BEFORE THE MEDICAL BOARD OF CALIFORNIA DEPARTMENT OF CONSUMER AFFAIRS STATE OF CALIFORNIA In the Matter of the Accusation Against: RONALD GLOUSMAN, M.D. Case No. 06-2010-208420 Physician's and Surgeon?s Certificate No. 45186 Respondent. DECISION AND ORDER The attached Stipulated Settlement and Disciplinary Order is hereby adopted by the Medical Board of California, Department of Consumer Affairs, State of California, as its Decision in this matter. This Decision shall become effective at 5:00 pm. on September 3, 2014. IT IS SO ORDERED August 4, 2014. MEDICAL BOARD OF CALIFORNIA By: Barbara Yaroslawl?sky! Chair Panel A KAMALA D. HARRIS Attorney General of California ROBERT MCKIM BELL Supervising Deputy Attorney General COLLEEN M. MCGURRIN Deputy Attorney General State Bar Number 147250 300 South Spring Street, Suite 1702 Los Angeles, California 90013 Telephone: (213) 620?25 11 Facsimile: (213) 897?9395 Attorneys for Complainant BEFORE THE MEDICAL BOARD OF CALIFORNIA DEPARTMENT OF CONSUMER AFFAIRS STATE OF CALIFORNIA In the Matter of the Accusation Against: Case No. 06-2010-208420 RONALD GLOUSMAN, MD. 999 N. Tustin Avenue, Suite 114 Santa Ana, California 92705-6505 OAH No. 2013070420 STIPULATED SETTLEMENT AND Physician's and Surgeon's Certi?cate Number DISCIPLINARY ORDER G45186 Respondent. IT IS HEREBY STIPULATED AND AGREED by and between the parties to the above? entitled proceedings that the following matters are true: PARTIES 1. Linda K. Whitney (?Complainant?) is the Former Executive Director of the Medical Board of California. She brought this action solely in her of?cial capacity and was represented in this matter by Kamala D. Harris, Attorney General of the State of California, by Colleen M. McGurrin, Deputy Attorney General. 2. Respondent RONALD GLOUSMAN, M.D. ("Respondent") is represented in this proceeding by attorneys Henry Lewin, Esq., whose address is 11377 West Olympic Boulevard, 5th Floor, Los Angeles, California 90064-1683 and Peter Osinoff, Esq., of Bonne Bridges Mueller O?Keefe Nichols, whose address is 3699 Wilshire Boulevard, 10th Floor, Los Angeles, California 90010?2719. STIPULATED SETTLEMENT (06-2010-208420) about July 2, 1981, the Medical Board of California issued Physician's and Surgeon's Certi?cate No. 45186 to Respondent. Said Certi?cate was in full force and effect at all times relevant to the charges brought in Accusation No. 06?2010?208420 and will expire on October 31, 2014, unless renewed. JURISDICTION 4. Accusation No. 06?2010?208420 was ?led before the Medical Board of California (Board) Department of Consumer Affairs, and is currently pending against Respondent. The Accusation and all other statutorily required documents were properly served on Respondent on May 21, 2013. Respondent timely ?led his Notice of Defense contesting the Accusation. 5. A copy of Accusation No. 06?2010-208420 is attached as exhibit A and incorporated herein by reference. ADVISEMENT AND WAIVERS 6. Respondent has carefully read, fully discussed with counsel, and understands the charges and allegations in Accusation No. 06?2010-208420. Respondent has also carefully read, fully discussed with counsel, and understands the effects of this Stipulated Settlement and Disciplinary Order. 7. Respondent is fully aware of his legal rights in this matter, including the right to a hearing on the charges and allegations in the Accusation; the right to be represented by counsel at his own expense; the right to confront and cross-examine the witnesses against him; the right to present evidence and to testify on his own behalf; the right to the issuance of subpoenas to compel the attendance of witnesses and the production of documents; the right to reconsideration and court review of an adverse decision; and all other rights accorded by the California Administrative Procedure Act and other applicable laws. 8. Respondent freely, voluntarily, knowingly, and intelligently waives and gives up each and every right set forth above. CULPABILITY 9. Respondent understands and agrees that the charges and allegations in Accusation No. 06-2010-208420, if proven at a hearing, constitute cause for imposing discipline upon his 2 STIPULATED SETTLEMENT (06?2010?208420) Physician's and Surgeon?s Certi?cate. 10. For the purpose of resolving the Accusation without the expense and uncertainty of further proceedings, Respondent agrees that, at a hearing, Complainant could establish a prima facie factual basis for the charges in the Accusation No. 06-2010-208420, and that Respondent hereby gives up his right to contest those charges. 11. Further, Respondent agrees that if he ever petitions to modify or terminate any term or condition set forth herein, including but not limited to probation, or should the Board or any other California regulatory agency institute any other action or proceeding against Respondent, including, but not limited to, a Accusation and/or Petition to Revoke Probation, all of the allegations and facts set forth in Accusation No. 06-2010-208420 shall be deemed true, correct and fully admitted by Respondent for purposes of any such proceeding or any other licensing proceeding involving Respondent and the State of California. 12. Respondent agrees that his Physician's and Surgeon's Certificate is subject to discipline and he agrees to be bound by the Board?s probationary terms as set forth in the Disciplinary Order below. CONTINGENCY 13. This stipulation shall be subject to approval by the Medical Board of California. Respondent understands and agrees that counsel for Complainant and the staff of the Medical Board of California may communicate directly with the Board regarding this stipulation and settlement, without notice to or participation by ReSpondent or his counsel. By signing the stipulation, Respondent understands and agrees that he may not withdraw his agreement or seek to rescind the stipulation prior to the time the Board considers and acts upon it. If the Board fails to adopt this stipulation as its Decision and Order, the Stipulated Settlement and Disciplinary Order shall be of no force or effect, except for this paragraph, it shall be inadmissible in any legal action between the parties, and the Board shall not be disquali?ed from further action by having considered this matter. 14. The parties understand and agree that Portable Document Format (PDF) and facsimile copies of this Stipulated Settlement and Disciplinary Order, including Portable Document Format 3 STIPULATED SETTLEMENT (06-2010-208420) (PDF) and facsimile signatures thereto, shall have the same force and effect as the originals. 