BEFORE THE STATE BOARD OF MEDICAL EXAMINER OF SOUTH CAROLINA In the Matter of: TAHIR ALI JAVED, M.D. TEMPORARY SUSPENSION Medical License 16549, (M-257-03) Respondent. WHEREAS, Respondent is a physician duly licensed by the State Board of Medical Examiners (the Board) to practice medicine in this State; and WHEREAS, on or about September 30, 2003, Respondent?s license was revoked by the State of Nebraska Department of Health and Human Services based upon an Agreed Settlement with the Respondent. The Affidavit of Henry B. Morgan, Assistant Adminstrator/Investigations, is attached hereto as Exhibit 1; and WHEREAS, ReSpondent admitted to unprofessional conduct in that he failed to provide sufficient training and appropriate oversight, which lead to improper infection control during treatment; and WHEREAS, Respondent admitted gross negligence in that he failed to supervise basic care and failed to correct improper basic infection control practices; and WHEREAS, Respondent admitted gross negligence in that he failed to protect patients from serious risk or harm; and WHEREAS, Respondent admitted negligent conduct in that he failed to take steps to protect patients, thus placing patients at additional risks; and WHEREAS, Respondent admitted unprofessional conduct in that his conduct and practice was outside the normal standard of care and resulted in harm to at least ninety?nine (99) patients including the death of at least one (1) patient; and WHEREAS, Respondent admitted unprofessional conduct in that he obtained test results without a patient?physician relationship; and WHEREAS, Respondent admitted to unprofessional conduct in that he admitted to patient abandonment; and WHEREAS, the Board ?nds that Respondent?s admitted conduct constitutes a serious threat to the public health, safety, or welfare; and WHEREAS, the Board further ?nds that the public interest imperatively requires that Respondent's continued practice of medicine be immediately temporarily suspended pending hearing and until further Order of the Board. THEREFORE, IT IS ORDERED THAT, in accordance With SC. Code Ann. 1-23- 370(c), Respondent's license to practice medicine in this State is hereby temporarily suspended, effective immediately, pending hearing and until further Order of the Board. AND IT IS SO ORDERED. SOUTH CAROLINA DEPARTMENT OF LABOR, LICENSING REGULATION BOARD OF MEDICAL EXAMINERS ROGER A. RAY, MD. President of the Board Page 2 of 2 SOUTH CAROLINA DEPARTMENT OF LABOR, LICENSING REGULATION BEFORE THE BOARD OF MEDICAL EXAMINERS In the Matter of: Tahir Ali Javed, M.D., License 16549 AFFIDAVIT (M-257-O3) PERSONALLY appeared before me, Henry B. Morgan, who, being duly sworn, states the following facts: 1. Af?ant is the Assistant Administrator for Investigations for the South Carolina Board of Medical Examiners (Board) and in said capacity has received certain documents related to the Licensee from the State of Nebraska Department of Health and Human Services. 2. Pursuant to an Order of Agreed Settlement, dated September 30, 2003, the license of the Licensee was revoked by the state of Nebraska for seven causes documenting unprofessional conduct, gross negligence, and negligent conduct. Further Af?ant saith naught. r/eg?this I My Commission Expires: is; 2 . BEFORE THE SOUTH CAROLINA STATE BOARD OF MEDICAL EXAMINERS In the Matter of: TAHIR ALI JAVED, M.D., FINAL ORDER Medical License #16549, (Public) Respondent. This matter came before the State Board of Medical Examiners (the Board) for hearing on February 6, 2006, as a result of the Notice and Complaint which was served upon the Respondent in accordance with Regulation 81-23 and-?led with the Board. A quorum of Board members was present. The hearing was held pursuant to SC. Code Ann. ??40-47?200 and 21 1 as amended, to consider the Certi?ed Report of the DisciplinaryPanel and to determine whether the Respondent?s license to practice medicine in the State of South Carolina should be revoked, suspended, or otherwise modi?ed as provided by law. Marvin G. Frierson, Esquire, Assistant General Counsel with the SC Department of Labor, . Licensing and Regulation, represented the State. The Respondent was not present for the hearing and was not represented by counsel. The Respondent was charged with violation of SC. Code Ann. and (12) (1976), as. amended; and Regulation ofthe Rules and Regulations of the Board. FINDINGS OF FACT Based upon the preponderance of the evidence on the whole record, the Board ?nds the facts of the case to be as follows: 1 . The Respondent is aphysician duly licensed to practice medicine in South Carolina, and was so licensed at all times relevant to raised in the Complaint ?led inthis matter. Respondent?s license was temporarily suspended pursuant to an Order ofTemporary Suspension dated December 29, 2003 . 2. The State presented evidence showing that the Respondent previously practiced as an oncologist at the Fremont Cancer Center in Fremont, Nebraska. On or about July 22, 2003 a Petition for Disciplinary Action was ?led the Nebraska Department of Health and Human Services in which the Respondent was the named Defendant. (A of the Petition was placed into evidence by the State). Page 1 of 3 The disciplinary matter was settled when on or about September 29, 2003, the Respondent entered into avoluntary agreement wherein he admitted to certain violations of the Nebraska statutes and regulations regulating the practice of medicine. (A copy of the Agreed Settlement and Voluntary Appearance was placed into evidence by the State). 