NEVADA STATE BOARD OF VETERINARY MEDICAL EXAMINERS

Transcription

1 NEVADA STATE BOARD OF VETERINARY MEDICAL EXAMINERS BOARD MEETING at Las Vegas Chamber of Commerce 3720 Howard Hughes Parkway Conference Room LAS VEGAS, NEVADA On Thursday, March 16, 2006 at 9:00a.m. Board Members Present Jon Pennell, DVM, President Chris Yach, DVM, VP Richard Simmonds, DVM, MS Craig Schank, DVM Gary Ailes, DVM Beverly Willard Staff Present Debbie Machen, Exec. Dir. Tracie Estep, Admin. Asst. Keith Marcher, Senior Deputy AG Mike Chumrau, DVM, Investigator William Taylor, DVM (absent) MINUTES 1

2 Dr. Pennell called the meeting to order at 9:10a.m. *1. Approval of Board Minutes: A. December 8, 2005 Board Meeting Minutes Motion: Beverly Willard moved to approve. Second: Dr. Simmonds Passed: Unanimously *2. Disciplinary Action A. HN Letter of Reprimand, Don Hittenmiller, DVM The review panel found that there was sufficient evidence to proceed with disciplinary action and recommended discipline. The Public Letter of Reprimand stipulated to the following violation: 1) NAC , in that the Licensee allowed nonlicensed personnel to perform animal health tasks that are specific to a licensed veterinary technician. The stipulated adjudication is as follows: 1) The Licensee shall take and pass the Nevada Jurisprudence Examination within 30 days; 2) Carson Tahoe Veterinary Hospital shall be subject to random inspections at staff s discretion and at licensee s expense; 3) The Licensee will refrain from referring to unlicensed veterinary technicians, staff members, or licensed veterinary technicians as Nurses; 4) The Licensee shall pay attorney fees, investigative costs and Board costs, totaling $250.00; and 5) The Licensee will not allow any of his employees to perform tasks for which licensure is required as a veterinary technician (as listed in NAC ) unless such employee is licensed as a veterinary technician or registered with the Board as veterinary technician in training. 6) The Licensee will receive a Public Letter of Reprimand which will be reported to the National Veterinary Disciplinary Database of the Association of Veterinary State Boards (AAVSB); Motion: After discussion of the Letter of Reprimand, Dr. 2

3 Simmonds moved to approve the Letter of Reprimand as presented. Second: Dr. Schank Passed: Unanimously, Dr. Pennell abstained B. LS Letter of Reprimand, John Lindaman, DVM The review panel found that there was sufficient evidence to proceed with disciplinary action and recommended discipline. The Public Letter of Reprimand stipulated to the following violation: 1) NAC , negligence, a departure from the standard of practice of veterinary medicine in that the Licensee did not properly monitor anesthesia. The stipulated adjudication is as follows: 1) The Licensee will receive a Public Letter of Reprimand which will be reported to the National Veterinary Disciplinary Database of the Association of Veterinary State Boards (AAVSB); 2) The Licensee will complete three hours of continuing education in critical care which shall be provided to the Board written proof of the completion of these hours by October 31, These hours must be over and above those that are required by state law; and 3) The Licensee will pay attorney fees, investigative costs and Board costs, totaling $ Motion: After discussion of the Letter of Reprimand, Dr. Yach moved to approve the Letter of Reprimand with a change to the continuing education requirement. Second: Dr. Schank Passed: Unanimously, Dr. Ailes abstained. C. KS Jon Kempf, DVM The review panel found that there was sufficient evidence to proceed with disciplinary action and recommended discipline. The Consent Decree stipulated to the following violation: 3

