1 2 3 4 5 6 Duane A. Admire (Bar No. 173699) Email: duaneadmire@outlook.com ADMIRE & ASSOCIATES 12880 Carmel Country Road, Ste D110 San Diego, CA 92130 Telephone: (858) 350-5566 Facsimile: (858) 350-1046 Attorney for Respondent, ADAM F. DORIN, M.D. 7 8 BEFORE THE 9 MEDICAL BOARD OF CALIFORNIA 10 DEPARTMENT OF CONSUMER AFFAIRS 11 STATE OF CALIFORNIA 12 13 In the Matter of the Accusation Against Case No. 800-2013-000930 OAH No. 2015120747 ADAM F. DORIN, M.D. DECLARATION OF DUANE A. ADMIRE IN OPPOSITION TO NON-PARTIES MOTION FOR ORDER RE INJUNCTION; WRIT OF POSSESSION AND/OR PROTECTIVE ORDER 14 15 16 17 18 19 Respondent. Motion Hearing Date: 8/26/16 10:30 am 20 21 22 23 24 25 26 27 I, DUANE ADMIRE, declare: 1. I am an attorney licensed to practice before the courts of the State of California. I am an attorney at the law firm of Admire & Associates, attorney for Claimant, in this action and have personal knowledge of these facts. If called upon to testify, I would testify as follows: 2. All of the statements in the attached Opposition to Motion for injunction; writ of possession and/or protective order are true, except as to those matters stated on information and belief, and as to those matters, I believe them to be true. 1 1 3. On Saturday May 7, 2016, after receiving a request from KPBS reporter Cheryl Clark 2 asking me to specifically tell her how many video clips Sharp had showing Dr. DORIN 3 removing drugs from the carts, I began again reviewing Sharps discovery more thoroughly. 4 Prior to May 2016, I had only reviewed items from the Attorney General’s office and very 5 briefly the material Sharp had produced along with the thumb drive of videos—I may have 6 7 8 9 10 11 12 13 14 15 16 started reviewing the videos at times, but never to any real extent and had not taken any notes. 4. Upon receiving Sharp’s discovery on November 11, 2015, on that very day, I did provide a copy of Sharp’s response to our subpoena (which included a copy of the videos and documents) via email to my client Dr. Dorin and my law partner Dr. John Alexander, M.D., J.D. Sharps response to our subpoena, was uploaded on my work and laptop computer, both of which have multiple online and local hard drive back-ups. I only recalled that I emailed them the contents some days after giving back the drive to Ms. Carder and then went back through my emails to confirm that I had in fact on November 11, 2015 copied sent a copy to my client and law partner. 5. On May 7, 2016, in an attempt to respond to Ms. Clark’s questions, as well as to 17 thoroughly go through the evidence against my client, I began watching the video clips Sharp 18 had produced and taking notes on what they contained. The task was monotonous as there was 19 no way to easily fast forward through the clips on the video viewer I used, so I simply skipped 20 through them, mainly concentrating on anybody who was near the anesthesia cart, looking for 21 evidence that could be used for or against my client. 22 6. During my review, I noted multiple occurrences of what I believed was exculpatory 23 video evidence. I also came upon a clip that didn’t appear to have Dr. Dorin as one of the doctors 24 and there was a patient being treated, which raised my suspensions that possibly that clip was 25 26 27 included in error. The vast majority of the clips that I viewed did not contain patients and almost all of them included Dr. Dorin as the anesthesiologist. I then came upon a few clips back to back that continued to contain patients. I then decided to cease watching the clips and resolved in my 2 1 mind to contact Rick Barton (Sharps Attorney) to discuss if some of these clips were given in 2 error. 3 7. I did not view the majority of the clips. As to the ones that I did view, I skipped 4 through the majority of those clips. To put things in perspective, Sharp gave me a total of 77 5 video clips of varying length. Almost all of the ones I viewed had Dr. Dorin in them. Sharp now 6 7 8 9 10 11 12 13 14 15 16 claims that 14 patients were included in the 77 clips. 8. Thereafter on the same day, Saturday, May 7, 2016, I responded via email to Ms. Clarks questions and informed her that I first indeed did want to talk to any patients that believed they were in those videos and I still do, as I believe those videos will contain further exculpatory evidence for Dr. Dorin’s benefit—namely him using drugs he had placed in shirt pocket during the procedures. I secondly informed Ms. Clark that I couldn’t answer hear questions as to the exact number of videos, as I discontinued viewing the videos as I had seen clips of patients and believed they were given in error and told her I was going to contact Mr. Barton to determine if they were given in error (See Exhibit F). 9. On Monday, May 9th, 2016, before I could clear my schedule to make contact with 17 Mr. Barton, I received a call from him about the issue as Ms. Clark had apparently contacted him 18 directly via email after I emailed her letting her know I was not going to watch all the videos as I 19 believed some of the videos may have been given in error. 20 10. On the following day, Tuesday, May 10, 2016, I personally delivered the thumb drive 21 back to Mr. Barton’s office. I have not watched all the videos that Sharp provided. I did not 22 share the thumb drive with anybody and nobody outside our firm other than my client has ever 23 seen any of these videos. 24 25 26 27 11. During that time period, I was receiving calls from reporters asking if the patients were visible in the videos during their procedures. These reporters had told me that Sharp was claiming the patients were not visible or identifiable in the videos. Since that was not the case, I decided to take a screen shot of an empty operating room, which I then converted to a pdf file on Sunday, May 8, 2016. This pdf is attached hereto as Exhibit G. I also shared this pdf with News 3 1 reporters, including Wendy Fry from NBC, as she was specifically requesting that I prove that 2 patients were visible in the background of the video, as she informed me that Sharp had told 3 them there were not. Despite her requests, I declined to share any video with patients and told 4 her the still shot of the empty operating room was all I was willing to share. 5 6 7 8 9 10 11 12. I showed this picture to Ms. Carder as we discussed that Sharp had told the press that the patients were either not in the view of the camera or not identifiable. In either event, the only photo I had on my phone was that pdf which is attached as Exhibit G. 13. Although I only viewed bits of the video provided, I did find and make notes of several clips that show exculpatory evidence: • room and removes a bottle of medication from the top drawer of the anesthesia cart 12 and then immediately leaves the room. 13 14 • 17 pocket. • something in her left front pants pocket as she leave the room. In that clip, the 19 camera does not show her entering the room and only shows the back of her head as 20 22 23 24 25 26 Also on April 3rd, 2013 an unidentified female was bending down in front of the anesthesia cart—she then stood up abruptly in front of the cart and appears to put 18 21 On another clip from April 3rd, 2013 shows Dr. Dorin entering the room he then empties his front pocket back into the anesthesia cart and leaves with an empty front 15 16 On a clip from April 3rd, 2013 an unidentified male who is NOT Dr. Dorin enters the she leaves. • On March 27th, 2013 a doctor other than Dr. Dorin places something from the anesthesia cart into his front left pocket. • On April 22nd, 2013 two doctors are seen who are not Dr. Dorin and one of the doctors at the anesthesia carts puts items that appear to be medication into his front pocket on at least two occasions during the video clip. 27 4 1 14. It is clear from the videos viewed that Dr. Dorin and other anesthesiologist regularly 2 use their front upper pocket of their scrubs to put medications, syringes, supplies etc., in and 3 there are multiple instances of them putting drugs in and taking drugs out of their shirt pockets. 