STATE OF WASHENGTON DEPARTMENT OF HEALTH OEympia, Washington 98504 RE: David M. Heimbach, MD Master Case No.: Document: Agreed Order Regarding your request for information about the above?named practitioner; attached is a true and correct copy of the document on file with the State of Washington, Department of Health, Adjudicative Clerk Office. These records are considered Certified by the Department of Health. Certain information may have been withheld pursuant to Washington state laws. While those laws require that most records be disclosed on request, they also state that certain information should not be disclosed. The following information has been withheld: NONE If you have any questions or need additional information regarding the information that was withheld, please contact: Customer Service Center PO. Box 47865 Olympia, WA 98504-7865 Phone: (360) 236?4700 Fax: (360) 586?2171 You may appeal the decision to withhold any information by writing to the Privacy Officer, Department of Health, PO. Box 47890, Olympia, WA 98504-7890. STATE OF WASHINGTON DEPARTMENT OF HEALTH MEDICAL QUALITY ASSURANCE COMMISSION In the Matter of the License to Practice I as a Physician and Surgeon of: No. DAVID M. MD STIPULATED FINDINGS OF FACT, License No. CONCLUSIONS OF LAW AND AGREED ORDER Respondent. The Medical Quality AssuranceCommission (Commission), through Suzanne L. Mager, Commission Staff Attorney,_and Respondent, stipulate and-agree to the following: 1. PROCEDURAL STIPULATIONS 1.1 On March 11, 2014, the Commission issued a Statement of Charges against Respondent. 7. A 1.2 In the Statement of Charges, the Commission alleges that Respondent violated (7)1 (13). (22), 45 CFR164.502, 154.514(b) and RCW 70.02.0200). 1.3 The Commission is prepared to proceed to a hearing on the allegations in the Statement of Charges- 1.4 Respondent has the right to defend against the allegations in the Statement of Charges by presenting evidence at a hearing. 7 1.5 The Commission has the authority to impose sanctions pursuant to RCW 18.130160 it the allegations are proven at a hearing. I 1.6 The parties agree to resolve this matter by means of this Stipulated Findings of Fact, Conclusions of Lav?r and Agreed Order (Agreed Order). Respondent waives the opportunity for a hearing on the Statement of Charges if the Commission Agreed. Order. 1.8 This Agreed Order is not binding unless it is accepted and signed lay-the Commission. OF FACT, - PAGE 1 OF 9 CONCLUSIONS OF LAW AND AGREED ORDER . NO. M2012-1222 r. -. 51L 1.0 If the Commission accepts this Agreed Order, it will be reported to the National Practitioner Data Bank (45 CFR Part 60), the Federation of State Medical Boards' Physician Data Center and elsewhere as required bylaw. 1.10 This Agreed Order is a public document. it will be placed on the Department of Health's website. disseminated via the Commission?s electronic mailing list, and - disseminated according to the Uniform Disciplinary Act (Chapter 18.130 ROW). it maybe disclosed to the public upon request pursuant to? the Public Records Act (Chapter 42.56 ROW). It will remain part of Respondents ?le according to the state's records retention law and cannot be expunged. 1.11 if the Commission rejects this Agreed Order, Respondent waives? any objection to the participation at hearing of any Commission members who heard the Agreed Order presentation. I 2. FINDINGS OF FACT Respondent and the. Commission acknowledge that the evidence is suf?cient to justifythe following ?ndings and the Commission makes the foliowing ?ndings: 2.1 On April 11, 19?4,rthe state of Washington issued Respondent a license to practice as a physician and surgeon. Respondent?s license~is currently active. Respondent is board-certi?ed in surgery. 7 2.2 Respondent is a retired burn surgeon who worked for the University of Washington's Harborview Medical Center (HMC) as the Burn Center Director until November 2002 and was also a University of Washington School of Medicine (UWSOM) 1. faculty member. Reapondent retired from the UWSOM in July 2011. . 2.3 Beginning in 2009, and prior to his retirement from the UWSOM, Respondent served as a consultant for Citizens for Fire Safety Institute (CFS). CFS portrayed itself to the pubtic, state legislators, and the news media as a coalition of ?re professionais. educators, community activists, bum centers, doctors, ?re departments and industry leaders interested in ?re prevention and fire safety. This was not true._ In fact, 7 CFS was an organization created and entirely funded by the three large manufacturers of chemical flame retardants to ?promote common business interests of members involved with the-chemical manufacturing industry.? Between 2008 and 2012 CFS's three STIPULATED FINDINGS OFFAGT, . PAGE 2 OF 9 OF LAW AND AGREED ORDER NO. - a 1? KL: members provided million in funding-to CFS to support its lobbying and politiCal expenses. 