BEFORE THE MEDICAL BOARD OF CALIFORNIA DEPARTMENT OF …4patientsafety.org/documents/Mehra, Neal...

BEFORE THE MEDICAL BOARD OF CALIFORNIA

DEPARTMENT OF CONSUMER AFFAIRS STATE OF CALIFORNIA

In the Matter of the Amended Accusation Against:

NEAL MEHRA, M.D.

Physician's and Surgeon's Certificate No. A 95686

Respondent

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Case No. 800-2014-003821

DECISION

The attached Stipulated Settlement and Disciplinary Order is hereby adopted as the Decision and Order of the Medical Board of California, Department of Consumer Affairs, State of California.

This Decision shall become effective at 5:00p.m. on September 16, 2016.

IT IS SO ORDERED: August 17,2016.

MEDICAL BOARD OF CALIFORNIA

KAMALA D. HARRIS Attorney General of California

2 VLADIMIR SHALKEVICH Acting Supervising Deputy Attorney General

3 MEGAN R. O'CARROLL Deputy Attorney General

4 State Bar No. 2154 79 1300 I Street, Suite 125

5 P.O. Box 944255 Sacramento, CA 94244-2550

6 Telephone: (916) 324-5288 Facsimile: (916) 327-2247

7 Attorneys for Complainant

8 BEFORETHE MEDICAL BOARD OF CALIFORNIA

9 DEPARTMENT OF CONSUMER AFFAIRS STATE OF CALIFORNIA

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In the Matter of the Accusation Against:

NEAL MEHRA, M.D. 5150 Fair Oaks Blvd., Ste. 101/135 Carmichael, CA 95608-5758

Physician's and Surgeon's Certificate No. A 95686

Respondent.

Case No. 800-2014-003821

OAH No. 2015100663

STIPULATED SETTLEMENT AND DISCIPLINARY ORDER

18 IT IS HEREBY STIPULATED AND AGREED by and between the parties to the above-

19 entitled proceedings that the following matters are true:

20 PARTIES

21 1. Kimberly Kirchmeyer (Complainant) is the Executive Director of the Medical Board

22 of California. She brought this action solely in her official capacity and is represented in this

23 matter by Kamala D. Harris, Attorney General of the State of California, by Megan R. O'Carroll,

24 Deputy Attorney General.

25 2. Respondent Neal Mehra, M.D. ("Respondent") is represented in this proceeding by

26 attorney Mitchell Green, whose address is: 50 California Street, 34th Floor, San Francisco, CA

27 94111-4707.

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STIPULATED SETTLEMENT (800-2014-003821)

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3. On or about May 26, 2006, the Medical Board of California issued Physician's and

Surgeon's Certificate No. A 95686 to Neal Mehra, M.D. (Respondent). The Physician's and

Surgeon's Certificate was in full force and effect at all times relevant to the charges brought in

Accusation No. 800-2014-003821, and will expire on September 30,2017, unless renewed.

JURISDICTION

4. Accusation No. 800-2014-003821 was filed before the Medical Board of California

(Board), Department of Consumer Affairs, and is currently pending against Respondent. The

Accusation and all other statutorily required documents were properly served on Respondent on

September 17, 2015. Respondent timely filed his Notice of Defense contesting the Accusation.

5. A copy of Amended Accusation No. 800-2014-003821 is attached as exhibit A and

incorporated herein by reference.

ADVISEMENT AND WAIVERS

6. Respondent has carefully read, fully discussed with counsel, and understands the

charges and allegations in Amended Accusation No. 800-2014-003821. Respondent has also

carefully read, fully discussed with counsel, and understands the effects of this Stipulated

Settlement and Disciplinary Order.

7. Respondent is fully aware of his legal rights in this matter, including the right to a

18 hearing on the charges and allegations in the Amended Accusation; the right to confront and

19 cross-examine the witnesses against him; the right to present evidence and to testify on his own

20 behalf; the right to the issuance of subpoenas to compel the attendance of witnesses and the

21 production of documents; the right to reconsideration and court review of an adverse decision;

22 and all other rights accorded by the California Administrative Procedure Act and other applicable

23 laws.

24 8. Respondent voluntarily, knowingly, and intelligently waives and gives up each and

25 every right set forth above.

26 CULPABILITY

27 9. Respondent admits the truth of each and every charge and allegation in Amended

28 Accusation No. 800-2014-003821.

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10. Respondent agrees that his Physician's and Surgeon's Certificate is subject to

2 discipline and he agrees to be bound by the Board's probationary terms as set forth in the

3 Disciplinary Order below.

4 RESERVATION

5 11. The admissions made by Respondent herein are only for the purposes of this

6 proceeding, or any other proceedings in which the Medical Board of California or other

7 professional licensing agency is involved, and shall not be admissible in any other criminal or

8 civil proceeding.

9 CONTINGENCY

10 l 2. This stipulation shall be subject to approval by the Medical Board of California.

