STATE OF NEVADA. Western Veterinary Conference Oquendo Center for Clinical Education 2425 East Oquendo Road Las Vegas, Nevada 89120

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1 STATE OF NEVADA BOARD OF VETERINARY MEDICAL EXAMINERS 4600 Kietzke Lane, Building O-265 Reno, Nevada Phone /fax BOARD MEETING at Western Veterinary Conference Oquendo Center for Clinical Education 2425 East Oquendo Road Las Vegas, Nevada Thursday, October22, 2009 MINUTES Board Members Present Craig Schank, DVM, President Richard Simmonds, DVM VP Gary Ailes, DVM William Taylor, DVM Scott Bradley, DVM Beverly Willard Mark Iodence, DVM Staff Present Debbie Machen, Exec. Dir. Tracie Estep, Admin. Asst. Mike Chumrau, DVM, Investigator Jenna Horton, LVT, Inspector Kim Arguello, Esq. Deputy A.G. Dr. Schank called the meeting to order at 8:03 a.m. 1

2 Dr. Schank made a special presentation to Dr. Ailes for his 12 years of service to the Board, and also gave accolades to Dr. Simmonds who received the NVMA s 2009 Veterinarian of the Year award. 1. Approval of Board Minutes A. July 16,2009 Board Meeting Motion: Dr. Taylor moved to approve. Second: Beverly Willard Passed: Unanimously 2. Disciplinary Action A. BS Hany Botros, DVM: Order of Probation Discussion: At the July 16, 2009 Board Meeting the Board voted to proceed with disciplinary action. A Stipulated Agreement signed by Dr. Botros was presented to the Board for consideration. A Modified Order of Probation stipulated to the following: A violation of NAC (2), negligence, a departure from the standard of practice of veterinary medicine in that the licensee diagnosed and treated for renal failure in a critical patient without sufficient diagnostics. The Stipulated Adjudication is as follows: 1. Licensee s license is suspended. However, the suspension is stayed and the licensee is placed on a minimum of one (1) year probation; and 2. Licensee shall take an additional 15 hours of continuing education in internal medicine for each year of the probation. 3. Licensee shall send to the Board office one completed internal medicine case per month for the period of the probation. 4. Licensee shall pay a fine of $ Licensee shall pay Board costs of $ Motion: Dr. Ailes moved to accept the Modified Order of Probation as presented. Second: Dr. Taylor Passed: Unanimously. Dr. Simmonds abstained. 2

3 B. FS PS / William Flannery, DVM & Dudley Pflaum, DVM; Letter of Reprimand. Discussion: FS At the July 16, 2009 Board Meeting the Board voted to proceed with disciplinary action. A signed Stipulated Agreement signed by Dr. Flannery was presented to the Board for consideration. A Letter of Reprimand stipulating to the following: 1) NAC , lack of medical records, in that the Licensee failed to maintain a complete medical record for the veterinary care of Bear. Specifically, all clinical information pertaining to the animal, including, without limitation, sufficient information to justify the diagnosis or determination of the medical status of the animal and to warrant any treatment recommended for or administered to the animal; Any medication and treatment administered, including, without limitation, the amount and frequency; and the progress and disposition of the case. 2) NAC Neglect in dispensing a dose of Rimadyl that is significantly higher than recommended by the manufacturer with a lack of communicating to the owner possible side effects. 3) NAC , Principles of Veterinary Medical Ethics: Specifically, if there is an ongoing medical or surgical condition, the patient should be referred to another veterinarian for diagnosis, care, and treatment. The former attending veterinarian should continue to provide care, as needed, during the transition. 4) NRS ; NRS ; Violation of a Pharmacy Board regulation. Specifically, a label was hand written by an unlicensed veterinary assistant with a lack of information including, name of the client, their address, prescription number, name of prescribing veterinarian, the number of dosage units, and the expiration date of the drug. The Stipulated Adjudication is as follows: 1. Receive a Public Letter of Reprimand which will be noticed to the national disciplinary database. 2. Retake and pass the jurisprudence examination; and 3. Pay attorney fees, investigative costs, and Board costs of $

