MINUTES Board Members Present Staff Present Board Members Absent

Transcription

1 STATE OF NEVADA BOARD OF VETERINARY MEDICAL EXAMINERS 4600 Kietzke Lane, Building O-265 Reno, Nevada Phone /fax BOARD MEETING at Airport Plaza Hotel & Conference Center 1981 Terminal Way Reno, Nevada Thursday, July 22, 2010 MINUTES Board Members Present Richard Simmonds, DVM VP Ronald Sandoval DVM William Taylor, DVM Scott Bradley, DVM Mark Iodence, DVM Beverly Willard Staff Present Debbie Machen, Exec. Dir. Tracie Estep, Admin. Asst. Mike Chumrau, DVM, Investigator Christina Johnson, LVT, Inspector Louis Ling, Esq. Board Members Absent Craig Schank, DVM, President 1

2 Dr. Simmonds called the meeting to order 8:48 at a.m. 1. Approval of Board Minutes A. April 22, 2010 Motion: Dr. Taylor moved to approve. 2. Disciplinary Action A. AN Maureen Adams, DVM: Consent Decree. Discussion At the April 22, 2010 Board Meeting the Board voted to proceed with disciplinary action. A Stipulated Agreement was signed by Dr. Adams and presented to the Board for consideration. A Consent Decree stipulating to the following: 1) The course of diagnosis and treatment of Bulldozer was negligent because it departed from the standard of practice in that Dr. Adams released Bulldozer post-surgically to his owner when Bulldozer was non-responsive and non-ambulatory, and thus Dr. Adams violated NRS (1) and (6) and NAC ) In dispensing two vials of inject able morphine to Bulldozer s owners without any labeling or directions for use, Dr. Adams was negligent and, thus, violated NRS (1) and (6) and NAC ) In taking samples and payment for laboratory analysis and then in failing to provide those samples to the laboratory for testing and analysis, Dr. Adams was negligent and, thus, violated NRS (1) and (6) and NAC and ) Dr. Adams did not perform a post-anesthetic examination on Bulldozer and released him when he was not ambulatory, and thus Dr. Adams violated NRS (1) and NAC (1)(c). The Stipulated Adjudication is as follows: 1) Dr. Adams shall be on probation for a period of two years according to the following terms and conditions: a) Dr. Adams hospital shall be subject to random inspections throughout the period of probation. b) Dr. Adams shall comply with all laws, whether federal or state and whether statutory or regulatory, related to the practice of veterinary medicine. c) Dr. Adams shall pay the Board s attorney fees and investigative costs of $ d) Dr. Adams shall satisfactorily complete three hours in continuing education specifically regarding the treatment of critical care patients. 2

3 Motion: Dr. Bradley moved to accept the Consent Decree as presented. Second: Dr. Taylor. Dr. Iodence abstained. B. DN Benjamin Davidson, DVM; Letter of Reprimand. Discussion: At the April 22, 2010 Board Meeting the Board voted to proceed with disciplinary action. A Stipulated Agreement was signed by Dr. Davidson and presented to the Board for consideration. A Letter of Reprimand stipulating to the following: 1) (NRS) (1) and (6) and NAC Negligence, in that Dr. Davidson is responsible for determining the competency of an unlicensed assistant to perform a particular task and in supervising the assistant s performance of the task. The Stipulated Adjudication is as follows: 1) The Licensee will pay attorney fees, investigative costs, and Board costs of $ Motion: Ms. Willard moved to accept the Letter of Reprimand as presented.. Dr. Taylor/Dr. Sandoval abstained. C. FS William Flannery, DVM: Consent Decree Discussion: At the April 22, 2010 Board Meeting the Board voted to proceed with disciplinary action. A Stipulated Agreement was signed by Dr. Flannery and presented to the Board for consideration. A Consent Decree stipulating to the following: 1) The course of diagnosis and treatment of Precious was negligent because it departed from the standard of practice in the treatment of a cat with renal failure in that (a) Dr. Flannery failed to perform a urinalysis, (2) Dr. Flannery failed to monitor Precious weight throughout the course of treatment, and (3) Dr. Flannery did not discuss with the owner the option of euthanasia, and thus Dr. Flannery violated NRS (1) and (6) and NAC The Stipulated Adjudication is as follows: 1) Dr. Flannery shall pay the Board s attorney fees and investigative costs of $ ) Dr. Flannery shall satisfactorily complete three hours in continuing education specifically regarding the treatment of renal disease. 3

