Download July 31, 2014 - Veterinary Medical Examiners

STATE OF NEVADA
BOARD OF VETERINARY MEDICAL EXAMINERS
BOARD MEETING
at
Hyatt Place
1790 E. Plumb Lane
Reno, Nevada 89502
MINUTES
July 31, 2014
BOARD MEMBERS PRESENT
William Taylor, DVM – President
Ronald Sandoval, DVM - Vice-President
Steve Damonte, DVM
Scott Bradley, DVM
Kevin Collins, DVM
Melissa Schalles, LVT
Davyd Pelsue, DVM
Sherita Rogers, Public Member
BOARD STAFF PRESENT
Debbie Machen - Executive Director
Tracie Estep – Administrative Asst.
Louis Ling, Esq. – Board Counsel
Christina Johnson, LVT – Inspector
Patricia Handal, DVM-Investigator
Dr. Taylor called the meeting to order and called roll at 9:30 a.m.
1. Public Comment
None
2. Approval of Board Minutes for Possible Action
A. April 24, 2014 Board Meeting
Motion: Ms. Schalles moved to accept the minutes with changes to 10 B.
Second: Ms. Rogers
Passed: Unanimous
3. Review & Determination of Complaints/Disciplinary Action & Disciplinary Hearings for Possible
Action:
A. GS01-091113, License #2175, Steven Godbey, DVM: Letter of Reprimand
Discussion: Mr. Ling provided the Board with an overview of the proposed stipulated
agreement.
Motion: Dr. Bradley moved to accept the Letter of Reprimand as written.
Second: Dr. Pelsue
Passed: Unanimous; Dr. Sandoval abstained
B. 2014DVM-003, License #1246, Henry Kostecki, DVM: Letter of Reprimand
Discussion: Mr. Ling provided the Board with an overview of the proposed stipulated
agreement.
Motion: Dr. Sandoval moved to accept the Letter of Reprimand as written.
Second: Dr. Bradley
Passed: Unanimous; Dr. Taylor abstained
C. 2014DVM-004, License #1492, Kristin Clark, DVM: Letter of Reprimand
Discussion: Mr. Ling provided the Board with an overview of the proposed stipulated
agreement. The complainant was present and addressed the Board.
Motion: Dr. Damonte moved to accept the Letter of Reprimand as written.
Second: Dr. Collins
Passed: Unanimous; Dr. Bradley abstained
D. 2014FAC-002B; 2014DVM-002A License #H302 & 1210, Ann Road Animal Hospital & Cyril
Bullard, DVM: Letter of Reprimand
Discussion: Mr. Ling provided the Board with an overview of the proposed stipulated
agreement.
Motion: Dr. Pelsue moved to accept the Letter of Reprimand as written.
Second: Ms. Rogers
Passed: Unanimous; Dr. Sandoval abstained
E. 2014FAC-006
Discussion: After discussion of the complaint assessment with the review panel the Board
dismissed the complaint due to the fact that there was not sufficient evidence to believe that the
licensee had committed an act which constitutes a cause for disciplinary action.
Motion: Dr. Bradley moved to dismiss.
Second: Dr. Sandoval
Passed: Unanimous. Dr. Pelsue abstained
F. 2014DVM-007
Discussion: After discussion of the complaint assessment with the review panel the Board
dismissed the complaint due to the fact that there was not sufficient evidence to believe that the
licensee had committed an act which constitutes a cause for disciplinary action and directed
staff to send a letter of concern to the licensee regarding: 1) New policies and procedures need
to be established with all personnel for verifying prescription medication that is being dispensed;
and 2) When there are complications leading to plate removal it is recommended that a culture
be obtained at the time of the plate removal. The complainant was present and addressed the
Board with her concerns.
Motion: Dr. Bradley moved to dismiss with a letter of concern.
Second: Dr. Damonte
Passed: Unanimous. Dr. Taylor and Dr. Pelsue abstained
G. 2014FAC-008
Discussion: After discussion of the complaint assessment with the review panel the Board
dismissed the complaint due to the fact that there was not sufficient evidence to believe that the
licensee had committed an act which constitutes a cause for disciplinary action and directed
staff to send a letter of concern to the facility regarding: Informed consent/pre-anesthesia
medication 1) When you have an at risk patient (cardiac) it is important to include on the written
anesthetic/surgical release form all options discussed, accepted, or declined; and 2) The use of
Atropin with a patient that has a heart rate of 180 b.p.m..
