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The South Carolina Veterinary Board has demonstrated that, although it has a mission to "protect citizens by ensuring that only qualified and competent veterinary practitioners operate in South Carolina," like other vet boards, it doesn't seem particularly eager to publicize the details that gave rise to its disciplinary actions.
As a rule, South Carolina's "Consent Agreements" are lacking in adequate detail for a consumer to really figure out what happened. Why is this a problem?
This is a problem because, as a consumer, it is vitally important for us to know what the veterinarian did, so that we can evaluate and assess his or her behavior. This kind of information is critical for making informed choices about veterinary care.
So, it is a good thing that recently, the South Carolina Vet Board began making the "Formal Complaints" available on its website. The Formal Complaint is the document filed by the Veterinary Board charging the vet with violations, and it typically includes more detail than the final "Consent Agreement."
Nonetheless, the IMPACT on the patient of the vet's behavior is often omitted from both documents. Perhaps this is because vet boards do not want to state that the vets behavior actually caused the death or injury of the animal. And maybe they don't want to say so because they can't be sure that's true. On the other hand, maybe they don't want to say so because it would indicate to the consumer exactly how dangerous this vet may be. Goodness knows, we wouldn't want to give the consumer information that would steer him away from a vet, would we? Even if that vet had behaved dangerously. Oh, but there is that little problem of the mission statement . . .
Both the Consent Agreement and the Formal Complaint filed by the Board in the case of Frank Hooper and his treatment of Patch Parker are lacking one important fact, and leave the reader asking: "WHAT HAPPENED TO 'PATCH'?"
Well, I think we can make an educated guess. Here are the facts that we do know . . .
In the Formal Complaint, the Veterinary Board asserted that in January 2007 " . . . an American Pit Bull named 'Patch' was presented to Guingnard Veterinary Clinic incident to a severe limp. Patch could not place weight o his front right legl. Patch was examined by another veterinarian. The owner reports that the other veterinarian opined that the leg was fractured and required surgery. The owner provided consent to repair the fracture."
Two days later, vet Frank Hooper operated on Patch. The Board says that Hooper's "records do not document the completion of a physical examination of Patch before commencing surgery. [Hooper] did not notify Patch's owner that Patch's surgery would be more extensive than originally assumed by the other veterinarian."
[OK, what's that supposed to mean? Please tell me -- if you DO NOT conduct a physical exam of a patient prior to cutting into him, how the heck do you know you need to, uh, expand the surgery and make it more extensive?]
Hooper, the document says, did not contact the owners before surgery.
Then, the document says, "The surgical procedure was extended due to the unavailability of certain equipment, a personnel shortage, and the complexity of the procedure."
[Um, what? Did he not CHECK to make sure he had all the needed equipment and staff before starting????? So, basically, this dog was under anesthesia longer . . . ?????
Hooper, it says, ". . . interrupted the surgical process while the animal remained under anesthesia. [Hooper] permitted his technician to depart from the area without ensuring that someone monitored the animal. [Hooper] failed to ensure that the oxygen supplies for Patch's surgery were adequate and to ensure the availability of equipment that was necessary for Patch's surgery."
"A review of [Hooper's] records relating to this mattre reveal that a physical examination was not conducted prior to the procedure. [Hooper] failed to rcord the route of administation of Telazol, a controlled substance. [Hooper] did not record the dose and administration of Atropine."
The document goes on to cite the violations the Board charged Hooper with, which include failure to "provide or maintain proper facilities, engag[ing] in unprofessional or unethical conduct, and engag[ing] in incompetent or negligent conduct" as well as failure to provide proper supervision of the technician and failure to keep proper records for Patch's treatment and drug administration.
What the document does NOT say is what happened to Patch.
What do you think?
Is it your guess -- as it is mine -- that the dog probably DIED? After all, we have:
- Failure to examine the dog prior to surgery
- Expanding the surgery to make it more "extensive" without ever having examined the dog
- Prolonged surgery in which the patient was apparently left under anesthesia while people left the area
- Reference to inadequate oxygen supplies and inadequate equipment, as well as failure to record how much anesthetic drugs they gave Patch and how they were administered
Do you think -- without saying what happened to Patch -- consumer's will realize that this kind of behavior COULD LEAD to the death of a patient, whether or not it did?
