BEFORE THE MEDICAL BOARD OF CALIFORNIA DEPARTMENT OF ...4patientsafety.org/documents/Dominguez,...

BEFORE THE MEDICAL BOARD OF CALIFORNIA

DEPARTMENT OF CONSUMER AFFAIRS STATE OF CALIFORNIA

In the Matter of the Petition for Reconsideration filed by:

RONALD E. DOMINGUEZ, M.D. Physician's and Surgeon's Certificate No. A114123

Petitioner.

) ) ) ) ) ) ) ) )

Case No. 8002014002410

DENIAL BY OPERATION OF LAW PETITION FOR RECONSIDERATION

No action having been taken on the petition for reconsideration, filed by Ronald E. Dominguez, M.D., and the time for action having expired at 5 p.m. on December 9, 2016, the petition is deemed denied by operation oflaw.

BEFORE THE MEDICAL BOARD OF CALIFORNIA

DEPARTMENT OF CONSUMER AFFAIRS STATE OF CALIFORNIA

In the Matter of the Accusation ) Against: )

) )

RONALD ERIC DOMINGUEZ, M.D. ) )

Physician's and Surgeon's ) Certificate No. A114123 )

) Respondent ) __________________________ )

Case No. 8002014002410

DECISION

The attached Stipulated Settlement and Disciplinary Order is hereby adopted as the Decision and Order of the Medical Board of California, Department of Consumer Affairs, State of California.

This Decision shall become effective at 5:00 p.m. on December 9 ,2016.

IT IS SO ORDERED: November 9, 2016.

MEDICAL BOARD OF CALIFORNIA

1 KAMALA D. HARRIS Attorney General of California

2 ALEXANDRA M. ALVAREZ Supervising Deputy Attorney General

3 MICHAEL C. BRUMMEL Deputy Attorney General

4 State Bar No. 236116 California Department of Justice

5 2550 Mariposa Mall, Room 5090 Fresno, CA 93 721

6 Telephone: (559) 477-1679 Facsimile: (559) 445-5106

7 E-mail: [email protected] Attorneys for Complainant

BEFORE THE

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MEDICAL BOARD OF CALIFORNIA DEPARTMENT OF CONSUMER AFFAIRS

STATE OF CALIFORNIA

13 In the Matter of the Accusation Against:

14 RONALD E. DOMINGUEZ, M.D. 449 S Madera Ave.

15 Kerman, CA 93630

16 Physician's and Surgeon's Certificate No. A114123

Respondent.

Case No. 800-2014-002410

STIPULATED SETTLEMENT AND DISCIPLINARY ORDER

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IT IS HEREBY STIPULATED AND AGREED by and between the parties to the above-

entitled proceedings that the following matters are true:

PARTIES

1. Kimberly Kirchmeyer (Complainant) is the Executive Director of the Medical Board

23 of California. She brought this action solely in her official capacity and is represented in this

24 matter by Kamala D. Harris, Attorney General of the State of California, by Michael C. Brummel,

25 Deputy Attorney General.

26 2. Respondent Ronald E. Dominguez, M.D. ("Respondent") is represented in this

27 proceeding by attorney Roger T. Nuttall, whose address is: 2333 Merced Street, Fresno, CA

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STIPULATED SETTLEMENT AND DISCIPLINARY ORDER (800-2014-002410)

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3. On or about September 24, 201 0, the Medical Board of California issued Physician's

and Surgeon's Certificate No. All4123 to Ronald E. Dominguez, M.D. (Respondent). The

Physician's and Surgeon's Certificate was in full force and effect at all times relevant to the

charges brought in Accusation No. 800-2014-002410, and will expire on December 31, 2017,

unless renewed.

JURISDICTION

4. Accusation No. 800-2014-002410 was filed before the Medical Board of California

(Board), Department of Consumer Affairs, and is currently pending against Respondent. The

Accusation and all other statutorily required documents were properly served on Respondent on

November 13, 2015. Respondent timely filed his Notice of Defense contesting the Accusation.

5. A copy of Accusation No. 800-2014-002410 is attached as Exhibit A and

incorporated herein by reference.

ADVISEMENT AND WAIVERS

6. Respondent has carefully read, fully discussed with counsel, and understands the

charges and allegations in Accusation No. 800-2014-002410. Respondent has also carefully read,

fully discussed with counsel, and understands the effects of this Stipulated Settlement and

Disciplinary Order.

7. Respondent is fully aware of his legal rights in this matter, including the right to a

hearing on the charges and allegations in the Accusation; the right to confront and cross-examine

the witnesses against him; the right to present evidence and to testify on his own behalf; the right

to the issuance of subpoenas to compel the attendance of witnesses and the production of

documents; the right to reconsideration and court review of an adverse decision; and all other

rights accorded by the California Administrative Procedure Act and other applicable laws.

8. Respondent voluntarily, knowingly, and intelligently waives and gives up each and

every right set forth above.

CULPABILITY

9. Respondent admits the truth of each and every charge and allegation in Accusation

No. 800-2014-002410.

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10. Respondent agrees that his Physician's and Surgeon's Certificate is subject to

2 discipline and he agrees to be bound by the Board's probationary terms as set forth in the

3 Disciplinary Order below.

4 CONTINGENCY

5 11. This stipulation shall be subject to approval by the Medical Board of California.

6 Respondent understands and agrees that counsel for Complainant and the staff of the Medical

7 Board of California may communicate directly with the Board regarding this stipulation and

8 settlement, without notice to or participation by Respondent or his counsel. By signing the

9 stipulation, Respondent understands and agrees that he may not withdraw his agreement or seek

10 to rescind the stipulation prior to the time the Board considers and acts upon it. If the Board fails

11 to adopt this stipulation as its Decision and Order, the Stipulated Settlement and Disciplinary

12 Order shall be of no force or effect, except for this paragraph, it shall be inadmissible in any legal

13 action between the parties, and the Board shall not be disqualified from further action by having

14 considered this matter.

