before the medical board of california department of ...4patientsafety.org/documents/beaumont,...

BEFORE THE MEDICAL BOARD OF CALIFORNIA

DEPARTMENT OF CONSUMER AFFAIRS STATE OF CALIFORNIA

In the Matter of the Accusation ) Against: )

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Graham Beaumont, M.D. ) )

Physician's and Surgeon's ) Certificate No. A24516 )

) Respondent )

Case No. 800-2013-000598

DECISION

The attached Stipulated Surrender of License and 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 5, 2016

IT IS SO ORDERED December 29, 2015

MEDICAL BOARD OF CALIFORNIA

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KAMALA D. HARRis Attorney General of California JOSE R. GUERRERO Supervising Deputy Attorney General EMILY L. BRlNKMAN Deputy Attorney General State Bar No. 219400

455 Golden Gate Avenue, Suite 11000 San Francisco, CA 94102-7004 Telephone: (415) 703-5742 Facsimile: (415) 703-5843 E-mail: [email protected]

Attorneys for Complainant



In the Matter of the Accusation Against:

GRAHAM BEAUMONT, M.D. 301 College Ave. San Francisco, CA 94112

Case No. 800-2013-000598

STIPULATED SURRENDER OF LICENSE AND ORDER

14 Physician's and Surgeon's Certificate No. A24516

15 Respondent.

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

entitled proceedings that the following matters are true:

PARTIES

20 1. Kimberly Kirchmeyer (Complainant) is the Executive Director of the Medical Board

21 of California. She brought this action solely in her official capacity and is represented in this

22 matter by Kamala D. Harris, Attorney General of the State of California, by Emily L. Brinkman,

23 Deputy Attorney General.

24 2. Graham Beaumont, M.D. (Respondent) is represented in this proceeding by attorney

25 Ann H. Larson, whose address is Craddick, Candland & Conti, 2420 Camino Ramon, Suite 202,

26 San Ramon, CA 94583-4202.

27 3. On or about October 18, 1971, the Medical Board of California issued Physician's and

28 Surgeon's Certificate No. A24516 to Graham Beaumont, M.D. (Respondent). The Physician's

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Stipulated Surrender ofLicense (Case No. 800-2013-000598)

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

in Accusation No. 800-2013-000598 and expired on November 30, 2015.

JURISDICTION

4. Accusation No. 800-2013-000598 was filed before the Medical Board of California

(Board), Department of Consumer Affairs, and is currently pending against Respondent. The

Accusation and all other statutorily required documents were properly served on Respondent on

April27, 2015. Respondent timely filed his Notice of Defense contesting the Accusation. A

copy of Accusation No. 800-2013-000598 is attached as Exhibit A and incorporated by reference.

ADVISEMENT AND WAIVERS

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

charges and allegations in Accusation No. 800-2013-000598. Respondent also has carefully read,

fully discussed with counsel, and understands the effects of this Stipulated Surrender ofLicense

and Order.

6. Respondent is fully aware of his legal rights in this matter, including the right to a

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

16 his own expense; the right to confront and cross-examine the witnesses against him; the right to

17 present evidence and to testify on his own behalf; the right to the issuance of subpoenas to compel

18 the attendance of witnesses and the production of documents; the right to reconsideration and

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

20 Administrative Procedure Act and other applicable laws.

21 7. Respondent voluntarily, knowingly, and intelligently waives and gives up each and

22 every right set forth above.

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24 8.

CULPABILITY

Respondent understands that the charges and allegations in Accusation No. 800-2013-

25 000598, if proven at a hearing, constitute cause for imposing discipline upon his Physician's and

26 Surgeon's Certificate.

27 9. For the purpose of resolving the Accusation without the expense and uncertainty of

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

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1 basis for the charges in the Accusation and that those charges constitute cause for discipline.

2 Respondent hereby gives up his right to contest that cause for discipline exists based on those

3 charges.

4 10. Respondent understands that by signing this stipulation he enables the Board to issue

5 an order accepting the surrender of his Physician's and Surgeon's Certificate without further

6 process.

7 CONTINGENCY

8 11. This stipulation shall be subject to approval by the Medical Board of California.

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

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

11 surrender, without notice to or participation by Respondent or his counsel. By signing the

12 stipulation, Respondent understands and agrees that he may not withdraw his agreement or seek

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

14 to adopt this stipulation as its Decision and Order, the Stipulated Surrender and Disciplinary

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

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

1 7 considered this matter.

