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4 Common Causes of Medical Injury in the Elderly

Tue, 18 Apr 2023 01:19:58 GMT

Unfortunately, medical malpractice is common, and while most healthcare providers do their best to avoid malpractice, there are many common causes and mistakes that can lead to expensive lawsuits, especially when seniors are involved. If you would like to know more to better protect yourself as a medical practitioner from medical malpractice cases, read these four common causes of medical injury in the elderly.

1. Failure to Administer Medications Correctly

A medication error may occur for a wide variety of reasons, such as:

Incorrect label/information
Wrong dosage
Wong medication

Additionally, the medication/information passes a lot of hands before it reaches the patient, so there is more opportunity for error. With seniors, a caregiver may be administering the medication to them. As a result, there are many chances for a possible mistake.

In addition, many seniors take multiple medications, and some medications don't interact well together. For this reason, it's imperative to understand the regulations and directions of any:

Prescribed medication
Over-the-counter medication
Vitamin and supplement

2. Failure to Attend to Patient’s Needs

Negligence is incredibly common, especially in busy settings like nursing homes and hospitals. Negligence can happen on purpose at the hands of caregivers, but in most cases, negligence of certain needs happen by mistake, due to a misunderstanding, or because a caregiver is overworked.

For example, if a patient develops bedsores because no one is repositioning them in the bed, this could be a case of malpractice because someone either neglected their responsibilities on purpose or because they didn’t understand why or how to reposition the patient.

Senior neglect comes in many forms, including:

Medical neglect
Emotional neglect
Personal hygiene neglect
Basic living needs neglect

As the name suggests, medical neglect includes anything related to health care, such as administering medications. However, depending on the patient's needs, you may be neglecting them if you are:

Isolating patients
Not providing mobility devices
Failing to bathe regularly
Failing to provide oral hygiene
Not providing sufficient food/water
Not keeping the area clean

In some cases, negligence can be helped by giving providers adequate time off and limited hours. Hiring additional staff can also help. In the long run, however, you can help reduce negligence in healthcare settings by:

Remaining empathetic to patients
Documenting everything
Following all guidelines and regulations

3. Failure to Inform of Known Risks

Health care providers must warn patients of all possible risks before treatments, medications, and tests. In healthy patients, this may not be hard. However, seniors may be more prone to experience uncommon side effects and complications.

For example, a patient taking blood thinners may be more prone to bleeding during and after surgery. For this reason, the doctor may recommend they stop taking blood thinners for a short time. If the patient is not informed of the risks by their doctor or caregiver, they may not take the recommendation seriously.

It's also crucial for doctors and healthcare providers to fully know the extent of their patient’s medical conditions and the associated treatment and medications, so they can properly inform them of any potential risks.

4. Failure to Diagnose

Anyone can be misdiagnosed or undiagnosed with a serious condition. Unfortunately, once more, seniors get the short end of the stick. They tend to have more complications that can hide health risks or concerns. They may also have been exposed to certain health hazards for longer, such as cancer-causing materials and chemicals.

Doctors may be inclined to overlook an ache or pain as part of getting older. On the other hand, they may chase an unrelated symptom and end up with the wrong diagnosis. You may be able to reduce the risk of failing to diagnose by urging patients to be honest with their health and habits. Other tips include:

Listening and considering all the patient's complaints
Using special computer decision support systems
Receiving continuing education to learn about new and evolving conditions

No one wants to commit medical malpractice, but mistakes happen, and even experienced doctors can make these mistakes. If you would like to better protect yourself from these cases, you should know more about medical malpractice. For more information, contact us at Spiga and Associates today.

Mental Health Malpractice Lawsuits: 4 Common Claims

Thu, 21 Oct 2021 16:18:19 GMT

Americans' collective mental health has faced some extraordinary challenges in recent years, making the therapeutic role of mental health practitioners more critical than ever. However, patients may file lawsuits against psychiatrists, psychologists, and other mental health professionals if they have allegedly suffered from malpractice.

As a mental health professional, you need to understand why a patient or patient's representative has decided to sue you for malpractice, what kinds of transgressions may constitute mental health malpractice, and how to exercise your legal defense options. Start by examining the following four common types of claims.

1. Breach of Trust or Privacy

A breach of professional trust or patient privacy counts as grounds for a mental health malpractice lawsuit. Sexual harassment of a patient would obviously constitute such a professional breach, as would maintaining a close personal relationship with a patient under your care since it represents a conflict of professional interest.

Mental health professionals must adhere to the same standards of medical record privacy as other kinds of doctors. Although patients cannot sue individual doctors who violate the Health Insurance Portability and Accountability Act (HIPAA), they can bring legal action against the offending doctor's workplace.

Patients who feel that a mental health professional has violated their HIPAA rights may file a lawsuit on the grounds that the practitioner violated one or more state laws. For example, a patient may sue a practitioner for breach of personal data, breach of fiduciary duty, breach of contract, or data theft.

2. Patient Suicide or Murder

Mental health practitioners must often treat individuals who display suicidal tendencies, have attempted suicide in the past, or run an elevated risk for suicide. Despite a high standard of professional care, some of these patients may eventually succumb to their suicidal impulses and kill themselves.

In such cases, the patient's surviving loved ones may understandably try to blame the practitioner's treatment methods. They may argue that the practitioner failed to take the suicidal tendencies seriously, take the appropriate notes, assess the patient's everyday environment for risks, or discuss the issue with the patient's loved ones.

On the surface, disclosing a patient's problems with others without that patient's consent might seem like a violation of professional ethics. However, in the world of mental and behavioral health, doctors may choose to discuss specific elements of a case and recommended treatments when it involves possible self-harm.

The same flexibility holds true in cases where mental health patients have expressed the intention or desire to hurt or kill someone else. If a mental health practitioner knows about this situation and keeps quiet about it, the survivors of a murder victim may then try to sue the practitioner for not warning them or notifying the police.

3. Faulty Documentation

Failure to keep appropriate medical records can make you vulnerable to a mental health malpractice suit. If you have not maintained detailed patient records, you may have little evidence that you can use in your defense. The failure to keep adequate documents represents an ethical violation in itself.

You could also get into trouble for documenting the wrong kinds of data. Acceptable documentation typically includes details about a mental health patient's medical diagnosis, case history, treatment, suicide risk, and informed consent. Unacceptable records include interpersonal conflicts, the names of other individuals, and sexual details.

4. Faulty Diagnosis or Prescription

A faulty mental health diagnosis can prove just as disastrous for a patient (and for the doctor accused of making the error) as any other medical misdiagnosis. These mistakes may occur when the practitioner prescribes treatment based mainly on surface symptoms, such as a thyroid imbalance masquerading as depression.

A misdiagnosed condition can cause a patient to receive ineffective care for years. The mental health practitioner may compound the damage done by prescribing medications that could make the patient's mental or physical health even worse than before.

Any of these four infractions can provide plaintiffs with serious ammunition against a mental health professional whose patient suffered losses or even death as a result. If you face such accusations, Spiga & Associates can analyze your case and provide you with skilled legal counsel. Contact our office today.

6 Medical Error Definitions You Should Be Aware Of

Fri, 15 Oct 2021 21:06:01 GMT

Medical errors are an unfortunately common event in the medical industry. Stakeholders have taken significant steps to improve patient safety by promoting accountability among healthcare workers.

These measures necessitate clear definitions and understanding of what constitutes a medical error to prevent undue liability and punishment. The consensus is that medical errors result from multiple factors, some of which are beyond medical practitioners' control. Discussed below are six medical errors definitions you should know.

1. Active Errors

Active errors occur when a person interacts directly at a point of contact as part of a larger system. In simple terms, these errors happen when a frontline health worker such as a clinician is dealing with a patient on behalf of the hospital.

A surgeon operating on the wrong leg is a classic example of an active error.

2. Adverse Event

Adverse events arise from issues with a medical procedure instead of the patient's underlying medical condition. Healthcare workers are liable if they fail to follow the acceptable or recommended practice at the individual or system level. In such a case, the error could have been prevented.

However, not all adverse events can be prevented. Faults with the healthcare system can result in adverse events for which medical practitioners are not liable. An example of adverse events is physical disability caused by a poorly conducted surgery or medical intervention.

3. Latent Error

Issues with faulty system design, faulty installation, or inefficient organizational structure result in latent errors. These errors do not cause harm by themselves, and they often go unnoticed until people get involved.

Latent errors are essentially accidents that are about to happen. The combination of human errors with latent errors is the primary cause of medical errors. An example is a poorly organized patient system that can lead to misdiagnosis or wrong medical intervention.

4. Negligence

Negligence occurs when healthcare providers offer substandard medical care. Typically, there is a set standard in healthcare delivery that qualified clinicians and nurses should provide for all patients under the same circumstances.

For example, it is negligence if a surgeon damages a nerve after confusing it with an artery. All surgeons are expected to know and differentiate between specific arteries and nerves before operating on a patient.

A negligent adverse event is a common subcategory of negligence used to determine legal liability among medical practitioners who conduct substandard medical management.

5. Never Event

Some medical errors should never exist, and they fall under never events. These mishaps are often atypical yet preventable blunders, such as performing surgery on the wrong part of the patient.

The National Quality Forum developed the never event list in 2002 to keep track of errors that could lead to identifiable serious issues such as death or disability. Seven subcategories constitute the list.

An example of a never event is when a person pretending to be a health care professional performed an invasive medical procedure.

6. Near Miss

Near miss describes events in which the potentially fatal outcomes are averted through some form of intervention. Near miss events are similar to adverse events in all ways except the outcome.

An example is when an artery punctured accidentally due to negligence is fixed without leading to dire patient outcomes.

The medical industry has a growing need for accountability because of the number of medical errors. Accordingly, you should know the elements that constitute a medical error, as the definition is so broad. These six medical error definitions are vital in establishing liability or lack thereof among affected individuals.

At Spiga & Associates, we defend licensed healthcare professionals against their professional boards in California. Contact us if you have any issues relating to medical errors or malpractice.

Tips to Avoid Dental Malpractice Lawsuits

Mon, 12 Jul 2021 09:07:49 GMT

While uncommon, dental malpractice cases can be costly and time-consuming and ruin your dental practice's hard-earned reputation and credibility. A dental malpractice lawsuit can cost you approximately $53,000 - excluding legal defense costs. The best way to avoid dental malpractice cases is to prevent them with these tips.

