1 DANIEL E. LUNGREN, Attorney General of .the State of California
2 SUSAN K. MEADOWS Deputy Attorney General
3 California Department of Justice 50 Fremont Street, Suite 300
4 San Francisco, California 94105-2239 Telephone: (415) 356-6282
5 Facsimile: (415) 356-6257
6 Attorneys for Complainant
7 BEFORE THE
8
9
DIVISION OF MEDICAL QUALITY MEDICAL BOARD OF CALIFORNIA
STATE OF CALIFORNIA
10
11 In the Matter of the Accusation Against:
12 RYSZARD CHETKOWSKI, M.D.
13 2999 Regent Street, #101-A Berkeley, CA 94705
14 Physician's and Surgeon's
15 Certificate No. G41258
16 Respondent.
17
Case No. 12-95-46238
OAH No. N 9604036
STIPULATION FOR SETILEMENT
18 IT IS HEREBY STIPULATED by and between Ryszard
19 Chetkowski, M.D. (hereinafter "respondent") with the counsel and
20 advice of his attorneys, Robert Sullivan, of the law firm
21 Nossaman, Guthner, Knox & Elliott, and Penelope Cooper, of the
22 law firm of Cooper, Arguedas & Cassman, and complainant Ronald
23 Joseph, in his official capacity as Executive Director of the
24 Medical Board of California ("Board"), by and through its
25 attorney, Daniel E. Lungren, Attorney General, by Susan K.
26 Meadows, Deputy Attorney General, as follows:
27 1. Third Amended Accusation No. 12-95-46238
1.
1 (hereinafter referred as "the Accusation") is presently pending
2 against Ryszard Chetkowski, M.D. (hereinafter referred to as the
3 "respondent"), physician and surgeon's certificate number G-47258
4 before the Division of Medical Quality of the Medical Board of
5 California (hereinafter referred to as the "Division").
6 2. The complainant in said Accusation, Ron Joseph, is
7 the Executive Director of the Board and brought said Accusation
8 in his official capacity only.
9 3. Respondent has fully discussed with his attorneys,
10 Robert Sullivan and Penelope Cooper, the charges and allegations
11 contained in the Accusation and therefore has been fully advised
12 concerning his rights in this matter.
13 4. Respondent's license history and status as set
14 forth in paragraph 2 of the Accusation is true and correct and
15 respondent's address of record is as set forth in the caption of
16 this Stipulation. (A copy of said Accusation is attached as
17 Exhibit A and incorporated by reference in this stipulation.)
18 5. This settlement resolves a contested matter. It
19 does not constitute an admission of liability on any of the
20 allegations contained in the Third Amended Accusation. It shall
21 not be admissible for any purpose in legal proceedings, except
22 those between respondent and the Board.
23 6. For purposes of the settlement of the action
24 pending against respondent in case No. 12-95-46238 and to avoid a
25 lengthy administrative hearing, respondent agrees to comply with
26 the following:
27 A. COMPETENCY EXAMINATION
2.
1 (1) Within six months following the effective date of
2 this stipulation, respondent shall, at his own expense, take and
3 pass an oral clinical examination. This examination is
4 voluntarily taken by respondent.as part of a negotiated
5 settlement of the charges in the Third Amended Accusation. Said
6 oral clinical examination shall be conducted according to the
7 procedures outlined in Business and Professions Code section
8 2293. The examination shall be administered by three physician
9 examiners selected by the Division or its designee. Each of the
10 three physician examiners shall be board certified in
11 obstetrics/gynecology. The examiners shall test for medical
12 knowledge in obstetrics/gynecology with special emphasis on the
13 performance of pelvic examinations and ultrasound procedures. The
14 examination shall be tape recorded.
15 (2) A failing grade from two of the examiners shall
16 constitute a failure of an examination. In the event of a
17 failure, the board shall supply a true and correct copy of a tape
18 of the examination to respondent. If respondent fails the
19 examination, within 45 days following receipt of the tape of the
20 examination, he may request a hearing before an administrative
21 law judge as designated in Government Code section 11371 to
22 determine whether he is entitled to take a second examination.
23 Any such hearing shall be held in accordance with the
24 Administrative Procedures Act, and shall be limited to the
25 determination of the fairness of the examination. Upon a finding
26 that the examination or procedure is unfair or that one or more
27 of the examiners manifested a bias towards respondent, a
3.
1 reexamination shall be ordered.
