Disciplinary Actions against
Rodney N. Dotson, M.D.
Stephen Barrett, M.D.
The Texas Medical Board has been concerned about Rodney Dotson, M.D. since the early 1980s. In 1983, following a pre-hearing conference, Dotson pledged not to prescribe thyroid medication "except for patients with demonstrated traditional indications established by current acceptable laboratory tests . . . properly documented in the patient's record." He also agreed to take certain continuing education courses and to have his practice monitored by another doctor. Between 1991 and 2004, the board issued six orders which concluded that Dotson had inappropriately treated many patients and ordered him to serve on probation with additional training and monitoring. In 2008, as noted below, he was ordered to serve on probation for seven more years, ordered undergo a peer-review evaluation, and take and pass a licensure test within one year. In May 2009, after concluding concluded that Dotson had failed to comply with the 2008 order, the Board suspended his license, and charged him with noncompliance. In November 2009, rather than facing these charges, Dotson agreed to voluntarily surrender his medical license.
LICENSE NO. D-9988
IN THE MATTER OF
THE LICENSE OF
RODNEY NORMAN DOTSON, M.D.
TEXAS MEDICAL BOARD
MEDIATED AGREED ORDER
On the 8fh day of February, 2008, came on to be heard before the Texas Medical Board (the "Board"), duly in session, the matter of the license of Rodney Norman Dotson, M.D. ("Respondent").
On May 25, 2006, Respondent appeared in person, with counsel Courtney Newton, at an Informal Show Compliance Proceeding and Settlement Conference in response to a letter of invitation from the staff of the. Board. Roger Calhoun represented Board staff. The Board's representatives were Timothy J. Turner, a member of the Board, and Allan Shulkin, M.D., a member of the District Review Committee.
A mediation conference was held on January 18, 2008. Respondent appeared with counsel, Courtney Newton and J.E. Sauseda. The Board was represented by Timothy J. Turner, a member of the Board. Board staff was represented by Mark Martyn.
Upon the recommendation of the Board's representatives and with the consent of Respondent, the Board makes the following Findings of Fact and Conclusions of Law and enters this Agreed Order.
FINDINGS OF FACT
The Board finds that:
1. Respondent received all notice required by law. All jurisdictional requirements have been satisfied. Respondent waives any defect in notice and any further right to notice or hearing under the Medical Practice Act, Title 3, Subtitle B, Texas Occupations Code (the "Act") or the Rules of the Board.
2. Respondent currently holds Texas Medical License No. D-9988. Respondent was originally issued this license to practice medicine in Texas on December 11, 1972. Respondent is not licensed to practice in any other state
2. Respondent is primarily engaged in the practice of general practice. Respondent is not board certified.
3. Respondent is 69 years of age.
4. Respondent has previously been the subject of disciplinary action by the Board.
5. The Respondent has six prior Board Orders, dated January 12, 1991; August 22, 1998; February 4, 2000; March 30, 2001; October 4, 2002 and December to, 2004. Copies of each Board Order are attached and incorporated by reference herein.
6. Respondent violated his December 10, 2004, Modified Agreed Order, which placed Respondent under a monitor.
7. The monitor reviewed selected medical records and provided a written report documenting perceived deficiencies and any recommendations to improve Respondent's practice of medicine.
Log Nos. 05-2242, 05-2243, and 05-2244
8. Respondent failed to meet the standard of care, in his treatment of 11 patients (L.V., D.R., J.N., K.V., A.E., J.S., M.B., M.E., V.A.; J.F., and L.P.)
9. Respondent's failure to meet the standard. of care includes, but not limited to, the management of metabolic syndrome, diabetes, hyperlipidemia, and influenza.
10. Respondent's medical records for these 11 patients did not show adequate diagnostic evaluation of multiple medical complaints, and showed a trend toward over-treatment.
Order No. 03-012
11. The medical records indicated that Respondent failed to meet the standard of care as follows:
12. Respondent treated 18 pediatric patients. Respondent's diagnosis of pinworm infestation by history without laboratory confirmation is not consistent with the standard of medical care in Texas. Respondent treated six of the pediatric patients, whom were under the age of two, with Vermox. Prescribing Vermox to patients under the age of two is not within the standard of care.
13. Respondent treated three patients received injections of B-complex vitamins without . evidence in their medical records that they suffered from B-complex vitamin deficiencies; These injections are not medically necessary. '
i 4. Respondent treated 13 patients with oral courses of Nystatin. The medical records for these patients did not show evidence that they had a fungal infection requiring treatment.
15. Respondent has cooperated in the investigation of the allegations related to this Agreed Order. Respondent's cooperation, through consent to this Agreed Order, pursuant to the provisions of Section 164.002 the Act, will save money and resources for the State of Texas. To avoid further investigation, hearings, and the expense and inconvenience of litigation, Respondent agrees to the entry of this Agreed Order and to comply with its terms and conditions.
