OO-JCN \28- XAVIER BECERRA Attorney General of California STEVEN MUNI . Supervising Deputy Attorney General JANNSEN TAN Deputy Attorney General - State Bar No. 237826 1300 I Street, Suite 125 P.0. Box 944255 Sacramento, CA 94244-2550 Telephone: (916) 210-7549 Facsimile: (916) 327-2247 Attorneys for Complainant FILED STATE OF CALIFORNIA ME AL BOA CALIFORNIA ?711122. 2 M- BY . ANALYST BEFORE THE NIEDICAL BOARD OF CALIFORNIA DEPARTMENT OF CONSUMER AFFAIRS STATE OF CALIFORNIA In the Matter of the Accusation Against: Case No. 800?2017?033242 Daniel George Clark, MD. A A I 5250 Morningside Ave. Auburn, CA 95602 Physician's and Surgeon's Certi?cate No. A 23338, Respondent. Complainant alleges: PARTIES 1. Kimberly Kirchmeyer (Complainant) Accusation solely in her of?cial Affairs (Board). 7 7 capacity as the Executive Director of the Medical Board of California, Department of Consumer 2. On or about July 1, 1969, the Medical Board issued Physician's and Surgeon's Certi?cate No. A 23333 to Daniel George Clark, M.D. (Respondent). The Physician's and Surgeon's Certificate was in full force and effect at all times relevant to the charges brought herein and expired on May 31, 2016, is in delinquent status, and has not been renewed. 1 (DANIEL GEORGE CLARK, MD.) ACCUSATION NO. 800-2017-03 3242 313@00qu 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. 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 1n Section 11371 of the Government Code, or whose default has been entered, and who 1s found guilty, or who has entered into a stipulation for disciplinary action with the board, may, in accordance with the provisions of thischapter: 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 one year upon order of the board. . i Be placed on probation and be required to pay the costs of probation monitoring-upon order of the board. 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. A Any matterheard pursuant to subdivision except for warning letters, medical review or advisory conferences, professional competency examinations, 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 confidential or privileged by 3 existing law, is deemed public, and shall be made available to the public by the board pursuant to Section 803.1.? 5. Section 2234 of the Code, states: ?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: 2 (DANIEL GEORGE CLARK, MD.) ACCUSATION NO. 800-2017?033242 Violating or attempting to violate, directly or indirectly, 'as?si-sting in or abetting the violation of, or conspiring to violate any provision of this chapter. I 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 appropriatefor .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. Incompetence. The commission of any act. involving dishonesty or corruptionwhich 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. The practice of medicine fromthis state into another state or country without meeting the legal requirements of that state or country for the practice of medicine. Section 2314 shall not apply to this subdivision. This subdivision shall become operative upon the implementation 0f the prOposed registration program described in Section 2052.5. The repeated failure by a certi?cate holder, in the absence of good cause, to attend and participate in an interview by the board. This subdivision shall only apply -to a certi?cate holder who is the subject of an investigation by the board.? 6. Section 725 of the Code states: Repeated acts of clearly excessive prescribing, furnishing, dispensing, or administering? of drugs or treatment, repeated. acts of clearly excessive use of diagnostic procedures, or repeated acts of clearly excessive use of diagnostic or treatment facilities as determined by the standard of 3 (DANIEL GEORGE CLARK, M.D.) ACCUSATION NO. 800-2017-033242" 4:1? OOQON the community of licensees is unprofessional conduct for a physician and surgeon, dentist, podiatrist, physical therapist, chiropractor, optometrist, speech?language pathologist, or audiologiSt. Any person who engages in repeated acts of clearly excessive prescribing or administering ofdrugs or treatment is guilty of a misdemeanor and shall be punished by a ?ne of not less than one hundred