11 Respondent understands and agrees that counsel for Complainant and the staff of the Medical

12 Board of California may communicate directly with the Board regarding this stipulation and

13 settlement, without notice to or participation by Respondent or his counsel. By signing the

14 stipulation, Respondent understands and agrees that he may not withdraw his agreement or seek

15 to rescind the stipulation prior to the time the Board considers and acts upon it. If the Board fails

16 to adopt this stipulation as its Decision and Order, the Stipulated Settlement and Disciplinary

17 Order shall be of no force or effect, except for this paragraph, it shall be inadmissible in any legal

18 action between the parties, and the Board shall not be disqualified from further action by having

19 considered this matter.

20 13. The parties understand and agree that PortableDocument Format (PDF) and facsimile

21 copies of this Stipulated Settlement and Disciplinary Order, including PDF and facsimile

22 signatures thereto, shall have the same force and effect as the originals.

23 14. In consideration of the foregoing admissions and stipulations, the parties agree that

24 the Board may, without further notice or formal proceeding, issue and enter the following

25 Disciplinary Order:

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DISCIPLINARY ORDER

2 lT IS HEREBY ORDERED that Physician's and Surgeon's Certificate No. A 95686 issued

3 to Respondent Neal Mehra, M.D. is revoked. However, the revocation is stayed and Respondent

4 is placed on probation for four ( 4) years on the following terms and conditions.

5 1. CONTROLLED SUBSTANCES -ABSTAIN FROM USE. Respondent shall abstain

6 completely from the personal use or possession of controlled substances as defined in the

7 California Uniform Controlled Substances Act, dangerous drugs as defined by Business and

8 Professions Code section 4022, and any drugs requiring a prescription. This prohibition does not

9 apply to medications lawfully prescribed to Respondent by another practitioner for a bona fide

10 illness or condition.

11 Within 15 calendar days of receiving any lawfully prescribed medications, Respondent

12 shall notify the Board or its designee of the: issuing practitioner's name, address, and telephone

13 number; medication name, strength, and quantity; and issuing pharmacy name, address, and

] 4 telephone number.

15 If Respondent has a confirmed positive biological fluid test for any substance (whether or

16 not legally prescribed) and has not reported the use to the Board or its designee, Respondent

17 shall receive a notification from the Board or its designee to immediately cease the practice of

18 medicine. The Respondent shall not resume the practice of medicine until final decision on an

19 accusation and/or a petition to revoke probation. An accusation and/or petition to revoke

20 probation shall be filed by the Board within 15 days of the notification to cease practice. Ifthe

2 J Respondent requests a hearing on the accusation and/or petition to revoke probation, the Board

22 shall provide the Respondent with a hearing within 30 days of the request, unless the Respondent

23 stipulates to a later hearing. A decision shall be received from the Administrative Law Judge or

24 the Board within 15 days unless good cause can be shown for the delay. The cessation of practice

25 shall not apply to the reduction of the probationary time period.

26 If the Board does not file an accusation or petition to revoke probation within 15 days of the

27 issuance of the notification to cease practice or does not provide Respondent with a hearing

28 within 30 days of a such a request, the notification of cease practice shall be dissolved.

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2. ALCOHOL - ABSTAIN FROM USE. Respondent shall abstain completely from the

2 use of products or beverages containing alcohol.

3 If Respondent has a confirmed positive biological fluid test for alcohol, Respondent shall

4 receive a notification from the Board or its designee to immediately cease the practice of

5 medicine. The Respondent shall not resume the practice of medicine tmtil final decision on an

6 accusation and/or a petition to revoke probation. An accusation and/or petition to revoke

7 probation shall be filed by the Board within 15 days of the notification to cease practice. If the

8 Respondent requests a .hearing on the accusation and/or petition to revoke probation, the Board

9 shall provide the Respondent with a hearing within 30 days of the request, unless the Respondent

10 stipulates to a later hearing. A decision shall be received from the Administrative Law Judge or

11 the Board within 15 days unless good cause can be shown for the delay. The cessation of practice

12 shall not apply to the reduction of the probationary time period.

13 If the Board does not file an accusation or petition to revoke probation within 15 days of the

14 issuance of the notification to cease practice or does not provide Respondent with a hearing

15 within 30 days of a such a request, the notification of cease practice shall be dissolved.

16 3. PROFESSIONALISM PROGRAM (ETHICS COURSE). Within 60 calendar days of

17 the effective date of this Decision, Respondent shall enroll in a professionalism program, that

18 meets the requirements of Title 16, California Code of Regulations (CCR) section 1358.

19 Respondent shall participate in and successfully complete that program. Respondent shall

20 provide any information and documents that the program may deem pertinent. Respondent shall

21 successfully complete the classroom component of the program not later than six ( 6) months after

22 Respondent's initial enrollment, and the longitudinal component of the program not later than the

23 time specified by the pro gram, but no later than one (1) year after attending the classroom

24 component. The professionalism program shall be at Respondent's expense and shall be in

25 addition to the Continuing Medical Education (CME) requirements for renewal of licensure.

26 A pwfessionalism program taken after the acts that gave rise to the charges in the

27 Accusation, but prior to the effective date of the Decision may, in the sole discretion of the Board

28 or its designee, be accepted towards the fulfillment of this condition if the program would have

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STIPULATED SETILEMENT (800-2014-003821)

1 been approved by the Board or its designee had the program been taken after the effective date of

2 this Decision.

