XAVIER BECERRA Attorney General of California MATTHEW M. DAVIS Supervising Deputy Attorney General TESSA L. HEUNIS- Deputy Attorney General State Bar No. 241559 600 West Broadway, Suite 1800 San Diego, CA 92101 PO. Box 85266 San Diego,-CA 92186-5266 . Telephone: (619) 738-9403 Facsimile: (619) 645-2061 Attorneys for Complainant FILED STATE OF CALIFORNIA MEDICAL BOARD OF CALIFORNIA SACRAMENTO iggb 20 BEFORE THE MEDICAL BOARD OF CALIFORNIA DEPARTMENT OF CONSUMER AFFAIRS STATE OF CALIFORNIA In the Matter ofthe Accusation Against:' hAlyn Gary Anderson, M.D., 17822 Beach Boulevard, Ste. 166 Huntington Beach, CA 92647 Physician?s and Surgeon?s Certificate No. A 25674, Respondent. ACCUSATION Complainant alleges: PARTIES - Case No. 800?2017?03 1071 . ANALYST 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 October 24, 19.73, the Board issued Physician?s and Surgeon?s Certi?cate No. A 25674 to Alyn Gary Anderson, 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 October 31, 2019, unless renewed. 1 (ALYN GARY ANDERSON, MD.) ACCUSATION-NO. 800-2017r031071 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 (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 one year upon order of the board. I I i Be placed on probation and be required to pay the costs of probation monitoring upon order of the board. - i A Bepublicly 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. 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 ofthis article, unprofessional conduct includes, but is not limited'to, the following: . i Violating Or attempting to Violate, directly or indirectly, assisting in orabetting the violation of, or c0nSpiring to violate any provision of this chapter. . 2 (ALYN GARY ANDERSON, MD.) ACCUSATION No. 800-2017-031071 Repeated negligent acts. To be repeated, there must be M0 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. 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.? . 7. Section 2241.5 of the Code states: I A physician and surgeOn may prescribe for, or dispense or administer. to, a person under his or her treatment for a medical condition dangerous drugs or prescription controlled substances for the treatment of pain or a condition causing pain, including, but not limited to, intractable pain. No physician and. surgeon shall be? subject to disciplinary action for prescribing, dispensing, or administering dangerous drugs or prescription controlled substances in accordance with this section. This section shall not affect the power of the board to take any action described in Section 2227 against a physician and surgeon who does any of the following: i Violates subdivision or of Section 2234 regarding gross negligence, repeated negligent acts, or incompetence. CG *3 (ALYN GARY ANDERSON, ACCUSATION NO. 300-2017-03?1071 42-bitPrescribes, administers, or. dispenses in violation of this chapter, or in violation of Chapter 4 (commencing with Section 11150) or Chapter 5 (commencing with Section 11210) of Division 10 of the Health and Safety Cede. A physician and surgeon shall exercise reasonable care in determining whether a particular patient or condition, or the complexity of a patient?s treatment, including, but not 1 limited to,? a current or recent pattern of drug abuse, requires consultation with, or referral to, a more quali?ed specialist. CC 59 8. Section?4021 of the Code states: ??Controlled substance? means any substance listed in Chapter 2- (commencing with Section 11053) of Division 10 ofthe Health and Safety Code.? 9. Section 4022 of the Code states: I ??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 only,? or words of similar import. Any other drug or device that by federal or state law can be lawfully dispensed only on prescription or furnished pursuant to Section 4006.? i I FIRST CAUSE FOR DISCIPLINE (Repeated Negligent Acts) 10. Respondent is subject to disciplinary action under sections 2227 and 2234, as de?ned by section 2234, subdivision (0), of the Code, in that he committed repeatedlnegligent acts in his care and treatment of Patient as more particularly alleged-hereinafter: 1 ?Patient is used to protect the patient?s privacy. 4 (ALYN GARY ANDERSON, M.D.) ACCUSATION NO. 800-2017-031071 .23, 24 25 26 27 28 11. Respondent was the primary care physician of Patient A from 2008 through approximately February 23, 2013 (?the treatment period?). 2 12. During the treatment period, Patient A also saw a and a pain management . physician from time to time. However, respondent was the main prescriber of Patient A?s medications. I 13. A report, shows that from at least on or about November 29, 2010, through the end of the treatment period, respondent routinely prescribed to Patient A a combination of Hydrocodone Bitrartrate Acetaminophen? (at least six (6) 325mg/ 10mg tablets per day), and I Alprazolam5 (at least four (4) 2mg tablets per day). In addition, respondent prescribed to Patient A either Oxycodone HCL-Acetaminophen6 500mg/7.5mg, or Hydromorphone HCL7 2mg. From at least on or about July 30, 2012, through the end of the treatment period, respondent added a prescription for Patient A for Carisoprodol8 (at least three (3) 350mg tablets per day). 