NORTHWESTERN UNIVERSITY MEDICAL SCHOOL
- 6/05/2017— MALPRACTICE JUDGMENT IN THE AMOUNT OF $1,348,715.64.
- 1/27/2017—NEW DECISION FOUR YEARS PROBATION SHALL RUN CONCURRENT WITH ALL OTHER TERMS AND CONDITIONS OF PROBATION PREVIOUSLY ORDERED AND SHALL BEGIN ON 01/27/17. RESTRICTIONS: SHALL NOT ORDER, PRESCRIBE, DISPENSE, ADMINISTER OR FURNISH AMBIEN AND PROHIBITED FROM SUPERVISING PHYSICIAN ASSISTANTS AND ADVANCED PRACTICE NURSES.
- 4/25/2014—CASE NO. 10-2011-214928 FIVE YEARS PROBATION WITH VARIOUS TERMS AND CONDITIONS.
- 8/13/2013—ILLINOIS MEDICAL LICENSE WAS ISSUED AN ORDER OF REFUSAL TO RENEW LICENSE. BASED ON ACTION TAKEN BY THE MEDICAL BOARD OF CALIFORNIA.
- 8/15/2012— MALPRACTICE JUDGMENT IN THE AMOUNT OF $5,747,273.65.
- 6/08/2012—PUBLIC REPRIMAND.
- 5/03/2012—PANEL A HEARING (NO VIDEO)
- 10/16/2007— MISDEMEANOR CONVICTION
- SUPERIOR COURT OF CA, COUNTY OF SAN DIEGO
- M015404
- PLED GUILTY TO ONE COUNT OF VIOLATING VEHICLE CODE SECTION 23152(B) (DRIVING WITH A BLOOD ALCOHOL LEVEL OF 0.08 PERCENT).
- SENTENCED TO SUMMARY PROBATION FOR FIVE YEARS WITH TERMS AND CONDITIONS. HE MUST PAY A FINE OF $1,784.00, ENROLL IN AND COMPLETE
Excerpt from Accusation dated 12/29/2016:
FIRST CAUSE FOR DISCIPLINE
(Gross Negligence)
10. Respondent has subjected his Physician's and Surgeon's Certificate Number G78677 to disciplinary action under sections 2227 and 2234, as defined in section 2234, subdivision (b), of the Code, in that respondent committed gross negligence in his care and treatment of patient T.S., as more particularly alleged hereinafter:
(a) From 1997 to 2013, respondent worked as a team and head orthopaedic physician for the National Football League's (NFL) San Diego Chargers Football Team (Chargers) in San Diego, California.
(b) In 1997, respondent began treating patient T.S. Patient T.S. played for the Chargers at the linebacker position from 1990 until 2003, at which time he was traded to another NFL football team. In 2010, patient T.S. retired after playing twenty (20) seasons as a linebacker in the NFL. On May 2, 2012, patient T.S. committed suicide by a self-inflicted gunshot to his chest.
(c) On November 20, 2014, respondent was interviewed by Division of Investigation's Health Quality Investigation Unit Investigator J.P. about the background and history of respondent's care and treatment of patient T.S. including, prescribing controlled substances, management of chronic insomnia, and physical examinations and records maintenance for patient T.S. By way of background, respondent stated that he had developed a strong relationship with patient T.S. that began when he was a player for the Chargers. Respondent explained that it began as a "doctor/patient" relationship while treating him as a player; but over time, a close and personal friendship developed and was maintained by the two of them long after patient T.S. stopped playing for the Chargers. Respondent further stated that he continued treating patient T.S. as a primary care physician throughout the rest of patient T.S.'s NFL career, and even after his retirement in 2010. Respondent further explained that he had maintained frequent communication and personal contact with patient T.S. over the years, that he knew him very well as his physician and his close friend, and that they often shared their personal lives with one another including discussing personal life stressors. At one point, respondent and patient T.S. formed a "pact" together with a few other friends following the suicide of a mutual friend in 2009. The "pact" was made to ensure a similar tragedy would not happen again, and they vowed to communicate any personal issues with one another for support. According to respondent, after the "pact" was made he remained in close and frequent contact with patient T.S., often discussing patient T.S.'s health and well-being.
