MINUTES Board Members Present Staff Present Board Members Absent

(1)

STATE OF NEVADA

BOARD OF VETERINARY MEDICAL EXAMINERS

4600 Kietzke Lane, Building O-265

Reno, Nevada 89502 Phone 775 688-1788/fax 775 688-1808 vetbdinfo@vetboard.nv.gov www.nvvetboard.us BOARD MEETING at Airport Plaza

Hotel & Conference Center 1981 Terminal Way

Reno, Nevada

Thursday, July 22, 2010

MINUTES

Board Members Present Staff Present

Richard Simmonds, DVM VP Debbie Machen, Exec. Dir. Ronald Sandoval DVM Tracie Estep, Admin. Asst. William Taylor, DVM Mike Chumrau, DVM, Investigator Scott Bradley, DVM Christina Johnson, LVT, Inspector Mark Iodence, DVM Louis Ling, Esq.

Beverly Willard

Board Members Absent

(2)

Dr. Simmonds called the meeting to order 8:48 at a.m. 1. Approval of Board Minutes

A. April 22, 2010

Motion: Dr. Taylor moved to approve. Second: Dr. Bradley

Passed: Unanimously 2. Disciplinary Action

A. AN01-022010-1060 Maureen Adams, DVM: Consent Decree.

Discussion At the April 22, 2010 Board Meeting the Board voted to proceed with disciplinary action. A Stipulated Agreement was signed by Dr. Adams and presented to the Board for consideration.

A Consent Decree stipulating to the following:

1) The course of diagnosis and treatment of “Bulldozer” was negligent because it departed from the standard of practice in that Dr. Adams released “Bulldozer” post-surgically to his owner when “Bulldozer” was non-responsive and non-ambulatory, and thus Dr. Adams violated NRS 638.140(1) and (6) and NAC 638.045.

2) In dispensing two vials of inject able morphine to “Bulldozer’s” owners without any labeling or directions for use, Dr. Adams was negligent and, thus, violated NRS 638.140(1) and (6) and NAC 639.045.

3) In taking samples and payment for laboratory analysis and then in failing to provide those samples to the laboratory for testing and analysis, Dr. Adams was negligent and, thus, violated NRS 638.140(1) and (6) and NAC 639.045 and 639.046.

4) Dr. Adams did not perform a post-anesthetic examination on “Bulldozer” and released him when he was not ambulatory, and thus Dr. Adams violated NRS 638.140(1) and NAC 638.710(1)(c). The Stipulated Adjudication is as follows:

1) Dr. Adams shall be on probation for a period of two years according to the following terms and conditions:

a) Dr. Adams’ hospital shall be subject to random inspections throughout the period of probation.

b) Dr. Adams shall comply with all laws, whether federal or state and whether statutory or regulatory, related to the practice of veterinary medicine.

c) Dr. Adams shall pay the Board’s attorney fees and investigative costs of $400.00.

d) Dr. Adams shall satisfactorily complete three hours in continuing education specifically regarding the treatment of critical care patients.

(3)

Motion: Dr. Bradley moved to accept the Consent Decree as presented.

Second: Dr. Taylor

Passed: Unanimously. Dr. Iodence abstained.

B. DN01-020110-1631 Benjamin Davidson, DVM; Letter of Reprimand. Discussion: At the April 22, 2010 Board Meeting the Board voted to proceed with disciplinary action. A Stipulated Agreement was signed by Dr. Davidson and presented to the Board for consideration.

A Letter of Reprimand stipulating to the following:

1) (NRS) 638.140(1) and (6) and NAC 638.045. Negligence, in that Dr. Davidson is responsible for determining the competency of an unlicensed assistant to perform a particular task and in supervising the assistant’s performance of the task.

The Stipulated Adjudication is as follows:

1) The Licensee will pay attorney fees, investigative costs, and Board costs of $400.00.

Motion: Ms. Willard moved to accept the Letter of Reprimand as presented.

Second: Dr. Bradley

Passed: Unanimously. Dr. Taylor/Dr. Sandoval abstained. C. FS01-020910-1320 William Flannery, DVM: Consent Decree Discussion: At the April 22, 2010 Board Meeting the Board voted to proceed with disciplinary action. A Stipulated Agreement was signed by Dr. Flannery and presented to the Board for consideration.

