4patientsafety.org4patientsafety.org/documents/payawal, jonathan haber 2016-04-26.pdfjonathan...

BEFORE THE MEDICAL BOARD OF CALIFORNIA

DEPARTMENT OF CONSUMER AFFAIRS STATE OF CALIFORNIA

In the Matter of the First Amended Accusation Against:

Jonathan Haber Payawal, M.D.

Physician's and Surgeon's Certificate No. A 103732

Respondent

) ) ) ) ) ) ) ) ) )

Case No. 800-2013-001094

_________________________ )

DECISION

The attached Stipulated Settlement and Disciplinary Order is hereby adopted as the Decision and Order of the Medical Board of California, Department of Consumer Affairs, State of California.

This Decision shall become effective at 5:00p.m. on May 26,2016.

IT IS SO ORDERED: Apri126, 2016.

MEDICAL BOARD OF CALIFORNIA

Howard Krauss, Chair Panel B

KAMALA D. HARRIS Attorney General of California

2 JUDITH T. ALVARADO Supervising Deputy Attorney General

3 TANN. TRAN Deputy Attorney General

4 State Bar No. 197775 300 So. Spring Street, Suite 1702

5 Los Angeles, CA 90013 Telephone: (213) 897-6793

6 Facsimile: (213) 897-9395

7

8

9

10

Attorneysfor Complainant

BEFORE THE MEDICAL BOARD OF CALIFORNIA

DEPARTMENT OF CONSUMER AFFAIRS STATE OF CALIFORNIA

In the Matter ofthe First Amended Accusation Case No. 800-2013-001094 11 Against:

12

13

14

15

16

17

18

19

20

21

22

23

24

25

26

27

28

JONATHAN PAYAWAL, M.D. 4867 West Sunset Blvd. Los Angeles, CA 90027 Physician's and Surgeon's Certificate No. A103732

OAH No. 2015060810

STIPULATED SETTLEMENT AND DISCIPLINARY ORDER

Respondent.

IT IS HEREBY STIPULATED AND AGREED by and between the parties to the above-

entitled proceedings that the following matters are true:

PARTIES

1. Kimberly Kirchmeyer ("Complainant") is the Executive Director of the Medical

Board of California. She brought this action solely in her official capacity and is represented in

this matter by Kamala D. Harris, Attorney General of the State of California, by Tan N. Tran,

Deputy Attorney General.

2. Respondent JONATHAN PAY A W AL, M.D. ("Respondent") is represented in this

proceeding by attorney Peter R. Osinoff, whose address is: 3699 Wilshire Boulevard, Tenth

Floor, Los Angeles, CA 90010-2719.

I I I

STIPULATED SETTLEMENT (800-2013-001094)

3. On or about May 2, 2008, the Medical Board of California issued Physician's and

2 Surgeon's Certificate No. A103732 to JONATHAN PA YAWAL, M.D. (Respondent). The

3 Physician's and Surgeon's Certificate was in full force and effect at all times relevant to the

4 charges brought in Accusation No. 800-2013-001094 and will expire on April3, 2016, unless

5 renewed.

6 JURISDICTION

7 4. Accusation No. 800-2013-001094 was filed before the Medical Board of California

8 (Board), Department of Consumer Affairs, and is currently pending against Respondent. The

9 Accusation and all other statutorily required documents were properly served on Respondent on

10 January 13, 2014. A First Amended Accusation was also filed and served on Respondent.

11 Respondent timely filed his Notice of Defense contesting the Accusation.

12 5. A copy of First Amended Accusation No. 800-2013-001094 is attached as exhibit A

13 and incorporated herein by reference.

14 ADVISEMENT AND WAIVERS

15 6. Respondent has carefully read, fully discussed with counsel, and understands the

16 charges and allegations in First Amended Accusation No. 800-2013-001094. Respondent has

17 also carefully read, fully discussed with counsel, and understands the effects of this Stipulated

18 Settlement and Disciplinary Order.

19 7. Respondent is fully aware of his legal rights in this matter, including the right to a

20 hearing on the charges and allegations in the First Amended Accusation; the right to be

21 represented by counsel at his own expense; the right to confront and cross-examine the witnesses

22 against him; the right to present evidence and to testify on his own behalf; the right to the

23 issuance of subpoenas to compel the attendance of witnesses and the production of documents;

24 the right to reconsideration and court review of an adverse decision; and all other rights accorded

25 by the California Administrative Procedure Act and other applicable laws.

26 8. Respondent voluntarily, knowingly, and intelligently waives and gives up each and

27 every right set forth above.

28 ///

2

STIPULATED SETTLEMENT (800-20 13-00 I 094)

2

3

4

5

6

7

8

9

10

CULPABILITY

9. Respondent does not contest that at an administrative hearing, complainant could

establish a prima facie case with respect to the charges and allegations contained in First

Amended Accusation No. 800-2013-001094, except paragraphs 19.C (2) and 20.B (2), and that he

has thereby subjected his Physician's and Surgeon's Certificate No. A 103732 to disciplinary

action.

10. Respondent agrees that his Physician's and Surgeon's Certificate is subject to

discipline and he agrees to be bound by the Board's probationary terms as set forth in the

Disciplinary Order below.

RESERVATION

11 11. The admissions made by Respondent herein are only for the purposes of this

12 proceeding, or any other proceedings in which the Medical Board of California or other

13 professional licensing agency is involved, and shall not be admissible in any other criminal or

14 civil proceeding.

15 CONTINGENCY

16 12. This stipulation shall be subject to approval by the Medical Board of California.

1 7 Respondent understands and agrees that counsel for Complainant and the staff of the Medical

18 Board of California may communicate directly with the Board regarding this stipulation and

19 settlement, without notice to or participation by Respondent or his counsel. By signing the

20 stipulation, Respondent understands and agrees that he may not withdraw his agreement or seek

21 to rescind the stipulation prior to the time the Board considers and acts upon it. If the Board fails

22 to adopt this stipulation as its Decision and Order, the Stipulated Settlement and Disciplinary

23 Order shall be of no force or etTect, except for this paragraph, it shall be inadmissible in any legal

24 action between the parties, and the Board shall not be disqualified from further action by having

25 considered this matter.

26 13. The parties understand and agree that Portable Document Format (PDF) and facsimile

27 copies of this Stipulated Settlement and Disciplinary Order, including PDF and facsimile

28 signatures thereto, shall have the same force and effect as the originals.

