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1 NEVADA STATE BOARD OF MEDICAL EXAMINERS
BOARD MEETING
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10 TRANSCRIPT OF PROCEEDINGS
11 June 5th, 1999
12 Reno, Nevada
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22 REPORTED BY: STEPHANIE KOETTING, CCR #207,
RPR
Computer-Aided Transcription
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DISCOVERY REPORTING (775) 329-3500
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1 I N D E X
Page
2 AGENDA ITEM NUMBER 4:
Comments Re: The Adpotion, Amendment or Repeal
3 of Regulations Pertaining to Chapter 630 of
the
Nevada
Administrative Code 3
4
AGENDA
ITEM NUMBER 6:
5 Petition for Change of Licensure Status from
Active-
Restricted to Active, Attila Somoshegyi-Szokol, MD 5
6
AGENDA
ITEM NUMBER 12:
7 Consideration fo Acceptance of Applications
for
Licensure:
8 Amtul Ahmad, MD; Stephen Archer, MD; Timonty
Brown,
MD;
Daniel Fabito, MD; Edmund Faro, MD; Mary Haupt, MD;
9 Dilip Kar, MD 5
10 AGENDA ITEM NUMBER 13:
Consideration of Acceptance of Applications for 1999-
11 2001 Diennial Renewal of License:
George
Chung, MD; Adam Levy, MD
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AGENDA
ITEM NUMBER 17:
13 Consideration of Acceptance of Stipulation
for
Settlement in the Matter of Chad R. Niles, MD 107
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AGENDA
ITEM NUMBER 18:
15 Consideration fo Aceptance of Stipulation
for
Settlement in the Matter of Alban I. Miller, Jr., MD 120
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DISCOVERY REPORTING (775) 329-3500
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1 DATED: At Reno, Nevada, Saturday, June 5th,
1999, 9:00 a.m.
2 --oOo--
3
4 DR. ROSENCRANTZ: We'll call the meeting back to
5 order.
And now is the time for the public hearing to
6 receive comments from all interested persons
regarding the
7 adoption amendment or repeal regarding
Chapter 630 of the
8 Nevada Administrate Code.
9 MR. LEGARZA: For your information and for
10 purposes of the record, notices of workshops
were posted
11 throughout the state in every county library
in the State
12 of Nevada and the other places that we
normally post things
13 on behalf of the Board. And a workshop was conducted in
14 Las Vegas, Nevada and a workshop was
conducted in Reno,
15 Nevada for these proposed changes in the
regulations.
16 No one appeared to testify or make
any
17 presentation at the workshop in Las
Vegas. No one appeared
18 to make a presentation or to testify or to
be considered
19 having the input with respect to the
proposed changes in
20 the regulations in Reno.
21 As you recall, you approved at a
meeting some
22
months ago for us to go ahead with these proposed changes
23 to the regulation. And the change is a very, very simple
24 change, a very, very minimal change. Where the only change
25 is with respect to the examinations a person
has to take
DISCOVERY REPORTING (775) 329-3500
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1 for licensure and what they must pass for
licensure
2 changing from subspecialties and all that
kind of stuff
3 to -- they have to have specs, part three of
the National
4 Board of Medical Examiners, component two,
federation or
5 step three, a USMLE, Canadian examination or
examination
6 for primary certification by a specialty
Board of the
7 American Board of Medical Specialties and
receive primary
8 certification from that Board taking out
examination for
9 certification by subspecialty or
subspecialty Board. So
10 that's where -- or spec. So that's where we are. It's
11 changing it now to primary certification and
receiving
12 primary certification from that Board as one
of the exams.
13 And we had no input.
14 We need some discussion or a
motion to approve
15 the adoption of the proposed regulations or
not adopt them.
16 DR. STEWART: I move that we approve the addition
17 of this section six to our rules and
regulations.
18 DR. BUCHWALD: Second.
19 DR. ROSENCRANTZ: We have a motion and a second.
20 Any discussion? Not hearing any discussion, offer the
21 question.
All those in favor?
22 All those opposed?
23 Chair votes in favor of the
motion. Motion
24 carries.
25 --oOo--
DISCOVERY REPORTING (775)
329-3500
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1 DR. ROSENCRANTZ: Item number six.
2 MR. LEGARZA: Item number six, this was an
3 application by Dr. Szokol to remove the
restrictions on his
4 license.
I have been advised by both Dr. Rueckl and Dr.
5 Tracy that Dr. Szokol was here, Dr. Szokol
advised them
6 that he was withdrawing his application and
I would like
7 the record to reflect is that correct,
Doctor?
8 DR. TRACY: That's absolutely correct.
9 MR. LEGARZA: Thank you, sir.
10 --oOo--
11 MS. GAUL-RICHARD: Dr. Ahmad has provided copies
12 of letters of recommendation and copy of a
release that she
13 would not sign from Mercy Medical Center.
14 DR. BUCHWALD: Are these letters in addition to
15 the letters?
16 MS. GAUL-RICHARD: She faxed them here this
17 morning.
18 DR. AHMAD: Good morning.
19 DR. ROSENCRANTZ: Good morning, Dr. Ahmad. I'm
20
Arne Rosencrantz, President of the Board. These are other
21 Board members, staff and legal counsel. We're here to
22 consider your application for the
licensure. Dr. Buchwald?
23 DR. BUCHWALD: Dr. Ahmad, your application
24 obviously kicked out because of the summary
suspension that
25 occurred from Mercy Medical Center.
DISCOVERY REPORTING (775) 329-3500
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1 THE WITNESS: Right.
2 DR. BUCHWALD: My initial impression is that the
3 summary suspension followed the death of two
neonates in
4 the same weekend.
5 THE WITNESS: Right.
6 DR. BUCHWALD: This is a two-week suspension that
7 even you agreed was an appropriate thing
given the
8 circumstances that led up to that.
9 DR. AHMAD:
Right.
10 DR. BUCHWALD: Is that same summary suspension
11 one that still exists or is in force at this
time?
12 DR. AHMAD: Right.
13 DR. BUCHWALD: Can you tell me after that
14 two-week summary suspension, which you
agreed to or agreed
15 the necessity to, what has lead to the
perpetuation of that
16 suspension?
17 DR. AHMAD: They promised me that they will
18 investigate and there will be a hearing and
there will be a
19 panel who will be asking for
explanation. And they did
20 formally, but nobody listened to me and
nobody gave what I
21 said, because to begin with, it wasn't due
to deaths.
22 Those deaths were due to because of SIDS and
there was
23 nothing I did not do or there was nothing I
did do other
24 than the standard care.
25 But at that time, when they did
the summary
DISCOVERY REPORTING (775) 329-3500
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1 suspension, I did not know that they are
questioning
2 another baby who came before those two
babies and I
3 transported that baby as a suspected sepsis
from my office
4 to the hospital in a private automobile and
it was
5 uneventful.
6 After that, the baby survived just
because I
7 acted so fast. I think I just copied a letter of mother,
8 today's copies, who commended me on that,
the Colombia
9 Children's Hospital included. Turned out to be cranial
10 hemorrhage which was there no sign or
symptom for a
11 hemorrhage at that time. When I saw the person, the
12 fontanel was flat and a little bit sunken
and the baby was
13 one week.
14 And the post diagnosis was sepsis
and did the
15 sepsis workup and sent the baby for
antibiotics. That baby
16 when reached hospital was to be transferred
from Columbus
17 Hospital from Mercy Hospital where my office
was 25 minutes
18 away.
That baby arrested just before the transport and
19 they had to intubate to take to Columbus
Children and they
20 said that my private and my transport
through automobile
21 was wrong.
22 And my explanation that I always,
most of the
23 pediatricians do transfer babies through
private
24 automobiles through suspected sepsis. We don't call
25 ambulance for that diagnosis when the baby
is especially
DISCOVERY REPORTING (775) 329-3500
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1 stable.
In spite of my saying baby was stable, everyone
2 was say baby was not stable. How do you know? I'm saying
3 I saw this baby. My documentation is very good. I'm
4 always 91, 92 percent on the insurances as
far as my
5 documentation is and those two other babies
turn out to be
6 death due to SIDS.
7 One was asphyxiated at night due
to some reason,
8 nobody knows. There was no sign of any sepsis, which I
9 missed and just because I act a more careful
doctor, so I
10 thought this baby was initially little bit
premature,
11 35-weeker, let me go beyond one step and
give a blood
12 culture.
It's a weekend and I don't want the mother to
13 just not do anything because she refuses to
go to Dayton.
14 She refuses to go to Mercy. They treat her saying Dr.
15 Ahmad patient why did you go to Ahmad.
16 The peers were started all this,
were very
17 jealous.
I was the only female pediatrician.
People
18 started running. I had good bedside manners and my
19 insurance reputation was very good. And this colleague of
20 mine who was from Indiana and I was director
of Well Child
21 Services from me everything was taken from
me. He's the
22 director there and I'm out.
23 DR. BUCHWALD: Can you explain to me if -- where
24 the communication breakdown exists, if you
have a
25 one-weeker that's a premie, although minimal
and you
DISCOVERY REPORTING (775) 329-3500
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1 admitted as a septic workup?
2 DR. AHMAD: That was not premie. The cases was
3 transport.
That was the third case. If you
see the
4 hearing panel to Board in my papers they
clear me from
5 first two cases saying one of them was
unfortunate case,
6 second one there was no deviation from
standard of care.
7 DR. BUCHWALD: Let me rephrase this. If you
8 admit a baby who is still a neonate that
you're concerned
9 about a septic workup and this baby is unstable,
say that,
10 I'm not questioning what you said, I'm just
giving you a
11 scenario.
12 DR. AHMAD: Right.
13 DR. BUCHWALD: How would it have changed your
14 behavior?
15 DR. AHMAD: I would transport that baby to the
16 ambulance through the emergency ER ambulance
or call the
17 hospital.
18 DR. BUCHWALD: To the baby that was in your
19 office?
20 DR. AHMAD: Right.
21 DR. BUCHWALD: If this baby is already in the
22 hospital and you're informed that that baby
is unstable and
23 your office is 25 minutes from that
hospital.
24 DR. AHMAD: Right.
And the Dean from Columbus is
25 already on the way to pick that baby to take
to Columbus
DISCOVERY REPORTING (775) 329-3500
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1 Children's Hospital.
2 DR. BUCHWALD: I guess if you admit a sick child
3 that has potential for instability and your
office is 25
4 minutes from that hospital, who covers that
sick child for
5 you?
6 DR. AHMAD: I was given two hospitals, one
7 hospital had my office in it and they don't
admit the
8 pediatrics.
They say my nurses are not comfortable.
9 They're not going to admit any babies. I had no choice but
10 to admit this was not my practice. I was employed by the
11 hospital, whatever office did provide me,
whatever time
12 they did provide me I have to do it. It wasn't my choice
13 that I was 25 minutes away. I hated that because in that
14 case, you have to go 25 minutes driving in
traffic and then
15 you don't know because there's nobody
actually in that
16 hospital at the hospital who is covering me.
17 DR. BUCHWALD: There is no pediatrician, there is
18 no intensivist at this hospital that sent
this child?
19 DR. AHMAD: There was an anesthesiologist to
20 intubate the baby if needed or the baby
would be sent to
21 the emergency room. Those were the two choices if I am not
22 there in time like I am on my way. Those are the two
23 choices.
24 DR. BUCHWALD: I guess what concerns me that you
25 didn't go to the hospital with this neonate
that you were
DISCOVERY REPORTING (775) 329-3500
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1 concerned about sepsis. I would think that would
2 potentially be a very unstable situation and
you sent them
3 to a hospital that didn't have facilities to
treat that
4 child.
5 DR. AHMAD: I didn't understand what you're
6 saying because it was a rural area where I
was practicing.
7 The judgment had to be done by me, myself
and the only
8 support from hospital was that you can admit
to this
9 hospital, you cannot admit to this one.
10 And when the baby left my office,
was crying
11 aggressively, hemodynamically stable and we
have always,
12 always transported baby. I am trained from Colombia New
13 York, Harlem Hospital and New York Medical
Center, real
14 aggressive places. They're centered. They beat you up to
15 train you.
There was nothing wrong in me deciding that
16 this baby is perfectly stable and can go
with the mother in
17 the automobile when mother's sister was
driving the car.
18 DR. BUCHWALD: And you are still employed by this
19 same Mercy system?
20 DR. AHMAD: I was employed by them. I'm not
21 employed now, because they terminated my
contract because
22 of the summary suspension. So I lost everything there.
23 DR. BUCHWALD: You're still working for a Mercy
24 Hospital?
25 DR. AHMAD: No. I
am in Wisconsin now. I am
DISCOVERY REPORTING (775) 329-3500
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1
well stable there, because at that time I applied for
2 Nevada license and I was told that if I
withdraw my
3 application that's not a good record and
also because I got
4 a Wisconsin license right away, they interviewed
me just
5 like this, also just to make sure.
6 MR. LESSLY: Did you give Wisconsin the
7 information about the hospital?
8 DR. AHMAD: Everything.
9 MR. LESSLY: Why wouldn't you give it to us?
10 DR. AHMAD: Which information?
11 MR. LESSLY: I understand that you refused to
12 sign the release so our staff could get the
summary
13 suspension.
14 DR. AHMAD: I did not give -- Mercy Hospital does
15 not want to give any information. I sign a release.
16 MR. LESSLY: You won't sign a release to get that
17 information.
18 DR. AHMAD: I did.
19 MR. LESSLY: You didn't.
20 DR. AHMAD: On Wisconsin license application had
21 a release form themself and their attorney
said this
22 release is good but they didn't -- still
they didn't send
23 any information. But one of my Mercy primary care
24 president, she sent information to them
privately. That's
25 how they gave me license and they
interviewed me and they
DISCOVERY REPORTING (775) 329-3500
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1 listened to me, but because I have a lawsuit
against them
2 they said they don't want to release any
information.
3 MR. LESSLY: They're willing to release it to us
4 if you'll sign the release to give it to us
so we can
5 complete the background information.
6 DR. AHMAD: This they said I have to release
7 saying you will not sue us, and I have
already filed a
8 suit.
I don't know how I can do that.
I'm only fighting
9 them to clear my name from data bank.
10 MR. LESSLY: The point is we can't confirm all
11 the information you were telling us from the
hospital and
12 that's one of the reasons you're appearing
here today is
13 we're unable to complete the investigation
on your
14 background for licensure because we can't
get that
15 information from the hospital unless you
have them give it
16 to us.
So we can't confirm all that you're telling us here
17 this morning.
18 DR. AHMAD: I can still sign the release. There
19 is nothing wrong with that and I asked my
attorney, he said
20 it's not standing in the court because
nobody can ask you
21 to sign those types of things that you will
never sue.
22 MR. LESSLY: Because we've never licensed anyone
23 who has not given us the information for a
complete
24 background check. I would suggest that we have her execute
25 that release and we table this matter until
the August
DISCOVERY REPORTING (775) 329-3500
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1 meeting and at such time the staff can
provide that
2 information to the Board.
3 DR. JONES: Does she have the release, this
4 release refers to the suit.
5 MR. LESSLY: It's her problem to get the
6 information.
It's not our problem about what kind of
7 release she has to sign or what she has to
do. It's her
8 problem to get the information to us. That is between her
9 and her lawyer and the hospital.
10 DR. AHMAD: There was a release, which my lawyer
11 sent out, and I signed that release and send
it to them.
12 They just don't accept it. They said you have to sign the
13 release we have prepared.
14 MR. LESSLY: And I appreciate your problem, but
15 that's not our problem.
16 DR. AHMAD: I understand.
And also I have all
17 the reporting, minute reporting from the
hearing,
18 everything, all the depositions and I have
this whole stack
19 here.
Anybody wants to read them and see how superficial
20 their testimony was.
21 DR. ROSENCRANTZ: I believe it's sort of the
22 feeling --
23
DR. BAGGETT: I guess I don't
understand. It
24 seems like we do have documentation that was
sent to Dr.
25 Ahmad about the report of the review
committee, et cetera.
DISCOVERY REPORTING (775) 329-3500
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1 Where else could we get that?
2 MR. LESSLY: We want the information from the
3 hospital so that the hospital will confirm
exactly what
4 happened.
5 DR. BAGGETT: You don't believe that this
6 document is from the hospital.
7 DR. AHMAD: Excuse me.
There is a report from
8 Dr. Beliah, the president of Mercy Primary
Care. He was
9 our president from where I was working and
there was a
10 report, I said, I called him, I said you
need a letter from
11 the hospital saying all what happened there
and I think
12 that report is with you.
13 DR. ROSENCRANTZ: Let me ask you a question,
14 Doctor.
I'm kind of unclear, because Mr. Legarza and I
15 were talking. Did you say you'd like to withdraw your
16
application from the State of Nevada, but you've been
17 advised that it's not a good thing to do for
your record?
18 That you are established in Wisconsin and
you don't have
19 any intention of coming to Nevada.
20 DR. AHMAD: Right.
At one point I thought about
21 it and I was told that if I withdraw it's
not good and the
22 other side you can deny my application that
can also go to
23 data bank so I was in between. I'm not sure.
24 MR. LEGARZA: Who told you it's not a good idea
25 to withdraw that? Did you get legal advice?
DISCOVERY REPORTING (775) 329-3500
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1 DR. AHMAD: No. It
was colleagues, other
2 doctors.
3 MR. LEGARZA: You understand that if the Nevada
4 State Board of Medical Examiners denied it,
it would be
5 reportable.
6 DR. AHMAD: That's more scary to me.
7 MR. LEGARZA: If you're not interested in coming
8 to Nevada or proceeding with this matter at
a later time I
9 think it's incumbent upon me as the lawyer
for the Board to
10 indicate to you that if you tell us you want
to withdraw
11 your application here, we don't report that
to anyone.
12 There's no black mark on your record.
13 DR. AHMAD: Okay.
14 MR. LEGARZA: You've flown here from somewhere.
15 DR. AHMAD: Wisconsin.
16 MR. LEGARZA: Correct me if I'm wrong, if this
17
lady wants to withdraw his application, which is
18 something --
19 MR. LESSLY: Now would be the time.
20 MR. LEGARZA: We won't report it to Wisconsin or
21 Ohio or the National Practitioners Data
Bank.
22 MS. LYONS: I do the reporting for the Board and
23 this is not a reportable action. Not at all.
24 DR. AHMAD: Thank you for helping me because I
25 don't know about that.
DISCOVERY REPORTING (775) 329-3500
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1 MR. LEGARZA: I understand.
2 DR. ROSENCRANTZ: If you would like to withdraw?
3 DR. AHMAD: They love me.
I did not tell them
4 I'm coming here. They would be freaked out because I have
5 three colleagues working with me, they're
very senior
6 15-year, 30-year practice and they love me.
7 DR. LUBRITZ: Is it your statement doctor that if
8 we tell you as a board that this is not a
reportable item
9 that it would not go anywhere that you would
withdraw at
10 this moment?
11 DR. AHMAD: Yes.
12 DR. ROSENCRANTZ: We'll take it as a withdrawal.
13 It will not be reportable.
14 DR. AHMAD: Make it easy for me. Thank you.
15 --oOo--
16 MS. GAUL-RICHARD: Dr. Archer has withdrawn his
17 application.
