Doctor's Name

SAINT LOUIS UNIVERSITY SCHOOL OF MEDICINE

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Cross Reference: Julian Omidi, Mirali Zarrabi

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Wikipedia Page

Brother of Dr. Julian Omidi, partners in 1-800-GET-THIN

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• 8/22/2016—PUBLIC LETTER OF REPRIMAND.
• 7/08/2015—SECOND AMENDED ACCUSATION FILED.
• 5/14/2015—FIRST AMENDED ACCUSATION FILED.
• 4/23/2013—ACCUSATION FILED.
  • 6/14/2012—FLORIDA BOARD ISSUED A LETTER OF CONCERN AND ASSESSED A FINE. BASED ON ACTION TAKEN BY THE MEDICAL BOARD OF CALIFORNIA.
• 10/03/2011—PROBATION COMPLETED.
  • 9/08/2009—FLORIDA BOARD ISSUED DR. OMIDI A LETTER OF CONCERN AND PLACED HIM ON ONE YEAR PROBATION WITH RESTRICTIONS BASED ON ACTION TAKEN BY THE MEDICAL BOARD OF CALIFORNIA.
• 9/04/2008—PLACED ON THREE YEARS PROBATION WITH TERMS AND CONDITIONS.
• 5/15/2007—ACCUSATION FILED.

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Excerpt from Decision dated 8/22/2016:

DISCIPLINARY ORDER

15. IT IS HEREBY ORDERED that upon completion of the following course work, Physician's and Surgeon's Certificate No. A 84519 issued to Respondent Michael Omidi, M.D. will be publicly reprimanded pursuant to California Business and Professions Code section 2227, subdivision (a)(4). This public reprimand, which is issued in connection with Respondent's care and treatment of Patients G.B. and R.D. as set forth in the Second Amended Accusation No. 05-2012-223866 is as follows:

You failed to maintain adequate and accurate medical records in violation of Business and Professions Code section 2266, as more fully described in the·Second Amended Accusation No. 05-2012-223866.

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Excerpt from Accusation dated 7/08/2015:

FIRST CAUSE FOR DISCIPLINE
(Repeated Negligent Acts - Patient G.B. and Patient R.D.)

7. Respondent is subject to disciplinary action under section 2234 subdivision (c) of the Code, in that he was negligent in the care and treatment of patients G.B. and R.D. The circumstances are as follows:

Patient G.B.

8. G.B., an adult female patient, was attracted to the plastic surgery practice of Respondent as a result of paid advertising. She met with Respondent on February 20, 2007. He diagnosed her with capsular contracture of both breasts.

9. They decided to proceed with surgery consisting of removal of the ruptured silicone gel implants that G~B. had from prior surgery and the capsule around the old breast implants that was responsible for G.B.'s discomfort would be removed. New breast implants would also be placed.

10. Surgery was performed on February 28, 2008. To G.B.'s distress, she suffered a recurrence of capsular contracture shortly after her operation. Following her surgery, she was seen for a follow-up visit the next day, February 29, 2008, and approximately two weeks later on March 4, 2008, when she had the surgical drains removed. However, her medical chart contains no reference to any additional follow-up visits for two years, until March 10, 2010. Neither is there any record of Respondent's office attempting to contact G.B. for follow-up or missed follow-up appointments.

11. On April 3, 2010, Respondent diagnosed G.B. with a recurrence of capsular contracture for which revision surgery was proposed.

12. It is the standard of care to be available to meet and re-examine the postoperative patient as frequently as needed or to provide alternative medical coverage. The care of the patient with capsular contracture continues beyond the operative room, and especially for one who has had a recurrence. Respondent was unavailable for the postoperative care of G.B. from a week after the February 28, 2008 surgery until March 2010, two years later. Respondent's failure to properly follow up with G.B., or to make arrangements for another physician to do so, is a departure from the standard of care.

13. It is the standard of care to keep and maintain complete medical records on all patients who have received medical services. Preoperative records should include proof of informed consent and an explanation of a patient's choices. G.B.'s preoperative records do not show that Respondent informed her about the high probability of a postoperative recurrence of capsular contracture. G.B. 's preoperative records also do not show that she gave informed consent about the high probability of a postoperative recurrence of capsular contracture.

Patient R.D.

14. On or about January 28, 2010, R.D., an adult female patient, visited the practice of Respondent to inquire about the lap band procedure in order to reduce her weight. Patient R.D. was encouraged to have breast reduction surgery instead of bariatric surgery.