2 B. EDUCATION
3 (1) Respondent shall successfully complete a Division-
4 approved educational course in the field of gynecologic/pelvic
5 examination in the practice of reproductive endocrinology.
6 Respondent shall propose the course and submit it to the Division
7 for its approval within 30 days after this Stipulation becomes
8 effective. Respondent shall complete the course within 6 months
9 of the effective date of this Stipulation. The course shall
10 include both a didactic and clinical instruction. Respondent
11 shall be examined on his performance in this course.
12 C. COMMUNICATION TRAINING
13 (1) Within six (6) months of the effective date of
14 this Stipulation, respondent shall complete a course in
15 communication and sensitivity training that emphasizes the
16 patient's perception of the physician-patient relationship. This
17 training course shall be no less than 10 hours in length and
18 shall be approved in advance by the Division or its designee.
19
20
D. COSTS OF INVESTIGATION
(1) Respondent shall pay the sum of $5,000.00 (five
21 thousand) to the Division or its designee for the costs of
22 investigation and prosecution of this case. These costs shall be
23 paid in fu1l. within six (6) months of the effective date of
24 Stipulation.
25 7. In the event respondent passes the oral competency
26 examination (or reexamination as applicable) , successfully
27 completes the education requirement, successfully completes the
4 .
1 communication training requirement, and pays cost recovery,
2 respondent agrees to the following:
3 (a) Respondent waives each of his rights, including
4 the right to a hearing on the charges and allegations; his right
5 to confront and cross-examine witnesses who would testify against
6 his; his right to present evidence in his favor or to call
7 witnesses on his behalf, or to so testify himself; his right to
8 contest the charges and allegations and any other rights which
9 may be accorded his pursuant to the California Administrative
10 Procedure Act (Government Code §11500 et seq.); his right to
11 reconsideration, appeal to superior court and to any other or
12 further appeal.
13 (b) Respondent admits that there is jurisdiction for
14 the Board under section 2234 of the Business and Professions Code
15 to enter into this stipulation and to impose a public letter of
16 reprimand upon his certificate of licensure to practice medicine
17 pursuant to section 2233 of the Business and Professions Code.
18 (c) The Division shall withdraw Accusation No. 12-95-
19 46238 heretofore filed, and respondent shall be publicly
20 reprimanded by way of a letter issued by the Executive Director
21 of the Medical Board under section 2233 of the Business and
22 Professions Code. Said public letter of reprimand shall be in
23 the same form as the letter attached as Exhibit B hereto.
24 8. In the event respondent fails the oral competency
25 examination and is not afforded the right to reexamination, or in
26 the event he fails to pass a reexamination, or fails to
27 successfully complete the additional course of education, or
5.
1 fails to successfully complete the communication training or
2 fails to pay cost recovery:
3 (a) Accusation No. 12-95-46238 shall be reinstated and
4 another accusation may be filed charging the respondent with,
5 including, but not limited to, incompetency under section 2234(d)
6 and/or general unprofessional conduct in violation of Business
7 and Professions Code section 2234.
8 (b) The findings and conclusions reported by the
9 physicians conducting the oral competency examination may be
10 received as evidence in the administrative hearing on the
11 Accusation. In the event the Accusation is so reinstated,
12 respondent specifically waives any claim of laches in the
13 prosecution of the action.
14 9. IT IS FURTHER STIPULATED AND AGREED that the terms
15 set forth herein shall be null and void, and in no way binding
16 upon the parties hereto, unless and until accepted by the Medical
17 Board of California. Respondent further agrees that in addition
18 to submitting this stipulation to the Board for acceptance and
19 adoption, counsel for complainant may also submit to the Board a
20 memorandum recommending the stipulation's adoption. Respondent
21 agrees that the memorandum recommending adoption shall not, under
22 any circumstances, be discoverable or disclosed to respondent.
23 ACCEPTANCE
24 I HEREBY CERTIFY that I have read this Stipulation for
25 Settlement in its entirety, that I fully understand the terms of
26 this Stipulation, and I voluntarily agree to them.
27 IN WITNESS THEREOF, I affix my signature this /z~ day
6.
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of
RYSZARD CHETKOWSKI Respondent
I have fully discussed with respondent Ryszard
Chetkowski, M.D. the terms and conditions and other matters
contained in the above Stipulated Settlement and Decision and
approve its form
DATED:
and content.
