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1 XAVIER BECERRA Attorney General of California

2 ALEXANDRAM. ALVAREZ Supervising Deputy Attorney General

3 MICHAEL C. BRUMMEL Deputy Attorney General

4 State Bar No. 236116 California Department of Justice

5 2550 Mariposa Mall, Room 5090 Fresno, CA 93721

6 Telephone: (559) 477-1679 Facsimile: (559) 445-5106

7 E-mail: [email protected]

8 Attorneys for Complainant

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FILED STATE OF CALIFORNIA

MEDICAL BOARD OF CALIFORNIA SACRAMENTO ~"-' \ \Q 20_.8:. BY . V-_. ~' ~C:v. s. ANALYST

BEFORE THE 10

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MEDICAL BOARD OF CALIFORNIA DEPARTMENT OF CONSUMER AFFAIRS

STATE OF CALIFORNIA

13 In the Matter of the Accusation Against:

14 Maciej Gerard Ossowski, M.D. 780 W Olive Ave., #105

15 Merced, CA 95348-2437

16 Physician's and Surgeon's Certificate No. A38380,

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Case No. 800-2015-015425

ACCUSATION

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Respondent.

Complainant alleges:

20 PARTIES

21 1. Kimberly Kirchmeyer (Complainant) brings this Accusation solely in her official

22 capacity as the Executive Director of the Medical Board of California, Department of Consumer

23 Affairs (Board).

24 2. On or about April 26, 1982, the Medical Board issued Physicians and Surgeon's

25 Certificate No. A38380 to Maciej Gerard Ossowski, M.D. (Respondent). The Physician's and

26 Surgeon's Certificate was in full force and effect at all times relevant to the charges brought

27 herein and will expire on April 30, 2018, unless renewed.

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(MACIEJ GERARD OSSOWSKI, M.D.) ACCUSATION NO. 800-2015-015425

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JURISDICTION

3. This Accusation is brought before the Board, under the authority of the following

laws. All section references are to the Business and Professions Code unless otherwise indicated.

4. Section 22 of the Code states:

'"'Board' as used in any provision of this Code, refers to the board in which the

administration of the provision is vested, and unless otherwise expressly provided, shall include

'bureau,' 'commission,' 'committee,' 'department,' 'division,' 'examining committee,'

'program,' and 'agency.'

5. Section 2227 of the Code states:

'"(a) A licensee whose matter has been heard by an administrative law judge of the Medical

Quality Hearing Panel as designated in Section 11371 of the Government Code, or whose default

has been entered, and who is found guilty, or who has entered into a stipulation for disciplinary

action with the board, may, in accordance with the provisions of this chapter:

'"(1) Have his or her license revoked upon order of the board.

"(2) Have his or her right to practice suspended for a period not to exceed one year upon

order of the board.

"(3) Be placed on probation and be required to pay the costs of probation monitoring upon

order of the board.

"(4) Be publicly reprimanded by the board. The public reprimand may include a

requirement that the licensee complete relevant educational courses approved by the board.

"(5) Have any other action taken in relation to discipline as part of an order of probation, as

the board or an administrative law judge may deem proper.

"(b) Any matter heard pursuant to subdivision (a), except for warning letters, medical

review or advisory conferences, professional competency examinations, continuing education

activities, and cost reimbursement associated therewith that are agreed to with the board and

successfully completed by the licensee, or other matters made confidential or privileged by

existing law, is deemed public, and shall be made available to the public by the board pursuant to

Section 803 .I."

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6. Section 2234 of the Code, states:

''The board shall take action against any licensee who is charged with unprofessional

conduct. In addition to other provisions of this article, unprofessional conduct includes, but is not

limited to, the following:

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"(b) Gross negligence.

"(c) Repeated negligent acts. To be repeated, there must be two or more negligent acts or

omissions. An initial negligent act or omission followed by a separate and distinct departure from

the applicable standard of care shall constitute repeated negligent acts.

"(1) An initial negligent diagnosis followed by an act or omission medically appropriate

for that negligent diagnosis of the patient shall constitute a single negligent act.

"(2) When the standard of care requires a change in the diagnosis, act, or omission that

constitutes the negligent act described in paragraph ( 1 ), including, but not limited to, a

reevaluation of the diagnosis or a change in treatment, and the licensee's conduct departs from the

applicable standard of care, each departure constitutes a separate and distinct breach of the

standard of care.

