BEFORE THE MEDICAL BOARD OF CALIFORNIA

DEPARTMENT OF CONSUMER AFFAIRS STATE OF CALIFORNIA

In the Matter of the Accusation Against:

Naina Sachdev, M.D.

Physician's and Surgeon's Certificate No. G 88925

Respondent

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Case No. 16-2012-224258

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DECISION

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

This Decision shall become effective at 5:00 p.m. on September 9, 2016.

IT IS SO ORDERED: August 10, 2016.

MEDICAL BOARD OF CALIFORNIA

Howard Krauss, M.D., Chair Panel B

BEFORE THE MEDICAL BOARD OF CALIFORNIA

DEPARTMENT OF CONSUMER AFFAIRS STATE OF CALIFORNIA

In the Matter of the Accusation Against:

NAINA SACHDEV., M.D.,

Physician's and Surgeon's Certificate No. G 88925

Respondent.

Case No. 16-2012-224258

OAH No. 2016030857

PROPOSED DECISION

This matter came on regularly for hearing on June 8, 2016, in Los Angeles, California, before H. Stuart Waxman, Administrative Law Judge, Office of Administrative Hearings, State of California.

Jane Zack Simon, Supervising Deputy Attorney General, represented Kimberly Kirchmeyer (Complainant).

Naina Sachdev (Respondent) was present and was represented by Jennifer A. Hansen, Attorney at Law.

Oral and documentary evidence was received. The record was closed on the hearing date, and the matter was submitted for decision.

FACTUAL FINDINGS

1. Complainant is the Executive Director of the Medical Board of California (California Board).

2. On April13, 2011, the Board issued Physician's Certificate Number G 88925 to Respondent. The license was in full force and effect at all relevant times. It is scheduled to expire on February 28, 2017.

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3. Trained in internal medicine, Respondent presently practices functional and integrative medicine. That practice views the patient as a whole person rather than as a series of systems and symptoms to be treated individually and separately by various medical specialists. It is an evidence-based approach of viewing imbalances in the body and addressing them by altering lifestyle, diet, and nutrition. Thus, the practice applies concepts such as nutrigenomics, mind-body medicine, spirituality, nutrition, and the like. Respondent is board certified in anti-aging by the Academy of Anti-Aging and Regenerative Medicine. That board is not recognized by the American Board of Medical Specialties.

4. Respondent has both a television and a radio show in which she discusses integrative medicine. She lectures extensively and has published some of her research.

5. Respondent is pursuing a Master of Science degree in functional medicine. Much of her studies are completed online. Respondent is unsure of the name of the institution offering that degree.

6. On June 20, 1989, the Oregon Medical Board (Oregon Board) issued Medical Doctor license number LL04029 to Respondent. On June 7, 2012, Respondent and the Oregon Medical Board entered into an agreement for an Interim Suspension Order under which Respondent agreed to suspend her medical practice and place her license on inactive status pending the outcome of an investigation by the Oregon Board. Respondent violated the terms of the Interim Suspension Order on several occasions thereafter.

7. On October 2, 2014, the Oregon Board revoked Respondent's Medical Doctor license 1 citing various violations of the Interim Suspension Order (Exhibit 5, pp. 86-91 ), which included the following:

a. Respondent instructed a member of her staff to perform a laser facial treatment of Botox on a patient. Her instructions included the number of laser pulses to use and the precise location for the treatment. Respondent also instructed the staff member to modify the amount of Botox to use on the patient.

b. In a text message, Respondent agreed to a patient's request for a dosage change of the patient's medication. She instructed her staff to document the dosage change.

c. Respondent reviewed patient charts and, based on those reviews, instructed her staff members to order tests for certain patients and to make other treatment decisions.

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1 Respondent appealed the Oregon Board's decision to revoke her license. The appeal is pending.

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8. The Oregon Board found that Respondent's violations of the Interim Suspension Order were willful and intentional, but not malicious.

9. In its Final Order (!d. at 102-139), the Oregon Board also found that Respondent committed the following violations exclusive of Respondent's practicing medicine while suspended:

a. Respondent prescribed testosterone injections for her husband, but she did not conduct a medical history, physical examination, evaluation or assessment, and she did not follow-up on the efficacy of the treatment. She also failed to keep a medical record of that treatment.

b. Respondent self-prescribed testosterone but did not create a medical record of that treatment.

c. Respondent prescribed controlled substance to her office stafi members. She instructed them to have the prescriptions filled and to return the medications to the office to be used as "office stock."

d. Respondent prescribed Phentermine (a controlled substance used for weight loss) to patients but failed to conduct and/or document either an evaluation or the medical indication for the medication. The manner in which Phentermine is to be evaluated and prescribed is specified by Oregon law.

e. Respondent prescribed Adderall to patients but failed to conduct and/or document a clinical evaluation to justify its use or a diagnosis of attention deficit disorder (ADD) or attention deficit hyperactivity disorder (ADHD). She also failed to follow-up on the efficacy of the treatment.

f. Respondent failed to conduct and/or document an evaluation or medical indication before prescribing testosterone to patients. She also failed to document a proper informed consent.

g. Respondent prescribed an ineffective dose of an antibiotic to treat a patient's infection.

h. Respondent failed to maintain a written inventory of the controlled substances she maintained in her office.