15. In consideration of the foregoing admissions and stipulations, the parties agree that the Board may, without further notice or formal proceeding, issue and enter the following Disciplinary Order: DISCIPLINARY ORDER IT IS HEREBY ORDERED that: 1. REVOCATION. Physician's and Surgeon's Certi?cate Number 45186 issued to Respondth Ronald E. Glousman, MD. is revoked. 2. STANDARD STAY ORDER. However, revocation stayed and Respondent is placed on seven (7) years probation on the following terms and conditions. 3. COMMUNITY SERVICE - FREE SERVICES Within 60 calendar days of the effective date of this Decision, Respondent shall submit to the Board or its designee for prior approval a community service plan in which Respondent shall within the ?rst 4 years of probation, provide 500 (?ve hundred) hours of free non-medical services to a community or non- pro?t organization. Prior to engaging in any community service Respondent shall provide a true copy of the Decision(s) to the chief of staff, director, of?ce manager, program manager, of?cer, or the chief executive of?cer at every community or non?pro?t organization where Respondent provides community service and shall submit proof of compliance to the Board or its designee within 15 calendar days. This condition shall also apply to any change(s) in community service. Community service performed prior to the effective date of the Decision shall not be accepted in ful?llment of this condition. 4. PROFESSIONALISM PROGRAM (ETHICS COURSE). Within 60 calendar days of the effective date of this Decision, Respondent shall enroll in a professionalism program, that meets the requirements of Title 16, California Code of Regulations (CCR) section 1358. Respondent shall participate in and successfully complete that program. Respondent shall provide any information and documents that the program may deem pertinent. Respondent shall successfully complete the classroom component of the program not later than six (6) months after 4 STIPULATED SETTLEMENT (06-2010-208420) Respondent?s initial enrollment, and the longitudinal component of the program not later than the time specified by the program, but no later than one (1) year after attending the classroom component. The professionalism program shall be at Respondent?s expense and shall be in addition to the Continuing Medical Education (CME) requirements for renewal of licensure. A professionalism program taken after the acts that gave rise to the charges in the Accusation, but prior to the effective date of the Decision may, in the sole discretion of the Board or its designee, be accepted towards the ful?llment of this condition if the program would have been approved by the Board or its designee had the program been taken after the effective date of this Decision. Respondent shall submit a certification of successful completion to the Board or its designee not later than 15 calendar days after successfully completing the program or not later than 15 calendar days after the effective date of the Decision, whichever is later. 5. PROFESSIONAL BOUNDARIES PROGRAM. Within 60 calendar days from the effective date of this Decision, Respondent shall enroll in a professional boundaries program equivalent to the Professional Boundaries Program offered by the Physician Assessment and Clinical Education Program at the University of California, San Diego School of Medicine (?Program?). Respondent, at the Program?s discretion, shall undergo and complete the Program?s assessment of Respondent?s competency, mental health and/or performance, and at minimum, a 24 hour program of interactive education and training in the area of boundaries, which takes into account data obtained from the assessment and from the Decision(s), Accusation(s) and any other information that the Board or its designee deems relevant. The Program shall evaluate Respondent at the end of the training and the Program shall provide any data from the assessment and training as well as the results of the evaluation to the Board or its designee. Failure to complete the entire Program not later than six (6) months after Respondent?s initial enrollment shall constitute a violation of probation unless the Board or its designee agrees in writing to a later time for completion. Based on Respondent?s performance in and evaluations from the assessment, education, and training, the Program shall advise the Board or its designee 5 STIPULATED SETTLEMENT (06-2010-208420) LDJN its recommendation(s) for additional education, training, and other measures necessary to ensure that Respondent can practice medicine safely. Respondent shall comply with Program recommendations. At the completion of the Program, ReSpondent shall submit to a ?nal evaluation. The Program shall provide the results of the evaluation to the Board or its designee. The professional boundaries program shall be at Respondent?s expense and shall be in addition to the Continuing Medical Education (CME) requirements for renewal of licensure. The Program has the authority to determine whether or not Respondent successfully completed the Program. A professional boundaries course taken after the acts that gave rise to the charges in the Accusation, but prior to the effective date of the Decision may, in the sole discretion of the Board or its designee, be accepted towards the ful?llment of this condition if the course would have been approved by the Board or its designee had the course been taken after the effective date of this Decision. 6. EVALUATION. Within 30 calendar days of the effective date of this Decision, and on whatever periodic basis thereafter may be required by the Board or its designee, Respondent shall undergo and complete a evaluation (and testing, if deemed necessary) by a Board-appointed board certi?ed who shall consider any information provided by the Board or designee and any other information the deems relevant, and shall furnish a written evaluation report to the Board or its designee. evaluations conducted prior to the effective date of the Decision may, in the sole discretion of the Board, be accepted towards the ful?llment of this requirement. Respondent shall pay the cost of all evaluations and testing. Respondent shall comply with all restrictions or conditions recommended by the evaluating within 15 calendar days after being noti?ed by the Board or its designee. 