'' ,,

7. Section 2266 of the Code states: "The failure of a physician and surgeon to maintain

adequate and accurate records relating to the provision of services to their patients constitutes

unprofessional conduct."

Ill

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Ill

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FIRST CAUSE FOR DISCIPLINE

2 (Gross Negligence)

3 8. Respondent Maciej Gerard Ossowski, M.D. is subject to disciplinary action under

4 section 2234, subdivision (b) in that he committed multiple acts and/or omissions constituting

5 gross negligence. The circumstances are as follows:

6 9. On or about August 10, 201 1, patient J.A. 1, then a 57 year old female, sought

7 treatment from Respondent for back pain. Patient J.A. presented with a history that included a

8 past motor vehicle accident, an unrelated accident, bilateral carpal tunnel, neck pain and back

9 pain. Patient J.A. told Respondent that she had taken pain medications intermittently from 1991

10 through 1999, and that she did not currently have medical insurance. At that time, Respondent

11 prescribed patient J.A. Norco2 10/325 mg #180 and Soma3 350 mg #90.

12 10. From on or about August 10, 2011 through August of 2016, Respondent continued to

13 treat patient J.A. as her primary care provider. At each visit, Respondent would evaluate patient

14 J.A. and provide her with prescriptions for pain medications.

15 2011

16 11. From on or about August 10, 2011 through December 22, 2011, patient J.A. sought

17 treatment from Respondent approximately four times for pain management. At the initial visit,

18 Respondent did not document patient J .A.'s psych iatric history, history of medication abuse, did

19 not include a pain contract, and did not document written informed consent prior to prescribing

20 controlled substances. Respondent's notes included references to care provided by other

21 physicians that were illegible.

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1 Initials are used herein for privacy purposes. The full name of the "patient" will be provided in response to a written request for discovery.

2 Norco is a brand name for acetaminophen and hydrocodone bitartrate, a Schedule III controlled substance pursuant to Health and Safety Code section 11056, subdivision (e), and a dangerous drug pursuant to Business and Professions Code section 4022. Norco is an opiate/narcotic medication.

3 Soma, a brand name for carisoprodol, is a muscle relaxant with a known potentiating effect on narcotics. It is a muscle relaxer that works by blocking pain sensations between the nerves and the brain. In December 2011, the Federal Drug Administration listed carisoprodol as a Schedule IV controlled substance. (76 Fed.Reg. 77330 (Dec. 12, 2011).) Soma is also a dangerous drug pursuant to Business and Professions Code section 4022.

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12. From on or about August I 0, 2011 through December 22, 2011, Respondent wrote

2 patient J .A. approximately 4 prescriptions for Norco for a total of I ,320 pills, and 1 prescription

3 for Soma for a total of 450 pills.

4 13. From on or about August 10, 2011 through December 22, 2011, Respondent

5 continued to prescribe patient J.A. high doses of opioids without any clear positive response, such

6 as a decrease in pain level. The records indicate that patient J.A. experienced a decrease in pain,

7 but they do not contain any assessment of her pain level. On or about September 8, 2011, the

8 dosage of Norco was increased from 180 pills per month to 240 pills per month without any

9 rationale or documentation in support of the increase in medication.

10 14. From on or about August 10, 2011 through December 22, 2011, Respondent did not

11 refer patient J.A. for any diagnostic studies to determine if other pathology existed for her pain

12 symptoms, refer her to physical therapy, or require her to have a toxicology screen. Respondent

13 did not refer patient J.A. to a pain management specialist or document consideration of referring

14 patient J.A. to a pain management specialist.

15 15. From on or about August 10, 2011 through December 22, 2011, Respondent did not

16 review the course of pain treatment of patient J .A., assess the appropriateness of continued use of

17 the current treatment plan, or consider the use of other therapeutic modalities. Respondent

18 commonly did not document in the treatment notes the medications that patient J.A. was taking

19 for her ongoing medical problems which included chronic neck pain, back pain and insomnia.

20 Respondent commonly did not document in the treatment notes or the treatment plan multiple

21 refills of Soma.

22 16. From on or about August 10, 2011 through December 22, 2011, Respondent's records

23 for patient J.A. were inconsistent in their level of completeness. Respondent documented an

24 extensive physical examination on some occasions, while on other occasions, he did not

25 document a physical examination at all and only made reference to prior examinations.