1. Respondent failed to coordinate care with and communicate with a patient's oncologist.

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10. The Oregon Board made the following findings in determining the level of discipline to be imposed on Respondent:

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At hearing, Dr. Sachdev stated more than once that she is a "perfectionist," and that she has extremely high standards of practice. The record, however, demonstrates otherwise with regard to her conduct as a physician. The Board has established that Dr. Sachdev repeatedly exercised poor clinical judgment by prescribing controlled substances without conducting and/or documenting adequate clinical evaluations and follow-up care; by continuing to prescribe controlled substances to patients without documenting any justification for the continuing treatment; by failing to engage in or document any coordination of care with a multiple myeloma patient's treating oncologist; by providing insufficient doses of antibiotics to treat a patient's potential post-operative wound infection; by self-treating with IM testosterone and not documenting the medical indications or the efficacy of the treatment; and by prescribing IM testosterone to a family member without conducting an examination of the patient, documenting the medical indication and conducting any follow up to determine how the patient was responding to the treatment.

At hearing, Dr. Sachdev was loathe to admit to any mistakes or deficiencies in her medical practice, and she frequently had convoluted, contradictory, or downright puzzling explanations for her conduct. For example, when asked whether she considered it important to document that a patient had stopped taking her Phentermine medication, she explained that when she charts, she is really only concerned with things that are dangerous to a patient, and because she was focusing on other issues with this particular patient she did not feel it was important to chart the patient's non-life-threatening discontinuation of the medication. This was just one of several troubling justifications she provided at hearing for conduct that failed to meet standards of care.

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Ultimately, the Board must determine whether, in light of Dr. Sachdev's demonstrated practice deficiencies, she can nonetheless modify her conduct to meet the standards of care in the future. During the investigatory phase of this case, Dr. Sachdev entered into a stipulated agreement with the Board, wherein she agreed to refrain from the practice of medicine pending resolution of the matter. She, unfortunately breached that agreement. In so doing, she demonstrated that she was unwilling to cooperate with the Board for a finite period of time. This casts serious doubt on her willingness and ability to comply with the Board on a long-term basis.

(!d. at pp. 141-142.)

11. Respondent also declined to admit her mistakes when she testified at the hearing in the instant case. For example, when asked repeatedly if she believed the Oregon Board was correct in its findings, Respondent testified that she took the findings of the Oregon Board seriously and "to heart." (Respondent's term.)

12. Respondent has changed her medical practice in several ways since her Oregon license was revoked.

a. She has reduced the number of patients she sees each day from between 25 and 30 to between one and three.

b. Respondent no longer dictates her notes to be transcribed. Instead, she types her own notes into an electronic medical record system. All paper documents relating to a patient are scanned into the system. By typing laboratory results into the system, Respondent is able to see minute trends in the patient's condition and treatment.

c. Respondent spends up to two hours with a new patient taking a physical and psycho-social history, performing a review of systems, and performing a physical examination, and she spends another hour entering the information from those processes into the electronic medical record keeping system. She devises a treatment plan and types the treatment protocol and gives it to the patient. That protocol includes medications, consent forms, and side effects.

d. Respondent uses a variety of forms to maintain information on patients, and she periodically updates the information on the forms.

e. Respondent performs only minor, minimally invasive surgical procedures such as Botox injections, chemical peels, and laser treatments.

f In order to improve her coordination of care, she asks her patients the identity of their other physicians, and she occasionally contacts those physicians. She also occasionally observes procedures performed on her patients by their other physicians.

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g. Respondent no longer prescribes medications for herself, her family members, or office staff members. She attempts to be "hyper-vigilant" (Respondent's term) about prescribing, and she has reduced the amount of controlled substances she prescribes. She calls the patient's pharmacist and asks him/her to check CURES2 to determine if the patient is receiving the same medication from another source.

13. Respondent attributes her practicing medicine after the Oregon Board suspended her license to her attorney's advice, which she tried to follow meticulously. She believes that, in retrospect, she should have communicated with the Oregon Board before performing the services that eventually led to her license revocation. However, she claims she had no motive to do anything either the Oregon Board or the California Board would consider "willful."

