'

DECISION AND ORDER

The Stipulation in Settlement is hereby adopted as the Decision and Order of the Division of Medical Quality of the Medical Board of California, Department of Consumer Affairs, State of California.

This Decision shall become effective at 5:00 p.m. on March 8, 1999

DATED February _ 4, 1999

MEDICAL BOARD OF CALIFORNIA

Ira Lubell, M.D., President Division of Medical Quality

1 BILL LOCKYER, Attorney General of the State of California

2 JANE ZACK SIMON, State Bar No. 116564 Deputy Attorney General

3 California Department of Justice 50 Fremont Street, Suite 300

4 San Francisco, California 94105-2239 Telephone: (415) 356-6286

5 Facsimile: (415) 356-6257

6 Attorneys for Complainant

BEFORE THE 7

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DIVISION OF MEDICAL QUALITY MEDICAL BOARD OF CALIFORNIA

STATE OF CALIFORNIA

11 In the Matter of the Accusation Against:

12 JEFFREY FRIEDMAN, M.D.

13 911 Moraga Road, Suite 205 Lafayette, CA 94549

14 Physician's and Surgeon's

15 Certificate No.G46244,

16 Respondent.

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Case No. 12-92-21413

STIPULATION FOR SETTLEMENT

18 IT IS HEREBY STIPULATED by and between Jeffrey

19 Friedman, M.D. (hereinafter "respondent") with the counsel and

20 advice of his attorney, David M. Galie, of the law firm Freeman &--

21 Galie, and complainant Ron Joseph, in his official capacity as

22 Executive Director of the Medical Board of California ("Board"),

23 by and through its attorney, Bill Lockyer, Attorney General, by

24 Jane Zack Simon, Deputy Attorney General, as follows:

25 1. First Amended Accusation No. 12-92-21413 ("the

26 Accusation") is presently pending against Jeffrey Friedman, M.D.,

27 physician and surgeon's certificate number G-46244, before the

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1 Division of Medical Quality of the Medical Boar~ of California

2 (hereinafter referred to as the "Division'').

3 2. The complainant in said Accusation, Ron Joseph is

4 the Executive Director of the Board and brought said Accusation

5 in his official capacity only.

6 3. Respondent has fully discussed with his attorney,

7 David M. Galie the charges and allegations contained in the

8 Accusation and therefore has been fully advised concerning his

9 rights in this matter.

10 4. Respondent hereby freely and voluntarily waives his

11 right to a hearing on the charges and allegations contained in

12 the Accusation, and further, respondent agrees to waive his right

13 to reconsideration, judicial review and any and all other rights

14 which may be accorded him by the Administrative Procedure Act and

15 other laws of the State of California, excepting his right to

16 petition for reinstatement of his certificate pursuant to

17 Business and Professions Code section 2307.

18 5. All admissions of fact and conclusions of law

'19 contained in this stipulation are made exclusively for this

20 proceeding and any future proceedings between the Division and

21 respondent and shall not be deemed to be admissions for any

22 purpose in any other administrative, civil, or criminal action,

23 forum or proceeding.

24 6. Respondent's license history and status as set

25 forth in paragraph 2 of the Accusation is true and correct and

26 respondent's address of record is as set forth in the caption of

27 this Stipulation. (A copy of the First Amended Accusation is

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1 attached as Exhibit A and incorporated by refer~nce in this

2 stipulation.)

3 7. For purposes of the settlement of the action

4 pending against respondent in case No. 12-92-21413, and any other

5 cases presently known to the Board, and to avoid a lengthy

6 administrative hearing, respondent admits that factual and legal

7 bases exist for imposition of discipline against his physician

8 and surgeon's certificate, and that the Board has jurisdiction

9 under section 2234 of the Business and Professions Code to adopt

10 this stipulation for settlement as its decision and final

11 resolution of this matter. Respondent admits that he exercised

12 poor judgment in entering into the sexual relationship alleged in

13 the Accusation, and in signing a disability document without

14 verifying its accuracy.

15 In mitigation, during the time when the acts alleged in

16 the Accusation occurred, Dr. Friedman was in the midst of a

17 divorce and custody action, which created a difficult, emotional

18 and stressful period in his life. Respondent has acknowledged

·· 19 the deficiencies in his conduct, and has taken steps on his own

20 to correct those problems. Dr. Friedman has voluntarily

21 undergone psychotherapy to address issues in his life that

22 contributed to the conduct alleged in the Accusation. The

23 psychotherapy has addressed issues of professional ethics,

24 including appropriate physician-patient boundaries, and moral and

25 ethical dilemmas that might confront a practicing physician.