1) The course of diagnosis and treatment of “Precious” was negligent because it departed from the standard of practice in the treatment of a cat with renal failure in that (a) Dr. Flannery failed to perform a urinalysis, (2) Dr. Flannery failed to monitor “Precious’” weight throughout the course of treatment, and (3) Dr. Flannery did not discuss with the owner the option of euthanasia, and thus Dr. Flannery violated NRS 638.140(1) and (6) and NAC 638.045.

1) Dr. Flannery shall pay the Board’s attorney fees and investigative costs of $400.00.

2) Dr. Flannery shall satisfactorily complete three hours in continuing education specifically regarding the treatment of renal disease.

(4)

Motion: Dr. Taylor moved to accept the Consent Decree as presented.

Second: Dr. Bradley Passed: Unanimously.

D. JS01-020910-1307 Kimberli Johnson, DVM: Consent Decree. Discussion: At the April 22, 2010 Board Meeting the Board voted to proceed with disciplinary action. A Stipulated Agreement was signed by Dr. Johnson and presented to the Board for consideration.

1) Dr. Johnson’s course of diagnosis and treatment of “Tina” was negligent in that it departed from the standard of practice in that Dr. Johnson failed to perform appropriate diagnostics on “Tina,” a diabetic dog in critical condition, and thus Dr. Johnson violated NRS 638.140(1) and (6) and NAC 638.045.

1) Dr. Johnson shall pay the Board’s attorney fees and investigative costs of $400.00.

2) Dr. Johnson shall satisfactorily complete three hours in continuing education specifically regarding the treatment of critical care patients.

Motion: Ms. Willard moved to accept the Consent Decree as presented.

Passed: Unanimously. Dr. Simmonds abstained

E. DS01-022510 Robert Dawson, DVM: Consent Decree.

Discussion: At the April 22, 2010 Board Meeting the Board voted to proceed with disciplinary action. A Stipulated Agreement was signed by Dr. Dawson and presented to the Board for consideration.

1) The course of diagnosis and treatment of “Cinnamon” was negligent because it departed from the standard of practice in that Dr. Dawson did not provide appropriate fluid support for a hemorrhaging dog such as “Cinnamon” and Dr. Dawson did not mention a swollen vulva as part of his pre-anesthesia examination of “Cinnamon,” and thus Dr. Dawson violated NRS 638.140(1) and (6) and NAC 638.045.

2) The medical records made and maintained by Dr. Dawson regarding “Cinnamon’s” treatment were inadequate and less than

(5)

required by applicable law, and thus Dr. Dawson violated NRS 638.140(1) and NAC 638.0475(2).

3) Dr. Dawson’s dealings with the secondary hospital and the emergency hospital, especially in getting both to agree to take “Cinnamon” upon his assurance of payment and then subsequently failing to pay their charges, was unethical, and thus Dr. Dawson violated NRS 638.140(1) and NAC 638.046.

1) Dr. Dawson shall take and pass the Board’s jurisprudence examination.

2) Dr. Dawson shall pay the Board’s attorney fees and investigative costs of $400.00.

Motion: Dr. Bradley moved to accept the Consent Decree as presented.

Second: Dr. Iodence.

Passed: Unanimously. Dr. Sandoval abstained. F. AN01-032910

Discussion: The review panel recommended the Board dismiss 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. Willard moved to dismiss. Second: Dr. Iodence

Passed: Unanimously. Dr. Bradley abstained. G. LS01-033010

Motion: Dr. Taylor moved to dismiss. Second: Dr. Iodence

Passed: Unanimously. H. DR02--040810

Discussion: The review panel recommended the Board dismiss 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 send a letter of recommendation to the Licensee regarding:the use of a steroid prior to staining, when there are concerns of corneal trauma.

(6)

Motion: Dr. Taylor moved to dismiss with a letter of recommendation.

Second: Dr. Iodence

Passed: Unanimously. Dr. Bradley abstained. I. SS01-040810

Motion: Dr. Iodence moved to dismiss. Second: Dr. Taylor

Passed: Unanimously. Dr. Sandoval abstained. J. TO01-041610

Discussion: After discussion of the above noted complaint the review panel recommended that disciplinary action be initiated against the licensee.

