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1 BEFORE THE
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13 TRANSCRIPT OF PROCEEDINGS
14 MEETING
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25 Reported by: STEPHANIE KOETTING, CCR #207
Computer-aided Transcription
DISCOVERY REPORTING (775) 329-3500
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1 DATED: At
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4 DR. HUG-ENGLISH: We'll call this continuation of
5 the Nevada State Board of Medical Examiners
back to order.
6 And we left off, we
got such a lot accomplished last night,
7 so I think we will go back to agenda item
number four,
8 which is consideration of request by Steven Kessinger -- we
9 did four.
I apologize.
10 MR. LESSLY: Go to nine and let Mike proceed with
11 his report.
12 DR. HUG-ENGLISH: That's the one. Okay.
To
13 agenda item number nine, my apologies, and
do we have
14 Michael?
15 MR. GARCIA: Yes, good morning. Actually, as a
16 representative of our committee, we do not
have a formal
17 report at this time. The agenda items we worked on were
18 basically handled by Steven and you all met
yesterday
19 afternoon. I might ask were the programs approved and
were
20 the lists approved that we submitted?
21 DR. HUG-ENGLISH: Yes.
22 MR. GARCIA: Wonderful.
I'll return to our
23 constituency with
our report.
24 DR. HUG-ENGLISH: I think the only other item
25 under number nine was the investigative
report.
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1 DR. STEWART: We had a small meeting this morning
2 and what we did will appear on the next --
pass around the
3 list of closed cases, people we
reviewed. And I think
4 there are three or four that we have more
work to do. And
5 then we will have a telephone conference to
decide what's
6 going to be there. There was some cases that we really
7 looked at and we looked at and decided that
we could not
8 file, we didn't have the ability to get
someone to come
9 testify, so we closed that.
10 DR. HUG-ENGLISH: What does that mean?
11 DR. STEWART: It's a he said, she said kind of
12 issue and the he is somewhere in the eastern
part of the
13
14 request.
On the 7th of August, we had a meeting in Las
15 Vegas.
The cases that are listed there, close to two and a
16 half pages, we did all in August. So far we've had two
17 meetings in an attempt to get through the
really mammoth
18 workload that we're
getting now.
19 DR. HUG-ENGLISH: Okay.
The list of cases that
20 have been closed is circulated and I want to
thank the IC
21 for all their work. It truly is a tremendous amount of
22 time and effort to be on that committee and
go through
23 those cases. So thank you all for all of your time and
24 effort on those.
25 And I guess we'll wait until this
circulates for
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1 approval till everyone has seen it. After people have had
2 a chance to look at it, let me know, and
I'll need a
3 motion.
4 DR. MONTOYA: While we're at a lull here,
5 something that the three of us on the
investigative
6 committee, and we were talking last night,
is that maybe if
7 our legal counsel could come up with some
other remedies
8 that we could use to let doctors know we're
thinking about
9 them instead of just -- instead of having to
file on
10 everybody. Something that doesn't raise
up to a level
11 where we want to jerk their ticket.
12 MR. LESSLY:
A serious Christmas card.
13 DR. MONTOYA: Something like that: Oh, you're
14 busted.
We think there has to be some way that all the
15 minds in this room can come up with
something.
16
MR. LESSLY: We can do it and I
don't think the
17 legislature would
approve it. There's a great deal of
18 emphasis on everything being totally open, I
think, if we
19 do anything in the form of disciplinary
action or criticism
20 or whatever.
21 DR. BAEPLER: It may be that we can discover that
22 we could be totally open. In talking to people in the
23 meeting in
24 federation, there are some states that have
a range of
25 options.
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1 has a whole range of options. I wonder if we could select
2 how you pick them. Half a dozen states that have a pretty
3 good system just to see what some other
states are doing or
4 an idea or two in
there that we can incorporate.
5 MR. LESSLY: It takes a statutory change.
6 DR. BAEPLER: Takes a statutory. It always
7 reaches the point,
everybody on the investigative committee
8 always reaches a
point of frustration. It's not bad
enough
9 to jerk a license. We don't know what to do, we generally
10 punt, which means
call them in.
11 MS. JONES: We used to send a letter which we
12 can't do anymore.
13 DR. BAEPLER: And so the sense of frustration
14 occurs that at just about every meeting, I
wish we had a
15 couple of options. And maybe there are no options. That
16 may be the answer.
17 MR. LEGARZA: Thinking out loud, there may be
18 something that the
legislature may buy, perhaps, and maybe
19 I'll tell you that I'll look at it, if you
want me to, I'll
20 be glad to look at it in the other states
where maybe
21 there's something we can enter into by way
of some sort of
22 stipulation that
would allow us to do something, but I
23 think that would still have to be probably
some sort of a
24 public document.