26 Respondent voluntarily enrolled in and completed the Board's

27 Ethics course in 1997. Dr. Friedman has gained significant

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1 insight into these areas, and better understands and appreciates '

2 the importance of physician ethics. Moreover, Dr. Friedman has

3 voluntarily ceased performing calf implant procedures and has

4 changed his off ice procedures to ensure that no documents are

5 signed in blank or without hi~ approval.

6 8. BASED UPON THE FOREGOING RECITALS, IT IS FURTHER

7 STIPULATED AND AGREED that the Medical Board of California, upon

8 its adoption of the Stipulation herein set forth, may, without

9 further notice, prepare a decision and enter the following order:

10 Physician and Surgeon Certificate No. G-46244

11 heretofore issued to Jeffrey Friedman, M.D., respondent, by the

12 Medical Board of California, is hereby revoked; PROVIDED HOWEVER,

13 that execution of this order of revocation is stayed, and

14 respondent is placed on probation for a period of five (5) years,

15 upon the following terms and conditions:

16 Within fifteen (15) days after the effective date of

17 this decision the respondent shall provide the Division, or its

18 designee, proof of service that respondent has served a true copy

19 of this decision on the Chief of Staff or the Chief Executive

20 Officer at every hospital where privileges or membership are

21 extended or where respondent is employed to practice medicine and

22 on the Chief Executive Officer at every insurance carrier where

23 malpractice insurance coverage is extended.

24 SPECIAL CONDITIONS

25 A. ACTUAL SUSPENSION As part of probation,

26 respondent is suspended from the practice of medicine for thirty

27 (30) days, beginning the sixteenth (16th) day after the effective

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date of this decision.

B. CLINICAL TRAINING PROGRAM: Within six (6) months

of the effective date of this decision, respondent shall, at his

own expense, enroll in the Physician Assessment and Clinical

Education Program at the University of California, San Diego

School of Medicine (hereafter the "PACE Program") and shall

undergo assessment, clinical training, and education. Respondent

shall first undergo the comprehensive assessment program

including measurement of medical skills and knowledge and

appraisal of physical health. After this assessment, the PACE

Evaluation Committee will review all results and make a

recommendation to the Division or its designee, the respondent,

and other authorized personnel. The recommendation will

include, but will not be limited to, the specific type of

clinical training required including the scope and length of

training, the treatment of any medical condition, and any other

factors affecting respondent's practice of medicine. Respondent

shall undertake whatever clinical training and treatment of any

medical condition may be recommended by the PACE Program.

Upon completion of all training and/or treatment

recommended by the PACE Evaluation Committee, respondent shall

submit to an examination on his program's contents and substance.

The examination shall be designed and administered by the PACE

Program faculty. Respondent shall not be deemed to have

successfully completed the program unless and until he passes

this examination. Respondent agrees that the determination of

the PACE Program faculty as to whether or not he has passed the

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1 examination and/or successfully completed the P~CE Program shall

2 be binding.

3 Respondent specifically agrees to authorize the PACE

4 Program to provide the Division or its designee with any

5 information pertinent to his performance in the program which the

6 Division deems necessary to the discharge of its statutory

7 responsibility to protect the public.

8 c. EDUCATIONAL PROGRAM

9 In each year of probation, respondent shall submit to

10 the Division or its designee for its prior approval an

11 educational program or course focusing on the area of cosmetic

12 surgery. Respondent shall complete at least forty (40) hours of

13 educational courses for each of the first two years of probation,

14 and shall complete at least twenty five (25) hours of educational

15 courses for the third year of probation. For the first two (2)

16 years of probation, this educational program shall include at

17 least one course in ethics. This program shall be in addition to

18 the Continuing Medical Education requirements for re-licensure.

19 Respondent shall pay all costs of the educational

20 program.

21 D . PSYCHOTHERAPY For the first year of probation,

22 respondent shall undergo treatment with Norman Cavior, Ph.D. or

23 another.therapist approved in advance by the Division or its

24 designee. The therapy shall focus in significant part on issues

25 of physician-patient boundaries and on ethics. Respondent shall

26 have the treating psychotherapist submit quarterly status reports

27 to the Division or its designee. The respondent shall pay the

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1 cost of the therapy and evaluations.

