A History of Prior Violations and New Allegations of Animal Cruelty, but The CA Vet Board Still Wants Them to Get Their Filthy Paws on your Pets!!!!

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

AT ALL?

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."

Harold Hill and Alpine Veterinary Hospital in Alpine CA: Inspections show "serious health threat to animal patients, their owners, and staff"

Shockingly, in spite of a history of prior violations, and several inspections which showed shocking and dangerous conditions, this story ends with the California Veterinary Board re-instating the suspended operating license of Alpine Veterinary Hospital, and then "staying" a revocation of that license, allowing the business to keep operating, albeit "on probation." I think that the history of this place should give serious pause to any one who lives in the area, uses this business, or ever even has thought of doing so.

Why?

First of all, at the time of these violations, Harold Hill had been the managing veterinarian at Alpine Hill since April, 2004. He already had a history of violations.

In 2002, he was cited for "violation Business and Professions Code sections [which relate to] fraud, deception, negligence or incompetence in the practice of veterinary medicine" and "failure to properly register a place of practice." He was fined only $300. In 2004 he was cited for violation regulations pertaining to both record-keeping AND ANESTHESIA. In keeping with the veterinary boards' often baffling history of punishing subsequent violations even more lightly than the one before, he was fined only $250 for that latter violation.

Then came the inspections.

In September 2005 a complaint was filed with the Veterinary Board stating that Alpine Veterinary Hospital was very unsanitary.

The Vet Board sent an inspector, who found that:

". . . the facility was far below the minimum standards and a serious health threat to animal patients, their owners, and the staff that worked there. The condition wa2so poor that it could not be remedied without substantial work and renovation."

Moreover, at the time of the inspection, there was NO veterinarian on the premises, and the inspector observed a unlicensed staff member performing veterinary medicine without a license.

As a result of this inspection, on November 16th of that year, an "interim suspension" was issued to both Harold Hill, DVM, and Alpine Animal Hospital itself.

The inspector went back for a recheck on November 25th, finding that "the condition of the facility was still below the minimum standards and a serious health threat to animal patients, their owners, and the staff . . ." Hill was again not present at the facility, and it is noted that he had not been there for months, and no one knew how to reach him.

What were the details of the dangerous and unsanitary conditions? Here are some excerpts:

"The surgical room was extremely unsanitary . . ."

"The floors, tables and counters in the surgical room were unsanitary. Paint was peeling off the walls and there were holes and leaks in the ceilings, dust on everything, and clutter everywhere . . . "

"The reception room was unsanitary and the lighting was too dim . . . "

"Non-surgery related items were left in the surgical room and there was no proper place for surgery . . . "

"There was no emergency light in the surgical room . . . "

"Oxygen equipment . . . was not properly maintained."

"The exposure and developing techniques for x-rays were unnacceptable . . . "

"There was no centrifuge for adequate blood preparation to ensure qulaity readings, there were also no other available basic and/or emergency lab tests on site, therefore, the laboratory services were unnacceptable . . . "

"Exercise runs . . . have wood floors . . . "

"Emergency drugs were not properly maintained . . . need to replace expired drugs . . . "

"Resuscitation bags were not properly maintained . .. Need to buy ambu-bag."

"Failed to post sign indicating 'no staff on premises overnight' . . . "

"Improper x-ray identification . . . "

"Improper hazardous waste disposal . . . "

"Inadequate anesthetic monitoring . . . "

"Failure to follow proper sanitary surgical procedures . . . "

". . . the consultant observed employee Dawn McKinney practising veterinary medicine without a license. The consultant observed Ms. McKinney perform an examination, provide treatment, and prescribe medication for the dog. The consultant confirmed that Ms. McKinney is not licensed by the California Veterinary Medical Board to practice veterinary medicine, nor is she certified as a Registered Veterinary Technician . . . "

There is more . . . but do you need more?

It seems odd to me that anyone walking into this place wouldn't have had a huge feeling of danger and walked right out with their pet. However, some people are very trusting, or may have had the kind of relationship with this place that caused them not to realize what was happening over time. And surely, no one who took their pets there knew the dirty little secrets of the surgical suite.

This story ended with Harold Hill surrendering his license, but Alpine Hospital is still in business.

