4patientsafety.org4patientsafety.org/documents/Harms, Monica M 2016-09-07.pdf14 incorporated herein by reference. 15 ADVISEMENT AND WAIVERS 16 6. Respondent has carefully read, fully

BEFORE THE MEDICAL BOARD OF CALIFORNIA

DEPARTMENT OF CONSUMER AFFAIRS STATE OF CALIFORNIA

In the Matter of the Accusation ) Against: )

) )

MONICA M. HARMS, M.D. ) )

Physician's and Surgeon's ) Certificate No. A 94064 )

) Respondent )

________________________ )

Case No. 04-2013-235685

DECISION

The attached Stipulated Settlement and Disciplinary Order is hereby adopted as the Decision and Order of the Medical Board of California, Department of Consumer Affairs, State of California.

This Decision shall become effective at 5:00p.m. on October 7, 2016.

IT IS SO ORDERED: September 7, 2016.

MEDICAL BOARD OF CALIFORNIA

J a · Wright, JD, Chair Panel A

1 KAMALA D. HARRIS Attorney General of California

2 E. A. JONES III Supervising Deputy Attorney General

3 CHRIS LEONG Deputy Attorney General

4 State Bar No. 141079 California Department of Justice

5 300 So. Spring Street, Suite 1702 Los Angeles, CA 900 13

6 Telephone: (213) 897-2575 Facsimile: (213) 897-9395

7 E-mail: [email protected] Attorneys for Complainant

8 BEFORE THE MEDICAL BOARD OF CALIFORNIA

9 DEPARTMENT OF CONSUMER AFFAIRS

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STATE OF CALIFORNIA

In the Matter of the Accusation Against:

MONICA HARMS, M.D. 1450 Park Newport Newport Beach, CA 92660

Physician's and Surgeon's Certificate No. A 94064,

Respondent.

Case No. 04-2013-235685

OAH No. 2015120597

STIPULATED SETTLEMENT AND DISCIPLINARY ORDER

In the interest of a prompt and speedy settlement of this matter, consistent with the public

interest and the responsibility of the Medical Board of California ("Board''), the parties hereby

agree to the following Stipulated Settlement and Disciplinary Order which will be submitted to

the Board for approval and adoption as the final disposition of the Accusation.

PARTIES

1. Kimberly Kirchmeyer ("Complainant") is the Executive Director of the Board. She

brought this action solely in her official capacity and is represented in this matter by Kamala D.

Harris, Attorney General ofthe State of California, by Chris Leong, Deputy Attorney General.

I II

STIPULATED SETTLEMENT (OAH No. 2015120597)

1 2. Respondent MONICA HARMS, M.D. ("Respondent") is represented in this

2 proceeding by attorney Courtney E. Pilchman, Esq., whose address is: 2030 Main St., Suite 1300

3 Irvine, CA 92614.

4 3. On or about February 15, 2006, the Board issued Physician's and Surgeon's

5 Certificate No. A 94064 to MONICA HARMS, M.D. The Physician's and Surgeon's Certificate

6 was in full force and effect at all times relevant to the charges brought in Accusation No.

7 04-2013-235685 and will expire on June 30, 2017, unless renewed.

8 JURISDICTION

9 4. Accusation No. 04-2013-235685 was tiled before the Board and is currently pending

10 against Respondent. The Accusation and all other statutorily required documents were properly

11 served on Respondent on April 28, 2015. Respondent timely filed her Notice of Defense

12 contesting the Accusation.

13 5. A copy of Accusation No. 04-2013-235685 is attached as Exhibit A and is

14 incorporated herein by reference.

15 ADVISEMENT AND WAIVERS

16 6. Respondent has carefully read, fully discussed with counsel, and understands the

17 charges and allegations in Accusation No. 04-2013-235685. Respondent has also carefully read,

18 fully discussed with counsel, and understands the effects of this Stipulated Settlement and

19 Disciplinary Order.

20 7. Respondent is fully aware of her legal rights in this matter, including the right to a

21 hearing on the charges and allegations in the Accusation; the right to be represented by counsel at

22 her own expense; the right to confront and cross-examine the witnesses against her; the right to

23 present evidence and to testify on her own behalf; the right to the issuance of subpoenas to

24 compel the attendance of witnesses and the production of documents; the right to reconsideration

25 and court review of an adverse decision; and all other rights accorded by the California

26 Administrative Procedure Act and other applicable laws.

27 8. Respondent voluntarily, knowingly, and intelligently waives and gives up each and

28 every right set forth above.

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1 CULPABILITY

2 · 9. Respondent understands and agrees that the charges and allegations in Accusation

3 No. 04-2013-235685, if proven at a hearing, constitute cause for imposing discipline upon her

4 Physician's and Surgeon's Certificate.

5 10. For the purpose of resolving the Accusation without the expense and uncertainty of

6 further proceedings, Respondent agrees that, at a hearing, Complainant could establish a factual

7 basis for the charges in the Accusation, and that Respondent hereby gives up her right to contest

8 those charges.

9 11. Respondent agrees that her Physician's and Surgeon's Certificate is subject to

10 discipline and she agrees to be bound by the Board's probationary terms as set forth in the

11 Disciplinary Order below.

12 12. Respondent agrees that if he ever petitions for early termination of probation or

13 modification of probation, or if the Board ever petitions for revocation of probation, all of the

14 charges and allegations contained in Accusation No. 04-2013-235685, shall be deemed true,

15 correct and fully admitted by Respondent for purposes of that proceeding or any other licensing

16 proceeding involving Respondent in the State of California.

17 CONTINGENCY

18 13. This stipulation shall be subject to approval by the Medical Board of California.

19 Respondent understands and agrees that counsel for Complainant and the staff of the Medical

20 Board of California may communicate directly with the Board regarding this stipulation and

21 settlement, without notice to or participation by Respondent or her counsel. By signing the

22 stipulation, Respondent understands and agrees that she may not withdraw her agreement or seek

23 to rescind the stipulation prior to the time the Board considers and acts upon it. If the Board fails

24 to adopt this stipulation as its Decision and Order, the Stipulated Settlement and Disciplinary

25 Order shall be of no force or eflect, except for this paragraph, it shall be inadmissible in any legal

26 action between the parties, and the Board shall not be disqualified from further action by having

27 considered this matter.

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STIPULATED SETTLEMENT (OAH No. 20 15120597)

1 14. The parties understand and agree that Portable Document Format (PDF) and facsimile

2 copies of this Stipulated Settlement and Disciplinary Order, including PDF and facsimile

3 signatures thereto, shall have the same force and effect as the originals.

4 15. In consideration of the foregoing admissions and stipulations, the parties agree that

5 the Board may, without further notice or formal proceeding, issue and enter the following

6 Disciplinary Order:

7 DISCIPLINARY ORDER

8 IT IS HEREBY ORDERED that Physician's and Surgeon's Certificate No. A 94064 issued

9 to Respondent MONICA HARMS, M.D. is revoked. However, the revocation is stayed and

10 Respondent is placed on probation for five (5) years on the following terms and conditions.

11 1. ALCOHOL - ABSTAIN FROM USE. Respondent shall abstain completely from the

12 use of products or beverages containing alcohol.

13 If Respondent has a confirmed positive biological fluid test for alcohol, Respondent shall

14 receive a notification from the Board or its designee to immediately cease the practice of

15 medicine. The Respondent shall not resume the practice of medicine until final decision on an

16 accusation and/or a petition to revoke probation. An accusation and/or petition to revoke

17 probation shall be filed by the Board within 15 days of the notification to cease practice. If the

18 Respondent requests a hearing on the accusation and/or petition to revoke probation, the Board

19 shall provide the Respondent with a hearing within 30 days of the request, unless the Respondent

20 stipulates to a later hearing. A decision shall be received from the Administrative Law Judge or

21 the Board within 15 days unless good cause can be shown for the delay. The cessation of practice

22 shall not apply to the reduction of the probationary time period.

23 If the Board does not file an accusation or petition to revoke probation within 15 days of the

24 issuance of the notification to cease practice or does not provide Respondent with a hearing

25 within 30 days of a such a request, the notification of cease practice shall be dissolved.

26 2. CONTROLLED SUBSTANCES- ABSTAIN FROM USE. Respondent shall abstain

27 completely from the personal use or possession of controlled substances as defined in the

28 California Uniform Controlled Substances Act, dangerous drugs as defined by Business and

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1 Professions Code section 4022, and any drugs requiring a prescription. This prohibition does not

2 apply to medications lawfully prescribed to Respondent by another practitioner for a bona fide

3 illness or condition.

4 Within 15 calendar days of receiving any lawfully prescribed medications. Respondent

5 shall notify the Board or its designee of the: issuing practitioner's name, address, and telephone

6 number; medication name, strength, and quantity; and issuing pharmacy name, address, and

7 telephone number.

8 If Respondent has a confirmed positive biological fluid test for any substance (whether or

9 not legally prescribed) and has not reported the use to the Board or its designee, Respondent

10 shall receive a notification from the Board or its designee to immediately cease the practice of

11 medicine. The Respondent shall not resume the practice of medicine until final decision on an

12 accusation and/or a petition to revoke probation. An accusation and/or petition to revoke

13 probation shall be filed by the Board within 15 days of the notification to cease practice. If the

14 Respondent requests a hearing on the accusation and/or petition to revoke probation, the Board

15 shall provide the Respondent with a hearing within 30 days of the request, unless the Respondent

16 stipulates to a later hearing. A decision shall be received from the Administrative Law Judge or

17 the Board within 15 days unless good cause can be shown for the delay. The cessation of practice

18 shall not apply to the reduction of the probationary time period.

