREGORY V. BABIGIAN, M.D., LIC. #46494 Dr. Babigian participated telephonically and Counsel Scott King was present. Board staff summarized that the Board initiated the case after receiving notification of a quality of care incident at a Hospital where Respondent held privileges on May 13-14, 2016 involving Babigian, the on-call teleradiologist. The Board’s MC opined that Dr. Babigian misinterpreted a patient’s CT scans as normal. The MC noted that there was no actual harm, but opined that there was potential for respiratory failure and death. In opening, Mr. King requested dismissal of this case as Dr. Babigian denies having reviewed the films at issue and citing a forensic report prepared on behalf of Dr. Babigian. Mr. King noted that prior to this complaint, Dr. Babigian’s error rate was 0.1% and Dr. Babigian has no prior Board history. Dr. Babigian commented that the dictation style is not his at all and stated that he could not have read these films in the time indicated. During questioning, Dr. Babigian explained that two computers were set up by IT to allow him to view films and confirmed that the over read was completed by the ER radiologist. Dr. Babigian stated that he is also unaware of the five other cases cited in the forensic report.


Dr. Krahn expressed concern regarding services billed as being associated to the physician when he has not provided the service. Dr. Gillard commented that the fractures were too obvious for a radiologist to miss and opined that this could not have been read in the timeframe provided. Board staff clarified that the forensic report found no patient reports that were generated during the time frame in question but patient reviews were attributed to the physician. Ms. Bain found it concerning that the doctor has not taken the time to establish his work schedule and is unable to confirm whether or not he had worked the days in question. Board members expressed concern regarding the lack of clear work timeline and information from Dr. Babigian’s prior employer and a need for further investigation. Dr. Bethancourt noted the time inconsistencies on the faxing of the films and the preliminary reports. Board staff commented that this case has been ongoing for 16 months with no supplemental response from the physician, until the forensic report was provided one week before the interview. In closing, Mr. King requested that no further investigation take place and requested dismissal of the case. During deliberation, Dr. Krahn opined that this is a serious situation where a CT was misread. Board members expressed concern regarding making a decision at this time with the information provided and that further investigation is required. MOTION: Dr. Paul moved to return the case for further investigation to obtain additional information from FMC and AVR. SECOND: Dr. Farmer. VOTE: 10-yay, 0-nay, 0-abstain, 0-recuse, 0-absent. MOTION PASSED.

P. LICENSING INTERVIEWS 1. MD-17-0487A, SCOTT C. ROBERTSON, M.D., LIC. # N/A

Dr. Robertson was present without counsel. Board staff summarized that the Board initiated the case after receiving Dr. Robertson’s license application wherein he disclosed two 2007 malpractice settlements. The MC found multiple deviations from the standard of care in both cases to include consistently poor documentation, poor surgical technique and delay in timely care. Dr. Robertson agreed that documentation could have been better and he has since made changes to rectify the concern. Dr. Robertson explained the circumstances that resulted in the delay of care in both cases. During questioning, Dr Robertson expressed his reasoning behind the use the off label Infuse to ensure the fusion would be successful and that the patient would not need to undergo a second surgery. Dr. Robertson explained his decision to replace the bone graft and instrumentation at the revision surgery Dr. Farmer commented that two malpractice cases in twenty years of neurosurgery are not abnormal and opined that the physician has adequately addressed the concerns regarding the inadequate medical records and delay in care.


Dr. Robertson clarified that he has since received other state licenses since these two malpractice cases without additional discipline and is Board certified in Neurosurgery. MOTION: Dr. Farmer moved to grant the license. SECOND: Dr. Bethancourt. VOTE: 10-yay, 0-nay, 0-abstain, 0-recuse, 0-absent. MOTION PASSED.

Q. FORMAL INTERVIEWS 1. MD-14-1286A, NICHOLAS KALAYEH, M.D., LIC. #36839

Dr. Kalayeh was present with Counsel Paul Giancola, Esq. Board staff summarized that the Board initiated the case after receiving notification from the Hospital where Respondent held privileges stating that Dr. Kalayeh resigned his interventional cardiology privileges while the Medical Executive Committee was investigating the increased complications in interventional cardiac procedures. Dr. Kalayeh’s investigation was closed without a conclusion, and he retains all other privileges while remaining a member of the Medical Staff in good standing. The case was forwarded to the Board’s MC for quality of care review of six of the eleven patients reported in the complaint. The MC identified concerns including proper patient selection for PCI, technical errors, and documentation issues. Dr. Kalayeh informed the Board of his education, training and work history. Dr. Kalayeh explained that these cases all occurred during his first year of practice with limited environmental resources. Due to these cases he felt he was unable to provide adequate care and resigned his interventional cardiology privileges.