3. For purposes of the agreement with Nebraska authorities, the Respondent admitted that he allowed his staff to reuse disposable syringes thereby exposing patients to cross contamination. As a result of the cross contamination, 99 patients were infected with Hepatitis Virus (HCV), genotype 3 a, which is the least common form of HCV in the United States and represents 5% of all cases. At the time of the Nebraska agreement, at least one patient had died ?om HCV. 4. As a part of the agreement, the ReSpondent admitted that his failure to properly provide I for and supervise infection control was He further admitted that his failure to correct the improper infection control practices at his clinic, even after being repeatedly put on notice, showed a pattern of negli gent conduct. As a result of the agreement, on or about September 3 0, 2003 the Chief Medical Of?cer for the Nebraska Department ofHealth and Human Services issued an Order revoking the Respondent?s license to practice medicine in the State of Nebraska. 5. Based upon the evidence presented, the Board ?nds that the Respondent has violated the Board?s Practice Act as more fully set forth below. CONCLUSIONS OF LAW I Based upon careful consideration of the facts in this matter, the Board ?nds and concludes as a matter of law that: 1 . The Board has jurisdiction inthis matter and, upon ?nding that a licensee has violated any of the provisions of SC. Code Ann. ?40-47?200, sum, has the authority to order the revocation or suspension of a license to practice medicine or osteopathy, publicly or privately reprimand the holder of I a license, or take other reasonable action short of revocation or suspension, such as requiring the licensee to undertake additional professional training subject to the direction and supervision of the Board or imposing restraint upon the medical or osteopathic practice of the licensee as circumstances warrant until - the licensee demonstrates to the Board adequate professional competence. Additionally, the Board may require the licensee to pay a civil penalty of up to ten thousand dollars to the Board and the costs of the disciplinary action. 2. The Respondent has violated 8.0. Code Ann. (1976), as amended, in that he has violated thefollowing Principles of Medical Ethics adopted by the Board: A. Regulation in that the Respondent failed to provide competent medical service with compassion and respect for human dignity, as evidenced by the Respondent? voluntary Page 2 of3 admission that he violated Nebraska statutes and regulations that govern the practice of medicine in the State ofNebraska, and his admission that the violations constituted gross negligence and showed a pattern of negligent conduct. . 3. The Respondent has violated S.C. Code Ann. 1 2) (1976), as amended, in that the admissions made by the Respondent in theNebraska disciplinary action shows that the Respondent lacks the ethical and professional competence to practice medicine in the State of South Carolina. 4. The sanction imposed is consistent with the purpose of these proceedings and has been made after weighing the public interest and the need for the continuing services of quali?ed medical doctors against the countervailing concern that society be protected from professional ineptitude and misconduct. 5. The sanction imposed is designed not to punish the Respondent, but to protect the life, health and welfare of the people at large. NOW, THEREFORE, IT IS HEREBY ORDERED, ADJUDGED AND DE CREED that the Respondent?s license to practice medicine in the State of South Carolina shall be, and hereby is, revoked. I IT IS FURTHER ORDERED that the Respondent shall, within one (1 year ofthe date ofthis ?nal order, pay costs associated with this matter. Said costs being in the amount of One Thousand Eighty and-06/100 ,080.06) Dollars, and these costs shall not be deemed paid until received by the Board. AND IT IS SO ORDERED. STATE BOARD OF MEDICAL EXAMINERS SATISH M. PRABHU, MD. President of the Board February 513 ,2006. Page 3 of 3 New York State Board for Professional Medical Conduct 433 River Street, Suite 303 0 Troy, New York 12180?2299 0 (518) 402-0863 Antonia C. Novello, M.D..M.P.H., Dr. P.H. Commissioner in NYS Department of Health 5/ Michael A. Gonzalez, R.P.A. Dennis P. Whalen Vice Chair Executive Deputy Commissioner i it} NYS Department of Health 5' Ansel R. Marks. MD. JD. "in Executive Secretary Dennis J. Graziano. Director Of?ce of Professional Medical Conduct March 18, 2004 CERTIFIED MAIL-RETURN RECEIPT REQUESTED Tahir Javed, M.B.B.S. 7H7H ohertown Lahore, Pakistan Re: License No. 193045 Dear Dr. aved: Enclosed please ?nd Order 04-51 of the New York State Board for Professional Medical Conduct. This order and any penalty provided therein goes into effect March 25, 2004. If the penalty imposed by the Order is a surrender, revocation or suSpension of this license, you are required to deliver to the Board the license and registration within ?ve (5) days of receipt of the Order to the Board for Professional MediCal Conduct, New York State Department of Health, Hedley Park Place, Suite 303, 433 River Street, Troy, New York 12180. Sincerely, Ansel .Marks, M. ., . . Executive Secretary Board for Professional Medical Conduct Enclosure cc: Amy T. Kulb, Esq. Jacobson and Goldberg, LLP 585 Stewart Avenue Garden City, NY 11530 STATE OF NEW YORK DEPARTMENT OF HEALTH STATE BOARD FOR PROFESSIONAL MEDICAL CONDUCT IN THE MATTER SURRENDER OF ORDER TAHIR ALI JAVED, M.B.B.S. BPMC ?'51 TAHIR ALI JAVED, M.B.B.S., says: On or about July 22, 1993, I was licensed to practice medicine as a physician in the State of New York having been issued License No. 193045 by the New York State Education Department. I currently reside at 7H7H Johertown, Lahore, Pakistan. I am not currently registered with the New York State Education Department to practice as a physician in the State of New York. I understand that the New York State Board for Professional Medical Conduct has charged me with two (2) specifications of professional misconduct as set forth in the Statement of Charges, annexed hereto, made a part hereof, and marked as Exhibit I am applying to the State Board for Professional Medical Conduct for an agreement to allow me to surrender my license as a physician in the State of New York and request