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TRANSCRIPT
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GEORGIA COMPOSITE MEDICAL BOARD
MINUTES
NOVEMBER 1-2, 2012
The Georgia Composite Medical Board (GCMB) held its regular meeting on November 1-2,
2012 at 2 Peachtree Street, NW, 36th
Floor, Atlanta, Georgia 30303, to consider Medical Board
matters:
Board Members in attendance on Thursday, November 1, 2012
William Butler, MD, Chairperson
John S. Antalis, MD
Gilbert Chandler, MD
Daniel DeLoach, MD
Alexander Gross, MD
Kathy Kemle, PA Ex-Officio Board Member
Kathy Kinlaw, Consumer Member
Marion O’Neil Lee, MD
Cami McGarity, Consumer Member
Trey Powell, MD
David Retterbush, MD
William Sightler, DO
Board Members absent on Thursday, November 1, 2012
Alice House, MD
Richard Weil, MD
Wendy Troyer, MD
Representatives from the Attorney General’s Office
Janet Wray, Senior Assistant Attorney General
Amelia Baker, Senior Assistant Attorney General
Wylencia Hood Monroe, Senior Assistant Attorney General
Reagan Dean, Senior Assistant Attorney General
Dr. Butler called the meeting to order at 8:00 a.m.
AGENDA
Motion Ms. Kinlaw, seconded by Dr. Lee, to approve the Agenda of the November 1-2, 2012
meeting. The motion carried unanimously.
MINUTES
Motion Dr. Gross, seconded by Dr. DeLoach, to approve the minutes of the October 4-5, 2012
Board meeting. The motion carried unanimously.
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JEFF LANE’S RETIREMENT RECOGNITION
Ms. Hughes reminded the Board that this meeting is Jeff Lane’s last meeting. Dr. Butler, Chair,
thanked Mr. Lane for his faithful service to the Board and the citizen of Georgia. The Board and
staff gave Mr. Lane a standing ovation for his service.
WELCOME NEW DIRECTOR
Mr. Tony Winborn, incoming Director of Investigations was introduced to the Board. Dr. Butler
performed the swearing in ceremony for Mr. Winborn.
EXECUTIVE DIRECTOR’S REPORT
LaSharn Hughes, Executive Director represented the following information for review:
The Board voted to have the January 2013 Board meeting at Mercer University Campus Field
House in Macon.
Prescription Monitoring Program – the contract should be awarded after the first of the year.
Physician Health Program (PHP) update – The Board sent letters to 39 licenses whom were
eligible for the admittance to the PHP, out of the 39 – 19 enrolled and 20 opted out. The Board
will include information regarding the PHP on identification cards for physicians and physician
assistants.
Letter from Terence L. O’Rourke, Jr. MD – regarding his refusal to submit immigration
documents and his desire to put his license on inactive status; the Board agreed to allow him to
place this license on inactive status.
Letter from John Culverhouse – inquiring how the adoption of Rule 360-3-.07 would make it
easier to utilize telemedine and receive reimbursement.
Letter inquiring when does the patient relationship end? The Board responded that the physician
must send the patient a letter terminating the physician patient relationship or if the patient has
not been evaluated or treated the patient for a period of at least two (2) years.
The Board accepted the following as information:
Health Insurance Exchanges – Georgia Health Policy Center
Article “Congress extends visa waiver program for IMGs.”
Article “Washington Doctor’s license permanently revoked for not cooperating with
investigation.”
Article Scope Newsletter – “GSA hails new Physician Health Program.”
Article “GA Reps urge CMS to reconsider CRNA pain rule.”
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Federation of State Medical Board regarding call for nominations for officers for the upcoming
year.
The Board discussed a request to be a part of clinical trials for Patient Qualification Review
Panel. The Board voted to inform the individual that this Panel is no longer functioning.
RULES HEARING
The Board comments on rules posted from interested parties on the following rules:
Dr. Gross made a motion seconded by Dr. Lee to adopt the proposed Rule 360-2-.14
“Requirements for Approval of International Medical Schools” to find the formulation and
adoption of this rule does not impose excessive regulatory cost on any licensee and any cost to
comply with the proposed rule cannot be reduced by a less expensive alternative that fully
accomplishes the objectives of the applicable laws.
That the Board find that it is not legal or feasible to meet the objectives of the applicable laws to
adopt or implement differing actions for businesses as listed at O.C.G.A 50-13-4 (a) (3) (A), (B),
(C), and (D).
Dr. Gross made a motion seconded by Dr. Retterbush to adopt the proposed Rule 360-15-.01
“Requirements for Physicians” and to find the formulation and adoption of this rule does not
impose excessive regulatory cost on any licensee and any cost to comply with the proposed rule
cannot be reduced by a less expensive alternative that fully accomplishes the objectives of the
applicable laws.
That the Board find that it is not legal or feasible to meet the objectives of the applicable laws to
adopt or implement differing actions for businesses as listed at O.C.G.A 50-13-4 (a) (3) (A), (B),
(C), and (D).