2 E. PRACTICE RESTRICTION During the period of

3 probation, respondent shall not perform or assist in any calf

4 augmentation procedures.

5 F. FACILITY ACCREDITATION/PEER REVIEW Respondent

6 shall not perform cosmetic surgical procedures except in

7 hospitals licensed under Health and Safety Code section 1251,

8 1253 and 1265, and Title 22 California Code of Regulations

9 section 70041, 70101, 70103 and 70117, or in outpatient

10 facilities accredited under Health and Safety Code sections

11 1248.1, 1248.15 and 1248.2. During a period after the suspension

12 described in paragraph A of this Stipulation, where respondent's

13 outpatient facility accreditation may lapse, and he is actively

14 in the process of obtaining accreditation or reaccreditation, he

15 may perform cosmetic surgical procedures in said facility for not

16 more than ten (10) weeks, as long as the facility is operating

17 within the guidelines for accredited facilities.

18 Respondent shall participate in legitimate and regular

19 peer review at each and every facility where he practices. Said

20 peer review must include at least quarterly meetings of a

21 committee of not fewer than three (3) cosmetic surgeons, and

22 shall establish standards and procedures for patient care,

23 assessment of physician performance, and review of care rendered.

24 Minutes of committee meetings shall be kept, and said minutes

25 shall be made available to the Division or its designee upon

26 request.

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1 G. COST RECOVERY The respondent is pereby ordered to

2 reimburse the Division the amount of $10,000 (ten thousand

3 dollars) within ninety (90) days of the effective date of this

4 decision for its investigative and prosecution costs. Failure to

5 reimburse the Division's cost of investigation and prosecution

6 shall constitute a violation of the probation order, unless the

7 Division agrees in writing to payment by an installment plan

8 because of financial hardship. The filing of bankruptcy by the

9 respondent shall not relieve the respondent of her responsibility

10 to reimburse the Division for its investigative and prosecution

11 costs.

12 H. PROBATION COSTS Respondent shall pay the costs

13 associated with probation monitoring each and every year of

14 probation in the amount of $200.00 (two hundred dollars) per

15 month for the first three (3) years of probation and $100 (one

16 hundred dollars) per month for the remaining years of probation.

17 Such costs shall be payable to the Division of Medical Quality

18 and delivered to the designated probation surveillance monitor at

19 the beginning of each calendar year. Failure to pay costs within

20 thirty (30) days of the due date shall constitute a violation of -

21 probation.

22 I. SUPERVISION OF PHYSICIAN ASSISTANTS Respondent

23 shall not supervise any physician assistants.

24 STANDARD CONDITIONS

25 J. OBEY ALL LAWS Respondent shall obey all federal,

26 state and local laws, all rules governing the practice of

27 medicine in California and remain in full compliance with any

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1 court-ordered criminal probation, payments and ?ther orders.

2 K. QUARTERLY REPORTS Respondent shall submit

3 quarterly declarations under penalty of perjury on forms provided

4 by the Division stating whether there has been ·compliance with

5 all the conditions of probation.

6 L. PROBATION SURVEILLANCE PROGRAM COMPLIANCE

7 Respondent shall comply with the Division's probation

8 surveillance program. Respondent shall, at all times, keep the

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Division informed of his addresses of business and residence

which shall both serve as addresses of record. Changes of such

addresses shall be immediately communicated in writing to the

12 Division. Under no circumstances shall a post office box serve

13 as an address of record.

14 Respondent shall also immediately inform the Division,

15 in writing, of any travel to any areas outside the jurisdiction

16 of California which lasts, or is contemplated to last, more than

17 thirty (30) days.

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M. INTERVIEW WITH THE DIVISION, ITS DESIGNEE, OR ITS

DESIGNATED PHYSICIAN Respondent shall appear in person for

interviews with the Division, its designee or its designated

physician(s) upon request at various intervals and with

reasonable notice.