4 Motion: Dr. Taylor moved to accept the Consent Decree as presented.. D. JS Kimberli Johnson, DVM: Consent Decree. Discussion: At the April 22, 2010 Board Meeting the Board voted to proceed with disciplinary action. A Stipulated Agreement was signed by Dr. Johnson and presented to the Board for consideration. A Consent Decree stipulating to the following: 1) Dr. Johnson s course of diagnosis and treatment of Tina was negligent in that it departed from the standard of practice in that Dr. Johnson failed to perform appropriate diagnostics on Tina, a diabetic dog in critical condition, and thus Dr. Johnson violated NRS (1) and (6) and NAC The Stipulated Adjudication is as follows: 1) Dr. Johnson shall pay the Board s attorney fees and investigative costs of $ ) Dr. Johnson shall satisfactorily complete three hours in continuing education specifically regarding the treatment of critical care patients. Motion: Ms. Willard moved to accept the Consent Decree as presented.. Dr. Simmonds abstained E. DS Robert Dawson, DVM: Consent Decree. Discussion: At the April 22, 2010 Board Meeting the Board voted to proceed with disciplinary action. A Stipulated Agreement was signed by Dr. Dawson and presented to the Board for consideration. A Consent Decree stipulating to the following: 1) The course of diagnosis and treatment of Cinnamon was negligent because it departed from the standard of practice in that Dr. Dawson did not provide appropriate fluid support for a hemorrhaging dog such as Cinnamon and Dr. Dawson did not mention a swollen vulva as part of his pre-anesthesia examination of Cinnamon, and thus Dr. Dawson violated NRS (1) and (6) and NAC ) The medical records made and maintained by Dr. Dawson regarding Cinnamon s treatment were inadequate and less than 4

5 required by applicable law, and thus Dr. Dawson violated NRS (1) and NAC (2). 3) Dr. Dawson s dealings with the secondary hospital and the emergency hospital, especially in getting both to agree to take Cinnamon upon his assurance of payment and then subsequently failing to pay their charges, was unethical, and thus Dr. Dawson violated NRS (1) and NAC The Stipulated Adjudication is as follows: 1) Dr. Dawson shall take and pass the Board s jurisprudence examination. 2) Dr. Dawson shall pay the Board s attorney fees and investigative costs of $ Motion: Dr. Bradley moved to accept the Consent Decree as presented... Dr. Sandoval abstained. F. AN Motion: Ms. Willard moved to dismiss.. Dr. Bradley abstained. G. LS Motion: Dr. Taylor moved to dismiss.. H. DR constitutes a cause for disciplinary action and send a letter of recommendation to the Licensee regarding: the use of a steroid prior to staining, when there are concerns of corneal trauma. 5

6 Motion: Dr. Taylor moved to dismiss with a letter of recommendation.. Dr. Bradley abstained. I. SS Motion: Dr. Iodence moved to dismiss. Second: Dr. Taylor. Dr. Sandoval abstained. J. TO Discussion: After discussion of the above noted complaint the review panel recommended that disciplinary action be initiated against the licensee. Motion: Dr. Taylor moved to have staff and Board Counsel initiate action against the licensee due to there being sufficient evidence to proceed with disciplinary action. Second: Ms. Willard. Dr. Simmonds abstained. K. SL Tabled for further investigation. L. BS Motion: Ms. Willard moved to dismiss. Second: Dr. Sandoval. M. MS Motion: Dr. Taylor moved to dismiss.. Dr. Simmonds abstained. 6