The Board heard comments on Rule 360-3-.02 “Unprofessional Conduct Defined and 360-3-
.07 Practice Through Electronic or Other Such Means.” The Board will vote on this rule at
the December 6, 2012 meeting.
ADJOURN
Dr. Gross made a motion, seconded by Dr. Antalis, to adjourn until the completion of
investigative interviews. The motion carried unanimously.
RECONVENED
Dr. Butler declared the meeting in open session at 3:00 p.m.
APPLICATION QUESTIONAIRE INITIAL & RENEWAL
Motion Dr. Powell, seconded Dr. Retterbush to approve the following language for initial
renewal, and reinstatement applications:
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INITIAL/REINSTATEMENT During the last 7 years, have you suffered from any physical, psychiatric, or substance use
disorder that could impair or require limitations on your functioning as a (replace with
profession name, i.e. physician assistant, physician, etc….), or has resulted in the inability
to practice medicine for more than 30 days, or required court-ordered treatment or hospitalization?
NOTE: You DO NOT need to answer YES to this question if you are enrolled in the Georgia
Physicians Health Program.
RENEWAL:
During the last two years, or since your last renewal, have you been diagnosed or treated for:
a. Alcohol or drug dependency?
_____Yes _____No or enrolled in the GAPHP
b. Any mental or neuropsychological disorder?
_____Yes _____No
If Yes, briefly describe below and submit treatment documentation with your renewal form.
CLOSED MEETING
Motion Dr. Gross, seconded Dr. Lee and motion carried to go into close session to discuss
Investigate and Wellness matters:
LAW ENFORCEMENT ACTION REPORT
Dr. Gross made a motion, seconded Dr. DeLoach to accept the following report. The motion
carried unanimously. The Board took the following actions:
1. Request from AC for a letter from the Board stating that he has not filed a complaint -
approve request
2. Request from DEA for the names of all PAs past and present, working, or have worked for a
pain center. – share information.
3. 20111775 – Accept Consent Order.
4. 20121268 – Accept Consent Order
5. 20130132 – Accept Consent Order
6. 20111186 – Accept Consent Order
7. 20090073 – Accept Consent Order
8. 20120955 – Accept Inactive Status
9. 20041074 & 20051541 – Deny removal of information from physician profile.
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10. 20120628 – Refer to Attorney General’s Office
11. 20130406 – Accept Consent Order.
12. 20130328 – Accept Consent Order and allow to renew.
13. 20091029 – Accept Consent Order
14. 20111286 - Tabled
15. 20111124 – Request approved
16. 20100656 – Tabled
17. 20040164 – Refer to AG
18. 20100539 – Tabled
ADJOURN
Dr. Lee made a motion, seconded by Dr. Gross to adjourn and reconvene Friday morning.
Motion carried unanimously.
The Meeting adjourned at 4:30 p.m.
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GEORGIA COMPOSITE MEDICAL BOARD
MINUTES
NOVEMBER 1-2, 2012
RECONVENED
Dr. Butler called the meeting to order at 8:00 a.m.
Board Members in attendance on Friday, November 2, 2012
William Butler, MD, Chairperson
John S. Antalis, MD
Gilbert Chandler, MD
Daniel DeLoach, MD
Alexander Gross, MD
Kathy Kemle, PA Ex-Officio Member
Cami McGarity, Consumer Member
Trey Powell, MD
David Retterbush, MD
Board Members absence on Friday, November 2, 2012
Alice House, MD
Kathy Kinlaw, Consumer Member
Marion O’Neil Lee, MD
William Sightler, DO
Wendy Troyer, MD
Richard Weil, MD
Charles White, DO
Representative from the Attorney General’s Office
Janet Wray, Senior Assistant Attorney General
RULES HEARING
Dr. Gross made a motion seconded by Dr. Lee to adopt the proposed Rule 360-2-.05 “Renewal
Applications” and to find the formulation and adoption of this rule does not impose excessive
regulatory cost on any licensee and any cost to comply with the proposed rule cannot be reduced
by a less expensive alternative that fully accomplishes the objectives of the applicable laws.
That the Board find that it is not legal or feasible to meet the objectives of the applicable laws to
adopt or implement differing actions for businesses as listed at O.C.G.A 50-13-4 (a) (3) (A), (B),
(C), and (D).
Dr. Gross made a motion seconded by Dr. Retterbush to adopt the proposed Rule 360-2-.07
“Reinstatement” and to find the formulation and adoption of this rule does not impose
excessive regulatory cost on any licensee and any cost to comply with the proposed rule cannot
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be reduced by a less expensive alternative that fully accomplishes the objectives of the applicable
laws.
ADVISORY COMMITTEE REPORTS
ACUPUNTURE ADVISORY COMMITTEE REPORT
Dr. Gross presented the report of the Acupuncture Advisory Committee. Dr. Antalis seconded
the Committee’s motion and it carried unanimously.