During questioning, Dr. Kalayeh clarified his current practice and privileges under a proctorship. In the cases of TV and DF, Dr. Kalayeh explained why such a large volume of contrast was used during PCI. In closing, Mr. Giancola requested that the Board acknowledge the opinion of his expert who found that Dr. Kalayeh met the standard of care based on the circumstances he faced. Mr. Giancola stated that Dr. Kalayeh has learned from these cases and requested that this case not rise to the level of discipline. During deliberation, Dr. Figge commented that there are standards of care regarding contrast and although there is always a risk vs. benefit analysis, the situation occurred multiple times. MOTION: Dr. Figge moved for a finding of unprofessional conduct in violation of A.R.S. § 32-1401(27)(q) for reasons as stated by SIRC. SECOND: Dr. Bethancourt. Dr. Farmer commented that there are conflicting expert opinions in this case however, practicing in a rural setting affects a physician’s options. Ms. Bain found it mitigating that the physician had removed himself from the field when this occurred and has now pursued a proctorship for guidance. VOTE: 10-yay, 0-nay, 0-abstain, 0-recuse, 0-absent. MOTION PASSED. MOTION: Dr. Bethancourt moved to issue an Advisory Letter and Order for Non-Disciplinary CME for failure to follow guidelines for contrast media during cardiac catheterization. There is insufficient evidence to support discipline. Within six months, complete no less than 6 hours of Board staff pre-approved Category l CME in percutaneous coronary intervention and proper utilization of contrast. The CME hours shall be in addition to the hours required for license renewal.


SECOND: Dr. Figge. Board members agreed that this case does not rise to the level of discipline due to mitigating factors. Dr. Bethancourt commented that if the practice setting is not meeting standards it should be brought to the facility’s attention. VOTE: 10-yay, 0-nay, 0-abstain, 0-recuse, 0-absent. MOTION PASSED.

2. MD-17-0083A, JOSE M. PISCOYA, M.D., LIC. #25569 Dr. Piscoya was present with Counsel Greg Hunt, Esq. Board staff summarized that the Board initiated the case after receiving a complaint from patient MR alleging that Dr. Piscoya engaged in an inappropriate sexual relationship with her while she was a patient. Dr. Piscoya admitted to having a sexual relationship with the patient and an additional patient, as well as to sexually molesting a child several years prior to obtaining an Arizona license. Dr. Piscoya underwent a psychosexual evaluation where he was found not safe to practice after which Dr. Piscoya entered into an Interim Consent Agreement for Practice Restriction. Dr. Piscoya’s counsel requested that he be allowed to use a medical assistant as a chaperone rather than a licensed professional as generally required by the Board. Board staff requested that the chaperone be a licensed healthcare professional per the evaluators’ recommendation. Mr. Hunt explained that Dr. Piscoya serves an underprivileged area and that he has no Board history. Mr. Hunt further stated that Dr. Piscoya has been compliant and forthcoming regarding his treatment and the Board’s investigation. Mr. Hunt requested the physician be allowed to practice with a licensed professional chaperone when treating female and underage patients. Limiting his treatment for the first two years to adult males only would be detrimental to his ability to serve his community. During questioning, Dr. Piscoya explained that he will follow the Board’s decision and that requested his required chaperone be a medical assistant to alleviate the financial burden of hiring a licensed professional. Dr. Piscoya stated that he understands the seriousness of his actions and requests that the Board to allow him to continue to practice medicine. In closing, Mr. Hunt stated that ultimately Dr. Piscoya will follow the Board’s recommendations so that he may return to the practice of medicine. Dr. Krahn opined that the egregious nature of unprofessional conduct is concerning and that Dr. Piscoya has not demonstrated a clear understanding of what he has learned through this process. MOTION: Dr. Krahn moved for a finding of unprofessional conduct in violation of A.R.S. § 32-1401(27)(z). SECOND: Dr. Farmer. VOTE: 10-yay, 0-nay, 0-abstain, 0-recuse, 0-absent. MOTION PASSED. Dr. Farmer commented that there is a pattern of egregious behavior and the only reason for not pursuing revocation is the recommendations from the treating facilities. Dr. Farmer agreed with Dr. Krahn that under no circumstances should the physician treat minors. MOTION: Dr. Krahn moved for a draft Findings of Fact, Conclusions of Law and Order for a Decree of Censure and 20 Year Probation with Practice Restriction. Dr. Piscoya shall be prohibited from practicing until completing a Board approved neuropsychological evaluation and comply with any recommendations, subject to approval. If the physician is safe to practice, he shall be permitted to return to work with the following conditions: have a chaperone present when seeing all patients in all settings who is an Arizona licensed female healthcare provider, after two


