Pating v. Board of Medical Quality Assurance

130 Cal. App. 3d 608, 182 Cal. Rptr. 20, 1982 Cal. App. LEXIS 1414
California Court of Appeal·Decided April 13, 1982·No. Civ. 61947·Published·Cited by 16 cases

Opinion

Opinion

HANSON (Thaxton), J .

The appeal and cross-appeal in this case raise issues relating to the admissibility of patient medical records from the hospital and the doctor’s office, respectively, in a disciplinary hearing before the Division of Medical Quality and the Board of Medical Quality Assurance (hereinafter referred to collectively as the Board). Roger Fating, M.D., appeals from a judgment granting his petition for writ of mandate insofar as the court found admissible the hospital records pertaining to certain patients named in the accusation on whom he allegedly performed or failed to perform specific surgical procedures. The *612 Board cross-appeals from the judgment insofar as the court ruled that the office medical charts relating to the same patients, together with information obtained therefrom, were not admissible at the hearing before the Board.

Facts

On or about March 7, 1979, the Board, the state agency charged with enforcement of the Medical Practice Act (Bus. & Prof. Code, § 2000 et seq.) filed an accusation against Roger Fating, M.D. The Board therein charged Fating with acts involving dishonesty and the falsification of medical records (Bus. & Prof. Code, §§ 2361, subd. (e) and 2411) in connection with his treatment of 10 named patients from 1970 through 1973. The accusation alleged that in the case of each identified patient Fating made entries in the hospital charts showing that a specific surgical procedure was performed and the surgery was so billed whereas in fact the surgical procedure thus reported in each instance was not performed. The accusation further alleged that Fating treated the 10 named patients while engaged in practice as a member of the San Gabriel Valley ENT Medical Group, Inc. (hereinafter referred to as the Medical Group) and that hospital and office charts would show that Fating billed insurance carriers for these surgeries recorded in the charts but not performed.

On March 14, 1979, Fating was served. On March 26, 1979, he filed a notice of defense in which he raised certain affirmative defenses and requested a hearing. On June 12, 1979, Fating was notified that hearing would be conducted by an administrative law judge pursuant to provisions of the Administrative Procedures Act (Gov. Code, § 11500 et seq.) in December 1979.

At the hearing which commenced December 3, 1979, Fating was present in person and with counsel and proceedings were reported. Fating moved to exclude the hospital and office records of each of the 10 patients named in the accusation on the grounds that such records were improperly and illegally obtained by the Board in violation of the physician-patient privilege and the patients’ rights to privacy. On stipulation of counsel the evidence presented at the hearing was limited to the issue of the admissibility of these records with the understanding that the question might be presented to the court for decision prior to completion of the proceedings, all parties waiving exhaustion of administrative remedies due to the significance of the preliminary issues presented.

*613 The evidence adduced at the hearing discloses that on June 24, 1976, Donald Adams, the executive vice president of Foothill Presbyterian Hospital (hereinafter referred to as Foothill Hospital) notified the Board pursuant to Business and Professions Code section 805 that Fating had resigned from the medical staff after his staff privileges were summarily suspended December 16, 1975, pending review by a medical committee. The Board on July 26, 1976, assigned Senior Special Investigator John Butler to investigate the circumstances relating to this disciplinary report. Butler on September 16, 1976, visited Foothill Hospital where he met with Adams, Dr. Morgan, chief of staff, and Dr. Zalta, immediate past chief of staff.

The hospital administrator and both doctors were cooperative and expressed their willingness to provide whatever information was available. Butler learned that Fating during the period when these patients were treated (1970 through 1973) had practiced medicine in a professional medical corporation with Drs. Zalta and Morgan. Fating terminated his association with the Medical Group in January 1974. The doctors told Butler that Fating had resigned from the hospital staff after it was learned that numerous patients of his had undergone surgery that was not needed and that operative reports made by Fating recited events that had not actually happened during surgery. At the time of this interview they gave Butler case summaries which they had prepared relating to 10 named patients. In these summaries they itemized what they believed was wrong in Pating’s treatment of each patient and listed the charges. They also attached a list of physician witnesses.

Without further investigation and without contacting any of the identified patients, Butler on September 23, 1976, prepared separate declarations with respect to a number of investigative subpoenas. Each subpoena duces tecum requested the custodian of records at the several hospitals (Glendora Community Hospital, San Dimas County Hospital and Queen of the Valley Hospital, respectively) to produce the complete medical records of specific patients.

Butler made the following allegations in each declaration: “I am a senior special investigator of the Department of Consumer Affairs of the State of California; I am conducting an investigation of Roger Fating, M.D. involving an allegation of treatment to patients detrimental to their health. These activities, if confirmed, are violations of the Business and Professions Code of the State of California. Section *614 2361(b) B & P Code—Gross Negligence. Section 2361(c) B & P Code —Incompetence. The medical records pertaining to patients on page 1 may offer evidence to substantiate the aforementioned allegations related to the practice of medicine.”

The subpoenas were served on all three hospitals September 24, 1976. Without objection each hospital served with a subpoena furnished to the Board between September 30 and October 5, 1976, the hospital charts on the named patients. One more hospital, Covina Inter-Community Hospital, when served with a similar subpoena in May 1977, responded promptly and without objection delivered the requested hospital records.

Butler at no time prior to the hearing in December 1979 contacted - the patients whose records he obtained in this manner from the various hospitals nor did he attempt to procure from them consents or waivers. He nonetheless interviewed the physicians named who had examined the patients following surgery and obtained from them declarations concerning their postsurgery treatments.

None of these patients had been treated at Foothill Hospital. Drs. Zalta and Morgan told Butler they had acquired information regarding patients treated in other hospitals from patient files at the offices of the Medical Group where at least two of the patients were still being treated. Butler obtained from these doctors sometime between September 16 and October 15, 1976, without subpoena, the office medical records of the patients named in the accusation who had been treated by the Medical Group. Although Butler testified that he did not recall the details relating to the receipt of the office records, it may be inferred that they were offered to him by Drs.

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Pating v. Board of Medical Quality Assurance, 130 Cal. App. 3d 608, 182 Cal. Rptr. 20, 1982 Cal. App. LEXIS 1414 (Cal. Ct. App. 1982).

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