Communicate Effectively

Among the most common dental malpractice claims is failing to provide patients with adequate information about treatment, procedures, and medication, resulting in the patient's inability to make an informed choice. To avoid this lawsuit, always communicate with your patients clearly before treatment. Ensure that they understand the procedures they undergo and any risks involved.

While a procedure may be basic and seem like a no-brainer, do not assume that the patient knows about it. Explain to the patient clearly and allow them to ask questions. You can go a step further and request your patients to sign a consent form that affirms they understand and agree to undertake a treatment.

Also, if a mistake happens, notify the patient and document it. This way, the patient can watch out for complications, and you can argue your case if sued.

Refer When Necessary

A good way to avoid malpractice lawsuits is to refer patients to dental specialists for conditions outside your realm of expertise and experience. In fact, providing referrals shows your commitment to quality care and ensures patients get the best care possible.

You can refer a patient to an oral surgeon, endodontist, or periodontal specialist, depending on their unique case. Do not be tempted to use your little knowledge and experience for a specialty case; it can backfire on you. It is not uncommon for patients to affirm that a specialist could have done better when a treatment fails.

Diligent Recordkeeping

Keeping timely, accurate, and detailed patient records can go a long way in preventing lawsuits. Do not forget to document even the slightest details like equipment failure. Also, in case of a rescheduled treatment, make sure you note the reason for it to prevent misunderstandings and claims in the future.

It is best practice to keep patients' records clean and free from deleted entries. In case of an incorrect entry, cross it and mark it 'incorrect entry' followed by the date you altered. A patient record with numerous erased entries may look suspicious if a patient files suit.

Follow up

While patients have many reasons for missing appointments, consider following up. Also, have a standard protocol for rescheduling missed or canceled opportunities as soon as possible.

Too many missed appointments increase the likelihood of failing to identify an issue that requires immediate attention. As a result, a patient can sue you for negligence, claiming you failed to diagnose their condition on time. However, proving you followed up on a patient that refused to show up can be the difference between you or the patient winning a malpractice case.

Cooperate with Dental Board's Inquiries

When the Dental Board sends you an inquiry letter seeking to investigate a malpractice case, it will help if you respond to it. Do not ignore it and assume the complaints are baseless and unwarranted.

Instead, cooperate with the board and help them see the truth of the matter. You can provide treatment records and other supporting documents to prove your case. Importantly, solicit the help of a dental malpractice attorney for help responding to the claim.

Even with all these precautions, you can face a dental malpractice case. When this happens, get in touch with Spiga & Associates . We have 25 years of experience protecting and advising dentists charged with dental malpractice. Whether you are a subject of inquiry or investigation, we use our experience and case-specific knowledge to your advantage.

3 Commonly Asked Questions About Medical Malpractice

Wed, 02 Jun 2021 19:00:44 GMT

Being a doctor is a rewarding career because you get to help people and save lives. However, the medical field can be fraught with medical malpractice claims. Even the most careful doctor might make an error that leads to a lawsuit. If you would like to learn more, check out these three commonly asked questions about medical malpractice.

Can You Lose Your License for Medical Malpractice?

If a patient feels your negligence or errors caused an injury, they will likely file a lawsuit. However, this doesn't mean your license is immediately revoked. In fact, the courts don't have the authority to take your license. Their sole goal is to ensure the plaintiff is made whole again. Of course, the lawsuit and complaint must be reported to the Medical Board of California.

The board may conduct their own investigation. Your license may be suspended for a period as punishment, but in most cases, you won't lose your license except in extreme situations. For example, if the board found that you were grossly negligent or committed fraud, you can lose your license.

What Is the Statute of Limitations on Medical Malpractice Claims?

Medical injuries may appear immediately, but in some cases, it takes time to fully understand the extent of the injury and the long-term consequences. For this reason, a patient is given a reasonable timeframe in which to file the claim.

In California, the statute of limitations on medical malpractice claims is three years after the date of the injury. Naturally, this also protects you against sudden malpractice claims from 10 years ago. However, if the case involved fraud by anyone, the statute of limitations may be lengthened.

In addition to a three-year statute of limitations, California puts a cap on non-economic damages. Non-economic damages include physical and mental pain and suffering. These kinds of injuries can affect a person for the rest of their life, making them become costly fast. For this reason, California has a cap of $250,000 on non-economic damages.

What If the Patient Was Partially Responsible?

In some cases, the doctor is totally responsible for the injury because of their negligence. However, sometimes, the patient is also partially to blame. For example, a patient might come in with a dislocated knee. Normally, you would put the knee back in place and conduct imaging tests to spot any underlying damage. If you forget to do this, you could be found negligent if the knee worsens or doesn't heal properly.

However, in this same example, you may have instructed your patient to wear a brace and stay off the knee. If they fail to listen to your advice, it increases the risk of complications. Therefore, even though they can argue you made a mistake, you can argue they made a mistake too.

Identifying a patient's level of responsibility is important because California follows comparative negligence laws. Comparative negligence laws are often tied to car accidents, but they are important for every personal injury case, including medical malpractice.

Comparative negligence simply means that if a patient is found to be partially responsible, their settlement will be diminished by an appropriate amount. Therefore, if a patient is found to be 20 percent responsible for their injuries, and their settlement is $100,000, they only get $80,000.

No doctor wants a medical malpractice lawsuit on their record. Luckily, in most cases, you won't lose your license, but the costs can quickly add up. Your best bet is to find a skilled attorney who can help you, especially if your license is on the line. If you would like to know more, contact us at Spiga & Associates today.

3 Potential Defenses for a Medical Malpractice Case

Mon, 03 May 2021 20:20:15 GMT

If you are a doctor, you know the importance of medical malpractice insurance. However, even with insurance to carry the cost, you don't want that terrible mark on your record if you didn't do anything wrong. If you would like to learn more about how to defend yourself, keep reading to learn about three defense strategies for medical malpractice cases.

Rejection of Expert Testimony

Unlike regular witnesses, an expert witness has certain knowledge, experience, and education that makes thema valuable resource to help the plaintiff or the defendant. However, one possible defense strategy for your medical malpractice case is to identify any unqualified experts and inadequate expert testimony. You and your attorney can do this in many ways.

First, you can have testimony thrown out based on Daubert factors. This means that the witness did not meet the criteria needed to establish certain admissibility criteria. Typically, the criteria ensure experts must have proven examples, tests, standards, and error rates before they use any stats or examples for their testimony.

Naturally, an expert can also be disqualified if they are not qualified. In addition, the expert must stick to the scope of their expertise. An expert at pharmaceuticals can talk about how a pharmaceutical has side effects that may affect mental health, but they can't then give expert testimony on mental health or the state of your mental health.

In some cases, the expert's testimony is not helpful in determining who is at fault. In the above example, if the pharmaceutical expert only talked about statistics on how many doctors prescribe the wrong medication, the courts will likely toss it out since it can't be used to determine your specific case.

Reduction of Damages

In a malpractice case, the plaintiff needs to prove they sustained damages due to the negligence. Damages usually refer to medical bills, lost income, lost future income, pain and suffering, or ongoing medical bills. However, if you can prove the plaintiff is lying, you may get a reduction or elimination of damages.

One of the best ways to prove the plaintiff is lying about their injuries is with social media. A good attorney will have private investigators look at all social media sites to look for evidence that can help. Perhaps the plaintiff complains they can't walk for long periods of time now, but the investigator finds photos of a recent hike they took up a mountain.

You may also be able to have damages reduced if you can prove the plaintiff didn't mitigate damages. If a patient was hurt by negligence but refused to seek treatment (or they didn't follow through with treatment prescribed by a doctor), your attorney can argue they weren't that injured if they didn't bother to continue treatment.

Absence of Causation

To be responsible for a patient's damages, you must have caused themwith your negligence. This can be easy to prove thanks to medical records, but you can just as easily disprove this with medical records. With the pharmaceutical example, imagine you prescribed the corrected medicine, but the pharmacist filled the wrong medicine. If you can prove this, you prove you didn't cause the damages.

In addition, even if you are at fault for some damages, the chain of causation may have been broken. This happens when an unforeseeable event occurs that worsens the injuries. Your lawyer can help you trace the defendant's injuries to the source.

Medical malpractice happens all the time, but if you did nothing wrong, you shouldn't be punished. Luckily, there are many defenses to medical malpractice lawsuits. If you would like to learn more about medical malpractice, or if you need to defend your license, contact us at Spiga & Associates today.

6 Common Reasons Doctors Lose Their Medical Licenses

Tue, 06 Apr 2021 14:11:02 GMT

Doctors spend years in school, put in extra effort to pass challenging exams, and even enroll in residency programs as they practice their careers. Doctors only get a medical license when they complete their schooling and earn the title of a doctor, so the loss of a license is usually a cause for alarm.

Here are six reasons why a licensed doctor may lose their practice license.

1. Substance Addiction

Stress from loss of patients, insurance changes, and personal life challenges can make some doctors become addicted to drugs to manage the stress. A doctor who is always drunk or in possession of drugs may not perform their medical duties well, and this act can make one lose their practice licenses.

Doctors should avoid excessive use of drugs, even when they are stressed. The nature of their career requires them to interact with many people, which means that someone can easily recognize their drunken state and report them. Numerous complaints from patients or other doctors in regards to drug addiction can easily cause the loss of a medical license.

2. Insurance Fraud

Every doctor should maintain honesty, integrity, and ethics at all times, and especially when dealing with insurance firms. A doctor, who knowingly alters the medical records, enters the wrong insurance codes, or charges more insurance costs to some patients can lose their medical licenses.

The Medical Licensing Board takes such mistakes as fraud, no matter how small they are. Doctors should be keen and avoid mistakes or fraud which could provoke the medical board to take their licenses.

3. Patient Abuse

It's the responsibility of every doctor to listen to their patients and treat them well. Any abuse or misconduct towards the patients can make the doctor lose their license or job.

The main types of patient abuse include sexual harassment, physical abuse, or verbal abuse. Doctors should be careful about what they tell their patients or the patients' families. They should not in any way abuse the trust that the patients have in their doctor.

4. Drug Prescription Violation

Doctors should be keen on drug prescriptions because a single mistake can make them lose their hard-earned medical licenses. An incorrect drug prescription can cause adverse health effects on the patients or even death in the worst scenarios.

