ffidicine l. d.p.m~,4patientsafety.org/documents/redko, peter 2011-09-14.pdf · 1 7 that the board...
TRANSCRIPT
BEFORE THE BOARD OF PODIATRJC MEDICINE
DEPARTMENT OF CONSUMER AFFAIRS STATE OF CALIFORNIA
· In the Matter of the Accusation ) Against: )
) PETER M. RED KO, D.P .M. )
) Doctor of Podiatric Medicine ) License No. E 4517 )
) )
Respondent. )
File No. lB-2009-200359
DECISION AND ORDER
The attached Stipulated Settlement; Decision and Order is hereby accepted and adopted by the Board of Podiatric Medicine of the Department of Consumer Affairs, State of California as its Decision in the ab{}ve-entitled matter.
This Decision shall become effective at 5:00 p.m. on October 14, 2011
DATED September 14, 2011
BOARD OF PODIATRIC i\ffiDICINE
Karen L. Wrubel, D.P.M~, President
l KAMALA D. HARRIS Attorney General of California
2 JOSE R. GUERRERO Supervising Deputy Attorney General
3 DAVIDCARR Deputy Attorney General
4 State Bar No. 131672 455 Golden Gate A venue, Suite 11000
5 San Francisco, CA 94102-7004 Telephone: (415) 703-5538
6 Facsimile: (415) 703-5480 Attorneysfor Complainant
BEFORE THE 7
8
9
BOARD OF PODIATRIC MEDICINE DEPARTMENT OF CONSUMER AFFAIRS
ST ATE OF CALIFORNIA
10 In the Matter of the Accusation Against: Case No. lB-2009-200359
11 PETER M. REDKO, D.P.M. OAH No. 2011031006
12 1400 Professional Drive, Suite 102
13 Petaluma, CA 94954 STIPULATED SETTLEMENT;
14 DECISION & ORDER
15
16
17
Podiatric Medicine License No. E 4517
Respondent.
18 To effect a prompt and speedy settlement of this matter, consistent with the public interest
19 and the responsibility of the Board of Podiatric Medicine ("Board") of the Department of
20 Consumer Affairs, the parties hereby agree to.the following Stipulated Settlement and
21 Disciplinary Order which will be submitted to the Board for approval and adoption as the final
22 disposition of the Accusation.
23 PARTIES
24 1. Complainant James Rathlesberger is the Executive Officer of the Board of
25 Podiatric Medicine. He brought this action solely in his official capacity and is represented in this
26 matter by Kamala D. Harris, Attorney General of the State of California, by David CmT, Deputy
27 Attorney General.
28
1
STIPULATED SETTLEMENT (lB-2009-200359)
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
2. Peter M. Redko, D.P.M. ("Respondent") is represented in this proceeding by
attorneys Steven D. Hillyard, John H. Dodd, and Theresa A. Dillard, 345 California Street, Suite
1770, San Francisco, California, 94104.
,JURISDICTION
3. The Board of Podiatric Medicine issued Podiatric Medicine License E 4517 to
Respondent on or about September 22, 2003. Unless renewed, this license will expire on July
31, 2011.
4. Accusation No. lB-2009-200359 was filed before the Board of Podiatric
Medicine, Department of Consumer Affairs, and is currently pending against Respondent. The
Accusation and all other statutorily required documents were properly served on Respondent
November 2, 2010. Respondent timely filed a Notice of Defense contesting the Accusation. A
copy of Accusation No. lB-2009-200359 is attached as Exhibit A and incorporated herein by
reference.
ADVISEMENT AND WAIVERS
5 Respondent has carefully read, fully discussed with counsel, and understands the
charges and allegations in Accusation No. lB-2009-200359. Respondent has also carefully read,
fully discussed with counsel, and understands the effects of this Stipulated Settlement and
Disciplinary Order.
6. Respondent is fully aware of his legal rights in this matter, including the right to a
hearing on the charges and allegations in the Accusation; the iight to be represented by counsel at
his own expense; the iight to confront and cross-examine the witnesses against him; the right to
present evidence and to testify on his own behalf; the right to the issuance of subpoenas to compel
the attendance of witnesses and the production of documents; the right to reconsideration and
court review of an adverse decision; and all other rights accorded by the California
Administrative Procedure Act and other applicable laws.
7. Respondent voluntarily, knowingly, and intelligently waives and gives up each and
every right set forth above.
