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Administrative Law Court
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SC Administrative Law Court Decisions

CAPTION:
Raymond C. Elam, D.V.M. vs. SCDLLR

AGENCY:
South Carolina Department of Labor, Licensing and Regulation

PARTIES:
Appellant:
Raymond C. Elam, D.V.M.

Respondents:
South Carolina Department of Labor, Licensing and Regulation, State Board Veterinary Medical Examiners
 
DOCKET NUMBER:
?

APPEARANCES:
n/a
 

ORDERS:

CONSENT ORDER

This matter came to the Administrative Law Judge Division by Petition for Judicial Review (Notice of Appeal) filed by Raymond C. Elam, D.V.M., concerning the August 23, 1997 Order of the State Board of Veterinary Examiners of South Carolina.

The parties to the matter have come to an agreement concerning this matter as set forth below.

(1) Pursuant to this agreement, the State Board of Veterinary Medical Examiners of South Carolina will amend its Order dated August 15, 1997. The text of the amended order is attached. (Attachment 1).

(2) Pursuant to this agreement, the Respondent agrees to withdraw his Petition for Judicial Review (Notice of Appeal).

IT IS THEREFORE ORDERED that upon receipt of the amended order of the State Board of Veterinary Examiners, this Petition will be dismissed.

AND IT IS SO ORDERED.

JOHN D. GEATHERS, JUDGE

ADMINISTRATIVE LAW JUDGE DIVISION

WE CONSENT:

Thomas Gottshall, Sinkler & Boyd, P.A.

Attorney for Appellant

Sharon A. Dantzler

Attorney for the South Carolina

Department of Labor, Licensing &

Regulation









BEFORE THE STATE BOARD OF VETERINARY MEDICAL EXAMINERS

OF SOUTH CAROLINA

IN THE MATTER OF: )

)

Raymond C. Elam, D.V.M. )

License No. 326 ) ORDER

)

Respondent. )

)

)

This matter came before the Board of Veterinary Medical Examiners (the Board) for hearing on July 10, 1997, pursuant to an Order of Remand from the Administrative Law Judge Division, dated October 2, 1996, and a February 27, 1997 Order of the Honorable Marc H. Westbrook, Richland County Court of Common Pleas (96-CP-40-3699).

A quorum of board members was present. Sharon A. Dantzler, Deputy General Counsel, South Carolina Department of Labor, Licensing and Regulation, presented the case for the State. Respondent appeared personally along with his counsel, Thomas R. Gottshall, Esquire of Sinkler & Boyd, Columbia, SC.

The Respondent was originally charged with violation of S.C. Code Ann. §§40-69140(12)(Supp. 1995) and Board Regulation 120-3.5. After notice and a hearing on April 25, 1996, the Board in an order dated May 10, 1996, found that Respondent had violated Regulation 120-3.5 and imposed discipline. Respondent appealed the May 10, 1996 Order to the Administrative Law Judge Division. In an order dated October 2, 1996, the Honorable Marvin F. Kittrell vacated the Board's order and remanded the matter to this Board for further action. The Board appealed the ALJ decision to the Richland County Court of Common Pleas. Pursuant to instructions in Judge Westbrook's order dismissing the appeal as not being timely, the Board was given the option of holding a contested new hearing by using the existing record and permitting counsel to reargue the merits of the case using the clear and convincing evidence standard of proof (2/27/97 Order of Judge Westbrook, p. 2). The parties elected this option and agreed to proceed upon the existing record. A copy of the transcript of record from the April 25, 1996 hearing was provided to the Board for review along with the exhibits which included treatment records from Respondent and the Emergency Animal Clinic. Counsel for both parties were also heard in oral argument.

FINDINGS OF FACT

After reviewing the evidence of record, including the exhibits and documentary evidence and after evaluating the testimony of the witnesses, and reviewing the parties' written and oral arguments, the Board, based upon the clear and convincing evidence on the whole record, makes the following Findings of Fact:

1. The Respondent is licensed to practice veterinary medicine in this State and was so licensed at all times relevant to the conduct referenced in this case.

2. "Lady June" was a female Registered Cocker Spaniel born on April 14, 1993, one of a litter of a client of Respondent, and purchased by Elizabeth Melendez. Respondent treated the animal on five occasions prior to the treatment in question. Respondent saw the animal for a pregnancy examination on November 8, 1994 and post whelping on November 25, 1994. Other visits between 1993-94 were for routine examination, vaccinations and removal of a cyst.

3. On June 8, 1995 "Lady June", pregnant and soon to deliver, was brought to Elam Animal Hospital with a presenting complaint of having passed out. This was Lady June's second litter; the first litter was born approximately six months earlier. The animal's temperature was taken and Respondent checked her. Respondent testified that he conducted a vaginal examination. Ms. Melendez was in the room at all times and disputed this, indicating Respondent only rubbed the dog's belly. There is nothing in the records to indicate a vaginal examination.

4. Ms. Melendez is a hairdresser and was scheduled to go out of town to do a wedding. It was arranged for "Lady June" to remain at the hospital for observation. Ms. Melendez left the animal at the hospital for approximately one and a half (1 I/2) hours but subsequently canceled her trip and after checking with the hospital picked "Lady June" up to deliver at home. There are no written notes from this period of observation.

5. Later in the evening the first two pups delivered were dead and the hospital referred Ms. Melendez to the Emergency Animal Clinic when unable to reach Respondent, after repeated attempts. Lady June died at the Emergency Animal Clinic.

