ORDERS:
ORDER OF REMAND
STATEMENT OF THE CASEThis matter is an appeal by Dr. William F. Bolt (Appellant) of a decision of the Board of Medical Examiners of South Carolina
(Board) which publicly reprimanded Bolt, imposed a $10,000 fine and suspended his medical license subject to certain conditions.
Counsel for both parties presented oral arguments at the Adminstrative Law Judge Division (ALJD) on September 13, 2000.
FACTUAL BACKGROUND
The Appellant is a physician licensed to practice medicine in South Carolina. Appellant has been in practice for 37 years and in 1992
he began practicing in the area of bariatrics.
A formal complaint was filed against Dr. Bolt on December 17, 1998 alleging violations of several provisions of S.C. Code Ann. §
40-47-200 (Supp. 1999) and 26 S.C. Code Regs. 81-60 (Supp 1999). A hearing was held on November 3, 1999 before a Hearing
Panel composed of three members of the Medical Disciplinary Commission. The Hearing Panel issued its Report on November 14,
1999 and found Appellant guilty of violating S.C. Code Ann. § 40-47-200(F)(7) and (8) (Supp. 1999) and 26 S.C. Code Regs. 81-60(A) and (C) (Supp 1999). A hearing before the Board was conducted on February 7, 2000. The Board issued its Final Order on
March 1, 2000. The Board found Appellant guilty of violating S.C. Code Ann. § 40-47-200(F)(7) (Supp. 1999) and 26 S.C. Code
Regs. 81-60(A) (Supp 1999), in that Appellant did not provide competent medical service because he did not adequately document
medical findings and treatment. The Board publicly reprimanded Appellant and ordered him to pay a $10,000 fine. Furthermore,
Appellant was ordered by the Board to attend and complete a drug education course, at his own expense, offered by Forensic and
Educational Consultants in New Jersey and to successfully complete and pass the SPEX (Special Purpose) examination within one
year from the date of the Board's order. On August 4, 2000, Appellant made a Motion to Stay the Final Order of the Board for a
period of six (6) months after his appellate rights have been exhausted.
ANALYSIS
The standard of review in appeals from the Board is set forth in the Adminstrative Procedures Act, specifically S.C. Code Ann. § 1-23-380 (Supp. 1999). Section 1-23-380(A)(6) expressly provides that an appellate court "may affirm the decision of an agency or
remand the case for further proceedings." Upon careful consideration of the Board's March 1, 2000 Order, I find that it is appropriate
to remand the case to the Board so that it may set forth a detailed explanation to support Findings of Fact numbers 3, 4, 5, 6, 8, and 9.
An administrative agency has an obligation to state clearly and completely the facts essential to its conclusion; where the agency fails
to do this, remand is appropriate. 2 Am. Jur. 2d Administrative Law § 630 (1994); see Campbell v. La-Z-Boy East, 295 S.C. 384,
368 S.E.2d 679 (Ct. App. 1988) (holding that where agency failed to define basis for finding of fact, case should be remanded for
agency to make sufficiently detailed findings.)
Proceedings seeking to suspend or revoke a license of a professional are serious matters. The professional's ability to earn a living is
at stake. Of equal gravity is the public's legitimate interest in the continued services of qualified professionals. Unequivocally, in the
case at hand, the Board is charged with protecting the public interest by administering the laws and regulations governing the practice
of medicine.
It is therfore imperative, given the magnitude of a case such as this, that the Board's Order clearly and completely articulate the facts
and rationale of its conclusion. In the present case, the Board stated in Finding of Fact # 3 that Appellant did not properly document
medical records in 19 of the 20 cases reviewed. However, the Board does not specify which 19 cases had inadequate documentation.
Also, the Board stated that in 12 of the 20 cases the patient was not a proper candidate for controlled medication. The Board did not
specify which 12 patients were not proper candidates for the controlled medication. Furthermore, the Board stated that in 15 of the 20
cases the suggested standards and guidelines of the American Society of Bariatric Physicians were not followed. Once again, the
Board did not specify the 15 cases in which Appellant did not follow the proper guidelines. In Finding of Fact # 5, the Board stated
that "many of the charts contained visits where controlled medications were prescribed but there were no initials or signature of a
physician." The Board did not indicate which charts lacked these initials or signature. In Finding of Fact #9, the Board stated that
Respondent failed to follow the suggestions contained in the standards and guidelines of the American Society of Bariatric
Physicians. Since these standards and guidelines have not been adopted in South Carolina, the Board must set forth whether the
violation of these standards were considered in determining that Appellant violated the medical standard of care, and, if so, the Board
must state the authority that allows it to use these suggested standards and guidelines in making such a decision.
Furthermore, in the Conclusions of Law, the Board stated that Appellant had violated 26 S.C. Code Regs. 81-60(A) (Supp 1999)
because he did not provide competent medical service. The Board further explained that this violation was evidenced by Appellant's
failure to adequately document medical findings and treatment. The Board makes no mention of any other Finding of Fact in the
Conclusion. While the Board may have considered the other Findings of Fact in making its decision, it did not fully articulate its
rationale in the conclusion.
Therefore, this tribunal is unable to determine the Board's reasoning and conduct a meaningful review of the Board's decision. Our
Supreme Court has recently held on several occasions that an administrative agency must make specific findings of fact and explain
its rationale in sufficient detail to afford judical review. Porter v. S.C. Public Service Comm'n, 333 S.C. 12, 507 S.E2d 328 (1998).
This tribunal will not sua sponte search the record for substantial evidence supporting a decision when an administrative agency's
order inadequately sets forth the agency's findings of fact and reasoning. Id. While the Board may have conducted an orderly
analysis to reach its conclusion, it did not provide such an analysis in its Order.
ORDER
IT IS THEREFORE ORDERED that this case is REMANDED to the Board so that it may set forth a detailed explanation to
support Findings of Fact numbers 3, 4, 5, 6, 8, and 9. (1)
IT IS FURTHER ORDERED that the Appellant's Motion to Stay is GRANTED. The Appellant has six (6) months from the date
of this order to attend and complete a drug education course offered by Forensic and Educational Consultants in New Jersey and to
successfully complete and pass the SPEX (Special Purpose) examination.
AND IT IS SO ORDERED
________________________________
C. Dukes Scott
Adminstrative Law Judge
Columbia, South Carolina
November 7, 2000
1. See Parker v. S.C. Public Service Comm'n, 288 S.C. 304, 342 S.E. 2d 403 (1986), and Piedmont Natural Gas Co., Inc., 301 S.C.
50, 389 S.E.2d 655 (1990) (administrative agency may not consider additional evidence upon remand unless court allows it because
that afford a party two bites at the apple.) |