4 5 15. Attached to the Notice of Lodgment herein are true and correct copies of items as described: 6 7 8 EXHIBIT NO. A. 10/29/2013 Letter from Sharp to the Medical Board of California B. 5/16/2016 Open letter to the Public from Dr. Patrick Sullivan which was downloaded by clicking on a link from Exhibit 9 of Respondents NOL C. 5/19/2016 news article which is A clearer a copy of the same Exhibit 9 filed with Respondents NOL. 13 D. 7/26/13 Letter from Sharp illustrating Dr. Dorin’s fitness to practice. 14 E. 9/9/2015 copy of the Dr. Dorins report from the National Practitioner Data Bank 16 F. 11/10/2014 Demand from the Medical Board for Testing of Dr. Dorin 17 G. 3/21/2013 photo of empty operating room from secret video camera H. 3/25/2016 Declaration of Carlisle Lewis I. 5/7/2013-5/9/2013 E-mail string between Cheryl Clark, Duane Admire and Rick Barton J. 8/1/2008 Union Tribune article relating to death at Sharp Hospital K. 7/27/2016 Deposition Subpoena for Business Records relating to Dr. Dorin’s files which would include the Sharp videos. 9 10 11 12 15 18 19 20 21 22 23 24 25 26 27 I declare under penalty of perjury under the laws of the State of California that the foregoing is true of my personal knowledge, except as to those matters which are therein stated 5 1 upon information and belief, and as to those matters, I believe it to be true. Executed at Del Mar, 2 California. 3 4 5 6 7 DATED: August 15, 2016 _____________/s/_______________ Duane A. Admire, Esq. Attorney for Respondent ADAM F. DORIN, M.D. 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 6 1 2 PROOF OF SERVICE Dorin, Adam F.—Office of Administrative Hearings 3 4 5 I am a resident of the State of California, over the age of eighteen years, and not a party to the within action. My business address is: 12880 Carmel Country Road, Ste D110, San Diego, CA 92130. On Augustl 15, 2016 I served the within documents: Declaration of Duane A. Admire, Esq. 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 x by transmitting via EMAIL the document(s) listed above to the EMAIL address(s) set forth below on this date before 5:00 p.m. by placing the document(s) listed above in a sealed envelope with postage thereon fully prepaid, in United States mail in the State of California addressed as set forth below. (witness list and exhibits put in U.S. Mail and sent via email as per agreement) by personally delivering the document(s) listed above to the person(s) at the address(es) set forth below. by placing a true copy thereof enclosed in a sealed envelope, at a station designated for collection and processing of envelopes and packages for overnight delivery by Express Mail by U.S. post office as part of the ordinary business practices of Admire & Associates LLP described below, addressed as follows: Petitioner Kamala D. Harris, Attorney General of California Alexandra M. Alvarez, Supervising Deputy Attorney General Jason Ahn, Deputy Attorney General 600 West Broadway, Suite 1800 San Diego, CA 92101 Tel. (619) 645.2093 Email: jason.ahn@doj.ca.gov Non-party SHARP Richard D. Barton (Bar No. 102613) E-mail: rick.barton@procopio.com Shelley A. Carder (Bar No. 137755) E-mail: shelley.carder@procopio.com Natalie V. Mueller (Bar No. 292714) E-mail: natalie.mueller@procopio.com PROCOPIO, CORY, HARGREAVES & SAVITCH LLP 12544 High Bluff Drive, Suite 300 San Diego, CA 92130 Telephone: 858.720.6300 Facsimile: 619.235.0398 27 I am readily familiar with the firm’s practice of collection and processing correspondence for mailing. Under that practice it would be deposited with the U.S. Postal Service on that same 7 1 2 3 4 5 day with postage thereon fully prepaid in the ordinary course of business. I am aware that on motion of the party served, service is presumed invalid if postal cancellation date or postage meter date is more than one day after the date of deposit for mailing in affidavit. I declare under penalty of perjury under the laws of the State of California that the above is true and correct. Executed on August 15, 2016, at San Diego, California. 6 ________________/s/________________ Duane Admire 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 8 EXHIBIT A .. .. 02::Eiil liiai I (ShrasstIKJIit flhospntal October 29, 2013 Medical Board of California Central Complaint Unit 2005 Evergreen Street, Suite 1200 Sacramento, CA 95 815 Re: Adam Dorin, MD. . . Physician License Number; (386440 Dear Medical Board: Dr. Adam Darin, a California licensed physician and an anesthesiologist, resigned his membership on the Grossmont Hospital Corporation medical sta?? on October 15, 2013. Grossrnont Hospital believes that although the of Dr. Dorin?s resignation do not require an 805 report to the California Medical Board, the Medical Board should .be aware of recent actions and conduct by Dr.- Dorin while a meniber of Grossmont Hospital?s medical staff. On April 9, 2013, Grossmont Herpital?s Medical Executive Committee was presented with infomation concemhtg Dr. Dorin?s apparent removal (on a number of occasions during 2013)'of propofol from anesthesia carts located in unoccupied operating rooms. Due to concerns about the potential for substance abuse and the uneXplained taking (and use) of the removed propofol, the MEC summarily suspended Dr. Dorin?s clinical privileges that day. The MEC met with Dr. Darin on April 10, 2013. After interviewing Dr. Dorin and receiving other information?, the MEC determined there was . no reasonable likelihood of substance abuse by Dr. Dorin and terminated the summary, suspension. At that time the MEC also decided that Medical Sta?' leadership (the current, former and newly elected Chiefs of Staff) should investigate Dr. Dorin?s conduct with regard to the removal of the propofol from the operating room anesthesia carts and the subsequent use of that propofol. The Medical Staff Leadership conducted its investigation and reported its ?ndings to the MEC on June 11, 2013. At that time the MEC determined to end the investigation and issue DI. Darin a fonnal admonishment (no restriction on clinical privileges or medical In interviews. Dr. Dorln said it was his practice to have extra vials of propofol and certain other medications available on his person so that he could administer needed medications to patients on an emergent basis if the medications were not immediatew otherwise available. He also indicated that he would deposit unused vials of removed medications in anesthesia drug carts at various locations in the hospital. Dr. Darin said that he did not administer rammed drugs to himself and that he did not take the removed drugs from the hospital?s premises. Health Care System Since 1945 ?v no. 30): 158. La Mesa, California 91944-0158 ,l (619) 74045000 P. 002 .3081 -L aszs as 09 02:45 PM FAX No. P. 003 Medical Board of California October 29, 2013 - Page 2 of 2 staff membership). Dr. Dorin was informed of the formal admonishmenr by letter dated June 18, 2013. The conduct by Dr. Darin that led to the admonishment was: 1. Dr. Dorin?s failure to fully explain how medications (Speci?cally propofol) that Dr. Darin temo'Ved from operating room anesthesia drug carts at various times in 2013 were used, relocated or disposed. 