7. Within 60 calendar days of the effective date of this Decision, Respondent shall submit to the Board or its designee for prior approval the name and quali?cations of a California-licensed board certi?ed or a licensed who has a doctoral degree in and at least ?ve years of postgraduate experience in the 6 STIPULATED SETTLEMENT (06-2010-208420) diagnosis and treatment of emotional and mental disorders. Upon approval, Respondent shall undergo and continue treatment, including any modi?cations to the frequency of until the Board or its designee deems that no further is necessary. The shall consider any information provided by the Board or its designee and any other information the deems relevant and shall furnish a written evaluation report to the Board or its designee. Respondent shall cooperate in providing the any information and documents that the may deem pertinent. Respondent shall have the treating submit quarterly status reports to the Board or its designee. The Board or its designee may require Respondent to undergo evaluations by a Board?appointed board certi?ed If, prior to the completion of probation, Respondent is found to be mentally un?t to resume the practice of medicine without restrictions, the Board shall retain continuing jurisdiction over Respondent?s license and the period of probation shall be extended until the Board determines that Respondent is mentally ?t to resume the practice of medicine without restrictions. Respondent shall pay the cost of all and evaluations. 8. THIRD PARTY CHAPERONE. During probation, Respondent shall have a third party chaperone present while consulting, examining or treating all patients (male and female) for each and every of?ce visit, and shall not consult, examine or treat any patient in a hospital or surgery center without a nurse or other third party present. Respondent shall, within 30 calendar days of the effective date of the Decision, submit to the Board or its designee for prior approval name(s) of persons who will act as the third party chaperone. A third party chaperone, however, shall not be required for patients seen in a hospital or surgery center when a nurse or other third party is present with Respondent during those visits as speci?ed above. If Respondent fails to obtain approval of a third party chaperone within 60 calendar days of the effective date of this Decision, Respondent shall receive a noti?cation from the Board or its designee to cease the practice of medicine within three (3) calendar days after being so noti?ed. Respondent shall cease the practice of medicine until a chaperone is approved to provide monitoring responsibility. STIPULATED SETTLEMENT (06-2010-208420) Respondent shall ensure that each third party chaperone sign (in ink or electronically) and date each patient medical record at the time the chaperone?s services are provided. Each third party chaperone shall read the Decision(s) and the Accusation(s), and fully understand the role of the third party chaperone, nurse or other third party. Respondent shall maintain a log of all patients seen for whom a third party chaperone is required. The log shall contain the: 1) patient initials, address and telephone number; 2) medical record number; and 3) date of service. Respondent shall keep this log in a separate ?le or ledger, in chronological order, shall make the log available for immediate inspection and copying on the premises at all times during business hours by the Board or its designee, and shall retain the log for the entire term of probation. Respondent is prohibited from terminating employment of a Board-approved third party chaperone solely because that person provided information as required to the Board or its designee. If the third party chaperone resigns or is no longer available, Respondent shall, within 5 calendar days of such resignation or unavailability, submit to the Board or its designee, for prior approval, the name of the person(s) who will act as the third party chaperone. If Respondent fails to obtain approval of a replacement chaperone within 60 calendar days of the resignation or unavailability of the chaperone, Respondent shall receive a noti?cation from the Board or its designee to cease the practice of medicine within three (3) calendar days after being so noti?ed. Respondent shall cease the practice of medicine until a replacement chaperone is approved and assumes monitoring responsibility. Respondent shall provide written noti?cation to Respondent?s patients that a third party chaperone shall be present during all consultations, examination, or treatment with all patients (male and female) for each and every of?ce visit. Respondent shall maintain in the patient?s ?le a copy of the written noti?cation, shall make the noti?cation available for immediate inspection and copying on the premises at all times during business hours by the Board or its designee, and shall retain the noti?cation for the entire term of probation. 9. NOTIFICATION. Within seven (7) days of the effective date of this Decision, the 8 STIPULATED SETTLEMENT (06w2010-208420) Respondent shall provide a true copy of this Decision and Accusation to the Chief of Staff or the Chief Executive Of?cer at every hospital where privileges or membership are extended to Respondent, at any other facility where Respondent engages in the practice of medicine, including all physician and locum tenens registries or other similar agencies, and to the Chief Executive Of?cer at every insurance carrier which extends malpractice insurance coverage to Respondent. Respondent shall submit proof of compliance to the Board or its designee within 15 calendar days. This condition shall apply to any change(s) in hospitals, other facilities or insurance carrier. 10. SUPERVISION OF PHYSICIAN ASSISTANTS. During probation, ReSpondent is prohibited from supervising physician assistants. 11. OBEY ALL LAWS. ReSpondent shall obey all federal, state and local laws, all rules governing the practice of medicine in California and remain in full compliance with any court ordered criminal probation, payments, and other orders. 12. QUARTERLY DECLARATIONS. Respondent shall submit quarterly declarations under penalty of perjury on forms provided by the Board, stating whether there has been compliance with all the conditions of probation. Respondent shall submit quarterly declarations not later than 10 calendar days after the end of the preceding quarter. 