When that happens, the patient can sue the doctor for medical negligence or malpractice. If the patient has enough evidence that they were prescribed the wrong medication, chances are high that the doctor will lose their license or pay hefty court fines.

Health practitioners should ensure that they prescribe the right medication to their patients and seek help from other doctors if necessary to reduce the cases of prescription violations.

5. Records Loss or Misplacement

Every doctor has to keep patient data and other sensitive information secure. Doctors who fail to keep records safe can easily face a record misplacement lawsuit, especially if the patients' data lands in the wrong hands.

Doctors should maintain the patients' reports well, and if possible, create a database backup just in case the papers get lost. The patient should get handy information if in case of any data breach.

6. Patient Discrimination

Every doctor should treat all patients equally, irrespective of their religion, race, age, or gender. Any patient discrimination case can lead to serious legal repercussions, with the main one being the loss of the medical license.

The above are just a few of the many possible reasons why doctors may lose their licenses. If you are charged with any mistake which could make you lose your medical license, reach out to Spiga & Associates as soon as possible. Our dedicated legal team will defend you and help you retain your medical license.

What You Need to Know About Patient Abandonment

Mon, 01 Mar 2021 18:17:27 GMT

Sometimes a doctor-patient relationship doesn't work out. Maybe a patient owes payment for six months of service. Maybe they've become unruly or won't comply with medical advice, or perhaps it's as simple as your retirement and the need to close your practice. No matter the reason for terminating the relationship, you must handle it correctly.

California laws allow a physician to stop seeing a patient as long as the decision doesn't involve discrimination or prejudice, but you'll need to follow proper procedures. Without them, the Medical Board of California can charge you with unprofessional conduct for patient abandonment. In such instances, you may need to hire a medical license defense attorney to protect your license.

What California Law Considers Patient Abandonment

California defines patient abandonment as terminating the relationship without written notice to the patient. By law, the patient must have enough time to find another physician. If they decline further treatment or consent to the termination, however, they cannot legally claim abandonment. Instances when a patient can file a complaint include:

You end the relationship without providing a reasonable opportunity for the patient to find a new doctor
You verbally express to the patient that you won't treat them anymore but don't follow up in writing
You won't schedule a follow-up with a non-compliant patient but you haven't followed the legal steps for termination
You won't schedule a follow-up with a patient who owes back payments but you haven't properly discharged them
You close your practice without giving your patients notice or instructing them on how they can retrieve their medical records

If the Medical Board of California (MBC) decides that you abandoned your patient, they may put you on probation, or even suspend or revoke your license. Not only that, but the patient can sue you for medical malpractice if they feel their abandonment caused them harm.

How You Can Avoid an Unprofessional Conduct Claim

To avoid ending up before the MBC for patient abandonment as a form of unprofessional conduct, you must follow certain legal steps. They recommend the following to prevent allegations:

Provide written notice of the termination date
Give the patient at least 15 days to get emergency treatment and medication
Provide written recommendations of other practices where the patient may seek care
Instruct the patient of specific steps they need to take to obtain their medical records

If you have written proof that you did everything possible for that patient to find adequate medical elsewhere, any claim they may file against you isn't likely to hold.

What to Do If You're Contacted By a Medical Board Investigator

If you receive a letter or call from a Board Investigator, assume there was a complaint filed against you. Don't offer them information without your lawyer present. No matter how friendly they may seem, remember that their job is finding evidence to use against you.

To have the best chance of beating a patient abandonment allegation, contact an attorney as soon as you get that first phone call or letter. With legal assistance, you may be able to resolve the issue at the interview stage. A lawyer will advocate that they close the complaint in a manner that allows you to keep your license.

When you make the uncomfortable decision to terminate your relationship with a patient, be careful and follow legal procedures to avoid allegations of unprofessional conduct. If a patient still files an abandonment complaint against you with the medical board, Spiga & Associates can help. Call us today for assistance. We'll fight to protect your license and your livelihood so you can continue providing excellent care.

CALIFORNIA PHYSICIANS DEFENSE ATTORNEY: SCHEDULE II SUBSTANCES

Wed, 24 Feb 2021 22:14:03 GMT

You see him or her on your television, in your professional journals, and on your home page . . . the “Poster Child.” The Physician existing on the fringe of the profession, who gets arrested for overwriting prescriptions for Schedule II substances . Their example is easy to dismiss. The average M.D. engaged in legitimate practice seemingly has nothing to worry about. This fate befalls the slacker, the greedy, the foolhardy. Don't be so sure, any M.D. who prescribes Schedule II substances as a regular part of their practice is only one adverse patient outcome away from California Medical Board and possibly criminal investigation.

For example, Surgeons and Physicians practicing in Emergency Medicine, Oncology, and Pain Management, routinely write hundreds, if not thousands of prescriptions for Schedule II substances. There is no way for a Physician to control the patient’s use of controlled substances, yet a dangerous and influential myth is being propagated that a physician is a fortune teller and can predict which patients will misuse the substances provided. Further complicating the issue is the difficult ethical landscape navigated by Physicians dealing with patients presenting legitimate symptoms demanding treatment with Schedule II and III substances, but who are nevertheless, drug dependent. Long term pain management patients are at particular risk of overdose due to their high tolerances leading to increasing dosages and the difficulty in weaning them off the substances they have become dependent upon.

Should a patient die or suffer an adverse outcome that is somehow connected to a prescription for a schedule II substance, a criminal and California Medical Board investigation is sure to follow. Oftentimes the investigation will be spearheaded by investigators for the California Department of Consumer Affairs working in conjunction with local law enforcement but who also work on behalf of the Medical Board of California. These investigators are sworn peace officers and have the power to arrest and working with the Attorney General or local District Attorney also have the ability to bring criminal charges against a Physician.

These investigations start out invisibly with scrutiny of CURES II reports detailing a Physician’s prescription history. All patients receiving scheduled substances will be given particular attention. Soon after, the physician will receive a request for patient records, followed by a letter of investigation from a California Department of Consumer Affairs Investigator indicating that a complaint has been made and requesting an interview. They do not inform the Physician of his or her right to counsel or whether the Physician even has the right to refuse the interview. Nor do they inform him or her of their right to review the complaint. Believe it or not, one of the common mistakes Physicians make in dealing with these investigations is not taking it seriously. They will delay responding or not respond at all. Often Physicians confident in their prescribing practices will have a false sense of confidence going in to such an interview and will wing it without consulting consul. Those Physicians learn the error of that approach through hard experience. If you are facing such an inquiry. Take it very seriously, Your medical license is your most important asset.

If you have an adverse patient outcome that has come to the attention of your Hospital Administration, The Medical Board of California or local law enforcement, call Spiga and Associates immediately. Because of our 25 years of experience in both Criminal and Administrative defense we are uniquely qualified to defend you and your medical license.

WHAT DO YOU DO WHEN AN INVESTIGATOR ACTING ON BEHALF OF THE CALIFORNIA MEDICAL BOARD CALLS YOU DEMANDING AN INTERVIEW?

Wed, 24 Feb 2021 21:31:47 GMT

First, do not get upset or panic!

Second, call A California Medical Board Attorney at Spiga and Associates for a consultation. Do it quickly, because we may need to respond to a deadline or preserve evidence on your behalf. Our first goal of representation is to relieve you of the stress of communicating with the Board. After retaining us, we handle all communications and you take a deep breath and relax.

Third, listen to your attorney. Our 5th Amendment Privilege against Self-Incrimination should be a guide in all spheres of our lives. We would all be much wiser to invoke it more often. At no time is that right more important than when under investigation. However, when you apply and hold a Physician’s license to practice medicine, you agree to, within limits, submit to the California Medical Board’s authority. Thus, if you want to keep your license, you are going to have to cooperate at some level. But you SHOULD NEVER TALK to any investigator unless you have spoken to qualified counsel first. At Spiga and Associates we are expert at guiding your right to remain silent and experienced at preparing you for an investigative interview or testimony.

Fourth, be prepared for the long haul Most California Medical Board investigations take years before they are concluded. A Physician may have a California Medical Board investigation hanging over his or her head for several years. Physicians and Surgeons, along with most people holding professional licenses, are not accustomed to critical scrutiny, suspicion or disfavor from authorities. Most Physicians are ill-equipped for the anxiety and doubt such accusations / investigations create. We are here to reduce your anxiety and once we are retained, you will be able to unclench your teeth and go on about your life while knowing your case is being expertly handled.

Finding the right Medical License Defense Attorney will make all the difference. If the California Medical Board is denying your application for a medical license or threatening your license for any reason, Call California Medical Board Attorneys at Spiga and Associates immediately.

THE RIGHT OF ALL HEALTHCARE PROFESSIONALS TO INSPECT THEIR CENTRAL FILE.

Wed, 24 Feb 2021 20:54:16 GMT

Doctors, Dentists, Veterinarians, Nurses and all California Licensees in the healthcare profession are unfortunately rarely aware of their right to inspect and copy their entire central file maintained by their licensing agencies. Under Business and Professions’ Code § 800 (3)(c)(1) the licensee has a right to inspect his central file and the Licensing Board must specifically disclose to the licensee any:

“personal information that could be considered detrimental, disparaging or threatening to a licensee’s reputation, rights, benefits, privileges or qualifications or be used by the Board to make a determination that would affects a licensee’s rights, benefits, privileges or qualifications.”

The reason most licensees do not know about this right is the various Licensing Boards and their investigators do not tell licensees that they have the right to see the complaints against them (minus the identities of informants and patients etc . . ) and any negative item in their file. A licensee has no more important right than this.

Whether you are facing a Board investigation as a Doctor , Dentis t , Nurse , Veterinarian, Chiropractor , Psychologist etc . . . one of the first things your lawyer should do is request a copy of your central file. Knowledge is power. Once you see the administrative agencies information, it is like getting a copy of their playbook. There is no better way to prepare yourself for an interview than to inform yourself of the basis of their investigation. Your answers can be more precise and you can more easily avoid a perjury trap.

Like a surgeon’s scalpel, these statutes are a good lawyer’s tools. This is but one tool. There are many more. Like any specialized tool they can be useful but not optimum in the hands of an inexperienced layman. If you are under investigation call Spiga and Associates where an experienced medical and nursing license defense attorney is standing by.