3


14. In consideration of the foregoing admissions and stipulations, the parties agree that

2 the Board may, without further notice or formal proceeding, issue and enter the following

3 Disciplinary Order:

4 DISCIPLINARY ORDER

5 IT IS HEREBY ORDERED that Physician's and Surgeon's Certificate No. A 103732 issued

6 to Jonathan Payawal, M.D. (Respondent) is revoked. However, the revocation is stayed and

7 Respondent is placed on probation for five (5) years on the following terms and conditions.

8 1. CONTROLLED SUBSTANCES - ABSTAIN FROM USE. Respondent shall abstain

9 completely from the personal use or possession of controlled substances as defined in the

10 California Uniform Controlled Substances Act, dangerous drugs as defined by Business and

11 Professions Code section 4022, and any drugs requiring a prescription. This prohibition does not

12 apply to medications lawfully prescribed to Respondent by another practitioner for a bona fide

13 illness or condition.

14 Within 15 calendar days of receiving any lawfully prescribed medications, Respondent

15 shall notify the Board or its designee ofthe: issuing practitioner's name, address, and telephone

16 number; medication name, strength, and quantity; and issuing pharmacy name, address, and

1 7 telephone number.

18 If Respondent has a confirmed positive biological fluid test for any substance (whether or

19 not legally prescribed) and has not reported the use to the Board or its designee, Respondent

20 shall receive a notification from the Board or its designee to immediately cease the practice of

21 medicine. The Respondent shall not resume the practice of medicine until final decision on an

22 accusation and/or a petition to revoke probation. An accusation and/or petition to revoke

23 probation shall be filed by the Board within 15 days of the notification to cease practice. If the

24 Respondent requests a hearing on the accusation and/or petition to revoke probation, the Board

25 shall provide the Respondent with a hearing within 30 days of the request, unless the Respondent

26 stipulates to a later hearing. A decision shall be received from the Administrative Law Judge or

2 7 the Board within 15 days unless good cause can be shown for the delay. The cessation of practice

28 shall not apply to the reduction of the probationary time period.

4


1 If the Board does not file an accusation or petition to revoke probation within 15 days of the

2 issuance of the notification to cease practice or does not provide Respondent with a hearing

3 within 30 days of a such a request, the notification of cease practice shall be dissolved.

4 2. ALCOHOL - ABSTAIN FROM USE. Respondent shall abstain completely from the

5 use of products or beverages containing alcohol.

6 If Respondent has a confirmed positive biological f1uid test for alcohol, Respondent shall

7 receive a notification from the Board or its designee to immediately cease the practice of

8 medicine. The Respondent shall not resume the practice of medicine until final decision on an

9 accusation and/or a petition to revoke probation. An accusation and/or petition to revoke

10 probation shall be filed by the Board within 15 days ofthe notification to cease practice. Ifthe

11 Respondent requests a hearing on the accusation and/or petition to revoke probation, the Board

12 shall provide the Respondent with a hearing within 30 days of the request, unless the Respondent

13 stipulates to a later hearing. A decision shall be received from the Administrative Law Judge or

14 the Board within 15 days unless good cause can be shown for the delay. The cessation of practice

15 shall not apply to the reduction of the probationary time period.

16 If the Board does not file an accusation or petition to revoke probation within 15 days of the

17 issuance of the notification to cease practice or does not provide Respondent with a hearing

18 within 30 days of a such a request, the notification of cease practice shall be dissolved.

19 3. CONTROLLED SUBSTANCES- MAINTAIN RECORDS AND ACCESS TO

20 RECORDS AND INVENTORIES. Respondent shall maintain a record of all controlled

21 substances ordered, prescribed, dispensed, administered, or possessed by Respondent for all

22 patients other than for the purpose of providing peri-operative anesthesia, and any

23 recommendation or approval which enables a patient or patient's primary caregiver to possess or

24 cultivate marijuana for the personal medical purposes of the patient within the meaning of Health

25 and Safety Code section 11362.5, during probation, showing all the following: 1) the name and

26 address of patient; 2) the date; 3) the character and quantity of controlled substances involved;

27 and 4) the indications and diagnosis for which the controlled substances were furnished.

28 Respondent shall keep these records in a separate file or ledger, in chronological order. All

5

STIPULATED SETTLEMENT (800-20 13-001 094)

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

records and any inventories of controlled substances shall be available for immediate inspection

and copying on the premises by the Board or its designee at all times during business hours and

shall be retained for the entire term of probation.

4. BIOLOGICAL FLUID TESTING. Respondent shall immediately submit to

biological fluid testing, at Respondent's expense, upon request of the Board or its designee.

"Biological fluid testing" may include, but is not limited to, urine, blood, breathalyzer, hair

follicle testing, or similar drug screening approved by the Board or its designee. Respondent shall

make daily contact with the Board or its designee to determine whether biological fluid testing is

required. Respondent shall be tested on the date of the notification as directed by the Board or its

designee. The Board may order a Respondent to undergo a biological fluid test on any day, at

any time, including weekends and holidays. Except when testing on a specific date as ordered by

the Board or its designee, the scheduling of biological fluid testing shall be done on a random

basis. The cost of biological fluid testing shall be borne by the Respondent.

During the first year of probation, Respondent shall be subject to 52 to 104 random tests.

During the second year of probation and for the duration of the probationary term, up to five ( 5)

years, Respondent shall be subject to 36 to 104 random tests per year. Only if there has been no

positive biological t1uid tests in the previous five (5) consecutive years of probation, may testing

be reduced to one (I) time per month. Nothing precludes the Board from increasing the number

of random tests to the first-year level of frequency for any reason.

Prior to practicing medicine, Respondent shall contract with a laboratory or service,

approved in advance by the Board or its designee, that will conduct random, unannounced,

observed, biological fluid testing and meets all the following standards:

(a) Its specimen collectors are either certified by the Drug and Alcohol Testing

Industry Association or have completed the training required to serve as a collector for the

United States Department of Transportation.

(b) Its specimen collectors conform to the current United States Department of

Transportation Specimen Collection Guidelines.

(c) Its testing locations comply with the Urine Specimen Collection Guidelines

6


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

published by the United States Department of Transportation without regard to the type of

test administered.

(d) Its specimen collectors observe the collection of testing specimens.

(e) Its laboratories are certified and accredited by the United States Department of

Health and Human Services.

(f) Its testing locations shall submit a specimen to a laboratory within one (1) business

day of receipt and all specimens collected shall be handled pursuant to chain of custody

procedures. The laboratory shall process and analyze the specimens and provide legally

defensible test results to the Board within seven (7) business days of receipt ofthe

specimen. The Board will be notified of non-negative results within one (1) business day

and will be notified of negative test results within seven (7) business days.

(g) Its testing locations possess all the materials, equipment, and technical expertise

necessary in order to test Respondent on any day of the week.

(h) Its testing locations are able to scientifically test for urine, blood, and hair

specimens for the detection of alcohol and illegal and controlled substances.

(i) It maintains testing sites located throughout California.

(j) It maintains an automated 24-hour toll-free telephone system and/or a secure on-

line computer database that allows the Respondent to check in daily for testing.