CONCLUSIONS OF LAW
Based on the above Findings of Fact, the Board concludes that:
1. The Board has jurisdiction over the subject matter and Respondent pursuant to the Act.
2. Section 164.051(a)(3) of the Act authorizes the Board to take disciplinary action against Respondent based on Respondent's violation of Board Rule 165, which requires the maintenance of adequate medical records.
3. Section 164.051(a)(6) of the Act authorizes the Board to take disciplinary action against Respondent based on Respondent's failure to practice medicine in an acceptable professional manner consistent with public health and welfare.
4. Section 164.001 of the Act authorizes the Board to impose a range of disciplinary actions against a person for violation of the Act or a Board rule. Such sanctions include: revocation, suspension, probation, public reprimand, limitation or restriction on practice, counseling or treatment, required educational or counseling programs, monitored practice, public service, and an administrative penalty.
5. Section 164.002(a) of the Act authorizes the Board to resolve and make a disposition of this matter through an Agreed Order.
Based on the above Findings of Fact and Conclusions of Law, the Board ORDERS that Respondent is placed under the following terms and conditions for seven years from the date of entry of this Order:
The entry of this Order shall constitute a PUBLIC REPRIMAND by the Board.
Within one year from the entry of this. Order, Respondent shall enroll in and successfully complete the Health Science Center Rural and Community Health Institute (HSC-RCHI) peer review evaluation programs offered by the Texas A&M Health Science Center. Respondent shall submit documentation of attendance and successful completion of this requirement to. the Director of Enforcement for the Board on or before the expiration of the time limit set forth for completion of the course.
a. Respondent shall attend HSC-RCHI peer review sessions four times per month for the first three months and the Compliance Division shall submit within this time period four files as having deficiency identified in investigative logs 05-2242, 05-2243, 05-2244 and Order 03-012 for a peer review session.
b. For each subsequent quarterly review Respondent shall attend a minimum of two times per month for the next nine months following completion of subparagraph (a) or as frequently as his records are scheduled for peer review in this HSC-RCHI peer review program.
c. Respondent shall submit to the HSC-RCHI peer review program charts identified by the TMB monitor as deficiencies and shall participate in the peer review process that will discuss each of these specific charts.
d. Upon the completion of 12 months in the program Respondent shall personally appear before the Board, a committee of the Board, or a panel of Board representatives for purposes of reporting on and addressing issues relating to Respondent's compliance with the terms and conditions of this Order including compliance with monitor recommendations, peer review recommendations and overall assessment by the HSC-RCHI peer review program of his practice. Respondent shall continue to participate in the HSC-RCHI peer review program as provided for above and Respondent may seek modification or termination of participating in this HSC-RCHI peer review program after completion of 12 months in this program. Respondent shall continue in the HSC-RCHI peer review program until such time as a modification or termination: has been granted by the Board.
e. Respondent shall submit any and all evaluations from the HSC-RCHI peer review program to the Compliance Division.
f. Respondent shall assume the cost for submission of documents and participation in this HSC-RCHI peer review program. Respondent shall not charge the compensation and cost paid to HSC-RCHI to any patients.
3. Respondent shall have a licensed medical assistant with education, training, or experience in medical terminology. This person shall assist Respondent in documenting patient complaints and history and will review the chart for completeness pertaining to Respondent's physical exam, diagnosis and treatment plan, including an· explanation of any off-label use of medications and their risks and benefits.
4. Within one year following the entry of this Order, Respondent shall take and pass with a score of 75 or above the Special Purpose Examination (SPEX) as promulgated by the Federation of State Medical Boards of the United States. Respondent is allowed three attempts to successfully pass this examination. Respondent's failure to take and pass the SPEX within three attempts within one year following the entry of this Order shall constitute a violation of this Agreed Order. After a committee of· the Board or a panel of Board representatives (Board Representatives), has considered the information related to Respondent's violation of this provision and has determined that Respondent has not fulfilled the requirements of this provision, Respondent's medical license shall be immediately suspended pursuant to correspondence to Respondent from the Executive Director or Secretary-Treasurer of the Board indicating that Board Representatives have considered the information related to Respondent's violation of this provision and have determined that Respondent has not fulfilled the requirements of this provision. Although Respondent shall be invited to provide information or testimony to the Board Representatives, Respondent specifically waives any administrative due process under the Medical Practice Act, or the Administrative Procedure Act, for the Board Representatives to consider this information. THIS SUSPENSION SHALL BE EFFECTIVE WITHOUT THE NEED FOR A HEARING AT THE STATE OFFICE OF ADMINISTRATIVE HEARINGS OR OTHER ADMINISTRATIVE DUE. PROCESS UNDER THE MEDICAL PRACTICE ACT OR THE ADMINISTRATIVE PROCEDURE ACT, AND RESPONDENT SPECIFICALLY WAIVES ANY SUCH HEARING OR DUE PROCESS AND ALL RIGHTS OF APPEAL. Respondent shall be notified of any suspension by certified mail, return receipt requested to Respondent's last known address on file with the Board. If Respondent's license is suspended on such a basis, the suspension shall remain in effect until such time as Respondent takes and passes the SPEX and subsequently appears before the Board in person and provides sufficient evidence which, in the discretion of the Board, is adequate to show that Respondent possesses the skills and knowledge to safely practice in Texas and is otherwise physically and mentally competent to resume the practice in this state.