25 DR. BAEPLER: I don't think we object to that. I
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1 don't think that that should hang us up from
having more
2 options.
3 MS. BIBLE: You have the doctors respond to the
4 complaints?
5 MR. LEGARZA: Uh-huh.
6 MS. BIBLE: Do you then ever bring those doctors
7 before you?
8 MR. LEGARZA: Of course.
9 MR. LESSLY: Sure.
10 MS. BIBLE: When you bring them before you, at
11 that time, do you decide at that -- do you
know at that
12 particular time
where you're going with the complaint?
13 MR. LEGARZA: Uh-huh.
14 MS. BIBLE:
You have them come in and talk with
15 you. What about like exit interviews with doctors?
16 MR. LEGARZA: What do you mean "exit
interviews"?
17 MS. BIBLE: Have them come back in to tell them
18 what the results of the
complaint is and it's not that
19 there's not enough evidence, you would just
tell them that
20 we are not going to proceed on this because
we don't have
21 the evidence to make our case, but this is a
very serious.
22 DR. BAEPLER: We probably have to meet for three
23 days when you look at the numbers and it's a
little bit
24 one-sided, whereas we frequently interview
the doctors, we
25 never interview the complainant. So we're always getting
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1 the one side. I don't know if you've brought a complainant
2 in to have them fully explain the case. We kind of neglect
3 these people.
4 DR. STEWART: The worry that I think we have by
5 giving them a closed door yelling and
screaming don't do
6 that again is that it -- that's the private
reprimand that
7 the psychologist got.
8 MR. LESSLY: You can't get a reprimand until you
9 determine that there's something wrong. It's not wrong
10 unless it violates the
medical practice act.
11 DR. MONTOYA: Some people are just right there on
12 the edge that you want to tell them, say,
look, whatever
13 you're doing, quit
it.
14 DR. STEWART: Quit doing it. Think about it.
15 DR. HUG-ENGLISH: Like a letter of concern.
16 DR. MONTOYA: Want to send out a letter of
17 concern without saying that, because that
seems to be a bad
18 word.
19 MR. LESSLY: We can't do it unless the
20 legislature
approves it.
21 MS. BIBLE: Can't you do a letter, not a
22 reprimand.
You say, this is on the line and we cannot find
23 this on the evidence.
24 MR. LESSLY: I believe it's your own office that
25 says we can't do
that.
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1 MS. BIBLE: Do you think it's still a reprimand,
2 if you say the reasons I'm not going forward
is because
3 we're not going forward is
on the line.
4 MR. LESSLY: It would have to not rise to the
5 level of violation. You can't give them a letter of
6 concern unless there's been a violation.
7 MS. BIBLE: Not a letter of concern telling them
8 we are not going to take action and the
reason we're not
9 taking action is because the evidence that
we have obtained
10 we do not believe that we could support our
case.
11 MR. LEGARZA: Why are you writing the letter if
12 you don't have a case against the
doctor. You better leave
13 him alone.
14 MS. BIBLE: The letter would say it's still a
15 concern, we're not proceeding.
16 MR. LEGARZA: If it's not a violation of the
17 medical practice act,
you leave him alone.
18 DR. BAEPLER: You reach the point in the
19 committee where it does
not violate the medical practice
20 act in the strictest concerns. We can see the thing
21 heading in that
direction.
22 MR. LEGARZA: Maybe you can put more grounds for
23 disciplinary action
that may not be as heinous. But then I
24 think there's still a point where you may or
may not have
25 to file a formal
complaint. How do you get around
that?
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1 DR. BAEPLER: If it rises to that level, we'll do
2 it.
3 MR. LESSLY: You want to add rudeness is the
4 grounds of rudeness, would take care of a
lot of your
5 problems.
6 MS. BIBLE: But in your complaint, when you file
7 a complaint, you can also indicate the type
of action you
8 want to take. You're not going to revoke, we specifically
9 want to fine or we specifically want you to
take CME, so
10 when it's out in the public, the public
knows what your
11 concern is.
12 DR. BAEPLER: And it puts it in the perspective.
13 DR. ANJUM: It might be more satisfying to the
14 person who is complaining that some action,
even though
15 it's not strictest, the person who is
complaining might
16 have a better feeling and that will make us
feel like we're
17 doing something for
them.
18 DR. HUG-ENGLISH: I'm gathering that the board is
19 indicating that we would like Dick to look
at some other
20 possibility.
21 MR. LEGARZA: Thank you.
22 DR. HUG-ENGLISH: Is that what I'm hearing? And
23 you can offer that in December.