~(!1/ct1-
··/)~~ ROBERT SULLIVAN Attorney for Respondent
15 I have fully discussed with respondent Ryszard
16 Chetkowski, M.D. the terms and conditions and other matters
17 contained in the above Stipulated Settlement and Decision and
18 approve its form and content.
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20
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22
23 ENDORSEMENT
24 The foregoing Stipulated Settlement and Decision is
25 hereby respectfully submitted for consideration of the Division
26 of Medical Quality, Medical Board of California, Department of
27
7.
1 Consumer Affairs pursuant to Business and Professions Code
2 section 2233 for consideration and approval.
3 DATEDo ,/kfUtch 11, fftJ 4
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General
Deputy Attorney General
DECISION AND ORDER
The above Stipulation for Settlement is adopted and
shall become the decision of the Medical Board of California,
Division of Medical Quality effective __ M_a..::..y_1'_1o.:._' ______ , 19 9 7.
IT IS SO ORDERED this _]..Sth day of __ nAp~rLlw.lL-___ , 1997.
IRA LUBELL, M.D. Division of Medical Quality Medical Board of California
8.
EXHIBIT A
1 DANIEL E. LUNGREN, Attorney General of the State of California
2 SUSAN KAY MEADOWS (State Bar No. 115092) Deputy Attorney General
3 California Department of Justice 50 Fremont Street, Suite 300
4 San Francisco, California 94105 Telephone: (415) 356-6282
5 Attorneys for Complainant
6
7 BEFORE THE
8
9
DIVISION OF MEDICAL QUALITY MEDICAL BOARD OF CALIFORNIA
DEPARTMENT OF CONSUMER AFFAIRS STATE OF CALIFORNIA
10
11 In the Matter of the Accusation Against:
12
Case No. OAH. No.
12-95-46238 N9604036
Ryszard Chetkowski, M.D. 13 2999 Regent Street, #101-A
Berkeley, CA 94705
) ) ) ) ) ) )
TlllRD Al\IENDED ACCUSATION
14 )
15 License No. G47258 ) ) ) 16 Respondent. ______________________________________ )
17
18 The Complainant alleges:
19 PARTIES
20 1. Complainant, Ron Joseph, is the Executive Director
21 of the Medical Board of California (hereinafter the "Board") and
22 brings this accusation solely in his official capacity.
23 2. On or about April 12, 1982, License No. G47258 was
24 issued by the Board to Ryszard Jerzy Chetkowski (hereinafter
25 "respondent''), and at all times relevant to the charges brought
26 herein, this license has been in full force and effect. Unless
27 renewed, it will expire on March 31, 1998.
1.
1 JURISDICTION
2 3. This accusation is brought before the Division of
3 Medical Quality of the Medical Board of California, Department of
4 Consumer Affairs (hereinafter the "Division''), under the
5 authority of the following sections of the California Business
6 and Professions Code (hereinafter "Code"):
7 A. Section 2227 of the Code provides that the Board
8 may revoke, suspend for a period not to exceed one year, or
9 place on probation, the license of any licensee who has been
10 found guilty under the Medical Practice Act.
11 B. Section 2234 of the Code provides that
12 unprofessional conduct includes, but is not limited to, the
13 following:
14 (c) Repeated negligent acts.
15 C. Section 125.3 of the Code provides, in part, that
16 the Board may request the administrative law judge to direct
17 any licentiate found to have committed a violation or
18 violations of the licensing act, to pay the Board a sum not
19 to exceed the reasonable costs of the investigation and
20 enforcement of the case.
21 FIRST CAUSE FOR DISCIPLINE
22 (Patient M.W.!1)
23 (Unprofessional Conduct)
24 4. On or about April 14, 1994, respondent undertook
25
26 1. Initials are used to identify the patients in this Accusation to protect their privacy. The full names of the
27 patients identified will be disclosed to respondent pursuant to any Request for Discovery.
2.
1 to treat patient M.W. who saw respondent for consultation
2 regarding infertility. During the April 14, 1994 appointment,
3 respondent took a medical history from M.W. and performed a
4 pelvic examination. A nurse was present during the pelvic
5 examination the entire time. However, the nurse remained at the
6 head of the examination table.
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5. During the pelvic examination, respondent fondled
and/or massaged M.W.'s.clitoris for a brief period. M.W. was
stunned at this physical contact. After the pelvic examinatio~,
respondent advised M.W. that she would be a good candidate for in
vitro fertilization.