15. On April 22, 2010, R.D. underwent a reduction mammaplasty and suction assisted lipectomy of her breasts bilaterally, performed by Respondent. She had a large volume of material removed and suffered a right nipple-areolar loss with loss of sensation and asymmetry requiring re-operation.

16. R.D. remained a patient of the practice of Respondent and participated in preparations to undergo bariatric surgery. As part of those preparations, she was instructed to undergo a sleep apnea study, endoscopy, and ultrasound. On or about February 2011, she was told by Respondent's staff that she "qualified for a C-PAP (continuous positive airway pressure) machine." The C-PAP machine is designed to help patients with documented obstructive sleep apnea to increase inflow of air while they sleep. It is designed specifically for patients with a documented diagnosis of obstructive sleep apnea. R.D. never had any complaints or diagnoses of obstructive sleep apnea.

17. The standard of care is to do all those medical actions that are medically necessary to ensure the successful and safe outcome ofthe procedure in a humane and ethical manner. Accordingly, any preoperative testing that may contribute to improved patient safety during the operative procedure is certainly within the standard of care. However, offering the patient inaccurate or misleading information about their health status - in this case, that she had the condition of obstructive sleep apnea—is a departure from the standard of care.

18. R.D.'s medical chart is devoid of the sleep apnea test results for which Respondent referred her.

19. Respondent's acts and/or omissions as set forth in paragraphs 8 through 19, inclusive above, whether proven individually, jointly, or in any combination therefore, constitute repeated. negligent acts pursuant to section 2234, subdivision (c) of the Code. Therefore, cause for discipline exists.

SECOND CAUSE FOR DISCIPLINE
(Failure to Maintain Adequate and Accurate Records -Patients G.B. and R.D.)

20. By reason ofthe facts set forth above in the First Cause for Discipline, Respondent is subject to disciplinary action under Business and Professions Code section 2266 for failure to maintain adequate and accurate medical records.

DISCIPLINE CONSIDERATIONS

21. To determine the degree of discipline, if any, to be imposed on Respondent, Complainant alleges that on October 3, 2008, in a prior disciplinary action entitled, In the Matter ofthe Accusation Against Michael Omidi, MD., Medical Board of California Case No. 05-2005-170875, Respondent's license was revoked, with the revocation stayed and three (3) years of probation imposed together with other requirements, including completing an ethics course, for violating Business and Professions Code section 2216 (restrictions on use of anesthesia) and Health and Safety Code section 1248.1, subdivision (g) (operation and maintenance of outpatient setting; restrictions) with respect to the surgeries that he performed on three patients. That decision is now final and is incorporated by reference as if fully set forth.

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Excerpt from Accusation dated 5/15/2007:

PRELIMINARY STATEMENT

27. The care and treatment of the patients named in this 'Accusation was rendered by persons employed by Respondent including Tammi Isaacs RN ("RN Isaacs"), Michelle Pollock RN ("RN Pollock"), Elizabeth Wong CRNA ("CRNA Wong"), Natalie Ngapirin ("PA Ngapirin"), medical assistant Michelle McLean ("McLean"), medical assistant Matthew Sheets ("Sheets"), medical assistant Cindy Sandoval ("Sandoval"), Nurse Practitioner Furnisher Richard Staggs ("NPF Staggs"), and/or Respondent at his clinic Pacific West Plastic Surgery, Dermatology, and Laser Center, also known as the Woodlake Ambulatory Surgery Center, located at 7320 Woodlake Avenue, Suite 320, West Hills, California 91307. These individuals also worked at Respondent's offices located at Pacific West Dermatology 18182 Highway 18, Suite 106, Apple Valley, California 92307, 465 North Roxbury Drive, Suite 1012, Beverly Hills, California 90210, and/or 44404 16th Street, Lancaster, California. Because these individuals were supervised by Respondent, their negligence is therefore imputed to Respondent pursuant to the Medical Practices Act, including Code section 3502, subdivision (f), and Title 16, California Code of Regulations, section 1399.656(g) [physicians assistants]; section 2052, subdivision (b)(2) [medical assistants], section 2069, subdivision (b), and 2836, subdivision·(f) [-nurses] and sectfon 2264 unlicensed persons and for persons exceeding -- the scope of their authority].

28. At all times relevant to this Accusation, the West Hills facility was not accredited pursuant to Business and Professions Code sections 2216, 2216.1 and Health and Safety Code sections 1248 and 1248.15.

1. Respondent co-owns this facility with his brother, Julian Omidi, M.D., who is the subject of Medical Board Accusation No. 17-2004-162146.

