PUBLIC AGENDA ALABAMA BOARD OF MEDICAL …

PUBLIC AGENDAALABAMA BOARD OF MEDICAL EXAMINERS

MAY 16, 2018

I MINUTES

PUBLIC MINUTES OF APRIL 12, 2018

PUBLIC MINUTES OF APRIL 14, 2018

II ENDORSEMENT

Name Medical School Endorsement

1 Tapan Abrol Acharya Shri Chander COM Sciences USMLE/NY

2 * Erwin Eduardo Argueta Sosa Universidad Francisco Marraquin USMLE

3 * Ahmed Asfari University of Aleppo USMLE/AR

4 Danielle deMontigny Avila Universidad Autonoma De Guadalajara USMLE

5 Benjamin Douglas Barlow Uniformed Services Univ of Health Sciences USMLE/IN

6 John Israel Baron University of South Carolina School of Medicine USMLE/CT

7 Joshua Sterling Bentley A T Still Univ School of Osteopathic Medicine COMLEX/IL

8 Ryan Daniel Black University of Tennessee Memphis COM USMLE

9 Joseph Daniel Boaen Medical College of Georgia School of Medicine USMLE

10 Michelle Marie Boudreau Philadelphia College of Osteopathic Medicine COMLEX/CT

11 Srikanth Challagundla J.J.M. Medical College USMLE/NY

12 Juliana Joy Coleman Medical College of Georgia School of Medicine USMLE

13 Kathy Camille Cornelius Wright State University School of Medicine USMLE/PA

14 * William Allen Cutchen USACOM USMLE

15 Rajat Dhungana Kathmandu University SOM Sciences USMLE/ME

16 * Cameron Laseter Diaz UASOM Birmingham USMLE

17 Ninh Ba Doan University of Illinois College of Medicine Chicago USMLE/WI

18 Luke David Dolezal Univ of Minnesota Medical School Minneapolis USMLE/MO

19 Susan Victoria Ellor University of Central Florida COM USMLE/MD

20 Hussien Mohammed Farrag Ain Shams University Faculty of Medicine USMLE/MA

21 Christopher Miles Fowler Medical College of Georgia School of Medicine USMLE

22 Katie Anne Fritz University of Wisconsin Medical School USMLE/WI

23 William Foster Gaillard Jr. Medical University of South Carolina COM USMLE

24 Donald Wayne Gauldin Jr. University of Arkansas College of Medicine USMLE

25 Olumide Babajide Gbolahan University of Ibadan USMLE/IN

26 Whitney Nicole Goldsberry University of Louisville School of Medicine USMLE

27 Maura Elaine Gonzalez Inst Superior Ciencias Med Santiago Cuba USMLE/FL

1ABME Public Agenda May 16, 2018

28 Zachary Michael Griffith USACOM USMLE

29 Ronald Leon Gross West Virginia University School of Medicine USMLE/TX

30 * Bryan Keith Guillory University of Kentucky College of Medicine USMLE/TX

31 Virginia Beth Hemelt University of Texas - Houston Medical School USMLE/TX

32 * Michael Joseph Hernon University of Massachusetts Medical School USMLE/CT

33 Jennifer Ann Hoefert Rush Medical College of Rush University USMLE

34 Janielle Kalyani Hyde Drexel University College of Medicine USMLE/FL

35 Emily Elizabeth Johnston Stanford University School Of Medicine USMLE/CA

36 Julie Ann Zitterkopf Larson Creighton University School of Medicine USMLE/LA

37 Chen Lin Medical College of Georgia School of Medicine USMLE/IL

38 Diana Murro Lin Augusta University USMLE/IL

39 Ajani Wayne Mason Howard University College of Medicine USMLE

40 Brandon Heath Mitchell UASOM Birmingham USMLE/VA

41 * Susan Nyamagera Moruri University of Texas Medical School at Galveston USMLE/PA