7 N. SS Motion: Dr. Taylor moved to dismiss.. Dr. Sandoval abstained. O. GS Motion: Dr. Bradley moved to dismiss. Second: Ms. Willard. Dr. Simmonds abstained. P. MR Motion: Dr. Taylor moved to dismiss.. Dr. Iodence abstained. Q. WS Motion: Dr. Taylor moved to dismiss.. Dr. Simmonds abstained. R. LS

8 Motion: Dr. Iodence moved to dismiss.. 3. Continuing Education-Request for approval of CE's for: A. Local and Regional Anesthesia by Dr. Ko, DVM, DACVA & Dr. Dearmin, DVM, DACVS 4 hours of Continuing Education for Veterinary Technicians. Motion: Dr. Taylor moved to approve for 4 hours of continuing education for veterinary technicians. B. Intervertebral Disk Disease by David Mason, B. Vet Med, MRCVS, DACVS, DECVS 1 ½ hours of continuing education for veterinarians. Motion: Dr. Taylor moved to approve for 1 ½ hours of continuing education for veterinarians. C. Stifle Disease in Veterinary Patients by Christopher Horstman, DVM, MS, DACVS 1 ½ hours of continuing education for veterinarians. Motion: Dr. Taylor moved to approve for 1 ½ hours of continuing education for veterinarians. D. Managing Urinary Tract Infections by Shane Lyon, DVM, DACVIM 1 ½ hours of continuing education for veterinarians. Motion: Dr. Taylor moved to approve for 1 ½ hours of continuing education for veterinarians. E. Diagnostics and Treatment of Corneal Disease by William Weinstein, DVM, MS 1 ½ hours of continuing education for veterinarians. 8

9 Motion: Dr. Taylor moved to approve for 1 ½ hours of continuing education for veterinarians. F. Tracheal Collapse by Jeffery Geels, DVM, MS, ACVS 1 hour of continuing education for veterinary technicians. Motion: Dr. Taylor moved to approve for 1 hour of continuing education for veterinary technicians. G. Ophthalmology by William Weinstein, DVM. MS 1 hour of continuing education for veterinary technicians. Motion: Dr. Taylor moved to approve for 1 hour of continuing education for veterinary technicians. H. Thoracic Surgery Post-Op Care and Complications by David Mason, MRCVS, DAVCS, DECVS 1 hour of continuing education for veterinary technicians. Motion: Dr. Taylor moved to approve for 1 hour of continuing education for veterinary technicians. I. Continuing education hours for Nevada licensees that attend board meetings. Discussion: Ms. Machen advised the Board that there has been some inquires by licensees regarding obtaining continuing education (CE) hours for attending the complaint portion of the board meetings. Motion: Dr. Bradley moved to approve up to no more than 4 hours of continuing education for veterinarians per year and 2 hours of continuing education for veterinary technicians per year who attended the complaint portion of the Board meetings. Second: Dr. Taylor 4. Deputy Attorney General Legal Report-Louis Ling, Esq. A. New controlled substance and dispensing pharmaceutical laws. Review Panel meeting follow-up. 9

10 Discussion: Mr. Ling provided a draft of new laws regarding the dispensing of pharmaceuticals by Nevada veterinarians. He explained that Dr. Taylor and Dr. Schank met with a representative of the pharmacy board and Dr. Dennis Wilson of the Nevada Veterinary Medical Association and discussed these changes. After the Board discussed the regulations they instructed staff to proceed with sending the draft to LCB. B. Open/Pending Complaints/Hearings Mr. Ling advised the Board that here is a possibility that we will have a short administrative hearing at the October 2010 meeting in Las Vegas. 5. Requests for Licensure/Reinstatement A. David Elmore,DVM,MPVM, Request for special circumstances. License to practice as a veterinarian without examination. Discussion: Dr. Elmore was present and explained to the Board his special circumstances and why the species specific examinations would not be relative to his limited practice in the field of nonhuman primate medicine. Dr. Elmore submitted an application for veterinary licensure in the State of Nevada requesting the Board waive the requirement of taking the Species Specific examinations due to his specialty. The Board reviewed his application and all supplemental documentation. Motion: Dr. Taylor moved to accept his application waiving the species specific requirement.. Dr. Simmonds abstained. B. Eunice Kim, Application for LVT and veterinary technician in training with a Bachelor of Science-major in molecular biology. Discussion: Ms. Kim submitted an application for veterinary technician-in-training and veterinary technician licensure in the State based on her Bachelor of Science Degree in Molecular Biology. The Board reviewed her application and all supplemental documentation. Motion: Dr. Taylor moved to accept her application. 10