4 Motion: Dr. Taylor moved to accept the Letter of Reprimand as presented. Second: Dr. Bradley. Passed: Unanimously. Dr. Ailes abstained. PS At the July 16, 2009 Board Meeting the Board voted to proceed with disciplinary action. A signed Stipulated Agreement signed by Dr. Pflaum was presented to the Board for consideration. A Letter of Reprimand stipulating to the following: 1) NAC , lack of medical records, in that the Licensee failed to maintain a complete medical record for the veterinary care of Bear. Specifically, all clinical information pertaining to the animal, including, without limitation, sufficient information to justify the diagnosis or determination of the medical status of the animal and to warrant any treatment recommended for or administered to the animal. 2) NAC , Neglect in not reviewing the medical record prior to evaluating a situation when the client called with concerns regarding their animals health. 3) NRS ; NRS : Violation of a Pharmacy Board regulation. Specifically, a label was hand written by an unlicensed veterinary assistant with a lack of information including, name of the client, their address, prescription number, name of prescribing veterinarian, the number of dosage units, and the expiration date of the drug. The Stipulated Adjudication is as follows: 1. Receive a Public Letter of Reprimand which will be noticed to the national disciplinary database. 2. Retake and pass the jurisprudence examination; and 3. Pay attorney fees, investigative costs, and Board costs. Motion: Dr. Simmonds moved to accept the Letter of Reprimand as presented. Second: Dr. Taylor. Passed: Unanimously. Dr. Ailes abstained. C. AN complaint with Board recommendations being sent to the 4

5 veterinarian regarding the following: Review after-care protocol to ensure that the answering service is providing information to the client regarding emergency care and the availability of the veterinarian. Motion: Dr. Taylor moved to dismiss with recommendation. Second: Dr. Ailes Passed: Unanimously. Dr. Bradley abstained. D. AS Motion: Dr. Simmonds moved to dismiss. Second: Dr. Iodence. Passed: Unanimously. Dr. Ailes abstained. E. AS complaint with Board recommendations being sent to the veterinarian regarding the following: Medical records are inconsistent in regards to physical examination information. Motion: Dr. Taylor moved to dismiss with recommendations. Second: Dr. Ailes Passed: Unanimously. Dr. Schank abstained. F. BS Discussion: This complaint has been tabled for further investigation. G. BS Second: Dr. Ailes Passed: Unanimously. Dr. Simmonds abstained. H. BS Discussion: After discussion of the above noted complaint the review panel recommended that disciplinary action be initiated 5

6 against the licensee. Motion: Dr. Ailes moved to have staff and Ms. Arguello initiate action against the licensee due to there being sufficient evidence to proceed with disciplinary action. Second: Dr. Simmonds Passed: Unanimously. Dr. Iodence abstained. I. BS Second: Dr. Iodence Passed: Unanimously. Dr. Ailes abstained. J. BS Discussion: This complaint has been tabled for further investigation. K. HN Discussion: This complaint has been tabled for further investigation. L. CN Discussion: This complaint has been tabled for further investigation. M. CN Discussion: This complaint has been tabled for further investigation. N. JS Discussion: After discussion of the above noted complaint the review panel recommended that disciplinary action be initiated against the licensee. Motion: Dr. Ailes moved to have staff and Ms. Arguello initiate action against the licensee due to there being sufficient evidence to proceed with disciplinary action. Second: Dr. Taylor Passed: Unanimously. Dr. Simmonds abstained. 6

7 O. KN Motion: Dr. Simmonds moved to dismiss. Second: Dr. Ailes Passed: Unanimously. Dr. Taylor abstained. P. KN Second: Dr. Ailes Passed: Unanimously. Dr. Iodence abstained. Q. LS Second: Dr. Ailes Passed: Unanimously. Dr. Simmonds abstained. R. RR complaint with Board recommendations being sent to the veterinarian regarding the following: When a medical record simply states spay or neuter with no details regarding these routine procedures, the hospital should have written protocol for each of these procedures describing specifically what is meant by routine, i.e., describing the surgical approach, methods of removal of the target tissues, suture materials and patterns used, etc. Further, the written procedures should be dated and all subsequent revisions dated with all previous versions archived. Motion: Dr. Simmonds moved to dismiss with recommendations. Second: Beverly Willard 7

8 Passed: Unanimously. Dr. Taylor abstained. S. RS Second: Dr. Ailes Passed: Unanimously. Dr. Schank abstained. T. TS Second: Dr. Bradley Passed: Unanimously. Dr. Schank abstained. U. FS Second: Dr. Simmonds Passed: Unanimously. Dr. Ailes abstained. V. FN Second: Beverly Willard Passed: Unanimously. Dr. Bradley abstained. W. GR