FIRST CAUSE FOR DISCIPLINE
(Grossly Negligent Acts)

29. Respondent is subject to disciplinary action under section 2234, subdivision (b), of the Code in that he committed grossly negligent acts in his care and treatment of patients Clinton J., Jennifer C. and Charlsetta R. The circumstances are as follows:

PATIENT CLINTON J.

30. Patient Clinton J., a 6'3," 27-year-old, 300 pound male, was first seen by Respondent on or around July 29, 2005 at Respondent's Apple Valley office for fifteen minutes.

31. On September 14,2005 Clinton J. went to the West Hills facility where he signed consents for liposuction and anesthesia. Respondent completed a history and physical exam of Clinton J. He did not complete an anesthesia plan. Respondent performed a liposuction of Clinton J. 's abdomen, flanks, thighs and chest at the West Hills facility, which was not accredited at that time. The surgery was taped for an episode of the television showDr. 90210. RN Pollock, CRNA Wong, PA Dooley and medical assistant McLean assisted Respondent.

32. The intra-operative anesthesia record records that a total of 300 mg of Fentanyl was administered. However, this drug is administered in micrograms.  Further, the post-operative narcotics disposition only accounts for "200" without referencing the relevant measuring units.

33. The intra-operative anesthesia record also notes that Clinton J.'s oxygen saturation was between 95 and 98% under controlled ventilation through an endotracheal tube.

34. The operative report lists Dr. Omidi as the surgeon, Elizabeth Wong as the anesthetist and Michael Dooley P.A. as the assistant. The patient was prepped standing then placed on the operating table where Wong induced the patient with general anesthesia. Liposuction was performed with the infusion of 4200cc tumescent solution and aspiration of 5900cc. There is no description of the composition of the tumescent solution used. Operating room and recovery records were completed and signed by Michelle Pollock RN who also functioned as a circulating nurse. Recovery room time was 2 hours with stable vital signs.

35. Once in the recovery area, Clinton J.'s oxygen saturation was a 94 and he is described as able to breathe deeply and cough freely, an inconsistency in patients with oxygen saturation of between 90 and 94.

36.Post operative visits were recorded on September 21, 2005 and October 10, 2005.

37. Dr. Omidi was grossly negligent in his care and treatment of Clinton

A. Due to Fentanyl's well-established reputation for abuse, dependency, and illicit diversion to the black or "street" market, this drug should be precisely accounted for. The intra-operative anesthesia record records a total of 300 milligrams of Fentanyl being administered to the patient (Fentanyl is administered in micrograms). However, the postoperative narcotics disposition record only accounts for "200" without any reference to units. Dr. Omidi 's failure to properly document the disposition of the remaining 100 micrograms of Fentanyl is an extreme departure from the standard of care.

B. Dr. Ormidi's failure to provide a date and time on his preoperative note is a simple departure in the standard of care.

C. Dr. Omidi's did not fill out an anesthesia plan for this patient, other than to describe in his undated and untimed preoperative report that "[...] Anesthesia service described the risks of sedation anesthesia and general anesthesia. Anesthesia plan was changed to general from sedation due to the patient's size and airway per discretion of the anesthesia service [...]." This is a simple departure.

D. Dr. Omidi 's use of general anesthesia on this patient with a loss of his life preserving reflexes at an unaccredited outpatient facility is an extreme departure from the standard of care

E. Dr. Omidi performance of the liposuction procedure on Clinton J. at an unaccredited facility is an extreme departure from the standard of care.

PATIENT JENNIFER C.

38. Patient Jennifer C., a 5' 7" 182 pound 26 year-old female, was first seen by Respondent in a consultation for a liposuction procedure on September 8, 2005. Consent forms for surgery were signed at that visit.

39. On September 8, 2005, NPF Staggs wrote a prescription for Jennifer C. for thirty Percocet (oxycodone). The prescription listed "Pacific West Dermatology 18182 HWY 18, Suite 106, Apple Valley, California 92307.'' There is no annotation in the medical record regarding this prescription.

40. On the morning of October 11, 2005, Dr. Omidi performed a liposuction procedure on Jennifer C.'s abdomen, back, flank, and inner and outer thighs at the West Hills Surgery Center, which was not accredited at the time. RN Isaacs assisted him.

41. Documents in the medical record reference Respondent's Lancaster facility but a line has been drawn through that and the West Hills facility written in.

42. A typed-operative report lists the surgery date as October 11, 2005 and the surgeon as Dr. Omidi but no assistants, operating staff or anesthetist/anesthesiologist. Sedation is listed as the anesthesia. The patient was prepped standing, placed on the operating table and then sedated with versed and Propofol. There is no record of IV placement regarding position, needle gauge or who placed it or any record of the sedation cocktail described above being given. A tumescent solution of unlisted composition was injected, total I900cc, and 2950cc aspirated.