15 12. The parties understand and agree that Portable Document Format (PDF) and facsimile

16 copies of this Stipulated Settlement and Disciplinary Order, including PDF and facsimile

17 signatures thereto, shall have the same force and effect as the originals.

18 13. In consideration of the foregoing admissions and stipulations, the parties agree that

19 the Board may, without further notice or formal proceeding, issue and enter the following

20 Disciplinary Order:

21 DISCIPLINARY ORDER

22 IT IS HEREBY ORDERED that Physician's and Surgeon's Certificate No. A114123 issued

23 to Respondent Ronald E. Dominguez, M.D. is revoked. However, the revocation is stayed and

24 Respondent is placed on probation for four ( 4) years on the following terms and conditions.

25 1. CONTROLLED SUBSTANCES - ABSTAIN FROM USE. Respondent shall abstain

26 completely from the personal use or possession of controlled substances as defined in the

27 California Uniform Controlled Substances Act, dangerous drugs as defined by Business and

28 Professions Code section 4022, and any drugs requiring a prescription. This prohibition does not

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1 apply to medications lawfully prescribed to Respondent by another practitioner for a bona fide

2 illness or condition.

3 Within 15 calendar days of receiving any lawfully prescribed medications, Respondent

4 shall notify the Board or its designee of the: issuing practitioner's name, address, and telephone

5 number; medication name, strength, and quantity; and issuing pharmacy name, address, and

6 telephone number.

7 If Respondent has a confirmed positive biological fluid test for any substance (whether or

8 not legally prescribed) and has not reported the use to the Board or its designee, Respondent

9 shall receive a notification from the Board or its designee to immediately cease the practice of

10 medicine. The Respondent shall not resume the practice of medicine until final decision on an

11 accusation and/or a petition to revoke probation. An accusation and/or petition to revoke

12 probation shall be filed by the Board within 15 days of the notification to cease practice. If the

13 Respondent requests a hearing on the accusation and/or petition to revoke probation, the Board

14 shall provide the Respondent with a hearing within 30 days of the request, unless the Respondent

15 stipulates to a later hearing. A decision shall be received from the Administrative Law Judge or

16 the Board within 15 days unless good cause can be shown for the delay. The cessation of practice

17 shall not apply to the reduction of the probationary time period.

18 If the Board does not file an accusation or petition to revoke probation within 15 days of the

19 issuance of the notification to cease practice or does not provide Respondent with a hearing

20 within 30 days of a such a request, the notification of cease practice shall be dissolved.

21 2. ALCOHOL - ABSTAIN FROM USE. Respondent shall abstain completely from the

22 use of products or beverages containing alcohol.

23 If Respondent has a confirmed positive biological fluid test for alcohol, Respondent shall

24 receive a notification from the Board or its designee to immediately cease the practice of

25 medicine. The Respondent shall not resume the practice of medicine until final decision on an

26 accusation and/or a petition to revoke probation. An accusation and/or petition to revoke

27 probation shall be filed by the Board within 15 days of the notification to cease practice. If the

28 Respondent requests a hearing on the accusation and/or petition to revoke probation, the Board

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shall provide the Respondent with a hearing within 30 days of the request, unless the Respondent

stipulates to a later hearing. A decision shall be received from the Administrative Law Judge or

the Board within 15 days unless good cause can be shown for the delay. The cessation of practice

shall not apply to the reduction of the probationary time period.

If the Board does not file an accusation or petition to revoke probation within 15 days of the

issuance of the notification to cease practice or does not provide Respondent with a hearing

within 30 days of a such a request, the notification of cease practice shall be dissolved.

3. NOTICE OF EMPLOYER OR SUPERVISOR INFORMATION. Within seven (7)

days of the effective date of this Decision, Respondent shall provide to the Board the names,

physical addresses, mailing addresses, and telephone numbers of any and all employers and

supervisors. Respondent shall also provide specific, written consent for the Board, Respondent's

worksite monitor, and Respondent's employers and supervisors to communicate regarding

Respondent's work status, performance, and monitoring. For purposes of this section,

"supervisors" shall include the Chief of Staff and Health or Well Being Committee Chair, or

equivalent, if applicable, when Respondent has medical staff privileges.

4. BIOLOGICAL FLUID TESTING. Respondent shall immediately submit to

biological fluid testing, at Respondent's expense, upon request of the Board or its designee.

"Biological fluid testing" may include, but is not limited to, urine, blood, breathalyzer, hair

follicle testing, or similar drug screening approved by the Board or its designee. Respondent shall

make daily contact with the Board or its designee to determine whether biological fluid testing is

required. Respondent shall be tested on the date of the notification as directed by the Board or its

designee. The Board may order Respondent to undergo a biological fluid test on any day, at any

time, including weekends and holidays. Except when testing on a specific date as ordered by the

Board or its designee, the scheduling of biological fluid testing shall be done on a random basis.

The cost of biological fluid testing shall be borne by Respondent.

During the first year of probation, Respondent shall be subject to 52 to 104 random tests.

During the second year of probation and for the duration ofthe probationary term, up to five ( 5)

years, Respondent shall be subject to 36 to 104 random tests per year. Only if there has been no

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positive biological fluid tests in the previous five ( 5) consecutive years of probation, may testing

be reduced to one (1) time per month. Nothing precludes the Board from increasing the number

of random tests to the first-year level of frequency for any reason.

Prior to practicing medicine, Respondent shall contract with a laboratory or service,

approved in advance by the Board or its designee, that will conduct random, unannounced,

observed, biological fluid testing and meets all the following standards:

A. Its specimen collectors are either certified by the Drug and Alcohol Testing

Industry Association or have completed the training required to serve as a collector for the United

States Department of Transportation.

