Oregon Medical Board BOARD ACTION REPORT 16...• Saks, Seldon Keith, MD; MD15511; Tualatin, OR If...
Transcript of Oregon Medical Board BOARD ACTION REPORT 16...• Saks, Seldon Keith, MD; MD15511; Tualatin, OR If...
Oregon Medical Board
BOARD ACTION REPORT January 15, 2020
The information contained in this report summarizes new, interim, and final actions taken by the
Oregon Medical Board between December 16, 2019, and January 15, 2020.
Scanned copies of Interim Stipulated Orders, Orders of Emergency Suspension, Stipulated
Orders, Final Orders, Termination Orders, Modification Orders, Voluntary Limitations, and non-
disciplinary Corrective Action Agreements are included at the end of this report in the order that
they appear in the report. These orders are marked with an * asterisk. Scanned copies of the
following actions are not included in this report:
• Consent Agreements and their modifications/terminations (non-disciplinary, do not
impose practice limitations)
• Terminations of non-disciplinary Corrective Action Agreements
• Complaint and Notices of Proposed Disciplinary Action (not final actions by the Board)
These documents, however, are public and are available upon request.
Printed copies of documents not provided with this report are available to the public. To obtain a
printed copy of a document not provided in this report, please complete the License Verification
and Malpractice Report Request (http://www.oregon.gov/OMB/ombforms1/request-licensee-
info-verification.pdf) found under the Forms link on the Board's web site. You may submit the
form by fax to (971) 673-2670, by email to [email protected], or by mail to:
Oregon Medical Board
1500 SW 1st Ave, Ste 620
Portland, OR 97201
Copies of the Orders listed below are mailed to Oregon hospitals where the Licensee self-
reported that he/she has privileges.
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*Buncke, Geoffrey Harry, MD; MD23806; Denver, CO
On January 9, 2020, the Board issued an Order Modifying Stipulated Order. This Order
modifies Licensee's July 12, 2018, Stipulated Order.
*Delabruere, Beverly Ann, MD; MD15031; Oregon City, OR
On January 9, 2020, Licensee entered into a non-disciplinary Corrective Action Agreement with
the Board. In this Agreement, Licensee agrees to follow Oregon Opioid Prescribing Guidelines;
contract with CPEP for the development of any education plan; complete the CPEP education
plan; and complete a pre-approved course on chronic pain and opioids.
*Hassan, Sammy, MD; MD20117; Portland, OR
On January 9, 2020, Licensee entered into a Stipulated Order with the Board for unprofessional
or dishonorable conduct; repeated acts of negligence; willful violation of any rule adopted by the
Board; and prescribing controlled substances without following accepted procedures for
examination of patients or for record keeping. This Order reprimands Licensee; assesses a
$5,000 civil penalty; places Licensee on probation for 5 years; restricts Licensee from
prescribing for family, friends, or himself; and requires Licensee to complete a pre-approved
course on professional boundaries.
*Jungwirth-Large, Lance Brandon, MD; MD23110; Jefferson, OR
On January 9, 2020, Licensee entered into a Stipulated Order with the Board for unprofessional
or dishonorable conduct; gross or repeated acts of negligence; willful violation of any rule
adopted by the Board; and prescribing controlled substances without a legitimate medical
purpose or without following accepted procedures for examination of patients or for record
keeping. This Order reprimands Licensee; assesses a $7,500 civil penalty; restricts Licensee
from supervising physician assistants; requires Licensee to complete a CPEP evaluation, contract
with CPEP for the development of any education plan, and complete the CPEP education plan;
requires Licensee to undergo an evaluation by a healthcare provider; requires Licensee to only
practice at pre-approved sites; and subjects Licensee to no-notice chart audits and office visits by
the Board's designee.
*King, Ronald Lloyd, PA; PA160674; Portland, OR
On January 9, 2020, Licensee entered into a Stipulated Order with the Board for unprofessional
or dishonorable conduct and gross or repeated acts of negligence. This Order restricts Licensee
from treating any patient with testosterone, and requires Licensee to only practice at pre-
approved sites.
*Markham, Juliet Kristina, MD; MD26356; Pendleton, OR
On January 9, 2020, Licensee entered into a Stipulated Order with the Board for unprofessional
or dishonorable conduct and repeated acts of negligence. With this Order, Licensee surrenders
her medical license while under investigation.
*McNabb, Earl Dean, DPM; DP00344; Keizer, OR
On January 9, 2020, Licensee entered into a Stipulated Order with the Board for unprofessional
or dishonorable conduct; fraud or misrepresentation in applying for or procuring a license or
registration to practice in this state; and willful violation of any rule adopted by the Board or
Board order. This Order reprimands Licensee and assesses a $10,000 civil penalty, $7,000 of
which is held in abeyance as long as Licensee's license remains at a non-practicing status.
*Morin Rayburn, Rachael Chantal, DO; DO176571; Silverton, OR
On January 9, 2020, Licensee entered into a non-disciplinary Corrective Action Agreement with
the Board. In this Agreement, Licensee agreed to complete a pre-approved course in
preeclampsia and high-risk obstetrics, and obtain a pre-approved board-certified mentor prior to
resuming an obstetrics practice.
*Mullen, John Thomas, MD; MD20837; Portland, OR
On January 9, 2020, Licensee entered into a Stipulated Order with the Board for unprofessional
or dishonorable conduct and willful violation of a Board Order. With this Order, Licensee retires
his medical license while under investigation.
*Pham, Nhan Van, DO; DO168404; Springfield, OR
On December 19, 2019, Licensee agreed to an Interim Stipulated Order, which requires Licensee
to have a pre-approved board-certified general surgeon scrub in for any surgical procedure
performed; report any complications to the Board within one business day; and not take trauma
call pending the completion of the Board's investigation into his ability to safely and competently
practice medicine.
*Roberts, Warren Gregory, MD; MD153449; Salem, OR
On January 9, 2020, Licensee entered into a non-disciplinary Corrective Action Agreement with
the Board. In this Agreement, Licensee agreed to complete a one-year mentorship program with
a pre-approved board-certified physician; submit a re-entry plan to the Board for approval prior
to resuming a surgical practice; and complete 40 hours of pre-approved CME.
*Rodriquez, Alberto, PA; PA01439; Portland, OR
On January 9, 2020, the Board issued an Order Modifying Stipulated Order. This Order
modifies Licensee's October 8, 2015, Stipulated Order.
*Rysenga, Juliet Catherine, MD; MD18740; Ontario, OR
On January 9, 2020, the Board issued an Order Modifying Stipulated Order. This Order
modifies Licensee's July 7, 2016, Stipulated Order.
*Saks, Seldon Keith, MD; MD15511; Tualatin, OR
On January 9, 2020, the Board issued a Default Final Order for failure to file any tax return or
pay any tax to the Oregon Department of Revenue. This Order suspends Licensee's medical
license.
*Schrader, Jerry Lee, MD; MD06736; Salem, OR
On January 9, 2020, Licensee entered into a Stipulated Order with the Board for unprofessional
or dishonorable conduct; impairment; gross or repeated acts of negligence; failing to comply
with a Board rule or request; and prescribing controlled substances without a legitimate medical
purpose or without following accepted procedures for examination of patients or for record
keeping. With this Order, Licensee retires his medical license while under investigation.
Swann, Allyson Paige, PA; PA173992; Springfield, OR
On January 9, 2020, Licensee entered into a non-disciplinary Consent Agreement for Re-Entry to
Practice with the Board. In this Agreement, Licensee agreed to 100% chart review by her
Supervising Physician for 60 days and to maintain NCCPA certification.
*Thibert, Mark Alan, MD; MD169232; Bend, OR
On January 9, 2020, Licensee entered into a Stipulated Order with the Board for unprofessional
or dishonorable conduct; gross or repeated acts of negligence; and prescribing controlled
substances without a legitimate medical purpose or without following accepted procedures for
examination of patients or for record keeping. This Order reprimands Licensee; requires
Licensee to follow the Oregon Opioid Prescribing Guidelines; prohibits Licensee from
concurrently prescribing opioids with benzodiazepines, sedatives, or hypnotics to any new
patient and taper benzodiazepines, sedatives, or hypnotics for any current patient taking opioids;
requires Licensee to query the PDMP every three months for any patient prescribed controlled
substances; requires Licensee to perform urine drug screens every six months for any patient
prescribed opioids, benzodiazepines, sedatives, or hypnotics; requires Licensee to complete a
pre-approved education plan for the treatment of chronic pain and substance use disorder; and
subjects Licensee's practice to no-notice chart audits and office visits by the Board's designee.
*Von Dippe, Patrick Beauregard, MD; MD27158; Coquille, OR
On January 9, 2020, the Board issued an Order Terminating Interim Stipulated Order. This
Order terminates Licensee's July 11, 2019, Interim Stipulated Order.