(k) It maintains a secure, HIPAA-compliant website or computer system that allows

staff access to drug test results and compliance reporting information that is available 24

hours a day.

(l) It employs or contracts with toxicologists that are licensed physicians and have

knowledge of substance abuse disorders and the appropriate medical training to interpret

and evaluate laboratory biological fluid test results, medical histories, and any other

information relevant to biomedical information.

(m) It will not consider a toxicology screen to be negative if a positive result is

obtained while practicing, even if the Respondent holds a valid prescription for the

substance.

7


Prior to changing testing locations for any reason, including during vacation or other

2 travel, alternative testing locations must be approved by the Board and meet the requirements

3 above.

4 The contract shall require that the laboratory directly notify the Board or its designee of

5 non- negative results within one (1) business day and negative test results within seven (7)

6 business days of the results becoming available. Respondent shall maintain this laboratory or

7 service contract during the period of probation.

8 A certified copy of any laboratory test result may be received in evidence in any

9 proceedings between the Board and Respondent.

10 If a biological fluid test result indicates Respondent has used, consumed, ingested, or

11 administered to himself or herself a prohibited substance, the Board shall order Respondent to

12 cease practice and instruct Respondent to leave any place of work where Respondent is practicing

13 medicine or providing medical services. The Board shall immediately notifY all of Respondent's

14 employers, supervisors and work monitors, if any, that Respondent may not practice medicine or

15 provide medical services while the cease-practice order is in effect.

16 A biological fluid test will not be considered negative if a positive result is obtained while

17 practicing, even if the practitioner holds a valid prescription for the substance. If no prohibited

18 substance use exists, the Board shall lift the cease-practice order within one ( 1) business day.

19 After the issuance of a cease-practice order, the Board shall determine whether the

20 positive biological fluid test is in fact evidence of prohibited substance use by consulting with the

21 specimen collector and the laboratory, communicating with the licensee, his or her treating

22 physician(s), other health care provider, or group facilitator, as applicable.

23 For purposes of this condition, the terms "biological fluid testing" and "testing" mean the

24 acquisition and chemical analysis of a Respondent's urine, blood, breath, or hair.

25 For purposes of this condition, the term "prohibited substance" means an illegal drug, a

26 lawful drug not prescribed or ordered by an appropriately licensed health care provider for use by

27 Respondent and approved by the Board, alcohol, or any other substance the Respondent has been

28 instructed by the Board not to use, consume, ingest, or administer to himself.

8

STJPULA TED SETTLEMENT (800-20 13-001 094)

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

If the Board confirms that a positive biological t1uid test is evidence of use of a prohibited

substance, Respondent has committed a major violation, as defined in section 1361.52(a), and the

Board shall impose any or all of the consequences set forth in section 1361.52 (b), in addition to

any other terms or conditions the Board determines are necessary for public protection or to

enhance Respondent's rehabilitation.

5. PROFESSIONALISM PROGRAM (ETHICS COURSE). Within 60 calendar days

of the effective date of this Decision, Respondent shall enroll in a professionalism program, that

meets the requirements of Title 16, California Code of Regulations (CCR) section 1358.

Respondent shall participate in and successfully complete that program. Respondent shall

provide any information and documents that the program may deem pertinent. Respondent shall

successfully complete the classroom component of the program not later than six (6) months after

Respondent's initial enrollment, and the longitudinal component of the program not later than the

time specified by the program, but no later than one (1) year after attending the classroom

component. The professionalism program shall be at Respondent's expense and shall be in

addition to the Continuing Medical Education (CME) requirements for renewal of licensure.

A professionalism program taken after the acts that gave rise to the charges in the

Accusation, but prior to the effective date of the Decision may, in the sole discretion of the Board

or its designee, be accepted towards the fulfillment of this condition if the program would have

been approved by the Board or its designee had the program been taken after the effective date of

this Decision.

Respondent shall submit a certification of successful completion to the Board or its

designee not later than 15 calendar days after successfully completing the program or not later

than 15 calendar days after the effective date of the Decision, whichever is later.

6. PSYCHIATRIC EVALUATION. Within 30 calendar days ofthe effective date of

this Decision, and on whatever periodic basis thereafter may be required by the Board or its

designee, Respondent shall undergo and complete a psychiatric evaluation (and psychological

testing, if deemed necessary) by a Board-appointed board certified psychiatrist, who shall

consider any information provided by the Board or designee and any other information the

9

STIPULATED SETTLEMENT (800-20 I 3-00 I 094)

psychiatrist deems relevant, and shall furnish a written evaluation report to the Board or its

2 designee. Psychiatric evaluations conducted prior to the effective date of the Decision shall not

3 be accepted towards the fulfillment of this requirement. Respondent shall pay the cost of all

4 psychiatric evaluations and psychological testing.

5 Respondent shall comply with all restrictions or conditions recommended by the evaluating

6 psychiatrist within 15 calendar days after being notified by the Board or its designee.

7 7. MEDICAL EVALUATION AND TREATMENT. Within 30 calendar days ofthe

8 effective date of this Decision, and on a periodic basis thereafter as may be required by the Board

9 or its designee, Respondent shall undergo a medical evaluation by a Board-appointed physician

10 who shall consider any information provided by the Board or designee and any other information

11 the evaluating physician deems relevant and shall furnish a medical report to the Board or its

12 designee. Respondent shall provide the evaluating physician any information and documentation

13 that the evaluating physician may deem pertinent.

14 Following the evaluation, Respondent shall comply with all restrictions or conditions

15 recommended by the evaluating physician within 15 calendar days after being notified by the

16 Board or its designee. If Respondent is required by the Board or its designee to undergo medical

17 treatment, Respondent shall within 30 calendar days of the requirement notice, submit to the

18 Board or its designee for prior approval the name and qualifications of a California licensed

19 treating physician of Respondent's choice. Upon approval of the treating physician, Respondent

20 shall within 15 calendar days undertake medical treatment and shall continue such treatment until

21 further notice from the Board or its designee.

22 The treating physician shall consider any information provided by the Board or its designee

23 or any other information the treating physician may deem pertinent prior to commencement of

24 treatment. Respondent shall have the treating physician submit quarterly reports to the Board or

25 its designee indicating whether or not the Respondent is capable of practicing medicine safely.

26 Respondent shall provide the Board or its designee with any and all medical records pertaining to

27 treatment, the Board or its designee deems necessary.

28 If, prior to the completion of probation, Respondent is found to be physically incapable of

10


resuming the practice of medicine without restrictions, the Board shall retain continuing

2 jurisdiction over Respondent's license and the period of probation shall be extended until the

3 Board determines that Respondent is physically capable of resuming the practice of medicine

4 without restrictions. Respondent shall pay the cost of the medical evaluation(s) and treatment.