N. TOLLING OF PROBATION In the event respondent

24 should leave California to reside or to practice outside the

25 State or for any reason should respondent stop practicing

26 medicine in California, respondent shall notify the Division or

27 its designee in writing within ten (lO) days of the dates of

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1 departure and return or the dates of non-practi~e within

2 California. Non-practice is defined as any period of time

3 exceeding thirty (30) days in which respondent is not engaging in

4 any evidence defined in Sections 2051 and 2052 of the Business

5 and Professions Code. All time spent in an intensive training

6 program approved by the Division or its designee shall be

7 considered as time spent in the practice of medicine. Periods of

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temporary or permanent residence or practice outside California

or of non-practice within California, as defined in this

condition, will not apply to the reduction of the probationary

period.

0. COMPLETION OF PROBATION Upon successful completion

of probation, respondent's certificate shall be fully restored.

P. VIOLATION OF PROBATION If respondent violates

probation in any respect, the Division, after giving respondent

notice and the opportunity to be heard, may revoke probation and

carry out the disciplinary order that was stayed. If an

accusation or petition to revoke probation is filed against

respondent during probation, the Board shall have continuing

jurisdiction until the matter is final, and the period of

probation shall be extended until the matter is final.

Q. LICENSE SURRENDER Following the effective date of

this probation, if respondent ceases practicing due to

retirement, health reasons or is otherwise unable to satisfy the

terms and conditions of probation, respondent may voluntarily

tender his certificate to the Division. The Division reserves

the right to evaluate the respondent's request and to exercise

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1 its discretion whether to grant the request, or to take any other ,,

2 action deemed appropriate and reasonable under the circumstances.

3 Upon formal acceptance of the tendered license, respondent will

4 no longer be subject to the terms and conditions of probation.

5 9. IT IS FURTHER STIPULATED AND AGREED that the terms

6 set forth herein shall be null and void, and in no way binding

7 upon the parties hereto, unless and until accepted by the Medical

8 Board of California. Respondent further agrees that in addition

9 to submitting this stipulation to the Board for acceptance and

10 adoption, counsel for complainant may also submit to the Board a

11 memorandum recommending the stipulation's adoption. Respondent

12 agrees that the memorandum recommending adoption shall not, under

13 any circumstances, be discoverable or disclosed to respondent.

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1 ENDORSEMENT

2 The foregoing Stipulated Settlement and Decision is

3 hereby respectfully submitted for consideration of the Division

4 of Medical Quality, Medical Board of California, Department of

5 Consumer Affairs.

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DATED:

BILL LOCKYER, Attorney General of the State of California

13.

1 DANIEL E. LUNGREN, Attorney General of the State of California

2 JANE ZACK SIMON, State Bar No. 116564 Deputy Attorney General

3 California Department of Justice 50 Fremont Street, Suite 300

4 San Francisco, California 94105-2239 Telephone: ( 415) 356-6286

5 Facsimile: (415) 356-6257

6 Attorneys for Complainant

BEFORE THE 7

8

9

DIVISION OF MEDICAL QUALITY MEDICAL BOARD OF CALIFORNIA

STATE OF CALIFORNIA

10

11 In the Matter of the Accusation Against:

Case No. 12-92-21413

12 FIRST AL'1ENDED ACCUSATION JEFFREY FRIEDMAN, M.D.

13 911 Moraga Road, Suite 205 Lafayette, CA 94549

14 Physician's and Surgeon's

15 Certificate No.G46244,

16 Respondent.

The Complainant alleges:

PARTIES

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20 1. Complainant, Ron Joseph, is tt.e Executi "'Ie Director

21 of the Medical Board of California (hereinafter the "Board") and

22 brings this First Amended Accusation solely in his official

23 capacity. This First Amended Accusation shall supersede and

24 replace the Accusation previously filed on April 18, 1996.

25 2. On or about October 2, 1981, Certificate No.

26 G46244 was issued by the Board to JEFFREY FRIEDMAN, M.D.

27 (hereinafter "respondent"), and at all times relevant to the

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charges brought herein, this license has been in full force and

effect. Unless renewed, it will expire on July 31, 1999.

JURISDICTION

3. This First Amended Accusation is brought before

the Division of Medical Quality of the Medical Board of

California, Department of Consumer Affairs (hereinafter the

"Division"), under the authority of the following sections of the

California Business and Professions Code (hereinafter "Code"):

A. Section 2227 of the Code provides that a licensee

who is found guilty under the Medical Practice Act may have

his 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 othe~ action taken in

relation to discipline as the Division deems proper.