Motion: Dr. Taylor moved to have staff and Board Counsel initiate action against the licensee due to there being sufficient evidence to proceed with disciplinary action.

Second: Ms. Willard

Passed: Unanimously. Dr. Simmonds abstained. K. SL01-042010

Tabled for further investigation. L. BS01-042210

Motion: Ms. Willard moved to dismiss. Second: Dr. Sandoval

Passed: Unanimously. M. MS01-051310

Motion: Dr. Taylor moved to dismiss. Second: Dr. Bradley

(7)

N. SS01-051510

Passed: Unanimously. Dr. Sandoval abstained. O. GS01-052410

Motion: Dr. Bradley moved to dismiss. Second: Ms. Willard

Passed: Unanimously. Dr. Simmonds abstained. P. MR01-052810

Passed: Unanimously. Dr. Iodence abstained. Q. WS01-060910

Passed: Unanimously. Dr. Simmonds abstained. R. LS02-061410

(8)

Motion: Dr. Iodence moved to dismiss. Second: Dr. Bradley

Passed: Unanimously.

3. Continuing Education-Request for approval of CE's for:

A. Local and Regional Anesthesia by Dr. Ko, DVM, DACVA & Dr. Dearmin, DVM, DACVS 4 hours of Continuing Education for Veterinary Technicians.

Motion: Dr. Taylor moved to approve for 4 hours of continuing education for veterinary technicians.

Second: Dr. Bradley Passed: Unanimously

B. Intervertebral Disk Disease by David Mason, B. Vet Med, MRCVS, DACVS, DECVS 1 ½ hours of continuing education for veterinarians.

Motion: Dr. Taylor moved to approve for 1 ½ hours of continuing education for veterinarians.

Second: Dr. Iodence Passed: Unanimously

C. Stifle Disease in Veterinary Patients by Christopher Horstman, DVM, MS, DACVS 1 ½ hours of continuing education for veterinarians.

D. Managing Urinary Tract Infections by Shane Lyon, DVM, DACVIM 1 ½ hours of continuing education for veterinarians. Motion: Dr. Taylor moved to approve for 1 ½ hours of continuing education for veterinarians.

E. Diagnostics and Treatment of Corneal Disease by William Weinstein, DVM, MS 1 ½ hours of continuing education for veterinarians.

(9)

F. Tracheal Collapse by Jeffery Geels, DVM, MS, ACVS 1 hour of continuing education for veterinary technicians.

Motion: Dr. Taylor moved to approve for 1 hour of continuing education for veterinary technicians.

G. Ophthalmology by William Weinstein, DVM. MS 1 hour of continuing education for veterinary technicians.

H. Thoracic Surgery Post-Op Care and Complications by David Mason, MRCVS, DAVCS, DECVS 1 hour of continuing education for veterinary technicians.

I. Continuing education hours for Nevada licensees that attend board meetings.

Discussion: Ms. Machen advised the Board that there has been some inquires by licensees regarding obtaining continuing education (CE) hours for attending the complaint portion of the board meetings.

Motion: Dr. Bradley moved to approve up to no more than 4 hours of continuing education for veterinarians per year and 2 hours of continuing education for veterinary technicians per year who attended the complaint portion of the Board meetings.

Second: Dr. Taylor Passed: Unanimously

4. Deputy Attorney General Legal Report-Louis Ling, Esq.

A. New controlled substance and dispensing pharmaceutical laws. Review Panel meeting follow-up.

(10)

Discussion: Mr. Ling provided a draft of new laws regarding the dispensing of pharmaceuticals by Nevada veterinarians. He explained that Dr. Taylor and Dr. Schank met with a representative of the pharmacy board and Dr. Dennis Wilson of the Nevada Veterinary Medical Association and discussed these changes.

After the Board discussed the regulations they instructed staff to proceed with sending the draft to LCB.

B. Open/Pending Complaints/Hearings

Mr. Ling advised the Board that here is a possibility that we will have a short administrative hearing at the October 2010 meeting in Las Vegas.

5. Requests for Licensure/Reinstatement

A. David Elmore,DVM,MPVM, Request for special circumstances. License to practice as a veterinarian without examination. Discussion: Dr. Elmore was present and explained to the Board his special circumstances and why the species specific examinations would not be relative to his limited practice in the field of nonhuman primate medicine.