*Warden, Craig Robert, MD; MD16181; Portland, OR
On January 8, 2020, Licensee entered into an Interim Stipulated Order to voluntarily withdraw
from practice and place his license in Inactive status pending the completion of the Board's
investigation into his ability to safely and competently practice medicine.
_____________________________________________________________________________
The following Licensees were issued Complaint and Notices of Proposed Disciplinary Action.
Note, in some of these instances the Board has not taken a final action.
• Abreu, Enrique Alexander, DO; DO25617; Portland, OR
• Cull, Anthony Salvatore, MD; MD25143; Portland, OR
• King, Ronald Lloyd, PA; PA160674; Portland, OR
• Saks, Seldon Keith, MD; MD15511; Tualatin, OR
________________________________________________________________________
If you have any questions regarding this service, please call the Board at (971) 673-2700 or toll-
free within Oregon at (877) 254-6263.
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PAGE 1 - ORDER MODIFYING STIPULATED ORDER - Geoffrey Hairy Buncke, MD
BEFORE THE
OREGON MEDICAL BOARD
STATE OF OREGON
In the Matter of
GEOFFREY HARRY BUNCKE, MDLICENSE NO. MD23806
)) ORDER MODIFYING) STIPULATED ORDER
1.
On July 12, 2018, Geoffrey Harry Buncke, MD (Licensee) entered into a Stipulated
Order with the Oregon Medical Board (Board). This Order placed certain conditions on
Licensee’s medical license. On September 27, 2019, Licensee submitted a written request asking
the Board to terminate Terms 5.4 and 5.6 of this Order. Terms 5.4 and 5.6 read:
5.4 Licensee must enter into a professional coaching relationship as outlined in the Acumen assessment of April 18, 2017. The professional coach must be preapproved by the Board’s Medical Director and shall initially submit quarterly reports to the Board’s Compliance Section. Licensee must sign all necessary releases to allow full communication and exchange of documents and reports between the Board and the professional coach. After one year of compliance with this term the frequency of the reports may be reduced by the Board’s Medical Director. All changes must be requested in writing and with written support from the professional coach, including the cessation of the relationship. Licensee will be notified in writing of any changes to the requiredfrequency of reports.
5.6 Within 60 days from the effective date of this Order, Licensee must hire or identify an employee within his practice to serve as an advisor to Licensee’s social interactions with patients, as outlined in the Acumen assessment of April 18, 2017. In the event the advisor leaves employment with the practice, a new advisor must be identified within 30 days. Licensee must report the name of the appointed advisor, and any changes to the advisor to the Board’s Compliance Section within ten calendar days.
2.
Having fully considered Licensee’s request and compliance with these terms, the Board
terminates terms 5.4 and 5.6 of the July 12, 2018, Stipulated Order effective the date this Order
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PAGE 2 - ORDER MODIFYING STIPULATED ORDER - Geoffrey Hany Buncke, MD
is signed by the Board Chair. All other terms of the July 12, 2018, Stipulated Order are
unchanged and remain in full force and effect.
IT IS SO ORDERED this 9th day of January, 2020.
OREGON MEDICAL BOARDState of Oregon
K. DEAN GUBLER, DOBoard Chair
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PAGE 7 - CORRECTIVE A CTION AGREEMENT ~ Beverly Ann Delabruere, MD
BEFORE THE
OREGON MEDICAL BOARD
STATE OF OREGON
In the Matter of )
BEVERLY ANN DELABRUERE, MD ) CORRECTIVE ACTION AGREEMENT LICENSE NO. MD15031 )
)
1.
The Oregon Medical Board (Board) is the state agency responsible for licensing,
regulating and disciplining certain health care providers, including physicians, in the State of
Oregon. Beverly Ann Delabruere, MD (Licensee) is a licensed physician in the State of Oregon.
2.
On December 12, 2019, the Board issued a Complaint and Notice of Proposed
Disciplinary Action (Notice) in which the Board proposed to take disciplinary action by
imposing up to the maximum range of potential sanctions identified in ORS 677.205(2), that may
include the revocation of license, a $10,000 civil penalty per violation, and assessment of costs,
against Licensee for violations of the Medical Practice Act, to wit: ORS 677.190(1 )(a)
unprofessional or dishonorable conduct, as defined in ORS 677.188(4)(a) any conduct or practice
which does or might constitute a danger to the health or safety of a patient or the public; ORS
677.190(13) gross or repeated acts of negligence; ORS 677.190(17) willful violation of any
Board rule, specifically OAR 847-015-0030 Written Notice Disclosing the Material Risks
Associated with Prescribed or Administered Controlled Substances for the Treatment of
“Intractable Pain”; and ORS 677.190(24) prescribing controlled substances without a legitimate
medical purpose or without followi ng accepted procedures for examination of patients or for
record keeping. Prior to the issuance of the Notice, on July 30, 2018, Licensee entered into an
Interim Stipulated Order with the Board in which she agreed to certain restrictions regarding her
prescribing of controlled substances,
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PAGE 2 ~ CORRECTIVE ACTION AGREEMENT-Beverly Ann Delabruere, MD
3.
In regard to the above-referenced matter, Licensee and the Board desire to settle this
matter by entry of this Agreement. Licensee understands that he has the right to a contested case
hearing under the Administrative Procedures Act (chapter 183), Oregon Revised Statutes.
Licensee fully and finally waives the right to a contested case hearing and any appeal therefrom
by the signing of and entry of this Agreement in the Board’s records. The Board agrees to close
the current investigation and does not make a finding in regard to any violation of the Medical
Practice Act. This Agreement is a public document; however, it is not a disciplinary action. The
Agreement is reportable to the National Practitioner Data Bank and the Federation of State
Medical Boards.
4.
In order to address the concerns of the Board and for purposes of resolving this
investigation, Licensee and the Board agree that the Board will close this investigation
contingent upon Licensee agreeing to the following conditions:
4.1 Licensee agrees to comply with the Oregon Opioid Prescribing Guidelines
published by the Oregon Health Authority when prescribing opioids.
4.2 Within 30 days of the effective date of this Agreement, Licensee agrees to
contract with CPEP for the development of an education plan. Licensee agrees to bear the cost
of the completion of any CPEP recommendations, the development of an education plan, and any
post-education evaluation. Licensee agrees to sign all necessary releases to allow full
communication and exchange of documents and reports between the Board and CPEP. Licensee
agrees to ensure CPEP submits the education plan and reports directly to the Board.
4.3 Licensee agrees to sign the appropriate paperwork indicating that she agrees to
enroll in the education plan and return the signed documents to CPEP within 15 days of approval
of the educational plan by the Board’s Medical Director. Licensee agrees to successfully
complete the CPEP education plan, including any post-education evaluation, within 18 months
from the date the educational plan is approved. Licensee agrees to comply with any educational
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PAGE 3 - CORRECTIVE ACTION AGREEMENT -Beverly Arm Delabruere, MD
recommendations, practice modifications, and timelines set forth by CPEP. Licensee agrees to
bear all costs associated with the approved education plan and any post-education evaluation.
Any educational mentor must be pre-approved by CPEP and the Board’s Medical Director.
Licensee agrees to sign all necessary releases to allow full communication and exchange of
documents and reports between the Board, CPEP, and any mentors. Licensee agrees to keep the
Boa rd apprised of her compliance with the CPEP education plan throughout its duration.
4.4 Licensee agrees to provide the Board with written proof from CPEP upon
successful completion of the approved education plan, including successful completion of any
post-education evaluation, as defined above,
4.5 Upon a submitted request from CPEP that Licensee’s July 30, 2018, Interim
Stipulated Order be terminated in order to allow Licensee to complete the education plan, the
Board’s Medical Director may approve the termination of the Interim Stipulated Order. If no
request is received from CPEP, the Interim Stipulated Order will be terminated upon receipt of
documentation, of Licensee’s successful completion of the education plan. Licensee will be
notified in writing if and when this termination occurs.
4.6 Within 18 months of completion of the CPEP education plan, Licensee agrees to
successfully complete the OHSU ECHO Certificate Program focusing on chronic pain and
opioids. If this program is unavailable to Licensee, Licensee must complete a program that has
been pre-approved by the Board’s Medical Director.
4.7 Licensee agrees to inform the Compliance Section of the Board of any and all
practice sites, as well as any changes in practice address(es), employment, or practice status
within 10 business days. Additionally, Licensee agrees to notify the Compliance Section of any
changes in contact information within 10 business days.
4.8 Licensee agrees to obey all federal and Oregon state laws and regulations
pertaining to the practice of medicine.
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PAGE 4 - CORRECTIVE ACTION AGREEMENT- Beverly Ann Delabruere, MD
4.9 Licensee agrees that any violation of the terms of this Agreement shall be grounds
for disciplinary action under ORS 677,190(17).
IT IS SO AGREED this 5^ day of , 20<X».
