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BEFORE THE MEDICAL BOARD OF CALIFORNIA
DEPARTMENT OF CONSUMER AFFAIRS STATE OF CALIFORNIA
In the Matter of the Accusation Against:
SEKSAN SREPHICHIT, M.D.
Physician's and Surgeon's Certificate No. A103108
Respondent
) ) ) ) ) ) ) ) ) )
Case No. 800-2015-016247
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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 5:00 p.m. on January 4, 2017.
IT IS SO ORDERED: December 5, 2016.
MEDICAL BOARD OF CALIFORNIA
Michelle Anne Bholat, M.D., Chair Panel B
1 . KAMALA D. HARRIS Attorney General of California
2 ROBERT MCKIM BELL Supervising Deputy Attorney General
3 CHRIS LEONG Deputy Attorney General
4 State BarNo. 141079 CALIFORNIA DEPARTMENT OF JUSTICE
5 300 So. Spring Street, Suite 1702 Los Angeles, CA 90013
6 Telephone: (213) 897-2575 Facsimile: (213) 897-9395
7 E-mail: [email protected] Attorneys for Complainant
8 BEFORETHE MEDICAL BOARD OF CALIFORNIA
9 DEPARTMENT OF CONSUMER AFFAIRS
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STATE OF CALIFORNIA
In the Matter of the Accusation Against:
SEKSAN SREPHICHIT, M.D. 9333 Imperial Hwy Downey, CA 90242-2812
Case No. 800-2015-016247
STIPULATED SETTLEMENT AND DISCIPLINARY ORDER
14 Physician's and Surgeon's Certificate No. Al03108
Respondent.
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) of the Department of
Consumer Affairs, 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
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23 1. Kimberly Kirchmeyer (Complainant) is the Executive Director of the Board. She
24 brought this action solely in her official capacity and is represented in this matter by Kamala D.
25 Harris, Attorney General of the State of California, by Chris Leong, Deputy Attorney General.
26 2. Respondent SEKSAN SREPHICHIT, M.D. (Respondent) is represented in this
27 proceeding by attorney Peter R. Osinoff, Esq., whose address is: 3699 Wilshire Blvd., 1Oth Floor
28 Los Angeles, CA 90010.
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STIPULATED SETTLEMENT (800-20 15-01624 7)
1 3. On or about March 13, 2008, the Board issued Physician's and Surgeon's Certificate
2 No. A 103108 to Respondent. The Physician's and Surgeon's Certificate was in full force and
3 effect at all times relevant to the charges brought in Accusation No. 800-2015-016247, and will
4 expire on December 31, 201 7, unless renewed.
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6 4.
JURISDICTION
Accusation No. 800-2015-016247 was filed before the Board, and is currently
7 pending against Respondent. The Accusation and all other statutorily required documents were
8 properly served on Respondent on April15, 2016. Respondent timely filed his Notice ofDefense
9 contesting the Accusation.
10 5. A copy of Accusation No. 800-2015-016247 is attached as Exhibit A and is
11 incorporated herein by reference.
12 ADVISEMENT AND WAIVERS
13 6. Respondent has carefully read, fully discussed with counsel, and understands the
14 charges and allegations in Accusation No. 800-2015-016247. Respondent has also carefully read,
15 fully discussed with counsel, and understands the effects of this Stipulated Settlement and
16 Disciplinary Order.
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7. Respondent is fully aware of his legal rights in this matter, including the right to a
hearing on the charges and allegations in the Accusation; the right to confront and cross-examine
the witnesses against him; the right to present evidence and to testify on his own behalf; the right
to the issuance of subpoenas to compel the attendance of witnesses and the production of
documents; the right to reconsideration and court review of an adverse decision; and all other
rights accorded by the California Administrative Procedure Act and other applicable laws.
8. Respondent voluntarily, knowingly, and intelligently waives and gives up each and
every right set forth above.
CULPABILITY
9. Respondent understands and agrees that the charges and allegations in Accusation
No. 800-2015-016247, if proven at a hearing, constitute cause for imposing discipline upon his
Physician's and Surgeon's Certificate.
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STIPULATED SETTLEMENT (800-2015-016247)
1 10. For the purpose of resolving the Accusation without the expense and uncertainty of
2 further proceedings, Respondent agrees that, at a hearing, Complainant could establish a factual
3 basis for the charges in the Accusation, and that Respondent hereby gives up his right to contest
4 those charges.
5 11. Respondent agrees that his Physician's and Surgeon's Certificate is subject to
6 discipline and he agrees to be bound by the Board's probationary terms as set forth in the
7 Disciplinary Order below.
8 12. Respondent agrees that if he ever petitions for early termination of probation or
9 modification of probation, or if the Board ever petitions for revocation of probation, all of the
10 charges and allegations contained in Accusation No. 800-2015-016247, shall be deemed true,
11 correct and fully admitted by Respondent for purposes of that proceeding or any other licensing
12 proceeding involving Respondent in the State of California.
13 CONTINGENCY
14 13. This stipulation shall be subject to approval by the Medical Board of California.
15 Respondent understands and agrees that counsel for Complainant and the staff of the Medical
16 Board of California may communicate directly with the Board regarding this stipulation and
17 settlement, without notice to or participation by Respondent or his counsel. By signing the
18 stipulation, Respondent understands and agrees that he may not withdraw his agreement or seek
19 to rescind the stipulation prior to the time the Board considers and acts upon it. If the Board fails
20 to adopt this stipulation as its Decision and Order, the Stipulated Settlement and Disciplinary
21 Order shall be of no force or effect, except for this paragraph, it shall be inadmissible in any legal
22 action between the parties, and the Board shall not be disqualified from further action by having
23 considered this matter.
24 14. The parties understand and agree that Portable Document Format (PDF) and facsimile
25 copies of this Stipulated Settlement and Disciplinary Order, including PDF and facsimile
26 signatures thereto, shall have the same force and effect as the originals.