Protect Yourself During Virtual Appointments: What You Need to Know

Fri, 29 Jan 2021 14:21:04 GMT

In-person medical appointments are difficult to schedule these days. Due to the pandemic, patients across the country must have consultations and appointments with their doctors and other medical providers via the Internet. Although this can be convenient, practitioners must still take precautions to avoid a medical malpractice lawsuit.

While you may be able to see your patients as you discuss his or her health issue, you may find difficulty in gauging a diagnosis because you are not able to do a manual examination. Certain areas of medicine, such as oncology, cardiology, and other chronic illnesses are difficult to treat and prescribe medication virtually and can open you up to a misdiagnosis, incorrect prescription, or a failure to diagnose.

For that reason, practitioners must have a policy in place surrounding virtual medical appointments to prevent liability issues. The following are some policies you may want to implement in your practice.

Determine Which Conditions You Will Treat Virtually

Before you begin seeing patients virtually, decide whether or not you will handle all medical anomalies within your specialty during virtual appointments. You may not feel safe providing medical care to a patient if you cannot palpitate an area to assess for cancer, for example. Have a plan for in-person visits for certain medical issues.

Require a Face-to-Face Physical Exam

Although virtual medical visits are helpful during the pandemic, certain specialties or specific symptoms may require an initial physical exam in person before you move forward with treatment. Although you will have a medical history of the patient prior to a virtual appointment, you should consider a quick exam based on his or her symptoms.

You should reconsider prescribing medication virtually until you have met the patient, reviewed his or her medical history, and asked important questions about the medical issue at hand.

Phone calls to the patient or answers to a medical survey do not provide enough information for you to provide treatment without the possibility of something going wrong. In-person appointments are still possible, even if you have to meet the patient outdoors.

Maintain Impeccable Medical Records

As you treat patients virtually, make sure your records and notes show you have an established relationship with the patient. You should note your accessibility to the patient during diagnosis and keep a record of all symptoms he or she experienced.

You also must keep a record of the patient's medical history with your records to show you had the most accurate information regarding your patient's health.

Only See Patients with an Established History

If you are onboarding new patients during the pandemic, you may want to require them to schedule an initial in-person appointment. You will develop an idea as to the issue the patient is facing and may feel more confident when prescribing medication or providing virtual treatment going forward.

Establish Informed Consent

When you treat a patient virtually, you must be crystal clear regarding informed consent. The patient must know all possible outcomes and risks of the treatment plan. Your informed consent procedures should include information of all providers involved in his or her treatment, such as names, credentials, the names of the facilities necessary to provide treatment, and so on.

One of the most important issues to consider is communication with your patient. Make sure you have clear consent from your patients. Do not rely on the words of others, whether they be staff members or the family of the patient.

Along with shortages in providers, the pandemic has increased the need for virtual medical appointments. However, you must take caution to avoid any liability issues. If you have any questions about medical malpractice or liability, please contact Spiga and Associates .

3 Mental Health Rights to Be Aware Of

Wed, 20 Jan 2021 19:59:48 GMT

Few professions are as emotionally taxing as the mental health profession. The field is relatively new and requires staying on top of research and development, which means if you aren't careful as a professional, you could violate rights that you didn't know were protected.

Today, take a look at some of the most commonly contested mental health rights and take whatever steps you must to prevent your practice from infringing on them.

1. Confidentiality

For psychologists, psychiatrists, and any kind of counselor, one of the most common issues that may occur is a violation of patient confidentiality. Especially when the patient is a minor or under the care of another adult, a therapist will often feel responsible to inform the caretaker of some issues the patient faces. When the patient becomes harmful to self or others, the concern becomes necessary.

Despite the professional's intrinsic desire to help their patients, many ethical issues are rooted in any form of a confidentiality breach, where the plaintiff asserts that the doctor shared private information without consent. To avoid some of these suits, you can share as little as possible if you find you must break confidentiality, but bear in mind that your legal duty to report in certain cases will supersede these concerns and likely win your case.

2. Refusal of Treatment

Except for within a narrow set of circumstances, mental health patients are considered fully autonomous and are able to make decisions about their lives, including the treatments they will and will not accept. Your job, as their mental health professional, is to present them with options that will help them get through life, not force them along any specific path.

Mental health is a process that each person must go through for themselves, and forcing any particular treatment will only damage your relationship with your patient without doing any good. Avoid charges of forced or coerced treatment by keeping careful records of any agreements you and your patient make, as well as copies of the prescriptions or therapy assignments you might give them.

Advance directives are making their way onto the scene as a helpful way to let mental health patients retain some level of autonomy. When the patient is in a healthy state of mind, you can help them work through their preferred treatment options if a crisis occurs where they cannot make wise decisions. Having this in writing will help protect them from treatments they don't want and protect you from accusations of using force.

3. Informed Consent

Of course, your patients won't be able to make these decisions without understanding their position and their options, which falls to you and their other medical professionals to explain. In every case, the patient should feel that they have the information necessary to determine what they would prefer and how they need to receive treatment.

You can foster that sense of being informed if you strive to break down barriers to understanding as much as you can with each patient. While they may not be able to grasp all of the intricacies that come from your study of their conditions, if they feel that you explained everything well, you're less likely to receive a charge of coercing treatment via lack of information.

For any legal issues in the medical field, you'll need a lawyer who can fight to defend you. Look no further than Spiga and Associates. We've been fighting to protect the rights and licenses of medical professionals for 28 years, in over 100 distinct cases. Contact us today and see how we can advocate for you in an arduous legal world.

Signs You Need a Professional License Defense Lawyer

Mon, 30 Nov 2020 21:43:13 GMT

If you are a licensed physician, nurse, pharmacist, chiropractor, or mental health professional, maintaining a valid medical license is critical to retaining your career and right to earn a living in it. Your license may be in jeopardy if any of the following situations arise.

You Have Been Convicted of a Crime

Under California law , the Medical Board of California can suspend or revoke a health care provider's license if they are convicted of a crime that is substantially related to their practice of medicine or their fitness to be a health care provider.

What the Medical Board of California considers substantially related depends on the individual circumstances. The board warns that it does not give legal advice to licensees and that it reviews the records related to every conviction of a health care provider as well as underlying issues.

Therefore, a felony or misdemeanor may provide grounds for disciplinary action against your medical license. Some crimes that may lead to disciplinary action include:

Drug crimes
DUI
Insurance fraud
Medical fraud
Medical Practice Act violations
Medi-Cal violations
Murder
Prescribing medication illegally
Rape
Reckless driving
Sex crimes

Licensees are required to report to the board if they are charged with a felony or if they are found guilty of any crime. Failing to do so is considered a separate public offense. This requirement also applies if you plead no contest to an offense, so be sure your criminal defense lawyer works in conjunction with your professional license defense lawyer to minimize the risk of losing your license.

Your License Was Suspended in Another State

California law also allows the Medical Board to suspend or revoke a doctor's medical license if his or her license was suspended or revoked in another state. For example, if you are licensed to practice medicine in Arizona and California and the medical board in Arizona suspends your medical license, your license can also be suspended in California.

You Acted With Gross Negligence

If you are charged with medical malpractice or an act of simple negligence, your license may not necessarily be affected. However, if you are charged with gross negligence, your license may be at risk. Gross negligence may imply that you have a disregard for the health or safety of your patients.

Gross negligence may occur in situations, such as:

You have a repeated history of offenses
You take unilateral action that deviates from the accepted standard of care
You fail to properly evaluate patients
You fail to order necessary and reasonable diagnostic tests

You Receive Notice You Are Under Investigation

The Medical Board may begin an investigation into your actions if it receives a complaint or report of a possible violation. You will generally receive notice of the investigation against you.

Additionally, you may be asked to attend an interview with investigators. If you discover that you are under investigation or you receive notice of a request for an interview, you should contact a professional license attorney immediately.

Your lawyer may help you prepare for your interview. They can also run interference with the investigators and present information in the light most favorable to you.

Additionally, your lawyer may be able to negotiate an agreement between you and the board while the case is still in an informal status. For example, you may be able to agree to seek alcohol or drug treatment if you have recently developed a problem. Your lawyer may also be able to convince the board that there are mitigating factors that do not warrant disciplinary action.

Learn More About Your Rights and Options

If you find yourself in any of these situations and would like to learn more about your legal rights and options, contact a professional license defense lawyer from Spiga & Associates .

Protect Your Veterinary License: When to Hire a Lawyer

Thu, 05 Nov 2020 12:27:22 GMT

Veterinarians commit years of their life to education and training so they can protect the animals they love. Licensing issues can threaten to destroy the plans or practices of competent animal medical specialists. Sometimes, the resolution happens easily, but other events require the individual to receive professional legal advice.

Denial for Criminal Record

Anyone can make mistakes. A criminal conviction in the past will not immediately make someone ineligible to hold a professional license. California laws allow several exceptions for veterinarians with prior convictions. Fight the decision if a licensing board refuses an application despite meeting the guidelines.

The time of a conviction matters. California allows people to practice their profession if the conviction happened at least seven years prior to applying for a license. The time is from when the conviction took place and not from when charges occurred, or when the defendant paid a fine or completed other punishment.

A dismissal of the crime, clemency, or proof of meeting court-ordered rehabilitation can also allow people to receive a license despite a prior conviction. Juvenile offenses, minor traffic crimes with fines below $500, or an arrest without a conviction should not affect licensure. If a license refusal still occurs, a lawyer can help with an appeal.

Explanations for Conviction Irrelevance

Not every conviction will cause a denial. The California licensing board may still approve a license application, even if the applicant has a recent conviction. The relevance to the work the applicant performs and what the conviction was for factors into the decision. A lawyer can help to defend an applicant when the board unfairly claims relevance.

A veterinarian charged with drug offenses or with felony animal abuse is less likely to regain their license or receive their initial license than someone with a felony traffic violation. A lawyer can help people convicted of relevant crimes to find alternatives like counseling or rehabilitation programs that may convince the board to reconsider the decision.

Defense Against Unfair Complaints

Losing a license because of unfair claims or outright lies can cost veterinarians their livelihood. Complaints from clients about malpractice, outright abuse, and other issues with veterinary care continue to rise. The increase may have little to do with the behavior of the vet. Licensing boards may not hear all the facts and unfairly punish the veterinarian.