Since he appeared before the Board in
18 December, he joined the Navy as a flight
surgeon. He does
19 not anticipate coming to Nevada,
specifically Fallon, for
20 another three years, so he wants to get
three good years on
21 his bill before he applies for license.
22 --oOo--
23 DR. ROSENCRANTZ: Dr. Brown is next, and that is
24 Paul Stewart.
25 Dr. Brown, I'm Arne Rosencrantz,
President of the
DISCOVERY REPORTING (775) 329-3500
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1 Board.
These are other members of the Board, staff and
2 legal counsel. You're here to discuss your application for
3 licensure.
And Dr. Stewart?
4
DR. STEWART: Hello, sir. Can you tell me about
5 your preceptorship after the people at
Nellis reduced your
6 surgical privileges?
7 DR. BROWN: Yes, sir.
Basically the Surgeon
8 General of the Air Force made the statement
that an
9 unbiased evaluation of my clinical
competency be performed.
10 So for that, I went to David Grant Medical
Center in
11 California for three months. David Grant Medical Center is
12 an Air Force teaching hospital with a
general surgery
13 residency.
While I was at David Grant, I was expected to
14 function as a staff surgeon and actually
train residents.
15 I did 70 broad-spectrum surgical procedures
and
16 was evaluated by Dr. Wiederman, who is the
chairman of the
17 general surgery residency. He submitted a full report,
18 which I can summarize for you.
19 My technical skills were intact, my
complication
20 rate was low at 1.4 percent with all
complications managed
21 appropriately.
22 My medical documentation was
complete and my
23 reliability for patient care
consistent. It was after that
24 evaluation that I returned back to Nellis
and actually
25 asked for his credentials recommendations
for our
DISCOVERY REPORTING (775) 329-3500
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1 commanders to act on and basically he
recommended
2 independent surgical privileges in all areas
that he
3 evaluated.
That was the majority of cases a general
4 surgeon would be expected to face. So with those
5 recommendations, our hospital credentials
function acted on
6 those and I'm back practicing now with
independent
7 privileges.
8 DR. STEWART: When did that credentials committee
9 meet?
10 DR. BROWN: The credentials function, originally
11 when I got back there in February and the
credentials
12 function met in, I believe it was March, and
made their
13 original decisions about some privileges
that they would
14 restore.
They have since remet again, just a couple of
15 days ago, and the decision was made at that
time to restore
16 more surgical privileges. So this is kind of have been an
17 incremental thing for the hospital.
18 DR. STEWART: So our information as of April 8th
19 that you still have limited surgical privileges
would then
20 be correct?
21 DR. BROWN: That is correct, sir, incrementally
22 right now -- no, there are certain surgical
privileges that
23 are independent right now. There are other privileges,
24 because it's a long list that they haven't
restored
25 because -- basically because of the acuity
of the cases and
DISCOVERY REPORTING (775) 329-3500
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1 they're sort of in the process of evaluating
me and making
2 sure that I'm ready to accept some more
responsibility.
3 DR. STEWART: Joel?
4 DR. LUBRITZ: I'd like to know several things.
5 DR. BROWN: Yes, sir.
6 DR. LUBRITZ: What are those things specifically
7 that you are allowed not to do, but perhaps
more
8 importantly, what was the original reason
that they had you
9 go take some training slash evaluation? So what prompted
10 you to lose your privileges or have them
diminished?
11 DR. BROWN: When I first got to Nellis, it was in
12
1996. During '96 and '97, I
worked for the chief of the
13 medical staff that had recruited me to the
hospital. The
14 hospital was expanding its capabilities at
the time and it
15 was my job, really, to upgrade the surgery
department.
16 That was what was expected of me.
17 DR. LUBRITZ: When you say "upgrade," tell me
18 what you mean.
19 DR. BROWN: At the time, the hospital was new,
20
the surgeons that were working there were not doing any
21 advanced laparoscopy. A lot of the more complex cases, the
22 emergency cases were being sent
downtown. So it was my
23 responsibility to take on those cases and
treat basically
24 sick patients.
25 There were some challenges because
we had a new
DISCOVERY REPORTING (775) 329-3500
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1 hospital.
My support staff of technicians and nurses, I
2 guess, like most Air Force hospitals, they
were young,
3 inexperienced and they turned over
rapidly. So it was
4 difficult for me to maintain some
experienced support.
5 DR. LUBRITZ: I was going to ask you
6 specifically, in the OR, in the recovery
room, on the
7 floor; in other words, what -- it's nice to
speak
8 generalities. But specifically what technical support did
9 you lack?
10 DR. BROWN: Specifically, we lacked very -- we
11 only had high school graduates, if you will,
in the
12 operating room. We had nurses and technicians just out of
13 technical school and training in the ICU and
we were
14 constantly and actually still have the
problem today
15 training the nurses on the ward. It was a complete, total
16 spectrum and it's just one of the challenges
in our
17 hospital that we seem to face every day.
18 Be that as it may, I continued on
with my busy
19 practice until the beginning of 1998 by
which time we had a
20 new chief of the medical staff, who I
believe had a
21 completely different philosophy.
22 DR. LUBRITZ: Who is that?
23 DR. BROWN: The new is a Colonel Barno. She was
24 the new chief at the time.
25 Up to that point, I had received a
lot of
DISCOVERY REPORTING (775) 329-3500
22
1 positive feedback in my practice and I was
very gratified
2 with it.
There were patient letters of appreciation that
3 came across my desk on a regular basis and
the command
4 staff had actually promoted me for my
efforts.
5 DR. LUBRITZ: Tell us what trouble you got into.
6 DR. BROWN: That's what I'm getting to. I'm
7 sorry, sir, if I'm taking your time. I had reported my
8 complications, my surgical complications,
again, keeping in
9 mind that I had taken on the more complex
cases, because
10 that's what I was directed and recruited to
do. And I had
11 reported my complications to peer review and
without
12 exception standard of care was met. The new chief of the
13 medical staff rereviewed those cases and
proposed the
14 restriction on my practice based upon the
cases that I
15 previously reported to peer review. So I was surprised.
16 DR. LUBRITZ: I'm trying to ask you, I know
17 you're trying condense it for me,
specifically what
18 complications did you have that prompted
this?
19 DR. BROWN: There were, I mean, the usual types
20 of -- I guess the two biggest complications
that the
21 hospital were concerned about were vascular
complications
22 on vascular patients.
23 DR. LUBRITZ: Which were?
24 DR. BROWN: There was a gentleman, who had
25 bilateral carotid disease. I planned to stage his
DISCOVERY REPORTING (775) 329-3500
23
1 operations, do the worst side first and the
other side a
2 week later.
He had a stroke, a week not related to what I
3 had done, but to the other side. The hospital's position,
4 we talked to the family, the neurologist, we
decided
5 because of the stroke let the patient
recover, not operate
6 on the other side. The hospital's position was if I had
7 operated on the other side, I would not have
met standard
8 of care.
That didn't make any sense, because I had not
9 operated on there.
10 DR. LUBRITZ: How much previous training on
11 carotid enterectomy, if that's what it was,
had you had?
12
DR. BROWN: I did a general
surgery residency and
13 we did a fair number of carotid.
14 DR. LUBRITZ: You did specifically?
15 DR. BROWN: I did, yes, sir.
16 DR. LUBRITZ: What was your result?
17 DR. BROWN: And I had done some carotid
18 enterectomy before that, but my complication
was between
19 the two to four percent stroke rate.
20 DR. LUBRITZ: What was the next case?
21 DR. BROWN: The next one was a vascular
22 operation, again, that I did on a gentleman
who had a large
23 aneurysm in his abdomen, which I
repaired. He had a
24 serious complication within 12 hours of
surgery, which I
25 recognized and I took him back to the
operating.
DISCOVERY REPORTING (775) 329-3500
24
1
DR. BUCHWALD: What was the
complication?
2 DR. LUBRITZ: What was the complication?
3 DR. BROWN: He had an ischemic sigmoid colon
4 after that operation. The IMA was -- couldn't be salvaged
5 at the first operation and it was really
occluded so I did
6 not replant it. He had an ischemic colon after the first
7 operation, which manifested with bleeding
through the
8 rectum.
9 I recognized this at 3:00 o'clock,
I write notes.
10 At 6:00 o'clock in the morning, I write
notes. I took him
11 back, did a flex sig. He had black mucosus. I opened him
12 up very carefully, resected. There was no transmural
13 involvement at that time.
14 Interestingly enough, the
hospital's position was
15 another physician had actually recognized
this complication
16 and told me about it. So I said, well, that's an
17 interesting position. So we put the physician under oath
18 at the hearing and asked him that question
and he refused
19 to verify the hospital's position on
that. We went back
20
and looked at my notes.
21 DR. LUBRITZ: One more question, two parts. What
22 are you allowed to do now and what are you
not allowed to
23 do at this point?
24 DR. BROWN: At this point, I am, the hospital has
25 allowed me to perform endoscopies, minor
procedures,
DISCOVERY REPORTING (775) 329-3500
25
1 anal/rectal procedures. And as of just a day ago, they
2 upgraded my privileges in hernia repair,
breast and
3 gallbladder.
Basically, bread and butter.
4 DR. LUBRITZ: You can do entero-abdominal surgery
5
now?
6 DR. BROWN: That's correct.
7 DR. BAGGETT: What was the second part? What are
8 you not allowed to do now?
9 DR. BROWN: The hospital is again being very
10
careful and what they don't want me to do at this point are
11 high acuity cases that put patients in the
ICU. I fully
12 expect that will change in the upcoming
months or so.
13 DR. LUBRITZ: What high acuity?
14 THE WITNESS: Adrenalectomy, they said no, no;
15 total gastrectomy, they said no, no;
vascular procedures, I
16 don't want to tackle those in my
hospital. I don't believe
17 we can support it. I believe there's too many other
18 problems.
So those are the two.
19 DR. LUBRITZ: Thank you.
20 DR. DESAI: If you apply for privileges in any
21 other hospital or community anywhere you go,
they always
22 know about this history.
23 DR. BROWN: Yes, sir.
24 DR. DESAI: And the credentialing department of
25 the hospital would decide what privileges to
give you.
DISCOVERY REPORTING (775) 329-3500
26
1 DR. BROWN: Yes, sir.
As a matter of fact, I'm
2 in the process of getting out of the Air
Force and I've
3 applied for credentials with a locum tenens
company at this
4 point, and the credentials I applied for,
they granted.
5 DR. BUCHWALD: So at this point in time, however,
6 if you do an entero-abdominal procedure, who
has to help
7 you?
8 DR. BROWN: It depends on the type of procedure.
9 If it is one that I do not have a one on, a
code one on, I
10 have to get a general surgeon to help me.
11 Now, those procedures at this
point in time are
12 not the usual bread and butter operations
and this is just
13 at the Michael Callahan Federal Hospital
within the Air
14
Force. Another general surgeon
would help me if it falls
15 within an entero-abdominal operation that I
don't have
16 credentials for, another general surgeon.
17 DR. DESAI: They are watching you very closely.
18 DR. BROWN: Yes, sir, they are. They're watching
19 me very closely. I'm just back from Travis. This was a
20 bone that they have to swallow, but they're
going to be
21 very, very cautious.
22 DR. BUCHWALD: When you went to Travis to begin
23 with, were you straight out of training?
24 DR. BROWN: No, ma'am.
I had actually -- this
25 was the reason why they recruited me, I did
four years of
DISCOVERY REPORTING (775) 329-3500
27
1 intensive trauma at Woverhall Medical
Center, which is the
2 Air Force -- another Air Force medical
center. I had done
3 trauma there, advanced laparoscopy and
basically other
4 bread and butter type of procedures.
5 DR. LUBRITZ: No problems there?
6 DR. BROWN: No, sir.
No, sir. I had some
7 complications. Again, a lot of these patients were run
8 over by trucks and trains.
9 DR. LUBRITZ: Right.
Okay.
10 DR. STEWART: You did no vascular procedures at
11 Travis?
12 DR. BROWN: At Travis, I did one. It was just to
13 help out the vascular surgeon. It was just a minor shunt
14 in the forearm and it was just to help him
out. The case
15 went well.
But I did no high acuity vascular surgery. I'm
16 not interested in that anymore.
17 DR. DESAI: When you heard of privileges at
18 Michael Callahan Hospital, did they grant to
you vascular
19 privileges when you were -- or you did not
have vascular
20 privileges and you were just doing it?
21 DR. BROWN: No, sir.
This was part of the
22 upgrading process. When I got there, the commanders were
23 very interested in upgrading and doing more
extensive type
24 of procedures.
25 I asked for a vascular consultant
to come from
DISCOVERY REPORTING (775) 329-3500
28
1 Wolverhall to say, yes, no. I shared with him my
2 experiences, what I had done in the
past. I had done some
3 at Wolverhall and quite a bit in residency
and we had a
4 meeting and this was also passed through our
credentials
5 function on just a limited number of general
vascular cases
6 that could be done there. There was just no tolerance for
7 complications and that's why I'm not going
to be doing any
8 more vascular procedures.
9 DR. BUCHWALD: I find it inconsistent and maybe
10 you can explain it to me that you would come
under this
11 intense review and have some limited
practice for --
12 following what you describe as a rereview of
old news, so
13 to speak.
The two do not go together.
14 DR. BROWN: I think that's a very good question,
15 ma'am.
And I've pondered that. The
commander who
16 originally hired me was a fellow who
said: Let's do the
17 bigger cases and the bigger operations. And I did that,
18 and I did it to the best of my ability. And I honestly
19 reported my complications to peer
review. It was when we
20 switched commanders that things
changed. There really was
21 a change in hospital philosophy. The new commander had
22 come from a history, if you will, of small
Air Force
23 hospitals where these kinds of operations
just weren't done
24 because of facility limitations.
25 DR. BUCHWALD: What's wrong with them just
DISCOVERY REPORTING (775) 329-3500
29
1 telling you not to do those? Why did you come under
2 review, if they're saying that the hospital
is not capable
3 of supporting or handling these kinds of
cases?
4 DR. BROWN: No, those were the small Air Force
5 hospitals.
This hospital that I was in, the Michael
6 Callahan, again, we asked the vascular
consultant to come
7 in.
We had reviewed my experience, we run this through the
8 credentials function, we looked at what the
American
9 College of Surgeons would allow me to do and
we did a very
10 limited amount of vascular surgery
there. Actually, that
11 was encouraged. The first patient that I did there, the
12 first vascular case I did there, was a
direct referral from
13 my commander.
14 DR. STEWART: I have no more questions.
15 DR. ROSENCRANTZ: Doctor, can we excuse you for
16 just a minute? Don't go too far away.
17 (The doctor left the room at this
time.)
18 DR. BUCHWALD: Something is not ringing true
19 here.
20 DR. BAEPLER: The difficulties he suffered do not
21 warrant the thing he's --
22 MR. LESSLY: At this stage in his career.
23 DR. BUCHWALD: There's something that is not
24 ringing true. We don't have the evidence to support it or
25 deny it.
DISCOVERY REPORTING (775) 329-3500
30
1 DR. DESAI: First of all, we are not giving him
2 the privileges to do surgery. We're giving him whether
3 he's okay to be a doctor.
4 DR. BUCHWALD: Well, I'm concerned about that,
5 because I'm concerned that he's not telling
us the truth.
6 DR. BAGGETT: What about the peer review?
7 DR. STEWART: The peer review says they did 70
8 cases, they seem moderate in intensity.
9 DR. BUCHWALD: These are woozy cases.
10 DR. STEWART: The preceptor said that he's a
11 rough surgeon, he pulls on tissues and is
impatient and
12 doesn't see the errors of his ways if you
read through
13 that.
And the preceptor kind of guided him in the correct
14 way and things went well.
15 DR. BUCHWALD: And he got better.
16 DR. STEWART: Over a period of three months, yes.
17 DR. BUCHWALD: I think there's a --
18 unfortunately, there's no evidence to
support what I feel,
19 but I feel that there's a personality
problem here or a
20 personality disorder or something is wrong
with this young
21 man.
He may be actually a good surgeon.
I mean, there's a
22 lot of rough surgeons, but I'm not going
there, but there's
23 something that he's unwilling or unable to
tell us and I'm
24 not sure that we have the grounds to deny
him a license on
25 that basis, but --
DISCOVERY REPORTING (775) 329-3500
31
1 DR. BAGGETT: He does have a plausible
2 explanation.
The hospital commander wanted to be
3 aggressive, wanted to get more, he had a
change in hospital
4 commander to somebody who wanted to pull
back, and the
5 complications, and sometimes in the
military, sometimes you
6 shift blame:
Hey, this surgeon, we're going to put it on
7 you.
8 DR. DESAI: There were two active reviews also.
9 DR. BAGGETT: I agree the surgeon says he's rough
10 on tissue.
He still says this man is a competent general
11 surgeon and that his complication rate is no
greater than
12 other surgeons.
13 MR. LESSLY: I would tell you that that's a
14 serious restriction for an Air Force
hospital to apply to a
15 physician at that point in his training and
career.
16 DR. STEWART: Why wouldn't the lady commander say
17 we're lopping off the top ten difficult
things because we
18 don't have staff, we don't have techs, we
don't have
19 nurses.
We just aren't going to do this anymore, thank
20 you, stop.
21 MR. LESSLY: He doesn't function well in that
22 environment, that's the problem.
23 DR. LUBRITZ: Can we neither deny or grant and
24 have our investigators go out and talk to
the commander?
25 MR. LESSLY: I don't know that our investigators
DISCOVERY REPORTING (775) 329-3500
32
1 would get any information from them. I don't think you
2 have any grounds to deny him. The hospital is going to do
3 your credentialing chore for you as far as
what privileges
4 he
gets. Your question is well put, the
hospital is going
5 to know about the restrictions in the Air
Force.
6 DR. DESAI: We have the knowledge that no one may
7 give him the privileges.
8 MR. LEGARZA: You have the grounds if you agree
9 that he's unable to practice medicine with
reasonable skill
10 and safety.
11 DR. STEWART: You have a letter from the teaching
12 hospital saying that he did 70 cases.
13 MR. LESSLY: He's a marginal case.
14 DR. BUCHWALD: I think he's a name that Dr. Tracy
15 ought to tuck under his hat because this
young man is going
16 to have problems if he doesn't already have
them.
17 DR. TRACY: He reminds me of a couple of other
18 surgeons and have the personality disorder,
a
19 characterological thing. Of course, that's a prerequisite,
20 isn't it?
But I think the cases that I've dealt with in
21 this, it really -- it comes back, they'd
have to -- they
22 want to get the issues dealt with because if
he's right
23 then he hasn't had a due process on this
stuff, it would
24 come back whether or not we could support it
through his
25 medicine, because if he's being picked on
and he can
DISCOVERY REPORTING (775) 329-3500
33
1 account for every action that he did, he's
right. If not,
2 he has absolutely no insight in his being
accountable for
3 his actions and is a liar.