2.4 Between 2009 through 2012, legislation was proposed in Washington, California, and Alaska to restrict the use of chemical ?ame retardants in some consumer products. The legislation was introduced after federal 'studies suggested that chemical ?ame retardants in clothing and furniture not only posed signi?cant health risks but also were ineffective in burn prevention. 2.5 in at least 2010 and 2011 CFS paid Respondent $120,000 each year for his ?time and expertise" as a consultant. During this time the University of Washington School of Medicine required its employees to request and receive approval to accept compensation for work outside of the university. Respondent neither submitted such a request nor received approval to receive any compensation for work outside the university. I 2.6 in 2009 through 2012, Respondent testi?ed in interest at legislative - hearings on bills seeking to restrict the use of chemical ?ame retardants in three states: Washington, California, and Alaska. Although CFS paid Respondent's travel expenses 1 when he testi?ed in person, and although Respondent was paid $240,000 by CFS in 2010 and 2011, Respondent never revealed his relationship with the chemical flame retardant industry. Instead, Respondent represented himself as an unbiased bum expert opposed to proposed statutory restrictions on the use of chemical ?ame retardants. 2.7 At the four legislative hearings in Washington, California, and Alaska, Respondent testi?ed in opposition to the proposed restrictions on his client?s products. Each time he testi?ed, Respondent told a compelling story about his treating a speci?c infant bu rn victim whose injuries he claimed were sustained from fabrics and products not treated with'chemical flame retardants. Respondent later admitted that he made up the infant burn patients hedescribed, but alleged that the stories he told in the legislative hearings all were embellished characterizations of Patient A, a real patient, although not one whom he had treated. . 2.8 . On May 18, 2009, PatientA, a ?ve?weekiold girl, was admitted to HMO for burn injuries sustained from a house ?re. Patient A had 35% total body surface area burns (chest, face, and upper?extremities), inhalation injury, acute respiratory failure, postvbum shock, hemodynamic instability, and anuria. Two HMC burn physicians treated Patient A?s STIPULATED FINDINGS OF FACT, A PAGE 3 OF 9 CONCLUSIONS or LAW AND AGREED ORDER - No. mama?1222 . .j I critical condition during her six-day hospitatization. Neither one was Respondent. Despite full medical management, Patient A?s condition worsened. On May 23, 2009, Patient A died. 2.0 The fire that caused Patient A?s injuries started after the infant, who'was wrapped in a'blanket, was placed on her parents? had and left alone by her mother for four minutes. Patient A?s mother saw smoke coming from the bedroom, rushed in, took Patient A out of the, room, and immediately drove her to a local hospital. She was transferred to HMO because of the severity of her burn injuries. 2.10 The county fire marshal?s investigation determined that the house fire was caused by an overloaded and overheated extension cord located in the room where Patient A slept. The absence of ?ameretardant bedding, blankets, or the infant's clothing was not mentioned in the report, and no other records mention the presence or absence of ?ame retardants in Patient A?s bedding or clothing. 2.11 Patient A's treatment and total hospitalization charges were approximately $90,000. Patient Awas insured by Medicaid, which paid the contracted amount of approximately 2.12 On July 7, 2000, Respondent testi?ed at a California Senate hearing to Oppose limitations on chemical flame retardants. Respondent claimed that he treated children with burn injuries sustained from clothing not treated with ?re retardants. Respondent told of a nine-week?old female patient who was burned when the mother placed a candle next to the crib and left the room. He stated that the candle fell over, causing the fire, and he suggested that the crib materials were not treated with chemical I ?ame retardants. Respondent claimed he had treated this infant: he said she was the size of a "teddy bear,? she had suffered 80% burns on her body; her ?ngers and arms had to be split open; and she died after three and a half weeks in the hospital. Respondent also claimed that the patient?s hospital bill was $500,000 which was paid by Medicaid. 