years the licensee may petition the Board to request permission to see adult female patients, continue individual therapy with quarterly reports to the Board, and establish care with a primary provider. The physician shall be prohibited from treating pediatric patients for the duration of Probation. Upon return to work, the physician shall comply with return to work recommendations of his treatment providers and comply with ongoing therapy with his treatment providers. Pursuant to R4-16-103(B), the Board finds that rehearing or review of the Board's decision is impracticable; therefore, this is a final decision for purposes of administrative review. SECOND: Dr. Farmer. MOTION: Ms. Jones moved for the Board to enter into Executive Session pursuant to A.R.S. § 38-431.03(A)(3). SECOND: Ms. Bain. VOTE: 10-yay, 0-nay, 0-abstain, 0-recuse, 0-absent. MOTION PASSED. The Board entered into Executive Session at 2:32 p.m. The Board returned to Open Session at 2:39 p.m. No legal action was taken by the Board during Executive Session. Dr. Krahn expressed concern regarding the physician’s judgment and noted that the physician does not exhibit an understanding of how he used his position of power on subordinates. Dr. Connolly noted that the LPN can be utilized in the office as more than just a chaperone to alleviate the financial burden. ROLL CALL: Roll call vote was taken and the following Board members voted in favor of the motion: Dr. Gillard, Dr. Farmer, Dr. Bethancourt, Dr. Connolly, Dr. Krahn, Dr. Paul and Ms. Salter. The following Board member voted against the motion: Ms. Bain, Dr. Figge and Ms. Jones. VOTE: 7-yay, 3-nay, 0-abstain, 0-recuse, 0-absent. MOTION PASSED.

R. LICENSING INTERVIEWS 1. MD-17-0820A, RAUL J. R. SORA, M.D., LIC. # N/A

Dr. Sora was present with Counsel Cal Raup, Esq. Board staff summarized that the Board initiated the case after receiving Dr. Sora’s license application wherein he disclosed his adverse license history, pending Board investigations, and Pennsylvania Medical Board Order for Probation. On April 5, 2017 the Board allowed Dr. Sora to withdraw his application for relicensure in lieu of denial. He reapplied on August 2, 2017 and included new information related to his health issues. However, the issue before the Board is to determine whether Dr. Sora’s disclosure of his medical condition and past license history with the Board has been remediated to the degree that he should be licensed in Arizona. Dr. Sora explained his treatment history and requested that the Board grant him the ability to practice medicine in the State of Arizona and is willing to comply with the Board’s recommendations. During questioning, Dr. Sora commented that in regards to the two pending cases with the Board he is more than willing to complete additional CME for medical records and acknowledges that his medical records could have been better. Dr. Sora stated that it his intention to work with the Native Behavioral Health Services. Dr. Sora explained that he has passed the SPEX exam, plans to complete additional courses in opioid prescribing and a comprehensive review in psychiatry and agreed that a physician must learn and adapt with the changes that occur in the practice.


MOTION: Ms. Jones moved for the Board to enter into Executive Session pursuant to A.R.S. § 38-431.03(A)(3). SECOND: Ms. Bain. VOTE: 10-yay, 0-nay, 0-abstain, 0-recuse, 0-absent. MOTION PASSED. The Board entered into Executive Session at 3:45 p.m. The Board returned to Open Session at 4:00 p.m. No legal action was taken by the Board during Executive Session. MOTION: Dr. Figge moved to table the matter. SECOND: Dr. Farmer. VOTE: 9-yay, 0-nay, 0-abstain, 0-recuse, 1-absent. MOTION PASSED. AAG Smith informed the Board that a new Consent Agreement has been prepared which includes the findings of fact and conclusions of law that were in the previous agreement with two additional findings of fact for a Probationary license with a Letter of Reprimand, to include periodic chart reviews, and continued treatment by his psychiatrist. MOTION: Dr. Figge moved to accept the proposed Consent Agreement for a probationary license and Letter of Reprimand. For a period of one year, Dr. Sora shall be subject to periodic chart reviews, to be performed by a Board approved monitoring company at the physician's expense. Dr. Sora shall continue treatment with a Board approved psychiatrist for treatment at a duration and frequency recommended by the treating psychiatrist. After one year, Dr. Sora may petition the Board to terminate the Probation. The petition must be accompanied by a report supporting the termination of monitoring from Dr. Sora's treating psychiatrist. SECOND: Dr. Paul. ROLL CALL: Roll call vote was taken and the following Board members voted in favor of the motion: Dr. Gillard, Dr. Farmer, Ms. Bain, Dr. Bethancourt, Dr. Connolly, Dr. Figge, Ms. Jones, Dr. Krahn, Dr. Paul and Ms. Salter. VOTE: 10-yay, 0-nay, 0-abstain, 0-recuse, 0-absent. MOTION PASSED.

CONSENT AGENDA S. CASES RECOMMENDED FOR DISMISSAL

MOTION: Dr. Krahn moved to dismiss the pending investigation in item numbers 1 and 2. SECOND: Dr. Bethancourt. VOTE: 10-yay, 0-nay, 0-abstain, 0(1 recusal in item 2)-recuse, 0-absent. MOTION PASSED.