5 8. WORKSITE MONITOR. Within thirty (30) calendar days of the effective date of

6 this Decision, Respondent shall submit to the Board or its designee for prior approval as a

7 worksite monitor, the name and qualifications of one or more licensed physician and surgeon,

8 other licensed health care professional if no physician and surgeon is available, or, as approved by

9 the Board or its designee, a person in a position of authority who is capable of monitoring the

1 0 Respondent at work.

11 The worksite monitor shall not have a current or former financial, personal, or familial

12 relationship with Respondent, or any other relationship that could reasonably be expected to

13 compromise the ability ofthe monitor to render impartial and unbiased reports to the Board or its

14 designee. If it is impractical for anyone but Respondent's employer to serve as the worksite

15 monitor, this requirement may be waived by the Board or its designee, however, under no

16 circumstances shall Respondent's worksite monitor be an employee or supervisee of the licensee.

17 The worksite monitor shall have an active unrestricted license with no disciplinary action

18 within the last five (5) years, and shall sign an affirmation that he or she has reviewed the terms

19 and conditions of Respondent's disciplinary order and agrees to monitor Respondent as set forth

20 by the Board or its designee.

21 Respondent shall pay all worksite monitoring costs.

22 The worksite monitor shall have face-to-face contact with Respondent in the work

23 environment on as frequent a basis as determined by the Board or its designee, but not less than

24 once per week; interview other staff in the office regarding Respondent's behavior, if requested

25 by the Board or its designee; and review Respondent's work attendance.

26 The worksite monitor shall verbally report any suspected substance abuse to the Board and

2 7 Respondent's employer or supervisor within one ( 1) business day of occurrence. If the suspected

28 substance abuse does not occur during the Board's normal business hours, the verbal report shall

11


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

be made to the Board or its designee within one (1) hour ofthe next business day. A written

report that includes the date, time, and location of the suspected abuse; Respondent's actions; and

any other information deemed important by the worksite monitor shall be submitted to the Board

or its designee within 48 hours of the occurrence.

The worksite monitor shall complete and submit a written report monthly or as directed by

the Board or its designee which shall include the following: (1) Respondent's name and

Physician's and Surgeon's Certificate number; (2) the worksite monitor's name and signature; (3)

the worksite monitor's license number, if applicable; (4) the location or location(s) ofthe

worksite; (5) the dates Respondent had face-to-face contact with the worksite monitor; (6) the

names ofworksite staffinterviewed, if applicable; (7) a report ofRespondent's work attendance;

(8) any change in Respondent's behavior and/or personal habits; and (9) any indicators that can

lead to suspected substance abuse by Respondent. Respondent shall complete any required

consent forms and execute agreements with the approved worksite monitor and the Board, or its

designee, authorizing the Board, or its designee, and worksite monitor to exchange information.

If the worksite monitor resigns or is no longer available, Respondent shall, within five ( 5)

calendar days of such resignation or unavailability, submit to the Board or its designee, for prior

approval, the name and qualifications of a replacement monitor who will be assuming that

responsibility within fifteen ( 15) calendar days. If Respondent fails to obtain approval of a

replacement monitor within sixty (60) calendar days of the resignation or unavailability of the

monitor, Respondent shall receive a notification from the Board or its designee to cease the

practice of medicine within three (3) calendar days after being so notified. Respondent shall

cease the practice of medicine until a replacement monitor is approved and assumes monitoring

responsibility.

9. SUBSTANCE ABUSE SUPPORT GROUP MEETINGS. Within thirty (30) days of

the effective date of this Decision, Respondent shall submit to the Board or its designee, for its

prior approval, the name of a substance abuse support group which he or she shall attend for the

duration of probation. Respondent shall attend substance abuse support group meetings at least

once per week, or as ordered by the Board or its designee.

12


Respondent shall pay all substance abuse support group meeting costs.

2 The facilitator of the substance abuse support group meeting shall have a minimum of

3 three (3) years' experience in the treatment and rehabilitation of substance abuse, and shall be

4 licensed or certified by the state or nationally certified organizations. The facilitator shall not

5 have a current or former financial, personal, or business relationship with Respondent within the

6 last five (5) years. Respondent's previous participation in a substance abuse group support

7 meeting led by the same facilitator does not constitute a prohibited current or former financial,

8 personal, or business relationship.

9 The facilitator shall provide a signed document to the Board or its designee showing

10 Respondent's name, the group name, the date and location of the meeting, Respondent's

11 attendance. and Respondent's level of participation and progress. The facilitator shall report any

12 unexcused absence by Respondent from any substance abuse support group meeting to the Board,

13 or its designee, within twenty- four (24) hours of the unexcused absence.

14 10. NOTICE OF EMPLOYER OR SUPERVISOR INFORMATION. Within seven (7)

15 days of the effective date of this Decision, Respondent shall provide to the Board the names,

16 physical addresses, mailing addresses, and telephone numbers of any and all employers and

17 supervisors. Respondent shall also provide specific, written consent for the Board, Respondent's

18 worksite monitor, and Respondent's employers and supervisors to communicate regarding

19 Respondent's work status, performance, and monitoring.

20 For purposes of this section, "supervisors" shall include the Chief of Staff and Health or

21 Well Being Committee Chair, or equivalent, if applicable, when the Respondent has medical staff

22 privileges.

23 11. NOTIFICATION. Within seven (7) days ofthe effective date ofthis Decision, the

24 Respondent shall provide a true copy of this Decision and Accusation to the Chief of Staff or the

25 Chief Executive Officer at every hospital where privileges or membership are extended to

26 Respondent, at any other facility where Respondent engages in the practice of medicine,

27 including all physician and locum tenens registries or other similar agencies, and to the Chief

28 Executive Officer at every insurance carrier which extends malpractice insurance coverage to

13


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. Respondent shall submit proof of compliance to the Board or its designee within 15

calendar days.

This condition shall apply to any change(s) in hospitals, other facilities or insurance carrier.

12. SUPERVISION OF PHYSICIAN ASSISTANTS. During probation, Respondent

is prohibited from supervising physician assistants.

13. OBEY ALL LAWS. Respondent shall obey all federal, state and local laws, all

rules governing the practice of medicine in California and remain in full compliance with any

court ordered criminal probation, payments, and other orders.

14. QUARTERLY DECLARATIONS. Respondent shall submit quarterly

declarations under penalty of perjury on forms provided by the Board, stating whether there has

been compliance with all the conditions of probation.

Respondent shall submit quarterly declarations not later than 10 calendar days after the end

of the preceding quarter.

15. GENERAL PROBATION REQUIREMENTS.

Compliance with Probation Unit

Respondent shall comply with the Board's probation unit and all terms and conditions of

this Decision.