4 DR. ROSENCRANTZ: He has a list of things that
5 they rate him to do and not do. If we give him a license,
6 even though he goes out of the military
setting, he's going
7 to be able to do those.
8 DR. HUG-ENGLISH: He has to be credentialed at
9 the hospital.
10 DR. DESAI: He will never be able to do at the
11 outpatient or the hospital because he has to
go to the
12 credentialing committee to get a credential
to perform
13 these procedures or surgeries.
14 DR. ROSENCRANTZ: They'll be concerned about it?
15 DR. DESAI: They will be more concerned than we
16 are.
They will tear him apart.
17 MR. LESSLY: This is their liability.
18 DR. ROSENCRANTZ: Should we bring him back in?
19 DR. STEWART: There's a list of, I guess, 40
20 cases.
There's a total of 70 cases, then there's 70 names,
21 then there's a list of the 40 that I guess
are considered
22 the supervised operative procedures for
patients. And it
23 says it should be noted during this time
that Dr. Brown did
24 not have a direct responsibility for the
care of the
25 patient, who is following along in the
interests of the
DISCOVERY REPORTING (775) 329-3500
34
1 case and his desire to be involved in
surgery. That's a
2 little different than I interpreted this to
begin with.
3 DR. BUCHWALD: I agree, but, again, I don't think
4 we have grounds to deny him a license. I think that the
5 credentialing is going to be a major problem
for him.
6 MR. LESSLY: I hope so.
7 DR. LUBRITZ: That's not a grounds.
8 DR. BUCHWALD: It's not a our problem yet.
9 DR. DESAI: Make motion to go into open session?
10 DR. STEWART: Second.
11 (Dr. Brown reentered the
room)
12 DR. DESAI: Make a motion to accept Dr. Brown's
13 application for license.
14 DR. LUBRITZ: Second.
15 DR. ROSENCRANTZ: Motion is seconded. Any
16 discussion?
Being no decision, all those in favor?
17 All those opposed?
18 Chair votes in favor of the
motion.
19 Dr. Brown, I don't mean to make a
warning, but
20 the State of Nevada holds its people in high
esteem and
21 would hope that you will take the utmost
care in doing the
22 kinds of procedures that you're going to do
and consider
23 that as you go about your practice in the
state. Okay.
24 License has been accepted.
25 DR. BROWN: Thank you.
DISCOVERY REPORTING (775) 329-3500
35
1 --oOo--
2
DR. ROSENCRANTZ: Call the Board
meeting back to
3 order.
Dr. Fabito.
4 DR. FABITO: Yes, sir.
5 DR. ROSENCRANTZ: I'm Arne Rosencrantz. These
6 are other members of the Board, staff and
legal counsel.
7 DR. FABITO: Nice to meet you.
8 DR. ROSENCRANTZ: Dr. Lubritz is going to
9 interview you.
10 DR. LUBRITZ: Just to let you know, Dr. Fabito is
11 in general surgery. He graduated from Far Eastern
12 University of Manila, Philippines. He is a board certified
13 surgeon, practices in Missouri.
14 DR. FABITO: Yes, sir.
15 DR. LUBRITZ: And was first board certified by
16 the American Board of Surgery in 1976,
recertified in 1986
17 and 1998.
And the reason for his appearance here before
18 the Board is because he answered affirmatively
to question
19 12 about any legal action, professional
liabilities and
20 there are actually six claims here. And if you don't mind,
21 Doctor, rather briefly, we'll ask you to go
over each of
22 those and the first one is Patient
Cole. Anything else you
23 would like to preface this, you certainly
can do that.
24 DR. FABITO: No.
What was the name of the first
25 patient?
DISCOVERY REPORTING (775) 329-3500
36
1 DR. LUBRITZ: Patient Cole, C-o-l-e, paid
2 $400,000.00.
3 DR. FABITO: This is a patient who was referred
4 to me because of a gastral problem. He was first admitted
5 by other primary care doctor and had some
problems with his
6 pulmonary status.
7 So after the patient improved with
his pulmonary
8 status, he was referred to me because of
problems with his
9 lower legs.
So when I saw him, I ordered a vascular study
10 and indeed the vascular study, disorder was
abnormal in
11 order to look more on the needs of the
patient I said we
12 need an arteriogram. So I order an arteriogram. That was
13 four days after the initial admission of the
patient.
14 And in our hospital, the
radiologist would do the
15 test and radiologist would determine whether
this patient
16 would require a test or not or if there
would be some
17 contraindications to the test.
18 And so the patient was seen by our
radiologist
19 who is an invasive radiologist. That's how they call them,
20 invasive radiologist. And he did the arteriogram.
21 And in the afternoon, the patient
developed some
22 problems and was transported to the
intensive care unit and
23 so we have followed the patient, I've
discussed the
24 situation with the family and I said that
indeed the
25 patient has an occlusion of the femoral
bipedal vessel and
DISCOVERY REPORTING (775) 329-3500
37
1 we need to revascular, but we need to
stabilize.
2 Unfortunately, I think the patient had some
other problems
3 and he went into heart condition failure and
developed some
4 difficulties and he died.
5 DR. LUBRITZ: This is before you did any surgery?
6 DR. FABITO: I didn't do any surgery. All I did
7 is ordered an arteriogram so they included
the meeting with
8 the -- they sued including the hospital and
the
9 radiologist.
I know it was a defensible case because all I
10 did was order an arteriogram. Unfortunately, during the
11 discovery period, the lawyer representing me
presented a
12 witness who is supposed to be a common law
wife of the
13 patient, but apparently was discovered that she
was not, so
14 the plaintiff lawyer jumped on the situation
that we were
15 presenting an imposter witness. So the situation turned
16 around that they were after the law firm
already.
17 So I guess probably mistake on my
part to agree
18 on the -- my defense lawyer's suggestion,
you know, if they
19 get out of the case they will get another
law firm then
20 they will take a long time again and so on
and so forth.
21 And I think they were protecting your
interests because the
22 plaintiff lawyer has written them a
threatening letter that
23 he will do something with it. So I said, you know --
24 DR. LUBRITZ: It was settled for $400,000.00.
25 DR. FABITO: But the situation was we will settle
DISCOVERY REPORTING (775) 329-3500
38
1
this because the other two doctors, the primary care doctor
2 and the radiologist, in essence, in the time
we'll settle
3 them we'll ask them to contribute. So I said, you know,
4 I'm not the lawyer. You are the expert in these cases, so
5 go ahead and do it. So later on, my lawyer, who is with
6 BIE tried to --
7 DR. LUBRITZ: That's your insurance company?
8 DR. FABITO: -- to collect your part, which is
9 more of -- the radiologist was the more one
to be sued and
10 the -- they didn't want to be involved again
and at that
11 time BIE is having problems. I don't know if you know
12 about the problems with BIE. So he dismissed. In fact, he
13 actually sued the other two physicians so
that's the
14 background of this case.
15 Number two was V-o-z-o-r. By the way, that case
16 we discussed was in 1988.
17 Patient Vozor was when?
18 DR. FABITO: I think that was later.
19 DR. LUBRITZ: That was dismissed with prejudice.
20 DR. FABITO: Yes.
Mr. Vozor is a patient from
21 Michigan in the hospital.
22 DR. LUBRITZ: If I could, I would ask, because of
23 the other physicians that are here, be very
brief.
24 DR. FABITO: Yes, sir.
This patient underwent a
25 continence pouch, which we usually do, we
remove the
DISCOVERY REPORTING (775) 329-3500
39
1 existing ileostomy and we create an internal
pouch. This
2 patient would not wear anymore external
pouch. And the
3 patient had colitis and gross colitis at the
current time.
4 We should not do cases like this when you
have an active
5 disease, but Mr. Vozor does not have no
active disease for
6 the last eight years, 15 years. He qualifies under the
7 qualifications. And we did the pouch and he developed some
8 fistula.
That's the reason why they sued.
But the surgeon
9 in Michigan went ahead and removed the
fistula, the pouch
10 which should not be done, I think you do the
ileostomy and
11 the fistula, there was no problems in the
pouch. That's
12 why it was dismissed.
13 DR. LUBRITZ: Miss Straus, dismissed.
14 DR. FABITO: Miss Straus was a -- did a bypass
15 for morbid obesity. She was scared at nighttime. She ask
16 her boyfriend at the time, I don't know what
they were
17 doing in the bathroom at night, the patient
had a fall and
18 she claimed that she hurt her belly.
19 Following that, I saw the
patient. The abdominal
20 wound I have to bring her upstairs and
resuture her. She
21 did well.
She came to the office, she went to the
22 hospital, was trying to tell her, I said,
you know, I don't
23 think there's any problem here, you think
that should be,
24 they're watching them all the time and
that's false. So
25 the lawyers sued the hospital and included
me. But, you
DISCOVERY REPORTING (775) 329-3500
40
1 know, nothing came out of that, because I
really didn't do
2 anything wrong about it.
3 DR. LUBRITZ: Patient Day, paid $378,000.00 in
4 1992.
5 DR. FABITO: Right.
Mr. Day has a severe disease
6 with problem with his left leg. I went ahead and did a
7 arterial femoral bypass. He developed bleeding. When he
8 went home, he apparently was on the bathroom
and he stood
9 up and had a bleeding in the left
groin. He was brought to
10 the emergency room and the hospital so I
took care of him.
11 I brought him to surgery to repair. Apparently the suture
12 broke.
I have to repair the connection and so on.
13 And then later on, he rebled in
the hospital
14 after bringing him back. I have to do some bypass from the
15 groin down to the vessel below the
knee. And while in the
16 hospital, he smokes, he has diabetes, he
developed
17 infection and it was a horrendous,
horrendous case. We
18 ended up doing amputation and so I did a
first below the
19
knee amputation and MSRA infection which is very hard to
20 treat in spite of vancomycin and all. And I had to do
21 above the knee. And situations like this, they sued us and
22 I had been in court, if you see somebody
without the leg,
23 there's always that element of compassion,
so my insurance,
24 BIE was also having problems and settled.
25 DR. LUBRITZ: Patient five was Patient Bollinger
DISCOVERY REPORTING (775)
329-3500
41
1 in 1996, paid $109,000.00.
2 DR. FABITO: Mrs. Bollinger had a gallbladder
3 problem.
According to the classes, it was a procedure,
4 laparoscopic discotomy. I have done many procedures like
5 that.
Unfortunately, she developed problem with her common
6 bile duct and five weeks later we did all
the diagnostic
7 tests, we were unable to uncover the
problem.
8 I brought her to surgery. I did a connection
9 with the small bowel to the colon bile duct
and everything
10 was fine and then she sued.
11 And at the time, this is a
defensible case,
12 however, BIE Insurance is now in the last
leg of being
13 bankrupt so that we were -- all the policy
holders and
14 their BIE are being nervous, including me
and I was able to
15 get another insurance, but then BIE, the
State of Ohio,
16 they already renew your license so that in
Missouri I don't
17 know in Nevada if we have that, but in
Missouri we have
18 what we call the Missouri guarantee
insurance that would
19 take over cases like this and they took over
and so we went
20 ahead and settled them.
21 DR. LUBRITZ: Your last case is currently
22 pending, June of 1998, and that was patient
Minter,
23 M-i-n-t-e-r.
24 DR. FABITO: Yes.
This patient is very nice guy.
25 He was from one doctor to another, had seen
psychologist
DISCOVERY REPORTING (775) 329-3500
42
1 and primary care doctor before patient to me
needs surgery
2 for hiatal hernia. He has been treated for one year and
3
unresponsive to medical treatment.
4 And I said, you know, we can do,
and there was
5 some question about his gallbladder and I
said once we are
6 there, if I find that the gallbladder is
diseased, we'll
7 remove it, so that would prevent you from
having another
8 surgery in the future.
9 That's what we did. We did well.
10 Postoperatively he complains of pain. He went to St. Louis
11 U,
went to another doctor, and finally went to another
12 doctor who operated on him and he didn't
find anything,
13 except my lesions. Well, I don't know. I treated him
14 nice.
I always answered his calls when he calls, but I
15 don't know, there are just some people just
want to sue
16 you, I guess.
17 DR. DESAI: Make a motion to go into open
18 session.
19 DR. ROSENCRANTZ: All in favor?
20 DR. BAGGETT: I would move that we accept the
21 application of Dr. Fabito.
22 DR. DESAI: Second.
23 DR. ROSENCRANTZ: Discussion?
24 All those in favor?
25 All those opposed?
DISCOVERY REPORTING (775) 329-3500
43
1 Chair votes in favor.
2 Thank you, Dr. Fabito.
3 DR. FABITO: Thank you very much.
4 --oOo--
5 DR. ROSENCRANTZ: Dr. Faro.
Is it Dr. Faro?
6 DR. FARO: Yes.
7 DR. ROSENCRANTZ: I'm Arne Rosencrantz, members
8 of the Board these are other members of the
Board, staff
9 and legal counsel. We're here to review your application
10 and Dr. Desai is going to talk to you.
11 DR. DESAI: Dr. Faro is a medical graduate from
12 Philippines.
He did his residency from '94 to '97 in USC
13 Los Angeles.
And he's not Board certified in Pediatrics.
14 He finished his residency in '97. What have you been doing
15 since '97?
16 DR. FARO: The main problem for me since 1997 was
17 finding a job. I really started looking for a job in
18 December of 1997. I had a few calls that they called me
19 back, they said they were interested, but
eventually they
20 considered other candidates.
21 My only real solid at any time was
in January of
22 1998 for a group practice in Lancaster,
California, offered
23 me a job, but it had a catch that I had to
be on call every
24 day and every night with no other
compensation aside from a
25 basic salary, so I turned that down.
DISCOVERY REPORTING (775) 329-3500
44
1 And after that, I wasn't able to
find another
2 opportunity until January of 19 -- of this
year when I was
3 interviewed by a medical group up in Las
Vegas. And from
4 the strength of my interview, he considered
my residency,
5 my -- and my experience that he more of
considered my
6 interview, which after then, he offered me a
position. I
7 have to tell you, basically, it was very
difficult finding
8 a job especially on the West Coast when for
every position
9 there's many applicants and I understand I
am not as
10
qualified as most other applicants.
11 DR. DESAI: Is it difficult to find a job in
12 pediatrics?
13 DR. FARO: In pediatrics especially on the West
14 Coast for every position there's 50
applicants and there's
15 physicians from the East Coast with five
years more
16 experience are applying on the West Coast.
17 DR. DESAI: How are you keeping up with your CME?
18 DR. FARO:
I have kept up with my CME pretty
19 well.
I have accumulated almost 90 category one hours for
20 the past two years. I do it through the journals, like the
21 Pediatric Review and on the Internet there's
also if you go
22 through MedScape and the CDC has there own
websites where
23 they have CME, American Heart Association,
American Medical
24 Association.
So I've kept up well with my CME.
25 DR. DESAI: Is your job offer still open for you?
DISCOVERY REPORTING (775) 329-3500
45
1 DR. FARO: The job offer, they contacted me last
2
month and the clinic manager told me that since you had
3 difficulty obtaining licensure and they had
other plans,
4 they hired another physician, but two weeks
ago, the
5 medical director of this group contacted me
through
6 electronic mail and told me if you're able
to obtain a
7 Nevada state license, we might consider you
for another
8 position that we will have in the future.
9 DR. DESAI: Anyone has a question?
10 DR. LUBRITZ: I do.
11 DR. BUCHWALD: I'm sorry, Dr. Faro, are you Board
12 eligible?
13 DR. FARO: I'm Board eligible. I registered for
14 this year's pediatric boards.
15 DR. LUBRITZ: When are you able to take your
16 pediatric boards? How long?
You finished your residency
17 in 1997?
18 DR. FARO: Yes.
19 DR. LUBRITZ: When could you have taken it?
20 DR. FARO: I took it in 1997, but I did not pass
21 it.
22 DR. LUBRITZ: When would you be eligible? Can
23 you take it yearly?
24 DR. FARO: You can take it yearly. There's no
25 maximum number of times that you can take
it. I think it's
DISCOVERY REPORTING (775) 329-3500
46
1 instituted two years ago. There's no maximum number of
2 times that you can take it.
3 DR. LUBRITZ: I noticed that it said that you
4 were studying for your boards.
5 DR. FARO: Yes, I studied after because I
6 finished in August of '97, I did a
self-study at home for
7 the boards, for the pediatric boards and I
don't think it
8 wasn't sufficient enough for me to pass it
in retrospect.
9 DR. LUBRITZ: In what areas did you feel that you
10 needed perhaps a little more training or
more studying?
11 Was it various areas of pediatrics?
12 DR. FARO: More of intensive care unit.
13 DR. LUBRITZ: How much of that were you exposed
14 to UCLA ?
15 DR. FARO: USC.
We were exposed fairly well at
16 USC.
We had an eight-bed unit pediatric intensive care
17 unit.
18 DR. LUBRITZ: How have you been getting by
19 financially over the past three years?
20 DR. FARO: Financially, my parents have been
21 supporting me. My father is retired in the Philippines.
22 He served in the U.S. Army, so he's been
understanding and
23 supportive.
24 DR. LUBRITZ: If you were to take and pass the
25 American Board of Pediatrics, would that
make you a more
DISCOVERY REPORTING (775) 329-3500
47
1 eligible candidate for work?
2 DR. FARO: It would.
3 DR. LUBRITZ: Do you feel you would need any
4 refresher, you haven't been in patient
contact for two
5 years.
6 DR. FARO: Two years.
7 DR. LUBRITZ: By the time you take it again, it
8 will be three years. If you take your boards and don't
9 pass, when would you be eligible to take it
again?
10 DR. FARO: I'll be eligible if I don't pass it
11 this year I'm still eligible. It's up to four years.
12 DR. LUBRITZ: Up to four.
13 DR. FARO: I believe.
14 DR. LUBRITZ: So you would have been two years
15 without any patient contact.
16 DR. FARO: I believe so.
17 DR. LUBRITZ: Would you feel that you needed to
18 go back and refresh?
19 DR. FARO: Not necessarily. This time period has
20 given me more time to actually read the
stuff that I wasn't
21 able to do in residency. During residency, especially at
22 Los Angeles County, they have increased
volume of patients
23 compared to other programs for a large
percentage of your
24 work is procedural, IVs.
25 DR. LUBRITZ: What kind of time did you spend?
DISCOVERY REPORTING (775) 329-3500
48
1 Were you on 12 off 12 on 24 off 12 on?
2 DR. FARO: At county USC?
3 DR. LUBRITZ: Uh-huh.
4 DR. FARO: During your ward rotation, you're on
5 call for 48 hours basically, because you
start at 7:00
6 o'clock in the morning and the following
morning, you give
7 morning report, then you have to, you know,
do rounds with
8 your own attending and do sign out rounds in
the afternoon.
9 So basically it's not exactly. It's more 36.
Nd then you
10 don't have to go back on duty the following
day. You have
11 to come in in rounds again. It's the same, you have to
12 sign out to the on-call team.
13 DR. LUBRITZ: Thank you.
14 DR. DESAI: Make a motion to go in open session.
15 DR. STEWART: Second.
16 DR. ROSENCRANTZ: All in favor?
17 Open session. Any motion?
18 DR. DESAI: I make a motion to accept Dr. Faro's
19 application.
