Saturday, August 20, 2005
Summary of Events TSBME Suspension
HIGHLIGHTS of TSBME SUSPENSION
Texas State Board of Medical Examiners (TSBME)
Vs. Roland Chalifoux, Jr., D.O.
$ June 12, 2002: TSBME initiates an informal hearing and requests RFC to voluntarily surrender license after four cases of alleged improper patient care issues submitted by competitors at a local hospital, not by the patients who are satisfied with RFC’s care. RFC refuses. RFC has had no contact with TSBME since September of 2001. RFC has performed 546 cases during this time period without patient or hospital complaint. Present at the ISC is Donald Patrick M.D. (executive director of the TSBME and retired neurosurgeon) who acted as a neurosurgical consultant during the hearing and stated that these four cases “were the worst I’ve ever heard of”, falling below the standard of care. These same four cases were later evaluated during the SOAH hearing and thrown out for lack of evidence of any wrong doing or being below the standard of care.
$ July 19, 2002: RFC given two days’ notice to appear at TSBME for disciplinary hearing regarding suspension of license due to adverse peer review actions at four area hospitals that had not elevated RFC to active staff. According to statute, the respondent (RFC) is to be granted 10 days to prepare for hearing. RFC received TSBME’s complaint packet three (3) days after the hearing. RFC and attorney asked for a continuance. It was denied. Upon his attorney’s advice, RFC waived his right to appear due to lack of A due process.” Upon his departure, Hearing Panel deliberated for a total of twenty-nine minutes, suspended RFC’s license and referred case to State Office of Administrative Hearings (SOAH). RFC laid-off four of five full-time employees and closes the office. Thirty (30) patients were notified that their surgeries were cancelled and would be transferred to the care of other physicians.
$ According to the Texas Medical Practice Act 151.002(a)(2) “continuing threat to the public welfare” means a real and present danger to the health of a physician’s patients caused through the physician’s lack of competence, impaired status, or failure to care adequately for the physician’s patients. A real and present danger exists if patients have an exposure to or risk of injury that is not merely abstract, hypothetical or remote and is based on actual actions or inactions of the physician. This issue of being a “clear and present danger” is difficult to understand since up until July 19,2002 I was on staff at three hospitals and had performed 546 cases from 1999-2002 without any medical staff or hospital actions at these facilities.
$ Three days later, RFC received two different complaint packages from TSBME re: suspension hearing. Temporary suspension hearing packet contained five (5) additional complaints that were not sent to SOAH by TSBME.
$ RFC and attorney were ready to appear before SOAH judge late-August/early-September; TSBME said they would not be ready until October even though the TSBME used the same reviewer for all the complaints and had had the information since 1997.
$ October 2002: SOAH hearing begins with a total of 18 charges that TSBME paid a retired neurosurgeon Arthur Evans MD, to review who under oath testified that he had no experience in one form of surgical treatment in question and it was shown later that he was not current in the care and treatment of patients in five other cases. It was also learned during the hearing that he had been involved in a malpractice case where the patient was unaware that he was the surgeon performing surgery instead of the patient’s treating surgeon. During that same case, the expert admitted to not taking an intraoperative x-ray and operating on the wrong level of the patient’s back.
$ TSBME finds a second retired neurosurgeon, Martin Barrash MD in late September and uses him as a paid witness (after becoming aware that RFC had 25 unpaid witnesses in his defense including two patients) to agree with their first witness. This second witness admits that he does not perform fusions by himself, which amounts to 9 of the 13 cases in question. Additionally, he stated the need to review the actual x-rays of several of the complaints before he could make a decision even though he continued to agree with the allegations. This doctor, the state’s second witness, states during the SOAH hearing that RFC should not have had his license suspended.
$ Original SOAH judge finds multiple errors in TSBME’s first complaint. She forces them to amend their original complaint. During the hearing the judge strikes five of the State’s allegations that were found to be hearsay reducing number of complaints against RFC from 18 to 13. SOAH judge also strikes many sections of the remaining 13 complaints since they were found to be untrue.