27 Ill
28 Ill
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STIPULATED SETTLEMENT (800-2015-016247)
1 15. In consideration of the foregoing admissions and stipulations, the parties agree that
2 the Board may, without further notice or formal proceeding, issue and enter the following
3 Disciplinary Order:
4 DISCIPLINARY ORDER
5 IT IS HEREBY ORDERED that Physician's and Surgeon's Certificate No. A1 03108 issued
6 to Respondent SEKSAN SREPHICHIT, M.D. is revoked. However, the revocation is stayed and
7 Respondent is placed on probation for five (5) years on the following terms and conditions.
8 1. CONTROLLED SUBSTANCES - ABSTAIN FROM USE. Respondent shall abstain
9 completely from the personal use or possession of controlled substances as defined in the
10 California Uniform Controlled Substances Act, dangerous drugs as defined by Business and
11 Professions Code section 4022, and any drugs requiring a prescription. This prohibition does not
12 apply to medications lawfully prescribed to Respondent by another practitioner for a bona fide
13 illness or condition.
14 Within 15 calendar days of receiving any lawfully prescribed medications, Respondent
15 shall notify the Board or its designee of the: issuing practitioner's name, address, and telephone
16 number; medication name, strength, and quantity; and issuing pharmacy name, address, and
1 7 telephone number.
18 If Respondent has a confirmed positive biological fluid test for any substance (whether or
19 not legally prescribed) and has not reported the use to the Board or its designee, Respondent
20 shall receive a notification from the Board or its designee to immediately cease the practice of
21 medicine. The Respondent shall not resume the practice of medicine until final decision on an
22 accusation and/or a petition to revoke probation. An accusation and/or petition to revoke
23 probation shall be filed by the Board within 15 days of the notification to cease practice. If the
24 Respondent requests a hearing on the accusation and/or petition to revoke probation, the Board
25 shall provide the Respondent with a hearing within 30 days of the request, unless the Respondent
26 stipulates to a later hearing. A decision shall be received from the Administrative Law Judge or
27 the Board within 15 days unless good cause can be shown for the delay. The cessation of practice
28 shall not apply to the reduction of the probationary time period.
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STIPULATED SETTLEMENT (800-20 15-01624 7)
If the Board does not file an accusation or petition to revoke probation within 15 days ofthe
2 issuance of the notification to cease practice or does not provide Respondent with a hearing
3 within 30 days of a such a request, the notification of cease practice shall be dissolved.
4 2. ALCOHOL - ABSTAIN FROM USE. Respondent shall abstain completely from the
5 use of products or beverages containing alcohol.
6 If Respondent has a confirmed positive biological fluid test for alcohol, Respondent shall
7 receive a notification from the Board or its designee to immediately cease the practice of
8 medicine. The Respondent shall not resume the practice of medicine until final decision on an
9 accusation and/or a petition to revoke probation. An accusation and/or petition to revoke
10 probation shall be filed by the Board within 15 days of the notification to cease practice. If the
11 Respondent requests a hearing on the accusation and/or petition to revoke probation, the Board
12 shall provide the Respondent with a hearing within 30 days of the request, unless the Respondent
13 stipulates to a later hearing. A decision shall be received from the Administrative Law Judge or
14 the Board within 15 days unless good cause can be shown for the delay. The cessation of practice
15 shall not apply to the reduction of the probationary time period.
16 If the Board does not file an accusation or petition to revoke probation within 15 days ofthe
17 issuance of the notification to cease practice or does not provide Respondent with a hearing
18 within 30 days of a such a request, the notification of cease practice shall be dissolved.
19 3. PROFESSIONALISM PROGRAM (ETHICS COURSE). Within 60 calendar days of
20 the effective date of this Decision, Respondent shall enroll in a professionalism program, that
21 meets the requirements of Title 16, California Code of Regulations (CCR) section 1358.
22 Respondent shall participate in and successfully complete that program. Respondent shall
23 provide any information and documents that the program may deem pertinent. Respondent shall
24 successfully complete the classroom component of the program not later than six (6) months after
25 Respondent's initial enrollment, and the longitudinal component of the program not later than the
26 time specified by the program, but no later than one (1) year after attending the classroom
27 component. The professionalism program shall be at Respondent's expense and shall be in
28 addition to the Continuing Medical Education (CME) requirements for renewal of licensure.
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STIPULATED SETTLEMENT (800-2015-016247)
1 A professionalism program taken after the acts that gave rise to the charges in the
2 Accusation, but prior to the effective date of the Decision may, in the sole discretion of the Board
3 or its designee, be accepted towards the fulfillment of this condition if the program would have
4 been approved by the Board or its designee had the program been taken after the effective date of
5 this Decision.
6 Respondent shall submit a certification of successful completion to the Board or its
7 designee not later than 15 calendar days after successfully completing the program or not later
8 than 15 calendar days after the effective date of the Decision, whichever is later.
9 4. PSYCHIATRIC EVALUATION. Within 30 calendar days ofthe effective date of
1 0 this Decision, and on whatever periodic basis thereafter may be required by the Board or its
11 designee, Respondent shall undergo and complete a psychiatric evaluation (and psychological
12 testing, if deemed necessary) by a Board-appointed board certified psychiatrist, who shall
13 consider any information provided by the Board or designee and any other information the
14 psychiatrist deems relevant, and shall furnish a written evaluation report to the Board or its
15 designee. Psychiatric evaluations conducted prior to the effective date ofthe Decision shall not
16 be accepted towards the fulfillment of this requirement. Respondent shall pay the cost of all
17 psychiatric evaluations and psychological testing.
18 Respondent shall comply with all restrictions or conditions recommended by the evaluating
19 psychiatrist within 15 calendar days after being notified by the Board or its designee.
20 5. MEDICAL EVALUATION AND TREATMENT. Within 30 calendar days ofthe
21 effective date of this Decision, and on a periodic basis thereafter as may be required by the Board
22 or its designee, Respondent shall undergo a medical evaluation by a Board-appointed physician
23 who shall consider any information provided by the Board or designee and any other information
24 the evaluating physician deems relevant and shall furnish a medical report to the Board or its
25 designee. Respondent shall provide the evaluating physician any information and documentation
26 that the evaluating physician may deem pertinent.