Would you EVER go there? I sure woudln't!



California Vet Board Newsletter Announcing Disciplinary Action

California Veterinarian Larry Romine Ordered to Surrender License; Veterinary Board Alleges Romine Committed Negligence; Botched Spay

Yet another botched spay story from California.

In June, 2007, veterinarian Larry Romine was ordered to surrender his license in the State of California to settle a complaint brought against him by the veterinary board. As a part of the settlement agreement, Romine admnitted that the Board "could establish a factual basis for the charges in the Accusation" if further proceedings were conducted. These charges dealt with Romine's treatment of a 5-month old rat terrier female named "Roxy."

Roxy's owner brought Roxy to the Kaweah Veterinary Clinic, operated by Romine, in Visalia, California, to have her spayed.

Two days after hte surgery, Roxy's owner brought her back in to the clinic, because Roxy was lethargic and unsteady on her feet. The staff at Romine's clinic told her that "Roxy's condition was likely due to the affects of the anesthesia, and she was instructed to prevent Roxy from drinking any fluids for the remainder of the day."

But the next day, Roxy was worse. In distress, she was vomiting any time she tried to drink fluids. Her owner then took her to a different clinic -- an emergency clinic.

The examination revealed "a build up of fluid in her abdomen, with indications of kidney damage."

The next day, Roxy was seen at yet another hospital, for more evaluation and testing. Exploratory surgery was done on Roxy, and they found that Roxy appeared to have been born with only one kidney, and that a three-inch section of the right ureter (which carries urine from the kidney to the bladder) had been surgically removed "during the same surgical procedure removing her right ovary, right ovarian horn, and uterus." In other words, when he did the "spay", Romine cut the ureter leading from Roxy's ONLY kidney.

In addition, the document said, Roxy's left ovary and left ovarian horn were still intact. Which means that not only was she butchered by having her right ureter cut, but the spay wasn't even finished.

Not that the latter issue mattered much, because "due to the inability to repair damage to Roxy's one kidney and ureter, she was euthanized."

The board asserted that Romine had commited negligence, both in removing the section of the ureter, and in not removing the left ovary and left ovarian horn.

In addition, they said that another element of negligence was that Romine had "failed to recognized symptoms consistent with post-surgical abdominal pain and clinical depression" when Roxy was brought back to him after the spay.

(Gee, "depression????" I'd be depressed too, if someone cut my only ureter . . .making it impossible for my body to clear urine and essentially causing me to be unable to continue living. Depressed? Ya think?)

In addition, when Roxy was brought back to him after surgery, he "failed to perform a physical exam" on her.

Other "causes of dicipline" cited by the board included their failure to make entries in Roxy's record describing the surgical procedure performed, the sedatives or anesthetics used, and the name of the surgeon who did the butchery, uh, I mean, operation.

Other record keeping violations were cited.

In addition, the board said that an inspection of the hospital showed that Romine:

Did not have a dedicated froom for surgery;
Did not have emergency drugs or equipment in the room where surgeries are performed;
Did not have a notice telling clients that 24-hour supervision is not provided;
Did not dispose of expired drugs; he did not record the names of patients or prescribing veterinarians in the drug log;
Did not have a properly functioning anesthesia machine in the surgery room;
Did not have an autoclave device (for sterilization);
Did not wear appropriate attire in the surgery room;
Did not enter his initials on exam records;
Did not have equipment for monitoring patients under anesthesia in the surgical room;
Had stored "products intended for human consumption" in the surgery room refrigerator.


The board noted that Romine had previously bee cited for failing to comply with minimum standards of veterinary care.

What Do We Do with the Drugged Out Veterinarian, Installment #2

Ah, what a temptation it must be to be able to access narcotics -- at the stroke of a pen. Or at least it would seem so, since it's a temptation so many vets seem unable to avoid. If the behavior only endangered the vet, I wouldn't be writing about it here. But you see -- you don't really want your pet under the scalpel of a vet under the influence, do you?

One such vet is California's Heather Kerr, who ingested such a staggering amount of narcotics (which she obtained under the guise of having a legitimate veterinary use, but then instead took herself!) over a period of 14 years while practising veterinary medicine that it can scarcely be believed.