Beverly aw-j delabruere, md
IT IS SO AGREED this
OREGON MEDICAL BOARDState of Oregon
K. DEAN GUBLER, DO Board Chair
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Page
BEFORE THE
OREGON MEDICAL BOARD
STATE OF OREGON
In the Matter of ))
SAMMY HASSAN, MD ) STIPULATED ORDERLICENSE NO. MD20117 )
1.
The Oregon Medical Board (Board) is the state agency responsible for licensing,
regulating and disciplining certain health care providers, including physicians, in the State of
Oregon. Sammy Hassan, MD (Licensee) is a licensed physician in the State of Oregon.
2. .
On September 12,2019, the Board issued a Complaint and Notice of Proposed
Disciplinary Action in which the Board proposed to take disciplinary action by imposing up to
the maximum range of potential sanctions identified in ORS 677.205(2), that may include the
revocation of license, a $10,000 civil penalty per violation, and assessment of costs, against
Licensee for violations of the Medical Practice Act, to wit: ORS 677.190(l)(a) unprofessional or
dishonorable conduct, as defined in ORS 677.188(4)(a) any conduct or practice contrary to
recognized standards of ethics of the medical profession or any conduct or practice which does
or might constitute a danger to the health or safety of a patient or the public; ORS 677.190(13)
repeated acts of negligence; ORS 677.190(17) willful violation of any rule adopted by the board,
specifically OAR 847-015-0010(2)(a) thorough review of prior treatment records before
initiating treatment utilizing a Schedule III or IV controlled substance for purposes of weight
reduction OAR 847-015-0010(2)(b) obtain a thorough history, perform a thorough physical
examination of the patient, and rule out the existence of any recognized contraindications to the
use of the controlled substance to be utilized before initiating treatment utilizing a Schedule 111
or IV controlled substance; and ORS 677.190(24) prescribing controlled substances without
1 -STIPULATED ORDER - Sammy Hassan, MD
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Page 2 -STIPULATED ORDER - Sammy Hassan, MD
following accepted procedures for examination of patients, or prescribing controlled substances
without following accepted procedures for record keeping.
3.
Licensee and the Board desire to settle this matter by the entry of this Stipulated Order.
Licensee understands that he has the right to a contested case hearing under the Administrative
Procedures Act (Oregon Revised Statutes chapter 183), and fully and finally waives the right to a
contested case hearing and any appeal therefrom by the signing of this Order in the Board’s
records. Licensee neither admits nor denies, but the Board finds that Licensee engaged in the
conduct described in the September 12,2019, Complaint and Notice of Proposed Disciplinary
Action and that this conduct violated ORS 677,190(l)(a), as defined in ORS 677.188(4)(a); and
ORS 677.190(13); ORS 677.190(17), specifically OAR 847-015-0010(2)(a), and OAR 847-015-
0010(2)(b); and ORS 677.190(24). Licensee understands that this Order is a public record and
is a disciplinary action that is reportable to the National Practitioner Data Bank and the
Federation of State Medical Boards.
4.
Licensee and the Board agree that the Board will close this investigation and resolve this
matter by entry of this Stipulated Order, subject to the following conditions:
4.1 Licensee is reprimanded.
4.2 Licensee must pay a civil penalty of $5,000. The first $2,500 is due within 90
days from the effective date of this Order. The remaining $2,500 is held in abeyance as long as
Licensee submits $2,500 in full within 90 days of the effective date of this Order. If Licensee
fails to submit the $2,500 within 90 days, the final $2,500 is due within 60 additional days.
4.3 Licensee is placed on probation for a minimum period of five years and shall
report in person to the Board at each of its quarterly meetings at the scheduled times for a
probation interview, unless otherwise directed by the Board’s Compliance Officer or its
Investigative Committee. Additionally, at the Board’s discretion, interviews may be held
electronically between Licensee and the Board’s Compliance Officer (or its designee) using
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Page 3 -STIPULATED ORDER - Sammy Hassan, MD
Board established protocols for the location and electronic transmission of the meeting. Licensee
is responsible for maintenance of the equipment and technology necessary for the electronic
meetings to occur. Licensee will be notified if and when such meetings are scheduled in lieu of
an in-person appearance. This term will be held in abeyance as long as Licensee’s Oregon
medical license is at a non-practicing status.
4.4 Licensee must not prescribe any medications for any family member, friends, or
himself.
4.5 Licensee must complete a course in professional boundaries that has been pre
approved by the Board’s Medical Director.
4.6 Licensee must inform the Compliance Section of the Board of any and all practice
sites in Oregon, as well as any changes in practice address(es), employment, or practice status
within 10 business days. Additionally, Licensee must notify the Compliance Section of any
changes in contact information within 10 business days.
4.7 Licensee must obey all federal and Oregon state laws and regulations pertaining
to the practice of medicine.
4.8 Licensee stipulates and agrees that any violation of the terms of this Order shall
be grounds for further disciplinary action under ORS 677.190(17).
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Page 4 -STIPULATED ORDER - Sammy Hassan, MD
5.
This Order becomes effective the date it is signed by the Board Chair.
day of' 2020.IT IS SO ORDERED this
OREGON MEDICAL BOARDState of Oregon
IT IS SO STIPULATED this
K. DEAN GUBLER, DOBoard Chair
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BEFORE THE
OREGON MEDICAL BOARD
STATE OF OREGON
In the Matter of )
LANCE BRANDON JUNGWIRTH- ) STIPULATED ORDERLARGE, MD )LICENSE NO. MD23110 )
1.
The Oregon Medical Board (Board) is the state agency responsible for licensing,
regulating and disciplining certain health care providers, including physicians, in the State of
Oregon. Lance Brandon Jungwirth-Large, MD (Licensee) is a licensed physician in the State of
Oregon.
2.
On October 16, 2019, the Board issued a Complaint and Notice of Proposed Disciplinary
Action (Notice) in which the Board proposed taking disciplinary action by imposing up to the
maximum range of potential sanctions identified in ORS 677.205(2), which may include the
revocation of license, a $10,000 civil penalty per violation, and assessment of costs, against
Licensee for violations of the Medical Practice Act, to wit: ORS 677.190(l)(a) unprofessional or
dishonorable conduct, as defined in ORS 677.188(4)(a) any conduct or practice contrary to
recognized standards of ethics of the medical profession or any conduct or practice which does
or might constitute a danger to the health or safety of a patient or the public; ORS 677.190(13)
gross or repeated acts of negligence; ORS 677.190(17) willful violation of any rule adopted by
the Board, specifically OAR 847-015-0010 bariatrics practice; and ORS 677.190(24) prescribing
controlled substances without a legitimate medical purpose or without following accepted
procedures for examination of patients or for record keeping. Prior to the issuance of the Notice,
on September 27, 2018, Licensee entered into an Interim Stipulated Order with the Board in
which he voluntarily agreed to certain prescribing limitations for chronic pain.
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Page 1 - STIPULATED ORDER - Lance Brandon Jungwirth-Large, MD
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3.
Licensee and the Board desire to settle this matter by entry of this Stipulated Order.
Licensee understands that he has the right to a contested case hearing under the Administrative
Procedures Act (chapter 183), Oregon Revised Statutes. Licensee fully and finally waives the
right to a contested case hearing and any appeal therefrom by the signing of and entry of this
Order in the Board’s records. Licensee neither admits nor denies, but the Board finds that he
engaged in the conduct described in the Notice dated October 16, 2019, and that this conduct
violated ORS 677.190(l)(a), as defined in ORS 677.188(4)(a); ORS 677.190(13); ORS
677.190(17), specifically OAR 847-015-0010; and ORS 677.190(24). Licensee understands that
this Order is a public record and is a disciplinary action that is reportable to the National
Practitioner Data Bank and the Federation of State Medical Boards.
4.
Licensee and the Board agree to resolve this matter by the entry of this Stipulated Order
subject to the following terms and conditions:
4.1 Licensee is reprimanded.
4.2 Licensee must pay a civil penalty of $7,500 within 90 days from the effective date
of this Order.
4.3 Licensee must not act as the supervising physician for any physician assistant.
4.4. Within 30 days from the date this Order is signed by the Board Chair, Licensee, at
his own expense, must enroll to undergo a comprehensive physician evaluation at the Center for
Personalized Education for Professionals (CPEP). Licensee must complete this evaluation
within 180 days from the date this Order is signed by the Board Chair. Licensee must sign all
necessary releases to allow full communication and exchange of documents and reports between
the Board and CPEP. Licensee must ensure CPEP submits the evaluation reports directly to the
Board.
4.5 In the event that CPEP identifies the need for remedial education, Licensee must
contract with CPEP for the development of an education plan within 30 days of receipt of the
evaluation report. Licensee must bear the cost of the completion of any CPEP recommendations,
Page 2 - STIPULATED ORDER - Lance Brandon Jungwirth-Large, MD
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the development of an education plan, and any post-education evaluation. Licensee must sign all
necessary releases to allow full communication and exchange of documents and reports between
the Board and CPEP. Licensee must ensure CPEP submits the education plan and reports
directly to the Board.
