BEFORE THE MINNESgp. .J.~ 'tjj ' v;~~ BOARD OF MEDICAL PRACTICE

Transcription

1 Y BEFORE THE MINNESgp..J.~ 'tjj ' v;~~ BOARD OF MEDICAL PRACTICE TRUE AND EXACT OF ORIGINAL In the Matter of the Medical License of Dr. Stanislav Kruglikov Date of Birth: 4/24/60 LicenseNumber: 43,311 STIPULATION AND ORDER FOR INDEFINITE SUSPENSION IT IS HEREBY STIPULATED A1\tlJ) AGREED, by and between Dr. Stanislav Kruglikov ("Respondent") and the Complaint Review Committee ("Committee") of the Minnesota Board of Medical Practice ("Board") as follow's: 1. During all times herein, Respondent has been and now is subject to the jurisdiction of the Board from which he holds a license to practice medicine and surgery in the State of Minnesota. 2. Respondent has been advised by Board representatives that he may choose to be represented by legal counsel in this matter. Although aware of his right to representation oy counsel, Respondent has knowingly and expressly waived that right. The Committee was represented by Nathan W. Hart, Assistant Attorney General, 1400 NCL Tower, 445 Minnesota Street, St. Paul, Minnesota 55101, telephone (651) FACTS 3. For the purpose of this stipulation, the Board may consider the following facts as true: a. Respondent graduated in 1985 from Riga Medical Institute in Riga, Latvia. In April 1993, Respondent began psychiatry residency training in New Jersey. Respondent was released from the program after a few months because of probable alcoholism

2 .. and entered a long-tenn treatment center for alcohol dependency. Respondent successfully completed an alcohol rehabilitation program and was monitored until he moved to Ohio in b. While in Ohio, Respondent relapsed to alcohol use in April 1999 and entered an outpatient treatment program. On April 30, 1999, Respondent was discharged from the program and was compliant with aftercare recommendations. c. In June 2000, Respondent applied for licensure to practice medicine and surgery in the State of Minnesota. The Board's Licensure Committee referred Respondent to the Health Professionals Services Program ("HPSP"), based on infonnation contained in his Application for Licensure regarding his chemical dependency. On November 13, 2000, Respondent signed an HPSP Participation Agreement and entered into a Monitoring Plan that included a minimum of six urine and/or blood screens per quarter, a work-site monitor, quarterly self-reports, and required abstinence from alcohol and any other mood-altering chemicals. Respondent was successfully discharged from HPSP in April d. Respondent was licensed by the Board on January 13, Respondent practices psychiatry in Duluth, Minnesota. e. On September 3, 2002, Respondent self-reported to.h:fsp that he had relapsed to alcohol use. On September 4, 2002, Respondent entered inpatient chemical dependency treatment and was discharged on October 2, On October 4, 2002, Respondent entered a long-tenn, residential chemical dependency treatment center. Respondent was discharged on December 3, 2002, with recommendationsinc1uding that he not work more than 50 hours a week and that he participate in an aftercare group. f. On December 13, 2002, Respondent entered into a Participation Agreement and Monitoring Plan with HPSP. 2

3 g. On December 26, 2002, Respondent self-reported to HPSP that he had relapsed to the use of alcohol, stating that he drank alcohol between December 20 and 25,2002. Respondent stated his psychiatrist recommended an assessment at an intensive outpatient. chemical dependency program. Respondent agreed to refrain from practice on this date. h. On December 30, 2002, Respondent reported to HPSP that his last drink was "five minutes ago." 1. On January 6, 2003, Respondent spoke with HPSP staff and consulted with staff from an outpatient chemical dependency treatment program. The treatment program staff recommended Respondent meet twice a week with a program representative. HPSP recommended that Respondent refrain from practice for six months. J. In a letter to the Board dated March 11, 2003, Respondent reported that he drank alcohol for two hours on February 11, Respondent stated he was still committed to, recovery. k. On March 20, 2003, Respondent met with the Committee to discuss his history of chemical dependency and relapses. STATUTES 4. The Committee views Respondent's practices as inappropriate in such a way as to.require Board action under Minn. Stat , subd.l(l) and (r) (2002), and Respondent agrees that the conduct cited above constitutes a reasonable basis in law and fact to justify the disciplinary action under these statutes. REMEDY 5. Upon this stipulation and all of the files, records, and proceedings herein, and without any further notice or hearing herein, Respondent does hereby consent that until further ( 3