B. Its specimen collectors conform to the current United States Department of

Transportation Specimen Collection Guidelines.

C. Its testing locations comply with the Urine Specimen Collection Guidelines

published by the United States Department of Transportation without regard to the type of test

administered.

D. Its specimen collectors observe the collection of testing specimens.

E. Its laboratories are certified and accredited by the United States Department of

Health and Human Services.

F. Its testing locations shall submit a specimen to a laboratory within one (1) business

day of receipt and all specimens collected shall be handled pursuant to chain of custody

procedures. The laboratory shall process and analyze the specimens and provide legally

defensible test results to the Board within seven (7) business days of receipt of the specimen. The

Board will be notified of non-negative results within one (1) business day and will be notified of

negative test results within seven (7) business days.

G. Its testing locations possess all the materials, equipment, and technical expertise

necessary in order to test Respondent on any day of the week.

H. Its testing locations are able to scientifically test for urine blood, and hair

27 specimens for the detection of alcohol and illegal and controlled substances.

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1 J. It maintains an automated 24-hour toll-free telephone system and/or a secure on-

2 line computer database that allows Respondent to check in daily for testing.

3 K. It maintains a secure, HIP AA-compliant website or computer system that allows

4 staff access to drug test results and compliance reporting information that is available 24 hours a

5 day.

6 L. It employs or contracts with toxicologists that are licensed physicians and have

7 knowledge of substance abuse disorders and the appropriate medical training to interpret and

8 evaluate laboratory biological fluid test results, medical histories, and any other information

9 relevant to biomedical information.

10 M. It will not consider a toxicology screen to be negative if a positive result is

11 obtained while practicing, even if Respondent holds a valid prescription for the substance.

12 Prior to changing testing locations for any reason, including during vacation or other

13 travel, alternative testing locations must be approved by the Board and meet the requirements

14 above.

15 The contract shall require that the laboratory directly notify the Board or its designee of

16 non-negative results within one (1) business day and negative test results within seven (7)

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18 days of the results becoming available. Respondent shall maintain this laboratory or service

19 contract during the period of probation.

20 A certified copy of any laboratory test result may be received in evidence in any

21 proceedings between the Board and Respondent.

22 If a biological fluid test result indicates Respondent has used, consumed, ingested, or

23 administered to himself a prohibited substance, the Board shall order Respondent to

24 cease practice and instruct Respondent to leave any place of work where Respondent is practicing

25 medicine or providing medical services. The Board shall immediately notify all of Respondent's

26 employers, supervisors and work monitors, if any, that Respondent may not practice medicine or

27 provide medical services while the cease-practice order is in effect.

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1 A biological fluid test will not be considered negative if a positive result is obtained while

2 practicing, even if the practitioner holds a valid prescription for the substance. If no prohibited

3 substance use exists, the Board shall lift the cease-practice order within one ( 1) business day.

4 After the issuance of a cease-practice order, the Board shall determine whether the

5 positive biological fluid test is in fact evidence of prohibited substance use by consulting with the

6 specimen collector and the laboratory, communicating with the licensee, his treating

7 physician(s), other health care provider, or group facilitator, as applicable.

8 For purposes of this condition, the terms "biological fluid testing" and "testing" mean the

9 acquisition and chemical analysis ofRespondent's urine, blood, breath, or hair.

10 For purposes of this condition, the term "prohibited substance" means an illegal drug, a

11 lawful drug not prescribed or ordered by an appropriately licensed health care provider for use by

12 Respondent and approved by the Board, alcohol, or any other substance Respondent has been

13 instructed by the Board not to use, consume, ingest, or administer to himself

14 If the Board confirms that a positive biological fluid test is evidence of use of a prohibited

15 substance, Respondent has committed a major violation, as defined in section 1361.52(a), and the

16 Board shall impose any or all of the consequences set forth in section 1361.52(b), in addition to

17 any other terms or conditions the Board determines are necessary for public protection or to

18 enhance Respondent's rehabilitation.

19 5. SUBSTANCE ABUSE SUPPORT GROUP MEETINGS. Within thirty (30) days

20 ofthe effective date of this Decision, Respondent shall submit to the Board or its designee, for its

21 prior approval, the name of a substance abuse support group which he shall attend for the duration

22 of probation. Respondent shall attend substance abuse support group meetings at least once per

23 week, or as ordered by the Board or its designee.

24 Respondent shall pay all substance abuse support group meeting costs.

25 The facilitator of the substance abuse support group meeting shall have a minimum of

26 three (3) years' experience in the treatment and rehabilitation of substance abuse, and shall be

27 licensed or certified by the state or nationally certified organizations. The facilitator shall not

28 have a current or former financial, personal, or business relationship with Respondent within the

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1 last five (5) years. Respondent's previous participation in a substance abuse group support

2 meeting led by the same facilitator does not constitute a prohibited current or former financial,

3 personal, or business relationship.

4 The facilitator shall provide a signed document to the Board or its designee showing

5 Respondent's name, the group name, the date and location ofthe meeting, Respondent's

6 attendance, and Respondent's level of participation and progress. The facilitator shall report any

7 unexcused absence by Respondent from any substance abuse support group meeting to the Board,

8 or its designee, within twenty-four (24) hours of the unexcused absence.

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6. VIOLATION OF PROBATION CONDITION FOR SUBSTANCE-ABUSING

LICENSEES. Failure to fully comply with any term or condition of probation is a violation of

probation.