42 Umesh Narsinghani Panjabrao Alias Bhausaheb Deshmukh Med Col USMLE/GA

43 Richard Paul Newman U of Buffalo SUNY SOM & Biomedical Sciences FLEX/MD

44 * Tracy Askew Nims Vanderbilt University School of Medicine NBME/NC

45 * Katie Snider Novitski UASOM Birmingham USMLE

46 Gregson Orobosa Oghafua Howard University College of Medicine NBME/DC

47 Efosa Omonuwa Ogiamien University of Mississippi School of Medicine USMLE

48 Walter Tyson Parker UASOM Birmingham USMLE/MN

49 John Light Parks University of Mississippi School of Medicine USMLE/MS

50 Hershel Rajendrakumar Patel University of South Florida College of Medicine USMLE

51 Irene Victoria Perez Young Universidad De Panama USMLE/TX

52 Caleb Andrew Pierce UASOM Birmingham USMLE/TX

53 * Robert Sumner Pilcher Medical College of Georgia School of Medicine USMLE/GA

54 Pranitha Vijaya B. Reddy Prodduturvar Government Medical College Nagpur University ISMLE/IL

55 Pervez I. Qureshi King Edward Medical School USMLE/NY

56 Erich Oscar Richter Ohio State Univ COM & Public Health USMLE/FL

57 * Brandon Michael Roane U of NC School at Chapel Hill SOM USMLE

58 * Amanda Lea Robinson Lincoln Memorial U Debusk Col of Osteo Med COMLEX

59 John A. Rodriguez-Feo III UASOM Birmingham USMLE/GA

60 Jay Ryan Salmon University of Florida College of Medicine USMLE

61 * Martin Fleming Schreeder UASOM Birmingham USMLE/LA

62 Brandon Scott Schwartz University of Maryland School of Medicine USMLE

63 * Allan Michael Seibert UASOM Birmingham USMLE

64 * Jesse Daniel Shaw Lake Erie College of Osteopathic Medicine COMLEX/VA

65 * Terry Daniel Smith USACOM USMLE/GA

66 Clay Alexander Spitler Medical College of Georgia School of Medicine USMLE/TN

67 Murad M. Talahma Jordan University of Science & Technology USMLE/OH

68 Jared Timothy Tobolski Drexel University College of Medicine USMLE

69 Sam Dean Toney USACOM USMLE/FL

70 James David Torrisi Midwestern University Downers Grove COMLEX/FL


71 * Omer M. Wali Saba University School of Medicine USMLE/VA

72 Michael Broughten Whitlow Medical College of Georgia School of Medicine USMLE

73 Sanithia Lee Williams Case Western Reserve University SOM USMLE/CA

74 William Lee Young Philadelphia College of Osteopathic Medicine COMLEX/GA

75 Juan Carlos Zorrilla Northwestern University Medical School USMLE/AZ

PROVISIONAL ENDORSEMENT


No Provisional Endorsement Applicants

RETIRED SENIOR VOLUNTEER PROGRAM LICENSE (RSVP)

Name Facility Location

No RSVP License Applicants

SPECIAL PURPOSE LICENSE

Name Location Type of Practice

No Special Purpose License Applicants

INTERSTATE MEDICAL LICENSURE COMPACT REPORTS(Scanned with Endorsements)

(661) 1. Interstate Medical Licensure Compact Licensees(662) 2. Interstate Medical Licensure Compact Letters of Qualification

II LIMITED LICENSE


1 Ahmed Marzouk Amer Tanta Univ Mansoura Univ Faculty of Medicine LL/AL

2 * Jin Suh Kim Soon Chun Hyang U College of Medicine LL/AL

3 Shuo Shawn Liu Peking Union Medical University LL/AL

4 Annamalai Nadarajan Jr. Amrita School of Medicine LL/AL

5 * Jeong Mi Park Seoul National University LL/AL


6 * Kedar Gopal Sharbidre B J Medical College, University of Pune LL/AL

7 Namita Tiwari Mymensingh Medical College LL/AL

8 Semjon Tsyrlin Perpetual Help College Of Medicine LL/AL

IV PHYSICIAN ASSISTANTS / ADVANCED PRACTICE NURSES

(2) Cover Sheet

P.A. License

Name School NCCPA

1 * Kelli Chambers Touro College 10667572 Holly Taylor Duquesne University 10370853 * Margaret Shadix UAB 11502514 Natalie Barefield UAB 10969805 Jessie Coffey UAB 11504716 Lesley Owens University of Kentucky 1089339