The Committee made the following recommendations to the Board:
Accept NCCAOM exam score for:
Chah, Maria
Accept the following Quarterly Report:
Huh, Cameron
Approve the following applicant for initial licensure:
Ana Villanueva
Approve the following applicant for reinstatement of licensure:
Alice Honican
Approve request for withdrawal of application:
Steingraber, Marcia
PHYSICIAN LICENSING AND PROFILES ADVISORY COMMITTEE REPORT Dr. Gross presented the report of the Physician Licensing and Profiles Advisory Committee. Dr.
Butler seconded the Committee’s motion and it carried unanimously.
The Board took the following actions:
1. Tabled the following applications:
J.D.
J.R.
F.G.
2. Refer to Wellness:
C.S.
3. Allow to Withdraw:
M.K. M.I.
4. Approved requests for Waivers of Rule 360-2-.02 for the following applicants:
McCorvey, David
Naqvi, Sheba
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5. Approved the following for Reinstatement of Licensure:
1. Cliatt, Thomas DO - 55932
2. Davis, Sanford MD - 56094
3. Harrison, David Glenn MD- 33348
4. Norris, Jeanette MD- 34678
5. Parikh, Sunil MD - 54642
6. Spiltalny, Neil MD - 51388
6. Other Business:
a) Gudapati, Rao - Refer applicant to FSMB to request Flex Transcript for score transcript.
b) Molina, Armondo - Approved request to send information to NM Medical Board.
c) Khalil, Magdy – Denied request to provide primary source documents to another State
Board.
d) Haque, Nabila - Approved request to retake Step 3.
e) Foley, Sean - Denied request to accept verification from another Board.
f) Leum, Carl - Approved request to send information to Idaho Medical Board.
7. Approved the following applications for physician licensure:
LIC_NBR NAME Designation
68847 PITA, MARK ANTHONY MD
68848 PHILIBERT, ROBERT ALAN MD
68849 PALLE, SIRISH K MD
68850 PATEL, KAVITA MD
68851 PENALVER, ALBERTO ANGEL MD
68852 RUDOLPH, PRIYA MD
68853 SABOLICH, MARKO ANTON MD
68854 SAMUEL, AMBER MD
68855 SHARMA, DIPIKA MD
68856 SIMPSON, ANDREW MD
68857 SINGLETON, DANIEL HARPER MD
68858 STOKES, TASHAWNA DENISE MD
68859 THOMAS, CYMANTHIA KEESHA MD
68860 TRONCONE, STEVEN KERR DO
68861 UY, CLARENCE N MD
68862 VUKELIC, SASA MD
68863 WALTON, ZEKE JONATHA MD
68864 WANG, LUOQUAN MD
68865 WATSON, GEORGE R MD
68866 WEEKS, WOODWIN MICHAEL DO
68867 WENGER, FRED GRIGGS JR DO
68868 WILLIAMSON, DAVID KELLEY MD
68869 WIMBUSH, TRACY ELIZABETH MD
68870 YE, DONGJIU MD
68871 ZLOTNIK, RICHARD D MD
68872 ZAKHIREH, MOHAMMED ALI MD
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68873 ADAMSKI, JOHN HENRY II MD
68874 ADLER, JEFFREY BRIAN MD
68875 AFRIDI, ZAHID MD
68876 AGRAWAL, RUCHIR MD
68877 ALI, BAKHTIAR MD
68878 ALURKAR, AJEY SASHIKANT MD
68879 BARALT, DIANA MARIA MD
68880 BAUDOIN, DEREK MD
68881 BOYD, CHARLES MONTGOMERY MD
68882 BRADDOCK, DEMETRIOS MD
68883 BRODERSEN, MARK PRESTON MD
68884 BUTALA, RAJESH M MD
68885 COPPOLA, MICHAEL MD
68886 CORREOSO-THOMAS, LYLA JANEIL MD
68887 DARKWA, NANA YAW ASANTE MD
68888 DAYAN, STEPHEN ALAN MD
68889 DIAZ, ENRIQUE MD
68890 ELLIS, DAVID HOWARD DO
68891 EDGEWORTH, MICHAEL L MD
68892 DZIUBAN, ERIC JOSEPH MD
68893 FARRAG, TARIK Y MD
68894 FIGUEROA, ESTUARDO MD
68895 FISHER, KEVIN EDWARD MD
68896 FRENCH, MARSHALL LEVON MD
68897 GARZA, JOSE MIGUEL MD
68898 GILMAN, JORDANA SARAH MD
68899 GLEASON, BRIANA CLAIRE MD
68900 GLOGOVER, PHILIP HERBERT MD
68901 GONE, KAVITA REDDY MD
68902 GOTTLIEB, SIDNEY OTTO MD
68903 GRIFFITH, KENDALL MARCUS MD
68904 GRIFFITH, MICHELE YOLANDA MD
68905 GRIMM, CHELSEY LEIGH MD
68906 LYNN, CHRISTINA PITTS MD
68907 ONWUMERE, IKENNA U MD
68908 LEE, JOO WON MD
68909 LAZZARO, BETSY MD
68910 HENRY, ARNOLD FAUNTLEROY MD
68911 LANE, ZHAOLI MD
68912 MEADOWS, TODD JASON MD
68913 MARGOLES, LINDSAY MARGARET MD