13. GENERAL PROBATION REQUIREMENTS. Compliance with Probation Unit ReSpondent shall comply with the Board?s probation unit and all terms and conditions of this Decision. Address Changes Respondent shall, at all times, keep the Board informed of Respondent?s business and residence addresses, email address (if available), and telephone number. Changes of such addresses shall be immediately communicated in writing to the Board or its designee. Under no circumstances shall a post office box serve as an address of record, except as allowed by Business and Professions Code section 2021(b). STIPULATED SETTLEMENT (06-2010-208420) Place of Practice Respondent shall not engage in the practice of medicine in Respondent?s or patient?s place of residence, unless the patient resides in a skilled nursing facility or other similar licensed facility. License Renewal Respondent shall maintain a current and renewed California physician?s and surgeon?s license. Travel or Residence Outside California Respondent shall immediately inform the Board or its designee, in writing, of travel to any areas outside the jurisdiction of California which lasts, or is contemplated to last, more than thirty (30) calendar days. In the event Respondent should leave the State of California to reside or to practice Respondent shall notify the Board or its designee in writing 30 calendar days prior to the dates of departure and return. 14. INTERVIEW WITH THE BOARD OR ITS DESIGNEE. Respondent Shall be available in person upon request for interviews either at Respondent?s place of business or at the probation unit of?ce, with or without prior notice throughout the term of probation. 15. WHILE ON PROBATION. Respondent shall notify the Board or its designee in writing within 15 calendar days of any periods of non-practice lasting more than 30 calendar days and within 15 calendar days of Respondent?s return to practice. Non?practice is de?ned as any period of time Respondent is not practicing medicine in California as de?ned in Business and Professions Code sections 2051 and 2052 for at least 40 hours in a calendar month in direct patient care, clinical activity or teaching, or other activity as approved by the Board. All time spent in an intensive training program which has been approved by the Board or its designee shall not be considered non-practice. Practicing medicine in another state of the United States or Federal jurisdiction while on probation with the medical licensing authority of that state or jurisdiction shall not be considered non-practice. A Board?ordered suspension of practice shall not be considered as a period of non-practice. 10 STIPULATED SETTLEMENT (06?2010-208420) the event ReSpondent?s period of non-practice while on probation exceeds 18 calendar months, Respondent shall successfully complete a clinical training program that meets the criteria of Condition 18 of the current version of the Board?s ?Manual of Model Disciplinary Orders and Disciplinary Guidelines? prior to resuming the practice of medicine. ReSpondent?s period of non-practice while on probation shall not exceed two (2) years. Periods of non-practice will not apply to the reduction of the probationary term. Periods of non-practice will relieve Respondent of the responsibility to comply with the probationary terms and conditions with the exception of this condition and the following terms and conditions of probation: Obey All Laws; and General Probation Requirements. 16. COMPLETION OF PROBATION. Respondent shall comply with all ?nancial obligations restitution, probation costs) not later than 120 calendar days prior to the completion of probation. Upon successful completion of probation, Respondent?s certi?cate shall be fully restored. 17. VIOLATION OF PROBATION. Failure to fully comply with any term or condition of probation is a violation of probation. If Respondent violates probation in any respect, the Board, after giving Respondent notice and the opportunity to be heard, may revoke probation and carry out the disciplinary order that was stayed. If an Accusation, or Petition to Revoke Probation, or an Interim Suspension Order is ?led against Respondent during probation, the Board shall have continuing jurisdiction until the matter is ?nal, and the period of probation shall be extended until the matter is ?nal. 18. LICENSE SURRENDER. Following the effective date of this Decision, if Respondent ceases practicing due to retirement or health reasons or is otherwise unable to satisfy the terms and conditions of probation, Respondent may request to surrender his or her license. The Board reserves the right to evaluate Respondent?s request and to exercise its discretion in determining whether or not to grant the request, or to take any other action deemed appropriate and reasonable under the circumstances. Upon formal acceptance of the surrender, Respondent shall within 15 calendar days deliver Respondent?s wallet and wall certi?cate to the Board or its designee and ReSpondent shall no longer practice medicine. Respondent will no longer be subject 11 STIPULATED SETTLEMENT (06-2010?208420) 10no'oo'qoxmh.m DATED: I. to the terms and conditions of probation. reopplies for a medical license, the Shall be treated as a petition for reinstatement of a revoked certificate. .19. Respondent shall pay the costs associated with piobatiron Hooch and Valery yoor ofofobatlon, as designatod by the Board, which may Ibo adjusted on an annual basis. Such costs shall be payable to the Medical Board of California and delivered to the Board or its designce no latel- than January 31 of each calendar year. i AQCEPEAECE I have carefully read the above Stipulaled Settlement and Disciplinary Order and have fully discussed it with my attorneys, Honry Lew-in, Esq. and Peter Usimff, Esq. I u-ndorsta-nd the stipulation and the offect it will have on my Physician?s and Surgeon's Certi?cate. lenter into this I S?pulatod Settlement and Disciplinary Order ?ooly, voluntarily, knowingly, and intelligently, and i agree to be bound by the Doeislon and Order of the Moclioal Board of California. RONALD :31. . Respondent . 5/ 1? We have read and fully dismissed with Respondent RONALD GLOUSMAN, MD. tin: towns and conditions and other matters contained in the above Stipu-lated Settlement and Disciplinary Order. We appwve its form and content. Henry Lewin, Bog}. Attorney for It a i DATED: Ll/la i yer Osinoff, Esq. Howey for Respondent STIPULATED SEWLBMENT (06~2010~208420) ENDORSEMENT The foregoing Stipulated Settlement and Disciplinary Order is hereby respectfully submitted for consideration by the Medical Board of California. Dated: ?at/7" LA2013608327 61245195.docx l3 ReSpectfully submitted, KAMALA D. HARRIS Attorney General of California ROBERT MCKIM BELL Supervising puty Attorney General COLLEEN M. MCGURRIN Deputy Attorney General Attorneys for Complainant STIPULATED SETTLEMENT (06-2010-208420) Exhibit A Accusation N0. 06?2010-208420 KAMALA D. HARRIS Attorney General of California ROBERT MCKIM BELL a . . 1 {mm Supervrsing Deputy Attorney General a VOW COLLEEN M. MCGURRIN if? 1 Deputy Attorney General I . 