27 Following the evaluation, Respondent shall comply with all restrictions or conditions
28 recommended by the evaluating physician within 15 calendar days after being notified by the
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STIPULATED SETTLEMENT (800-2015-0 16247)
1 Board or its designee. If Respondent is required by the Board or its designee to undergo medical
2 treatment, Respondent shall within 30 calendar days of the requirement notice, submit to the
3 Board or its designee for prior approval the name and qualifications of a California licensed
4 treating physician of Respondent's choice. Upon approval of the treating physician, Respondent
5 shall within 15 calendar days undertake medical treatment and shall continue such treatment until
6 further notice from the Board or its designee.
7 The treating physician shall consider any information provided by the Board or its designee
8 or any other information the treating physician may deem pertinent prior to commencement of
9 treatment. Respondent shall have the treating physician submit quarterly reports to the Board or
10 its designee indicating whether or not the Respondent is capable of practicing medicine safely.
11 Respondent shall provide the Board or its designee with any and all medical records pertaining to
12 treatment, the Board or its designee deems necessary.
13 If, prior to the completion of probation, Respondent is found to be physically incapable of
14 resuming the practice of medicine without restrictions, the Board shall retain continuing
15 jurisdiction over Respondent's license and the period of probation shall be extended until the
16 Board determines that Respondent is physically capable of resuming the practice of medicine
17 without restrictions. Respondent shall pay the cost of the medical evaluation(s) and treatment.
18 6. PSYCHOTHERAPY. If psychotherapy is recommended by either the psychiatric or
19 medical evaluation, within sixty (60) calendar days, Respondent shall submit to the Board or its
20 designee for prior approval the name and qualifications of a California-licensed board certified
21 psychiatrist or a licensed psychologist who has a doctoral degree in psychology and at least five
22 years of postgraduate experience in the diagnosis and treatment of emotional and mental
23 disorders. Upon approval, Respondent shall undergo and continue psychotherapy treatment,
24 including any modifications to the frequency of psychotherapy, until the Board or its designee
25 deems that no further psychotherapy is necessary.
26 The psychotherapist shall consider any information provided by the Board or its designee
27 and any other information the psychotherapist deems relevant and shall furnish a written
28 evaluation report to the Board or its designee. Respondent shall cooperate in providing the
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STIPULATED SETTLEMENT (800-2015-016247)
1 psychotherapist any information and documents that the psychotherapist may deem pertinent.
2 Respondent shall have the treating psychotherapist submit quarterly status reports to the
3 Board or its designee. The Board or its designee may require Respondent to undergo psychiatric
4 evaluations by a Board-appointed board certified psychiatrist. If, prior to the completion of
5 probation, Respondent is found to be mentally unfit to resume the practice of medicine without
6 restrictions, the Board shall retain continuing jurisdiction over Respondent's license and the
7 period of probation shall be extended until the Board determines that Respondent is mentally fit
8 to resume the practice of medicine without restrictions.
9 Respondent shall pay the cost of all psychotherapy and psychiatric evaluations.
10 7. NOTICE OF EMPLOYER OR SUPERVISOR INFORMATION. Within seven (7)
11 days of the effective date of this Decision, respondent shall provide to the Board the names,
12 physical addresses, mailing addresses, and telephone numbers of any and all employers and
13 supervisors. Respondent shall also provide specific, written consent for the Board, respondent's
14 worksite monitor, and respondent's employers and supervisors to communicate regarding
15 respondent's work status, performance, and monitoring. For purposes ofthis section,
16 "supervisors" shall include the Chief of Staff and Health or Well Being Committee Chair, or
17 equivalent, if applicable, when the respondent has medical staff privileges.
18 8. BIOLOGICAL FLUID TESTING. Respondent shall immediately submit to
19 biological fluid testing, at respondent's expense, upon request of the Board or its designee.
20 "Biological fluid testing" may include, but is not limited to, urine, blood, breathalyzer, hair
21 follicle testing, or similar drug screening approved by the Board or its designee. Respondent shall
22 make daily contact with the Board or its designee to determine whether biological fluid testing is
23 required. Respondent shall be tested on the date of the notification as directed by the Board or its
24 designee. The Board may order a respondent to undergo a biological fluid test on any day, at any
25 time, including weekends and holidays. Except when testing on a specific date as ordered by the
26 Board or its designee, the scheduling of biological fluid testing shall be done on a random basis.
27 The cost of biological fluid testing shall be borne by the respondent.
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STIPULATED SETTLEMENT (800-20 15-0 16247)
During the first year of probation, respondent shall be subject to 52 to 104 random
2 tests. During the second year of probation and for the duration of the probationary term, up to
3 five (5) years, respondent shall be subject to 36 to 104 random tests per year. Only if there has
4 been no positive biological fluid tests in the previous five (5) consecutive years of probation, may
5 testing be reduced to one (1) time per month. Nothing precludes the Board from increasing the
6 number of random tests to the first-year level of frequency for any reason.
7 Prior to practicing medicine, respondent shall contract with a laboratory or service, approved in
8 advance by the Board or its designee, that will conduct random, unannounced, observed,
9 biological fluid testing and meets all the following standards:
10 (a) Its specimen collectors are either certified by the Drug and Alcohol Testing Industry
11 Association or have completed the training required to serve as a collector for the United
12 States Department of Transportation.
13 (b) Its specimen collectors conform to the current United States Department of
14 Transportation Specimen Collection Guidelines
15 (c) Its testing locations comply with the Urine Specimen Collection Guidelines published
16 by the United States Department of Transportation without regard to the type of test
1 7 administered.
18 (d) Its specimen collectors observe the collection of testing specimens.
19 (e) Its laboratories are certified and accredited by the United States Department of Health
20 and Human Services.
21 (f) Its testing locations shall submit a specimen to a laboratory within one (1) business
22 day of receipt and all specimens collected shall be handled pursuant to chain of custody
23 procedures. The laboratory shall process and analyze the specimens and provide legally
24 defensible test results to the Board within seven (7) business days of receipt of the
25 specimen. The Board will be notified of non-negative results within one (1) business day
26 and will be notified of negative test results within seven (7) business days.
27 (g) Its testing locations possess all the materials, equipment, and technical expertise
28 necessary in order to test respondent on any day of the week.
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STIPULATED SETTLEMENT (800-2015-016247)
(h) Its testing locations are able to scientifically test for urine, blood, and hair specimens
2 for the detection of alcohol and illegal and controlled substances.