A.A. License

Name School NCCAA

No A.A. License Applicants

Temporary P.A. License

Name School NCCPA

1 Kathryn Mahaffey UAB Awaiting Exam Results

Temporary P.A. License to Full License

Name School NCCPA

No Temporary PA License to Full License Applicants


P.A. Registration

Without additional duties; Qualified remote sites; Formulary: #2, #21, and #23

P.A. / Physician Registration / Formulary Requests Recommendation

1. Mason Chasteen, PAPatrick Louis, M.D.

Registration

2. Jacob Dobbs, PARobert Williams, M.D.

RegistrationBirth Control Drugs and Devices

3. Heather Hallman, PAJenna Johnson, M.D.

Registration Birth Control Drugs and Devices

4. Matthew Johnson, PAMichael Patterson, M.D.

Registration

5. Ashley King, PAJames Jones, M.D.


6. Katherine Koshofer, PACathi Spear, M.D.


7. Cicely Kyle, PAPhillip Hicks, M.D.

Registration

8. Jessica Melvin, PAJames Royal, M.D.


9. Claire Naylor, PAJon Simmons, M.D.

Registration Remote siteBirth Control Drugs and Devices

10. Julie Nguyen, PAMichael Mahoney, M.D.

Registration

11. Trudie Seirafi, PAPamela Strickland, M.D.


12. Kathleen Strickland, PAAmit Kachalia, M.D.

Registration

13. Holly Taylor, PAFred Holland, M.D.

Registration

14. Steven Thompson, PACharles Johnson, M.D.

Registration

15. Laurie Ward, PASara Taylor, M.D.


16. Myrtell Cantrell, PAAbiodun Badewa, M.D.


17. Myrtell Cantrell, PAPallavi Sunkavalli, M.D.


18. Katelyn Griffin, PAFarrell Mendelsohn, M.D.

Registration

19. Suzanne Haddock, PALawrence Lewak, M.D.

Registration

20. Jitcsadaporn Harrison, PAEmily Fortenberry, M.D.

Registration


P.A. / Physician Registration / Formulary Requests Recommendation

21. Scott Hennigar, PADaniel Neuberger, M.D.


22. Kimberlee Johnson, PAMarc Passman, M.D.

Registration

23. Linda Langston, PARupa Shivalingaiah, M.D.


Additional duties, remote site, formulary requests

P.A. / Physician Registration / Skill / Remote Site /Formulary

Recommendation

(63) 1. Paxton Johanson, PAKyle Eusailey, M.D.

RegistrationTransfer of skills:Endoscopic vein harvestingThoracostomy Tube PlacementCVL Placement, IJ and FemoralIntra-aortic Balloon Pump Placement andRemoval

A.A. Registration

No AA registration applicants

P.A. Miscellaneous Requests / Reports

P.A. / Physician Skill; Formulary; Misc Requests

Recommendation

(81) 1. Haley French, PAJerry Szflarski, M.D.

Vagal Nerve Stimulation Certificateof Training

(83) 2. Amy Christensen, PARicardo Colberg, M.D.

Documentation of Training:Joint injections: knee and shoulder

(86) 3. GlyCare Diabetes Management Exemption from specialty and FTErequirement

(91) 4. Freddy Dillard, PARonald Roan, M.D.

CVL Placement, IJ and FemoralArterial line placement, Femoral

(97) 5. William Davis, PAAlan Cease, M.D.

Additional practice site


P.A. QACSC Registration

P.A. Physician

1 Deborah Winberry Linda Lee, M.D.2 Stanley White Thomas Dempsey, M.D.3 JoLee Harkness Garry Magouirk, M.D.

PA Limited Purpose Special Permit

(99) Cover Sheet

Physician / PA / Specialty LPSP Formulary RecommendationApprove Deny

(100) 1. Henry Born, M.D.James Lombardo, PAFM

ADHD MedicationsHydrocodone CombinationsOxycodone IR

(101) 2. Richard Price, M.D.Kristin Landham, PAOcc Med

Hydrocodone CombinationsHydrocodone Cough Preps

(102) 3. Robert Serio, M.D.James Kisner, PASleep / Pulmonary

ADHD Medications

(103) 4. Richard Sharp, M.D.Olivia Walsh, PAOrtho

Hydrocodone CombinationsOxycodone IR

(105) 5. Jorge de la Torre, M.DIris Stuart, PAPlastic Surgery

Hydrocodone CombinationsOxycodone IR

APN Miscellaneous Requests / Reports

(106) Cover Sheet

Skills Request Within Protocol

Physician / APN Skill; Restricted Drug; Misc Requests

Recommendation

(110) 1. John Grecco, M.D.Kristin Torbic, CRNP

Supervised Practice:Joint Injections: shoulder, knee,greater trochanteric bursa, elbow