43. Tammy Isaacs RN completed the pre-anesthesia history and physical, post-anesthesia evaluation, recovery room record and anesthesia record. The anesthesia plan lists the patient as an ASA I and the anesthesia provider as "Omidi."The anesthesia record lists anesthesia time as 1 hr 25 min and surgery time 1 hr 10 min. Initial medications are Listed as 40cc Dipravan, SOmg Benadryl, 2cc Glycopyrrolate, 2rng Versed, 2cc Ketamine; 1 Gm Ancef and 4 Mg Dexamethasone. An Additional 2mg Versed was given about 15 minutes later and 2cc Dipravan about 30 Minutes Later. No supplemental oxygen is listed. Vital signs are listed. The anesthesia record fails to note any charting for sinus rhythm (SR) and normal sinus rhythm (NSR) meaning that no EKG was applied intraoperatively. The anesthesia record is also vague and ambiguous by the improper use of an "x" to denote pulse rate, when it is used to denote arterial pressure (MAP), and the use of a"." to denote oxygenation, when it should be used to denote heart rate. The anesthesia record fails to include the totals for the Versed, Ketamine, and Propofol administered to this patient according to the operative report. Heart rate, blood pressure and oxygen saturation were stable throughout the procedure.

44. 50 mg of Demerol IM was given in recovery. There is no indication in the record who actually gave the patient these medications. In fact, a negative is listed under anesthesia provider. There is no description of the composition of the tumescent solution used. The patient also received 500 cc of normal saline IV during the course of surgery. Recovery room time is listed as 40 minutes with stable vital signs. There is a brief discharge summary completed by Omidi.

45: The patient was seen again on October 20, 2005 and that note was signed by Dr. Omidi. No other office visits or problems were recorded.

46. Dr. Omidi was grossly negligent in his care and treatment of Jennifer C. as follows:

A. Dr. Omidi' s failure to provide a total of the anesthetic agents administered for the case is a simple departure from the standard of care.

B. Dr. Omidi's failure to note in the operative report the fact that Ketamine was administered to the patient and his failure to note in the anesthesia record the total Versed and Propofol administered to the patient is an extreme departure from the standard of care. It is the standard of care that the medical record reflect the patient's anesthetic experience by the charting of both the drugs administered to the patient and the effect on the patient's vital signs.

C. Dr. Omidi's failure to monitor the patient with an EKG during conscious sedation indicates a lack of basic knowledge of this standard of care used by anesthesiologists and surgeons and as required by California Code of Regulations, section 1356.6, subdivision (b)(3)(D). Dr. Omidi 's failure to use an EKG intraoperatively, suggested by the failure to record sinus rhythm (SR) and Nonna) Sinus Rhythm (NSR), is an extreme departure from the standard of care.

D. Dr. Omidi's failure to have all personnel present in the operating room documented in the medical record is a simple departure from the standard of care.

E. Dr. Omidi's failure to use the standardized notations in the patient's anesthesia record for heart rate and pulse oxymeter data constitutes a simple departure from the standard of care. Minimal monitoring standards for sedation include EKG, blood pressure, and pulse oximeter. It is also standard to record the respiratory rate of the patient and whether or not the patient was breathing spontaneously, with assistance or by controlled ventilation.

F. Dr. Omidi's performance of the liposuction procedure on Jennifer C. at an unaccredited facility is an extreme departure from the standard of care.

G. Dr. Omidi's failure to document that Jennifer C. was prescribed oxycodone is a simple departure from the standard of care.

PATIENT CHARLSETTA R.

47. Patient Charlsetta R., a 5'4," 168 pound, 34-year-old female, was first seen by Respondent at his office in Apple Valley on or around July 21, 2005 for fifteen minutes.

48. Charlsetta R. returned to the office on July 28, 2005 and September 22, 2005. The note for July 28, 2005 lists "sedation."

49. On September 22, 2005, NPF Staggs wrote a prescription for Charlsetta R. for thirty Percocet (Oxycodone). The prescription listed "Pacific West Dermatology 18182 HWY 18, Suite 106, Apple Valley, California 92307." There is no annotation in the medical record regarding this prescription. The documents in the medical record have headings for medical offices in Lancaster and Beverly Hills facilities, however, a line was drawn through this heading and "Wood Lake Ambulatory Surgery Center" was written instead.

