CONSUMER SERVICES. AND lloL'ert; AGENCY Departmento/Coaiamermairr 20mm) 6. snow 00.. Governor MEDICAL BOARD OF CALIFORNIA Central Complaint Unit December ll, 20l7 Ako Alimayou Jacintho, MD Patient. Control Number: Dates of Service: Dear Dr. The Medical Board of California (Board) is in receipt of a complaint regarding the care and treatment provided to the above named patient. Pursuant to the provisions of Section some) of the Business and Professions Code, we are providing a comprehenslve summary of the complaint filed against you, The complaint alleges the following- I 'car old male died -- from acute combined methadone and intoxitati..n Lust pi-estription of methadone 10 mg was on 03/20/2012 Ior #240, with prior prestriptinn for iitrthadone on 01/19/2012 for #150. It is unknown what medical conditions the patient suflel'ed to receive such meditation. Pursuant to Section ofthe Business and Professions Code, the Board is required to provide you with an opportunity to respond to the allegations noted above. As such, in accordance with the enclosed Authorization for Release ofMedical Information form, please provide a Written summary ofthe care and treatment rendered to this patient and a copy of your curriculum vitae. You may also provide any additional expert testimony or literature which you feel would be pertinent to the Board in evaluating this complaint. In addition to the above, please forward a CERTIFUED copy of the patient's medical records, including diagnostic images if applicable, to the Board Please complete the enolosed Certification of Records/Declaration ofCustodian of Records to certify that the reeords are a "true copy" and a complete set and return it with the records to the address shown below it would he appreciated if you would also include a copy ofthis letterwith your response. Pursuant tuBusiness and Professions Co 'on 2225(e) and 2225.5 (copy enclosed), failure to produce the records lay the date requested 'ta 'on and fine or assessment ofoivil penalties om 000 per day. The records, summary and copy of your curriculum vitae are to he provid by 01/08/2017. Plea send this material to the attention of: Erika Calderon Medical Board of California 2005 Evergreen St., Suite 1200 Sacramento, CA 95815-3831 MioC.Ut 2005 Evergreen Street. Suite l200, Sacramento, CA (915) 26372528 - FAX (91026372435 - mite ca gov Page 1 2 The Medical Board of California is a regulatory law enforcement agency requesting these records for con?dential review. If you have any questions, please feel free to contact me. Thank you for your cooperation in this matter. Sincerely, Eril?Celeeon Consumer Services Analyst 916-263-2453 Enclosures: Authorization for Release of Medical Information Business and Professions Code Section 2225.5 Declaration of Custodian of Records/Certi?cation of Records NOTICE: A licensee that fails to provide the certi?ed medical records within 15 days, or a health care facility within 30 days, of receipt of a request for certified, medical records may constitute a violation of Section 2225.5 of the Medical Practice Act and may result in a civil penalty of 31,000 per day for each day that the documents have not been produced. ?Certi?ed medical recards? is defined as ?a copy of the patient?s medical records authenticated by the licensee or health care facility, as appropriate, on a form prescribed by the board.? - ?2005 Evergreen Street Suite 1200, Sacramento, CA 958153831 (916) 263'2528 FAX: (916) 263'243-5