STATE OF NEVADA BOARD OF VETERINARY MEDICAL EXAMINERS Board Meeting at: Airport Plaza Hotel & Conference Center 1981 Terminal Way Reno, Nevada 89502 MINUTES Thursday, January 26 th, 2017 Board Members Present William Taylor, DVM, DABVP, President Ronald Sandoval, DVM, Vice President Davyd Pelsue, DVM, DACVS James Hengels, RN, BSN Stephen Damonte, DVM Scott Bradley, DVM Kevin Collins, DVM Melissa Schalles, LVT Board Staff Present Jennifer Pedigo, Executive Director Christina Johnson, LVT, Hospital Inspector Louis Ling, Esq., Board Counsel Patricia Handal, DVM, Board Investigator 1
Dr. Taylor called the meeting to order at 9:00 A.M. He took roll of the Board members, welcomed the Veterinary Technician class from TMCC, explained the complaint process to the class, and addressed questions. AGENDA 1. Public Comment None 2. Approval of Board Minutes for Possible Action A. October 13, 2016 Workshop Minutes B. October 20, 2016 Board Meeting Minutes and Workshop Minutes Discussion: None Motion: Dr. Bradley moved to approve agenda items 2A and 2B with no changes. Second: Ms. Schalles 3. Review & Determination of Complaints/Disciplinary Action & Disciplinary Hearings for Possible Action: The Board may convene in closed session to consider the character, alleged misconduct, professional competence or physical or mental health of a person. (NRS 241.030) A. 07-2016DVM-26; George Stoecklin, DVM, License #0537: Consent Decree or Board decision for administrative hearing. Discussion: Mr. Ling reviewed the case and provided the Board with an overview of the proposed Consent Decree. Motion: Dr. Damonte moved to approve the Consent Decree. ; Dr. Sandoval abstained. B. 08-2016DVM-36; Maureen Adams, DVM, License #1060: Consent Decree or Board decision for administrative hearing. Discussion: Mr. Ling reviewed the case and provided the Board with an overview of the proposed Consent Decree. Motion: Dr. Sandoval moved to approve the Consent Decree. Second: Ms. Schalles ; Dr. Bradley abstained. C. 06-2016DVM-19; Sircy Moore, DVM, License #2174: Letter of Reprimand or Board decision for administration hearing. Discussion: Mr. Ling provided the Board with an overview of the proposed Letter of Reprimand. Motion: Dr. Pelsue moved to approve the Letter of Reprimand. Second: Dr. Collins ; Ms. Schalles abstained. 2
D. 08-2016DVM-37 recommended that disciplinary action be initiated against the licensee. Motion: Dr. Taylor moved to have staff and Mr. Ling initiate action against the licensee due to there being sufficient evidence to proceed with disciplinary action. ; Dr. Sandoval abstained. E. 09-2016DVM-38 dismissed the complaint due to the fact there was not sufficient evidence to believe that the licensee had committed an act which constitutes a cause for disciplinary action. Motion: Dr. Collins moved to dismiss the complaint with a letter of concern. Second: Dr. Bradley ; Dr. Taylor abstained. F. 09-2016DVM-40 and 09-2016FAC-41 dismissed the complaint due to the fact there was not sufficient evidence to believe that the licensee had committed an act which constitutes a cause for disciplinary action. Motion: Dr. Bradley moved to dismiss the complaint. Second: Dr. Collins ; Dr. Taylor and Dr. Pelsue abstained. G. 09-2016DVM-42 Discussion: After discussion of the complaint assessment with the review panel the Board dismissed the complaint due to the fact there was not sufficient evidence to believe that the licensee had committed an act which constitutes a cause for disciplinary action. Motion: Dr. Pelsue moved to dismiss the complaint. Second: Dr. Collins ; Dr. Sandoval abstained. H. 09-2016FAC-43 recommended that disciplinary action be initiated against the facility. Motion: Dr. Pelsue moved to have staff and Mr. Ling initiate action against the facility due to there being sufficient evidence to move forward with disciplinary action. Second: Ms. Schalles ; Dr. Collins abstained. 3
