Doctors Name: Arudra Bodepudi
License Number: 73676
License Status:  Current - (Dues Paid)
Suspended
Limits on Practice
Probation
Cease Practice Order


City of Record: Stockton
Region: San Francisco
License issued on: 12/28/2000
Licensing Boards: Medical
Specialties : Psychiatrist

Gender: Female

Accusations and Infractions or Causes for Discipline:  Repeated Negligent Acts
Gross Negligence

Date of Last MBC Action: 11/15/2019

Repeat Offender:  Yes
Ongoing Discipline:  Yes
Out of State Discipline:  No
No Medical Board Activity:  

_____________________________________________________________________________________________________
Medical Board Documents, News Articles, Court Documents, Etc.

Decision 1/17/2012
Decision 7/26/2016
Cease Practice Order 11/15/2019
 

______________________________________________________________________________________________________

Additional Information (Medical School, Dated Actions, Excerpts from Disciplinary Actions, Notes) OSMANIA UNIVERSITY, GANDHI MEDICAL COLLEGE
#ETHN
Excerpt from Accusation dated 7/13/2010:

FIRST CAUSE FOR DISCIPLINE
(Gross Negligence)
[B&P Code Section 2234(b)]

8. Respondent is a physician and surgeon, and is certified by the American Board of Psychiatry and Neurology. Her subspecialty is in geriatric psychiatry. At the time the events giving rise to the instant Accusation occurred, Respondent was providing medical services through the Permanente Medical Group (Kaiser), in Stockton, California.

9. Respondent committed gross acts of negligence relative to her care and treatment of two separate patients. The facts constituting gross negligence are set forth, infra.

Patient PCC218

10. Patient PCC218 ("PCC") was a 71 year-old female patient who presented to Respondent on or about March 6, 2008, for "medication management". At that time, PCC reported she was taking Tagamet (histamine antagonist), lisinopril (blood pressure control), Trimpex (antibiotic), Pamelor (antidepressant), prednisone (corticosteroid), Zymar (eye drops), and Klonopin (antianxiety), and that she was medication compliant. She also reported that she had been recently convicted of driving under the influence of alcohol, and that she was scheduled to undergo cataract surgery. PCC stated she was "going to school." The type of school is not specified in the progress note. She expressed displeasure over having to depend upon others for her transportation. PCC claimed she had been "sober" since June of2007. Respondent did not document an assessment of current symptoms, except to indicate PCC was stable on her medication regimen, that she had been sober for approximately 8 months, and that her global assessment of functioning ("OAF") was relatively good. Respondent documented she discussed tapering and eventually discontinuing Klonopin with PCC. Respondent's documented plan was to have PCC return in June of 2008, to evaluate her medications.

11. PCC was next seen by Respondent on or about June 19, 2008. Her presenting diagnoses were noted as chronic depression and anxiety disorder, not otherwise specified. Respondent reported she was attending "DUI class". She had undergone cataract surgery since the prior visit, but was still having some vision difficulties. Respondent noted PCC was in good spirits, making jokes, and that she stated her sleep pattern and appetite were satisfactory. Her current medications were listed as Vytorin (cholesterol control), lisinopril, Flexeril (muscle relaxant), Pamelor, Klonopin, Relafen (NSAID), Tagamet, and several hormonal agents. Respondent performed a mental status examination on PCC and found she was doing very well. Her thought process was logical, and the content was appropriate. Her affect was normal, and she appeared well-groomed. Her GAF was higher than it had been the previous visit. Recent lab work had all been returned as normal, except that blood was found in PCC's stool. Consequently, she had been scheduled to undergo a sigmoidoscopy and colonoscopy. Respondent made no medication changes, and advised PCC to return in September of 2008, for medication evaluation.

12. PCC next presented to Respondent on or about September 19, 2008. At that time, PCC reported that her medical problems were having a negative impact on her psychological well-being. She stated that her lungs "were bad", she had two bulging disks, and she was having difficulty sleeping. She also complained that she was having intermittent panic attacks. Since PCC's last visit with Respondent, Vicodin (narcotic analgesic) had been added to her list of medications. Respondent performed a mental status examination on PCC, which was within normal limits, aside from a dysphoric mood that Respondent attributed to the patient's health concerns. Respondent's treatment plan was to add Prozac to PCC' s medication regimen, and to have her return three months later for further evaluation.

