In veterinary medicine, license revocations are rare. In Oregon, they are super rare. That's why their actions in the case of William Powell show that they must think he is a particularly BAD VET. But does this action REALLY have any meaning, since the vet was 77 years old when his license was revoked? Isn't that pretty much the same as simply waiting until a vet is ready to retire anyway, before doing something?
This is a case that also raises the important issue of SUBSTANDARD CARE provided to pets presented to a low-cost spay neuter clinic or treated at a shelter. As you read this, please consider the following questions:
If you are considering having your pet spayed or neutered at a low-cost (or free) clinic, how do you know that your pet will be provided with the kind of competent, quality care that is ABSOLUTELY CRITICAL to ensuring that your pet does not die of complications or botched surgery? At the end of this post, we will provide some things you MUST ask for whenever your pet is going to have a surgical procedure. PLEASE REALIZE that sometimes the "cheap" option is really the costliest of all.
In my mind, this is a case that calls into question the relationship between non-profits, or shelters, and the vets who provide "free" or "low cost" services there. As far as I can tell, some or all of the "services" referenced in this board document were performed by Powell for a local shelter. Online research leads me to believe that one of these shelters was likely Coos County Animal Shelter in Coos Bay Oregon. Although one website refers to him as a "volunteer" at the shelter, and an article available online says that Powell provided "free" spay/neuter services at the shelter, the IRS documentation for the local organization "Friends of Coos County Animals" explains that it's $54,827 expenditures for the year 2007 went to provide medical care for the County shelter's animals -- specifying spaying and neutering -- and finding them homes. The "home finding" part was, I imagine, the far smaller expense, I wonder how much of that money was spent paying Dr. Powell for spays and neuters he "volunteered" to perform? And how many of those did he botch before his license was yanked in November, 2007?
Another online reference I found today included a statement about Friends of Coos County Animals raising money to pay for spays and neuters. The facts in the vet board document give us a bit of an idea about the "quality" of some of the spays provided by Dr. William Powell.
Here are the Board's Findings of Fact:
"The evidence of record establishes that [Powell] violated the Medical Practices Act, in that:
1. On May 19, 2004, [Powell] performed a spay on 'Dory' a kitten at a local shelter. He reported that it was a standard procedure but difficult because the patient was small and had a 'friable uterus.' On June 2, 2004, the owner who adopted 'Dory' took her to a different veterinarian for a 'wellness examination.' On examination the veterinarian found some abnormal findings that concerned him, specifically a 'significant incision infection' and what appeared to be an abnormal bladder because it was 'very full and not movable.' Following a course of antibiotics, 'Dory' still had a distended bladder that was painful on palpation. The veterinarian performed exploratory surgery which revealed 'troubling' findings, including many adhesions, a large retoperitoneal cavity filled with bloody urine and the right ureter (the tube from the kidney to the bladder) was included in the ligature when the right ovary was ligated, the result of which was that the right kidney had to be removed." [Note: a "ligation" is when the vet "ties off" where he has cut. In this case, he "tied off" the tube that led from her kidney to her bladder. Had he done this on both sides rather than just on one, she would have died. Had she not had surgery to correct this as she died, it is probably likely that she would have also died.]
The document continues:
"He reported that the fact that he saw: 'a significant incision infection, many abdominal adhesions and a ligated ureter'" caused him to conclude that "'this surgery was of a substandard nature.'"
"2. On March 12, 2005, [Powell] performed a spay on 'Baby Girl,' aka 'Roxy.' A subsequent treating veterinarian discovered hydronephrotic right kidney and evidence that the right ureter had been ligated, which resulted in removal of the dog's kidney."
"3. On November 19, 2005, [Powell] treated 'Taz' whose owner presented the dog for symptoms that included vomiting. Without performing any diagnostic testing, [Powell] diagnosed salmon poisoning and administered Oxylet, atropine and Lax'aire. Within minutes, the client returned with the dog, claiming it had stopped breathing and had a swollen tongue. [Powell] confirmed his diagnosis of salmon poisoning and advised client to return the following day. On November 21 . .. the client took 'Taz' to a different veterinarian who property diagnosed and successfully treated 'Taz' for a genital tract infection. This veterinarian opined that [Powell's] care did not meet the standard of care provided in the local community. Her opinion was based on [Powell's] lack of diagnostic testing, lack of fluid support and [Powell's] choice of medications. [Powell] refused to provide the owner with 'Taz's' medical records when they were requested."
"4. On January 11, 2006, [Powell] examined three dogs, 'Riley,' 'Ben,' and 'Molly,' that belonged to a local shelter. He diagnosed Canine Hip Dysplasia without performing any diagnostic testing. He stated that his diagnosis was by 'palpation.' Based on his diagnosis, he performed pectinal [sic] myotemies on all three dogs."