26 Respondent commonly did not document specific objective findings in patient J.A.'s medical

27 records. Respondent's records for patient J.A. appear to be written by another person without

28 documentation of the author in the medical records. Respondent's records for J.A contained little

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information, if any, in support of ongoing refills of Soma. Respondent failed to adequately and

2 accurately document the monitoring of medications provided to patient J .A. which included

3 barbiturate-like sedatives opiates.

4 2012

5 17. From on or about February 1 through December 18, 2012, patient J.A. sought

6 treatment from Respondent approximately four times for pain management. On or about

7 February 14,2012, Respondent examined patient J.A.'s lumbar spine and noted that it remained

8 unchanged from August 10, 2011 examination. On or about June 8, 2012, Respondent engaged in

9 a discussion with patient J.A. about reducing the dosage of the Norco prescription. Respondent

10 documented that patient J.A. rejected the idea because she had been taking opiates continuously

11 since 1999 and was working 16 hours a day taking care of her grandchild. On or about November

12 5, 2012, Respondent denied a request for an early refill on patient J.A.'s Norco prescription

13 writing in the medical record "NO! MUST BE SEEN!" The progress notes for these visits did

14 not contain any assessment of patient J.A.'s pain level.

15 18. From on or about February 1 through December 18, 2012, Respondent wrote patient

16 J.A. approximately 7 prescriptions for Norco for a total of 2,640 pills, and 5 prescriptions for

17 Soma for a total of I ,080 pills.

18 19. From on or about February 1 through December 18,2012, Respondent continued to

19 prescribe patient J .A. high doses of opioids without any clear positive response, such as a

20 decrease in pain level. Patient J.A. continued to take 240 pills of Norco per month throughout

21 2012. Respondent did not make any adjustments in the dose of Norco provided to patient J.A.

22 despite her statement that she was unable to stop taking Norco and the denied request for a refill

23 in November of 2012.

24 20. From on or about February 1 through December 18, 2012, Respondent did not refer

25 patient J.A. for any diagnostic studies to determine if other pathology existed for her pain

26 symptoms, refer her to physical therapy, or require patient J.A. to have a toxicology screen.

27 Respondent did not refer patient J.A. to a pain management specialist or document consideration

28 of referring patient J.A. to a pain management specialist.

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21. From on or about February 1 through December 18, 2012, Respondent did not review

2 the course of pain treatment of patient J.A., assess the appropriateness of continued use of the

3 current treatment plan, or consider the use of other therapeutic modalities. Respondent




7 refills of Soma.

8 22. From on or about February I through December 18, 2012, Respondent's records for

9 patient J .A. were inconsistent in their level of completeness. Respondent documented an





14 documentation of the author in the medical records. Respondent's records for patient J.A

15 contained little information, if any, in support of ongoing refills of Soma. Respondent failed to

16 adequately and accurately document the monitoring of medications provided to patient J.A. which

17 included barbiturate-like sedatives and opiates.

18 2013

19 23. From on or about January 13 through December 20, 2013, patient J.A. sought

20 treatment from Respondent approximately twelve times for pain management. Respondent

21 performed an extensive physical examination in January of2013, however, he did not document

22 any discussion of the treatment plan in the medical record. Respondent began prescribing patient

23 J.A. temazepam,4 a benzodiazepine, for severe insomnia in addition to the other medications she

24 was already taking. Respondent frequently did not document the prescription for temazepam in

25 the treatment plan.

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4 Temazepam is a generic brand for Restoril and is a Schedule IV controlled substance pursuant to Health and Safety Code section 11057, subdivision (d), and a dangerous drug pursuant to Business and Professions Code section 4022.

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1 24. On or about November 28, 2013, patient J.A. presented to Respondent for treatment.

2 Respondent noted that patient J.A.'s boyfriend of thirty two years suddenly died on November 6,

3 2013. Respondent prescribed patient J.A. Norco and Valium 10 mg.