4 order of the Board, made after notice and hearing upon application by Respondent or upon the Board's own motion, the Board may make and enter an order suspending Respondent's license to. practice medicine and surgery in the State of Minnesota as follows: a. Respondent's license is INDEFINITELY SUSPENDED. b. During the period of suspension, Respondent shall not in any manner practice medicine and surgery in Minnesota. c. Respondent may petition for reinstatement of his license upon submission of satisfactory evidence of at least six months of documented, uninterrupted recovery. Satisfactory evidence shall include, but shall not be limited to, random urine and/or blood screens, satisfactory completion of chemical dependency treatment programs, written documentation of regular attendance and participation at meetings of a self-help group in support of recovery, and a report from a treating physician that Respondent is fit and competent to resume the practice of medicine with reasonable skill and safety to patients. d. Upon petitioning for reinstatement, Respondent shall appear before the Committee to discuss his petition and progress in recovery. Upon hearing Respondent's petition, the Committee may recommend that the Board continue, modify, or remove the suspension or impose conditions or restrictions as deemed necessary. e. Respondent shall sign all necessary releases allowing the Board access to all medical, mental health, evaluation, therapy, chemical dependency, or other records from any treating or evaluating health professional or facility. Respondent shall allow the Board or its designee to communicate with all treating health professionals and facilities. 6. Within ten days of signing the Stipulation to this Order, Respondent shall provide the Board with a list of all hospitals and skilled nursing facilities at whic!1 Respondent currently 4

5 5

6 At the hearing, the Board will detennine whether to impose additional disciplinary action, including additional conditions or limitations on Respondent's practice, or suspension or revocation of Respondent's license. 9. In the event the Board in its discretion does not approve this settlement, this stipulation is withdrawn and shall be of no evidentiary value and shall not be relied upon nor introduced in any disciplinary action by either party hereto except that Respondent agrees that should the Board reject this stipulation and if this case proceeds to hearing, Respondent will assert no claim that the Board was prejudiced by its review and discussion of this stipulation or of any records relating hereto. 10. Respondent waives any further hearings on this matter before the Board to which Respondent may be entitled by Minnesota or United States constitutions, statutes, or rules and agrees that the order to be entered pursuant to the stipulation shall be the final order herein. 11. Respondent hereby acknowledges that his has read and understands this stipulation and has voluntarily 'entered into the stipulation without threat or promise by the Board or any of its members, employees, or agents. This stipulation contains the entire agreement between the parties, there being no other agreement of any kind, verbal or otherwise, which varies the terms of this stipulation. Dated: 'I/12 j;f,,2003 I I Dated:._3 M_'_::J--f--' 2003 Respondent UGLIKOV ::5j AL~ Iw rip FOR THE COMMITTEE 6

7 ORDER Upon consideration of this stipulation and all the files, records, and proceedings herein, IT IS HEREBY ORDERED that the this stipulation are adopted and implemented by the Board this ~rrj. day of -----''-L-f----'-''"'~o , MINNESOTA BOARD OF MEDI L PRACTIC AG: # vl By: 7

8 AFFIDA VIT OF SERVICE BY U.S. MAIL Re: In the Matter of the Medical License of Dr. Stanislav Kruglikov License No. 43,311 STATEOFMINNESOTA ) ) ss. COUNTY OF RAMSEY ) TAMMIE L. REEVES, being first duly sworn, deposes and says: That at the City of St. Paul, County of Ramsey and State of Minnesota, on May 5, 2003, slhe caused to be served the STIPULATION AND ORDER FOR INDEFINITE SUSPENSION, by depositing the same in the United States mail at said city and state, true and correctcopy(ies) thereof, properly enveloped with prepaid first-class postage, and addressed to: DR. ST ANISLA V KRUGLIKOV 8202 E SPIRIT COVE DR DULUTH MN Subscribed and sworn to before me ~ae~ TAMMIE L. REEVES this ~ day of May, ~a-~ NOTARY PUBLIC ~, ~. ~"'~ DEBORAH A. BASTYR ~ ~e". Sf NOTARY PUBUC M/NNESOTA...'JtI My Comm. Exp. Jan "....~.. La..L.o'-: J4 AG: # vl