2- Dr. Dorin?s initial denial that he removed medications (including prepofol) from anesthesia drug carts in unoccupied/inactive operating rooms in 2013. Dr. Dorie later admitted removing the propofol after being told that his actions 'were recorded on video tape. - The Board of Directors of Grossmont Hospital was informed of the actions with respect to Dr. Darin in June 2013. At its July 16, 2013, the Board of Directors voted to convene a Joint Conference Committee (composed of members of the Board of Directors and the Medical Staff Leadership) to discuss the decisions regarding'Dr. Darin. The Joint Conference Committee met several times in August and September 2013. On September 17, 2013, the Board of Directors voted to request that the MEC consult with the Board of Directors about reconsidering its discipline of Dr. Dorin (the letter of admonishment) and to instead revoke Dr. Dorin?s medical staff membership; it being?the sensc of the Board that Dr. Dorin?s conduct described above was potentially detrimental to patient safety and demonstrated a lack of integrity and honesty. Prior to the MEC consulting with the Board of Directors on the matter and without notice to Dr. Dorin of the Board of Director?s consultation request, Dr. Darin resigned his membership ?'om Grossmont Hospital?s medical staff on October 15, 2013. Dr. Dorin was on Grossrnont Hospital?s medical staff continuously from NoVember 19, 2002 to October 15, 2013. During that time, Dr. Dorin had not been the subject of any investigations or disciplinary actions prior to the investigation that led to the admonishment described above. Thank you for considering this information. Sincerely, . WJCMEL 0m lad Michele Tarbet Senior Vice President and Chief Executive Of?cer EXHIBIT May 16, 2016 An Open Letter to the Public My name is Dr. Patrick Sullivan, an anesthesiologist at Sharp Grossmont Hospital from June 19, 1994-Jan 15, 2016. I was Chief of the Anesthesia Department in 2008-2009 and Anesthesia Department representative to the Sharp Grossmont Women's Center and its Ob/Gyn Supervisory Committee for the past 19 years. I served in this capacity, because I spent more of my practice in the Women?s Center than any other anesthesiologist and probably spent more time there than any other individual, including administrators and Ob/Gyn physicians. I performed exactly 28,603 anesthetics at Grossmont Hospital, approximately 20,000 of them in the Women?s Center. I was privileged and honored that 20,000 or so mainly East County women put their faith and trust in me during my time there, and it was a pleasure to be a part of their lives and of some of the most precious moments of their lives. I got to know their families and developed relationships with many of them that are still ongoing. I have been specially requested to provide anesthesia for other doctors, hospital staff and their families literally hundreds of times. I spent over 2 decades of my life dedicating myself to the Women?s Center, introducing improvements, promoting quality of care and patient safety to the best of my ability, volunteering my time attending meetings and troubleshooting and resolving Women?s Center issues for the Anesthesia Department. I regularly communicated with the OB Anesthesiology Medical Directors and Chiefs of Anesthesia at Sharp Mary Birch and Sharp Chula Vista to coordinate Anesthesia policies and procedures. I sat on the selection committee interviewing candidates for the last 3 vacancies in the Sharp Grossmont Women's Center Director position and for 5 vacancies in the Manager position. Because of my extreme investment and involvement in the Women's Center, I can no longer stay silent about what is going on there. In my opinion, Sharp Healthcare and Sharp Grossmont Hospital have severely violated and betrayed the public trust of East County women and the East County community in general. The story so far has been focused on Dr. Adam Dorin, who has been accused of ?stealing anesthesia drugs?, mainly based on video clips of him putting drugs in the front pocket of his shirt inside an operating room. While the topics of narcotic abuse and healthcare employees taking drugs are currently riding a wave of national publicity making it easy to assume that anyone accused is guilty, I do not believe he is guilty of a drug diversion in any way whatsoever. I will explain below. Much more importantly, this diverts attention from the more important story, which is that the videos never should have been taken. In an extreme betrayal of trust, Sharp placed secret, hidden cameras in the WC operating rooms recording thousands of clips that we now know contain images of patients. According to Sharp, ?There are 6,966 images contained within the multitude of images of women undergoing operations of a very personal, private nature, unconscious and in states of In addition to these videos, there were 6 months more video clips (extrapolating that would be 14,000 more video clips) taken that supposedly ?were not retained by Sharp Grossmont Hospital.? It is public knowledge that during an Ob/Gyn procedure, women are often put in the lithotomy (also known as the legs spread apart) position while staff place prep sponges, catheters and instruments inside their genitalia. One can only imagine what might be on these video clips. To add insult to injury, multiple sources reported that the video clips were reviewed by a MALE Sharp security employee. East County women and national women?s groups should be fuming mad about this. When land several of the 0b/Gyn physicians and anesthesiologists discovered the existence of these cameras in March of 2013, we passionately complained to the Women?s Center Director and implored her to remove the cameras, but she refused. So instead, anesthesiologists protected patients by putting a piece of tape over the tiny cameras during surgeries until eventually one day they disappeared. Regarding Dr. Dorin, for the entire duration of Doctor Adam Dorin's ten year tenure as an anesthesiologist with Sharp, let me say unequivocally that he was an exceptionally good and highly valuable anesthesiologist on my team, with no adverse patient care issues of any kind, and never any indication of drug use, theft or diversion. The Women?s Center Director had been told repeatedly by me and others that the ?missing Propofol" could be explained by the fact that many anesthesiologists were taking Propofol from one area of the hospital to another, because there was a yearlong local and national shortage of Propofol, and Sharp could not procure enough Propofol to put patients to sleep in all areas of the hospital. There were literally times when patients were on the operating table with the surgeon ready and there was no Propofol to put them to sleep. It?s that simple. I witnessed many anesthesiologists coming from other operating rooms to get Propofol from the Women?s Center ORs because good patient care demanded it, and oftentimes the Women?s Center ORs were its only repository in the hospital. Alternative agents to Propofol do exist but have signi?cant side effects. Over the years, I firmly believe that many physicians were seen on film taking meds and supplies, as well as nurses and ancillary staff, for use in a neighboring OR or other patient care area. In addition, Dr. Dorin was a well known whistleblower, speaking out publicly about patient safety issues. Sharp's refusal (backed up by a judge) to turn over all video clips is a miscarriage ofjustice. All of the clips need to be turned over. Women who were viewed by the Sharp security employee and/or others have a right to see them in case they are entitled to damages. Dr. Dorin?s attorney has a right to see them to clear Dr. Dorin. find it odd that so many anesthesiologists took drugs out of the Women?s Center carts for patient use, but the only video clips Sharp will turn over are the ones showing the whistleblower taking drugs. East County women and the Grossmont Healthcare District Board should be outraged over this and should demand the following: 1. The immediate resignation of the Women?s Center Director, under whose supervision all of this occurred. 