A. If Respondent commits a major violation of probation as defined by section

1361.52, subdivision (a), of Title 16 of the California Code of Regulations, the Board shall take

one or more of the following actions:

(1) Issue an immediate cease-practice order and order Respondent to undergo a

clinical diagnostic evaluation to be conducted in accordance with section 1361.5,

subdivision (c)(l), ofTitle 16 of the California Code of Regulations, at

Respondent's expense. The cease-practice order issued by the Board or its

designee shall state that Respondent must test negative for at least a month of

continuous biological fluid testing before being allowed to resume practice. For

purposes of the determining the length of time Respondent must test negative

while undergoing continuous biological fluid testing following issuance of a cease

practice order, a month is defined as thirty calendar (30) days. Respondent may

not resume the practice of medicine until notified in writing by the Board or its

designee that he may do so.

(2) Increase the frequency of biological fluid testing.

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1 (3) Refer Respondent for further disciplinary action, such as suspension,

2 revocation, or other action as determined by the Board or its designee. (Cal. Code

3 Regs., tit. 16, § 1361.52, subd. (b).)

4 B. If Respondent commits a minor violation of probation as defined by section

5 1361.52, subdivision (c), ofTitle 16 ofthe California Code ofRegulations, the Board shall take

6 one or more of the following actions:

7 ( 1) Issue a cease-practice order;

8 (2) Order practice limitations;

9 (3) Order or increase supervision of Respondent;

1 0 ( 4) Order increased documentation;

11 (5) Issue a citation and fine, or a warning letter;

12 ( 6) Order Respondent to undergo a clinical diagnostic evaluation to be

13 conducted in accordance with section 1361.5, subdivision (c)(l), ofTitle 16 ofthe

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California Code ofRegulations, at Respondent's expense;

(7) Take any other action as determined by the Board or its designee. (Cal.

Code Regs., tit. 16, § 1361.52, subd. (d).)

Nothing in this Decision shall be considered a limitation on the Board's authority

18 to revoke Respondent's probation if he has violated any term or condition of probation. (See Cal.

19 Code Regs., tit. 16, § 1361.52, subd. (e).) If Respondent violates probation in any respect, the

20 Board, after giving Respondent notice and the opportunity to be heard, may revoke probation and

21 carry out the disciplinary order that was stayed. If an Accusation, or Petition to Revoke

22 Probation, or an Interim Suspension Order is filed against Respondent during probation, the

23 Board shall have continuing jurisdiction until the matter is final, and the period of probation shall

24 be extended until the matter is final.

25 7. PROFESSIONALISM PROGRAM (ETHICS COURSE). Within 60 calendar

26 days of the effective date of this Decision, Respondent shall enroll in a professionalism program,

27 that meets the requirements of Title 16, California Code of Regulations (CCR) section 1358.

28 Respondent shall participate in and successfully complete that program. Respondent shall

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1 provide any information and documents that the program may deem pertinent. Respondent shall

2 successfully complete the classroom component of the program not later than six ( 6) months after

3 Respondent's initial enrollment, and the longitudinal component of the program not later than the

4 time specified by the program, but no later than one (1) year after attending the classroom

5 component. The professionalism program shall be at Respondent's expense and shall be in

6 addition to the Continuing Medical Education (CME) requirements for renewal of licensure.

7 A professionalism program taken after the acts that gave rise to the charges in the

8 Accusation, but prior to the effective date of the Decision may, in the sole discretion of the Board

9 or its designee, be accepted towards the fulfillment of this condition if the program would have

10 been approved by the Board or its designee had the program been taken after the effective date of

11 this Decision.

12 Respondent shall submit a certification of successful completion to the Board or its

13 designee not later than 15 calendar days after successfully completing the program or not later

14 than 15 calendar days after the effective date of the Decision, whichever is later.

15 8. PSYCHOTHERAPY. Within 60 calendar days of the effective date of this

16 Decision, Respondent shall submit to the Board or its designee for prior approval the name and

17 qualifications of a California-licensed board certified psychiatrist or a licensed psychologist who

18 has a doctoral degree in psychology and at least five years of postgraduate experience in the

19 diagnosis and treatment of emotional and mental disorders. Upon approval, Respondent shall

20 undergo and continue psychotherapy treatment, including any modifications to the frequency of

21 psychotherapy, until the Board or its designee deems that no further psychotherapy is necessary.

22 The psychotherapist shall consider any information provided by the Board or its designee

23 and any other information the psychotherapist deems relevant and shall furnish a written

24 evaluation report to the Board or its designee. Respondent shall cooperate in providing the

25 psychotherapist any information and documents that the psychotherapist may deem pertinent.

26 Respondent shall have the treating psychotherapist submit quarterly status reports to the

27 Board or its designee. The Board or its designee may require Respondent to undergo psychiatric

28 evaluations by a Board-appointed board certified psychiatrist. If, prior to the completion of

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1 probation, Respondent is found to be mentally unfit to resume the practice of medicine without

2 restrictions, the Board shall retain continuing jurisdiction over Respondent's license and the

3 period of probation shall be extended until the Board determines that Respondent is mentally fit

4 to resume the practice of medicine without restrictions.

5 Respondent shall pay the cost of all psychotherapy and psychiatric evaluations.

6 9. NOTIFICATION. Within seven (7) days ofthe effective date ofthis Decision, the

7 Respondent shall provide a true copy of this Decision and Accusation to the Chief of Staff or the

8 Chief Executive Officer at every hospital where privileges or membership are extended to

9 Respondent, at any other facility where Respondent engages in the practice of medicine,

10 including all physician and locum tenens registries or other similar agencies, and to the Chief

11 Executive Officer at every insurance carrier which extends malpractice insurance coverage to

12 Respondent. Respondent shall submit proof of compliance to the Board or its designee within 15

13 calendar days.

14 This condition shall apply to any change(s) in hospitals, other facilities or insurance carrier.

15 10. OBEY ALL LAWS. Respondent shall obey all federal, state and local laws, all

16 rules governing the practice of medicine in California and remain in full compliance with any

17 court ordered criminal probation, payments, and other orders.