19 If the Board does not file an accusation or petition to revoke probation within 15 days of the

20 issuance of the notification to cease practice or does not provide Respondent with a hearing

21 within 30 days of a such a request, the notification of cease practice shall be dissolved.

22 "' .). NOTICE OF EMPLOYER OR SUPERVISOR INFORMATION.

23 Within seven (7) days of the effective date of this Decision, Respondent shall provide to

24 the Board the names, physical addresses, mailing addresses, and telephone numbers of any and all

25 employers and supervisors. Respondent shall also provide specific, written consent for the Board,

26 Respondent's worksite monitor, and Respondent's employers and supervisors to communicate

27 regarding Respondent's work status, performance, and monitoring.

28 For purposes ofthis section, "supervisors" shall include the ChiefofStaffand Health or

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Well Being Committee Chair, or equivalent, if applicable, when the Respondent has medical staff

2 privileges.

3 4. BIOLOGICAL FLUID TESTING.

4 Respondent shall immediately submit to biological fluid testing, at Respondent's expense,

5 upon request of the Board or its designee. "Biological fluid testing" may include, but is not

6 limited to, urine, blood, breathalyzer, hair follicle testing, or similar drug screening approved by

7 the Board or its designee. Respondent shall make daily contact with the Board or its designee to

8 determine whether biological fluid testing is required. Respondent shall be tested on the date of

9 the notification as directed by the Board or its designee. The Board may order Respondent to

10 undergo a biological fluid test on any day, at any time, including weekends and holidays. Except

11 when testing on a specific date as ordered by the Board or its designee, the scheduling of

12 biological fluid testing shall be done on a random basis. The cost of biological fluid testing shall

13 be borne by the Respondent.

14 During the first year of probation, Respondent shall be subject to 52 to 104 random tests.

15 During the second year of probation and for the duration of the probationary term, up to five ( 5)

16 years, Respondent shall be subject to 36 to 104 random tests per year. Only ifthere has been no

17 positive biological fluid tests in the previous five (5) consecutive years of probation, may testing

18 be reduced to one (1) time per month. Nothing precludes the Board from increasing the number

19 of random tests to the first-year level of frequency for any reason.

20 Prior to practicing medicine, Respondent shall contract with a laboratory or service,

21 approved in advance by the Board or its designee, that will conduct random, unannounced,

22 observed, biological fluid testing and meets all the following standards:

23 (a) Its specimen collectors are either certified by the Drug and Alcohol Testing Industry

24 Association or have completed the training required to serve as a collector for the United States

25 Department of Transportation.

26 (b) Its specimen collectors conform to the current United States Department of

27 Transportation Specimen Collection Guidelines

28 (c) Its testing locations comply with the Urine Specimen Collection Guidelines published

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by the United States Department of Transportation without regard to the type of test administered.

2 (d) Its specimen collectors observe the collection of testing specimens.

3 (e) Its laboratories are certified and accredited by the United States Department of Health

4 and Human Services.

5 (f) Its testing locations shall submit a specimen to a laboratory within one (1) business day

6 of receipt and all specimens collected shall be handled pursuant to chain of custody procedures.

7 The laboratory shall process and analyze the specimens and provide legally defensible test results

8 to the Board within seven (7) business days of receipt of the specimen. The Board will be

9 notified of non-negative results within one (1) business day and will be notified of negative test

10 results within seven (7) business days.

11 (g) Its testing locations possess all the materials, equipment, and technical expertise

12 necessary in order to test Respondent on any day of the week.

13 (h) Its testing locations are able to scientifically test for urine, blood, and hair specimens for

14 the detection of alcohol and illegal and controlled substances.

15 (i) It maintains testing sites located throughout California.

16 (j) It maintains an automated 24-hour toll-free telephone system and/or a secure on-line

17 computer database that allows the Respondent to check in daily for testing.

18 (k) It maintains a secure, HIPAA-compliant website or computer system that allows staff

19 access to drug test results and compliance reporting information that is available 24 hours a day.

20 (l) It employs or contracts with toxicologists that are licensed physicians and have

21 knowledge of substance abuse disorders and the appropriate medical training to interpret and

22 evaluate laboratory biological f1uid test results, medical histories, and any other information

23 relevant to biomedical information.

24 (m) It will not consider a toxicology screen to be negative if a positive result is obtained

25 while practicing, even if the Respondent holds a valid prescription for the substance.

26 Prior to changing testing locations for any reason, including during vacation or other travel,

27 alternative testing locations must be approved by the Board and meet the requirements above.

28 The contract shall require that the laboratory directly notify the Board or its designee of

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non-negative results within one (1) business day and negative test results within seven (7)

2 business days of the results becoming available. Respondent shall maintain this laboratory or

3 service contract during the period of probation.

4 A certified copy of any laboratory test result may be received in evidence in any

5 proceedings between the Board and Respondent.

6 If a biological fluid test result indicates Respondent has used, consumed, ingested, or

7 administered to himself a prohibited substance, the Board shall order Respondent to cease

8 practice and instruct Respondent to leave any place of work where Respondent is practicing

9 medicine or providing medical services. The Board shall immediately notify all of Respondent's

10 employers, supervisors and work monitors, if any, that Respondent may not practice medicine or

11 provide medical services while the cease-practice order is in effect.

12 A biological fluid test will not be considered negative if a positive result is obtained while

13 practicing, even if the practitioner holds a valid prescription for the substance. If no prohibited

14 substance use exists, the Board shall lift the cease-practice order within one (1) business day.

15 After the issuance of a cease-practice order, the Board shall determine whether the positive

16 biological t1uid test is in fact evidence of prohibited substance use by consulting with the

17 specimen collector and the laboratory, communicating with the licensee, his or her treating

18 physician(s), other health care provider, or group facilitator, as applicable.

19 For purposes of this condition, the terms "biological fluid testing" and "testing" mean the

20 acquisition and chemical analysis of a Respondent's urine, blood, breath, or hair.

21 For purposes of this condition, the term "prohibited substance" means an illegal drug, a

22 lawful drug not prescribed or ordered by an appropriately licensed health care provider for use by

23 Respondent and approved by the Board, alcohol, or any other substance the Respondent has been

24 instructed by the Board not to use, consume, ingest, or administer to himself.

25 If the Board confirms that a positive biological t1uid test is evidence of use of a prohibited

26 substance, Respondent has committed a major violation, as defined in section 1361.52(a), and the

27 Board shall impose any or all ofthe consequences set forth in section 1361.52(b), in addition to

28 any other terms or conditions the Board determines are necessary for public protection or to

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enhance Respondent's rehabilitation.

5. PSYCHIATRIC EVALUATION. Within 30 calendar days of the effective date of

this Decision, and on whatever periodic basis thereafter may be required by the Board or its

designee, Respondent shall undergo and complete a psychiatric evaluation (and psychological

testing, if deemed necessary) by a Board-appointed board certified psychiatrist, who shall

consider any information provided by the Board or designee and any other information the

psychiatrist deems relevant, and shall furnish a written evaluation report to the Board or its

designee. Psychiatric evaluations conducted prior to the effective date of the Decision shall not

be accepted towards the fulfillment of this requirement. Respondent shall pay the cost of all

psychiatric evaluations and psychological testing.

11 6. WORKSITE MONITOR FOR SUBSTANCE-ABUSING LICENSEE.

12 Within thirty (30) calendar days of the effective date ofthis Decision, Respondent shall

13 submit to the Board or its designee for prior approval as a worksite monitor, the name and

14 qualifications of one or more licensed physician and surgeon, other licensed health care

15 professional if no physician and surgeon is available, or, as approved by the Board or its designee,

16 a person in a position of authority who is capable of monitoring the Respondent at work.

17 The worksite monitor shall not have a current or former financial, personal, or familial

18 relationship with Respondent, or any other relationship that could reasonably be expected to

19 compromise the ability of the monitor to render impartial and unbiased reports to the Board or its

20 designee. If it is impractical for anyone but Respondent's employer to serve as the worksite

21 monitor, this requirement may be waived by the Board or its designee, however, under no

22 circumstances shall Respondent's worksite monitor be an employee or supervisee of the licensee.

23 The worksite monitor shall have an active unrestricted license with no disciplinary action

24 within the last five (5) years, and shall sign an af1irmation that he has reviewed the terms and

25 conditions of Respondent's disciplinary order and agrees to monitor Respondent as set forth by

26 the Board or its designee.

27 Respondent shall pay all worksite monitoring costs.

28 The worksite monitor shall have face-to-face contact with Respondent in the work

9

STIPULATED SETTLEMENT (OAH No. 20 I 5 I 20597)

environment on as frequent a basis as determined by the Board or its designee, but not less than

2 once per week; interview other staff in the office regarding Respondent's behavior, if requested

3 by the Board or its designee; and review Respondent's work attendance.

4 The worksite monitor shall verbally report any suspected substance abuse to the Board and

5 Respondent's employer or supervisor within one (1) business day of occurrence. If the suspected

6 substance abuse does not occur during the Board's normal business hours, the verbal report shall

7 be made to the Board or its designee within one (1) hour of the next business day. A written

8 report that includes the date, time. and location of the suspected abuse; Respondent's actions; and

9 any other information deemed important by the worksite monitor shall be submitted to the Board

10 or its designee within 48 hours of the occurrence.