Address Changes

Respondent shall, at all times, keep the Board informed of Respondent's business and

residence addresses, email address (if available), and telephone number. Changes of such

addresses shall be immediately communicated in writing to the Board or its designee. Under no

circumstances shall a post office box serve as an address of record, except as allowed by Business

and Professions Code section 2021 (b).

Place of Practice

Respondent shall not engage in the practice of medicine in Respondent's or patient's place

of residence, unless the patient resides in a skilled nursing facility or other similar licensed

facility.

License Renewal

14

STIPULATED SETTLEMENT (800-20 13-001 094)

1 Respondent shall maintain a current and renewed California physician's and surgeon's

2 license.

3 Travel or Residence Outside California

4 Respondent shall immediately inform the Board or its designee, in writing, oftravel to any

5 areas outside the jurisdiction of California which lasts, or is contemplated to last, more than thirty

6 (30) calendar days.

7 In the event Respondent should leave the State of California to reside or to practice

8 Respondent shall notify the Board or its designee in writing 30 calendar days prior to the dates of

9 departure and return.

10 16. INTERVIEW WITH THE BOARD OR ITS DESIGNEE. Respondent shall be

11 available in person upon request for interviews either at Respondent's place of business or at the

12 probation unit office, with or without prior notice throughout the term of probation.

13 17. NON-PRACTICE WHILE ON PROBATION. Respondent shall notify the Board or

14 its designee in writing within 15 calendar days of any periods of non-practice lasting more than

15 30 calendar days and within 15 calendar days of Respondent's return to practice. Non-practice is

16 defined as any period of time Respondent is not practicing medicine in California as defined in

17 Business and Professions Code sections 2051 and 2052 for at least 40 hours in a calendar month

18 in direct patient care, clinical activity or teaching, or other activity as approved by the Board. All

19 time spent in an intensive training program which has been approved by the Board or its designee

20 shall not be considered non-practice. Practicing medicine in another state of the United States or

21 Federal jurisdiction while on probation with the medical licensing authority ofthat state or

22 jurisdiction shall not be considered non-practice. A Board-ordered suspension of practice shall

23 not be considered as a period of non-practice.

24 In the event Respondent's period of non-practice while on probation exceeds 18 calendar

25 months, Respondent shall successfully complete a clinical training program that meets the criteria

26 of Condition 18 of the current version of the Board's "Manual of Model Disciplinary Orders and

27 Disciplinary Guidelines" prior to resuming the practice of medicine.

28 Respondent's period of non-practice while on probation shall not exceed two (2) years.

15


Periods of non-practice will not apply to the reduction of the probationary term.

2 Periods of non-practice will relieve Respondent of the responsibility to comply with the

3 probationary terms and conditions with the exception of this condition and the following terms

4 and conditions of probation: Obey All Laws; and General Probation Requirements.

5 18. COMPLETION OF PROBATION. Respondent shall comply with all financial

6 obligations (e.g., restitution, probation costs) not later than 120 calendar days prior to the

7 completion of probation. Upon successful completion of probation, Respondent's certificate shall

8 be fully restored.

9 19. VIOLATION OF PROBATION. Failure to fully comply with any term or condition of

10 probation is a violation of probation. If Respondent violates probation in any respect, the Board,

11 after giving Respondent notice and the opportunity to be heard, may revoke probation and carry

12 out the disciplinary order that was stayed. If an Accusation, or Petition to Revoke Probation, or an

13 Interim Suspension Order is filed against Respondent during probation, the Board shall have

14 continuing jurisdiction until the matter is final, and the period of probation shall be extended until

15 the matter is final.

16 20. VIOLATION OF PROBATION CONDITION FOR SUBSTANCE-ABUSING

17 LICENSEES. Failure to fully comply with any term or condition of probation is a violation of

18 probation.

19 A If Respondent commits a major violation of probation as defined by

20 section 1361.52, subdivision (a), ofTitle 16 ofthe California Code of Regulations, the Board

21 shall take one or more of the following actions:

22 (2) Issue an immediate cease-practice order and order Respondent to undergo a

23 clinical diagnostic evaluation to be conducted in accordance with section 1361.5,

24 subdivision ( c )(1), of Title 16 of the California Code of Regulations, at

25 Respondent's expense. The cease-practice order issued by the Board or its

26 designee shall state that Respondent must test negative for at least a month of

27 continuous biological fluid testing before being allowed to resume practice. For

28 purposes of the determining the length of time a Respondent must test negative

16


1 while undergoing continuous biological fluid testing following issuance of a cease-

2 practice order, a month is defined as thirty calendar (30) days. Respondent may

3 not resume the practice of medicine until notified in writing by the Board or its

4 designee that he or she may do so.

5 (3) Increase the frequency of biological fluid testing.

6 ( 4) Refer Respondent for further disciplinary action, such as suspension,

7 revocation, or other action as determined by the Board or its designee. (Cal. Code

8 Regs., tit. 16, § 1361.52, subd. (b).)

9 B. If Respondent commits a minor violation of probation as defined by

10 section 1361.52, subdivision (c), of Title 16 of the California Code of Regulations, the Board

11 shall take one or more of the following actions:

12 ( 1) Issue a cease-practice order;

13 (2) Order practice limitations;

14 (3) Order or increase supervision of Respondent;

15 ( 4) Order increased documentation;

16 ( 5) Issue a citation and fine, or a warning letter;

17 (6) Order Respondent to undergo a clinical diagnostic evaluation to be

18 conducted in accordance with section 1361.5, subdivision ( c )(1), of Title 16 of the

19 California Code of Regulations, at Respondent's expense;

20 (7) Take any other action as determined by the Board or its designee. (Cal.

21 Code Regs., tit. 16, § 1361.52, subd. (d).)

22 Nothing in this Decision shall be considered a limitation on the Board's authority to

23 revoke Respondent's probation if he or she has violated any term or condition of probation. (See

24 Cal. Code Regs., tit. 16, § 1361.52, subd. (e).) If Respondent violates probation in any respect,

25 the Board, after giving Respondent notice and the opportunity to be heard, may revoke probation

26 and carry out the disciplinary order that was stayed. If an Accusation, or Petition to Revoke

27 Probation, or an Interim Suspension Order is filed against Respondent during probation, the

28 Board shall have continuing jurisdiction until the matter is final, and the period of probation shall

17


be extended until the matter is final.

2 21. LICENSE SURRENDER. Following the effective date of this Decision, if

3 Respondent ceases practicing due to retirement or health reasons or is otherwise unable to satisfy

4 the terms and conditions of probation, Respondent may request to surrender his or her license.

