STATE OF NEVADA BOARD OF VETERINARY MEDICAL EXAMINERS Board Meeting at: Oquendo Center for Clinical Education 2425 East Oquendo Road Las Vegas, Nevada 89120 MINUTES Thursday, October 19, 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 7:46AM. He took roll of the Board members, explained the complaint process to the audience. Dr. Damonte was not present, but arrived on a later flight. Public Comment None CONSENT AGENDA The Consent Agenda contains matters of routine acceptance. The Board Members may approve the consent agenda items as written or, at their discretion, may address individual items for discussion or change. 1. Approval of Board Minutes for Possible Action A. July 13, 2017 Workshop and Board meeting minutes Discussion: None Motion: Dr. Sandoval 2. Review & Determination of Complaints for Possible Action: A. 07-2017DVM-29; 07-2017FAC-30; 07-2017DVM-31 B. 08-2017DVM-37 Discussion: None Motion: Dr. Pelsue Second: Dr. Bradley ; Ms. Schalles abstained on item 2A; Dr. Bradley abstained on item 2B. REGULAR AGENDA 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. 08-2016DVM-37; Anton Roach, DVM, License #1501: Letter of Reprimand or Board decision for administrative hearing. Discussion: Mr. Ling reviewed the case and provided the Board with an overview of the proposed Letter of Reprimand. Motion: Dr. Bradley moved to accept the Letter of Reprimand. Second: Dr. Collins ; Dr. Sandoval abstained. 2
B. 09-2016DVM-044; David Burgener, DVM, License #LTD-18: Letter of Reprimand or Board decision for administrative hearing. Discussion: Mr. Ling reviewed the case and provided the Board with an overview of the proposed Letter of Reprimand. Motion: Dr. Bradley moved to approve the Letter of Reprimand. Second: Dr. Sandoval ; Dr. Pelsue abstained. C. 03-2017DVM-07; Lyle Whitaker, DVM, License #2362; Letter of Reprimand or Board decision for administrative hearing. Discussion: Mr. Ling reviewed the case and provided the Board with an overview of the proposed Letter of Reprimand. Motion: Dr. Bradley moved to approve the Letter of Reprimand. Second: Ms. Schalles ; Dr. Damonte was not present. D. 04-2017DVM-14; Letter of Reprimand or Board decision for administrative hearing. Discussion: Agenda item was tabled at the licensee s request and staff will continue negotiations with licensee. E. 04-2017DVM-16; Alyssa Adams, DVM, License # 2283; Letter of Reprimand or Board decision for administrative hearing. Discussion: Mr. Ling reviewed the case and provided the Board with an overview of the proposed Letter of Reprimand. Motion: Ms. Schalles moved to accept the Letter of Reprimand. Second: Mr. Hengels ; Dr. Collins abstained. F. 03-2017DVM-12; 03-2017DVM-13 (Dr. Damonte arrived at 8:19 a.m.) moved to dismiss the complaint against the licensees with a letter of concern. Motion: Dr. Taylor moved to dismiss the complaint with letter of concern. Second: Dr. Bradley ; Dr. Sandoval and Dr. Damonte abstained. Public comment was given. 3
G. 05-2017DVM-20 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. Second: Dr. Bradley ; Dr. Pelsue abstained. H. 05-2017DVM-22; 05-2017DVM-23; 05-2017DVM-24 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. Sandoval moved to dismiss the complaint. Second: Dr. Collins ; Dr. Pelsue abstained. I. 05-2017DVM-25 This item was tabled pending further investigation and is tentatively scheduled to be presented at the January, 25, 2018 Board meeting. J. 06-2017DVM-26 table the complaint for further investigation and instructed staff open a complaint against the facility pending further investigation. Motion: Dr. Pelsue moved to table the complaint and open a complaint against the facility. Second: Dr. Bradley ; Dr. Sandoval abstained. K. 06-2017DVM-27 dismissed the complaint against the licensees with a Letter of Concern. Motion: Dr. Pelsue moved to dismiss the complaint with a Letter of Concern. Second: Dr. Bradley ; Dr. Sandoval abstained. 4
L. 06-2017DVM-28 recommended that disciplinary action be initiated against the licensee. Motion: Dr. Bradley 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. Collins Passed: 6- Aye; 1-Nay; Dr. Sandoval abstained. Public comment was given. M. 07-2017DVM-32 recommended that disciplinary action be initiated against the licensee. Motion: Ms. Schalles 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: Mr. Hengels ; Dr. Sandoval abstained. N. 07-2017DVM-33 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. Sandoval ; Dr. Damonte abstained. O. 07-2017DVM-34 recommended that disciplinary action be initiated against the licensee. Motion: Dr. Pelsue 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. Sandoval ; Dr. Damonte abstained. P. 07-2017DVM-35 5
Discussion: After discussion of the complaint assessment with the review panel, Dr. Collins moved to dismiss the complaint against the licensees with a letter of concern. Motion: Dr. Collins moved to dismiss the complaint with a letter of concern. Second: Ms. Schalles ; Dr. Pelsue abstained. Public comment was given. Q. 08-2018DVM-36 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: Ms. Schalles ; Dr. Bradley and Dr. Collins abstained. Public comment was given. R. 08-2017DVM-45 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: Ms. Schalles moved to dismiss the complaint with a letter of concern. Second: Dr. Collins ; Dr. Damonte abstained. 4. Requests for License/Extensions/Education Approval/Reinstatement for Possible Action A. Agniezska M. Chia, approval of education for veterinary technician in training (VTIT) and licensed veterinary technician (LVT) application Discussion: The Board reviewed all documentation presented. Ms. Chia was not present. Motion: Ms. Schalles moved to approve Ms. Chia s education for VTIT and LVT application. Second: Dr. Taylor B. Joshua Aden, VTIT Registration Extension Discussion: The Board reviewed all documentation presented. Mr. Aden was present. Motion: Dr. Sandoval moved to extend Mr. Aden s VTIT registration for 1 year. Passed: Aye-6; Nay -1; Dr. Collins abstained. 6