11 The worksite monitor shall complete and submit a written report monthly or as directed by

12 the Board or its designee which shall include the following: (1) Respondent's name and

13 Physician's and Surgeon's Certificate number; (2) the worksite monitor's name and signature; (3)

14 the worksite monitor's license number, if applicable; ( 4) the location or location(s) of the

15 worksite; (5) the dates Respondent had face-to-face contact with the worksite monitor; (6) the

16 names of worksite staff interviewed, if applicable; (7) a report of Respondent's work attendance;

17 (8) any change in Respondent's behavior and/or personal habits; and (9) any indicators that can

18 lead to suspected substance abuse by Respondent. Respondent shall complete any required

19 consent forms and execute agreements with the approved worksite monitor and the Board, or its

20 designee, authorizing the Board, or its designee, and worksite monitor to exchange information.

21 If the worksite monitor resigns or is no longer available, Respondent shall, within five ( 5)

22 calendar days of such resignation or unavailability, submit to the Board or its designee, for prior

23 approval, the name and qualifications of a replacement monitor who will be assuming that

24 responsibility within fifteen ( 15) calendar days. If Respondent fails to obtain approval of a

25 replacement monitor within sixty (60) calendar days of the resignation or unavailability of the

26 monitor, Respondent shall receive a notification from the Board or its designee to cease the

27 practice of medicine within three (3) calendar days after being so notified. Respondent shall

28 cease the practice of medicine until a replacement monitor is approved and assumes monitoring

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responsibility.

2 7. SUBSTANCE ABUSE SUPPORT GROUP MEETINGS.

3 Within thirty (30) days of the effective date of this Decision, Respondent shall submit to the

4 Board or its designee, for its prior approval, the name of a substance abuse support group which

5 he shall attend for the duration of probation. Respondent shall attend substance abuse support

6 group meetings at least once per week, or as ordered by the Board or its designee. Respondent

7 shall pay all substance abuse support group meeting costs.

8 The facilitator of the substance abuse support group meeting shall have a minimum of three

9 (3) years experience in the treatment and rehabilitation of substance abuse, and shall be licensed

10 or certified by the state or nationally certified organizations. The facilitator shall not have a

11 current or former financial, personal, or business relationship with Respondent within the last five

12 (5) years. Respondent's previous participation in a substance abuse group support meeting led by

13 the same facilitator does not constitute a prohibited current or former financial, personal, or

14 business relationship.

15 The facilitator shall provide a signed document to the Board or its designee showing

16 Respondent's name, the group name, the date and location of the meeting, Respondent's

17 attendance, and Respondent's level of participation and progress. The facilitator shall report any

18 unexcused absence by Respondent from any substance abuse support group meeting to the Board,

19 or its designee, within twenty-four (24) hours of the unexcused absence.

20 8. NOTIFICATION. Within seven (7) days of the effective date of this Decision, the

21 Respondent shall provide a true copy of this Decision and Accusation to the Chief of Staff or the

22 Chief Executive Officer at every hospital where privileges or membership are extended to

23 Respondent, at any other facility where Respondent engages in the practice of medicine,

24 including all physician and locum tenens registries or other similar agencies, and to the Chief

25 Executive Officer at every insurance carrier which extends malpractice insurance coverage to

26 Respondent. Respondent shall submit proof of compliance to the Board or its designee within 15

27 calendar days.

28 This condition shall apply to any change(s) in hospitals, other facilities or insurance carrier.

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9. SUPERVISION OF PHYSICIAN ASSISTANTS. During probation, Respondent is

prohibited from supervising physician assistants.

10. OBEY ALL LAWS. Respondent shall obey all federal, state and local laws, all rules

governing the practice of medicine in California and remain in full compliance with any court

ordered criminal probation, payments, and other orders.

11. QUARTERLY DECLARATIONS. Respondent shall submit quarterly declarations

under penalty of perjury on forms provided by the Board, stating whether there has been

compliance with all the conditions of probation.

Respondent shall submit quarterly declarations not later than 10 calendar days after the end

of the preceding quarter.

12. GENERAL PROBATION REQUIREMENTS.

Compliance with Probation Unit

Respondent shall comply with the Board· s probation unit and all terms and conditions of

this Decision.

Address Changes

Respondent shall, at all times, keep the Board informed of Respondent's business and

residence addresses, email address (if available), and telephone number. Changes of such

addresses shall be immediately communicated in writing to the Board or its designee. Under no

circumstances shall a post office box serve as an address of record, except as allowed by Business

and Professions Code section 2021 (b).

Place of Practice

Respondent shall not engage in the practice of medicine in Respondent's or patient's place

of residence, unless the patient resides in a skilled nursing facility or other similar licensed

facility.

License Renewal

Respondent shall maintain a current and renewed California physician's and surgeon's

license.

Ill

12

STIPULATED SETTLEMENT (OAH No. 20 I 5 120597)

Travel or Residence Outside California

2 Respondent shall immediately inform the Board or its designee, in writing, of travel to any

3 areas outside the jurisdiction of California which lasts, or is contemplated to last, more than thirty

4 (30) calendar days.

5 In the event Respondent should leave the State of California to reside or to practice

6 Respondent shall notify the Board or its designee in writing 30 calendar days prior to the dates of

7 departure and return.

8 13. INTERVIEW WITH THE BOARD OR ITS DESIGNEE. Respondent shall be

9 available in person upon request for interviews either at Respondent's place of business or at the

10 probation unit office, with or without prior notice throughout the term of probation.

11 14. NON-PRACTICE WHILE ON PROBATION. Respondent shall notify the Board or

12 its designee in writing within 15 calendar days of any periods of non-practice lasting more than

13 30 calendar days and within 15 calendar days of Respondent's return to practice. Non-practice is

14 defined as any period of time Respondent is not practicing medicine in California as defined in

15 Business and Professions Code sections 2051 and 2052 for at least 40 hours in a calendar month

16 in direct patient care, clinical activity or teaching. or other activity as approved by the Board. All

17 time spent in an intensive training program which has been approved by the Board or its designee

18 shall not be considered non-practice. Practicing medicine in another state of the United States or

19 Federal jurisdiction while on probation with the medical licensing authority of that state or

20 jurisdiction shall not be considered non-practice. A Board-ordered suspension of practice shall

21 not be considered as a period of non-practice.

22 In the event Respondent's period of non-practice while on probation exceeds 18 calendar

23 months, Respondent shall successfully complete a clinical training program that meets the criteria

24 of Condition 18 of the current version of the Board's "Manual of Model Disciplinary Orders and

25 Disciplinary Guidelines" prior to resuming the practice of medicine.

26 Respondent's period of non-practice while on probation shall not exceed two (2) years.

27 Periods of non-practice will not apply to the reduction of the probationary term.

28 Periods of non-practice will relieve Respondent of the responsibility to comply with the

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STIPULATED SETTLEMENT (OAH No. 20!5120597)

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probationary terms and conditions with the exception of this condition and the following terms

and conditions of probation: Obey All Laws; and General Probation Requirements.

15. COMPLETION OF PROBATION. Respondent shall comply with all financial

obligations (e.g., restitution, probation costs) not later than 120 calendar days prior to the

completion of probation. Upon successful completion of probation, Respondent's certificate shall

be fully restored.

16. VIOLATION OF PROBATION CONDITION FOR SUBSTANCE ABUSING

LICENSEES.

10 Failure to fully comply with any term or condition of probation is a violation of probation.

11 A. If Respondent commits a major violation of probation as defined by section

12 1361.52, subdivision (a), ofTitle 16 ofthe California Code of Regulations, the Board shall take

13 one or more of the following actions:

14 ( 1) Issue an immediate cease-practice order and order Respondent to undergo a clinical

15 diagnostic evaluation to be conducted in accordance with section 1361.5, subdivision (c)(l), of

16 Title 16 of the California Code of Regulations, at Respondent's expense. The cease-practice

17 order issued by the Board or its designee shall state that Respondent must test negative for at least

18 a month of continuous biological fluid testing before being allowed to resume practice. For

19 purposes of the determining the length of time a respondent must test negative while undergoing

20 continuous biological fluid testing following issuance of a cease-practice order, a month is

21 defined as thirty calendar (30) days. Respondent may not resume the practice of medicine until

22 notified in writing by the Board or its designee that he may do so.

23 (2) Increase the frequency of biological fluid testing.

24 (3) Refer Respondent for further disciplinary action, such as suspension, revocation, or

25 other action as determined by the Board or its designee.

26 B. If Respondent commits a minor violation of probation as defined by section 1361.52,

27 subdivision (c), ofTitle 16 ofthe California Code of Regulations, the Board shall take one or

28 more of the following actions:

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( 1) Issue a cease-practice order;

2 (2) Order practice limitations;

3 (3) Order or increase supervision of Respondent;

4 ( 4) Order increased documentation;

5 (5) Issue a citation and fine, or a warning letter;

6 (6) Order Respondent to undergo a clinical diagnostic evaluation to be conducted in

7 accordance with section 1361.5, subdivision ( c )(1 ), of Title 16 of the California Code of

8 Regulations, at Respondent's expense;

9 (7) Take any other action as determined by the Board or its designee.