II I
2
STIPULATED SETTLEMENT (lB-2009-200359)
1 CULP ABILITY
2 8. In order to resolve this matter without the expense and uncertainty of further
3 proceedings, Respondent agrees that at a formal hearing Complainant could establish a factual
4 basis for the allegations of the Accusation.
5 CIRCUMSTANCES IN MITIGATION
6 9. Respondent has never been the subject of any prior disciplinary action. Respondent
7 has been cooperative and forthright in the course of the Board's investigation of this matter.
8 10. Respondent agrees that his podiatric medicine license is subject to discipline and
9 he agrees to be bound by the Board's Decision and Order as set forth below.
1 O CONTINGENCY
11 11. This stipulation shall be subject to approval by the Board of Podiatric Medicine.
12 Respondent understands and agrees that counsel for Complainant and the staff of the Board of
13 Podiatric Medicine may communicate directly with the Board regarding this stipulation and
14 settlement, without notice to or participation by Respondent or his counsel. By signing the
15 stipulation, Respondent understands and agrees that he may not withdraw his agreement or seek
16 to rescind the stipulation prior to the time the Board considers and acts upon it. If the Board fails
17 to adopt this stipulation as its Decision and Order, the Stipulated Settlement and Disciplinary
18 Order shall be of no force or effect, except for this paragraph; it shall be inadmissable in any legal
19 action between the parties; and the Board shall not be disqualified from further action by having
20 considered this matter.
21
22
23
24
25
26
27
28
12. The paiiies understand and agree that facsimile copies of this Stipulated Settlement
and Disciplinary Order, including facsimile signatures thereto, shall have the same force and
effect as the originals.
13. In consideration of the foregoing admissions and stipulations, the parties agree that
the Board may, without fmiher notice or formal proceeding, issue and enter the following Order:
3
STIPULATED SETTLEMENT (1 B-2008-194863)
1 ORDER
2 IT IS HEREBY ORDERED that Podiatric Medicine License E-4517 is hereby revoked.
3 However, the revocation is stayed and probation imposed for a period of 35 months. Pursuant to
4 the provisions of Business and Professions Code section 2307(b)(3), Respondent may petition for
5 termination of probation after 1 year of probation. Probation is imposed on the following terms
6 and conditions:
7 1. CLINICAL TRAINING PROGRAM Within 60 calendar days of the effective date
8 of this Decision, Respondent shall enroll in a podiatry clinical training or educational program
9 equivalent to the Physician Assessment and Clinical Education Program (PACE) offered at the
1 O University of California - San Diego School of Medicine ("Program").
11 The Program shall consist of a Comprehensive Assessment program comprised of a two-
12 day assessment of Respondent's physical and mental health; basic clinical and communication
13 skills common to all clinicians; and medical knowledge, skill and judgment pertaining to
14 Respondent's specialty or sub-specialty, and at minimum, a 40 hour program of clinical education
15 in the area of practice in which Respondent was alleged to be deficient and which takes into
16 account data obtained from the assessment, Decision(s), Accusation(s), and any other information
1 7 that the Board or its designee deems relevant. Respondent shall pay all expenses associated with
18 the clinical training program.
19 Based on Respondent's performance and test results in the assessment and clinical
20 education, the Program will advise the Board or its designee of its recommendation(s) for the
21 scope and length of any additional educational or clinical training, treatment for any medical
22 condition, treatment for any psychological condition, or anything else affecting Respondent's
23 practice of podiatric medicine. Respondent shall comply with Program recommendations.
24 At the completion of any additional educational or clinical training, Respondent shall
25 submit to and pass an examination. The Program's determination whether or not Respondent
26 passed the examination or successfully completed the Program shall be binding.
27 Respondent shall complete the Program not later than six months after Respondent's initial
28 enrollment unless the Board or its designee agrees in writing to a later time for completion.
4
STIPULATED SETTLEMENT (J B-2008-194863)
Failure to participate in and complete successfully all phases of the clinical training
2 program outlined above is a violation of probation. If Respondent fails to complete the clinical
3 training program within the designated time period, Respondent shall cease the practice of
4 podiatry within 72 hours after being notified by the Board or its designee that Respondent failed
5 to complete the clinical training program.
6 2. NOTIFICATION Respondent shall provide a true copy of the Decision(s) and
7 Accusation(s) to the Chief of Staff or the Chief Executive Officer at every hospital where
8 privileges or membership are extended to Respondent, at any other facility where Respondent
9 engages in the practice of podiatry, including all podiatric and locum tenens registries or other
Io similar agencies, and to the Chief Executive Officer at every insurance carrier which extends ·
11 malpractice insurance coverage to Respondent. Respondent shall submit proof of compliance to
12 the Board or its designee within 15 calendar days of the effective date of this Order.