14. The Florida Medical Board revoked Respondent's license to practice medicine in that state based on the discipline imposed in Oregon. Although Respondent was previously licensed in Florida, she never practiced there.

15. Respondent has taken numerous training courses and classes involving integrative and functional medicine and aesthetics, as well as more traditional medical subjects. She took those courses and classes both before and after the Oregon Board revoked her license to practice medicine.

16. Steven Ross, D.C. is Respondent's colleague in integrative medicine. He is the co-founder and president of the American College oflntegrative and Functional Medicine, an organization for which Respondent has lectured on two occasions. He has known Respondent for five years. Dr. Ross finds Respondent's coordination of care and record keeping excellent and her understanding of biochemistry and physiology second to none. He has witnessed Respondent's changes in her practice and believes she is sincere in her attempts to improve it.

17. Respondent submitted letters from several individuals, including patients and colleagues, which were admitted as "administrative hearsay" pursuant to Government Code section 11513, subdivision (d). The letters' authors collectively attest to Respondent's skill and compassion as a physician, and they corroborate Respondent's testimony concerning the improvements she has made to her medical practice.

18. Respondent was credible in her testimony that she desires a compliant and cooperative relationship with the California Board. She is willing to accept a probation of any duration, and she is prepared to comply with any and all probationary terms and conditions.

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2 CURES is an acronym for Controlled Substance Utilization Review, a database of Schedule II, III, and IV controlled substance prescribed and dispensed in California.

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LEGAL CONCLUSIONS

1. Cause exists to discipline Respondent's certificate, pursuant to Business and Professions Code3 sections 141 and 2305, for discipline imposed by another state, as set forth in Findings 6, 7, 8, 9, and 10.4

2. Respondent argues that discipline should not be imposed by the California Board because the discipline in Oregon was based on a preponderance of the evidence standard of proof while, in California, the standard of proof is clear and convincing evidence to a reasonable certainty. (Ettinger v. Board (?f Medical Quality Assurance (1982) 135 Cal.App.3d 853, 856; In reMarriage of Weaver (1990) 224 Cal.App.3d 478.) The argument was not persuasive. Neither section 141 nor section 2305 require Complainant to re-prove the matters that resulted in sister state discipline by a higher standard of proof than used in that state.

3. Section 141, subdivision (a) requires only the fact that a licensee's license in another state was disciplined. "A certified copy of the record of the disciplinary action taken against the licensee by another state ... shall be conclusive evidence of the events related therein." Complainant entered into evidence a certified copy of the Oregon Board's disciplinary proceedings, thus satisfYing the criteria set forth in section 141.

4. Section 2305 calls for discipline of a California physician's certificate if the discipline in a sister state "would have been grounds for discipline in California" under the applicable provisions of the Medical Practice Act. Complainant proved, by clear and convincing evidence, that the violations found by the Oregon Board would have been causes for discipline in California. (See, for example, Bus. & Prof. Code§§ 2234 and 2266.)

5. It is the fact that a California licensee was disciplined in another state which must be proven by clear and convincing evidence in California, not the underlying allegations that resulted in the sister-state discipline. (Merek v. Board (?f Podiatric Medicine (1993) 16 Cal.App.4th 1089, 1096; Medical Board (?fCal?fornia v. Superior Court (Lam) (200 1) 88 Cal.App.4th 1001.) The California Board need not consider difTering standards of proof between California and another state in which discipline was imposed. (Clare v. State Board (?f Accountancy ( 1992) 10 Cal.App.4th 294.)

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3 All statutory references are to the Business and Professions Code unless otherwise indicated.

4 The revocation of Respondent's license by the Florida Board, as referenced in Factual Finding l4, is not alleged as a cause for discipline in the Accusation. Therefore, the Florida revocation is not included as a cause for discipline in this decision.

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6. Section 2229 states:

(a) Protection of the public shall be the highest priority for the Division of Medical Quality, the California Board of Podiatric Medicine, and administrative law judges of the Medical Quality Hearing Panel in exercising their disciplinary authority.

(b) In exercising his or her disciplinary authority an administrative law judge of the Medical Quality Hearing Panel, the division, or the California Board of Podiatric Medicine, shall, wherever possible, take action that is calculated to aid in the rehabilitation of the licensee, or where, due to a lack of continuing education or other reasons, restriction on scope of practice is indicated, to order restrictions as are indicated by the evidence.

(c) It is the intent of the Legislature that the division, the California Board of Podiatric Medicine, and the enforcement program shall seek out those licensees who have demonstrated deficiencies in competency and then take those actions as are indicated, with priority given to those measures, including further education, restrictions from practice, or other means, that will remove those deficiencies. Where rehabilitation and protection are inconsistent, protection shall be paramount.