$ TSBME finds and pays an out of state neurosurgeon Issam Awad MD $1,000/hr to review and give a deposition on one of the thirteen complaints. The outside reviewer’s testimony is also at odds with the TSBME’s other two reviewers. Several months later, it is found that this expert perjured himself during his testimony by denying he had ever been the subject of an investigation of his medical competency. He was eventually forced out of his university seat and practices in another state.
$ SOAH hearing completed on 11/8/2002. It has been four months since RFC has practiced medicine and has had his livelihood cut-off.
$ Dec.19, 2002, SOAH judge asked the TSBME to mediate with respondent since “Serious consideration could be given to what was actually shown by the facts in evidence, rather than the mere allegations in the complaint.” The TSBME countered by requesting that 3(three) members of the TSBME review the evidence and decide if they would consider mediation. TSBME staff attorney stated that no TSBME board members had reviewed the state’s case at this point.
$ January 14, 2003, the Administrative Law Judge (ALJ) issues an order requesting mediation between RFC and the TSBME. TSBME rejects mediation.
$ January 31, 2003, the Administrative Law Judge (ALJ) issues order No. 17, requiring mediation in March. Contemporaneous with the mediation, all closing arguments are to be filed with the ALJ Friday, February 28, 2003. Order No. 17 is a result of the TSBME stating to the ALJ that their position has not changed and they still want revocation of RFC’s license—despite (1) the judge’s striking of five of the state’s allegations and the amendment of numerous sections of the remaining complaint due to the state’s errors and untrue statements and (2) the questionable experience of the State’s paid consultants who, by their own admission, are not proficient in the type of cases RFC performs and/or have not adequately reviewed all the pertinent materials relevant to the cases.
$ March 14, 2003, the TSBME attends the ordered mediation. Present for the TSBME is a retired 72 year-old internist who admits to not reading the hearing transcript. He was one of two physicians present at the temporary suspension hearing on July 19, 2002, who took 4 minutes to come to a decision to temporarily suspend RFC’s license. The mediation is progressing until the internist receives a phone call from the TSBME and he and the Board’s attorney leave abruptly without any explanation.
$ April 14, 2003, the closing arguments are in from both sides awaiting the Administrative Law Judge’s ruling on the merits of the case.
$ June 2003, new information that the TSBME’s outside expert (paid $1,000/hr) perjured himself during his disposition at the SOAH hearing by stating that he was not nor ever had been under investigation by a hospital review panel. The doctor had had his hospital privileges suspended from the Univ. of Colorado on Nov.28, 2002 three weeks after his SOAH testimony for having too many complications. He was asked to explain this situation when the case was reopened but declined to respond. He has resigned from the Chair of Neurosurgery at the Univ. of Colorado. He subsequently left Colorado and now practices in Illinois.
$ February 2004, RFC contacts one of his state representatives to see if she can find out the status of his case. SOAH is contacted by phone and states that the judge who originally heard RFC’s case is no longer employed by SOAH and that RFC’s case has been transferred to two new ALJ’s who would rule on the case within sixty days. RFC has not practiced medicine since July 19, 2002(for 20 months and has had his income obliterated).
$ On March 30, 2004, RFC received notice from his attorney of the ALJs’ preliminary findings. The ALJ’s determination was that the evidence did not support the revocation of RFC’s license. RFC was exonerated of violating the Texas Medical Practice Act in twelve of the 13 cases left. RFC has twenty days to provide additional clarification to the ALJs regarding his treatment of the remaining case.
