.. HEARING CONDUCTED BY TEXAS STATE OFFICE HEARINGS SOAH DOCKET NO.: 50.3.4055 - LICENSE No. R-os9o . IN THE MATTER OF THE. - I COMPLAINT AGAINST: TEXAS STATEEOARDOE MILTIADIs N. . MEDICAL EXAMINERS I . TO THE HONORABLE TEXAS STATE BOARD OF MEDICAL EXAMINERS AND THE . I HONORABLE ADMINISTRATIVE LAW JUDGE To BE - COMES NOW, the staff of the Texas State Board of- Medical Examiners (?the Board?), ?les this Complaint against Miltiadis-N. Leon, M.D., on Respondentisgalleged violations Title subtitle 3B "(Vernon 2004) I (?the Act?), and would show the following: I L. may ggon I The?l-ing' of Complaint and the relief requested are necessary--to-proteet-;the health and. publici-interest of the: citizens of the State-of Texas, as provided in Section 151-51003- of? the Act. 7 Respondent is aTexas-physicianand holds-Texas medical license number'K-eOS-Qo, issued by the Board on August 17-. 1996, which Was in 'fOr-ce and effect at-all timesm??ali and relevant to this Complaint. All'jurisdictional requirements have been satis?ed. ?op-2H "mm Alva?Hwa - The Board infoniiation may h?e and, based on that infomat-ion, conducted an investigation. The investigation compiled Page-1 of9 I . evidence that support allegations of a violation. 2. Respondent. was invited to attend-an Informal Show Gempliance Proceeding and Settlement Conference held on October 11, 2004, Which was. conducted in TEX. CODE (Vernon ?164.004 of the .- Act. The Board representatives (the ?Pane1?i), .includediat least: "one physician. I reviewed and considered evidence- from the investigation, as as anyinformatio? presented- by Respondent. The Panel determined that lRespcindent had .not compliance with all-requirements of the Act. 3. No agreement to- settle this matter has-been-reaChed byethe. parties. The Board has received information ahdon-?that information believes All. I . violated the Act. Based on-sueh' inforr'nati belief; the Beard alleges-:- Violations at: Odessa'Heart-Institute (soar?) I A. Patten - I 1. On or about January 23, 2003, Patient) -.V.L., in ICU at I Respondent rubbed himself'against- her-whilethe?hadssan-erection; and'j'ti?ied'to make-rub his erection. I 2. Again'in June Respondent made unwanted sexual advances toward 3. On or about septeinber 19, 2003, Respondent hugged grabbed?hers-buttocks, and tied to touch her breast. I I - - B. Patign- . . . On or about November 2003. patient" .V. complained-4 that. previous examination, Respondent inappropriately touchedg_..her breast: Respondent. also . asked. 35;, out? before{93; - that about September-:25, 2003., Reapondent had her. 3 to I mmfor visits with him. .Page?zers - These actions by Respondent are violations of the Medical 'fPractice Act, including. but not limited to: unprofessional and dishonorable conduct, violation Board Rule 190.8, failure to - practice medicine in a professional acceptable manner, bOundary Violations, and inability to practice medicine with reasonable and safety due to a mental or physical- condition. D. OHI 'PIeer Review On or about October 10, 2003-, CHI disciplined Respondent, directing that he ."IlOt have . any further contact with patient V.L., that he net .be alone any female patient an - examination room or at the heapital, but have a nurse. or an theristaff member-in at all. times with any female patients, and that he not "have any one-en?one contact female employee 0f OHI or any female representatives Of'any Pharma?utical or medical. 'elill?llpment or- company calling I I . I . The action. constitutes a violation of the Medical Practice Act-irelated to Peer. . review action taken by a hospital or medical staff of a facility. This violation is and allegation from the Vi?lati?n5 Respondent committed upon the individual patients-JaEOHI. Violations at Medical Center? Hospital of . A. Employee . . - I 0.3. reperted that Respondent intentionally eitposed his genitalia to her and; ?This is what you could be having.? - - B. Employee about February 2, 2002, A.S. reported that Respondent approac' his erect penis against her arm. A.S. further-I complained that Respondent. had. prwiouslymade unwanted sexual advancestotvard herihat Respondent made sexual advance and spoke in a - -- Page 3 of 9 about July-31, 2003, .B. reported that Respondent asked several inappropriate sexually oriented questions, and then rubbed his erect penis against her arm. E. Employee .C. . -J.C. reportedthat. Respondent asked if they see each other; socially outside of the work place, and made offensive remarks concerning- her marital status.