5 The Board reserves the right to evaluate Respondent's request and to exercise its discretion in

6 determining whether or not to grant the request, or to take any other action deemed appropriate

7 and reasonable under the circumstances. Upon formal acceptance of the surrender, Respondent

8 shall within 15 calendar days deliver Respondent's wallet and wall certificate to the Board or its

9 designee and Respondent shall no longer practice medicine. Respondent will no longer be subject

10 to the terms and conditions of probation. If Respondent re-applies for a medical license, the

11 application shall be treated as a petition for reinstatement of a revoked certificate.

12 22. PROBATION MONITORING COSTS. Respondent shall pay the costs associated

13 with probation monitoring each and every year of probation, as designated by the Board, which

14 may be adjusted on an annual basis. Such costs shall be payable to the Medical Board of

15 California and delivered to the Board or its designee no later than January 31 of each calendar

16 year.

17 I I I

18 I I I

19 II I

20 Ill

21 II I

22 Ill

23 Ill

24 Ill

25 Ill

26 Ill

27 Ill

28 Ill

18


·\C( 'I·.PT:\'\!( 'L

l ha\..: car..:!Ltlh read the abow Stipulated Settlement c1lid Discipiinar:, C )nkr and ha\ t..' i[!lh

-1 luw on m; Ph; sici;m's and Surgt..'nn's ( ·t..'rti!icatc. I t..'ntcr intu this Stipuiatcli :--.dtkmcnt and

II II

q i I

1. ! !

Discil)iinar; Clrd~.:r iuluntarily. k.lhl\\ingl;. and inklligt..'11!ly. and agr'-'"-' to he h(llllll: h; the

Dt..·cisi\111 ~md < lrdcr Pt' th'-' ~kdical Board or Calit\xnia.

D.\ I!-!>:

l hct\l' r..:ad and fully discussed i\ith Respondent .IU!I\:.\TI 1.\'\ P.\ Y.\\\ .. \1. \l.D. th.·

, J)iscipiindr; ";J~ q ~ ;'~!""' c it' !<mn and 1\/\ .. 1 ~ . '

I ).\Tl I): Pctg R. <~ino~l :\ttorne\ !'or Resl)(lntknt

T11l· !(,r..:goint,: Stipulate,! Settlement and Disciplinary ( )rdcr is hereby rL·spectt\!11:. :s

"I i

' ' _-t

t .\.~{t 1-+h: ~~~ (' 2X h;S.2i~);IJ,-.L.l'-'

I <J

Rcspt..·ct!'ull; suhmin,.:d.

K\\1\: .. \ J).ll \!ZRIS

.\ttnrnL'\ (!cncr::l (IJ'Caii·(mJia J I I) l 1 1 i I . :\ [ \ \ R \ [)( I

Supl'l'\ ising lkput; . \ttu:·nc; C.:nt..·ral

l\'-\.'.TR\'-lkputy .\ttornc; (it..'ncr;!l .1llornc_n tor ( 'o!llj)/iiill<ii!!

Exhibit A

First Amended Accusation No. 800-2013-001094

FILED

1 KAMALA D. HARRIS Attorney General of California

2 JUDITH T. ALVARADO

STATE OF CALIFORNIA MEDICAL BOARD· OF CALIFORNIA

SACRAMENTO I I~ ) ~ 20 ~ BY _ ----;--"'> .tz \./' r:111 n:t.. "'J ANALYST

Supervising Deputy Attorney General 3 TANN. TRAN

Deputy Attorney General 4 State Bar No. 197775

California Department of Justice 5 300 So. Spring Street, Suite 1702

Los Angeles, CA 90013 6 Telephone: (213) 897-6793

Facsimile: (213) 897-9395 7 Attorneys/or Complainant

BEFORE THE 8

9

10

11

12

MEDICAL BOARD OF CALIFORNIA DEPARTMENT OF CONSUMER AFFAIRS

STATE OF CALIFORNIA

In the Matter of the First Amended Accusation Case No. 800-2013-001094 Against:

OAH No. 2015060810 JONATHAN PAY A W AL, M.D.

13

14

15

16

17

4867 West Sunset Blvd. FIRST AMENDED A C C US AT I 0 N Los Angeles, CA 9002 7 Physician's and Surgeon's Certificate No. A103732,

Respondent.

18 Complainant alleges:

19 PARTIES

20 1. Kimberly Kirchmeyer (Complainant) brings this Accusation solely in her official

21 capacity as the Executive Director of the Medical Board of California, Department of Consumer

22 Affairs.

23 2. On or about May 2, 2008, the Medical Board of California issued Physician's and

24 Surgeon's Certificate Number A103732 to JONATHAN PAYAWAL, M.D. (Respondent). The

25 Physician's and Surgeon's Certificate was in full force and effect at all times relevant to the

26 charges brought herein and will expire on April 30, 2016, unless renewed.

27 Ill

28 Ill

1

Accusation

1

2

3

4

5

JURISDICTION

3. This Accusation is brought before the Medical Board of California (Board),

Department of Consumer Affairs, under the authority ofthe following laws. All section

references are to the Business and Professions Code unless otherwise indicated.

4. Section 2004 of the Code states:

6 "The board shall have the responsibility for the following:

7 "(a) The enforcement of the disciplinary and criminal provisions of the Medical Practice

8 Act.

9 "(b) The administration and hearing of disciplinary actions.

10 "(c) Carrying out disciplinary actions appropriate to findings made by a panel or an

11 administrative law judge.

12 "(d) Suspending, revoking, or otherwise limiting certificates after the conclusion of

13 disciplinary actions.

14 "(e) Reviewing the quality of medical practice carried out by physician and surgeon

15 certificate holders under the jurisdiction of the board.

16 "(f) Approving undergraduate and graduate medical education programs.

17 "(g) Approving clinical clerkship and special programs and hospitals for the programs in

18 subdivision (f).

19 "(h) Issuing licenses and certificates under the board's jurisdiction.

20 "(i) Administering the board's continuing medical education program."

21 5. Section 2227 of the Code provides that a licensee who is found guilty under the

22 Medical Practice Act may have his or her license revoked, suspended for a period not to exceed

23 one year, placed on probation and required to pay the costs of probation monitoring, or such other

24 action taken in relation to discipline as the Board deems proper.

25 6. Section 2234 of the Code, states:

26 "The board shall take action against any licensee who is charged with unprofessional

27 conduct. In addition to other provisions of this article, unprofessional conduct includes, but is not

28 limited to, the following:

2

Accusation

1 "(a) Violating or attempting to violate, directly or indirectly, assisting in or abetting the

2 violation of, or conspiring to violate any provision of this chapter.

3 "(b) Gross negligence.

4 "(c) Repeated negligent acts. To be repeated, there must be two or more negligent acts or

5 omissions. An initial negligent act or omission followed by a separate and distinct departure from

6 the applicable standard of care shall constitute repeated negligent acts.

7 "(1) An initial negligent diagnosis followed by an act or omission medically appropriate

8 for that negligent diagnosis of the patient shall constitute a single negligent act.