3 Respondent shall submit a certification of successful completion to the Board or its

4 designee not later than 15 calendar days after successfully completing the program or not later

5 than 15 calendar days after the effective date of the Decision, whichever is later.

6 4. PSYCHOTHERAPY. Within 60 calendar days of the effective date of this Decision,

7 Respondent shall submit to the Board or its designee for prior approval the name and

8 qualifications of a California-licensed board certified psychiatrist or a licensed psychologist who

9 has a doctoral degree in psychology and at least five years of postgraduate experience in the

10 diagnosis and treatment of emotional and mental disorders. Upon approval, Respondent shall

11 undergo and continue psychotherapy treatment, including any modifications to the frequency of

12 psychotherapy, until the Board or its designee deems that no further psychotherapy is necessary.

13 The psychotherapist shall consider any information provided by the Board or its designee

14 and any other information the psychotherapist deems relevant and shall furnish a written

15 evaluation report to the Board or its designee. Respondent shall cooperate in providing the

16 psychotherapist any information and documents that the psychotherapist may deem pertinent.

17 Respondent shall have the treating psychotherapist submit quarterly status reports to the

18 Board or its designee. The Board or its designee may require Respondent to undergo psychiatric

19 evaluations by a Board-appointed board certified psychiatrist. If, prior to the completion of

20 probation, Respondent is found to be mentally unfit to resume the practice of medicine without

21 restrictions, the Board shall retain continuing jurisdiction over Respondent's license and the

22 period of probation shall be extended until the Board determines that Respondent is mentally fit

23 to resume the practice of medicine without restrictions.

24 Respondent shall pay the cost of all psychotherapy and psychiatric evaluations.

25 5. NOTICE OF EMPLOYER OR SUPERVISOR INFORMATION

26 Within seven (7) days of the effective date of this Decision, respondent shall provide to the

27 Board the names, physical addresses, mailing addresses, and telephone numbers of any and all

28 employers and supervisors. Respondent shall also provide specific, written consent for the Board,

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respondent's worksite monitor, and respondent's employers and supervisors to communicate

regarding respondent's work status, performance, and monitoring.

For purposes of this section, "supervisors" shall include the Chief of Staff and Health or

Well Being Committee Chair, or equivalent, if applicable, when the respondent has medical staff

privileges.

6. BIOLOGICAL FLUID TESTING

Respondent shall immediately submit to biological fluid testing, at respondent's expense,

upon request of the Board or its designee. "Biological fluid testing" may include, but is not

limited to, urine, blood, breathalyzer, hair follicle testing, or similar drug screening approved by

the Board or its designee. Respondent shall make daily contact with the Board or its designee to

determine whether biological fluid testing is required. Respondent shall be tested on the date of

the notification as directed by the Board or its designee. The Board may order a respondent to

undergo a biological fluid test on any day, at any time, including weekends and holidays. Except

when testing on a specific date as ordered by the Board or its designee, the scheduling of

biological fluid testing shall be done on a random basis. The cost of biological fluid testing shall

be borne by the respondent.

A cetiified copy of any laboratory test result may be received in evidence in any

proceedings between the Board and Respondent.

During the first year of probation, respondent shall be subject to 52 to 104 random tests.

During the second year of probation and for the duration of the probationary term, up to five (5)

years, respondent shall be subject to 36 to 104 random tests per year. Only ifthere has been no

positive biological fluid tests in the previous five (5) consecutive years of probation, may testing

be reduced to one (1) time per month. Nothing precludes the Board from increasing the number

of random tests to the first-year level of frequency for any reason.

Prior to practicing medicine, respondent shall contract with a laboratory or service,

approved in advance by the Board or its designee, that will conduct random, unatmounced,

observed, biological fluid testing and meets all the following standards:

(a) Its specimen collectors are either certified by the Drug and Alcohol Testing

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STIPULATED SETTLEMENT (800-20 14-003 821)

1 Industry Association or have completed the training required to serve as a collector for the

2 United States Department of Transportation.

3 (b) Its specimen collectors conform to the current United States Department of

4 Transportation Specimen Collection Guidelines.

5 (c) Its testing locations comply with the Urine Specimen Collection Guidelines

6 published by the United States Department of Transportation without regard to the type of

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(d)

(e)

Its specimen collectors observe the collection of testing specimens.

Its laboratories are certified and accredited by the United States Department of

10 Health and Human Services.

11 (f) Its testing locations shall submit a specimen to a laboratory within one (1) business

12 day of receipt and all specimens collected shall be handled pursuant to chain of custody

13 procedures. The laboratory shall process and analyze the specimens and provide legally

14 defensible test results to the Board within seven (7) business days of receipt of the specimen. The

15 Board will be notified of non-negative results within one (1) business day and will be notified of

16 negative test results within seven (7) business days.

17 (g) Its testing locations possess all the materials, equipment, and technical expertise

18 necessary in order to test respondent on any day of the week.

19 (h) Its testing locations are able to scientifically test for urine, blood, and hair

20 specimens for the detection of alcohol and illegal and controlled substances.

21 (i) It maintains testing sites located throughout California.

22 G) It maintains an automated 24-hour toll-free telephone system and/or a secure on-

23 line computer data\Jase that allows the respondent to check in daily for testing.