(126) 2. Porcia Love, M.D.Amanda Brook, CRNP

Supervised Practice:Interlesional injections



Recommendation

(129) 3. Constantine Athanasuleas, M.D.Lauren Jensen, CRNP

Critical Care Specialty Protocol:CVL Insertion: IJ and FemoralCVL remove and replace overguidewireArterial line insertion: FemoralRemoval of:pacing wiresleft atrial cathetermediastinal chest tubespulmonary artery catheter, SwanGanzIntra-aortic balloon pump

(144) 4. Randall N. Beyl, Jr., M.D.Bobby J. Smith, CRNP

Orthopedic Specialty Protocol:ArthrocentesisJoint injections: shoulder, greatertrochanteric bursa, knee

(153) 5. William Blythe, M.D.Meredith Genetski, CRNP

Otolaryngology Protocol:Flexible Fiberoptic DiagnosticLaryngoscopy/StroboscopyFlexible NasopharyngoscopyDiagnostic Nasal Endoscopy

(175) 6. Juan Penaranda Canal, M.D.Martin Wesley Carter, CRNP

Critical Care Specialty Protocol:Removal of:Pacing wiresMediastinal chest tubes

(184) 7. Erik Orozco Hernandez, M.D.Amanda C. McCarty, CRNP

Critical Care Specialty Protocol:CVL Insertion: IJ and FemoralCVL remove and replace overguidewireRemoval of:pacing wiresleft atrial cathetermediastinal chest tubespulmonary artery catheter, SwanGanzIntra-aortic balloon pump

(195) 8. Erik Orozco Hernandez, M.D.Lacie Naggatz, CRNP

Critical Care Specialty Protocol:CVL Insertion: IJ and FemoralCVL remove and replace overguidewireArterial line insertion: FemoralRemoval of:pacing wiresleft atrial cathetermediastinal chest tubespulmonary artery catheter, SwanGanzIntra-aortic balloon pump



Recommendation

(207) 9. Charles Hoopes, M.D.Robert L. Richardson, CRNP

Critical Care Specialty Protocol:CVL Insertion: IJ and FemoralCVL remove and replace overguidewireRemoval of:pacing wiresleft atrial cathetermediastinal chest tubespulmonary artery catheter, SwanGanzIntra-aortic balloon pump

(219) 10. William Edward Kirby, M.D.Meghan Golson, CRNP

Orthopedic Specialty Protocol:Joint injections: shoulder, elbow(Olecranon bursa) greatertrochanteric bursa, knee

(227) 11. Lawrence Lemak, M.D.Bryan Wimbish, CRNP

Orthopedic Specialty Protocol:ArthrocentesisJoint injections: shoulder, elbow,greater trochanteric bursa, kneeTrigger point injections

(234) 12. Stanley Lochridge, M.DCarli M. Patrick, CRNP

Critical Care Specialty Protocol:Removal of:Pacing wiresLeft atrial cathetersMediastinal chest tubes

(254) 13. Manuel Pouparinas, M.D.Jesse Strickland, CRNP

Orthopedic Specialty Protocol:ArthrocentesisJoint injections: shoulder, elbow,greater trochanteric bursa, knee

(262) 14. Jonathan H. Quade, M.D.Sara J. Rawlins, CRNP

Orthopedic Specialty Protocol:ArthrocentesisJoint injections: shoulder, elbow(Olecranon Bursa), greatertrochanteric bursa, knee

(273) 15. Joshua E. Smith, M.D.Andrew A. Short, M.D.