9 "(2) When the standard of care requires a change in the diagnosis, act, or omission that

10 constitutes the negligent act described in paragraph (1 ), including, but not limited to, a

11 reevaluation of the diagnosis or a change in treatment, and the licensee's conduct departs from the

12 applicable standard of care, each departure constitutes a separate and distinct breach of the

13 standard of care.

14 "(d) Incompetence.

15 "(e) The commission of any act involving dishonesty or corruption which is substantially

16 related to the qualifications, functions, or duties of a physician and surgeon.

17 "(f) Any action or conduct which would have warranted the denial of a certificate.

18 "(g) The practice of medicine from this state into another state or country without meeting

19 the legal requirements of that state or country for the practice of medicine. Section 2314 shall not

20 apply to this subdivision. This subdivision shall become operative upon the implementation of

21 the proposed registration program described in Section 2052.5.

22 "(h) The repeated failure by a certificate holder, in the absence of good cause, to attend and

23 participate in an interview the board. This subdivision shall only apply to a certificate holder who

24 is the subject of an investigation by the board."

25 7. Section 2241 ofthe Code states:

26 "(a) A physician and surgeon may prescribe, dispense, or administer prescription drugs,

27 including prescription controlled substances, to an addict under his or her treatment for a purpose

28 other than maintenance on, or detoxification from, prescription drugs or controlled substances.

3

Accusation

1 "(b) A physician and surgeon may prescribe, dispense, or administer prescription drugs or

2 prescription controlled substances to an addict for purposes of maintenance on, or detoxification

3 from, prescription drugs or controlled substances only as set forth in subdivision (c) or in Sections

4 11215, 11217, 11217.5, 11218, 11219, and 11220 ofthe Health and Safety Code. Nothing in this

5 subdivision shall authorize a physician and surgeon to prescribe, dispense, or administer

6 dangerous drugs or controlled substances to a person he or she knows or reasonably believes is

7 using or will use the drugs or substances for a nonmedical purpose.

8 "(c) Notwithstanding subdivision (a), prescription drugs or controlled substances may also

9 be administered or applied by a physician and surgeon, or by a registered nurse acting under his

10 or her instruction and supervision, under the following circumstances:

11 "(1) Emergency treatment of a patient whose addiction is complicated by the presence of

12 incurable disease, acute accident, illness, or injury, or the infirmities attendant upon age.

13 "(2) Treatment of addicts in state-licensed institutions where the patient is kept under

14 restraint and control, or in city or county jails or state prisons.

15 "(3) Treatment of addicts as provided for by Section 11217.5 of the Health and Safety

16 Code.

17 "(d)(l) For purposes of this section and Section 2241.5, 'addict' means a person whose

18 actions are characterized by craving in combination with one or more of the following:

19 "(A) Impaired control over drug use.

20 "(B) Compulsive use.

21 "(C) Continued use despite harm.

22 "(2) Notwithstanding paragraph (1 ), a person whose drug-seeking behavior is primarily due

23 to the inadequate control of pain is not an addict within the meaning ofthis section or Section

24 2241.5."

25 8. Section 2242 of the Code states:

26 "(a) Prescribing, dispensing, or furnishing dangerous drugs as defined in Section 4022

27 without an appropriate prior examination and a medical indication, constitutes unprofessional

28 conduct.

4

Accusation

1 "(b) No licensee shall be found to have committed unprofessional conduct within the

2 meaning of this section if, at the time the drugs were prescribed, dispensed, or furnished, any of

3 the following applies:

4 "(1) The licensee was a designated physician and surgeon or podiatrist serving in the

5 absence of the patient's physician and surgeon or podiatrist, as the case may be, and ifthe drugs

6 were prescribed, dispensed, or furnished only as necessary to maintain the patient until the return

7 of his or her practitioner, but in any case no longer than 72 hours.

8 "(2) The licensee transmitted the order for the drugs to a registered nurse or to a licensed

9 vocational nurse in an inpatient facility, and if both of the following conditions exist:

10 "(A) The practitioner had consulted with the registered nurse or licensed vocational nurse

11 who had reviewed the patient's records.

12 "(B) The practitioner was designated as the practitioner to serve in the absence of the

13 patient's physician and surgeon or podiatrist, as the case may be.

14 "(3) The licensee was a designated practitioner serving in the absence of the patient's

15 physician and surgeon or podiatrist, as the case may be, and was in possession of or had utilized

16 the patient's records and ordered the renewal of a medically indicated prescription for an amount

17 not exceeding the original prescription in strength or amount or for more than one refill.

18 "(4) The licensee was acting in accordance with Section 120582 ofthe Health and Safety

19 Code."

20 9. Section 2266 of the Code states: "The failure of a physician and surgeon to maintain

21 adequate and accurate records relating to the provision of services to their patients constitutes

22 unprofessional conduct."

23 10. Section 725 ofthe Code states:

24 "(a) Repeated acts of clearly excessive prescribing, furnishing, dispensing, or administering

25 of drugs or treatment, repeated acts of clearly excessive use of diagnostic procedures, or repeated

26 acts of clearly excessive use of diagnostic or treatment facilities as determined by the standard of

27 the community of licensees is unprofessional conduct for a physician and surgeon, dentist,

28

5

Accusation

1 podiatrist, psychologist, physical therapist, chiropractor, optometrist, speech-language

2 pathologist, or audiologist.

3 "(b) Any person who engages in repeated acts of clearly excessive prescribing or

4 administering of drugs or treatment is guilty of a misdemeanor and shall be punished by a fine of

5 not less than one hundred dollars ($1 00) nor more than six hundred dollars ($600), or by

6 imprisonment for a term of not less than 60 days nor more than 180 days, or by both that fine and

7 imprisonment.

8 "(c) A practitioner who has a medical basis for prescribing, furnishing, dispensing, or

9 administering dangerous drugs or prescription controlled substances shall not be subject to

10 disciplinary action or prosecution under this section.

11 "(d) No physician and surgeon shall be subject to disciplinary action pursuant to this section

12 for treating intractable pain in compliance with Section 2241.5."

13 11. Section 2238 ofthe Code provides the following:

14 "A violation of any federal statute or federal regulation or any of the statutes or regulations

15 ofthis state regulating dangerous drugs or controlled substances constitutes unprofessional

16 conduct."

17 12. Section 2239, subdivision (a), of the Code provides the following:

18 "The use or prescribing for or administering to himself or herself, of any controlled

19 substance; or the use of any of the dangerous drugs specified in Section 4022, or of alcoholic

20 beverages, to the extent, or in such a manner as to be dangerous or injurious to the licensee, or to

21 any other person or to the public, or to the extent that such use impairs the ability of the licensee

22 to practice medicine safely or more than one misdemeanor or any felony involving the use,

23 consumption, or self-administration of any of the substances referred to in this section, or any

24 combination thereof, constitutes unprofessional conduct. The record of the conviction is

25 conclusive evidence of such unprofessional conduct.