2.13 On March 17', 2010, Respondent testi?ed by phone at an Alaska Senate hearing regarding limits on chemical ?ame retardants and toxic chemicals in consumer products. Respondent opposed the iegislation and stated that he was ?not in the pocket" of chemical ?ame retardant manufacturers. Respondent claimed that he had treated a six- week-oid baby fron'rru'ral Washington: the patient was in a crib when a dog knocked over STIPULATED Flnoinss or FACT, FAGE 4 or: 9 or LAW AND AGREED ORDER. NO.M2012-1222 {p . a candle; the crib itself was not flame- retardant but the pillow had been treated and did not catch on ?re; the infant sustained burns of 75% full thickness on the lower half of her body; and the patient eventually died: I 2.14 in 2011, Respondent testi?ed at another Galifornia Senate hearing in opposition to legislation which would have set furniture flammability standards and would have limited the use of chemical flame retardants. Respondent told the committee that he had treated a seven-weekuold baby girl from Alaska: the infant was no bigger than the size of his "Italian greyhound;" she had?sustained burns when her mother placed a candle in the crib which caused the ?re; her injun'es resulted in 50% severe body burn in her upper body half because her pillow had not been treated with chemical ?ame retardantsfand she suffered three weeks of ?pain and misery" before she died. Respondent stated that the - hospitalization costs were ?needy $1 million" and were paid by medicaid. He also stated that the burn patients he had treated were impoverished and covered by Medicaid, and that products with chemical flame retardants are made for ?those who are most oppressed and who don?t have the same resources as rich people.? 2.15 On January 26, 2012, Respondent testi?ed at a Washington Senate hearing to oppose legislation that would ban chemical flame retardants inchiidren's products. As he had in previous testimony, Respondent again ciaimed that he was Director of the HMC Burn Center and had been Director for thirty-five years, and he stated that he had treated virtually every major burn patient from four states- He claimed that a majority of burn patients were children "from the lower socioeconomic class,? that their hospitalizations cost about $8,000 per a day, and that the costs are paid by ?state-funded Medicaid." Respondent asserted that a ban on chemical flame retardants would cause more flame- burn injuries to poor children, resulting in large ?scalcosts to the state budget. 2.1.8 In 2011 Respondent was asked to lead a ?President?s Plenary session" at the April 2011 American Burn Association meeting in Chicago. In preparing his presentation, Respondent obtained electronic copies of three photographs of Patient A . which were part of Patient A's HMC records. Respondent showed two photographs of I. Patient A during his presentation and did not blur any part of the photos. 2.17 lrflihen Respondent retired from UWSOM in July 2011, he took the electronic copies of the photographs of Patient A into his personal possession. STIPULATED OF FACT, PAGE 5 OF 9 CONCLUSIONS OF LAWAN AGREED ORDER ll: -- urn-i HEEL 2.18 When challenged by an investigative reporter for the Chicago Tifbune who asserted that Respondent had fabricated the patients about whom he testi?ed, Respondent defended himself by alleging that his testimonies about the infant burn patients were based on one particular HMC patient, Patient A. To-defend himsetf' against the accusation that he had fabricated his legislative testimony, Respondent emailed photographs of PatientA to the reporter. 2.19 Respondent nevertreateleatient A, nor did he consult with the two attending physicians who treated her for the six days she was hospitalized. Respondent learned about Patient A by attending rounds with the new HMC Burn Center Director during Patient A?s hospitalization. The reporter centacted Patient A?s mother who con?rmed Patient A's identi?cation and the actual details of the ?re which had Caused Patient A?s burns which were not as described by Respondent in any of his testimonies. 