6. Once the examination was finished, M.W. dressed and
returned to respondent's office with her husband. Respondent
told her to make another appointment when she was ready to begin
15 with the procedure. Because of respondent's conduct during the
16 pelvic examination, M.W. never returned to respondent's office
17 for a follow-up appointment.
18 7. Respondent's conduct with respect to patient M.W.
19 as alleged above constitutes cause for disciplinary action
20 pursuant to section 2234 (unprofessional conduct) of the Code.
21 SECOND CAUSE FOR DISCIPLINE
22 (Patient D.S)
23 (Unprofessional Conduct)
24 8. On or about November 28, 1994, respondent undertook
25 to consult with and treat patient D.S. for infertility. D.S. was
26 referred to respondent by her physician because she and her
27 husband wanted to have a second child and were not having
3.
1 success. At her first appointment, D.S. and her husband spoke
2 with respondent in his office for approximately one half an hour.
3 Respondent asked her husband to wait in the waiting room while
4 respondent performed a physical examination on D.S.
5 9. Once in the examination room, D.S. undressed, put
6 on a cover-up, and got into the stirrups for a pelvic
7 examination. D.S. commented to respondent that she was very cold
8 and he rubbed her left'thigh in a circular motion with his palm
9 about four times. After rubbing her thigh, the nurse came into
10 the examining room.
11 10. The nurse positioned herself at D.S.' head while
12 respondent performed the pelvic examination. During the
13 examination, respondent briefly rubbed D.S.'s clitoris
14 approximately four to five times. Respondent's touch was firm.
15 11. D.S. had undergone an unusually high number of
16 pelvic examinations due to her infertility problems, and no other
17 physician had ever touched her in the manner hereinbefore
18 described.
19 12. When respondent conducted the bimanual
20 examination, D.S. felt that everything seemed normal. However,
21 the last part of the examination involved an ultrasound by use of
22 a vaginal probe. During the ultrasound, respondent again rubbed
23 D.S.'s clitoris two or three times as he inserted the probe into
24 her vagina. Again, D.S. had undergone the ultrasound procedure
25 several times in the past and no other physician had ever touched
26 her clitoris in this manner.
27 13. D.S. was very upset regarding respondent's conduct
4.
1 during the pelvic examination and did not make any future
2 appointments with respondent.
3 14. Respondent's conduct with respect to patient
4 D.S. as alleged above constitutes cause for disciplinary action
5 pursuant to section 2234 (unprofessional conduct) of the Code.
6
7 THIRD CAUSE FOR DISCIPLINE
8 (Patient A.S.)
9 (Unprofessional Conduct)
10 15. On or about November of 1990, respondent undertook
11 to consult with and treat patient A.S. for infertility. During
12 the pelvic examination that respondent performed on A.S.,
13 respondent briefly rubbed A.S.'s clitoris with his fingers. A
14 nurse was in the room at the time, but she was not obser~ing the
15 examination and was busy writing. A.S. had undergone many pelvic
16 examinations before and had never had her clitoris rubbed in this
17 manner by the examining physician.
18 16. A.S. had to return to respondent's office the next
19 day, or soon after her first visit to continue the fertility
20 procedures. On the next visit, before respondeni inserted the
21 vaginal probe, he again rubbed her clitoris with his fingers.
22 17. Respondent's conduct with respect to patient
23 A.S. as alleged above constitutes cause for disciplinary action
24 pursuant to section 2234 (unprofessional conduct) of the Code.
25
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FOURTH CAUSE FOR DISCIPLINE
(Patient W. K.)
(Unprofessional Conduct)
5.
1 18. On or about February or March of 1989, respondent
2 undertook to consult with and treat patient W.K. for infertility.
3 During the course of this treatment, respondent performed only
4 one pelvic examination on patient W.K. During this examination,
5 just before respondent inserted the speculum into her vagina,
6 W.K. felt respondent stroke her clitoris briefly with his finger.
7 19. Respondent's conduct with respect to patient
8 W.K. as alleged above constitutes cause for disciplinary action
9 pursuant to section 2234 (unprofessional conduct) of the Code.
10 FIFTH CAUSE FOR DISCIPLINE
11 (Patient J.G)
12 (Unprofessional Conduct)
13 20. On or about April of 1987, respondent undertook to
14 consult with and treat patient J.G. for infertility. J.G. had
15 suffered four spontaneous abortions at ten to twelve weeks and
16 had been referred to respondent for consultation. On her first
17 visit, respondent took her into his examination room and
18 performed a pelvic examination. During the pelvic examination,
19 respondent stimulated her clitoris briefly. Although a nurse was
20 present in the room during the pelvic examination, the nurse was
21 standing in the corner and could not observe the pelvic
22 examination.