50. On the afternoon of October 11, 2005, Dr. Omidi performed a liposuction procedure on Charlsetta R. 's abdomen, flanks, back, and inner and outer thighs at the West Hills facility, which was not accredited at the time. RN Isaacs assisted him. The medical records for Charlsetta R., including the intra-operative reports, fails to list any other personnel present during the procedure. The consent for anesthesia signed by the patient lists "general anesthesia." The patient was also asked to sign preoperative instructions on the same day of her surgery.

51. An operative report only lists the surgeon as Dr. Omidi. Anesthesia is listed as "sedation." The patient was prepped standing, placed on the operating table and then sedated with Versed, Ketamine and Propofol. There is no record of IV placement regarding position; needle gauge or who placed it or any record of the sedation cocktail described above being given. The operative report however fails to reflect that Mereperidine (Demerol) was administered to the patient as reflected in the anesthesia record. A tumescent solution of unlisted composition was injected totaling l 900cc, and 2650cc were aspirated.

52. RN Isaacs completed thepreanesthesia history and physical, post-anesthesia evaluation, recovery room record and anesthesia. There is no ASA designation for this patient. The anesthesia record lists anesthesia time as 2 hours and 19 minutes; surgery time as 2 hours and 11 minutes. The is no ASA designation for the patient. Initial medications are listed as 40cc Dipravan, 50mg. Benadryl, 2cc Glycopyrrolate, 2mg. Versed, 2cc Ketamine and 4mg. Dexamethasone. The patient was placed on 2 liters NC oxygen. An additional 4cc, 2cc, 3cc and 2cc of Dipravan, 25 mg. Meperidine, 3mg. Versed, 50 mg. Ketamine, 19 mg Ancef and 5 mg. Labetolol were given during surgery. There is no documentation of Propofol being administered, as cited in the operative report. Vital signs are listed. The timing of vital signs recording is unclear because uneven values have apparently been given to the squares on the record. Heart rate, blood pressure and oxygen saturation were stable throughout the procedure. However, the anesthesia record fails to note any charting for sinus rhythm (SR) and normal sinus rhythm (NSR), which means that no EKG was applied intraoperatively. The anesthesia record is also vague and ambiguous by the improper use of an "x" to denote pulse rate, when it is used to denote arterial pressure. Likewise, the use of a"." to denote oxygenation when it is used to denote heart rate. The anesthesia record fails to includes the totals for the Versed, Ketamine, and Propofol administered to this patient, drugs which are referenced in the operative report. 50 mg. of Demerol IM was given in recovery. The anesthesia provider is listed as Dr. Omidi. There is no description of the composition of the tumescent solution used, other than a later citation to "lidocaine (with) ep. 1% 20 ml." The patient also received 500 cc of normal saline IV during the course of surgery. Recovery room time is listed as 45 minutes with stable vital signs. There is a brief discharge summary signed by Respondent.

53. The patient was seen again on October 20, 2005 and December 1, 2005. Dr. Omidi signed notes relating to these visits that listed both the Apple Valley and West Hills facilities.

54. Dr. Ornidi was grossly negligent in his care and treatment of Charlsetta R. as follows:

A. Dr. Omidi's failure to monitor the patient with an EKG during conscious sedation indicates a lack of basic knowledge of this standard of care used by anesthesiologists and surgeons and as required by California Code of Regulations, section 1356.6, subdivision (b)(3)(D). Dr. Omidi's failure to use an EKG intraoperatively, suggested by the failure to record sinus rhythm (SR) and Normal Sinus Rhythm (NSR), is an extreme departure from the standard of care.

B. Dr. Omidi 's failure to use the standardized notations in the patient's anesthesia record for heart rate and pulse oximeter data constitutes a simple departure from the standard of care. Minimal monitoring standards for sedation include EKG, blood pressure, and pulse oximeter. It is also standard to record the respiratory rate ofthe patient and whether or not the patient was breathing spontaneously, with assistance or by controlled ventilation.

C. Dr. Omidi's failure to note in the operative report the fact that Demerol was administered to the patient and his failure to note in the anesthesia record the total Versed, anesthetic experience.Ketamine, and Propofol administered to the patient is an extreme departure from the standard of care. It is the standard of care to chart the drugs administered to the patient and the effect on the vital signs to reflect the patient's

D. Dr. Omidi's use of Demerol in the patient is an extreme departure from the standard of care because its use in this case decreased the patient's life

preserving reflexes, thereby subjecting her to great risk. Demerol was administered to this patient intraoperatively and in the recovery room.

