LII ?gwm XAVIER BECERRA Attorney General of California ALEXANDRA M. ALVAREZ . Supervising Deputy Attorney General JOSEPH F. MCKENNA . Deputy Attorney General State Bar No. 231195 600 West Broadway, Suite 1800 San Diego, California 92101 P.O. Box 85266 FILED . STATE OF CALIFORNIA MEDICAL BOARD OF CALIFORNIA . SACRAJVIETO I -. 2018. - ANALYST. San Diego, California 92186-5266 Telephone: (619) 73 8-941 7 Facsimile: (619) 645-2061 Attorneys for Complainant . BEFORE THE NIEDICAL BOARD OF CALIFORNIA DEPARTMENT OF CONSUMER AFFAIRS STATE OF CALIFORNIA In the Matter of the Accusation Against: Case No. 800-2017-035844 Ronald David Richmond, MD. A A I 26991 Crown Valley Parkway Mission Viejo, California 92691?6528 Physician?s and Surgeon?s Certi?cate No. G74763, Respondent: I a Complainant alleges: PARTIES - 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. 2. On or about July 23, 1992, the Medical Board issued Physician?s and Surgeon?s Certi?cate No. G74763 to Ronald David Richmond, 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 expire on July 31, 2020, unless renewed. 1 (RONALD DAVID RICHMOND, MD.) ACCUSATION NO. 800-2017-035 844 This Accusation is brought before the Medical Board of California (Board), Department of Consumer Affairs, 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 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 andr?equired to pay the costs of probation monitoring, be publicly ?reprimanded which may include a requirement that the licensee complete relevant educational courses, or have such other action taken in relation to discipline as the Board deems proper. 5. Section 2234 of the Code states, in relevant 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, assisting in or abetting the violation of, or conSpiring to violate any provision of this chapter. 7 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. Unprofessional conduct under section 2234 of the Code is 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 un?tness to practice medicine. (Shea v. Board of Medical Examiners (1978) 81 Cal.App.3d 564, 575.). 7. Section 2242 of the Code states: I Prescribing, dispensing, or furnishing dangerous drugs as de?ned in I I 2 (RONALD DAVID RICHMOND, MD.) ACCUSATION NO. 800?2017-035844 10 ll 12 '13Section 4022 without an appropriate prior examination and a medical indication, constitutes unprofessional conduct. No licenSee shall be found to have committed unprofessional conduct within the meaning of this section if, at the time the drugs were prescribed, dispensed, or furnished, any of the following applies: The licensee was a designated physician and surgeon or podiatrist serving in the absence of the patient?s physician and surgeon or podiatrist, as the case may be, and if the drugs were prescribed, dispensed, or furnished only as necessary to maintain the patient until the return of his or her practitioner, but in any case no longer than 72 hours. The licensee transmitted the order for the drugsto a registered nurse or to . a licensed vocational nurse in an inpatient facility, and if both of the following conditions exist: The practitioner had consulted with the registered nurse or licensed vocational nurse who had reviewed the patient?s records. practitioner was designated as the practitioner to serve in the absence of the patient?s physician and surgeon or podiatrist, as the case may be. The licensee was a designated practitioner serving in the absence of the patient?s physician and surgeon or podiatrist, as the case may be, and was in possession of or had utilized the patient?s records and ordered the renewal of a medically indicated prescription for an amount not exceeding the original prescription in strength or amount or for more than one refill. 8. The licensee was acting in accordance with Section 120582 of the, Health and Safety Code.? 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 i 3 (RONALD DAVID RICHMOND, MD.) ACCUSATION NO. 800-2017-035844' OOQONUI-FUJN 10 11 12 13 14 '15Section 4022 of the Code'states: ??Dangerous drug? or ?dangerous device? means any drug or device unSafe for self-use in humans or animals, and includes the following: Any drug that bears the legend: ?Caution: federal law prohibits dispensing Without prescription,? ?Rx words of similar import. Any device that bears the statement: ?Caution: federal law restricts this device to sale by or on the order of a . ?Rx' only,? or words of similar import, the blank to be ?lled in with the designation of the practitioner licensed to use or order use'of the device. I Any other drug or device that by federal or state law can be'lawfully dispensed only on prescription or furnished pursuant to Section 4006.? FIRST CAUSE FOR DISCIPLINE (Gross Negligence) 10. Respondent has subjected his Physician?s and Surgeon?s Certificate No. G74763 to disciplinary action under sections 2227 and 2234, as de?ned in section 2234, subdivision of the Code, in that Respondent committed gross negligence in his care and treatment of Patient .Alv as more particularly alleged hereinafter: 11. Between in or around 2010, through in or around 2012, Respondent saw Patient A as her primary care physician.2 Respondent treated Patient A for a number of medical conditions including, but not limited to, chronic neck pain and insomnia. Patient A also had a long and documented history of severe alcoholism. 12. Respondent routinely prescribed zolpidem and alprazolam to Patient A despite the risks- posed by prolonged use of these controlled medications including, but not limited to, dependency, abuse, and addiction. Moreover, Respondent did not refer this patient for therapy or. other treatment modalities to address her severe alcoholiSm. 1? Letters A and are used for the purposes of maintaining patient con?dentiality. 