9 Motion: Dr. Ailes moved to dismiss. Second: Dr. Bradley Passed: Unanimously. Dr. Taylor abstained. X. AFLS Motion: Dr. Ailes moved to dismiss. Second: Dr. Iodence Passed: Unanimously. Dr. Simmonds abstained. Y. KS complaint with Board recommendations being sent to the veterinarian regarding the following: Termination of a client relationship is best followed up with a letter to the client explaining the situation. The letter should be sent with a return receipt requested. Motion: Dr. Taylor moved to dismiss with recommendations. Second: Beverly Willard Passed: Unanimously. Dr. Simmonds abstained. Z. FS Second: Dr. Bradley Passed: Unanimously. Dr. Simmonds abstained. AA. FS Discussion: After discussion of the above noted complaint the review panel recommended that disciplinary action be initiated against the licensee. Motion: Dr. Simmonds moved to have staff and Ms. Arguello initiate action against the licensee due to there being sufficient evidence to proceed with disciplinary action. 9

10 Second: Dr. Bradley Passed: Unanimously. Dr. Schank abstained. BB. SS CC. BS DD. SS Discussion: The above noted complaints were discussed together due to them having been filed against the same veterinarian. The review panel recommended the Board dismiss the complaints with Board recommendations being sent to the veterinarian regarding the following: Medical records being incomplete in regards to documenting the type of monitoring used during surgery; and pursuant to NAC which limits the activities of unlicensed veterinary assistants; specifically, the use of unlicensed veterinary assistants performing dentals. Motion: Dr. Taylor moved to dismiss with recommendations. Second: Simmonds Passed: Unanimously. Dr. Schank abstained. 3. Continuing Education-Request for approval of CE's for: A. A Night of Dermatology by Ann Trimmer, DVM, DACVD and Kimberly Coyner, DVM, DACVD for 1 ½ hours for veterinarians. Motion: Dr. Taylor moved to approve for 1½ hours of continuing education for veterinarians. Second: Dr. Simmonds Passed: Unanimously B. Pain Management by Victoria Lukasik, DVM, ACVA, 2 hours for DVMs. Motion: Dr. Taylor moved to approve for 2 hours of continuing education for veterinarians. Second: Dr. Simmonds Passed: Unanimously C. Critical Care by Linda Weatherton, DVM. 1 hour for LVTs. Motion: Dr. Simmonds moved to approve for 1 hour of continuing education for veterinary technicians. Second: Dr. Bradley Passed: Unanimously D. Las Vegas Veterinary Referral Center, Multiple topics by 10

11 multiple specialist. 7 hours DVMs. Motion: Dr. Taylor moved to approve for 7 hours of continuing education for veterinarians. Second: Beverly Willard Passed: Unanimously. 4. Deputy Attorney General Legal Report-Kim Arguello, Esq. Discussion: Ms. Arguello reminded the Board members that an Attorney General Board Training meeting was scheduled in November. Anyone interested in attending could contact her for specific information. 5. Requests for Licensure A. Otto Stanislaw, DVM Discipline in Arizona Discussion: Dr. Stanislaw submitted an application to practice veterinary medicine in the State of Nevada. Dr. Stanislaw has previous discipline in the State of Arizona. The Board reviewed his information and all supplemental documentation. Motion: Dr. Taylor moved to approve his application. Second: Dr. Bradley Passed: Unanimously. B. Kathina Lightner, VTIT & LVT (Bachelor of Arts) Discussion: This application was tabled from the July meeting so Ms. Lightner may present the Board with more information regarding her practical experience. Ms. Lightner submitted an application for veterinary technician/vtit based on a Bachelor of Arts degree. Ms. Lightner was present to answer Board questions and concerns. The Board reviewed her information and all supplemental documentation. Motion: Dr. Simmonds moved to deny application based on insufficient education. Second: Dr. Bradley Passed: Unanimously. C. Adam Brown; VTIT & request to take the VTNE. Discussion: Mr. Brown submitted an application for veterinary technician/vtit. He has a previous history of drug abuse and a felony conviction. Mr. Brown was present to answer Board questions and concerns. The Board reviewed his information and all supplemental documentation. 11