7. Remorse for one's conduct and the acceptance of responsibility are the cornerstones of rehabilitation. Rehabilitation is a "state of mind" and the law looks favorably on rewarding one who has achieved "reformation and regeneration" with the opportunity to serve. (Pacheco v. State Bar (1987) 43 Cal. 3d 1041, 1058.) Fully acknowledging the wrongfulness of past actions is an essential step towards rehabilitation. (Seide v. Committee of Bar Examiners (1989) 49 Cal.3d 933, 940.) However, mere remorse does not demonstrate rehabilitation. A truer indication of rehabilitation is sustained conduct over an extended period of time. (In re Menna (1995) 11 Cal.4th 975, 991.) The evidentiary significance of misconduct is greatly diminished by the passage of time and by the absence of similar, more recent misconduct. (Kwasnik v. State Bar (1990) 50 Cal.3d 1061, 1 070.) In the instant case, although Respondent's reluctance to accept responsibility for her actions in Oregon is troubling, it is countered by her strong efforts to improve her practice. However, those efforts demonstrate only the beginning, not the conclusion, of her rehabilitation, especially in light of the fact that Respondent's Oregon medical license was revoked only in October 2014.

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8. While Respondent's improvements in her medical practice are promising, if she is to continue practicing medicine in California, she must assure the California Board that she can do so safely and in compliance with California law. To that end, Respondent will be placed on probation under various terms and conditions. The terms and conditions will include certain classes and courses designed to address the violations and shortcomings found by the Oregon Board. The classes and courses must be taken despite Dr. Ross's high opinions of Respondent's record keeping and coordination of care because ( 1) Dr. Ross is a chiropractor who could be judging Respondent by a different standard than is used for physicians, and (2) the California Board is entitled to assurance that Respondent has been properly trained such that public protection is ensured.

9. Respondent must complete the courses and classes as described below. Accordingly, her California license shall be suspended for a period of time to provide her the opportunity to complete them and to contemplate a method of practicing medicine that will avoid the kinds of violations she committed in Oregon. In addition, Respondent shall maintain a practice and billing monitor during the entire probationary period to ensure regular and consistent compliance with California law and the standard of care.

ORDER

Certificate No. G 88925 issued to Respondent, Naina Sachdev, M.D., is revoked pursuant to Legal Conclusions 1, 2, 3, 4, 5, 6, 7, and 8, separately and for all of them. However, the revocation is stayed, and Respondent is placed on probation for five years upon the following terms and conditions.

1. Actual Suspension

As part of probation, Respondent is suspended from the practice of medicine for 180 days beginning the 16th day after the effective date of this Decision.

2. Prescribing Practices Course

Within 60 calendar days of the effective date of this Decision, Respondent shall enroll in a course in prescribing practices equivalent to the Prescribing Practices Course at the Physician Assessment and Clinical Education Program, University of California, San Diego School of Medicine, approved in advance by the Board or its designee. Respondent shall provide the program with any information and documents that the program may deem pertinent. Respondent shall participate in and successfully complete the classroom component of the course not later than six months after Respondent's initial enrollment. Respondent shaH successfully complete any other component of the course within one year of enrollment. The prescribing practices course shall be at Respondent's expense and shall be in addition to the Continuing Medical Education (CME) requirements for renewal of licensure.

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A prescribing practices course taken after the acts that gave rise to the charges in the Accusation, but prior to the effective date of the Decision may, in the sole discretion of the Board or its designee, be accepted towards the fulfillment of this condition if the course would have been approved by the Board or its designee had the course been taken after the effective date of this Decision.

Respondent shall submit a certification of successful completion to the Board or its designee not later than 15 calendar days after successfully completing the course, or not later than 15 calendar days after the effective date of the Decision, whichever is later.

3. Medical Record Keeping Course

Within 60 calendar days of the etTective date ofthis Decision, Respondent shall enroll in a course in medical record keeping equivalent to the Medical Record Keeping Course offered by the Physician Assessment and Clinical Education Program, University of California, San Diego School of Medicine, approved in advance by the Board or its designee. Respondent shall provide the program with any information and documents that the program may deem pertinent. Respondent shall participate in and successfully complete the classroom component of the course not later than six months after Respondent's initial enrollment. Respondent shall successfully complete any other component of the course within one year of enrollment. The medical record keeping course shall be at Respondent's expense and shall be in addition to the Continuing Medical Education (CME) requirements for renewal of licensure.

A medical record keeping course taken after the acts that gave rise to the charges in the Accusation, but prior to the effective date of the Decision may, in the sole discretion of the Board or its designee, be accepted towards the fulfillment of this condition if the course would have been approved by the Board or its designee had the course been taken after the effective date of this Decision.