4 25. On or about December 13, 2013, Respondent prescribed patient J.A. 220 pills of

5 Norco. Later the same day, patient J.A. was admitted to the Mercy Medical Center Emergency

6 Department after being located face down in the hallway of her home. A preliminary screen for

7 drugs of abuse performed in the Emergency Department was positive for the presence of Norco

8 and Valium. Patient J.A. was subsequently admitted involuntarily to the Marie Green Psychiatric

9 Center. The Initial Psychiatric Assessment states that patient J.A. had fallen and was

10 unresponsive when located. Patient J.A.'s family reported that she was taking Vicodin5 and

11 benzodiazepines6, had no food in the refrigerator, had been falling, experiencing visual

12 hallucinations and was unable to take care of herself. Patient J .A.'s psychiatric history identified

13 a prior admission after becoming distressed as well as use of a friend's Haldol for relief of

14 anxiety. The Involuntary Patient Advisement identified patient J.A. as "Gravely Disabled" and

15 stated that J.A. had "been abusing Vicodin benzos. You were found face down on the hardwood

16 floor. You are not eating properly ... you are experiencing visual hallucinations ... " Patient J.A.

17 was treated for two days with individual and milieu therapy, but was not started on any

18 psychotropic medications. The discharge diagnosis included bereavement, major depressive

19 disorder, chronic back pain, high blood pressure, obesity and loss of husband three weeks prior.

20 The record contains no mention of suicidal ideation or attempt.

21 26. On or about December 17, 2013, patient J.A. 's daughter contacted Respondent's

22 office and reported that her mother had suffered a drug overdose. The notes state that "her

23 mother was found face down in her hallway supposedly with drug overdose. She was stabilized

24 and went to Marie Green for 48 hour hold ... "

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5 Vicodin is a trade name for acetaminophen and hydrocodone bitartrate, also known as Norco.

6 Benzodiazepines are a class of agents that work on the central nervous system, acting on select receptors in the brain that inhibit or reduce the activity of nerve cells within the brain. Valium, diazepam and temazepam are all benzodiazepines.

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27. From on or about January 13 through December 20, 2013, Respondent wrote patient

2 J.A. approximately thirteen prescriptions for Norco for a total of 2,790 pills, twelve prescriptions

3 for Soma for a total of 1,080 pills, ten prescriptions for temazepam for a total of 300 pills, one

4 prescription for Restoril for a total of 120 pills, one prescription for Valium 7 for a total of 60 pills,

5 and 1 prescription for Diazepam for a total of 60 pills.

6 28. From on or about January 13 through December 20, 2013, Respondent continued to

7 prescribe patient J.A. high doses of opioids without any clear positive response, such as a

8 decrease in pain level. Patient J.A. continued taking 240 pills of Norco per month until June of

9 2013 when Respondent reduced the dosage to 180 pills per month. In August of 2013,

10 Respondent elected to increase patient J .A.'s dosage of Norco to 210 pills per month.

11 29. From on or about January 13 through December 20, 2013, Respondent did not refer

12 patient J.A. for any diagnostic studies to determine if other pathology existed for her pain

13 symptoms, refer her to physical therapy, or require her to have a toxicology screen. Respondent



16 30. From on or about January 13 through December 20, 2013, Respondent did not review






22 refills of temazepam and Soma.

23 31. From on or about January 13 through December 20, 2013, Respondent's records for

24 patient J.A. were inconsistent in their level of completeness. Respondent documented an


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7 Diazepam (Valium) is a Schedule IV controlled substance pursuant to Health and Safety Code section 11057, subdivision (d), and a dangerous drug pursuant to Business and Professions Code section 4022. Diazepam is in the class of benzodiazepines.

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document a physical examination at all and only made reference to prior examinations.




5 contained little information, if any, in support of ongoing refills of temazepam and Soma.

6 Respondent failed to adequately and accurately document the monitoring of medications provided

7 to J.A. which included barbiturate-like sedatives, benzodiazepines and opiates.

8 2014



11 referred patient J.A. for the first documented imaging study since the outset of her treatment, a

12 lumbosacral x-ray. The x-ray revealed the presence of "osteoporosis and moderate-to-moderately

13 severe diffuse degenerative spondyloarthropathy." On or about February 15, 2015, Respondent

14 documented consideration of a lumbosacral MRI. Respondent's notes were commonly illegible

15 regarding what medications were discontinued and which new medications were being

16 prescribed. Respondent commonly did not document the continuing prescription of Norco in the

17 treatment plan or in the record of the examination. Frequently, the medical records appeared to

18 be partially completed by a medical assistant with subsequent notations added by Respondent. In

19 or around May of2012, Respondent diagnosed patient J.A. as suffering from chronic pain,

20 anxiety, depression and hyperlipidemia. Rather than performing and documenting a new physical

21 examination at each visit, Respondent frequently referred back to prior physical examinations. In

22 or around July of2014, Respondent noted that patient J.A.'s depression was "much better." In or

23 around September of 2014, Respondent documented that patient J .A.'s back exam has not

24 changed since 2011 with the exception of more tenderness and left sciatica.