3 (i) It maintains testing sites located throughout California.
4 (j) It maintains an automated 24-hour toll-free telephone system and/or a secure on-line
5 computer database that allows the respondent to check in daily for testing.
6 (k) It maintains a secure, HIPAA-compliant website or computer system that allows staff
7 access to drug test results and compliance reporting information that is available 24 hours
8 a day.
9 (1) It employs or contracts with toxicologists that are licensed physicians and have
1 0 knowledge of substance abuse disorders and the appropriate medical training to interpret
11 and evaluate laboratory biological fluid test results, medical histories, and any other
12 information relevant to biomedical information.
13 (m) It will not consider a toxicology screen to be negative if a positive result is obtained
14 while practicing, even if the respondent holds a valid prescription for the substance.
15 Prior to changing testing locations for any reason, including during vacation or
16 other travel, alternative testing locations must be appro.ved by the Board and meet the
17 requirements above. The contract shall require that the laboratory directly notify the Board or its
18 designee of non-negative results within one ( 1) business day and negative test results within
19 seven (7) business days of the results becoming available. Respondent shall maintain this
20 laboratory or service contract during the period of probation. A certified copy of any laboratory
21 test result may be received in evidence in any proceedings between the Board and respondent.
22 If a biological fluid test result indicates respondent has used, consumed, ingested, or administered
23 to himself or herself a prohibited substance, the Board shall order respondent to cease practice
24 and instruct respondent to leave any place of work where respondent is practicing medicine or
25 providing medical services. The Board shall immediately notify all of respondent's employers,
26 supervisors and work monitors, if any, that respondent may not practice medicine or provide
27 medical services while the cease-practice order is in effect. A biological fluid test will not be
28 considered negative if a positive result is obtained while practicing, even if the practitioner holds
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STIPULATED SETTLEMENT (800-20 15-0 16247)
a valid prescription for the substance. If no prohibited substance use exists, the Board shall lift
2 the cease-practice order within one (1) business day.
3 After the issuance of a cease-practice order, the Board shall determine whether the
4 positive biological fluid test is in fact evidence of prohibited substance use by consulting with the
5 specimen collector and the laboratory, communicating with the licensee, his or her treating
6 physician(s), other health care provider, or group facilitator, as applicable.
7 For purposes of this condition, the terms "biological fluid testing" and "testing" mean the
8 acquisition and chemical analysis of a respondent's urine, blood, breath, or hair.
9 For purposes of this condition, the term "prohibited substance" means an illegal drug, a lawful
10 drug not prescribed or ordered by an appropriately licensed health care provider for use by
11 respondent and approved by the Board, alcohol, or any other substance the respondent has been
12 instructed by the Board not to use, consume, ingest, or administer to himself or herself.
13 If the Board confirms that a positive biological fluid test is evidence of use of a prohibited
14 substance, respondent has committed a major violation, as defined in section 1361.52(a), of the
15 Boards regulations and the Board shall impose any or all of the consequences set forth in section
16 1361.52(b), of the Board's regulations in addition to any other terms or conditions the Board
17 determines are necessary for public protection or to enhance respondent's rehabilitation.
18 9. SUBSTANCE ABUSE SUPPORT GROUP MEETINGS Within thirty (30) days
19 of the effective date of this Decision, respondent shall submit to the Board or its designee, for its
20 prior approval, the name of a substance abuse support group which he or she shall attend for the
21 duration of probation. Respondent shall attend substance abuse support group meetings at least
22 once per week, or as ordered by the Board or its designee. Respondent shall pay all substance
23 abuse support group meeting costs.
24 The facilitator ofthe substance abuse support group meeting shall have a
25 minimum of three (3) years experience in the treatment and rehabilitation of substance abuse, and
26 shall be licensed or certified by the state or nationally certified organizations. The facilitator shall
27 not have a current or former financial, personal, or business relationship with respondent within
28 the last five (5) years. Respondent's previous participation in a substance abuse group support
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STIPULATED SETTLEMENT (800-20 I 5-01624 7)
1 meeting led by the same facilitator does not constitute a prohibited current or former financial,
2 personal, or business relationship.
3 The facilitator shall provide a signed document to the Board or its designee
4 showing respondent's name, the group name, the date and location of the meeting, respondent's
5 attendance, and respondent's level of participation and progress. The facilitator shall report any
6 unexcused absence by respondent from any substance abuse support group meeting to the Board,
7 or its designee, within twenty-four (24) hours of the unexcused absence.
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10. WORKSITE MONITOR FOR SUBSTANCE-ABUSING LICENSEE Within
thirty (30) calendar days of the effective date ofthis Decision, respondent shall submit to the
Board or its designee for prior approval as a worksite monitor, the name and qualifications of one
or more licensed physician and surgeon, other licensed health care professional if no physician
and surgeon is available, or, as approved by the Board or its designee, a person in a position of
authority who is capable of monitoring the respondent at work.
The worksite monitor shall not have a current or former financial, personal, or
familial relationship with respondent, or any other relationship that could reasonably be expected
to compromise the ability of the monitor to render impartial and unbiased reports to the Board or
its designee. 1 If it is impractical for anyone but Respondent's employer to serve as the worksite
monitor, this requirement may be waived by the Board or its designee, however, under no
circumstances shall respondent's worksite monitor be an employee or supervisee of the licensee.
The worksite monitor shall have an active unrestricted license with no disciplinary action within
the last five (5) years, and shall sign an affirmation that he or she has reviewed the terms and
conditions of respondent's disciplinary order and agrees to monitor Respondent as set forth by the
Board or its designee. Respondent shall pay all worksite monitoring costs.
The worksite monitor shall have face-to-face contact with Respondent in the work
environment on as frequent a basis as determined by the Board or its designee, but not less than
once per week; interview other staff in the office regarding respondent's behavior, if requested by
1 The work site monitor may be the Chief of Anesthesiology or the Assistant Chief of Anesthesiology at Respondents place of employment.
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1 the Board or its designee; and review respondent's work attendance.