The reasons for unfair complaints are many. An inability to pay a veterinary bill or the natural death of a pet can cause people to react in anger. Some complaints may come from habitual complainers known to file frivolous lawsuits. A fired employee may file a complaint as revenge. A lawyer will research to protect the reputation and license of the veterinarian.

Fighting Against Unfair Restrictions

Veterinarians want to do everything possible for their patients. COVID-19 made it unsafe for people and their pets to receive in-person healthcare. California restrictions against the use of telemedicine for new veterinary patients caused a lot of concern for many in the animal health field. Veterinarians that failed to follow the restrictions learned their licenses were at risk.

A lawyer can help veterinarians that received punishment after treating new patients virtually. Not everyone could prepare in advance for a pet illness, and no one could have predicted the lockdown and the length of the time services would become unavailable. Veterinarians that did what they thought was the most responsible for their staff, clients, and themselves should appeal any license lost for this reason.

At Spiga & Associates , we want to help compassionate and capable veterinarians to keep their practices open and save lives. Do not accept an unfair licensing board decision. Any veterinarian with a licensing issue should contact us to discuss the case.

3 Reasons to Hire an Attorney for Chiropractic License Application Help

Mon, 26 Oct 2020 23:09:10 GMT

Since 1922 , the California Board of Chiropractic Examiners has made chiropractic services safe for Californians by upholding strict licensure standards for all Chiropractors in the state. Without a valid and current license, no one can serve legally chiropractic patients.

Although this practice keeps patients safe, it can be cumbersome for some license applicants. If you want to become a chiropractor in the state of California and have past criminal convictions or license issues, you almost certainly need the help of an attorney when filling out your license application.

This blog covers just a few of the most common reasons to hire an attorney to help you with your chiropractic license application.

1. You Have Been Convicted of a Crime as an Adult

Past criminal convictions can be difficult burdens to bear, especially for job seekers. Even if you have a thorough education and honorable work history, a past criminal conviction can make the application for a chiropractor's license exceptionally difficult.

The application requires everyone to submit lengthy court documents as evidence of past misdemeanor and felony convictions, but not all convictions must be documented. Generally speaking, cannabis convictions and juvenile court convictions don't have to be reported, but you should definitely consult an attorney if you have an adult criminal history of any kind.

Not only will your attorney help you determine whether or not you should disclose your criminal history, but they will also guarantee that the application has all of the supporting legal documents necessary to fully report your history.

2. You Have Suffered From a Documented Drug or Alcohol Addiction

Drug and alcohol addictions can change lives and have far-reaching effects. To make sure all patients get the best possible care from their chiropractors, the California Board of Chiropractic Examiners requires applicants to disclose their former or current addictions.

If you were previously dependent on drugs or alcohol to the point that you got into legal trouble, you likely need to report this on your application. This is especially true if you were under a conservatorship at any point.

An attorney will help you determine whether or not your addiction warrants reporting and how to fully disclose it to the board. Working with an attorney who specializes in professional license defense will help you get the best possible chance at obtaining a valid chiropractic license no matter how you lived in the past.

3. You Have Had a Professional License Revoked in the Past

Even if you haven't had trouble with the legal system, you could still face a barrier to receiving your chiropractic license: former professional license suspensions or revocations. Even if you have never been a chiropractor, any professional license issues should be disclosed on your application.

Although many professional license issues have little relation to the field of chiropractic medicine, in order to protect patients, the California Board of Chiropractic Examiners still requires supporting documentation that details all professional license issues.

Even former chiropractors who had their chiropractic licenses revoked can petition to have them reinstated, so no matter what happened in your past, you still have a chance at getting your license in the near future.

The legal documentation around license revocations and suspensions in California and other states varies wildly based on the professional board that creates it and state laws. An attorney can help you find the correct forms to fill out and obtain all of the supporting documentation your application requires.

Chiropractors help thousands of people live happier, healthier lives, and at Spiga & Associates, we help people from all walks of life become professional, licensed chiropractors in the state of California. If you think you need help with your application to the California Board of Chiropractic Examiners, contact us today.

California Registered Nursing Facing Accusation

Sun, 23 Aug 2020 17:19:30 GMT

Don’t ignore the Board. Keep Your Mouth Shut. Talk to an Attorney!

The California Board of Registered Nurses has a variety of choices in disciplining Nurses who have been arrested or have had misconduct reported to the Board. The most severe form of discipline involves the filing of an Accusation against a nurse for misconduct. Virtually every Accusation at the outset seeks the revocation of the nurse’s license. It is a serious legal document that immediately places a nurse’s career on the line.

A California Board of Registered Nursing study of the Accusations it filed against Registered Nurses found that 51% were due to substance abuse or DUI, 28% were due to practice error, 18% were due to criminal misconduct, 3% were due to practice error & drug/misconduct. If you have been convicted or accused of any of the above, chances are good that an Accusation is in your future.

Nevertheless, I cannot tell you the amount of times I have received calls from nurses who have failed to answer their Accusation in the allotted time and thereby waived their right to contest the revocation of their license. I have been able to petition the Board for relief from default and it has been granted but that is the exception rather than the rule. If you fail to answer your accusation within the 15 days allotted by the Board for you to answer; you stand a good chance of losing your career through simple neglect.

So always keep your address updated with the Board and check your mail. If you have been convicted of a crime, or accused of any of the above listed misconduct you can count on the fact the Board will try to reach you. Nurses in this predicament are usually but not always contacted by a California Department of Consumer Affairs investigator who will want to ask you questions. Before speaking to the Board or an investigator, you should first consult an attorney who practices nursing license defense . The attorney cannot only negotiate on your behalf but he or she can also prevent you from incriminating yourself and making your problems worse. Further, an attorney can often take preemptive action that results in a lesser form of discipline or sometimes no discipline at all. If you are having problems with the California Board of Registered Nursing call Spiga and Associates at 818-501-8600 or email us at spigalaw@sbcglobal.net .

SYSTEMIC RACISM . . . . .WHAT IT IS

Fri, 10 Jul 2020 17:14:05 GMT

SEPULVEDA CORRIDOR IN THE VALLEY IS A WELLKNOWN SEX MARKETPLACE PLIED BY BOTH PROSTITUTES AND FEMALE VICE OFFICERS ATTEMPTING TO LURE MEN INTO A SOLICITATION CHARGE. TYPICALLY, THE FEMALE OFFICER, ACTING AND BEHAVING AS A PROSTITUTE, STAKES OUT A STREET CORNER WHILE IN RADIO CONTACT WITH FELLOW OFFICERS WAITING NEARBY.

THEIR GOAL IS TO ENGAGE MEN IN CONVERSATIONS AND RECORD THEM SOLICITING SEX FOR MONEY. IT’S LIKE SHOOTING FISH IN A BARREL. BUT SOMETIMES, AS YOU MIGHT IMAGINE, THE COPS GET BORED. AND THAT’S WHERE MY CLIENT, A MIDDLE AGED, AFRICAN AMERICAN, BUSINESSMAN COMES IN. LIKE MANY MEN, HE HAS AN UNFORTUITOUS TASTE FOR THE NAUGHTY LADIES OF THE EVENING. THIS IS HOW ONE PARTICULAR SUMMER NIGHT TURNED INTO A NIGHTMARE.

JOHN DOE SAW HER STANDING IN A DRIVEWAY AND PULLED UP TO HER IN HIS SEDAN FOR THE OBVIOUS REASONS. WHAT HE DIDN’T KNOW WAS THAT SHE WAS A YOUNG FEMALE VICE OFFICER BEING SUPERVISED BY ONLY A SLIGHTLY MORE EXPEREINCED FEMALE LAPD OFFICER. THEY DECIDED FOR REASONS BEST KNOWN TO THEMSELVES THAT THEY WERE GOING TO IGNORE HIS DESPERATE ENTREATIES FOR CONNUBIAL RELATIONS AND INSTEAD TRY TO SET HIM UP NOT FOR SOLICITATION, BUT FOR A PIMPING AND PANDERING CHARGE, WHICH CARRIES A MANDATORY STATE PRISON SENTENCE. WHY?

THEY THOUGHT HE WAS HUGGY BEAR OBVIOUSLY. COULD THE HOLLYWOOD DRIVEN STEREOTYPE OF THE BLACK PIMP SEX TRAFFICKER BEEN UNCONSCIOUSLY MOTIVATING THEM? WHO KNOWS? BUT THEY DID PICK HIM AT RANDOM AND THERE IS NO WAY RACE DID NOT PLAY A ROLE IN THAT DECISION.

SO THE SCHEME INVOLVED THE PROSTITUTE GETTING MY CLIENT’S PHONE NUMBER AND CALLING HIM BACK THE VERY SAME NIGHT PROMISING HIM SEX IF HE WOULD ONLY BE HER “DADDY.” MY CLIENT, WEAK AS HE WAS, READILY AGREED. HOW COULD HE NOT? BUT “DADDY” THEN MORPHED INTO HER ASKING HIM TO PUT HER UP AND TAKE CARE OF HER WHILE SHE PLYED HER TRADE ON THE SIDE. MY CLIENT HAD HIS EYE ON THE PRIZE AND WOULD HAVE AGREED TO ASSASINATE THE POPE JUST TO TOUCH HER ZIPPER. HE PLAYED ALONG. LONG STORY SHORT, THEY CHARGED HIM WITH SEX TRAFFICKING AND OFFERED HIM THREE YEARS IN PRISON. I GOT MAD. TOLD THE DA THE CASE WAS B.S. IN A FAIRLY DIRECT WAY. MENTIONED THE POSSIBILITY OF NAACP INVOLVMENT ETC . . . MY CLIENT GOT TEN DAYS OF CALTRANS FOR THE CRIME HE WAS GUILTY OF, SOLICITATION. THIS WAS A SETUP THAT DOESN’T HAPPEN TO WHITE PEOPLE.

WHEN IS A NURSE REPORTED TO THE CALIFORNIA BRN?

Thu, 04 Jun 2020 17:13:00 GMT

In 2017, The California Legislature enacted Senate Bill 799 which among other things authorized the California Research Bureau “to prepare and deliver a report to the Legislature by January 1, 2019, that evaluated to what extent employers voluntarily report disciplined nurses to the board and that offers options for consistent and reasonable reporting mechanisms.”