- F. Em lo eeB.N. B.N. reported that: during the summer of 2003, Respondent made inappropriate sexual- comments to her during a telephone conversation. These actions by Respondent are violations of the Medical Practice Act, includingbut not . limited to: unprofessional and dishonorable conduct, violation of Board Rule 190.8,, boundary violations, acting in a disruptive manner toward hospital personnel, and inability to- practice medicine with reasonable-and?safety--dueto --a-inenta1 or physical condition. G. MCH Peer-Reg 'ew On or about October 9, 2003, Respondent was noti?ed that a peer review proceeding had recommended after ?nding Respondent had violated the Hospital Board By-Law-s and the Hospital Abuse and Harassment Policy through inappropriate sexual conduct, behavior and conunents to MCH personnel and others. On April 9,2004, Reapondent voluntarily surrendered his clinical privileges at MCH while under --investigation relating to professional competence or conduct. The actions of- Respondent that resulted in a peer review by. MCH constitutes-a: violation of the Medical Practice-Act, related to peer reviewaction taken a hospital or staff of a facility. This violation is a separate action and allegation {from the. violations Respondent "uncommittediipon the indi?dii?al?mt?f'T? Page 4 of .. . . .- .. .. 3L Applicable Statutes, Rules, and Agency Policy Respondent's conduct, as described above,lconstitutes grounds for the Board to revoke - or suspend Respondent's Texas medical license or to impose any other authorized means Of discipline upon the Respondent. The following statutes, rules, and agency policy are applicable to this matter: A. PROCEDURES FOR THE CONDUCT OF THIS HEARING: I 1. Section 164.007(a) of the Act requires that. the Boardadopt procedures governing formal disposition of a contested case before the State Of?ce of Administrative Hearings. 2. 22 TEX. ADMIN. CODE, Chapter --.-187- sets forth the procedures adopted-by the I Board under the requirement of Section 164.007(a) of the Act. I 3. TEX. ADMIN. CODE ?155.3(c) provides that the procedural rules of "the state agency on behalf of which the hearing is conducted govern procedural matters that relate to the - hearing as required by law, to wit: Actgt'asgci-ted- above. 4. 1 TEX. ADMIN. CODE, CHAPTER 155 sets forth the rules of procedure adopted by- SCAH for contested case proceedings. B. VIOLATIONS WARRANTING DISCIPLINARY ACTION: . . 1-- Seamus 154351-69300 and 164.056 of the Act authorize the Board take disciplinary action against Respondent based on Respondent?s inability to practice__..medicine with reasonable skill and safety to patients because Of illness; drunljgennes's; excessive use of drugs,- narcotics, chemicals, Or _-anothersubstance; or as aresult- of any mental or physical condition. - 2. I Section 1642051(a)(6) of the Act authorizes the-Board to take disciplinary action against Respondent based on Respondent?s failure to practice medicine in an acceptable professional manner consistent With public health. mdeelfare. 3. Section of the Act authorizes the Board to take disciplinary action based on disciplinary action. by Respondent?s peers. 4. SectiOn of disciplmary'__ against Respondent based on Respondent?s violation Of a rule adopted under the Act. Page 5 of 9 - mus-wanna?: 5. Section of the Act authorizes the Board to take disciplinary action against Respondent based on Respondent?s committing an act prohibited under Section 164.052. 6. Section of the Act authorizes the Board to take disciplinary action against Respondent'based on Respondent?s committing unprofessional or dishonorable conduct that is deceive or defraud the public, as provided by Section 164.053, or injure the public. Unprofessional and Dishonorable Conduct is de?ned to include but is not limited-to those actions described in 22 TEX. ADMIN. CODE I 7. 22 TEX. ADMIN. . CODE adopted under the Act, provides that a physician violates the Act by- engaging in sexual contact with a patient. I I 8. 22 TEX. ADMIN. CODE under the Act, provides that a physician violates the Act by engaging in sexually inappropriate?f-behavior or comments --directed towards a patientTEX. ADMIN. CODE adopted under the Act, provides that a viol-ates-the-Act-by behavingin- a?abusive aor. assaultive-tnanner towards a patient or the patient?s family or? representatives that interferes with patient care or could be-reasonably expected to adversely impact the quality of care rendered to a patient. 10. 