(d) On November 20, 2014, during the same interview with Investigator J.P., respondent indicated that he was aware of a driving accident involving patient T.S. wherein the vehicle he was driving left the road and veered off a cliff located in Carlsbad, California. The accident occurred in the morning sometime after 8:00 a.m., on or about October 18, 2010. Patient T.S. survived the accident and was hospitalized. Earlier that same morning, patient T.S. had been arrested by police and released from jail on suspicion of spousal assault with injury during an incident involving patient T.S.'s girlfriend. Respondent stated that he visited patient T.S. in the hospital on the day of the accident and asked him if driving his vehicle off of the cliff was an attempted suicide. Patient T.S. denied it was a suicide attempt and insisted that he had fallen asleep while driving. Respondent further stated during the interview with Investigator J.P. that he knew there had been issues between patient T.S. and his girlfriend. Respondent explained that he had questioned patient T.S. at the hospital and, finding patient T.S.'s explanation of the accident credible, he did not believe the accident was a suicide attempt.
(e) Notwithstanding the seriousness of recent events in patient T.S.'s life including, the vehicular accident occurring under suspicious circumstances following an arrest and jailing for alleged domestic violence; the "pact" with patient T.S. and the reasons why it was made; and respondent's close personal relationship with patient T.S. and knowledge of significant stressors in patient T.S.'s personal and professional life; at no time did respondent ever refer patient T.S. to a mental health care provider or recommend to patient T.S. that he see a mental health care provider, for signs and/or symptoms of depression or suicidal thoughts.
(f) Respondent prescribed Ambien to patient T.S. during and after his professional football career. During the last eighteen (18) months of patient T.S. 's life, respondent wrote patient T.S. fourteen (14) prescriptions for Ambien, as depicted in the table below: (See document)
(g) As a controlled substance, Ambien is a sedative used for the short-term treatment of insomnia, typically two to three (2 to 3) weeks. If treatment of insomnia with Ambien extends beyond this initial period, regular follow-up by the treating physician is recommended to assess for efficacy, possible side-effects and harms, as well as to evaluate other treatment approaches including other medication classes. Ambien has central nervous system depressant effects and its use can potentially worsen symptoms of depression and suicidal thoughts in patients suffering from depression. The use of Ambien is associated with increased incidence of impaired driving and completed suicide. It should be prescribed with caution in patients suspected of having depression or suicidal thoughts, and in the lowest effective dose.
(h) Respondent described patient T.S. as a "modest sleeper" and that he rarely slept much throughout his NFL career. During patient T.S.'s NFL career, respondent prescribed Ambien to him upon request. According to respondent, he informed patient T.S. of the potential addiction and tolerance issues related to the use of Ambien and that patient T.S. lacked any contraindications for Ambien. Specifically, respondent observed patient T.S. to be without depression or any other psychological issues, including during the week just prior to patient T.S. committing suicide. He believed there was no need to refer patient T.S. for a mental health evaluation by a psychologist or psychiatrist. Furthermore, respondent stated that at no time did patient T.S.'s ex-wife or children, whom he also regularly treated as patients, ever indicate to him that patient T.S. was depressed.
(i) On November 20, 2014, during the same interview with Investigator J.P., respondent discussed a patient note addendum that he had written and later added to patient T.S.'s medical chart on or about June 25, 2014. According to respondent's 2014 patient note addendum, "records of [respondent's] prescriptions" had been maintained in a medical record keeping system but were lost due to system failure and were not retrievable. Significantly, however, respondent failed to document any evaluation of patient T.S. as it related to the ongoing treatment of his chronic insomnia with a controlled substance including, appropriate history and physical exam; development of a treatment plan; informed consent documenting discussion of possible risks and side effects of treatment; periodic review of the treatment's efficacy; and consultation with another medical provider.
(j) Notwithstanding the existence of red flags involving patient T.S. and his extended use of Ambien, respondent continued to prescribe the controlled substance without closely monitoring patient T.S. for ongoing signs and symptoms of depression and suicidal ideation. For example, only three (3) days after patient T .S.'s vehicular accident occurring under suspicious circumstances following an arrest and jailing for alleged domestic violence, respondent issued another prescription to patient T.S. for Ambien.