2.20 in 2012, during the Commission?s investigation of Respondent, the Respondent claimed to the Commission that he had f?clearly identified" himself to the state legislatures as "a [sic] individual speaking on behalf of Citizens for Fire Safety, and not on behan of the University of Washington or Harborview Medical Center.? This statement is not true: Respondent never revealed to the legislative committees that the he was being paid by CFS and he never revealed that CFS was really the trade association of the chemical flame retardant industry. Respondent portrayed himself as an unbiased, concerned burn expert and UWSOM faculty member who opposed restrictions on - chemical flame retardant use. 2.21 When Current and former state legislators learned of Respondent's misreprESentations, they wrote a letter, dated June 4., 2012, to successor organization. These legislators represented several states across the country, as well as Washington. The letter stated that the legislators believed that CFS had deliberately misrepresented the effectiveness of ?ame retardant chemicals by "empioying an expert witness who repeatedly invoked a phony story of a child dying in a ?re in orderto justify? . interests. The legislators characterized Respondent's ?lying about the death of an infant girl? as ?abhorrent? and ?egregious.? I 2.22 Most of Respondents testimony, which he presented as documented facts, was fabricated. Respondent?s misrepresentations to legislators, to burn expens, and to STIPULATED OF FACT, PAGE 5 OF 9 - CONCLUSIONS OF LAW AND AGREED ORDER - a . no. mama-1222 . . i i! other'doctors is conduct which harms the reputation of the profession. In addition, this conduct demonstrates an to bear the responsibilities, or enjoy the privileges, of the profession. 3. CONCLUSIONS OF LAW The Commission and Respondent agree to the entry of the following Conclusions of Law. 3.1 The Commission has jurisdiction over Respondent and overthe subject matter of this proceeding. - 3.2 Respondent has committed unprofessional conduct in violation of (1), (13), and 3.3 The above violations provide grounds for'imposing sanctions under RCW18.130.160. I 4.. AGREED ORDER A Based on the [findings of Fact and Conclusions of Law, Respondent agrees to entry of the following Agreed Order. I 4.1 Voluntary Surrender. Respondent permanentiy retires from the practice of medicine, and surrenders his license as a physician and surgeon. Respondent may'not resume any practice of medicine, including temporary, emergency. or volunteer practice in the state of Washington. Respondent may not seek reinstatement of his license and may not submit an application for a license to practice medicine in Washington. 42 Return of License. Respondent must mail his wallet iicense card and wall iicense certi?cate to: Compliance Of?cer, Medical Quality Assurance Commission, PO Box 47866, Olympia, Washington 98504-7866. 1? 4.3. Date. The effective date of this Agreed Order is the date the Adjudicative Clerk Of?ce places the Isigned Agreed Order into the US. mail. 5. COMPLIANCE WJTH SANCTION RULES 5.1 The Commission appiies WAGES-16600, et seq, to determine appropriate sanctions. STIPULATED FINDINGS OF FACT, - 1 7 OF 9 CONCLUSIONS OF LAW AND AGREED ORDER ,9 - . . i. No. mow?1222 - .. t; 5.2 WAC provides that surrender of a Respondent?s medical license is an acceptable resolution when the Respondent her effective practice and surrender alone is enough to protect the pubiic. Respondent is retired and no ionger practicing. Respondent?s surrender of his license is enough on its own to protect the public; no other sanctions are necessary. Consideration of mitigating or aggravating factors is unnecessary. 6. ACCEPTANCE l, M. HEIMBACH. Respondent, certify thatl have read this Agreed Order in its entirety; that i fully understand and agree to all of it; that I have chosen not to retain counsel; and that the Agreed Order may be presented to the Commission without my appearance. If the Commission accepts the Agreed Order, i understand that i will receive a signed copy. We? Hem 390(4? M. HEIMBACH, MD DATE I RESPONDENT Case No; M1082 I rr 1: It If snPuu-tTEo FINDINGS OF FACT, . I PAGE or 9 CONCLUSIONS OF LAW AND AGREED ORDER NO. wow?1222 r" L.. 7. ACCEPTANCE AND ORDER The Commission accepts and enters this Stipulated Findings of Fact, Conclusions! of Law and Agreed Order. I DATED: ?9 A ., 2014. OF WASHINGTON DEPARTMENT OF HEALTH MEDICAL ASSURANCE I I L: MAGER, WSBA #19234 COMMISSION STAFF ATTORNEY STIPULATED FINDINGS OF FACT, PAGE 9 OF 9 CONCLUSIONS OF LAW AND AGREED ORDER A A - Hi Lilli