BEFORE THE NORTH CAROLINA MEDICAL BOARD In re: ) ) NOTICE OF CHARGES Jorge David Flechas, M.D., ) AND ALLEGATIONS ) NOTICE OF HEARING Respondent. ) The North Carolina Medical Board (hereafter Board) has preferred and does hereby prefer the following charges and allegations: 1. The Board is a body duly organized under the laws of North Carolina and is the proper party to bring this proceeding under the authority granted it in Article 1 of Chapter 90 of the North Carolina General Statutes. 2. Respondent, Jorge David Flechas, M.D. (hereafter Dr. Flechas), is a physician licensed by the Board on or about June 10, 1980, license number 26865. 3. During the times relevant herein, Dr. Flechas practiced medicine in Hendersonville, North Carolina. 4. Between approximately 2000 and 2006, Dr. Flechas treated seven patients identified herein as Patients A through G. FIRST CLAIM 5. Paragraphs one through four are re-alleged and Notice of Charges and Allegations Jorge David Flechas, M.D. Page 1 of 10
6. Dr. Flechas treated Patient A in 2005. Patient A presented requesting refills of thyroid replacement medications. 7. Dr. Flechas did not perform an adequate history and thorough physical examination with regard to Patient A, nor did he order laboratory work to determine whether Patient A had hypothyroidism, basing his diagnosis solely on Patient A s explanation to Dr. Flechas that she had had thyroid surgery previously. Additionally, Dr. Flechas failed to provide and/or failed to document in the patient s medical record Patient A s response to the large amount of thyroid replacement that Dr. Flechas prescribed. 8. With regard to Patient A, by failing to adequately diagnose and treat Patient A, and failing to record adequate information in the Patient s medical record, Dr. Flechas engaged in unprofessional conduct, including, but not limited to, departure from, or the failure to conform to, the standards of acceptable and prevailing medical practice, or the ethics of the medical profession within the meaning of N.C. Gen. Stat. 90-14(a)(6), which is grounds for the Board to annul, suspend, revoke, condition, or limit Dr. Flechas license to practice medicine and surgery issued by the Board. Notice of Charges and Allegations Jorge David Flechas, M.D. Page 2 of 10
SECOND CLAIM 9. Paragraphs one through four are re-alleged and 10. Dr. Flechas treated Patient B in 2005. Patient B presented with concerns that he may have contracted a sexually transmitted disease. 11. Dr. Flechas did not perform an adequate history and thorough physical examination with regard to Patient B, nor did he order appropriate laboratory work to determine whether Patient B had contracted a sexually transmitted disease. Dr. Flechas documentation in the patient s medical record was inadequate. Dr. Flechas prescribed Patient B a prescription for an antibiotic without knowing that the patient had contracted a disease and the antibiotic medication prescribed for Patient B was inappropriate for the sexually transmitted disease that Dr. Flechas assumed Patient B had contracted. 12. With regard to Patient B, by failing to adequately diagnose and treat Patient B, and failing to record adequate information in the Patient s medical record, Dr. Flechas engaged in unprofessional conduct, including, but not limited to, departure from, or the failure to conform to, the standards of acceptable and prevailing medical practice, or the ethics of the medical profession within the meaning of N.C. Gen. Stat. 90-14(a)(6), Notice of Charges and Allegations Jorge David Flechas, M.D. Page 3 of 10
which is grounds for the Board to annul, suspend, revoke, condition, or limit Dr. Flechas license to practice medicine and surgery issued by the Board. THIRD CLAIM 13. Paragraphs one through four are re-alleged and 14. Dr. Flechas treated Patient C from approximately 2000 to 2006. Patient C was treated for chronic pain, fibromyalgia, chronic fatigue, depression, insomnia, degenerative disc disease, and hyperlipidemia. 15. Dr. Flechas failed to order appropriate laboratory work for Patient C, including annual mammograms, lipid screens and immunizations. Dr. Flechas prescribed narcotic pain medication and muscle relaxant medication inappropriately for Patient C. Dr. Flechas documentation in the patient s medical record was inadequate, including but not limited to documentation of a surgical procedure performed by another physician, and follow-up care of the surgery, which Dr. Flechas provided. 16. By failing to adequately diagnose and treat Patient C, and failing to record adequate information in the medical record, Dr. Flechas engaged in unprofessional conduct, including, but not limited to, departure from, or the failure to conform to, the standards of acceptable and prevailing medical practice, or the Notice of Charges and Allegations Jorge David Flechas, M.D. Page 4 of 10
ethics of the medical profession within the meaning of N.C. Gen. Stat. 90-14(a)(6), which is grounds for the Board to annul, suspend, revoke, condition, or limit Dr. Flechas license to practice medicine and surgery issued by the Board. FOURTH CLAIM 17. Paragraphs one through four are re-alleged and 18. Dr. Flechas treated Patient D from approximately 2002 to 2006. Patient D presented to Dr. Flechas with hypertension and hyperlipidemia. 19. Dr. Flechas failed to perform a complete physical examination and detailed history on a regular basis for Patient D, order appropriate laboratory work for Patient D, including diagnostic blood testing. Dr. Flechas failed to manage Patient D s hypertension adequately. Dr. Flechas documentation in the patient s medical record was inadequate. 20. By failing to adequately diagnose and treat Patient D, and failing to record adequate information in the medical record, Dr. Flechas engaged in unprofessional conduct, including, but not limited to, departure from, or the failure to conform to, the standards of acceptable and prevailing medical practice, or the ethics of the medical profession within the meaning of N.C. Gen. Stat. 90-14(a)(6), which is grounds for the Board to annul, suspend, revoke, condition, or limit Dr. Flechas license to Notice of Charges and Allegations Jorge David Flechas, M.D. Page 5 of 10