LINKS:
Board Consent Agreement with Frank A. Hooper
The Order Signed by the California Veterinary Board in August, 2008 wasn't the first violation committed by Oasis Veterinary Clinic and Hospital and Ronald Walker, DVM, its managing vet. In 2006 the CA Vet Board ordered Walker and his clinic to "take such measures as [were] necessary to practice at an acceptable level of care." Yet, the dizzying and frightening list of violations alleged by the CA Vet Board -- seven in all, including an animal cruelty -- beg the question: WHY DOES THE CALIFORNIA VET BOARD ALLOW OASIS AND WALKER TO CONTINUE PRACTISING
The facts are these:
Approximately 3 years after fining and disciplining Walker, the Veterinary Board issued an accusation against Walker and his clinic based on an inspection conducted by a board investigator. The Vet Board charged Walker and his clinic with:
- Unsanitary Conditions
- Failure to Maintain Aseptic Surgical Suite
- Animal Cruelty
- Failure to Comply with Emergency Services Requirements and Inoperable Phone
- Maintenance of Misbranded or Expired Drugs
- Violation of Health & Safety Code Section 2514.13 (this deals with failure to properly dispose of x-ray developer fluid, which the inspector said was being improperly disposed of into the public sewer. Public health endangerment, perhaps?
- Failure to Provide Medical Records on Demand
The outcome of this case is that the Board entered into (yet another) "stipulated settlement" with Walker and Oasis. In this settlement, Walker and his clinic admitted to all of the charges except for animal cruelty - and guess what? As part of the "settlement" with the vet, the Vet Board simply dropped (dismissed) it's animal cruelty charges. Please read what the investigator report says, you be the judge! (It is right for the vet board to dismiss charges of animal cruelty in spite of what the investigator saw with his own eyes!???)
For the remaning 6 violations, the vet board placed them on 3 years probation. They ordered Walker and the hospital to reimburse them for their "enforcement" costs, in the amount of $3,575. Please note that this was reimbursement to the board for it's costs, NOT a punitive fine for their dizzying and horrifying violations. Outrageous! No punitive fines! The Board ordered them to take 8 hours a year of continuing education -- that's just one working day!
Oh, the Board "revoked" their license but STAYED THE REVOCATION (which means, pretty much, decided not to enforce it), opting instead for mere probation which means of course, they keep funneling pets in the door.
Now, you tell me: Given the history of prior violations, and the truly frightening findings of the Board investigator (details below), do YOU think the Board's discipline is sufficient, either as a punitive measure or to incentivize Walker and Oasis to clean up their act? More importantly, is it sufficient to "protect consumers and animals" -- which they SAY is their mission?????
Here are the accusations based on the investigation, in detail. You will recall, as I stated above, that Walker and Oasis admitted them all except for the animal cruelty charge -- so the vet board simply retracted that charge in the final settlement. I guess BOTH Walker AND the Board know what kind of incendiary effect an admission of animal cruelty might have on public perception of a vet -- but unless the investigator is outright lying (do you think he is, with everything else Walker admitted to?) then he SAW what he SAW, so YOU be the judge as to whether it is "cruelty" or not -- I certainly think it is!
As you will read, among the allegations ADMITTED to, include caged animals sitting in their own waste with no food or water, keeping used syringes to be cleaned for RE-USE (!), un-sterile conditions including dirty surgical instruments, and more!
UNSANITARY CONDITIONS
(The truth of this charge was admitted by respondents Ronald Walker and Oasis Veterinary Clinic in the settlement)
"On or about January 25, 2008, during the course of an unannounced inspection, the Board's inspector identified many violations of the Board's standards of cleanliness and sanitary conditions, including, but not limited to, the following:
- a. The reception area was dimly lit, and smelled of urine
- b. Bulk liquids were stored in a cupboard with a mixture of spilled medication completely covering the cupboard's bottom, cementing an old cardboard box and stuffed animal toy along with the bottles to the bottom of the cupboard.