1. MD-16-0961A, ALEXANDRE M. BENJO, M.D., LIC. #50594 Dr. Gillard knows the physician but it would not affect his ability to adjudicate the case.

RESOLUTION: Dismissed.

2. MD-17-0041A, PHILLIP C. RICHEMONT, M.D., LIC. #18163 Dr. Paul was recused from this case.

RESOLUTION: Dismissed.

T. CASES RECOMMENDED FOR ADVISORY LETTERS MOTION: Ms. Jones moved to issue an Advisory Letter in item numbers 2- 4 and 7-10. SECOND: Dr. Krahn. VOTE: 10-yay, 0-nay, 0-abstain, 0-recuse, 0-absent. MOTION PASSED.


1. MD-17-0491A, DAVID N. FLIEGER, M.D., LIC. #7439 Ms. Jones noted that the MC found no deviation from the standard of care but opined that the medical records were poor. Ms. Jones opined that this case did not rise to the level of an advisory letter. MOTION: Ms. Jones moved to dismiss. SECOND: Dr. Farmer. VOTE: 10-yay, 0-nay, 0-abstain, 0-recuse, 0-absent. MOTION PASSED.

2. MD-17-0327A, GAGANDEEP S. MANGAT, M.D., LIC. #45437 RESOLUTION: Issue an Advisory Letter for failure to diagnose breast cancer on a screening mammography. There is insufficient evidence to support disciplinary action.

3. MD-17-0245A, JAMES J. GONZALES, M.D., LIC. #42124 RESOLUTION: Issue an Advisory Letter for failure to appropriately evaluate and treat an unstable patient prior to transfer to a different facility. There is insufficient evidence to support disciplinary action.

4. MD-16-1038A, JUNG T. DAO, M.D., LIC. #29246 RESOLUTION: Issue an Advisory Letter for inadequate medical records. There is insufficient evidence to support disciplinary action.

5. MD-17-0154A, OMAR ABDUL-HADI, M.D., LIC. #49298 Dr. Abdul-Hadi and Counsel Scott King, Esq. addressed the Board during the Public Statements portion of the meeting. Dr. Gillard commented that there is conflicting expert testimony regarding the care and treatment in this case and noted that there were no complaints of instability by the patient. MOTION: Dr. Figge moved to dismiss. SECOND: Dr. Gillard. VOTE: 10-yay, 0-nay, 0-abstain, 0-recuse, 0-absent. MOTION PASSED.

6. MD-16-1305A, JASON E. GRENNAN, M.D., LIC. #34355 Dr. Paul summarized that this case is regarding a radiologist who missed an emboli on a CT scan but was found on a follow up MRI. Dr. Paul noted that the initial film was also reviewed by anther radiologist who also missed the finding. MOTION: Dr. Paul moved to dismiss. SECOND: Dr. Connolly. VOTE: 10-yay, 0-nay, 0-abstain, 0-recuse, 0-absent. MOTION PASSED.

7. MD-17-0285A, WADE G. ALLEMAN, M.D., LIC. #42970 RESOLUTION: Issue an Advisory Letter for improper interpretation of a lower extremity MRI. While the licensee has demonstrated substantial compliance through remediation that has mitigated the need for disciplinary action, the Board believes that repetition of the activities that led to the investigation may result in further Board action against the licensee.

8. MD-17-0481A, LAILUN N. KAMAL, M.D., LIC. #44210


RESOLUTION: Issue an Advisory Letter for inadequate medical records. There is insufficient evidence to support disciplinary action.

9. MD-17-0214A, TAMERA B. JORDAN, M.D., LIC. #34494 RESOLUTION: Issue an Advisory Letter for improper repair of a laceration using skin adhesive. There is insufficient evidence to support disciplinary action.

10. MD-17-0240A, STEPHEN M. PANEBIANCO, M.D., LIC. #36149 RESOLUTION: Issue an Advisory Letter for failure to follow up on a radiologic study and for inadequate medical records. While the licensee has demonstrated substantial compliance through remediation that has mitigated the need for disciplinary action, the Board believes that repetition of the activities that led to the investigation may result in further Board action against the licensee.

11. MD-17-0401A, RALPH E. MORALES, M.D., LIC. #43975 Ms. Jones noted that the patient was a high risk patient with Type ll Diabetes and the physician missed a diagnosis of heart disease. Ms. Jones opined that additional education may be appropriate. MOTION: Ms. Jones moved to issue an Advisory Letter and Order for Non-Disciplinary CME for failure to pursue a cardiac evaluation in a patient with past coronary artery disease and atypical symptoms of active coronary artery disease. There is insufficient evidence to support discipline. Within six months, complete no less than 4 hours of Board staff pre-approved Category l CME in diagnosing acute coronary syndrome. The CME shall be in addition to the hours required for license renewal. SECOND: Dr. Bethancourt. VOTE: 10-yay, 0-nay, 0-abstain, 0-recuse, 0-absent. MOTION PASSED.

