XAVIER BECERRA . Attorney General of California MATTHEW M. DAVIS Supervising Deputy Attorney General JASON J. AHN Deputy Attorney General State Bar No; 253172 600 West Broadway, Suite 1800 San Diego, CA 92101 PO. Box 85266 San Diego, CA 92186?5266 Telephone: (619?) 738?9433 Facsimile: (619) 645-2061 Attorneys for Complainant FILED STATE OF CALIFORNIA MEDICAL BCARDCF CALIFORNI SACRAMENTO a - 20 BY E31 ANALYST BEFORE THE MEDICAL BOARD OF CALIFORNIA DEPARTMENT OF CONSUMER AFFAIRS STATE OF CALIFORNIA In the Matter of the Investigation Against; Case No. 800:2017-038059 Charles Yang, MD. I A A I 17552 BEACH BLVD., STE. ., - HUNTINGTON BEACH, CA 92647 Physician?s and Surgeon?s Certi?cate No. A 35385, Respondent. Complainant alleges: . 1. Kimberly Kirchmeyer (Complainant) brings this Accusation solely in her of?cial capacity as the Executive Director of the Medical Board of California, Department of Consumer Affairs (Board). 2. On or about June 18, 1980, the Medical Board issued Physician?s and Surgeon?s Certi?cate No. A 35385 to Charles Yang, MD. (Respondent). The Physician?s and Surgeon?s Certi?cate was in full force and effect at all times relevant to the charges brought herein and will 1 (CHARLES YANG, M.D.) ACCUSATION NO. 800-2017-03 8059 expire on June 30, 2020, unless renewed. JURISDICTION I 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 (Code) unless otherwise . indicated. 4. Section 2227 of the Code states: A licensee whose matter has been heard by an administrative law judge of the Medical Quality Hearing Panel as designated in Section 11371 of the Government Code, or whose default has been entered, and who is found guilty, or who has entered into a stipulation for disciplinary action with the board, may,_in accordance with the provisions of this chapter: Have his or her license revoked upon order of the board. Have his or her right to practice suspended for a period not to exceed I one year upon order of the board. Be placed on probation and be required to pay the costs of probation monitoring upon order of the board. I i Be publicly reprimanded by the board. The public reprimand may include a requirement that the licensee complete relevant educational courses approved by the board. Have any other action taken in relation to discipline as part of an order of probation, as the board or an administrative law judge may deem proper. Any matter heard pursuant to subdivision(a), except for warning letters, medical review or advisery conferences, professional competency examinations, I continuing education activities, and cost reimbUrsement associated therewith that - are agreed to with the board and successfully completed by the licensee, or other matters made cen?dential'or privileged by existing law, is deemed public, and shall be made available to the public by the board pursuant to Section 803.1.? 2 (CHARLES YANG, MD.) ACCUSATION NO. . Section 2234 of the Code, states: f?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: 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 applicable standard of care, each departure constitutes a separate and distinct breach of the standard of care. i 6. Section 2266 of the Code states: ?The failure of a physician and surgeon to maintain adequate and accurate records relating to the provision of services to their patients constitutes unprofessional conduct.? I 7. Unprofessional conduct under Business and Professions Code section 2234 is conduct, which breaches the rules or ethical code of the medical profession, or conduct which is unbecoming a member in good standing of the medical profession, and which demonstrates an un?tness to practice medicine. (Shea v. Board of Medical Examiners-(1978) 81 Cal.App.3d 564, .575.) 3 (CHARLES YANG, NO. 800-2017-03805?9 FIRST CAUSE FOR DISCIPLINE . (Gross Negligence) 8. Respondent has subjected his'Physician?s and Surgeon-?3 Certi?cate No. A 35385 to -. disciplinary action under sections 2227 and 2234, as de?ned by section 2234, subdivision of the Code, in that he committed gross negligence in his care and treatment of Patient as more I particularly alleged hereinafter: 9. Respondent treated Patient A at various times from December 1992 until Patient A?s death in January 2012 and has prescribed one or more controlled substances to Patient A since September 2010.2 ,-Patient A had a history of chronic back pain. 10. Between on or about November 3, 2011 to on or about January 9, 2012, Respondent prescribed the following controlled substances to Patient A: Filled Drug Name I Quantity Prescriber 11-03?11 . Hydrocodone3 ?Acetaminophen10-325 80 Respondent 12_12_11 Hydrocodone Acetaminophen 10-325 80 Respondent 1 References to ?Patient are used to protect patient privacy. 2 Conduct occurring more than seven (7) years from the ?ling date of this Accusation is for informational purposes only and is not alleged as a basis for disciplinary action. 3 Hydrocodone/APAP (V icodin?, Lortab? and Norco?) is a hydrocodone combination of hydrocodone bitartrate and acetaminophen which was formerly a Schedule controlled substance pursuant to Health and Safety Code section 11056, subdivision (6), and a dangerous drug pursuant to Business and Professions Code section 4022. On August 22, 2014, the DEA published a ?nal rule rescheduling hydrocodone combination products (HCPs) to Schedule II of the Controlled Substances Act, which became effective October 6, 2014.