24 (k) It maintains a secure, HIPAA-compliant website or computer system that allows

25 staff access to drug test results and compliance reporting information that is available 24 hours a

26 day.

27 (1) It employs or contracts with toxicologists that are licensed physicians and have

28 knowledge of substance abuse disorders and the appropriate medical training to interpret and

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evaluate laboratory biological fluid test results, medical histories, and any other information

2 relevant to biomedical infom1ation.

3 (m) It will not consider a toxicology screen to be negative if a positive result is

4 obtained while practicing, even if the respondent holds a valid prescription for the substance.

5 Prior to changing 'testing locations for any reason, including during vacation or other travel,

6 alternative testing locations must be approved by the Board and meet the requirements above.

7 The contract shall require that the laboratory directly notify the Board or its designee of

8 non- negative results within one (1) business day and negative test results within seven (7)

9 business days of the results becoming available. Respondent shall maintain this laboratory or

10 service contract during the period of probation.

11 A certified copy of any laboratory test result may be received in evidence in any

12 proceedings between the Board and respondent.

13 lf a biological fluid test result indicates respondent has used, consumed, ingested, or

14 administered to himself or herself a prohibited substance, the Board shall order respondent to

15 cease practice and instruct respondent to leave any place of work where respondent is practicing

16 medicine or providing medical services. The Board shall immediately notify all of respondent's

17 employers, supervisors and work monitors, if any, that respondent may not practice medicine or

18 provide medical services while the cease-practice order is in effect.

19 A biological fluid test will not be considered negative if a positive result is obtained while

20 practicing, even if the practitioner holds a valid prescription for the substance. If no prohibited

21 substance use exists, the Board shall lift the cease-practice order within one ( 1) business day.

22 After the issuance of a cease-practice order, the Board shall determine whether the positive

23 biological fluid test is in fact evidence of prohibited substance use by consulting with the

24 specimen collector and the laboratory, communicating with the licensee, his or her treating

25 physician(s), other health care provider, or group facilitator, as applicable.

26 For purposes of this condition, the terms "biological fluid testing" and "testing" mean the

27 acquisition and chemical analysis of a respondent's urine, blood, breath, or hair.

28 For purposes of this condition, the term "prohibited substance'' means an illegal drug, a

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STIPULATED SETILEMENT (800-2014-003821)

lawful drug not prescribed or ordered by an appropriately licensed health care provider for use by

2 respondent and approved by the Board, alcohol, or any other substance the respondent has been

3 instructed by the Board not to use, consume, ingest, or administer to himself or herself.

4 If the Board confirms that a positive biological fluid test is evidence of use of a prohibited

5 substance, respondent has committed a major violation, as defined in section 1361.52(a), and the

6 Board shall impose any or all of the consequences set forth in section 1361.52(b ), in addition to

7 any other terms or conditions the Board determines are necessary for public protection or to

8 enhance respondent's rehabilitation.

9 In consideration of Respondent's fulfillment of criteria set forth by Code of Regulations,

10 title 16, section 1361.5(3)(1)(2) (Violation(s) Outside of Employment) and 1361.5(3)(1)(1)

11 (Previous Testing Orders/Sobriety), Respondent is permitted to bypass the first-year testing

12 frequency requirements set forth above. Accordingly, the second-year testing frequency

13 requirements will apply upon Respondent's commencement ofprobation.

14 7. SUBSTANCE ABUSE SUPPORT GROUP MEETINGS

15 Within thitiy (30) days ofthe effective date ofthis Decision, respondent shall submit to the

16 Board or its designee, for its prior approval, the name of a substance abuse support group which

17 he or she shall attend for the duration of probation. Respondent shall attend substance abuse

18 support group meetings at least once per week, or as ordered by the Board or its designee.

19 Respondent shall pay all substance abuse support group meeting costs.

20 The facilitator of the substance abuse support group meeting shall have a minimum of

21 three (3) years' experience in the treatment and rehabilitation of substance abuse, and shall be

22 licensed orcertified by the state or nationally certified organizations. The facilitator shall not

23 have a currentor former financial, personal, or business relationship with respondent within the

24 last five (5) years. Respondent's previous participation in a substance abuse group support

25 meeting led by the same facilitator does not constitute a prohibited current or former financial,

26 personal, or business relationship.

27 The facilitator shall provide a signed document to the Board or its designee showing

28 respondent's name, the group name, the date and location of the meeting, respondent's attendance,

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STIPULATED SETTLEMENT (800-20 14-003 821)

and respondent's level of participation and progress. The facilitator shall report any unexcused

2 absence by respondent fro':1 any substance abuse support group meeting to the Board, or its

3 designee, within twenty-four (24) hours of the unexcused absence.

4 8. WOIU<SITE MONITOR FOR SUBSTANCE-ABUSING LICENSEE

5 Within thirty (30) calendar days of the effective date ofthis Decision, respondent shall

6 submit to the Board or its designee for prior approval as a worksite monitor, the name and

7 qualifications of one or more licensed physician and surgeon, other licensed health care

8 professional if no physician and surgeon is available, or, as approved by the Board or its designee,

9 a person in a position of authority who is capable of monitoring the respondent at work.