Critical Care Specialty Protocol:CVL Insertion: IJ and FemoralCVL remove and replace overguidewireArterial line insertion: FemoralRemoval of:CVL: percutaneous and tunneled

(289) 16. David James Thomason, M.D.Stefanie R. Miller, CRNP

Trigger point injections

(292) 17. Wilfredo I. Vergara, M.D.Alisha Jane Kolle, CRNP

Critical Care Specialty Protocol:CVL Insertion: IJ

(297) 18. Brad Woodworth, M.D.Shannon Locke Guthrie, CRNP

Otolaryngology Protocol:Nasopharyngoscopy: Flexible andRigid


Skills Request Outside of Protocol


Recommendation

(305) 1. Paul B. Canale, M.D.Shireen Knowles, CRNP

Supervised Practice:Joint injections: shoulder, greatertrochanteric bursa, ankleRequests continuation of training forolecranon bursa

(311) 2. Justin Daigre, M.D.Rebecca Stephenson, CRNP

Supervised Practice:Joint injections: shoulder, elbow,greater trochanteric bursa, knee, ankle

(316) 3 Howard L. Brazil, M.D.Travis Woodley, CRNP

Reveal LINQ cardiac monitor insertion

(338) 4. Jesanna Cooper, M.D.Hamilton Yarborough, CNM

Male neonatal circumcision

(342)(352)

5. Priya Prabhakaran, M.D.Jeremy D. Jordan, CRNPMaggie Lawrence, CRNP

For pediatric patients:Critical Care Specialty Protocol:CVL Insertion: IJ, Femoral, SubclavianArterial line insertion: FemoralCVL remove and replace overguidewireRemoval of:CVL: percutaneous and tunneled

(361) 6 Chrystal Rutledge, M.D.Kristen C. Waddell, CRNP

For pediatric patients:Critical Care Specialty Protocol:CVL Insertion: IJ, Femoral, SubclavianArterial line insertion: FemoralCVL remove and replace overguidewireRemoval of:CVL: percutaneous and tunneled

(370) 7 J. Michael Straughn, Jr., M.D.Bethany Fees, CRNP

ColposcopyColposcopically directed cervicalbiopsy and endocervical curettageIUD insertionEndometrial biopsy/pipelle sampling

(393) 8 Samuel Windham, III, M.D.Regina Seay, CRNP

Percutaneous Needle Biopsy: muscleand adipose/fat

(411) 9. Eligibility Requirements: Removal of central venous catheters,percutaneous and tunneled

(SA) 10. William Kuczerpa, M.D.Angela M. Bryant, CRNP

Joint Injections: Shoulder


Collaborative Practice / APN QACSC Registration

(SA) Collaborative Practice Registration (SA) Collaborative Practice Registration Modifications

(SA) Collaborative Practice Covering Physician Applicants

(SA) CRNP / CNM QACSC Registration Applicants

APN Limited Purpose Special Permit

(414) Cover Sheet

Physician / APN / Specialty LPSP Formulary RecommendationApprove Deny

(419) 1. Felix Allen, M.D.Ritchelle Broadnax, CRNPIM / FM

ADHD MedicationsHydrocodone CombinationsHydrocodone Cough PrepsMorphine Sulfate IROxycodone IR

(420) 2. Sammy Becdah, M.D.Ann Elizabeth Wood, CRNPOnc / Hem / Acute

Hydrocodone CombinationsHydrocodone Cough PrepsMorphine Sulfate IROxycodone IRTapentadolFentanyl LAHydrocodone ER/LAHydromorphoneMorphine Sulfate LAOxycodone LAOxymorphone LATapentadol ER

(422) 3. Ashley Burchfield, M.D.Laura Roche, CRNPFM

ADHD MedicationsHydrocodone CombinationsHydrocodone Cough PrepsOxycodone IR

(423) 4. Justin Daigre, M.D.Rebecca Stephenson, CRNPOrtho / Adult / Geri / Acute

Hydrocodone CombinationsMorphine Sulfate IROxycodone IRFentanyl LAMorphine Sulfate LAOxycodone LA

(425) 5. Josiah Daily, M.D.LaMon Norton, CRNPEM / FM

Hydrocodone CombinationsHydrocodone Cough Preps



(426) 6. Marlin Gill, M.D.Alan Heidt, CRNPFM / Adult / Geri / Acute


(427) 7. Jody Gilstrap, M.D.Bonnie Moore, CRNPFM

ADHD MedicationsHydrocodone CombinationsHydrocodone Cough PrepsFentanyl LA

(429) 8. Timothy Goodwin, M.D.Benjamin Clark, CRNPEM / FM

ADHD MedicationsHydrocodone CombinationsHydrocodone Cough PrepsMorphine Sulfate IROxycodone IRTapentadol