13. PCC returned to Respondent's office on or about January 27, 2009. She had turned 72 years of age since her prior appointment. PCC reported she was doing well at that time. She denied any problems with sleep, appetite, energy, mood, depression, or anxiety. New medications she was taking since her last visit with Respondent included OxyContin (narcotic 4 analgesic) and Neurontin. Based on her assessment of PCC, Respondent felt she was doing quite well; significantly better since her last appointment. Respondent made no medication changes, and her plan was to have PCC return in three months for continuing psychiatric evaluation.

14. On or about the morning of February 25, 2009, PCC presented to the Kaiser Psychiatry Department on an emergent basis. She complained of racing thoughts, an inability to concentrate, and reported feeling at possible risk for hurting herself and/or others. She was initially evaluated by Jan Moore, R.N., and was then seen by Respondent. PCC told Respondent she was having difficulty getting along with her sister, had been irritable, and that her mind would not "shut-up". A mental status examination performed by Respondent indicated PCC was hyperkinetic, paranoid, delusional, and was experiencing both visual and auditory hallucinations. Respondent did not feel PCC was a danger to herself or others. According to the medication list, PCC was no longer taking OxyContin at that time. Respondent diagnosed PCC as having bipolar disorder. Her plan was to continue PCC on Klonopin and Pamelor, and to start her on Seroquel (antipsychotic). Respondent also referred PCC to attend a bipolar class, a depression class, and to see an individual psychotherapist. PCC was instructed to return to Respondent's office the next week for follow-up.

15. PCC did not return to Respondent's office until March 18, 2009. PCC reported that since her last contact with Respondent she had moved into an assisted living facility called Casa de Sol. She was accompanied to her appointment with Respondent by an attendant from the facility. Respondent noted that PCC's speech was rambling in nature, but that she "makes sense." PCC stated she was having problems with sleep, appetite, energy, and irritability. PCC had been hospitalized since her last office visit with Respondent for reasons not specified in Respondent's progress note. Respondent performed a mental status examination on PCC and noted she was hyperverbal, hypomanic, and demonstrated tangential and paranoid ideation. Nonetheless, PCC was appropriately groomed, and was pleasant and cooperative. Respondent's treatment plan included increasing PCC's Seroquel dosage, and continuing her on Pamelor and Klonopin. Respondent also changed the form of the Depakote (anti-manic) PCC had been prescribed since her last visit. Respondent did not order any lab work at that time, but requested PCC to return for follow-up in two weeks.

16. PCC returned for follow-up with Respondent on or about April l, 2009, and was accompanied by an attendant from Casa del Sol. PCC told Respondent she was not feeling "together" that day. The attendant reported that PCC had been "slurry" and leaning to one side at some point, and had been advised to follow-up with her primary care physician. The attendant also stated PCC had been hallucinating intermittently. A mental status examination conducted by Respondent revealed PCC was experiencing paranoia, delusions, and hallucinations. Respondent felt that, overall, PCC was doing better than she had been at the previous appointment. Her diagnosis for PCC was bipolar disorder with psychotic features. Respondent decreased PCC's Seroquel dosage, and kept her on Pamelor, Klonopin, and Depakote. She ordered a Depakote blood level, and requested PCC to return two weeks later.

17. Respondent last saw PCC as a patient on or about Apri1 21, 2009. At that time, PCC reported she did not feel she was doing very well, and was having trouble sleeping. Hallucinations were still present. On examination, Respondent felt PCC's affect was improved, but she noted PCC was still suffering from paranoid ideation, delusions, and hallucinations. But, PCC was pleasant, oriented x3, and was less manic than before. Respondent's increased PCC's Seroquel and Depakote dosages, and kept her on Pamelor and Klonopin. Respondent ordered a Depakote level to be taken two weeks later, but did not document the results of the prior Depakote level. She requested PCC to return in one month for continuing assessment.