68914 OUTERBRIDGE, YI-HWA MD
68915 HENDRICKS, LATONYA MICHELLE DO
68916 NOVAK, JOSHUA DANIEL MD
68917 HUNLEY, CHARLES FRANKLIN MD
68918 LEE, POSHING MD
68919 HAWTHORNE, KINJI LOTHARIO MD
68920 JONES, CHELSEA RAE MD
68921 JACOBSON, SIG-LINDA MD
68922 NAQVI, SHEBA MD
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68923 MAGLOIRE, MARIA ZITA FRANCISCA MD
68924 MILLER, CELESTE MD
68925 KRAMER, MICHAEL KEVIN MD
68926 ISOM, JOEL TERRANCE MD
68927 MARSHALL, TRISTA J MD
68928 OUTTEN, STEPHEN SINCLAIR DO
68929 HALL, DANNY MD
68930 LEVERETT, BARBARA MILLER MD
68931 MAYS, WILLIAM RANDOLPH MD
68932 MILLER, ALAN B MD
68933 MOOK, WILLIAM RANDOLPH MD
68934 MCKNIGHT, AISHA JENELLE MD
68935 LECKIE, STEVEN KOUFMAN MD
68936 SHARIF, RAMLA MD
68937 DESAI, SUDHEN BIHARI MD
68938 GOODWIN, ALYSON MD
PHYSICIAN ASSISTANT ADVISORY COMMITTEE
Dr. Sighter presented the report of the PA Advisory Committee. Dr. Gross seconded the
Committee’s motion and it carried unanimously.
The Committee made the following recommendations:
1. Approve the following additional duties requests:
Physician Assistant Additional Duties Requested
1. Kathleen Boettcher 1. Stress Test
2. Lauren Fogelgren 1. Lumbar Puncture with Intrathecal
Chemotherapy
2. Bone Marrow Aspirate
3. Bone Marrow Biopsy
3. Georgia Griffis 1. Botox/Fillers
4. Jessica Hart 1. Botox/Fillers
5. Jon Khoury 1. Central Lines
2. Paracentesis
3. Toracentesis
4. Vascualr Catheter Placement
Physician Assistant Additional Duties Requested
6. Katherine Perry Thyroid Ultrasound
7. John Plourd 1. Nerve Conduction Studies
8. Greg Steahr 1. Arterial Lines
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2. Central Lines
3. Pulmonary Artery Catheters
9. Phan Tasco-Anderson 1. Cosmetic Botox injections
2. Filler Injections
3. Chemical Peels (light to moderate)
4. Mircroderabrasions
5. Sclerotherapy
2. Table the following additional duty request:
1. Phan Tasco-Anderson 1. Venus Freeze Medical Device
3. Approve the following applications for initial licensure
Physician Assistant Supervising Physician
Jonathan Beck Steven Disch, MD
Caroline Bond Nicole Sroka, MD
Harmony Church Angela Bookout, DO
Justin Clack Carter Co, MD
Whitney Cobb William Watkins, MD
Kate Courtney Michael Sopt, MD
Sarah Craven John Edsworth, MD
Maggie Dear Michael Hulse, MD
Kimberly Dykeman Nibdita Patro, MD
Casey Farris Jay Kher, MD
Karen Ferguson Mark McLaughlin, MD
Bethany Gilley Michael Ikler, MD
Grace Hall Jeffrey Kovacic, MD
Lindsay Howard Stephanie Hsu, MD
Jarrod Luttjohann Ronald Perry, MD
Amanda McCook Dennis Harper, MD
Charishma Nayyar Mark Sultan, MD
Samantha Nowak Carroll Cooper, MD
Laura Oliver Richard Rowe, MD
Sejal Patel Sharon Amaya, MD
Alicia Provenzano Asif Qadri, MD
Ernest Rinaldi Ruchir Khuraha, MD
Mark Roman Hope McDaniel-Desarmes, MD
Brittany Stanczak Victor Zubar, MD
Courtney Stevens Jeffrey Winge, MD
Questa Tait Charles Mitchell, MD
Rodger Wagoner Anthony Hoots, MD
Charice Wilson Millard Collier, Jr., MD
4. Approve the following applications to add or change supervising physicians
PA/Name Previous Phy Phy/Name
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Ann Abercrombie Sharma Amit, MD Dennis Ricketts, MD
Abigail Afshari Paul Hawkins, MD Willis McVay, MD
Emily Baise-Shuman Ortelio Bosch, MD Jeffrey Kingsly, DO
Caroline Bliven Jimmy Hewitt, MD Jason Alisangco, MD
Willie Booker Matthew Andeldis, MD Eric Davis, MD
Michael Boyd Jin Yang, MD Jimson Smith, MD
Ashla Bryant Luther Vance, MD Van Millin, DO
Alaina Burran Gerald Slagel, MD Joseph DeVeau, MD
Barbara Burk Mary Hughes, MD Thomas Seay, MD
Charle Cameron Jenaine Oliga , MD Michael Ross, MD
Meghan Campbell Woody Francis, MD Fidias DeLeon, MD
Harold Caraviello, Jr Kenneth Rice, MD Jerry Williams, Jr., MD