18 12. The parties understand and agree that Portable Document Format (PDF) and facsimile

19 copies of this Stipulated Surrender ofLicense and Order, including Portable Document Format

20 (PDF) and facsimile signatures thereto, shall have the same force and effect as the originals.

21 13. In consideration of the foregoing admissions and stipulations, the parties agree that

22 the Board may, without further notice or formal proceeding, issue and enter the following Order:

23 ORDER

24 IT IS HEREBY ORDERED that Physician's and Surgeon's Certificate No. A24516, issued

25 to Respondent Graham Beaumont, M.D., is surrendered and accepted by the Medical Board of

26 California.

27 1. The surrender ofRespondent's Physician's and Surgeon's Certificate and the

28 acceptance of the surrendered license by the Board shall constitute the imposition of discipline

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Stipulated Surrender of License (Case No. 800-2013-000598)

against Respondent. This sripuiation constitutes a record ofthe discipline and shall become a part

of Respondent's license history with the Medical Board of California.

2. Respondent shall lose all rights and privileges as a Physician and Surgeon in

California as of the effective date of the Board's Decision and Order.

3. Respondent shall cause to be delivered to the Board his pocket license and, if one was

issued, his wall certificate on or before the effective date of the Decision and Order.

4. If Respondent ever files an application for licensure or a petition for reinstatement in

comply with all the laws, regulations and procedures for reinstatement of a revoked license in

effect at the tin:e the petition is filed, and a!1 ofthe charges and allegations contained in

Accusation No. 800-2013-000598 shall be deemed to be true, correct and admitted by Respondent

when the Board determines whether to grant or deny the petition.

ACCEPTANCE

I have carefully read the above Stipulated Surrender of License and Order and have fully

discussed it with my attorney, Ann H. Larson. I understand the stipulation and the effect it will

have on my Physician's and Surgeon's Certificate. 1 enter into this Stipulated Sunender of

License and Order voluntarily, knowingly, and intelligently, and agree to be bound by the

Decision and Order of the Medical Board of California.

DATED: I '7 /li.f j/ .-.,.._ - ,J__·.:;:.·);..__ __ •

I have read and fully discussed with Respondent Graham Beaumont, ~,.1..J. the terms and

conditions and other matters contained in this Stipulated Surrender of License and Order.

approve its form and content.

DATED: lc:? lt g /I .s-f !

/' .. .[ r /'! (~ (' cli:&JQL--~..-____ ._-+

ANN H. LARSON Attorney for Respondent

4 - ' d Stipulated SwTender of License (Case No. 800-20 13-000598)

ENDORSEMENT

2 The foregoing Stipulated Surrender of License and Order is hereby respectfully submitted

3 for consideration by the Medical Board of California of the Department of Consumer Affairs.

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Dated: /t/z;j-zotC

SF2015400849 13 41429782.doc

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Respectfully submitted,

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Exhibit A

Accusation No. 800-2013-000598

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KAMALA D. HARRIS Attorney General of California JOSE R. GUERRERO Supervising Deputy Attorney General EMILY L. BRINKMAN Deputy Attorney General State Bar No. 219400

455 Golden Gate Avenue, Suite 11000 San Francisco, CA 94102-7004 Telephone: (415) 703-5742 Facsimile: (415) 703-5843 E-mail: [email protected]

Attorneysfor Complainant

FILED STATE OF CAUFORNIA

MEDICAL BOARD OF CALIFORNIA SACRAMENTO ~or\ \ 'L ~ 20 \ s BY 1-.. ~'a....~Ms. ANALYST



In the Matter of the Accusation Against:

Graham Beaumont, M.D. 301 College Ave. San Francisco, CA 94112

Case No. 800-2013-000598

ACCUSATION

14 Physician's and Surgeon's Certificate No. A24516,

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16 Respondent.

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18 Complainant alleges:

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, Department of Consumer

22 Affairs (Board).

23 2. On or about October 18, 1971, the Medical Board issued Physician's and Surgeon's

24 Certificate Number A24516 to Graham Beaumont, M.D. (Respondent). The Physician's and

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

26 and will expire on November 30,2015, unless renewed.

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JURISDICTION

2 .., .), This Accusation is brought before the Board, 1 under the authority of the following

3 laws. All section references are to the Business and Professions Code unless otherwise indicated.