Dr. Elmore submitted an application for veterinary licensure in the State of Nevada requesting the Board waive the requirement of taking the Species Specific examinations due to his specialty. The Board reviewed his application and all supplemental documentation.

Motion: Dr. Taylor moved to accept his application waiving the species specific requirement.

Passed: Unanimously. Dr. Simmonds abstained.

B. Eunice Kim, Application for LVT and veterinary technician in training with a Bachelor of Science-major in molecular biology.

Discussion: Ms. Kim submitted an application for veterinary technician-in-training and veterinary technician licensure in the State based on her Bachelor of Science Degree in Molecular Biology. The Board reviewed her application and all supplemental documentation.

Motion: Dr. Taylor moved to accept her application. Second: Dr. Iodence

(11)

C. Peregrine Wolff, DVM; Request for special circumstances-License to practice as a veterinarian without examination. Discussion: Dr. Wolff submitted an application for veterinary licensure in the State of Nevada requesting that the Board waive the requirement of taking the Species Specific examinations due to her practice limited to wildlife and exotic species. The Board reviewed her application and all supplemental documentation.

Motion: Dr. Taylor moved to accept her application waiving the taking of the species specific examinations.

Second: Dr. Bradley Passed: Unanimously

D. Kristin Clark, DVM, status and determination of current Probation, medical records release, and disciplinary action posted via the internet.

Discussion: Dr. Clark was present to discuss her current Probation, the release of her medical records, and her discipline being posted on the internet.

Dr. Clark stated that she is planning to move out of state and “wants to take care of this issue and leave on a good note.” She feels “strongly about her reputation and morals and feels that it is silly to continue on Probation when she is not working in the State of Nevada.”

Ms Machen stated that Dr. Clark is not currently working in Nevada and her license is currently “inactive.”

Motion: Dr. Iodence moved to terminate Dr. Clark’s Probation with the provision that if she reactivates her license she would have to appear before the Board for review.

Second: Dr. Taylor Passed: Unanimously.

Dr. Clark explained to the Board her upset in that her discipline history had been posted on various web-sites. She did not understand why the Board would post discipline for the past 20 years. Mr. Ling had written a letter to Ms. Clark explaining that her disciplinary actions are considered public documents and are reported to several agencies.

Dr. Clark expressed concern that her “medical records” had been released. Mr. Ling had written a response to Dr. Clark explaining that the Board had received two court issued subpoenas requesting the information. The Board office responded to the subpoenas following notification of Dr. Clark’s attorney.

(12)

Dr. Simmonds noted that the Board could not be responsible for

Dr. Clark’s attorney’s lack of communication with her.

6. Discussion of Regulations/New Policies

A. Sterilization of gloves and syringes-standard of practice vs. manufacture recommendations.

Discussion: Ms. Machen explained that during a compliance inspection it was found that a hospital was sterilizing surgical gloves for non-surgical reuse. Ms. Johnson had called the manufacture and found that the gloves are labeled for “single use.” The consensus of the Board was that if during inspections this practice of re-sterilization of materials designated as “single use” by the manufacturer was occurring then a “concern” should be noted on the inspection.

B. Physical examination prior to vaccines being given at a vaccination clinic. NAC638.610

Discussion: Dr. Simmonds had been asked by a colleague to have the Board consider taking the physical examination requirement out of the vaccination clinic regulations. Companies that are providing this service in California are not required to do physicals. Further, Dr. Simmonds noted that his colleague’s concern were that the TPR’s taken at a vaccination clinic were often unreliable due to the fact that many, if not most of the animals being vaccinated at these events were extremely agitated and excited. The consensus of the Board is that the physicals are important to determine the health of the animal prior to vaccination and they did not feel that the law warranted any change.

C. What should be included in an anesthesia/surgery log? Discussion: The Board directed staff to modify the current regulation, NAC 638.0475, (i) to add a requirement that the surgery log include the surgery start and finish time with pulse, heart rate, and respiration being taken and recorded at intervals of no less than every 15 minute.

D. Interpretation of NRS 638.133, Duty to report malpractice. Discussion: Ms. Machen explained that there is some confusion in regard to the reporting of a malpractice claim against a veterinarian to the Board. After discussion the consensus was that anytime a claim is made to a veterinarians’ or veterinary technicians’ malpractice insurance company the Board must be notified of this action and ultimately, the disposition of the claim.