18 11. QUARTERLY DECLARATIONS. Respondent shall submit quarterly

19 declarations under penalty of petjury on forms provided by the Board, stating whether there has

20 been compliance with all the conditions of probation.

21 Respondent shall submit quarterly declarations not later than 10 calendar days after the end

22 of the preceding quarter.

23 12. GENERAL PROBATION REQUIREMENTS.

24 Compliance with Probation Unit

25 Respondent shall comply with the Board's probation unit and all terms and conditions of

26 this Decision.

27 Address Changes

28 Respondent shall, at all times, keep the Board informed of Respondent's business and

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1 residence addresses, email address (if available), and telephone number. Changes of such

2 addresses shall be immediately communicated in writing to the Board or its designee. Under no

3 circumstances shall a post office box serve as an address of record, except as allowed by Business

4 and Professions Code section 2021 (b).

5 Place of Practice

6 Respondent shall not engage in the practice of medicine in Respondent's or patient's place

7 of residence, unless the patient resides in a skilled nursing facility or other similar licensed

8 facility.

9 License Renewal

10 Respondent shall maintain a current and renewed California physician's and surgeon's

11 license.

12 Travel or Residence Outside California

13 Respondent shall immediately inform the Board or its designee, in writing, of travel to any

14 areas outside the jurisdiction of California which lasts, or is contemplated to last, more than thirty

15 (30) calendar days.

16 In the event Respondent should leave the State of California to reside or to practice

17 Respondent shall notify the Board or its designee in writing 30 calendar days prior to the dates of

18 departure and return.

19 13. INTERVIEW WITH THE BOARD OR ITS DESIGNEE. Respondent shall be

20 available in person upon request for interviews either at Respondent's place of business or at the

21 probation unit office, with or without prior notice throughout the term of probation.

22 14. NON-PRACTICE WHILE ON PROBATION. Respondent shall notify the Board

23 or its designee in writing within 15 calendar days of any periods of non-practice lasting more than

24 30 calendar days and within 15 calendar days of Respondent's return to practice. Non-practice is

25 defined as any period of time Respondent is not practicing medicine in California as defined in

26 Business and Professions Code sections 2051 and 2052 for at least 40 hours in a calendar month

27 in direct patient care, clinical activity or teaching, or other activity as approved by the Board. All

28 time spent in an intensive training program which has been approved by the Board or its designee

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1 shall not be considered non-practice. Practicing medicine in another state of the United States or

2 Federal jurisdiction while on probation with the medical licensing authority of that state or

3 jurisdiction shall not be considered non-practice. A Board-ordered suspension of practice shall

4 not be considered as a period of non-practice.

5 In the event Respondent's period of non-practice while on probation exceeds 18 calendar

6 months, Respondent shall successfully complete a clinical training program that meets the criteria

7 of Condition 18 of the current version of the Board's "Manual of Model Disciplinary Orders and

8 Disciplinary Guidelines" prior to resuming the practice of medicine.

9 Respondent's period of non-practice while on probation shall not exceed two (2) years.

10 Periods of non-practice will not apply to the reduction of the probationary term.

11 Periods of non-practice will relieve Respondent of the responsibility to comply with the

12 probationary terms and conditions with the exception of this condition and the following terms

13 and conditions of probation: Obey All Laws; and General Probation Requirements.

14 15. COMPLETION OF PROBATION. Respondent shall comply with all financial

15 obligations (e.g., restitution, probation costs) not later than 120 calendar days prior to the

16 completion of probation. Upon successful completion of probation, Respondent's certificate shall

17 be fully restored.

18 16. VIOLATION OF PROBATION. Failure to fully comply with any term or

19 condition of probation is a violation of probation. If Respondent violates probation in any

20 respect, the Board, after giving Respondent notice and the opportunity to be heard, may revoke

21 probation and carry out the disciplinary order that was stayed. If an Accusation, or Petition to

22 Revoke Probation, or an Interim Suspension Order is filed against Respondent during probation,

23 the Board shall have continuing jurisdiction until the matter is final, and the period of probation

24 shall be extended until the matter is final.

25 17. LICENSE SURRENDER. Following the effective date of this Decision, if

26 Respondent ceases practicing due to retirement or health reasons or is otherwise unable to satisfy

27 the terms and conditions of probation, Respondent may request to surrender his or her license.

28 The Board reserves the right to evaluate Respondent's request and to exercise its discretion in

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determining vvhether or not to grant the request, or to take any other action deemed appropriate

2 and reasonable under the circumstances. Upon formal acceptance of the surrender, Respondent

3 shall within 15 calendar days deliver Respondent's wallet and wall certificate to the Board or its

4 designee and Respondent shall no longer practice medicine. Respondent will no longer be subject

5 to the terms and conditions of probation. If Respondent re-applies for a medical license, the

6 application shall be treated as a petition for reinstatement of a revoked certificate.

7 18. PROBATION MONITORING COSTS. Respondent shall pay the costs associated

8 with probation monitoring each and every year of probation, as designated by the Board, which

9 may be adjusted on an annual basis. Such costs shall be payable to the Medical Board of

10 California and delivered to the Board or its designee no later than January 31 of each calendar

11 year.

12 ACCEPTANCE

13 I have carefully read the above Stipulated Settlement and Disciplinary Order and have fully

14 discussed it with my attorney, Roger T. Nuttall. I understand the stipulation and the effect it will

15 have on my Physician's and Surgeon's Certificate. I enter into this Stipulated Settlement and

16 Disciplinary Order voluntarily, knowingly, and intelligently, and agree to be bound by the

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Decision and Order of the Medical Board of California. ., I

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/ / L;;,{ t.t:e--/ / / ,(,

{/RONALD E. DOMINGUEZ, M.D. Respondent

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22 I have read and fully discussed with Respondent Ronald E. Dominguez, M.D .. the terms and

23 conditions and other matters contained in the above Stipulated Settlement and Disciplinary Order.