The reason this report was authorized in the first place was because the legislature was alerted to the discrepancy between the employer mandatory reporting requirements of Licensed Vocational Nurses as opposed to California Registered Nurses for whom there is no reporting requirement.

If you go on The BRN website you will find the Board emphasizes a nurse’s moral obligation to report Nursing Practices Act violation but admits there is no legal duty to do so:

“To ensure safe quality nursing care, it is critical to immediately address nurses suspected of diverting drugs or using drugs. While filing a complaint with the BRN is not mandated by law, health professionals do have an ethical responsibility. The American Nurses Association (ANA) addresses the topic of impaired practice in its Code of Ethics for Nurses, which states – in part – that nurses must be vigilant to protect the patient, the public, and the profession from potential harm when a colleague’s practice, in any setting, appears to be impaired. In a situation where a nurse suspects another’s practice may impaired, the nurse’s duty is to take action. Complaints may be filed online or by mail/fax.”

You will undoubtedly notice that the above does not even mention employers or healthcare providers. However, they too have no mandatory reporting requirement for wayward nurses. Change is in the air however.

The audit recommended that the Legislature update the Nursing Practice Act to include a requirement that employers of registered nurses “report to BRN [Board of Registered Nursing] the suspension, termination, or resignation of any registered nurse due to alleged violations of the Nursing [Practice] Act.” (California State Auditor, 2016).

This hole in the law can for the time being be of great benefit to a nurse facing discipline. Often counsel can negotiate a resignation on behalf of a nurse that also concludes the investigation against her with no subsequent official finding of wrongdoing and no report to the Board of Nursing. Whether such agreements are within the public interest or not, they are definitely in the interests of a nurse facing possible career ruin over a mistake or oversight.

If you are a nurse under investigation by your employer for some real or imagined violation, contact Attorney Carlo A. Spiga at 818-501-8600 or email me at spigalaw@sbcglobal.net

DOCTORS SPREADING COVID 19 DISINFORMATION BEWARE.

Tue, 26 May 2020 17:10:35 GMT

Two Bakersfield Doctors who operate Urgent Care Clinics could soon find themselves in hot water with the California Medical Board after spreading misinformation on the Covid-19 virus. Dr. Dan Erickson and Dr. Artin Massihi appeared on primetime shows two nights in a row and published a YouTube video indicating that based on their testing, Covid-19’s dangers were being overblown. The doctors, who are not epidemiologists held a news conference on April 22 to share their conclusions about the results of 5,213 coronavirus tests at their clinics, extrapolating their findings to the whole California population. https://www.cnn.com/2020/04/29/health/california-doctors-coronavirusclaims/index.html

"Do we need to still shelter in place? Our answer is emphatically no. Do we need businesses to be shut down? Emphatically no. Do we need to test them and get them back to work? Yes, we do," Erickson said at the news conference.

Their comments were roundly condemned and their YouTube video was taken down pursuant to YouTube’s policy regarding suppressing misinformation regarding the COVID 19 crises.

"There is a lot to object to from a scientific point of view," Andrew Noymer, an epidemiologist, told CNN. He said one big problem is that the doctors made estimates based on their clinics' clients who were tested, not a sampling of the general population.

"What these doctors are doing is corrupting the process from the start to make it seem like they are doing an honest policy analysis," added Noymer, who is an associate professor of population health and disease prevention at the University of California, Irvine.

The video also prompted the American College of Emergency Physicians and American Academy of Emergency Medicine to issue a forceful joint statement on Monday calling the pair's claims "reckless and untested musings" that "are inconsistent with current science and epidemiology regarding COVID-19.

" Why should these Doctors be worried about the California Medical Board? Because there are rules against dishonesty and unprofessional conduct. And while their statements are not conclusive proof of either, based upon the opinions of their colleagues, a good case could be made that no reasonable Doctor would make such statements based upon the evidence and that such statements were at the very least misleading and at worst dishonest. Further, these statements tend to undermine public health practices in a pandemic and could result in more Covid -19 cases and bad patient outcomes.

Doctors have a right to free speech, but it is a qualified right. If one uses their medical license to spread misinformation that could be injurious to the general public, then they should not be surprised that such speech comes at the expense of their medical license. Further, even when such speech is not a sufficient basis for discipline, it can often trigger the Board’s scrutiny in other areas.

In short, the advocacy of bad medical information is unprofessional conduct subject to Board scrutiny. The advocacy and implementation of unproven treatments is both unprofessional and in certain cases medical negligence upon which the Board will act. So Doctors should always be circumspect regarding the information they put out to the general public. They should also be even more cautious concerning unproven treatments. Many a Doctor has lost their license after going down that road. Do not be that Doctor. (See also In re Dr. Michael Arata M.D. Case No. 800-2015-014936) https://lymescience.org/michael-arata/

Carlo Spiga

California Medical License Defense Lawyer

NURSES FIRED FOR PROTECTING THEMSELVES FROM COVID-19

Wed, 13 May 2020 16:17:47 GMT

CAN A NURSE BE DISCIPLINED BY THE CALIFORNIA BOARD OF REGISTERED NURSING FOR REFUSING TO WORK ON COVID 19 PATIENTS BECAUSE THEIR HOSPITAL DID NOT PROVIDE THEM WITH PROPER PROTECTIVE GEAR?

Both the World Health Organization and Center for Disease Control guidelines have established that N-95 masks are the minimal personal protection equipment (PPE) required to protect healthcare professionals working on COVID -19 patients. After one of the nurses on their Unit tested positive for Covid -19, 10 nurses from Providence St John’s Medical Center ICU were suspended and threatened by their employer with Board Discipline for refusing to treat COVID-19 patients because St John’s refused to provide them with any N-95 masks.

The nurses were suspended and placed under investigation by their employer for unprofessional conduct and accused of Patient Abandonment. Under The Nursing Practices Act, “Patient Abandonment” occurs when 1) After having accepted a patient assignment establishing a nurse patient relationship 2) The nurse severs that nurse-patient relationship without giving reasonable notice to the appropriate person, i.e. Supervisor, so that arrangements can be made for continuation of nursing care by others.

So where does that leave the nurses in Santa Monica? First they claim they did not abandon patients but were simply refusing to work without the same protective equipment being given Doctors and Clinicians. It was clear that despite the shortage of N-95 masks, St John’s did have them, they were just parceling them out to Doctors rather than the Nurses who were in constant contact with the patients and the ones most likely to get infected. Nevertheless, St John’s reported at least one nurse to the California Board of Registered Nursing for Patient Abandonment. Several Nurse have also reported St John’s to the Board.

I believe the nurses did not abandon the patients as they immediately notified their supervisor, stayed on shift and simply refused to put their lives at risk. Second with respect to several of the nurses who were just starting their shift, it is unclear whether there was ever a nurse-patient relationship to begin with. Third, there are a host of federal laws and OSHA requirements with respect to workplace safety that St. John’s was most likely in violation of. And finally, no law or workplace regulation can compel a private person to risk their life and the lives of their families who they may infect.

For those reasons should the California Board of Registered Nurses choose to prosecute these nurses, they will most likely lose. However, just because the Board may fail in disciplining a particular nurse that does not mean that their employer can’t fire them. So if you choose to make a stand count on losing your job. Fortunately, as long as you follow the requirements above you will keep your license and protect the lives of you and your loved ones.

https://www.cnn.com/2020/04/17/us/california-coronavirus-nurses-suspended-trnd/index.html

Nurses and the Right to Free Speech During the Covid-19 Crises

Fri, 10 Apr 2020 15:49:08 GMT

Recently there have been several incidents of nurses being fired for critical comments they made either online or in the media about their hospital’s preparedness for the Covid 19 crises. See: https://www.nytimes.com/2020/04/09/business/coronavirus-health-workers-speak-out.html This of course raises the question of whether nurses have a right to free speech to point out dangers and wrongdoing in the workplace during the Covid-19 crises. The answer may disturb you.

The first amendment to the United States Constitution enshrines the right to free speech. However, there is no right more riddled with exceptions. One does not have the right to use “fighting words” or to threaten other people. One does not have the right to yell fire in a crowded theater or to incite a riot. One does not have the right to lie to obtain a public or private benefit. One does not have the right to use a curse word on their license plate, etc. ad infinitum. When our founding fathers wrote of free speech, they meant political speech. They were primarily concerned with preserving the ability to critique the prevailing power without fear of governmental retribution. And that is the rub, the constitution only restrains the government. It does not restrain private actors such as private hospital administrators from firing you because they do not like your online comments or a comment you may have made to a reporter or media personality. However, if you work for a public hospital you may have slightly more right to speak out, but even then you do so at your own peril.

Here is why:

Traditionally public employees had little free speech protection. As Justice Oliver Wendell Holmes Jr. famously wrote in McAuliffe v. New Bedford (1892): “The petitioner may have a constitutional right to talk politics, but he does not have a constitutional right to be a policeman.” That prevailing judicial view relaxed somewhat over the years culminating with the Supreme Court decision in the late 60’s, Pickering v. Board of Education. There, the Supreme court held that Illinois public school teacher, Marvin Pickering, had a free speech right to write to the editor of his local newspaper critical of the school board’s allocation of money.

Justice Thurgood Marshall opined: “The problem in any case is to arrive at a balance between the interests of the teacher, as a citizen, in commenting upon matters of public concern and the interest of the state, as an employer, in promoting the efficiency of the public services it performs through its employees.”

However, two United States Supreme Court cases, Connick v. Myers (1983) involving Harry Connick Sr., District Attorney for New Orleans (father to the famous crooner) and Garcetti v. Ceballos (2006), involving Gilbert Garcetti, District Attorney for the County of Los Angeles, virtually eliminated public employees’ right to make any comments concerning their work or working conditions.

In Garcetti, the court declared that public employees have no free speech protection when making statements pursuant to their official duties. And that is true even if the speech blows the whistle on governmental malfeasance or corruption. So, unless there is a specific whistle-blower statute in your state even a state/government agency can fire you for exercising your right to free speech. Garcetti’s reach is expansive encouraging courts to dismiss employee free speech cases even when an employee is not making a comment related to his or her official duties. Because, based on Connick and Garcetti courts give great deference to an employer’s judgment that the employee’s inflammatory posts will impact public services by causing disharmony in the workplace or by putting the employer in a bad light.

So, the bottom line is whether you are a nurse working for a private or a public hospital the price for being a good citizen and speaking out will most likely be your job.