that the Board issue this Surrender Order. I, hereby, agree not to contest Factual Allegations A and and (5) and the Second Specification set forth in the Statement of Charges (Exhibit A). I understand that, in the event that this proposed agreement is not granted by the State Board for Professional Medical Conduct, nothing contained herein shall be binding upon me or construed to be an admission of any act of misconduct alleged or charged against me, such proposed agreement shall not be used against me in any way, and shall be kept in strict confidence during the pendency of the professional misconduct disciplinary proceeding; and such denial by the State Board for Professional Medical Conduct shall be made without prejudice to the continuance of any disciplinary proceeding and the final determination by a Committee on Professional Medical Conduct pursuant to the provisions of the Public Health Law. i agree that, in the event the Board grants my Application, as set forth herein, an order of the Chairperson of the Board shall be issued in accordance with same upon issuance by the Board, which may be accomplished by mailing, by ?rst class mail, a copy of the Order to me at the address set forth above or to my attorney or upon transmission via facsimile to me or my attorney, whichever is first. I am making this agreement of my own free will and accord and not under duress, TAHIR JAVED, M.B.B.S. Respondent compulsion or restraint of any kind of manner. Date: 2004 AGREED TO: Date: 3i <3 ,2004 AMY T.K LB, ESQ. Attorney for Respondent i0 Date: ROBERT BOGAN Associate Counsel Bureau of Professional Medical Conduct WIANO ector, Of?ce of Professional Medical Conduct Date: 31? M120 L1 ,2004 STATE OF NEW YORK DEPARTMENT OF HEALTH STATE BOARD FOR PROFESSIONAL MEDICAL CONDUCT IN THE MATTER STATEMENT OF UP TAHIR ALI JAVED, M.B.B.S. CHARGES CO-O3-10-4601-A TAHIR ALI JAVED, M.B.B.S., the Respondent, was authorized to practice medicine in New York state on July 22, 1993, by the issuance of license number 193045 by the New York State Education Department. FACTUAL ALLEGATIONS A. On or about September 30, 2003, the State of Nebraska, Department of Health and Human Services, Regulation and License, (hereinafter ?Nebraska Board?), by an Order on Agreed Settlement (hereinafter ?Nebraska Order"), revoked Respondent?s license to practice medicine, based on unprofessional conduct and gross negligence. B. 'The conduct resulting in the Nebraska Board disciplinary action against Respondent would constitute misconduct under the laws of New York state, pursuant to the following sections of New York state Law: 1 New York Education Law ?6530(3) (negligence on more than one occasion); 2. New York Education Law ?6530(4) (gross negligence); 3. New York Education Law ?6530(20) (moral un?tness); 4. New York Education Law ?6530(30) (abandoning or neglecting a patient under and in need of immediate professional care, without making reasonable arrangements for the continuation of such care); and/or 5. New York Education Law ?6530(32) (failure to maintain a record for each patient which accurately reflects the evaluation and treatment of the patient). SPECIFICATIONS Respondent violated New York Education Law ?6530(9)(b) by having been found guilty of improper professional practice or professional misconduct by a duly authorized professional disciplinary agency of another state where the conduct upon which the ?nding was based would, if committed in New York state, constitute professional misconduct under the laws of New York state. in that Petitioner charges: 1. The facts in Paragraphs A and/or B. SECOND SPECIFICATION Respondent violated New York Education Law ?6530(9)(d) by having disciplinary action taken by a duly authorized professional disciplinary agency of another state, where the conduct resulting in the disciplinary action would, if committed in New York state, constitute professional miscondUct under the laws New York state, in that Petitioner charges: 2. The facts in Paragraphs A and/or B. DATED: W430, 2003 mm Albany, New York PETER D. VAN BUREN Deputy Counsel Bureau of Professional Medical Conduct ORDER Upon the proposed agreement of TAHIR ALI JAVED, M.B.B.S., to Surrender his license as a physician in the State of New York, which proposed agreement is made a part hereof, it is AGREED TO and ORDERED, that the proposed agreement and the provisions thereof are hereby adopted; it is further ORDERED, that the name of the Respondent be stricken from the roster of physicians in the State of New York; it is further ORDERED, that this Order shall be effective upon issuance by the Board, which may be accomplished by mailing, by ?rst class mail, a copy to Respondent at the addresses set forth in this agreement or to Respondent?s attorney or upon transmission via facsimile to Respondent or Respondent?s attorney, whichever is earliest. DATED: Wit-Lek I ?7 .2004 MICHAEL A. GONZALEZ, R.P.A. Vice Chair State Board for Professional Medical Conduct - A . STATEOFNEB KA -. a Tm: DEPARTMENT or HEALTH AND HUMAN REGULATION AND ucmsum: . SEP 3 a 2003 STATE or . JON Attorney General, 69 . smfu-thlv? Hr . Plaintiff, ORDER 0N v. AGREED TAHIR ALI JAVED, Dcfcildant. OR FOR CONSIDERATION on the AM ?led with The a. 29, 2003. The Chief meg: 0mm being advised ?ndsThat the Agreed Settleman a ?opy of which is auth and is incorporated by reference. is approved. I I. . 4 2. The licensc oflhc berm?, Tahit Ali lav-ed. is revoked based upon the allegations in the rim. Second. mm. Founh. Fink. Tenth, and Twelfth Causes or I Action. individually collectively. - 7 3. A Sixth. Seventh. Eighth, Ninth. and Eleventh Causes? or Action are dismissed. ORDER 1 - - IT 15 HEREBY ORDERED am The license oI'Tahir Au Javcd to practice medicine and-surgery i2 tll? ate ofNebraslu is revoked effective immediately, A I DATED this day org . .2003. pr.- 'I'Illi AND lilh IAN 5E REGULATION AND LICENSU STATE OF NEBRASKA - - HHS REGULATION - memo LICENSUBE . . AGREED SETTLEMENT . 