(430) 9. Jeremy Hon, M.D.Deborah Ding, CRNPOnc / Hem / Adult / Geri /Acute

Hydrocodone CombinationsHydrocodone Cough PrepsMorphine Sulfate IROxycodone IRTapentadolFentanyl LAHydrocodone ER/LAHydromorphoneMorphine Sulfate LAOxycodone LAOxymorphone LATapentadol ER

(432) 10. Kirk Jackson, M.D.Heather Carter, CRNPIM / FM

ADHD MedicationsHydrocodone CombinationsOxycodone IRMorphine Sulfate LA

(434) 11. Jitendra Jain, M.D.Teairah Wilder, CRNPPed / FM

ADHD MedicationsHydrocodone CombinationsHydrocodone Cough Preps

(435) 12. Karis Knight, M.D.Melissa Karrh, CRNPPsych / MH

ADHD Medications

(436) 13. Troy Layton, M.D.Baylee Martz, CRNPOrtho / FM

Hydrocodone CombinationsHydrocodone Cough PrepsOxycodone IRTapentadolTapentadol ER

(438) 14. Charles Marchman, M.D.Sharron Boatwright, CRNPOcc Med

Hydrocodone Combinations

(439) 15. Marcial Mendez, M.D.James Atkins, CRNPIM / Acute




(440) 16. Angelina Orgera, M.D.Sherry Clounch, CRNPFM / Adult / Geri / Acute

ADHD MedicationsHydrocodone CombinationsHydrocodone Cough Preps

(441) 17. Ferdinand Osuji, M.D.Leana Voss, CRNPIM / Adult / Geri / Acute

Hydrocodone CombinationsHydrocodone Cough PrepsOxycodone IR

(442) 18. Naresh Purohit, M.D.Amanda Hall, CRNPPeds

ADHD Medications

(443) 19. Michael Reeves, M.D.Ritchelle Broadnax, CRNPFM

ADHD MedicationsHydrocodone CombinationsHydrocodone Cough PrepsMorphine Sulfate IROxycodone IRFentanyl LA

(445) 20. Connie Richardson, M.D.Jessica Godwin, CRNPFM

Hydrocodone CombinationsHydrocodone Cough PrepsOxycodone IR

(446) 21. Steven Santino, M.D.Layla Beverly, CRNPPMR / Acute

Hydrocodone CombinationsOxycodone IRTapentadol

(447) 22. James Wilhite, M.D.Patricia Nelson, CRNPIM / NHR / FM

Hydrocodone CombinationsHydrocodone Cough PrepsMorphine Sulfate IROxycodone IRFentanyl LAHydrocodone ER/LAHydromorphoneMorphine Sulfate LAOxycodone LAOxymorphone LA

(449) 23. Anika Wilson, M.D.Harmony Rose, CRNPPsych / MH

ADHD Medications

(450) 24. Jacqueline Crespo, M.D.Jennivie Latham-Hickman,CRNPPed / FM

Modify Existing LPSP:Hydrocodone Combinations

(451) 25. William Spiegel, M.D.Dennis Doss, CRNPIM / HPC / Adult / Geri / PC

Modify Existing LPSP:Methadone

Physician Assistant Advisory Committee

Physician Assistant Advisory Committee Meeting - May 15, 2018, 5:30 p.m.

Joint Committee for Advanced Practice Nursing

Joint Committee for Advanced Practice Nursing Meeting - May 15, 2018, 6:00 p.m. @ ABN


V CURRENT BUSINESS

(2) 1. Collaborative Practice(9) 2. Interstate Medical Licensure Compact (13) 3. Naloxone - Re: Co-Prescribing(156) 4. Office-based Primary Care Procedures(175) 5. Physician Assistant Advisory Committee(176) 6. State Advisory Council on Palliative Care and Quality of Life(179) 7. Presentation: Robert H. Moon, M.D., CMO, Alabama Medicaid

Wednesday, May 16, 2018, 10:00 a.m.

PERSONNEL

No Personnel Items

VI HEARINGS

(2) ABME Hearing Schedule

(3) 1. William T. Hall, M.D., BirminghamShow Cause Hearing, Wednesday, May 16, 2018, 12:30 p.m.

EXECUTIVE SESSION


Documents

PUBLIC AGENDA ALABAMA BOARD OF MEDICAL …