I. 09-2016DVM-44, 07-2016DVM-27, 07-2016FAC-28, and 07-2016FAC-29 recommended that disciplinary action be initiated against both veterinarians and both facilities. Motion: Dr. Taylor moved to have staff and Mr. Ling initiate action against both veterinarians and both facilities due to there being sufficient evidence to move forward with disciplinary action. Second: Dr. Sandoval ; Dr. Pelsue abstained. J. 10-2016DVM-45 recommended that disciplinary action be initiated against the licensee. Motion: Mr. Hengels moved to have staff and Mr. Ling initiate action against the licensee due to their being sufficient evidence to move forward with disciplinary action. ; Dr. Bradley abstained. K. 11-2016DVM-46 recommended that disciplinary action be initiated against the licensee. Motion: Dr. Taylor moved to have staff and Mr. Ling initiate action against the licensee due to there being sufficient evidence to move forward with disciplinary action. Second: Dr. Bradley, Dr. Pelsue abstained. L. 11-2016DVM-47 dismissed the complaint due to the fact there was not sufficient evidence to believe that the licensee had committed an act which constitutes a cause for disciplinary action. Motion: Dr. Damonte moved to dismiss the complaint Second: Ms. Schalles, Dr. Sandoval abstained 4. Discussion of Potential Regulation Changes to NAC 638 for Possible Action. A. Discussion of possible regulation changes/additions on the following topics from LCB File Number RO73-16: Dr. Taylor opened the discussion at 1:00 P.M. for RO73-16 and R100-16. a. Redefining facility owned by licensed veterinarian, indirect supervision, vaccination clinics, and mobile clinics A minimum 10% ownership defines facility owned by licensed veterinarian. A Veterinary Technician in Training can t do work without the 4
supervision of a Licensed Veterinary Technician. Mobile clinics require medical grade oxygen b. Increase in fees for veterinary owned and mobile facilities no changes c. AVMA Principles of Ethics (2003) no changes d. Inventory requirements for controlled substances no changes e. Editing of medical records no changes f. Responsibilities of Veterinarian-in-Charge no changes g. Possession of expired drugs no changes h. Repackaging of drugs no changes i. Filing of Accusations no changes j. Non-anesthetic cleaning of teeth Removed the word cosmetic. An oral exam within one year of cleaning procedure is required, maybe change to 6 months. k. Ordering of compounded drugs two weeks is the standard for most patients, and the range is usually 14 to 30 days Discussion: The consensus of the Board was that RO73-16 should proceed to a regulatory workshop on April 27, 2017 with the above noted minor changes. B. Discussion of possible regulation changes and additions on the following topics from R110-16: a. Equine Dentistry Mr. Ling explained the changes to the language that were made as a result of the public workshops. Jenee Rhodes spoke before the Board and is concerned about the changes to the laws making equine dentistry cost prohibitive for her. Jean Jorgensen spoke before the Board. Ms. Jorgensen doesn t think a veterinarian should have to be on site and has had problems even after a veterinarian did a dental. Kristi Ruby, DVM spoke before the Board. Dr. Ruby is a practicing equine veterinarian and she said she never performs a dental procedure prior to performing a physical exam. Gloria Kafouty spoke before the Board. Ms. Kafouty stated all veterinarians are different, and don t all do the same thing. Ms. McKenna spoke before the Board and stated she believes some animals need to be examined more often than others. Ms. McKenna is concerned that without direct supervision of a veterinarian, if something happened while the equine dental provider was working on the animal it would put the animal at risk. Velvet Allen spoke before the Board. Ms. Allen is a member of the IAED and wants to work with the veterinarians. Ms. Allen believes it is the horse owner s responsibility to choose who works on their horse and is concerned the Board s regulations are so strict they will create a black market. Ron Sandoval, DVM asked how many of the procedures do you think can be done without sedation. Mark Allen stated he thinks the horse should be sedated before all procedures. He does a thorough 5
exam of the head and neck prior to sedation, and if he sees something serious he tells the horse owner to have their horse examined by a veterinarian. Mr. Allen says the sedation being done prior to his work is the horse owner s responsibility. Dr. Sandoval asked about how the sedation is done. Dr. Damonte stated typically intravenously, could be given intramuscular, there are oral products available as well. Dr. Sandoval asked, as horse owners, how are you administrating the sedation left with you by the veterinarian prior to the dental procedure being done. Ms. Rhodes stated she can administer the sedation through IV. The veterinarian prescribes the medicine and it s administered by the owner. Dr. Ruby said she does it intravenously and stated it s not without risk even if they are capable. Dr. Ruby said it is the risk associated with the horse with the jugular vein