The Texas Medical Board has taken disciplinary action against 32 licensed physicians

Since its last Board meeting in April, the Texas Medical Board has taken disciplinary action against 32 licensed physicians. Actions included 14 violations based on quality of care; three actions based on unprofessional conduct; two actions based on nontherapeutic prescribing; one action based on inappropriate conduct involving physician-patient relationships; three actions based on inadequate medical records; two actions based on impairment due to alcohol or drugs; two actions based on violations of probation or prior orders; one action based on other state board actions; one action based on a criminal conviction; one action based on a peer review action; and two minimal statutory violations. Administrative penalties totaling $76,000 were assessed. At its May 19 board meeting, the Texas Physician Assistant Board took disciplinary action against one physician assistant.

Of special interest are the following actions

QUALITY OF CARE VIOLATIONS:

· ARREDONDO, ADAM GALLARDO, M.D., WAXAHACHIE, TX, Lic. #K7648
On June 2, 2006, the Board and Dr. Arredondo entered into an Agreed Order publicly reprimanding Dr. Arredondo and placing him on probation for five years with the following requirements: monitoring of his practice by another physician; modification of his Drug Enforcement Administration Controlled Substances Registration Certificate and his Texas Department of Public Safety Controlled Substances Registration Certificate to eliminate his authority to prescribe Schedules II and III; completing 50 hours per year of continuing medical education in pain management; no supervising or teaching residents or supervising or delegating prescriptive authority to a physician assistant or advanced practice nurse; and assessing an administrative penalty of $20,000. The action was based on allegations that Dr. Arredondo failed to meet the standard of care in treating 10 patients for the following reasons: failure to review past records; inadequate assessments prior to starting opioid therapy; failure to perform behavior evaluation prior to starting therapy; failure to perform drug screens prior to starting therapy; failure to perform a trial of physical therapy and/or non-opioids; failure to document a treatment plan; inadequate monitoring of patient responses to therapy; prescribing excessive and nontherapeutic doses of schedule II drugs; inappropriate follow up; prescribing inappropriate dose escalation; lack of attention to red flags for abuse; and performing procedures that were not indicated.

INAPPROPRIATE CONDUCT INVOLVING PHYSICIAN-PATIENT RELATIONSHIP VIOLATIONS:

· HELLER, CARL STUART, M.D., KINGWOOD, TX, Lic. #F8154
On June 2, the Board and Dr. Heller entered into a 10-year Mediated Agreed Order publicly reprimanding Dr. Heller and requiring that he complete courses of at least 20 hours each in pain management and risk management and 10 hours in medical records; prohibiting him from engaging in the practice of pain management, requiring that he complete the “Maintaining Proper Boundaries” course presented by the Center for Professional Health at the Vanderbilt Medical Center or a similar course approved by the executive director of the board; requiring that he maintain adequate medical records on all patient office visits; requiring that his practice be monitored by another physician for a period of five years; requiring that he take and pass the Medical Jurisprudence Examination; prohibiting him from prescribing to family members or other persons with whom he has a personal relationship outside the physician-patient relationship; and assessing an administrative penalty of $3,000. Additionally, Dr. Heller’s license may be immediately suspended if he fails to comply with the terms of the order. The action was based on allegations that Dr. Heller treated a young man, previously homeless, who came to live with him and for whom he became an informal guardian, for complaints including anxiety, depression and chronic pain due to an accident, but did not meet the standard of care in keeping medical records for this treatment. Additional allegations were that Dr. Heller prescribed medications to the young man, who drank alcohol, that were dangerous to use concurrently with alcohol, and wrote prescriptions for excessive amounts of habit-forming medications and was refilling them early, even though the young man was a known abuser of medications. Dr. Heller also prescribed Fentanyl for the young man for the treatment of pain following dental surgery. The young man was later found dead in Dr. Heller’s home from an overdose of Fentanyl. No criminal charges were filed.