Hoffman v. State Medical Board

113 Ohio St. 3d 376
CourtOhio Supreme Court
DecidedMay 23, 2007
DocketNo. 2005-1754
StatusPublished
Cited by32 cases

This text of 113 Ohio St. 3d 376 (Hoffman v. State Medical Board) is published on Counsel Stack Legal Research, covering Ohio Supreme Court primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Hoffman v. State Medical Board, 113 Ohio St. 3d 376 (Ohio 2007).

Opinion

Lanzinger, J.

{¶ 1} This discretionary appeal presents the question of whether Ohio Adm. Code 4731-24-04(A), which prohibits anesthesiologist assistants from performing epidural and spinal anesthetic procedures, conflicts with R.C. 4760.09, which permits anesthesiologist assistants to assist supervising anesthesiologists with the performance of a variety of procedures. We hold that because there is a conflict, the Ohio Administrative Code regulation is invalid.

Case Background

2} In May 2000, the Ohio General Assembly enacted R.C. Chapter 4760, which regulates the training, certification, and practice of anesthesiologist assistants in Ohio. Am.Sub.S.B. No. 278, 148 Ohio Laws, Part V, 11484 (“S.B. 278”). Previously, anesthesiologist assistants had not been required by statute to undergo any specific training or certification.

{¶ 3} The appellee, the State Medical Board of Ohio, determines which applicants satisfy certification requirements to become anesthesiologist assistants. [377]*377R.C. 4760.04. The board is also authorized by R.C. 4760.19 to adopt rules to implement R.C. Chapter 4760. In May 2003, the board adopted Ohio Adm.Code 4731-24-04(A), which prohibits anesthesiologist assistants from performing epidural and spinal anesthetic procedures.

{¶ 4} Joseph Hoffman, the appellant, is a certified anesthesiologist assistant in Cleveland. Since he began his career in 1982, he has performed epidural and spinal anesthetic procedures as part of his practice. In 2003, he filed an action for declaratory and injunctive relief against the board, asserting that Ohio Adm.Code 4731-24-04(A) conflicts with R.C. 4760.09, the statute that lists the authorized activities of anesthesiologist assistants. After considering cross-motions for summary judgment, the trial court granted summary judgment in favor of Hoffman, finding the rule to be in clear conflict with the statute.

{¶ 5} On appeal to the Tenth District Court of Appeals, the board argued that the administrative rule did not conflict with the statute. Both parties focused their arguments on the word “assist,” a word found both in the administrative rules and in the statute. The board asserted that the statute and rules should be read together and interpreted to mean that the anesthesiologist assistant may merely help the supervising anesthesiologist as the supervising anesthesiologist personally performs the specified procedure. Hoffman, on the other hand, contended that the statutory language should be interpreted to mean that the anesthesiologist assistant, who is permitted to perform the procedure personally, thereby helps the supervising anesthesiologist in the overall treatment of the patient. The court of appeals reversed the trial court’s judgment, agreeing with the board that the rule did not clearly conflict "with the statute.

The Statute and the Administrative Rule

{¶ 6} R.C. 4760.09 governs the scope of practice of anesthesiologist assistants and provides:

{¶ 7} “If the practice and supervision requirements of section 4760.08 of the Revised Code are being met, an anesthesiologist assistant may assist the supervising anesthesiologist in developing and implementing an anesthesia care plan for a patient. In providing assistance to the supervising anesthesiologist, an anesthesiologist assistant may do any of the following:

{¶ 8} “(A) Obtain a comprehensive patient history and present the history to the supervising anesthesiologist;

{¶ 9} “(B) Pretest and calibrate anesthesia delivery systems and monitor and obtain and interpret information from the systems and monitors;

{¶ 10} “(C) Assist the supervising anesthesiologist with the implementation of medically accepted monitoring techniques;

[378]*378{¶ 11} “(D) Establish basic and advanced airway interventions, including intubation of the trachea and performing ventilatory support;

{¶ 12} “(E) Administer intermittent vasoactive drugs and start and adjust vasoactive infusions;

{¶ 13} “(F) Administer anesthetic drugs, adjuvant drugs, and accessory drugs;

{¶ 14} “(G) Assist the supervising anesthesiologist with the performance of epidural anesthetic procedures and spinal anesthetic procedures;

{¶ 15} “(H) Administer blood, blood products, and supportive fluids.” (Emphasis added.)

{¶ 16} The board adopted Ohio Adm.Code 4731-24-04(A) after R.C. 4760.09 was enacted. This rule expressly prohibits anesthesiologist assistants from performing epidural and spinal anesthetic procedures: “(A) Nothing in this chapter of the Administration Code or Chapter 4760. of the Revised Code shall permit an anesthesiologist assistant to perform any anesthetic procedure not specifically authorized by Chapter 4760. of the Revised Code, including epidural and spinal anesthetic procedures and invasive medically accepted monitoring techniques. For purposes of this chapter of the Administrative Code, ‘invasive medically accepted monitoring techniques’ means pulmonary artery catheterization, central venous catheterization, and all forms of arterial catheterization with the exception of brachial, radial and dorsalis pedis cannulation.”

The Conflict Issue Between the Rule and the Statute

{¶ 17} Administrative rules are designed to accomplish the ends sought by the legislation enacted by the General Assembly. Carroll v. Dept of Adm. Servs. (1983), 10 Ohio App.3d 108, 110, 10 OBR 132, 460 N.E.2d 704. Therefore, “[rjules promulgated by administrative agencies are valid and enforceable unless unreasonable or in conflict with statutory enactments covering the same subject matter.” State ex rel. Curry v. Indus. Comm. (1979), 58 Ohio St.2d 268, 269, 12 O.O.3d 271, 389 N.E.2d 1126. The board derives its power to adopt administrative rules from R.C. 4760.19, which authorizes the board to adopt rules to implement R.C. Chapter 4760. However, an administrative rule may not add to or subtract from a legislative enactment. Cent. Ohio Joint Vocational School Dist. Bd. of Edn. v. Ohio Bur. of Emp. Servs. (1986), 21 Ohio St.3d 5, 10, 21 OBR 269, 487 N.E.2d 288. If it does, it creates a clear conflict with the statute, and the rule is invalid. Id.

{¶ 18} The board contends that the administrative rule does not conflict with the statute. Pointing to the legislative history, the board argues that the legislature did not intend to allow anesthesiologist assistants to perform epidural and spinal anesthetic procedures. It is the board’s position that by using the word “assist” in the statute, the legislature intended to preclude anesthesiologist [379]*379assistants from actually inserting the needle during epidural or spinal anesthetic procedures.

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Bluebook (online)
113 Ohio St. 3d 376, Counsel Stack Legal Research, https://law.counselstack.com/opinion/hoffman-v-state-medical-board-ohio-2007.