23 21. After the examination, J.G. paid her bill and left
24 respondent's office. J.G. was upset with respondent. She never
25 returned to respondent for follow-up treatment because of his
26 conduct during the pelvic examination.
27 22. Respondent's conduct with respect to patient
6.
1 J.G. as alleged above constitutes cause for disciplinary action
2 pursuant to section 2234 (unprofessional conduct) of the Code.
3 SIXTH CAUSE FOR DISCIPLINE
4 (Patient D.C.)
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{Unprofessional Conduct)
23. On or about 1989, respondent began to treat
patient D.C. for infertility. D.C. was unable to become pregnant
at that time and because of insurance coverage concerns was
unable to continue treatment with respondent. In the summer of
1991, D.C.'s insurance coverage changed and she again sought
treatment from respondent for infertility. During the summer of
1991, respondent performed a pelvic examination and a breast
examination on D.C. No nurse was present in the room during
these examinations.
24. When respondent performed the pelvic examination,
he slid his fingers down her clitoris. D.C. found this touching
to be inappropriate and degrading.
25. D.C. was extremely uncomfortable and upset with
19 respondent's conduct. However, D.C. returned to respondent for
20 further treatment because she wanted to have a baby.
21 26. Respondent's conduct with respect to patient
22 D.C. as alleged above constitutes cause for disciplinary action
23 pursuant to section 2234 (unprofessional conduct) of the Code.
24 SEVENTH CAUSE FOR DISCIPLINE
25 (Patients M.W., D.S., A.S., W.K, J.G., and D.C.)
26 (Repeated Negligent Acts & Unprofessional Conduct)
27 27. Respondent's conduct as set forth above in all
7.
1 Causes for Discipline whether jointly, or in any combination
2 thereof, constitutes cause for discipline pursuant to sections
3 2234 (c) (repeated negligent acts) and 2234 (unprofessional
4 conduct) of the Code.
5 PRAYER
6 ~REFORE, the complainant requests that a hearing be
7 held on the matters herein alleged, and that following the
8 hearing, the Division issue a decision:
9 1. Revoking or suspending License Number G47258
10 heretofore issued to respondent Ryszard J. Chetkowski;
11 2 . Revoking, suspending or denying approval of the
12 respondent's authority to supervise physician's assistants,
13 pursuant to Business and Professions Code section 3527;
14 3. Ordering respondent to pay the Division the actual
15 and reasonable costs of the investigation and enforcement of this
16 case under section 125.3 of the Code;
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4 . Taking such other and further action as the
Division deems necessary and proper.
DATED: frl Mt.JJ J-1 I ~fl 7 I
Executive Director Medical Board of California Department of Consumer Affairs State of California
Complainant
8.
EXHIBIT B
Ryszard Chetk:owski, M.D. 2999 Regent Street, #101-A Berkeley, CA 94705
EXHIBITB
PROPOSED LETTER OF REPRIMAND
re: Letter of Reprimand in Case No. 12-95-46238, entitled, In the Matter of the Accusation Against Ryszard Chetk:owski, M.D., Certificate No. G47258.
Dear Dr. Chetk:owski:
On or about March 5, 1997, the Medical Board of California filed a Third Amended Accusation No. 12-95-46238 (hereinafter the "Accusation") against your license to practice medicine. This Accusation was based on allegations concerning the performance of pelvic examinations and infertility procedures in your practice.
It has been decided by the Division of Medical Quality of the Medical Board for California pursuant to Business and Professions Code section 2233 that a Public Letter of Reprimand shall be issued in this case. It has been determined that by your successful completion of an oral competency examination in the performance of pelvic examinations and ultrasound procedures, and your successful completion of additional education courses and communication training that you have demonstrated competency in your area of practice.
WHEREFORE, pursuant to the authority of section 2233 of the Business and Professions Code, the Division of Medical Quality of the Medical Board of California hereby withdraws Third Amended Accusation No. 12-95-46238 and issues a public letter of reprimand in this matter, and understands from your conduct and representations that due to the knowledge and insight you have gained, no future violations of the Business and Professions Code will occur.
Very truly yours,
Ron Joseph Executive Direcotr Medical Board of California
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