- c. The treatment area was dirty and had a pit bull patient with wounds on its rear legs running around freely. This dog had no access to food or water.
- d. The treatment room's counter was dirty and had 15-20 used syringes with needles stabbed into a pad, many used needles in the sink, a plastic jar full of used needles, and several used needles lying around the sink. There were also used syringes with condensation inside apparently to be used on patients again. The floor was dirty with blood and scrub, or surgical soap. Many old endotracheal tubes, some without viable cuffs, were piled in a bowl on a dirty cart.
- e.The surgery room's sink was dirty and appeared to be partially disconnected from the water supply, but still connected to the drain. The surgery table was littered with used surgery instruments, including several hemostats still clamped to a uterus. The mayo stand (a small stand used in surgery) was covered in blood and dirty instruments. A surgery pack was opened and used for a procedure, but there was no indication of a sterile indicator in the pack remnants. The flooring was cracked and pulling away from the wall in places. The wall was damaged and has chunks missing in one corner.
- f. The ambu-bag, a squeezable bag used to assist a patient to breathe, was left out on the O2 tank rack and was crushed and covered in an unidentifiable sticky black material. The stored packs, packs of surgical instruments used for a procedure, were wrapped in porous towels and had no sterile indicator tape on them. The orthopedic kit was not sterilized. The door from treatment into surgery has a hole in it were the window used to be.
- g. The back kennel area was extremely dirty and smelled so strongly of animal waste it was difficult to breathe. Every animal there was sitting in a mixture of feces and urine. None of the dogs had food or water. Only a cage with two kittens had food and their water was dirty.
- h. The bathing area had water flooding on the floor. There was also a bucket of used needles and syringes which were apparently waiting to be cleaned for re-use."
FAILURE TO MAINTAIN ASEPTIC SURGICAL SUITE
(The truth of this charge was admitted by respondents Ronald Walker and Oasis Veterinary Clinic in the settlement)
During the inspection referenced above, the inspector found that:
"The surgery room was not clean and sterile. The floor and walls have damage that makes it impossible to adequately sanitize certain areas as required . . . The instruments that were present were dirty, including the presence of animal tissue in violation of [citation]. The surgical packs present were wrapped in a porous material that would allow contamination to strike through the material and contaminate the instruments inside. There were no devices to measure and confirm sterility of the packs pursuant to the requirement of [citation]. A sick patient was being housed in the aseptic surgery room. This patient might have contaminated the room, exposing the next patient to risk of illness. The sink in the surgery room with the connected drain is a source of infection for patients. The condition of the surgery room was so inadequate that no surgeries could be properly performed there, and, in any case, [Walker] did not have the necessary equipment to perform sterile surgery."
ANIMAL CRUELTY
(Walker and Oasis Veterinary Clinic denied these charges, and the vet board withdrew them. However, in the "accusation", the inspector for the board reported seeing the following . . . )
- a. There were two dogs (patients) running free, one in the treatment room and one in surgery. Neither dog had access to food or water. The dog in the surgery room appeared to be very ill, barely responding when the inspector entered the room. The dog also appeared to have an injury on its left rear leg. All of the client-owned animals in the treatment room cages had feces and uring in their cages. Two cats had no litter boxes, food or water in their cages. One of the cats appeared very ill and the Board's inspector was told that [Ronald Walker and Oasis Veterinary Clinic] were not treating him because the owners were probably going to euthanize him. Otherwise, the Respondents' employee did not know who the patients were, and was unable to indentify them by name or owner.
- b. The kennel area was extremely dirty and smelled so strongly of animal waste it was difficult for the inspector to breathe. The runs did not have passive drainage, and all the animals were sitting in feces and urine pooled on the floor of the compartments. None of the dogs had food or water. All bowls were empty. Two kittens had food in their cage, and only dirty water."