10 The worksite monitor shall not have a current or former financial, personal, or familial

11 relationship with respondent, or any other relationship that could reasonably be expected to

12 compromise the ability ofthe monitor to render impartial and unbiased reports to the Board or its

13 designee. If it is impractical for anyone but respondent's employer to serve as the worksite

14 monitor, this requirement may be waived by the Board or its designee, however, under no

15 circumstances shall respondent's worksite monitor be an employee or supervisee of the licensee.

16 The worksite monitor shall have an active unrestricted license with no disciplinary action

17 within the last five (5) years, and shall sign an affirmation that he or she has reviewed the terms

18 and conditions of respondent's disciplinary order and agrees to monitor respondent as set forth by

19 the Board or its designee.

20 Respondent shall pay all worksite monitoring costs.

21 The worksite monitor shall have face-to-face contact with respondent in the work

22 environment on as frequent a basis as determined by the Board or its designee, but not less than

23 once per week; interview other staff in the office regarding respondent's behavior, if requested by

24 the Board or its designee; and review respondent's work attendance.

25 The worksite monitor shall verbally report any suspected substance abuse to the Board

26 and respondent's employer or supervisor within one ( 1) business day of occurrence. If the

27 suspected substance abuse does not occur during the Board's normal business hours, the verbal

28 report shall be made to the Board or its designee within one (1) hour of the next business day. A

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written report that includes the date, time, and location of the suspected abuse; respondent's

2 actions; and any other information deemed important by the worksite monitor shall be submitted

3 to the Board or its designee within 48 hours of the occurrence.

4 The worksite monitor shall complete and submit a written report monthly or as directed by

5 the Board or its designee which shall include the following: (1) respondent's name and Physician's

6 and Surgeon's Certificate number; (2) the worksite monitor's name and signature; (3) the worksite

7 monitor's license number, if applicable; (4) the location or location(s) of the worksite; (5) the

8 dates respondent had facc~to-face contact with the worksite monitor; (6) the names ofworksite

9 staff interviewed, if applicable; (7) a report of respondent's work attendance; (8) any change in

10 respondent's behavior and/or personal habits; and (9) any indicators that can lead to suspected

11 substance abuse by respondent. Respondent shall complete any required consent forms and

12 execute agreements with the approved worksite monitor and the Board, or its designee,

13 authorizing the Board, or its designee, and worksite monitor to exchange information.

14 If the worksite monitor resigns or is no longer available, respondent shall, within five (5)

15 calendar days of such resignation or unavailability, submit to the Board or its designee, for prior

16 approval, the name and qualifications of a replacement monitor who will be assuming that

17 responsibility within fifteen (15) calendar days. If respondent fails to obtain approval of a

18 replacement monitor within sixty (60) calendar days of the resignation or unavailability of the

19 monitor, respondent shall receive a notification from the Board or its designee to cease the

20 practice of medicine within three (3) calendar days after being so notified. Respondent shall

21 cease the practice of medicine until a replacement monitor is approved and assumes monitoring

22 responsibility.

23 9. NOTIFICATION. Within seven (7) days of the effective date ofthis Decision, the

24 Respondent shall provide a true copy of this Decision and Accusation to the Chief of Staff or the

25 Chief Executive Officer at every hospital where privileges or membership arc extended to

26 Respondent, at any other facility where Respondent engages in the practice of medicine,

27 including all physician and locum tenens registries or other similar agencies, and to the Chief

28 Executive Officer at every insurance carrier which extends malpractice insurance coverage to

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STIPULATED SETTLEMENT (800-2014-003 821)

Respondent. Respondent shall submit proof of compliance to the Board or its designee within 15

2 calendar days.

3 10. This condition shall apply to any change(s) in hospitals, other facilities or insurance

4 carrier.

5 11. SUPERVISION OF PHYSICIAN ASSISTANTS. During probation, Respondent is

6 prohibited from supervising physician assistants.

7 12. OBEY ALL LAWS. Respondent shall obey all federal, state and local laws, all rules

8 governing the practice of medicine in California and remain in full compliance with any court

9 ordered criminal probation, payments, and other orders.

10 13. QUARTERLY DECLARATIONS. Respondent shall submit quarterly declarations \

11 under penalty of perjury on forms provided by the Board, stating whether there has been

12 compliance with all the conditions of probation.

13 Respondent shall submit quarterly declarations not later than 10 calendar days after the end

14 ofthe preceding quarter.

15 14. GENERAL PROBATION REQUIREMENTS.

16 Compliance with Probation Unit

17 Respondent shall comply with the Board's probation unit and all terms and conditions of

18 this Decision.

19 Address Changes

20 Respondent shall, at all times, keep the Board informed of Respondent's business and

21 residence addresses, email address (if available), and telephone number. Changes of such

22 addresses shall be immediately communicated in writing to the Board or its designee. Under no

23 circumstances shall a post office box serve as an address of record, except as allowed by Business

24 and Professions Code section 2021 (b).

25 Place of Practice

26 Respondent shall not engage in the practice of medicine in Respondent's or patient's place

27 of residence, unless the patient resides in a skilled nursing facility or other similar licensed

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License Renewal

2 Respondent shall maintain a current and renewed California physician's and surgeon's

3 license.