3 State Bar Number 147250 300 South Spring Street, Suite 1702 JJ Los Angeles, California 90013 Telephone: (213) 620?2511 Facsimile: (213) 897-9395 Attorneys for Complainant BEFORE THE MEDICAL BOARD OF CALIFORNIA DEPARTMENT OF CONSUMER AFFAIRS STATE OF CALIFORNIA In the Matter of the Accusation Against: Case No. 06-2010-208420 RONALD GLOUSMAN, M.D. OAH No. 6801 Park Terrace, Suite 500 Los Angeles, California 90045 A A I Physician's and Surgeon's Number 45186 Respondent. Complainant alleges: PARTIES 1. Linda K. Whitney (Complainant) brings this Accusation solely in her official capacity as the Executive Director of the Medical Board of California (Board), Department of Consumer Affairs. 2. On or about July 2, 1981, the Board issued Physician's and Surgeon's Certificate Number 45186 to Ronald Glousman, MD. (Respondent). Said certi?cate is in full force and effect at all times herein mentioned and will expire on or about October 31, 2014. JURISDICTION 3. This Accusation is brought before the Board under the authority of the following laws. All section references are to the Business and Professions Code unless otherwise indicated. Accusation U) U: ?49 4. Section 2220 of the Code states: Except as otherwise provided by law, the Division of Medical Quality may take action against all persons guilty of violating this chapter [Chapter 5, the Medical Practice Act]. The division shall enforce and administer this article as to physician and surgeon certi?cate holders, and the division shall have all the powers granted in this chapter for these purposes including, but not limited to: Investigating complaints from the public, from other licensees, from health care facilities, or from a division of the board that a physician and surgeon may be guilty of 35 unprofessional conduct. . . . - 5. Section 2004 of the Code states, in pertinent part: I "The board shall have the responsibility for the following: The enforcement of the disciplinary and criminal provisions of the Medical Practice Act. The administration and hearing of disciplinary actions. Carrying out disciplinary actions apprOpriate to ?ndings made by a panel or an administrative law judge. Suspending, revoking, or otherwise limiting certi?cates after the conclusion of disciplinary actions. Reviewing the quality of medical practice carried out by physician and surgeon certi?cate holders under the jurisdiction of the board. - 6. Section 2230.5 of the Code states, in pertinent part: Except as provided in subdivisions . . . any accusation ?led against a licensee pursuant to Section 11503 of the Government Code shall be ?led within three years after the board, or a division thereof, discovers the act or omission alleged as the ground for disciplinary action, or within seven years after the act or omission alleged as the ground for disciplinary action occurs, whichever occurs ?rst. Accusation U.) U1 - An accusation ?led against a licensee pursuant to Section 11503 of the Government Code alleging sexual misconduct shall be ?led within three years after the board . . . discovers the act or omission alleged as the ground for disciplinary action, or within 10 years after the act or omission alleged as the ground for disciplinary action occurs, whichever occurs ?rst. This subdivision shall apply to a complaint alleging sexual misconduct received by the board on and after January 1, 2002, The limitations period provided by subdivision shall be tolled during any period if material evidence necessary for prosecuting or determining whether a disciplinary action would be appropriate is unavailable to the board due to an ongoing criminal investigation." 7. Section 2227 of the Code provides that a licensee who is found guilty under the Medical Practice Act may have his or her license revoked, suspended for a period not to exceed one year, placed on probation and required to pay the costs of probation monitoring, or such other action taken in relation to discipline as the Division deems proper. 8. Section 729 of the Code states, in pertinent part: Any physician and surgeon, . . . who engages sexual contact with a patient . . . is guilty of sexual exploitation . . . Sexual exploitation . . . is a public offense: (1) An act in violation of subdivision shall be punishable by imprisonment in a county jail for a period of not more than six months, or a ?ne not exceeding one thousand dollars or by both. . . (2) Multiple acts in violation of subdivision with a single victim, when the offender has no prior convictions for sexual exploitation, shall be punishable by imprisonment in a county jail for a period of not more than six months, or a ?ne not exceeding one thousand dollars orbyboth. . .. (3) - ?For purposes of subdivision in no instance shall consent of the patient . . . be a defense. However, physicians and surgeons shall not be guilty of sexual exploitation for touching 3 Accusation U) U1 any intimate part of a patient . . . unless the touching is outside the scope of medical examination and treatment, or the touching is done for sexual gratification.? For purposes of this section: (1) - (2) (3) ?Sexual contact? means . . . the touching of an intimate part of a patient for the purpose of sexual. arousal, grati?cation, or abuse. (4) ?Intimate part? and ?touching? have the same meanings as de?ned in Section 243.4 of the Penal Code.? 9. Section 726 of the Code states, in pertinent part, ?The commission of any act of sexual abuse, misconduct, or relations with a patient . . . constitutes unprofessional conduct and grounds for disciplinary action for any person licensed under this division, under any initiative act referred to in this division and under Chapter 17 (commencing with Section 9000) of Division 3. 10. Section 2234 of the Code, states, in pertinent part: "The board shall take action against any licensee who is charged with unprofessional conduct. In addition to other provisions of this article, unprofessional conduct includes, but is not limited to, the following: Violating or attempting to violate, directly or indirectly . . . any provision of this chapter. Gross negligence. Repeated negligent acts. To be repeated, there must be two or more negligent acts or omissions. An initial negligent act or omission followed by a separate and distinct departure from the applicable standard of care shall constitute repeated negligent acts. An initial negligent diagnosis followed by an act or omission medically appropriate for that negligent diagnosis of the patient. shall constitute a single negligent act. When the standard of care requires a change in the diagnosis, act, or omission that constitutes the negligent act described in. paragraph (1), including, but not limited to, a reevaluation of the diagnosis or a change in treatment, and the licensee's conduct departs from the 4 Accusation applicable standard of care, each departure constitutes a separate and distinct breach of the standard of care. . . . The commission of any act involving dishonesty or corruption