- Schedule II controlled substances are substances that have a currently accepted medical use in the United States, but also have a high potential for abuse, and the abuse of which may lead to severe or physical dependence. When properly prescribed and indicated, it is used for the treatment of moderate to severe pain. In addition to the potential for and physical dependence there is also the risk of acute liver failure which has resulted in a black box warning being issued by the Federal Drug Administration (FDA). The FDA black box warning provides that ?Acetaminophen has been associated with cases of acute liver failure, at times resulting in liver transplant and death. Most of the cases of liver injury are associated with use of the acetaminophen at doses that exceed 4,000 milligrams (4.grams) per day, and often involve more than one acetaminophen containing produCt.? . 4 . (CHARLES YANG, MD.) ACCUSATION NO. .800-2017?03 8059 {ll 10 I 11 12 13 14- 15Filled Drug Name Quantity Prescriber 12-12-1 1 Alp razolam" 1mg 30 Respondent 12?21?1 1 Alp razolam 1mg 15 Respondent 1'2_21_1 1 Hydrocodone-Acetaminophen 10?325 40 Respondent 01/09/12- Hydrocodone-Acetaminophen 10:325 120 Respondent 12. Respondent prescribed the above controlled substances without a controlled substances agreement. 13. Respondent saw Patient A on November 3, 2011, December 12,2011, December 21, 2011, and January 9, 2012- (?of?ce visits?). 14. For the above of?ce visits, Respondent failed to adequately document one or more ?of the following elements related to the safe preseribing of controlled substances including, but not limited to, family history, social history, past medical history, indications, bene?ts, risks, and alternatives. 15. Respondent?s progress notes documenting above of?ce ?visits were. illegible and/Or dif?cult to decipher. 16. Respondent failed to properly reconcile medications Patient A was taking during the time period covering above of?ce visits. . 4 Alprazolam is a Schedule IV controlled substanCe pursuant to Health and Safety Code section 11057, subsection and a dangerous drug pursuant to Business and Professions Code section 4022. When properly prescribed and indicated, Alprazolamis generally used to treat anxiety and panic disorders. 5 (CHARLES YANG, MD.) ACCUSATION NO. 800-2017?038059 17. Respondent committed gross negligence in his care and treatment of Patient A, . which included, but was not limited to, the following: Respondent prescribed the above controlled substances without a controlled substances agreement; I I Respondent failed to adequately document one or more of the following elements related to the safe prescribing of controlled substances including, but not limited to, family history, social history, past medical history, indications, bene?ts, risks, and alternatives; Respondent?s progress notes documenting Patient A?s of?ce visits were illegible and/or dif?cult [to decipher; and i Respondent failed to properly reconcile. medications Patient A was taking. SECOND CAUSE FOR DISCIPLINE (Repeated ?Negligent Acts) '18. Respondent has further subjected his Physician?s and Surgeon?s Certi?cate No. A 35385 to disciplinary action under sections 2227 and 2234, as de?ned by section 2234, subdivision of the Code, in that he committed repeated negligent actsin his care and treatment of Patient A, as more particularly alleged herein. Paragraphs 8 through 17, above, are hereby incorporated by reference and realleged as if fully set forth herein. - THIRD CAUSE FOR DISCIPLINE (Failure to Maintain Adequate-and Accurate Records) 19. Respondent has further subjected his Physician?s and surgeon?s Certi?cate No. A 35385 to disciplinary action under sections 2227 and 2234, as de?ned by section 2266, of the Code, in'that respondent failed to maintain adequate and accurate records regarding his care and treatment Iof Patient A, as more particularly alleged in paragraphs 8 through 18, above, which are 6 (CHARLES YANG, M.D.) ACCUSATION NO. 800-2017-038059 10 .11 12 13 14 15 ?1hereby incorporated by reference and realleged as if fully set fOrth herein. FOURTH CAUSE FOR DISCIPLINE (General Unprofessional Conduct) 20. Respondent has further subjected his Physician?s and Surgeon?s Certi?cate No. - A 35385 to disciplinary action under sections 2227 and 2234 of the Code, in that he'has engaged I in conduct which breaches the rules or ethical code of the medical profession, or conduct which is unbecoming to a member in good standing 'of the medical profession, and which demonstrates an unfitness to practice medicine, asmore particularly alleged in paragraphs 8 through 19, above, which are hereby incorporated by reference as if fully set forth herein. PRAYER WHEREFORE, Complainant requests that a hearing be held on the matters herein alleged, and that following the'hearing, the Medical Board of California issue a decision: 1. Rekaing or suspending Physician's and Surgeon's Certi?cate Number A 35385, issued to Charles Yang, 2. Revoking, suspending or denying approval of Charles 'Yang, M.Df.?s authority to supervise physician assistants and advanced practice nurses; 2. Ordering. Charles Yang, M.D., if placed on probation, to pay the Board the costs of probation monitoring; and i 4. Taking such other and further action as deemed necessary and proper. DATED: . October 25 2018 KIMBERL Executive 137 ector Medical Board of California Department of Consumer Affairs State of California Complainant 7 (CHARLES YANG, MD.) ACCUSATION NO. 800?2017-03 8059