1 i STATE OF NEBRASKA. Plainti?'. AM) . - - ALI VOLUNTARY APPEARANCE Defendant. 559 a 2093 The Plaintil?t? and Defendant Tahir Ali lave-d. M.B.BS.. in connideration of the M. mutual covenants and. agreements contained herein. agree as follotts A i I inert-Mam Tahir Ali Javcd-was issued-lich heather-{299734 mm October 3. . - lot?. by the Nebraska Department of l-lealth'and Human Services Regulation-and ?1 7 i 7' I Licensurc to practice medicine and surgery in the State ol?NebrasLa. which license is currently held by the Defendant 2? - The Defendant acknowledge-.5 receipt ol?a copy ot'the Petition for Disciplinary Action and aives the need for further service of the Petition on him Before disciplinary measures may be taken against the Defendant's license. the Defendant is entitled to. a hearing as provided by law The Defendant wait-es the right to a hearing. 'l'he'i)et'endartt also wanes any right to godtetal' In ten of a disciplinary order that approves the terms of this Agreed Settlement I I ?l No coercion. threats. or promiaes. other than those slate-d herein, ?etc made to the Defendant to induce him to enter this Agreed Settlement 5 The Defendant has been represented by Michael Jones of the tan tit-m - of Ellick. Jones. Bueh. Blazek and-Longo; and has received adxiee oteounael prior to entering into this Agreed Settlement. i t) The Defendant admits the ai-iegations of paragraph I: through 6. paragraph 50. paragraphs 75 and 70. paragraph; 80 through so. and: 94 and 95. The Defendant denies the allegations of paragraphs SI through paragraph-a 57 through 74. and 87 through ?33, except the references in paragraph '57. no. mt. and 93 to numbered paragraphs Speci?cally admitted The Defendant does not admit the remainingI allegations. speci?cally paragraphs '7 through St) and paragraph: 77 through 39, but elects not to comm those dilemma and for .p?rpows of mowing the . Depmmem?s Chief Medical Of?cer to enter a ?nal order in accordm with the [erms ofthis Agreed swim. um those may be considered to be true. although the defendant speci?cally does no: admit the :0 be truc? 7. The Plaintiffs:ng the Sixth. Seventh, Eighth, Ninth; Causes of Action be 7 - . s. The Defendant consents to me Depanmemfs Chief Medical 0mm entering a' ?nal order that revokes the Defehdam?s license. to practice nwdiginc and I based upon Causes of Action I. 2. 3. 4. 5. l0, and 12, individually and in the aggregate. and any combina?on of those causes ofaction? gift?T 9. - Notice oi?titis Agt?cd Settlement has bcett given to-thc of Medicine and Surgery and the input of the Bdard has been received in accordance \iith?t .ii, Rtatt I to. This Agreed Setth is a compromise'ag?emni withitt the meaning or NFB. REV. Sm. $527408. Irthe Chief Mcdicai Of?ce: does not approvt: this. Agreed Settlement. this Setticment shall become nuii and void and will mt be admissible for any purpose at any hearing that may be hcid on this mattct. AGREED TO: . V. ?ve-au- WM - . . Tahir Ali Javed. Hwy-whale 1 WA ?i'for' 'l?uhir Ali-Jami 'x (It?culi?? q] the I STATE OF Plainti??. JON Attorney Genet-3i HEEL. nut-tr}? 7 Assistant. Nutmeg: General 0. [Box 95029 . Satin-nah mm, Lincoln. NF. 03509-5020 Adeggi3J-11LM 1 Tc! (402)-1714050' i Amman-Hut Approved as to form: f; 4! ., Michaei D. Jones. aim? Eliick. Jones. Buelt. Blank and Longo 8805 Indian Hills Drive. 3230 Omaha. Nebraska 08! 14-4070 a 11.11:. by FILED . THE DEPARTMENTOFHEALTH AND HUMANSEFVICES . - - - REG 1t ULATION AND LICENSU - STATE OF NEBRASKA - HHS REGULATION. w- AND LtCEtaszv-v . STATE: or NEBRASKA. Plaintiff, moAvrT v. . TAHIR ALI JAVEDM.B.B.S., srA'rt-z or NEBRASKA . m. VCOUNTYOFLANCASTER - Susanne Rydberg. being ?rst duly sworn upmoath. states as follows: I. I am an employee of the Divisiott of the of Health and Human services Regt?ttation and I 2. In the course of my employment I have investigated complaints the above named Tahir Ali Jam. - . 3. As put ?that [Lind with the Defendant. both in person and bytelephonc. Prior to July l3. 2002 tires- informed his residence . address was 16l Sh Spender Street. Omaha. Nebraska; during the most recent teleohone conversations the Defendant has informed me that he is currently?living in Pakistan at this address: mm Latte-re. Poitistan. 4. As part oflhc investigation I received a copy ora letter sent by the Defendant to some ofhis patients telling them that he was going overseas: a copy of that letter. dated .luly l2. 2002. is attached. . - S. The of?cial lntemet site for the Government of the Punjab Province of . - Pakistan lists the Defendant as an elected maniac: ol' the Punjab Provincial Assembly and states that he serves in the Cabinet in the post of'Provi'rtcial Health Minister. The site lists the following as his current address: House No. 3-3. Street No; 27. nsn. and his of?ce address as: M-S. Council Block Punjab Civil Secretariat. Lahore- 6. I had contact with the Defendant through his attomcy Michael Jones. who ha; indicated that the Defer-Adam is currently residing in Pakistan; 7. The Defendant?s only of?cc lo?atcd at 450 . . . 8. The Defendant pmvided me address r2745 Skylark Sum, Frean Nebraska as his address at the sime he beam: licensed in mi": stale; and, did no! inform the Department of any change ofhis address; - - - 9. . -Thc Defendant?siastknown Nebraskaaddresswas wuss spam? Sum, ammucbmk'a, - Further Imam sayeth not. Dated: ll 0 I: Subscri .1 1. 32AM: 3mm HIva tr: 3.4% . - a I FILED THE DEPARTMENT OF HEALTH AND HUM Still, I ha REGULATION AND LICENSUR STATE OF NEBRASKA 2 2 HHS neonurton STATE or NEBRASKA. AND LICENSURE . Plaintiff. PETITION FOR v. - . DISCIPLINARY ACTION I l, ALI .IAVED. l. ?41 nits: .- Defendant. The Plaintiff alleges as follows: 4 JUL 3 1 2003 ALLEGATIONS common TO ALL causes or ACTION I Jtirisdiction is based on STAT. -l 2. - OttOctobcr 8. 