E. Administration of vaccinations for zoonotic diseases. Discussion: Ms. Machen explained that there is confusion among

(13)

animal control agencies in regard to who can administer rabies vaccinations to shelter animals and if a physical examination has to be done. The communicable disease laws, NRS 571 do not address this issue and NRS 638 does not apply to the shelters. The Board requested Ms. Machen meet with the State veterinarian and discuss these issues and report back to the Board at a future meeting.

F. Veterinary technicians and/or unlicensed veterinary assistants providing the following tasks: express anal glands & nail trimming.

Discussion: The Board directed staff to add the task of anal gland expression to the veterinary technician duties.

7. Staff Reports

A. Financial Report – Debbie Machen

Discussion: Ms. Machen presented the un-audited financial report to the Board’s satisfaction. The yearly audit has been scheduled for Mid-August of 2010.

B. Budget 2010-11 – Debbie Machen

Discussion: Ms. Machen presented the Budget for 2010-2011 to the Board’s satisfaction. Ms. Machen explained that the GL Suite contract for the licensing software for the database has been re-negotiated for a savings of approximately $6500.00/yr. The Lease for the office space has also been re-negotiated for a saving of approximately $3600.00/yr.

Motion: Dr. Taylor to accept Second: Ms. Willard

Passed: Unanimously

C. Administrative Report – Tracie Estep

Discussion: Ms. Estep presented the administrative report to the Board’s satisfaction.

D. Hospital Inspection Report – Christina Johnson

Discussion: Ms. Johnson presented the administrative report to the Board’s satisfaction.

8. Discussion and Determination

A. The Animal Foundation correspondence to the Board 5-25-2010. Dr. Jennifer Stone-Director Lied Animal Shelter

Discussion: Jennifer Stone, DVM and Jason Smith from Lied Animal Shelter were present to discuss the issue of the new ordinances in Las Vegas and Clark County that requires mandatory spay and neutering of domestic animals. Dr. Stone presented statistics on the over population of animals in Clark County.

(14)

After an in depth discussion regarding the shelters commitment in maintaining compliance with the Clark County ordinance, the consensus of the Board and Legal Counsel was that since the animals are “owner identified” and the owner has been contacted, a veterinary-client-patient relationship has been established pursuant to NAC 638.0175 with Lied Animal Shelter, a licensed facility. Thus, these animals would have to be treated under the provisions of NRS/NAC 638 and WOULD require that the owner sign a surgical release.

The Board discussed the option of Lied establishing an alliance with either Pima or Southern Nevada Veterinary Technician Programs in allowing their second year students (veterinary technicians in training) to do their externships at Lied, providing the shelter with supervised technicians in training.

The Board directed staff to respond to Dr. Stone with a letter addressing the issues discussed.

B. Leadership continuing education-follow-up on costs or possible alternatives.

Discussion: Ms. Machen provided the Board with added information on leadership continuing education classes. The consensus of the Board was that due to economic times that involvement with a project of this size should be tabled until possibly next year. C. Articles for November newsletter

Discussion: The following Board members and staff will write the following articles:

 Hospital Inspections – Most asked Questions/Answers-Christina Johnson

 Monitoring of Boarded Animals-Dr. Chumrau

 Dispensing veterinary drugs/Providing client with information regarding a Drug-Louis Ling

 Continuing education and the audit process-Dr. Simmonds

 President’s letter-Dr. Schank

 Malpractice-Dr. Taylor

 New Board Member – Dr. Sandoval

D. Report from Governors’ meeting July 21, 2010.

Discussion: Ms. Machen and Dr. Simmonds reported on the summit meeting that was held with the Governor’s staff and other boards and commissions last week regarding the following items:

 State Budget Act and Financial Reporting

 Board Operations, Personnel and Reporting

(15)

 Consolidation of some Boards and Commissions

 Providing an efficient, streamline, and resourceful government

E. Set Board Meetings, October 21, 2010-Las Vegas; January 27, 2011-Reno; April 2011-Las Vegas.

Discussion: Future Board Meetings: October 21, 2010-Las Vegas; January 27, 2011-Reno; April 21, 2011-Las Vegas

*9. Public Comment Discussion: None

10. Agenda items for next meeting None