B. Section 2234 of the Code provides that the Board

may take action against any licensee who is charged with

unprofessional conduct. Unprofessional conduct includes,

but is not limited to, the following:.

(a) Violating or attempting to violate, directly or

indirectly, or assisting in or abetting the violation of, or

conspiring to violate, any provision of this chapter.

(b) Gross negligence.

(c) Repeated negligent acts.

(d) Incompetence.

(e) The commission of any act involving dishonesty or

corruption which is substantially related to the

qualifications, functions, or duties of a physician and

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surgeon.

(f) Any action or conduct which would have warranted

the denial of a certificate.

C. Section 810 of the Code provides that it shall

constitute unprofessional conduct and grounds for

disciplinary action for a health care provider to knowingly

present or cause to be presented any false or fraudulent

claim for the payment of a loss under a contract of

insurance, or to knowingly prepare, make or subscribe to any

writing with intent to present or use the same, or to allow

it to be used in support of any such claim.

D. Section 2262 provides, in pertinent part, that

altering or modifying the medical record of any person, with

fraudulent intent, or creating any false medical record,

with fraudulent intent, constitutes unprofessional conduct.

In addition to imposing disciplinary action against a

licentiate, the Division is authorized to impose a civil

penalty of $500.00 for violation of this section.

E.· Section 125.3 of the Code provides, in part, that

the Board may request the administrative law judge to direct

any licentiate found to have committed a violation or

violations of the licensing act, to pay the Board a sum not

to exceed the reasonable costs of the investigation and

enforcement of the case.

F. Section 16.01 of the Budget Act of the State of

California provides, in pertinent part, that: (a) no funds

appropriated by this act may be expended to pay any Medi-Cal

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claim for any service performed by a physician while that

physician's license is under suspension or revocation due to

a disciplinary action of the Medical Board of California;

and, (b) no funds appropriated by this act may be expended

to pay any Medi-Cal claim for any surgical service or other

invasive procedure performed on any Medi-Cal beneficiary by

a physician if that physician has been placed on probation

due to a disciplinary action of the Medical Board of

California related to the performance of that specific

service or procedure on any patient, except in any case

where the board makes a determination during its

disciplinary process that there exist compelling

circumstances that warrant continued~edi-Cal reimbursement

during the probationary period.

FIRST CAUSE FOR DISCIPLINE

(Patient C. S .. ll)

(Gross Negligence/Incompetence, Unprofessional Conduct)

4. Respondent, who specializes .in cosmetic surgery,

19 first saw patient C.S. on or about June 8, 1992. C.S. initially

20 consulted with respondent concerning the possibility of a scar

21 revision procedure and liposuction. At some point during C.S.'s

22 initial visit, a member of respondent's office staff suggested to

23 C.S. that she consider calf implementation surgery. C.S. spoke

24 with respondent, who told her that although he had not performed

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1. Initials are used to identify the patients in this First Amended Accusation to protect their privacy. The full names of the patients will be disclosed to respondent pursuant to a Request for Discovery.

4.

':,.', :''':.

1 the calf implant procedure before, he could do the procedure. On

2 or about July 2, 1992, C.S. returned to respondent's office for

3 further consultation regarding calf implant surgery, and she

4 decided to undergo the procedure. C.S. returned to respondent's

5 office on July 14, 1992 to complete a medical history form.

6 5. On or about July 22, 1992, respondent, with the

7 assistance of another physician, performed calf implant surgery

8 on C.S. Prior to the surgery, respondent prepared for the

9 procedure by viewing a videotape and by reading some articles.

10 6. Following surgery, C.S. developed epidermolysis,

11 ecchymosis, swelling, pain, tenderness, serous discharge, low

12 grade fever and an inability to walk. C.S. was seen by

13 respondent on or about July 24, 1992, and respondent noted

14 superficial epidermolysis on the left leg, and a blister was

15 drained. For the next 10 days, C.S. made repeated telephone

16 calls to respondent to notify him of her condition. Respondent,

17 who was on vacation, was not available to see C.S. On or about

18 July 26, 1992, respondent consulted by telephone with other

19 doctors, prescribed Decadron and maintained C.S. on antibiotics.