1997 the Defendant Tahir Ali Jared as issued a lieettsc?tit?m A practice medicine and surgery by the Nebraska Department of I lcaltlt and Human I Services Regulation and Licensure thereinaftcr and at all times relevant herein. has been the holder of that license (#20624). I 3. The Department is the agency of the State. of Sebraska authorized to . enforce the provisions of the uniform Licensing Law regulating the practice of medicine and surgery. 4. The Nebraska Board of Medicine and Surgery has Considered the investigation of this matter and made its recommendation to the Attuntey General to ?it: . disciplinary proceedings against the Dcl'cndant's license-to practice medicine and I I surgery. I I i S. . l?rom January I. NOS until July 2002 the Defendant owned and operated a medical practice as selc practitioner the name the Cancer . Center. 450 liast 23Id Street. Fremont. Nebraska. I I (3. Front January I. museum July I3. 2002 the Fremont (?cnter was the site of the Defendant's medical of?ce and as the primar) site ?here practiced medicine and surgery. specializing in oncology. COMMON 1'0 Till?. FIRST TWO CAUSES OF ACTION 7. I Front January l. 1998 to June 22. 200] no other medical doctor regularly practiced at the-Fremont Cancer Center. attd tlte Defendant teas responsible for the Operation of tlte medical office. including all medical treatment. 8. The Defendant employed at his tnedical of free a registered nurse on a full-time basis from December I997 to June 22. 200i. and an additional registered burst: on a part-time basis front January 2.00! through March 2002. The Defendant provided all oncology training to the registered nurses. From January until after April l9. 20m the Defendant instituted few written infection control polices or procedures for the operation clinic. The registered nurses employed by the Defendant is ere assigned by the Defendant to chemotherapy as part of their usual duties. including preparing . medications and chemotherapy agents. aiE'cessing implanted vascular access devices 7 7 I (hereinafter IVADs). drawing blood from ?ushing and infusing the medications and chemotherapy agents. 10. From the time the elinieepened the regirtlered nurses failed to follow basic infection control requirements. Improper acts included: I Taking single-use disposable syringes and drawing blood from patients. reusing the s31inges to obtain saline from a - source common to all patients. and then reusing the syringes to ?ush the With the saline: and. tit ot'patients' discard blood into the same patients. I ll. I Jannary I998 to at least June 23. 30m every patient ol'tlte I Defendant. in host: chemotherapy treatment at Fremont (?timer Center included accessing an l?c?Al). v. as _e\posed to risk ol'ltarn-t due to the failure of the stat't' to folio? basic infection a hen providingtreatntent. I I ll. i'l'fhe provision ol?eltentotherapy is a basic and integral part ol?an oncology practice. improper acts ofthe Defendant occurred during treatment in the oncology treatment room. and patient examination rooms. while under the supen ision ot?tlte Defendant. he Defendant at all times has responsible for tlte medical oncology treatment of all of the patients and had access to the oncology room and patient examination rooms. . FIRST CAUSE OF ACTION l3. Paragraphs '1 through l2 unincorporated by reference. i4. - 711w Defendant's actions in failing to have suf?cient proacdurcs in piece. 7 in failing to proiridc suf?cient training to staff. or in failing to exercise appropriate oversight, any or all of which allowed the continued and repeated acts of improper infection control during therapy. resulted from the lack of or inappropriate direction or lack of or inappropriate direct supervision ofa licenced health care provider cmpioyed by the Defendant and constitutes ?unprofessional conduct? in violation of Title in Nebraska Administrative Code. Chapter 88 Regulations Governing the Practice of - Medicine and Surgery and Osteopathic Medicine and ?013.2l. I . 15,- Violation of the reguiationg de?ning ?unprofessional conduct". as de?ned by the Boardoi' Medicine and Surgery pursuant to Nun. Rev. sot. us is grounds on which disciplinary measures may be taken against the lkictidant's license pursuant to Man. REV. 5m. ?7l-l47 (10). and pursuant to 172 55834312031. sccOno cause or ACTION l6. Paragraphs 1 through 12 are incorporated by reference. t1. The Defendant's-lack of supervision oftitc basic his ntcdical practice provided and his failure to correct the improper basic infection control practices subjected patients. to a serious risk of harm. which constitutes the practice of the profession with gross I I IS. Practice of the profession with gross violates Mu. Rtit'. STAT. ?7l 447 (St to). and. Title 172 Nebraska Administrative Code. Chapter 88 Regulations Got-?cming the Practice of Medicine and Surgery and Osteopathic Medicine and Surgery. ?12.03? . I l9. Violation of any ofthc provisions of NEH. tht'. I at. is grounds on which disciplinary measures ma); be taken against the Defendant's license. 20. Violation ol'any of the provisions- of I'll! 2.03 is grounds. on which the Department may discipline a license. - ALLEGATIONS COMMON To rm: 11mm causes or ACTION 0n and before November 22. I999 the receptionist. who 'was? trained as a dental hygienist. informed the Defendant of the impmper infection control I practice: being used. by the registered nurses employed by the Defendant. 22. individual was infected with Hepatitis Virus (hereinafter HCV) genotype 3a prior to becoming a patient of the Defendant. individual if i beeame a patient of the Defendant on February 2. 2000. and the Defendant was aware that individual . was infected with when. individual his patient. this patient did not I receive in-offtce blood draws or chermtherapy in Defendant's ofliee untii May 2000. a 23. lin genotype 3a is the that eornntOII_fontt of new ht?thc united States representing approximately tit; percent 6f the'reponed'cases. 4 24. ott February-5. 