2 The worksite monitor shall verbally report any suspected substance abuse to the
3 Board and respondent's employer or supervisor within one (1) business day of occurrence. If the
4 suspected substance abuse does not occur during the Board's normal business hours, the verbal
5 report shall be made to the Board or its designee within one (1) hour of the next business day. A
6 written report that includes the date, time, and location of the suspected abuse; respondent's
7 actions; and any other information deemed important by the worksite monitor shall be submitted
8 to the Board or its designee within 48 hours of the occurrence.
9 The worksite monitor shall complete and submit a written report monthly or as directed by the
10 Board or its designee which shall include the following: (1) respondent's name and Physician's
11 and Surgeon's Certificate number; (2) the worksite monitor's name and signature; (3) the
12 worksite monitor's license number, if applicable; (4) the location or location(s) ofthe worksite;
13 ( 5) the dates respondent had face-to-face contact with the worksite monitor; ( 6) the names of
14 worksite staff interviewed, if applicable; (7) a report ofrespondent's work attendance; (8) any
15 change in respondent's behavior and/or personal habits; and (9) any indicators that can lead to
16 suspected substance abuse by respondent. Respondent shall complete any required consent forms
17 and execute agreements with the approved worksite monitor and the Board, or its designee,
18 authorizing the Board, or its designee, and worksite monitor to exchange information.
19 If the worksite monitor resigns or is no longer available, respondent shall, within five ( 5) calendar
20 days of such resignation or unavailability, submit to the Board or its designee, for prior approval,
21 the name and qualifications of a replacement monitor who will be assuming that responsibility
22 within fifteen (15) calendar days. If respondent fails to obtain approval of a replacement monitor
23 within sixty (60) calendar days ofthe resignation or unavailability of the monitor, respondent
24 shall receive a notification from the Board or its designee to cease the practice of medicine within
t .:5 three (3) calendar days after being so notified. Respondent shall cease the practice of medicine
· 26 until a replacement monitor is approved and assumes monitoring responsibility.
27 11. VIOLATION OF PROBATION CONDITION FOR SUBSTANCE ABUSING
28 LICENSEES Failure to fully comply with any term or condition of probation is a violation of
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STIPULATED SETTLEMENT (800-20 I 5-01624 7)
1 probation.
2 A. If respondent commits a major violation of probation as defined by section
3 1361.52, subdivision (a), ofTitle 16 ofthe California Code ofRegulations, the Board shall take
4 one or more of the following actions:
5 (1) Issue an immediate cease-practice order and order respondent to
6 undergo a clinical diagnostic evaluation to be conducted in accordance with section 1361.5,
' 7 subdivision ( c )(1 ), of Title 16 of the California Code of Regulations, at respondent's expense.
8 The cease-practice order issued by the Board or its designee shall state that respondent must test
9 negative for at least a month of continuous biological fluid testing before being allowed to resume
10 practice. For purposes of the determining the length of time a respondent must test negative
11 while undergoing continuous biological fluid testing following issuance of a cease-practice order,
12 a month is defined as thirty calendar (30) days. Respondent may not resume the practice of
13 medicine until notified in writing by the Board or its designee that he or she may do so.
14 (2) Increase the frequency of biological fluid testing.
15 (3) Refer respondent for further disciplinary action, such as suspension,
16 revocation, or other action as determined by the Board or its designee.
17 B. If respondent commits a minor violation of probation as defined by section
18 1361.52, subdivision (c), ofTitle 16 ofthe California Code of Regulations, the Board shall take
19 one or more of the following actions:
20 (1) Issue a cease-practice order;
21 (2) Order practice limitations;
22 (3) Order or increase supervision of respondent;
23 ( 4) Order increased documentation;
24 (5) Issue a citation and fine, or a warning letter;
25 (6) Order respondent to undergo a clinical diagnostic evaluation to be
26 conducted in accordance with section 1361.5, subdivision (c)(l), ofTitle 16 ofthe California
2 7 Code of Regulations, at respondent's expense;
28 (7) Take any other action as determined by the Board or its designee.
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STIPULATED SETTLEMENT (800-2015-0 16247)
1 c. Nothing in this Decision shall be considered a limitation on the Board's
2 authority to revoke respondent's probation if he or she has violated any term or condition of
3 probation. If respondent violates probation in any respect, the Board, after giving respondent
4 notice and the opportunity to be heard, may revoke probation and carry out the disciplinary order
5 that was stayed. If an Accusation, or Petition to Revoke Probation, or an Interim Suspension
6 Order is filed against respondent during probation, the Board shall have continuing jurisdiction
7 until the matter is final, and the period of probation shall be extended until the matter is final.
8 12. NOTIFICATION. Within seven (7) days ofthe effective date ofthis Decision, the
9 Respondent shall provide a true copy of this Decision and Accusation to the Chief of Staff or the
10 Chief Executive Officer at every hospital where privileges or membership are extended to
11 Respondent, at any other facility where Respondent engages in the practice of medicine,
12 including all physician and locum tenens registries or other similar agencies, and to the Chief
13 Executive Officer at every insurance carrier which extends malpractice insurance coverage to
14 Respondent. Respondent shall submit proof of compliance to the Board or its designee within 15
15 calendar days.
16 This condition shall apply to any change( s) in hospitals, other facilities or insurance carrier.
17 13. SUPERVISION OF PHYSICIAN ASSISTANTS. During probation, Respondent is
18 prohibited from supervising physician assistants.
19 14. OBEY ALL LAWS. Respondent shall obey all federal, state and local laws, all rules
20 governing the practice of medicine in California and remain in full compliance with any court
21 ordered criminal probation, payments, and other orders.
22 15. QUARTERLY DECLARATIONS. Respondent shall submit quarterly declarations
23 under penalty of perjury on forms provided by the Board, stating whether there has been
~24 compliance with all the conditions of probation.
'25 Respondent shall submit quarterly declarations not later than 10 calendar days after the end
26 of the preceding quarter.
27 9. GENERAL PROBATION REQUIREMENTS.
28 Compliance with Probation Unit
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STIPULATED SETTLEMENT (800-2015-016247)
1 Respondent shall comply with the Board's probation unit and all terms and conditions of
2 this Decision.
3 Address Changes
4 Respondent shall, at all times, keep the Board informed of Respondent's business and
5 residence addresses, email address (if available), and telephone number. Changes of such
6 addresses shall be immediately communicated in writing to the Board or its designee. Under no
7 circumstances shall a post office box serve as an address of record, except as allowed by Business
8 and Professions Code section 2021 (b).