20 On or about July 28, 1992, respondent suggested that c.s. consult

21 with the physician who had assisted him in the surgery. C.S. saw

22 that physician on or about July 31, 1992. Respondent returned

23 from vacation, and saw C.S. on or about August 3, 5 and 8, 1992.

24 He noted continued serous drainage from both legs and erythema.

25 Respondent prescribed a different antibiotic. On August 10,

26 1992, respondent saw C.S., and observed that the incisions on

27 both legs were open. He re-sutured the incisions. C.S.

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1 continued to telephone respondent with complaints and concern

2 about her condition. Throughout this time, respondent and/or his

3 office staff repeatedly discouraged C.S. from seeking medical

4 assistance or opinions from her Kaiser health provider.

5 7. On or about August 13, 1992, respondent saw C.S.

6 and observed that the wounds were again open, and that the

7 implants were exposed. Respondent then performed surgery to

8 remove the implants. C.S. telephoned respondent on August 14 and

9 told him that she continued to have bleeding and drainage. On

10 August 17, C.S. went to respondent's office. Respondent was not

11 available, and C.S. was seen by his office nurse, who provided

12 wound care.

13 8. On August 18, 1992, C.S. so~ht treatment from

14 another physician. She was hospitalized and treated for severe

15 soft tissue infection of the lower extremities. c.s. was given

16 intravenous. antibiotic therapy and wound care, and remained

17 hospitalized for 12 days. Following the hospitalization, C.S.'s

18 wounds healed slowly, with necrosis of a portion of her calf skin

19 and breakdown of the popliteal wounds. She suffered permanent

20 scarring.

21 9. During the time C.S. was hospitalized, respondent

22 visited her frequently, and offered her money and gifts.

23 Respondent also criticized the care that C.S. was receiving at

24 Kaiser.

25 10. At some time subsequent to July 22, 1992,

26 respondent signed documents certifying that C.S. was disabled as

27 a result of her July 22, 1992 surgery. In those documents,

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1 respondent intentionally and falsely stated a diagnosis of "bad

2 circulation in legs", and described the surgical procedure as

3 "varicose surgery, vein stripping." In fact, C.S. did not

4 suffer from bad circulation in her legs, and respondent did not

5 perform varicose surgery or vein stripping.

6 11. Respondent's conduct in performing a calf implant

7 surgery without adequate training, knowledge or ability

8 constitutes unprofessional conduct, gross negligence and/or

9 incompetence and therefore constitutes cause for disciplinary

10 action pursuant to sections 2234, 2234(b) and/or 2234(d) of the

11 Code.

12 SECOND CAUSE FOR DISCIPLINE

13 (Patient C. S.)

14 (Gross Negligence/Incompetence)

15 12. The allegations of paragraphs 4-8 are incorporated

16 herein as fully set forth.

17 13. Respondent's conduct in failing to adequately

18 assess, recognize and respond to C. S. post.- surgical complications

19 constitutes gross negligence and/or incompetence and therefore

20 constitutes cause for disciplinary action pursuant to sections

21 2234(b) and/or 2234(d) of the Code.

22 THIRD CAUSE FOR DISCIPLINE

23 (Patient C. S.)

24 (Unprofessional Conduct)

25 14. The allegations of paragraphs 4-9 are incorporated

26 herein as if fully set forth.

27 15. Respondent's conduct in offering C.S. money and

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1 gifts during and after her hospitalization constitutes

2 unprofessional conduct and therefore constitutes cause for

3 disciplinary action pursuant to section 2234 of the Code.

4 FOURTH CAUSE FOR DISCIPLINE

5 (Patient C.S.)

6 (Dishonest/Corrupt Acts; Insurance Fraud)

7 16. The all~gations of paragrap~s 4 -10 are

8 incorporated herein as if fully set forth.

9 17. Respondent's conduct in knowingly falsifying

10 C.S.'s disability statements constitutes acts of dishonesty and

11 corruption which are substantially related to the qualifications,

12 functions or duties of physician and is therefore grounds for

13 discipline pursuant to section 2234(e). -

14 18. Respondent's conduct in knowingly falsifying

15 C.S.'s disability statements constitutes the knowing preparation,

16 making, subscribing or presentation of a false or fraudulent

17 claim for payment under an insurance contract, and is therefore

18 unprofessional conduct and grounds for disciplinary action

19 pursuant to section 810 of the Code.

20 FIFTH CAUSE FOR DISCIPLINE

21 (Patient K.A.)