10 C. Nothing in this Decision shall be considered a limitation on the Board's authority to

11 revoke Respondent's probation if he has violated any term or condition of probation. If

12 Respondent violates probation in any respect, the Board, after giving Respondent notice and the

13 opportunity to be heard, may revoke probation and carry out the disciplinary order that was

14 stayed. If an Accusation, or Petition to Revoke Probation, or an Interim Suspension Order is filed

15 against Respondent during probation, the Board shall have continuing jurisdiction until the matter

16 is final, and the period of probation shall be extended until the matter is final.

17 17. LICENSE SURRENDER. Following the effective date of this Decision, if

18 Respondent ceases practicing due to retirement or health reasons or is otherwise unable to satisfy

19 the terms and conditions of probation, Respondent may request to surrender his or her license.

20 The Board reserves the right to evaluate Respondent's request and to exercise its discretion in

21 determining whether or not to grant the request, or to take any other action deemed appropriate

22 and reasonable under the circumstances. Upon formal acceptance of the surrender, Respondent

23 shall within 15 calendar days deliver Respondent's wallet and wall certificate to the Board or its

24 designee and Respondent shall no longer practice medicine. Respondent will no longer be subject

25 to the terms and conditions of probation. If Respondent re-applies for a medical license, the

26 application shall be treated as a petition for reinstatement of a revoked certificate.

27 18. PROBATION MONITORING COSTS. Respondent shall pay the costs associated

28 with probation monitoring each and every year of probation, as designated by the Board, which

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1 may be adjusted on an annual basis. Such costs shall be payable to the Medical Board of

2 California and delivered to the Board or its designee no later than January 31 of each calendar

3 year.

4 19. NOTIFICATION. Within seven (7) days of the effective date of this Decisi~ the

5 Respondent shall pro"tide a true copy of this Decision and Accusation to the Chief of Staff or the

6 Chief Executive Officer at every hospital where privileges or membership are extended to

7 Respondent. at any other facility where Respondent engages in the practice of medicine,

8 including all physician and locum tenens registries or other similar agencies, and to the Chief

9 Executive Officer at every insurance catrier which extends malpractice insurance coverage to

10 Respondent. Respondent shall submit proof of compliance to the Board or its designee within 15

11 calendar days.

12 This condition shall apply to any change(s) in hospitals, other facilities or insurance carrier.

13 20. SUPERVISION OF PHYSICIAN ASSISTANTS. During probati~ Respondent is

14 prohibited from supervising physician assistants.

15 ACCEPTANCE

16 I have carefully read the above Stipulated Settlement and Disciplinary Order and have fully

11 discussed it with my attomey, Courtney E. Pilchman, Esq. I understand the stipulation and the

18 effect it will have on my Physician's and Surgeon's Certificate. I enter into this Stipulated

19 Settlement and Disciplinary Order voluntarily, knowingly, and intelligently, and agree to be

20 bound by the Decision and Order of the Board.

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23 DATED:

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MONICA HARMS, M.D. Respondent

27 I have read and fully discussed with Respondent MONlCA HARMS, M.D. the terms and

28 conditions and other matters contained in the above Stipulated Settlement and Disciplinary Order.

16

STIPULATED SETD.EMa.t (OAH No. 2015120597)

1 I approve its form and content.

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DATED: ~ ( 'Z. { ( (:,

COiJRTNEYE.ptLCHMAN, Esq. Attorney for Respondent

ENDORSEMENT

6 The foregoing Stipulated Settlement and Disciplinary Order is hereby respectfully

7 submitted for consideration by the Medical Board of California.

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Dated:

16 LA20 15600935 61923114.docx

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Respectfully submitted,

KAMALA 0. HARRIS Attorney General of California E. A. JONES UI Supervising Deputy Attorney General

~J~ LLcr CHRIS LEONG Deputy Attorney General Attorneys for Complainant

11--------------------------------~==~~~~~------ ----~ STIJltJLATED SETTLEMENT (OAII No. :!0 IS120S97)

Exhibit A

Accusation No. 04-2013-235685

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KAMALA D. HARRIS Attorney General of California E. A. JONES III Supervising Deputy Attorney General CHRIS LEONG Deputy Attorney General State Bar No. 141079

CALIFORNIA DEPARTMENT OF JUSTICE 300 South Spring Street, Suite 1702 Los Angeles, CA 900 13 Telephone: (213) 897-2575 Facsimile: (213) 897-9395

Attorneys for Complainant

FILED STATE OF CALIFORNIA

MEDICAL SOARD Of CALIFORMA ZACAAiliENTOftrri I z '1 I 20£ rlY· ::1-T£ Lc- kl"' ~ ANALYST



In the Matter of the Accusation Against:

MONICA M. HARMS, M.D. 23331 El Toro Road, Suite 102 Lake Forest, California 92630

Case No. 04-2013-235685

ACCUSATION

14 Physician's and Surgeon's Certificate No. A 94064

Respondent.

Complainant alleges:

PARTIES

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

20 capacity as the Executive Director of the Medical Board of California ("Board"), Department of

21 Consumer Affairs.

22 2. On or about February 15, 2006, the Board issued Physician's and Surgeon's

23 Certificate Number A 94064 to MONICA M. HARMS, M.D. ("Respondent"). The Physician's

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

25 herein and will expire on June 30,2015, unless renewed.

26 JURISDICTION

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

28 laws. All section references are to the Business and Professions Code ("Code") unless otherwise

ACCUSATION (Case No. 04-2013-235685)

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indicated.

4. Section 2227 ofthe Code states that a licensee who is found guilty of a violation of

the Medical Practice Act (Bus. & Prof. Code, § 2000 et seq.), or who has entered into a

stipulation for disciplinary action with the Board, may have his license revoked; suspended for a

period not to exceed one year; placed on probation and required to pay the costs of probation

monitoring; or have any other action taken in relation to discipline as the Board may deem proper.

5. Section 2236 of the Code states:

"(a) The conviction of any offense substantially related to the qualifications, functions,

or duties of a physician and surgeon constitutes unprofessional conduct within the meaning of this

chapter [Chapter 5, the Medical Practice Act]. The record of conviction shall be conclusive

evidence only of the fact that the conviction occurred.

"(b) The district attorney, city attorney, or other prosecuting agency shall notify the

Division of Medical Quality of the pendency of an action against a licensee charging a felony or

misdemeanor immediately upon obtaining information that the defendant is a licensee. The

notice shall identify the licensee and describe the crimes charged and the facts alleged. The

prosecuting agency shall also notify the clerk of the court in which the action is pending that the

defendant is a licensee, and the clerk shall record prominently in the file that the defendant holds

a license as a physician and surgeon.

"(c) The clerk of the court in which a licensee is convicted of a crime shall, within 48

hours after the conviction, transmit a certified copy of the record of conviction to the board. The

division may inquire into the circumstances surrounding the commission of a crime in order to fix

the degree of discipline or to determine if the conviction is of an offense substantially related to

the qualifications, functions, or duties of a physician and surgeon.

"(d) A plea or verdict of guilty or a conviction after a plea of nolo contendere is

deemed to be a conviction within the meaning of this section and Section 223 6.1. The record of

conviction shall be conclusive evidence of the fact that the conviction occurred."

6. Section 2239 ofthe Code states:

I I I

2

ACCUSATI01\ (Case No. 04-2013-235685)

"(a) The use or prescribing for or administering to himself or herself, of any controlled

2 substance; or the use of any of the dangerous drugs specified in Section 4022, or of alcoholic

3 beverages, to the extent, or in such a manner as to be dangerous or injurious to the licensee, or to

4 any other person or to the public, or to the extent that such use impairs the ability of the licensee

5 to practice medicine safely or more than one misdemeanor or any felony involving the use,

6 consumption, or self-administration of any of the substances referred to in this section, or any

7 combination thereof, constitutes unprofessional conduct. The record of the conviction is

8 conclusive evidence of such unprofessional conduct.

9 "(b) A plea or verdict of guilty or a conviction following a plea of nolo contendere is

10 deemed to be a conviction within the meaning of this section. The Division of Medical Quality 1

11 may order discipline of the licensee in accordance with Section 2227 or the Division of Licensing

12 may order the denial of the license when the time for appeal has elapsed or the judgment of

13 conviction has been affirmed on appeal or when an order granting probation is made suspending

14 imposition of sentence, irrespective of a subsequent order under the provisions of Section 1203.4

15 of the Penal Code allowing such person to withdraw his or her plea of guilty and to enter a plea of

16 not guilty, or setting aside the verdict of guilty, or dismissing the accusation, complaint,

17 information, or indictment."

18 FIRST CAUSE FOR DISCIPLINE

19 (Conviction of a Crime)

20 7. Respondent is subject to disciplinary action under Code section 2236 in that she

21 was convicted of two crimes substantially related to the qualifications, functions, or duties of a

22 physician and surgeon. The circumstances are as follows:

23 2014 Conviction

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8. On or about September 20, 2013, a Misdemeanor Complaint was filed in the

1 Business and Professions Code section 2002, effective January 1, 2008, provides that unless otherwise expressly provided, the term "Board" as used in the State Medical Practices Act (Bus. & Prof. Code, § 2002 et seq.) means the "Medical Board of California," and references to the "Division of Medical Quality" and "Division of Licensing" in the Act or any other provision of law shall be deemed to refer to the Board.