18. PCC's psychiatric care was thereafter transferred to Mindy Rothbard, M.D., ("Dr. Rothbard"), who first saw PCC as a patient on or about June 11, 2009. PCC was accompanied by her younger sister who held power of attorney for PCC's medical decisions. At the time Dr. Rothbard first saw PCC, she was delusional, and unable to communicate a coherent history. Consequently, her sister provided a patient history. Dr. Rothbard documented a thorough patient history and evaluation. Dr. Rothbard immediately made significant changes to PCC's medication regimen, ordered laboratory studies, and initiated steps to coordinate care with PCC's primary care physician.

19. Respondent's care and treatment of PCC was grossly neglige.nt in the following two respects: 1) Respondent failed to assess the etiology of PCC' s new-onset psychosis; and, 2) Respondent failed to properly manage PCC's medications and failed to appropriately consider drug interactions.

20. PCC presented to Respondent on or about February 25, 2009, exhibiting psychotic signs and symptoms for the first time while under Respondent's care. PCC had been Respondent's patient for almost a full year by that point, and had only sought treatment for depression and anxiety. When the new-onset psychosis emerged, the standard of care required that Respondent initiate an investigation as to the etiology of the psychosis. There is no indication from the progress notes that Respondent made any efforts to determine why a patient who had a history of depression and anxiety, had a sudden onset of psychosis at age 72. Respondent did not document any consideration of the anticholinergic effects of the numerous medications PCC was taking, or make any effort to coordinate care with PCC's primary care physician. Respondent's treatment plan consisted of an effort to treat the psychosis in a vacuum, without any regard to the totality of factors at play. Respondent's failure to adequately assess PCC' s psychosis represents an extreme departure from the ordinary standard of conduct required of a physician in caring for a patient.

21. Throughout the time Respondent cared for PCC, she was on a variety of medications; some prescribed by Respondent, some prescribed by other physicians. It is critical that physicians assess potential drug interactions in their patients, especially among the elderly, and that physicians coordinate care to ensure patient safety. Respondent failed to assess the potential interactions of the myriad drugs PCC was taking while she was under Respondent's care. Even when PCC developed new-onset psychoses, Respondent failed to adequately consider the role drug interactions may have been playing in PCC's mental status. For example, Pamelor is a substrate of cytochrome P450 2D6, and ifP450 206 is not properly metabolized, its anticholinergic side-effects can be toxic, particularly in elderly persons. On or about September 19, 2008, Respondent added Prozac to PCC's medication regimen. Prozac is a potent inhibitor cytochrome P450 2D6 metabolism, and its presence can cause up to a six-fold increase in Pamelor blood levels. Vicodin and OxyContin are substrates of cytochrome P450 2D6, and the presence of other substrates and metabolic inhibitors can adversely impact the biochemical processing of those medications. At the time Respondent saw PCC as a patient on or about January 27, 2009, Prozac, Vicodin, and OxyContin had been added to her pre~existing medications, which included Pamelor. Less than one month later, PCC suffered a psychotic break. Yet, on or about February 25, 2009, when PCC first presented to Respondent with psychotic signs and symptoms, Respondent did not consider drug interactions, or any other factors, in PCC's development of psychotic ideation. She simply attempted to treat the psychosis by prescribing Seroquel. Another example of Respondent's failure to properly manage PCC's medication regimen is the fact that she never communicated with PCC's primary care physician to coordinate car, and to ensure that PCC did not experience negative drug interactions. Respondent's failure to appropriately manage PCC's medications represents an extreme departure from the ordinary standard of conduct required of a physician in caring for a patient.