20 DR. STEWART: Second.
21 DR. ROSENCRANTZ: Any discussion? All those in
22 favor?
23 All opposed?
24 Chair votes in favor of the
motion.
25 Thank you, Doctor.
DISCOVERY REPORTING (775) 329-3500
49
1 --oOo--
2 DR. ROSENCRANTZ: Dr. Haupt, I'm -- who is Dr.
3 Haupt?
4 MS. NELSON: I'm Karen Nelson, her attorney.
5 DR. ROSENCRANTZ: I'm Arne Rosencrantz, President
6 of the Board. These are other members of the Board, staff
7 and legal counsel. You want to have your legal counsel
8 representing you today?
9 MS. NELSON: I'm actually here to answer any
10 questions, if you have any questions about
reinstatement to
11 the medical program as a resident. I'm not here in an
12 advocacy position.
13 DR. ROSENCRANTZ: Your name for the record?
14 MS. NELSON: Sharon Nelson.
15 DR. ROSENCRANTZ: Dr. Jones?
16 DR. JONES: Dr. Haupt, she has completed three
17 years successfully in her residency program
and was
18 terminated from her fourth year. And at this time, you've
19 been reinstated, from what I understand, in
the residency.
20 DR. HAUPT: Since like Monday I went back to
21 work.
22 DR. JONES: You want to tell us why you were
23 terminated?
24 DR. HAUPT: I wasn't given a specific reason by
25 the program, but it was maybe a week or so
after I filed a
DISCOVERY REPORTING (775) 329-3500
50
1 complaint at the Nevada Equal Rights
Commission.
2 DR. LUBRITZ:
I'm sorry. I can't hear.
3 DR. HAUPT: I filed a complaint with the Nevada
4 Equal Rights Commission. A week later, I was told to drop
5 my suit or I wouldn't know what would
happen. And shortly
6 thereafter, I was suspended and then
terminated. I wasn't
7 given specific reasons why I was terminated
but that's the
8 time line.
9 DR. JONES: It's stated in some of the
10 information we have here that you were met
with -- to
11 discuss inappropriate professional attitude
and behavior
12 towards your colleagues and continued
inability and
13 unwillingness to provide safe, effective patient
care
14 commensurate with your level of
education. Would you go
15 along with that?
16 DR. HAUPT: I wouldn't go along with that. I
17 heard comments to that effect after the
fact, after the
18 termination.
19 DR. JONES: Did you indeed meet with someone to
20 discuss the actions that I just
outlined?
21 DR. HAUPT: I had several meetings with the
22 program directors, Dr. Rogis and the
chairman of the
23 department.
During the meetings, what was spoken wasn't
24 what was on the paper. Afterwards I would get memos or
25 something, I would see communications that
would be written
DISCOVERY REPORTING (775) 329-3500
51
1 on the letters, but during the meetings
that's not what was
2 stated.
3 DR. JONES:
So it was your -- the information
4 that you had was that you were not dealing
properly or
5 safely with your patients and you were not
dealing with
6 your colleagues properly, is that the
information in the
7 memo?
8 DR. HAUPT: That would be after I had a meeting.
9 The memo regarding the meeting would say
something like
10 that.
11 DR. HUG-ENGLISH: What was said during the
12 meeting, though?
13 DR. HAUPT: It's difficult to put it all in a
14 nutshell.
I was told different things. I
mean, I would go
15 into a meeting and they would say I have
nothing wrong,
16 there's no problem with your knowledge base,
there's no
17 problem with your surgical skills, you know,
there's --
18 they would -- I can't even, like I said, I
can't put it --
19 I wish I could give you a sentence of what
they said.
20 Nothing specifically really told to me. It was just kind
21 of one of those we think maybe we're going
to extend your
22 residency.
23 DR. JONES: What was your relationship like with
24 your colleagues?
25 DR. HAUPT: Before all of this, it was wonderful.
DISCOVERY REPORTING (775) 329-3500
52
1 I mean, we called each other sisters and
brothers. We
2 lived together at the hospitals residence,
spent 100 hours
3 a week at least together.
4 DR. JONES: And then what happened?
5 DR. HAUPT: There was a private meeting stating
6 that I was filing a lawsuit against the
residency and the
7 university medical center at a time when I
had not filed a
8 lawsuit.
Immediately thereafter, I was kind of getting the
9 cold shoulder from the residents. A little while down the
10 line, I would. I filed a NERC complaint. Another private
11 meeting was held between the residents. It was the other
12 ten residents, not including myself or
another, the other
13 female physician. They were told that I filed this NERC
14 complaint and then right after that, it was
all
15 communication broke off between the other
residents and
16 myself.
17 DR. JONES: What was the complaint?
18 DR. HAUPT: Sexual discrimination, sexual
19 harassment.
20 DR. JONES: So then you were terminated?
21 DR. HAUPT: I was suspended a week after that.
22 The week after that, the week after the
complaint went to
23 the NERC, I'm trying to think, a week after
that, I went on
24 vacation, that's about the same time they
heard about the
25 complaint.
It was just before I went on vacation they
DISCOVERY REPORTING (775) 329-3500
53
1
said: Go over there, drop the
complaint, throw your hands
2 in the air and say April fools or I don't
know what
3 happened to me. I went on vacation for a week, I came
4 back, the day I came from vacation I was
suspended for
5 three weeks.
After I came back from suspension, I was
6 terminated.
7 DR. JONES: What was the reason given at that
8 point?
9 DR. HAUPT: It was just a general feeling that I
10 should be terminated.
11 DR. JONES: You didn't receive anything in
12 writing?
13 DR. HAUPT: The following day I did.
14 DR. JONES: It stipulated what it was that -- the
15 reasons why you were terminated?
16 DR. HAUPT: It was leadership. I don't remember
17 what all was on that the memo.
18 DR. JONES: What has changed now that you're
19 going to be reinstated? What has changed in that period of
20 time since November 1st?
21 DR. HAUPT: Well, I haven't had any communication
22 with the residents. My attending, my past attendings, I
23 haven't had any communication with them
except through
24 attorneys so I don't know what has changed.
25 DR. JONES: I'm wondering, you were unsuccessful
DISCOVERY REPORTING (775) 329-3500
54
1 the last part and you were terminated. What has changed so
2 that you feel that it will be successful
from this point
3
on? Has anything different
happened or have you --
4 DR. HAUPT: I guess I don't -- just that
5 negotiations have taken place and that
they're going to
6 offer me a spot to finish my residency.
7 DR. JONES: And I understand you'll be working
8 with Dr. Tracy?
9 DR. HAUPT: With Dr. Rueckl, I understand.
10 DR. JONES: With Dr. Rueckl. Okay.
And how do
11 you feel about that?
12 DR. HAUPT: If it's what I need to do to get my
13 license and to continue and to finish my
residency.
14 DR. JONES: You feel there's no reason to be
15 there?
16 DR. HAUPT: I feel like -- yeah. I've never had
17 a problem.
18 DR. JONES: Okay.
19 DR. DESAI: I have a question. The complaint you
20 filed and your lawyers pursued the complaint
and they made
21 a settlement with the medical school
residency program and
22 they yielded and they said, basically, we
release you back
23 to your position.
24 MS. NELSON: That's correct.
25 DR. DESAI: As long as you go ahead and join Dr.
DISCOVERY REPORTING (775) 329-3500
55
1 Tracy's program.
2 MS. NELSON: No.
The only condition she has to
3 dismiss her complaint from the equal rights,
the result of
4 joining the foundation, that she was acting
impaired so her
5 joining the foundation is completely
separate from the
6 settlement.
7 DR. DESAI: The settlement, you don't do anything
8 to us, we don't do anything to you, leave us
alone.
9 MS. NELSON: That's what we're hoping. She's
10 joining the foundation, but not as a result
of the school
11 requiring her to join it to be reinstated.
12 DR. DESAI: You feel you've been wronged by the
13 medical school?
14 DR. HAUPT: Yes, I do.
15 DR. JONES: That's the point I was trying to get
16 at.
How is this, you know, your feeling the same way you
17 are, so how is this relationship going to be
any better
18 than when you left?
19 DR. HAUPT: All I know is what I can do. All I
20 know is I can go in there and be the best
resident I can
21 be.
22 MS. NELSON: Tell them about your academic.
23 DR. HAUPT: Dr. Shield will be acting as my
24 academic advisor. He will be formulating a curriculum. We
25 have a liaison, we have not chosen one yet,
who will go
DISCOVERY REPORTING (775)
329-3500
56
1 between Ritsen and myself so I won't have
any contact and
2 won't have communication with him.
3 DR. DESAI:
And Dr. Rogis is retired so --
4 DR. HAUPT: He's retired, but he still works in
5 the office.
So he's semi active with the residents.
6 DR. DESAI: What kind of anxiety do you have
7 joining the program back that there will be
no retribution?
8 DR. HAUPT: I'm not saying I'm not without
9 anxiety.
You mean personally myself?
10 DR. DESAI: Yes.
11 DR. HAUPT: All I can do is, you know, my end of
12 the contract. All I can do is uphold that end of it.
13 DR. HUG-ENGLISH: I'm having trouble with the
14 sequencing of this as far as you indicated
that everything
15 was going just very smoothly and fine but
yet you filed a
16 complaint with the Equal Rights
Commission. So something
17 wasn't going fine. What happened that you felt changed
18 that?
What caused you to file that claim?
19 DR. HAUPT: I guess I meant with the residents
20 everything was fine until they were informed
of my actions,
21 of lawsuits, NERC complaints. As far as with the
22 administration or my attending physicians,
should I start
23 back in March?
24 MS. NELSON: Just answer the question.
25 DR. HAUPT: I think I was beginning to get
DISCOVERY REPORTING (775) 329-3500
57
1 rumors, not I think I was, there was rumor
that my
2 residency was going to be extended. This was at a time
3 when I had no write-ups placed in my file, I
had average or
4 above average evaluations from everybody,
all my
5 attendings.
This is the last thing in the world I ever
6 expected.
Things were going smoothly. Then
I started
7 getting, hearing rumors that my residency --
8 DR. HUG-ENGLISH: From residents or
9 administration?
10 DR. HAUPT: From attending physicians. They had
11 all overheard Dr. Ritsen, Rogis and Hazen
talking about
12 extending my residency.
13 I went to Dr. Rogis to confront
him to ask him is
14 this true, I'm going to be extended. He didn't say it was
15 true, he didn't deny it. At that time, he said: I don't
16 have any problem with you. But then a little while later,
17 I got my first note saying, yeah, we were
thinking about
18 extending you for three months. I asked for a due process
19 at that time. I wanted to hear it from the attendings
20 themselves.
21 Dr. Ritsen told me that the
attendings were all
22 in agreement that I should be extended. The thing is I
23 went to the attendings one by one and said,
this is what
24 they said:
Do you believe I should be extended?
And each
25 one said, no, it wasn't said, it wasn't
brought up in the
DISCOVERY REPORTING (775) 329-3500
58
1 meeting.
2 You know, so I'm hearing on one
hand all the
3 attendings saying I should be accepted and
on the other
4 attendings saying no. I asked for due process I wanted to
5 hear it from the attendings themselves. That was denied.
6 I asked the school of medicine for due
process, that was
7 denied.
And it just seemed like things started to snowball
8 after that.
The more I wanted the reason it was being
9 extended, the more it's -- it seemed like it
just got
10 nastier after that and I don't have my paper
work. I don't
11 remember too much of the sequence. It just snowballed.
12 So as far as the administration,
things weren't
13 going fine there, but with the residents, it
was going
14 fine.
15 DR. BUCHWALD: Could you address the -- I'm
16 sorry, Dr. Baggett. Would you address the issue, I'd like
17 to hear about your program director being
concerned enough
18 to request or require that you join the foundation
or
19 participate in diversion. Why would he ask you to do that?
20 I have heard you earlier say that you did it
because you
21 were told to do it but not because you felt
you needed to
22 or wanted to.
23 DR. HAUPT: He didn't ask me. I guess maybe
24 indirectly he asked me. The first I knew of the
25 foundation, it was in October after I was
suspended. Dr.
DISCOVERY REPORTING (775) 329-3500
59
1 Tracy called and came over and said that
somebody had
2 reported me for being impaired at work. I took a urine
3 test, which came back clean. And it seems like since then
4 they've been saying why don't we do random
urines to prove
5 to the Board that you're willing to do
this. And you'll
6 come up clean for two years. It's not, I don't think
7 indirectly, I guess the program director
asked the
8 foundation to get involved, but he didn't
ask me.
9 MS. NELSON: Why do you think?
10 DR. HAUPT: Can I say the word "retaliation."
11 DR. HUG-ENGLISH: Were you ever impaired at work?
12 THE WITNESS: Absolutely not. I don't have a
13 drug problem. I do not have an alcohol problem. I never
14 even experimented in high school.
15 DR. BAGGETT: You would be in a unique position
16 having an independent license, most
residents have
17 institutional licenses so that if the Board
grants you a
18 license, are you planning to do
moonlighting?
19 DR. HAUPT: I don't believe I'm going to do any
20 moonlighting. I'm going to finish my residency and play it
21 by ear after that.
22 DR. BAGGETT: You don't have any other issues
23 that a license outside of the institutional
license would
24 be important for you?
25 DR. HAUPT: I think what stands out most in my
DISCOVERY REPORTING (775) 329-3500
60
1 mind is the fact that I've worked hard for
this. I've
2 completed three years and it's a license
that I deserve.
3 I've worked for it. Whether or not I use it inside or
4 outside the institution, I haven't gotten
that far in my
5 thinking.
It's just that.
6 DR. BAGGETT: If you had problems again in the
7 residency and they said you're suspended,
what would you do
8 at that time?
9 DR. HAUPT: I don't know what I could do with the
10 license.
I asked Dr. Rueckl prior to coming here, can I
11 practice with this if I don't go back to
residency? That
12 might be an avenue I'll look into later, go
into an
13 underserved community, but I haven't gotten
that far in my
14 thinking right now. My goal is to get my permanent
15 license.
I worked long and hard for it and then to finish
16 my residency.
17 DR. BAGGETT: Mr. Chairman?
18 DR. RUECKL: I wanted to say this application was
19 started before this agreement was reached,
you know, the
20 agreement with the residency program. There was definite
21 reasons to get the license at that point
besides the
22 residency program.
23 DR. LUBRITZ: I'm sorry.
I did not understand.
24 DR. RUECKL: Was asking why do you need a license
25 besides a residency license if you're going
back to the
DISCOVERY REPORTING (775) 329-3500
61
1 residency.
The reality of it at the point this license was
2 applied for, she wasn't going back into the
residency.
3 That agreement had not been reached yet. So in order for
4 her to work, she needed a license.
5 DR. ROSENCRANTZ: Rex, what you're saying at this
6 point she goes back into the residency
program, she doesn't
7 need this unrestricted unless she does
moonlight, which is
8 not out of the question. I mean she's done three years.
9 She's eligible for a license in the state.
10 DR. BAGGETT: It's a moot point that she
11 qualifies.
She meets the requirements for the licensure
12 and she would be a unique resident in that
she would have a
13 license that the other residents don't have.
14 DR. HAUPT: May I -- actually, all the four
15 years --
16 DR. ROSENCRANTZ: Go ahead.
17 DR. HAUPT: The four years every July apply for
18 their license and get it. At fourth year each person in
19 our program does have it.
20 DR. BAGGETT: They do?
21 MS. GAUL-RICHARD: Traditionally, the OB
22 residents apply at the end of their third
year.
23 DR. DESAI: For clarification, no residents are
24 allowed to moonlight without permission of
the program
25 director.
So I am not worried about that.
DISCOVERY REPORTING (775) 329-3500
62
1 DR. ROSENCRANTZ: She would have to get
2 permission.
3 DR. DESAI: Have to have permission from the
4 program director.
5 DR. STEWART: Arne, may I follow-up on Cheryl's
6 question?
You said that you filed a discrimination suit
7 with the Equal Rights Commission, but you
also said that
8 there was sexual harassment. I don't mean to pry. Could
9 you give me an umbrella explanation?
10 DR. HAUPT: I can't think of one day that went by
11 in residency that wasn't just full of sexual
innuendos.
12 Not even innuendos, just blatant. I mean, if it wasn't
13
just a plain joke that's told at a table here and there, it
14 was pointing at a breast, to mentioning
breasts, to talking
15 about skirts being too short. I had to hear other
16 residents talking about how they do their
patients, how
17 their patients are naked on the table when
they get in
18 there.
Every day. I can't sum it
up. It was so huge the
19 amount.
The stars on patient's charts when they were good
20 looking.
It's just --
21 DR. STEWART: So the environment was harassing.
22 DR. HAUPT: Yes.
23 DR. STEWART: Were you harassed by the
24 attendings?
25 THE WITNESS: Residents, attendings, right up to
DISCOVERY REPORTING (775) 329-3500
63
1 Dr. Ritsen himself. I mean, I don't know how specific you
2
want.
3 DR. STEWART: That's fine.
Thank you, ma'am.
4 DR. LUBRITZ: Have there been other female
5 residents prior to you in the program?
6 DR. HAUPT: Just in general? Are there other
7 residents, or do you mean harassed?
8 DR. LUBRITZ: Make it simple. Are you the first
9 female resident in that program?
10 DR. HAUPT: No.
11 DR. LUBRITZ: So there have been predecessors to
12 you females in that same, particular
program?
13 DR. HAUPT: Just in general, being residents in
14 the program?
15 DR. LUBRITZ: Yes, ma'am.
16 DR. HAUPT: I'm not the first female resident.
17 DR. LUBRITZ: Had they been harassed?
18 DR. HAUPT: Yes.
It was mentioned by one of the
19 females that I'll just quote her, she
said: You know we
20 could get Dr. Hazen on sexual harassment,
but it just isn't
21 worth it.
I'm here fighting for my job as sitting proof
22 that it's not worth it.
23 DR. LUBRITZ: Would you address the letter and
24 I'll read the parts October 23rd, 1998 and
it is signed by
25 Jeffrey Ritsen, Chair. It says:
During this meeting,
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64
1 October 20th, with Dr. Haupt, we discussed
her
2 inappropriate professional attitude and
behavior towards
3 her colleagues and she -- and her continued
inability and
4 her unwillingness to provide safe, effective
and
5 responsible patient care commensurate with
the level of
6 responsibility expected of a senior
resident.
7 Dr. Haupt continued to deny her
weaknesses and
8 saw no need to improve her performance or
change her
9 behavior, placing the blame for her
shortcomings on the
10 faculty and her peers.
11 Following that meeting, Dr. Rogis
and I
12 considered our responsibilities within the
standards set
13 forth by the accreditation counsel for
graduate medical
14 education and found it necessary to continue
Dr. Haupt's
15 suspension through October 31 and terminate
her contract on
16 that date.
17 Can you tell me why -- what was
the reason that
18 you were given as to why you did not provide
safe,
19 effective, responsible patient care
commensurate with the
20 level of responsibility were there any
significant
21 problems, any significant complaints, any
complaints that
22 led to that conclusion as far as you know?