13 This condition shall apply to any change(s) in hospitals, other facilities, or insurance carrier.
14 3. OBEY ALL LAWS Respondent shall obey all federal, state, and local laws, and all
15 rules governing the practice of podiatry in California. Respondent shall remain in full compliance
16 with any court ordered conditions of criminal probation, payments, and other orders.
17 4. QUARTERLY DECLARATIONS Respondent shall submit quarterly declarations
18 under penalty of perjury on forms provided by the Board, stating whether there has been
19 compliance with all the conditions of probation. Respondent shall submit quarterly declarations
20 not later than 10 calendar days after the end of the preceding quarter.
21 5. PROBATION UNIT COMPLIANCE Respondent shall comply with the directions
22 of the Board's probation unit. Respondent shall, at all times, keep the Board informed of
23 Respondent's business and residence addresses. Changes of such addresses shall be immediately
24 communicated in writing to the Board or its designee. Under no circumstances shall a post office
25 box serve as an address of record, except as allowed by Business and Professions Code section
26 2021(b).
27 Respondent shall not engage in the practice of podiatry in Respondent's place ofresidence.
28 Respondent shall maintain a current and renewed California podiatric medicine license.
5
STIPULATED SETTLEMENT ( 1 B-2008-194863)
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
Respondent shall immediately inform the Board or its designee, in writing, of travel to any
areas outside the jurisdiction of California which lasts, or is contemplated to last, more than 30
calendar days.
6. INTERVIEW WITH THE BOARD OR ITS DESIGNEE Respondent shall be
available in person for interviews either at Respondent's place of business or at the probation unit
office, with the Board or its designee, upon reasonable request at various intervals, and either
with or without prior notice, throughout the term of probation.
7. RESIDING OR PRACTICING OUT-OF-STATE In the event Respondent should
leave the State of California to reside or to practice, Respondent shall notify the Board or its
designee in writing 30 calendar days prior to the dates of departure and return.
All time spent in an intensive training program outside the State of California which has
been approved by the Board or its designee shall be considered as time spent in the practice of
podiatry within the State. Periods of temporary or permanent residence or practice outside
California will not apply to the reduction of the probationary term. Periods of temporary or
permanent residence or practice outside California will relieve Respondent of the responsibility to
comply with the probationary terms and conditions with the exception of this condition and the
following terms and conditions of probation: Obey All Laws and Probation Unit Compliance.
Respondent's license shall be automatically cancelled if Respondent's periods of temporary
or permanent residence or practice outside California total two years. However, Respondent's
license shall not be cancelled as long as Respondent is residing and practicing medicine in
another state of the United States and is on active probation with the podiatry licensing authority
of that state, in which case the two year period shall begin on the date probation is completed or
terminated in that state.
8. FAILURE TO PRACTICE PODIATRY- CALIFORNIA RESIDENT
In the event Respondent resides in the State of California and for any reason Respondent
stops practicing podiatry in California, Respondent shall notify the Board or its designee in
writing within 30 calendar days prior to the dates of non-practice and return to practice. Any
period of non-practice within California, as defined in this condition, will not apply to the
6
STIPULATED SETTLEMENT ( lB-2008-194863)
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
reduction of the probationary term and does not relieve Respondent of the responsibility to
comply with the terms and conditions of probation. Non-practice is defined as any period of time
exceeding 30 calendar days in which Respondent is not engaging in any activities defined in
section 24 72 of the Business and Professions Code.
All time spent in an intensive training program which has been approved by the Board or its
designee shall be considered time spent in the practice of podiatry. For purposes of this
condition, non-practice due to a Board-ordered suspension or in compliance with any other
condition of probation, shall not be considered a period of non-practice.
Respondent's license shall be automatically cancelled if Respondent resides in California
and for a total of two years, fails to engage in California in any of the activities described in
Business and Professions Code section 2472.
9. COMPLETION OF PROBATION Respondent shall comply with all financial
obligations (e.g., probation monitoring costs) not later than 120 calendar days prior to the
completion of probation. Upon successful completion of probation, Respondent's certificate shall
be fully restored.