25 33. On or about November 10, 2014, patient J.A. presented to Respondent for medication

26 refills, a recheck on back pain and requesting an MRI. The notes for this visit appear to be a

27 combination of three different sets of entries. The note for the neck examination contains an

28 additional entry indicating a limited range of motion. The note for the lumbar spine exam

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1 includes an additional entry indicating right lumbar spine radiculopathy. In the space designated

2 in the record for Review of Radiology, EKG, PFT, LAB, there is a note mentioning issues with a

3 six year old boy that is mostly unintelligible. The record does contain a depression assessment, a

4 Staying Healthy questionnaire, and a pain contract. The medical records contain no mention of

5 the medications in the treatment plan. Respondent prescribed patient J.A. 220 pills of Norco.

6 34. On or about December 8, 2014, patient J.A. presented to Respondent for medication

7 refills and a recheck on back pain. Respondent ordered a lumbar x-ray for patient J.A. The

8 cervical spine x-ray revealed slight straightening of the normal lordotic curve and "moderate to

9 severe spondylosis in the lower cervical region." It was recommended that clinical correlation

10 and correlation with MRI of the cervical spine be performed for further evaluation.

11 35. From on or about January 17 through December 8, 2014, Respondent wrote patient

12 J.A. approximately twenty-two prescriptions for Norco for a total of 2,540 pills, thirteen

13 prescriptions for Soma for a total of 1,080 pills, twelve prescriptions for temazepam for a total of

14 360 pills.

15 36. From on or about January 17 through December 8, 2014, Respondent continued to

16 prescribe patient J .A. high doses of opioids without any clear positive response, such as a

17 decrease in pain level. J.A. continued taking 220 pills of Norco per month throughout 2014. The

18 progress notes for these visits did not contain any assessment of J.A.'s pain level.


20 patient J.A. to physical therapy, or require her to have a toxicology screen. Respondent did not

21 refer patient J.A. to a pain management specialist or document consideration of referring patient

22 J.A. to a pain management specialist.






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12 to patient J.A. which included barbiturate-like sedatives, benzodiazepines and opiates.

13 2015



16 continued prescribing J.A. temazepam absent any documentation in the medical record to support

17 the basis for the prescription. Respondent's notes were commonly illegible regarding what

18 medications were discontinued and which new medications were being prescribed. Rather than

19 performing and documenting a new physical examination at each visit, Respondent frequently

20 referred back to prior physical examinations. Respondent commonly did not document the

21 continuing prescription of Norco in the treatment plan or in the record of the examination.

22 Respondent began providing patient J.A. with multiple prescriptions for Norco on the same visit

23 without providing any documentation to support his decision to provide multiple prescriptions on

24 the same date. In April of 2015, Respondent documented an extensive physical examination of

25 patient J.A.'s neck and back. Respondent ordered an MRI of patient J.A.'s cervical spine which

26 revealed multi-level disc desiccation with annular bulging and cervical spondyloarthropathy with

27 no neural impingement. On occasion, Respondent had patient J.A. complete a depression

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questionnaire. Respondent commonly did not adequately and accurately identify a treatment plan

2 for patient J.A.

3 41. On or about July 13, 2015, patient J.A. was admitted to the hospital with respiratory

4 failure due to an overdose of temazepam and Norco. While at the hospital patient J .A. was also

5 diagnosed with staphylococcus, bilateral pneumonia, a closed fracture of her nasal bones, COPD,

6 asthma with acute exacerbation nicotine, severe anxiety, insomnia, electrolytes imbalance and a

7 history of depression.

8 42. On or about July 31, 2015, patient J.A. presented to Respondent after a recent

9 hospitalization for a drug overdose. The chief complaint is listed in the medical record as "pain

10 in tailbone/coccyx- severe." Respondent failed to document a physical examination of the

11 sacrum. Respondent's notes for the visit make reference to prior physical examinations.