23 DR. HAUPT: Prior to this time, my file was
24 clean.
25 DR. LUBRITZ: Have we verified that?
DISCOVERY REPORTING (775) 329-3500
65
1 DR. DESAI: We don't have to verify that, because
2 if someone does have a problem for three
years in
3 residency, and one day the problem starts,
some event took
4 place that started this paper trail. So everyone was
5 trying to cover everyone.
6 DR. LUBRITZ: I have no further questions.
7 DR. ROSENCRANTZ: Any further questions?
8 DR. DESAI: No questions.
9 DR. LUBRITZ: One more thing. Could she be
10 issued a license for institutional only
until she completes
11 residency?
12 DR. STEWART: That's not the request before us.
13 DR. LUBRITZ: I'm not asking if it's the request.
14 I'm asking could we. She's going back into the residency
15 and at the completion of that residency,
could she then be
16 granted, apply for and be given another
license? My
17 question at this point, since she's going
back to complete
18 a residency, have you been accepted into the
program?
19 MS. NELSON: Yes, assuming that a license will be
20 issued, she's scheduled to start Monday, the
7th of June.
21 DR. LUBRITZ: Would you be willing to accept an
22 institutional --
23 MR. LESSLY: I don't think you can ask her that
24 question.
25 DR. LUBRITZ: Okay.
I won't.
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66
1 DR. STEWART: Could we discuss this in closed
2 session?
3 DR. ROSENCRANTZ: Can we discuss this, Doctor?
4 If you'll excuse us for just a moment.
5 (Dr. Haupt left the room.)
6 DR. LUBRITZ: You want to slap my hand?
7 MR. LESSLY: Paul's right.
You would have no
8 authority to take any action to issue her a
resident
9 license.
10 DR. STEWART: In open session I will move to give
11 her an unrestricted license.
12 DR. BAGGETT: Is there anything else?
13 DR. LUBRITZ: There has got to be.
14 DR. DESAI: This is the second or third case
15 that's happened in Las Vegas.
16 DR. HUG-ENGLISH: From that same department?
17 DR. DESAI: Different department.
18 DR. STEWART: It happens in the university, I'm
19 sorry to say.
20 DR. DESAI: To the point one resident was
21 suspended, filed a complaint with the
Commission, put her
22 in Reno, pay her for lodging and keep her in
an apartment.
23 Okay.
So there is a breakdown in their due process.
24 MR. LESSLY: She has three years of good
25 residency training with no problem. She's eligible for
DISCOVERY REPORTING (775) 329-3500
67
1 licensure.
The only reason we brought her to you is when
2 there is a problem, is there something about
that problem
3 that makes her unfit to practice? I don't see that here.
4 I mean, that's not the kind of testimony
you're hearing.
5 DR. DESAI: And the same department is taking her
6 back?
7 MR. LEGARZA: The diversion. Do you remember the
8 lawyer?
9 DR. JONES: Yes.
10 DR. LUBRITZ: Yes, I do.
11 MR. LEGARZA: You remember?
12 DR. LUBRITZ: Yes, I do.
13 DR. BAGGETT: There's a story there, Dick.
14 DR. RUECKL: I'll tell you she was involved with
15 another case with another resident, another
female resident
16 and they called us because there was scripts
being written
17 back and forth and there was a lot of
scripts written.
18 DR. TRACY: And impaired at the job.
19 DR. RUECKL: And they said impaired at the job,
20 too, yes.
And there was scripts being written by
21
residents, but also attendings to residents. This is a big
22 can of worms like you're talking about
there. Basically
23 we've come to the conclusion that she
probably does not
24 have a drug problem. On the other hand, because of the
25 prescription writing, because of the fact
that there was a
DISCOVERY REPORTING (775) 329-3500
68
1 question of impairment, we've asked her to
submit to urines
2 for two years and she's agreed to do that.
3 DR. BAGGETT: Was she writing scripts for other
4 residents?
5 DR. HUG-ENGLISH: Why didn't she say that when we
6 specifically asked her that?
7 DR. RUECKL: I don't know if you specifically
8 asked her that.
9 DR. TRACY: I didn't hear you specifically ask
10
her that.
11 DR. HUG-ENGLISH: The question was asked as to
12 why she was to be part of the
diversion. She said it very
13 vaguely.
14 DR. TRACY: She said the urine was clean. I
15 believe that it was positive for Butalbital
and I sent her
16 to a psychiatrist for an evaluation and he
said she wasn't
17 chemically dependent.
18 MR. LESSLY: You don't have a problem with the
19 denial comment here?
20 DR. BAGGETT: If her story is as she stated it,
21 and we don't really have any factual
information otherwise,
22 I think we just move to give her a
license. She's going to
23 be the same as all the other fourth year
residents.
24 DR. LUBRITZ: Except she did not answer the
25 question correctly.
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69
1 MR. LESSLY: Bring her back in and ask her that
2 question again.
3 DR. HUG-ENGLISH: I have no problem in granting
4 her license.
I don't see anything that we have to hold
5 that up.
But it bothers me when I ask the question of what
6 got you into diversion, why did you ask to
be part of that,
7 and she said: I don't know.
8 MR. LESSLY: Bring her back and say you were
9 investigated by the diversion program, the
med school and
10 whoever about writing scripts for
residents. Is that what
11 got you in the problem? Why didn't you tell me that?
12 DR. DESAI: Isn't there other residents also
13 going to the diversion?
14 DR. TRACY: One is in treatment.
15 DR. DESAI: The attending got into the diversion.
16 DR. RUECKL: No attending yet.
17 DR. TRACY: The other person we've been involved
18 with.
19 DR. LUBRITZ: It was her friend.
20 MR. LEGARZA: Vicki, controlled? Are these
21 controlled substances?
22 MS. KNOPF: Some were controlled, yes.
23 DR. ROSENCRANTZ: She's agreed to be monitored
24 for two years. Is she going to have any other thing part
25 of her program? Is she going to need counseling?
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1 DR. RUECKL: No.
2
DR. ROSENCRANTZ: Nothing, just
monitoring?
3 DR. RUECKL: From our standpoint.
4 DR. TRACY: The other thing is, the prescription,
5 the way it works, at UNR they're given a --
their DEA
6 number is the same for everybody. They're given a suffix
7 of four digits that's rarely tracked in the
pharmacies.
8 DR. RUECKL: We can't get the same kind of
9 evidence on them.
10 DR. BUCHWALD: But if you recommended to her over
11 the next year or so that she get counseling?
12 DR. RUECKL: It's in our contract that we can do
13 what we want during the course of this. The only thing
14 we're doing --
15 DR. TRACY: It wasn't recommended from the
16 psychiatrist.
17 DR. RUECKL: It was not recommended by a
18 psychiatrist. She does not, according to him, have a
19 substance abuse problem.
20 DR. BAGGETT: Did she write for other residents
21 that were inappropriate?
22 DR. RUECKL: Definitely, at least one. And that
23
resident has been in front of this -- not the Board, but
24 the IC before and has gone to treatment.
25 Now, there are other attendings
that have done
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1 the same.
I'll just tell you that. I think
there's a lot
2 of problems in this department.
3 DR. BUCHWALD: In that program, not the
4 department.
5 DR. RUECKL: In that particular one, yeah. I
6 think they get new residents July 1st. We need to have a
7 nice little meeting on what you can and
cannot do.
8 DR. STEWART: I know what to do with this lady.
9 I know what I'm going to do. But I don't know what to do
10 with an allegation that's been dropped and
the chairman of
11 the department and she now works through a
liaison so they
12 don't see each other and talk to each other
and I don't
13 know with the allegation that's been made
before the Board
14 that she was sexually harassed by the
chairman of the
15 department who we give a license to.
16 Do we just close our eyes and walk
away or do we
17 investigate?
It's a negotiated drop of the suit.
I want
18 to finish my residency, and I will put all
these things in
19
place so I can finish my residency.
20 MR. LESSLY: I'll sign up for the diversion
21 program and I don't think I have a problem.
22 DR. STEWART: I'll ask any doctor in the room
23 have you ever written out a prescription and
then figured
24 out it was the wrong prescription, if
anybody says no,
25 they're lying. So I don't even hold to me. That's a
DISCOVERY REPORTING (775) 329-3500
72
1 nonissue.
But is this a university issue or medical issue?
2 MR. LESSLY: May well be.
3 DR. BAEPLER: It's a medical university problem,
4 maybe more.
5 DR. STEWART: Counsel, we've heard his statement.
6 Do we investigate or do we close our eyes?
7 MR. LESSLY: I think you refer the matter to the
8 investigative committee.
9 DR. STEWART: Thank you.
10 DR. ROSENCRANTZ: I'd like to see you ask her
11 that question.
12 DR. STEWART: Back in open session.
13 DR. ROSENCRANTZ: Open session.
14 (Dr. Haupt returned to the
room.)
15 DR. HUG-ENGLISH: Dr. Haupt, I have one more
16 question.
When you were asked to be part of the diversion,
17 was that true because indeed you were
writing
18 prescriptions, inappropriate prescriptions
to other
19 residents?
20 DR. HAUPT: I don't know if it would be called
21 inappropriate. I look back on it and now that I know all
22 the laws that pertain to that, I see that it
was wrong and
23 I'm sorry.
But that's some of it.
24 DR. HUG-ENGLISH: Why didn't you tell me that
25 when I asked that question before?
DISCOVERY REPORTING (775) 329-3500
73
1 DR. HAUPT: I'm sorry, which question?
2 DR. HUG-ENGLISH: Why you were asked to be part
3 of diversion?
4 DR. HAUPT: I wasn't hiding anything from you. I
5 just didn't think of it.
6 DR. HUG-ENGLISH: You didn't think that that
7 would be an important piece of information
that we had as a
8 Board as part of your diversion program that
you were
9 writing prescriptions?
10 DR. HAUPT: I guess I assumed that Dr. Rueckl had
11 filled you in on everything.
12 DR. HUG-ENGLISH: Okay.
Thank you.
13 DR. STEWART: Dr. Rosencrantz, I'd move to go
14 into open session.
15 DR. BUCHWALD: Second.
16 DR. ROSENCRANTZ: All those in favor?
17 DR. STEWART: I'd like to make another motion,
18 that we grant an unrestricted full license
for the practice
19 of medicine in the State of Nevada.
20 DR. HUG-ENGLISH: Second.
21 DR. ROSENCRANTZ: We have a motion and a second.
22 All those in favor?
23 Chair votes in favor.
24 Anyone opposed?
25 Chair votes in favor of the
motion, motion
DISCOVERY REPORTING (775) 329-3500
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1 carries.
2 DR. STEWART: I'd like to make motion that we
3 refer to the investigative committee the
issues that have
4 been discussed here to the investigation to
verify what, if
5 anything, they wish to do about this.
6 DR. ROSENCRANTZ: Would you do that again, Paul?
7 DR. STEWART: That we refer to the investigation
8 committee the issues that were discussed
here today for the
9 investigative committee to define what, if
anything, we
10 should do about this.
11 DR. BAGGETT: And I second.
12 DR. ROSENCRANTZ: Second.
Any discussion?
13 DR. BUCHWALD: I'm sorry.
I didn't hear the
14
motion.
15 DR. ROSENCRANTZ: We repeated it twice.
16 MR. LEGARZA: I was occupying her time.
17 DR. BUCHWALD: Yes, third.
18 DR. LUBRITZ: Discussion?
19 DR. ROSENCRANTZ: We're in discussion.
20 DR. LUBRITZ: What are you looking for? Are you
21 looking for the sexual harassment? Are you looking for the
22 drug writing?
23 MR. LESSLY: Any violation of the medical
24 practice act by any of our licensees.
25 DR. LUBRITZ: Sexual harassment.
DISCOVERY REPORTING (775) 329-3500
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1 MR. LESSLY: It could be.
2 DR. LUBRITZ: Yes.
3 DR. BAEPLER: Sexual harassment.
4 DR. DESAI: Unsafe environment to work.
5 DR. BAEPLER: You're talking about a climate to
6 work.
7 DR. DESAI: That's not part of the medical
8 practice act.
9 MR. LESSLY: What Dr. Stewart said, send it to
10 the investigative committee to see if
there's any violation
11 of the medical practice act by any of our
licensees.
12 DR. STEWART: That's where I'm headed.
13 MR. LESSLY: That's pretty broad.
14 DR. HUG-ENGLISH: As part of it, I think the
15 investigative committee might want to
communicate with the
16 university because I believe there has been
some
17 investigation into this.
18 DR. DESAI: Vicki, you heard that. We can solve
19 whole problem.
20 MR. LEGARZA: Let us remember that if we target
21 that she has settled the case based upon
some information
22
she's given us, we may be doing something to possibly
23 jeopardize her completion of this residency.
24 DR. BAGGETT: I didn't hear her say anything that
25 trying to -- I didn't hear her say anything
that triggered
DISCOVERY REPORTING (775) 329-3500
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1 me to second the motion.
2 MR. LEGARZA: You didn't hear her that she was
3 sexually harassed.
4 DR. BAGGETT: Sexual harass didn't bother me.
5 DR. BUCHWALD: I didn't hear that.
6 DR. BAGGETT: I didn't hear what the sexual
7 harassment was except what she said. That wasn't the
8 point.
9 DR. ROSENCRANTZ: We have a motion on the floor.
10 All those in favor?
11 Anyone opposed?
12 Chair votes in favor of the
motion.
13 --oOo--
14 DR. ROSENCRANTZ: We're ready for Dr. Kar. Good
15 afternoon, Dr. Kar. I'm Arne Rosencrantz, President of the
16 Board.
These are other members of the Board, staff and
17 legal counsel. We're here to discuss your application with
18 the State of Nevada. Dr. Hug-English?
19 DR. HUG-ENGLISH: Hi, Dr. Kar.
You're here today
20
because you answered affirmatively about a malpractice case
21 that was settled for $200,000.00. Can you tell us just
22 briefly about that case?
23 DR. KAR: Yes.
She was my patient and I gave her
24
prenatal care. Everything was
normal during pregnancy and
25 then she came in labor, which was when I was
away for a
DISCOVERY REPORTING (775) 329-3500
77
1 conference, and another solo obstetrician
who covers me for
2 my time off was on call. His name is Dr. Flanagan. And as
3 soon as patient came in, the fetal monitor
tracing
4 definitely showed fetal distress. And by the time the
5 patient, immediately the decision was made
to do a
6 C-section and after baby was born, that baby
is a case of
7 cerebral palsy.
8 So patient decided to sue us, that
means myself,
9 Dr. Flanagan, and the hospital. And basically saying that
10 causation of cerebral palsy was our neglect.
11 And case went to -- took long
time. She did not
12 find a lawyer who will take the case. And after eight,
13 nine years, she found a firm and they
brought the baby into
14 the court and the judge saw the baby. I think at that time
15 the baby was about eight, nine years
old. And looking at
16 the condition of the baby, the judge took us
in the back
17 room and said: Why don't you settle? And the case was
18 settled.
19 DR. HUG-ENGLISH: And you were named as part of
20 that suit because of your prenatal care that
you provided
21 even though you had nothing to do with the
actual delivery?
22 DR. KAR: That is correct.
23 DR. HUG-ENGLISH: I don't have any further
24 questions.
25 DR. DESAI: How much was the total settlement?
DISCOVERY REPORTING (775) 329-3500
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1 DR. KAR: On my behalf, $200,000.00.
2 DR. DESAI: Total settlement?
3 DR. KAR: I'm not supposed to know that, I know,
4 it's not because -- the other doctor decided
on his own and
5 the hospital decided on his own.
6 DR. DESAI: Okay.
7 DR. KAR: I can tell, if you want. It was $1.2
8 million.
$1 million came from hospital and Dr. Flanagan,
9 $200,000.00 came from me.
10 DR. DESAI: Make a motion to go in open session.
11 DR. BUCHWALD: Second.
12 DR. DESAI: Make a motion to accept Dr. Kar's
13 application.
14 DR. BUCHWALD: Second.
15 DR. ROSENCRANTZ: All those in favor?
16 Thank you, Dr. Kar. Congratulations.
17 --oOo--
18 MR. LESSLY: Thirteen on here is here once every
19 two years.
We've only done this one other time where we've
20 looked at the issue of renewing the
license. You know, all
21 the statutes say that the following things
are grounds for
22 disciplinary action or denial of
licensure. So we put
23 these two on because they would be grounds
for disciplinary
24 action or denial of licensure.
25 Here we are on renewal and they
disclosed those
DISCOVERY REPORTING (775) 329-3500
79
1 on their renewal application. You have a tricky situation
2 here.
You have the authority to deny licensure based on
3 the things that occurred here, you have the
authority,
4 correct me if I'm wrong, to go ahead and
license these
5 people and seek disciplinary action against
them, however,
6 if
you make the decision to do that and to seek
7 disciplinary action against them, you're
never going to be
8 in a position to revoke their license,
because you gave
9 them a new one.
10 DR. BAGGETT: Question.
Was there an application
11 for the renewal on the retired license of
Dr. Chung?
12 MR. LESSLY: Yes, sir.
13 DR. BAGGETT: Mr. Rosencrantz, I'll be happy on
14 the information I gained and a couple of
questions I have.
15 One was that there's a statement
by Dr. Chung for
16 his conviction. If you don't remember, Dr. Chung was a
17 cardiovascular surgeon here in Reno. I've referred cases
18 to him and remember him quite well. He was convicted of a
19 felony having to do with sexual misconduct.
20 And on his application, he was
relicensed in July
21 1st of 1997, and on that application, there
was no
22 statement that he was under investigation or
had been
23 convicted.
His conviction was not until 7/22/97.
He filed
24 his application on 4/2/97.
25 I guess there's another question
that if he knew
DISCOVERY REPORTING (775) 329-3500
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1 he was under investigation, most of those
type cases don't
2 run
a short course of two months or three months, and so
3 there would be a question in my mind of
whether he knew he
4 was under investigation at the time he filed
that licensure
5 or if he was advised of the investigation
after he filed it
6 and he dated it 4/2/97, if he was obliged to
tell the Board
7 and did not do so. Both of those would have been
8 violations of our statutes. And the other thing is that if
9 we
were considering a licensure for someone who is a
10 convicted felon and, frankly, it comes down
to, we should
11 not be renewing his license.
12 DR. BUCHWALD: Is he here?
He is not here.
13 MS. GAUL-RICHARD: We gave him the option to
14 appear and he said no.
15 DR. BAGGETT: So in open session, I would move
16 that we do not renew the license with Dr.
George Chung.
17 DR. DESAI: Second.
18 DR. ROSENCRANTZ: Motion and a second. Any
19 discussion?
Call for the question. All those
in favor?
20 Anyone opposed?
21 Chair votes in favor of the
motion. His license
22 is not approved.
23 MR. LEGARZA: Reason?
24 DR. ROSENCRANTZ: Based on a felony.
25 MR. LEGARZA: Felony or an offense involving
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1 moral turpitude. Conviction of an offense involving moral
2 turpitude.
Is that the reason for the denial of license,
3 Doctor?
4 DR. BAGGETT: If I remember correctly that it was
5 a felony conviction.