which is substantially related to the quali?cations, functions, or duties of a physician and surgeon. Any action or conduct which would have warranted the denial of a certi?cate. - 1. Section 2266 of the Code states: AThe failure of a physician and surgeon to maintain adequate and accurate records relating to the provision of services to their patients constitutes unprofessional conduct. PENAL CODE 12, Section 243.4 of the Penal Code states, in pertinent part: - Any person who touches an intimate part of another person for the purpose of sexual arousal, sexual gratification, or sexual abuse, and the Victim is at the time unconscious of the nature of the act because the perpetrator fraudulently represented that the touching served a professional purpose, is guilty of sexual battery. As used in subdivisions . . and . . . ?touches? means physical contact with the skin of another person whether accomplished directly or through the clothing of the person committing the offense.? As used in this section, the following terms have the following meanings: 3! ?Intimate part? means the sexual organ, anus, groin, or buttocks of any person, . . . . and surgeon, . . . who engages sexual contact with a patient . . . is guilty of sexual exploitation . . . - 5 Accusation BACKGROUND 13. On or about March 17, 2008, patient R.A., a Spanish-speaking male, sustained injuries at work when a rack toppled over and struck him on the right shoulder and right side of his head. As a result, patient R.A. ?led a worker?s compensation claim. 14. On or about June 10, 2008, patient RA. injured his lumbar spine while lifting a 90- pound box while working for the same employer. 15. On or about June 30, 2008, patient RA. presented to the Sobol Orthopedic Medical Group, Inc. for a worker?s compensation evaluation. Philip A. Sobol, M.D., an orthopedic surgeon, using a Spanish interpreter, examined R.A. Dr. Sobol diagnosed R.A. with right shoulder cervical Sprain/ strain with right upper extremity radiculitis,1 spondyolosis2 of the cervical spine at and a lumbar sprain/strain. Dr. Sobol ordered a lumbar stabilization brace to increase support and prevent further injury to lower back, and prescribed physical therapy and acupuncture numerous times a week for the injured areas. Dr. Sobol also ordered numerous diagnostic studies, including an x?ray of the lumbar spine to rule out disc herniation. Dr. Sobol also noted that MRI scans of cervical and lumbar spine along with a diagnostic ultrasound of his right shoulder should be considered if the patient?s did not improve with treatment. 16. On or about August 5, 2008, Dr. Sobol examined neck, back and right shoulder again. Dr. Sobol provided R.A. with a back brace due to his severe low back pain. Dr. Sobol?s treatment plan was to obtain an MRI of the lumbar spine and an electromyography3 (EMG)/nerve conduction velocity4 (N CV) study of the bilateral lower extremities, and continue physical therapy three times a week for his neck, shoulder and back for another month. 1 Radiculitis is the in?ammation of the spinal nerve root, resulting in pain and hyperesthesia (increased sensitivity to stimulation, particularly to touch). Spondyolosis is the ankylosis (the stiffening or immobility of a joint resulting from disease, trauma, surgery or bone fusion) of a vertebral joint or degenerative spinal changes due to osteoarthritis. Electromyography (commonly referred to as EMG) is a type of test in which a nerve?s function is tested by stimulating a nerve with electricity, and then measuring the speed and strength of the corresponding muscle?s response. Nerve conduction velocity test (commonly referred to as NCV) is a test that measures the time it takes a nerve impulse to travel a specific distance over the nerve after electronic stimulation. Accusation 17. Patient RA. saw Dr. Sobol again on or about September 16, 2008, and complained of severe neck and right shoulder pain (9 out of 10), and low back pain (6 out of 10). Dr. Sobol continued physical therapy treatments two times a week for an additional month to the injured areas, among other things. 18. On or about October 28, 2008, Dr. Sobol saw patient RA. for a follow-up visit and diagnosed him with lumbar spine sprain/strain with disc desiccation5 and a bulge at L4-L5 and LS-S 1. 19. Dr. Sobol continued to treat patient RA. from on or about December 8, 2008, through on or about March 20, 2009. At that time, RA. expressed some relief from the trigger point injections he had received in his right shoulder. RA. was also scheduled for a pain management consultation regarding his lumbar spine, among other things. 20. On or about April 30, 2009, Dr. Sobol saw patient RA. for another follow-up visit. At that time, the patient complained of pain in his right shoulder with popping and clicking, and that he had pain and difficulty washing his hair and getting dressed. RA. also complained of low back pain and right-sided neck pain radiating into his right shoulder and head. Because of the patient?s continued complaints about his right shoulder, Dr. Sobol requested a worker?s compensation authorization for a surgical consultation with Ronald Glousman, M.D. (Respondent). Respondent is an orthopedic surgeon specializing in sports medicine, and shoulder, elbow, and knee injuries at Kerlan-Jobe Orthopaedic Clinic. 21. On or about June 5, 2009, Dr. Sobol saw patient RA. for another follow-up Visit. At that time, Dr. Sobol. noted that the patient was scheduled for a surgical consultation for his right shoulder with Respondent on June 26, 2009. FIRST CAUSE FOR DISCIPLINE (Sexual Exploitation of Patient) 22. Respondent is subject to disciplinary action under Business and Professions Code section 729 in that ReSpondent sexually exploited patient RA. The circumstances are as followsDesrccation IS the act of or process of becoming dry. Accusation 23. On or about June 26, 2009, ReSpondent first saw patient RA. at Dr. Sobol?s office for a surgical consultation regarding his right shoulder injury. After he examined the right shoulder, Respondent?s impression were that RA. was suffering from persistent right shoulder impingement an industrial clavicle arthrosis,6 and. a possible labral7 tear which had been unresponsive to conservative treatment. Respondent recommended surgery to right shoulder, which included arthroscopic acromioplasty,8 distal clavicle resection, and a possible labral repair versus debridement. During the consultation, Respondent utilized a Spanish interpreter. 24. On or about September 8, 2009, ReSpondent performed surgery on patient right shoulder. The surgery was uneventful. 