2. A subpoena for a 3rd party forensic computer investigator to search all of Sharp?s servers (including deleted files) for evidence of the missing 6 months of video clips. 3. An appeal of the court order denying the request that all 6,966 video clips be turned over to Dr. Dorin?s attorney. OR the subpoena could be modified to turn the video clips over to a lone female 3rd party agreed to by both attorneys. The tapes should be reviewed for any exculpatory evidence regarding Dr. Dorin. 4. An investigation by state and federal agencies. 5. Termination of the lease agreement between Sharp Healthcare and the Grossmont Healthcare District Board based on a breach of section 14.16 which states: ?Tenant shall operate the Hospital according to the best interests of the public health of the communities served by the La ndlord.? 6. A class action lawsuit brought by women of East County who were damaged by this. Sharp?s hypocrisy is astounding. Sharp is concerned about 14 videos they took that were released to an attorney, because of concern that they violated patient privacy. Why aren?t they concerned about the other multiple hundreds or thousands of clips that were reviewed by the Sharp security employee? Although well intended, Sharp took way, way too much liberty with this secret videotaping. Many innocent nurses and physicians working in the Women?s Center felt that their privacy was violated as well. Always at your service MAM Patrick G. Sullivan, M.D. EXHIBIT “inew&ource+produce&+provocative+and &timulating+inve&tigative+work.” -+Maggie+Me9er+ +Donor  About Topics Data Newsletter Support Us  ! ! Search... Truth Matters. Help us find it. Donate Now  inew%ource!i#!an!independent nonprofit!dedicated!to!#ati#f.ing!a need!for!credi0le,!in-depth,!datadriven!journali#m!on!the!we0,!radio and!TV. Operating+room+in+the+Women'&+Health+Center+of+; Cc:Carder, Shelley A. ; Mueller, Natalie N. ; Duane&'First,'I'apologize'for'any'profanity.'It'reflected'the'anger'that'Sharp'would'have'accusations'like'this'made before'you'ever'clarified'the'relevant'issue,'i.e.,'whether'patients'consented'to'having'photographs'and'videos'taken while'at'Sharp.'Second,'you'are'totally'confused'about'the'statements'made'in'our'papers'filed'in'support'of'the motion'to'quash.'Our'argument'to'the'OAH'was'that'dissemination*of*the*photos*or*videos*to*you'would'violate employees'and'patients’'rights.'The'court'agreed'with'this'in'its'rulings'on'both'the'original'motion'and'in'your motion'for'reconsideration. As'I'said,'my'outrage'is'that,'notwithstanding'our'good'relationship'over'these'years'and'your'nice'comments'to'Ms. Clark'about'me,'you'only'sought'the'high'road'on'this'after'setting'forth'incendiary'allegations'about'Sharp'in'the press.''As'I'also'said,'I'have'no'obligation'to'provide'you'with'any'information'regarding'patient'consents.'Your evidentiary'and'‘fruit'of'the'poisonous'tree”'arguments'are'for'the'court'to'decide,'not'the'media.'You'had'every opportunity'to'litigate'this'issue'in'your'motion. Please'return'to'our'office'the'flash'drive'and'anything'else'you'received'responsive'to'the'content'of'the'videos. Please'do'not'make'copies'and'please'do'not'disseminate'any'information'or'images'to'anyone.'We'will'clarify whether'the'information'you'received'is'the'same'as'what'was'provided'to'the'Medical'Board.'We'will'also'provide you'with'a'response'that'is'exactly'what'we'provided'to'the'Medical'Board'and'is'consistent'with'the'now,'multiple rulings'from'the'OAH.'Rick ! RICHARD D. BARTON PARTNER PROCOPIO P. 619.515.3299 rick.barton@procopio.com 525 B STREET, SUITE 2200, SAN DIEGO, CA 92101 [www.procopio.com]View Profile Linkedin procopio.com ' From: Duane Admire [mailto:duaneadmire@outlook.com] Sent: Monday, May 09, 2016 3:40 PM To: Barton, Richard D. Subject: Re: speaking with the press Rick:' ' Sorry'we'ended'up'yelling'at'each'other'over'the'phone.''However,'if'you'have'any'ability'to'either'show'me'a consent'for'such'secret'video'or'some'type'of'law'that'doesn't'require'a'patients'consent,'I'will'let'anybody with'the'media'knows'that'calls'me.''Simply'yelling'that'I'don't'know'what'the'Fuck'I'm'talking'about just'pisses'me'off'and'makes'me'want'to'call'the'press'directly!''Thanks,'Duane ' From:'Duane'Admire' Sent:'Monday,'May'9,'2016'3:13'PM To:'rick.barton@procopio.com Subject:'email'to'Cheryl ' On'May'7,'2016,'at'9:23'PM,'Duane'Admire''wrote: ' Cheryl: ' Thanks'for'the'questions.'Your'questions'sparked'further'information'I'was'unaware'of'as discussed'below.' ' First,'I'also'would'like'to'talk'to'any'patients'that'believe'they'were'in'any'of'those'operating rooms'during'the'timeframe,'please'send'them'my'number'and'ask'them'to'please'call'me.'' ' Secondly,'in'order'answer'your'questions'about'how'many'clips'were'given'to'us,'I'decided'to'go back'and'review'the'flash'drive'that'was'provided'to'our'office'and'presumably'the'Medical Board.''I'have'just'stopped'reviewing'it'as'I'have'now'found'some'files'within'files'and'can'only assume'they'gave'us'these'clips'in'error.''I'have'now'in'my'brief'review'of'these'additional'files'on the'flash'drive'(and'without'going'though'the'vast'majority'of'them)'found''multiple'clips'of women'undergoing'surgery.''Of'the'first'four'patients'that'I'happened'to'view'before'I'quit'and decided'to'figure'out'how'best'to'deal'with'the'problem,'discovered'that'two'of'the'women patients'were'not'under'anesthesia&&as'one'of'them'walked'into'the'operating'room,'another'you can'clearly'see'was'adjusting'herself'and'her'hair'cap'etc.,'and'the'other'two,'did'seem'to'be under'anesthesia.''As'for'what'to'do'about'this,'I'm'a'bit'unsure.''I'happen'to'know'and'have'had several'cases'over'the'years'against'Rick'Barton'(he'is'the'partner'from'Procopio'that'represents Sharp'on'their'motion'to'quash,'I'will'make'contact'with'him'next'week'and'discuss'how'we should'handle'their'disclosure&&I'm'sure'he'is'unaware'that'they'sent'these'clips&&I'know'Mr. Barton'and'trust'and'respect'him'and'believe'he'will'be'able'to'handle'this'with'his'client'Sharp). ' mailgw01.procopio.com made the following annotations --------------------------------------------------------------------Mon May 09 2016 17:15:56 This is an email from Procopio, Cory, Hargreaves & Savitch LLP, Attorneys at Law. This email and any attachments hereto may contain information that is confidential and/or protected by the attorney-client privilege and attorney work product doctrine. This email is not intended for transmission to, or receipt by, any unauthorized persons. Inadvertent disclosure of the contents of this email or its attachments to unintended recipients is not intended to and does not constitute a waiver of attorney-client privilege or attorney work product protections. If you have received this email in error, immediately notify the sender of the erroneous receipt and destroy this email, any attachments, and all copies of same, either electronic or printed. Any disclosure, copying, distribution, or use of the contents or information received in error is strictly prohibited. --------------------------------------------------------------------- EXHIBIT EXHIBIT 1 2 Richard D. Barton (Bar No. 102613) E-mail:rick.barton@procopio.com Shelley A. Carder (Bar No. Bar No.: 137755) E-mail:shelley.carder@procopio.com 3 PROCOPIO, CORY, HARGREAVES & SAVITCH LLP 4 5 12544 High Bluff Drive, Suite 300 San Diego, CA 92130 Telephone: 858.720.6300 Facsimile: 619.235.0398 6 Attorneys for non-party SHARP GROSSMONT HOSPITAL 7 8 BEFORE THE 9 MEDICAL BOARD OF CALIFORNIA 10 DEPARTMENT OF CONSUMER AFFAIRS 11 STATE OF CALIFORNIA 12 13 Case No. 800-2013-000930 OAH NO.: 2015120747 In the Matter of the Accusation Against DECLARATION OF CARLISLE LEWIS, III IN SUPPORT OF MOTION TO QUASH AND/OR FOR PROTECTIVE ORDER 14 15 ADAM F. DORIN, M.D. 16 17 [GOV. CODE §§11507.5 AND 11507.6; CIVIL CODE § 56 ET SEQ.; CODE OF CIVIL PROCEDURE §§2031.060 AND 2017.020(A); 45 C.F.R. §165.512;.