12 Motion: Dr. Taylor moved to have PRN evaluate and make recommendations back to the Board and accept his application contingent on Mr. Brown following PRN s recommendations. Second: Dr. Simmonds Passed: Unanimously D. Tanya Bartlett, DVM; Reinstatement of Veterinary License. Discussion: Dr. Bartlett submitted an application for reinstatement due to a consumer complaint being filed for unlicensed activity. Dr. Bartlett submitted a letter to the Board and explained that she travels to Nevada for horse related events and had not intentionally practiced in Nevada without a license. Dr. Bartlett s primary veterinary license is in Utah and is active and in good standing without any prior discipline. Motion: Dr. Bradley moved to approve her application contingent on her paying back fees for renewals of 2007, 2008, and Second: Dr. Simmonds Passed: Unanimously. Dr. Iodence abstained. E. Charlotte MacLucas, VTIT & LVT (Bachelor of Science Environmental Biology/Zoology) Discussion: Ms. MacLucas submitted an application for veterinary technician/vtit based on a Bachelor of Science degree in Biology. The Board reviewed her application and all supplemental documentation. Motion: Dr. Simmonds moved to accept her application. Second: Dr. Taylor Passed: Unanimously. F. Kristin Clark, DVM; Progress report on Probation. Discussion: Dr. Clark was present to answer any questions the Board may have regarding her current probation which is in effect until April of As requested by the Board she presented a letter from her doctor regarding her current treatment plan. The Board reviewed the information presented and Dr. Schank requested she appear at the October 2010 Board Meeting. 6 Discussion of Regulations/New Policies A. Senator Weiner s proposed Bill for the 2011 Legislative Session regarding recycling non-controlled drugs to non-profit organizations or clients that can t afford the drugs. Discussion: Senator Weiner had contacted the Board regarding a 12

13 Bill that she wanted to present at the 2011 Legislative session regarding the recycling of prescription drugs. Senator Weiner would like the Board s input to this proposed legislation. The consensus of the Board was that the intent of this legislation is good but there are concerns regarding the liability of the veterinarian in recycling medication that could have been contaminated and the veterinarian would have no way of knowing this. 7. Staff Reports A. Audit Debbie Machen Discussion: Ms. Machen presented the audit to the Board s satisfaction. Motion: Dr. Simmonds moved to accept. Second: Beverly Willard Passed: Unanimously B. Financial Report Debbie Machen Discussion: Ms. Machen presented the financial report to the Board s satisfaction. Motion: Dr. Taylor moved to accept. Second: Dr. Bradley Passed: Unanimously C. Administrative Report Tracie Estep Discussion: Ms. Estep presented the administrative report to the Board s satisfaction. D. Hospital Inspection Report Jenna Horton Discussion: Ms. Willard and Dr. Simmonds noted that they had accompanied Ms. Horton on separate hospital inspections and expressed their accolades to Jenna for her professionalism and efficiency in how she conducts these inspections. Ms Horton presented the administrative report to the Board s satisfaction and requested the Board s input on whether or not storage of medication/food & drinks in the same refrigerator should be considered a violation. Ms. Machen explained that the Pharmacy Board was working on new regulations that prohibit food and beverages from being stored in the same refrigerator as medicine. She asked for the Board s input regarding this regulation and should the same parameters be met for veterinary medicine? The consensus of the Board is that this is already an OSHA requirement but if this conduct is happening in veterinary hospitals, Ms. Horton needs to write 13

14 this up as a concern during hospital inspections. 8. Discussion and Determination A. Special appropriation for a new copier, web-site upgrades and computers for Dr. Chumrau and Jenna Horton. Discussion: Ms. Machen requested an appropriation of $12, from the Board reserve for the above noted items. Motion: Dr. Taylor moved to appropriate up to $12,000 from the Board s reserves and increase the expenses by said amount in the budget. Second: Dr. Bradley Passed unanimously B. Employee evaluations. Discussion: Ms. Machen explained that even though the Board was financially stable and did not have to follow the State mandate for furloughs and no pay increases it was felt that it was prudent to not give any merit or cost of living raises in 2009 even though staff did deserve raises. The Board unanimously endorsed and lauded Ms. Machen s decision regarding increases this year and concurred with her statement that the staff deserved raises due to their excellent job performance. C. Travel to the CPE in Las Vegas and the VCSA in Texas by a Board member. Discussion: Dr. Schank explained that he was planning to go to Texas to observe the VCSA practical examination for PAVE in January. He recently had observed the CPE examination in Las Vegas. He ll report back to the Board in January E. Set Board Meeting, January 28, 2010-Reno; April 22, 2010-Las Vegas. Board meetings are set for January 28, 2010 in Reno and April 22, 2010 in Las Vegas. *9. Notice of Intent to Act Upon a Regulation-RO Dr. Schank opened the public hearing at 2:00 p.m. He directed all parties present that each section of the regulation would be reviewed and discussed by the board members, and then public comment would be taken. Dr. Simmonds provided an overview of suggestions and comments that were made during the Public Workshop. 14