Respondent shall submit a certification of successful completion to the Board or its designee not later than 15 calendar days after successfully completing the course, or not later than 15 calendar days after the effective date of the Decision, whichever is later.

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4. Education Course

Within 60 calendar days of the effective date of this Decision, and on an annual basis thereafter, Respondent shall submit to the Board or its designee for its prior approval educational program(s) or course(s) which shall not be less than 40 hours per year, for each year of probation. The educational program( s) or course( s) shall be aimed at correcting any areas of deficient practice or knowledge and shall be Category I certified. The educational program(s) or course(s) shall be at Respondent's expense and shall be in addition to the Continuing Medical Education (CME) requirements for renewal of licensure. Following the completion of each course, the Board or its designee may administer an examination to test Respondent's knowledge of the course. Respondent shall provide proof of attendance for 65 hours of CME of which 40 hours were in satisfaction of this condition.

5. Professionalism Program (Ethics Course)

Within 60 calendar days of the effective date of this Decision, Respondent shall enroll in a professionalism program that meets the requirements of California Code of Regulations, title 16, section 1358. Respondent shall participate in and successfully complete that program. Respondent shall provide any information and documents that the program may deem pertinent. Respondent shall successfully complete the classroom component of the program not later than six months after Respondent's initial enrollment, and the longitudinal component of the program not later than the time specified by the program, but no later than one year after attending the classroom component. The professionalism program shall be at Respondent's expense and shall be in addition to the CME requirements for renewal of licensure.

A professionalism program taken after the acts that gave rise to the charges in the Accusation, but prior to the effective date of the Decision may, in the sole discretion of the Board or its designee, be accepted towards the fulfillment of this condition if the program would have been approved by the Board or its designee had the program been taken after the effective date of this Decision.

Respondent shall submit a certification of successful completion to the Board or its designee not later than 15 calendar days after successfully completing the program or not later than 15 calendar days after the efTective date of the Decision, whichever is later.

6. Clinical Training Program

Within 60 calendar days of the termination of suspension, Respondent shall enroll in a clinical training or educational program equivalent to the Physician Assessment and Clinical Education Program (PACE) ofiered at the University of California- San Diego School of Medicine. Respondent shall successfully complete the program not later than six months after Respondent's initial enrollment unless the Board or its designee agrees in writing to an extension of that time.

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The program shall consist of a Comprehensive Assessment program comprised of a two-day assessment of Respondent's physical and mental health; basic clinical and communication skills common to all clinicians; and medical knowledge, skill and judgment pertaining to Respondent's area of practice in which Respondent was alleged to be deficient, and at minimum, a 40 hour program of clinical education in the area of practice in which Respondent was alleged to be deficient and which takes into account data obtained from the assessment, Decision(s), Accusation(s), and any other information that the Board or its designee deems relevant. Respondent shall pay all expenses associated with the clinical training program.

Based on Respondent's performance and test results in the assessment and clinical education, the program will advise the Board or its designee of its recommendation( s) for the scope and length of any additional educational or clinical training, treatment for any medical condition, treatment for any psychological condition, or anything else affecting Respondent's practice of medicine. Respondent shall comply with program recommendations.

At the completion of any additional educational or clinical training, Respondent shall submit to and pass an examination. Determination as to whether Respondent successfully completed the examination or successfully completed the program is solely within the program's jurisdiction.

If Respondent fails to enroll, participate in, or successfully complete the clinical training program within the designated time period, Respondent shall receive a notification from the Board or its designee to cease the practice of medicine within three calendar days after being so notified. Respondent shall not resume the practice of medicine until enrollment or participation in the outstanding portions of the clinical training program has been completed. If Respondent did not successfully complete the clinical training program, Respondent shall not resume the practice of medicine until a final decision has been rendered on the accusation and/or a petition to revoke probation. The cessation of practice shall not apply to the reduction of the probationary time period.

Within 60 days after Respondent successfully completes the clinical training program, Respondent shall participate in a professional enhancement program equivalent to the one offered by the Physician Assessment and Clinical Education Program at the University of California, San Diego School of Medicine, which shall include quarterly chart review, semi­annual practice assessment, and semi-annual review of professional growth and education. Respondent shall participate in the professional enhancement program at Respondent's expense during the term of probation, or until the Board or its designee determines that further participation is no longer necessary.

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7. Practice and Billing Monitoring

Within 30 calendar days of the effective date of this Decision, Respondent shall submit to the Board or its designee for prior approval as a practice and billing monitor, the name and qualifications of one or more licensed physicians and surgeons whose licenses are valid and in good standing, and who are preferably American Board of Medical Specialties (ABMS) certified. A monitor shall have no prior or current business or personal relationship with Respondent, or other relationship that could reasonably be expected to compromise the ability of the monitor to render fair and unbiased reports to the Board, including but not limited to any form of bartering, shall be in Respondent's field of practice, and must agree to serve as Respondent's monitor. Respondent shall pay all monitoring costs.