4 4. Section 2227 of the Code provides that a licensee who is found guilty under the

5 Medical Practice Act may have his or her license revoked, suspended for a period not to exceed

6 one year, placed on probation and required to pay the costs of probation monitoring, or such other

7 action taken in relation to discipline as the Division deems proper.

8 5. Section 2234 ofthe Code, states:

9 "The board shall take action against any licensee who is charged with unprofessional

10 conduct. In addition to other provisions of this article, unprofessional conduct includes, but is not

11 limited to, the following:

12 "(a) Violating or attempting to violate, directly or indirectly, assistingin or abetting the

13 violation of, or conspiring to violate any provision of this chapter.

14 "(b) Gross negligence.

15 " (c) Repeated negligent acts. To be repeated, there must be two or more negligent acts or

16 omissions. An initial negligent act or omission followed by a separate and distinct departure from

17 the applicable standard of care shall constitute repeated negligent acts.

18 "(1) An initial negligent diagnosis followed by an act or omission medically appropriate

19 for that negligent diagnosis of the patient shall constitute a single negligent act.

20 "(2) When the standard of care requires a change in the diagnosis, act, or omission that

21 constitutes the negligent act described in paragraph (1 ), including, but not limited to, a

22 reevaluation of the diagnosis or a change in treatment, and the licensee's conduct departs from the

23 applicable standard of care, each departure constitutes a separate and distinct breach of the

24 standard of care.

25 "(d) Incompetence.

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1 The term "Board" means the Medical Board of California. "Division of Medical Quality" or "Division" shall also be deemed to refer to the Board (Bus. & Prof. Code section 2002).

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"(e) The commission of any act involving dishonesty or corruption which is substantially

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

3 "(f) Any action or conduct which would have warranted the denial of a certificate.

4 "(g) The practice of medicine from this state into another state or country without meeting

5 the legal requirements of that state or country for the practice of medicine. Section 2314 shall not

6 apply to this subdivision. This subdivision shall become operative upon the implementation of the

7 proposed registration program described in Section 2052.5.

8 "(h) The repeated failure by a certificate holder, in the absence of good cause, to attend and

9 participate in an interview scheduled by the mutual agreement of the certificate holder and the

10 board. This subdivision shall only apply to a certificate holder who is the subject of an

11 investigation by the board."

12 6. Section 2266 states:

13 "The failure of a physician and surgeon to maintain adequate and accurate records relating

14 to the provision of services to their patients constitutes unprofessional conduct."

15 7. Section 2242 states, in relevant part:

16 "(a) Prescribing, dispensing, or furnishing dangerous drugs as defined in Section 4022

17 without an appropriate prior examination and a medical indication, constitutes unprofessional

18 conduct."

19 FIRST CAUSE FOR DISCIPLINE

20 (Unprofessional conduct: Gross Negligence and/or Repeated Negligent Acts and/or

21 Incompetence and/or Furnishing Drugs Without an Examination and/or Inadequate

22 Medical Records for Patient TS)

23 8. Respondent is subject to disciplinary action under sections 2234 [unprofessional

24 conduct] and/or 2234(b) [gross negligence] and/or 2234(c) [repeated negligent acts] and/or

25 2234(d) [incompetence/lack of knowledge] and/or 2242 [furnishing drugs without an

26 examination] and/or 2266 [inadequate medical records] based on the care he provided to Patient

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2 9. Respondent is an 85 year old Physician and Surgeon, practicing as a psychiatrist, who

3 is board certified in Internal Medicine and Neurology and Psychiatry. He closed his office

4 practice in April of 2012 but continues to see a handful of patients in various public settings (i.e.

5 coffee shops) for psychiatry appointments. During an interview with an investigator with the

6 Health Quality Investigations Unit at the San Jose District Office on December 23, 2014,

7 Respondent stated he stopped billing patients for his services when he closed his office.

8 10. Respondent began treating TS on July 24,2004. TS is approximately 65 years old

9 with a diagnosis of Panic Disorder with Agoraphobia, Depressive Disorder, and Alcohol

10 Dependence (in remission for approximately ten years). TS also had a strong family history of

11 depression and anxiety. TS moved from the San Francisco Bay Area in 2009, eventually settling

12 in Oregon. Respondent continued to prescribe Prozac3 and Xanax4 to her and occasionally had

13 phone appointments with TS to discuss her medical issues.