6 DR. DESAI: His sentence was five years probation
7 with $25,000.00 restitution to his step
daughter and
8 completion of a sex offender counseling
course.
9 DR. BAGGETT: It says felony conviction.
10 MS. GAUL-RICHARD: The Oregon stipulation also
11 states it was a felony conviction.
12 MR. LEGARZA: Okay.
That's the reason for the
13 denial?
14 DR. BAGGETT: Yes, sir.
15 MR. LEGARZA: We have to let him know.
16 --oOo--
17 DR. ROSENCRANTZ: Are we ready for Dr. Levy?
18 MR. LESSLY: I passed out faxed letters that
19 we've received for Dr. Levy over the last
two or three
20 days.
That should be something you should consider also.
21 MS. LYONS: There wasn't anyone assigned to Dr.
22 Levy at the time the memo was put together
so he was not on
23 the agenda, so there is not a particular
person assigned to
24 him.
25 MR. LEGARZA: Dr. Levy was not convicted of a
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1 felony.
You're aware of that.
2 DR. BAGGETT: Yes.
3 MR. LEGARZA: Gross misdemeanor Child Abuse and
4 Neglect.
5 DR. LUBRITZ: He pled that?
6 DR. BUCHWALD: He pled down to that.
7 MR. LEGARZA: That's correct.
8 DR. LUBRITZ: That was under some --
9 MR. LEGARZA: Alford plea means I'm not guilty,
10 but you have enough evidence to convict
me. If you convict
11 me, you can convict me of something more
than what I'm
12 entering my Alford plea to. That's what an Alford plea is.
13 DR. LUBRITZ: So there is moral turpitude?
14 MR. LEGARZA: He is convicted of two counts of
15 gross misdemeanor Child Abuse and Neglect,
which I think
16 would be considered in most circles
convictions of moral
17 turpitude, not a felony. It's grounds for denial of
18 conviction of felony and/or a crime of moral
turpitude.
19 DR. LUBRITZ: And/or.
20 MR. LEGARZA: Or a crime involving the practice
21 of medicine.
22 DR. LUBRITZ:
If he examines his children, he is
23 practicing medicine. If he examines, treats his children,
24 he is practicing medicine. Okay.
Got it.
25 MR. LESSLY: He's present.
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1 DR. MARTIN: He's been here since 9:00 o'clock.
2 DR. BUCHWALD: When he pleads down to that, he
3 says that he's not guilty.
4 DR. LUBRITZ: He's guilty?
5 MR. LEGARZA: Technically he has been adjudged
6 guilty.
He hasn't been sentenced. He
won't be sentenced
7 until Monday or Tuesday of next week.
8 DR. BAEPLER: That is a technicality.
9 DR. ROSENCRANTZ: Good afternoon, Dr. Levy. I'm
10 Arne Rosencrantz. These are other Board members, staff and
11
legal counsel and we're here today to talk to you about
12 your application in the State of Nevada.
13 I understand from reading this
file that you have
14 accepted a plea bargain of two counts of
misdemeanor Child
15 Abuse.
16 DR. LEVY: That's correct.
17 DR. ROSENCRANTZ: Would you like to explain?
18 DR. LEVY: I'd be happy to explain it to the
19 Board.
Out of a very contested and bitter divorce, my wife
20 alleged that I abused my daughters and she
has successfully
21 pressed the issue. And after consulting with my legal
22 counsel, rather than fight this issue in
court, which I
23 certainly have a right to do, I decided it
would be best if
24 I went ahead and accepted a plea bargain.
25 This was done primarily because,
well, actually
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1 it was for several different reasons. First, the trauma of
2 going through a trial and also the negative
publicity, even
3 if I do prevail, would be catastrophic both
to me and my
4 children.
And I just didn't think that was the wisest
5 thing to do.
6 I mean, I've gone over this with
my attorney
7 numerous times, and this, one of the reasons
why the plea
8 bargain was even offered is because they
realize that their
9 case really has very little chance of
successful
10 conviction.
And so, you know, this was advice given to
11
legal counsel and this is the advice that was taken.
12 DR. ROSENCRANTZ: By accepting this plea bargain,
13 I know you have not been sentenced as of
yet.
14 DR. LEVY: As of yet.
15 DR. ROSENCRANTZ: Do you have a feeling or your
16 attorney advised you as to what is going to
happen?
17 DR. LEVY: Yes, he's certain that, reasonably
18 certain that the judge will follow the recommendations
laid
19 out in the plea agreement. It's possible that he may even
20 dismiss the charges completely. My attorney has been in
21 contact with the judge and has provided the
judge with new
22 information about the case so -- but this is
what I expect.
23 The plea bargain is what I expect.
24 MR. LEGARZA: When is your sentencing?
25 DR. LEVY: It should be done tomorrow.
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1 MR. LEGARZA: Has your sentencing been continued?
2 DR. LEVY: It was continued originally because
3 the file in the District Attorney's Office
was never
4 forwarded to the probation department, so
they continued
5 it.
And the hearing is actually the -- the sentencing is
6 department three.
7 MR. LEGARZA: How many times has your sentencing
8 been continued?
9 DR. LEVY: I believe twice.
10 MR. LEGARZA: Has the Department of Parole and
11 Probation done a presentence
investigation?
12 DR. LEVY: Yes, they have.
13 MR. LEGARZA: Have you read that?
14 DR. LEVY: I haven't had access to it.
15 MR. LEGARZA: Your lawyer hasn't given you a copy
16 of the presentence investigation?
17 MR. LEGARZA: Not to this point, no.
18 MR. LEGARZA: Does your lawyer have it in his
19 possession?
20 DR. LEVY: Yes, he does.
21 MR. LEGARZA: Has your lawyer told you what the
22 recommendation is of the Department of
Parole and Probation
23 is?
24 DR. LEVY: A little foggy on that.
25
MR. LEGARZA: Do you have any
objection to our
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1 requesting a copy of that presentence report
and
2 investigation?
3 DR. LEVY: That's not a problem with that. I
4 have nothing to hide from the Board.
5 MR. LEGARZA: Would you instruct your lawyer to
6 send a copy of the presentence report and
investigation to
7 me?
8 DR. LEVY: Sure.
9 MR. LEGARZA: My name is in front of me, Richard
10 Legarza, General Counsel, Nevada State Board
of Medical
11 Examiners.
12 DR. ROSENCRANTZ: Any other questions?
13 DR. BAGGETT: I heard you say that your attorney
14 advised you that there's a probability the
case wouldn't
15 hold up.
16 DR. LEVY: Correct.
17 DR. BAGGETT: You, because of the publicity,
18 which you felt would be devastating to you
and putting your
19 license at risk in front of this Board, you
decided to
20 still plea bargain?
21 DR. LEVY: No. It
had nothing to do with the
22 Board and the license. What it had to do with is basically
23 my wife has put my children through hell and
they've been
24 manipulated by her, they've been injured by
her emotionally
25 and I felt that a trial would just create
more problems for
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1 them, would put them through more emotional
trauma and I
2 just wasn't willing to do that.
3 DR. BAGGETT: Okay.
That's a good explanation.
4 DR. HUG-ENGLISH: What is your current
5 relationship?
6 DR. LEVY: At this point, the family court has
7 released any restriction of my access. They initially
8 restricted me, and my wife's attorney still
has blocked
9 my -- any kind of contact despite the
Court's removal of
10 any restriction, and we have not argued that
in family
11 court yet, because we want this issue to be
solved. We
12 want this issue to be closed before we go
back to family
13 court.
14 I mean, we have numerous
information to present
15 in family court. We have her testimony on record in a
16 deposition where she committed perjury. We have numerous
17 witnesses and taped testimony where it shows
that she
18 conspired to try to ruin me and destroy my
reputation and
19 we have a tremendous amount of information
that we are
20 going to go back to family court with.
21 And, naturally, if we had decided
to go to the
22 criminal trial, this stuff would have come
out and would
23 have been part of the our defense. But these are very --
24 I'm put in a position of trying to prove my
innocence,
25 which is a very difficult thing to do in
these kinds of
DISCOVERY REPORTING (775) 329-3500
88
1 cases.
That's what I'm faced with. And
it's been very
2 traumatic on me. It's taken its toll. I mean, I just --
3 but that's where we're at with that.
4 DR. HUG-ENGLISH: You mentioned in your statement
5 that there were occasions when you touched
your daughter's
6 genitalia as far as exam.
7 DR. LEVY: With my wife present.
8 DR. HUG-ENGLISH: How often?
9 DR. LEVY: I have three daughters. In my entire
10 life with them, it was perhaps five. She's the one who
11 would bring them and say: Adam, what's wrong? She's
12 complaining, itching or burning or something
going on. The
13 nature of my pediatric exam would simply be
an external
14 look, make sure there's no masses or lesion
I would have to
15 have her treated for, that I would bring her
in for. I
16 look back on that and I wonder if that was
very smart. I
17 mean, I think most parents would want to
look at their
18 children's skin and look at their body and
make sure
19 they're healthy if they had a
complaint. But in
20 retrospect, I gave her ammunition and if I
was to do it
21 over again, I probably would never have done
that.
22 DR. HUG-ENGLISH: Okay.
But when you have a
23 father who takes care of a daughter who is a
single parent,
24 what do you advise him to do? I mean, it's a very -- it's
25 a very difficult situation.
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1 DR. LEVY: I've talked to many pediatricians.
2 Initially, I started calling some
pediatricians, if you had
3 a daughter, would you examine her? Would you think that
4 was appropriate or unethical? And most of the
5 pediatricians I talked to would examine
their daughters,
6 you know.
And I actually had some pediatricians write
7 statements to that effect. You know, again, in retrospect,
8 it was probably not a good idea.
9 DR. ROSENCRANTZ: Are you presently working now?
10 DR. LEVY: Well, I was up until the beginning of
11 June.
My mother is in the hospital, she's in renal failure
12 and I've gone out their temporarily to take
care of her.
13 Dr. Jeffrey Lu has been taking care of my
practice.
14 DR. ROSENCRANTZ: Are you in private practice?
15 DR. LEVY: Yes, I am, sir.
16 DR. LUBRITZ: I think in your statement on the
17 examination of your children, you not only
examined them,
18 but you applied ointment, cream or whatever
in order to be
19 able to show them how to do that. Is that correct?
20 DR. LEVY: I think I mentioned that. I think
21 maybe I did that once. Most of the children were old
22 enough at that point where they could do it
themselves.
23 DR. LUBRITZ: How old?
24 DR. LEVY: Pardon me?
25 DR. LUBRITZ: How old?
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1 DR. LEVY: Like I said, I have three daughters,
2 eight, seven and four at the time.
3 DR. LUBRITZ: You examined all three of them?
4
DR. LEVY: I don't believe I
examined the
5 youngest.
She wasn't old enough to have any problems. I
6 may, but
--
7 DR. LUBRITZ: What was the problem that you
8 found?
9
DR. LEVY: Most of the time it was
just vulvitis.
10 Sometimes there would be external like a
cellulitis.
11 They've had straddle injuries, you know,
bicycle and things
12 like that.
You know, the run-of-the-mill kinds of things
13 that happen.
And, fortunately, no tumors or things like.
14 I was faced with a case of seeing a
pediatric with a
15 sarcoma and it was missed by the family
practice. I guess
16 that's what sensitized to me. When a child has a
17 complaint, you don't ignore it.
18 DR. LUBRITZ: How many times have you ever seen
19 other than that one time, seven-year-old,
eight-year-old,
20 four-year-old would have a tumor?
21 DR. LEVY: It would be very rare.
22 DR. LUBRITZ: Saddle injury vulvitis.
23 DR. LEVY: Very, very rare.
24 DR. LUBRITZ: Extremely.
25 DR. LEVY: When you see things in residency, it
DISCOVERY REPORTING (775) 329-3500
91
1 sensitizes you. I think it sensitized me to that. Can I
2 have some water?
3 DR. LUBRITZ: If your wife was there, in
4 retrospect, could she have showed them how
to apply?
5 DR. LEVY: I think so, but I think that she
6 expected me as a physician to take care of
them. You know,
7 I think there was a certain expectation that
she had.
8 DR. LUBRITZ: What about your expectation as a
9 parent?
10
DR. LEVY: Like I said, in
retrospect, it was a
11 horrible idea. You know, now looking back on it, if I was
12 to counsel a patient and their father, I
probably would
13 tell them you should have a female show the
child what to
14 do.
15 DR. LUBRITZ: Is that on multiple occasions?
16 DR. LEVY: That I medicated? One time.
17 DR. LUBRITZ: How many times did you examine?
18 DR. LEVY: Like I said, maybe five in their whole
19 life time.
That's three children. That's
amongst three
20 children.
21 DR. LUBRITZ: Thank you, sir.
22 MR. LEGARZA: Your sentencing is Monday?
23 DR. LEVY: I'm sorry.
What is today? Today is
24 Saturday.
It's not Monday. It's
Tuesday. I'm sorry. I'm
25 a little mixed up on my days.
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92
1 MR. LEGARZA: So it's the 8th of June?
2 DR. LEVY: The 8th, correct.
3 MR. LEGARZA: The lady seated to my left, the
4 Deputy Attorney General who is one of the
board's lawyers,
5 could you make arrangements for your lawyer
to provide her
6 with a copy, her or someone representing her
at your
7
sentencing with a copy of the presentence report and
8 investigation prior to your sentencing?
9 MS. NIELSON: It may be someone from my office
10 who represents themselves as a
representative from the
11 attorney general.
12 MR. LEGARZA: Maybe if he could contact her
13 Monday and get a copy over to her.
14 DR. LEVY: You want it in the same report.
15 MR. LEGARZA: Give it to her and you won't have
16 to give it to me.
17 DR. LEVY: Oh.
Okay.
18 DR. BUCHWALD: I find it very difficult to rule
19 on a situation that is so current, that it's
not completed
20 and that the completion would have a
significant impact on
21 my assessment. And I don't know if it's possible, but I
22 would like to have it considered that this
be tabled at
23 least until Wednesday. I understand there's a time line
24 here that has to be met legally as far as
relicensing is
25 concerned.
DISCOVERY REPORTING (775) 329-3500
93
1 DR. DESAI: We can have a teleconference.
2 DR. BAEPLER: The time line is June 30. I agree
3 with that.
4 MR. LEGARZA: We can get the information and we
5 can -- he will be sentenced, I assume. You don't know
6 whether or not there will be any
continuances?
7 DR. LEVY: I hope not, sir.
8 MR. LEGARZA: We'll have a copy of the
9
presentence report and investigation, which will include
10 another evaluation and recommendation and at
least there
11 will be more information in that and we can
get the
12 information to everyone and you can decide
what you want to
13 do, either have a telephone conference call
or hold it in
14 abeyance for determination with the
understanding that
15 you'll make your decision some other time,
but I think --
16 can we
do that? Is that okay?
17 MR. LESSLY: As long as you get it done before
18 June the 30th.
19 DR. BUCHWALD: I would like to move that we table
20 this application until completion of the
sentencing, is
21 that correct?
22 MR. LEGARZA: Yes.
23 DR. BUCHWALD: And adequate time has been allowed
24 for a telephone conference.
25 DR. BAEPLER: I'll second it.
DISCOVERY REPORTING (775) 329-3500
94
1 DR. ROSENCRANTZ: Anymore discussion?
2 DR. STEWART: Before we go, can I ask a couple of
3 questions?
4 DR. ROSENCRANTZ: Sure.
5 DR. STEWART: I'm sensitive to your plight. If
6 you're going to go back to family court,
would you maybe be
7
able to have a closed session and portray all of these
8 issues in family court which will be heard
before the
9 family court judge? What is the difference of having it
10 heard in front of the criminal court judge
in your opinion?
11 DR. LEVY: Well, one is that the family court is
12 closed.
It's completely sealed. So
there's no publicity
13 possible.
And that's probably one of the biggest issues.
14 The
other issue is in family court the children do not have
15 to be involved. They do not have to call the children up
16 in front of the family court judge. So that's one of the
17 things.
18 DR. STEWART: Do your children have CASA
19 intermediary?
20 DR. LEVY: They vacated that. They had a CASA
21 report and they vacated that. They vacated that because
22 the charges that were leveled against me.
23 DR. STEWART: What did the CASA report say?
24 DR. LEVY: CASA report said I was a fit dad and
25 frankly most of the kids would prefer to
stay with me. My
DISCOVERY REPORTING (775) 329-3500
95
1 wife had thrown my son, at that time he was,
let's see 13
2 and a half, thrown my son out of her
home. That's what
3
prompted the CASA report, and that's what prompted the
4 child custody issue.
5 DR. STEWART: Do the children have a guardian ad
6 litem?
7 DR. LEVY: No.
I'm not sure what that means.
8 DR. STEWART: A guardian for the legal aspects of
9 the case?
10 DR. LEVY: They were wards of the court for a
11 while, but I'm not sure what you mean. You're using a
12
legal term and I'm not aware what that means.
13 DR. STEWART: Have the children been represented
14 in court by an attorney unto
themselves?
15 DR. LEVY: No.
They have not been permitted to
16 do so.
17 DR. STEWART: Have the children been examined by
18 a court appointed psychologist or
psychiatrist?
19 DR. LEVY: They've been examined physically, but
20 they have not been seen, except for
CASA. They do have a
21 CASA evaluation, but not a court appointed
psychiatrist.
22 We tried to do that.
23 DR. STEWART: Is there an FMAC report from your
24 standpoint you must have seen?
25 DR. LEVY: It's been a while. It was positive.
DISCOVERY REPORTING (775) 329-3500
96
1 It basically told the Court I was a fit
father, that my
2 children love me, they wanted to be with me
and there was
3 no perception at that time of any difficulty
at all.
4 And so, you know, my -- I mean, if
you look at
5 the case in total, there's a lot of
inconsistencies, if you
6 start to dissect. You know, I know a lot more about this
7 issue now that I've been embroiled in it and
it's been an
8 education for me. But if you look at the child in total,
9 you'll find that her grades were never down,
she always had
10 friends, she was well-adjusted. It was none of the
11 monikers of an abused child syndrome. There's nothing that
12 goes along with that.
13 DR. STEWART: How did this get to child abuse
14 arena at the District Attorney's Office?
15 DR. LEVY: Any time charges are brought into
16 family court, they automatically go to the
police
17 department.
That's just the nature of the beast.
18 DR. STEWART: This was a referral from family
19 court?
20 DR. LEVY: Right.
It wasn't a referral from
21 family court, because it bypasses that whole
system. It
22 goes right from CPS into the police
department.
23 DR. STEWART: Could we also get the CASA or FMAC
24 report?
25 DR. LEVY: I'm not sure if they'll give it to
DISCOVERY REPORTING (775) 329-3500
97
1 you.
They wouldn't give it to me. I
could go read it, but
2 I can't copy it. It's in Judge Jones' office.
3 DR. STEWART: Can we excuse him for a moment?
4 (Dr. Levy left the room at this
time.)