Patient CAM559

22. Patient CAM559 ("CAM") was an 88 year~old female patient who first presented to Respondent on or about March 30, 2009, on referral by her primary care physician secondary to problems with sleep. At the time of her initial presentation, CAM was under urological care for incontinence, and under a cardiologist's care for congestive heart failure. CAM was accompanied to the appointment by her niece. By history, CAM had been living in an assisted living retirement community in Stockton. When she could no longer afford to live there, though, she moved in with her niece. At some point, CAM was taken to Dameron Hospital with a chief complaint of chest pains. After she was released from the hospital, she went to stay at Meadowood Health and Rehabilitation Center in Stockton. While there, she made a suicidal attempt/gesture by wrapping a cord around her neck. Consequently, she was sent to the psychiatric ward at Dameron Hospital for evaluation, and was later released. Her in~patient hospitalization occurred earlier that month. CAM told Respondent she was depressed, and that she was worried about her living situation and limited financial resources. However, she denied that she would ever really commit suicide because of her religious beliefs. Aside from noting some recent history information as described above, Respondent did not conduct anything approaching a thorough patient history on CAM.

23. Respondent noted that during her initial patient visit with CAM, she complained about anxiety, depression, sleep problems, psychomotor retardation, hallucinations, delusions, paranoia, and recurrent thoughts of death. CAM was on a number of medications at the time she presented to Respondent, including antibiotics, Vicodin, blood pressure medication, thyroid medication, and imipramine. (Imipramine treats depression and enuresis.) Respondent performed a mental status examination on CAM, which she documented as being well within normal limits. Respondent determined that CAM was not a suicide risk at that time, and she contracted with CAM to not hurt herself. After her evaluation, Respondent added Remeron (antidepressant) to CAM's medication regimen, recommended psychotherapy, and asked CAM to return in two weeks for further assessment. She did not order any laboratory work.

24. Respondent was grossly negligent in her care and treatment of CAM on or about March 30, 2009, because she failed to adequately assess the patient's psychosis in relation to her overall medical status. When CAM first presented to Respondent, Respondent learned that CAM had a history of psychosis, and that she had recently made an attempt at suicide, (Whether the attempt may properly be called a "gesture" is of no moment.) She also learned that CAM was on imipramine, which is an anticholinergic. Thus, imipramine is prescribed with caution to the elderly, and with extreme caution to elderly persons who are psychotic. Despite the foregoing, Respondent did not take a thorough patient history, failed to consider the etiology of CAM's psychosis, and failed to assess the potential drugs and/or drug interactions which may have been affecting both CAM's physical and psychological well-being. Respondent then prescribed Remeron, which is an antihistaminic medication, without any apparent regard to CAM's underlying psychosis, and without any plan for a neurological and/or metabolic analysis. Respondent ignored CAM's psychosis and gave her a highly antihistarninic agent in addition to imipramine, which is also a highly antihistaminic and an anticholinergic, which together can adversely affect mental status in an 88 year-old psychotic patient. Respondent's failure to adequately assess CAM's psychosis in relation to her overall medical status represents an extreme departure from the ordinary standard of conduct required of a physician in caring for a patient.

SECOND CAUSE FOR DISCIPLINE
(Repeated Negligent Acts)
[B&P Code Section 2234(c)]

25. Respondent's license is subject to disciplinary action under section 2234(c) in that she is guilty of repeated negligent acts relative to her care and treatment of four separate patients. The facts constituting the negligence are set forth, infra.

Patient PCC218

26. Complainant hereby incorporates paragraphs 11-18 of the instant Accusation as though fully set forth herein.

27. When she first presented to Respondent on or about March 6, 2008, PCC reported that she had been recently convicted of driving under the influence of alcohol, but that she had been sober since June of 2007. Despite that knowledge, Respondent never assessed PCC for alcoholism at any time while PCC was under her care. When PCC developed a sudden-onset psychosis, Respondent never considered the potential role of alcohol; either secondary to acute use, or the interaction of alcohol with the many drugs she was taking which could adversely affect her mental status. Respondent also failed to assess PCC's issues with alcohol despite keeping her on Klonopin, and when she became aware that PCC had been prescribed Vicodin and OxyContin in addition to her Klonopin, she did not consider the combination of medications and how they would affect mental status as well as the possibility of the effect of adding alcohol to the interaction. Respondent appears to have simply accepted PCC's representation that she had quit drinking at the visit of June 19, 2008, and never reassessed whether it was still the case that she was not drinking when she presented with psychosis in February of 2009. When she was "slurry" and leaning to one side, Respondent's failure to assess the use of substances of abuse including alcohol, her pain medications and Klonopin led her to reduce her antipsychotic medication, rather than to address the other sedative agents PCC was taking. Respondent's failure to adequately assess and manage PCC for substance abuse issues constitutes a departure from the applicable standard of care relative to Respondent's care and treatment of patient PCC.