24 I approve its form and content.

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DATED:

Ill

ROGER T. NUTTA Attorney for Respondent

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STIPULATED SETTLEMENT A~D DISCIPLINARY ORDER (800-20 14-002410)

ENDORSEMENT

2 The foregoing Stipulated Settlement and Disciplinary Order is hereby respectfully

3 submitted for consideration by the Medical Board of California.

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Dated: C( [2-~ jzo I (p

FR20 15302228 95199497 .docx

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Respectfully submitted,

KAMALA D. HARRIS Attorney General of California ALEXANDRA M. ALVAREZ

Supervising ~ Attornfl General

~~ MICHAEL C. BRUMMEL Deputy Attorney General Attorneys for Complainant


Exhibit A

Accusation No. 800-2014-002410

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KAMALA D. HARRIS Attorney General of California JANE ZACK SIMON Supervising Deputy Attorney General MICHAEL C. BRUMMEL Deputy Attorney General State Bar No. 236116

California Department of Justice 2550 Mariposa Mall, Room 5090 Fresno, CA 93721 Telephone: (559) 477~1679 Facsimile: (559) 445-5106 E-mail: Michael.Brummel@doj .ca.gov

Attorneys for Complainant

BEFORE THE

FILED CALIFORNIA

OF CALIFORNIA .. '3 20 /~

~~- ANALYST

MEDICAL BOARD OF CALIFORNIA DEPARTMENT OF CONSUMER AFFAIRS

STATE OF CALIFORNIA

In the Matter of the Accusation Against:

Ronald E. Dominguez, M.D. 449 S Madera Ave. Kerman, CA 93630

Physician's and Surgeon's Certificate No. A 114123,

Respondent.

Complainant alleges:

Case No. 800-2014-002410

ACCUSATION

PARTIES

1. Kimberly Kirchmeyer (Complainant) brings this Accusation solely in her official

capacity as the Executive Director ofthe Medical Board of California, Department of Consumer

Affairs (Board) 1•

2. On or about September 24, 201 0, the Medical Board issued Physician's and Surgeon's

Certificate Number A 114123 to Ronald E. Dominguez, M.D. (Respondent). The Physician's and

1 The term "Board" means the Medical Board of California. "Division of Medical Quality" shall also be deemed to refer to the Board.

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(RONALD E. DOMINGUEZ, M.D.) ACCUSATION NO. 800-2014-002410

Surgeon's Certificate was in full force and effect at all times relevant to the charges brought

2 herein and will expire on December 31, 2015, unless renewed.

3 JURISDICTION

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3. This Accusation is brought before the Board, under the authority of the following

laws. All section references are to the Business and Professions Code unless otherwise indicated.

4. Section 2227 of the Code states:

"(a) A licensee whose matter has been heard by an administrative law judge of the Medical

Quality Hearing Panel as designated in Section 11371 of the Government Code, or whose default

has been entered, and who is found guilty, or who has entered into a stipulation for disciplinary

action with the board, may, in accordance with the provisions of this chapter:

"(1) Have his or her license revoked upon order of the board.

"(2) Have his or her right to practice suspended for a period not to exceed one year upon

order of the board.

"(3) Be placed on probation and be required to pay the costs of probation monitoring upon

order of the board.

"(4) Be publicly reprimanded by the board. The public reprimand may include a

requirement that the licensee complete relevant educational courses approved by the board.

"(5) Have any other action taken in relation to discipline as part of an order of probation, as

the board or an administrative law judge may deem proper.

"(b) Any matter heard pursuant to subdivision (a), except for warning letters, medical

review or advisory conferences, professional competency examinations, continuing education

activities, and cost reimbursement associated therewith that are agreed to with the board and

successfully completed by the licensee, or other matters made confidential or privileged by

existing law, is deemed public, and shall be made available to the public by the board pursuant to

Section 803.1."

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1 5. Section 2234 of the Code, states:

2 "The board shall take action against any licensee who is charged with unprofessional

3 conduct. In addition to other provisions of this article, unprofessional conduct includes, but is not

4 limited to, the following:

5 "(a) Violating or attempting to violate, directly or indirectly, assisting in or abetting the

6 violation of, or conspiring to violate any provision of this chapter.

7 "(b) Gross negligence.

8 "(c) Repeated negligent acts. To be repeated, there must be two or more negligent acts or

9 omissions. An initial negligent act or omission followed by a separate and distinct departure from

10 the applicable standard of care shall constitute repeated negligent acts.

11 "(1) An initial negligent diagnosis followed by an act or omission medically appropriate

12 for that negligent diagnosis of the patient shall constitute a single negligent act.

13 "(2) When the standard of care requires a change in the diagnosis, act, or omission that

14 constitutes the negligent act described in paragraph (1 ), including, but not limited to, a

15 reevaluation of the diagnosis or a change in treatment, and the licensee's conduct departs from the

16 applicable standard of care, each departure constitutes a separate and distinct breach of the

17 standard of care.

18 "(d) Incompetence.

19 "(e) The commission of any act involving dishonesty or corruption which is substantially

20 related to the qualifications, functions, or duties of a physician and surgeon.

21 "(f) Any action or conduct which would have warranted the denial of a certificate.

22 "(g) The practice of medicine from this state into another state or country without meeting

23 the legal requirements of that state or country for the practice of medicine. Section 2314 shall not

24 apply to this subdivision. This subdivision shall become operative upon the implementation of the

25 proposed registration program described in Section 2052.5.

26 "(h) The repeated failure by a certificate holder, in the absence of good cause, to attend and

27 participate in an interview by the board. This subdivision shall only apply to a certificate holder

28 who is the subject of an investigation by the board."

