Ramona Animal Clinic

BEFORE THE VETERINARY MEDICAL BOARD DEPARTMENT OF CONSUMER AFFAIRS STATE OF CALIFORNIA In the Matter of the Modified Citation Against: Don Dumitru Popa, DVM, Veterinarian License No. VET 12935, and Ramona Animal Clinic, Premises Registration No. HSP 5347, Respondents Modified Citation No. 4602019000767 MODIFIED CITATION Complainant alleges: PARTIES 1. Jessica Sieferman (“Complainant”) brings this Citation solely in her official capacity as the Executive Officer of the Veterinary Medical Board (“Board”), Department of Consumer Affairs, State of California. 2. The Board’s records reveal that Don Dumitru Popa, DVM (“Respondent”) has been issued Veterinarian License Number 12935. 3. The Board’s records reveal that Ramona Animal Clinic (Veterinary Premises) has been issued Veterinary Premises Registration Number HSP 5347. STATUTORY PROVISIONS 2 4. Business and Professions Code (BPC) sections 125.9 and 4875.2 authorize the Executive Officer of the Board to issue citations containing orders of abatement and/or administrative fines against a licensee of the Board, or to an unlicensed person, who has committed any acts or omissions in violation of the Veterinary Medicine Practice Act (Act). 5. BPC section 4829.5 states: (a) Each time a veterinarian initially prescribes, dispenses, or furnishes a dangerous drug, as defined in Section 4022, to an animal patient in an outpatient setting, the veterinarian shall offer to provide, in person or through electronic means, to the client responsible for the animal, or his or her agent, a consultation that includes the following information: (1) The name and description of the dangerous drug. (2) Route of administration, dosage form, dosage, duration of drug therapy, the duration of the effects of the drug, and the common severe adverse effects associated with the use of a short-acting or long-acting drug. (3) Any special directions for proper use and storage. (4) Actions to be taken in the event of a missed dose. (5) If available, precautions and relevant warnings provided by the drug’s manufacturer, including common severe adverse effects of the drug. (b) If requested, a veterinarian shall provide drug documentation, if available. (c) A veterinarian may delegate to a registered veterinary technician or veterinary assistant the task of providing the consultation and drug documentation required by this section. (d) It shall be noted in the medical record of the animal patient if the consultation described in this section is provided or declined by the client or his or her agent. 6. BPC section 4883 states, in pertinent part: The board may deny, revoke, or suspend a license or registration or assess a fine as provided in Section 4875 for any of the following: [ . . . ] (c) Violation or attempting to violate, directly or indirectly, any of the provisions of this chapter. [ . . . ] 3 (g) Unprofessional conduct, that includes, but is not limited to, the following: [ . . . ] (3) A violation of any federal statute, rule, or regulation or any of the statutes, rules, or regulations of this state regulating dangerous drugs or controlled substances. [ . . . ] (i) Fraud, deception, negligence, or incompetence in the practice of veterinary medicine. [ . . . ] (o) Violation, or the assisting or abetting violation, of any regulations adopted by the board. [ . . . ] REGULATORY PROVISIONS 7. California Code of Regulations (CCR), title 16, section 2030 states, in pertinent part: All fixed premises where veterinary medicine and its various branches are being practiced, and all instruments, apparatus and apparel used in connection with those practices, shall be kept clean and sanitary at all times and shall conform to or possess the following minimum standards: [ . . . ] (f) The veterinary premises shall meet the following standards: [ . . . ] (6) All drugs and biologicals shall be maintained, administered, dispensed and prescribed in compliance with state and federal laws. [ . . . ] (g) A veterinary premises which provides aseptic surgical services shall comply with the following: (1) A room, separate and distinct from all other rooms shall be reserved for aseptic surgical procedures which require aseptic preparation. A veterinarian may perform emergency aseptic surgical procedures in another room when the room designated for aseptic surgery is occupied or temporarily unavailable. [ . . . ] 4 (3) Open shelving is prohibited in the surgical room. [ . . . ] 8. CCR, title 16, section 2032.3, states, in pertinent part: (a) Every veterinarian performing any act requiring a license pursuant to the provisions of Chapter 11, Division 2, of the code, upon any animal or group of animals shall prepare a legible, written or computer generated record concerning the animal or animals which shall contain the