11. Respondent committed gross negligence in his care and treatment of patient T.S. which included, but was not limited to, the following:
(a) Respondent failed to document an appropriate history and physical exam prior to treatment of patient T.S. with a controlled substance;
(b) Respondent failed to document the development of a treatment plan including, objectives of care prior to and during the ongoing treatment of patient T.S. with a controlled substance;
(c) Respondent failed to document any informed consent including, discussion of possible risks and side effects of treatment prior to and during the ongoing treatment of patient T.S. with a controlled substance;
(d) Respondent failed to document any periodic review of the treatment's efficacy during the ongoing treatment of patient T.S. with a controlled substance;
(e) Respondent failed to consult with and/or document any consultation with another medical provider during the ongoing treatment of patient T.S. with a controlled substance, and
(f) Respondent failed to properly manage patient T.S.'s insomnia with close follow-up including, the failure to exercise caution in the extended use of Ambien with a patient exhibiting signs and symptoms of depression and suicidal ideation.
SECOND CAUSE FOR DISCIPLINE
(Repeated Negligent Acts)
12. Respondent has further subjected his Physician's and Surgeon's Certificate Number G78677 to disciplinary action under sections 2227 and 2234, as defined in section 2234, subdivision (c), of the Code, in that respondent committed repeated negligent acts in his care and treatment of patient T. S., as more particularly alleged hereinafter:
13. Paragraphs 10(d), 10(e), 10(f), 10(h), 10(i) and 10(j), above, are incorporated by reference and realleged as if fully set forth herein.
14. Respondent committed repeated negligent acts in his care and treatment of patient T.S. which included, but was not limited to, the following:
(a) Respondent failed to document an appropriate history and physical exam prior to treatment of patient T.S. with a controlled substance;
(b) Respondent failed to document the development of a treatment plan including, objectives of care prior to and during the ongoing treatment of patient T.S. with a controlled substance;
(c) Respondent failed to document any informed consent including, discussion of possible risks and side effects of treatment prior to and during the ongoing treatment of patient T.S. with a controlled substance;
(d) Respondent failed to document any periodic review of the treatment's efficacy during the ongoing treatment of patient T.S. with a controlled substance;
(e) Respondent failed to consult with and/or document any consultation with another medical provider during the ongoing treatment of patient T.S. with a controlled substance, and
(f) Respondent failed to properly manage patient T.S.'s insomnia with close follow-up including, the failure to exercise caution in the extended use of Ambien with a patient exhibiting signs and symptoms of depression and suicidal ideation.
THIRD CAUSE FOR DISCIPLINE
(Prescribing Without an Appropriate Prior Examination)
15. Respondent has further subjected his Physician's and Surgeon's Certificate Number G78677 to disciplinary action under section 2227 and 2234, as defined in sections 2242 and 4022, of the Code, in that respondent prescribed, dispensed, or furnished dangerous drugs to patient T.S. without an appropriate prior examination and a medical indication, as more particularly alleged hereinafter:
16. Paragraphs 10(f), 10(h), 10(i) and 10(j), above, are hereby incorporated by reference and realleged as if fully set forth herein.
FOURTH CAUSE FOR DISCIPLINE
(Failure to Maintain Adequate and Accurate Medical Records)
17.Respondent has further subjected his Physician's and Surgeon's Certificate Number G78677 to disciplinary action under section 2227 and 2234, as defined in section 2266, of the Code, in that respondent failed to maintain adequate and accurate records in connection with his care and treatment of patient T.S., as more particularly alleged hereinafter:
18. Paragraphs 1O(f), 1O(h), 1O(i) and 1O(j), above, are hereby incorporated by reference and realleged as if fully set forth herein.
FIFTH CAUSE FOR DISCIPLINE
(Unprofessional Conduct)
19. Respondent has further subjected his Physician's and Surgeon's Certificate Number G78677 to disciplinary action under sections 2227 and 2234 of the Code, in that respondent has engaged in conduct which breaches the rules or ethical code of the medical profession, or conduct which is unbecoming to a member in good standing of the medical profession, and which demonstrates an unfitness to practice medicine, as more particularly alleged hereinafter:
(a) Paragraphs 10(d), 10(e), 10(f), 10(h), 10(i), 10(g), and paragraphs 11 through 18 above, are hereby incorporated by reference and realleged as if fully set forth herein.
DISCIPLINARY CONSIDERATIONS
20. To determine the degree of discipline, if any, to be imposed on respondent, Complainant alleges that on or about June 8, 2012, in a prior disciplinary action entitled "In the Matter of the Accusation Against David Jee Wei Chao, M.D.," Case Number 10-2007-187749, the Medical Board of California issued a public reprimand against Respondent's Physician's and Surgeon's Certificate No. G 78677 based on findings that respondent was convicted of a crime substantially related to the practice of medicine and engaged in dishonest and corrupt acts. That decision is now final and is incorporated by reference as if fully set forth herein.
