Dhabuwala v. State Board for Professional Medical Conduct

225 A.D.2d 209, 651 N.Y.2d 249, 651 N.Y.S.2d 249, 1996 N.Y. App. Div. LEXIS 12867
CourtAppellate Division of the Supreme Court of the State of New York
DecidedDecember 26, 1996
StatusPublished
Cited by5 cases

This text of 225 A.D.2d 209 (Dhabuwala v. State Board for Professional Medical Conduct) 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
Dhabuwala v. State Board for Professional Medical Conduct, 225 A.D.2d 209, 651 N.Y.2d 249, 651 N.Y.S.2d 249, 1996 N.Y. App. Div. LEXIS 12867 (N.Y. Ct. App. 1996).

Opinion

OPINION OF THE COURT

Peters, J.

Pursuant to a notice of hearing and statement of charges, petitioner, an obstetrician/gynecologist, was charged by the Bureau of Professional Medical Conduct (hereinafter BPMC) with practicing with gross negligence, negligence on more than one occasion, ordering unwarranted treatment, fraudulent practice and failing to maintain accurate records. The conduct alleged occurred with respect to three patients during the period between 1987 and 1989.

At the conclusion of a hearing held before a Hearing Committee of respondent State Board for Professional Medical Conduct, all charges, other than those alleging gross negligence and that of fraudulent practice, were sustained. However, in the issuance of its order, it was noted that "[although [petitioner] must bear full responsibility for the serious charges sustained against him, the [Hearing] Committee recognizes that the conduct of others contributed to the inadequate medical care received”. Hence, it imposed a two-year suspension of petitioner’s license, which was stayed, placed him on probation for two years and required that he submit quarterly reports to the Office of Professional Medical Conduct (hereinafter OPMC) to determine whether his decisions to pursue surgical intervention were appropriate.

BPMC thereafter filed a notice of appeal with the Administrative Review Board for Professional Medical Conduct (hereinafter ARB) to specifically challenge the penalty imposed. The sole request made was for the ARB to "add a requirement that, prior to performing a vaginal or abdominal hysterectomy, [petitioner] be required to obtain a concurring, but independent second opinion from a suitably board certified physician” (emphasis in original). By this simple modification, counsel for BPMC contended that "adequate protection of the public” would be ensured. Counsel for petitioner immediately notified the ARB that based upon their understanding that acceptance of this agreement would circumvent further review, they agreed to the modification.

[211]*211After setting forth the scope of its permissible review (see, Public Health Law § 230-c), the ARB remanded this matter to the Hearing Committee for more information as to the penalty imposed "or why the Committee feels the penalty is sufficient to protect the public”. In so doing, the ARB requested the Hearing Committee to address nine specific questions which included, inter alia, the following:1

"4. Does the Committee feel that [petitioner’^ negligence was the result of poor judgment, poor surgical skills or both? "5. Is [petitioner] competent to continue practicing surgery? "6. Does [petitioner] have sufficient knowledge to make the proper judgments in practicing surgery? * * *
"9. Did the Committee consider sending [petitioner] for an evaluation of his skills as a physician?”

The supplemental determination, fully responsive to the questions posed, noted that "[petitioner’s] surgical skills were never questioned” and that "[a]ll of [petitioner’s] inappropriate treatment was in response to requests or demands from his Supervisory Physician and/or his patients. He used poor judgment in responding to these requests or demands.” In response to the particular questions posed, the Hearing Committee advised the ARB that it felt that petitioner’s negligence was the result of poor judgment, that he is competent to continue practicing surgery, that he possesses "sufficient knowledge to make the proper judgments in practicing surgery”, and that while it considered sending him for an evaluation of his skills, such option was rejected upon its finding that petitioner’s negligence was based upon poor judgment "rather than lack of skills”.

Although the ARB sustained the Hearing Committee’s determination on the charges, "concerned that [petitioner’s] poor judgement may be the result of poor cognitive skills and that * * * [his] negligence and ordering of excessive treatment may indicate a lack of basic knowledge necessary to practice [212]*212medicine”, it modified the penalty by ordering, petitioner to undergo an evaluation by the Physician Prescribed Educational Program (hereinafter PPEP).2 Therein, the ARB detailed that if such evaluation determined that petitioner "possesse[d] the requisite knowledge to safely and effectively practice medicine”, the penalty imposed would be probation for a period of two years, with the conditions of probation being those which were originally recommended by the Hearing Committee and then further modified and agreed to by petitioner. If, however, the evaluation determined that petitioner did not possess the requisite knowledge to practice medicine safely and effectively, "then the matter [would] be returned to the [ARB] for a further deliberation on the appropriate penalty”.

Petitioner fully participated in the PPEP evaluation. Recognizing that the ARB required PPEP to make only one of those two decisions, the program director concluded that "the findings of the evaluation are not definitive enough to make such a dichotomous decision without bias”. The ARB therefore found that because "PPEP * * * was unable to [determine] that * * * [petitioner] could practice medicine safely and effectively”, each party was permitted 30 days to provide comments upon the appropriate penalty in this case, based upon the ARB’s "findings of misconduct” and upon "the finding from the PPEP Evaluation”.

Counsel for BPMC sought revocation of petitioner’s license or a suspension with mandatory retraining. Petitioner contended that since the review did not find him unfit to practice medicine, the prior penalty, as modified by agreement, should remain undisturbed. The ARB’s final determination and order increased the probationary period to seven years and ordered that petitioner’s license be limited to permit him to practice only in a hospital or other facility licensed pursuant to Public Health Law article 28. Petitioner then commenced this proceeding.

Petitioner contends that the notice requirements of due process preclude an administrative agency from finding a professional guilty of conduct which was not specifically set forth in the statement of charges (see, Matter of Block v Ambach, 73 [213]*213NY2d 323; Matter of Murray v Murphy, 24 NY2d 150; Matter of Orozco v Sobol, 162 AD2d 834). We agree. The record clearly reflects that the penalty imposed was based upon the uncharged offense of incompetence, a separate act of misconduct under the Education Law (compare, Education Law § 6530 [3], [4], with Education Law § 6530 [5], [6]). OPMC itself specifically distinguishes between negligence and incompetence. In an internal memorandum defining terms relating to professional malpractice, the general counsel to the Department of Health stated that "[n]egligence is applicable to an act or omission of a physician which constitutes a breach of the duty of care [whereas] [i]ncompetence is directed to the lack of the requisite knowledge or skill in the performance of an act”. While the ARB’s review powers include the authority to increase the severity of a sanction imposed by a Hearing Committee (Matter of Kabnick v Chassin, 89 NY2d 828), it cannot ground such sanction upon conduct not charged.

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Cite This Page — Counsel Stack

Bluebook (online)
225 A.D.2d 209, 651 N.Y.2d 249, 651 N.Y.S.2d 249, 1996 N.Y. App. Div. LEXIS 12867, Counsel Stack Legal Research, https://law.counselstack.com/opinion/dhabuwala-v-state-board-for-professional-medical-conduct-nyappdiv-1996.