EDITORIAL COMMENT: I find it outrageous, and a perversion of justice, that the veterinary board withdrew the animal cruelty charge -- which was based on its own inspectors report -- particularly when many of the same allegations in the animal cruelty charge were repeated in charges that the vet, Ronald Walker, ADMITTED TO. He admitted to the truth of the other six counts. Those six counts include a reiteration of the observation that animals were kept in their own feces, most without access to food and water. Is this, or is it not, cruelty? Don't ask the vet board -- apparently, just a little resistance from the vet, and they change their mind and decide that it's not. DO YOU THINK IT'S CRUEL?
FAILURE TO COMPLY WITH EMERGENCY SERVICES REQUIREMENTS AND INOPERABLE PHONE
(The truth of this charge was admitted by respondents Ronald Walker and Oasis Veterinary Clinic in the settlement)
During the inspection described above, the inspector found that Oasis Veterinary Clinic "did not have notices posted outside their building of where emergency services could be obtained when their clinic was closed as required . . . The phone number listed for emergencies was the clinic's own telephone number . . . [which they admitted] had been inoperative for some time, and the number was not answered when the Board's inspector tried to call it. Moreover, there was no functioning answering machine to provide an outgoing message as to where emergency services could be obtained. Additionally, there was an absence of notice that there was no 24-hour supervision of patients as mandated . . . Finally, the facility was found closed during nomral posted business hours, yet no referral was available for emergency services."
MAINTENANCE OF MISBRANDED OR EXPIRED DRUGS
(The truth of this charge was admitted by respondents Ronald Walker and Oasis Veterinary Clinic in the settlement)
The inspector found that "The pharmacy area was stocked with many expired drugs, which Respondents' employee indicated were routinely dispensed to the animals treated at [Oasis Veterinary Clinic & Hospital]. The controlled drug drawer was unlocked . . . The vaccine refrigerator/freezer had human food stored in it. The bulk liquids were stored in a cupboard with a mixture of spilled medication completely covering the bottom, cementing an old cardboard box and stuffed animal toy along with the bottles to the bottom of the cupboard. There were several bottles of liquid medication pre-packaged with only a drug name on them. These bulk and expired drugs which were either expired or so oldthat the expiration dates of the drugs could not be read, and the stuffed animal which was adhered to the medication spilled in the cupboard . . . The sale of expired prescription drugs is prohibited by law."
VIOLATION OF HEALTH AND SAFETY CODE
(The truth of this charge was admitted by respondents Ronald Walker and Oasis Veterinary Clinic in the settlement)
The inspector found that Oasis Veterinary Clinic's "x-ray developer is a hand-dipping tank, and was set up to have the chemicals drain into a pipe connected to the public sewer system. The x-ray waste generated . . . contains a silver-conten levfel that exceeds that which may properly be disposed of into the public sewer, and [Oasis Veterinary Clinic did not] have a contract with a licensed company for the disposal of their x-ray waste, or otherwise provide for the proper disposal of Respondent's x-ray waste in accordance with applicable law."
[ Oh, great! Threats to human health, as well!]
FAILURE TO PROVIDE MEDICAL RECORDS ON DEMAND (The truth of this charge was admitted by respondents Ronald Walker and Oasis Veterinary Clinic in the settlement)
" . . . The Board initiated an investigation based on a consumer complaint submitted by a consumer, Ms. J. J. on July 10, 2007. The complaint stated that on June 20, 2007, Ms. J.J. took her 5-year old Miniature Pinscher, Rex, to [Oasis Veterinary Clinic] for a neutering procedure and [he] ended up dead. As part of its investigation, the Board requested that [Oasis] produce the medical records for Rex. [Oasis Veterinary Clinic] failed to do so and later reported that the records for Rex were 'shredded' and destroyed . . ." [An Oasis employee later] "informed the Board's inspector that notwithstanding Respondent's requirements to maintain animal records fore a minimum of three years, [Oasis Veterinary Clinic] had a practice of destroying old records, including records of animals that died, such as Rex."