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DANIEL E. LUNGREN, Attorney General of the State of California ADRIAN K. PANTON, Deputy Attorney General California Department of Justice 3 00 South Spring Street, Suite 5212 Los Angeles, California 90013-1204 Telephone: (213) 897-6593 Attorneys for Complainant

6 7 8 9 10 11 12 MILTON H. UHLEY, M.D. 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 1. BEFORE THE DIVISION OF MEDICAL QUALITY MEDICAL BOARD OF CALIFORNIA DEPARTMENT OF CONSUMER AFFAIRS STATE OF CALIFORNIA

In the Matter of the Accusation Against: 3 60 North Bedford Drive Beverly H i l l s , CA 90210 P h y s i c i a n ' s and Surgeon's C e r t i f i c a t e No. C10122, Respondent. The Complainant a l l e g e s :
PARTIES

NO. 05-93-29050
ACCUSATION

Complainant, Dixon Arnett, is the Executive

Director of the Medical Board of California (hereinafter the "Board") and brings this accusation solely in his official capacity. 2. On or about May 20, 1947, Physician's and

Surgeon's Certificate No. C10122 was issued by the Board to MILTON H. UHLEY, M.D. (hereinafter "respondent"), and at all times relevant to the charges brought herein, this license has

1.

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been in full force and effect. Unless renewed, it will expire on November 30, 1996. JURISDICTION 3. This accusation is brought before the Division of

Medical Quality of the Medical Board of California Department of Consumer Affairs (hereinafter the "Division"), under the authority of the following sections of the California Business and Professions Code (hereinafter "Code"): A. Section 2227 provides that the Board may revoke,

suspend for a period not to exceed one year, or place on probation, the license of any licensee who has been found guilty under the Medical Practice Act.
B

-

Section 2234 provides that unprofessional conduct

includes, but is not limited to, the following: "(a) Violating or attempting to violate, directly or indirectly, or assisting in or abetting the violation
of

* °r conspiring to violate, any provision of this

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chapter. (b) Gross negligence. (c) Repeated negligent acts. (d) Incompetence. (e) The commission of any act involving dishonesty or corruption which is substantially related to the qualifications, functions, or duties of a physician and surgeon. (f>
An

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5

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y action or conduct which would have warranted

the denial of a certificate."

2.

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10

C.

Code section 125.3 provides, in part, that the

Board may request the administrative law judge to direct any licentiate found to have committed a violation or violations of the licensing act, to pay the Board a sum not to exceed the reasonable costs of the investigation and enforcement of the case. D. In relevant part Code section 72 5 provides:

"Repeated acts of clearly excessive prescribing or administering of drugs . . . as determined by the

standard of the community of licensees is unprofessional conduct for a physician and surgeon . . . ." E. In relevant part, Code section 2241 provides:

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"[T]he prescribing, selling, furnishing, giving away, or administering or offering to prescribe, sell, furnish, give away, or administer any of the drugs or compounds mentioned in Section 223 9 to an addict or habitue constitutes unprofessional conduct."
F

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Code section 2242, subdivision(a), states:

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"Prescribing, dispensing, or furnishing dangerous drugs as defined in Section 4211 without a good faith prior examination and medical indication therefor, constitutes unprofessional conduct." G. Section 4211 of the Code in part states:

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"'Dangerous drug' means any drug unsafe for selfmedication . . . and includes the following: • * ' * * * * * * „

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3.

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"(c)

Any other drug or device that by federal or

state law can be lawfully dispensed only on prescription . . . ."

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CAUSES OF ACTION
Patient C.C. I

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8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 4.

GROSS NEGLIGENCE
Respondent MILTON H. UHLEY, M.D., is subject to

disciplinary action under Code section 2234(b) for gross negligence in that without a good faith prior examination or medically indicated reason, he repeatedly wrote clearly excessive prescriptions for Percocet, a dangerous drug and Schedule II controlled substance, on behalf of C.C. who was known by respondent to be chemically dependent. follows: A. Respondent, who practices internal medicine, The circumstances are as

began treating C.C. in September 1988 for migraine headaches, back and neck pain, and sinusitis. As part of

the treatment for these conditions, respondent began to prescribe Percocet in 1989. In April 1989, respondent

became aware that C.C. had a chemical dependence problem yet he continued to prescribe Percocet. Respondent was also

aware in 1989 that C.C. underwent rehabilitation for alcoholism in 1985. Respondent continued to prescribe

Percocet to C.C. without performing a good faith examination, or otherwise assessing the medical necessity for the prescriptions, after he became aware of C.C.'s

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chemical dependence problem.