4.6 Licensee must sign the appropriate paperwork indicating that he agrees to enroll
in the education plan and return the signed documents to CPEP within 15 days of approval of the
educational plan by the Board’s Medical Director. Licensee must successfully complete the
CPEP education plan, including any post-education evaluation, within 18 months from the date
the educational plan is approved. Licensee must comply with any educational recommendations,
practice modifications, and timelines set forth by CPEP. Licensee must bear all costs associated
with the approved education plan and any post-education evaluation. Any educational' mentor
must be pre-approved by CPEP and the Board’s Medical Director. Licensed must sigh’all
necessary releases to allow full communication and exchange of documents and reports between
the Board, CPEP, and any mentors. Licensee must keep the Board apprised of his compliance
with the CPEP education plan throughout its duration.
4.7 Licensee must provide the Board with written proof from CPEP upon successful
completion of the approved education plan, including successful completion of any post
education evaluation, as defined above.
4.8 Eighteen months after the effective date of this Order, Licensee must undergo an
evaluation by a healthcare provider who has been pre-approved by the Board’s Medical Director.
Licensee must sign all necessary releases to allow full communication between the Board and the
provider.
4.9 Licensee may only practice at sites that are pre-approved by the Board’s Medical
Director.
4.10 At the discretion of the Board or its designees, random, no notice chart audits and
office visits may be conducted by Board designees.
4.11 Upon completion of the CPEP assessment, the assessment report will be reviewed
by the Board’s Medical Director. If there are no areas identified related to Licensee’s
Page 3 - STIPULATED ORDER - Lance Brandon Jungwirth-Large, MD
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prescribing, the Medical Director may authorize the termination of the September 27, 2018,
Interim Stipulated Order (ISO). If the assessment report identifies educational needs related to
Licensee’s prescribing, the Medical Director may authorize termination of the ISO either (1)
after receipt of documentation of Licensee’s successful completion of the educational plan or
coursework, or (2) upon request from CPEP to facilitate completion of the educational plan.
4.12 Licensee may petition the Board for modification of the terms of this Order.
Licensee must limit requests to one request per calendar year.
4.13 Licensee must inform the Compliance Section of the Board of any and all practice
sites, as well as any changes in practice address(es), employment, or practice status within 10
business days. Additionally, Licensee must notify the Compliance Section of any changes in
contact information within 10 business days.
4.14 Licensee must obey all federal and state laws and regulations pertaining to the
practice of medicine.
4.15 Licensee stipulates and agrees that any violation of the terms of this Order shall
be grounds for further disciplinary action under ORS 677.190(17).
4.16 Licensee stipulates and agrees that this Order becomes effective the date it is
signed by the Board Chair.
IT IS SO STIPULATED THIS day of 2019.
UNGWIRTH-LARGE, MD
IT IS SO ORDERED THIS
LANCE B
OREGON MEDICAL BOARDState of Oregon
K. DEAN GUBLER, DO BOARD CHAIR
Page 4 - STIPULATED ORDER - Lance Brandon Jungwirth-Large, MD
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BEFORE THE
OREGON MEDICAL BOARD
STATE OF OREGON
In the Matter of ))
RONALD LLOYD KING, PA ) STIPULATED ORDERLICENSE NO. PAI 60674 )
)
1.
The Oregon Medical Board (Board) is the state agency responsible for licensing,
regulating and disciplining certain health care providers, including physician assistants, in the
State of Oregon. (Licensee) is a licensed physician assistant in the State of Oregon.
2.
On December 17,2019, the Board issued a Complaint and Notice of Proposed
Disciplinary Action (Notice) in which the Board proposed to take disciplinary action by
imposing up to the maximum range of potential sanctions identified in ORS 677.205(2), to
include the revocation of license, a $10,000 civil penalty, and assessment of costs, against
Licensee for violations of the Medical Practice Act, to wit: ORS 677.190(l)(a) unprofessional or
dishonorable conduct, as defined in ORS 677.188(4)(a) any conduct or practice which does or
might constitute a danger to the health or safety of a patient or the public, ORS 677.188(4)(b)
willful performance of any surgical or medical treatment which is contrary to acceptable medical
standards, and ORS 677.188(4)(c) administration of unnecessary treatment, or otherwise
utilizing medical service for diagnosis or treatment which is or may be considered inappropriate
or unnecessary; and ORS 677.190(13) gross or repeated acts of negligence.
3.
Licensee and the Board desire to settle this matter by entry of this Stipulated Order.
Licensee understands that he has the right to a contested case hearing under the Administrative
Procedures Act (chapter 183), Oregon Revised Statutes. Licensee fully and finally waives the
right to a contested case hearing and any appeal therefrom by the signing of and entry of this
Page 1 - STIPULATED ORDER - Ronald Lloyd King, PA
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Order in the Board’s records. Licensee neither admits nor denies, but the Board finds that his
conduct as described in the December 17, 2019, Complaint and Notice of Proposed Disciplinary
Action violated ORS 677.190(l)(a) as defined in ORS 677.188(4)(a), ORS 677.188(4)(b), and
ORS 677.188(4)(c); and ORS 677.190(13). Licensee understands that this Order is a public
record and is a disciplinary action that is reportable to the National Practitioner Data Bank and
the Federation of State Medical Boards.
4.
Licensee and the Board agree to resolve this matter by the entry of this Stipulated Order
subject to the following terms and conditions:
4.1 Licensee must not treat any patient with testosterone.
4.2 Licensee may only practice at sites that are pre-approved by the Board’s Medical
Director.
4.3 Licensee must inform the Compliance Section of the Board of any and all practice
sites, as well as any changes in practice address(es), employment, or practice status within 10
business days. Additionally, Licensee must notify the Compliance Section of any changes in
contact information within 10 business days.
4.4 Licensee must obey all federal and Oregon state laws and regulations pertaining
to the practice of medicine.
4.5 Licensee stipulates and agrees that any violation of the terms of this Order shall
be grounds for further disciplinary action under ORS 677.190(17).
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Page 2 - STIPULATED ORDER - Ronald Lloyd King, PA
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4.6 Licensee stipulates and agrees that this Order becomes effective the date it is
signed by the Board Chair.
IT IS SO ORDERED THIS
OREGON MEDICAL BOARDState of Oregon
K. DEAN GUBLER, DO BOARD CHAIR
Page 3 - STIPULATED ORDER - Ronald Lloyd King, PA
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Page 1 -STIPULATED ORDER - Juliet Kristina Markham, MD
BEFORE THE
OREGON MEDICAL BOARD
STATE OF OREGON
In the Matter of ))
JULIET KRISTINA MARKHAM, MD ) STIPULATED ORDERLICENSE NO. MD26356 )
)
1.
The Oregon Medical Board (Board) is the state agency responsible for licensing,
regulating and disciplining certain health care providers, including physicians, in the State of
Oregon. Juliet Kristina Markham, MD (Licensee) is a licensed physician in the State of Oregon.
2.
On July 9,2018, the Board opened an investigation after receiving credible information
regarding Licensee’s possible violation of the Medical Practice Act and concerns regarding
Licensee’s knowledge, skill, and ability to deliver safe patient care as an obstetrics and
gynecology physician.
3.
Licensee and the Board desire to settle this matter by the entry of this Stipulated Order.
Licensee understands that she has the right to a contested case hearing under the Administrative
Procedures Act (Oregon Revised Statutes chapter 183), and fully and finally waives the right to a
contested case hearing and any appeal therefrom by the signing of and entry of this Order in the
Board’s records. Licensee neither admits nor denies, but the Board finds that Licensee engaged
in conduct that violated the Medical Practice Act, to wit: ORS 677.190(l)(a), unprofessional or
dishonorable conduct, as defined in ORS 677.188(4)(a); ORS 677.190(13) repeated acts of
negligence; and ORS 677.190(26) failure to report to the Board any adverse action taken by any
health care institution. Licensee understands that this Order is a public record and is a
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Page 2 -STIPULATED ORDER - Juliet Kristina Markham, MD
disciplinary action that is reportable to the National Practitioner Data Bank and the Federation of
State Medical Boards.
4.
Licensee and the Board agree that the Board will close this investigation and resolve this
matter by entry of this Stipulated Order, subject to the following conditions:
4.1 Licensee surrenders her Oregon medical license while under investigation.
4.2 Licensee must obey all Federal and Oregon State laws and regulations pertaining
to the practice of medicine.
4.3 Licensee stipulates and agrees that any violation of the terms of this Order shall
be grounds for further disciplinary action under ORS 677.190(17).
5.
This Order becomes effective the date it is signed by the Board Chair.
IT IS SO STIPULATED this S day of 2019.......................................... k .............. ffi'h .... 1 ............ .................
OREGON MEDICAL BOARDState of Oregon
IT IS SO ORDERED this 2020.
