NEW YORK UL lo it C, state department of Nirav Shah, MD, MP H. Sue Kelly Commissioner Executive Deputy Commissioner June 6, 2013 CERTIFIED TURN RECEIPT REQUESTED John Weston Siebert, MD. REDACTED Re: License No. 16582] Dear Dr. Siebert: Enclosed is a copy of the New York State Board for Professional Medical Conduct (BPMC) Order No. 13?168. This order and any penalty provided therein goes into effect June l3. 2013. Please direct any questions to: Board for Professional Medical Conduct, 90 Church Street, 4th Floor. New York. NY 10007-2919, telephone it 212-417-4445. Sincerely, REDACTED Katherine A. Hawkins. M.D., JD. Executive Secretary Board for Professional Medical Conduct Enclosure cc: Wilfred T. Friedman, Esq. 60 East 42nd Street New York. NY 10165 HEALTH.NY.GOV faeebookeomeYSDOH MinerromHHe-alth NEW YORK STATE DEPARTMENT OF HEALTH BPMC No. STATE BOARD FOR MEDICAL CONDUCT IN THE MATTER OF CONSENT JOHN SIEBERT, MD. ORDER 13-168 Upon the application of (Respondent) JOHN SIEBERT. MD in the attached Consent Agreement and Order. which is made a part of this Consent Order. it is ORDERED. that the Consent Agreement, and its terms, are adopted and it is further ORDERED. that this Consent Order shall be effective upon issuance by the Board. either by mailing of a corny of this Consent Order. either by ?rst class mail to Respondent at the address in the attached Consent Agreement or by certi?ed mail to Respondent's attorney. OR upon facsimile transmission to Respondent or Respondent's attorney. whichever is ?rst. so ORDERED. DATE: 5/5/2013 5595915? ARTHUR s. HENOERER. MD. Chair State Board for Professional Medical Conduct NEW YORK STATE DEPARTMENT OF HEALTH 'l STATE BOARD FOR PROFESSIONAL MEDICAL CONDUCT l? THE MATTER CONSENT I or R?gesmmr I JOHN SIEBERT. no. ORDER JOHN Mil. represents that all of the folan statemnm am true: That on or about April 8, 1936. I wan llcens?ed to practice as a physician In the State of New York, and issuad License No. 165321. by the New Yul-ll: State Education Depamnent. My current addms ls . and I will ande the Dimmer all the Ol?ce of Professiin?l Ma?ladl Conduai 6135} change of address. I understand that the Now York Stat! Board for Prufeaalonal Medical Conduct (Board) has charged me one speci?cation of prufaasional mlsconduct. as set forth in a Statement of Charges. marked as Exhibll attached to and part of this Canaan: Agreement do not 0071133! the charge, In full satisfaction of the charges against me. and agree to the following new Porsuant to N.Y. Pub. Health Law my license to practice medicine in New York State shall be owner-idea tor a period of three years. with such period of suspension to be entirelyI Stayed. Pursuant to NY. Pub. Health Law 2304(9). I shall be placed on probation for a periDd of 36 months, subject to the terms set forth in attached Exhibit I further agree that the Consent Order shall impose the following conditions: Th9? shall. in the course of practicing medicine in Maw Yam State. examine and tram any tar-rial. patient only in the mm of a Chapmm- as is more fully set rortii In attached Exhibit This condition ix shall take af?ict 120 days after the Consent Order: effective date and will Ki: continua so long as Respondent remains a licenses in New York State; and That Respondent shall remain in continuous compliance with all raquh'emanls of MY. Educ Law including but not limited to the requirements that a licensee shall register and continue to be registered with the New York State Education Department (except during periods of actual suspension) and mat a licensee shall payI all registration lees. Respondent shall not exercise the option provided in NH. Educ. Law 5502(4) to avoid registration and payment ottees. This condition shall take effect 120 days after the Consent Order?s emotive data and continua so long as Respondent remains a licensee in New York State: and That Respondent Shall cooperate fully with the Of?ce of Professional Medlcel Conduct (OWE) in its administration and enforcement of this Consent Order and In rt: investigatlone of matters concerning Respondent. Reopondent shall respond in a timely manner to all DPMC requests for written periodic veri?cation of Respondent's compliance with Consem Order. Respondent shall meet with a person designated by the Director MOPMC. as dimmed. Respondent shall respond and provide all documents and Information Mtl'lln Respondent?s control. as directed. This Goodman shall take effect upon the Board's issuonoa of the Consent Order and will continue so long as Reoponoent remains lloeneed in New York State I stipulate that my failure to comply with any conditions of this Consent Order shall constitute misconduct as de?ned by NY. Edm. Law 353M291 I agree that, rf I am chow with professional misoonouot in future. this Consent Agreement and Order shall be admitted into evidence in that prooeadlng. I ask the Board to adopl this Consent Agreement- i understand