E. The administration of Propofol to the patient by~RN Isaacs who is a non-dedicated anesthesia provider is an extreme departure from the standard of care because it may result in deeper than intended levels of sedation and anesthesia and, consequently, needless risk for the patient.

F. Dr. Omidi's use of Labetolol during surgery without documentation of the patient's heart rate both before and after the administration of it is an extreme departure from the standard of care.

G. Dr. Omidi's failure to have all personnel present in the operating room documented in the medical reco~d is a simple departure from the standard of care.

H. Dr. Omidi 's failure to document that the patient was prescribed Oxycodone is a simple departure from the standard of care.

I. Dr. Omidi's performance of the liposuction at an unaccredited facility is an extreme departure from the standard of care.

SECOND CAUSE FOR DISCIPLINE
(Repeatedly Negligent Acts)

55. By reason of the matters alleged in paragraphs 27 through 54 above, Respondent is subject to disciplinary action under section 2234, subdivision (c), of the Business and Professions Code in that in his care of patients Clinton J., Charlsetta R. and Jennifer C., he committed acts and omissions constituting repeatedly negligent acts.

THIRD CAUSE FOR DISCIPLINE
(Failure to Supervise Physician Assistants)

56. Respondent is subject to disciplinary action under sections 2234, 2264 and 3501.2 of the Code and under California Code of Regulations (CCR), title 16, section 1399.540, l 399.545(d), l 399.545(e) and 1399.545(g) in that he failed to properly supervise physician assistants Natalie Ngaripin by failing to have a delegation of services for their duties. The circumstances are as follows:

57. In May 2005, PA Ngapirin began working as a Physician Assistant at Respondent's Lancaster facility. She was hired to assist during surgeries. Respondent, however, did not establish written guidelines for supervision as required by CCR section 1399.545.(e); did not establish written transport and back up procedures as required by CCR 1399.545(d); and, did not establish written protocols as authorized by Code section 3502.1 (b)(2) until September 2006.

FOURTH CAUSE FOR DISCIPLINE
(Aiding or Abetting the Unlicensed Practice of Medicine)

58. Respondent is subject to disciplinary action under section 2264 in that he aided or abetted the unlicensed practice of medicine of his employees McLean, Sheets, and Sandoval. The circumstances are as follows:

59. Respondent employed Michelle McLean, Matthew Sheets, and Cindy Sandoval who, at all times relevant to the Causes for Discipline alleged herein, did not possess a physician and surgeon's certificate, a license as a registered nurse, or any other health care professional license issued by the State of California. McLean possessed a medical assistant certificate. These facts were known to Dr. Omidi. He conspired with, aided and/or abetted with McLean, Sheets, and Sandoval for the latter to practice medicine at his medical clinic. Dr. Omidi engaged in a scheme to allow McLean, Sheets, and Sandoval to practice medicine. Specifically, McLean, Sheets, and Sandoval treated the physical condition of at least four of Dr. Omidi's patients as described below.

60. Michelle McLean began working for Respondent and/or his brother, Julian Omidi, M.D., at their office located at 44404 16th Street West, Suite 205 in Lancaster, California in November 2004, a month before receiving a medical assistant certificate from Antelope Valley Medical College. In July 2005, Respondent taught McLean how to suture patients, including a triple layer closure of an abdominoplasty incision. While employed with Respondent and with his consent but outside his presence, McLean performed sutures on patients at least twice a week, closed patients' surgical sites, injected marcaine into abdominoplasty drains, injected intravenous (IV) antibiotics into an IV line at least five times, used the liposuction machine on a patient's thigh, and mixed tumescent liposuction solution, IV bags of sedatives (Propofol, Versed and Benadryl) and conscious sedation drips (Propofol in normal saline). Respondent would routinely leave McLean alone for ten to twenty minutes to suture patients during surgery so that he could do patient consultations elsewhere in the office or start on another patient surgery. In June 2006, McLean assisted in breast augmentation surgeries by injecting saline to fill up the implant. Although Dr. Omidi was present while she injected saline into implants, he was usually working on the other breast to create the pocket for the implant. She also has removed sutures and staples from patients during the post operative appointment. She also removed drains by herself.

61. Matthew Sheets was employed at Respondent's Lancaster office from August 2005 to February 2006. Respondent was aware that Sheets did not have a medical assistant certificate at the time. During this time, Respondent taught him how to suture patients and allowed him to suture ten patients. While employed with Respondent and with his consent, Sheets mixed bags of medication for conscious sedation (Propofol in normal saline) and liposuction (Epinephrine and Lidocaine in saline), and giving IV boluses of Propofol and other medications to patients. At least ten times during his employment, he monitored patients under conscious sedation during surgery by sitting by the patient's head and monitoring blood pressure, oxygen saturation, and heart rate readings. Additionally, Respondent allowed him to liposuction a patient's leg for about five minutes in his presence.