12 Respondent prescribed amitriptyline8 to patient J.A. Respondent documented in J .A.'s medical

13 record that he had reviewed the hospital records related to her hospitalization and concluded that

14 she had suffered from acute withdrawal of opiates. Respondent documented that he would not

15 continue prescribing benzodiazepines to patient J.A. The records include a note about Norco

16 which is unintelligible. Respondent failed to sign the medical records. The first two pages of the

17 medical record for this visit include a date stamp, while the final three pages fail to include the

18 same date stamp. It is unclear if the physician notes contained in the last three pages were

19 completed contemporaneously at the time of the visit, or if they were added at a later date.

20 Respondent provided J.A. two separate prescriptions of Norco for 90 pills in each prescription,

21 noting that this was intended to limit the patient to no more than a two week supply at a time.

22 43. On or about August 17, 2015, patient J.A. received an x-ray of her coccyx that

23 revealed degenerative changes of the sacroiliac joints and lower lumbosacral junction as well as

24 osseous demineralization.

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8 Amitriptyline is a tricyclic antidepressant. Amitriptyline affects chemicals in the brain that may be unbalanced in people with depression and is used to treat symptoms of depression. It is a dangerous drug pursuant to Business and Professions Code section 4022.

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44. On or about November 2, 2015, patient J.A. presented to Respondent for medication

2 refills. Respondent did not document a new physical examination and only made reference to

3 prior physical examinations. Respondent did not document in the medical record which

4 medications were provided to patient J.A. Respondent diagnosed patient J.A. with chronic pain

5 and chronic opioid dependence then provided her with two prescriptions of Norco totaling 240

6 pills.

7 45. On or about November 22,2015, patient J.A. completed a Medication Management

8 Agreement. The agreement documents that patient J .A. was currently taking 180- 220 pills of

9 Norco and 90 pills of Soma each month.

10 46. From on or about January 12 through December 30, 2015, Respondent wrote patient

11 J.A. approximately twenty-four prescriptions for Norco for a total of 2,560 pills, eleven

12 prescriptions for Soma for a total of 990 pills, eight prescriptions for temazepam for a total of 240

13 pills, and, six prescriptions for amitriptyline for a total of 150 pills.

14 47. From on or about January 12 through December 30,2015, Respondent continued to


16 decrease in pain level. J.A. continued taking 220 pills of Norco per month until July of 2015

17 when Respondent reduced J.A.'s Norco dose to 180 pills per month. In or around September of

18 2015, Respondent increased J.A.'s Norco dose to 200 pills per month. In or around October of

19 2015, Respondent increased J.A.'s Norco dose once more to 220 pills per month.


21 patient J.A. to physical therapy, or require patient J.A. to have a toxicology screen. Respondent








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(MACIEl GERARD OSSOWSKI, M.D.) ACCUSATION NO. 800-2015-015425













13 2016

14 51. From on or about January 28 through August 16, 2016, patient J.A. sought treatment

15 from Respondent approximately six times for pain management. Respondent's notes were

16 commonly illegible regarding what medications were discontinued and which new medications

17 were being prescribed. Rather than performing and documenting a new physical examination at

18 each visit, Respondent frequently referred back to prior physical examinations. Respondent

19 commonly did not document the continuing prescription of Norco in the treatment plan or in the

20 record of the examination. Respondent provided patient J.A. with multiple prescriptions for

21 Norco on the same visit without providing any documentation to support his decision to provide

22 multiple prescriptions on the same date. Respondent commonly did not document a diagnosis,

23 treatment plan or sign the medical record. Occasionally, patient J .A.'s records include physician

24 notes that appear to have been added at a later date as they fail to contain the same time and date

25 stamp as the first page in the record. Respondent commonly did not identify patient J.A.'s current

26 medication regimen. On or about April 7, 2016, patient J.A. received a lumbar MRI that revealed

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(MACIEl GERARD OSSOWSKI, M.D.) ACCUSATION NO. 800-2015-015425

multilevel degenerative disc disease. On or about April 22, 2016, Respondent listed "diazide 9" as

2 the only medication that patient J .A was currently taking despite multiple current prescriptions.

3 52. On or about May 19, 2016, patient J.A. presented to Respondent with neck pain, back

4 pain and for medication refills. Respondent documented patient J.A.'s physical examination of

5 the cervical, thoracic and lumbar spine with an electronic medical record for the first time.

6 Respondent documented a discussion with the patient regarding the possibility of ending her use

7 of Norco. Respondent wrote that patient J .A. was "nervous, anxious, then burst in tears."