14. A review of Respondent?s medical records for Patient A shows diagnoses listed with no plans to address them, and no rationale provided for actions taken. 2 Conduct occurring outside the statute of limitations period is for informational purposes only and is not alleged as abasis for disciplinary action. 3 Controlled Substance Utilization Review and Evaluation System, compiled by the California Department of Justice, Bureau of Criminal Identi?cation and Investigative Services as part of its Prescription Drug?Monitoring Program. 4 Hydrocodone Bitartrate Acetaminophen is a controlled substance pursuant to Health and Safety Code section 11056, subdivision (6), and a dangerous drug pursuant to Business and Professions Code section 4022. 5 Alprazolam is a, Schedule IV controlled substance pursuant to Health and Safety Code section 11057, subdivision and a dangerous drug pursuant to Business and Professions Code section 4022. . '6 Oxycodone is a Schedule II controlled substance pursuant to Health and Safety Code section 11055, subdivision and a dangerous drug pursuant to Business and Professions Code section 4022. It is combined with acetaminophen in medications such as Percocet. 7 Hydromorphone is a SChedule II controlled substance pursuant to Health and Safety Code section 11055, subdivision and a dangerous drug pursuant to Business and Professions . Code section 4022. I 8 Carisoprodol is a Schedule IV drug under the Uniform Controlled Substances Act, and a dangerous drug pursuant to Business and Professions Code section 4022. 5 (ALYN GARY ANDERSON, ACCUSATION NO. 800-2017-031071 10 11 12 13' 14 15 16'26' 27 28 15. Patient A?s records contain no explicit treatment plan, with stated objectives, by . whiCh the plan can be evaluated andfor adapted. Instead, Respondent appears to have changed Patient A?s pain medication periodically, without discussing or contemplating other treatment modalities. 16. Respondent?s medical records for Patient A also give no indication that Respondent discussed with Patient A the risks and bene?ts of the controlled substances he prescribed, versus other treatment modalities. i 17. On or about February 12,- 2013, Patient A was hospitalized for alprazolam Withdrawal. According to the hospital records, Patient A had been taking extra alprazolam due to stressful situations at home, and ran out of the medication two to three days before admission. Patient A Was discharged from-the hospital on or about February 13, 2013, with a prescription for 30 alprazolam 2mg tablets. I 18. After discharge, Patient A followed up with respondent on or about February 18, 2013. Respondent did not discuss with Patient A her misuse of alprazolam and/or address her suboptimal management cf her anxiety that led to that misuse. Respondent did not refer Patient A back to her but gave her a new prescription for 120 alprazolam 2 mg tablets. According to a CURES report for the relevant period, Patient A ?lled this newprescription on or . about February 20, 2013. 7 19. On or about February 23, 2013, there were 79 of the 120 alprazolam tablets remaining. 20. Respondent committed repeated negligent acts in his care and treatment of Patient A which include,- but are not limited to: Failing to document atreatment plan; Failing to provide informed consent; (0) Failing to address Patient A?s misuse of alprazolam, modify treatment accordingly and/ or refer back to and Failing to maintain accurate and adequate records. mi I 6 (ALYN GARY ANDERSON, MD.) ACCUSATION NO. 800-2017-031071 4:14?25 26' ?27 28. SECOND CAUSE FOR DISCIPLINE (Failure to Maintain Adequate and Accurate Records) 21. Respondent is further subject to disciplinary action under sections 2227_and 2234, as de?ned by section 2266, of the Code, in that he failed to maintain adequate and accurate records relating to the provision of services to Patient A. The circumstances are set forth in paragraphs 11 through 20, above, which are hereby incorporated by reference and realleged as if (fully set forth herein. A 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. Revoking or suspending Physician?s and Surgeon?s Certi?cate No. A 25674, issued to Alyn Gary Anderson, M. D. I 2.7 Revoking, suspending or denying approval of Alyn Gary AndersOn, M. D. authority to supervise physician assistants and advanced practice nurses; 3. Ordering Alyn Gary Anderson, M.D., ifplaced 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: December 6, 2018 KIRCHMEYER Executive irector Medical Board of California Department of Consumer Affairs State of California Complainant SD2018702228 71668600.docx 7 1 (ALYN GARY ANDERSON, MD.) ACCUSATION NO. 800-2017-031071