In November of 2007 a "Decision and Order" went into affect based on a settlement Kerr entered into with the California Veterinary Board, which included a disciplinary order placing her on probation for 5 years. Oh, yeah, the board revoked her license but STAYED the revocation, which means they didn't REALLY revoke it -- she can keep right on practising. And in fact today I found the website www.kerrequine.com, "Kerr Equine Services" -- marketing her "equine sports medicine and surgery." SURGERY?

Um, if you are going to be taking your horse to this woman, there are a few things you ought to know. And before you say -- "Aw, that was over six months ago, she's probably clean by now!" -- Just remember, this woman abused drugs repeatedly over the course of 14 years, do you really think she's clean now? Oh, yeah, she's supposed to be in a rehab program and is supposed to be submitting "biological fluid samples" -- but do you trust her operating on your horse?

Here is the deal: The causes for discipline cited were:

UNPROFESSIONAL CONDUCT: SELF-ADMINISTERING CONTROLLED SUBSTANCES

Kerr "purchased, possessed, and handled Oxycodone, under the guise that the narcotics would be prescribed, administered, or dispensed for a legitimate medical purpose in the course of professional practice . . . In 2002 [Kerr] purchased 14,000 tablets of Oxycodone . . . In 2003 [Kerr] purchased 13,000 tablets of Oxycodone . . In 2004 [Kerr] purchased 15,000 tablets of Oxycodone . . . In 2005 [Kerr] purchased 30,000 tablets of Oxycodone . . . In 2006 through April [the beginning of the year] [Kerr] purchased 5,000 tablets of Oxycodone."

"[Kerr] admittedly began diverting and self-administering 4 to 5 tablets of Oxycodone per day but gradually increased dosage so that by September 2006 she was taking 25 to 30 tablets per day."

Kerr "admittedly self-administered Demerol and Morphine on an irregular basis, during the time period between May 1992 and September 2006."

OK, so I looked up Oxycodone and APAP, and this combination is commonly known as Percocet. Could this woman possible take 25-30 percocet a day for so many years? Aside from the "admitted" drug abuse -- does anything else seem weird to you?

Let's do some math.

Kerr said she "gradually" worked up to 25 to 30 tablets of percocet per day.

This is quite unbelievable. But looking at the statistics for her orders 2002-2005, let's just say for the sake of argument that by 2002, she was already up to 25 per day.

25 times 365 days in the year is 9,125. She ordered 14,000 tablets that year. What happened to the nearly 5,000 she didn't gobble?

And at her height, she was supposed to be ingesting 30 of these per day. 30 times 365 is 10,950. Yet, in 2005, she ordered 30,000 of them. What happened to the 19,000 tablets she didn't gobble?

Is it even possible for someone to take 25-30 a day and survive? Apparently so -- there are people who have done it -- (see http://www.drugtalk.com/percocet/drugthread.php/t-175550.html); but you would be really messed up and not in any shape to practice any kind of medicine!

But to consume 30,000 pills, she would have to take over 80 a day. And that's just not possible So -- I ask again -- what about the other 19,000 pills?

This Board document doesn't accuse her of selling, and I have no proof of that. But it sure seems fishy to me.

Academically speaking, according to
http://www.prescription-drug-rehab.com/oxycodone.html, "The major source of oxycodone to the street has been through forged prescriptions, professional diversion through unscrupulous pharmacists, doctors, and dentists . . . " etc.

So hypothetically speaking of course, if a vet WERE selling this drug -- let's say, 19,000 tabs in a year -- how much black market income would that yield? According to that same article, oxycodone sells on the black market for about 50 cents to $1 per milligram. Let's split the difference at 75 cents. At 5 mgs a tablet, let's say, that's 3.75 each. 19,000 would be $71,250.

Now, I'm not accusing anyone of anything, and the reader is reminded that there is nothing in the state findings saying that Dr. Kerr ever did such a thing.

But it's all very interesting . . . that and the unnaccounted for, ungobbled 19,000 pills.

Back to the safety of our pets -- why would someone totally high on percocet NOT be someone you want operating on your pet?

Well, some people describe the feeling they get on this drug as "zoned out." If someone has ingested 30 of these babies in a day, it's a pretty good bet they don't have their wits about them to practice good medicine on you pet.