The Board or its designee shall provide the approved monitor with copies of the Decision(s) and Accusation(s), and a proposed monitoring plan. Within 15 calendar days of receipt of the Decision(s), Accusation(s), and proposed monitoring plan, the monitor shall submit a signed statement that the monitor has read the Decision(s) and Accusation(s), fully understands the role of a monitor, and agrees or disagrees with the proposed monitoring plan. If the monitor disagrees with the proposed monitoring plan, the monitor shall submit a revised monitoring plan with the signed statement for approval by the Board or its designee.

Within 60 calendar days of the termination of suspension, and continuing throughout probation, Respondent's practice and billing shall be monitored by the approved monitor. Respondent shall make all records available for immediate inspection and copying on the premises by the monitor at all times during business hours and shall retain the records for the entire term of probation.

If Respondent fails to obtain approval of a monitor within 60 calendar days of the effective date of this Decision, Respondent shall receive a notification from the Board or its designee to cease the practice of medicine within three calendar days after being so notified. Respondent shall cease the practice of medicine until a monitor is approved to provide monitoring responsibility.

The monitor(s) shall submit a quarterly written report to the Board or its designee which includes an evaluation of Respondent's performance, indicating whether Respondent's practices are within the standards of practice of medicine and billing, and whether Respondent is practicing medicine safely and billing appropriately. It shall be the sole responsibility of Respondent to ensure that the monitor submits the quarterly written reports to the Board or its designee within 10 calendar days after the end of the preceding quarter.

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If the monitor resigns or is no longer available, Respondent shall, within five calendar days of such resignation or unavailability, submit to the Board or its designee, for prior approval, the name and qualifications of a replacement monitor who will be assuming that responsibility within 15 calendar days. If Respondent fails to obtain approval of a replacement monitor within 60 calendar days of the resignation or unavailability of the monitor, Respondent shall receive a notification from the Board or its designee to cease the practice of medicine within three calendar days. After being so notified, Respondent shall cease the practice of medicine until a replacement monitor is approved and assumes monitoring responsibility.

In lieu of a monitor, Respondent may participate in a professional enhancement program equivalent to the one offered by the Physician Assessment and Clinical Education Program at the University of California, San Diego School of Medicine, that includes, at minimum, quarterly chart review, semi-annual practice assessment, and semi-annual review of professional growth and education. Respondent shall participate in the professional enhancement program at Respondent's expense during the term of probation.

8. Notification

Within seven days of the effective date of this Decision, Respondent shall provide a true copy of this Decision and Accusation to the Chief of Staff or the Chief Executive Officer at every hospital where privileges or membership are extended to Respondent, at any other facility where Respondent engages in the practice of medicine, including all physician and locum tenens registries or other similar agencies, and to the Chief Executive Officer at every insurance carrier which extends malpractice insurance coverage to Respondent. Respondent shall submit proof of compliance to the Board or its designee within 15 calendar days of the effective date of this Decision.

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

9. Supervision of Physician Assistants

During probation, Respondent is prohibited from supervising physician assistants.

10. Obey All Laws

Respondent shall obey all federal, state and local laws, all rules governing the practice of medicine in California and remain in full compliance with any court ordered criminal probation, payments, and other orders.

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11. Quarterly Declarations

Respondent shall submit quarterly declarations under penalty of perjury on forms provided by the Board, stating whether there has been compliance with all the conditions of probation.

Respondent shall submit quarterly declarations not later than 10 calendar days after the end of the preceding quarter.

12. General Probation Requirements

Compliance with Probation Unit

Respondent shall comply with the Board's probation unit and all terms and conditions of this Decision.

Address Changes

Respondent shall, at all times, keep the Board informed of Respondent's business and residence addresses, email address (if available), and telephone number. Changes of such addresses shall be immediately communicated in writing to the Board or its designee. Under no circumstances shall a post office box serve as an address of record, except as allowed by Business and Professions Code section 2021, subdivision (b).

Place of Practice

Respondent shall not engage in the practice of medicine in Respondent's or patient's place of residence, unless the patient resides in a skilled nursing facility or other similar licensed facility.

License Renewal

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

Travel or Residence Outside California

Respondent shall immediately inform the Board or its designee, in writing, of travel to any areas outside the jurisdiction of California which lasts, or is contemplated to last, more than 30 calendar days.

In the event Respondent should leave the State of California to reside or to practice, Respondent shall notify the Board or its designee in writing 30 calendar days prior to the dates of departure and return.