3

ACCUSATION (Case No. 04-20 13-235685)

Superior Court of California, County of Orange in the case entitled The People of the State of

2 Cal~fornia v. lYfonica Michelle Harms, Case Number NBPD 13-008044. Respondent was charged

3 with the following allegations:

4 "COUNT 1: On or about September 17, 2013, in violation of Section 23152(a) of the

5 Vehicle Code (DRIVING UNDER THE INFLUENCE OF ALCOHOL/DRUGS WITH

6 ONE PRIOR) , a MISDEMEANOR, MONICA MICHELLE HARMS did unlawfully

7 drive a vehicle while under the influence of an alcoholic beverage, a drug(s) and under the

8 combined influence of alcoholic beverage and drug(s), and pursuant to Vehicle Code

9 section 23540, the [Respondent] MONICA MICHELLE HARMS, within ten (1 0) years of

10 the commission of the above offense, committed a separate violation of Vehicle Code

11 Section 23103 as specified in section 23103.5, Vehicle Code Section 23152, and Vehicle

12 Code section 23153, for which the defendant was convicted.

13 '·COUNT 2: On or about September 17, 2013, in violation of Section 23152(b) of the

14 Vehicle Code (DRIVING WITH BLOOD ALCOHOL .08% OR MORE WITH ONE

15 PRIOR), a MISDEMEANOR, MONICA MICHELLE HARMS did unlawfully drive a

16 vehicle while [Respondent's] blood alcohol concentration was 0.08 percent(%) or more

17 by weight of alcohol in [Respondent's] blood, and pursuant to vehicle Code section

18 23540, the [Respondent], MONICA MICHELLE HARMS, within ten (10) years of the

19 commission of the above offense, committed a separate violation of Vehicle Code Section

20 23103.5, Vehicle Code Section 23152, and Vehicle Code section 23153, for which the

21 defendant was convicted.

22 "OTHER ALLEGA TION(S)

23 "As to Count(s) 1 and 2, it is further alleged pursuant to Vehicle Code section 23578

24 (BLOOD ALCOHOL .15 percent), that defendant MONICA MICHELLE HARMS

25 unlawfully had concentration of alcohol in his/her blood of .15% and more by weight.

26 "PRIOR CONVICTION(S)

27 "As to Count(s) 1 and 2, it is further alleged, on or about May 16,2009,

28 MONICA MICHELLE HARMS violated Section 23152(b) of the Vehicle Code,

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resulting in a conviction on or about July 24, 2009 in the CITRUS (WEST COVINA)

Court of the State of California, in and for the County of LOS ANGELES, case number:

9JB0493501."

9. On or about April 30, 2014, Respondent plead guilty to Count 1 and Count 2. On

the same day, Respondent offered the following factual basis for her plea:

"On 9117113 in OC I did willfully and unlawfully drive a motor vehicle under the

inf1uence of alcohol to wit .17 BAC and I have previously been convicted of DUI in case

no. 9JB0493501 on 5116/07."

10. Respondent was sentenced to 5 years informal probation on terms and conditions,

including among others:

A.

B.

Violate no law.

Obey all orders, rules, and regulations, and directives of the court and jail.

C Do not drive a motor vehicle with a measurable amount of alcohol in your

blood and submit to a chemical test of your blood on demand of any peace officer,

probation officer, or mandatory supervision officer.

D. Pay FINE of $390.00 plus penalty assessment.

E. Pay $50.00; plus Alcohol Abuse Education Fee.

F. Pay $50.00; DUI Lab/Blood Alcohol Penalty.

G. Pay $1 00.00; Alcohol & Drug Assessment Program Fee.

H. Pay mandatory laboratory analysis fee of $50.00 for each specified drug

offense.

I. Pay mandatory $140 Probation Restitution Fine.

J. Pay $140 Probation Revocation Restitution Fine, stayed to become

effective only upon revocation of probation.

K. Pay $40 Court Operation Fee per convicted count.

L. Pay criminal conviction assessment, per convicted count of $30.00 per

misdemeanor.

M. Serve 90 days in Orange County Jail. Stayed until 6/27/2014.

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N. Attend and complete 18 month Multiple Offender Alcohol Program.

0. Attend and complete Mothers Against Drunk Driving (MADD) Victim

Impact Panel.

P. Pay booking fees to Newport Beach Police Department $347.00.

The facts and circumstances of the above conviction are as follows.

A. Respondent was observed by a Newport Beach Police Department

7 officer. The officer activated his emergency lights to stop the vehicle for a violation of California

8 Vehicle Code section 22349, subdivision (a) (Exceeding the State Maximum Speed Limit). The

9 vehicle yielded on the southbound Jamboree Road north of San Joaquin Hills Road. The officer

I 0 contacted the driver and sole vehicle occupant Respondent, from the front driver side window.

11 The officer immediately smelled the very strong odor of an alcoholic beverage emanating from

12 within the vehicle.

13 B. The officer told Respondent that he could smell the odor of an alcoholic

14 beverage coming from the vehicle. He asked her if she drank any alcohol and she told him that

15 she had wine with dinner. Another officer arrived at the scene to assist. Respondent was asked to

16 exit the vehicle and she complied.

17 C. The officers could smell the strong odor of an alcoholic beverage

18 emanating from Respondent's breath and person as she stood outside her vehicle. Respondent

19 was wobbly on her feet and repeatedly told the officer that she could park her vehicle at its

20 current location and walk home. Respondent was given a Field Sobriety Test. The officer

21 formed the opinion that Respondent was too intoxicated to safely operate a vehicle. She was

22 placed under arrest and placed in handcuffs.

23 D. Respondent chose to take a breath test. Respondent successfully

24 completed the test on the second trial. The results were 0.17 and 0.17 Blood Alcohol Content.

25 2009 Conviction

26 12. On or about June 5, 2009, a Misdemeanor Complaint was filed in the Superior

27 Court of California, County of Los Angeles, in the case entitled The People of the State of

28 California v. Afonica Michelle Harms, Case Number 9JB04935. Respondent was charged with

6


the following allegations:

2 "COUNT 1: On or about May 16, 2009, in the County of Los Angeles, the crime of

3 DRIVING UNDER THE INFLUENCE OF ALCOHOL OR DRUGS, in violation of

4 Vehicle Code section 23152(a), a Misdemeanor, was committed by MONICA

5 MICHELLE HARMS, who did unlawfully, while under the influence of an alcoholic

6 beverage and a drug and under the combined influence, drive a vehicle.

7

8 "COUNT 2: On or about May 16, 2009, in the County of Los Angeles, the crime of

9 DRIVING WHILE HAVING A 0.08% OR HIGHER BLOOD ALCOHOL, in violation

10 of Vehicle Code section 23152(b), a Misdemeanor, was committed by MONICA

11 MICHELLE HARMS, who did unlawfully, while having 0.08 percent and more, by

12 weight, of alcohol in the blood, drive a vehicle.

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14 "It is further alleged as to Count(s) 1 and 2 that the [Respondent's] concentration of blood

15 alcohol was 0.15 percent by weight and more, within the meaning of vehicle Code section

16 23578."

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dismissed.

On or about July 24, 2009, Respondent plead no contest to Count 2. Count 1 was

14. Respondent was sentenced to 3 years summary probation on terms and conditions,

including among others:

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B.

C.

D.

E.

F.

G.

Pay a fine of $470.

Pay a State Penalty Fund Assessment of $1 ,222.00.

Pay $94.00 criminal fine.

Pay $83.00 for the Laboratory Service Fund.

Pay $75.00 Alcohol and Drug Program Assessment.

Pay $50 Alcohol Abuse/Prevention Assessment.

Pay $30 Criminal Conviction Assessment (Total fine: $2,145.00)

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H. Complete a nine (9) month Licensed First-Offender Alcohol and other

Drug Education and Counseling Program.

I. Not Drive a motor vehicle with any measurable amount of alcohol in blood

system.

I. Not Refuse to Take A Chemical/Breath Test for Alcohol or Drug consumption

when requested by a peace officer.

K. Obey all orders and obey all laws.

L. Respondent spent one day in custody.

15. The facts and circumstances of the above conviction are as follows.

A. A California Highway Patrol Officer made the following statements in his

"[Respondent] was located within the [number]! lane standing next to the left rear of

Vehicle # 1 (Lex us) of the [west bound] I -10 freeway upon my arrival. All traffic lanes

were stopped[at] the I-1 0 westbound, east of Baldwin park Blvd. I contacted

[Respondent] within the# 1 lane and immediately detected the strong odor of alcoholic

beverage emanating from her person and breath. I asked her if she was injured and she

stated that she was not injured. I instructed [Respondent] to walk to the right shoulder.

Once [Respondent] was standing on the right shoulder ofthe [west bound] I-10, V-1 was

pushed to the right and the roadway was cleared. [Respondent] determined to be the

driver of V -1 at the time of the collision based on the fact of her own admission and

statements, she is the registered owner of V -1 and the seat belt abrasion on her chest is

consistent with her being seated in the driver seat at the time of collision. [Respondent]

also had an abrasion on her right forearm from the airbag being deployed on the drivers

side. Upon conducting my traffic collision investigation, [Respondent] stated that she was

driving V -1 northbound on State Rout 241. [Respondent did not remember anything

about the collision. As I was speaking with [Respondent], her eyes appeared to be red and

watery and she had a strong odor of an alcoholic beverage emanating from her person and

from her breath. [Respondent's) speech was slow and slurred and she was unsteady while

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I questioned her. She kept separating her feet approximately 12 inches. [Respondent] did

not have any shoes on at this time. I asked her if she had shoes and she stated that they

were in the car. I asked her if she had consumed any alcoholic beverages earlier this

evening. She said that she drank two margaritas at a friend's house in Claremont.