4 Travel or Residence Outside California

5 Respondent shall immediately inform the Board or its designee, in writing, of travel to any

6 areas outside the jurisdiction of California which lasts, or is contemplated to last, more than thirty

7 (30) calendar days.

8 In the event Respondent should leave the State of California to reside or to practice

9 Respondent shall notify the Board or its designee in writing 30 calendar days prior to the dates of

1 0 departure and return.

11 15. INTERVIEW WITH THE BOARD OR ITS DESIGNEE. Respondent shall be

12 available in person upon request for interviews either at Respondent's place of business or at the

13 probation unit office, with or without prior notice throughout the term of probation.

14 16. NON-PRACTICE WHILE ON PROBATION. Respondent shall notify the Board or

15 its designee in writing within 15 calendar days of any periods of non-practice lasting more than

16 30 calendar days and within 15 calendar days of Respondent's return to practice. Non-practice is

1 7 defined as any period of time Respondent is not practicing medicine in California as defined in

18 Business and Professions Code sections 2051 and 2052 for at least 40 hours in a calendar month

19 in direct patient care, clinical activity or teaching, or other activity as approved by the Board. All

20 time spent in an intensive training program which has been approved by the Board or its designee

21 shall not be considered non-practice. Practicing medicine in another state of the United States or

22 Federal jurisdiction while on probation with the medical licensing authority ofthat state or

23 jurisdiction shall not be considered non-practice. A Board-ordered suspension of practice shall

24 not be considered as a period of non-practice.

25 In the event Respondent's period of non-practice while on probation exceeds 18 calendar

26 months, Respondent shall successfully complete a clinical training program that meets the criteria

27 of Condition 18 ofthe current version ofthe Board's "Manual of Model Disciplinary Orders and

28 Disciplinary Guidelines" prior to resuming the practice of medicine.

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Respondent's period of non-practice while on probation shall not exceed two (2) years.

2 Periods of non-practice will not apply to the reduction of the probationary term.

3 Periods of non-practice will relieve Respondent of the responsibility to comply with the

4 probationary terms and conditions with the exception of this condition and the following terms

5 and conditions of probation: Obey All Laws; and General Probation Requirements.

6 17. COMPLETION OF PROBATION. Respondent shall comply with all financial

7 obligations (e.g., restitution, probation costs) not later than 120 calendar days prior to the

8 completion of probation. Upon successful completion of probation, Respondent's certificate shall

9 be fully restored.

10 18. VIOLATION OF PROBATION. Failure to fully comply with any term or condition

11 of probation is a violation of probation. If Respondent violates probation in any respect, the

12 Board, after giving Respondent notice and the opportunity to be heard, may revoke probation and

13 carry out the disciplinary order that was stayed. If an Accusation, or Petition to Revoke

14 Probation, or an Interim Suspension Order is filed against Respondent during probation, the

15 Board shall have continuing jurisdiction until the matter is final, and the period of probation shall

16 be extended until the matter is final.

17 19. Failure to fully comply with any term or condition of probation is a violation of

18 probation.

19 A. If respondent commits a major violation of probation as defined by section

20 1361.52, subdivision (a), of Title 16 of the California Code of Regulations, the Board shall

21 take one or more of the following actions:

22 ( 1) Issue an immediate cease-practice order and order respondent to undergo a clinical

23 diagnostic evaluation to be conducted in accordance with section 1361.5, subdivision (c)(l), of

24 Title 16 of the California Code of Regulations, at respondent's expense. The cease-practice order

25 issued by the Board or its designee shall state that respondent must test negative for at least a

26 month of continuous biological fluid testing before being allowed to resume practice. For

27 purposes of the determining the length of time a respondent must test negative while undergoing

28 continuous biological fluid testing following issuance of a cease-practice order, a month is

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defined as thirty calendar (3 0) days. Respondent may not resume the practice of medicine until

2 notified in writing by the Board or its designee that he or she may do so.

3 (2) Increase the frequency of biological fluid testing.

4 (3) Refer respondent for further disciplinary action, such as suspension, revocation, or

5 other action as determined by the Board or its designee. (Cal. Code Regs., tit. 16, § 1361.52,

6 subd. (b).)

7 B. If respondent commits a minor violation of probation as defined by section

8 1361.52, subdivision (c), of Title 16 ofthe California Code of Regulations, the Board shall take

9 one or more of the following actions:

10 (1) Issue a cease-practice order;

11 (2) Order practice limitations;

12 (3) Order or increase supervision of respondent;

13 ( 4) Order increased documentation;

14 (5) Issue a citation and fine, or a warning letter;

15 (6) Order respondent to undergo a clinical diagnostic evaluation to be conducted in

16 accordance with section 1361.5, subdivision (c)(l ), of Title 16 of the California Code of

17 Regulations, at respondent's expense;

18 (7) Take any other action as determined by the Board or its designee. (Cal. Code

19 Regs., tit. 16, § 1361.52, subd. (d).)

20 C. Nothing in this Decision shall be considered a limitation on the Board's authority

21 to revoke respondent's probation if he or she has violated any term or condition of probation. (See

22 Cal. Code Regs., tit. 16, § 1361.52, subd. (e).) If respondent violates probation in any respect, the

23 Board, after giving respondent notice and the opportunity to be heard, may revoke probation and

24 carry out the disciplinary order that was stayed. If an Accusation, or Petition to Revoke

25 Probation, or an Interim Suspension Order is filed against respondent during probation, the Board

26 shall have continuing jurisdiction until the matter is final, and the period of probation shall be

27 extended until the matter is final.