8 Respondent reported that patient J.A. told him that she would purchase Norco on the streets if she

9 was unable to get it from him. Respondent provided patient J.A. with two prescriptions for Norco

1 0 totaling 220 pills.

11 53. On or about June 20, 2016, patient J.A. presented to Respondent to review and renew

12 her medications. Respondent indicated in the treatment plan that he intended to decrease patient

13 J .A.'s Norco dosage from 210 pills per month to 200 pills per month. Despite the note indicating

14 a plan to reduce the Norco, Respondent provided patient J.A. with two prescriptions for Norco

15 totaling 220 pills.

16 54. From on or about January 28 through August 16, 2016, Respondent wrote patient J.A.

17 approximately fourteen prescriptions for Norco for a total of 1,540 pills.

18 55. From on or about January 28 through August 16, 2016, Respondent continued to


20 decrease in pain level. Patient J.A. continued taking 220 pills of Norco per month through

21 August of 2016.

22 56. From on or about January 28 through August 16, 2016, Respondent did not refer

23 patient J.A. to physical therapy, or require her to have a toxicology screen. Respondent did not

24 refer patient J.A. to a pain management specialist or document consideration of referring patient

25 J.A. to a pain management specialist.

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9 Most likely a misspelling of "Dyazide." Dyazide is a combination of two diuretics, hydrochlorothiazide and triamterene. It is commonly used to treat fluid retention and high blood pressure.

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57. From on or about January 28 through August 16, 2016, Respondent did not review

2 the course of pain treatment of patient J .A., assess the appropriateness of continued use of the






8 58. From on or about January 28 through August 16, 2016, Respondent's records for





13 records. Respondent's records for patient J .A. appear to be written by another person without


15 contained little information, if any, in support of ongoing refills oftemazepam and Soma.



18 59. Respondent's management of patient J.A. with opiate medication, as alleged in

19 paragraphs 9 through 58, constitutes an extreme departure from the standard of care.

20 SECOND CAUSE FOR DISCIPLINE

21 (Repeated Negligent Acts)

22 60. Respondent is subject to disciplinary action under section 2234, subdivision (c), in

23 that he committed repeated acts and/or omissions constituting negligence in the care and

24 treatment of patient J.A. The circumstances are as follows:

25 61. The allegations contained in paragraphs 9 through 58 are incorporated by reference as

26 if set forth fully herein.

27 62. Respondent failed to refer and/or document consideration of referring J.A. to a pain

28 management specialist, which constitutes a departure from the standard of care.

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1 THIRD CAUSE FOR DISCIPLINE

2 (Failure to Maintain Adequate and Accurate Records)

3 63. Respondent is subject to disciplinary action under section 2266, of the Code in that he

4 failed to maintain adequate and accurate records in his care and treatment of patient J.A. The

5 circumstances are as follows:

6 64. The allegations contained in paragraphs 9 through 58 are incorporated by reference as

7 if set forth fully herein.

8 65. Respondent failed to document the medications being provided to J.A. for her chronic

9 neck pain, back pain and insomnia, which constitutes a departure from the standard of care.

10 66. Respondent failed to document a complete physical examination in the care and

11 treatment of patient J.A., which constitutes a departure from the standard of care.

12 67. Respondent failed to adequately document and/or monitor the medications prescribed

13 to J.A., which constitutes a departure from the standard of care.

14 68. Respondent's medical records for patient J.A. were illegible constituting a departure

15 from the standard of care.

16 I I I

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1 PRAYER

2 WHEREFORE, Complainant requests that a hearing be held on the matters herein alleged,

3 and that following the hearing, the Medical Board of California issue a decision:

4 1. Revoking or suspending Physician's and Surgeon's Certificate No. A38380, issued to

5 Respondent Maciej Gerard Ossowski, M.D.;

6 2. Revoking, suspending or denying approval of Respondent Maciej Gerard Ossowski,

7 M.D.'s authority to supervise physician assistants and advanced practice nurses;

8 3. Ordering Respondent Maciej Gerard Ossowski, M.D., if placed on probation, to pay

9 the Board the costs of probation monitoring; and

10 4. Taking such other and further action as d~em/ nece~s ry and proper.

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16 FR20 17303230

17 95215443.docx

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KI Executive Director Medical Board of California Department of Consumer Affairs State of California Complainant

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xavier becerra alexandram. alvarez ~-' 20 .8:. by s. …4patientsafety.org/documents/ossowski,...

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