Nor was there any indication

that respondent complied with any of the mandates of Code section 2241.5 as they relate to intractable pain. B. Beginning January 20, 1989 and

continuing through November 19, 1992, respondent wrote 36 prescriptions for Percocet for C.C. which in the quantities dispensed approximates 1,890 dosage units for that time period. The dates of the prescriptions

and the quantities for which they were written are as follows: January 20, 1989 May 15, 1989 August 23, 1989 May 15, 1990 June 25, 1990 July 9, 1990 August 9, 1990 August 15, 1990 September 11, 1990 September 22, 1990 October 1, 1990 October 8, 1990 October 18, 1990 November 15, 1990 November 29, 1990 December 6, 1990 December 26, 1990 50 100 30 50 50 50 30 50 50 50 30 30 30 30 30 50 30

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17

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27

5.

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 5.

July 18, 1991 September 2, 1991 November 10, 1991 December 2, 1991 December 14, 1991 December 14, 1991 January 20, 1992 February 4, 1992 March 23, 1992 April 13, 1992 August 17, 1992 September 6, 1992 September 15, 1992 September 27, 1992 October 4, 1992 October 12, 1992 October 18, 1992 October 28, 1992 November 19, 1992 TOTAL

50 30 30 30 50 SO1' 30 50 50 50 100 50 100 50 100 100 100 100 30 1890

I I EXCESSIVE PRESCRIBING
Respondent is subject to disciplinary action under

Code section 725 in that with respect to C.C., he engaged in repeated acts of clearly excessive prescribing of Percocet. The

l. Two separate prescriptions were written for December 14, 1991 and were filled at different pharmacies. 6.

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circumstances are as follows: A. The facts and allegations in paragraph

4, subparagraphs A and B, inclusive, are incorporated here by reference. Il l PRESCRIBING TO ADDICTS 6. Respondent is subject to disciplinary action under

Code section 2241 in that he prescribed Percocet to C.C. with knowledge of C.C.'s addiction problem. follows: A. The facts and allegations in paragraph The circumstances are as

4, subparagraphs A and B, inclusive, are incorporated here by reference.

rv
PRESCRIBING WITHOUT A GOOD FAITH PRIOR EXAMINATION 7. Respondent is subject to disciplinary action under

Code section 2242 in that he prescribed Percocet to C.C. without conducting a good faith prior examination or otherwise determining the medical necessity for the prescriptions. circumstances are as follows: A. The facts and allegations in paragraph The

4, subparagraphs A and B, inclusive, are incorporated by reference. V REPEATED NEGLIGENT ACTS 8. Respondent is subject to disciplinary action under

Code section 2234(c) in that with respect to the Percocet

7.

prescriptions written for C.C., he engaged in repeated negligent acts. The circumstances are as follows: A. The facts and allegations in paragraph

4, subparagraphs A and B, inclusive, are incorporated here by reference. VI INCOMPETENCE 9. Respondent is subject to disciplinary action under

Code section 2234(d) in that with respect to the Percocet prescriptions written for C.C., he demonstrated his incompetence in drug prescribing practices. A. The circumstances are as follows:

The facts and allegations in paragraph

4, subparagraphs A and B, inclusive, are incorporated here by reference. Patient C.K. VII GROSS NEGLIGENCE 10. Respondent is subject to disciplinary action under

Code section 2234(b) for gross negligence in that he failed to properly examine, diagnose and treat patient C.K. for a perforated duodenal ulcer. C.K. ultimately succumbed from the The circumstances are as

complications of the perforation. follows: A.

C.K. had been respondent's patient since 1981 and

had a medical history of peptic ulcer disease and gastrointestinal bleeding. On or about October 16, 1988,

C.K.'s wife telephoned respondent to report that C.K. had a

8.

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fever of approximately 103 degrees and was complaining of abdominal pains and chills. Respondent, over the telephone,

diagnosed C.K.'s condition as the flu and prescribed a "protocol" of Tylenol, Valium and hot showers. The telephonic diagnosis and recommended treatment without taking a history and performing a physical examination was an extreme departure from the standard of care. B. On or about October 17, respondent by

telephone was informed that C.K.'s condition remained unchanged. At respondent's directive, C.K. came to

respondent's office and was given an injection of Gamma Globulin and Lincocin by respondent's nurse. Respondent himself did not see C.K. On the afternoon

of October 17, C.K.'s wife telephoned again to report that C.K.'s temperature was over 104 degrees and his abdomen was distended. Respondent, again over the

telephone, advised C.K. to continue the protocol of Tylenol, Valium and hot showers every four hours. Given the patient's symptomatology and history of ulcers and gastrointestinal bleeding, it was an extreme departure from the standard of care for respondent to have prescribed Tylenol and to not have personally evaluated C.K. prior to having his nurse administer Gamma Globulin and Lincocin. C. When C.K.'s wife telephoned respondent on the