Patient CAM559

28. Complainant hereby incorporates paragraphs 23-24 of the instant Accusation as though fully set forth herein.

29. As noted, supra, CAM presented to Respondent on or about March 30, 2009, with a history of psychosis, congestive heart failure, and enuresis. C A M was taking a host of prescribed medications at the time with a variety of indications. Nonetheless, Respondent failed to obtain an adequate medical history; not even documenting CAM's congestive heart failure. Respondent charted no effort to determine the drug interactions which may have been contributing to CAM's psychosis, or whether adding another antihistaminic medication (Remeron) was appropriate for the patient. Respondent simply addressed CAM's sleep disorder in complete isolation, and without regard to the totality of her clinical picture. Respondent's failure to take an adequate patient history, particularly in an 88 year-old patient with serious known co-morbidities, constitutes a departure from the applicable standard of care relative to Respondent's care and treatment of patient CAM.

Patient TEB457

30. Patient TEB457 ("TEB") was a 47 year-old female patient with a complex medical history, which included post-traumatic stress disorder ("PTSD"), atrial fibrillation, hypothyroidism, hypertension, alcohol abuse, and anticoagulation monitoring when she was first seen by Dr. Bodepudi on or about January 28, 2009. TEB's PTSD stemmed from being robbed at gun point in June of2007, while working as a bank teller. TEB's psychiatric history was positive for having attempted suicide three times, and for several psychiatric hospitalizations. During her initial visit with Respondent, TEB complained of anxiety, depression, insomnia, and recurrent thoughts of death. Her current medication list included anti-psychotic, anti-depressant, and pain medication. TEB reported she was on disability from work due to a wrist injury, and that she was seeing Respondent for medications. Respondent did not document a psychosocial history, and did not document TEB 's history with respect to alcohol abuse. She simply noted that TEB denied any current substance abuse problems. Respondent continued TEB's antipsychotic and antidepressant medications. (It is unclear from the record as to when TEB was to return for follow-up.)

31. Respondent next saw TEB as a patient on or about March 30, 2009. TEB reported that, since her last office visit, she had moved and had temporarily lived alone. She did not like living by herself, and had twice called the police because she thought she had seen shadows. There is no indication Respondent followed-up on TEB's reports regarding "seeing shadows", and there is no indication that the issue of substance abuse was addressed during this visit. In addition to having called the police on two occasions, Respondent also indicated that she felt "antsy" and uncomfortable in crowds. Nonetheless, Respondent determined that TEB was stable and doing well. She continued her medications, and instructed her to return in three months.

32. On or about April 27, 2009, TEB's daughter called Kaiser and spoke with a nurse in the Mental Health Department. She reported that her mother had been "drinking all the time", and that she refused to come out of her house. She stated her mother was convinced there was a man outside her house and had called the police. The police responded, but did not see anybody. The nurse discussed emergency protocol with TEB 's daughter, and advised her to call back if her mother's condition worsened.

33. TEB saw a different Kaiser psychiatrist, Alice Park, M.D., ("Dr. Park"), on or about August 24, 2009. Dr. Park documented the problems TEB was having with alcohol abuse, and TEB acknowledged she should not be drinking while on psychiatric medications. It does not appear from the records that Respondent saw TEB as a patient again after she was seen by Dr. Park.