K. DEAN GUBLER, DOBoard Chair
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Page 1 -STIPULATED ORDER - Earl Dean McNabb, DPM
BEFORE THE
OREGON MEDICAL BOARD
STATE OF OREGON
In the Matter of ))
EARL DEAN MCNABB, DPM ) STIPULATED ORDERLICENSE NO. DP00344 )
)
1.
The Oregon Medical Board (Board) is the state agency responsible for licensing,
regulating and disciplining certain health care providers, including podiatric physicians, in the
State of Oregon. Earl Dean McNabb, DPM (Licensee) is a licensed podiatric physician in the
State of Oregon whose license is lapsed.
2.
Licensee is a board-certified podiatric physician who formerly practiced in Keizer,
Oregon. On October 2, 2014, Licensee entered into a non-disciplinary Corrective Action
Agreement which placed conditions on his podiatric licensee. On October 11, 2016, the Board
issued a Complaint and Notice of Proposed Disciplinary Action in which the Board proposed to
take disciplinary action by imposing up to the maximum range of potential sanctions identified in
ORS 677.205(2), to include the revocation of license, a $10,000 fine, and assessment of costs,
pursuant to ORS 677.205 against Licensee for violations of the Medical Practice Act, to wit:
ORS 677.190(l)(a) unprofessional or dishonorable conduct, as defined by ORS 677.188(4)(a);
ORS 677.190(8) fraud or misrepresentation in applying for or procuring a license or registration
to practice in this state; and ORS 677.190(17) willfully violating any rule adopted by the Board
or Board order.
3.
Licensee and the Board desire to settle this matter by the entry of this Stipulated Order.
Licensee understands that he has the right to a contested case hearing under the Administrative
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Page 2 -STIPULATED ORDER - Earl Dean McNabb, DPM
Procedures Act (Oregon Revised Statutes chapter 183), and fully and finally waives the right to a
contested case hearing and any appeal therefrom by the signing of and entry of this Order in the
Board’s records. Licensee neither admits nor denies, but the Board finds that Licensee engaged
in conduct that violated the Medical Practice Act, to wit ORS 677J 90(l)(a), as defined by ORS
677.188(4)(a); ORS 677.190(8); and ORS 677.190(17). Licensee understands that this Order is a
public record and is a disciplinary action that is reportable to the National Practitioner Data Bank
and the Federation of State Medical Boards.
4.
Licensee and the Board agree that the Board will close this investigation and resolve this
matter by entry of this Stipulated Order, subject to the following conditions:
4.1 Licensee is reprimanded.
4.2 Licensee must pay a civil penalty of $10,000, $7,000 of which is held in abeyance
as long as Licensee’s license remains at a non-practicing status and Licensee does not apply to
reactivate his podiatric license. The remaining $3,000 is due within one year from the effective
date of this Order. Licensee may make payments as long as no payment, excepting the final
payment, is less than $100.
4.3 The Corrective Action Agreement of October 2,2014, terminates effective the
date the Board Chair signs this Order.
4.4 Licensee must obey all federal and Oregon state laws and regulations pertaining
to the practice of medicine.
4.5 Licensee stipulates and agrees that any violation of the terms of this Order shall
be grounds for further disciplinary action under ORS 677.190(17).
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Page 3 -STIPULATED ORDER - Earl Dean McNabb, DPM
5.
This Order becomes effective the date it is signed by the Board Chair.
2020.
DEAN MCNABB, DPM
IT IS SO ORDERED this 2020.
OREGON MEDICAL BOARD State of Oregon
day of ‘
IT IS SO STIPULATED this
Uuuuy-
K. DEANGUBLER, DO Board Chair
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BEFORE THE
OREGON MEDICAL BOARD
STATE OF OREGON
In the Matter of ))
RACHAEL CHANTAL MORIN ) CORRECTIVE ACTION AGREEMENTRAYBURN, DO )LICENSE NO. DO176571 )
The Oregon Medical Board (Board) is the state agency responsible for licensing,
regulating and disciplining certain health care providers, including physicians, in the State of
Oregon. Rachael Chantal Morin Rayburn, DO (Licensee) is a licensed osteopathic physician in
the State of Oregon.
2.
On September 25, 2019, the Board issued a Complaint and Notice of Proposed
Disciplinary Action in which the Board proposed to take disciplinary action by imposing up to
the maximum range of potential sanctions identified in ORS 677.205(2), that may include the
revocation of license, a $10,000 civil penalty per violation, and assessment of costs, against
Licensee for violations of the Medical Practice Act, to wit: ORS 677.190(l)(a) unprofessional or
dishonorable conduct, as defined in ORS 677.188(4)(a) any conduct or practice which does or
might constitute a danger to the health or safety of a patient or the public; and ORS 677.190(13)
gross or repeated acts of negligence.
3,
Licensee and the Board now desire to settle this matter by entry of this Agreement.
Licensee understands that she has the right to a contested case hearing under the Administrative
Procedures Act (chapter 183), Oregon Revised Statutes. Licensee fully and finally waives the
right to a contested case hearing and any appeal therefrom by the signing of and entry of this
Agreement in the Board's records. The Board agrees to close the current investigation and does
Page 1 - CORRECTIVE ACTION AGREEMENT ~ Rachael Chantal Morin Rayburn, DO
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not make a finding in regard to any violation of the Medical Practice Act. This Agreement is a
public document; however, it is not a disciplinary action. This document is reportable to the
National Practitioner Data Bank and the Federation of State Medical Boards,
4.
In order to address the concerns of the Board and for purposes of resolving this
investigation, Licensee and the Board agree that the Board will close this investigation
contingent upon Licensee agreeing to the following conditions;
4.1 Within 180 days of the effective date of this Agreement, Licensee agrees to
successfully complete a course in preeclampsia and high-risk obstetrics that has been pre
approved by the Board's Medical Director.
4.2 In the event Licensee returns to an obstetrics practice, at her own expense.
Licensee agrees to obtain a mentor who is board-certified in obstetrics and has been pre
approved by the Board’s Medical Director. Licensee agrees to conduct monthly meetings with
the mentor for the purpose ofchart review; the mentor will submit quarterly reports to the
Board’s Medical Director. Licensee may request relief from this term after six months with
written support from her mentor, Monthly meetings will continue until the Board’s Medical
Director approves Licensee’s request in writing.
4.3 Licensee agrees to inform the Compliance Section of the Board of any and all
practice sites, as well as any changes in practice address(es), employment, or practice status
within 10 business days. Additionally, Licensee must notify the Compliance Section of any
changes in contact information within 10 business days.
4.4 Licensee agrees to obey all federal and Oregon State laws and regulations
pertaining to the practice of medicine.
4.5 Licensee agrees that any violation of the terms of this Agreement constitutes
grounds to take disciplinary action under ORS 677.190(17).
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Page 2 - CORRECTIVE ACTION AGREEMENT - Rachael Chantal Morin Rayburn, DO
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4,6 Licensee agrees that this Agreement becomes effective the date it is signed by the
Board Chair.
IT IS SO STIPULATED THIS day ofQctob&V' . 2019.
JHAEL CHANTAL MORIN RAYBURN, DO
IT IS SO ORDERED THIS
OREGON MEDICAL BOARDState of Oregon
K. DEAN GUBLER, DO BOARD CHAIR
Page 3 - CORRECTIVE ACTION AGREEMENT - Rachael Chantal Morin Ray bum, DO
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Page 1 -STIPULATED ORDER - John Thomas Mullen, MD
BEFORE THE
OREGON MEDICAL BOARD
STATE OF OREGON
In the Matter of ))
JOHN THOMAS MULLEN, MD ) STIPULATED ORDERLICENSE NO. MD20837 )
)
1.
The Oregon Medical Board (Board) is the state agency responsible for licensing,
regulating and disciplining certain health care providers, including physicians, in the State of
Oregon. John Thomas Mullen, MD (Licensee) is a licensed physician (inactive status) in the
State of Oregon.
2.
On January 12,2012, Licensee entered into a Corrective Action Agreement (Agreement)
with the Board. This Agreement placed conditions on Licensee’s Oregon medical license, On
May 23,2018, the Board opened an investigation due to Licensee’s non-compliance with the
Agreement.
3.
Licensee and the Board desire to settle this matter by the entry of this Stipulated Order.
Licensee understands that he has the right to a contested case hearing under the Administrative
Procedures Act (Oregon Revised Statutes chapter 183), and fully and finally waives the right to a
contested case hearing and any appeal therefrom by the signing of and entry of this Order in the
Board’s records. Licensee neither admits nor denies, but the Board finds that Licensee engaged
in conduct that violated the Medical Practice Act, to wit! ORS 677.190(l)(a) unprofessional or
dishonorable conduct, as defined in ORS 677.188(4)(a) any conduct or practice contrary to
recognized standards of ethics of the medical profession; and ORS 677*190(17) willful violation
of a Board order. Licensee understands that this Order is a public record and is a disciplinary
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Page 2 -STIPULATED ORDER - John Thomas Mullen, MD
action that is reportable to the National Practitioner Data Bank and the Federation of Statef
Medical Boards.