12. MD-17-0307A, PANKAJ M. JAIN, M.D., LIC. #32772 Ms. Jones noted that this physician was issued an Advisory Letter in 2016 for failure to document and there are concerns regarding documentation in this case. Ms. Jones opined that CME in medical recordkeeping may be appropriate. MOTION: Ms. Jones moved to issue an Advisory Letter and Order for Non-Disciplinary CME for failure to timely follow up with the patient and for inappropriate antibiotic selection for a procedure. There is insufficient evidence to support discipline. Within six months, complete no less than 10 hours of Board staff pre-approved Category l CME in an intensive, in-person course regarding medical recordkeeping. The CME shall be in addition to the hours required for license renewal. SECOND: Dr. Krahn. VOTE: 10-yay, 0-nay, 0-abstain, 0-recuse, 0-absent. MOTION PASSED.

U. CASES RECOMMENDED FOR NON-DISCIPLINARY CONTINUING MEDICAL EDUCATION ORDERS

1. MD-17-0340A, WILLIAM T. MESHIER, M.D., LIC. #15822 Dr. Gillard summarized that the MC opined the physician was not out of line but may benefit from CME to learn of current recommendations for treating chronic pain. MOTION: Ms. Jones moved to issue a Non-Disciplinary CME Order for imprecise management of opioid prescribing. Within six months, complete no less than 15 hours of Board staff pre-approved Category l CME in an intensive, in-person


course for prescribing controlled substances. Dr. Meshier shall be allowed to apply the additional CME to his next license renewal cycle. SECOND: Dr. Krahn. VOTE: 10-yay, 0-nay, 0-abstain, 0-recuse, 0-absent. MOTION PASSED.

V. CASES RECOMMENDED FOR ADVISORY LETTERS WITH NON-DISCIPLINARY CONTINUING MEDICAL EDUCATION ORDERS

1. MD-17-0389A, AJAY M. NARWANI, M.D., LIC. #35814 MOTION: Krahn moved Issue an Advisory Letter and Order for Non-Disciplinary CME for inadequate controlled substance management involving two patients and for inadequate medical recordkeeping. Within twelve months, complete no less than 15 hours of Board staff pre-approved Category l CME in an intensive, in-person course regarding medical recordkeeping; and, no less than 15 hours of Board staff pre-approved Category l CME in an intensive, in-person course for controlled substance prescribing. The CME hours shall be in addition to the hours required for license renewal. SECOND: Bethancourt VOTE: 10-yay, 0-nay, 0-abstain, 0-recuse, 0-absent. MOTION PASSED.

2. MD-17-0162A, DARREN P. HEE, M.D., LIC. #20800 Dr. Hee addressed the Board during the Public Statements portion of the meeting. Dr. Figge recused from this case. Dr. Farmer commented that given the physician’s attempt to do the right thing and correctly practiced as a primary care physician. MOTION: Dr. Farmer moved to dismiss. SECOND: Dr. Krahn. Dr. Krahn noted the physician’s attempts at alternative treatments before administering opioids. VOTE: 9-yay, 0-nay, 0-abstain, 1-recuse, 0-absent. MOTION PASSED.

3. MD-15-1234A, MUHAMMAD A. KHAN, M.D., LIC. #9994

Dr. Khan and Counsel Steve Myers, Esq. addressed the Board during the Public Statements portion of the meeting. Dr. Connolly noted the physician’s public statement where he stated he has already completed lengthy CME to address the Board’s concern. MOTION: Dr. Connolly moved to issue an Advisory Letter for delay of transfer of care in a patient with a bile leak. There is insufficient evidence to support disciplinary action. SECOND: Dr. Paul. VOTE: 7-yay, 2-nay, 0-abstain, 0-recuse, 1-absent. MOTION PASSED.

4. MD-17-0375A, CATHERINE M. WESTERBAND, M.D., LIC. #26791 Ms. Bain knows the physician but it would not affect her ability to adjudicate the case. Dr. Figge recused from this case. Ms. Salter expressed concern about the physician’s choice to restart the Pitocin when there was fetal distress. Ms. Salter also found it concerning the physician instructed the


staff to prep for a C-section but did not proceed with that route and executed four vacuum attempts. Ms. Salter noted concerns regarding the nursing staff. Board staff clarified that the patient was in labor and the fetus was in distress. There was a delay by the nursing staff in notifying the physician of the fetal distress and therefore the physician prepped for a cesarean section. Board staff was directed to refer the nurse in this case to the Nursing Board. MOTION: Ms. Salter moved to issue an Advisory Letter and Order for Non-Disciplinary CME for improper management of labor. There is insufficient evidence to support disciplinary action. Within six months, complete no less than 5 hours of Board staff pre-approved Category l CME in fetal monitoring and abnormal tracings. The CME hours shall be in addition to the hours required for license renewal. SECOND: Dr. Bethancourt. VOTE: 9-yay, 0-nay, 0-abstain, 1-recuse, 0-absent. MOTION PASSED.