34. TEB was a medically complex patient, with a history of alcohol abuse, and a significant psychiatric history, including three suicide attempts. Yet, Respondent failed to take an adequate medical history during either office visit she had with TEB. Respondent also failed to address TEB's substance abuse issues in any manner, even after TEB reported she had been seeing "shadows", and talked about being "antsy" and uncomfortable in crowds. As demonstrated by the call to Kaiser placed by TEB's daughter on or about April 27, 2009, substance abuse was an on-going problem for TEB. Despite numerous warning signs, Respondent took no steps to assess or manage the issue. Respondent's failure to ever obtain an adequate medical history, and her failure to ever assess or manage TEE's substance abuse issues constitutes a departure from the applicable standard of care relative to Respondent's care and treatment of patient TEB.

Patient DLJ170

35. Patient DLJ170 ("DLJ") was a 30 year-old male patient who was concerned that he may have been suffering from undiagnosed bipolar disorder when he initially presented to Respondent for evaluation on or about October 23, 2008. During his initial appointment with Respondent, he revealed that he had been having "issues" all his life, and that his previous doctor thought he might be bipolar. DLJ expressed problems with excessive worry, hypervigilence, depression, finances, insomnia, and alcohol abuse. He reported past manic episodes consisting of elevated mood, grandiose feelings, and increased energy, but stated he was in a depressive cycle at that time. He indicated that he consumed "1-2 beers", and used marijuana on a daily basis. DLJ's prescription medications included an antihistamine/narcotic cough suppressant, ibuprofen(600 mg.), Flexeril, and Celexa (antidepressant). Respondent did not document a medical history. She performed a mental status examination, and noted DLJ was "overweight and slender." Aside from depressed mood, DLJ's mental status examination was documented as being within normal limits. Respondent decided to initiate treatment with lithium, which is frequently prescribed to treat bipolar disorder. She ordered pre-lithium lab work, and an electrocardiogram, and she indicated DLJ should return in four weeks for assessment. Respondent did not document discussing with the patient any possible consequences of using lithium in conjunction with ibuprofen, alcohol, and/or marijuana.

36. DLJ failed to show for his November 20, 2008, appointment. He did not see Respondent again until January 20, 2009. At that visit, DLJ reported that he was doing much better, and that his family had noticed a "wonderful change" in him. By the time DLJ saw Respondent the second time, naproxen had been added to his medication regimen. Like ibuprofen, naproxen is a non-steroidal anti-inflammatory drug (NSAID). Respondent again failed to obtain a medical history from DLJ, and she did not document the results of any prior lithium levels. Her progress notes from that day make no mention at all with respect to DLJ's alcohol consumption or cannabis use. And again, there is no documented discussion between Respondent and DLJ regarding the use of lithium with NSAIDs, alcohol, and/or marijuana. Respondent made no medication changes, ordered a lithium level, and advised DLJ to return in three months.

37. Respondent saw DLJ as a patient for the third and final time on or about March 23, 2009. At that time, DLJ reported he was not doing as well as at the time of his prior visit. He reported problems with anxiety and acute sadness, with some associated crying spells. He stated that he felt "down" most of the time. His medications had not changed since his last office visit with Respondent. DLJ requested Respondent to fill-out Family Medical Leave Act ("FMLA") forms on his behalf, as he was apparently having difficulty maintaining his employment. Once again, Respondent did not obtain a medical history, did not document the results of any lithium levels, and did not document any discussions with DLJ regarding his alcohol and marijuana use. Respondent's plan was to obtain a lithium level, and increase DLJ's lithium dosage in accordance with the laboratory values. She also added Wellbutrin (antidepressant) to DLJ's medications, and recommended follow-up one month later.

38. Roger Siouffey, M.D., ("Dr. Siouffey") assumed DLJ's psychiatric care and treatment from Respondent, and first saw DLJ as a patient on or about August 6, 2009. At that time DLJ reported that the lithium had not helped him, and that he had not taken the medication "for months."

39. When DLJ first presented to Respondent on or about October 23, 2008, he was already on psychotropic medication. Despite that fact, Respondent did not document any history involving DLJ's current or prior use of psychotropic medications, or any other relevant medical history. Respondent's failure to document DLJ's past medical history, particular as it related to the use of psychotropic medications constitutes a departure from the applicable standard of care relative to Respondent S care and treatment of patient DLJ.