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morning of October 18 to report that C.K.'s temperature
wa

s still over 104 degrees, respondent advised that

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C.K. probably still had the flu but directed her to take him to the emergency room at Cedars Sinai Medical Center. D. Later on the morning of October 18, the

hospital telephoned respondent to report that C.K. had been admitted. Respondent, over the telephone, ordered

the continuation of the protocol of Tylenol, Valium and hot showers. When respondent failed to come to

evaluate C.K. until over 12 hours after his admission, C.K.'s wife dismissed him from the case. Given the

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patient's symptomatology and history, it was an extreme departure from the standard of care for respondent to have ordered a treatment regimen without having performed a physical examination and to have delayed

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his personal evaluation of C.K. until 12 hours after the patient's hospital admission.
E

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C

- K - w as subsequently diagnosed as having a

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perforated duodenal ulcer. He suffered resultant septic shock, renal insufficiency and gastrointestinal bleeding. C.K. died in the hospital on December 4,

1988. Early assessment of C.K.'s condition at the onset of his complaints by a physical evaluation, proper diagnosis and surgical intervention would have improved his chances of survival. Respondent's failure

to make an assesment of C.K.'s condition by a physical 26 27 examination at any time after the onset of the patient's complaints was an extreme departure from the

10.

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 / / / /

standard of care. VIII INCOMPETENCE 11. Respondent is subject to disciplinary action

under Code section 2234(d) for incompetence based on his demonstrated lack of knowledge, skill and ability in the evaluation, diagnosis and treatment of ulcers and their attending complications. The circumstances are as follows: A. The facts and allegations in paragraph

10, subparagraphs A through E, inclusive, are incorporated here by reference. PRAYER WHEREFORE, the complainant requests that a hearing be held on the matters herein alleged, and that following the hearing, the Division issue a decision: 1. Revoking or suspending Physician's and Surgeon's

Certificate Number C10122, heretofore issued to respondent MILTON H. UHLEY, M.D.; 2. Revoking, suspending or denying approval of the

respondent's authority to supervise physician's assistants, pursuant to Business and Professions Code section 3527; 3. Ordering respondent to pay the Division the actual

and reasonable costs of the investigation and enforcement of this case;

11.

4. Taking such other and further action as the Division deems proper. DATED: JULY 21. 1995

Dixon Arnett -Executive-Director Medical Board of California Department of Consumer Affairs State of California Complainant

/l*\- /Lrih-

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DIVIDER

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DANIEL E. LUNGREN, Attorney General of the State of California ADRIAN K. PANTON, Deputy Attorney General California Department of Justice 300 South Spring Street, Suite 5212 Los Angeles, California 90013-1204 Telephone: (213) 897-6593 Attorneys for Complainant

6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 IT IS HEREBY STIPULATED AND AGREED by and between the parties to the above-entitled proceedings, that the following matters are true: 1. Complainant, Ron Joseph, is the Executive Director Physician's and Surgeon's Certificate No. C10122, Respondent. MILTON H. UHLEY, M.D. 3 60 North Bedford Drive Beverly Hills, CA 90210 In the Matter of the Accusation Against: Case No. 05-93-29050 OAH No. L-9601226 STIPULATION FOR SURRENDER OF LICENSE BEFORE THE DIVISION OF MEDICAL QUALITY MEDICAL BOARD OF CALIFORNIA DEPARTMENT OF CONSUMER AFFAIRS STATE OF CALIFORNIA

of the Medical Board of California, Department of Consumer Affairs ("Board") and is represented by Daniel E. Lungren, Attorney General of the State of California by Adrian K. Panton, Deputy Attorney General. 2. MILTON H. UHLEY, M.D., ("respondent") is

represented in this matter by attorney David J. O'Keefe, whose

1.