practice medicine and surgery issued by the Board. FIFTH CLAIM 21. Paragraphs one through four are re-alleged and 22. Dr. Flechas treated Patient E in 2005. Patient E presented with a chronic cough and a history of nasal polyps. 23. Dr. Flechas failed to order appropriate laboratory work for Patient E, including allergy testing, but nevertheless reached the conclusion that Patient E had food allergies and ordered him to avoid certain foods. Dr. Flechas prescribed Nystatin to Patient E with no evidence in the medical record of its necessity. 24. By failing to adequately diagnose and treat Patient E, Dr. Flechas engaged in unprofessional conduct, including, but not limited to, departure from, or the failure to conform to, the standards of acceptable and prevailing medical practice, or the ethics of the medical profession within the meaning of N.C. Gen. Stat. 90-14(a)(6), which is grounds for the Board to annul, suspend, revoke, condition, or limit Dr. Flechas license to practice medicine and surgery issued by the Board. SIXTH CLAIM 25. Paragraphs one through four are re-alleged and 26. Dr. Flechas treated Patient F in 1993 and 2005. Patient Notice of Charges and Allegations Jorge David Flechas, M.D. Page 6 of 10
F was treated for medical conditions including hypertension and diabetes. 27. Dr. Flechas failed to perform an adequate detailed history and physical examination or to order appropriate laboratory work for Patient F. Dr. Flechas prescribed medications to treat Patient F s hypertension but did not schedule appropriate follow-up appointments. Dr. Flechas failed to treat Patient F s diabetes adequately. The medical record for Patient F is inadequate. 28. By failing to adequately diagnose and treat Patient F, and failing to record adequate information in the medical record, Dr. Flechas engaged in unprofessional conduct, including, but not limited to, departure from, or the failure to conform to, the standards of acceptable and prevailing medical practice, or the ethics of the medical profession within the meaning of N.C. Gen. Stat. 90-14(a)(6), which is grounds for the Board to annul, suspend, revoke, condition, or limit Dr. Flechas license to practice medicine and surgery issued by the Board. SEVENTH CLAIM 29. Paragraphs one through four are re-alleged and 30. Dr. Flechas treated Patient G in 2004 and 2005. Patient G was treated for pain following an accident several years prior. 31. Dr. Flechas failed to perform a detailed history and Notice of Charges and Allegations Jorge David Flechas, M.D. Page 7 of 10
physical examination or to order appropriate laboratory work for Patient G, including x-rays. Dr. Flechas documentation in the patient s medical record was inadequate, including but not limited to documentation supporting his diagnosis of hypoplastic posterior fossa in Patient G. Dr. Flechas prescribed narcotic pain medications to Patient G based on his inadequate diagnosis of the source or reasons for Patient G s pain. 32. By failing to adequately diagnose and treat Patient G, and failing to record adequate information in the medical record, Dr. Flechas engaged in unprofessional conduct, including, but not limited to, departure from, or the failure to conform to, the standards of acceptable and prevailing medical practice, or the ethics of the medical profession within the meaning of N.C. Gen. Stat. 90-14(a)(6), which is grounds for the Board to annul, suspend, revoke, condition, or limit Dr. Flechas license to practice medicine and surgery issued by the Board. NOTICE TO DR. FLECHAS Pursuant to N.C. Gen. Stat. 90-14.2, it is hereby ordered that a hearing on the foregoing Notice of Charges and Allegations will be held before the Board, or a panel thereof, at 8:00 a.m., Wednesday, April 18, 2007, or as soon thereafter as the Board may hear it, at the offices of the Board at 1203 Front Street, Raleigh, North Carolina, to continue until completed. The hearing will be Notice of Charges and Allegations Jorge David Flechas, M.D. Page 8 of 10
held pursuant to N.C. Gen. Stat. 150B-40, 41, and 42, and N.C. Gen. Stat. 90-14.2, 14.4, 14.5, and 14.6. You may appear personally and through counsel, may cross-examine witnesses and present evidence in your own behalf. You may, if you desire, file written answers to the charges and complaints preferred against you within 30 days after the service of this notice. The identity of Patients A through G and the date and place of treatment of these patients are being withheld from public disclosure pursuant to N.C. Gen. Stat. 90-8. However, this information will be provided to you upon your request. Pursuant to N.C. Gen. Stat. 150B-40(c)(5), it is further ordered that the parties shall arrange a pre-hearing conference at which they shall prepare and sign a stipulation on pre-hearing conference. The pre-hearing stipulation shall be submitted to the undersigned no later than seven days prior to the hearing date. The right to be present during the hearing of this case, including any such right conferred or implied by N.C. Gen. Stat. 150B-40(d), shall be deemed waived by a party or his counsel by voluntary absence from the Board s office at a time when it is known that proceedings, including deliberations, are being conducted, or are about to be conducted. In such event, the proceedings, including additional proceedings after the Board has Notice of Charges and Allegations Jorge David Flechas, M.D. Page 9 of 10
retired to deliberate, may go forward without waiting for the arrival or return of counsel or a party. This the 12 th day of February, 2007. NORTH CAROLINA MEDICAL BOARD By: H. Arthur McCulloch, M.D. President Notice of Charges and Allegations Jorge David Flechas, M.D. Page 10 of 10