that If the Board does not adopt this Consent Agreement. none of its terms shall hind me or constitute an admission of any of the acts of alleged misconduct; this Consent Agreemnt shall not be used against me in any way and shall be kept in strict con?dence; and the Board's denial shat! be without prejudice to the pending disciplinary proceeding and the Board's final determination pursuant to NY. Pub. Hearth Law. I I I . i agree that. if the Board adapts this Consent Agreement. the Chair of the Board shall issue a Consent Order in accordance with its terms. I agree that this Consent Order shall take effect upon its issuance by the Board, either by mailing of a copy of the Consent Order by ?rst class mail to me at the address in this Consent Agreement. or to my attomey I by certi?ed ma it, OR upon facsimile trans mission to me or my attorney. whichever is first. I The Consent Order, this agreement. and all attached Exhibits shalt be public documents. with only patient Identities. if any. redacted. As public documents. they may he posted on the Department's website. OPMC shall report this action to the National Practitioner Data Bank and the Federation of State Medical Boards. and any other entities that the Director of OPMC shall deem appropriate. I stiputate that the proposed sanction and Consent Order are auth orlzad by NY Pub. Health Law 230 and 230-9. and that the Board and 0PMC have the requisite powers to carry out all included tan-no. i ask the Board to adopt this Consent Agreement of my own free will and not under duress, or restraint. in ooneideratlon of the value to me at the Board's adoptlon of this Coneent Agreement allowing me to resolve this 1 matter withom the various risks and burdens of a hearing on the merits. knowingly wan-e my right to ooth the Consent Order for which i apply, whether adminitrattvely or i i i juoim'o?y: agree to be bound by the Consent Order. and I ask that the Board adopt this Consent Agreement. I understand and agroe that the attomEy for the proposed agreement and Consent Order, DATL i Dopanment. the Director of 0PMC and the Chair of tho Board each ratain complete either to enter into the based upon my application. or to decline to do so. I further understand and agree that no prior or separate mitten or oral can Iirnl?t that discretion. RE DACTED J0 NSIEBERTJE. n_ PONDENT I I El {1 l'l?ie uriderSIgn-ed agree to Respondent?s attached Consent Agreement and to IIS proposed penalty. terms and conditions. DATE: REDACTED WILFRED FRIEDMAN ESQ. Attorney for Respondent REDACTED DATE: JEAN ERESLER ASSociate Counsel Bureau of Professional Medical Conduct REDACTED yew new? Director Office of Professional Medical Conduct DATE, new YORK STATE DEPARTMENT OF HEALTH STATE BOARD FOR MEDICAL CONDUCT tN THE MATTER 1 STATEMENT or OF CHARGES JOHN SIEBERT, MD. JOHN SIEBERT. M.D.. the Respondent. was authorized to practice medicine in New York State on or about April 3. 1986. by the issLiance of license number 165821 by the New York State Education Department. FQCTUAL A. Respondent. a plastic surgeon, treated Patient A. (patients identi?ed in appendix attached) from on or about January 2000 through and including July 2008. Respondent treated Patient A at his private of?ces at 799 Park Avenue. New York. NY and 50 East Street. New York. NY and performed multiple surgeries on Patient A at Manhattan Eye. Ear. 8. Throat Hospital and Institute of Reconstructive Plastic Surgery, New York University Medical Center. 1. Between on or about June 2006. through on or aboot December 2008 Respondent engaged in an inappropriate intimate relationship with Patient A. SPECJFICATION OF CHARGES FIRST semncanon goats. unnmess Reapondent is charged with committing professional misconduct as de?ned In NY. Educ. Law 6530(20) by engaging in conduct in the ptactice of the profession of medicine that evidences moral un?tness to practice as alleged in the facts of tho rI fotlowing: l. Paragraphs A, A1. I 1 2013 - New York. New York I REDACTED .r I Roy ?ehorson, Deputy Gaunsol Bureau of Professional Medina! Conduct 1) 2) 3) 4i 5} 3) Eat-Ila" if Term. of Probation Respondent?s conduct shall conform to moral and profuseional standards of conduct and governing law. Any act of professional misconduct by Respondent as de?ned by NY. Educ. Law 55 8530 or 6531 shall module a violation of probation and may subject Respondent to an action pursuant to NY. Pub. Health Law 230(19). Reopondent shall maintain active registration of Respondent?s license (except during periods of actmi unopension) with the New York State Education Department Division of Professional Licensing Services. and shall pay all registration tees. Respondent shall provide the Director. Of?ce of Profeceional Medical Conduct (OPMCJ, Riverview Center. 