10. VIOLATION OF PROBATION Failure to fully comply with any term or c~ndition
of probation is a violation of probation. If Respondent violates probation in any respect, the
Board, after giving Respondent notice and the opportunity to be heard, may revoke probation and
carry out the disciplinary order that was stayed. If an Accusation, Petition to Revoke Probation,
or an Interim Suspension Order is filed against Respondent during probation, the Board shall have
continuing jurisdiction until the matter is final, and the period of probation shall be extended until
the matter is final.
11. LICENSE SURRENDER Following the effective date of this Decision, if
Respondent ceases practicing due to retirement or health reasons or is otherwise unable to satisfy
the terms and conditions of probation, Respondent may request the voluntary surrender of
Respondent's license. The Board reserves the right to evaluate Respondent's request and to
exercise its discretion whether or not to grant the request, or to take any other action deemed
appropriate and reasonable under the circumstances. Upon formal acceptance of the surrender,
7
STIPULATED SETTLEMENT (1 B-2008-194863)
1 Respondent shall v.ithin 15 calendar days deliver Respondent's wallet and wall certificate to the
2 Board or its designce and Respondent shall no longer practice podiatry. Respondent will no
3 longer be subject to the terms and conditions of probation aud the surrender of Respondent's
4 license shall be deemed disciplinary action. If Respondent re-applies for a podiatry license, the
5 application shall be treated as a petition for reinstatement of a revoked certificate.
6 12. PROBATION MONITORJNG COSTS Respondent sball pay the actual costs of
7 probation monitoring each and every year of probation, as determined by the Board, which may
8 be adjusted on an annual basis. Such costs shall be payable to the '"Board of Podiatric Medicine"
9 and delivered to the Board or its designee no later than January 31 of each calendar year. Failure
10 to pay costs within 30 calendar days of the due date is a violation ofprob.ation.
11 13. COSTS OF ENFORCEMENT Respondent shall reimburse the Board for its costs of
12 investigation and enforcement in this matter in the amount of $8,612.00, which may be payable
13 over time by arrangement with the Board. The full amount must be paid before the termination
14 of Respondent's probation.
15
16
17
18
19
20
21
22
23
24
25
26
27
28
ACCEPTANCE
l have carefully read the above Stipulated Settlement and Disciplinary Order and have
fully discussed it with my attorney, Jolm H. Dodd. I understand the stipulation and the effect it
will have on my podiatric medicine license. I enter into this Stipulated Settlement and
Disciplinary Order voluntarily, knowingly, and intelligently, and agree to be bound by the Order
of the Board of Podi.atlic Medicine
Dated:
PETER M. RED KO, DPM Respondent
8
STIPULATED SETTLEMENT ( 1B~2008- J 94863)
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
. 23
24
25
26
27
28
I have read and fully discussed with Respondent Peter M. Redko, DPM, the terms and
I approve its form and content.
' li1 I J1 Dated: j I
ORSEMENT
The foregoing Stipulated Settlement and Disciplinary Order is hereby respectfully
submitted for consideration by the Board of Podiatric Medicine of the Department of Consumer
Affairs.
.f ? Dated: 1;;p,-f-,, J() // (," (/
9
Respectfully Submitted,
KAMALA D. HARRIS, Attorney General of California
JOSE R. GUERRERO Supervising Deputy Attorney General
&2~/~ DAVID CARR Deputy Attorney General Attorneys for Complainant
STIPULATED SETTLEMENT (I B-2008-194863)
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
Exhibit A
Accusation No. lB-2008-194863
Stipulated Settlement 1 B-2008-194863
EDMUND G. BROWN JR. Attorney General of California
2 JOSE R. GUERRERO Supervising Deputy Attorney General
3 DAVID CARR Deputy Attorney General
4 State Bar No. 131672 455 Golden Gate Avenue, Suite 11000
5 San Francisco, CA 94102-7004 Telephone: ( 415) 703-5538
6 Facsimile: ( 415) 703-5480 Attorneys for Complainant
7
FILED STATE OF CALIFORNIA
MEDICAL BOARD OF ALIFORNIA SAC MENT ~ 2 20 /() BY I ANALYST
BEFORE THE 8
9
10
BOARD OF POD IA TRIC MEDICINE DEPARTMENT OF CONSUMER AFFAIRS
STATE OF CALIFORNIA
11 In the Matter of the Accusation Against:
12 PETER REDKO, D.P.M.
13 1400 Professional Drive, Suite 102 Petaluma, CA 94954
14
15
16
17
Podiatric Medicine License No. E 4517,
Respondent.