W. REVIEW OF EXECUTIVE DIRECTOR DISMISSALS MOTION: Dr. Figge moved to uphold the dismissal in item numbers 1 and 2. SECOND: Dr. Paul. VOTE: 10-yay, 0-nay, 0-abstain, 0-recuse, 0-absent. MOTION PASSED.

1. MD-17-0316A, EDWIN D. STUMP, M.D., LIC. #33601 Dr. Gillard summarized that the complainant did not wait for discharge instructions, was rude to the staff however, was also treated appropriately. RESOLUTION: Dismissal upheld.

2. MD-16-1336A, THEODORE R. HOFSTEDT, M.D., LIC. #23010 Dr. Gillard summarized that there were known complications that occurred and the MC opined that the patient was treated appropriately. RESOLUTION: Dismissal upheld.

X. PROPOSED CONSENT AGREEMENTS (Disciplinary) 1. MD-17-0556A, PHILLIP L. SAUNDERS, M.D., LIC. #27714

Dr. Gillard summarized that there were issues regarding compliance with PHP with the Alabama Medical Board and a Consent Agreement for Surrender was signed by the physician. MOTION: Dr. Krahn moved to accept the proposed Consent Agreement for Surrender of License. SECOND: Ms. Jones. ROLL CALL: Roll call vote was taken and the following Board members voted in favor of the motion: Dr. Gillard, Dr. Farmer, Ms. Bain, Dr. Bethancourt, Dr. Connolly, Dr. Figge, Ms. Jones, Dr. Krahn, Dr. Paul and Ms. Salter. VOTE: 10-yay, 0-nay, 0-abstain, 0-recuse, 0-absent. MOTION PASSED.

2. MD-16-1568A, GREGORY L. ELLISON, M.D., LIC. #12426

Dr. Gillard summarized that the physician surrendered his DEA license; there were multiple concerns with prescribing of controlled substances, inappropriate relations with a patient and a drug abuse problem. The physician has signed a Consent Agreement for Surrender.


MOTION: Ms. Jones moved to accept the proposed Consent Agreement for Surrender of License. SECOND: Dr. Connolly. ROLL CALL: Roll call vote was taken and the following Board members voted in favor of the motion: Dr. Gillard, Dr. Farmer, Ms. Bain, Dr. Bethancourt, Dr. Connolly, Dr. Figge, Ms. Jones, Dr. Krahn, Dr. Paul and Ms. Salter. VOTE: 10-yay, 0-nay, 0-abstain, 0-recuse, 0-absent. MOTION PASSED.

Y. LICENSE APPLICATIONS i. APPROVE OR DENY LICENSE APPLICATION

MOTION: Dr. Krahn moved to grant the license in item numbers 1, 3, 4, 5 and 6. SECOND: Dr. Paul. VOTE: 10-yay, 0-nay, 0-abstain, 0-recuse, 0-absent. MOTION PASSED. 1. MD-17-0190A, ASHFAQUE SAYA, M.D., LIC. #N/A

RESOLUTION: Grant the license. 2. MD-17-0845A, JOHN A. KIM, M.D., LIC. #N/A

Ms. Jones noted that this physician is employed full time by a hospital in New Jersey providing ER services. Dr. Gillard noted that the physician currently holds ten licenses and was issued a warning letter from Hawaii since he was a physician attached to a group. Board staff confirmed he is Board Certified in emergency medicine and holds a full unrestricted license in Hawaii. MOTION: Ms. Jones moved to grant the license. SECOND: Dr. Krahn. VOTE: 10-yay, 0-nay, 0-abstain, 0-recuse, 0-absent. MOTION PASSED.

3. MD-17-0979A, STEVEN E. LONGACRE, M.D., LIC. #N/A RESOLUTION: Grant the license.

4. MD-17-1008A, KRISSEDA S. SOLOMON, M.D., LIC. #N/A RESOLUTION: Grant the license.

5. MD-17-1081A, GINO C. BOTTINO, M.D., LIC. #N/A RESOLUTION: Grant the license.

6. MD-17-1104A, MARTIN J. SMITH, M.D., LIC. #N/A RESOLUTION: Grant the license.

7. MD-17-0817A, SAMUEL M. ANDERSON, M.D., LIC. #N/A Board staff summarized that the Board initiated the case after receiving Dr. Anderson’s license application wherein he disclosed a health condition, state board and postgraduate training (“PGT”) action. During his PGT, Dr. Anderson was placed on administrative leave from September 2015 to February 2016 during the New Mexico Board’s investigation of allegations which resulted in an Advisory Letter. MOTION: Dr. Krahn moved to grant the license. SECOND: Dr. Paul. VOTE: 9-yay, 0-nay, 1-abstain, 0-recuse, 0-absent. MOTION PASSED.