40. When DLJ first presented to Respondent on or about October 23, 2008, he reported daily cannabis and alcohol use. The use of cannabis has an effect on the course of bipolar disorder, and yet Respondent did not document any discussion with DLJ regarding the impact of cannabis use on bipolar disorder, and she did not document substance abuse. Further, the use of alcohol, particularly beer, can have a deleterious impact on the effectiveness of lithium in a bipolar patient. Respondent documented no discussions with DLJ relative to the negative impact his daily consumption of beer could have on the effectiveness of taking lithium for his bipolar disorder. Respondent's failure to counsel DLJ regarding his cannabis use, basically ignoring the issue, and her failure to discuss the negative consequences of combining alcohol and lithium with DLJ constitute a departure from the applicable standard of care relative to Respondent's care and treatment of patient DLJ.

41. When Respondent first presented to Respondent on or about October 23, 2008, his medication list included ibuprofen, which is an NSAID. During the course of DLJ's treatment with Respondent, a second NSAID, naproxen, was added to DLJ's medication regimen. NSAIDs can raise lithium levels. The therapeutic range for lithium is very narrow, and lithium can be toxic if blood levels exceed the therapeutic range. There is no indication from the patient record that Respondent ever talked to DLJ about his use of NSAIDs. She did not determine the frequency or the dosage of his NSAID use. Had he been taking NSAID medications frequently and in high dosages, the standard of care would require Respondent to begin lithium at a lower than usual starting dose, and to check DLJ's blood levels after 5-7 days. Even if Respondent determined DLJ was not using NSAIDs at high level, he clearly had a history of significant NSAID use, and needed to be advised that if his use of NSAIDs were to increase, it would be imperative for him to request a lithium level. Similar to DLJ's cannabis use, Respondent ignored DLJ's NSAID use relative to her treatment plan. Respondent's failure to obtain a history regarding DLJ's current and past NSAID use, her failure to consider his NSAID use in establishing his starting dose of lithium, her failure to assess DLJ's lithium level in a standard timeframe, and her failure to warn DLJ about the potential impact of NSAIDs on lithium levels constitute a departure from the applicable standard of care relative to Respondent's care and treatment of patient DLJ.

42. When Respondent saw DLJ as a patient for the third and final time on or about March 23, 2009, he reported an increase in his depressed mood, and that he was feeling "down" most of the time. Without assessing the dose of the antidepressant DLJ was already taking, and without assessing whether his lithium level was maximized, Respondent started DLJ on a second antidepressant medication (Wellbutrin). At that time, Respondent was on a very low dose of Celexa (1 0 mg.), and there is no indication that Respondent considered raising the dose of the Celexa, which DLJ was already tolerating, rather than adding a second antidepressant. She did not investigate whether DLJ had been on a higher dosage of Celexa in the past, and if so, if it had been beneficial. She also failed to ensure that DLJ had reached an optimum therapeutic level before initiating treatment with the Wellbutrin. Respondent's addition of a second antidepressant to DLJ's medication regimen without first exploring the efficacy of raising his Celexa dosage, and without first assessing his lithium level, constitutes a departure from the applicable standard of care relative to Respondent's care and treatment of patient DLJ.

43. In sum, Respondent's actions as described, supra, constitute repeated negligent acts within the meaning of section 2234(c) relative to her care and treatment of patients PCC, CAM, TEB, and DLJ, respectively, as follows:

a. Respondent failed to adequately assess and manage patient PCC for substance abuse issues.

b. Respondent failed to obtain an adequate patient history from patient CAM when patient CAM initially presented to Respondent on or about March 30, 2009, particularly in view of CAM's advanced age (88), and significant health issues.

c. Respondent failed to obtain an adequate medical history from patient TEB, who was a medically complex patient, and failed to assess and/or manage TEB's substance abuse issues.

d. Respondent failed to obtain an adequate medical history from DLJ when he first presented to her for care and treatment on or about October 23, 2008, particularly as he was seeking treatment for suspected bipolar disorder, and was already on a low dose of the psychotropic medication Celexa.