I am sure that if you are a layperson like me, you need to look that term up. What is a pectinal myotemy? Can't find it, but I can find "pectineal myotemy" and that, I think, is what they intended to type.
This following online document, written by a PhD on Canine Hip Dysplasia, describes the procedure as follows:
"Originally developed by J. Barden, Larry J. Wallace, D.V.M., M.S., modified the procedure in 1967 to include the tenectomy (cutting out a portion of the tendon) or tenotomy (cutting of the tendon) of the pectineus tendon of insertion (that part of the muscle that goes into and attaches to the bone). . . Wallace’s procedure is by no means a cure for CHD, but has been described as somewhat effective in temporarily relieving pain and restoring function. . . . The rationale for this procedure is to relieve the tension on the joint capsule, caused by the upward force on the coxofemoral joint from a contracted pectineus muscle. It is also thought that improved weight loading of the femoral head within the acetabulum may result from the increased range of abduction. . . . This type of surgery should be considered strictly therapeutic in nature and does little or nothing to stabilize the dysplastic hip. Therefore, the owner of an affected animal can expect the degenerative changes due to osteoarthritis to continue."
It cites complications of the procedure as including "fibrotic reattachment of the muscle or tendon and seroma formation. Seroma are tumor-like collections of blood and serum in the muscle tissue."
The document continues:
"'Riley' was subsequently treated by another veterinarian who stated that he could not support the diagnosis and treatment without previous radiographs [x-rays] on record. 'Riley's' wound dihiscence [presumably from the surgery performed by Powell] required two surgeries to repair. This veterinarian opined that the surgery [done by Powell] was unnecessary and the radiographs he took afterwards showed 'no evidence of osteoarthritis, let alone hip dysplasia."
One wonders what became of Riley, Ben and Molly -- and how much the shelter paid Powell for these surgeries. Did these surgeries cause one of them, or all of them, to be less adoptable, thus leading to the sad outcome that awaits unadopted shelter pets? Or were one or more of them fortunate enough to be adopted, but by owners who might find themselves soon incurring additional veterinary costs due to the surgeries performed by Powell?
"5. On December 14, 2006, a dog, 'Biscuit,' was presented to [Powell] with what [Powell] described as an 'obvious orthopaedic injury,' which appeared to be the result of the dog being hit by a car. Although [Powell's] clinic did not have radiographic equipment" [x-ray machine] "[Powell] applied a splint to the dog's leg. On December 15, 2006, a subsequent treating veterinarian stated that her examination revealed a palpable fracture involving the left stifle, a grossly swollen left tarsus and deep ulcerated wounds to the lateral and medial left tarsus. The owner reported that [Powell] had applied a cast to the leg, but the cast had fallen off. 'Biscuit' was euthanized because of his poor condition and prognosis. The veterinarian stated that the dog 'should not have been made to suffer for so long with such extensive injuries and inadequate medical care."
"6. Based on the multiple complaints and concerns expressed regarding [Powell's] practice, in April 2006, the Board ordered [Powell] to review the minimum standards for facilities and veterinarians as provided by ORS chapter 688 and OAR chapter 875 (Veterinary Practice Act) and report back within 30 days regarding improvements made. [Powell] failed to respond. In August, 2006, the Board renewed its request for a report about improvements in the licensees clinic. On September 8, 2006, [Powell] responded as follows:
'In reply to your letter dated August 1, 2006, I have complied with your instructions. All equipment listed under rule #875-015-0030 is in place and operational at the clinic. Paperwork has been modified to include all requirements listed. If you have any questions, do not hesitate to contact me.'
The Board determined that the response was inadequate. In November, 2006, the Board provided specific instructions to Dr. Powell on expected improvements at the cinic and determined it would be necessary to conduct a site visit.
The Board conducted a site visit on June 25, 2007." [Wow, nearly 11 months after their letter to him. Wonder what happened in the meantime? To animals, I mean.]
"The following conditions were found at [Powell's] clinic:
a. The facility was not properly ventilated to exhaust odors.
b. Surgical area was not aseptic. A dog in the surgery area had been tied to a chair for two days for treatment for 'salmon poisoning' with primary clinical symptoms of diarrhea and bloody diarrhea. [Powell], at times, does not use a cap and gown during surgeries. Animal containment facilities consisted of airline crates.'
[Ok, does that sound very sanitary? A dog with bloody diarrhea in the surgery area tied to a chair? And what's with the "salmon poisoning" thing . . . bloody diarrhea happens to be a parvovirus symptom . . . among other things.]