26 13. Section 11152 of the Health and Safety Code states:

27 "No person shall write, issue, fill, compound, or dispense a prescription that does not

28 conform to this division."

6

Accusation

1 14. Health and Safety Code section 1115 3 states in pertinent part:

2 "(a) A prescription for a controlled substance shall only be issued for a legitimate medical

3 purpose by an individual practitioner acting in the usual course of his or her professional

4 practice ....

5 "(b) Any person who knowingly violates this section shall be punished by imprisonment

6 pursuant to subdivision (h) of Section 1170 of the Penal Code, or in a county jail not exceeding

7 one year, or by a fine not exceeding twenty thousand ($20,000), or by both that fine and

8 imprisonment. ... "

9 15. Health and Safety Code section 11157 states:

10 "No person shall issue a prescription that is false or fictitious in any respect."

11 16. Health and Safety Code section 11173, subdivision (a), states:

12 "No person shall obtain or attempt to obtain controlled substances, or procure or attempt to

13 procure the administration of or prescription for a controlled substances, (1) by fraud, deceit,

14 misrepresentation, or subterfuge; or (2) by the concealment of a material fact."


16 "No person shall prescribe, administer, or furnish a controlled substance for himself."


18 "Every person who forges or alters a prescription or who issues or utters an altered

19 prescription, or who issues or utters a prescription bearing a forged or fictitious signature for any

20 narcotic drug, or who obtains any narcotic drug by any forged, fictitious, or altered prescription,

21 or who has in possession any narcotic drug secured by a forged, fictitious, or altered prescription,

22 shall be punished by imprisonment in the county jail for not less than six months nor more than

23 one year, or in the state prison."

24 FIRST CAUSE FOR DISCIPLINE

25 (Gross Negligence)

26 19. Respondent is subject to disciplinary action under section 2234, subdivision (b) of the

27 Code, in that he stole and misused controlled substances for himself and admitted to using same

28 while treating patients. The circumstances are as follows:

7

Accusation

1 A. After receiving an 805 report from Respondent's employer (Kaiser) regarding reports

2 that Respondent was exhibiting behavior that could be detrimental to patient safety, the Board

3 began an investigation by interviewing witnesses and reviewing documents.

4 B. On or about November 17, 2014, Respondent was interviewed by Board

5 representatives. During that interview, Respondent discussed his work history and drug use while

6 he was a resident and while working for Kaiser. Per Respondent, during an internal investigation

7 conducted by Kaiser, Respondent admitted that he had been stealing Fentanyl' and using same

8 while treating patients. After Respondent admitted to having a drug problem, Kaiser allowed

9 Respondent to take a leave of absence. 2

10 C. Respondent engaged in gross negligence as follows:

11

12

13

14

15

16

17 20.

(1) By stealing and misusing controlled substances for himself and admitting

to using same while treating patients

(2) By failing to provide even a modicum of essential information in

Respondent's records regarding the necessity/justification for the prescriptions.

SECOND CAUSE FOR DISCIPLINE

(Repeated Negligent Acts)

Respondent is subject to disciplinary action under section 2234, subdivision (c) of

18 the Code, in that Respondent engaged in acts and omissions, constituting repeated negligent acts.

19 The circumstances are as follows:

20 A. The facts and circumstances alleged in the First Cause for Discipline above are

21 incorporated here as if fully set forth.

22 B. Respondent engaged in repeated negligent acts as follows:

23

24

25

26

27

28

(1) By stealing and misusing controlled substances for himself and admitting

1 Fentanyl is a schedule II controlled substance pursuant to Health and Safety Code section 11055 and a dangerous drug pursuant to Business and Professions Code section 4022; is is an opioid analgesic used to treat severe pain.

2 At the Board interview, Respondent was very contrite and cooperative. He stated that he is currently in a rehabilitation program for addicts, and admitted that he had been stealing controlled substances such as Fentanyl since his residency and while working for Kaiser. Respondent also admitted that he has used controlled substances while treating patients in the past.

8

Accusation

1 to using same while treating patients

2 (2) By failing to provide even a modicum of essential information in

3 Respondent's records regarding the necessity/justification for the prescriptions.

4 THIRD CAUSE FOR DISCIPLINE

5 (Inadequate Records)

6 21. By reason ofthe facts and allegations set forth in the First Cause for Discipline

7 above, Respondent is subject to disciplinary action under section 2266 of the Code, in that

8 Respondent failed to maintain adequate and accurate records.

9 FOURTH CAUSE FOR DISCIPLINE

1 0 (Dishonest Acts)

11 22. By reason of the facts and allegations set forth in the First Cause for Discipline

12 above, Respondent is subject to disciplinary action for dishonest acts under section 2234,

13 subdivision (e), of the Code.

14 FIFTH CAUSE FOR DISCIPLINE

15 (Violation of Drug Statutes)


17 above, Respondent is subject to disciplinary action for violating drug statutes under section 2238

18 of the Code.

19 SIXTH CAUSE FOR DISCIPLINE

20 (Misuse of Controlled Substances)


22 above, Respondent is subject to disciplinary action for misuse of controlled substances under

23 section 2239, subdivision (a), of the Code.

24 SEVENTH CAUSE FOR DISCIPLINE

25 (Unprofessional Conduct)

26 25. Respondent is subject to disciplinary action under Code section 2234 in that he

27 engaged in unprofessional conduct. The allegations set forth in the First Cause for Discipline

28 above are incorporated here as if fully set forth.

9

Accusation

1 PAATIR

2 WHEREFORE, Complainant requests that a hearing be held on the matters herein alleged,

3 and that following the hearing, the Medical Board of California issue a decision:

4 1. Revoking or suspending Physician's and Surgeon's Certificate Number A 103732,

5 issued to Jonathan Payawal, M.D.;

6 2. Revoking, suspending or denying approval of Jonathan Payawal, M.D.'s authority to

7 supervise physician assistants, pursuant to section 3527 of the Code;

8 3. Ordering Jonathan Payawal, M.D. to pay the Medical Board of California the costs of

9 probation monitoring, if placed on probation; and

10 4. Taking such other and further action as deemed necessary and proper.

11

12

13

14

15

16

17

DATED: ___ J~a~n~u~a=ry~~1~9~,_2='0~1~6~ __

LA2014615506 18 61820477.docx

19

20

21

22

23

24

25

26

27

28

·a Executive Director Medical Board of California Department of Consumer Affairs State of California Complainant

10

/1

Accusation

4patientsafety.org4patientsafety.org/documents/payawal, jonathan haber 2016-04-26.pdfjonathan...

Documents