Motion: Dr. Pelsue moved to dismiss with a letter of concern.
Second: Dr. Collins
Passed: Unanimous. Dr. Sandoval abstained
H. 2014DVM-009
Discussion: After discussion of the complaint assessment with the review panel the Board
recommended that disciplinary action be initiated against the licensee.
Motion: Ms. Schalles moved to have staff and Mr. Ling initiate action against the licensee due to
there being sufficient evidence to proceed with disciplinary action.
Second: Dr. Damonte
Passed: Unanimous. Dr. Sandoval abstained
I.
2014DVM-010A & 2014FAC-010B
Discussion: After discussion of the complaint assessment with the review panel the Board
dismissed the complaint due to the fact that there was not sufficient evidence to believe that the
licensee had committed an act which constitutes a cause for disciplinary action and directed
staff to send a letter of concern to the licensee/facility regarding: Informed Consent: 1) Not
verbally discussing with the owner the risks involved when there is no overnight monitoring of
an animal that is being hospitalized and not offering transfer to a facility that has overnight
staffing to monitor.
Motion: Dr. Bradley moved to dismiss.
Second: Dr. Pelsue
Failed: Yes (3), No (4) Dr. Damonte abstained.
Motion: Dr. Taylor moved to dismiss with a letter of concern.
Second: Dr. Sandoval
Passed: Yes(4) No(3). Dr. Damonte abstained
J.
2014DVM-011A & 2014DVM-011B
Discussion: After discussion of the complaint assessment with the review panel the Board
dismissed the complaint due to the fact that there was not sufficient evidence to believe that the
licensee had committed an act which constitutes a cause for disciplinary action.
Motion: Dr. Collins moved to dismiss.
Second: Dr. Bradley
Passed: Unanimous. Dr. Damonte abstained
K. 2014DVM-012
Discussion: After discussion of the complaint assessment with the review panel the Board
dismissed the complaint due to the fact that there was not sufficient evidence to believe that the
licensee had committed an act which constitutes a cause for disciplinary action and directed
staff to send a letter of concern to the licensee regarding: For complete medical records it is
suggested to: 1) Add more detail in the medical record during the Initial consult, discussion of the
surgical procedure, recovery, and complications; and 2) Comments on radiographs should have
more detail.
Motion: Dr. Damonte moved to dismiss with a letter of concern.
Second: Dr. Bradley
Passed: Unanimous. Dr. Pelsue abstained
L. 2014DVM-013
Discussion: After discussion of the complaint assessment with the review panel the Board
dismissed the complaint due to the fact that there was not sufficient evidence to believe that the
licensee had committed an act which constitutes a cause for disciplinary action and directed
staff to send a letter of concern to the licensee regarding: Communication with client and
documentation in the medical record: 1) Pros, cons, and indications for a one-time use of
Vetalog in a diabetic patient, and 2) Addressing the source of pain on opening mouth by offering
an exam under sedation. The complainant was present and discussed her concerns with the
Board.
Motion: Dr. Pelsue moved to dismiss with a letter of concern.
Second: Dr. Sandoval
Passed: Unanimous. Dr. Bradley abstained
M. 2014DVM-014 (Primary Veterinarian)
Discussion: After discussion of the complaint assessment with the review panel the Board
recommended that disciplinary action be initiated against the primary veterinarian.
2014DVM-014 (Secondary Veterinarian)
Discussion: After discussion of the complaint assessment with the review panel the Board
dismissed the complaint due to the fact that there was not sufficient evidence to believe that the
secondary veterinarian had committed an act which constitutes a cause for disciplinary action
and directed staff to send a letter of concern to the secondary veterinarian regarding: When
mentoring a new associate or new graduate – 1) Be willing to share your skills, knowledge, and
expertise by being available to provide guidance and constructive feedback; 2) When the
situation arises, be prepared to step in and assist; and 3) Teach the associate to be open and ask
for support.