15 Section 2. Discussion & Testimony: Dr Simmonds stated that the concerns that were stated through public comment at the workshop was that the language was confusing in regard to responsible party vs. owner and the use of the term overnight. Mr. Dennis Lopez asked if these laws would be enforced for doggy hotels or boarding facilities. Ms. Machen explained that nonveterinarian boarding facilities are under the jurisdiction of animal control (NRS574) Dr. Ronald Sandoval testified that the existing language was confusing. After discussion and review of the suggestions from the workshop and hearing the following change to Section 2 was proposed: 1. A person who operates a veterinary facility during the hours that the veterinary facility is not regularly open to the public shall notify, in writing, to the owner of the animal or the designated representative of the owner when an animal is left after hours that the animal may be left unattended. 2. The veterinary facility shall ensure that the owner of the animal or the designated representative of the owner signs and dates the notice provided in subsection 1. Section 3. Revising a schedule of fees for all licensees. Discussion & Testimony: There was no public comment. Sections Providing for additional requirements for the licensing of veterinarians, veterinary technicians, veterinary technician in training, and animal physical therapists. Section 4. Discussion & Testimony: Dennis Lopez, LVT, Director of PIMA Veterinary Technology Program testified that the two additional distance learning continuing education providers are more geared towards technicians and should be added to the proposed language in section 4. The Board concurred with Mr. Lopez s suggested changes. Dr. Taylor read a letter for the record from Dr. Kelly Degroff asking the Board to consider carrying-over continuing education from the previous year. After discussion and review of the suggestions from the workshop and hearing the following change to Section 4 was proposed: 15

16 2. A licensed veterinary technician must annually complete 10 hours of continuing education approved by the Board as a prerequisite for renewal of his license. Except for courses offered by the Veterinary Information Network, the Veterinary Support Personnel Network or the National Association of Veterinary Technicians in America, not more than Section 5. Discussion & Testimony: After discussion and review of the suggestions from the workshop and hearing the following changes to Section 5 were recommended regarding the number of continuing education hours required for veterinarians as a condition of initial licensure: a) (3) Completed at least 40 hours of continuing. b) 3. determine whether or not to grant an application for a license under the provisions of this chapter and the conditions that will apply to any license granted. Section 6. Discussion & Testimony: There was no public comment. Section 7. Discussion & Testimony: After discussion and review of the suggestions from the workshop and hearing the following change to Section 7 was recommended regarding the number of continuing education hours required for a veterinarian changing his license status from inactive to active : (1) (c) Proof that he has completed at least 20 hours of continuing education Section 8. Discussion & Testimony: After discussion regarding the mislabeling of the numerical sequence, the following change to Section 8 was proposed: (2) (h) should be (2) (i) Pay to the board Section 9. Discussion & Testimony: Dennis Lopez, LVT commended the Board for making these changes to the technician laws and bringing high standards to the state regarding education and professionalism. He also emphasized what he believed to be the value of having the applicant send in two letters of recommendation to the Board. After discussion and review of the suggestions from the workshop and hearing the following change to Section 9 was proposed regarding the number of continuing education hours required for 16

17 veterinary technicians: (3) Completed at least 20 hours of continuing. Section There was no public comment. Motion: Dr. Simmonds moved to adopt RO with the changes that were previously proposed. Second: Dr. Taylor Passed unanimously 10. Public Comment None 11. Agenda items for next meeting Report from Dr. Schank on the VCSA examination. Report on the status of the new adopted regulations. *12. Adjournment Motion: Dr. Simmonds moved to adjourn 3:05 p.m. Second: Dr. Taylor Passed: Unanimously. 17