14 11. Respondent produced 11 pages of medical records for his care of TS, including the

15 "Initial Outpatient Client Plan/Authorization Form" from July 27,2004. The majority ofthe

16 handwritten medical records are illegible. During Respondent's Board interview, he admitted he

17 was not even able to read his own writing. The records include handwritten progress notes that

18 TS called Respondent for phone appointments on October 14,2013, January 8, 2014, and AprilS,

19 2014.

20 12. On or about January 8, 2014, TS called Respondent for a phone appointment. She

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indicated she was having increased depression, loneliness, and tearfulness. There also appears to

2 Initials will be used to protect the patient's privacy. Responden_t may learn the patient identities during the discovery process.

3 Prozac is the trade name for fluoxetine hydrochloride, an antidepressant. It is a dangerous drug as defined in section 4022.

4 Xanax is the trade name for alprazolam and is used for the management of anxiety disorders or for the short-term relief anxiety symptoms. It is a dangerous drug as defined in section 4022 and a Schedule IV controlled substance and narcotic as defined by Health and Safety Code section 11057, subdivision (d). Xanax has central nervous system (CNS) depressant effects and patients should be cautioned about the simultaneous ingestion of alcohol and other CNS depressant drugs while using Xanax. Doctors should carefully monitor patients with drug or alcohol abuse histories when prescribing Xanax because of their predisposition to habituation and dependence.

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be a discussion about TS having breast pain, but Respondent told her that the pain was most likely

2 benign. There was no indication that he suggested or recommended she should follow-up with

3 her primary care physician. Respondent increased Prozac from 20 milligrams (mg) to 40 mg per

4 day.

5 13. On or about January 13, 2014, Respondent wrote a letter toTS's health care providers

6 in Oregon outlining his treatment history of TS, as well as her family history related to anxiety

7 disorders. Respondent indicated that over the past nine years he prescribed her 40 mg of Prozac

8 every day and 0.5 mg ofXanax three times per day (90 pills per month) each month. He further

9 stated that "with these two prescriptions, her symptoms were relieved satisfactorily. I did not see

10 any evidence ofmisuse or diversion ofthis medication."

11 14. Respondent committed unprofessional conduct amounting to gross negligence, and/or

12 repeated negligent acts and/or incompetence/lack of knowledge and/or prescribing controlled

13 substances without an examination and/or inadequate medical records based on the:

14 a. Continued prescriptions for controlled substances, including Xanax, to a patient with

15 a known substance abuse history without regular face to face visits;

16 b. Lack of adequate and legible medical records, including documentation regarding her

17 history of depression, alcohol, and substance abuse, diagnosis, or a treatment plan and objectives;

18 c. Failure to contact TS's current medical providers in Oregon to ensure the transfer of

19 psychiatric services to a provider who could have face to face visits with TS.

20 SECOND CAUSE FOR DISCIPLINE


22 Incompetence and/or Furnishing Drugs Without an Examination and/or Inadequate

23 Medical Records for Patient LD)


25 conduct] and/or 2234(b) [gross negligence] and/or 2234(c) [repeated negligent acts] and/or

26 2234( d) [incompetence/lack of knowledge] and/or 2242 [furnishing drugs without an

27 examination] and/or 2266 [inadequate medical records] based on the care he provided to Patient

28 LD. The circumstances are as follows:

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16. Respondent began caring for LD, a 55 year old female, in approximately 1998.

2 Respondent diagnosed LD with Bipolar Disorder and Attention-Deficit Hyperactivity Disorder

3 (ADHD). She had a history of psychiatric hospitalizations, suicidal attempts, and alcohol abuse.

4 The handwritten medical records from Respondent are almost completely illegible making it

5 difficult to determine what care he provided and when.

6 17. After Respondent closed his private practice in April of2012, he continued to treat

7 LD by visiting her in her home or having telephone appointments. The progress notes from May

8 and August 2012 for various appointments for psychotherapy are mostly illegible.

9 18. According to Controlled Utilization Review and Evaluation System (CURES) and

10 pharmacy records, after April2012, Respondent continued to prescribe Adderall5 and diazepam6

11 to LD on a monthly basis. There are either no medical records supporting the medical basis for

12 the monthly prescriptions or the records do not indicate why these medications were prescribed

13 and what periodic review Respondent conducted. Respondent continued to prescribe these

14 medications through at least February 1, 2014.