4. ,
Licensee and the Board agree that the Board will close this investigation and resolve this
matter by entry of this Stipulated Order, subject to the following conditions:
4.1 Licensee retires his Oregon medical license while under investigation.
4.2 The January 12,2012, Corrective Action Agreement terminates effective the date
the Board Chair signs this Order.
4.3 Licensee must obey all Federal and Oregon State laws and regulations pertaining
to the practice of medicine.
4.4 Licensee stipulates and agrees that any violation of the terms of this Order shall
be grounds for further disciplinary action under ORS 677.190(17).
5.
This Order becomes effective the date it is signed by the Board Chair.
IT IS SO STIPULATED this / day of Q
IT IS SO ORDERED this
OREGON MEDICAL BOARD State of Oregon
2020.
K. DEAN GUBLER, DO Board Chair
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BEFORE THE
Page 1 -INTERIM STIPULATED ORDER -Nhan Van Pham, DO
OREGON MEDICAL BOARD
STATE OF OREGON
In the Matter of ) ')
NHAN VAN PHAM, DO ) INTERIM STIPULATED ORDERLICENSE NO. DOI 68404 )
1. .
The Oregon Medical Board (Board) is the state agency responsible for licensing,
regulating and disciplining certain health care providers, including physicians, in the state of
Oregon. Nhan Van Pham, DO (Licensee) is a licensed physician in the State of Oregon and
holds an active medical license.
2.
The Board received credible information regarding Licensee that resulted in the Board
initiating an investigation. The results of the Board’s investigation to date have raised concerns
to the extent that the Board believes it necessary that Licensee agree to certain terms until the
investigation is completed.
3.
Tn order to address the Board’s concerns, Licensee and the Board agree to the entry of
this Interim Stipulated Order, which is not an admission of any wrongdoing on the part of the
Licensee, and will remain in effect while this matter is under investigation, and provides that
Licensee shall comply with the following conditions:
3.1 Licensee must have a board-certified general surgeon who has been pre-approved
by the Board’s Medical Director scrub in for any surgical procedure performed by Licensee from
incision to close. Licensee may perform endoscopies and soft tissue procedures without a board-
certified surgeon present.
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Page 2 - INTERIM STIPULATED ORDER-Nmm Van Pham, DO
3.2 Licensee must report any complications from any surgical procedure to the
Board’s Medical Director within one business day.
3.3 Licensee must not take trauma call.
3.4 Licensee understands that violating any term of this Order will be grounds for
disciplinary action udder ORS 677.190(17).
3.5 Licensee understands this Order becomes effective the date he signs it.
4,
At the conclusion of the Board’s investigation, the Board will decide whether to close the
case or to proceed to some form of disciplinary action. If the Board determines, following that
review, not to lift the requirements of this Order, Licensee may request a hearing to contest that
decision.
5.
This order is issued by the Board pursuant to ORS 677.410, which grants the Board the
authority to attach conditions to the license of Licensee to practice medicine. These conditions
will remain in effect while the Board conducts a complete investigation in order to fully inform
itself with respect to the conduct of Licensee. Pursuant to ORS 677.425, Board investigative
materials are confidential and shall not be subject to public disclosure, nor shall they be admissible
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1 as evidence in any judicial proceeding. However, as a stipulation this Order is a public document
2 and is reportable to the National Practitioner Databank and the Federation of State Medical Boards.
XT XS SO STIPULATED THIS Itf day of. 2019.4
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NHAN VAN PHAM, DO
day of ,2019
OREGON MEDICAL BOARD State of Oregon
NIC0LE KRISHNASWAMI, JD EXECUTIVE DIRECTOR
Page 3-INTERIMSTIPULATED ORDER -Nhan Van Pham, DO
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BEFORE THE
OREGON MEDICAL BOARD
STATE OF OREGON
In the Matter of ))
WARREN GREGORY ROBERTS, MD ) CORRECTIVE ACTION AGREEMENT LICENSE NO. MD 153449 )
1.
The Oregon Medical Board (Board) is the state agency responsible for licensing,
regulating and disciplining certain health care providers, including physicians, in the State of
Oregon. Warren Gregory Roberts, MD (Licensee) is a licensed physician in the State of Oregon.
2.
Licensee is a board-certified neurosurgeon. Licensee has not performed neurosurgery
since mid-year 2015. On January 8, 2015, the Board issued an Amended Complaint and Notice
of Proposed Disciplinary Action, in which the Board proposed to take disciplinary action
pursuant to ORS 677.205(2), to include the revocation of license, a $10,000 civil penalty, and
assessment of costs, against Licensee for violations of the Medical Practice Act, to wit: ORS
677.190(1 )(a) unprofessional or dishonorable conduct, as defined in ORS 677.188(4)(a), (b) and
(c) and ORS 677.190(13) gross or repeated acts of negligence.
3.
In regard to the above-referenced matter, Licensee and the Board desire to settle this
matter by entry of this agreement. Licensee understands that he has the right to a contested case
hearing under the Administrative Procedures Act (chapter 183), Oregon Revised Statutes.
Licensee fully and finally waives the right to a contested case hearing and any appeal therefrom
by the signing of and entry of this agreement in the Board’s records. The Board agrees to close
the current investigation and does not make a finding in regard to any violation of the Medical
Practice Act. This agreement is a public document; however, it is not a disciplinary action. This
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Page 1 - CORRECTIVE ACTION AGREEMENT- Warren Gregory Roberts, MD
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document is reportable to the National Practitioner Data Bank and the Federation of State
Medical Boards.
4.
In order to address the concerns of the Board due to Licensee’s absence from active
surgical practice and for purposes of resolving this investigation, Licensee and the Board agree
to the following terms:
4.1 Licensee agrees to enter into and successfully complete a mentorship program for
a minimum of one-year with a board-certified physician who has been pre-approved by the
Board’s Medical Director. The mentoring physician will conduct on-going chart review and will
meet with Licensee to discuss patient care issues on a weekly basis. The mentoring physician
will submit quarterly reports to the Board concerning Licensee’s medical knowledge, clinical
judgment and ability to safely practice. Licensee agrees to sign all necessary releases to allow
for full and complete communication between the mentoring physician and the Board.
4.2 If Licensee intends to resume a surgical practice, Licensee agrees to submit a re
entry plan to the Board for review and approval that includes a minimum of one-year surgical
mentorship with a board-certified neurosurgeon who has been pre-approved by the Board’s
Medical Director. A surgical practice includes invasive procedures into the cranium, spine,
facial bones, peripheral nerves, thorax, abdomen, pelvis, or major joints. This term does not
apply to Licensee suturing wounds, draining soft tissue abscesses external to body cavities,
reducing dislocations and treating fractures in coordination with a qualified orthopedist
(including splinting or casting), establishing venous access when indicated, placing catheters and
airways when indicated, and providing routine post-surgical evaluation and care such as sterile
dressing change, and performing procedures that do not require general or neuraxial anesthesia
or blockade of a major nerve.
4.3 Within 12 months from the date this Agreement is signed by the Board Chair,
Licensee agrees to complete 40 hours of continuing medical education that is pre-approved by
the Board’s Medical Director.
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Page 2 - CORRECTIVE ACTION AGREEMENT ~ Warren Gregory Roberts, MD
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4.4 Upon completion of terms 4.1 and 4.3 of this Agreement, Licensee may submit
documentation of his successful completion and a letter in support from his mentor to the
Board's Medical Director. Upon review and approval by the Medical Director, terms 4.1 and 4.3
may be terminated. <
4.5 If Licensee submits a re-entry plan to resume a surgical practice, Licensee may
petition the Board for termination of this Corrective Action Agreement upon Board-approval of
the Consent Agreement for Re-Entry to (Surgical) Practice.
4.6 Licensee agrees to inform the Compliance Section of the Board of any and all
practice sites, as well as any changes in practice address(cs), employment, or practice status
within 10 business days. Additionally, Licensee agrees to notify the Compliance Section of any
changes in contact information within 10 business days.
4.7 Licensee must obey all federal and Oregon state laws and regulations pertaining
to the practice of medicine.
4.8 Licensee agrees that any violation of the terms of this Agreement constitutes
grounds to take disciplinary action under ORS 677.190(17),
IT IS SO AGREED this 2* day of 2019.
OREGON MEDICAL BOARD State of Oregon
IT IS SO AGREED this
K. DEAN GUBLER, DO Board Chair
Page 3 - CORRECTIVE ACTION AGREEMENT- Warren Gregory Roberts, MD
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PAGE 1 - ORDER MODIFYING STIPULATED ORDER - Alberto Rodriquez, PA
BEFORE THE
OREGON MEDICAL BOARD
STATE OF OREGON
In the Matter of )
ALBERTO RODRIQUEZ, PA ) ORDER MODIFYINGLICENSE NO. PA01439 ) STIPULATED ORDER
1.