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13. Interview with the Board or its Designee

Respondent shall be available in person upon request for interviews either at Respondent's place of business or at the probation unit office, with or without prior notice throughout the term of probation.

14. Non-practice While on Probation

Respondent shall notify the Board or its designee in writing within 15 calendar days of any periods of non-practice lasting more than 30 calendar days and within 15 calendar days of Respondent's return to practice. Non-practice is defined as any period of time Respondent is not practicing medicine in California as defined in Business and Professions Code sections 2051 and 2052 for at least 40 hours in a calendar month in direct patient care, clinical activity or teaching, or other activity as approved by the Board. All time spent in an intensive training program which has been approved by the Board or its designee shall not be considered non-practice. Practicing medicine in another state of the United States or Federal jurisdiction while on probation with the medical licensing authority of that state or jurisdiction shall not be considered non-practice. A Board-ordered suspension of practice shall not be considered as a period of non-practice.

In the event Respondent's period of non-practice while on probation exceeds 18 calendar months, Respondent shall successfully complete a clinical training program that meets the criteria of Condition 18 ofthe current version ofthe Board's "Manual of Model Disciplinary Orders and Disciplinary Guidelines" prior to resuming the practice of medicine.

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

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

Periods of non-practice will relieve Respondent of the responsibility to comply with the probationary terms and conditions with the exception of this condition and the following terms and conditions of probation: Obey All Laws; and General Probation Requirements.

15. Violation of Probation

Failure to fully comply with any term or condition of probation is a violation of probation. If Respondent violates probation in any respect, the Board, 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, or an Interim Suspension Order 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.

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16. License Surrender

Following the effective date of this Decision, if Respondent ceases practicing due to retirement or health reasons or is otherwise unable to satisfy the terms and conditions of probation, Respondent may request to surrender her license. The Board reserves the right to evaluate Respondent's request and to exercise its discretion in determining whether or not to grant the request, or to take any other action deemed appropriate and reasonable under the circumstances. Upon formal acceptance ofthe surrender, Respondent shall, within 15 calendar days, deliver Respondent's wallet and wall certificate to the Board or its designee and Respondent shall no longer practice medicine. Respondent will no longer be subject to the terms and conditions of probation. If Respondent re-applies for a medical license, the application shall be treated as a petition for reinstatement of a revoked certificate.

17. Probation Monitoring Costs

Respondent shall pay the costs associated with probation monitoring each and every year of probation, as designated by the Board, which may be adjusted on an annual basis. Such costs shall be payable to the Medical Board of California and delivered to the Board or its designee no later than January 31 of each calendar year.

18. Completion of Probation

Respondent shall comply with all financial obligations (e.g., restitution, probation costs) not later than 120 calendar days prior to the completion of probation. Upon successful completion of probation, Respondent's certificate shall be fully restored.

Dated: June 22, 2016

~ OocuSigned by:

ft. <;~ Wttf>~t:Wv 298AE76351A24FC

H. STUART WAXMAN Administrative Law Judge Office of Administrative Hearings

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KAt\IALA D. I-1.-'\RRIS Attorney General of California JANE 7ACK Sifv!Of\. Supervising Deputy Attorney General State Bar No. 1 !6564

455 Golden CJate ;\venue. Suite 11000 San Francisco. C A 941 02-7004 Telephone: ( 415) 703-5544 Facsimile: (415) 703-5480 F-m a i l : J m1.~zl~l: h.,.::;_LnJ.Q!:D.uilli.~t..cg~~

j I 1 urney.1 fin· ( 'olllfJ(o inanr

BEFORE THI<~ MEDICAL BOARD OF CALIFORNIA

DEPARTMENT OF CONSlJMER AFFAIRS STATE OF CALIFORNIA

11 In the 'v1atter of the Accusation Against: Case No. 16-2012-224258

12 ~AINA SACI-IDEV, M.D. ACCUSATION 450 N. fkdl'ord Drive. Suite 208

13 Beverly Hills. Ci\ 90210

14 Physician's and Surgeon ·s Certificate No. CJ88925

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16 Respondent.

17 The Complainant alleges:

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

\9 of California. Dt.":partment of Consumer Affairs, and brings this Accusation solely in her oft! cia!

20 capacity.

21 On April 13. 2011, Physician's and Surgeon's Certificate No. G88925 was issued by

/} the :Vkdical Board of' California to Naina Sachdev. l'v1.D. (Respondent.) The certiJicate is

rent:\vcd and current with an expiration date ofFd1ruary 28.2015.