dollars ($100) nor more than six hundred dollars or by imprisonment for a term of not less than 60 days nor more than 180 days, or. by'both that ?ne and imprisonment. I I A practitioner who has a medical basis for prescribing, furnishing, dispensing, or administering dangerous drugs or prescription controlled substances shall not be subject to disciplinary action or prosecution under this section. No physician and surgeon shall be subject to disciplinary action pursuantto this section for treating intractable pain in compliance with Section 2241.5.? I FIRST CAUSE FOR DISCIPLINE (Gross Negligence?Patient A) 7. Respondent 15 subject to disciplinary action under sections 2234, subdivision and 2234 1n that he committed acts of gross negligence and unprofessional conduct In his care and treatment of Patient A1. The circumstances are as follows: 8. On or about March 12, 2012, Respondent?saw Patient A as a new referral for back, pain. Patient A was a 22-year-old male who had back pain since 2011. Patient A?s medication A list at the time was Naproxen, Vicodin, Baclofen for back pain. Respondent documented I ?Patient A had right lumbar pain February, 2011, right thigh tingling with foot numbness August, 2011, with Emergency Department visit and dector?s visit in Castro Valley.? He noted- . negative x-ray September, 2011. He circled "No" on ETOH use. Respondent?s assessment'was with HNP With impingement, with radiculitis, without radiculopathy." Respondent documented his plan was "long discussion with diagram. model re: Dx, pathophysiology, 1 All patients will be identi?ed in discovery. 4 (DANIEL GEORGE CLARK, MD.) ACCUSATION NO. 300?2017?03 3242 treatment option. No surgical intervention. Refer for epidural. Add Neurontin 800, taper to 2 TID. DC Vicodin. Add Fentanyl 50 q3d I 9. Respondent advised Patient A to stop taking Hydrocodone-Acetaminophen 5/325, and prescribed Duragesic (Fentanyl) at 50 meg/hr, qty 10. Patient A last ?lled a prescription for Hydrocodone~Acetaminophen 5/325 on February 28, 2012, qty 60. 10. On or about March 20, 2012, Patient A ?lled a prescription from another provider for Hydrocodone- Acetaminophen 10/325, qty 30. 11. On or about March 23, 2012, Respondent saw Patient A for a follow up visit. Respondent documented ?leg pain signi?cant 1. Back pain? no bene?t with Fentanyl, stiff pain with each step.? Respondent circled ?Yes? use. Respondent documented his assessment as with 1 radiculitis." Respondent documented his plan Was Fentanyl 50- 00.#10, epidural referral." 12. Respondent increased Patient A?s Duragesic (Fentanyl) prescription to 100 meg/hrabout April 2, 20-12, Respondent documented that Patient A had died.? 14.. Respondent committed gross negligence in his care and treatment of Patient A in that he prescribed? a long acting'opioid, Duragesic .patch for a patient at a signi?cant increased dose during the ?rst visit and doubled the dosage two weeks later, while Patient A still possessed at least half of the supply of the previous dosage. SECOND CAUSE FOR DISCIPLINE (Excessive Prescribing-Patient A) 15. Respondent is subject to disciplinary action under sections 2234, and 725 in that he excessively prescribed Duragesic in his care and treatment of Patient A. The circumstances are as follows. Paragraphs 8 through 14, above, are hereby inCorporated by reference and realleged as if fully set forth herein. 1 5 (DANIEL GEORGE CLARK, MD.) ACCUSATION NO. 800-2017-033242 PRAYER WHEREFQRE, 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. Revoking or suspending Physician' and Surgeon' 3 Certi?cate No. A 23338, issued to Daniel George Clark, M. D., 2. Revoking, suspending or denying approval of Daniel George Clark, M. authority - to- supervise physician assistants and advanced practice nurses; I 3. Ordering Daniel George Clark, M. D., if placed on probation, to pay the Board the costs of probation monitoring; and - 4. Taking such other and further action as deemed necessary and proper. DATED: October 22, 2018 KIMBERLY IRCHMEYER Executive Di e-ctor Medical Board of California Department Of Consumer Affairs State Of California Complainant SA2017306160 3361l105.docx 6 (DANIEL GEORGE CLARK, MD.) ACCUSATION NO. 800-2017-033242