18 Complainant alleges:
Case No. lB 2009 200359
OAHNo.
ACCUSATION
19 PARTIES
20 1. James H. Rathlesberger ("Complainant") brings this Accusation solely in his official
21 capacity as the Executive Officer of the Board of Podiatric Medicine, Department of Consumer
22 Affairs.
23 2. On or about September 22, 2003, the Board of Podiatric Medicine issued Podiatric
24 Medicine License No. E 4517 to Peter Redko, D.P.M. ("Respondent"). Unless renewed, that
25 license will expire July 31, 2011.
26 Ill
27 Ill
28 Ill
Accusation l B-2009-200359
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
JURISDICTION
3. This Accusation is brought before the Board of Podiatric Medicine ("the Board"),
Department of Consumer Affairs, under the authority of the following laws. All section
references are to the Business and Professions Code unless otherwise indicated.
4. Section 2222 of the Code states: "The California Board of Podiatric Medicine shall
enforce and administer this article as to doctors ofpodiatric medicine. Any acts of unprofessional
conduct or other violations proscribed by this chapter are applicable to licensed doctors of
podiatric medicine and wherever the Medical Quality Hearing Panel established under Section
11371 of the Government Code is vested with the authority to enforce and carry out this chapter
as to licensed physicians and surgeons, the Medical Quality Hearing Panel also possesses that
same authority as to licensed doctors of podiatric medicine.
"The California Board of Podiatric Medicine may order the denial of an application or issue
a certificate subject to conditions as set forth in Section 2221, or order the revocation, suspension,
or other restriction of, or the modification of that penalty, and the reinstatement of any certificate
of a doctor of podiatric medicine within its authority as granted by this chapter and in conjunction
with the administrative hearing procedures established pursuant to Sections 11371, 11372, 11373,
and 11529 of the Government Code. For these purposes, the California Board of Podiatric
Medicine shall exercise the powers granted and be governed by the procedures set forth in this
1 9 chapter."
20 5. Section 2497 of the Code states:
21 "(a) The board may order the denial of an application for, or the suspension of, or the
22 revocation of, or the imposition of probationary conditions upon, a certificate to practice podiatric
23 medicine for any of the causes set forth in Article 12 (commencing with Section 2220) in
24 accordance with Section 2222.
25 "(b) The board may hear all matters, including but not limited to, any contested case or may
26 assign any such matters to an administrative law judge. The proceedings shall be held in
27 accordance with Section 2230. If a contested case is heard by the board itself, the administrative
28 law judge who presided at the hearing shall be present during the board's consideration of the case
2
Accusation IB-2009-200359
and shall assist and advise the board."
2 6. Section 2234 requires that the board take action against any licensee charged with
3 unprofessional conduct, which includes but is not limited to:
4 "(a) "
5 "(b) Gross negligence."
6 "( c) Repeated negligent acts."
" " 7
8 7. Section 2266 of the Code provides that failure to maintain adequate and accurate
9 records pertaining to patient care provided by the licensee constitutes unprofessional conduct.
1 O 8. Section 2497.5 of the Code states:
11 "(a) The board may request the administrative law judge, under his or her proposed
12 decision in resolution of a disciplinary proceeding before the board, to direct any licensee found
13 guilty of unprofessional conduct to pay to the board a sum not to exceed the actual and reasonable
14 costs of the investigation and prosecution of the case.
15 "(b) The costs to be assessed shall be fixed by the administrative law judge and shall
16 not in any event be increased by the board. When the board does not adopt a proposed decision
17 and remands the case to an admi.nistrative law judge, the administrative law judge shall not
18 increase the amount of any costs assessed in the proposed decision.
19 "( c) When the payment directed in the board's order for payment of costs is not made
20 by the licensee, the board may enforce the order for payment by bringing an action in any
21 appropriate court. This right of enforcement shall be in addition to any other rights the board may
22 have as to any licensee directed to pay costs.
23 "( d) In any judicial action for the recovery of costs, proof of the board's decision
24 shall be conclusive proof of the validity of the order of payment and the terms for payment.
25 "( e )(1) Except as provided in paragraph (2), the board shall not renew or reinstate the
26 license of any licensee who has failed to pay all of the costs ordered under this section.
27 "(2) Notwithstanding paragraph (1), the board may, in its discretion, conditionally
28 renew or reinstate for a maximum of one year the license of any licensee who demonstrates
3
Accusation 1 B-2009-200359
financial hardship and who enters into a formal agreement with the board to reimburse the
2 board within a .one year period for those unpaid costs.