5 DR. STEWART: What do we do with this?
6 DR. BUCHWALD: What's an FMAC report?
7 DR. STEWART: Family mediation court and a CASA
8 representative is they took the children
away from both
9 parents and gave them to a guardian who was
supposed to
10 look out for the well-being of the child.
11 MS. NIELSON: Court Appointed Special Advocate.
12 MR. LEGARZA: For the children.
13 DR. STEWART: For the children.
14 DR. DESAI: Looks like you know everything about
15 that.
16 DR. BUCHWALD: Yes.
17 DR. STEWART: I think I need to disclose
18 something.
My ex-wife tried to do this to me.
I fought
19 her, I won.
I have had a court appointed psychiatric
20 evaluation.
I fought it, I won. He has bad
legal advice
21 in my opinion. And I will not vote to take away his
22 license contrary to what we talked about
last time.
23 DR. BUCHWALD: If he ends up in jail, that's a
24 different issue.
25 DR. STEWART: He should have never made an Alford
DISCOVERY REPORTING (775)
329-3500
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1 plea.
2 DR. ROSENCRANTZ: I agree with that, Paul. I
3 don't understand. I would assume he would know that he's
4 going to have trouble with this medical
Board.
5 DR. BAGGETT: But he said very clearly the only
6 reason he wanted -- he didn't want his kids
to go into open
7 court.
He feels that they're traumatized.
8 DR. STEWART: The kids would never go into open
9 court.
They are of an incompetent age to testify.
10 DR. BAGGETT: That's what his understanding was,
11 though.
Maybe he's got bad legal.
12 DR. BAEPLER: I was a foreman of a jury with kids
13 suffering, and they were called into open
court to testify.
14 DR. STEWART: How old were they?
15 DR. BAEPLER: They were six or eight.
16 DR. STEWART: They're not incompetent to testify?
17 MR. LESSLY: Not if it's determined they're
18 competent to testify.
19
DR. BAGGETT: I think he said why
he's doing this
20 thing.
You know, I guess you can look at bad legal advice.
21 He chose his path to protect his kids. I think we're
22 obligated.
Wouldn't it be sad if the judge said, no, it's
23 a felony and you are convicted of a felony
and we're
24 looking like egg on our face. We don't know what that
25 presentence report is.
DISCOVERY REPORTING (775) 329-3500
99
1 MR. LEGARZA: The judge cannot change it to a
2 felony.
The District Attorney's Office has amended the
3 complaint and made the complaint a gross
misdemeanor. The
4 judge has to sentence him on the gross
misdemeanor. The
5 judge cannot say it now becomes a
felony. The judge does
6 not say that.
7 DR. BAGGETT: What about the parole and
8 probation?
9 MR. LEGARZA: The deal is, if you read the
10 stipulated settlement, he's going to get
probation, it's
11 going to a period of years, he has to behave
himself, he
12 has to make sure he's psychologically
adjusted, but if all
13 that stuff goes awry, then the conviction
will be pulled
14 back.
They'll come back, the DA will come back in with the
15 felony indictments and they'll proceed
against him with the
16 felonies.
However, if everything is copasetic, he'll be
17 okay and the gross misdemeanor convictions
will be
18 dismissed.
19 But a key to the whole thing is
the presentence
20 report and investigation which is a highly
confidential
21 document and his answer to me was that it's
foggy. It's a
22 foggy recommendation. Now, the judge doesn't have to go
23 along with any deal that the lawyers enter
into. He's
24 stuck with the gross misdemeanor, but he can
put this guy
25 in the Clark County jail for a year on each
one of these
DISCOVERY REPORTING (775) 329-3500
100
1 gross misdemeanors and he will run them
wild, he can make
2 them consecutive, and he can give him
another year on the
3 second one, he or she, and it basically says
that in the
4 settlement agreement that the judge can
disregard that.
5 But what is the recommendation of the
Department of Parole
6 and Probation with respect to the
presentence investigation
7 report and investigation in my opinion at
least is probably
8 an important document for this Board to at
least see and
9 look at.
10 MR. LESSLY: And one that he certainly ought to
11
understand and know something about this very day and not
12 be foggy on it.
13 DR. BAEPLER: If anyone, he'd know what was in
14 the report.
15 DR. BAGGETT: His attorney has it.
16 MR. LEGARZA: Doctor, it's my belief he knows
17 exactly what's in it.
18 MS. NIELSON: Let me make the point that the
19 sentence was this Tuesday. I believe that wasn't intended,
20 of course, I have no way to be sure, that
was not delayed
21 until this.
His lawyer has had that PSI for how long.
22 MS. KNOPF: Two weeks.
23 MR. LEGARZA: At least two weeks. He can give it
24 to us, and that's why I asked for it.
25 DR. LUBRITZ: I'd like to know how many feel that
DISCOVERY REPORTING (775) 329-3500
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1 it's appropriate for a male to examine his
female children
2 and show them how to apply an ointment on
themselves?
3 DR. BAGGETT: You know, I think --
4 MR. LESSLY: That's not the issue.
5 DR. BAGGETT: I'm wondering if there was an
6 allegation that he did something out of the
presence of his
7 wife.
We don't know that.
8 DR. LUBRITZ: We don't have to go there.
9 DR. BAGGETT: If my wife came to me and I had a
10 five-year-old, six-year-old daughter and
says she's
11 complaining of this, would you look at her,
I don't think
12 I'd have a question about looking at my
daughter. And with
13 the mother right there. There's nothing sexual about that.
14 Your child has got a problem and you're
looking and, by
15 golly, I think I would. And I don't -- I think there's a
16 different thing of daddy I got a problem and
you do an
17 internal examination or something. That's not appropriate.
18 But, you know, to look at the outside of her
genitalia.
19 DR. LUBRITZ: And show her how to apply cream.
20 DR. BAGGETT: Medication.
It's a rash. If it's
21 rash, I'd say: Honey, rub it in good. I don't think the
22 father, I'm looking at this man as a father
who loves his
23 child.
I don't see any sexual connotation with that
24 examination.
25 MR. LESSLY: Unless he's sick.
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1 DR. STEWART: You have a psychiatrist.
2 MR. LESSLY: Psychologist.
3 DR. DESAI: Sometimes they're better than
4 psychiatrists.
5 DR. LUBRITZ: Dee, would you?
6 DR. DESAI: My wife is a doctor so I don't have
7 to think about it.
8 DR. STEWART: That's a different question.
9 DR. LUBRITZ: I know it is.
10 DR. STEWART: I generally don't take care of my
11 children.
But when I was a fellow, I had a professor who
12 examined his daughter because she had a
headache and he
13 missed meningitis and she died. I will go along with Rex.
14 If there is a scrape and a bump, I'm going
to look at it.
15 I change Erin's diapers. I'm dad.
16 DR. LUBRITZ: Absolutely.
17 DR. STEWART: I put Desitin ointment when I
18 change diapers, when they're needed.
19 DR. LUBRITZ: She's a year old.
20 DR. STEWART: What's the difference if she's a
21 year old or five years old?
22 DR. DESAI: I had a professor who did surgery on
23 his own daughter with appendicitis. He took her to OR and
24 did surgery.
I wouldn't have thought about it.
That's a
25 difference of perception.
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1 DR. STEWART: I can see an OB-GYN, if wife brings
2 kid and says what's wrong. I mean, if you're an orthopedic
3 with a kid, you're going to look at it.
4 DR. BAGGETT: I would have no sexual connotation
5 of examining my daughter than looking in her
ear when she
6
had a sore ear. I think that's
the point.
7 DR. ROSENCRANTZ: There is another point. We
8 don't know if he's really guilty or
not. What you do and
9 what Paul does and what Dee and anybody is
something
10 different.
We do not know what he did. I
think he has bad
11 advice.
12 DR. BAGGETT: I don't know if there's allegations
13 that can be proven.
14 MR. LESSLY: Rex, you're saying apparently it's
15 not abundantly clear to the DA, why did they
charge him if
16 this is so clear cut. The district attorney after talking
17 with you when they did the reporting on the
licensing Board
18 and the physicians, so you cannot explain
why someone else
19 is thinking differently.
20 DR. BAEPLER: Are we going to move it until after
21 the sentencing?
22 MR. LEGARZA: We can get a police report as well.
23 DR. BAGGETT: I think that's a good idea.
24 DR. ROSENCRANTZ: Can we ask him to get a
25 psychiatrist to examine him?
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1 DR. HUG-ENGLISH: I don't think we need to do
2 that.
He's had a psychologist.
3 DR. ROSENCRANTZ: That's his.
4 MR. LEGARZA: But if the court might accept that.
5 He has to, in order to get probation, he has
to be able to
6 satisfy the Court with respect to.
7 DR. DESAI: Maybe you can talk to his lawyer
8 yourself and request anything you need.
9 DR. ROSENCRANTZ: I think we'll continue the case
10 until we get a better understanding of
what's happening
11 with this guy.
12 DR. DESAI: Okay.
We will call him in and tell
13 him that we are tabling it.
14 (Dr. Levy returns to the
room.)
15 DR. ROSENCRANTZ: We have a motion on the floor.
16 DR. STEWART: We have a motion and a second.
17 DR. BAGGETT: It said that you had agreed to AACT
18 counseling.
What is that?
19 DR. LEVY: AACT counseling is basically a
20
counseling for sex offenders.
It's an eight-week course
21 during which time they take people that
either have
22 admitted to sex offenses or who have been
remanded to do
23 that course and it's basically a sensitivity
training. As
24 I might point out, it's very good. It was a good education
25 for me and I got a lot out of the course.
DISCOVERY REPORTING (775) 329-3500
105
1 DR. BAGGETT: You've already taken it?
2 DR. LEVY: I've completed the psychiatric
3 evaluation of which you have a copy and I've
completed the
4 points on the plea agreement already with
the exception of
5 the probation.
6 DR. BUCHWALD: Excuse me.
I'm sorry. Have you
7 ever had any problems with drugs or alcohol?
8 DR. LEVY: No, ma'am.
Never. I'm not a drinker.
9 I don't smoke.
10 DR. ROSENCRANTZ: Who selected your psychologist?
11 You and your attorney pick him?
12 DR. LEVY: I believe my attorney referred me to
13 him.
But -- no, he's right next to my office.
He's in the
14 next street over. There's a number of psychologists there
15 and one -- a couple of them I knew. So they knew me as
16 referrals so I couldn't go to any of
them. So I'm not
17 quite sure where the connection was made,
but I believe it
18 was my attorney.
19 DR. ROSENCRANTZ: We have a motion on the table
20 to table this until we get a little further
information.
21 Is there any further discussion on
this? If not, I'll call
22 for the question. All those in favor of tabling?
23 All those opposed?
24 DR. ROSENCRANTZ: Chair votes in favor of the
25 motion.
DISCOVERY REPORTING (775) 329-3500
106
1 MS. NIELSON: I think we need to tell him what
2 that is, the presentence investigation.
3 DR. STEWART: The initial police report.
4 MR. LEGARZA: The presentence investigation
5 report.
You might tell your lawyer, if he'd give me a call
6 or Leslie a call first thing next week and
maybe we can
7 discuss about what it is he has in the file
that would give
8 us a full picture of what is everything that
goes on the
9 PSI and the police report and if he's got
it. Fair enough?
10 DR. LEVY: That's fair enough.
11 MS. NIELSON: The telephone call probably should
12 go to Dick.
That's (775) 688-2555.
13 MS. LYONS: 486-6244.
You don't have to call
14 long distance.
15 MR. LEGARZA: What is your lawyer's name?
16 DR. LEVY: Rob Lucherini.
17 MR. LEGARZA: Spell.
18 DR. LEVY: L-u-c-h-e-r-i-n-i.
19 DR. LEVY: Do you need me to come back here
20 myself?
21 MR. LESSLY: We don't know that.
22 DR. LEVY: Okay.
23 DR. BAGGETT: I think we should be able to give
24 assurance that we'll finish this thing
before the first of
25 July.
DISCOVERY REPORTING (775) 329-3500
107
1 DR. LEVY: I got that.
2 DR. BAGGETT: I think we ought to give you
3 assurance that the Board's intent is we'll
get it handled
4 as quickly as possible and it will be in
before the first
5 of July and you'll know whether your license
has or has not
6 been accepted.
7 DR. LEVY: Thank you very kindly.
8 --oOo--
9 DR. ROSENCRANTZ: We'll move to item 17,
10 consideration of acceptance of stipulation
for settlement
11 in the matter of Nevada State Board of
Medical Examiners
12 versus Chad R. Niles, MD, case number 99-12312-1.
13 Where is my attorney?
14 MR. LEGARZA: Right here.
May the record reflect
15 my name is Dick Legarza, general counsel for
Nevada State
16 Board of Medical Examiners. And may I request, Mr. Richard
17 Young for Dr. Niles be allowed to join me up
here and
18 represent to the members of the Board that
Mr. Young is an
19 attorney licensed to practice law in the
State of Nevada
20 and has practiced law in the State of Nevada
for several
21 years, represented Dr. Niles throughout
these proceedings
22 and asked me when we entered into the
stipulation whether
23 or not either him or the doctor were required
to be present
24 at which time I indicated, no, neither him
nor the doctor
25 are required to be present.
DISCOVERY REPORTING (775) 329-3500
108
1 Mr. Young stated that he would
like to be here
2 and, of course, he is here and you may enter
your
3 appearance for the record, if you care to do
so.
4 MR. YOUNG: Thank you, Mr. Legarza. My name is
5 Richard Young. My office is in Reno. Please excuse my
6 casual appearance today. I came from the garden, quite
7 frankly, and I'm here on behalf of Dr. Niles
and I hope you
8 excuse my appearance.
9 MS. NIELSON: Dr. Hug-English has a point she
10 would like to raise.
11 DR. HUG-ENGLISH: As part of the adjudicating
12 members, I would like to recuse myself
because I had
13 knowledge of this complaint and was actually
the one who
14 brought the complaint to the Board so I
would like to be
15 recused from the adjudication.
16 DR. ROSENCRANTZ: I think we'll accept that
17 recusal and I think we should read the names
of the
18 adjudicating members who are here. Myself, Susan Buchwald,
19 Rex Baggett, Paul Stewart and Donald
Baepler. Those are
20 the members who will be adjudicating the
case.
21 MR. LEGARZA: You have in your packet under
22 number 17 a copy of the complaint that was
filed by the
23 investigative committee against Dr. Niles
wherein he was
24
accused of engaging in two counts of -- engaging in conduct
25 intended to deceive.
DISCOVERY REPORTING (775) 329-3500
109
1 You have a copy of the stipulation for
settlement
2 wherein he entered a plea of guilty to the
complaint and
3 Count Two of the complaint. And also attached to the
4 settlement agreement is a one-page handwritten
statement of
5 Dr. Niles.
The original list is in the file at the Board
6 office and Dr. Niles's signature does appear
down at the
7 bottom.
8 I will represent to you that I
have never done
9 this before in any settlement agreement
prior to this time,
10 requested of the physician to actually in
their own
11 handwriting state what it is that they did.
12 The recommendation of myself and
the
13 investigative committee and the stipulation
that we have
14 entered into is that Dr. Niles, who has a
resident licensed
15 physician, that he be issued a public
reprimand and that by
16 definition means that the matter will be
reported to the
17 national practitioners data bank as well as
the federation,
18 which by definition this proceeding will
follow Dr. Niles.
19 That he be required to perform 20
hours of
20 community service at a location to be
approved by the
21 Secretary of the Board. Community service to be completed
22 within three months of the date of any order
of the Board
23 approving the stipulation. And he be required to pay
24 $20,081.26 for the administrative costs
associated with the
25 investigation and prosecution of the
complaint against him
DISCOVERY REPORTING (775) 329-3500
110
1 and that he be -- pay the sum of $2,000.00
as and for the
2 distribution of payments that may have been
received by him
3 because of his Internet activities in this
endeavor.
4 I stand ready to answer any
questions from any
5 member of the Board.
6 DR. ROSENCRANTZ: Dr. Baggett?
7 DR. BAGGETT: Has the State of Florida had any
8 inquiry as to somebody proposing that they
were an MD
9 licensed, kind of purporting that they were
licensed in the
10 State of Florida is -- is he licensed in the
State of
11 Florida?
12 MR. LEGARZA: To our knowledge, Dr. Niles is not
13 licensed in the State of Florida.
14 DR. BAGGETT: If we saw this as C. Niles, Pioche,
15 Nevada would we not be bringing charges of
practice of
16
medicine without a license? Just
counsel, just roughly,
17 wouldn't that be probably constituting
practice of medicine
18 without a license?
19 MR. LEGARZA: The way I read the testimonial
20
here, Doctor, I don't think so.
21 DR. BAGGETT: This says like he lives there.
22 MR. LEGARZA: Whether it would be Boca Raton or
23 an address in Nevada.
24 DR. BAGGETT: A number of my own patients, it
25 sounds like he was practicing medicine. He was promoting
DISCOVERY REPORTING (775) 329-3500
111
1 this program to his patients in Florida and
that's
2 practicing medicine without a license. I wonder, do we
3 have any obligation to let Florida know that
there's
4 somebody maybe practicing medicine without a
license in
5 Florida?
6 MR. LEGARZA: The only thing that I can tell you
7 there is no C. Illes, MD in Boca Raton,
Florida.
8 DR. BAGGETT: We know that this picture is Chad
9 Niles of Las Vegas, Nevada, who was
purporting himself.
10 MR. LEGARZA: Chad Niles of Sparks, Nevada, who
11 is purporting to be Dr. Illes of Boca
Raton. We charged
12 him with the conduct intending to deceive.
13 DR. BAGGETT: Okay.
I'd like to ask a question:
14 How do we get to 20 hours of public
service? You know,
15 I -- somebody who is holding themselves out
on the Internet
16 fictitiously and that there were things that
they gained
17 financially out of it, how do we get 20
hours? Is there
18 some sort of-- or was that a-- I guess I
don't know,
19 counsel.
How do we get to 20 hours?
20 MR. LEGARZA: I think that probably is my idea
21 based upon my experience of the last several
cases that we
22 have settled where we have required
approximately 20 hours
23 of community service of physicians who have
stipulated with
24 us a settlement of cases. And I think it -- quite frankly,
25 I represent to you that I started doing it
after Dr.
DISCOVERY REPORTING (775) 329-3500
112
1 Buchwald asked me one time how come we
didn't require
2 public service. So it's standard plea agreement with me
3 from now on.
That's why it's in there.
4 DR. BAGGETT: I think it may be at a time when we
5 can make a little discussion as our feelings
on this. You
6 know, here we have a person with a limited
license with us,
7 that has false representation of himself as
a practicing
8 physician, as I see it. I mean, he's dishonest, holding
9 himself out to the public and then he
compounds it with
10 this dishonest diatribe that he sends to
Board members
11 stating that this was not anything and then
he comes
12 through.
Obviously, when he's caught red-handed and
13 acknowledges, yes, it was me. Makes me mad as hell.
14 And it makes me think that this
guy's dishonesty
15 is
such that there's a bigger debt than 20 hours that he
16 owes to the public. And that's where I came up with that.
