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In this rare case that actually resulted in discipline, the following story is told in the public record documents of the Colorado Vet Board:
"[Debra Megonigle] was the registered agent of Animal Emergency Room and Medical Center, Inc., located in Pueblo, Colorado, on or about May 31 and June 1, 1999.
". . . the Animal Emergency Room and Medical Center, Inc., was contacted about a gelding horse suffering from colic. The horse and horse's owner were from California and were attending an AQHA horse show at the Colorado State Fairgrounds in Pueblo."
"[Debra Megonigle] sent Mr. "KC" (Casey) Cooper, a veterinary technician employed by Emergency Room and Medical Center, to treat the horse. Cooper administered mineral oil via a naso-gastric tube. Cooper also injected the horse with Bentamine."
"The horse ultimately died as a result of having mineral oil inserted into its lungs."
"At no time during Cooper's care of the horse was a veterinarian on premises or available to supervise his care of the horse."
"On or about June 18, 1999, [Debra Megonigle] completed a form supplied by Equine Insurance Claims Services, Inc. The form related to Cooper's treatment of the horse on May 31, 1999. In the space listing veterinarian, [Debra Megonigle] crossed out "Casey Cooper, DVM" and inserted "Debra Megonigle, DVM."
[NOTE TO READERS: Serious questions are raised by this passage.
Were the horse's owners led to believe that Cooper was a veterinarian? (This would explain why their insurance company's form would list him that way.)
Was Cooper even a licensed technician? (I doubt it, since it seems to me the document from the veterinary board would specify so if that were the case.)
In making this change, was Megonigle trying to mislead anyone into believing that she had actually been present when the incident occured?
The document continues . . . ]
"The above-described conduct constitutes violations of the Colorado Veterinary Practice Act . . . "
They go on to cite five violations of the act including sections pertaining to:
"Fraud, deception, misrepresentation, or dishonest or illegal practices in or connected with the practice of veterinary medicine" . .. .
"Incompetence, negligence, or other malpractice in the practice of veterinary medicine . . . "
"Unprofessional or unethical conduct . . . "
"An act or omission which fails to meet generally accepted standards of veterinary practice . . . "
As a result of these cited violations, the board suspended Megonigle's license for a month, placed her on probation for a year, and fined her $5,000 ($1,000 for each of 5 violations).
Although you might not think this is enough, it's more than boards usually do. I must ask however:
If the same thing had been done but the patient were a cat or dog, rather than a horse whose owners had equine insurance and were in town to attend an American Quarterhorse show, would the action have been as strong?
Can you even imagine the suffering that this horse must have gone through?
Public Record Document taken from the website of the Colorado Veterinary Board:
CASE UPDATES:
Dr. Megonigle never paid the Colorado Veterinary Board the $5,000 fine. In April, 2001, the Board sent her a letter regarding her non-payment. Later that year, without ever having paid any portion of the $5,000 fine, Debra Megonigle declared bankruptcy in Texas, and all of her debts were discharged on December 13, 2001. The Colorado Board informed her that this penalty was not dischargable in bankruptcy, but she still didn't pay it, and so faced with revocation of her license Megonigle surrendered her license in Colorado and is now practising in TEXAS.
Web searches on Dr. Megonigle seem to indicate that she was working at Island Animal Clinic in Port Aransas Texas in mid 2009.
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.
This is one of those rare cases that actually made it to court.
Here is an excerpt from the opinion of the court:
"Plaintiff [John Koester] left his dog at defendant VCA's kennel for a weekend. Plaintiff left explicit instructions not to use a collar on the dog because of a salivary gland problem for which VCA had previously treated the pet. Upon returning for the dog, plaintiff noticed that the dog's neck area was swollen. Within a few days, when the dog continued to exhibit swelling in the neck area, plaintiff returned to defendant VCA. Defendant [Marjorie] Field, a veterinarian, treated the dog by draining its enlarged gland and bandaging its neck and head. When plaintiff returned to pick up his dog after the procedure, he noticed that the dog appeared to have trouble breathing and asked defendant Field whether the bandages were too tight. Field responded that the dog would be fine once it calmed down. Later that same day, plaintiff left the dog alone for ten to fifteen minutes to run an errand. When plaintiff returned home, he discovered the dog laying motionless on the floor, having apparently choked to death. An autopsy determined that the dog suffocated to death because the bandages were wrapped too tightly."
Unfortunately, the Court did not award Koester the damages he sought for emotional distress. However, the facts of the case are there for all to see.
What kind of emotional distress do you think he suffered, contemplating his dog suffocating to death? Strangled to death by bandages wrapped too tight? What kind of emotional distress would YOU suffer?So, here is another question: Did vet Marjorie Field move to Ohio after this case, and did she continue to practice NEGLIGENTLY?
A web search of "Marjorie Field, DVM" brings up 2003 minutes from the Ohio Veterinary Board, discussing investigation into a complaint against "Marjorie Field, DVM."
Links:
Case Details, Koester vs. VCA Animal Hospital
Citation among list of animal law cases
Actual Case Document
In 2002, Connecticut Vet Mark Danetz (currently of Clinton Veterinary Hospital) saw a dog named "Carob," who had progressed from vomiting to vomiting blood.
Danetz did bloodwork on Carob, which revealed that Carob had a low platelet count, also called "thrombocytopenia."
There is no mention in the document of any treatment being given to Carob at that time.
Four months later, Carob's owner brought Carob back again. This time, he had a nosebleed. According to PetPlaces description of thrombocytopenia, this is one of the things to look for.
PetPlace says:
"When the concentration of platelets becomes too low, bruising and bleeding may occur. Dogs with blood platelet concentrations of less than 40,000 per microliter of blood are at risk for spontaneous bleeding . . . The severity of bleeding associated with thrombocytopenia depends on how low the platelet numbers fall . . . In general, the lower the platelet count, the more likely bleeding is to occur . . .
What to Watch For:
- Small red spots on the white parts of the eyes (sclera), the gums or the skin
- Bruises on the skin (ecchymoses)
- Nose bleeds (epistaxis)
- Bloody urine
- Bloody stool
According to PetPlace, there are numerous tests that may be done to identify the cause of thrombocytopenia. The causes range from tick-borne diseases like Rocky Mountain Spotted Fever or Erlichiosis; to cancer or autoimmune disease.
But according to the vet board document, Danetz didn't order any diagnostic tests when Carob was brought in with a nose bleed, in spite of his prior history of low platelets. Instead, he prescribed an "herbal, holistic agent."
The document says:
"In providing care and treatment to Carob, respondent negligently and/or unskillfully: prescribed an herbal/holistic agent without proper diagnosis of Carob's condition; failed to conduct diagnostic testing in relation to the symptoms presented; failed to ensure that the results of blood work were accurately transmitted to [Carob's owner]; and/or failed to properly diagnose and treat Carob."
The Board placed Danetz on probation for a year. They also ordered a random review of his cases by a supervisory veterinarian.
So WHAT happened to Carob?
DID he have cancer? A tick-borne disease? An immune problem? Did his lack of treatment by Danetz cause serious health consequences for Carob? What happened to his nosebleed?
What was the "herbal," "holistic" remedy Danetz gave?
What BAD thing happened to Carob that inspired his loving owner to file a complaint with the vet board?
Now, I'm not saying that holistic remedies are always hocus pocus. But they are no substitute for needed diagnostics.
Links:
Pet Place Info on Thrombocytopenia (low blood platelets) in dogs
Minutes referring to Consent Order signed by Board and Danetz