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1 6. Section 2236 ofthe Code states:

2 "(a) The conviction of any offense substantially related to the qualifications, functions, or

3 duties of a physician and surgeon constitutes unprofessional conduct within the meaning of this

4 chapter [Chapter 5, the Medical Practice Act]. The record of conviction shall be conclusive

5 evidence only of the fact that the conviction occurred.

6 "(b) The district attorney, city attorney, or other prosecuting agency shall notify the

7 Medical Board of the pendency of an action against a licensee charging a felony or misdemeanor

8 immediately upon obtaining information that the defendant is a licensee. The notice shall identify

9 the licensee and describe the crimes charged and the facts alleged. The prosecuting agency shall

10 also notify the clerk of the court in which the action is pending that the defendant is a licensee,

11 and the clerk shall record prominently in the file that the defendant holds a license as a physician

12 and surgeon.

13 "(c) The clerk of the court in which a licensee is convicted of a crime shall, within 48 hours

14 after the conviction, transmit a certified copy of the record of conviction to the board. The

15 division may inquire into the circumstances surrounding the commission of a crime in order to fix

16 the degree of discipline or to determine if the conviction is of an offense substantially related to

17 the qualifications, functions, or duties of a physician and surgeon.

18 "(d) A plea or verdict of guilty or a conviction after a plea of nolo contendere is deemed to

19 be a conviction within the meaning of this section and Section 2236.1. The record of conviction

20 shall be conclusive evidence of the fact that the conviction occurred."

21 7. Section 2239 ofthe Code states:

22 "(a) The use or prescribing for or administering to himself or herself, of any controlled

23 substance; or the use of any of the dangerous drugs specified in Section 4022, or of alcoholic

24 beverages, to the extent, or in such a manner as to be dangerous or injurious to the licensee, or to

25 any other person or to the public, or to the extent that such use impairs the ability of the licensee

26 to practice medicine safely or more than one misdemeanor or any felony involving the use,

27 consumption, or self-administration of any of the substances referred to in this section, or any

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combination thereof, constitutes unprofessional conduct. The record of the conviction is

conclusive evidence of such unprofessional conduct.

"(b) A plea or verdict of guilty or a conviction following a plea of nolo contendere is

deemed to be a conviction within the meaning of this section. The Medical Board may order

discipline of the licensee in accordance with Section 2227 or the Medical Board may order the

denial of the license when the time for appeal has elapsed or the judgment of conviction has been

affirmed on appeal or when an order granting probation is made suspending imposition of

sentence, irrespective of a subsequent order under the provisions of Section 1203.4 of the Penal

Code allowing such person to withdraw his or her plea of guilty and to enter a plea of not guilty,

or setting aside the verdict of guilty, or dismissing the accusation, complaint, information, or

indictment."

8. California Code ofRegulations, title 16, section 1360, states:

"For the purposes of denial, suspension or revocation of a license, certificate or permit

pursuant to Division 1.5 (commencing with Section 4 75) of the code, a crime or act shall be

considered to be substantially related to the qualifications, functions or duties of a person holding

a license, certificate or permit under the Medical Practice Act if to a substantial degree it

evidences present or potential unfitness of a person holding a license, certificate or permit to

perform the functions authorized by the license, certificate or permit in a manner consistent with

the public health, safety or welfare. Such crimes or acts shall include but not be limited to the

following: Violating or attempting to violate, directly or indirectly, or assisting in or abetting the

violation of, or conspiring to violate any provision of the Medical Practice Act."


"'Board' as used in any provision of this Code, refers to the board in which the

administration of the provision is vested, and unless otherwise expressly provided, shall include

'bureau,' 'commission,' 'committee,' 'department,' 'division,' 'examining committee,' 'program,' and

'agency.'

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2 "Whenever it appears that any person holding a license, certificate or permit under this

3. division or under any initiative act referred to in this division may be unable to practice his or her

4 profession safely because the licentiate's ability to practice is impaired due to mental illness, or

5 physical illness affecting competency, the licensing agency may order the licentiate to be

6 examined by one or more physicians and surgeons or psychologists designated by the agency.

7 The report of the examiners shall be made available to the licentiate and may be received as direct

8 evidence in proceedings conducted pursuant to Section 822."

9 11. Code section 822 states:

10 "If a licensing agency determines that its licentiate's ability to practice his or her

11 profession safely is impaired because the licentiate is mentally ill, or physically ill affecting

12 competency, the licensing agency may take action by any one of the following methods:

13 "(a) Revoking the licentiate's certificate or license.

14 "(b) Suspending the licentiate's right to practice.

15 "(c) Placing the licentiate on probation.

16 '.'(d) Taking such other action in relation to the licentiate as the licensing agency in its

17 discretion deems proper.

18 "The licensing agency shall not reinstate a revoked or suspended certificate or license until

19 it has received competent evidence of the absence or control of the condition which caused its

20 action and until it is satisfied that with due regard for the public health and safety the person's

21 right to practice his or her profession may be safely reinstated."

22 FIRST CAUSE FOR DISCIPLINE

23 (Impairment Affecting Competency)

24 12. Respondent is subject to disciplinary action under sections 822 and 2234(d), in that he

25 is impaired due to mental illness and unable to practice his profession safely. On or about May

26 23, 2015, pursuant to section 820, Respondent was examined by a psychiatrist, H.C.2, M.D. In

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28 2 Initials are used to protect the right of privacy of persons identified in this Accusation.

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1 his report dated the same day, H. C. found that Respondent "clearly suffers from a Substance Use

2 Disorder that requires treatment to prevent it from progressing from mild to moderate or worse."

3 H.C. stated that Respondent's behavior indicates a risk to patients "if the illness is not treated

4 adequately and aggressively."