2001 the learned that individual 132.3 - patient ofthe Defendant. had devciopcd HCV genotype 3a; - . 25. On February 15. 200.1 the scrotum learned that lndividttal n3. - also a patient of the Defendant. had developed HCV. 26. On or about March l, 200! . the. physician director of infection centre! fretn the Fremont Area Medical Center (hereina?er referred to as FAMC) the Defendant that patients of the Defendant had questioned infection control nurse about the propriety of certain medical practices daunting in the Defendant's office. including reusing syringes that were-once to obtain saline from a large bag of - I saline and using that statute to ?ush patients? ?mm. 27. On April l2. representatives from the Missouri Valley Cancer Consortium (hereinafter referred to as the Onson'ium) went to the lkl'ettdant's office for the purpose of evaluating. whether the Defendant?s of?ce enuid meet the sttutdards to allow participation for conducting cliniea! research. At that time one of the representatives of the Consortium. who was a registered nurse. obsen'ed the improper infection control practices referred to in paragraph it If). above. being permetetl by the full-tinte- registered nurSe employed by the Defendant. 28. Prior to April 19. 2001 representatives ofthe Consortium noti?ed the: Defendant orally. and on April 19. 200i notified him in writing of the improper infection control practices that the Consortium?s registered had observed heng performed by the full-time registered nurse employed by the Defendant. p, 29. Also on April l9. 20m the representatives of the Consortium met with the. - - Defendant-and his staff, including the registered nurses employed by the Defendan-t. and discussed methods of correcting problems observed. 7 7 30. On April 23. 2001 the representatives Consortium infomed the Defendant of their concern that they were unable to develop a plan With his staff for correcting the issues they had identified. Speci?callth indicated that the part time registered nurse and one elite? sitiff ntcin?r were overwhelmed by theiufonnation. and that the full time registered nurse appeared unwilling to discuss options to correct the practices. I . I . Between April 23. 200i and May 20m the Defendant met with representatives from to discuss the concerns roised by the of the Consortiumrepresentative ofthe Consortium a representative of FAth in writing of the specific concern-s about poor nursing practice and their opinion that the poor practices were affecting patient outcomes. Representatives of FAMC met with the Defendant on May I and May 20m concerning this report. - I 33. On May to. 200i the Defendant met with the infection control nurse of FMAC and discussed ongoing concerns voiced to her by patients of the Defendant about techniques utilized with I 3-1. On June" 5. 2001 the Defendant learned that individual 3-1. a patient of the Defendant. had developed HCV. I 35. On June s. 2001 the Defendant learned that Individual also at patient of the Defendant. had det?ciopcd Hev. - - 36. On June 22. 2001 the full time registered nurse?s employment with the Defendant wits and the Defendant instituted new procedures concerning infection control and other safely standardsresult of failing to follow basic infection control requirements. ninety-nine patients of the "Defendant who were between May 2. .2000 and June- 22. 200] have been diagnosed with HCV genotype 30; including three patients whose ?rst exposures occurred alter April 19. 200i . 38. I is viral liverdiscase that causes in?ammation and scarringol' the liver and stops the liver from working causing harm to the individuals who contract it. 39. As a result of the infection with genotype 3a the ninety-nine patients have been hanned. including Individual who died as a result of thc?llCV genotype 3n - -- infection. -.-. . . THIRD ACTION 40. Paragraphs 1 through 12 and 2: through 39 are incommch by term. - I 41. The November 22. 1999 andlunc 22. mm was repeatedly- placed on notice of the improper infection control practices occurring in his of?ce, its set out above. in each instance the Defendant- l'ailed to take?steps to protect his patients. and in each instance that he failed to act he placed additional patients at risk. Failure to protect his patients from a serious risk of harm constitutes the practice of the profession with gross negligence. Practice ofthe professibn With gratis negligence vioiates NED. REV. STAT. ?7l-l47 and. Title 1722 Nebraska Administrative Code. Chapter 88 Rc'gulations (inventing the Practice of Medicine and Surge-q and. Osteopathic Medicine and Surgery. $2.035 to). . . . 42. Violatit?m of any of the provisions Gleilt. Rev. Sun H7 is grounds on which disciplinary measures they be taken against the Defendant? license. 43. Violation ofnny ofthc provisions or 172' nae tits-m 2.03 is grounds on which the Department may discipline a license. I I FOURTH CAUSE OF ACTION 44. Paragraphs 1 through I2 and 2i through 39 are incorporated by reference. 45. The Defendant between November 22.. 19% nnd'ltnte 22. mm was placed on notice of the improper infectioncontrol practices occurring in his of?ce. as set out above. in each instance the Defendant failed to take steps to protect his ?p'atients. and in catch instanee that he failed to net he?piaced additional patiente at risk. Faiiure to correct-improper practice ri?e: repeatedly being made eware of the improper I 'praetice conStitutes the practice of the profession in a pattern of negligent conduct. Practice of the profession in a pattern or negiigent conduct vioiatcs Nan. Rev. Sm. - 4 147 (5) and. Title 172 Nebraska Administrative. Code. Chapter 38 - chinattons Governing the Practice of Medicine and Surgery and Osteopathie Medicine and Surgery, $2.035 I - 46. Violation ofany ofthe provisions REV. 5m. is groundi on Mitch disciplinary measures- may be taken against the Det'?ndant's license. 