17 I was wondering how we got that. I would really think that
18 probably closer to 100 hours and probably in
some sort of
19 menial position of maybe being a clerk for
an emergency
20 room where he is giving his services free to
whoever comes
21 in through that emergency room would have
been probably a
22
little bit better and why not 200 hours.
I guess I'm
23 generous.
24 MR. LEGARZA: Can I respond to the Doctor, first?
25 Certainly, the agreement itself says that
the Board has to
DISCOVERY REPORTING (775) 329-3500
113
1 approve the agreement. And if the Board doesn't approve
2 the agreement, we'll set it for trial, and
we's go to
3 hearing.
Or if the Board feels and you feel that you want
4 to instruct me as counsel for the Board to
meet with
5 counsel for Dr. Niles and see if some
settlement can be
6 made in the areas of the perimeters that you
or anyone else
7 may be suggesting, certainly I will do that
if counsel
8 would sit with me and do that. We'll go to hearing. So
9 obviously you don't have to approve this
settlement.
10 DR. BAGGETT: Okay.
11 DR. BUCHWALD: Mr. Legarza, is Dr. Niles a family
12 practice resident or an internal medicine
resident?
13 MR. LEGARZA: Internal medicine counsel.
14 DR. BUCHWALD: What year?
15 MR. LEGARZA: Just completing his first year, I
16 believe.
17 DR. BUCHWALD: I agree with Dr. Baggett. I'm
18 insulted by this gentleman's behavior. I find it really
19 reprehensible.
20 I think he's deceitful. I'm not sure what I want
21 but this isn't it. This is to me, this stipulation is kind
22 of like a pat on the butt and send him on
his way. I find
23 this disgusting and I really am not happy
with the
24 stipulation in any sense of the word.
25 DR. ROSENCRANTZ: Any other comment? Dr.
DISCOVERY REPORTING (775) 329-3500
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1 Stewart.
2 DR. STEWART: Nothing.
3 DR. BAEPLER: I agree with the sentiments
4 expressed by Dr. Buchwald and Dr. Baggett
very much.
5 DR. ROSENCRANTZ: I want to tell you that I agree
6 as well.
After reading the stipulation, I thought it was
7 very, very light. You know, I can't imagine a young
8 physician starting out this way and I'm not
sure that with
9 this kind of stipulation that he'll remember
this. I also
10 think that something else should be
done. We'll listen to
11 some direction.
12 DR. BAGGETT: I would propose that at a minimum
13 he have 100 hours of community service.
14 DR. BAEPLER: We have to let our attorney
15 negotiate.
16 DR. BAGGETT: This is an idea we can go back to
17 him, a minimum of 100 hours and I think it
ought to be in
18 some sort of a position where he is not
using his medical
19 talents, he's using a lower level of talent
to be of
20 service to the public. And maybe that would be something
21 that I would think like clerking in an
emergency room, he
22 would have some good information, he can be
of help and
23 folks coming through there and probably -- one
other thing,
24 I guess, is there any sanctions that his
program has -- are
25 they letting this thing slide? Do we know anything about
DISCOVERY REPORTING (775) 329-3500
115
1 that?
2 MR. LEGARZA: The only thing I can tell you is
3 that I think that you can make
suggestions. You can
4 certainly not accept the stipulation, at
which time I have
5 the burden of presenting evidence to
convince you to as
6 adjudicators to find him guilty and then you
have your
7 options once you do that under the medical
practice act.
8 You can revoke him, you can revoke him and
stay
9 the revocation and place him on probation,
you can issue a
10 public reprimand, you can require community
service, you
11 can require him to pay the costs, you can fine
him and you
12 can -- but you cannot get any -- so I guess
the question is
13 what we have, what I am proposing to you and
what we have
14 entered into doesn't appear to be strong
enough for you.
15 The next strongest thing is a revocation and
stay and then
16 the next strongest thing after that is
revocation.
17 DR. BAGGETT: I don't have any disagreement with
18 the disgorgement of funds, and I think this
man owes more
19 back to society. I think public service of longer duration
20 of 20 hours and what I was thinking, saying
is that as a
21 Board we deny this stipulation that we vote
against
22 accepting this stipulation, but empower you
to go back with
23 a larger amount of public service time, and
if he accepts
24 that, then he can come back to this Board
for approval.
25 MR. LEGARZA: I'm not hearing the same thing over
DISCOVERY REPORTING (775) 329-3500
116
1 on this end of the table.
2 DR. BUCHWALD: My concern is that he lied.
3 DR. BAGGETT: Oh, badly.
4 DR. BUCHWALD: I get the feeling that until he
5 was absolutely pressed to the wall did not
rescind that
6 lie.
We have enough dishonest physicians.
I don't think
7 we need to go looking for trouble. And at this moment,
8 when I read some of this stuff, I was ready
to revocate. I
9 don't care if he gets to his residency or
not. I'm not
10 sure he deserves to be in the
residency. I want to hear
11 from him.
I want to see this young man.
12 DR. BAGGETT: I think what we ought to look to,
13 we don't stand with the stipulation and that
means he goes
14 on to a hearing.
15 DR. BUCHWALD: I would move that we do not accept
16 the stipulation.
17 DR. BAGGETT: Second.
18 DR. ROSENCRANTZ: Well, we have a motion and a
19 second.
We'll have some discussion.
20 DR. ROSENCRANTZ: I could live with the
21 stipulation if we change it. I don't know if the end
22 results after a hearing would be a lot
different than what
23 we maybe can come up with. I think certainly the
24 attorney's here, he's hearing our
thoughts. I think the
25 100 hours of community service is good. I have no idea how
DISCOVERY REPORTING (775) 329-3500
117
1 much money this gentleman made, I think the
200
2 disgorgement is small. I think we can increase it. I know
3 he's just a resident. I think something that maybe would
4 hurt a little bit more like a $5,000.00
figure would make
5 me feel better. So that's my feelings on it. I think that
6 I could live with 100 hours of community
service and public
7 remand, the fine of paying the legal fees
and maybe a
8 $5,000.00 disgorgement. I think he would know, and this
9 record will follow him for the rest of his
life.
10 DR. BUCHWALD: I need to know that his program
11 knows what's going on and is willing to
reassess his
12 stature in that program on a regular basis
and evaluate
13 this gentleman on a regular basis so that
what we say and
14 do is just not a done deal and he just walks
on.
15 DR. BAEPLER: I was going to ask the question
16 relevant to that. Is it possible that the people in charge
17 of the residential program might take some
addition new
18 action?
19 DR. ROSENCRANTZ: We don't know.
20 DR. BAGGETT: Susan makes a real good point. Not
21 only once, but twice he just lied through
his teeth. And,
22 you know, the moral turpitude comes into
play here. We
23 have somebody who is not above lying like
everything.
24 DR. BAEPLER: It's not just a lie. This is very
25 much planned, premeditated, programmed. A lie is almost
DISCOVERY REPORTING (775) 329-3500
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1 too easy word to use here.
2 DR. BAGGETT: You're right.
It's despicable.
3 DR. BAEPLER: It was a plan that was a scheme,
4 you know.
5 DR. ROSENCRANTZ: You know, I'm usually pretty
6 tough on physicians. I think in a public manner, I want
7 you to consider, I think we have a great
case and we can
8 win, ask once we win the case, I mean if
it's a matter
9 unless you want revocation, I think, then
you're going to
10 stay the revocation, I think.
11 DR. BAGGETT: I don't think I want revocation. I
12 guess that's the thing. I'm looking more towards this guy
13 getting the message the Board is certainly
holding him to a
14 much higher standard.
15 MS. NIELSON: May I say that your option here as
16 you all know is to approve the stipulation
or not. I
17 understand you want to give direction to
counsel in their
18 further negotiations, but if the matter goes
to hearing,
19 then your decision would be made as to
what's the
20 appropriate sanction after the hearing and
after all the
21 evidence is in.
22 MR. LEGARZA: And after you've made a
23
determination that he in fact -- that I in fact proved the
24 case.
25 MS. NIELSON: After there is a guilty finding.
DISCOVERY REPORTING (775) 329-3500
119
1 So your suggestions to counsel as to what
your thoughts
2 are, that's wonderful, but I recommend that
the Board not
3 make any decision as to what the appropriate
sanction
4 should be in the future.
5 DR. BAGGETT: Counsel, I think the reason for
6 this is we see what is in our packets,
including his
7 written statement, and, you know, his
written statement is
8
just damming.
9 MS. NIELSON: But at hearing there will be
10 further evidence put on the record.
11 DR. BAGGETT: Uh-huh.
12 MS. NIELSON: So you have two options; that is,
13 to accept the stipulation or to let these
two work --
14 three, let these two go back and work on a
settlement that
15 might satisfy you or to go to hearing.
16 DR. BAEPLER: But to do that, do we have to
17 reject this?
18 MS. NIELSON: Absolutely.
19 DR. BAEPLER: The motion is appropriate.
20 DR. BAGGETT: Motion is seconded.
21 DR. ROSENCRANTZ: We'll vote on the motion which
22 was?
23 DR. BAGGETT: Susan, did you make the motion or I
24 made it.
I thought you made the motion.
25 MS. LYONS: Susan made the motion, and Rex
DISCOVERY REPORTING (775) 329-3500
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1 seconded to not accept the stipulation.
2 DR. ROSENCRANTZ: We have that motion on the
3 table.
Any further discussion? So let's
go with the
4 question.
All those in favor?
5 Anyone opposed?
6 Chair votes in favor of the
motion. We're not
7 accepting the stipulation.
8 DR. BUCHWALD: May I ask counsel, if we want Mr.
9 Legarza to go back and renegotiate the
stipulation?
10 MS. NIELSON: You're not giving Mr. Legarza any
11 instructions on as to how to negotiate the
stipulation.
12 That is for the investigative committee in
consultation
13 with Mr. Legarza to handle that matter.
14 DR. BAEPLER: We're done.
15 MS. NIELSON: That's right.
16 --oOo--
17 DR. ROSENCRANTZ: Next case, Alvin Miller. Is he
18 here?
19 MR. LEGARZA: I do not believe that Dr. Miller
20 will be here nor do I expect his attorney to
be here. Once
21 again, his attorney asked me whether either
him or the
22 doctor were required to be here and I said
no. So they
23 have chosen not to be here.
24 DR. ROSENCRANTZ: We're checking out there to
25 make sure that they're not here. We'll wait one second to
DISCOVERY REPORTING (775) 329-3500
121
1 make sure they're not.
2 MR. LEGARZA: Are you ready?
3 DR. ROSENCRANTZ: Number -- agenda item number
4 18, consideration of acceptance for
stipulation of
5 settlement in the matter of Nevada State
Board of Medical
6 Examiners vs. Alban I. Miller, case number
99-088. And the
7 adjudicating Board members will be Arne
Rosencrantz, Susan
8 Buchwald, Dr. Rex Baggett, Dr. Paul Stewart,
Dr. Cheryl
9 Hug-English and Donald H. Baepler. Mr. Legarza?
10 MR. LEGARZA: A copy of the complaint was not
11 included in your books.
12 DR. BAGGETT: No. I
don't know the facts of the
13 case?
14 MR. LEGARZA: I should have seen the copy of
15 the --
16 DR. BAGGETT: I'm sorry.
Yes, I do.
17 MR. LEGARZA: Is a copy of the complaint in
18
there?
19 DR. BAGGETT: Yes.
20 MR. LEGARZA: Do you have a copy of the complaint
21 in your books?
22 DR. BAEPLER: Yes, we have it.
23 DR. BAGGETT: I doesn't outline.
24 MR. LEGARZA: Let me tell you what the facts were
25 in the case.
Dr. Miller is plastic surgeon, I think.
DISCOVERY REPORTING (775) 329-3500
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1 MS. KNOPF: That's correct.
2 MR. LEGARZA: And he does procedures in his
3 office.
Scheduled this lady for a procedure in his office
4 to fix her ear lobes which just get cut over
the years from
5 pierced ears and she had a deviated septum
and she wanted
6 him to fix her nose at the same time. And he said I can't
7 do that procedure today, come back in a
couple of days, so
8 she did and she came back in a couple of
days and Dr.
9 Miller and an OT, operating technician, I
guess, a better
10 than who is not licensed so far as we know.
11 MS. KNOPF: Correct.
12 MR. LEGARZA: Began this procedure on this lady
13 and there's -- it was a time thing. Our experts, one
14 expert that had it reviewed by a peer review
by an
15 anesthesiologist and a plastic surgeon, they
both said
16 gross malpractice. He gave her 500 MC or MG, something of
17 Phenol, which the anesthesiologist said was
enough to kill
18 her because of her weight. At any rate, this thing went to
19 hell on him.
They started doing stuff, he called the
20 paramedics, he gave her something to reverse
this thing.
21 The paramedics came, they transported her to
the hospital
22 and she laid in a coma at UMC.
23 MS. KNOPF: UMC.
24 MR. LEGARZA: For 54 days and died. So we filed
25 one count of malpractice against him, and
this is the
DISCOVERY REPORTING (775) 329-3500
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1 stipulated.
2 DR. BAGGETT: One count of gross malpractice.
3 MR. LEGARZA: One count of gross malpractice.
4 DR. BAEPLER: Is there going to be any
5 litigation?
6 MR. LEGARZA: There is litigation. It's already
7 gone to the MLSP. There's a MLSP finding of reasonable
8 probability of malpractice, she was 24 years
old and two
9 children.
10 DR. HUG-ENGLISH: Did we get it from the MLSP.
11 MR. LEGARZA: We found out about it from a
12 physician in Las Vegas.
13 DR. BUCHWALD: Because we have this complaint, do
14 we or did we investigate any other
procedures that were
15 done in that office?
16 MR. LEGARZA: We have sent off. We were going to
17 hold off filing the gross malpractice
complaint, because of
18 the fact that gross malpractice is
conscience indifference,
19 which is almost like malice
aforethought. We have reviewed
20 three other cases, different procedure. We've sent those
21 off to be reviewed by an expert and all
three cases have
22 come back no malpractice. We're aware of one other
23 instance of a problem with someone on the
sedation in the
24 office, but that's it.
25 DR. BUCHWALD: His explanation of how this
DISCOVERY REPORTING (775) 329-3500
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1 occurred, was that ever part of your
discussions?
2 MR. LEGARZA: Yes.
Yes.
3 MS. KNOPF: He said after we go through the
4 procedure, the patient started to awaken and
felt the need
5 to give her more and he gave her more and
almost
6 immediately after he gave her more. All of the alarms went
7 off on the pulse oximeter and the other
things they had her
8 hooked up to and that was it.
9 DR. ROSENCRANTZ: Is this gentleman a board
10 certified plastic surgeon.
11 MR. LEGARZA: Yes.
He also has hospital
12 privileges currently at more than one
hospital in Clark
13 County.
14 DR. BAGGETT: The stipulated agreement is for
15 revocation and suspension of the revocation,
which
16 certainly at least would match what this
Board would
17 normally do in a case of gross malpractice.
18 MR. LEGARZA: This stipulation is one step short
19 of putting this guy out of business. My experience in
20 presenting gross malpractice cases to the
Nevada State
21 Board of Medical Examiners is tough to talk
about because,
22 let's talk about Gilbert, death cases. I don't know.
It
23 is my impression that if the case had gone
to hearing and
24 had been presented and you were convinced
under the
25 standards of proof that the doctor engaged
in conscience
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125
1 indifference, the only other thing you would
do to him is
2 just out and out revoke him and I don't know
that you
3 would.
We have put him out of this business forever in
4 this stipulation, I believe.
5 MS. LYONS: Can we go off the record for one
6 second minute
7 (off-the-record discussion.)
8 DR. ROSENCRANTZ: Back on the record.
9 DR. BAGGETT: So what this would do in essence,
10 it's a reportable event, if he would be
precluded from
11 doing office sedation, conscious sedation
surgery, so it
12 would be protective to the public. Do we have any
13 background history? I mean, has he had previous problems
14
before this Board or in other boards in other states?
15 MR. LEGARZA: I don't think we have any evidence
16 of any other problems with any other boards
in any other
17 states.
And we have just closed four cases, three cases,
18 but going back two months, like maybe three
or four other
19 cases.
20 DR. BAGGETT: Because there was not enough
21 evidence.
22 MR. LEGARZA: Nothing resulted in formal
23 complaints.
24 DR. ROSENCRANTZ: Tell me what kind of procedures
25 this is going to stop him from doing?
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1 DR. HUG-ENGLISH: It would stop him from doing
2 anything involving anesthesiology without an
3 anesthesiologist present. That's where he got in trouble
4 trying to provide his own anesthesia for his
patients.
5 DR. ROSENCRANTZ: He won't do facelifts or breast
6 reductions.
He'll do the surgeries in a supervised
7 environment with an anesthesiologist, is
that correct?
8 MR. LEGARZA: He can't do it in his office. He
9 has to do it in the hospital or one of these
approved
10 clinics and there's about six of them in
Clark County and
11
that's during his probationary period.
And after his
12 probationary period, he can't do it any
place except in a
13 hospital unless you guys say he can get
tighter after his
14 probationary period, which he has agreed to
here.
15 DR. BUCHWALD: That doesn't sound like it was
16 done with malice. It was a stupid moment, but not malice.
17 DR. HUG-ENGLISH: I like the stipulation. I
18 think it's complete. It does what we need it to do. It
19 takes him away from that type of practice
and I think it
20 definitely gets his attention. So I would move that we
21 approve this stipulation.
22 DR. STEWART: Second.
23 DR. ROSENCRANTZ: We have a motion and a second.
24 We have discussion. Has he agreed? The one we have is not
25 signed.
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1 MR. LEGARZA: He has signed it and Dr. Desai
2 signed it.
When the packet went out it had not been fully
3 executed by him or, I take that back. I didn't have his
4 back yet with his signature on it and Dr.
Desai just signed
5 it yesterday, but Dr. Desai had approved it
a week or so
6 ago.
It's all duly signed.
7 DR. ROSENCRANTZ: Any further discussion?
8 DR. BAEPLER: I have a question. Revoke
9 respondent's license to practice medicine?
10 MR. LEGARZA: Yes.
11 DR. BAEPLER: And for three years.
12 MR. LEGARZA: We stay the revocation.
13 DR. BAEPLER: I understand.
14 MR. LEGARZA: That gives us leg up on possible
15 future things because now all we have to do,
all we have to
16 do is prove any kind of other violation of
the Medical
17 Practice Act.
18 DR. BAEPLER: And you call his probation.
19 MR. LEGARZA: And then we would be able to on the
20 basis of that, because we stayed a
revocation, we would be
21 able to revoke him for looking askance,
practically.
22 DR. BAEPLER: Okay.
23 DR. ROSENCRANTZ: Any other discussion?
24 Motion's on the floor. All those in favor.
25 Anyone opposed?
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1 Chair votes in favor of the motion. We'll accept
2 the stipulation.
3 --oOo--
4 I, Stephanie Koetting, CCR #207,
do hereby
5 certify that the foregoing transcript,
consisting of pages
6 1 through 128, is true and correct to the
best of my
7 knowledge, skill and ability.
8 DATED: This 18th day June, 1999.
9 _________________________________
STEPHANIE KOETTING, CCR #207
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