5 SECOND CAUSE FOR DISCIPLINE

6 (Unprofessional Conduct: Substantially Related Criminal Conviction)

7 13. Respondent is subject to disciplinary action under sections 2234 and 2236, in that he

8 has been convicted of crimes substantially related to the qualifications, functions or duties of a

9 Physician and Surgeon. The circumstances are as follows:

10 14. On or about October 25, 1998, at approximately 1:30 a.m., the Respondent, was

11 observed driving in a residential area with significant damage to the front of his vehicle. Officers

12 arrived on scene and found the Respondent in the drivers seat of his vehicle. The passenger's

13 side of the front windshield was partially shattered, there was extensive damage to the left front

14 end of the vehicle, the front vehicle license plate was missing, both air bags had deployed and

15 Respondent was seated in the driver's seat with minor injuries to his face. Respondent told

16 officers that the vehicle damage was due to a recent accident in which he hit a tree. However, the

17 officers received a report of a hit and run on a parked vehicle only a few blocks away from where

18 they contacted Respondent. Respondent's license plate was found at the scene of the vehicle

19 damaged in the hit and run. Respondent presented with obvious signs of intoxication including:

20 a moderate odor of an alcoholic beverage emitting from his breath, bloodshot and watery eyes

21 and slow speech. Respondent provided a breath sample for a preliminary alcohol screening test

22 which resulted in a blood alcohol level of .198%. Respondent agreed to provide a urine sample at

23 approximately 3:44a.m. which resulted in a blood alcohol equivalent of .19%.

24 15. On or about April 7, 1999, Respondent entered a no contest plea to Vehicle Code

25 section 23152(b) [driving with a blood alcohol level of .08% or higher] in Fresno County

26 Superior Court. The remaining charges for violations of Vehicle Code sections 23152 (a)

27 [driving under the influence of alcohol] and 20002 (a) [hit and run] were dismissed at the time of

28 the plea. On or about Aprill4, 1999, Respondent was sentenced to attend a alcohol education

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1 program, serve five days in custody, pay fines and court fees, his driver's license was restricted

2 and he was placed on informal probation for three years.

3 16. On or about December 22, 2013, at approximately 2:15a.m., the Respondent drove

4 his vehicle in an erratic manner weaving back and forth within the lane, straddling the broken

5 white line between then number one and two lane and then moving quickly into the number two

6 lane without signaling causing another driver to apply their brakes to avoid a collision. Deputies

7 from the Fresno County Sheriffs Department followed Respondent's vehicle as he exited the

8 freeway. Respondent accelerated as he approached the red lightat the end of the off ramp and

9 when he stopped his vehicle it was straddling the cross walk. When the light turned green, the

10 sheriffs deputies initiated a traffic stop by activating the lights on their patrol car. Respondent

11 continued to drive and the deputies attempted to get his attention by illuminating his vehicle with

12 their spotlight several times until Respondent finally stopped driving. The sheriffs deputies

13 smelled a strong odor of alcohol on Respondent and requested that officers from the California

14 Highway Patrol assist in the investigation. Respondent was interviewed by CHP officers at the

15 location of the traffic stop. Respondent presented with obvious signs of intoxication including: a

16 strong odor of an alcoholic beverage emitting from his breath, bloodshot and watery eyes and

17 slurred speech. Respondent refused to provide a breath sample a.nd instead provided a blood

18 sample at approximately 3:45a.m. which revealed a blood alcohol level of .20%.

19 17. On or about January 31, 2014, the Fresno County District Attorney filed criminal

20 charges against Respondent alleging violations of Vehicle Code sections 23152(b) [driving with a

21 blood alcohol level of .08% or higher], 23152(a) [driving under the influence of alcohol] as well

22 as an enhancement for driving with an excessive blood alcohol level above .15% in violation of

23 Vehicle Code section 23578. On or about July 2, 2014, Respondent entered a plea of nolo

24 contendre to Vehicle Code section 23152(b) and admitted to a blood alcohol level of .20%.

25 Respondent was placed on probation for three years, ordered to serve 180 days in custody with

26 165 days suspended, ordered to pay fines and fees, ordered to attend a first offender alcohol

27 program and ordered not to drive a motor vehicle with a measureable amount of alcohol in his

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THIRD CAUSE FOR DISCIPLINE

(Unprofessional Conduct: Excessive Use of Alcohol)

3 18. Respondent is subject to disciplinary action under sections 2234 and 2239, in that he

4 has engaged in the use of alcoholic beverages, to the extent, or in such a manner as to be

5 dangerous or injurious to the licensee, or to any other person or to the public, or to the extent that

6 it impairs the ability of the Respondent to practice medicine safely, or has been convicted of more

7 than one misdemeanor involving the use, consumption, or self-administration of alcohol which

8 constitutes unprofessional conduct. The circumstances are set forth in paragraphs 14 through 17

9 of this Accusation which are incorporated as though fully set forth herein.

10 PRAYER

11 WHEREFORE, Complainant requests that a hearing be held on the matters herein alleged,

12 and that following the hearing, the Medical Board of California issue a decision:

13 1. Revoking or suspending Physician's and Surgeon's Certificate Number A 114123, t ·~

14 issued to Ronald E. Dominguez, M.D.;

15 2. Revoking, suspending or denying approval of Ronald E. Dominguez, M.D.'s authority

16 to supervise physician assistants, pursuant to section 3527 of the Code;

17 3. Ordering Ronald E. Dominguez, M.D., if placed on probation, to pay:~he Board the .,,

18 costs of probation monitoring; and

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4. Taking such other and further action as deemed necessary and proper.

21 DATED: November 13, 2015

22 Executive irector Medical Board of California

23 Department of Consumer Affairs State of California

24 Complainant

25 FR20 15302228

26 95159094.docx

27 I I I Ill

28 I I I

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