Brian Daitch Bozeman Sherwood, MD Jerry Wilborn, MD
Brandi Daniel Kennon MCLendon, MD Christopher Morgan, MD
Robert Darsey Andrew Long, MD Bradley Walter, MD
Gregory Davis Sharron Thompson, MD David Smith, MD
Gilian Dudley James Seward, MD Gary Godlewski, MD
Brian Foster Murray Robinson, MD Howard Chandler, MD
Morgan Gallagher Don Shaffer, MD David Clifford, MD
Dipsy Gandhi Bradford Gould, MD Lei Cheng, MD
Christie Gibson Robert Gantt, MD Manojna Sanjeev, MD
Kristine Germann Maureen Olson, MD Todd Schmidth, MD
Tanya Green Eric Deal, MD James Gore, MD
Georgia Griffis Marcus Roberts, MD Eugene Jackson, MD
Clifton Gunter Pamela Weigandt, MD Daniela Rusu, MD
Alex Harris Eduardo Molinary, MD John Stauffer, MD
Jessica Hart Kevin Neibaum, MD Eugene Jackson, MD
Kimberly Hart Shelly Samuel, MD David Nussbaum, MD
Terry Harwood Zeeba Siddiqi, MD Paul Murray, MD
Mark Houtson Denis Trto, MD Daniela Rusu, MD
Tommy Jackson Scott Barbour, MD John Hastings, III, MD
Mary Jones Jerrold Levy, MD Jay Johansen, MD
Andrew Kelly Christopher Whitson, MD Markus Klass, MD
Jeninne LaCroix Thomas Fitzgerald, MD Richard Warren, MD
Jeffrey Lambert Robert Cox, MD William Fackler, MD
Hugh McCollum Christopher Nichols, MD Martha Schuh, MD
Markeita McIntosh Tracey Lemon, MD Marin Honore’, MD
Markeita McIntosh Tracey Lemon, MD Stanton McKenna, MD
Markeita McIntosh Tracey Lemon, MD Nana Opare, MD
Marjorie McKeller Hillary Hahm, MD Suepy Chen, MD
Dorthea Mackey Vinod Sachdeva, MD Chiquita Fye, MD
Patricia Mackey Michael Katz, MD Kenneth Johnson, MD
Anthony Medina Philip Henderson, MD Joel Zivot, MD
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Terry Mize Theresa Berry, MD B. Wayne Blount, MD
Katherine Perri Cameron Nixon, MD James Graham, MD
Alexander Polsinelli Jamie Lin, MD John Vance, Jr., MD
Leah Reynolds Donald Davis, MD Jeffrey Goldberg, MD
Lani Roberts Jessica McCoun, MD Jodi Kuhlman, MD
Gilliam Robinson David Walker, MD Charles Ruis, MD
John Schmidt Patrick Railey, MD Viviana Goldenberg, MD
Dennis Short Otis Tillman, MD Jovito Estaris, MD
John Simms Charles White, MD Daniel Lopez, MD
Greg Steahr James Kauten, MD Joseph Ricotta, MD
Greg Steahr James Kauten, MD Brenda Hott, MD
Jejuan Stewart Tom Roberson, MD Karen Carlson, MD
Keenan Templeton Michael Maynor, MD Franklin Payne, MD
Kathryn Thatcher Bruce Depiev, MD Stephen Pohl, MD
Mariah Thaxton Salil Patel, MD Darryl Harris, MD
James Todd James Snow, MD Adam Lewis, MD
Julia Varnier Hany Helmi, MD Pricilla J. Ross, MD
Leeann Vrabel Mary Sparks, MD Stephen Pohl, MD
Rachel Youngblood Stanley Shin, MD Christopher Haberman, MD
Derek Walker John Quina, MD Robert G. Hollenbeck, MD
Freda Wall Sheryl Vickery, MD Howard Chandler, MD
5. Approve the following Reinstatement Application:
a. William Chandler
6. Other Business:
a. The Committee reviewed the additional duties request for D.K. and recommended
tabling pending further information.
b. The Committee recommended presenting a list of tasks which are not considered
additional duties to the Board for approval.
c. The Committee recommended to accept the revision of Rule 360-5-.11
(Standards for Physician Assistant Practice) with changes.
New Proposed Rule:
(6) While engaged in medical practice, a physician assistant must clearly identify
himself as such. He/she must also wear a clearly legible identification name tag
with the words “Physician Assistant” on it. A Physician Assistant is to be
addressed as Mr., Mrs., Ms., or Miss.
d. The Committee reviewed the General Job Description (Form F) and agreed to
accept.
e. The Committee reviewed a letter from N.W. and agreed to refer to the Board for
consideration.
f. The Committee reviewed the update to online renewal question and agreed to the
changes.