25. Thereafter, patient RA. was scheduled for numerous follow?up appointments with Respondent at Dr. Sobol?s of?ce. Respondent next saw the patient on or about September 18, 2009, and on or about October 30, 2009. These visits were uneventful. 26. On or about November 20, 2009, patient RA. saw Dr. Sobol for his continued neck and back complaints. 27. On or about December 7, 2009, Respondent saw patient RA. for a follow?up visit for his right shoulder. At that time, the patient also reported a significant ?are-up of his lumbar pain with complaints of pain radiating into his bilateral thighs and legs. Respondent?s plan was to continue physical therapy for the patient?s right shoulder and to refer him to Dr. Sobol for evaluation of his radicular cervical and. lumbar complaints, among other things. 28. On or about December 22, 2009, Dr. Sobol saw patient RA. and noted his diagnoses as a lumbar musculoligamentous sprain/strain with 1.0 millimeter (mm) disc bulges/desiccation at a 7.7 mm disc bulge at L4-L5, and a 2.8 mm bulge at among other things. 29. On or about January ll, 2010, patient R. A. saw Respondent at Dr. Sobol?s office for 6 Arthrosis is the disease ofajoint. Labra is from the word Labrum which is a ?brocartilaginous lip around the margin of the concave portion ofsome joints, also referred to as a lip, or lip-shaped structure. Acromioplasty is a surgical reshaping of the acromion (the lateral extension of the spine of the scapula, forming the highest point of the shoulder), frequently performed to remedy compression of the supraspinatus portion of the rotator cuff of the shoulder joint between the acromion and the greater tubercle of the humerus. Accusation Uanother follow?up visit regarding his right shoulder. At that time, R.A. complained of residual shoulder pain and weakness, neck pain with intermittent paresthesias into his arm, and lumbar pain radiating into his bilateral hips and occasionally into his right and left calves. Respondent examined the patient?s neck and back despite the fact that Respondent was only authorized to treat the patient?s right shoulder. Respondent also knew that Dr. Sobol had been following the patient for his other bodily complaints.9 When asked, during an interview with the Board,10 if he would have been paid for his examinations of the patient?s neck and back, Respondent said no because there had been ?no approval? to treat that area since Respondent?s authorization was limited to the patient?s right shoulder. Respondent told the Board that he also examined the patient?s hip and groin area on January 11, 2010 visit, however; he failed to document these alleged examinations in the patient?s chart. Respondent told the Board that after the patient pointed from his neck to his back and to his thighs, the patient then pointed towards his groin region where one would get an inguinal hernia (in the triangle where the thigh meets the pelvis just to the right or left of the genitalia). Respondent said that he began examining the patient?s groin area (where the upper scrotum meets the triangle of the thigh) and believed the patient was starting to get aroused. As ReSpondent continued to palpate the patient?s groin area, Respondent told the Board that he stopped the examination and told the patient to follow up with Dr. Sobol and his staff concerning his neck and back complaints. There is, however, no documentation of the hip or groin examinations. Additionally, the patient?s chart re?ects that Pilar Nario was the interpreter present during this visit. Patient R.A., however, recalled that on the January 1 1, 2010 visit Respondent entered the examination room, without an interpreter, and asked if RA. was having pain anywhere.11 9 Respondent had referred R.A. to Dr. Sobol on December 7, 2009 for evaluation of his radicular neck and back pain, and had access to the patient?s medical chart. Respondent was interviewed several times about this case by various agencies. In June 2010, when Respondent was ?rst interviewed about his care and treatment of patient R.A., Respondent denied that anything unusual or out of the ordinary had occurred during this or any other follow up visit. 1 Although patient RA. is Spanish speaking, he does understand and speak some English. Respondent also knows, understands and is able to speak some Spanish. Accusation Lu 27 28 After RA. responded that he was, Respondent instructed the patient to remove his pants and underwear. During that time, Respondent touched the patient?s genitalia without wearing examination gloves. The patient assumed this was part of a medical examination since he had told ReSpondent about his continued lower back pain which had been radiating into his leg. Respondent then told the patient to get dressed and left the examination room. Shortly thereafter, Respondent returned to the examination room with an interpreter and examined the patient?s right shoulder. 30. On or about January 29, 2010, Dr. Sobol saw patient R.A. for his complaints of increased neck and low back pain and spasms in his right calf. Dr. Sobol?s records indicate that the patient had a follow up with Respondent scheduled for February 8, 2010. 31, On or about February 8, 2010, patient RA. recalled being seen by Respondent, however, there are no medical records for this visit except for Dr. Sobol?s January 29, 2010 entry that notes that the patient was scheduled see Respondent on February 8, 2010. During this visit, the patient recalled that Respondent entered the room without an interpreter and told. him to remove his pants and underwear. At that time, Respondent touched the patient?s testicles and penis without wearing examination gloves. ReSpondent then stopped the examination, instructed the patient to put his clothes on, and left the examination room. Shortly thereafter, Respondent returned to the examination room with an interpreter and examined the patient?s right shoulder. There are no records for this visit. 