Department of Community Health v. Anderson

830 N.W.2d 814, 299 Mich. App. 591
CourtMichigan Court of Appeals
DecidedFebruary 26, 2013
DocketDocket No. 309675
StatusPublished
Cited by24 cases

This text of 830 N.W.2d 814 (Department of Community Health v. Anderson) is published on Counsel Stack Legal Research, covering Michigan Court of Appeals primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Department of Community Health v. Anderson, 830 N.W.2d 814, 299 Mich. App. 591 (Mich. Ct. App. 2013).

Opinion

PER CURIAM.

Respondent, Cynthia S. Anderson, D.V M., appeals by right the March 20,2012, final order of the Michigan Board of Veterinary Medicine Disciplinary Subcommittee finding that respondent violated MCL 333.16221(a) and MCL 333.16221(b)(i). The disciplinary subcommittee found that during a C-section to remove a dead fetus and a diseased uterus, respondent ligated1 the dog’s bladder rather than the uterine stump. The disciplinary subcommittee also found that respondent failed to break down adhesions (scar tissue) to separate the dog’s organs before attempting the ligation, which was further evidence of respondent’s negligent and incompetent care. The disciplinary subcommittee, in its final order, placed respondent on probation for two years, required her to complete 10 hours of continuing education, and assessed a $1,000 fine. We affirm.

On July 28, 2009, petitioner, Department of Community Health, Bureau of Health Professions, Board of Veterinary Medicine Disciplinary Subcommittee, filed an administrative complaint alleging that respondent had violated MCL 333.16221(a) “consisting of negligence or failure to exercise due .care . .. whether or not injury results,” and violated MCL 333.16221(b)(i), “[p]ersonal disqualifications, consisting of.. . [incompetence.” The complaint alleged in ¶ 5:

[594]*594On February 18, 2008, “Laya,” a female canine with a history of caesarians, presented to the facility because her water broke, but she never gave birth. Respondent performed a caesarian section and was given consent to perform a spay procedure. During the procedure, Respondent failed to break down the adhesions and ligated the bladder along with the uterine stump.

At a hearing on June 23, 2010, respondent, John Bumstead, Laya’s owner, and several other veterinarians testified. Dr. Kenneth McCrumb, who performed exploratory surgery on Laya on February 25, 2008, also testified. In a statement drafted on February 26, 2008, admitted as Exhibit C, McCrumb wrote that Laya’s “bladder had a ligature around it, eliminating 90% of its storage capacity and was necrotic. The uterine stump was represented by a large ball of necrotic tissue.” McCrumb also found Laya’s ureters were “unattached to the bladder and ending in the abdomen [and] were depositing urine into the abdomen and not into the bladder, consequently urine was leaking from the incision.” Laya was euthanized.

Respondent testified, denying that she had ligated Laya’s bladder or severed the dog’s ureters. Respondent also testified that on February 20, 2008, after Bumstead brought Laya back to respondent’s clinic because of her deteriorating condition, she had observed Laya urinating — something not possible if Laya’s bladder were tied off. This claim was supported by a file note dated February 20, 2008, at 4 p.m.: “urination noted.” But other evidence indicated that after the February 18 surgery Laya was leaking fluid from her incisions. Bumstead testified that he took Laya back to respondent’s clinic two days after the surgery because “her teeth were chattering, I mean, she wasn’t eating. She wasn’t peeing. She wasn’t pooping. So she wasn’t doing [595]*595anything that you would expect of a dog that’s in recover.”

On December 9, 2010, the hearing officer issued an amended proposal for decision that included findings 4 (respondent did not ligate the dog’s bladder), 6 (Laya could still urinate two days after surgery), and 7 (vomiting and wrenching can cause slippage of ligatures). In her proposed conclusions of law, the hearing officer noted that the evidence did not contradict respondent’s testimony that she observed urination days after the surgery, which veterinarians for both parties agreed would not have been possible if the dog’s bladder had been ligated during surgery two days previously. The hearing officer also accepted proffered defense expert testimony theorizing that there was slippage of a ligature due to wrenching caused by Laya’s vomiting. Consequently, the hearing officer recommended that the evidence did not establish any violation of general duty, negligence or failure to exercise due care under MCL 333.16221(a) nor did it establish incompetence under MCL 333.1622l(b)(i).

On February 23, 2012, the disciplinary subcommittee issued its findings of fact and conclusions of law, rejecting the hearing officer’s proposed findings 4, 6, and 7. With respect to proposed finding 4, the disciplinary subcommittee found that respondent did ligate the dog’s bladder during the surgery on February 18, 2008. The disciplinary subcommittee found compelling Dr. McCrumb’s February 26, 2008, statement regarding what he found a week after respondent’s surgical treatment of Laya.

The disciplinary subcommittee also rejected proposed finding 6, reasoning that:

. . . Dr. McCrumb observed that the ureters were not attached to the bladder, the bladder was necrotic, and the [596]*596ureters were depositing urine into the abdomen, not the bladder. Additionally, the owner brought the dog back to Respondent specifically because the dog had not urinated or defecated since being brought home from Respondent’s clinic. .. . Therefore,... the dog did not have the ability to urinate as Respondent documented.
In addition, when questioned as to whether the dog could urinate if the bladder had been tied off prior to February 20, 2008, Dr. McCrumb testified as follows: “I wouldn’t think so because there was essentially no bladder to produce urine.” . .. Also, Dr. McCrumb testified that the ureters were not connected to the bladder, the bladder was non-functional and the abdomen was full of fluid determined to be urine coming from the two detached ureters.

The disciplinary subcommittee also rejected finding 7, which theorized that a ligature might have slipped when the dog vomited. The disciplinary subcommittee found that a properly placed ligature would not slip in this way, reasoning as follows:

During his exploratory surgery, Dr. McCrumb had to break down additional adhesions to identify the bladder and uterine stump. The bladder and uterus are not naturally attached. The ligatures would not move from one organ to another, as ligatures are designed to be tight enough to cut off blood flow. Therefore, vomiting and wrenching could not cause slippage of ligatures if properly placed. The Disciplinary Subcommittee notes that the bladder was disconnected from the ureters and necrotic, which indicates the blood flow to the bladder was cut off by the ligatures. Therefore, the Disciplinary Subcommittee rejects Findings of Fact 7.

Applying its own findings of fact, the disciplinary subcommittee rejected the hearing officer’s proposed conclusion of law that respondent had not violated MCL 333.16221(a) and MCL 333.16221(b)(i). In addition to the findings summarized already, the disciplinary subcommittee relied on respondent’s own testimony:

[597]*597Respondent admitted that she failed to break down the adhesions and separate the organs before attempting ligation, causing the structures to remain stuck together, which the Disciplinary Subcommittee concludes is further evidence of Respondent’s negligent and incompetent care. As previously stated, Dr. McCrumb could not identify the bladder and uterine stump until he removed the adhesions. Therefore, the Disciplinary Subcommittee concludes the Respondent could not have been able to identify to what organ she attached the ligatures.

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Cite This Page — Counsel Stack

Bluebook (online)
830 N.W.2d 814, 299 Mich. App. 591, Counsel Stack Legal Research, https://law.counselstack.com/opinion/department-of-community-health-v-anderson-michctapp-2013.