4 1) NAC , negligence in the technique used in a c- section that was performed on a dog. The ligatures were not secure or transfixed, resulting in hypovolemic shock. The stipulated adjudication is as follows: 1) The licensee shall pay investigative costs to the Board in the amount of $ ) The licensee must take an additional five (5) hours of continuing education, three (3) hours in reproduction which must include surgical topics on c-sections and two (2) hours in critical care. Motion: Dr. Yach moved to accept the Consent Decree a change to the continuing education requirement. Second: Dr. Schank Passed: Unanimously, Dr. Ailes abstained. D. HR Motion: Dr. Simmonds moved to dismiss. Second: Dr. Ailes Passed: Unanimously, Dr. Pennell abstained. E. GMV Motion: Dr. Simmonds moved to dismiss. Second: Dr. Schank Passed: Unanimously, Dr. Ailes abstained F. MS Discussion: Mr. & Ms. Chapkis were presented and Mr. Chapkis discussed the following concerns with the Board: 1) Lack of communication with the veterinarian; 2) That the veterinarian discussed consulting with a physic to help with this case; 3) Not discussing with them the possibility that the dog could have distemper, the prognosis, or options of treatment. 4

5 The diagnosis was that the dog was living in a stressful environment; and 4) They continued to be billed for a wellness plan by the hospital after the dog had passed away. Mr. Chapkis also thanked the Board and the staff for conducting a thorough investigation and handling the complaint in an expeditious manner. Dr. Mike Chumrau, the Board investigator stated that the veterinarian s medical record did state that distemper was on the list of differentials and the prognosis was poor. Dr. Chumrau also stated that he discussed the physic comment with the veterinarian and he stated that he made the comment in jest and realized later that it was inappropriate and in bad judgment. The review panel recommended the Board dismiss the complaint due to the fact that there was not sufficient evidence to believe that the licensee had committed an act which constitutes a cause for disciplinary action. Motion: Dr. Simmonds moved to dismiss. Second: Dr. Yach Passed: Unanimously, Dr. Ailes abstained G. SS the complaint. The consensus of the review panel is that this case should be turned over to the Attorney General s office or the District Attorney for unlicensed activity. Motion: Dr. Simmonds moved to dismiss and turned over to the proper authorities for possible prosecution. Second: Dr. Ailes Passed: Unanimously. Dr. Schank abstained H. PCS Motion: Dr. Yach moved to dismiss. Second: Beverly Willard Passed: Unanimously, Dr. Schank abstained. I. DS

6 Motion: Dr. Yach moved to dismiss. Second: Beverly Willard Passed: Unanimously, Dr. Schank abstained. J. PS the complaint with a letter of concern being sent to the veterinarian regarding the following: 1) Failure to comply with a request for medical records within 14 days after receipt of a demand letter issued by the Board, 2) Having client s sign an estimate form pursuant to NAC (3) and the Code of Ethics Therapies (A). Motion: Dr. Yach moved to dismiss with a letter of concern. Second: Beverly Willard Passed: Unanimously, Dr. Schank abstained. K. AN Motion: Dr. Yach moved to dismiss. Second: Beverly Willard Passed: Unanimously, Dr. Schank abstained L. RS Motion: Beverly Willard Second: Dr. Yach Passed: Unanimously, Dr. Simmonds abstained M. TS

7 Motion: Dr. Yach moved to dismiss. Second: Beverly Willard Passed: Unanimously, Dr. Simmonds abstained. N. MR Motion: Dr. Ailes moved to dismiss. Second: Beverly Willard Passed: Unanimously O. HR Discussion: This complaint was tabled for further investigation. P. Request from James Reilly, DVM to modify existing Board Order dated March 4, Discussion: Dr. Reilly s attorney had contacted the Board office prior to the meeting and asked that we table this discussion until the next Board meeting. Q. Animal Kingdom Veterinary Hospital Inspection/Procedures for dentals Joanne Stefanatos, DVM. Discussion: Dr. Stefanatos was present to explain her protocol for dentals and answer any questions the Board might have. The Board had requested that staff provide the Board with an expert opinion, one from a dental expert and one from a holistic expert, for review and this meeting. These reports had been provided to the Board for their review. The Board s concerns were the following: 1) Can a dental cleaning/prophylaxis effectively and safely be performed on a geriatric and/or high risk patient without intubation or putting the patient under general anesthesia? 2) Should a client be able to sign a release form that allows them to waive the standard of veterinary 7