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STIPULATED SETTLEMENT (800-20 14-003821)

20. LICENSE SURRENDER. Following the effective date ofthis Decision, if

2 Respondent ceases practicing due to retirement or health reasons or is otherwise unable to satisfy

3 the terms and conditions of probation, Respondent may request to surrender his or her license.

4 The Board reserves the right to evaluate Respondent's request and to exercise its discretion in

5 determining whether or not to grant the request, or to take any other action deemed appropriate

6 and reasonable under the circumstances. Upon formal acceptance of the surrender, Respondent

7 shall within 15 calendar days deliver Respondent's wallet and wall certificate to the Board or its

8 designee and Respondent shall no longer practice medicine. Respondent will no longer be subject

9 to the terms and conditions of probation. If Respondent re-applies for a medical license, the

10 application shall be treated as a petition for reinstatement of a revoked certificate.

11 21. PROBATION MONITORING COSTS. Respondent shall pay the costs associated

12 with probation monitoring each ·and every year of probation, as designated by the Board, which

13 may be adjusted on an annual basis. Such costs shall be payable to the Medical Board of

14 California and delivered to the Board or its designee no later than January 31 of each calendar

15 year.

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2 I have carefully read the above Stipulated Settlement and Disciplinary Order and have fully

3 discussed it with my attorney, Mitchell Green. I understand the stipulation and the effect it will

4 have on my Physician's and Surgeon's Certificate. I enter into this Stipulated Settlement and

5 Disciplinary Order voluntarily, knowingly, and intelligently, and agree to be bound by the

6 Decision and Order of the Medical Board of California.

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DATED: .,-,- /;~ 12" it _Q _____ _ NEAL ~.fEHRA, M.D. Respondent

I have read and fully discussed with Respondent Neal Mehra, M.D. the terms and

I approve its form and content. \ \ 0 DATED: -~\ ID\ l ~

MITCHE E~N Attorneyfor e dent

ENDORSEMENT

The foregoing Stipulated Settlement and Disciplinary Order is hereby respectfully

submitted for consideration by the Medical Board of California.

20 Dated: '-jJ~a;-· :J/1 .}_()/ (:. Respectfully submitted,

KAMALA D. HARRIS 21

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Attorney General of California VLADIMIR SHALKEVICH Acting Supervising Deputy Attorney General ,,

'J?l~:z l O[%M_;,r!{ M~/N R. O'CARROLL D~ty Attorney General Attorneys for Complainant

STIPULATED SETTLEMENT (800-20 14-003821)

Exhibit A

Accusation No. 800-2014-003821

1 KAMALA D. HARRIS Attorney General of California

2 VLADIMIR SHALKEVICH Acting Deputy Attorney General

3 MEGAN R. O'CARROLL Deputy Attorney General

4 State Bar No. 215479 1300 I Street, Suite 125

5 P.O. Box944255 Sacramento, CA 94244~2550

6 Telephone: (916) 324-5288 Facsimile: (916) 327-2247

7 Attorneys for Complainant

FILED STATE OF CALIFORNIA

MEDICAL BOARD OF CALIFORNIA

SACRAMjl'!TO ~ 20_11, BY~~ ~\§C ~ALYST

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BEFORE THE MEDICAL BOARD OF CALIFORNIA

DEPARTMENT OF CONSUMER AFFAIRS STATE OF CALIFORNIA

12 In the Matter of the Accusation Against:

13 Neal Mehra, M.D. 5150 Fair Oaks Blvd., Ste. 101/135

14 Carmichael, CA 95608~5758

Physician's and Surgeon's Certificate No. A 95686,

Respondent.

Complainant alleges:

Case No. 800~2014~003821

OAH No. 2015100663

AMENDED ACCUSATION

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20 PARTIES

21 1. Kimberly Kirchmeyer (Complainant) brings this Amended Accusation solely in her

22 official capacity as the Executive Director of the Medical Board of California, Department of

23 Consumer Affairs (Board).

24 2. On or about May 26, 2006, the Medical Board issued Physician's and Surgeon's

25 Certificate Number A 95686 to Neal Mehra, M.D. (Respondent). The Physician's and Surgeon's

26 Certificate was in full force and effect at all times relevant to the charges brought herein and will

27 expire on September 30, 2017, unless renewed.

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(NEAL MEHRA, M.D.) AMENDED ACCUSATION NO. 800-2014-003821

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JURISDICTION

3. This Accusation is brought before the Board, under the authority of the following

laws. All section references are to the Business and Professions Code unless otherwise indicated.

4. Section 2227 of the Code provides that a licensee who is found guilty under the

Medical Practice Act may have his or her license revoked, suspended for a period not to exceed

one year, placed on probation and required to pay the costs of probation monitoring, or such other

action taken in relation to discipline as the Board deems proper.