15 19. Respondent committed unprofessional conduct amounting to gross negligence, and/or

16 repeated negligent acts and/or incompetence/lack of knowledge and/or prescribing controlled

17 substances without an examination and/or inadequate medical records based on the:

18 a. Lack of a comprehensive psychiatric workup with periodic reviews of LD' s bipolar

19 disorder and ADHD, including mental status examinations, chief complaints, and treatment plans

20 and objectives;

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5 Adderall is the trade name for a combination of amphetamine and dextroamphetamine. It is a dangerous drug as defined in section 4022 and is a Schedule II controlled substance as defined in Health and Safety Code section 11055, subsection (d). Adderall is indicated for the treatment of Attention Deficit Disorder with Hyperactivity(ADHD) and narcolepsy. Amphetamines have been extensively abused and continued use can result in tolerance, extreme psychological dependence, and severe social disability.

6 Diazepam is the generic name for Valium. It is a psychotropic drug used for the management of anxiety disorders or the short-term relief of the symptoms of anxiety. It is a dangerous drug as defined in section 4022 and a Schedule IV controlled substance as defined by Health and Safety Code section 11057. Diazepam can produce psychological and physical dependence and it should be prescribed with caution to patient with a history of drug or alcohol abuse because of the predisposition of such patients to habituation and dependence.

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b. Lack of the necessary evaluation to determine the medical necessity for the controlled

2 substances he prescribed, particularly with a patient with a substance abuse history. This also

3 includes his failure to regularly see the patient to evaluate her medical condition and use of

4 medications;

5 c. Lack of adequate and legible medical records, including a diagnosis, a treatment plan

6 and objectives, a history of her bipolar depression and ADHD;

7 d. Failure to maintain professional boundaries between himself and LD by failing to

8 provide a confidential and secure setting for psychotherapy visits.

9 THIRD CAUSE FOR DISCIPLINE


11 Incompetence and/or Inadequate Medical Records in the Care of Patient JB)


13 conduct] and/or 2234(b) [gross negligence] and/or 2234( c) [repeated negligent acts] and/or

14 2234( d) [incompetence/lack of knowledge] and/or 2266 [inadequate medical records] based on

15 the care he provided to Patient JB. The circumstances are as follows:

16 21. JB is Respondent's wife and he certified that he has no medical records for JB.

17 22. On or about June 23, 2012, Respondent prescribed 5 mg of diazepam (30 pills) with

18 three refills to JB. ·

19 23. Respondent committed unprofessional conduct amounting to gross negligence,

20 repeated negligent acts, incompetence, and/or inadequate medical records when he prescribed

21 controlled substances to a family member based on his failure to conduct a medical examination

22 to support the necessity of the medication and his failure to maintain a medical record for this

23 evaluation.

24 FOURTH CAUSE FOR DISCIPLINE

25 (Boundary Violations)


27 conduct] and/or 2234(b) [gross negligence] based on the boundary violations in providing

28 psychotherapy to his patients in settings that do not ensure patient confidentiality.

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25. During Respondent's interview with the HQIU investigator, he indicated that since he

2 closed his private practice, he continues to provide psychotherapy to approximately eight to ten

3 patients. For some of these patients, he will meet them at a coffee shop to discuss their medical

4 and/or mental health issues. Meeting patients in a coffee shop creates boundary violations

5 because the patient may not be able to differentiate between the therapeutic nature of the

6 relationship versus a non-therapeutic relationship. Respondent failed to maintain professional

7 boundaries between himself and his patients.

8 PRAYER

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

1 0 and that following the hearing, the Medical Board of California issue a decision:

11 1. Revoking or suspending Physician's and Surgeon's Certificate Number A24516,

12 issued to Graham Beaumont, M.D.;

13 2. Revoking, suspending or denying approval of Graham Beaumont, M.D.'s authority to

14 supervise physician assistants, pursuant to section 3 527 of the Code;

15 3. Ordering Graham Beaumont, M.D., if placed on probation, to pay the Board the costs

16 of probation monitoring; and

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

19 · DATED: April 27, 2015

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0 d'. KIMB RL Y KIRCHMEYER ~ · Executive Director

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

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before the medical board of california department of ...4patientsafety.org/documents/beaumont,...

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