3 "(f) Al1 costs recovered under this section shall be deposited in the Podiatry Fund as
4 a reimbursement in either the fiscal year in which the costs are actually recovered or the previous
5 fiscal year, as the board may direct."
6 9. At all times relevant to the allegations herein, Respondent was treating patients in his
7 offices in Petaluma, California.
· 8 FIRST CAUSE FOR DISCIPLINE
9 (Gross Negligence-Patient K.S.)
1 O 10. Respondent is subject to disciplinary action under section 2234(b) in that he was
11 grossly negligent in his care and treatment of patient K.S. 1• The circumstances are as follows:
12 11. On or about November 17, 2006, Respondent performed a scheduled bunionectorny
13 on 15 year old patient K.S.'s left foot. The procedure included a base wedge osteotomy of the
14 first metatarsal and osteotorny of the proximal phalanx of the hallux with K-wire stabilization. ln
15 his post-operative report, Respondent stated that the vascular status was intact to all areas of the
16 left foot. At the time of her discharge to home, K.S. was complaining of tingling in the foot but
1 7 Respondent assured her this was normal.
18 12. On November 21, 2006, Respondent was called by K.S.'s mother and told that K.S.
19 was in severe pain not palliated by medication. Directed to unwrap the bandages and examine
20 the foot, K.S. 'smother reported the toes looked black. Respondent saw K.S. in his office
21 promptly and found her left hallux was cyanotic and cool. Respondent removed all the wound
22 dressings and the fixing K-wire and applied ice to the left foot plantar ach to diminish the pain.
23 Respondent's medical record of this visit states there were no signs of infection, blisters, or open
24 lesions and that the cyanosis of the ha11ux had abated and wannth returned to the toe. Respondent
25 started K.S. on antibiotics at this time and told her to return the follow day.
26
27
28
1 In the interest of patient confidentiality, the subject patients are identified herein by initials only. The patients' names will be provided to Respondent upon request.
4
Accusation 1 B-2009-200359
13. On the next day's visit K.S. was still experiencing pain. Respondent's progress notes
2 for this office visit state the hallux was less visibly cyanotic than it had been the preceding day
3 and noted drainage from the incision sites on the hallux and first metatarsal. Respondent's
4 assessment was compartment syndrome but no compartment pressures were recorded. After 30
5 minutes of hydrotherapy Respondent prepped the foot and performed a fasciotomy by making a 1
6 centimeter incision over the 2nd metatarsal and cut the fascia over the adductor muscle through
7 the same 1 centimeter incision. Respondent then made a second 1 centimeter incision over the
8 4th metatarsal and stripped the interosseous muscle from the bone, followed by a 0.5 centimeter
9 stab incision in the medial aspect of the hallux. There is no mention in the chart notes for this
1 O visit of blisters in the areas being drained.
11 14. On November 23, 2006, K.S. was seen by another podiatrist in Respondent's practice.
12 That podiatrist noted oozing of all the incisions, coolness of the hallux, and his inability to assess
13 venous plexus filling time.
14 15. Respondent s~w K.S. again on November 24, 2006, at which time Respondent noted
15 a blister on the dorsal midfoot. His chart notes state there was pink, normal skin on the dorsal
16 medial hallux. Respondent then made 4 additional stab incisions over the area of the residual
17 cyanosis of the plantar, lateral aspect of the hallux. Nothing in Respondent's chart notes for that
18 day indicates Respondent was draining the blisters or that the blisters were clinically addressed in
19 any way.
20 16. Respondent saw K.S. approximately every second day for the following two weeks;
21 K.S. continued to complain of tingling and pain. Respondent's medical record lists a diagnosis of
22 venous congestion and edema, though he also described the formation of dry eschar on the distal
23 aspect of the hallux. There is no mention in the chart notes of any treatment of the blisters or of
24 the open wound on the top of the foot. There is a note by Respondent on the November 30 visit
25 that K.S. bad been evaluated by a vascular surgeon, who noted audible Doppler signals in the left
26 foot and hallux, but there is no documentation by the vascular surgeon in Respondent's medical
27 record.
28
5
Accusation lB-2009-200359
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
17. On the December 8, 2006, visit Respondent again notes the presence of dry eschar
and records that there is now no audible Doppler signals in the distal aspect of the hallux.