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g. The Committee met with C.C. and recommending tabling the application until
successful completion on Pance Exam, 240 hours of shadowing with Supervising
Physician and monthly monitoring reports.
PERFUSION ADVISORY COMMITTEE
Dr. Retterbush presented the report of the Perfusion Advisory Committee. Dr. Powell seconded
the Committee’s motion and it carried unanimously.
The Committee made the following recommendations to the Board:
1. Approve the following application for Perfusion Licensure:
a. Miguel Garcia
b. Joel Keene
c. Mark Moreau
2. Other Business:
a. The Committee recommended tabling to a future date:
Concern that Abiomed Impella Circulatory Support System and the TandemHeart
CardiacAssist Extracorporeal Circulatory Support System are being operated by
cardiac catheterization lab technicians.
b. The Committee recommended that B.B. submit a request for provisional licensure
and provide the Provisional Statement of Supervision Form ( Form F)
RESPIRATORY CARE ADVISORY COMMITTEE
Dr. Sightler presented the report of the Respiratory Care Advisory Committee. Dr. Antalis
seconded the Committee’s motion and it carried unanimously.
The Committee made the following recommendations to the Board:
1. Approve the following applicants requesting 12-month permits:
Okefenokee Technical College - pending Education verification
1. Davis, Kimberly
2. Hodges, Joshua
3. Medders, Farris
4. Taylor, Marlee
5. Tisby, Denise
6. Treat, Christy
7. White, Clarice
8. Williams, Monica
1a. The Committee reviewed the following applicants for licensure:
a. Malcolm, Elvis - recommended for a 12 month permit
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b. Myrtyl, Pascal - recommended for a 12 month permit pending receipt of 15 CEU’s in
Critical Care & completion of Reference form B
2. Approve the following applicants requesting licensure by reciprocity:
1. Morlino, Allison
2. Patricia Spencer - pending Reference form & 15 hours of CEU’s in Critical Care
3. Approve the following applicants for licensure by reinstatement:
1. Burke, Ann
2. Dacosta, Angel - pending 15 CEU’s in Critical Care
3. Hebert, Jay - pending state verification from SC
4. Houghton, Herbert - pending Reference form
5. Moore, Brian
4. Review of the following applicants for Permanent licensure:
1. Wynn, Morgan
2. Young, Steven
5. The following applicant appeared before the RCP Advisory Committee for an interview:
1. Watkinson, Amanda - recommended for licensure by Reciprocity
6. Approve of the following applicants for full licensure:
1. Ahmed, Maria
2. Boyd, Danielle
3. Bruner, Mary
4. Chadwick, Tiffany
5. Collins, William
6. Crews, Jeremy
7. Haralson, Christa
8. Hiers, Hannah
9. Johnson, Shonquita
10. Medders, Ryan
11. Poole, Barry
12. Quach, Minh
13. Ray, Ashley
14. Sherman, Mariana
15. Thornton, Presley
7. Other Business
1. The Committee discussed graduates who were granted Respiratory care licensure in
Georgia whose license has expired or lapsed and are re-applying for licensure, but
unable to obtain Reference from a previous Medical Director or find a Prospective
employer to complete the Reference form B and recommended revising the Reference
form B.
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2. The Committee discussed Robert Williams request for reinstatement of licensure and
recommended to grant licensure.
ORTHOTICS & PROSTHETICS ADVISORY COMMITTEE
Dr. Antalis presented the report of the Advisory Committee. Dr. Deloach seconded the
Committee’s motion and it carried unanimously.
The Committee made the following recommendations to the Board:
1. Approve the following applicants for Orthotic licensure:
a. Finney, Delana
b. Miller, Taavy
Other Business
1. The Committee discussed O.C.G.A. 43-34-193(12) (whether a Pedorthist can do
AFO’s) and recommended to table for discussion at our December 2012 meeting.