On October 8, 2015, Alberto Rodriquez, PA (Licensee) entered into a Stipulated Order
with the Oregon Medical Board (Board). This Order placed certain conditions on Licensee’s
physician assistant license. On October 31,2019, Licensee submitted a written request asking
the Board to terminate this Order. Terms 4.1,4.2, and 4.6 of the Order read:
4.1 Licensee is reprimanded,
4.2 Licensee must pay a civil penalty of $4,000, payable in full 60 days after the Board Chair signs this Order.
4.6 Licensee must complete a professional boundary course pre-approved bythe Board’s Medical Director.
2.
Having fully considered Licensee’s request and compliance with these terms, the Board
terminates terms 4.1, 4.2, and 4.6 of the October 8, 2015, Stipulated Order effective the date this
Order is signed by the Board Chair. All other terms of the October 8, 2015, Stipulated Order are
unchanged and remain in full force and effect.
IT IS SO ORDERED this 9th day of January, 2020.
OREGON MEDICAL BOARDState of Oregon
K. DEAN GUBLER, DOBoard Chair
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PAGE 1 - ORDER MODIFYING STIPULATED ORDER - Juliet Catherine Rysenga, MD
BEFORE THE
OREGON MEDICAL BOARD
STATE OF OREGON
In the Matter of ))
JULIET CATHERINE RYSENGA, MD ) ORDER MODIFYING LICENSE NO. MD18740 ) STIPULATED ORDER
)
1.
On July 7, 2016, Juliet Catherine Rysenga, MD (Licensee) entered into a Stipulated
Order with the Oregon Medical Board (Board). This Order placed certain conditions on
Licensee’s medical license. On August 21, 2019, Licensee submitted a written request asking
the Board to terminate Term 4.5 of this Order, which reads:
4.5 Licensee must maintain an on-going relationship with a healthcare provider who has been pre-approved by the Board's Medical Director, who will provide quarterly written reports to the Board.
2.
Having fully considered Licensee’s request, the Board modifies Term 4.5 of the July 7,
2016, Stipulated Order as follows:
4.5 Licensee must maintain an on-going relationship with a healthcare provider who
has been pre-approved by the Board’s Medical Director, who will provide semi-annual written
reports to the Board.
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III
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PAGE 2 - ORDER MODIFYING STIPULATED ORDER - Juliet Catherine Rysenga, MD
This modification becomes effective the date this Order is signed by the Board Chair.
All other terms of the July 7, 2016, Stipulated Order are unchanged and remain in full force and
effect.
IT IS SO ORDERED this 9th day of January, 2020.
OREGON MEDICAL BOARDState of Oregon
K. DEAN GUBLER, DOBoard Chair
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BEFORE THE
OREGON MEDICAL BOARD
STATE OF OREGON
In the Matter of ))
SELDON KEITH SAKS, MD ) DEFAULT FINAL ORDERLICENSE NO. MD15511 )
1.
The Oregon Medical Board (Board) is the state agency responsible for licensing,
regulating and disciplining certain health care providers, including physicians, in the State of
Oregon. Seldon Keith Saks, MD (Licensee) is a licensed physician in the State of Oregon.
2.
2.1 On September 4, 2018, the Board issued a Complaint and Notice of Proposed
Disciplinary Action in which the Board proposed to suspend Licensee’s medical license
pursuant to ORS 305.385.
2.2 On September 20, 2018, Licensee requested a hearing on the matter.
2.3 On November 15, 2019, Licensee formally withdrew his request for a hearing
onthis matter. As a result, Licensee now stands in default.
2.4 Copies of the entire investigation file are designated as the record for purposes
of default, including any submission from Licensee and all information in the administrative
file relating to the mailing of notices and any responses received.
NOW THEREFORE, after considering the Board’s file relating to this matter, the Board
enters the following Order.
3.
FINDINGS OF FACT & CONCLUSIONS OF LAW
The Board makes the following findings of fact and conclusions of law from the
Board’s file pertaining to this case:
PAGE 1 -DEFAULT FINAL ORDER - Seldon Keith Saks, MD
(Revenue) determines that any licensee who has neglected or refused to file any tax return or2
to pay any tax, that such person has not filed in good faith a petition before Revenue3
contesting the tax, and Revenue has been unable to obtain payment of the tax through other4
methods of collection, Revenue may notify the licensing agency and that agency shall5
suspend any license until it receives a certificate, issued by Revenue, that the licensee is in6
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the Board suspend the license of Licensee to practice medicine pursuant to ORS 305.3859
because Licensee (1) has neglected or refused to file any return or pay any tax, (2) has not10
filed a good faith petition before Revenue, and (3) Revenue has been unable to obtain
payment of the tax through other methods of collection.12
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notification by Revenue and after opportunity for hearing as provided by ORS 183.415.14
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16 305.385.
4.17
ORDER18
IT IS HEREBY ORDERED THAT the medical license of Seldon Keith Saks to19
practice as a physician in the State of Oregon is suspended. This suspension will remain in20
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3.4 Licensee’s medical license should be suspended in accordance with ORS
3.1 ORS 305.385(4)(a) provides that if the Oregon Department of Revenue
3.3 ORS 305.385(4)(c) requires the Board to suspend Licensee’s license upon
good standing.
/ 3.2 By letter dated April 30, 2018, Revenue notified the Board and requested that
PAGE 2 -DEFAULT FINAL ORDER - Seldon Keith Saks, MD
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effect until terminated by the Board after receipt of a Certificate of Good Standing issued by
Revenue regarding Licensee’s in good standing.
DATED this 9th day of January 2020.
OREGON MEDICAL BOARDState of Oregon
K. DEAN GUBLER, DOBOARD CHAIR
Right to Judicial Review
NOTICE: You are entitled to judicial review of this Order. Judicial review may be obtained
by filing a petition for review with the Oregon Court of Appeals within 60 days after the final
order is served upon you. See ORS 183.482. If this Order was personally delivered to you,
the date of service is the day it was mailed, not the day you received it. If you do not file a
petition for judicial review within the 60 days time period, you will lose your right to appeal.
PAGE 3 -DEFAULT FINAL ORDER - Seldon Keith Saks, MD
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Page 1 -STIPULATED ORDER - Jerry Lee Schrader, MD
BEFORE THE
OREGON MEDICAL BOARD
STATE OF OREGON
In the Matter of ))
JERRY LEE SCHRADER, MD ) STIPULATED ORDERLICENSE NO. MD06736 )
)
1.
The Oregon Medical Board (Board) is the state agency responsible for licensing,
regulating and disciplining certain health care providers, including physicians, in the State of
Oregon. Jerry Lee Schrader, MD (Licensee) is a licensed physician in the State of Oregon.
2.
On December 10, 2018, the Board opened an investigation after receiving credible
information regarding Licensee’s prescribing practices and his ability to safely practice
medicine. On May 6, 2019, the Board issued an Order of Emergency Suspension due to
concerns of immediate danger to the public and Licensee’s patients. On September 9, 2019, the
Board issued a Complaint and Notice of Proposed Disciplinary Action (Notice) alleging
violations of the Medical Practice Act.
3.
The Board has received credible information that Licensee lacks testamentary capacity
to make decisions for himself and has lacked that capacity since November 30, 2018 as
determined by his primaiy care physician.
4.
Licensee executed a Durable Power of Attorney (POA) on December 14,2016
appointing as his agent his daughter, Linda J. Schrader-Patton (Representative). She accepted
those responsibilities on or about October 3, 2019. Licensee's Representative has authority to
act on litigation matters pursuant to paragraph seven (7) of the executed POA.
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Page 2 -STIPULATED ORDER - Jerry Lee Schrader, MD
5.
Representative and the Board desire to settle this matter by the entiy of this Stipulated
Order. Representative understands that Licensee has the right to a contested case hearing
under the Administrative Procedures Act (Oregon Revised Statutes chapter 183), and fully and
finally waives the right to a contested case hearing and any appeal therefrom by the signing of
this Order in the Board’s records. Licensee, through his Representative, neither admits nor
denies, but the Board finds that Licensee engaged in conduct as described in the Notice dated
September 10, 2019, and this conduct violated the Medical Practice Act, to wit: ORS
677.190(l)(a), as defined in ORS 677.188(4)(a); ORS 677.190(7); ORS 677.190(13); ORS
677.190(17); and ORS 677.190(24). Representative understands that this Order is a public
record and is a disciplinary action against Licensee that is reportable to the National
Practitioner Data Bank and the Federation of State Medical Boards.
6.
Representative and the Board agree that the Board will close this investigation and
resolve this matter by entry of this Stipulated Order, subject to the following conditions:
6.1 The Representative for Licensee retires his Oregon medical license while under investigation.
6.2 The May 6, 2019, Order of Emergency Suspension terminates, effective the date
the Board Chair signs this Order.