Although Respondent's chart notes continue to state that he notes no signs of infection of the left
foot he continues her on antibiotics. Respondent makes no diagnosis of gangrene or any
description of an open wound anywhere in his chart notes for this post-operative period. K.S. last
saw Respondent in his office on December 11, 2006, 24 days after the surgery on her foot.
18. K.S. was soon thereafter seen by a vascular surgeon who diagnosed her as having
gangrene of the left hallux. After several weeks of wound care to heal the dorsum of the foot, on
January 30, 2007, K.S. underwent an amputation of her left hallux.
19. Respondent has subjected his license to discipline for violation of section 2234(b) in
that his post-operative care of patient K.S. was an extreme departure from the standard of care,
constituting gross negligence.
SECOND CAUSE FOR DISCIPLINE
(Gross Negligence-Patient K.S.)
20. The allegations of paragraphs 11 through 18 above are incorporated herein as if set
out in full. Respondent's license is subject to discipline for violation of section 2234(b) in that
Respondent's diagnosis and treatment of suspected compartment syndrome in patient K.S. was an
extreme departure from the standard of care, constituting gross negligence.
THIRD CAUSE FOR DISCIPLINE
(Gross Negligence--Patient K.S.)
21. The allegations of paragraphs 11 tlu·ough 18 above are incorporated herein as if set
out in full. Respondent's license is subject to discipline violation of section 2234(b) in that
Respondent's failure to timely diagnosis and treat the gangrene in K.S. 's left foot is an extreme
departure from the standard of care, constituting gross negligence.
FOURTH CAUSE FOR DISCIPLINE
(Failure to Maintain Adequate Records-Patient K.S.)
27 22. The allegations of paragraphs 11 through 18 above are incorporated herein as if set
28 out in full. Respondent's license is subject to discipline for unprofessional conduct in violation of
6
Accusation l B-2009-200359
section 2266 in that Respondent failed to maintain adequate and accurate records pertaining to his
2 care and treatment of patient K.S.
3 FIFTH CAUSE FOR DISCIPLINE
4 (Repeated Negligent Acts-Patient K.S.)
5 23. The allegations of paragraphs 11 through 18 above are incorporated herein by
6 reference as if fully set out. Respondent's license is subject to discipline for unprofessional
7 conduct by invocation of section 2234( c), in that Respondent's use of an antibiotic regimen to
8 treat a suspected infection of patient K.S.'s left foot without obtaining supporting cultures was a
9 departure from the standard of care, which considered with the negligent acts alleged in the First,
1 o Second, Third, Sixth, Seventh, Eighth, and Ninth Causes for Discipline herein, constitutes
11 repeated negligent acts.
12 SIXTH CAUSE FOR DISCIPLINE
13 (Repeated Negligent Acts-Patien~ K.S.)
14 24. The allegations of paragraphs 11 through 18 above are incorporated herein by
15 reference as if fully set out. Respondent's license is subject to discipline for unprofessional
16 conduct for violation of section 2234(c), in that Respondent's failure to perform an adequate
17 debridement and dressing of the open wound on the top of K.S. 's foot was a departure from the
18 standard of care, which considered with the negligent acts alleged in the First, Second, Third,
19 Fifth, Seventh, Eighth, and Ninth Causes for Discipline herein, constitutes repeated negligent
20 acts.
21 SEVENTH CAUSE FOR DISCIPLINE
22 (Repeated Negligent Acts-Patient L.L.)
23 25. Respondent has subjected his license to discipline for violation of section 2234( c) in
24 that his care and treatment of patient L.L. included repeated negligent acts. The facts are as
25 follows:
26 26. Patient L.L. first saw Respondent for a consultation on January 5, 2007, complaining
27 of a painful bunion of her left foot. Although L.L. infonned Respondent she suffered from
28 Factor-V Leiden thrombophilia, a genetic condition which increases the possibility of venous
7
Accusation l B-2009-200359
blood clots, Respondent's chart notes from that visit do not reflect that fact.
2 27. L.L. saw Respondent again on June 19, 2009 because the pain from her bunion had
3 become increasingly severe. L.L. agreed to surgery to correct the bone deformity of her left foot.
4 On July 30, 2009, Respondent performed corrective surgical procedures on LL. 's left foot,
5 including Lapidus bunionectomy, Akin osteotomy, 2nd and 5tb metatarsal osteotomies, and a
6 subtalar arthroeresis. The signed informed consent for the surgery Respondent performed on LL.
7 does not include any reference to an arthroeresis procedure.