ADVANCED PRACTICE NURSE ADVISORY COMMITTEE
Dr. Gross presented the report of the Advisory Committee. Dr. Deloach seconded the
Committee’s motion and it carried unanimously. he Board took the following actions:
1. The Board voted that the following APRN Protocol Agreements met the provisions of
OCGA 43-34-25:
APRN Last Name APRN First Name Delegating Physician
Adams Angela D. Asit K. Jha, MD
Anderson Tabatha Kecia Jones, MD Arrington John Matthew Wheatley, MD
Asa Michele Betsy S. Horton, MD
Barnette Katherine Matthew A. Wheatley, MD
Barrington Elizabeth Najaz Woods-Bishop, MD
Bartock Dawn Shawn Jobe, MD
Baughcum Milissa B. Kelly C. Grow, MD
Berg Shawna Gaye Hayes,MD
Biglow Anicia S Bharatkumar Patel, MD
Blackburn Billie Carol Bozeman Sherwood, MD
Bonk Donna M. Raymond R. Jarvis, MD
Bracewell Joanne E Lourdes B. deArmas, MD
Brown Michelle Angela J. Hale, MD
Browne Vickie H. Ralph C. Lyons, MD
Byars Terri Brooksbank, Roger MD
APRN Last Name APRN First Name Delegating Physician
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Campbell Joyce Denise Workman, DO
Ceasar Robbyn Clark, Curtis, MD
Cercone Elizabeth A. Robert E. Springer, MD
Chambers Donna Hussanin, Hina MD
Chessor Misty L. Jason Hefner, MD
Chetty Sundari Soyoola, Emmanuel MD
Clayton Brandi Baldwin, Richard MD
Cline Nyla Manley, Suzanne MD
Conley Gail Rao, Ramana MD
Croft Sheilia H. Reden C. Delgado, MD
Cummings Thelma B. Beverly Hyacinth, MD
Davis Lindsey N. Louis E. Hempel, MD
Denny Jean M. William E. Richards, MD
Driver Walline Wiley, Zanthia
Dupree Susan Lee Kenneth J. Howard, MD
Elrod Lean Neises, Kerry MD
Evans Natalie F. Alice R. House, MD
Fegely Karen J. Lee D. Jacobs, MD
Freeman Karen Christopher Recknor, MD
Gore Holly Dasher, William MD
Hale Tina Marie John C. Blankenship, MD
Hale Jessi Modi, Anil MD
Hammond Heather C. Bryan L. Philbrook, MD
Harley Dorthy Clyde Simmons, MD
Hedrick Caroline Rami Azzouz, MD
Hern Cynthia Susan Alfonso, MD
Holton Cynthia Higgins, Peter MD
Hull Melanie Kogan, Brian MD
Hurst Sabine C. Joseph D. DeVeau, MD
Jasper Lisa Gail Matthews, MD
Jennings Melindia Arnall, David MD
Jordan Sarah J.L. Raymond E. Gutierrez, MD
Kalm Heather Wheatley, Matthew MD
Kelker Cassandra Wallace Duncan, MD
Kelker Cassandra David Asrael, MD
Kerr Joanna Romualda Klicius, MD
Kerr Lakisha J. Howard Stirne, MD
Lee Erin Ramsdell, Bruce MD
Leigh Stacy Dennis Wiles, MD
Little Deborah J. Asad Hatem, MD
APRN Last Name APRN First Name Delegating Physician
18
Loeffel Laura Jean Antonius J. DeGrauw
Lopez Melanie B. Paul A. Martin, MD
Macera Tana Thomas Hobby, DO
Mann Linda J. Michelle Morgan, DO
McCollough Michael A. Joseph D. DeVeau, MD
McKay Angela Shirley, Victoria DO
McLendon Angela Buice, Thomas MD
Mekhoukh Jennifer Randy Yada, MD
Meyers Michelle Chandra, Anuj MD
Miller Jenifer Narashimhulu Neelagaru, MD
Millsap Lori Safia Pirani, MD
Mitchell Joan Cox-Thompson, Jackie MD
Moore C. Meredith Kenneth Taylor, MD
Oess Barbara Zorn, William MD
Outz Mary A. David A. Stone, MD
Page Douglas Brian Jordan, DO
Parrish Wendy Douglas Epps, MD
Pearce Robin John Gott,MD
Powell Pamela W. Michael C. Pinell, MD
Quattlebawn Adrian M Courage ATEKHA, MD
Ragland Kenya Jeffrey Oyler, MD
Robinson Lisa William Lynds, MD
Robinson Shannon Morris Pulliam, MD
Ruiz Oscar James Beiter, MD
Sanchez Victoria Shameka McElhaney, MD
Sayewich Laura John Bleacher, MD
Scoggins Kelly W. Greg Schlegel, MD
Shaw Lauren T. Cedric Porter, MD
Shea Kimberly Savage, Valeria MD
Shedd Cheryl Rios, Antonio MD
Simpson Utopia Vitaliy Gavrikov, MD
Smith Daniel J. Anthony J. Marchetti, MD
Smith Cassie Quzu, Farid MD
Smith-Vaughn Melissa Roger Brooksbank, MD
Springman Courtney Kogon, Brian MD
Stier Ingrid Kaveh Ehsanipoor, MD
Sumner Erin Israel B.D. Bryson, MD
Tarver Pamela Christopher Kang, MD
Taylor Wendy L. Warren J. Henderson, MD
Tenebruso Lillian Anurag Kumbham, MD
APRN Last Name APRN First Name Delegating Physician
19
Thompson Margaret Martinez, Manuel MD
Thrasher Mary A. Mark Elam, MD
Trouille Lori Steven Dawson, MD
Vanderburg George Brooksbank, Roger MD
VanPatten Laura Deering, Thomas MD
Von Herbulis Kelly A. Bradley S. Buckler, MD
Ward Sandra Charles Semones, MD
Webb Leah James Palazzolo, MD