8. MD-17-1113A, MICHAEL D. SORNSON, M.D., LIC. #N/A

Dr. Sornson addressed the Board during the Public Statements portion of the meeting. MOTION: Dr. Figge moved to grant the license. SECOND: Dr. Krahn. VOTE: 10-yay, 0-nay, 0-abstain, 0-recuse, 0-absent. MOTION PASSED.

ii. REVIEW, DISCUSSION AND POSSIBLE ACTION REGARDING RENEWAL APPLICATION MOTION: Dr. Figge moved to approve the license renewal application in item numbers 1-3. SECOND: Dr. Paul. VOTE: 10-yay, 0-nay, 0-abstain, 0-recuse, 0-absent. MOTION PASSED. 1. MD-17-0783A, LINCOLN C. BICKFORD, M.D., LIC. #48256

RESOLUTION: Grant the license renewal.

2. MD-17-0897A, TERESA L. F. STEFFY, M.D., LIC. #35295 RESOLUTION: Grant the license renewal.

3. MD-17-0848A, LARA E. YOBLONSKI, M.D., LIC. #25745 RESOLUTION: Grant the license renewal.

iii. REVIEW, DISCUSSION AND POSSIBLE ACTION REGARDING RENEWAL APPLICATION AND PROPOSED CONSENT AGREEMENT (Non-Disciplinary) 1. MD-17-0782A, ANN K. LARSEN, M.D., LIC. #22314

Dr. Figge stated he knows the physician but it would not affect his ability to adjudicate the case. Dr. Gillard summarized that the physician has signed a non-disciplinary Consent Agreement for Practice Limitation due to a health concern. MOTION: Dr. Paul moved to grant the license renewal and accept the proposed Consent Agreement for Practice Limitation. The physician’s practice is limited in that she shall not practice medicine in the State of Arizona and is prohibited from prescribing any form of treatment including prescription medications until the Physician applies to the Board and receives permission to do so. SECOND: Ms. Salter. VOTE: 10-yay, 0-nay, 0-abstain, 0-recuse, 0-absent. MOTION PASSED.

iv. APPROVE OR DENY LICENSE APPLICATION WITH

RECOMMENDATION FROM THE EXECUTIVE DIRECTOR 1. JOSEPH G. FRECHEN, M.D., LIC. #N/A

Dr. Frechen addressed the Board during the Public Statements portion of the meeting. Dr. Gillard summarized that the physician has licenses in four states with no disciplinary action. The recommendation is to grant the waiver and the license.


Board staff clarified that the physician has filed a suit against the closed clinic and is unable to obtain the required employment verification from the clinic. MOTION: Dr. Krahn moved to grant the waiver request and to grant the license. SECOND: Ms. Salter. VOTE: 10-yay, 0-nay, 0-abstain, 0-recuse, 0-absent. MOTION PASSED.

***END OF CONSENT AGENDA***

ACTION ON CASE(S)

Z. APPROVAL OF DRAFT FINDINGS OF FACT, CONCLUSIONS OF LAW AND ORDER

1. MD-16-0820A, GLENN G. ROBERTSON, M.D., LIC. #33045 Dr. Gillard stated that he knows the physician but it would not affect his ability to adjudicate the case. MOTION: Dr. Farmer moved to approve the draft Findings of Fact, Conclusions of Law and Order for Letter of Reprimand and Probation. SECOND: Ms. Bain. ROLL CALL: Roll call vote was taken and the following Board members voted in favor of the motion: Dr. Gillard, Dr. Farmer, Ms. Bain, Dr. Bethancourt, Dr. Connolly, Dr. Figge, Ms. Jones, Dr. Krahn, Dr. Paul and Ms. Salter. VOTE: 10-yay, 0-nay, 0-abstain, 0-recuse, 0-absent. MOTION PASSED.

2. MD-15-1106A, DANIEL M. LIEBERMAN, M.D., LIC. #28519 MOTION: Ms. Jones moved to approve the draft Findings of Fact, Conclusions of Law and Order for Letter of Reprimand. SECOND: Bethancourt. ROLL CALL: Roll call vote was taken and the following Board members voted in favor of the motion: Dr. Gillard, Dr. Farmer, Ms. Bain, Dr. Bethancourt, Dr. Connolly, Dr. Figge, Ms. Jones, Dr. Krahn, Dr. Paul and Ms. Salter. VOTE: 10-yay, 0-nay, 0-abstain, 0-recuse, 0-absent. MOTION PASSED.