§1026] Physician’s & Surgeon’s Certificate No. G86440, 18 Respondent. 19 20 1. Hearing Date: Oct. 17-21, 2016 I, Carlisle (“Ky”) C. Lewis, III, am the Senior Vice President and General Counsel 21 of Sharp HealthCare. I have personal knowledge of the matters set forth herein, except as to those 22 matters stated on information and belief and, as to those matters, I believe them to be true. If called 23 as a witness, I would competently testify to the same. 24 2. Sharp Grossmont Hospital (“SGH”) is one of the hospitals within the Sharp 25 HealthCare system. In or about May of 2012, SGH received a report that drugs were disappearing 26 from anesthesia cards in the three Women’s Health Center Operating Rooms. Accordingly, SGH’s 27 security undertook a number of steps to investigate the matter. On or about July 17, 2012, SGH 28 installed video cameras on the drug carts in the three operating rooms. Filming began thereafter DECLARATION OF CARLISLE LEWIS, III IN SUPPORT OF MOTION 1 and continued through June of 2013. Motion-detecting cameras were installed on the top of the 2 drug carts in the three operating rooms and would capture images whenever someone entered the 3 \room. 4 3. As would be expected with the multiple operating rooms and the lengthy period of 5 time during which this investigation was conducted, the video clips depict numerous persons 6 coming in and out of these operating rooms over eight months. Some of the video clips depict 7 patients in their most vulnerable state, under anesthesia, exposed and undergoing medical 8 procedures. The video clips also depict healthcare providers other than Dr. DORIN working in an 9 area that is not open and/or accessible to the public. The video clips even capture images of other 10 persons who had reason to come and go through the operating rooms, such as administrators, 11 maintenance staff, vendors, etc. 12 4. SGH security reviewed the video clips that were captured and found multiple 13 occasions between September 14, 2012 through April 3, 2013 in which Dr. DORIN is observed on 14 camera, entering one or more of the operating rooms and removing items from the drug carts 15 including propofol, and placing the items into his shirt pocket. Three clips captured on April 3, 16 2013 evidence a suspicious sequence of events. The first clip at 2:20 p.m. evidences the staff 17 stocking the cart with medications. The second clip at 2:23 p.m. evidences Dr. DORIN entering an 18 otherwise empty operating theater, taking drugs from the cart and putting them in his shirt. The 19 third clip of video evidences the staff re-entering the room to count the medications on the cart to 20 confirm that, indeed, propofol was now missing from the cart. 21 5. In order to present SGH’s findings to its Board, I directed that twelve clips of video 22 be collected together, the three clips previously mentioned from April 3, 2013, and the following 23 additional video clips: 2:18 a.m. on April 3, 2013; 11:34 p.m. on April 2, 2013; 2:04 p.m. on March 24 27, 2013; 5:02 a.m. on March 19, 2013; 9:37 p.m. on February 6, 2013; 12:27 a.m. on January 8, 25 2013; 2:45 a.m. on January 4, 2013; 12:11 a.m. on December 11, 2012 and 12:34 a.m. on 26 September 14, 2012. All twelve of these video clips were collected, copied and provided to SGH’s 27 executive committee, the joint committee of the Board of Directors and the Medical Executive 28 Committee, the Board of Directors. The purpose of this action was to support the investigatory 2 DECLARATION OF CARLISLE LEWIS, III IN SUPPORT OF MOTION 1 action commenced against Dr. DORIN. The same collection of video clips was also produced to 2 Dr. DORIN and the Attorney General/Medical Board of California. 6. 3 The remaining video clips capturing images between July 2012 and February of 4 2013 were not retained by SGH. However there are 6,966 video clips capturing images between 5 February 1, 2013 and June 25 of 2013. Expect for the video clips identified above, none of the 6 other 6,966 video clips were utilized in connection with any investigations involving Dr. DORIN at 7 SGH. None of the other 6,966 video clips were produced to the Attorney General/Medical Board 8 of California. None of the other 6,966 video clips provide any exculpatory evidence for Dr. 9 DORIN. For example, there are no clips contemporaneous to the produced clips which depict him 10 returning medication to the carts. In fact, thee depictions on these other video clips are completely 11 irrelevant to the question of whether Dr. DORIN acted in the manner alleged. 7. 12 On or about October 9, 2015, I was served as the representative of Sharp HealthCare 13 and SGH with an administrative subpoena requesting certain records in connection with the matter 14 pending against ADAM F. DORIN, M.D. filed by the Medical Board Of California, Accusation 15 No. 800-2013-000930. A true and correct copy of the subpoena is filed as Exhibit A in support of 16 this motion. In my capacity as Senior Vice President and General Counsel of Sharp HealthCare, I 17 reviewed the subpoena. Although it is my understanding and belief that Sharp HealthCare and/or 18 SGH was not required to comply with this subpoena, I directed that the same documents which had 19 been provided to the Medical Board also be provided to counsel for Dr. DORIN. 8. 20 By letter dated November 11, 2015, on behalf of Sharp HealthCare and SGH, I 21 responded to counsel for Dr. DORIN and objected to the request to produce “all video from all 22 video cameras installed in the Sharp Grossmont Hospital Women’s Health Center Operating 23 Rooms between July 17, 2012 through April 3, 2013.” In my correspondence I also raised Sharp 24 HealthCare and SGH’s objection to the requested production of documents covered by the 25 attorney/client privilege, attorney work product privilege, as well as documents containing 26 protected health information. A true and correct copy of my correspondence responding to the 27 subpoena is filed as Exhibit B in support of this motion. 28 /// 3 DECLARATION OF CARLISLE LEWIS, III IN SUPPORT OF MOTION 9. 1 I sought to assure Dr. DORIN that Sharp had “produced the video relating to Dr. 2 Dorin that was presented to Sharp Grossmont Hospital’s executive committee, the joint committee 3 of the Board of Directors and the Medical Executive Committee, as well as the Board of 4 Directors.” There were no video clips used in the administrative proceedings that were not 5 produced to the parties in this proceeding. 10. 6 In addition, on behalf of Sharp HealthCare and SGH, I declined to “. . . produce all 7 the video that was retained during the investigation as it may contain protected health information 8 and was not part of the information presented to the Medical Executive Committee, the joint 9 committee or the Board of Directors.” 11. 10 It is Sharp HealthCare and SGH’s position that the request for the entire nine 11 months of video runs afoul of privacy interests of a multitude of persons, protected by among other 12 things by Article 1, Section 1 of the California Constitution, the California Medical Information 13 Act (Civil Code § 56 et seq., and specifically §56.10), California Evidence Code § 994, the Fourth 14 and/or Ninth Amendments to the U.S. Constitution and/or the Health Insurance Portability and 15 Accountability Act (HIPAA). It is Sharp HealthCare and SGH’s position that disclosure of these 16 additional 6,966 video clips are irrelevant, unlikely to lead to any relevant or exculpatory evidence. 