California Watch

The California Medical Board appointed a doctor who lost his license after a patient died in childbirth to supervise a California physician who lost and regained his license after the death of two infants.

Since the board approved the arrangement, the doctor under supervision stands accused of lapses in the death of a 30-year-old Chinese immigrant during an abortion in August 2009.

That’s the bombshell reported yesterday by former Orange County Register investigative reporter William Heisel on a a blog hosted by the California Endowment’s Health Journalism Web site.

The Register also reports on details of the board’s shortcomings in appointing Dr. Christopher C. Dotson to oversee the conduct of Dr. Andrew Rutland (both of whom did not comment to either reporter):

Board rules require that doctors serve as monitors only if they have no record of disciplinary action. In this case, the board let [Dotson] of Los Angeles help oversee [Rutland's] five years of probation.

Rutland has again been accused of negligence after the death last year of Ying Chen, an abortion patient, 30, who suffered a toxic reaction to anesthesia on his operating table. Since her death, Rutland has been temporarily barred from surgery; he faces another disciplinary hearing next month.

Dotson, 78, completed five years of probation in 2005, part of his settlement of negligence allegations stemming from a mother who bled to death after a cesarean section and a separate case of a stillborn baby.

Dotson's license was taken away in New York for the same incident that gave rise to his probation in California, Heisel reported.

Still, Dotson offered his medical expertise to the medical board in an October letter vouching for Rutland's diligence in Chen's death:

Dr. Rutland and I discussed at length the tragic death of a patient by the name of Ying Chen who after the injection of a local anesthetic preparatory for the pregnancy termination suffered an anaphylactic reaction. In spite of appropriate resuscitation efforts, she succumbed in the hospital. In my opinion, Dr. Rutland is taking his probation very seriously and doing everything he can to more than meet the requisite requirements.

Earlier this month, the Register reported, an administrative law judge ruled that Rutland can keep his medical license but cannot perform deliveries or surgeries. That judge relied on Dotson as one of two medical experts evaluating Rutland's care, Heisel noted.

Asked about the supervisor-supervised arrangement, medical board spokeswoman Candis Cohen responded to Heisel, saying that Dr. Rutland asked and was allowed by the board staff to name Dotson as his supervisor:

Probation staff is auditing all approved practice monitors to confirm that none has any previous discipline. If any are identified, they will immediately be terminated as a practice monitor.

The Reigster notes that such supervisory arrangments are not typically made public, but were observed by reporters in court filings. In his blog, Heisel questions the board’s practice of allowing one troubled doctor to hand-pick his monitor, despite his past problems:

In the history of law enforcement, there must be a parole officer who had in the past served time for a crime. But the scenario has to be rare. In California, there are more than 100,000 physicians licensed to practice medicine. Would it really be too arduous for the medical board to find one without a disciplinary record to supervise a physician who is being disciplined?

As reported here in recent weeks, the medical board is operating under a new director and undergoing an independent review at the request of its members. Perhaps these matters will be explored.