62. Cindy Sandoval was employed by Respondent from around August 2005 until around February 2006. While employed with Respondent and with his consent, Sandoval sutured patients, mixed bags of sedatives (Propofol, Versed and Benadryl) into an IV bag, and acted as a recovery room nurse and surgery circulating nurse during patients' surgeries.

63. Dr. Omidi aided and abetted the unlicensed practice of medicine as follows:

A. Respondent-allowed Mc Lean and Sheets to administer local anesthetic agents to his patients in violation of section 2264.

B. Respondent allowed McLean, Sheets, and Sandoval to suture patients' incisions, including allowing McLean to perform a triple-layer suture.

C. Respondent allowed McLean, Sheets and Sandoval to mix bags of sedatives (Propofol, Versed and Benadryl) into an IV bag,

D. Respondent allowed McLean, Sheets, and Sandoval to act as recovery room, scrub and surgery circulating nurses during patients' surgeries.

E. Respondent allowed McLean to fill a breast implant with saline.

F. Respondent allowed McLean to inject marcaine into abdominoplasty drains.

G. Respondent allowed McLean to mix tumescent liposuction solution, IV bags of sedatives (Propofol, versed and benadryl) and conscious sedation drips (Propofol in normal saline).

H. Respondent allowed Sheets to perform liposuction.

I. Respondent allowed Sheets to mix bags of medication for conscious sedation (Propofol in normal saline) and liposuction (epinephrine and lidocaine in saline), solutions and to give JV boluses of Propofol and other medications to patients.

FIFTH CAUSE FOR DISCIPLINE
(Failure to supervise Medical Assistants)

64. By reason of the matters alleged in paragraphs 27 through 64 above Respondent is subject to disciplinary action under section 2069 of the Code in that he failed to properly supervise medical assistants Michelle Mc Lean, Matthew Sheets and Cindy Sandoval.

SIXTH CAUSE FOR DISCIPLINE
(Grossly Negligent Acts)

65. By-reason ofthe matters alleged in paragraphs 58 through-65 above, Respondent is subject to disciplinary action under section 2234, subdivision (b), of the Business and Professions Code in that in his employment, supervision and failure to supervise McLean, Sheets, and Sandoval he committed acts and omissions constituting gross negligence.

SEVENTH CAUSE FOR DISCIPLINE
(Failure to Supervise Nurse Practitioner Furnisher)

66. Respondent is subject to disciplinary action under Code section 2234 by failing to have a protocol or standardized procedure for nurse practitioner furnisher Richard Staggs (NPF Staggs) as required by Code section 2836.1. The circumstances are as follows:

67. In September 2005, NPF Staggs worked for Respondent as a nurse practitioner furnisher at his West Hills facility. Respondent, however, did not establish written standards or protocols as required by Code section 2836.1.

68. On September 8, 2005, NPF Staggs wrote a prescription for Jennifer C. for thirty Percocet (oxycodone) for pain. The prescription pad listed "Pacific West Dermatology 18182 HWY 18, Suite 106, Apple Valley, California 92307." This medication was not meant to be taken until the date of patient Jennifer C. 's surgery on October 11, 2005.

69. On September 22, 2005, NPF Staggs wrote a prescription for Charlsetta R. for thirty Percocet (oxycodone) for pain. The prescription pad listed "Pacific West Dermatology 18182 HWY 18, Suite 106, Apple Valley, California 92307." This medication was not meant to be taken until the date of patient Charlsetta R. 's surgery on October 11, 2005.

EIGHTH CAUSE FOR DISCIPLINE
(Improper Surgery - Outpatient Surgery Center)

70. By reason of the matters alleged in paragraphs 27 through 54, Respondent is subject to disciplinary action under Sections 2216 and 2216.1 of the Code and Health and Safety Code section 1248 and 1248.15 in that he performed surgery on Clinton J., Jennifer C. and Charlsetta R. at an unaccredited center. The circumstances are as follows:

71. Dr. Omidi performed cosmetic surgery procedures in an outpatient setting and administered anesthesia in doses that had the probability of placing patients CiInton J., Jennifer C. and Charlsetta R. at risk for loss of their life-preserving protective reflexes at his West Hills facility, which at the time did not comply with the requirements of an 'outpatient settings' as contained in the definition cited in Health and Safety Code section 1248.1, subdivision (c).