[Respondent] related she had no alcohol since the collision and she did not hit her head

during the collision. When I asked [Respondent] where we were at, she stated that we

were stopped in Claremont. I administered a series of field sobriety test (FST), which

[Respondent] was unable to perform as explained. During the FST's [Respondent] asked

me if she could ask me a question. [Respondent] stated the following, "Why did you stop

me? I informed [Respondent] that I did not contact [her] during an enforcement stop. I

contacted her because she was involved in a traffic collision. Based upon her objective

symptoms of alcohol intoxication, her inability to perform the FST's and the results of the

PAS detecting the presence of ethyl alcohol, I formed the opinion that [Respondent] had

been driving while under the influence of an alcoholic beverage. I arrested [Respondent]

for 23152(a) VC- Misdemeanor driving under the influence of alcohol per section

40300.5(a) VC- a person involved in a traffic collision. [Respondent] was placed in

handcuffs which were adjusted and double locked. I advised [Respondent] of23612 VC

Implied consent and she consented to take a breath test to determine the alcohol content in

her blood. [Respondent] was transported to the West Covina Police Department where

she provided three breath samples. I transported [Respondent] to Queen of the Valley

Hospital to get medical clearance to book. I transported [Respondent] to Industry Sheriffs

Department, where the subject was booked for the charges of 23152(A) VC and 23152(B)

VC."

B. Respondent took the breath test. The result was 0.24, .27 and 0.26 Blood

25 Alcohol Content.

26 Ill

27 Ill

28 Ill

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SECOND CAUSE FOR DISCIPLINE

2 (Excessive Use of Alcohol)

3 16. Respondent is subject to disciplinary action under Code sections 2239, in that she

4 used alcohol to the extent or in such a manner as to be dangerous or injurious to herself, other

5 persons, and the public. The facts and circumstances in the First Cause for Discipline are

6 incorporated herein as if fully set forth.

7 DISCIPLINE CONSIDERATIONS

8 17. To determine the degree of discipline, if any, to be imposed on Respondent,

9 Complainant alleges that on October 14, 2010, in a prior disciplinary proceeding before the Board

10 entitled In the Matter ofthe Accusation Against Monica M. Harms, M.D., Case No.

11 04-2009-199634. Respondent's Physician's and Surgeon's Certificate was Publicly

12 Reprimanded. The records of this proceeding are attached as Exhibit A and are incorporated

13 herein as if fully set forth.

14 PRAYER

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

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

17 1. Revoking or suspending Physician's and Surgeon's Certificate Number A 94064,

18 issued to Monica M. Harms, M.D.;

19 2. Revoking, suspending or denying approval of Monica M. Harms, M.D.'s authority to

20 supervise physician assistants pursuant to Code section 3527;

21 .., -'· Ordering Monica M. Harms, M.D., if placed on probation, to pay the Medical Board

22 of California the costs of probation monitoring; and

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4. Taking such other and further action as deemed necessary and proper.

DATED: April 28, 2015 Q e-__7 -{<h{_ul,__ {U) l{\jl~

LA20 15600935 61541545.docx

r,-./ KIMBeRLY KIRCHMEYER ~ Executive Director

Medical Board of California Department of Consumer Affairs State of California Complainant

10

ACCUSATION (Case No. 04-2013-235685)

Attachment A



In the Matter of the Accusation ) Against: )

) )

Monica M. Harms, M.D. ) )

Physician's and Surgeon's ) Certificate No. A 94064 )

) Respondent )

File No. 04-2009-199634

DECISION

The attached Stipulated Settlement and Disciplinary Order is hereby adopted as the Decision and Order of the Medical Board of California, Department of Consumer Affairs, State of California.

This Decision shall become effective at 5:00p.m. on October 14, 2010.

IT IS SO ORDERED September 16,2010

MEDICAL BOARD OF CALIFORNIA

By~~ Shelton Duruisseau, M.D., Chair Panel A

EDMUND G. BROWN JR. Attorney General of California

2 THOMAS S. LAZAR Supervising Deputy Attorney General

3 MATTHEW M. DAVIS Deputy Attorney General

4 State Bar No. 202766 110 West "A" Street, Suite 1100

5 San Diego, CA 92101 P.O. Box 85266

6 San Diego, CA 92186-5266 Telephone: ( 619) 645-2093

7 Facsimile: ( 619) 645-2061

8 Attorneys for Complainant

9 BEFORETHE MEDICAL BOARD OF CALIFORNIA

10 DEPART.MENT OF CONSUMER AFFAIRS STATE OF CALIFORNIA

11

12 In the Matter of the Accusation Against:

13 MONICA M. HARMS, M.D. 22032 El Paseo, Suite 130

14 Rancho Santa Margarita, CA 92688

15 Physician's and Surgeon's Certificate No. A 94064,

Case No. 04-2009-199634

STIPULATED SETTLEMENT AND DISCIPLINARY ORDER

16

17

18

Respondent.

IT IS HEREBY STIPULATED AND AGREED by and between the parties to the above-

19 entitled proceedings that the following matters are true:

20 PARTIES

21 1. Linda K. Whitney (hereinafter "complainant") is the Executive Director

22 of the Medical Board of California and is represented herein by Edmund G. Brown Jr., Attorney

23 General of the State of California, by Matthew M. Davis, Deputy Attorney General.

24 2. Respondent Monica Harms, M.D. (hereinafter "respondent") is

25 representing herself in this proceeding and has chosen not to exercise her right to be represented

26 by counsel.

27 Ill

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JURISDICTION

3. On or about February 15,2006, the Medical Board of California (Board)

issued Physician's and Surgeon's Certificate Number A 94064 to respondent Monica M. Harms,

M.D. The Physician's and Surgeon's Certificate was in full force and effect at all times relevent

to the charges and allegations in Accusation 04-2009-199634 and will expire on June 30,2011,

unless renewed.

4. On April 20, 2010, Complainant, Linda K. Whitney, in her official capacity

as the Executive Director of the Board, filed Accusation No. 04-2009-199634 against

respondent, a true and correct copy of which is attached hereto as Attachment "A" and

incorporated by reference as if fully set forth herein.

5. On April 20, 2010, respondent was served with a true and correct copy of

Accusation No. 04-2009-199634, together with true and correct copies of all other statutorily

required documents, at her address of record then on file with the Board: 22032 El Pasco, Suite

130, Rancho Santa Margarita, CA 92688. On or about May 4, 2010, respondent filed a Notice of

Defense and requested a hearing on the charges and allegations contained in Accusation No. 04-

16 2009-199634.

17 ADVISEMENT AND WAIVERS

18 6. Respondent has carefully read and fully understands the charges and

19 allegations contained in Accusation No. 04-2009-199634.

20 7. Respondent has carefully read and fully understands the contents, force,

21 and effect of this Stipulated Settlement and Disciplinary Order.

22 8. Respondent is fully aware of her legal rights in this matter including her

23 right to a hearing on the charges and allegations contained in Accusation No. 04-2009-199634,

24 her right to be represented by counsel at her own expense, her right to present witnesses and

25 evidence and to testify on her own behalf, her right to .confront and cross-examine all witnesses

26 testifying against her, her right to the issuance of subpoenas to compel the attendance of

27 witnesses and the production of documents, her right to reconsideration and court review of an

28 adverse decision, and all other rights accorded her pursuant to the California Administrative

2

Procedure Act, the California Code of Civil Procedure, and all other applicable laws.

2 9. Respondent voluntarily, knowingly, and intelligently waives and gives up

3 each and every right set forth above.

4 CULPABILITY

5 10. Respondent admits the complete truth and accuracy of each and every

6 charge and allegation contained in Accusation No. 04-2009-199634, a true and correct copy of

7 which is attached hereto as Attachment "A," and that she has thereby subjected her Physician's

8 and Surgeon's Certificate No. A 94064 to disciplinary action. Respondent further agrees to be

9 bound by the Board's imposition of discipline as set forth in the Disciplinary Order below.

10 CONTINGENCY

11 11. The parties agree that this Stipulated Settlement and Disciplinary Order

12 shall be submitted to the Board for its consideration in the above-entitled matter and, further, that

13 the Board shall have a reasonable period of time in which to consider and act on this Stipulated

14 Settlement and Disciplinary Order after receiving it.

15 12. The parties agree that this Stipulated Settlement and Disciplinary Order

16 shall be null and void and not binding upon the parties unless approved and adopted by the Board,

17 except for this paragraph, which shall remain in full force and effect. Respondent fully

18 understands and agrees that in deciding whether or not to approve and adopt this Stipulated

19 Settlement and Disciplinary Order, the Board may receive oral and written communications from

20 its staff and/or the Attorney General's office. Communications pursuant to this paragraph shall

21 not disqualify the Board, any member thereof, and/or any other person from future participation

22 in this or any other matter affecting or involving respondent. In the event that the Board, in its

23 discretion, does not approve and adopt this Stipulated Settlement and Disciplinary Order, with the

24 exception of this paragraph, it shall not become effective, shall be of no evidentiary value

25 whatsoever, and shall not be relied upon or introduced in any disciplinary action by either party

26 hereto. Respondent further agrees that should the Board reject this Stipulated Settlement and

27 Disciplinary Order for any reason, respondent will assert no claim that the Board, or any member

28 thereof, was prejudiced by its/his/her review, discussion and/or consideration of this Stipulated

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Settlement and Disciplinary Order or of any matter or matters related hereto.