JURISDICTION

25 ~, This Accusation is brought bef()rc the ivledical Board oJ'Calit<xnia (13oard) under the

:?.fl authmit:r llfthc l(>llowing sections ol'the Calit<xnia Business and Profcssiuns Code {Code) an<.Vor

17 other rd:.:vant statutory enactment:

28 :\. S~ction '2'2'27 nf the Cudc provides in part that the Board may revoke.

Accusatir>n

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suspend ror a period not to exceed one year, or place on probation, the license or any

licensee \vho has been found guilty under the Medical Practic~.: Act, and may recover the

costs ot' probation monitoring.

B. Section 2305 of the Code provides. in part, that the revocation, suspension, or

other discipline. restriction or limitation imposed by another state upun a license to

practice medicine issued hy that state. that would have been grounds for discipline in

California under the Medical Practice AcL constitutes grounds t()r discipline for

unprofessional conduct.

c.

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Section 141 or the Code provides:

'"(a) For any licensee holding a license issued by a board under the jurisdiction or a department, a disciplinary action taken by anolher state, by any agency of the kderal government. or by another country lor any act substantially r..:lated to the practice regulated by the California license, may be ground for disciplinary action by the respective state licensing board. A certified copy or the record of the disciplinary action taken against the licensee by another state, an agency or the federal government, or by another country shall be conclusive e\·iclence of the events related therein.

·'(b) Nothing in this section shall preclude a board from applying a specific statutory provision in the licensing act administered by the board that provides for discipline based upon a disciplinary action taken against the licensee by another state. an agency of the federal government, or another country.

FIRST CAUSE FOR DISCIPLINE

(Discipline. Restriction, or Limitation Imposed by Another State)

On October~. :2014. the Oregon Medical Board issued a Final Order revoking

Respondent's license to practice medicine in Oregon. The Final Order contains detailed factual

tindings regarding Respondent m~.:dical practice and professional conduct. The Oregon Medical

Bounrs factual findings include:

23 • On J um: 7, 2012 Rcsponck·nt enkrecl into a voluntary Interim Suspension Order under

\vhich shc withdrc\\ li·01n the practice of medicine and placed her license on inactive

25 status p~..·nding completion ufthc Oregon Board's investigation. On se\eral occasions

26 atkr thc issuance of the Interim Suspension Order. Respondent \\illfully. voluntarily and

intentionally violated the Interim Suspension Order by engaging in conduct which

28 constitut~.:d the practice uf medicine.

i\l:cusation

• Respondent prescribed controlled substances to her husband without following accepted

procedures for examination of patients or lor documenting medical treatment.

3 • Respondent \\TOte prescriptions for controlled substances to otlicc staff and directed them

to fill the prescriptions so that the medication could be kept and used as •·office stock" for

5 surgical procedures.

6 • Respondent treated herself with testosterone without proper documentation.

7 • Respondent prescribed controlled substances to patient without proper documentation of

medical indication or response to treatment.

9 • Respondent treated a patient without engaging in or documenting any coordination of care

10 \Vith th~: patient's treating oncologist.

11 • Respomknt provided inadequate dosages of antibiotics tu a patient \Vith a potential post-

12 ope rat i \ e in !ection.

13 5. In cktl'rmining tll revoke Respondent's Oregon license. the Oregon Medical Board

14 noted that while Respomknt repeatedly stated that she was a perfectionist vvith extremely high

15 standards of practice, the record demonstrated otherwise. She repeatedly exercised poor

16 clinical judgment but was loathe to admit any mistakes or cleticiencies. She provided

17 convoluted. contradictory or "'dovvnright puzzling'' explanations of her conduct. Moreover,

18 she entetTd into an Interim Suspension Order, but breached that agreement. These factors

19 demonstrated that Respondent was unwilling to cooperate with the Board for a finite period of

20 tim.:.

21 6. Respnndenf s conduct and th.: action of the Oregon Medical Board as set forth in

Paragraphs 4 <tnd 5. above. cun~titut~.: unprofessiunal conduct \Vithin th~: meaning of section 2305

and conduct subject to discipline within the meaning of section 141(a).

PRAYf:R

WIIEREFORF:. Complainant requests that a hearing be held on thL' matters herein

:26 alleged. and that following the hearing, the Board issue a decision:

27 !. Re\oking or suspending Physician's and Surgeon's Ccrtilicate Number 0889:25

28 issued to respondent Naina SachdL·\·. M.D.:

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Accusation

2. Revoking, suspending or denying approval of Respondent's authority to supervise

2 physician assistants:

3 " .) . Ordering Respondent, i r placed on probation, to pay the costs of probation

.f monitoring: and

5 4. raking such other and further action as the Board deems necessary and proper.

6 DATED:

January 2

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Executive lY rector t\1edical Board of California Department of Consumer Alhirs State of Cali rornia

Complainant

i\ccusat ion