150 Broadway. Suite 355. Albany. New York 12204- 2719. with the following mien-nation, in writing, and ensure that this information is kept current: a full descn?ption of Respondents employment and practice; all professional and residential addresses and relaphone numbers within and outside New State; and all investigations. arrests. charges, conviction: or disciplinary ac?on? by any local. State or federal agency. institution or tecllity. Reopondent shall notify CNS, in writing. within 30 days of any additions to or change-.3 in the required im?onnetton. Respondent shall cooperate fully with, and respond inc threly manner to. OPMC requests to provide written periodic veri?cation of Respondent's compliance with the terms or this Consent Order. Upon the Director of request, Respondent shall meet in person with the Director?s deslgtee. Respondent's failure to pay any monetary penalty by the prescribed date ahell 1 subject Respondent to all provisions of lowI relating to debt collection by New York State, including but not limited to: the intpooltlon of interest. late payment charges and collection fees; referral to the New York State Department of Taxation and Finance for collection; and non-renewal of permit: or licensee ex Law? 171(27): State Finance Law 18; CPLR 5001; Executive Law 32]. i The probation period shall toil when Respondent is not engaged in active medical I practlce in New York State for a period of 30 consowtlve days or more. Respondent shall notify the Director or 0PMC, in writing, if Respondent in nor I currently engaged in, or intends to leave, active Mica! practice in New York State I for a connective 30 day period. Reepondent shall then no?fy the Director again at least 14 days before returning to active practice. Upon Respondent?s return to active practice in New York State. the probation period shall resume and Respondent shall tul?li any un?it?lled probation tame and such requirements as the Director may impose as reasonably relate to the matters set forth in Ext-innit or as are to protein the public health. The Director of 0PMC may review Respondent?s professional perfonnanoe. This review may include but shall not be limited to: a review of of?ce records, patient records. hospital charts. andror electronic moorda; and intenrlews with or periodic visits with Respondent and staff at practice locations or OPMC of?cers. 6) Respondent shall adhere to federal and state guidelines and protestiionel standards 'of care with respect to infection control practices. Respondent shall ensure education. training and overnight of all of?ce personnel Involved In medical care. with respect to these practtoea. 9) Respondent shall maintain complete and legible medical records that accurater reflect the evatuatlon and treatment of patient: and contain all information requlred by State rules and regulations concerning oontroiled substances. 10)Respondent shalt enroll in and successfully complete a oontinuing education program in stream to be determined by the Director of DPMC. This cot-rumier I education program re subiect to the Director of prior written approval and shall be succemfulty completed within the ?rst 90 days of the probation period. I 11)Respondent Shall comply with this Consent Order and all its terms. and shall bear all assoc:th oompllanoo caste. Upon receiving evidence of noncompliance with. or a violation of, these terms. the Director of 0PMC andror the Board may inmate a - violation of probation proceeding, endior any other such proceeding authortzed by law. against Respondent twin; 1. CHAPERONE Respondent shall. in the course of practicing medicine In New York State. examine andior treat any female patient Dile in the presence of a chaparona. The ohaperone shall be a licensed or registered health care professional or other health care worker, shall not be a family member. personal friend. or be in a chaperona?s responsibilities. The chaperohe shall be proposed by Respondent and Subject to the written the approval at the Director of OPMC. Prior to the approval of any individual as chaperona. Respondent shall cause the proposed diaperono to execute and submit to the Director of OPMC an shall, without fail. cause the approved ohaperone to; a) Report quarteity to OPMC regarding the ohapemning of Respondents practice. in Report within 24 hours any failure of Respondent to comply With the Order, including. but not limited to. any fatura by Respondent to have lhe chaperone present when required. or any Inappropriate conduct. whether verbal or physical, by Respondent in the presence of any patient. Confirm the chaperona's presence at each and every examination and treatment of a fan-tale patient by Respondent, by placing the ohaparone's name. title and date In the patient record for each and every visit. and by maintaining a separate log. kept in the anaparone's own possession. listing the patient rim-Ia and date of visit for each and every patient visit chaperanad. cl) Provide oopiae of the log described in paragraph a, above. to 0PMC at least quarterly and also immediately upon the Director?s request.