8 28. L.L.'s first post-operative visit with Respondent was one week later, August 7, 2009.
9 Respondent's chart notes for that visit do not mention edema and state that LL. has no
10 complaints. L.L. was having pain and her leg was swollen by the end of the first week post-
11 operatively.
12 29. At the second post-operative visit on August 13, 2009, L.L. again tells Respondent
13 she is experiencing foot and leg pain and he; leg is swollen. Respondent's chart notes again state
14 that L.L. voiced no complaints, but Respondent told L.L. that she was doing too much on her leg
15 and that the hot weather was contributing to the swelling of her leg. Respondent told LL she
16 was to rest, elevate the foot, apply ice, and take a non-steroidal anti-inflammatory. He assured
17 L.L. that she did not have a blood clot in her leg.
18 30. LL. called Respondent's office on August 21, 2009, and infonned Respondent that
19 she had a fever. Respondent told her it was likely a virus but to come to Respondent's office if
20 the fever did not diminish. The fever did drop but the pain and leg swelling progressed and L. L.
21 called Respondent on August 23 because of those symptoms. Respondent advised L.L. to
22 continue to elevate and ice the leg and foot and to go to the emergency room if the symptoms did
23 not improve. On August 24, 2009, L.L. called her primary care physician, who told her to go
24 immediately to the emergency room. L.L. was soon thereafter diagnosed and treated for a deep
25 vein thrombosis in her left leg.
26 31. Respondent has subjected his license to discipline for violation of section 2234( c ), in
27 that his failure to provide clinically appropriate prophylaxis for deep vein thrombosis to a surgery
28 patient who will be relatively immobile post-operatively is a departure from the standard of care,
8
Accusation 1 B-2009-200359
which considered with the negligent acts alleged in the First, Second, Third, Fifth, Sixth, Eigbth,
2 and Ninth Causes for Discipline herein, constitutes repeated negligent acts.
3 EIGHTH CAUSE FOR DISCIPLINE
4 (Repeated Negligent Acts-Patient L.L.)
5 32. The allegations of paragraphs 26 through 30 above are incorporated herein by
6 reference as if fully set out. Respondent has subjected his license to discipline for violation of
7 section 2234(c), in that his failure to timely identify the signs of an emerging deep vein
8 thrombosis in a post-surgery patient with a thrombophilic condition is a departure from the
9 standard of care, which considered with the negligent acts alleged in the First, Second, Third,
1 O Fifth, Sixth, Seventh, and Ninth Causes for Discipline herein, constitutes repeated negligent acts.
11 NINTH CAUSE FOR DISCIPLINE
12 (Repeated Negligent Acts-Patient L.L.)
13 33. The allegations of paragraphs 26 through 30 above are incorporated herein by
14 reference as if fully set out. Respondent has subjected his license to discipline for violation of
15 section 2234( c ), in that his failure to properly include the arthroeresis procedure in the informed
16 consent signed by L.L. is a departure from the standard of care, which considered with the
17 negligent acts alleged in the First, Second, Third, Fifth, Sixth, Seventh, and Eighth Causes for
18 Discipline herein, constitutes repeated negligent acts.
19 TENTH CAUSE FOR DISCIPLINE
20 (Failure to Maintain Adequate Records--Patient L.L.)
21 34. The allegations of paragraphs 26 through 30 above are incorporated herein as if set
22 out in full. Respondent's license is subject to discipline for unprofessional conduct in violation of
23 section 2266 in that Respondent failed to maintain adequate and accurate records of his care and
24 treatment of patient L.L.
25 PRAYER
26 WHEREFORE, Complainant requests that a hearing be held on the matters herein alleged,
27 and that following the hearing, the Board of Podiatric Medicine issue a decision:
28
9
Accusation lB-2009-200359
1 1. Revoking or suspending Podiatric Medicine License Number E 4517, issued to Peter
2 Redko, D.P.M.;
3 2. Ordering Peter Redko, D.P.M. to pay the Board of Podiatric Medicine the actual and
4 reasonable costs of the investigation and enforcement of this case, pursuant to Business and
5 Professions Code section 2497.5, and ifhe is placed on probation, to pay the annual costs of
6 probation ,monitoring; and
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
3.
DATED:
Taking such other and further action as deemed necessary and proper.
November 2, 2010
cutive Officer oard of Podiatric Medicine
Department of Consumer Affairs State of California Complainant
10
Accusation 1 B-2009-200359