9 Place of Practice
1 0 Respondent shall not engage in the practice of medicine in Respondent's or patient's place
11 of residence, unless the patient resides in a skilled nursing facility or other similar licensed
12 facility.
13 License Renewal
14 Respondent shall maintain a current and renewed California physician's and surgeon's
15 license.
16 Travel or Residence Outside California
17 Respondent shall immediately inform the Board or its designee, in writing, of travel to any
18 areas outside the jurisdiction of California which lasts, or is contemplated to last, more than thirty
19 (30) calendar days.
20 In the event Respondent should leave the State of California to reside or to practice
21 Respondent shall notify the Board or its designee in writing 30 calendar days prior to the dates of
22 departure and return.
23 16. INTERVIEW WITH THE BOARD OR ITS DESIGNEE. Respondent shall be
24 available in person upon request for interviews either at Respondent's place of business or at the
25 probation unit office, with or without prior notice throughout the term of probation.
26 17. NON-PRACTICE WHILE ON PROBATION. Respondent shall notify the Board or
27 its designee in writing within 15 calendar days of any periods of non-practice lasting more than
28 30 calendar days and within 15 calendar days of Respondent's return to practice. Non-practice is
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STIPULATED SETTLEMENT (800-2015-016247)
1 defined as any period of time Respondent is not practicing medicine in California as defined in
2 Business and Professions Code sections 2051 and 2052 for at least 40 hours in a calendar month
3 in direct patient care, clinical activity or teaching, or other activity as approved by the Board. All
4 time spent in an intensive training program which has been approved by the Board or its designee
5 shall not be considered non-practice. Practicing medicine in another state of the United States or
6 Federal jurisdiction while on probation with the medical licensing authority of that state or
7 jurisdiction shall not be considered non-practice. A Board-ordered suspension of practice shall
8 not be considered as a period of non-practice.
9 In the event Respondent's period of non-practice while on probation exceeds 18 calendar
10 months, Respondent shall successfully complete a clinical training program that meets the criteria
11 of Condition 18 of the current version of the Board's "Manual of Model Disciplinary Orders and
12 Disciplinary Guidelines" prior to resuming the practice of medicine.
13 Respondent's period of non-practice while on probation shall not exceed two (2) years.
14 Periods of non-practice will not apply to the reduction of the probationary term.
15 Periods of non-practice will relieve Respondent of the responsibility to comply with the
16 probationary terms and conditions with the exception of this condition and the following terms
17 and conditions of probation: Obey All Laws; and General Probation Requirements.
18 18. COMPLETION OF PROBATION. Respondent shall comply with all financial
19 obligations (e.g., restitution, probation costs) not later than 120 calendar days prior to the
20 completion of probation. Upon successful completion of probation, Respondent's certificate shall
21 be fully restored.
22 19. VIOLATION OF PROBATION. Failure to fully comply with any term or condition
23 of probation is a violation of probation. If Respondent violates probation in any respect, the
24 Board, after giving Respondent notice and the opportunity to be heard, may revoke probation and
25 carry out the disciplinary order that was stayed. If an Accusation, or Petition to Revoke Probation,
26 or an Interim Suspension Order is filed against Respondent during probation, the Board shall have
27 continuing jurisdiction until the matter is final, and the period of probation shall be extended until
28 the matter is final.
17
STIPULATED SETTLEMENT (800-20 15-01624 7)
20. !)CEl'JSE_SURRENDER. Following the effective date of this Decision, if
2 Respondent ceases practicing due to retirement or health reasons or is otherwise unable to satisfy
3 the terms and conditions of probation, Respondent may request to surrender his or her license.
4 The Board reserves the right to eval11ate Respondenfs request and to exercise its discretion in
5 determining whether ot· not to grant the request, or to take any other action deemed appropriate
6 and reasonable tmder the circumstances. Upon formal acceptance of the suri·ender. Respondent
7 shall within 15 calendar days deliver Respondent's wallet and wall certificate to the Board or its
8 designee and Respondent shall no longet· practice medicine. Respondent will no longer be subject
9 to the terms and conditions of probation. If Respondent re~applies for a medical license, the
1 0 application shall be treated as a petition for reinstatement of a revoked certificate,
ll 21. PROBATION MONITORING COSTS. Respondent shall pay the costs associated
12 with probation monitoring each and every year of pro bationl as designated by the Board, which.
13 may be adjusted on an annual basis. Such costs shall be payable to the Medical Board of
14 California and delivered to the Board or its designee no later than January 3 1 of each calendar
15 year.
16 ACCEPTANCE
17 I have carefully read the above Stipulated Settlement and Disciplinary Order and have fully
18 discussed it with tny attorney, Peter R. Osinoff, Esq .. I understand the stipulation arid the effect it
19 will have on my Physician's and Surgeon's Certificate. I enter into this Stipulated Settlement and
20 Disciplinary Ot•der voluntarily, knowingly, and intelligently, m1d agree to be bound by the
21 Decision and Order ofthe Medical Board of California.
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DATED:
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SEKSAN SREPI-IICHIT, M.D. Respondent
28 (
18 !--------------·---------··-·······
STIPULATED SETILBMENT (800-20 15-0 16247)
I have read and fully discussed with Respondent SEKSAN SREPHICH[T, M.D. the terms
2 and conditions and other matters contained in the above Stipulated Settlement and Disciplinary
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Order. I approve its form and content.
DATED: lOu~/;~ I
P fER R. OSINOFF, ESQ. Attorney for Respondent
7 ENDORSEMENT
8 The foregoing Stipulated Settlement and Disciplinary Order is hereby respectfully
9 submitted for consideration by the Medical Board of California.