6.3 The Representative acknowledges on behalf of the Licensee must obey all Federal and
Oregon State laws and regulations pertaining to the practice of medicine.
6.4 The Representative acknowledges on behalf of the Licensee that any violation of the terms of
this Order shall be grounds for further disciplinary action under ORS 677.190(17).
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Page 3 -STIPULATED ORDER — Jerry Lee Schrader, MD
7.
This Order becomes effective the date it is signed by the Board Chair.
IT IS SO STIPULATED this II I day of 2019.
L A J. SCHRADER-PATTONPower of Attorney for JERRY LEE SCHRADER, MD
IT IS SO ORDERED this 2020.
OREGON MEDICAL BOARDState of Oregon
K. DEAN GUBLER, DOBoard Chair
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PAGE 1 - STIPLULATED ORDER - Mark Alan Thibert, MD
BEFORE THE
OREGON MEDICAL BOARD
STATE OF OREGON
In the Matter of ))
MARK ALAN THIBERT, MD ) STIPULATED ORDERLICENSE NO. MD169232 )
)
1.
The Oregon Medical Board (Board) is the state agency responsible for licensing,
regulating and disciplining certain health care providers, including physicians, in the State of
Oregon. Mark Alan Thibert, MD (Licensee) is a licensed physician in the State of Oregon.
2.
Licensee is a board-certified internal medicine physician practicing in Bend, Oregon. On
September 25, 2019, the Board issued a Complaint and Notice of Proposed Disciplinary Action
(Notice) in which the Board proposed taking disciplinary action for violations pursuant to ORS
677.205(2), that may include the revocation of license, a $10,000 civil penalty per violation, and
assessment of costs, against Licensee for violations of the Medical Practice Act, to wit: ORS
677.190(l)(a) unprofessional or dishonorable conduct, as defined in ORS 677.188(4)(a) any
conduct or practice which does or might constitute a danger to the health or safety of a patient or
the public; ORS 677.190(13) gross or repeated acts of negligence; and ORS 677.190(24)
prescribing controlled substances without a legitimate medical purpose or without following
accepted procedures for examination of patients or for record keeping.
3.
In regard to the above-referenced matter, Licensee and the Board desire to settle this
matter by entry of this Agreement. Licensee understands that he has the right to a contested case
hearing under the Administrative Procedures Act (chapter 183), Oregon Revised Statutes.
Licensee fully and finally waives the right to a contested case hearing and any appeal therefrom
by the signing of and entry of this agreement in the Board’s records. Licensee neither admits nor
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PAGE 2 - STIPLULATED ORDER - Mark Alan Thibert, MD
denies, but the Board finds that he engaged in the conduct described in Notice dated September
25, 2019, and that this conduct violated ORS 677.190(1 )(a), as defined in ORS 677.188(4)(a);
ORS 677.190(13); and ORS 677.190(24). Licensee understands that this Order is a public
record and is a disciplinary action that is reportable to the National Practitioner Data Bank and
the Federation of State Medical Boards.
4.
Licensee and the Board agree to resolve this matter by the entry of this Stipulated Order
subject to the following terms and conditions:
4.1 Licensee is reprimanded.
4.2 Licensee must follow the Oregon Opioid Prescribing Guidelines for the treatment
of acute and chronic pain.
4.3 Licensee must not prescribe benzodiazepines, sedatives, or hypnotics to any new
patient currently taking opioid medications.
4.4 For any current patient prescribed opioids, Licensee must taper the dose of
benzodiazepines, sedatives, or hypnotics by at least 5-10% per month. Alternatively, Licensee
may transfer the care of any patient for whom he is prescribing opioids with benzodiazepines,
sedatives, or hypnotics to another physician.
4.5 Licensee must query the Prescription Drug Monitoring Program for any patient
prescribed controlled substances. Queries must occur at least every three months.
4.6 Licensee must perform urine drug screens at least every six months for any
patient prescribed opioids, benzodiazepines, sedatives or hypnotics.
4.7 Within 120 days of the effective date of this Order, Licensee must enroll in an
educational plan pre-approved by the Board’s Medical Director for the treatment of chronic pain
and substance use disorder. The plan must include integration of behavioral health into the
Licensee’s practice. All costs associated with the education plan must be borne by Licensee and
Licensee must complete the education plan within 18 months of approval of the plan by the
Board’s Medical Director.
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PAGE 3 - STIPLULATED ORDER - Mark Alan Thibert, MD
4.8 Licensee must sign all necessary releases to allow full communication and
exchange of documents and reports between the Board and the education plan administrator.
Licensee must provide his quarterly PDMP data to the educational plan administrator upon
request.
4.9 At the discretion of the Board or its designees, random, no notice chart audits and
office visits may be conducted by Board designees.
4.10 Licensee must inform the Compliance Section of the Board of any and all practice
sites, as well as any changes in practice address(es), employment, or practice status within 10
business days. Additionally, Licensee agrees to notify the Compliance Section of any changes in
contact information within 10 business days.
4.11 Licensee must obey all federal and Oregon state laws and regulations pertaining
to the practice of medicine.
4.12 Licensee stipulates and agrees that any violation of the terms of this Order shall
be grounds for further disciplinary action under ORS 677.190(17).
4.13 Licensee stipulates and agrees that this Order becomes effective the date it is
signed by the Board Chair.
OREGON MEDICAL BOARDState of Oregon
K. DEAN GUBLER, DOBoard Chair
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BEFORE THE
OREGON MEDICAL BOARD
STATE OF OREGON
In the Matter of ))
PATRICK BEAUREGARD VON ) ORDER TERMINATING INTERIMDIPPE, MD ) STIPULATED ORDERLICENSE NO. MD27158
)
1.
On July 11,2019, Patrick Beauregard Von Dippe, MD (Licensee) entered into an Interim
Stipulated Order with the Oregon Medical Board (Board) in which he agreed to voluntarily
withdraw from practice and place his license at Inactive status. .
2.
At its meeting on January 9, 2020, the Board reviewed this matter. The Board terminates
the July 11, 2019, Interim Stipulated Order effective the date this Order is signed by the Board
Chair.
IT IS SO ORDERED this 9th day of January, 2020.
OREGON MEDICAL BOARD State of Oregon
K. DEAN GUBLER, DOBoard Chair
Page -1 ORDER TERMINATING INTERIM STIPULATED ORDER- Patrick Beauregard Von Dippe, MD
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BEFORE THE
OREGON MEDICAL BOARD
STATE OF OREGON
In the Matter of ))
CRAIG ROBERT WARDEN, MD ) INTERIM STIPULATED ORDERLICENSE NO. MD16181 )
)
t.
The Oregon Medical Board (Board) is the state agency responsible for licensing,
regulating and disciplining certain healthcare providers, including physicians, in the State of
Oregon. Craig Robert Warden, MD (Licensee) is a licensed physician in the State of Oregon.
2.
The Board received credible information regarding Licensee that resulted in the Board
initiating an investigation. The results of the Board’s investigation to date have raised concerns
to the extent that the Board believes it necessary that Licensee agree to cease the practice of
medicine until the investigation is completed.
3.
In order to address the concerns of the Board, Licensee and the Board agree to enter into
this Interim Stipulated Order, which is not an admission of any wrongdoing on the part of the
Licensee, and provides that Licensee shall comply with the following conditions effective the
date this Order is signed by Licensee:
3.1 Licensee voluntarily withdraws from the practice of medicine and his license is
placed in Inactive status pending the completion of the Board’s investigation into his ability to
safely and competently practice medicine.
3.2 Licensee understands that violating any term of this Order will be grounds for
disciplinary action under ORS 677.190(17).
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Page -1 INTERIM STIPULATED ORDER - Craig Robert Warden, MD
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4.
At the conclusion of the Board’s investigation, Licensee’s status will be reviewed in an
expeditious manner. Following that review, if the Board determines that Licensee shall not be
permitted to return to the practice of medicine, Licensee may request a hearing to contest that
decision.
5.
This Order is issued by the Board pursuant to ORS 677.265(1) and (2) for the puipose
of protecting the public, and making a complete investigation in order to fully inform itself with
respect to the performance or conduct of the Licensee and Licensee’s ability to safely and
competently practice medicine. Pursuant to ORS 677.425, Board investigative materials are
confidential and shall not be subject to public disclosure. However, as a stipulation this Order is
a public document and is reportable to the National Practitioner Data Bank and the Federation of
State Medical Boards.
6.
This Order becomes effective the date it is signed by the Licensee.
Ttt'""" yIT IS SO STIPULATED THIS IT day of 2020.
CRAIG ROBERT WARDEN, MD
IT IS SO ORDERED THIS 0 day of , 2020.
State of Oregon OREGON MEDICAL BOARD
NICOLE KRISHNASWAMI, JD EXECUTIVE DIRECTOR
Page -2 INTERIM STIPULATED ORDER - Craig Robert Warden, MD