Motion: Dr. Taylor moved to initiate action against the primary veterinarian due to there being
sufficient evidence to proceed with disciplinary action.
Second: Dr. Pelsue
Passed: Unanimous. Dr. Collins abstained
Motion: Dr. Taylor moved to initiate action against the secondary veterinarian due to there
being sufficient evidence to proceed with disciplinary action.
Second: Dr. Bradley
Failed: Yes (2) No (5). Dr. Collins abstained.
Motion: Dr. Taylor moved to dismiss with a letter of concern being sent to the secondary
veterinarian.
Second: Dr. Pelsue
Passed: Yes (5) No (2). Dr. Collins abstained.
N. 2014LVT-015
Discussion: After discussion of the complaint assessment with the review panel the Board
dismissed the complaint due to the fact that there was not sufficient evidence to believe that the
licensee had committed an act which constitutes a cause for disciplinary action.
Motion: Dr. Bradley moved to dismiss
Second: Dr. Collins
Passed: Unanimous. Ms. Schalles abstained
O. 2014DVM-016A
Discussion: After discussion of the complaint assessment with the review panel the Board
dismissed the complaint due to the fact that there was not sufficient evidence to believe that the
licensee had committed an act which constitutes a cause for disciplinary action and directed
staff to send a letter of concern to the licensee regarding: 1) Verbally going over at home
instructions with owner, including risks and potential side effects. 2) Discussing the use of
"extra-label" medications, especially in pocket pets.
Motion: Dr. Sandoval moved to dismiss with a letter of concern.
Second: Dr. Bradley
Passed: Unanimous. Dr. Pelsue abstained
2014DVM-016B
Discussion: After discussion of the complaint assessment with the review panel the Board
dismissed the complaint due to the fact that there was not sufficient evidence to believe that the
licensee had committed an act which constitutes a cause for disciplinary action.
Motion: Ms. Rogers moved to dismiss
Second: Ms. Schalles
Passed: Unanimous. Dr. Pelsue abstained
O. 2014FAC-017
Discussion: After discussion of the complaint assessment with the review panel the Board
dismissed the complaint due to the fact that there was not sufficient evidence to believe that the
licensee had committed an act which constitutes a cause for disciplinary action. The complainant
was present and addressed the Board with her concerns.
Motion: Dr. Pelsue moved to dismiss
Second: Dr. Sandoval
Passed: Unanimous. Dr. Bradley abstained
P. 2014DVM-018
Discussion: After discussion of the complaint assessment with the review panel the Board
dismissed the complaint due to the fact that there was not sufficient evidence to believe that the
licensee had committed an act which constitutes a cause for disciplinary action.
Motion: Dr. Bradley moved to dismiss.
Second: Ms. Rogers
Passed: Unanimous. Dr. Collins abstained
Q. 2014FAC-019
Discussion: After discussion of the complaint assessment with the review panel the Board
dismissed the complaint due to the fact that there was not sufficient evidence to believe that the
licensee had committed an act which constitutes a cause for disciplinary action.
Motion: Dr. Bradley moved to dismiss
Second: Dr. Pelsue
Passed: Unanimous. Dr. Damonte abstained
4. Discussion and Determination for Possible Action
A. Presentation of Expedited Licensure for Veterans:
Caleb Cage-Director of Military & Veterans Policy /Office of the Governor
Discussion: Mr. Cage discussed the Governor’s Executive Order from 2014 requiring licensing
Boards to establish reciprocity for service members and veterans in order to expedite the
licensing process. He also discussed new legislation that would require reciprocity and the
requirement that all Boards capture data regarding the number of veterans seeking licensure.
B. Laser Therapy in home by an LVT; Alissa Lenzora, LVT
Discussion: Ms. Lenzora, a licensed veterinary technician, presented the Board with a business
plan for “In-Home” laser therapy to be performed solely by Ms. Lenzora after the veterinarian
had made a diagnosis and put a treatment plan together. Mr. Ling cautioned the Board that the
intent of the supervision definitions for licensed veterinary technicians was that the tasks be
performed at a licensed veterinary facility.
Motion: Dr. Taylor moved to deny Ms. Lenzora the ability to perform “”In-Home” laser therapy
based on NAC 638 that states laser therapy must be done under indirect supervision in a licensed
veterinary facility.