C. Kristy Albanese, VTIT Registration Extension Discussion: The Board reviewed all documentation presented. Ms. Albanese was present. Motion: Ms. Schalles moved to extend Ms. Albanese s VTIT registration through the March/April VTNE exam. D. Julia Piza, VTIT Registration Extension Discussion: The Board reviewed all documentation presented. Ms. Piza was not present. Motion: Dr. Bradley moved to extend Ms. Piza s VTIT registration through the March/April VTNE exam. Second: Mr. Damonte ; Ms. Schalles abstained. E. Marcie Still, VTIT Registration Extension Discussion: The Board reviewed all documentation presented. Ms. Still was present. Motion: Ms. Schalles moved to extend Ms. Still s VTIT registration through the end of the year. Second: None Motion failed. Motion: Dr. Pelsue moved to extend Ms. Still s VTIT registration for 1 year. Second: Dr. Collins Passed: Aye- 7; Nay- 1 5. Presentation, Discussion and Adoption of Proposed Regulation changes to NAC 638 for Possible Action. The hearing began at 1:03PM. A. LCB File No. RO73-16. A regulation relating to: a. Redefining facility owned by licensed veterinarian, indirect supervision, vaccination clinics, and mobile clinics b. Increase in fees for veterinary owned and mobile facilities c. AVMA Principles of Ethics (2003) d. Inventory requirements for controlled substances e. Editing of medical records f. Responsibilities of Veterinarian-in-Charge g. Possession of expired drugs h. Repackaging of drugs i. Filing of Accusations j. Non-anesthetic cleaning of teeth k. Ordering of compounded drugs 7
Discussion: Mr. Ling and Dr. Pelsue gave a brief update regarding the current state of the potential regulation changes being presented at the hearing, and that the potential regulation changes would be discussed section by section and public comment could be offered at any point if there are questions or concerns. Procedurally, the Board has done the required workshops, public comment, and then discuss amongst the members of the Board, and can adopt, reject, or adopt with amendments. If you make a motion to adopt today, the regulations then go to the Legislative Commission and if approved, it would become law. Louis will stop if there is an unlawful amendment that is substantive enough to need to notify the public regarding the change. Public Comment: None Dr. Pelsue: stated that he would like clarification regarding the changes that have already been captured at previous workshops. Mr. Ling: clarified that the Board would want to identify those changes here and if they aren t substantive then we can make a motion to adopt with the amendments today. If the changes are substantive, the Board would want to hold another workshop and properly notify the public. Additional comments: None Motion: Dr. Pelsue moved adopt the regulation of RO73-16 with the aforementioned change and submit the language to the Legislative Council. Second: Dr. Taylor B. LCB File No. R110-16. A regulation relating to: a. Equine Dentistry Public comment as follows: Rochen Heers, DVM: stated that she was surprised by the Board meeting and disappointed that local equine groups were not specifically notified. She feels that the potential regulation changes for equine dental practitioners (EDP) are a done deal and that the creation of the regulations for EDs is not in the best interest of equine dentists. The equine dental practitioners are not as qualified as they claim to be. Dr. Heers asked what schools are being accepted and who s judging their appropriateness, and asked if the direct supervision can only be provided by Nevada licensed veterinarians? Furthermore, Dr. Heers asked what the content of the EDP continuing education would be and who would be determining the appropriateness of those courses? Dr. Taylor: explained that in order to accept the organizations, the individual organizations would approach us and apply for approval from the Board. Any organizations will be reviewed and then voted on as a Board. There would be research involved as to the quality and substance of an organization. The review and research would apply to both continuing education as well as the education organizations. 8