adjacent to the carotid artery, if the artery is hit the horse can go blind or even die. Mr. Rhodes stated he wants to work with the Board. He is concerned the restrictions are too strict and will lead to a black market. By working together and allowing a certified equine dentist to work on horses we can end the black market. Mr. Allen stated he wants to work together with the Board to create legislation. In Arizona they allow indirect supervision by a veterinarian. He emphasized creating legislation with the Board that will be effective like what they have in Arizona which he believes works well for all parties. Ms. Pedigo asked about the timeline between the horses being prescribed sedation by a veterinarian prior to being seen by the equine dentist. Mr. Allen explained the timeline is left to the discretion of the veterinarian, equine dentist and client. Mr. Allen asked the Board if they are willing to do what is being done in Arizona. Cindy Capurro spoke before the Board. Ms. Capurro said she trusts an equine dentist to work on her horse. She says it is their specialty and has no problem with it, and if they see a problem they are going to refer her to a veterinarian for examination of her horse. The Board staff will meet with Dr. Damonte and Dr. Pelsue and review Arizona equine dentistry laws and bring this back to the Board for further discussion, workshops and/or a hearing. No action was taken. 5. Requests for Licensure/Reinstatement/Review of Past or Present Disciplinary Action for Possible Action A. Holly Peterson, application for VTIT and LVT Discussion: The Board reviewed all documentation presented. Ms. Peterson was present and 6
answered all questions asked by the Board. Motion: Ms. Schalles motioned to deny the request for licensure based on educational equivalency. (NRS 638.122 (2) (b)). Second: Dr. Sandoval B. Daryl Frazetti, application for VTIT and LVT Discussion: The Board reviewed all documentation presented. Mr. Frazetti was present and answered all questions asked by the Board. Motion: Ms. Schalles motioned to deny the request for licensure based on educational equivalency. (NRS 638.122 (2) (b)). C. Susan Sage, application for LVT Discussion: The Board reviewed all documentation presented. Motion: Ms. Schalles moved to deny her request for licensure. Second: Mr. Hengels Motion: Failed to pass, 3 voted yay, and 4 voted nay. Motion: After further discussion, Dr. Pelsue moved to approve her for licensure. Second: Dr. Collins Passed: 4 voted yay, and 2 voted nay; motion passed. 6. Discussion and Determination for Possible Action A. Hospital Inspection Point System Ms. Pedigo explained this is a preliminary system using the Virginia Veterinary Medical Board point system as a model. There are major points and minor points factored into the total. Ms. Johnson explained currently there are some violations that need to be immediately rectified. Ms. Pedigo and Ms. Johnson will create examples using current inspections and represent at the next meeting. B. AAVSB Conference Report Ms. Pedigo provided the Board with an overview of the September 2016 AAVSB conference held in Phoenix, Arizona. 7. Staff Reports for Possible Action A. Financial Report Ms. Pedigo presented the financial report to the Board s satisfaction. 7
Motion: Ms. Schalles moved to approve budget as presented. Second: Dr. Bradley B. Administrative Report Ms. Pedigo presented the administrative report to the Board s satisfaction. Motion: Ms. Schalles moved to approve the administrative report as presented. C. Hospital Inspection Report-Christina Johnson, LVT Ms. Johnson presented the Hospital Inspection report to the Board s satisfaction. D. Legal Report, Louis Ling, Esq. a. Attorney General s Opinion (AGO) issued to the Board of Pharmacy Discussion: Mr. Ling discussed an AGO requested by the Pharmacy Board in August of 2016. Motion: Dr. Bradley moved to create a working group to participate in discussions with the Pharmacy Board staff. E. Legislative Update Ms. Laxalt gave the Board a legislative update. 8. Agenda items for next meeting 1. Hospital Inspection Point System 9. Public Comment: Ms. Wagner, Executive Director of the NVMA, spoke to the Board. She spoke with Ms. Kimberly Robinson, who used to be the Medical Director of Banfield in Nevada, and she will be coming to an NVMA meeting to speak in June about wellness programs as this issue is of great concern to the association. 10. Adjournment for Possible Action Motion: Dr. Taylor moved to adjourn the meeting at 3:20 PM. Second: Dr. Sandoval 8