Whaley Shelby Quinton Weldon, MD
Wood Patricia A. Robert D. Mixson, MD
Woods Jennifer Dania Atif Iqbal, MD
Yerke Julie Roger A. Brooksbank, MD
2. The Board voted that the following APRN Protocol Agreements met the provisions of OCGA 43-34-25 pending additional information.:
Adebayo, Monsurat Jada Bussey-Jones, MD,
Griffin, Shuvory Edwin Allen, MD,
Harley, Dorothy Clyde Simmons, MD,
Hart, Rebecca Costrini, Anthony MD
Jones, LaQuay Stinnette, William MD
Jones, LaQuay Blake, Bryan MD,
Kline, Gail Winston Jeshuran, MD
Merritt, Marcie Philip Reece, DO
Parks, Melissa Jay Schecter, MD
Perry, Venester Patel Roshni, MD
Povolny, Angela Bernertine King, MD
Singleton, Dawn Kesha Allen, MD
Sommers, Tanya Thomas Pantino, MD
Stemp, Linda Blake, Bryan MD
Stemp, Linda Stinnette, William MD
Watson, Donna Christopher Stevens, MD
Investigative Committee
Close the following cases:
20121311 20121387 20121581 20121612 20121653 20121788
20122027 20122034 20120056 20130116 20130229 20130421
Close the following cases with letter of concern:
20120875 20121016 20121019 20121189 20121416 20121740
20101334
Table the following cases:
20120955 20121768
20
Refer the following case to AG:
20110819 20120129 20120430 20120513 20130428 20111487
20130095 20130533 20130535
Invite for interview the following cases:
20120849 20120863 20121145 20121577 20121866 20122021
20121871
Cease & Desist on the following cases:
20121270 20121282 20121841 20121972
AG-OMPE on the following cases:
20130206 20130531 20130305
Initial Malpractice Evaluations:
Close the following cases:
20130109 20130168 20130239 20130240 20130498 20130543
20130544 20130546
Close and Flag the following case:
20130536
Initial Complaint Evaluations:
Close the following cases:
20100776 20100594 20110890 20111057 20111938 20120350
20120502 20120617 20120842 20120932 20120936 20121017
20121031 20121347 20121364 20121390 20121637 20121642
20121674 20121699 20121703 20121714 20121722 20121737
20121741 20121777 20121791 20121878 20121962 20121973
20122055 20122067 20130007 20130018 20130025 20130026
20130029 20130050 20130053 20130060 20130064 20130075
20130089 20130106 20130111 20130118 20130119 20130143
20130146 20130153 20130187 20130193 20130202 20130210
20130218 20130226 20130227 20130257 20130317 20130325
20130398 20130402 20130407 20130409 20130430 20130436
20130437 20130443 20130457 20130460 20130462
Close with letter of concern the following Initial Complaints:
20121100 20121344 20121488 20121518 20121552 20121560
20121601 20121687 20121695 20121996 20121877 20122013
20130087 20130142 20130183 20130209 20130291 20130298
Investigative Interview Report
21
20120197-PEER REVIEW
20111739-RESCHEDULED
20101008-CLOSE W/LOC
20121213-REFER TO AG
20110729-TABLED
20121504-TABLED
20130391-CLOSE
20112212-TABLED
20121436-CLOSE
20121811-CLOSE
20120281-CLOSE
20121299-CLOSE
20111197-CLOSE W/LOC
20120746-CLOSE W/LOC
20120081-CLOSE W/LOC
20120909-TABLED
20121756-NO SHOW
20110689-CLOSE
20111095-CLOSE
20120997-TABLED
20120787-CLOSE
0120500-TABLED
20111341-CLOSE W/LOC
WELLNESS COMMITTEE
Status report given by representative of the GA PHP.
1. Review probation and monitoring cases for suitability for referral to the GA PHP.
2. Case # 20100378-Table
3. Case # 20100768-Acknowledge receipt of information
4. Case # 20112015-(1) Cease and Desist and notify that that the Board requires new
supervisor. Dr. Lee and Dr. Chandler recused.
5. Case # 20121060-Terminate ANTP.
6. Case # 20101497-Deny request for modification.
7. Case # 20121256-Deny request for approval of particular treatment program
8. Committee notified of enrollment in the GAPHP
a) Case #20101451-Terminate Order
22
b) Case # 20091527-Terminate informal monitoring
c) Case #20070007-Terminate Consent Order.
d) Case #20110445-Terminate Order
9. Case # 20122011-Terminate ANTP
10. Case # 20122032-Terminate ANTP
11. Case # 20111988-Terminate CO
Adjournment
There being no further business, motion Dr. Retterbush, seconded Dr. Gross and motion carried to
adjourn the meeting at 10:18 a.m.
_________________________________
William Butler, MD
Chair
__________________________________
LaSharn Hughes, MBA
Executive Director
Recorded and typed by LaSharn Hughes, Executive Director.