Mr. Ling: clarified that the review would be done in a public meeting just like this and anyone could make comment at that time and be involved in the process. Tom Dory, DVM: indicated that he would like to see a different title from EDP used. Dr. Dory asked if direct supervision would be required for the oral exam as well in order for the veterinarian to sign-off on the procedure. Dr. Dory asked where the liability would fall for the procedure, and which individual would be responsible for which part of a procedure? Mr. Ling: explained that the EDP will be required to carry his or her own liability insurance, and therefore be responsible for any procedures or part of a procedure that he or she would provide. The owner(s) must also give signed consent for the EDP to do a procedure. Dr. Heers: asked if the potential regulation changes will satisfy what the EDPs are looking for in regulation. Dr. Sandoval: stated that from the feedback we have received at the previous workshops, the members of the group looking for EDP registration are opposed to the level of supervision being required. Mr. Ling: explained the process of how the regulations would proceed administratively to the Legislative Commission (LC) for review and if approved, could become law, likely, in January as they meet once a month. Dr. Heers: questioned that if the regulations were adopted and then the EDPs came back to the Board if they were unsatisfied and want to make changes, what would happen? Mr. Ling: explained that the Board has made changes based on the input that they have given us regarding their concerns. The EDP group could appear and request changes to the Board, but the Board would have to accept the changes and start the regulation making process again. Dr. Damonte: would like to secure an amendment to the language in Section 4 that refers to the specific name of the International Association of Equine Dentists (IAED) was to be omitted and replaced with to be determined by the Board. Ms. Pedigo: spoke to the concerns earlier from Dr. Heers regarding the review process for educational requirements for the EDPs, and stated that there would be a committee established by the Board to research specific organizations like the IAED and that is why we re replacing the specific name. Dr. Damonte: state that he would like to make and amendment as well to replace the term reestablishment in Section 2, subsection (b) with the term maintenance. We would want to make the correction otherwise the term could allow for a complication involving opening the pulp chambers and then possibly require veterinary intervention for correction. Dr. Dory: agreed that term maintenance was more clear and precise for the work that would need to be done in the mouth and to avoid complications or damage. 9
Motion: Dr. Damonte moved to adopt the regulations with the current amendments. Public comment: None Workshop closed. The Board made a motion to re-open the hearing to reconsider RO110-16 at 3:07PM. Motion: Ms. Schalles Second: Mr. Hengels Public comment: None Dr. Damonte: wanted to eliminate section 2C, specifying that the wording was ambiguous and could lead to complications if the whole tooth was rounded. Dr. Bradley: requested clarification regarding the definition of digitally loose and what specifically that would entail, for instance, if there was a regional block. Dr. Damonte: clarified that the intent was that if there is any soft tissue attachment and that you wouldn t be using an instrument. Mr. Ling: clarified that the tooth wouldn t be extracted if there was any soft tissue cutting or using mechanical means. Motion: Dr. Damonte moved to adopt the regulations inclusive of all three amendments. Public Comment: None Workshop Closed. 6. Discussion and Determination for Possible Action A. Continuing Education approval for Animal Care Clinic s Endoscopy; Veterinarians (9 hours), LVTs (5 hours). Discussion: Dr. Collins presented the CE review and recommends the course be approved. Motion: Ms. Schalles moved to approve the continuing education course as presented. 7. Staff Reports for Possible Action A. Financial Report Ms. Pedigo presented the financial report which consists of the Board s current quarterly financial revenues and expenses compared to the fiscal year s budget. 10
Motion: Ms. Schalles moved to approve the administrative report as presented. B. Hospital Inspection Report-Christina Johnson, LVT Ms. Johnson presented the hospital inspection report which consists of the total number of inspections completed during the previous quarter as well as a breakdown of the number of facilities that had to submit compliance corrections. The names of facilities are not listed in this report. The Board was satisfied with Ms. Johnson s report. B. Legal Report, Louis Ling, Esq. Mr. Ling presented the legal report which serves as an update to the Board regarding matters of legal interest that could affect the Board, current or future litigation, or potential legal matters of concern. Mr. Ling discussed his recent attendance at the Federation Association of Regulatory Boards and the nationwide discussion of how states are and will in the future handle anti-trust regulation. Mr. Ling also discussed the current changes to regulation of Vet Source s business model. The report was presented to the Board s satisfaction. D. Legislative Update Ms. Pedigo gave the Board a legislative update, which serves to update the Board regarding pending or future regulation changes that may affect the Board. Ms. Pedigo discussed the current language that is being discussed pertaining to dispensing practitioners and that the NVMA, the Veterinary Board, and the Pharmacy Board are cooperating to reach an amicable solution to the issue. The Board will likely receive language before the next Board meeting. The report was presented to the Board s satisfaction. 8. Agenda items for next meeting 1. Elections for Board President and Vice-President 2. Fear Free Practices 3. Telemedicine 9. Public Comment: Ms. Wagner, Executive Director of the Nevada Veterinary Medical Association (NVMA), spoke to the Board. 10. Adjournment for Possible Action Motion: Dr. Bradley moved to adjourn the meeting at 3:40p.m. Second: Dr. Sandoval 11