22 (Unprofessional Conduct)

23 19. Commencing on or about March 4, 1993, K.A., a 31

24 year old woman, consulted with respondent concerning cosmetic

25 breast surgery and a scar revision. K.A.'s husband was present

26 for the meeting with respondent. Following the initial

27 consultation K.A. decided to proceed with the breast surgery.

8.

1 K.A. was seen by a member of respondent's office staff on or

2 about March 23 or 24, 1993 for a preoperative visit. Respondent

3 did not see or examine K.A. on the March 23 or 24, 1993 visit;

4 nevertheless, he indicated in his medical records that he had in

5 fact examined K.A. on March 23 or 24, 1993.

6 20. During the initial consultation and again at the

7 March 23 or 24 preoperative visit, K.A. disclosed that she was

8 under psychiatric treatment for depression and was taking

9 antidepressant medication. Respondent took no steps to evaluate

10 or document K.A.'s mental and/or emotional status prior to

11 performing cosmetic surgery.

12 21. On or about March 31, 1993, respondent performed

13 breast augmentation surgery and a unilateral crescent mastopexy

14 on K.A. K.A. saw respondent for post-operative visits on or

15 about April 7, 15 and 22, 1993. During those visits, K.A.

16 disrobed in respondent's presence, and was not given a gown to

17 wear during examinations. Respondent spoke to K.A. about his

18 personal life, and disclosed intimate, personal information to

19 her.

20 22. Soon after the April 22, 1993 visit, respondent

21 and K.A. began to date, and shortly thereafter they began a

22 sexual relationship which continued until approximately mid-July,

23 1993. During the course of the personal relationship, respondent

24 continued to provide medical advice and services to K.A., and did

25 not terminate the physician/patient relationship between himself

26 and K.A.

27 23. Respondent's conduct in commencing a sexual

9.

1 relationship with K.A. in the immediate post-operative period,

2 and in continuing to act as her physician during the relationship

3 during the time he was engaged in a personal, sexual

4 relationship, and/or in sexualizing and personalizing the

5 professional relationship constitutes cause for disciplinary

6 action pursuant to section 2234 (unprofessional conduct) .

7 SIXTH CAUSE FOR DISCIPLINE

8 (Patient K.A.)

9 (Dishonest/Corrupt Acts; Medical Records Fraud)

10 24. The allegations of paragraphs 19-22 are

11 incorporated herein as if fully set forth.

12 25. At sometime after August, 1993 respondent created

13 an entry in K.A.'s medical record which pH-rports to terminate the

14 physician/patient relationship in order to pursue a personal

15 relationship based upon a full disclosure to K.A. by respondent.

16 In fact, no such discussion or disclosure was ever made by

17 respondent to K.A ..

18 26. Respondent's conduct in falsely manufacturing the

19 medical record reflecting the purported May 12, 1993 discussion

20 between K.A. and respondent constitutes cause for discipline

21 pursuant to section 2234(e) (dishonest and corrupt acts).

22 27. Respondent's conduct as alleged constitutes a

23 material alteration of K.A.'s medical records and is therefore a

24 violation of section 2262 of the Code.

25 28. Respondent's conduct in documenting in K.A.'s

26 medical record that he examined her on March 23 or 24, 1993 when

27 he had not done so, as alleged in paragraph 19 above, constitutes

10.

1 cause for discipline pursuant to section 2234(e) (dishonest and

2 corrupt acts.)

3 PRAYER

4 \VBEREFORE, the complainant requests that a hearing be

5 held on the matters herein alleged, and that following the

6 hearing, the Division issue a decision:

7 1. Revoking or suspending Certificate Number G46244,

8 heretofore issued to respondent Jeffrey Friedman;

9 2. Revoking, suspending or denying approval of the

10 respondent's authority to supervise physician's assistants,

11 pursuant to Business and Professions Code section 3527;

12 3 . Ordering respondent to pay the Division the actual

13 and reasonable costs of the investigation and enforcement of this

14 case; and, if placed on probation, the costs of probation

15 moni taring;

16

17

18

19

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21

22

23

24

25

26

27

4. Taking such other and further action as the

Division deems necessary and proper.

DATED: 1\~ \~ 3

~~~~~: %~ if~ J Medical Board of California Department of Consumer Affairs State of California

Complainant

11.