following information: [ . . . ] (2) Name, address and phone number of the client. [ . . . ] (5) Dates (beginning and ending) of custody of the animal, if applicable. [ . . . ] (7) Data, including that obtained by instrumentation, from the physical examination. [ . . . ] (9) Records for surgical procedures shall include a description of the procedure, the name of the surgeon, the type of sedative/anesthetic agents used, their route of administration, and their strength if available in more than one strength. [ . . . ] 9. CCR, title 16, section 2032.4 states, in pertinent part: [ . . . ] (b) When administering general anesthesia, a veterinarian shall comply with the following standards: [ . . . ] (6) Records for procedures involving general anesthesia shall include a description of the procedure, the name of the surgeon, the type of sedative and/or anesthetic agents used, their route of administration, and their strength if available in more than one strength. 10. Code of Federal Regulation (CFR), title 21, section 1304.11 states in pertinent part: (a) General requirements. Each inventory shall contain a complete and accurate 5 record of all controlled substances on hand on the date the inventory is taken, and shall be maintained in written, typewritten, or printed form at the registered location. An inventory taken by use of an oral recording device must be promptly transcribed. Controlled substances shall be deemed to be “on hand” if they are in the possession of or under the control of the registrant, including substances returned by a customer, ordered by a customer but not yet invoiced, stored in a warehouse on behalf of the registrant, and substances in the possession of employees of the registrant and intended for distribution as complimentary samples. A separate inventory shall be made for each registered location and each independent activity registered, except as provided in paragraph (e)(4) of this section. In the event controlled substances in the possession or under the control of the registrant are stored at a location for which he/she is not registered, the substances shall be included in the inventory of the registered location to which they are subject to control or to which the person possessing the substance is responsible. The inventory may be taken either as of opening of business or as of the close of business on the inventory date and it shall be indicated on the inventory. [ . . . ] (c) Biennial inventory date. After the initial inventory is taken, the registrant shall take a new inventory of all stocks of controlled substances on hand at least every two years. The biennial inventory may be taken on any date which is within two years of the previous biennial inventory date. [ . . . ] FACTUAL ALLEGATIONS 11. On or about October 16, 2018, the Board’s investigators performed an inspection of the Veterinary Premises (October 16, 2018 inspection). Medical records were collected at the time of the inspection (medical records). 12. On or about December 2, 2021, the Board’s investigators performed an inspection of the Veterinary Premises (December 2, 2021 inspection). Medical records were collected at the time of the inspection (medical records). CAUSES FOR MODIFIED CITATION 13. On or about October 17, 2018, Respondent failed to provide adequate postoperative pain control to the surgical patient, A. P. Such conduct constitutes a violation of BPC section 4883, subdivision (c) and BPC section 4883, subdivision (i), negligence. 14. On or about June 12, 2021, Respondent failed to provide adequate postoperative pain control to the surgical patient, B. P. Such conduct constitutes a violation of BPC section 4883, subdivision (c) and BPC section 4883, subdivision (i), negligence. 15. The October 16, 2018 inspection revealed that Respondent failed to keep the aseptic surgical suite separate by having open storage in the surgical suite. This violation was 6 repeated during the December 2, 2021 inspection. Such conduct constitutes a violation of BPC section 4883, subdivisions (o), CCR, title 16, section 2030, subsection (g)(3). 16. The October 16, 2018 inspection revealed that Respondent failed to log controlled substances in a biennial inventory. This violation was repeated during the December 2, 2021 inspection. Such conduct constitutes a violation of BPC section 4883, subdivisions (g)(3) and (o), CFR, title 21, section 1304.11, subsection (a) and (c), and CCR, title 16, section 2030, subsection (f)(6). 17. On or about and between October 19, 2018 and November 11, 2021, Respondent failed to prepare legible, written or computer generated records concerning animal patients, as follows: a. October 19, 2018 Patient R2. Po. b. June 12, 2021 Patient B. P. c. November 4, 2021 Patient F. R. d. November 11, 2021 Patient R2. Pi. e. Date Unknown Patient L. L. f. Date Unknown Patient Si. O. Such conduct constitutes six separate violations of BPC section 4883, subdivision (o) as defined by CCR, title 16, section 2032.3, subsection (a). 