21. To further determine the degree of discipline, if any, to be imposed on respondent, Complainant alleges that on or about April 25, 2014, in a prior disciplinary action entitled "In the Matter of the First Amended Accusation Against David Jee Wei Chao, M.D.," Case Number 10-2011-214928, the Medical Board of California issued a decision revoking respondent's Physician's and Surgeon's Certificate No. G 78677, staying that revocation, and placing respondent on probation for five (5) years on various terms and conditions. The Medical Board of California imposed discipline on respondent in this matter based on findings that respondent committed gross negligence, repeated negligent acts, failed to maintain adequate and accurate medical records, engaged in dishonest and corrupt acts, and committed general unprofessional conduct. That decision is now final and is incorporated by reference as if fully set forth herein.
Excerpt from Accusation dated 12/10/2010:
FIRST CAUSE FOR DISCIPLINE
(Conviction of a Crime Substantially Related to the Qualifications, Functions, or Duties of a Physician and Surgeon)
10. Respondent has subjected his Physician's and Surgeon's Certificate No. G78677 to disciplinary action under sections 2227 and 2234, as defined by sections 2236, subdivision (a), of the Code, in that he has been convicted of a crime substantially related to the qualifications, functions, or duties of a physician and surgeon, as more particularly alleged hereinafter:
A. On about August 31, 2006, at approximately 0037, California Highway Patrol (CHP) Officers M.M. and R.C. observed a 2002 Lexus (Lexus) traveling westbound on I-8 at approximately 65 mph. The Lexus was weaving from side to side in the #2 lane and approximately one foot into the #1 lane, and then swerved back into the #2 lane. The Lexus also drifted right with its right side wheels on the Botts Dots dividing the #2 and #3 lanes for approximately five seconds, then drifted back to the left and continued to weave from side to side in the #2 lane for approximately one-half mile.
B. Office M.M. activated the police vehicle's forward red lights and initiated a traffic stop of the Lexus. The driver of the Lexus did not respond to the police vehicle's red light and continued in the #2 lane. Office M.M. then activated the police vehicle's Code 3 emergency lights and siren, and used the public address system and instructed the driver of the Lexus to exit the freeway on the Taylor Street ramp. The driver of the Lexus did not respond to the police vehicle's emergency lights, siren and public address system, and continued to travel in the #2 lane.
C. As the Lexus passed the Taylor Street off-ramp, the Lexus slowly started to yield towards the right. Office M.M. instructed the driver of the Lexus to exit the freeway at Morena Blvd. and to park his vehicle in the parking lot located at the intersection of Morena Blvd. and Linda Vista Road.
D. Office M.M. exited the police vehicle, contacted the driver of the Lexus, and motioned for the driver to lower the passenger side window. As soon as the window was lowered, Officer M.M. smelled the odor of an alcoholic beverage emitting from inside the Lexus. When asked by Officer M.M. why he was weaving, respondent stated that he was talking on his cell phone and he apologized. Respondent was identified as the driver by his California Driver's License. When Officer M.M. asked respondent if he had consumed any alcoholic beverages, respondent stated, "I am not trying to cause any trouble, I was just helping a friend out."
E. Officer M.M. instructed respondent to meet him along the right side of the police vehicle. As respondent slowly walked towards Office M.M., he was swaying from side to side. Respondent was asked to stand with his feet together and to keep his arms at his sides. Respondent was unable to maintain his balance and stood with his feet approximately 8-10 inches apart.
F. Respondent stated to Officer M.M. that he was the team doctor for the San Diego Chargers and admitted to having a glass of wine at a banquet at the San Diego Charger's facility on Murphy Canyon Road and one shot of Patron tequila at McGregor's near Qualcomm Stadium. Respondent also stated that the only reason he was driving was because a friend needed a ride home from McGregor's.
G. Officer M.M. began to ask respondent a series of Pre-Field Sobriety Test questions and, as he was talking to respondent, he could smell the strong odor of an alcoholic beverage emitting from his breath. In addition, respondent's eyes were red and watery, his speech was slurred, and he was swaying from front to back as he answered the officer's questions. Respondent was unable to perform the Field Sobriety Test as explained and demonstrated.