22 TEX. ADMIN. CODE adopted .under the Act, provides that a physician violates the Act by behaving-in a disruptive manner toward hospital personnel, other medical personnel or- patients, among others, that interferes with patient care or could be reasonably expected to adversely impact the quality of care rendered to a patient. I I 11. 22 TEX. ADMIN. CODE .adopted under the Act, provides that a voluntary relinquishment of privileges or a failure to renew privileges with'a hospital, medical staff or medical association or society while investigation or a disciplinary action is?pending or is on appeal constitutes disciplinary action that is appropriate and reasonably supported by . evidence submitted to. the Board, within the meaning of section: of the ActPage _6 fof-9 c. THAT MAY IMPOSED: 1. Section 164.001 of the Act authorizes the Board to impose a range of'discipl-inary - actions against a person for violation of the Act or a Board rule. Such sanctions include: revocation, suspension, probation, public reprimand, limitation or restriction .on- practice, counseling or treatment, required educational or counseling programs, monitored practice,_public service, and an administrative penalty. I I 2. Chapter 165, Subchapter A of the Act sets forth statutory requirements for the amount and basis of an admmistrative penalty. 3. 22 Tax. ADMIN. CODE 187.39 authorizes the Board to-assess, in addition --tot?any penalty imposed, costs of the investigation and administrative hearing in the 'case. of a '-'7default judgment or upon adjudication that Respondent is in violation- bf the Act after a- trial?n the merits. . 4. 22 TEX. ADMIN. CODE Chapter ,19-0 provides disciplinary guidelines intended. to ..l..pro?ide.gladance. and :1 ?rmnework. of analysis-Tor -'adnii11istrative law judges in the maldns- of recommendations in contested licensure and-disciplinary matters and to {provide guidance as to the types of conduct that constitute violations of theAct or Boardrules. - 5. I When considering the allegations and conduct of the Respondent in regard to this Complaint and pursuant to Chapter 190, the follovving should be considered as aggravating factors: patient harm and the. severity of patient harm-increased potential for harm to, the public; prior misconduct; disciplinary history; misconduct; failure - to implement remedial. . measures to correct or mitigate harm from the misconduct; . of rehabilitative 'p?Otential or likelihood for future misconduct of a similar nature; and relevant circumstances increasing-the seriousness of the misconduct. an? um .um cc mH?u-nl?nw-n Page 7 of9 IF YOU DO NOT FILE A WRITTEN ANSWER To THIS NOTICE WITH THE STATE OFFICE OF ADMINISTRATIVE HEARINGS WITHING 20 DAYS OF. THE DATE NOTICE OF SERVICE WAS MAILED, A DEFAULT JUDGMENT MAY BE ENTERED AGAINST You. WHICH MAY INCLUDE THE 2ng OFLICENSURE RAW OR ALL or THE INCLUDING REVOCATION .OF-YOUR A DEFAULT JUDGMENT MAY BE AGAINST YOU.- MAY INCLUDE THE DENIAL 0F LICENSURE on ANY on ALL OF THE REQUESTED A. COPY OF YOU - STATE or. ADMINISTRATIVE DEE COORDINATOR OF THE-TEXAS STATEALE I I SREGIEICALLY OR DENY F, AL EGATION I IE AGAINST THE RESPONDENT, MAD PREMISES CONSIDER-ED, Board Staff requests that an administratiire law I judgemployedhy'the 'State?f?ce of ?dtr?nistr?ive-Hearings conduct a contested caSe.hea1-ing on the merits of the Complaint, in accordance With Section 164.007(a) of the Act. Upon ?nal hearing,- Board Staff requests that the Honor-able Administrative ELaw Judge issue .a Proposal for Decision that. re?ects Respondent?s violation of theAct as set forth in this Complaint. I Following issuance of the PFD, Board Staff requests that the Board, pursuant- to 164.001 and 165.003 of-the Act and Board Rules 187.30, 187.39, 190.8, 190.14, 190.15 and 190.16, enter . an Order imposing. any and all sanctions or disciplinary measures necessary to protect-health and. public welfare, including the imposition on Respondent of SOAH hearing costs; and an administrative penalty. Page 8-of'9 Respeot?illy submitted, TEXAS STATE BOARD OF MEDICAL EXAMINERS I Scott State Bel-No. 007 89299 333 Guadalupe, Tower 3, Suite 610 Austin; Texas 78701 I . Telephone: 7 (512) 305-7096 Fax: (512) 305?7007 THE STATE OF TEXAS . . COUNTY OF TRAVIS . SUBSCRIBED AND before me by the said Seott M. Freshour on this 29th. day of AuguSt #2005. I - ONJA AURELIUS NOTARY PUBLIC - *3 NOTARY WITHOUT BOND to, - sure or TEXAS coke-6gNotary Publ 1 State of Tex-as Filed with the Texas State Board of Medical Examiners on this day of Au gust 2005. Page 9 of.9