24 MR. LEGARZA: I'm sure if we are lucky enough to
25 get some sort of proposal, for the
legislature or two, and
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1 that all the board members will join us in
2 we propose it.
3 MR. LESSLY: As a matter of fact, I think they
4 really ought to propose it. They need to stand in front of
5 the existing proposed legislation.
6 DR. BAEPLER: You go to the legislature, you open
7 up that issue, and, my God, you have no idea
what might
8 come out.
9 MR. LESSLY: Wise comment.
10 DR. HUG-ENGLISH: We'll have a follow-up to this,
11 then, in December and look into it a little
bit. I think
12 it is good to look at what some other states
are doing,
13 perhaps, and whether there's
some other options out there
14 that would be easy to
introduce.
15 MS. KIRCH: If we have to bring more forward,
16 like
17 in the complaint saying, you know, this is a
lesser type
18 thing and then if it's public we do whatever
we have to do,
19 whether it's a letter of concern, or
following up.
20 DR. HUG-ENGLISH: Are we ready to start our
21 appearances? I think we'll move to agenda item number 12
22 and we do have quite a few appearances
today. The first
23 one is Brad Manny. This is in open session. And Dr. Anjum
24 is selected to ask
those questions. So is there anything
25 that we want to discuss or are you ready to
bring him in?
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1 DR. ANJUM: I want to briefly talk about this.
2 Do we go in the closed session before
that?
3 No? The only concern the gentleman being out of
4 practice since '99.
5 MR. LESSLY: That's it.
That's all.
6 DR. ANJUM: Early '99 or late or whatever. He's
7 in urology practice, been doing it for 20
years. I don't
8 think you can forget it.
9 MR. LESSLY: We would have given him a license
10 administratively, between Mr. Legarza and Dr. Stewart,
11 except he's been out of practice.
12 DR. ANJUM: Anybody have any comments on that
13 issue?
14 DR. BAEPLER: No.
15 DR. HUG-ENGLISH: Let's bring him in.
16 DR. MONTOYA: He went to one of the finest
17 medical schools in the
18 MS. KIRCH: I wonder which one that was?
19 DR. HUG-ENGLISH: Dr. Manny, welcome. Have a
20 seat.
21 DR. MANNY: Here?
22 DR. BAEPLER: Sure.
23 DR. HUG-ENGLISH: Welcome to the board. And I'm
24 Cheryl Hug-English. We know each other. These are other
25 members of the board and attorneys and staff
and we've
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1 invited you here to ask a few questions
about your wanting
2 to reactivated the
license. And Dr. Anjum
was going to
3 start it off.
4 DR. ANJUM: Hi. How
are you?
5 DR. MANNY: Good.
6 DR. ANJUM: We've reviewed your questions. The
7 only thing is you haven't practiced since
1999, early part
8 of 1999.
9 DR. MANNY: We left
10 DR. ANJUM: And you've done your CME and medical
11 ethics. You haven't forgotten those things in those
years?
12 DR. MANNY: No.
Actually spent the last few days
13 in the operating room with my old group
going around
14 familiarizing myself.
15 DR. ANJUM: I don't have any further questions.
16 DR. HUG-ENGLISH: Are you planning to come back
17 to
18 DR. MANNY: I don't know.
Not right at this
19 moment. My daughter's a senior in high school in
20 and she is loath to leave. Actually, my plan is to do
21 locum tenens work
until she gets out of high school and I'm
22 in the middle of a divorce right now, so I
have custody of
23 both kids so I can't really leave.
24 DR. HUG-ENGLISH: Anybody have any questions?
25 DR. MONTOYA: I move we grant his license.
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1 MS. KIRCH: Second.
2 DR. HUG-ENGLISH: There's a motion to change Dr.
3 Manny's status from retired to active. Any further
4 discussion?
5 All in favor?
6 Opposed?
7 Chair votes in favor of the motion
and the motion
8 carries, so you -- your license will be
reactivated and you
9 probably need to call the office at the
first part of the
10 week and make sure that all the paper work
is working.
11 Welcome back.
12 Okay. Our next one is Dr. Richnak
and this one
13 is in closed
session. So I need a motion to go into
closed
14 session.
15 (Board proceeded in closed session for the
rest of the
16 day.)
17 --oOo--
18 I, Stephanie Koetting,
CCR #207, do hereby
19 certify that the foregoing transcript,
consisting of pages
20 1 through 13, is true and correct to the
best of my
21 knowledge, skill and
ability.
22 DATED: This 7th day of October,
2002.
23 _________________________________
STEPHANIE KOETTING, CCR #207
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