Brigham v. DeBuono

228 A.D.2d 870, 644 N.Y.2d 413, 644 N.Y.S.2d 413, 1996 N.Y. App. Div. LEXIS 7246
CourtAppellate Division of the Supreme Court of the State of New York
DecidedJune 20, 1996
StatusPublished
Cited by15 cases

This text of 228 A.D.2d 870 (Brigham v. DeBuono) is published on Counsel Stack Legal Research, covering Appellate Division of the Supreme Court of the State of New York primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Brigham v. DeBuono, 228 A.D.2d 870, 644 N.Y.2d 413, 644 N.Y.S.2d 413, 1996 N.Y. App. Div. LEXIS 7246 (N.Y. Ct. App. 1996).

Opinion

Spain, J.

In January 1994 the State Board for Professional Medical Conduct (hereinafter BPMC) charged petitioner, a general practitioner licensed in 1987, with negligence and gross negligence in connection with his performance of late-term abortions on two patients. Petitioner performed a dilatation and evacuation (hereinafter D&E) procedure on both patients. The statement of charges pertaining to petitioner’s treatment of patients A and B include 12 separate charges (hereinafter the relevant charges will be referred to as follow: as to patient A [Al, A2-A9]; as to patient B [Bl, B2, B3]). An 11-day hearing was held before a Hearing Committee of the State Board for Professional Medical Conduct (hereinafter the Committee). After the hearing, the Committee recommended that respondent continue petitioner’s summary suspension; thereafter the Committee sustained charges Al, A3-A9, B2 and B3, found petitioner guilty of professional misconduct and imposed a penalty of revocation of petitioner’s license to practice medicine in New York. Upon administrative appeal, the Administrative Review Board for Professional Medical Conduct (hereinafter ARB) sustained the Committee’s findings regarding the charges and the penalty. Petitioner commenced this CPLR article 78 proceeding seeking annulment of the ARB’s determination.

Petitioner initially contends that he was not afforded adequate notice regarding the charges against him because the charges were distorted so as to circumvent any defense he prepared in contravention of his due process rights. It is axiomatic that the subject of an administrative disciplinary proceeding "is entitled to fair notice of the charges against him or her so that he or she may prepare and present an adequate defense and thereby have an opportunity to be heard” (Matter of Block v Ambach, 73 NY2d 323, 332). However, "the charges need only be reasonably specific, in light of all the relevant circumstances, to apprise the party whose rights are being determined of the charges against him” (supra, at 333; see, Matter of Garo[871]*871falo v Dowling, 223 AD2d 770, 772; Matter of Langhorne v Jackson, 213 AD2d 909, 910). Our review of the record reveals that the charges against petitioner covered all aspects of the abortion procedures performed and were not limited to the adequacy of the dilatated cervix, which charges (A2 and Bl) were not sustained. We conclude that petitioner was adequately apprised of each of the charges against him and that he had ample opportunity to defend himself against all charges, as he did so vigorously during the course of these proceedings.

We also find no merit to petitioner’s contentions that standards of care employed by the Committee were without authority, without any basis in the record and were imposed retrospectively and unilaterally. The proper standard of review is whether the ARB’s "determination was made in violation of lawful procedure, was affected by an error of law, was arbitrary and capricious or an abuse of discretion” (Matter of Minielly v Commissioner of Health of State of N. Y., 222 AD2d 750, 751; see, e.g, Matter of Chua v Chassin, 215 AD2d 953, 954, lv denied 86 NY2d 708; see also, CPLR 7803 [3]). This Court’s inquiry under this standard is "whether the administrative determination has a rational basis supported by fact” (Matter of Chua v Chassin, supra, at 954-955; see, e.g., Matter of Mansur v State of N. Y. Dept. of Health Bd. for Professional Med. Conduct, 223 AD2d 774; Matter of Okereke v State of New York, 129 AD2d 373, 376, lv denied 70 NY2d 611). Furthermore, this Court will not decide credibility issues or weigh the testimony of expert witnesses since these issues are the sole province of the administrative fact finder (see, Matter of Chua v Chassin, supra, at 955; Matter of Moss v Chassin, 209 AD2d 889, 891, lv denied 85 NY2d 805, cert denied — US —, 116 S Ct 170).

As to charge Al, petitioner asserts that the Committee developed a new counseling standard by imposing, inter alia, a requirement that a patient be affirmatively advised of the risk of the psychological impact of a voluntary termination of pregnancy. Although we agree with petitioner that such a standard was not proven, the record amply supports the ARB’s determination that patient A was not otherwise afforded appropriate counseling. It is uncontroverted that patient A was given a fact sheet for a first-term abortion which does not explain the complications of a late second-term abortion, even though she was requesting a late second-term abortion. The patient stated that there was no discussion of the fact sheet. She also testified that no one spoke to her about her social situation, the reason for the delay in seeking an abortion, her understanding or knowledge about abortions, or alternatives to [872]*872abortion. The record reveals that the majority of the counseling was conducted by one of petitioner’s employees whose testimony was discredited by the Committee.

It is clear that the ARB did not limit its decision on a need for counseling regarding the psychological affects of an abortion; its determination was supported by the standard of care for counseling as testified to in the record. Additionally, petitioner’s argument that he is not liable for the clinic’s counselor’s failure to adequately inform his patients is totally without merit; there is uncontroverted evidence in the record that the standard of care with respect to counseling imposes on the physician the responsibility to ensure that his or her patient is adequately counseled even if the physician delegates that responsibility. Further, a physician is required to keep adequate records of the counseling procedure and the record supports the ARB’s conclusion that the Committee properly found that petitioner’s records were inadequate in this regard.

Next, petitioner correctly contends that a transfer arrangement with a physician who has hospital privileges meets the requisite standard of care; the Committee erred in its determination that the standard of care requires that a transfer arrangement must be with a hospital. Petitioner testified that he had verbal backup in place with one physician who worked at the same facility and a written arrangement with William Knorr, another physician at the facility. However, petitioner testified that he could not say with certainty whether Knorr had complete hospital privileges or conditional privileges. Furthermore, there was nothing mentioned in the alleged transfer agreement with respect to Knorr’s privileges or regarding Knorr admitting any patients on petitioner’s behalf. The record also reveals that petitioner did not notify Knorr when complications arose and that he acted against the standard of care when he relied on 911 to send the patient to the hospital, which is further evidence of his lack of any backup arrangement. We conclude that although the Committee’s decision misstated the proper standard of care, the ARB’s determination that petitioner lacked any appropriate transfer arrangement was rationally based on the testimony and other evidence in the record.

We further conclude that the Committee’s determination regarding petitioner’s severely limited scope of visualization with respect to patient A was proper. Petitioner argues that the findings of gross negligence and negligence were predicated on petitioner visualizing the uterus, which is not only impossible to do but is not a required medical standard. Petitioner [873]

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Bluebook (online)
228 A.D.2d 870, 644 N.Y.2d 413, 644 N.Y.S.2d 413, 1996 N.Y. App. Div. LEXIS 7246, Counsel Stack Legal Research, https://law.counselstack.com/opinion/brigham-v-debuono-nyappdiv-1996.