5. Section 2234 of the Code, states:

"The board shall take action against any licensee who is charged with unprofessional

conduct. In addition to other provisions of this article, unprofessional conduct includes, but is not

limited to, the following:

"(a) Violating or attempting to violate, directly or indirectly, assisting in or abetting the

violation of, or conspiring to violate any provision of this chapter.

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"(f) Any action or conduct which would have warranted the denial of a certificate.

" "

6. Section 2239 of the Code states:

"(a) The use or prescribing for or administering to himself or herself, of any controlled

substance; or the use of any of the dangerous drugs specified in Section 4022, or of alcoholic

beverages, to the extent, or in such a manner as to be dangerous or injurious to the licensee, or to

any other person or to the public, or to the extent that such use impairs the ability of the licensee

to practice medicine safely or more than one misdemeanor or any felony involving the use,

consumption, or self-administration of any of the substances referred to in this section, or any

combination thereof, constitutes unprofessional conduct. The record of the conviction is

conclusive evidence of such unprofessional conduct.

Ill

Ill

" "

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1 FIRST CAUSE FOR DISCIPLINE

2 (Use of Alcoholic Beverages to Such an Extent, or in Such a Manner, as to be Dangerous or

· 3 Injurious to the Licensee, or to any other Person or to the Public)

4 7. Respondent Neal Mehra, M.D. is subject to disciplinary action under section 2239 in

5 that he used alcoholic beverages in a manner, or to such an extent, as to be injurious to himself:

6 another person, and/or the public. The circumstances are as follows:

7 8. On or about October 14, 2013, Respondent was employed by Healthlinknow, a

8 telemedicine service provider, as a project manager. He had been employed by Healthlinknow

9 for approximately two and one-half years. On or about 8:00a.m. on October 14,2013,

1 0 Respondent arrived at his office in the business headquarters of Healthlinlmow, with a rolling

11 laptop case that contained a bottle of vodka. During the course of the morning, while working in

12 his office, Respondent consumed vodka. Healthlinlmow has a policy prohibiting employees from

13 using or being under the influence of drugs or alcohol while at the Healthlinlmow business

14 premises.

15 9. At approximately 10:30 a.m. on or about October 14,2013, Respondent attended a

16 meeting with the CEO of Healthlinknow, and several other employees of the company. During

17 the course of the meeting, Respondent appeared confused, had difficulty communicating, and

18 smelled of alcohol. The CEO and other coworkers inquired of Respondent if he had a medical

19 condition, or was under the influence of alcohol or drugs. Respondent initially denied that

20 anything was wrong with him or that he was under the influence of alcohol or drugs.

21 10. An executive assistant of the company passed by Respondent's office and observed a

22 half-empty bottle of Vodka on Respondent's desk in plain view. The CEO and other staff

23 brought the bottle to the attention of Respondent and asked him again if he was tmder the

24 influence of alcohol. Respondent aclmowledged to company officials that he had consumed

25 alcohol in his office that morning. He further admitted that he had consumed alcohol in his office

26 on several previous occasions. Other employees had observed that over the several months

27 leading up to October of 2013, Respondent had appeared impaired and smelled of alcohol.

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Healthlinknow had a policy in force prohibiting using or being under the influence of alcohol at

2 work.

3 11. On or about October 14, 2013, the CEO ofHealthinknow offered Respondent an

4 immediate referral to a wellness program and counseling. Respondent declined. The CEO

5 further requested Respondent to provide her with his car keys, because she did not want him to

6 drive while under the influence of alcohol. Respondent declined to provide her with his car keys

7 and left the building, driving himself away in his car. Respondent was terminated from

8 employment with Healthlinknow following the October 14, 2013 incident.

9 SECOND CAUSE FOR DISCIPLINE

10 (General Unprofessional Conduct)

11 12. Respondent Neal Mehra, M.D. is subject to disciplinary action under section 2234 in

12 that he has engaged in conduct which breaches the rules or ethical code ofthe medical profession,

13 or conduct which is unbecoming in a member in good standing of the medical profession, and

14 which demonstrates an unfitness to practice medicine, as alleged in paragraphs 7-11 above, which

15 are incorporated by reference and rcalleged as if fully set forth here.

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(NEAL MEHRA, M.D.) AMENDED ACCUSATION NO. 800-2014~003821

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PRAYER

2 WHEREFORE, Complainant requests that a hearing be held on the matters herein alleged,

3 and that following the hearing, the Medical Board of California issue a decision;

4 l. Revoking or suspending Physician's and Surgeon's Certificate Number A 95686,

5 issued to Neal Mehra, M.D.;

2. Revoking, suspending or denying approval ofNeal Mehra, M.D.'s authority, to

7 supervise physician assistants, pursuant to section 3527 of the Code;

8 3. Ordering Neal Mehra, M.D., if placed on probation, to pay the Board the costs of

9 probation monitoring; and

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4. Taking such othe1· and further action as deemed necessary and proper.

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DATED: , ~,U?tb

SA2015301461 18 32473647.doc

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Exe tive Director Medical Board of California Department of Consumer Affairs State of California Complainant

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