12. 17 Disclosure of the additional video clips would be an unreasonable intrusion into the 18 privacy rights of many other persons and create a significant burden on SGH. The question of 19 whether or not the video clips already in the possession of the parties accurately and clearly 20 evidences the conduct alleged is not enhanced by any further production. The remaining 6,966 21 video clips are irrelevant to the allegations in the Accusation. To require production would be 22 unduly burdensome and invade significant rights of privacy of numerous persons who have a right 23 to the continued protection of their personal identifiable health information and their general rights 24 of privacy. 25 13. The 6,966 video clips all capture scenes within the three operating rooms, which are 26 not open to the public. There are images contained within the multitude of images of women 27 undergoing operations of a very personal, private nature, unconscious and in states of exposure 28 /// 4 DECLARATION OF CARLISLE LEWIS, III IN SUPPORT OF MOTION 1 depending on the operation being performed. In addition, there are depictions of staff and other 2 persons who also have rights of privacy which should be respected. 3 14. Code of Civil Procedure section 1985.3 requires notification of third parties whose 4 personal privacy will be infringed by compliance with subpoenas. Given the number of persons 5 who appear in the 6,966 video clips, this would require numerous hours to identify, find, and notify 6 such persons and it may not even be possible to accomplish this given the voluminous number of 7 video clips. Furthermore, the task of providing the identities of the persons who require 8 notification would also violate privacy interests of those persons and the law or require Sharp 9 Healthcare and/or SGH undertake the significant burden of attempting to accomplish this task. 10 Sharp HealthCare and SGH contends such action is unwarranted. The intangible benefit Dr. 11 DORIN hopes to obtain by production of the remaining video is far outweighed by the burden he 12 seeks to place on Sharp HealthCare and SGH. Given the fact that his unprofessional and 13 inappropriate conduct already necessitated time, expense and burden on Sharp HealthCare and 14 SGH to conduct the investigation, it is unreasonable to place additional burden on Sharp 15 HealthCare and SGH. 16 15. If this Court were to order production of all the 6,966 video clips and seek to protect 17 the images of patients and third parties, it would require the expertise of an outside vendor to de- 18 identify the depictions of persons captured on these thousands of video images. I cannot even 19 estimate how expensive this would be or how long this would take. This would create an 20 unreasonable burden which is incommensurate with any possible benefit that could be derived by 21 Dr. DORIN. 22 16. After receipt of my response, counsel for Dr. DORIN and I have had several 23 conversations regarding the videos. I have explained the concern that it would invade the most 24 crucial privacy rights of Sharp HealthCare and SGH’s patients, often in their most vulnerable state, 25 under anesthesia and exposed on the operating room table. In addition, production of the 26 remainder of the video would invade the privacy rights of Sharp HealthCare and SGH’s other 27 physicians and health care providers, employees, and other persons. I have sought to assure Dr. 28 DORIN there is nothing on these videos that is relevant to the issues raised in the Accusation. It is 5 DECLARATION OF CARLISLE LEWIS, III IN SUPPORT OF MOTION 45mmopinion Dr. DORIN has not, and indeed cannot, establish the compelling interest required to violate these significant rights of privacy of a multitude of persons. 17. Since Sharp HealthCare and response to the administrative subpoena through my letter of November 11, 2015, Dr. DORIN has raised no other objection to Sharp HealthCare and response except the continued demand for the entirety of video captured and retained by Sharp HealthCare and SGH. However, despite our meet and confer efforts, Dr. DORIN continues to assert a right to the entirety of video requested in the subpoena and Sharp HealthCare and SGH continues to assert he is entitled to no such thing. Although counsel for Dr. DORIN and I have met and conferred on the issue on several occasions, we have reached an impasse, necessitating this motion. 18. As documented in e?mails dated December 23, 2015 and March 9, 2016, counsel for Dr. DORIN agreed to waive any time requirement regarding the filing of this motion, as we agree a judge should rule on the merits of this motion. A true and correct copy of these emails are collectively filed as Exhibit C. I declare under penalty of perjury under the laws 0 he State of Cal' or th the foregoing is true and correct and that this declaration was ecuted 0 day of March, 2016, at San Diego, California By Car 1e oVice P) 11 an ounsel, arp HealthCare 6 DECLARATION OF CARLISLE LEWIS, 111 IN SUPPORT OF MOTION EXHIBIT I RE: speaking with the press Barton, Richard D. Mon 5/9/2016 5:16 PM To: 'Duane Admire' ; Cc:Carder, Shelley A. ; Mueller, Natalie N. ; Duane&'First,'I'apologize'for'any'profanity.'It'reflected'the'anger'that'Sharp'would'have'accusations'like'this'made before'you'ever'clarified'the'relevant'issue,'i.e.,'whether'patients'consented'to'having'photographs'and'videos'taken while'at'Sharp.'Second,'you'are'totally'confused'about'the'statements'made'in'our'papers'filed'in'support'of'the motion'to'quash.'Our'argument'to'the'OAH'was'that'dissemination*of*the*photos*or*videos*to*you'would'violate employees'and'patients’'rights.'The'court'agreed'with'this'in'its'rulings'on'both'the'original'motion'and'in'your motion'for'reconsideration. As'I'said,'my'outrage'is'that,'notwithstanding'our'good'relationship'over'these'years'and'your'nice'comments'to'Ms. Clark'about'me,'you'only'sought'the'high'road'on'this'after'setting'forth'incendiary'allegations'about'Sharp'in'the press.''As'I'also'said,'I'have'no'obligation'to'provide'you'with'any'information'regarding'patient'consents.'Your evidentiary'and'‘fruit'of'the'poisonous'tree”'arguments'are'for'the'court'to'decide,'not'the'media.'You'had'every opportunity'to'litigate'this'issue'in'your'motion. Please'return'to'our'office'the'flash'drive'and'anything'else'you'received'responsive'to'the'content'of'the'videos. Please'do'not'make'copies'and'please'do'not'disseminate'any'information'or'images'to'anyone.'We'will'clarify whether'the'information'you'received'is'the'same'as'what'was'provided'to'the'Medical'Board.'We'will'also'provide you'with'a'response'that'is'exactly'what'we'provided'to'the'Medical'Board'and'is'consistent'with'the'now,'multiple rulings'from'the'OAH.'Rick ! RICHARD D. BARTON PARTNER PROCOPIO P. 619.515.3299 rick.barton@procopio.com 525 B STREET, SUITE 2200, SAN DIEGO, CA 92101 [www.procopio.com]View Profile Linkedin procopio.com ' From: Duane Admire [mailto:duaneadmire@outlook.com] Sent: Monday, May 09, 2016 3:40 PM To: Barton, Richard D. Subject: Re: speaking with the press Rick:' ' Sorry'we'ended'up'yelling'at'each'other'over'the'phone.''However,'if'you'have'any'ability'to'either'show'me'a consent'for'such'secret'video'or'some'type'of'law'that'doesn't'require'a'patients'consent,'I'will'let'anybody with'the'media'knows'that'calls'me.''Simply'yelling'that'I'don't'know'what'the'Fuck'I'm'talking'about