11 C. Peregrine Wolff, DVM; Request for special circumstances- License to practice as a veterinarian without examination. Discussion: Dr. Wolff submitted an application for veterinary licensure in the State of Nevada requesting that the Board waive the requirement of taking the Species Specific examinations due to her practice limited to wildlife and exotic species. The Board reviewed her application and all supplemental documentation. Motion: Dr. Taylor moved to accept her application waiving the taking of the species specific examinations. D. Kristin Clark, DVM, status and determination of current Probation, medical records release, and disciplinary action posted via the internet. Discussion: Dr. Clark was present to discuss her current Probation, the release of her medical records, and her discipline being posted on the internet. Dr. Clark stated that she is planning to move out of state and wants to take care of this issue and leave on a good note. She feels strongly about her reputation and morals and feels that it is silly to continue on Probation when she is not working in the State of Nevada. Ms Machen stated that Dr. Clark is not currently working in Nevada and her license is currently inactive. Motion: Dr. Iodence moved to terminate Dr. Clark s Probation with the provision that if she reactivates her license she would have to appear before the Board for review. Second: Dr. Taylor. Dr. Clark explained to the Board her upset in that her discipline history had been posted on various web-sites. She did not understand why the Board would post discipline for the past 20 years. Mr. Ling had written a letter to Ms. Clark explaining that her disciplinary actions are considered public documents and are reported to several agencies. Dr. Clark expressed concern that her medical records had been released. Mr. Ling had written a response to Dr. Clark explaining that the Board had received two court issued subpoenas requesting the information. The Board office responded to the subpoenas following notification of Dr. Clark s attorney. 11

12 Dr. Simmonds noted that the Board could not be responsible for Dr. Clark s attorney s lack of communication with her. 6. Discussion of Regulations/New Policies A. Sterilization of gloves and syringes-standard of practice vs. manufacture recommendations. Discussion: Ms. Machen explained that during a compliance inspection it was found that a hospital was sterilizing surgical gloves for non-surgical reuse. Ms. Johnson had called the manufacture and found that the gloves are labeled for single use. The consensus of the Board was that if during inspections this practice of re-sterilization of materials designated as single use by the manufacturer was occurring then a concern should be noted on the inspection. B. Physical examination prior to vaccines being given at a vaccination clinic. NAC Discussion: Dr. Simmonds had been asked by a colleague to have the Board consider taking the physical examination requirement out of the vaccination clinic regulations. Companies that are providing this service in California are not required to do physicals. Further, Dr. Simmonds noted that his colleague s concern were that the TPR s taken at a vaccination clinic were often unreliable due to the fact that many, if not most of the animals being vaccinated at these events were extremely agitated and excited. The consensus of the Board is that the physicals are important to determine the health of the animal prior to vaccination and they did not feel that the law warranted any change. C. What should be included in an anesthesia/surgery log? Discussion: The Board directed staff to modify the current regulation, NAC , (i) to add a requirement that the surgery log include the surgery start and finish time with pulse, heart rate, and respiration being taken and recorded at intervals of no less than every 15 minute. D. Interpretation of NRS , Duty to report malpractice. Discussion: Ms. Machen explained that there is some confusion in regard to the reporting of a malpractice claim against a veterinarian to the Board. After discussion the consensus was that anytime a claim is made to a veterinarians or veterinary technicians malpractice insurance company the Board must be notified of this action and ultimately, the disposition of the claim. E. Administration of vaccinations for zoonotic diseases. Discussion: Ms. Machen explained that there is confusion among 12

