The Texas Medical Board (TMB) licenses and regulates physicians. As part of its duties, the TMB receives complaints about physicians, investigates those complaints, and brings formal disciplinary action against physicians as needed. Obtaining experienced legal counsel to represent your interests in disciplinary proceedings before the TMB can be a significant step in reaching a positive outcome in your case. Therefore, if you are facing disciplinary investigations, complaints, or formal proceedings before the Board, you should consult a physician license defense attorney for help.
Reporting Requirements and the TMB
22 Tex. Admin. Code §173.3 requires that physicians report some events to the TMB within varying timeframes. §173.3(7) requires that physicians report “[a]ny medical malpractice claim against the physician for which the physician was found liable, a jury awarded monetary damages to the claimant, and the award has been determined to be final and not subject to further appeal.” This section further states that “[t]his does not include any offers by the physician to settle the claim.” Therefore, a physician has a definitive duty to report these medical malpractice cases to the TMB.
Consequences of a Medical Malpractice Suit
Failing to report a medical malpractice claim for which you were found liable is a violation that could lead to disciplinary proceedings before the TMB, in that you would be violating a TMB rule or law. However, depending on the nature and severity of the behavior or actions that led to the medical malpractice suit, you could face additional disciplinary action.
Under 22 Tex. Admin. Code §190.8, various acts, practices, and conduct constitute practices that are inconsistent with public health and welfare, which are violations of the Texas Medical Practice Act. These violations can lead to disciplinary proceedings and sanctions. Many of these violations may form the basis for a medical malpractice lawsuit, including the following:
- Failure to treat a patient according to the generally accepted standard of care;
- Negligence in performing medical services;
- Failure to use proper diligence in one’s professional practice;
- Failure to safeguard against potential complications;
- Prescription or administration of a drug in a manner not in compliance with Chapter 200 of this title (relating to Standards for Physicians Practicing Complementary and Alternative Medicine) or that is either not approved by the Food and Drug Administration (FDA) for use in human beings or does not meet the standards for off-label use unless an exemption has otherwise been obtained from the FDA;
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Likewise, unprofessional, and dishonorable conduct likely to deceive, defraud, or injure the public also violates the Act and can lead to disciplinary proceedings and sanctions. Such conduct includes “repeated or recurring meritorious health care liability claims.” A claim is “meritorious” if there is “a finding by a judge or jury that a licensee was negligent in the care of a patient or if there is a settlement of a claim without the filing of a lawsuit or a settlement of a lawsuit against the licensee in the amount of $50,000 or more.” Claims are “repeated or recurring” if there are “three or more claims in any five-year period.” The date of the claim is when the licensee or the licensee’s medical liability insurer first receives notice of the claim.
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Medical malpractice claims can involve various actions or inactions by a physician that rise to the level of medical errors. These claims can include substandard care that harms a patient, misdiagnosis, surgical errors, medical mistakes, failure to properly monitor or supervise nurses, APRNs, or other staff, or other types of medical negligence.
Determining Sanctions for Medical Malpractice Claims
22 Tex. Admin. Code §190.14 sets forth the sanction guidelines for Texas Medical Practice Act violations. The guidelines are intended to promote consistency in sanctions for violations of the Medical Practice Act for similar violations, facilitate timely resolution of disciplinary cases, and encourage settlements. These guidelines provide a range of potential sanctions from “Low Sanction” to “High Sanction” based on a list of aggravating and mitigating factors that the TMB must consider in each case. Generally, violations based on deficits in patient care are more severe than those that involve purely administrative violations.
The maximum sanction is a license revocation, which may include a maximum administrative penalty of $5,000 per violation. Each day a violation continues, it is a separate violation. However, medical malpractice is unlikely to lead to license revocation except for recurring medical malpractice claims in which a physician is found liable involving multiple persons, particularly within a short period.
Some of the sanctions related to medical malpractice claims include the following:
- Failure to report a healthcare liability claim – Sanctions range from a remedial plan that includes four hours of ethics/risk management and a $500 administration fee to a $2,000 administrative penalty and retaking the jurisprudence exam;
- Prescribing, administering, or dispensing drugs in a manner inconsistent with the public health and welfare;
- One patient and no prior disciplinary history related to SOC or care-related violations – Sanctions range from a remedial plan with CME in the appropriate area and a $500 administration fee to an agreed order with proficiency testing, CME in the appropriate area, chart monitoring for eight cycles, and an administrative penalty of $3,000 per violation;
- More than one patient or prior disciplinary history related to SOC or care-related violations – Sanctions range from an agreed order with proficiency testing, CME in the appropriate area, chart monitoring for 12 cycles, and an administrative penalty of $3,000 per violation; to an agreed order with practice restrictions, including prescribing and administering controlled substances and dangerous drugs, and an administrative penalty of $5,000 per violation; if there are aggravating factors, revocation can be considered;
- Standard of care violations;
- One patient and no prior SOC or care-related violations – Sanctions range from a remedial plan with CME in the appropriate area and a $500 administration fee per year (no RP if the case involves a patient death) to an agreed order involving proficiency testing, directed CME, chart monitoring for eight cycles, and an administrative penalty of $3,000 per violation;
- One patient and one prior SOC or care-related violations – Sanctions range from an agreed order involving chart monitoring for eight cycles, directed CME, and an administrative penalty of $3,000 per violation to an agreed order involving practice limitations that could require the exclusion of one or more specified activities of medicine, proficiency testing, practice monitoring (chart monitoring for 12 cycles or supervising physician for several cases or a specified period), a public reprimand, and an administrative penalty of $5,000 per violation;
- One patient and more than one prior SOC or care-related violation or recurring meritorious healthcare claims that evidence professional incompetence likely to injure the public – Sanctions range from an Agreed Order involving a practice limitation or exclusion of one or more specified activities of medicine, proficiency testing, directed CME, monitoring of the practice (chart monitoring for 12 cycles or supervising physician for several cases or a specified period), and an administrative penalty of $3,000 per violation to an agreed order: KSTAR or PACE or equivalent proficiency testing, directed CME, chart monitoring for 16 cycles or supervising physician for several cases or specified period, practice restrictions, withdrawal of prescribing or delegating privileges a public reprimand, and an administrative penalty of $5,000 per violation.
- More than one patient and no prior SOC or care-related violations or recurring meritorious healthcare claims – Sanctions range from an agreed order involving chart monitoring for eight cycles, CME in the appropriate area, and an administrative penalty of $3,000 per violation to an agreed order involving proficiency testing, directed CME, chart monitoring for 12 cycles, a public reprimand, and an administrative penalty of $5,000 per violation.
- More than one patient and prior SOC or care-related violations or recurring meritorious healthcare claims – Sanctions range from an agreed order involving proficiency testing, directed CME, monitoring for 12 cycles, oversight or practice restrictions, a public reprimand, and an administrative penalty of $5,000 per violation to license suspension or revocation.
We Can Advocate on Your Behalf in Proceedings Before the TMB
The medical license defense lawyers of Bertolino LLP can help guide you through the disciplinary complaint process. No matter what allegations you face, we are here to represent your interests and work to minimize the negative effects of a complaint on your license and career. We can help resolve the case against you and maintain your medical license. Call us today at (512) 515-9518 to reach the offices of Bertolino LLP or contact us online.
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