47. Violation ofarty ofthe provisions of 112 NAC gas-mics is grounds on which the m?y_di??ipiinc a tiecnse. 7 i - rtmt'cnisaoir xenon 48-. Paragraphs I through 12 and 21 through 39 are incomorated by reference. 49. The conduct and praetiee of-the Defendant between January 1998 and I June 22., 200! was outside the normai standard ofcarc in the State of Nebraska and has resulted in harm to at least ninety-nine patients including death to at least one patient. conduct or practices outside the m: ofeare in State of Nebraska which is or might be hat-info! or dangerous to the health of patients constitutes "unprofessional conduct" in iolation of'l'i-tie I72 Nebraska Administrative Code. Chapter 88 - Regulations Goveming the Practice of Medicine and Surgery and Otteopothic Medicine and Surgery. ?0l 3.18. . . 50. Violation of the regulations de?ning ?unprofessinttni Conduct". de?ned by the Board of Medicine and Surgery pursuant to Nun. Ill-Lt". in}. ?7 48 (22). is grounds on which disciplinary measures may be taken against the Defendant's license pursuant to NEE. REV, STAT. ?7l-t4?7 and pursuant to 172 SAC ALLEGATIONS comical 10 THE SIXTH THROUGH TENTH . or - - 5i. During May of 2000 the Defendant began a sexiiai relationship with individual which relationship continued until approximately July I. 200! On or about April l. 2001 the Defendant began to provide medical treatment to ludiuiduul in? - and created a physicianvpaticnt relationship. billing individual #7 for at least some of the services. . - 52. During the time the Defendant maintained a physician-patient reiationship with individual in he intentionally provided individual #1 with false diugiiusis. telling . the individual that the individual a fatal disease. He told #7 not to seek I i 7- ircatment because ether?providers ?buidrinforrnindividnal company - and individual #7 wouid notbeabletoobtain insurance again. . . i 53. . During the time?thc Defendant maimained a physician-patient relationship with individual in he failed lo keep and maintain adequate records of. the irualmcni and . 54. - The personal and professional relationships between Individual #7 and mi: Defendant were terminated no inter than July' I. 2001. . - 55. Between July 19 and July 23. zoo! the Defendant contacted clinical laboratory in Omaha. Nebraska on two occasions. and by impersonating two ditTeren-t phyticians attempted to cancel certain laboratoty tests for Individual #7 ordered by individual #Ts then treating nurse ninetilioncr. I so. On July 23. 200: the Defetuianteontacted the clinical iaboraiory and obtained the test results on individual #17. an individual In ith whom he had no current physician-patient relationship. i I 1 Six CAUSE OF ACTION . Paragraphs i through 6 and Si and 52 are incomoralcd by reference. 58. The Defendant?s action of intentionally providing a false diagnosis to individual ii? during the time he maintained a physician-patient relationship with individual and influencing individual #7 not to seek other treatment. constitutes grossly immoral or dishonorable conduct evidencing un?tnoss for practice of the profession of medicine and surgery in this state. . .I 59. I Grossly immoral or dishonorable conduct evidencing un?incss for practice of the profession or 'mcdicinc and surgery in this state is'in violation 0min. REV. STAT. I ?7l-l47 m; and. Tine in Nebraska Administrative Codc. Chapter - Regulations Governing the Practice of Medicine and Surgery and Osteopathic Medicine and Surgery. 12.033. 7 . 60. Violation of any of the provisions REV. STAT. ?7l-l4?l is on which disciplinary. measures may be taken agnimt the Dcfendam's? iicciisc. 6L Violation of any oflhe pr'OVisions of in NAC is grounds on which the Department may discipline a license. I '7 or ACTION - 62. Paragraphs I through 6 and SI and 52 are incorporated by rci'crcnoc: I 63. The ncicndam's action or intentionally providing a false diagnosis in individual in during the time he maintainod both a sexual and a physician. patient relationship with Individual and in?uencing Individual it? not to othcr constituted sexual expioitntion of Individual . 64. Sexual exploitation of a patient constitutes ?unprofessional conduct" in violation of Non. REV. STAT. ?7l-l48 and Title in Nebraska?dministmtivc Chapter 88 - Regulations Governing the Practice of Medicine and Surgery and Osteopathic Medicine and Surgery. ?l 3.23. I 65. I Violation of the stotutc or of regulaiions de?ning . conduct" is grounds on which disciplinary measures may be taken the license pursuant to Nata. REV. STAT. ?7l-l-l7 (IO). and pursuant to I72 NAC ?88-0i2.031. . EIGHTH CAUSE or ACTION 66. Paragruphs I through 6 and 5! through 53 arc incorporated by reference. 67. The Defendant's action of not liccping adequate rcc-urds of and service for patient individual #7 constitutes "unprol?cssionnl conduct?f in Violation of NH). REV. STAT. ?7l -l48 and, Titlc 172 Nebraska Administrative Cod-c. _(?ltaptcr 88 Regulations Governing the Practice of Medicine and Surgery and Osteopathic Medicine and Surgery. ?Ol 3.24.- I 68. Violation of the statute or of regulations defining ?unprofessional conduct? is grounds on which disciplinary measum may-be taken against the license . pursuant to Nten, Rtiv. STAT. ?7l 447 and pursuant to 172 NAC ?as;otz.031. - mm: muss: or ACTION 69. Paragraphs 1 through 6 and 51 through 56 are incorpOratcd by reference. 70. 'lhe Defendant's action of impersonation of other physicians in an effort to interfere in the treatment of an eat-patient and in obtaining the test results on an individual with whom he had no current physician-patient relationship constitutes practice of the profession fraudulently. I . I?ll .. Practice of the profession fraudulently. violates Nan. Ray"; 8 int. (5) and. Title I72 Nebraska Administrative Code. Chapter 88 - Regulations Governing the Practice of Medicine and Surgery and Osteopathic Medicine and Surgery. . ?tz.o3ta . 