8 practice, specifically the use of general anesthesia/sedation without the use of endotracheal intubation? Dr. Stefanatos stated that her primary objective is the safety and welfare of the animals she is treating and having the right to choose the appropriate therapy, procedure, and pharmaceutical for each patient that benefits the individual animal presented. Dr. Pennell was concerned that her current waiver form and current procedure for a dental prophylaxis was not up to the current Standard of Care. Dr. Pennell asked her to explain how she can perform a full dental prophylaxis when the animal has a swallow reflex and is not under general anesthesia and intubated. Dr. Stefanatos explained that 75% of her clientele is made up of geriatric patients and she feels putting them under general anesthesia would be harmful to them. She uses Rompin and Atrapine to sedate the animal, except cats, and then performs an examination and a dental cleaning. She s been using these drugs for over 30 years without any adverse reactions. She provided a video to the Board of her performing the procedure. Dr. Ailes asked what good, Dr. Stefanatos, is actually doing for the animal when she is only cleaning what the eye can see. Dr. Ailes felt that it sounded like she was only performing dental hygiene and only removing the bacterial burden not a dental prophylaxis or dental therapy. Dr. Stefanatos stated she is willing to call her procedure whatever the Board feels appropriate but as a holistic veterinarian she uses non-toxic non-evasive procedures on her clients. Dr. Yach stated that he felt the public perception according to her consent form and her explanation of her dental procedures has the perception that it is a full dental prophylaxis when it is not. The Board instructed staff to write a letter to Dr. Stefanatos indicating the following concerns and recommendations: 1) That it is her responsibility to inform the client of the treatment, expected results, costs, and risks of each 8

9 treatment regimen. 2) It is most important that the client understands that generally a proper treatment plan of the teeth can t be assessed without the use of a general anesthesia. If she elects to perform an anesthesia-free procedure it is imperative that the client recognizes that the procedure being done is basically a dental hygiene procedure, the removing of some of the supragingival plaque and calculus and is not intended to be a complete cleaning or prophylaxis. *3. Continuing Education-Request for approval of CE's for: A. Wildlife Pharmaceuticals for Veterinarian s and Veterinary Technicians. (24 hours) Motion: Dr. Yach moved to approve the course for 24 hours of CE Credits. Second: Dr. Simmonds Passed: Unanimously *4. Deputy Attorney General Legal Report A. Open/Pending Complaints/Hearing Discussion: Mr. Marcher reported that there are no pending hearings. *5. Requests for Licensure A. Marcia Smith Application VTIT/LVT Discussion: Marcia Smith submitted an application for veterinary technician in training based on her being a senior at UNR with the intent to graduate with a Bachelor of Science Degree in Biology. Motion: Dr. Ailes moved to approve. Second: Dr. Yach Passed: Unanimously, Dr. Schank and Dr. Simmonds abstained B. Dawn Camp Application VTIT/LVT Discussion: Ms. Camp was present to answer any questions the Board may have regarding her application. Ms. Camp had indicated on her application that she was charged with a felony. The Board reviewed Ms. Camp s application for veterinary technician in training in the State of Nevada at the December 8 th Board Meeting. They had voted to approve the application contingent on: 1) A letter from her current supervising veterinarian stating he is fully aware of her previous criminal charges. 2) That she appear at the March 16, 2006 Board Meeting; and 3) The Board receives 9

10 verification that she has completed her probation and was released fully from Clark County Parole and Probation. Ms. Camp complied with all of the Boards requests. Ms. Camp informed the Board that she had to drop out of the Veterinary Technician Program at CCSN for health reasons. She has already turned in her reacceptance paperwork and was planning on being accepted contingent on the college s approval. Motion: Dr. Simmonds moved to approve her application contingent on being reaccepted into the program at CCSN. Second: Dr. Ailes Passed: Unanimously 6. Discussion of Regulations/New Policies A. Review Panel Reports of NAC NAC B. NAC NAC Review material from December 8, 2005 meeting. Discussion: The Board reviewed the material from the December 8, 2005 meeting and advised staff to proceed to a workshop/hearing on the proposed regulations. C. Basic scaling/polishing of dogs & cats teeth being performed by unlicensed veterinary assistants Woody Allen, DVM, Discussion: Dr. Woody Allen was present and provided the Board with material and outlined a proposal to change regulation that would allow unlicensed veterinary assistants with adequate training to scale and polish teeth of dogs and cats under anesthesia with immediate supervision of a licensed veterinarian or technician (LVT). Any dental procedures, other than basic scaling and polishing must be performed by a LVT. Unlicensed personnel would be required to complete a recognized course in performing healthy prophies and basic fundamentals of veterinary dentistry. Dr. Allen will discuss the Board concerns with the NVMA membership, the veterinary technician community, the public, and Dr. Koehm. The Board will consider an open forum at the June or September meeting to discuss this issue in more detail. 7. E xecuti 10