6. Although Respondent testified that he examined the animal vaginally and her temperature and heart rate were normal he acknowledges, and the Board so finds, that his records, with the exception of the temperature, did not reflect an examination nor the results of any exam or services. Respondent's explanation was that he normally just records abnormals.

7. Respondent's written records are woefully inadequate in documenting "Lady June's" June 8, 1995 visit. Respondent testified that the heart rate was normal, the animal was not in distress when brought in and there was no bleeding. Respondent indicated that when the animal remained she was placed in the treatment room (ICR) and observed; she broke some water, there was some bleeding and he did another digital exam. None of this information is in the written record. Respondent testified that the dog walked out on a leash when Ms. Melendez came to get her later that evening. Ms. Melendez testified she picked the animal up at the door and carried her. There is no written record regarding the animal's progress, status or condition at discharge nor disposition of the case. There are no written notations as to whether the animal was conscious or alert. There is no written history relating to Lady June's medical status. The only written information regarding the visit was the presenting complaint of the owner that the animal had "passed out" listed under problem. The Respondent left his chart blank under diagnosis. Under treatment and services Respondent wrote "going into delivery".

CONCLUSIONS OF LAW

Based upon careful consideration of the facts in this matter, the Board finds and concludes as a matter of law that:

1. The Board has jurisdiction in this matter and, upon finding that a licensee has violated any of the provisions of S.C. Code Ann. §40-69-140, supra, has the authority to order the revocation or suspension of a license to practice as a veterinarian, publicly or privately reprimand the holder of a license, or take other action restricting or otherwise disciplining the licensee as circumstances warrant.

2. The Respondent has failed to prepare an adequate written record for his patient,"Lady June" in violation of S.C. Code Ann. §40-69-140(1)(Supp. 1995) and Board Regulation 120-3.5, specifically (a)(5),(6), and (8) in the following particulars:

(a) Respondent has violated Regulation 120-3.5(a)(5) in that he failed to provide a short written history of the animal's condition as it pertains to the animal's medical status. Respondent makes the legal argument that the presenting complaint, "passed out" is a short history of the animal's condition as it pertains to the animal's medical status. The Board disagrees and finds this to be insufficient as even a short history. (See also Findings of Fact #6 & 7)

(b) Respondent has violated Regulation 120-3.5(a)(6) in that he failed to include in the written record a diagnosis or condition at the beginning of custody of the animal as evidenced by leaving diagnosis on his records form blank. The animal had been brought in by its owner because she had passed out, not because she was pregnant and soon to deliver.(See also Findings of Fact #6 &7)

(c ) Respondent has violated Regulation 120-3.5(a)(8) in that he failed to include progress and disposition of case in the written record. While the animal was left at the hospital for observation for at least 1 t/z hours there were no written status or progress notes. In fact you can not tell from the written records that the animal was even kept for observation. (See also Findings of Fact # 4, 6, & 7)

3. One of the fundamental principles in the practice of veterinary medicine is that if it isn't documented it isn't done. Respondent has failed to record the most basic and minimally required information regarding his treatment of this Registered Cocker Spaniel that subsequently died. The animal presented with a complaint of passing out. Respondent's woefully inadequate records provide no indication of any history as pertains to the animal's medical status, diagnoses or condition at the beginning of custody, nor progress and disposition. The importance of written records for the profession is recognized in Board Regulation 120-3.5 which mandates minimum record keeping standards. While Respondent has provided some of the mandated information in his written response to the Board and some in testimony, he failed to provide it in the written record as required. Any subsequent treating facility would not have been able to glean anything about the June 8, 1995 visit based upon the information recorded by Respondent.

The Board is firmly convinced and has no hesitancy in concluding, unanimously, that Respondent failed to comply with the written record keeping minimum standards set forth above.

4. The sanction imposed is consistent with the purpose of these proceedings and has been made after weighing the public interest and the need for the continuing services of qualified veterinarians against the countervailing concern that society be protected from professional ineptitude.

5. The sanction imposed is designed not to punish the Respondent, but to protect life, health and welfare and to ensure that competent and qualified persons practice veterinary medicine in this State.

NOW, THEREFORE, IT IS ORDERED, ADJUDGED AND DECREED that:

(1) The Respondent's license to practice veterinary medicine be, and hereby is, suspended for two (2) weeks, commencing ten (10) days following receipt of this order, followed by a period of probation of one (1) year. The probation is hereby stayed. Respondent must return his license certificate to the Board, at its offices with ten (10) days of notice of this order, to be held by the Board for the period of suspension.

(2) Respondent shall complete fifteen (15) additional hours of continuing education, by June 30, 1998, and provide documentation of same, in writing, to the Board. In the event that Respondent falls to provide such verification by June 30, 1998, his license to practice veterinary medicine will be automatically temporarily suspended until such time as he substantiates his completion of the continuing education hours. The stay of his probation will also be lifted and the remaining period of the probation will be in effect. It is the Board's preference that six (6) of these hours cover record keeping and documentation of veterinary medical treatment. The Board staff will assist Respondent in locating such courses.

(3) Respondent shall abide by the laws and regulations governing or relating to the practice of veterinary medicine in this State.

AND IT IS SO ORDERED by unanimous decision of the Board.

STATE BOARD OF VETERINARY

MEDICAL EXAMINERS

BY:

H. Earle McDaniel Jr., D.V.M.

CHAIRMAN

, 1997


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