72. Violation of any of the provisions-af?ne. REV. STAT. ??7l4147 is grounds on which disciplinary measures be taken against the Defendant's license. I 13. Violation of any of the provisions of 172 NAC is grounds on 'which the Department may discipline a license. return cause or ACTION 74. Paragraphs I through 6 and 5! through 56 an: incorporated by reference. 75. line lklendant's action of obtaining the test results on an individual with whom he had no physician-patient relationship constitutes willful violation of I con lidcntiality hctn'een a physician and patient and constitutes unprofessional conduct in t?iolation ol'litie 172 Nebraska Administrative Code. Chapter 88 Regulations. Go?vcming the Practice of Medicine and Surgery and Osteopathic Medicine and Surgery. 3301-102. i 70. Violation of regulations defining ?unprofessional conduct". as defined it) I the Board of Medicine and Surgery pursuant to Nan. REV. ?7 448 (22). is grounds on \titich disciplinary measures may be taken against the lkl'ettdunt?s license pursuant to Ntan. REV. Sm. ?7l .147 um. and 172 ALLEG armies COMMON 'ro. THE ELEVENTH AND in?rm . . CAUSES OF ACTION . . I 77. By the end of June Of 2002 the Defendant knew that seven of his patients in addition to Individttal #i had been diagnosed with HCV. and that they had developed I . the Nov after Individual as had started receiving treatment in the Defendant?s of?ce. The Defendant also knew that three of those individuals shared the specific genotype 3a that individuai #1 had. and that the HCV genotype for the other four individuals had not then determined. I - . rs. on July 2. 2002 the Defendant met with infection. control time to investigate the cause of the HCV infections. On July it). 2002 the Defendant met for a second time With the infection control nurse. At that time. that individual remindedthe Defendant of the the Department of Health and Human Services Reguiation and Licensure. 79. On July II. 2002 another Fremont. Nebraska area medical practitioner intended the De fondant that that practitioner had four patients who had been diagnosed with HCV genotype 3a. The practitioner also informed the Defendant that the practitioner knew that the four patients had in common the fact that they had received treatment in the kamtdant's office. - so. On or about July 13. 2002 etc Merriam ten the United States. I ~81. The Defendant sent a letter to some of his patients infontting them he I - was leaving immediately to go overseas due to a family charge-nee "this letter was prepared on July 12. 2002. but" was not mailed until July it. 2002. and not receitred by? - the patients until after the Defendant had already left the United States, 3 I 82. The above referenced letter indicated that during the Defendant's absence Dr. Pieclt would provide medical coverage. Dr. Haroon. who had been engaged to became the Defendants partner in the Defendant?s medical practice. tututd be covering for oneologi-eal and hematological emergencies. 83. The Defenth had not contacted Dr. about medical coverage prior to sending the letter. nor had Dr. Piecli agreed to prot-ide the coverage. 84. On July l3. 2002 Dr. Hamon'was still practicing in the state of Iowa. and was not scheduled to begin full-time practice at the Promont Cancer Center until August 13,2002. - as. . On July 13. 2002 or. Haroon did not have admitting privileges at the local hospitaltime prior to leaving the country did the Defendant inform Dr. Hat-eon of any aspect of the HCV infections in the Defendant?s patients. 81. Since leaving the country the Defendant has initial to provide appropriate information necessary for the continued care of patients of his practice. or to participate in their care. I shaves?" CAUSE OF Aerton . ss. . Paragraphs 1 through 21 through 39. and 77 thought? are incorporated by reference: 7? 89. The ?efendant's actions as set out above constitute patient I I abandonment which constitutes grossly inunoral dishonorable conduct evidencing . tm?tness for practice of the profession of medicine and surgery in this state. i 90. Grossly immoral or dishonorable conductevidencing un?tness for practice of the profession of medicine and surgery in this state is in violation of NEIL REV. STAT. ?1i~l47 (2): and. Title i722 Nebraska Administrative Code. Chapter 88 Regulations Governing the Practice of Medicine and Surgery and Osteopathic Medicine Surgery. . - . I 91. Violation orany critic-provisions othio. Rev; STAT, ?7 H47 is grounds . on which disciplinary measures may be takenagaimt the Defendant's license, 92. Violation of any of the provisions of .172 NAC is gmunds on which the Department may discipline 3 license. CAUSE or ACTION 03. Paragraphs 1 through 12. 21 through 39. and 77 through 37 are I - incorporated by reference. I a I 94. The Defendant's actions as set out above constitute patient abandonment; Patient abandonment is conduct or practice outside the mono! standard of care which is or might be harm l'ui or dangerous to the health of the patient; and constitutes ?unprofessional conduct? in violation of Title I72 Nebraska AdtniniStmtive Code. Chanter 88 - Regulations (inventing the Practice cf Medicine and Surgery and Osteopathic Medicine and surgery, ?Ol 3.18. I - 95., Violation or regulations de?ning ?unprofessionai conduct?. as de?ned by the Board-of Medicine and Surgery pursuant t6 HEB. STAT. WI 448 is grounds on which disciplinary measures may be taken against the Defendant?s license pursuant to Nina. REV. 5m. pursuant :rnAvnn . I WHEREFORE, the Plainti?? prays that the Chief Medical Of?cer set this matter for heating. order appropriate disciplinary action concerning the Defendant's license to I practice medicine and surgery in the State of Nebraska pursuant to Matt. RE. I and tax the costs of this action to the Defendant. I STATE-OF NEBRASKA Plaintiff. BY: JON BRUNING Attorney General 439, rink. etc-:29 . - Assistant Attomey General P. 0. Box 95026 . Limoln. NE Tel. (402) 471-4050 Attorney: for I?Iuimqr