Brookhurst Animal Medical Center, Inc.
In California, veterinary hospitals are subject to routine inspections from which inspectors are required to write detailed reports. The inspection reports produced from these routine inspections become public records. The inspection of Carlos R. Lopez’s Orange County practice, Brookhurst Animal Medical a.k.a. BAMC, unveiled a slew of major failures in safety, hygiene, and record-keeping protocols, thus prompting another inspection in January 2020 which yielded even more startling results.
A summary in March 2020 concluded:
“Petitioner proved by clear and convincing evidence that numerous, serious, and pervasive health and safety violations existed at respondent’s veterinary practice and respondent dispensed and transferred insulin from his practice for his brother’s use. Because of the extent of the violations, and as respondent appears to be operating his practice outside the scope of his licensure, it is necessary that his licenses be immediately suspended until a practice monitor is in place to supervise his practice and report to the board. Once this practice monitor is in place respondent will be required to maintain a log of all controlled substances and dangerous drugs dispensed, including insulin, and he will be prohibited from transferring any drugs to third persons for human use.”
In December 2019, Board inspector Tiffany Palozzi, DVM inspected Respondent Medical Center and Respondent Lopez’s veterinary practice. The premises was cluttered and dirty with equipment, supplies, debris, and other items covering every counter, shelf, floor, and other surface. The backyard resembled a garbage landfill. Inspector Palozzi identified 22 areas of the premises that needed improvement and numerous violations related to Respondent Lopez’s practice. Inspector Palozzi provided Respondent Lopez a copy of her Inspection Report setting forth the areas of noncompliance and outlining the required corrections.
- In January 2020, Respondent Lopez submitted documentation and photographs describing his efforts to make the required corrections. While it appeared from this information that some of the violations had been corrected, it was clear that many deficiencies remained. Accordingly, Inspector Palozzi performed a follow-up inspection a few weeks later. The follow-up inspection revealed that many of the “corrections” Respondent Lopez claimed were either not complete or had not been made at all. Moreover, Inspector Palozzi found additional violations during the follow-up inspection.
Diversion and Improper Handling of Controlled Substances.
During the follow-up inspection, Inspector Palozzi discovered tramadol, diazepam, and hydrocodone stored unsecured on a shelf in Respondent Lopez’s office. The hydrocodone appeared to have been prescribed to Respondent Lopez, but the tramadol and the diazepam were in the original manufacturers’ container without any prescription. Both were expired. Respondent Lopez told Inspector Palozzi both were his “personal medications” he takes for kidney stones.
- In addition to the hydrocodone, tramadol, and diazepam, Inspector Palozzi discovered other controlled substances during her inspections of the premises including an open bottle of phenobarbital. 2 Respondent Lopez gave conflicting explanations as to whether he uses phenobarbital in his practice. Inspector Palozzi also found an expired, misbranded prescription for buprenorphine stored unsecured on the premises.3 Respondent Lopez claimed the medication was for a current patient but the label showed it had been prescribed in May 2018.
- While Inspector Palozzi was collecting expired medications during her follow-up inspection, Respondent Lopez picked up expired glargine insulin, put it in his pocket and claimed he was going to give it to his brother in Guatemala so that he could use it to treat his diabetic condition.
Extreme Departure from Minimum Sanitary Conditions.
- Both inspections revealed the condition of the premises was a health risk and fire hazard endangering all humans and animals on the premises. The entire premises was cluttered and dirty…
- The back fenced yard where animals exercise and relieve themselves resembled a garbage landfill.
- The inside of the premises was in similar condition.
Failure to Properly Dispose of Medical Waste.
- During both visits, the Inspector found an inordinate amount of expired medication and other medical waste throughout the premises, including many dozens of boxes of expired suture and piles of trash bags containing expired medical supplies and other medical waste stacked several feet high. Respondent Lopez gave conflicting explanations regarding his disposal of expired drugs. ..
Surgery Room Deficiencies.
- During her initial visit, the Inspector found numerous deficiencies in the surgery room.
The entire surgery room was cluttered with equipment and medical supplies making it very difficult to move around in the room and restricting access to cupboards, supplies, and equipment. Endoscopy equipment was stored in the surgery room where septic endoscopy procedures were performed. The counters, shelves, and floor were inaccessible and unable to be cleaned or sanitized. In addition, the door, cabinets, shelves, and drawers were constructed of porous, unsealed wood preventing proper sterilization.
- Throughout both inspections, a strong smell of ammonia from urine permeated the premises. The Inspector’s report directed Respondent Lopez to perform a deep cleaning of the premises…
Record Keeping Violations.
During the first inspection, Respondents’ patient medical records were in complete disarray…
START: OCTOBER 2, 2020
END: OCTOBER 1, 2023
ACTION: REVOKED, STAYED, PROBATION
START: MARCH 25, 2020
ACTION: INTERIM SUSPENSION ORDER – LIMITED/RESTRICTED LICENSE