11 ve Direct or Report A. Financial Report B. Administrative Report C. Consumer Complaints Discussion: Ms. Machen reviewed the Financials and the Administrative Report to the Boards satisfaction. *8. Discussion and Determination A. PAVE & ECFVG update Discussion: Ms. Machen updated the Board on changes to the PAVE and ECFVG programs. B. Massage Therapy Amy Herzlich/letter from IAAMB Discussion: Ms. Herzlich, an animal massage therapist and a physical therapy assistant, provided a brief overview of the certification class she teaches on animal massage therapy, IP touch, in Southern Nevada. She educates the community on animal wellness and fitness. The Board has asked Dr. Ailes and Dr. Yach to observe Ms. Herzlich performing animal massage therapy on animals. They will report back to the Board at the next board meeting. C. Guidelines for new complaint/process/changes to current procedures. Discussion: The Board members are satisfied with the current complaint process and the review panel reports. D. Taking of x-ray s by ferrier s Discussion: Mr. Kevin Barns, a ferrier from northern Nevada had called the board office inquiring about ferrier s taking x-rays a service to their clients. Ms. Machen had called Adrian at Nevada Radiological Health to inquire if their laws (NRS459) would prohibit this activity. There are no radiological health laws in Nevada that would prohibit a lay person purchasing or running x- ray equipment. Even though there is no law prohibiting this activity the Board had concerns with the client possibly pressuring the ferrier into making a diagnosis, rendering advice or a recommendation regarding the x-ray. This activity would be considered the practice of veterinary medicine. E. Update on AVMA Site visits at PIMA and CCSN 11

12 Discussion: Ms. Machen advised the Board that both PIMA and CCSN had a site visit by the AVMA in March of Both colleges should receive a response regarding accreditation by the end of April. Mr. Lopez, director of the Pima Veterinary technician program, was present and advised the Board that the visit had gone well. The AVMA committee was skeptical because they don t normally accredit many for-profit, private, non-standard semester schools. The main concern was the relationship that PIMA has with Lied Animal Shelter. It is important that PIMA realizes that there is an educational standard and a shelter medicine standard and Lied with fulfill the educational standard in order to provide this surgical training to the students. PIMA is considering having a surgical area at the shelter for the sole purpose of a teaching environment. Dr. Dennis Olsen, Director of the CCSN program was present and advised the Board that the site visit had gone well. The advice and comments made by the AVMA site visit team were very beneficial and will only improve the program. The main concerns were the college s library and the on-line veterinary technician program. The college should have a decision regarding accreditation by April 28, F. AAVSB convention Kansas City September, 15-17, 2006 Discussion: The Board members discussed who would be able to attend the conference with Ms. Machen. It was decided Dr. Taylor would be the first choice, with Dr. Simmonds being first alternate, and Dr. Pennell would be 2 nd alternate. Ms. Machen would be the voting delegate if no member could be present. G. Set Board Meetings 2006-June 8 th, Sept 7 th, & Dec 7 th Discussion: Dr. Simmonds, Ms. Willard, and Mr. Marcher addressed the issue of possibly having the board meetings by video conference for convenience of the members not having to travel. This provides participation at both ends of the State without transportation. The Board members agreed to try this process for the next meeting. The 2006 Board meeting dates are June 1st, September 7th, and December 7th. *9. Public Comment: None 10. Agenda items for next meeting: 1) Regulation hearing 12

13 2) Animal massage therapy 3) On-line TMCC veterinary technician program approval by the Board. 11. Adjournment Motion: Dr. Simmonds moved to adjourn at 3:35pm. Second: Dr. Yach Passed: Unanimously 13