Carlo A. Spiga

Nursing License Defense Lawyer

NURSE HEALTHCARE COVID-19

Fri, 20 Mar 2020 15:25:32 GMT

NURSES NEED TO SUPPORT THE COVID-19 HEALTH CARE WORKER PROTECTION ACT OF 2020

A variety of worker’s right groups, consumer advocacy organizations and public health organizations have introduced legislation to congress to protect health care workers during the current COVID-19 pandemic. The purpose of the legislation is to:

1) Mandate that OSHA issues an Emergency Temporary Standard to protect healthcare workers. This bill will enforce the issuance of an ETS to protect healthcare workers and other workers that the Center for Disease control deems as high-risk for occupational exposure to SARS─CoV─2.

2) Provide protections for healthcare workers in the public and private sectors. Except for the 21 states that have state OSHA plans that cover public employers, OSHA regulations and standards normally only cover private employers. The COVID─19 Health Care Worker Protection Act will also apply to workers in public hospitals in all states that receive Medicare funding (same as OSHA’s Bloodborne Pathogen Control Standard). We also support Congress expanding protections to all public-sector high-risk workers.

3) To quickly provide temporary emergency standards to protect workers, while also providing for permanent measures to be put in place. This bill also protects workers in healthcare occupations from similar health emergencies in the future by requiring OSHA to proceed with implementing a permanent standard after the COVID─19 Health Care Worker Protection Act of 2020 is enacted.

We have seen in Italy and elsewhere the rampant infection of healthcare workers because of lack of protocols and equipment. Support this needed legislation because it will not only provide for protocols and standards for minimal protective gear and equipment, but it will ensure those standards are maintained for years to come.

Check the following link for more information.

https://www.nelp.org/publication/supporting-the-covid-19-health-care-worker-protection-act-of-2020/

Today's Nurse, Tomorrow's Criminal

Sat, 29 Feb 2020 15:20:10 GMT

RaDonda Vaught’s world is getting darker. After previously deciding not to initiate disciplinary proceedings, The Tennessee Nursing Board has reversed course and decided to revive disciplinary charges against the former Vanderbilt Medical Center Nurse accused of killing a patient in a medication dispensing error. The Board’s change of heart occurred after Nurse Vaught was criminally charged.

The criminal charges themselves have caused an outcry from medical professional organizations and experts in the field who argue that the criminalization of medical errors makes patients less safe as it discourages the prompt and honest reporting of errors.

Back in December of 2017, Vaught was attempting to give patient, Charlene Murphey, a dose of an anti-anxiety medication, midazolam (brand name Versed), before an imaging scan. Vaught instead gave Murphey vecuronium, a paralytic drug used during anesthesia that had the same first two letters. Murphey died in an intensive care unit the following day.

The Nashville District Attorney's Office made the decision to criminally charges Vaught, specifically because she administered the fatal medication after overriding the safety mechanism in the dispensing machine.

I agree the criminalization of medical errors is a disturbing trend that can only negatively affect patient care. There is a huge difference between simple negligence such as what occurred in this case and gross negligence or reckless conduct calculated to produce great bodily injury or death.

Here, a nurse became confused for obvious reasons. She overrode the medication dispensing warning system obviously thinking it was in error. It should not happen, yet it could happen to anybody. Should there be civil consequences? Of course. The patient is gone and a loss to her family through no fault of her own. But to criminally charge a nurse for an error simply because of its consequences is short sighted and not supported by law. I wish I was her lawyer. So . . . . be careful out there. People’s lives and potentially your freedom, could depend on it.

RaDonda Vaught: Health officials reverse decision not to punish ex-Vanderbilt nurse for fatal error

https://www.npr.org/sections/health-shots/2019/04/10/709971677/when-a-nurse-is-prosecuted-for-a-fatal-medical-mistake-does-it-make-medicine-saf

Nursing License Defense

Fri, 07 Feb 2020 15:17:08 GMT

BEWARE: Fake BRN Representation/DEA Agents Extortion Scam

The California Board of Registered Nursing (BRN or Board) has learned that scam artists posing as U.S. Drug Enforcement Administration (DEA) agents or Board investigators are calling California registered nurses as part of an extortion scheme.

No DEA agent, BRN investigator or staff member, will ever contact RNs by telephone to demand money or any other form of payment. If you receive a call such as the one described, refuse the demand for payment. Do not disclose any personal information, i.e., social security number, dates of birth, credit or debit card numbers.

Visit the California Board of Registered Nursing website to find out more!

GETTING YOUR PROFESSIONAL LICENSE AFTER A CRIMINAL CONVICTION

Thu, 05 Dec 2019 15:10:13 GMT

Case Results

One of the main reasons people seek my services is to assist them in getting their professional license after they have been convicted of a crime. Recently, a client came to me who completed Chiropractic School and wanted to become a Chiropractic Doctor in the State of California. However, some 6 years previously he was convicted of felony insurance fraud involving close to $100,000.

Now there is probably no more worthy conviction to attract the attention of The California Board of Chiropractic Examiners than insurance fraud. That is because one of the main reasons Chiropractors get in trouble is because they get involved, sometimes unwittingly, in sophisticated insurance fraud schemes usually revolving around staged accidents or fraudulent injuries.

Consequently, I knew we had our work cut out for us. In a case like this the task of getting his license would have been virtually impossible for an inexperienced layperson. Fortunately, he knew he needed help and wisely hired our firm.

I take great pride in helping translate my client’s story to a compelling personal narrative that we submit to the Board. In addition, we take a comprehensive approach, by forthrightly dealing with the offense and going over the top in presenting evidence of rehabilitation. In this case, we went all out and created a very persuasive package attesting to my client’s good character despite his conviction.

I expected that despite this effort the Board would still refuse our application and force us into a hearing. I should have had more faith because to my surprise the Board was so impressed by our mitigation package that they granted him his license right off the bat.

Had my client been denied he would have lost years of potential income as a Chiropractor. Especially when you take into account how competitive my fees are, he could not have made a better investment than hiring Spiga and Associates .

HISTORIC VICTORY IN UNITED STATES V. LANDA ET. AL.

Wed, 08 May 2019 14:57:33 GMT

Yesterday, May 7th 2019, for the first time in history, the United States lost a major Mexican Mafia conspiracy trial. I was part of that historic victory and I could not be more proud. In United States v. Landa, the government alleged my client, Jose Rodriguez Landa, an alleged Mexican Mafia leader, was the lead conspirator in a plan to unite the Mexican Mafia with the La Familia Drug Cartel. After 7 weeks of testimony and the playing of some 40 hours of video and audio evidence, the jury returned a string of not guilty verdicts starting with my client Jose Rodriguez Landa.

Mr. Landa has been the number one target of Southern California law enforcement for some 8 years. I have been representing Mr. Landa for 6 years and during that time I have been able to defeat both his state and federal cases. However this federal case victory is unprecedented.

The difficulties in representing alleged organized crime Kingpins is immense. The government always exaggerates the defendant’s dangerousness, highlights his tattoos and prison record, calls experts to tell the jury how bad he is, calls informants to tell the jury how guilty he is and by the end of the case, 99/100 times the government is rewarded with a guilty verdict. NOT THIS TIME!

The government’s game plan was anticipated and stymied through great jury selection, concise opening statements, excellent cross examination and persuasive closing arguments. I would like to thank my co-counsel Nicholas Rosenberg, my co-defense counsels Amy Jacks, Mark Windsor, Carlos Iriarte, Humberto Diaz, Kristen Richards and Linden Millard. Special thanks goes out to paralegals Christina Gits and Clark Arnwine. Every person contributed mightily to the miraculous defense win. I could not be more proud than to be associated with this great group of legal professionals.

Carlo A. Spiga

Lead Attorney Jose Rodriguez-Landa

People v. Christopher Bathum

Wed, 01 May 2019 14:43:42 GMT

Defense Alleges Misconduct in Sexual Assault Trial of 'Rehab Mogul'

The Christopher Bathum case has been continued to June 21, 2019, at which time the court will hear Attorney Carlo Spiga's Motion to Dismiss for Outrageous Government Conduct.

Click here to read more...

https://www.nbclosangeles.com/news/local/Defense-Alleges-Misconduct-in-Sexual-Assault-Trial-of-Rehab-Mogul-490611791.html

CARLO SPIGA DEFENDS ALLEGED MEXICAN MAFIA DRUG LORD

Fri, 12 Apr 2019 14:25:44 GMT

CARLO SPIGA LEADS THE DEFENSE OF ALLEGED MEXICAN MAFIA LEADER JOSE RODRIGUEZ, LANDA , AKA "FOX" AT THE UNITED STATES FEDERAL COURTHOUSE IN LOS ANGELES.

CLICK THE LINK TO LEARN MORE... https://www.courthousenews.com/informant-called-kingpin-in-federal-drug-cartel-trial/

Fraud Case - Client Result

Tue, 19 Feb 2019 14:07:02 GMT

Case No. 17 CR 00791

Defendant was accused of defrauding the post office of hundreds of thousands of dollars through sophisticated credit card scams. The case was filed by the United States Attorneys Office in the Federal District Court, a place where everyone goes to prison. Not our client, he did not do one day of jail time and only had to pay some $12,000.00 in restitution.

I must emphasize that every case is different and past results don’t guarantee anything. However, it does show what is possible with a little persistence.

If you need a criminal defense or administrative defense lawyer, call Spiga and Associates at 818.501.8600 .

Registered Nurse Failure to Complete Alcohol Program

Sat, 16 Feb 2019 14:02:21 GMT

OAH 2018-070014

The California Board of Registered Nursing sought to revoke our clients license as a registered nurse because she failed to complete an out of state alcohol program. The Board refused to enter any stipulated settlement and forced the case to a hearing. This was an unwise decision by the Board as they lost the hearing and our client remains a California Registered Nurse.

If you need a lawyer to fight the California Board of Registered Nursing, call Spiga and Associates at 818.501.8600 .

THE IMPENDING REVOCATION OF DR. CARMEN PULIAFITO’S LICENSE

Thu, 17 Jan 2019 13:53:30 GMT

THE IMPENDING REVOCATION OF DR. CARMEN PULIAFITO’S LICENSE.

PRACTICAL LESSONS FOR THE MEDICAL PRACTITIONER FACING CHARGES.