72. Dr. Omidi engaged in unprofessional conduct in violation of section 2216.1 because he performed procedures on patients Jennifer C. and Charlsetta R. in an outpatient setting that did not comply with section 2216 and did not have a minimum of two staff persons on the premises, one of whom shall either be a licensed physician and surgeon or a licensed health care professional with current certification in advanced cardiac life support (ACLS).

73. Dr. Omidi violated Health and Safety Code section 1248, subdivision (g), by operating, managing, conducting, and/or maintain an outpatient setting in this state that was not accredited by the division pursuant to Health and Safety Code Section 1248.15. Dr. Omidi's facilities not only were not accredited, but they also did not meet the minimum accreditation standards which include allied health staff shall be licensed or certified to the extent required by state or federal law, onsite equipment, medication, and trained personnel to facilitate handling of services sought or provided and to facilitate handling of any medical emergency that may arise in connection with services sought or provided, and for the facility to have a written transfer agreement with a local accredited or licensed acute care hospital, approved by the facility's medical staff and permit surgery only by a licensee who either (1) has admitting privileges at a local accredited or licensed acute care hospital or (2) have a written transfer agreement with licensees who-have·adm1ttin-g-privileges at local accredited or licensed acute care-- hospitals; and have a detailed procedural plan approved by an accrediting agency for handling medical emergencies.

74. Dr. Omidi performed liposuction procedures on Clinton J., Jennifer C. and Charlsetta R. in violation of section 1356.6 of title 19 of the California Code of Regulations due to the following:

A. Dr. Omidi performed liposuction procedures on Clinton J. under gener~l anesthesia and/or intravenous sedation which resulted in the extraction of 5,000 or more cubic centimeters of total aspirate at his facility which did not meet the requirements of Health and Safety Code Section 1248.1.

B. Dr. Omidi performed liposuction procedures on Clinton J., Jennifer C. and Charlsetta R without a written detailed plan for handling medical emergencies and all staff shall be informed of that plan, allowed anesthesia to be provided by unqualified licensed practitioners.

C. Dr. Omidi performed liposuction procedures on Jennifer C. while also administering or maintaining the anesthesia or sedation without having a licensed person certified in advanced cardiac life support present and monitoring the patient.

D. Dr. Omidi did not have the appropriate monitoring when he performed the procedures on Jennifer C. and Charlsetta R. While there is evidence that he used a pulse oximeter, the records do not reflect the use of an electrocardiogram.

NINTH CAUSE FOR DISCIPLINE
(Failure to Maintain Effective Control of Controlled Substances)

75. Respondent is subject to discipline pursuant to section 4170 of the Code in that he dispensed drugs pursuant to Section 4170 but failed to store all drugs to be dispensed in a locked and secure storage area within a physician's office and allowed unauthorized staff access to the storage area in violation of section 1356.3 of title 19 of the Regulations from May 2005 to September 2005 at his Lancaster, Beverly-Hills amlWest Hills facility. Dr. Omidi failed to maintain effective control over Propofol (Dipravan), Fentanyl, Ketamine, Merepidine, and Morphine, in addition to other dangerous drugs. He also failed to maintain required drug logs.

TENTH CAUSE FOR DISCIPLINE
(Failure to Maintain Adequate and Accurate Record—
Patients Clinton J., Charlsetta R. and Jennifer C.)

76. By reason of the matters alleged in paragraphs 27 through 54, Respondent is subject to disciplinary action under section 2266 of the Code and CCR, title 19, section 1356.6, subdivision (b)(4) in that he failed to maintain adequate and accurate records relating to his provision of services to patients Clinton J., Charlsetta R. and Jennifer C. The circumstances are as follows:

77. Respondent failed to maintain records in the manner necessary to meet the standard of practice for patients Clinton J., Charsletta R. and Jennifer C. in that he failed to include sufficient information to determine the quantities of drugs and fluids infused and the volume of fat, fluid and supranatant extracted and the nature and duration of any other surgical procedures performed during the same session as the liposuction procedure, in violation of section 1356.6, subdivision (b)(4), of title 19 of the Regulations.

78. Respondent failed to maintain records in the manner necessary to meet the standard of practice for patients Charsletta R. and Jennifer C. in that he failed to describe the persons present in the surgery setting.

TENTH CAUSE FOR DISCIPLINE
(Dishonest and Corrupt Acts)

79. By reason of the matters alleged in paragraphs 27 through 80, Respondent is subject to disciplinary action under section 2234, subdivision (e) in that Respondent has committed dishonest and corrupt acts which is substantially related to the qualifications, functions, or duties of a physician and surgeon.