ADDITIONAL PROVISIONS

13. This Stipulated Settlement and Disciplinary Order is intended by the

parties herein to be an integrated writing representing the complete, final and exclusive

embodiment of the agreements of the parties in the above-entitled matter.

14. The parties agree that facsimile copies of this Stipulated Settlement and

Disciplinary Order, including facsimile signatures of the parties, may be used in lieu of original

documents and signatures and, further, that facsimile copies and signatures shall have the same

force and effect as originals.

15. In consideration of the foregoing admissions and stipulations, the parties

11 agree the Board may, without further notice to or opportunity to be heard by respondent, issue

12 and enter the following Disciplinary Order:

13 DISCIPLINARY ORDER

14 A. PUBLIC REPRIMAND

15 IT IS HEREBY ORDERED that respondent Monica M. Harms, M.D., Physician's

16 and Surgeon's Certificate No. A 94064, shall be and is hereby Publicly Reprimanded pursuant to

17 California Business and Professions Code section 2227, subdivision (a)(4). This Public

18 Reprimand, which is issued in connection with respondent's unprofessional conduct as set forth

19 in Accusation No. 04-2009-199634, is as follows:

20 On May 16, 2009, you used alcoholic beverages to the extent, or in

21 such a manner, as to be dangerous or injurious to yourself, to other

22 persons and the public by driving a motor vehicle while under the

23 influence of alcoholic beverages, and driving with a blood alcohol

24 level of 0.24 percent. On July 24, 2009, you were convicted, upon

25 your plea of nolo contendere, to driving with a blood alcohol level

26 of 0.08 percent or more, a crime which is substantially related to the

27 qualifications, functions or duties of a physician and surgeon. Such

28 unprofessional conduct constitutes violations of provisions of the

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1 Medical Practice Act, and which breaches the rules or ethical code

2 of the medical profession, or conduct which is unbecoming of a

3 member in good standing of the medical profession, and which

4 demonstrates an unfitness to practice medicine, as more particularly

5 described in Accusation No. 04-2009-199634.

6 B. ETHICS COURSE

7 Within 60 calendar days of the effective date of this Decision, respondent shall

8 enroll in a course in ethics, at respondent's expense, approved in advance by the Board or its

9 designee. Failure to successfuily complete the course within one year of the effective date of this

10 Decision shall constitute unprofessional conduct and grounds for further disciplinary action.

11 An ethics course taken after the acts that gave rise to the charges in the

12 Accusation, but prior to the effective date ofthe Decision may, in the sole discretion of the

13 Division or its designee, be accepted towards the fulfillment of this condition if the course would

14 have been approved by the Board or its designee had the course been taken after the effective date

15 of this Decision.

16 Respondent shall submit a certification of successful completion to the Board or its

17 designee not later than 15 calendar days after successfully completing the course, or not later than

18 15 calendar days after the effective date ofthe Decision, whichever is later.

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ACCEPTANCE

2 I, Monica M. Harms, M.D., have carefully read this Stipulated Settlement and

3 Disciplinary Order and, enter into it freely, voluntarily, intelligently, and with full knowledge of

4 its force and effect on my Physician's and Surgeon's Certificate No. A 94064. I fully understand

5 that, after signing this stipulation, I may not withdraw from it, that it shall be submitted to the

6 Medical Board of California for its consideration, and that the Board shall have a reasonable

7 period of time to consider and act on this stipulation after receiving it. By entering into this

8 stipulation, I fully understand that, upon formal acceptance by the Board, I shall be publicly

9 reprimanded by the Board and shall be required to comply with all of the terms and conditions of

1 o the Disciplinary Order set forth above. I also fully understand that any failure to comply with the

11 terms and conditions of the Disciplinary Order set forth above shall constitute unprofessional

12 conduct and will subject my Physician's and Surgeon's Certificate No. A 94064 to further

13 disciplinary action.

14 DATED: ;L>.ju..vt:

Respondent

ENDORSEMENT

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The foregoing Stipulated Settlement and Disciplinary Order is hereby respectfully

submitted for consideration by the Division of Medical Quality, Medical Board ofCa1ifomia of 20

the Department of Consumer Affairs. 21

22 DATED: T~2_;20JO 23

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EDMUND G. BROWN JR., Attorney General of the State of California

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Attorneys for Complainant

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Attachment "A"

Accusation No. 04-2009-199634

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EDMUND G. BROWN JR. Attorney General of California

2 TllOMAS S. LAZAR Supervising Deputy Attorney General

3 MATI'HEW M. DAVIS Deputy Attorney General

4 State Bar No. 202766 110 West "A" Street Suite 1100

5 San Diego, CA 92 I 01 P.O. Box 85266

6 San Diego, CA 92186-5266 Telephone: (619) 645-2093

7 Facsimile: (619) 645-206 I

8 Attorneys.for Complainant

FILED ST/\TE OF CALIFORNIA

MEDICAL BOARD OF CALIFORNI SAC~M},NT04~t:~1·.~/ ZD, 20 0 By "1 4{/~ ·. 47/. · ., · · /~. A"JAl "T { 4 . '· ;:; ,,., · r; Ji!. r.·:, , ' ) 0

. I I

9 UF.FORE THE MEDICAL BOARD OF CALIFORNIA

10 DEPARTi\1f.NT OF CONSUMER AFFAIRS STATE OF CALIFORNIA

II --.. ----------------,

12 In the Matter of the Accusation Against:

13 MONICA M. HARMS, M.D. 22032 El Pasco, Suite 130

14 Rancho Santa Margarita, CA 92688

15 Physician's and Surgeon's Certificate No. A 94064,

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i Case No. 04-2009-199634 I

ACCUSATION

Respondent. 17

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Complainant alleges:

PARTIES

20 1. Linda K. Whitney (Complainant) brings !his Accusation solely in her

21 officinl capacity as the Interim Executive Director of the Medical Board of California,

22 Department of Consumer Affairs.

23 2. On or about February 15,2006, the Medical Board ofCalifornia (Board)

24 issued Physician's and Surgeon's Certificate Number A 94064 to Monica M. Ham1s, M.D.

25 (respondent). The Physician's and Surgeon's Certificate was in full force and effect at all times

26 rei event to the charges brought herein and will expire on June 30, 20 I J, unless renewed.

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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 (Code) unless

otherwise indicated.

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"(a) A licensee whose matter has been heard by an administrative lnw

judge of the McdicaLQuality Hearing Panel as designated in Section l 13 7 I of thc

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 division, may,

in accordance with the provisions of this chapter:

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

''(2) Have his or her right to practice suspended for a period not to exceed

one year upon order of the division.

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

monitoring upon order of the division.

"(4) Be publicly rcprimandt:d by the division.

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

order of probation, as the division 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 arc agreed to with the division 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 803.1."

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5. Section 118 of the Code states, in pertinent part:

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3 "(b) The suspension, expiration, or forfeiture by operation of law of a

4 license issued by a board in the department, or its suspension, forfeiture, or

5 cancellation by order of the board or by order of a court of law, or its surrender

6 without the written consent of the board, shall not, during any period in which it

7 may be renewed, restored, reissued, or reinstated, deprive the board of its

8 authority to institute or continue a disciplinary proceeding against the licensee

9 upon any ground provided by law or to enter an order suspending or revoking the

10 license or otherwise taking disciplinary action against the licensee on any such

11 ground.

12 "(c) As used in this section, 'board' includes an individual who is

13 authorized by any provision of this code to issue, suspend, or revoke a license,

14 and 'license' includes 'certificate,' 'registration,' and 'permit."'

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"The Division of Medical Quality' 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:

"(a) Violating or attempting to violate, directly or indirectly, assisting in

or abetting the violation of, or conspiring to violiltc any provision of this chapter

(Chapter 5, the Medical Practice Act].

1 Cali l(Jmia Business and Professions Code section 2002, as amended and ef!ccti ve January I, 2008, provides that, unless otherwise expressly provided, the term "board" as used in the State Medical Practice Act (Bus. & Prof. Code,§§ 2000, et seq.) mL:ans the "Medical Board of California," and references to the "Division of Medical Quality" and "Division of Licensing" in the Act or any other provision of law shall be deemed to refer to the Board.

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7. Unprofessional conduct under Business and Professions Code section 2234

is conduct which breaches the rules or ethical code of the medical profession, or conduct which is

unbecoming a member in good standing of the medical profession, and which demonstrates an

unfitness to practice medicine. (Shea v. Board o.f Medical Examiners (1978) 81 Cai.App.3d 564,

575.)


"(a) The conviction of any offense substantially related to the

qualifications, functions, or duties of a physician and surgeon constitutes

unprofessional conduct within the meaning of this chapter [Chapter 5, the Medical

Practice 1\ct'j. The record of conviction shall be conclusive evidence only of the

fact that the conviction occurred.

"(b) The district attorney, city attorney, or other prosecuting agency shall

notify the Division of Medical Quality of the pendency of an action against a

licensee charging a felony or misdemeanor immediately upon obtaining

information that the defendant is a licensee. The notice shall identify the licensee

and describe the crimes charged and the facts alleged. The prosecuting agency

shall also notify the clerk of the court in which the action is pending that the

defendant is a licensee, and the clerk shall record prominently in the file that the

defendant holds a license as a physician and surgeon.

"(c) The clerk ofthe court in which a licensee is convicted of a crime

shall, within 48 hours after the conviction, transmit a certified copy of the record

of conviction to the board. The division may inquire into the circumstances

surrounding the commission of a crime in order to fix the degree of discipline or

to determine if the conviction is of an offense substantially related to the

qualifications, functions, or duties of a physician and surgeon.