32. On or about February 22, 2010, Dr. Sobol saw patient RA. for complaints of numbness and tingling to both hands and wrists, and gastric problems secondary to his medication use. 33. On or about March 8, 2010, ReSpondent saw patient RA. for another follow-up visit of his right shoulder. Because of what occurred in the last two follow up visits, the patient decided to record this examination. The patient positioned his cell phone?s video camera to capture a majority of the examination room and table. Thereafter, Respondent entered the room with a male interpreter, and asked the patient how he had been doing. Respondent also asked when the patient had last seen Dr. Sobol, and what, if anything, Dr. Sobol recommend for the 10 Accusation IO U.) patient?s back complaints. Respondent then turned his attention to the patient?s shoulder complaints. Respondent told the patient to keep his follow up appointments with Dr. Sobol and that ?for the shoulder I think we can wait some for now. . . . but if the shoulder ?ares up, Dr. Sobol can send him back anytime . . . Thereafter, ReSpondent and the interpreter left the examination room, and Respondent went to dictate his report. Shortly thereafter, approximately four minutes later, while the cell phone?s video camera was still recording, Respondent returned to the examination room, without an interpreter or a chaperone, and began asking the patient questions. Respondent asked ??There?? ?It?s painful?? ?Duele??12 ReSpondent then touched and palpated bare back.13 Respondent was not authorized to treat this area of the patient?s body. Respondent then inquired if the pain shot down from his back. In response, the patient pointed to the front of his right thigh and down towards his groin area. Respondent asked to see and motioned for RA. to remove his underwear. After R.A. removed his underwear, Respondent touched and palpated the patient?s hip and thighs and asked if it hurt. Respondent, without wearing examination gloves, then touched the patient?s testicles, and touched and stroked the patient?s penis. Subsequently, the patient became aroused. After the patient was fully aroused, he laid down on the examination table. Respondent then approached the examination table with Kleenex in his left hand. ReSpondent then placed his right hand on the patient?s erect penis and laid the Kleenex down on the examination table. Respondent then began masturbating the patient while Respondent caressed the patient?s chest and stomach areas. Respondent masturbated the patient until he ejaculated. Respondent then used the Kleenex he had brought to the examination table and cleaned the patient up. After ReSpondent ?nished cleaning up the patient, he told the patient ?If you still have pain there, you should tell Dr. Sobol? important? ?[b]ecause they can make it better; they can treat it.? Respondent then inquired when the patient?s next appointment was with Dr. Sobol. Respondent then told R.A. ?if this is continuing, you should let him [Dr Sobol] know. They can 1? Duele means pain in Spanish. 3 When ReSpondent re-entered the room, R.A. still had his shirt off from the earlier examination. 11 Accusation do more tests, okay?? Respondent then left the examination room. This entire encounter was captured on the video camera on the patientis cell phone. Respondent told the Board that when he left the dictation room he saw patient RA. standing in the examination room door. Respondent stated that the patient seemed angry and a little agitated. Respondent stated I ?didn?t want him to make a scene? since was in someone else?s office.? When asked what Respondent was afraid that RA. might say, Respondent stated he did not know, however, ?if he was angry at me? he might ?make an outburst or a complaint. I . . . don?t know.? Respondent, however, admitted that by the time he walked back into the examination room Respondent intended to engage in a sexual act with RA. and possibly fondle genitals. Respondent further admitted that the purpose of fondling genitals was to sexually gratify RA. When asked why Respondent touched and palpated other portions of body before fondling his genitals, Respondent stated that was ?letting him lead me to something that I assume he wants.? Respondent further stated that RA. ?was directing me and I was in essence sensing that what he wanted by his direction . . . I didn?t walk in and just start touching his . . . genitals. I touched other areas and he led me in that direction and I did follow that lead.? Respondent continued by saying that was testing. It was sort of, you know, like a, like a ?irtatious dance.? Respondent told the Board that when he touched and palpated back, hips and thighs, he (Respondent) was not conducting a medical examination at that time. 34. The following acts in Respondent?s care and treatment of patient RA. constitute the sexual exploitation of a patient when Respondent: (A) Touched the patient?s testicles and penis without a chaperone present, without the use of examination gloves, and outside of Respondent?s authorized area of treatment; and (B) Engaged in sex act and masturbated patient RA. for the purposes of sexual arousal and grati?cation. l2 Accusation SECOND CAUSE FOR DISCIPLINE (Sexual Misconduct with Patient) 3S. Respondent is subject to disciplinary action under Business and Professions Code section 726 in that Respondent engaged in sexual misconduct with patient RA. The circumstances are as follows: 36, Paragraphs 23 through 33, inclusive, are incorporated herein by reference as if fully set forth. THIRD CAUSE FOR DISCIPLINE (Gross Negligence) 37. Respondent is subject to disciplinary action under Business and Professions Code section 2234, subdivision in that Respondent committed acts of gross negligence in his care and treatment of patient RA. The circumstances are as follows: 38, Paragraphs 23 through 33, inclusive, are incorporated herein by reference as if fully set forth, FOURTH CAUSE FOR DISCIPLINE (Repeated Negligent Acts) 39,, Respondent is subject to disciplinary action under Business and Professions Code section 2234, subdivision in that Respondent committed acts of repeated negligent acts in his care and treatment of patient RA. The circumstances are as follows: 40, Paragraphs 23 through 33, inclusive, are incorporated herein by reference as if fully set forth, FIFTH CAUSE FOR DISCIPLINE (Failure to Maintain Adequate and Accurate Records) 41. Respondent is subject to disciplinary action under Business and Professions Code section 226] in that Respondent failed to maintain adequate and accurate records in his care and treatment of patient RA. The circumstances are as follows 42, Paragraphs 23 through 33, inclusive, are incorporated herein by reference as if fully set forth. Accusation \10PRAYER WHEREFORE, Complainant requests that a hearing be held on the matters herein alleged, and that following the hearing, the Board issue a decision: 1. Revoking or suspending Physician's and Surgeon?s Certi?cate Number 45186, issued to Ronald Glousman, MD. 2. Revoking, suspending or denying approval of Respondent?s authority to supervise physician's assistants, pursuant to section 3527 of the Code; 3. Ordering him to pay the Medical Board of California the costs of probation monitoring, if placed on probation; and 4. Taking such other and further action as deemed DATED: May 21, 2013 LINDA K. WHITNEY Executive Director Medical Board of alifomia Department of onsumer Affairs State of California Complainant LA2010504069 61009399.docx 14 Accusation