$ May 2004, the Proposal for Decision (PFD) has been completed by the two new ALJ’s. They conclude that the TSBME was unable to substantiate 17 of the alleged 18 cases of substandard care. Essentially, RFC is “cleared” of 17 of 18 allegations that he initially faced in July 2002. Of the 307 Findings of Fact, the PFD identifies a total of four violations in the “Standard of Care” numbers 68, 69,215,246. In the Conclusions of Law, (number 8), the ALJ’s state that the TSBME failed to establish that Dr. Chalifoux violated an acceptable medical standard of care in the treatment of patients TL, ML, JS, GB, PR, TT, BR, HS, CP, or EA. The ALJ’s find one separate issue with the Standard of Care in RFC’s care in the treatment of two patients CY and AJ (who still had good outcomes). In fact, CY testified how pleased she was with the care she had received from Dr. Chalifoux. The ALJ’s felt that the one case EF (a giant aneurysm) could have been treated differently resulting in what they believed were a total of 2 deviations in the standard of care, but they do not concur with the TSBME’s attempted suspension/revocation of RFC’s license.
$ June 4, 2002, RFC faces the TSBME regarding the findings of the PFD and his medical license. In light of the fact that the TSBME has suspended his license for almost two years, the ALJ’s find that the TSBME is at best able to prove 4 of 83 allegations ( 4.82%). The remaining 79 (95.18%) were defended by Dr. Chalifoux.
The bigger issue deals with the thirteen (13) patients who were the reason for the “temporary suspension” in July 2002. Of these patients, ten (10) were found to have received the correct care. Nonetheless, the TSBME board members move for license revocation because of one patient death.
· July 19, 2004, the TSBME denies RFC request for a rehearing of the TSBME’s “REVOCATION” order. This is the two-year anniversary of RFC having his Texas Medical license suspended and then revoked. RFC must now file an appeal in the Travis County Court. RFC’s license is being revoked for one patient death and one known minor complication on two separate patients. The TSBME’s experts who were wrong in their allegations of substandard medical care of patients TL, ML, JS, GB, TT, BR, HS, CP, EA will not face any reprisal from the TSBME since they are immune even though they either gave “misleading” testimony which is not the standard of care or worst, lied about the patient’s care in the first place just to try to make the TSBME’s case against RFC.
Texas State Board of Medical Examiners (TSBME)
Vs. Roland Chalifoux, Jr., D.O.
$ June 12, 2002: TSBME initiates an informal hearing and requests RFC to voluntarily surrender license after four cases of alleged improper patient care issues submitted by competitors at a local hospital, not by the patients who are satisfied with RFC’s care. RFC refuses. RFC has had no contact with TSBME since September of 2001. RFC has performed 546 cases during this time period without patient or hospital complaint. Present at the ISC is Donald Patrick M.D. (executive director of the TSBME and retired neurosurgeon) who acted as a neurosurgical consultant during the hearing and stated that these four cases “were the worst I’ve ever heard of”, falling below the standard of care. These same four cases were later evaluated during the SOAH hearing and thrown out for lack of evidence of any wrong doing or being below the standard of care.
$ July 19, 2002: RFC given two days’ notice to appear at TSBME for disciplinary hearing regarding suspension of license due to adverse peer review actions at four area hospitals that had not elevated RFC to active staff. According to statute, the respondent (RFC) is to be granted 10 days to prepare for hearing. RFC received TSBME’s complaint packet three (3) days after the hearing. RFC and attorney asked for a continuance. It was denied. Upon his attorney’s advice, RFC waived his right to appear due to lack of A due process.” Upon his departure, Hearing Panel deliberated for a total of twenty-nine minutes, suspended RFC’s license and referred case to State Office of Administrative Hearings (SOAH). RFC laid-off four of five full-time employees and closes the office. Thirty (30) patients were notified that their surgeries were cancelled and would be transferred to the care of other physicians.
$ According to the Texas Medical Practice Act 151.002(a)(2) “continuing threat to the public welfare” means a real and present danger to the health of a physician’s patients caused through the physician’s lack of competence, impaired status, or failure to care adequately for the physician’s patients. A real and present danger exists if patients have an exposure to or risk of injury that is not merely abstract, hypothetical or remote and is based on actual actions or inactions of the physician. This issue of being a “clear and present danger” is difficult to understand since up until July 19,2002 I was on staff at three hospitals and had performed 546 cases from 1999-2002 without any medical staff or hospital actions at these facilities.