H. Respondent was arrested and transported to the San Diego CHP area ot1ice for a breath test. Respondent, however, was unable to provide a sufficient breath sample on six attempts. Respondent agreed to take a blood test and was transported to the San Diego County Jail. At approximately 0215, two vials of blood were drawn from respondent. Respondent was then booked into the San Diego County Jail.
I. On or about October 16, 2007, in the case entitled People of the State of California v. David J. Chao, Superior Court of California, County of San Diego, Case No. MO15404, respondent was convicted, upon his plea of guilty, of one count of violating California Vehicle Code section 23152(b) (driving a motor vehicle with .08% or more, by weight of alcohol in his blood), a misdemeanor. As a result of this conviction, respondent was sentenced to summary probation for 5 years under terms and conditions that included, among other things, that he pay a fine of $1,784.00, enroll in and complete a First Conviction Program, participate in the MADD program as directed by the assessor, and not operate a motor vehicle without a valid drivers license and liability insurance.
SECOND CAUSE FOR DISCIPLINE
(Use of Drugs or Alcoholic Beverages in a Manner, or to an Extent, as to be Dangerous to Himself, to Another Person, or to the Public)
11. Respondent has further subjected his Physician's and Surgeon's Certificate No. G78677 to disciplinary action under sections 2227 and 2234, as defined by section 2239, subdivision (a), of the Code, in that he used or prescribed, or administered to himself, drugs or alcoholic beverages to the extent, or in such a manner, as to be dangerous or injurious to him, to another person, or to the public, as more particularly alleged hereinafter:
Paragraph 10, above, is hereby incorporated by reference as if fully set forth herein.
THIRD CAUSE FOR DISCIPLINE
(Dishonesty or Corruption)
12. Respondent has further subjected his Physician's and Surgeon's Certificate No. G78677 to disciplinary action under sections 2227 and 2234, as defined by section 2234, subdivision (e), of the Code, in that he has committed an act or acts of dishonesty or corruption, as more particularly alleged hereinafter:
A. On or about April 11, 2006, respondent signed an application under penalty of perjury for reappointment as a Qualified Medical Evaluator for the Division of Worker's Compensation. Respondent certified under penalty of perjury that he would notify the Industrial Medical Council (IMC) of any future convictions related to the conduct of his practice and upon being placed on any court ordered probation. Respondent failed to notify the Industrial Medical Council (IMC) of his October 16, 2007, conviction and probation as set forth in paragraph 10, above, which is hereby incorporated by reference as if fully set forth herein.
B. On or about April 11, 2008, respondent signed an application under penalty of perjury for reappointment as a Qualified Medical Evaluator for the Division of Worker's Compensation. Respondent certified under penalty of perjury that he had not committed a misdemeanor or felony related to his practice and that he was not on any court ordered probation. Respondent further certified under penalty of perjury that he would notify the IMC of any future convictions related to the conduct of his practice or upon being placed on any court ordered probation. Respondent failed to disclose his conviction or notify the Industrial Medical Council IMC of his October 16, 2007, conviction and probation as set forth in paragraph 10, above, which is hereby incorporated by reference as if fully set forth herein.
C. On or about April 14, 2010, respondent signed an application under penalty of perjury for reappointment as a Qualified Medical Evaluator for the Division of Worker's Compensation. Respondent certified under penalty of perjury that he had not committed a misdemeanor or felony related to his practice. Respondent failed to disclose his October 16, 2007, conviction and probation as set forth in paragraph 10, above, which is hereby by reference as if fully set forth herein.
FOURTH CAUSE FOR DISCIPLINE
(General Unprofessional Conduct)
Respondent has further subjected his Physician's and Surgeon's Certificate No. 078677 to disciplinary action under section sections 2227 and 2234 of the Code in that he has engaged in conduct which breaches the rules or ethical code of the medical profession, or conduct which is unbecoming to a member in good standing of the medical profession, and which demonstrates an unfitness to practice medicine, as more particularly described in paragraph 10 through 12, above, which is hereby incorporated by reference and realleged as if fully set forth herein.
CIRCUMSTANCE IN AGGRAVATION
14. To determine the degree of discipline, if any, to be imposed on respondent, Complainant alleges that in 1995, in a prior criminal action, respondent pled guilty to a wet reckless arising out of his driving a motor vehicle while under the influence of alcohol.
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