Few things are more riveting then the spectacular flame out. The end stage of the train-wrecked career arc is the subject of stage, screen and unfortunately, litigation. Such is the case with the sad story of Dr. Carmen Puliafito

Dr. Puliafito, former dean of USC’s Keck School of Medicine, was not immune to the vices of this world and at some point while leading USC’s prestigious medical school, he began using methamphetamine. His use became severe as it always does with that drug and his life quickly spun out of control. The carnage consists of a host of moral, administrative and criminal violations, including cavorting with prostitutes, drug fueled bacchanalias involving USC students, allegations of treating patients while under the influence and allegations of providing methamphetamine to others etc. . . . His defense is that he should be allowed to continue practicing as he is in recovery while still disputing some of the significant allegations against him. In short, his case is difficult; his prognosis, grim.

Some might think Dr. Puliafito’s case is too atypical to serve as a cautionary tale to the average practitioner. Some would be wrong. Dr Puliafito’s case demonstrates on a grand scale, a lawyer’s concern in every professional licensing case. For example:

LESSON 1: AVOID PUBLICITY

Little fish get thrown back. Big fish get fried. Dr. Puliafito is a big fish. Regardless of Dr. Puliafito’s demonstrated recovery, the bad publicity will most likely dictate the Board’s decision. The Board is a political body sensitive to public opinion. If a doctor wants to survive discipline, the most important thing is to avoid publicity. Avoid press conferences and attorneys who give them. Stay silent and age the case. Do not rush into a hearing. Take your time. Gather your evidence. Be yesterday’s news, not today’s lunch. Public opinion affects results. Let things blow over. The unfortunate Dr. Puliafito had no such leeway. His prominence made publicity unavoidable. In September of 2017, the Board sought and received an interim suspension order against Dr. Puliafito, the Dr. had little choice but to go to hearing on an accelerated schedule.

LESSON 2: OWN IT. . . .IF YOU CAN.

The Board does not need to be convinced of your guilt beyond a reasonable doubt. Preponderance of the evidence is the standard of proof. That means the slightest tipping of the evidentiary scales against you is enough to result in an accusation followed by a revocation. So if the evidence preponderates against you, do not deny it. Do not run from it. Own it and explain how you got there. Disputing facts in which the evidence preponderates against you will be seen by the Board as denial and failing to take responsibility. This is a deadly sin and usually results in revocation. That does not mean you should be afraid to dispute facts, but if you are righteous you must be right, because the consequences for being wrong could be revocation.

Dr. Puliafito is disputing the most salacious allegations. He has little choice. Several of the allegations, if admitted, would be fatal. For example, there is one allegation he provided methamphetamine to a minor. This is not something the Dr. Puliafito can own. This fact is so damaging that its admission would probably result in revocation by itself. Dr. Puliafito must dispute them or give his license to the Board. The lesson? Dispute falsity and admit error. Take ownership if you can.

LESSON 3: REHABILITATION AND MITGATION

No matter what offense you have committed the Board wants to see that you took the commission of your error seriously and have done your utmost to correct it. First, the Board will consider evidence of your rehabilitation. If you are suffering from a drug addiction then you better show that you have gone through a program and have done regular testing, preferably hair follicle testing. You need to show the Board that your rehabilitation is ongoing, and you are regularly attending group and or individual counseling. If you are in trouble for a management or a practice issue the board will want to see that you have taken continuing education courses in professional practices such as office management, medical recordkeeping, prescription writing etc…

The Board will want to see evidence of mitigation; evidence that you have lessened the impact of your error. There is restitution-based mitigation. If you over-billed, then they want to see that you have paid the amount back. If you have damaged a patient, they want to see the patient made whole. Other things may not lend itself to direct mitigation through restitution. Other forms of mitigation are encouraged. For instance, If you diverted drugs, they might want to see that you addressed the broader impact of your error such as sitting on a panel and counseling other doctors on the issue, or helping to sponsor others through recovery. Donating your medical skill to the needy is always an excellent way to mitigate an offense and can be a spiritual lesson in and of itself.

While Doctor Puliafito demonstrated to the Administrative Law Judge that he is in recovery, it is unclear what he has done or shown in mitigation of his offense. Given the claims against him and the little time he has had to remediate, Dr. Puliafito faces an uphill climb.

The Medical Board of California has broad discretion in granting and revoking licenses to practice medicine. They have criteria they must follow and due process they must satisfy, but if so followed and satisfied, the Administrative Law judge will uphold their decision. There are fatal career errors, that no lawyer can save you from. Dr. Puliafito’s case probably demonstrates that as well as anyone’s. But most career errors are survivable if you do not make fatal errors in judgment. Whenever confronted by a law enforcement or Board inquiry, call a qualified attorney in Criminal, Medical and Nursing license defense. We at Spiga and Associates are here to serve and counsel you.

NURSES ON THE FIRING LINE

Fri, 07 Dec 2018 13:43:15 GMT

The Hospital Administration as the Enemy.

If you ever wondered whether a nurse facing discipline really needs a nursing license defense lawyer, look no further than the case of Alameda County’s Washington Hospital vs. Nurses, Christine Silcocks and Diane Strey. Silcocks and Strey were the Washington Hospital labor and delivery nurses, who through no fault of their own, delivered a stillborn baby to a teenage mother. Despite their innocence, they were nevertheless disciplined and drug through the coals by their hospital administrators. Washington Hospital is not unique. If you ever doubted it, this case shows that the Administration that hires you, is not your friend and they will throw a nurse under the bus in a second in order to save themselves.

In this case, the Washington Hospital administration immediately accused them of misconduct even before the autopsy on the infant was completed. When the autopsy results came back revealing the child died from infected amniotic fluid, the hospital administration still refused to relent. In a bid to satisfy state regulators, after the death and before the autopsy results were returned, the Hospital went on a firing spree and fired the two primary care nurses responsible for the mother’s care and then fired three nurses who in an effort to determine what went wrong, looked at the stillborn infant’s fetal monitoring charts.

The hospital administration wasn’t done. Despite Strey and Silcocks having no culpability, the administration had something special in store for them. Both Nurses were called into a meeting and were falsely informed that the Doctors in their department informed administration that the nurses were: “unsafe, lacked critical thinking skills, and couldn’t adequately chart fetal heart rates. “These false allegations were used as the basis to force the longtime nurses into remedial nursing courses for 6 and ½ weeks. Additionally, the Administration forced them to wear full whites and report to a windowless annex in order to make a spectacle of them. After being threatened by the administration with retaliation, Strey never returned to Washington Hospital. Silcocks returned, but was retaliated against and eventually resigned rather than be forced out with a false or exaggerated misconduct allegation.

Years of litigation followed in which, despite many obstacles, both nurses avoided discipline with the California Board of Registered Nursing , won money from the hospital and got the hospital reprimanded by the state for their labor practices. Nevertheless, the litigation has taken an incredible personal toll on the nurses. Strey was never able to find work again and Silcocks lost her home to foreclosure. Fortunately, because of lawyering and only because of lawyering they have a payday coming.

If you are a nurse facing discipline do not hesitate to call Spiga and Associates for the help you need. See: https://www.eastbayexpress.com/oakland/two-nurses-fight-back-after-losing-their-jobs-in-a-tragic-incident/Content?oid=14320046

- Carlo A. Spiga, esq

EFFECT OF ARREST ON CALIFORNIA REGISTERED NURSING LICENSE

Tue, 06 Nov 2018 13:29:18 GMT

Registered Nurses in the state of California must report any discipline or criminal conviction within 30 days to the California Board of Registered Nursing. This includes no contest pleas and traffic tickets with fines over $1,000.00. A nurse does not have to report arrests.

The report of discipline/conviction is very important, as it can act as a preemptive showing the nurse has been rehabilitated before, and without, Board intervention. The technical requirements of the report consists of four sub-parts, including an explanation of the “circumstances and events” leading to the discipline/conviction, arrest documents, court documents and “any related mitigating evidence or evidence of rehabilitation” that should be considered.

Even though arrests need not be reported, registered nurses should hire a nursing license defense lawyer with experience dealing with the California Board of Registered Nursing as soon as possible after arrest. A nursing license defense attorney will know the types of evidence likely to be required to prove rehabilitation from the offense. The earlier damage control can be done, the better. This is especially true if a nurse is actually innocent of the charges, for the earlier counsel is sought, the earlier certain defense measures can (and must) be taken. (In our office, we have specific protocols very helpful in proving innocence and in fighting false allegations, but some only work if we get hired within a week, maybe two, of arrest/ discipline .) However, the Board cannot officially take action to suspend or revoke a nursing license until time for appeal has passed, the conviction is affirmed on appeal or probation is ordered.

Basically, this means the process takes a very long time before a nurse can feel any sort of resolution from the Board after catching a case - from the time of arrest to the time of conviction to the time for appeal has passed. Many nurses find this waiting game to be the most brutal part of their ordeal, and that includes jail time! Hiring a nursing license defense attorney early in the process alleviates much of the stress and worry nurses feel when having to deal with a criminal case and scrutiny from the California Board of Registered Nursing. At the time of being hired, the best nursing license defense attorneys will have their client sign a Letter of Representation contemporaneous to the retainer agreement. And, the best nursing license defense lawyers will also draft their retainers to cover a certain number of years, commonly 1, 3 and 5, depending on the situation, at no extra cost. Then, when the California Board of Registered Nursing contacts a nurse about the arrest/discipline, all he must do is contact his attorney.

At this point, the nursing license defense attorney will submit the signed Letter of Representation to the Board requesting all further communication to be directed to the attorney’s office. Once the Board receives a Letter of Representation, it is illegal for them to even try to contact the nurse. Thus, having an experienced, aggressive nursing license defense lawyer prevents harassment from the Board and guards against self-incrimination that could be used to suspend or revoke a license at later hearing. If the California Board of Registered Nursing is denying your application for a nursing license or asking you to defend your license for any reason, do not go it alone. Do not take any Board action lightly. And, never voluntarily surrender your license without legal representation.

Protect yourself and contact aggressive, experienced and discreet Los Angeles nursing license defense attorney, Carlo A. Spiga , for a consultation. 818-501-8600

https://www.rn.ca.gov/enforcement/enfappdesk.shtml

https://www.rn.ca.gov/enforcement/convictions.shtml#disc1