$ Three days later, RFC received two different complaint packages from TSBME re: suspension hearing. Temporary suspension hearing packet contained five (5) additional complaints that were not sent to SOAH by TSBME.
$ RFC and attorney were ready to appear before SOAH judge late-August/early-September; TSBME said they would not be ready until October even though the TSBME used the same reviewer for all the complaints and had had the information since 1997.
$ October 2002: SOAH hearing begins with a total of 18 charges that TSBME paid a retired neurosurgeon Arthur Evans MD, to review who under oath testified that he had no experience in one form of surgical treatment in question and it was shown later that he was not current in the care and treatment of patients in five other cases. It was also learned during the hearing that he had been involved in a malpractice case where the patient was unaware that he was the surgeon performing surgery instead of the patient’s treating surgeon. During that same case, the expert admitted to not taking an intraoperative x-ray and operating on the wrong level of the patient’s back.
$ TSBME finds a second retired neurosurgeon, Martin Barrash MD in late September and uses him as a paid witness (after becoming aware that RFC had 25 unpaid witnesses in his defense including two patients) to agree with their first witness. This second witness admits that he does not perform fusions by himself, which amounts to 9 of the 13 cases in question. Additionally, he stated the need to review the actual x-rays of several of the complaints before he could make a decision even though he continued to agree with the allegations. This doctor, the state’s second witness, states during the SOAH hearing that RFC should not have had his license suspended.
$ Original SOAH judge finds multiple errors in TSBME’s first complaint. She forces them to amend their original complaint. During the hearing the judge strikes five of the State’s allegations that were found to be hearsay reducing number of complaints against RFC from 18 to 13. SOAH judge also strikes many sections of the remaining 13 complaints since they were found to be untrue.
$ TSBME finds and pays an out of state neurosurgeon Issam Awad MD $1,000/hr to review and give a deposition on one of the thirteen complaints. The outside reviewer’s testimony is also at odds with the TSBME’s other two reviewers. Several months later, it is found that this expert perjured himself during his testimony by denying he had ever been the subject of an investigation of his medical competency. He was eventually forced out of his university seat and practices in another state.
$ SOAH hearing completed on 11/8/2002. It has been four months since RFC has practiced medicine and has had his livelihood cut-off.
$ Dec.19, 2002, SOAH judge asked the TSBME to mediate with respondent since “Serious consideration could be given to what was actually shown by the facts in evidence, rather than the mere allegations in the complaint.” The TSBME countered by requesting that 3(three) members of the TSBME review the evidence and decide if they would consider mediation. TSBME staff attorney stated that no TSBME board members had reviewed the state’s case at this point.
$ January 14, 2003, the Administrative Law Judge (ALJ) issues an order requesting mediation between RFC and the TSBME. TSBME rejects mediation.
$ January 31, 2003, the Administrative Law Judge (ALJ) issues order No. 17, requiring mediation in March. Contemporaneous with the mediation, all closing arguments are to be filed with the ALJ Friday, February 28, 2003. Order No. 17 is a result of the TSBME stating to the ALJ that their position has not changed and they still want revocation of RFC’s license—despite (1) the judge’s striking of five of the state’s allegations and the amendment of numerous sections of the remaining complaint due to the state’s errors and untrue statements and (2) the questionable experience of the State’s paid consultants who, by their own admission, are not proficient in the type of cases RFC performs and/or have not adequately reviewed all the pertinent materials relevant to the cases.
$ March 14, 2003, the TSBME attends the ordered mediation. Present for the TSBME is a retired 72 year-old internist who admits to not reading the hearing transcript. He was one of two physicians present at the temporary suspension hearing on July 19, 2002, who took 4 minutes to come to a decision to temporarily suspend RFC’s license. The mediation is progressing until the internist receives a phone call from the TSBME and he and the Board’s attorney leave abruptly without any explanation.