13 animal control agencies in regard to who can administer rabies vaccinations to shelter animals and if a physical examination has to be done. The communicable disease laws, NRS 571 do not address this issue and NRS 638 does not apply to the shelters. The Board requested Ms. Machen meet with the State veterinarian and discuss these issues and report back to the Board at a future meeting. F. Veterinary technicians and/or unlicensed veterinary assistants providing the following tasks: express anal glands & nail trimming. Discussion: The Board directed staff to add the task of anal gland expression to the veterinary technician duties. 7. Staff Reports A. Financial Report Debbie Machen Discussion: Ms. Machen presented the un-audited financial report to the Board s satisfaction. The yearly audit has been scheduled for Mid-August of B. Budget Debbie Machen Discussion: Ms. Machen presented the Budget for to the Board s satisfaction. Ms. Machen explained that the GL Suite contract for the licensing software for the database has been re-negotiated for a savings of approximately $ /yr. The Lease for the office space has also been re-negotiated for a saving of approximately $ /yr. Motion: Dr. Taylor to accept Second: Ms. Willard C. Administrative Report Tracie Estep Discussion: Ms. Estep presented the administrative report to the Board s satisfaction. D. Hospital Inspection Report Christina Johnson Discussion: Ms. Johnson presented the administrative report to the Board s satisfaction. 8. Discussion and Determination A. The Animal Foundation correspondence to the Board Dr. Jennifer Stone-Director Lied Animal Shelter Discussion: Jennifer Stone, DVM and Jason Smith from Lied Animal Shelter were present to discuss the issue of the new ordinances in Las Vegas and Clark County that requires mandatory spay and neutering of domestic animals. Dr. Stone presented statistics on the over population of animals in Clark County. 13

14 After an in depth discussion regarding the shelters commitment in maintaining compliance with the Clark County ordinance, the consensus of the Board and Legal Counsel was that since the animals are owner identified and the owner has been contacted, a veterinary-client-patient relationship has been established pursuant to NAC with Lied Animal Shelter, a licensed facility. Thus, these animals would have to be treated under the provisions of NRS/NAC 638 and WOULD require that the owner sign a surgical release. The Board discussed the option of Lied establishing an alliance with either Pima or Southern Nevada Veterinary Technician Programs in allowing their second year students (veterinary technicians in training) to do their externships at Lied, providing the shelter with supervised technicians in training. The Board directed staff to respond to Dr. Stone with a letter addressing the issues discussed. B. Leadership continuing education-follow-up on costs or possible alternatives. Discussion: Ms. Machen provided the Board with added information on leadership continuing education classes. The consensus of the Board was that due to economic times that involvement with a project of this size should be tabled until possibly next year. C. Articles for November newsletter Discussion: The following Board members and staff will write the following articles: Hospital Inspections Most asked Questions/Answers- Christina Johnson Monitoring of Boarded Animals-Dr. Chumrau Dispensing veterinary drugs/providing client with information regarding a Drug-Louis Ling Continuing education and the audit process-dr. Simmonds President s letter-dr. Schank Malpractice-Dr. Taylor New Board Member Dr. Sandoval D. Report from Governors meeting July 21, Discussion: Ms. Machen and Dr. Simmonds reported on the summit meeting that was held with the Governor s staff and other boards and commissions last week regarding the following items: State Budget Act and Financial Reporting Board Operations, Personnel and Reporting Board Appointments and the Appointment Process 14

15 Consolidation of some Boards and Commissions Providing an efficient, streamline, and resourceful government E. Set Board Meetings, October 21, 2010-Las Vegas; January 27, 2011-Reno; April 2011-Las Vegas. Discussion: Future Board Meetings: October 21, 2010-Las Vegas; January 27, 2011-Reno; April 21, 2011-Las Vegas *9. Public Comment Discussion: None 10. Agenda items for next meeting None 11. Adjournment at 4:19 p.m. 15