6. While under the terms of this Order, Respondent's practice shall be monitored by a physician (“monitor"), in accordance with § 164.001 (b)(7) of the Act. The Compliance Division of the Board shall designate the monitor and may change the monitor at any time for any reason. The monitor shall have expertise in a similar specialty area as Respondent. The Compliance Division shall provide a copy of this Order to the monitor, together with other information necessary to assist the monitor.
a. As requested by the Compliance Division, Respondent shall prepare and provide complete legible copies of selected patient medical and billing records ("selected records"). The Compliance Division shall select records for at least thirty patients seen by Respondent during each three-month period following the last day of the month of entry of this Order ("reporting period"). The Compliance Division may select records for more than thirty patients, up to ten percent of the patients seen during a reporting period. If Respondent fails to see at least thirty patients during any three-month period, the term of this Order shall be extended until Respondent can submit a sufficient number of records for a monitor to review.
b. The monitor shall perform the following duties:
1) Personally review the selected records;
2) Prepare written reports documenting any perceived deficiencies and any recommendations to improve Respondent's practice of medicine or assist in the ongoing monitoring process. Reports shall be submitted as requested by the Compliance Division; and
3) Perform any other duty that the Compliance Division determines will assist the effective monitoring of Respondent's practice.
c. The Compliance Division shall provide to Respondent a copy of any deficiencies or recommendations submitted by the monitor. Respondent shall implement the recommendations as directed by the Compliance Division.
d. The monitor shall be the agent of the Board, but shall be compensated by the Respondent through the Board. Such compensation and any costs incurred by the monitor shall be paid by Respondent to the Board and remitted by the Board to the monitor. Respondent shall not charge the compensation and costs paid to the monitor to any patients.
7. ]f the chart monitor identifies five or more standard of care deficiencies in Respondent's medical records in any given reporting period, Respondent shall appear before the Board, a committee of the Board, or a panel of Board representatives. Such appearance shall be for the purpose of reporting on arid addressing issues related to Respondent's compliance with the terms and conditions of this Order, including compliance with monitor recommendations. If the panel determines that Respondent has five or more standard of care deficiencies within Respondent's medical records, Respondent's medical license shall be immediately REVOKED pursuant to correspondence to Respondent from the Executive Director of the Board. THIS REVOCATION SHALL BE EFFECTIVE WITHOUT THE NEED OF A HEARING OR OTHER ADMINISTRATIVE DUE PROCESS UNDER THE ACT OR THE ADMINISTRATIVE PROCEDURE ACT,. AND RESPONDENT SPECIFICALLY WAIVES ANY SUCH HEARING OR DUE PROCESS. Respondent shall be notified of any revocation by certified mail, return receipt requested to Respondent's last known address on file with the Board.
8. The above-referenced conditions shall continue in full force and effect without opportunity for amendment, except for clear error in drafting, for 12 months following entry of this Order. If, after the passage of the 12 month period, unless provided for otherwise in paragraph 2 above, Respondent wishes to seek amendment or termination of these· conditions, Respondent may petition the Board in writing. The Board may inquire into the request and may, in its sale discretion, grant or deny the petition. Petitions for modifying or terminating may be filed only once a year thereafter.
RESPONDENT WAIVES ANY AND ALL APPEALS TO THE BOARD OR TO ANY COURT IN REGARD TO ALL TERMS AND CONDITIONS OF THIS AGREED ORDER. RESPONDENT WAIVES ANY FURTHER HEARINGS ON THE MERITS OF THE DEFICIENCIES. RESPONDENT AGREES THAT THIS IS A FINAL ORDER.
THIS ORDER IS A PUBLIC RECORD.
I, RODNEY NORMAN DOTSON, M.D., HAVE READ AND UNDERSTAND THE FOREGOING AGREED ORDER. I UNDERSTAND THAT BY SIGNING, I WAIVE CERTAIN RIGHTS. I SIGN IT VOLUNTARILY. I UNDERSTAND THIS AGREED ORDER CONTAINS THE ENTIRE AGREEMENT AND THERE IS NO OTHER AGREEMENT OF ANY KIND, VERBAL, WRITTEN OR OTHERWISE.
DATED: 01-08, 2008
RODNEY NORMAN DOTSON, M.D.
SIGNED AND ENTERED by the presiding officer of the Texas Medical Board on this 8th DAY OF FEBRUARY, 2008.
Roberta M. Kalafut, D.O., President
Texas Medical Board