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Dated:
LA2016500650 62149959.doc
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Respectfully submitted,
KAMALA D. HARRIS Attorney General of California ROBERT MCKIM BELL Supervising Deputy Attorney General
(_~'- ~ ~ CHRIS LEONG- f . Deputy Attorney General Attorneys for Complainant
STIPULATED SETI'LEMENT (800-2015-0 16247)
Exhibit A
Accusation No. 800-2015-016247
1 KA~fALA 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 90013
6 Telephone: (213) 897-2575 Facsimile: (213) 897-9395
7 Attorneys for Complainant
FILED STATE OF CAUFORNIA
MEDICAL BOARD OF CALIFORNIA SACRAMENTO ~\('/,) \ S 20 ~ BY "h· \-,.,.~-~ ANALYST
8
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BEFORE THE MEDICAL BOARD OF CALIFORNIA
DEPARTMENT OF CONSUMER AFFAIRS STATE OF CALIFORNIA
11 In the Matter of the Accusation Against:
12 SEKSA~ SREPHICHIT, M.D.
9333 Imperial Highway Downey, California 90242
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17
Physician's and Surgeon's Certificate No. A103108,
Respondent.
18 Complainant alleges:
Case No. 800-2015-016247
ACCUSATIO~
19 PARTIES
20 1. Kimberly Kirchmeyer (Complainant) brings this Accusation solely in her official
21 capacity as the Executive Director of the Medical Board of California (Board).
22 2. On or about March 13, 2008, the Board issued Physician's and Surgeon's Certificate
23 Number A103108 to Seksan Srephichit, M.D. (Respondent). The Physician's and Surgeon's
24 certificate A 103108 was in full force and effect at all times relevant to the charges herein and will
25 expire on December 31, 2017, unless renewed.
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Accusation No. 800-20 15-0 I 624 7
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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4
5 4. Section 2227 of the Code provides that a licensee who is found guilty under the
6 Medical Practice Act may have his or her license revoked, suspended for a period not to exceed
7 one year, placed on probation and required to pay the costs of probation monitoring, or such other
8 action taken in relation to discipline as the Board deems proper.
9 5. Section 2234 of the Code, states:
10 "The board shall take action against any licensee who is charged with unprofessional
11 conduct. In addition to other provisions of this article, unprofessional conduct includes, but is not
12 limited to, the following:
13 "(a) Violating or attempting to violate, directly or indirectly, assisting in or abetting the
14 violation of, or conspiring to violate any provision ofthis chapter.
15 "(b) Gross negligence.
16 ''(c) Repeated negligent acts. To be repeated, there must be two or more negligent acts or
17 omissions. An initial negligent act or omission followed by a separate and distinct departure from
18 the applicable standard of care shall constitute repeated negligent acts.
19 "(1) An initial negligent diagnosis followed by an act or omission medically appropriate
20 for that negligent diagnosis of the patient shall constitute a single negligent act.
21 "(2) ·when the standard of care requires a change in the diagnosis, act, or omission that
22 constitutes the negligent act described in paragraph (1), including, but not limited to, a
23 reevaluation of the diagnosis or a change in treatment, and the licensee's conduct departs from the
24 applicable standard of care, each departure constitutes a separate and distinct breach of the
25 standard of care.
26 "(d) Incompetence.
27 "(e) The commission of any act involving dishonesty or corruption which is substantially
28 related to the qualifications, functions, or duties of a physician and surgeon.
2
Accusation No. 800-2015-016247
"(f) Any action or conduct which would have warranted the denial of a certificate.
2 "(g) The practice of medicine from this state into another state or country without meeting
3 the legal requirements of that state or country for the practice of medicine. Section 2314 shall not
4 apply to tllis subdivision. This subdivision shall become operative upon the implementation of the
5 proposed registration program described in Section 2052.5.
6 "(h) The repeated failure· by a certificate holder, in the absence of good cause, to attend and
7 participate in an interview by the board. This subdivision shall only apply to a certificate holder
8 who is the subject of an investigation by the board."
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6. Section 2239 of the Code states:
"(a) The use or prescribing for or administering to himself or herself, of any controlled
substance; or the use of any of the dangerous drugs specified in Section 4022, or of alcoholic
beverages, to the extent, or in such a manner as to be dangerous or injurious to the licensee, or to
any other person or to the public, or to the extent that such use impairs the ability of the licensee
to practice medicine safely or more than one misdemeanor or any felony involving the use,
consumption, or self-administration of any of the substances referred to in this section, or any
combination thereof, constitutes unprofessional conduct. The record of the conviction is
conclusive evidence of such unprofessional conduct.
"(b) A plea or verdict of guilty or a conviction following a plea of nolo contendere is
deemed to be a conviction within the meaning of this section. The Division of Medical Quality 1
may order discipline of the licensee in accordance with Section 2227 or the Division of Licensing
may order the denial of the license when the time for appeal has elapsed or the judgment of
conviction has been affirmed on appeal or when an order granting probation is made suspending
imposition of sentence, irrespective of a subsequent order under the provisions of Section 1203.4
of the Penal Code allowing such person to withdraw his or her plea of guilt-y and to enter a plea of
not guilty, or setting aside the verdict of guilty, or dismissing the accusation, complaint,
information, or indictment."
1 Pursuant to Business and Professions Code section 2002, "Division of Medical Quality" or "Division" shall be deemed to refer to the Medical Board of California.
3
Accusation No. 800-2015-0162471
2
3 7.
FIRST CAUSE FOR DISCIPLINE
(Alcohol Abuse)
Respondent is subject to disciplinary action under section 2239 of the Code in that
4 Respondent used alcohol in a manner as to be dangerous or injurious to himself, or to any other
5 person or to the public. The circumstances are as follows:
6 A. On or about August 3, 2015, Respondent, who was employed by Kaiser
7 Foundation Hospitals (Kaiser), performed a nerve block procedure on a patient. Kaiser has
8 developed a protocol for nerve block procedures which include several steps such as
9 reviewing consents, writing initials on the correct body part, safet-y checks, and others. On
10 this day, Respondent was not folloVving the standard protocol. Respondent did not proceed
11 through the typical check list. Respondent was "in a rush" and "annoyed by the list."
12 Respondent's behavior raised concerns of Kaiser staffP.G.2 The issue was reported to L.S.,
13 certified registered nurse anesthetist (CRNA) who is employed at Kaiser, regarding the
14 concerns about Respondent not following the protocols for the nerve block procedure.