"c. Review of the medical record of the dog found in the surgery area revealed a lack of a physical examination, diagnostics and treatment plan.
d. Licensee allowed his veterinary technician, who is not certified, to induce anesthesia.
e. Controlled drugs were stored in an unlocked cabinet; Ketamine and Diazepam where visible on a shelf. Medications for various patients were found throughout the preparation-surgery-recovery area, and also on most surfaces in the exam room. [Powell] does not have a locking cabinet for controlled drug storage. [Powell] also keeps controlled drugs in his car, which exposes the chemicals to elevated temperatures that lesson the efficacy of the drugs while the animal is under anesthesia."
The Board found that Powell breached the standard of care; performed substandard surgery resulting in complications; failed to maintain his clinic in compliance with standards; allowed unlicensed support staff to administer anesthesia; had unsanitary conditions; failed to isolate contagious animals; and more. Of note, the board commented that Powell's treatment of animals:
". . . demonstrate that he had an ongoing practice of providing substandard care, which constitutes a pattern of practising with negligence, ignorance and inefficiency in the practice of veterinary medicine . . . a pattern, practice or continuous course of negligence, ignorance, or inefficiency in the practice of veterinary medicine (OAR 875-011-0010(2)."
The "Pi Land Ranch" website accuses the veterinary board of a "harrassment and smear" campaign.
A Veterinary News article says that Dr. Powell alleges that the vet board made him a "target" because of his reduced price services, saying that the board is concerned with maintaining "revenue standards."
A 2005 article, written when Powell was 74 years old, quoted Powell as saying: "My hands are good, my eyes are good. As long as I can keep my (pistol) rounds on a playing card at 12 yards I figure my eyes and my hands are good enough to do surgery.'"
Perhaps a couple of ligated ureters wouldn't agree with that assessment.
Are these the discounted services that you want???????
In any case, The Board has revoked the now 77-year old Powell's license. Websites cited above said that he would appeal the ruling. I could find no updates.
Of interest, Powell is also listed on the website "Declaw Hall of Shame" for marketing his $65.00 reduced price cat declaws. The site lists Powell on their "The Bad Guys" page, whose header says "Dolts, Thugs, and Greedy Bastards." Of Powell they say: "The only worse thing than a pimp is a cheap pimp."
Also of interest:
The famous Lewis and Clark Law School in Oregon (famous for its animal law program) actually recognized Powell by making him a finalist in the "Nancy Perry Cougar Award" competition which recognizes an outstanding "animal advocate." So, do they even CARE about quality? Low cost spay and neuter is, I'd agree, a noble thing if done competently and at standard. But is that what this is????? Was????? Doesn't look like it to me.
If you are considering a low-cost spay neuter for your pet, you might want to read the guidelines published by the Association of Shelter Veterinarians for spay-neuter, and make sure the care that will be provided to your pet at least meets these guidelines.
From my own reading, I recommend you do the following:
1. Have pre-operative bloodwork done. Abnormal bloodwork can show underlying health conditions which make surgery less safe.
2. Have a full physical exam performed. Findings on physical exam can reveal heart murmurs and other conditions that make anesthesia less safe.
3. Ensure that either a veterinarian or a licensed technician will be administering and monitoring your pet under anesthesia.
4. Find out what anesthesia and pre-anesthetic, if any, will be used. Do online research and ask around to determine if these choices are the best available. Some drugs used as pre-anesthetic such as xylazine are associated with increased deaths. Some anesthetics like halothane have fallen out of favor because of potential effects on the organs. As far as I am aware, isoflourane and sevoflourane are more commonly used now, but even these anesthetics -- all anesthetics -- require careful monitoring. Which brings me to my next point.
5. Make sure your pets blood oxygen level, blood presure, respiration and temperature will be monitored throughout the procedure. A pulse oximeter monitor should be used for the oxygen monitoring.
6. Make sure your pet will be on constant rate infusion IVs during the procedure. This helps support blood pressure and hydration, and allows rapid access if medications need to be administered.
7. Make sure that someone will monitor your pet continuously post-operatively to make sure there are no problems regaining consciousness or coming out of anesthesia. Your pet should be monitored till it is able to sit up on its own.
8. Do NOT leave your pet overnight at a clinic that does NOT have overnight monitoring. If overnight hospitalization is needed, you should transfer your pet to a 24-hour practice.
9. Yes, your pet should receive something for pain after the operation. This is something that Dr. Powell may not be sure of, but think: Would you want to have a hysterectomny and get nothing for pain after?
** DISCLAIMER: I am not a vet. **
Not quite sure what that means, but I feel I must say it. Do the research yourself. See if you dont' come to the same conclusions. ined
Can all of the precautions above be obtained at a bottom of the barrel, cut rate price? Probably not.
Which is part of the reason, IMHO, low cost spay neuter in the wrong hands can be such a racket. If you are cutting so many corners (and cutting tubes leading to kidneys, too) you can still make far more than you should for such shoddy care while charging the lowest local price. BEWARE.