Mississippi State Board of Nursing v. Robin Mack

CourtCourt of Appeals of Mississippi
DecidedJune 15, 2021
Docket2019-SA-01620-COA
StatusPublished

This text of Mississippi State Board of Nursing v. Robin Mack (Mississippi State Board of Nursing v. Robin Mack) is published on Counsel Stack Legal Research, covering Court of Appeals of Mississippi primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Mississippi State Board of Nursing v. Robin Mack, (Mich. Ct. App. 2021).

Opinion

IN THE COURT OF APPEALS OF THE STATE OF MISSISSIPPI

NO. 2019-SA-01620-COA

MISSISSIPPI STATE BOARD OF NURSING APPELLANT

v.

ROBIN MACK APPELLEE

DATE OF JUDGMENT: 09/26/2019 TRIAL JUDGE: HON. JAMES CHRISTOPHER WALKER COURT FROM WHICH APPEALED: MADISON COUNTY CHANCERY COURT ATTORNEY FOR APPELLANT: BRETT B. THOMPSON-MAY ATTORNEY FOR APPELLEE: ADRIENNE P. PARKER NATURE OF THE CASE: CIVIL - STATE BOARDS AND AGENCIES DISPOSITION: AFFIRMED - 06/15/2021 MOTION FOR REHEARING FILED: MANDATE ISSUED:

BEFORE BARNES, C.J., WESTBROOKS AND SMITH, JJ.

BARNES, C.J., FOR THE COURT:

¶1. This appeal stems from a complaint filed by the Mississippi State Board of Nursing

(Board of Nursing) against Robin Mack, a nurse practitioner employed at the G.V. (Sonny)

Montgomery Veterans’ Administration Medical Center (VA). The complaint charged Mack

with two violations: (1) negligently or willfully practicing nursing in a manner that failed

to meet generally accepted standards of nursing practice, and (2) falsifying or negligently

making an incorrect entry on records, in violation of Mississippi Code Annotated section 73-

15-29(1)(e) and (g) (Rev. 2012), respectively.1 After an administrative hearing before a

1 This Code section provides for nursing license denial, revocation, or suspension:

(1) The board shall have power to revoke, suspend or refuse to renew any three-member panel of the Board of Nursing, Mack was found guilty of the two charges, and

her registered nursing license was placed on probation for a minimum of twelve months.

Mack appealed. Following a hearing before its full membership, the Board of Nursing voted

to affirm the panel’s decision. Mack appealed to the Chancery Court of Madison County.

After a hearing, the chancellor reversed the Board of Nursing’s decision, finding it was not

supported by substantial evidence and was arbitrary and capricious. We agree and affirm

the chancery court’s decision.

STATEMENT OF FACTS

¶2. In 2003, Mack started working at the VA as a nurse practitioner. As a new employee,

Mack was oriented on the VA’s Computerized Patient Record System (CPRS). The VA had

recruited Mack to operate a “stand alone” primary care clinic, the Pain Evaluation Triage

and Treatment Clinic. At this clinic, Mack made and cancelled her own appointments. She

was given additional responsibilities, such as developing a pain tele-medicine (CVT) clinic,

working with the regional VA office, and serving on the National Pain Management Board.

By this time, Mack had years of nursing experience.

¶3. In October 2012, after a change in the VA’s administration, Mack and many other

colleagues were moved to different areas of the VA. Mack was moved to Physical Medicine

and Rehabilitation Services (PMRS), while continuing her other extra responsibilities.

Nancy Bailey was the administrative coordinator of the PMRS clinic. Mack claims she was

license issued by the board, or to revoke or suspend any privilege to practice, or to deny an application for a license, or to fine, place on probation and/or discipline a licensee, in any manner specified in this article . . . .”

2 never instructed on how to schedule patients at the PMRS clinic; so she continued her

practice of scheduling and cancelling her patients herself. Mack testified she was unaware

that Bailey was actually responsible for handling the daily management of the clinic,

creating scheduling grids, and scheduling appointments. Further, Mack claimed she was

never told about the scheduling grid system, and she was unaware that the two clinics she

covered—the CVT and PMRS clinics—operated under two different scheduling systems;

therefore, double-booking was a recognized problem. Bailey, however, was aware of these

issues.

¶4. In May 2013, initial complaints about Mack’s scheduling and documentation

practices were reported to Bailey.2 In August 2013, Bailey and Dr. Liep Tjeng, chief of the

PMRS clinic and Mack’s direct supervisor, met with Mack and discussed incomplete or no

documentation in patient records, as well as copied-and-pasted documentation in patient

records, which resulted in patient continuity-of-care concerns regarding inadequate

documentation. Bailey and Dr. Tjeng also requested Mack to call patients personally to

cancel appointments instead of having administration staff do it. In November 2013, Joe

Battle, the VA Medical Center Director, sent a memo to Phyllis Johnson, a nurse practitioner

working in the PMRS clinic, assigning her to perform a fact-finding investigation on Mack

“surrounding concerns regarding the thoroughness, accuracy and timely completion of

documentation of patient care as well as clinic utilization.”

¶5. Fellow PMRS clinicians Jeanna Cockrell-Brown and Lynn Jones, both registered

2 Mack’s annual employment evaluations for job performance were usually “highly satisfactory” or “outstanding” until 2013, when she received some “satisfactory” marks.

3 nurses and long-time VA employees, also initiated complaints against Mack and testified

against her at the Board panel hearing. Cockrell-Brown testified to an incident that became

central to Mack’s prosecution and subsequent license probation. On November 15, 2013,

Mack documented in the electronic record of “Patient J.L.”3 a face-to-face encounter and

check-out time of 10:50 a.m., but Cockrell-Brown discovered that Mack had called the

patient the day before to cancel the appointment. The Board of Nursing later used this

incident as the basis for charges against Mack of intentionally falsifying patient records.

Mack, however, explained that on that day she was double-booked to see patients in both

the PMRS and CVT clinics. Therefore, to correct the problem, she called Patient J.L. to

cancel his PMRS clinic appointment in order to cover the CVT clinic and noted the

scheduling conflict in his electronic chart. Jones also testified that Mack’s lack of

documentation in patient records made it difficult to determine what the patients’ plans of

care were. She also stated Mack was difficult to reach at work, and Mack cancelled patients’

appointments in the clinic without notifying them.

¶6. On November 22, 2013, Johnson interviewed Mack, who admitted the following: she

had been untimely in documentation of nursing notes in patient records; and that she did see

Patient J.L. on November 15, because she had “switched him” to the CVT clinic from the

PMRS clinic. On November 25, 2013, Johnson released her formal fact-finding report on

Mack. For her investigation, Johnson interviewed ten VA employees, including Mack,

Jones, Cockrell-Brown, and Bailey, and analyzed numerous patient medical charts. In

3 Initials are used to protect the patient’s privacy.

4 December 2013, the VA suspended Mack’s clinical privileges, and she was removed from

patient care because “aspects of [her] clinical practice [did] not meet the accepted standards

of practice and potentially constitute an imminent threat to patient welfare”; specifically,

there were allegations “that on many occasions documentation [of] patient care [was] below

accepted standards.”

¶7. In March 2014, the VA chief-of-staff, Dr. David Walker, wrote to Mack proposing

her discharge based upon the fact-finding investigation by Johnson. He enumerated four

charges: failing to complete clinical notes in a timely manner, misrepresenting clinical

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Mississippi State Board of Nursing v. Robin Mack, Counsel Stack Legal Research, https://law.counselstack.com/opinion/mississippi-state-board-of-nursing-v-robin-mack-missctapp-2021.