$ April 14, 2003, the closing arguments are in from both sides awaiting the Administrative Law Judge’s ruling on the merits of the case.
$ June 2003, new information that the TSBME’s outside expert (paid $1,000/hr) perjured himself during his disposition at the SOAH hearing by stating that he was not nor ever had been under investigation by a hospital review panel. The doctor had had his hospital privileges suspended from the Univ. of Colorado on Nov.28, 2002 three weeks after his SOAH testimony for having too many complications. He was asked to explain this situation when the case was reopened but declined to respond. He has resigned from the Chair of Neurosurgery at the Univ. of Colorado. He subsequently left Colorado and now practices in Illinois.
$ February 2004, RFC contacts one of his state representatives to see if she can find out the status of his case. SOAH is contacted by phone and states that the judge who originally heard RFC’s case is no longer employed by SOAH and that RFC’s case has been transferred to two new ALJ’s who would rule on the case within sixty days. RFC has not practiced medicine since July 19, 2002(for 20 months and has had his income obliterated).
$ On March 30, 2004, RFC received notice from his attorney of the ALJs’ preliminary findings. The ALJ’s determination was that the evidence did not support the revocation of RFC’s license. RFC was exonerated of violating the Texas Medical Practice Act in twelve of the 13 cases left. RFC has twenty days to provide additional clarification to the ALJs regarding his treatment of the remaining case.
$ May 2004, the Proposal for Decision (PFD) has been completed by the two new ALJ’s. They conclude that the TSBME was unable to substantiate 17 of the alleged 18 cases of substandard care. Essentially, RFC is “cleared” of 17 of 18 allegations that he initially faced in July 2002. Of the 307 Findings of Fact, the PFD identifies a total of four violations in the “Standard of Care” numbers 68, 69,215,246. In the Conclusions of Law, (number 8), the ALJ’s state that the TSBME failed to establish that Dr. Chalifoux violated an acceptable medical standard of care in the treatment of patients TL, ML, JS, GB, PR, TT, BR, HS, CP, or EA. The ALJ’s find one separate issue with the Standard of Care in RFC’s care in the treatment of two patients CY and AJ (who still had good outcomes). In fact, CY testified how pleased she was with the care she had received from Dr. Chalifoux. The ALJ’s felt that the one case EF (a giant aneurysm) could have been treated differently resulting in what they believed were a total of 2 deviations in the standard of care, but they do not concur with the TSBME’s attempted suspension/revocation of RFC’s license.
$ June 4, 2002, RFC faces the TSBME regarding the findings of the PFD and his medical license. In light of the fact that the TSBME has suspended his license for almost two years, the ALJ’s find that the TSBME is at best able to prove 4 of 83 allegations ( 4.82%). The remaining 79 (95.18%) were defended by Dr. Chalifoux.
The bigger issue deals with the thirteen (13) patients who were the reason for the “temporary suspension” in July 2002. Of these patients, ten (10) were found to have received the correct care. Nonetheless, the TSBME board members move for license revocation because of one patient death.
· July 19, 2004, the TSBME denies RFC request for a rehearing of the TSBME’s “REVOCATION” order. This is the two-year anniversary of RFC having his Texas Medical license suspended and then revoked. RFC must now file an appeal in the Travis County Court. RFC’s license is being revoked for one patient death and one known minor complication on two separate patients. The TSBME’s experts who were wrong in their allegations of substandard medical care of patients TL, ML, JS, GB, TT, BR, HS, CP, EA will not face any reprisal from the TSBME since they are immune even though they either gave “misleading” testimony which is not the standard of care or worst, lied about the patient’s care in the first place just to try to make the TSBME’s case against RFC.
// posted by texas shammed @ 5:36 PM 