18. On or about and between June 12, 2021 and November 11, 2021, Respondent failed to document the address of the client in the medical record, as follows: a. June 12, 2021 Patient B. P. b. November 4, 2021 Patient F. R. c. November 11, 2021 Patient R2. Pi. d. Date Unknown Patient L. L. e. Date Unknown Patient Si. O. f. Date Unknown Patient M. R. g. Date Unknown Patient H. G. h. Date Unknown Patient Sa. G. i. Date Unknown Patient A. S. 7 Such conduct constitutes nine separate violations of BPC section 4883, subdivision (o) as defined by CCR, title 16, section 2032.3, subsection (a)(2). 19. On or about and between June 12, 2021 and November 4, 2021, Respondent failed to document dates (beginning and ending) of custody of animal patients in the medical record, as follows: a. November 4, 2021 Patient F. R. b. Date Unknown Patient L. L. c. Date Unknown Patient Si. O. d. Date Unknown Patient M. R. e. Date Unknown Patient Sa. G. f. Date Unknown Patient A. S. Such conduct constitutes six separate violations of BPC section 4883, subdivision (o) as defined by CCR, title 16, section 2032.3, subsection (a)(5). 20. On or about and between October 19, 2018 and November 11, 2021, Respondent failed to document data, including that obtained by instrumentation, from the physical examination in the medical record, as follows: a. October 19, 2018 Patient R2. Po. b. June 12, 2021 Patient B. P. c. November 11, 2021 Patient R2. Pi. d. Date Unknown Patient L. L. e. Date Unknown Patient Si. O. f. Date Unknown Patient M. R. g. Date Unknown Patient H. G. h. Date Unknown Patient Sa. G. i. Date Unknown Patient A. S. Such conduct constitutes nine separate violations of BPC section 4883, subdivision (o) as defined by CCR, title 16, section 2032.3, subsection (a)(7). 21. On or about November 4, 2021, Respondent violated BPC section 4883, subdivision (o), by failing to document physical exam data and interpretation of 8 diagnostic tests in the medical record for Patient F. R. as required by CCR, title 16, section 2032.3, subsection (a)(7). 22. On or about and between October 19, 2018 and November 11, 2021, Respondent failed to document description of the surgical procedure, type of sedative/anesthetic agents used, their route of administration, and strength if available in more than one strength, as follows: a. October 19, 2018 Patient R2. Po. b. June 12, 2021 Patient B. P. c. November 4, 2021 Patient F. R. d. November 11, 2021 Patient R2. Pi. e. Date Unknown Patient L. L. f. Date Unknown Patient Si. O. g. Date Unknown Patient M. R. h. Date Unknown Patient H. G. i. Date Unknown Patient Sa. G. j. Date Unknown Patient A. S. Such conduct constitutes ten separate violations of BPC section 4883, subdivision (o) as defined by CCR, title 16, section 2032.3, subsection (a)(9) and CCR, title 16, section 2032.4, subsection (b)(6). 23. On or about November 11, 2021, Respondent failed to document whether a consultation was provided, in person or through electronic means, to the client responsible for the patient, when initially prescribing, dispensing, or furnishing a dangerous drug to a patient in an outpatient setting, as follows: a. November 11, 2021 Patient R2. Pi. (Carprofen 25 mg/tab) b. Date Unknown Patient L. L. (Amoxi Drops 50 mg/ml & Meloxidyl 1.5 mg/ml) c. Date Unknown Patient H. G. (Carprofen 25 mg/tab) d. Date Unknown Patient Sa. G. (Carprofen 25 mg/tab) Such conduct constitutes four separate violations of BPC section 4883, subdivision (c) as defined by BPC section 4829.5, subdivision (d). 9 DETERMINATION OF ISSUES CAUSE OF ACTION 24. Violations exist pursuant to BPC section 4883, subdivision (c), based upon a violation of BPC section 4883, subdivision (i) as set forth above in Paragraph 13. A cause of action thereby exists. 25. Violations exist pursuant to BPC section 4883, subdivision (c), based upon a violation of BPC section 4883, subdivision (i) as set forth above in Paragraph 14. A cause of action thereby exists. 26. Violations exist pursuant to BPC section 4883, subdivision (o), based upon a violation of CCR, title 16, section 2030, subsection (g)(3) as set forth above in Paragraph 15. A cause of action thereby exists. 27. Violations exist pursuant to BPC section 4883, subdivision (o), based upon a violation of BPC section 4883 subdivision (g)(3), CFR, title 21, section 1304.11, subsection (a) and (c), and CCR, title 16, section 2030, subsection (f)(6) set forth above in Paragraph 16. A cause of action thereby exists. 28. Violations exist pursuant to BPC section 4883, subdivision (o), based upon a violation of CCR, title 16, section 2032.3 subsection (a) as set forth above in Paragraph 17. A cause of action thereby exists. 