15 B. Also on or about August 3, 2015, another Kaiser employee, F.G. was in the
16 doctor's latmge area eating lunch when Respondent entered the room speaking with
17 another physician. Respondent was showing the other physician his finger which he
18 claimed to have smashed the previous week. Respondent was asking the other physician
19 how he would treat the blood which had pooled under his fingernail which was causing
20 pressure. The other physician explained how it was treated but Respondent would not
21 accept his answer and kept repeating the question. Respondent's behavior was very
22 unusual for Respondent because he continued the conversation so forcefully. In F.G's
23 opinion Respondent was impaired at that time. When the other physician questioned
24 Respondent twice if he took something for pain due to his response, Respondent claimed he
25 was just tired. Respondent stated he had finished his last case and was off for the day. F.G.
26 observed Respondent blinking slow and slurring his words. F.G. stated that based on his
27
28 2 Kames of the witnesses are reduced for initials for confidentiality.
4
Accusation No. 800-20 15-01624 7
experience in providing sedation to his patients he recognized Respondent's condition as
2 being impaired,
3 C. F.G. was concerned about Respondent and contacted Dr. P.G. Dr. P.G also
4 works at Kaiser and is a personal friend of Respondent. F .G. informed Dr. P.G. about
5 Respondent's condition. Dr. P.G. recommended that F.G. inform the other physician in the
6 department that day.
7 D. L.S. was working during the nerve block procedure of
8 August 3, 2015. She first observed Respondent at the nursing station
9 prior to her first case of the day. L.S. stated Respondent smelled of
10 alcohol. She next saw him in a patienes room a few minutes later. L.S.
11 stated for that day Respondent was one of two anesthesiologists
12 assigned to perform all the pre-operative checks. L.S. observed
13 Respondent speaking with a patient in the room. L.S. observed
14 Respondent slurring his words and behaving differently than her
15 normal interactions with him. L.S. believed that Respondent was
16 hung over.
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E. Dr. W.F. is employed at Kaiser. He was notified by a CRNA
that Respondent was possibly impaired at work. l11e CRNA told him
that the anesthesia techs were complaining that Respondent was not
following the standard protocols for nerve blocks. The CR.J.'IA also
reported that she had observed unusual behavior from Respondent.
Dr. W.F. then observed Respondent slurring his words and smelled
alcohol directly from Respondent's breath. The time it was
approximately 1:00 p.m. and Dr. W.F. was concerned how Respondent
could still be impaired if he had been drinking prior to his shift starting
at 6:00a.m. Dr. W.F. went to the doctor's lounge area and observed
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Accusation No. 800-2015-0 1624 7
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a bag he believed belonged to Respondent. Dr. W .F. looked in the bag
and found a prescription bottle for Ativan which had Respondent's
name on it. Dr. W.F. also located a water bottle with clear liquid in
the bag. He opened the bottle and smelled the contents. Dr. W.F.
observed that the water bottle contents smelled like alcohol.
F. On August 4, 2015, Respondent took a blood test. The test results were as
follows: "Drugs Found:· Cocaine Metabolite." 3
G. In or about August 2015, Respondent had been to Las Vegas for a bachelor
party for Dr. PO. When Respondent retuned to work from Las Vegas on the following
Monday he was assigned as the supervisor for the control room at Downey Medica] Center.
F.G. was present, monitoring multiple CRNAs in several different procedures. F.G.
smelled alcohol coming from Respondent. He also described him as being "a lot looser"
and joking around with staff.
H. On or about September 2, 2015, Respondent was interviewed by J.P. who
works at Kaiser. Respondent admitted to using Fentanyl4 "pops" for sleep which he
obtained from a friend.
I. On September 9, 2015, the Executive Committee of the Professional Staff of
Kaiser Foundation Hospital, Downey approved a leave of absence for Respondent.
Respondent had: "exhibited demeanor suggestive of impairment while on duty at the
hospital, and his medical group employer removed him from practice. After being
interviewed during a review of the incident, he agreed to substance abuse evaluation and
entered into a treatment program."
3 Cocaine is a Schedule IT controlled substance as designated by Health and Safety Code section 11055, subdivision (b)( 6), and is a dangerous drug pursuant to Business & Professions Code section 4022.
4 Fentanyl is a Schedule II controlled substance as designated by Health and Safety Code section 11055, subdivision (c)(8), and is a dangerous drug pursuant to Business & Professions Code section 4022.
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Accusation ~o. 800-2015-016247
SECOND CAUSE FOR DISCIPLINE
2 (Drug Abuse)
3 8. Respondent is subject to disciplinary action under section 2239 of the Code in that
4 Respondent used a dangerous drug in a manner as to be dangerous or injurious to himself. The
5 circumstances in the First Cause for Discipline are incorporated here in as if fully set forth.
6 THIRD CAUSE FOR DISCIPLINE
7 (Use of Controlled Substances)
8 9. Respondent is subJect to disciplinary action under section 2239 of the Code in that
9 Respondent used or administered to himself controlled substances. The circumstances in the First
1 0 Cause for Discipline are incorporated here in as if fully set forth.
11 FOURTH CAUSE FOR DISCIPLJ:.JE
12 (Unprofessional Conduct)
13 10. Respondent is subject to disciplinary action under section 2234 of the Code in that he
14 engaged in unprofessional conduct. The facts and circumstances alleged in paragraphs 7 through
15 9 above are incorporated here as if fully set forth.
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7
Accusation No. &00-20 15-0 1624 7
PRAYER
2 \VHEREFORE, Complainant requests that a hearing be held on the matters herein alleged,
3 and that following the hearing, the Medical Board of California issue a decision:
4 1. Revoking or suspending Physician's and Surgeon's Certificate Number G 53323,
5 issued to Seksan Srephichit, M.D.
6 2. Revoking, suspending or denying approval of Seksan Srepbichit, M.D.'s authority to
7 supervise physicians assistants, pursuant to section 3527 oftbe Code;
8 3. Ordering Seksan Srephichit, M.D. to pay the Medical Board of California, if placed
9 on probation, the costs of probation monitoring; and
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4. Taking such other and further action as deemed necessary and proper.
13 DATED: A.pr-il 1 5 281 6
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18 61927179.docx
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Executive Direct Medical Board of California Department of Consumer Affairs State of California Complainant
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Accusation 1\ o. 800-20 15-0 1624 7