e. When Respondent prescribed lithium to patient DLJ to treat presumed bipolar disorder, she failed to counsel him regarding his cannabis use, basically ignoring the issue, and she failed to advise DLJ regarding the negative consequences of combining alcohol and lithium.

f. Respondent failed to consider DLJ's NSAID use in establishing his starting dose of lithium, she failed to assess DLJ's lithium level in a standard timeframe given his NSAID use, and failed to warn DLJ about the potential impact of NSAIDS on lithium levels.

g. Respondent added a second antidepressant to DLJ's medication regimen without first exploring the efficacy of raising his Celexa dosage, and without first assessing his lithium level.

Excerpt from Cease Practice Order dated 11/15/2019:

CEASE PRACTICE ORDER

In the Medical Board of California (Board) Case No. 800-2015-012722, the Board issued a Decision adopting a Stipulated Settlement and Disciplinary Order, which became effective August 25, 2016. In the Board's Order, Physician's and Surgeon's License No. A 73676, issued to Arudra Bodepudi, M.D., was revoked, revocation stayed and Respondent was placed on 35 months' probation.

Probationary Condition No. 3 - requires Respondent, within 30 calendar days of the effective date of the Decision, to submit to the Board or its designee for prior approval as a billing monitor(s), the name and qualifications of a billing service who will monitor Respondent's billing or one or more licensed physicians and surgeons whose licenses are valid and in good standing, and who are preferably American Board of Medical Specialties (ABMS). A monitor shall have no prior or current business or personal relationship with Respondent, or other relationship that could reasonably be expected to compromise the ability of the monitor to render fair and unbiased reports to the Board, including but not limited to any form of bartering, shall be in Respondent's field of practice, and must agree to serve as Respondent's monitor. Respondent shall pay all monitoring costs.

Within 60 calendar days of the effective date of the Decision, and cont.inuing throughout probation, Respondent's billing shall be monitored by the approved monitor. Respondent shall make all records available for immediate inspection and copying on the premises by the monitor at all times during business hours and shall retain the records for the entire term of probation.

If the Respondent fails to obtain approval of a monitor within 60 calendar days of the effective date of e Decision, Respondent shall receive notification from the Board or its designee to cease the practice of medicine within three (3) calendar days after being so notified. Respondent shall cease the practice of medicine until a monitor is approved to provide monitOring responsibility.

In lieu of a monitor, Respondent may participate in a professional enhancement program equivalent to the one offered by the Physician Assessment and Clinical Education Program at the University of California, San Diego School of Medicine, that includes, at minimum, quarterly chart review, semi-annual practice assessment, and semi-annual review of professional growth and education. Respondent shall participate in the professional enhancement program at Respondent's expense during the term of probation.

The Respondent has failed to obey Probationary Condition No. 3 as ordered in the above Decision, by failing to complete the Physician Enhancement Program (PEP) at the University of California, San Diego School of Medicine, and/or by failing to obtain an approved practice monitor within 60 days. Accordingly, Respondent, Arudra Bodepudi, M.D., is prohibited from engaging in the practice of medicine. The Respondent shall not resume the practice of medicine until a monitor is approved to provide monitoring responsibility.

#35 months

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Infractions are pulled from the "Board's" disciplinary documents themselves and/or news articles. Sometimes the categories and the categories here don't match the Board's exactly, so make sure you look up the infractions in the actual Medical Board documents.

Note: Accusations mean that a doctor has not had a hearing or been found guilty of any charges, but are being investigated by the Medical Board and/or the California Attorney General's Office.

**The California Medical Association (CMA) is a union of sorts for doctors in California. They have a lot of political power and donate a lot of money to the state's legislators in return for their "support." They appear to have a lot of "sway" over the Medical Board's members. One would think that most doctors would be members of the CMA with the amount of power they wield, but in actuality, 2/3 of this state's doctors refuse to join the CMA...which means that the majority of doctors in the state, choose to NOT be members.

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