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"(d) A plea or verdict of guilty or a conviction after a plea of nolo

2 contendere is deemed to be a conviction within the meaning of this section and

3 Section 2236.1. The record of conviction shaH be conclusive evidence of the fact

4 that the conviction occurred.''

5 9. Section 2239 of the Code states:

6 "(a) The use or prescribing for or administering to him~clf or herself, of

7 any controlled substance; or the use of any ofthe dangerous drugs specified in

8 Section 4022, or of alcoholic beverages, to the extent, or in such a manner as to be

9 dangerous or injurious to the licensee, or to any other person or to the public, or to

10 the extent that such use impairs the ability of the licensee to practice medicine

11 safely or more than one misdemeanor or any felony involving the usc,

12 consumption, or self-administration of any of the substances referred to in this

13 section, or any combination thereof, constitutes unprofessional conduct. The

14 record of the conviction is conclusive evidence of such unprofessional conduct.

15 "(b) A plea or verdict of guilty or a conviction following a plea of nolo

16 contendere is deemed to be a conviction within the meaning of this section. The

17 Division of Medical Quality may order discipline of the licensee in accordance

18 with Section 2227 or the Division of Licensing may order the denial ofthc license

19 when the time for appeal has elapsed or the judgment of conviction has been

20 affirmed on appeal or when an order granting probation is made suspending

21 imposition of sentence, irrespective of a subsequent order under the provisions of

22 Section 1203.4 of the Penal Code allowing such person to withdraw his or her

23 plea of guilty and to enter a plea of not l:,TUilty, or setting aside the verdict of

24 guilty, or dismissing the accusation, complaint, information, or indictment. "2

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2 There is a nexus between a physician's use of alcoholic beverages and his or her fitness to practice medicine, established by the Legislature in section 2239, "in all cases where a licensed physician used alcoholic beverages to the extent or in such u manner as to pose a danger to himself or others." (Watson v. Superior Court (Medical Board) (2009) 176 CaLApp.4th 1407, 1411.)

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I 0. California Code of Regulations, title 16, section 1360, states:

2 "For the purposes of denial, suspension or revocation of a license,

3 certificate or pcnnit pursuant to Division 1.5 (commencing with Section 475) of

4 the code, a crime or act shall be considered to be substantially related to the

5 quali tications, functions or duties of a pcrs0n holding a license, certificate or

6 penni! under the Medical Practice Act if to a substantial degree it evidences

7 present or potential unfitness of a person holding a license, certificate or permit to

8 perform the functions authorized by the license, certificate or pcrmi: in a manner

9 consistent with the public health, safety or welfare. Such crimes or acts shall

10 include but not be limited to the following: Violating or attempting to violate.

11 directly or indirectly, or assisting in or abetting the violation of, or conspiring to

12 violatl' any provision of the Medical Practice Act."

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FIRST CAUSE FOR DISCIPLINE

(Use of Drugs or Alcoholic Beverages in a Manner, or to an Extent, us to be Dangerous to Himself, to Another Person, or to the Public)

11. Respondent has subjected her Physician's and Surgeon's

17 Cc.:rtificate No. A 94064 to disciplin:.~ry nction under sections 22.27 and 2234, as defined by

18 section 22.39, of the Code, in that she used or prescribed, or administered to herself, drugs or

19 alcoholic beverages to the extent, or in such a manner, as to be dangerous or injurious to her, to

20 another person, or to the public, as more particularly alleged hereinafter:

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(a) On or about May I 6, 2009, respondent was contacted by a patrol officer

from the California Highway Patrol (CHP) at approximately I 0:22 p.m. after she was

involved in a single vehicle automobile accident on westbound Interstate 10. Respondent

inexplicably veered off the freeway and stmck a guard rail. Respondent over corrected,

traveled across all west bound lanes of Interstate l 0 and crashed into the center divide.

(b) After contacting respondent, the CHP officer smelled the strong odor of

alcohol on respondent's breath and person. Respondent's eyes were red and watery and

her speech was slurred. Respondent inquired why the CHP officer pulled her over. The

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CHP ot1iccr infonned respondent that she had not been pulled over and !hut she had been

involved in an automobile accident.

(c) The CHP officer administered a battt:ry of Standardized Fidd Sobriety

Tests (SFSTs).

(d) The CHP officer administered the Horizontal Gaze Nystagmus Test, and

respondent exhibited HGN with onset prior to 45 degrees and distinct and sustained IIGN

at the extremes.

(c) The CliP officer administered the finger count Test. Respondent was

unable to correctly count from one to four and then from four to one while simultaneously

touching the tips of each of her fingers.

(f) The CHP officer administered the Rhomhcrg Test. Respondent swayed in

a circular motion approximately three inches from center. Respondent estimated one

minute in forty-six actual seconds.

(g) The CHP officer administered the Finger to Nose Test. Respondent was

only able to touch the tip of her nose on one of six attempts.

(h) The CHP officer administered the Preliminary Alcohol Screening Test.

Respondent provided two breath samples with respective blood alcohol measurements of

.252 and .260.

(i) Respondent admitted to drinking "two margaritas" prior to driving.

(j) Respondent was arrested and taken to headquarters, at which time she

provided a breath sample that demonstrated a blood alcohol level or 0.24 percent.

(k) On or about June 1, 2009, the Los Angeles County District Attorney filed a

Criminal Complaint against n.::spondent in the matter of the People of the State o.f

California v. Monica Michel If' Harms, Superior Court Case No. 9J 804935. Count One

charged respondent with driving under the int1ucnce of drugs and/or alcohol, in violation

of Vehicle Code section 23152, subdivision (a), a misdemeanor. Count Two charged

respondent with driving with a blood alcohol content level of0.08 percent or more, in

violation of Vehicle Code section 23 I 52, subdivision (b), a misdemeanor, with a further

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allegation that respondent's concentration of blood alcohol was 0. I 5 percent by weight or

2 more, within the meaning of Vehicle Code section 23578.

3 (1) On or about July 24, 2009, respondent was convicted upon her plea of

4 nolo contcndrc to Count Two (driving with a blood alcohol content level of0.08 percent

5 or more). On or about July 24, 2009, the Superior Court sentenced respondent to

6 probation tor three years, with the following terms and conditions: ( 1) Pay fees and fines

7 totaling $2, 145.00, and (2) Enroll in a nine month First Conviction Program.

8 SECOND CAUSE FOR DISCIPLINE

9 (Con.viction of a Crime Substantially Related to the Qualifications,

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Functions, or Duties of a Physician and Surgeon)

Respondent has further subjected her Physician's and Surgeon's

12 Certificate No. A 94064 to disciplinary action under sections 2227 and 2234, as defined by

13 section 2236, of the Code, in that she has been convicted of a crime substantially related to the

14 qualifications, functions, or duties of a physician and surgeon, as more particularly alleged

1 5 hereinafter:

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(a)

forth herein.

13.

Paragraph I l, above, is hereby incorporated by reference as if fully set

THIRD CAUSE FOR DISCIPUNE

(Violation of the Medical Practices Act)

Respondent has further subjected her Physician's and Surgeon's

21 Certificate No. A 94064 to disciplinary action under sections 2227 and 2234, as defined by

22 section 2234, subdivision (a), of the Code, in that she has viola1ed or attempted to violate. directly

23 or indirectly, or assisted in or abetted the violation of, or conspired to violate a provision of the

24 Medical Practices Act, as more particularly alleged hereinafter:

25 (a) Paragraph 11 through 12, above, are hereby incorporated by reference as if

26 fully set forth herein.

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I<~OURTH CAUSE FOR DISCIPLINE

2 (General Unprofessional Conduct)

3 14. Respondent has further subjected her Physician's and Surgeon's Certificate

4 No. A 94064 to disciplinary action under sections 2227 and 2234 of the Code, in that she has

5 engaged in conduct which breaches the rules or ethical code of the medical ?rofession, or conduct

6 which is unbecoming to a member in good standing of the medical profession, and which

7 demonstrates an unfitness to practice medicine, as more particularly alleged hereinafter:

8 (a) Paragraph 1 I through 13, above, arc hereby incorporated by reference as if

9 fully set forth herein.

10 PRAYER

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

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

13 !. Revoking or suspending Physician's and Surgeon's Certificate Number 1\

14 940M, issued to respondent Monica M. Ham1s, M.D.;

15 2. Revoking, suspending or denying approval of respondent Monica M.

16 Harms, M.D.'s authority to supervise physician assistants, pursuant to section 3527 ofthe Code;

17 3. Ordering respondent Monica M. Ham1s, M.D. to pay the Medical Board of

18 California, if placed on probation, the costs of probation monitoring; and

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20 DATED:

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4. Taking such other and further action as qccmcd.pc'ccssary and proper. /// )·<>

April 20, 2010 . '/</ ,// , · /7 / // .•'.. / . / ir'1/ j . / / . /' .. · ,.,/ .

~~:Crir;T~~~i:ft~~~ct:~-7~' Medical Board of Califorp{a Dcpm1mcnt of Consumer Affairs State of Califomia · Complainant

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Documents

4patientsafety.org4patientsafety.org/documents/Harms, Monica M 2016-09-07.pdf14 incorporated herein by reference. 15 ADVISEMENT AND WAIVERS 16 6. Respondent has carefully read, fully