Board of Physician Quality Assurance v. Mullan

848 A.2d 642, 381 Md. 157, 2004 Md. LEXIS 247
CourtCourt of Appeals of Maryland
DecidedMay 10, 2004
Docket66, Sept. Term, 2003
StatusPublished
Cited by30 cases

This text of 848 A.2d 642 (Board of Physician Quality Assurance v. Mullan) is published on Counsel Stack Legal Research, covering Court of Appeals of Maryland primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Board of Physician Quality Assurance v. Mullan, 848 A.2d 642, 381 Md. 157, 2004 Md. LEXIS 247 (Md. 2004).

Opinion

RAKER, Judge.

This case concerns the interpretation of a provision in the Maryland Administrative Procedure Act (APA), Md.Code (1984, 1999 Repl. Vol., 2003 Cum. Supp.) §§ 10-101 to 10-305 of the State Government Article, 1 that permits the summary suspension of a medical doctor’s license — suspension without *161 first giving the licensee notice and an opportunity to be heard — when “the public health, safety, or welfare imperatively requires emergency action.” § 10-226(c)(2)(i). We must determine whether the passage of time between the agency’s discovery of potential circumstances demanding summary suspension and the agency’s final order to suspend is relevant to a finding that the suspension was imperatively required.

I.

On April 25, 2000, the parent of a minor patient treated by Dr. Paul A. Mullan, a pediatrician, filed a written complaint with the State Board of Physician Quality Assurance (the Board). The complaint alleged that Dr. Mullan had treated her son while under the influence of alcohol on April 10, 2000.

On May 17, 2000, a staff member of the Board visited Dr. Mullan at his office to give him a copy of the complaint as well as a letter from the Board demanding a written response within fifteen days to the parent’s allegations. The staff also served Dr. Mullan with a subpoena requesting the medical records of the complaining parent’s son and the sign-in sheet that would show all the other patients seen by Dr. Mullan on April 10, 2000. On June 13, 2000, he responded to the complaint by letter through his attorney. Dr. Mullan’s response to the allegations indicated that he did not drink alcoholic beverages and that any perception by the patient’s mother of glazed eyes and an unsteady gait could be explained by the doctor’s various physical ailments that emulated, but were not attributable to, intoxication. In the letter, Dr. Mullan’s attorney also claimed, mistakenly, that, the requested records and sign-in sheet had been sent to the Board.

As a result of the mistake and other delays, it was not until August 7, 2000 that the Board contacted the parents of all the other patients seen by Dr. Mullan on the day in question. Based on its investigation, on August 23, 2000, the Board summarily suspended Dr. Mullan’s medical license under § 10-226(c)(2) of the APA. Pursuant to § 10-226(c)(2)(ii) and the Board’s regulations, the Board also provided the doctor *162 with notice and an opportunity for reconsideration of the summary suspension. Availing himself of this option, Dr. Mullan appealed the decision, and in September 2000, a three-day hearing was held before an administrative law judge (ALJ).

The ALJ made the following findings of fact: Of the ten patients seen by Dr. Mullan on April 10, four corroborated the initial parent’s allegations, while another three noticed nothing out of the ordinary. On April 10, Dr. Mullan exhibited symptoms of intoxication which included slurred speech, incoherence, trembling hands, staggering, swaying, the mishandling of a cotton culture swab, and abrasiveness and belligerence toward the parents of his patients. Departing from his normal routine that day, Dr. Mullan failed to complete the patients’ charts, dictate his diagnoses, and make note of the medications he prescribed. Dr. Mullan, who had been treated for alcoholism since 1979, had admitted to his psychiatrist that he was consuming alcohol in May 1999 and May 2000.

The ALJ recommended affirmance of the summary suspension. Dr. Mullan filed exceptions to the findings, and on April 11, 2001, the Board issued a Final Decision and Order, adopting the ALJ’s findings and recommendation and suspending Dr. Mullan as “an emergency action taken to protect the public health and welfare under [§ 10-226(c)(2)].”

Dr. Mullan filed a petition for judicial review of the administrative agency’s decision in the Circuit Court for Baltimore County. The Circuit Court affirmed the Board’s summary suspension.

Dr. Mullan noted a timely appeal to the Court of Special Appeals. In an unreported opinion, that court reversed the Board’s finding that summary suspension was “imperatively required” because of a lack of substantial evidence. The court reasoned that the Board’s acquiescence to the delay of four months between the initial filing of the complaint and the decision to suspend, during which Dr. Mullan continued to see patients without complaint from either his patients or the Board, vitiated any evidence that might support the Board’s *163 determination that summary suspension was “imperatively required.” The court stated as follows:

“By allowing [Dr. Mullan] to treat patients for so long, it seems clear that the [Board] did not perceive an emergency. “In considering whether there truly was an imperative that required a summary suspension of [Dr. Mullan’s] medical license because of a risk to public health and safety, we ask, rhetorically, why the Board would have allowed [him] to treat patients for three months after learning of his conduct if it perceived an emergency. Therefore, we agree ... that the evidence did not justify a summary suspension, and we shall reverse the Order of Summary Suspension.”

The Board filed a petition for writ of certiorari in this Court, 377 Md. 111, 832 A.2d 204 (2003), presenting the following single question: “If a physician’s treatment of his pediatric patients while under the influence of alcohol poses an imminent danger to his patients, does a delay in the investigation of that danger preclude the Board as a matter of law from summarily suspending that physician?”

Before this Court, the Board argues that the Court of Special Appeals erred when it took into consideration the lapse of time between the Board’s cognizance of possible misconduct and its decision to suspend summarily. In the Board’s view, the only statutory requirement for summary suspension is that there be a threat to the public health, safety, or welfare, measured at the time the decision to suspend summarily is made. If at that time the threat persists, the length of the preceding investigation is irrelevant and should form no part of the consideration of whether the circumstances met the statutory criteria. In the alternative, the Board contends that even if the length of time preceding the decision is taken into consideration, the Board has supplied the substantial evidence necessary to uphold its decision to suspend summarily because whatever delay there might have been was reasonable and, moreover, the result of Dr. Mullan’s dilatory and uncooperative legal tactics throughout the investigation.

*164 Dr. Mullan, the respondent, contends that the issue is solely one of statutory interpretation and sufficiency of evidence. Because § 10-226(c)(2) permits summary suspension only when the agency finds a circumstance that “imperatively requires emergency action,” the Board was required to show evidence to that effect. It did not do so. The record, says respondent, was devoid of any evidence pointing to a substantial likelihood of serious harm at the time of the summary suspension in August.

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848 A.2d 642, 381 Md. 157, 2004 Md. LEXIS 247, Counsel Stack Legal Research, https://law.counselstack.com/opinion/board-of-physician-quality-assurance-v-mullan-md-2004.