2 Conduct occurring more than seven (7) years from the ?ling date of this Accusation is for informational purposes only and is notalleged as a basis for disciplinary action. 4 (RONALD DAVID RICHMOND, MD.) ACCUSATION NO. 800-2017-035844 .pwtxl3. Respondent, notwithstanding his knowledge of Patient A?s severe alcoholism, issued prescriptions to this patient for zolpidem and alprazolam on multiple dates including, but not limited to, November 5, 2011, November 27, 2011, December 4, 2011, December 21, 2011, and January 23, 2012. 14. Respondent committed gross negligence in his care and treatment of Patient A including, but not limited to, the following: i A Respondent routinely prescribed zolpidem and alprazolam without referring Patient A for treatment of her alcoholism. 15. Between in or around 2011, through in or around 2017, Respondent routinely prescribed controlled substances to family members including, his wife, daughter, Son, and father. Signi?cantly, Respondent did not have a physician-patient relationship with either of these family members, and he did not perform a relevant history and examination prior to prescribing them controlled substances. In addition, no medical records were maintained in connection with the issuance of these prescriptions documenting a proper indication and/or recording periodic monitoring of the use of the controlled substances prescribed to family members by Respondent. 16. Respondent committed gross negligence in prescribing controlled substances to his family members including, but not limited to, the following: Issuing multiple prescriptions for controlled substances to family members Without having a physician?patient relationship; and Issuing multiple preScriptions for controlled substances to family members without documenting a proper indication and/or recording periodic monitoring of the use of the prescriptions. SECOND CAUSE FOR DISCIPLINE (Repeated Negligent Acts) 17. Respondent has further subjected his Physician?s and Surgeon?s Certi?cate No. G74763 to disciplinary action under sections 2227 and 2234, as de?ned in section 2234, subdivision of the Code, in that Respondent committed repeated negligent acts .in his care and treatment of Patients A and B, as more particularly alleged hereinafter: 5 (RONALD DAVID RICHMOND, M.D.) ACCUSATION NO. 800-2017?035844 AWN 18. Patient A Paragraphs 10 through 14, above, are hereby incorporated by reference and realleged as if fully set forth herein. 19. Patient i . I Between in or around 2010, through in or around 2012, Respondent saw Patient as his primary care physician. Respondent treated Patient for a number of medical conditions including, but not limited to, chronic back pain. Respondent, despite prescribing controlled substances to Patient for chronic back pain, did not document in the patient?s medical record any diagnostic testing, orthopedic referral(s), and/or .referral(s) for physical rehabilitation. 20. Respondent committed repeated'negligent acts in his care and treatment of Patient including, but not limited to, the following: Respondent failed to document in Patient B?s medical record any diagnostic testing, orthopedic referral(s), and/or referral(s) for physical rehabilitation. I THIRD CAUSE FOR DISCIPLINE (Prescribing Dangerous Drugs Without an Appropriate Prior Examination and/or Medical Indication) 21. Respondent has further subjected his Physician?s and Surgeon?s Certi?cate No. G74763 to disciplinary action under sections 2227and 2234, as de?ned in sections 2242 and 4022, of the Code, in that Respondent prescribed, dispensed, or furnished dangerous drugs wIthout an appropriate prior examination and/or medical indication to family members including, his wife, daughter, son, and father, as more particularly alleged in. paragraphs 15 and 16, above, which are hereby incorporated by reference and realleged as if fully set forth herein. 7 FOURTH CAUSE FOR DISCIPLINE (Failure to Maintain Adequate and Accurate Medical Records) 22. Respondent has further subjected his Physician?s and Surgeon?s Certi?cate No. G74763 to disciplinary action under sections 2227 and 2234, as de?ned in section 2266, of the Code, in that Respondent failed to maintain adequate and accurate records in connection with 6 (RONALD DAVID RICHMOND, M.D.) ACCUSATION NO. 800-20 17?035 844 issuing prescriptions to family members and his care and treatment of Patient B, as more particularly alleged. in paragraphs 15, 16, 19, and 20, above, which are hereby incorporated by reference and realleged as'if fully set forth herein. FIFTH CAUSE FOR DISCIPLINE (Unprofessional Conduct) 23. Respondent has further subjected his Physician?s and Surgeon?s Certificate No. G74763 to disciplinary action under sections 2227 and 2234 of the Code, in that Respondent has engaged 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 un?tness to practice medicine, as more particularly alleged in paragraphs 10 through 22, above, which are hereby incorporated by reference and realleged as if fully set forth herein. . PRAYER WHEREFORE, Complainant requests that a hearing be held on the matters-herein alleged, and thatfollowing the hearing, the Medical Board ofCalifomia issue a decision: Revoking or suspending Physician?s and Surgeon?s Certi?cate No. G74763, issued to Respondent Ronald David Richmond, I I 2. Revoking,'suspending or denying approval of Respondent Ronald David Richmond, I authority to supervise physician assistants pursuant to section 3527 of the?Code, and advanced practice nurses; 3. Ordering Respondent Ronald David Richmond, M.D., 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 necessary and proper. DATED: November ?1 2018 Executive Director Medical Board of California Department of Consumer Affairs State of California SD2018700653 Doc.No.71646605 Complainant .7. (RONALD DAVID RICHMOND, MD.) ACCUSATION NO. 800-2017-035844