Second: Ms. Schalles
Passed: Unanimous.
C. Continuing Education non-compliance by licensees (discipline)
Discussion: Ms. Machen discussed with the Board the option of allowing staff to negotiate a
settlement in these cases where a licensee hasn’t complied with their CE requirement and an
investigation is complete; the final Order will be voted on by the Board.
Motion: Dr. Taylor moved to have Ms. Machen, Mr. Ling, and a Board member negotiate the
discipline prior to bringing the negotiated settlement to a Board Meeting.
Second: Dr. Bradley
Passed: Unanimous.
D. Accountability for telemedicine vs. consultants
Discussion: Ms. Machen discussed the issue of licensing out-of-state specialists that provide
services (radiology/labs/internal medicine) in Nevada.
E. Businesses that sell over-the-counter veterinary prescription drugs (NRS 639.2345)Dr. Damonte
Discussion: Dr. Damonte updated the Board on a meeting that he and Ms. Machen attended at
the pharmacy board regarding prescription medications being sold at feed stores. The pharmacy
board is working with these retail businesses, the Department of Agriculture, the Dairy
Commission, equine veterinarian’s and the Veterinary Board to determine what oversight is
needed and if new regulations need to be drafted to define the handling of these medications.
F. Update on LCB RO63-13-Dr. Pelsue
Discussion: Dr. Pelsue and Ms. Machen updated the Board on the Legislative Council Meeting
on June 23, 2014, in which, RO63-13 was passed without questions from the committee
members.
G. Should LVT’s be able to perform an epidural-Ms. Schalles
Discussion: At the Board Meeting in April the Board asked staff to research the issue of Licensed
Veterinary Technicians performing epidurals on small animals. Ms. Schalles advised the Board
that presently this procedure is not being taught by veterinary technology programs or is part of
the curriculum that is being required by the AVMA.
5. Staff Reports for Possible Action
A. Financial Report/Budget Revision -Debbie Machen
Discussion: The financial report and amended budget was presented to the Board’s satisfaction.
Motion: Dr. Taylor moved to amend the budget as presented.
Second: Ms. Schalles
Passed: Unanimous
B. Administrative Report-Tracie Estep
C. Hospital Inspection Report-Christina Johnson, LVT
Discussion: The administrative and hospital inspection report was presented to the Board’s
satisfaction.
D. Legal Report, Louis Ling, Esq
None
6. Requests for Licensure/Reinstatement for Possible Action
A. Jennifer Taylor, DVM
Discussion: Dr. Jennifer Taylor submitted an application for licensure and was requesting that the
requirement of taking the species specific examination (small animal or equine) be waived because
her practice is specifically bovine. The Board reviewed her application and all supplemental
documentation.
Motion: Dr. Pelsue moved to approve her application and waive the requirement of taking the
Species Specific Examination.
Second: Ms. Rogers
Passed: Unanimous
B. Samantha Uhrig
Discussion: Dr. Uhrig submitted an application for licensure and was requesting that the
requirement of taking the species specific examination (small animal or equine) be waived because
her practice is specifically wildlife. The Board reviewed her application and all supplemental
documentation.
Motion: Dr. Pelsue moved to approve her application and waive the requirement of taking the
Species Specific Examination.
Second: Dr. Sandoval
Passed: Unanimous
C. Michelle Ing, DVM
Discussion: Dr. Ing submitted an application for licensure and was requesting that the requirement
of taking the species specific examination (small animal or equine) be waived because her practice is
specifically alpacas. The Board reviewed her application and all supplemental documentation.
Motion: Dr. Pelsue moved to approve her application and waive the requirement of taking the
Species Specific Examination.
Second: Dr. Bradley
Passed: Unanimous
7. Public Comment
None
8. Agenda items for next meeting.
Discussion: Mentorships for new graduating veterinarians; recognizing specialties for Licensed
Veterinary Technicians; separate and distinct supervision levels for licensed veterinary technicians to
perform duties outside of licensed veterinary facilities.
9. Adjournment for Possible Action
Motion: Ms. Schalles moved to adjourn at 4:18 p.m.
Second: Dr. Sandoval
Passed: Unanimous.