just'pisses'me'off'and'makes'me'want'to'call'the'press'directly!''Thanks,'Duane ' From:'Duane'Admire' Sent:'Monday,'May'9,'2016'3:13'PM To:'rick.barton@procopio.com Subject:'email'to'Cheryl ' On'May'7,'2016,'at'9:23'PM,'Duane'Admire''wrote: ' Cheryl: ' Thanks'for'the'questions.'Your'questions'sparked'further'information'I'was'unaware'of'as discussed'below.' ' First,'I'also'would'like'to'talk'to'any'patients'that'believe'they'were'in'any'of'those'operating rooms'during'the'timeframe,'please'send'them'my'number'and'ask'them'to'please'call'me.'' ' Secondly,'in'order'answer'your'questions'about'how'many'clips'were'given'to'us,'I'decided'to'go back'and'review'the'flash'drive'that'was'provided'to'our'office'and'presumably'the'Medical Board.''I'have'just'stopped'reviewing'it'as'I'have'now'found'some'files'within'files'and'can'only assume'they'gave'us'these'clips'in'error.''I'have'now'in'my'brief'review'of'these'additional'files'on the'flash'drive'(and'without'going'though'the'vast'majority'of'them)'found''multiple'clips'of women'undergoing'surgery.''Of'the'first'four'patients'that'I'happened'to'view'before'I'quit'and decided'to'figure'out'how'best'to'deal'with'the'problem,'discovered'that'two'of'the'women patients'were'not'under'anesthesia&&as'one'of'them'walked'into'the'operating'room,'another'you can'clearly'see'was'adjusting'herself'and'her'hair'cap'etc.,'and'the'other'two,'did'seem'to'be under'anesthesia.''As'for'what'to'do'about'this,'I'm'a'bit'unsure.''I'happen'to'know'and'have'had several'cases'over'the'years'against'Rick'Barton'(he'is'the'partner'from'Procopio'that'represents Sharp'on'their'motion'to'quash,'I'will'make'contact'with'him'next'week'and'discuss'how'we should'handle'their'disclosure&&I'm'sure'he'is'unaware'that'they'sent'these'clips&&I'know'Mr. Barton'and'trust'and'respect'him'and'believe'he'will'be'able'to'handle'this'with'his'client'Sharp). ' mailgw01.procopio.com made the following annotations --------------------------------------------------------------------Mon May 09 2016 17:15:56 This is an email from Procopio, Cory, Hargreaves & Savitch LLP, Attorneys at Law. This email and any attachments hereto may contain information that is confidential and/or protected by the attorney-client privilege and attorney work product doctrine. This email is not intended for transmission to, or receipt by, any unauthorized persons. Inadvertent disclosure of the contents of this email or its attachments to unintended recipients is not intended to and does not constitute a waiver of attorney-client privilege or attorney work product protections. If you have received this email in error, immediately notify the sender of the erroneous receipt and destroy this email, any attachments, and all copies of same, either electronic or printed. Any disclosure, copying, distribution, or use of the contents or information received in error is strictly prohibited. --------------------------------------------------------------------- Weather Traffic Surf Maps Webcam Saturday, Aug. 13, 2016 Choose Category Friday »Next Story» News Local News Opinion Business Sports Currents Weekend Front Page (PDF) The Last Week Weekly Sections Subscribe to the UT Questions are raised on death at hospital 2 inquiries launched over care of patient at Sharp Grossmont By Cheryl Clark STAFF WRITER August 1, 2008 State health regulators and the county medical examiner are separately investigating whether a finance author died July 25 because of a lapse in care at Sharp Grossmont Hospital, which already is under scrutiny for three preventable deaths since March. The previous deaths and other serious patient care and management problems could prompt the government to stop all federal payments to the La Mesa hospital. Harvey Ira Houtkin, 59, who was dubbed “the father of day trading,” died at 9:25 p.m. – several hours after uneventful emergency surgery near his tonsils, according to his medical records. The cause of death was listed as natural: acute respiratory failure from a severe airway obstruction. The medical examiner, Dr. Glenn Wagner, declined to do an autopsy because hospital officials linked the death to Houtkin's medical history, which included diabetes and a tonsillar abscess. Houtkin's body was flown to Florida, where he lived. Sponsored Links But on Wednesday, Wagner revisited the case after a Sharp Grossmont physician anonymously sent an e-mail to him alleging that the surgeon who signed Houtkin's death certificate gave “erroneous, misleading and perhaps fraudulent” information. The doctor also sent e-mails and spoke with The San Diego Union-Tribune on the condition that he not be identified because of his working relationships with Sharp Grossmont officials. The newspaper verified that he has staff privileges at the hospital. Overview Background: Sharp Grossmont Hospital in La Mesa could lose all federal payments because of serious lapses in patient care and management, including the preventable deaths of three patients in March and April. What's changing: State regulators and the county medical examiner are investigating whether a fourth preventable death occurred July 25. The future: State and federal officials are reviewing the hospital's correction plans and will soon reinspect the facility. The physician said Houtkin actually died because of a problematic adjustment or dislodging of his breathing tube, which then blocked his airway while he was waiting for a bed in the intensive care unit, or ICU. No staff member had noticed quickly enough that Houtkin had turned blue, the doctor said, and efforts to save him came too late. “What ensued was a very messy scene where the anesthesiologists could not reintubate the patient and the surgeon could not establish” an opening in the windpipe, the physician said. Houtkin's death is “an indictment – albeit at an unfortunate time politically for the hospital – on the nursing and respiratory care at Sharp Grossmont,” the doctor said. Advertisements from the print edition Grossmont,” the doctor said. Sharp Grossmont's leaders denied that events unfolded that way. “The patient was very ill” with other health issues, said Dan Gross, executive vice president of Sharp HealthCare. “The patient did have complications post-surgery in ICU, coded and expired,” he said. “There is no evidence at this time the tube was dislodged and definitely no information regarding lack of observation.” Gross said the hospital was not required to report the event to the state, but did so because of the ongoing investigations by state and federal regulators. “I honestly believe this message is coming from an individual who has a history of conflict with our management, a man who has intent to harm Sharp Grossmont publicly,” he said. Last night, hospital officials said an autopsy would help determine why Houtkin went into cardiopulmonary arrest and died. Sharp's administrators acknowledged that they're under the gun. Federal and state regulators are reviewing their correction plans and will reinspect the hospital before Oct. 15. If deficiencies remain, the facility would lose all Medicare and Medi-Cal reimbursement, which make up 50 percent of its net patient revenue. The government programs cover treatment for seniors, the poor and the disabled. During two inspections of the hospital in April and May, state investigators found problems such as nurses poorly trained in cardiopulmonary resuscitation, improper use of restraints for psychiatric patients, an old operating-room mattress held together by tape and glue, outdated medications, wrong food storage and inadequate cleaning of kitchen equipment. At the top of their list were three preventable deaths: Larry Napolis, 45, a heart-attack patient who died March 21 because his ventilator was left off. Jeffrey Christopher, 25, a patient in the psychiatric unit who died April 11 after suffocating on his mattress because of improper restraints and monitoring by staff. Mary Ruth Keimig, 83, who died April 24 after a hysterectomy because the hospital's staff injected a powerful drug into her bloodstream instead of into her muscle. The inspectors attributed those deaths, and dozens of other serious issues, to deficiencies in hospital procedures, training and operations. In the Houtkin case, the state said yesterday it is investigating the death. Houtkin had come to the Optimum Health Institute in Lemon Grove for a three-week stay to lose weight, his son and daughter-in-law, Michael and Jamie Houtkin, said in an interview from Florida. On July 25, Houtkin went to an urgent-care clinic after two days of worsening throat pain. He was diagnosed with an abscess near his tonsils, according to his medical records. Houtkin was driven by car to Sharp Grossmont Hospital, where he underwent surgery. By state law, hospital officials must report “sudden” or “unexpected” deaths to the county Medical Examiner's Office, which performs autopsies and pathology testing to determine how those deaths occurred. Houtkin's family said it had ordered an autopsy because of concerns about how the patient died. The doctor who sent e-mails to Wagner and the Union-Tribune said, “Medical record-keeping was purposefully 'watered down' to avoid “Medical record-keeping was purposefully 'watered down' to avoid stating what actually happened and to avoid a formal inquiry and autopsy.” Wagner subpoenaed Houtkin's medical records Wednesday night and received them yesterday morning. He said he found “crucial information” not included in those documents, “including minute by minute patient monitoring data in the recovery room during which time Mr. Houtkin” went into cardiac arrest. With all of the new information, Wagner said, “I would likely have brought the case in for autopsy.” He said Houtkin's death could be changed from natural to accidental “depending on what we find in our investigation, as well as any provided findings by the family-requested autopsy in Florida.” »Next Story» Sponsored Links Contact SignOnSanDiego.com Online Media Kit Print Media Kit Frequently Asked Questions Make us your homepage Contact the Union-Tribune About the Union-Tribune Site Index Privacy Policy Your California Privacy Rights © Copyright 2008 Union-Tribune Publishing Co. • A Copley Newspaper Site EXHIBIT SUBP-O10 FOR COURT USE ONLY ATTORNEY OR PARTY WITHOUT ATTORNEY (Name, State Bar number, and address}: ard (21 1 098) James R. Patterson (211102) Allison H. God Patterson Law Group 402 West Broadwa ,29th Floor, San Diego, CA 92101 TELEPHONE No: 61 .756.6990 FAX Non-619.756.6991 ADDRESS: a i@pattersonlawg roup.com Plaintiff Melissa Escalera SUPERIOR COURT OF CALIFORNIA, COUNTY OF SAN DI EGO STREET ADDRESS: 220 west Broadway MAILING ADDRESS: San Diego, CA 92101 BRANCH NAME: Central Melissa Escalera Healthcare, et. al_ CASE NUMBER: DEPOSITION SUBPOENA FOR PRODUCTION OF BUSINESS RECORDS 37-2016-00017392 THE PEOPLE OF THE STATE OF CALIFORNIA, TO (name, address, and telephone number of deponent, if known): Admire Associates,12880 Carmel Country Rd,Suite D110, San Diego, Ca 92130; (858) 350-5565 1. YOU ARE ORDERED TO PRODUCE THE BUSINESS RECORDS described in item 3, as follows: To (name of deposition of?cer): Patterson Law Group On (date) :August 16, 2016 At (time):10200 am Location (address):402 West Broadway, 29th Floor, San Diego, CA 92101 Do not release the requested records to the deposition officer prior to the date and time stated above. a. by delivering a true, legible, and durable copy of the business records described in item 3, enclosed in a sealed inner wrapper with the title and number of the action, name of witness, and date of subpoena clearly written on it. The inner wrapper shall then be enclosed in an outer enveIope or wrapper, seated, and maiied to the deposition officer at the address in item 1. b. by delivering a true, legible, and durable copy of the business records described in item 3 to the deposition officer at the witness's address, on receipt of payment in cash or by check of the reasonable costs of preparing the copy, as determined under Evidence Code section 1563(b). c. I: by making the original business records described in item 3 availabie for inspection at your business address by the attorney?s representative and permitting copying at your business address under reasonable conditions during normal business hours. 2. The records are to be produced by the date and time shown in item 1 (but not sooner than 20 days after the issuance of the deposition subpoena, or 15 days after service, whichever date is later). Reasonable costs of locating records, making them available or copying them, and postage, if any, are recoverable as set forth in Evidence Code section 1563(b). The records Shall be accompanied by an affidavit of the custodian or other quali?ed witness pursuant to Evidence Code section 1561. The records to be produced are described as follows (if electronically stored information is demanded, the form or forms in which each type of information is to be produced may be speci?ed): Please see Attachment 3 [3 Continued on Attachment 3. 4. IF YOU HAVE BEEN SERVED WITH THIS SUBPOENA AS A CUSTODIAN OF CONSUMER OR EMPLOYEE RECORDS UNDER CODE OF CIVIL PROCEDURE SECTION 1985.3 OR 1985.6 AND A MOTION TO QUASH OR AN OBJECTION HAS BEEN SERVED ON YOU, A COURT ORDER 0R AGREEMENT OF THE PARTIES, WITNESSES, AND CONSUMER OR EMPLOYEE AFFECTED MUST BE OBTAINED BEFORE YOU ARE REQUIRED TO PRODUCE CONSUMER OR EMPLOYEE RECORDS. DISOBEDIENCE OF THIS SUBPOENA MAY BE PUNISHED AS CONTEMPT BY THIS COURT. YOU WILL ALSO BE LIABLE SUM OF FIVE HUNDRED DOLLARS AND ALL DAMAGES RESULTING FROM YOUR FAILURE TO OBEY. Date issued: July 27, 2016 Michael Roddy (SIGNATURE OF PERSON ISSUING POENA) (TYPE OR PRINT NAME) CLERK OF THE COURT (Proof of service on reverse) (TITLE) Page 1 of2 Code of Civil Procedure, 2020.410?2020440; DEPOSITION SUBPOENA FOR PRODUCTION Governmenmode? ?68097.1 Form Adopted for Mandatory Use courts. ca. gov Judicial Council of California OF BUSINESS RECORDS iRev. January 2012} SUBP-010 Healthcare, et. al. Escalera CASE NUMBER: 37-2016?00017392 1 . PROOF OF SERVICE OF DEPOSITION SUBPOENA FOR PRODUCTION OF BUSINESS RECORDS i sewed this Deposition Subpoena for Production of Business Records by personaliy delivering a copy to the person served as foliows: a. Person served (name): b. Address where served: 0. Date of delivery: (I. Time of delivery: e. (1) I: Witness fees were paid. Amount: (2) CI Copying fees were paid. Amount: f. Fee for service: 2. received this subpoena for service on (date): 3. Person serving: a. Not a registered California process server. b. CI California sheriff or marshal. c. Registered California process server. d. Employee or independent contractor of a registered California process server. e. Exempt from registration under Business and Professions Code section 22350(b). f- E: Registered professional photocopier. g. E: Exempt from registration under Business and Professions Code section 22451. it. Name, address, teiephone number, and, if applicable, county of registration and number: I declare under penalty of perjury under the laws of the State of (For California sheriff or marshal use only) Cafifomia that the foregoing is true and correct. I certify that the foregoing is true and correct. Date: Date: I I (SIGNATURE) (SIGNATURE) SUBPmOIRev?Januarv 1120121 DEPOSITION SUBPOENA FOR PRODUCTION ?962?? OF BUSINESS RECORDS