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address is BONNE, BRIDGES, MUELLER, O'KEEFE & NICHOLS, 3 699 Wilshire Boulevard, Tenth Floor, Los Angeles, CA 90010-2719. The respondent has counseled with his attorney concerning the effect of this stipulation which respondent has carefully read and fully understands. 3. Respondent has received and read the Accusation

which is presently on file and pending in Case Number 05-93-29050 before the Division of Medical Quality of the Medical Board of California Department of Consumer Affairs (hereinafter the "Division"), a copy of which is attached as Exhibit A and incorporated herein by reference. 4. Respondent understands the nature of the charges

alleged in the Accusation and that, if proven at hearing, such charges and allegations would constitute cause for imposing discipline upon respondent's license issued by the Board. 5. Respondent and his counsel are aware of each of

respondent's rights, including the right to a hearing on the charges and allegations, the right to confront and cross-examine witnesses who would testify against respondent, the right to testify and present evidence on his own behalf, as well as to the issuance of subpoenas to compel the attendance of witnesses and the production of documents, the right to contest the charges and allegations, and other rights which are accorded respondent pursuant to the California Administrative Procedure Act (Gov. Code, § 11500 et seq.) and other applicable laws, including the right to seek reconsideration, review by the superior court, and appellate review.

2.

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6.

In order to avoid the expense and uncertainty of a

hearing, respondent freely and voluntarily waives each and every one of these rights set forth above and admits the truth of the allegations in count IV of Accusation No. 05-93-29050 which charges a violation of Business and Professions Code section 2242 (prescribing dangerous drugs without a good faith prior examination and medical indication therefor). Based on this

admission, respondent hereby surrenders Physician's and Surgeon's Certificate C10122 for the Division's formal acceptance. 7. Respondent understands that by signing this

stipulation he is enabling the Division of Medical Quality to issue its order accepting the surrender of his Physician's and Surgeon's Certificate without further process. He understands

and agrees that Board staff and counsel for complainant may communicate directly with the Division regarding this stipulation, without notice to or participation by respondent or his counsel. In the event that this stipulation is rejected for

any reason by the Division, it will be of no force or effect for either party. The Division will not be disqualified from further

action in this matter by virtue of its consideration of this stipulation. 8. Upon acceptance of the stipulation by the

Division, respondent understands that he will no longer be permitted to practice as a physican and surgeon in California, and also agrees to surrender and cause to be delivered to the Division both his license and wallet certificate before the effective date of the decision.

3.

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(

9.

Respondent fully understands and agrees that if he

ever files an application for relicensure or reinstatement in the State of California, the Division shall treat it as a petition for reinstatement, the respondent must comply with all the laws, regulations and procedures for reinstatement of a revoked license in effect at the time the petition is filed, and all of the charges and allegations contained in Accusation No. 05-93-29050 will be deemed to be true, correct and admitted by respondent when the Division determines whether to grant or deny the petition. ACCEPTANCE I, MILTON H. UHLEY, M.D., have carefully read the above stipulation and enter into it freely and voluntarily with the advice of counsel, and with full knowledge of its force and effect, do hereby surrender my Physician's and Surgeon's Certificate, No. C10122, to the Division of Medical Quality, Medical Board of California for its formal acceptance. By

signing this stipulation to surrender my license, I recognize that upon its formal acceptance by the Division, I will lose all rights and privileges to practice as a physician and surgeon in

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the State of California and I also will cause to be delivered to

/ / / / / /

4.

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the Division both my license and wallet certificate before the effective date of the decision.

DATED:

(Zrf /$&/*
MILTON H. UHLEY, M Respondent

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I concur in the stipulation.

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DATED:

S ~ 13 " ^ \p

jy D. Werre Attorney for Respondent

K

DATED:

U.t^t>^v
-/-

3^

DANIEL E. LUNGREN, Attorney General of the State of California

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Adrian K. Panton Deputy Attorney General Attorneys for Complainant

5.

EXHIBIT A

DECISION AND ORDER OF THE DIVISION OF MEDICAL QUALITY MEDICAL BOARD OF CALIFORNIA

The s u r r e n d e r of P h y s i c i a n ' s and S u r g e o n ' s No. C10122, by r e s p o n d e n t ,

Certificate

MILTON H. UHLEY, M . D . , i s a c c e p t e d by M e d i c a l B o a r d of California

t h e D i v i s i o n cf M e d i c a l Q u a l i t y , D e p a r t m e n t of Consumer Affairs.

T h i s d e c i s i o n s h a l l become e f f e c t i v e of September It 19 96. , 1996 . i s so ordered t h i s 26th d a y of

on t h e

26th

day

September

,

FOR THE DIVISION OF MEDICAL QUALITY MEDICAL BOARD OF CALIFORNIA ANABEL ANDERSON IMBERT, M.D., CHAIR, PANEL B Exhibit A: Accusation

6.

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