29. Violations exist pursuant to BPC section 4883, subdivision (o), based upon a violation of CCR, title 16, section 2032.3 subsection (a)(2) as set forth above in Paragraph 18. A cause of action thereby exists. 30. Violations exist pursuant to BPC section 4883, subdivision (o), based upon a violation of CCR, title 16, section 2032.3 subsection (a)(5) as set forth above in Paragraph 19. A cause of action thereby exists. 31. Violations exist pursuant to BPC section 4883, subdivision (o), based upon a violation of CCR, title 16, section 2032.3 subsection (a)(7) as set forth above in Paragraph 20. A cause of action thereby exists. 32. Violations exist pursuant to BPC section 4883, subdivision (o), based upon a violation of CCR, title 16, section 2032.3 subsection (a)(7) as set forth above in Paragraph 21. A cause of action thereby exists. 33. Violations exist pursuant to BPC section 4883, subdivision (o), based upon a violation of CCR, title 16, section 2032.3, subsection (a)(9) and CCR section 2032.4, subsection (b)(6) as set forth above in Paragraph 22. A cause of action thereby exists. 34. Violations exist pursuant to BPC section 4883, subdivision (c), based upon a violation of BPC section 4829.5 as set forth above in Paragraph 26. A cause of action thereby exists. 10 PENALTY 35. In compliance with BPC sections 125.9 and 4875.2 and CCR, title 16, section 2043, it is determined that: Respondent be cited for a Class “C” violation in the amount of $3,000.00 for the Cause for Citation, based upon a determination that the above-described facts set forth in Paragraph 13 constitute a violation of BPC section 4883, subdivision (c), based upon a violation of BPC section 4883, subdivision (i). Respondent be cited for a Class “C” violation in the amount of $3,000.00 for the Cause for Citation, based upon a determination that the above-described facts set forth in Paragraph 14 constitute a violation of BPC section 4883, subdivision (c), based upon a violation of BPC section 4883, subdivision (i). Respondent be cited for a Class “C” violation in the amount of $2,000.00 for the Cause for Citation, based upon a determination that the above-described facts set forth in Paragraph 15 constitute a violation of BPC section 4883, subdivision (o), based upon a violation of CCR, title 16, section 2030, subsection (g)(3). Respondent be cited for a Class “C” violation in the amount of $2,000.00 for the Cause for Citation, based upon a determination that the above-described facts set forth in Paragraph 16 constitute a violation of BPC section 4883, subdivision (o), based upon a violation of BPC section 4483, subdivision (g)(3), CFR, title 21, section 1304.11, subsection (a) and (c), and CCR, title 16, section 2030, subsection (f)(6). Respondent be cited for a total of 41 Class “A” violations for each of the Causes for Citation, based upon a determination that the above-described facts set forth in Paragraphs 17, 18, 19, 20, 21, and 22 constitute a violation of BPC section 4883, subdivision (o), based upon a violation of CCR, title 16, sections 2032.3 and 2032.4. Respondent be cited for a total of 4 Class “A” violations for each of the Causes for Citation, based upon a determination that the above-described facts set forth in Paragraph 23 constitute a violation of BPC section 4883, subdivision (c), based upon a violation of BPC section 4829.5. 36. In compliance with BPC sections 125.9 and 4875.2, and CCR, title 16, section 2043, subdivision (c), the total penalty for the above violations is $10,000.00. However, pursuant to BPC section 125.9(b)(3) in no event shall the administrative fine assessed by the Board exceed $5,000.00. Therefore, total fine amount due to the Board is $5,000.00. 11 ORDER OF ABATEMENT The Board hereby orders that, within 60 days of the date of this citation, Respondent shall: • Enroll in, and successfully complete, a Board-approved course in veterinary medical record keeping of 8 to 10 hours in length. Said course shall be in addition to the Board’s continuing education (CE) requirements, and Respondent shall submit to the Board, for its prior approval, documented information as to the course’s content, duration, and provider. Upon successful completion of the course, Respondent shall provide the Board with proof of completion. The Board hereby orders Respondent to cease and desist from violating BPC section 4829.5, 4883, subdivisions (c), (g), (i), (o), CCR, title 16, sections 2030, subsections (f), (g), 2032.3 subsection (a), 2032.4, subsection (b), CFR, title 21, section 1304.11, subsections (a), (c). DATE JESSICA SIEFERMAN Executive Officer Veterinary Medical Board Department of Consumer Affairs State of California April 17, 2023 Signature on file