3. MD-16-1514A, STEPHEN J. GRAHAM, M.D., LIC. #19987 Dr. Graham and L.B. addressed the Board during the Public Statements portion of the meeting. MOTION: Dr. Krahn moved to approve the draft Findings of Fact, Conclusions of Law and Order for Letter of Reprimand and Probation. SECOND: Dr. Farmer. ROLL CALL: Roll call vote was taken and the following Board members voted in favor of the motion: Dr. Gillard, Dr. Farmer, Ms. Bain, Dr. Bethancourt, Dr. Connolly, Dr. Figge, Ms. Jones, Dr. Krahn, Dr. Paul and Ms. Salter. VOTE: 10-yay, 0-nay, 0-abstain, 0-recuse, 0-absent. MOTION PASSED.

4. MD-17-0235A, DONOVAN J. ANDERSON, M.D., LIC. #13491 MOTION: Dr. Figge moved to approve the draft Findings of Fact, Conclusions of Law and Order for Decree of Censure, Practice Restriction and Probation. SECOND: Dr. Paul.


ROLL CALL: Roll call vote was taken and the following Board members voted in favor of the motion: Dr. Gillard, Dr. Farmer, Ms. Bain, Dr. Bethancourt, Dr. Connolly, Dr. Figge, Ms. Jones, Dr. Krahn, Dr. Paul and Ms. Salter. VOTE: 10-yay, 0-nay, 0-abstain, 0-recuse, 0-absent. MOTION PASSED.

OTHER BUSINESS

AA. CONSIDERATION OF DUAL JURISDICTION OF THE AMB AND THE ARIZONA HOMEOPATHIC BOARD

1. MD-17-0744A, DEAN R. SILVER, M.D, LIC. #38223 Counsel Stephen Myers, Esq. addressed the Board during the Public Statements portion of the meeting on behalf of the physician. Ms. Smith explained that the physician’s counsel has requested cancelation of the license however; Board statute prohibits a licensee from canceling their license when there is an open investigation. Ms. McSorley has received communication indicating that the Homeopathic Board will undertake the investigation and she requested that the Board vote to assert jurisdiction in the event that the Homeopathic Board declines to conduct the investigation at their January meeting. MOTION: Dr. Krahn moved that if jurisdiction is declined by the Homeopathic Board at its upcoming meeting in January of 2018, the AMB will assert jurisdiction and investigate the matter. SECOND: Ms. Salter. VOTE: 9-yay, 0-nay, 0-abstain, 0-recuse, 1-absent. MOTION PASSED.

BB. REQUEST FOR MODIFICATION OF BOARD ORDER 1. MD-16-0305A, DOMICIANO E. SANTOS, M.D., LIC. #10120

Counsel Leslie Sorensen, Esq. addressed the Board during the Public Statements portion of the meeting on behalf of the physician. Board staff noted the terms of the agreement that the physician agreed to when he signed the Consent Agreement and that the physician is requesting the surrender be reversed so that he may return to practice. Ms. Smith clarified that Board statute requires a physician to wait five years to reapply for licensure once he surrenders the license, and the consent agreement not appealable. MOTION: Dr. Figge moved to deny the physician’s request for modification of a Board Order. SECOND: Dr. Krahn. VOTE: 10-yay, 0-nay, 0-abstain, 0-recuse, 0-absent. MOTION PASSED.

CC. REQUEST FOR TERMINATION OF BOARD ORDER 1. MD-15-0376A, JULIE E. DIXON, M.D., LIC. #34663

Dr. Dixon addressed the Board during the Public Statements portion of the meeting. Dr. Krahn was recused from this case. Dr. Gillard summarized that the physician is requesting early termination of a Board Order where she has been fully compliant. Dr. Farmer noted that the PHP contractor opined it is too early to terminate the Order and stated that a second opinion by a mental health professional may be beneficial in this case.


MOTION: Dr. Farmer moved to return the case for further investigation to allow the licensee to undergo a second opinion evaluation by a Board approved provider, at her expense. SECOND: Dr. Figge. Dr. Figge commented that the physician presented a compelling medical explanation for the actions that resulted in the Board Order. Dr. Gillard noted there was no patient care concern in this case. VOTE: 9-yay, 0-nay, 0-abstain, 1-recuse, 0-absent. MOTION PASSED.

DD. GENERAL CALL TO THE PUBLIC

No individuals addressed the Board during the General Call to the Public. MOTION: Ms. Bain moved to adjourn the meeting. SECOND: Ms. Salter. VOTE: 10-yay, 0-nay, 0-abstain, 0-recuse, 0-absent. MOTION PASSED. The meeting adjourned at 5:03 p.m.

Patricia E. McSorley, Executive Director

Documents

Arizona Medical Board - azmd.gov€¦ · 2. MD-15-0217A, DALTON R. CARPENTER, M.D., LIC. #32356 Dr. Gillard summarized that Dr. Carpenter was invited for a Formal Interview in February