Disciplinary Actions against Michael Platt, M.D.

Stephen Barrett, M.D.


Michael E. Platt, M.D., whose clinic Web site stated that he "places his attention on the causation of illness, and has developed a protocol to eliminate or alleviate disabling conditions such as ADD, ADHD, fibromyalgia, menopause, migraines, osteoporosis, restless leg syndrome, weight challenges and more," has surrendered his California medical license. In 2008, the board accused him of negligence, incompetence, and inadequate record-keeping in connection with his care of three women, two of whom he diagnosed as hypothyroid even though their hormone levels tested normal. In 2009, the charges were settled with an agreement under which he was ordered enroll in the University of California's Physician Assessment and Clinical Education (PACE) program and serve 5 years on probation, during which his practice would be monitored or reviewed. Platt did enroll, but the PACE faculty concluded that he was deficient in clinical reasoning, judgment, and performance and that even a 3- to 6-month intensive study would not bring him to the level of a competent physician who is safe to practice medicine. In August 2010 (as shown below) the board petitioned to revoke Platt's probation and an administrative law judge ordered that Platt's license be suspended while the board considered his case further. In April 2011, the board filed an amended complaint that included concerns about additional patients plus reports of two undercover investigators who posed as patients. A few weeks later, Platt voluntarily surrendered his license.


EDMUND G. BROWN JR.
Attorney General of California
THOMAS S. LAZAR
Supervising Deputy Attorney General
BETH FABER JACOBS
Deputy Attorney General
State Bar No. 89145
110 West "AO> Street, Suite 1100 San Diego, CA 92101
P.O. Box 85266
San Diego, CA 92186-5266
Telephone: (619) 645-2069
Facsimile: (619) 645-2061
Attorneys for Complainant

BEFORE THE
MEDICAL BOARD OF CALIFORNIA
DEPARTMENT OF CONSUMER AFFAIRS
STATE OF CALIFORNIA

In the Matter of the Accusation and Petition to
Revoke Probation Against:

MICHAEL E. PLATT, M.D.
72-785 Frank Sinatra Drive, #100
Rancho Mirage, CA 92270

Physician's and Surgeon's Certificate·
No. G-23729

Respondent.

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Case Nos. D1-2006-175931 and
19-2010-207355

OAR Case No. 2010070834

ACCUSATION AND PETITION TO
REVOKE PROBATION

Filed August 19, 2010.

Complainant alleges:

PARTIES

1. Linda K. Whitney (Complainant) brings this Accusation and Petition to Revoke Probation solely in her official capacity as the Executive Director of the Medical Board of California.

2. On or about November 24, 1972, the Medical Board of California issued Physician's and Surgeon's Certificate Number G23729 to Michael E. Platt, MD. (Respondent). The Physician's and Surgeon's Certificate has been in full force and effect at all times relevant to the charges brought herein and will expire on November 29, 2011, unless renewed.

DISCIPLINARY HISTORY

3. On or about May 2, 2008, the Executive Director of the Medical Board filed an Accusation against respondent in the matter entitled: "In the Matter a/the Accusation Against Michael Edward Platt, M.D." Medical Board Case No. 09-2006-175931.

4. On or about October 17, 2008, respondent signed a Stipulated Settlement and Disciplinary Order to resolve the Accusation. He did not contest the truth of the factual allegations in the Accusation.

5. By Decision dated February 5, 2009, and effective March 9, 2009, regarding "In the Matter a/the Accusation Against Michael E. Platt," Case No. 09-2006-175931, the Medical Board of California issued a Decision, revoking respondent's Physician's and Surgeon's certificate to practice medicine. The revocation was stayed and Respondent's certificate was placed on probation for a period of five (5) years with certain terms and conditions. A true and correct copy of the Decision is attached hereto as Exhibit A and is incorporated by reference.

6. On or about July 19, 2010, Complainant filed a noticed Petition for Interim Suspension Order. The noticed hearing on the petition was held on August 6, 2010. That matter is pending at this time.

JURISDICTION

7. . This Accusation and Petition to Revoke Probation is brought before the Medical Board of California under the authority of the following sections of the Business and Professions Code ("Code"):

8. Section 2220 of the Code states:

"Except as otherwise provided by law, the Division of Medical Quality1 may take action against all persons guilty of violating this chapter [Chapter 5, the Medical Practice Act]. The division shall enforce and administer this article as to physician and surgeon certificate holders, and the division shall have all the powers granted in this chapter. .

1California Business and Professions Code section 2002, as amended effective January 1, 2008, provides in part that the term "board" as used in the State Medical Practice Act (Business and Professions Code, section 2000, et seq.) means the "Medical Board of California," and that references to the "Division of Medical Quality" and "Division of Licensing" in the Act or any other provision of law shall be deemed to refer to the Board. . . ."

9. Section 2227 of the Code provides that a licensee who is found guilty under the Medical Practice Act may have his or her license revoked, suspended for a period not to exceed one year, placed on probation and required to pay the costs of probation monitoring, be publicly reprimanded, or have such other action taken in relation to discipline as the Division deems proper.

10. Section 2234 of the Code states:

"The Division of Medical Quality shall take action against any licensee who is , charged with unprofessional conduct. In addition to other provisions of this article, unprofessional conduct includes, but is not limited to, the following:

"(a) Violating or attempting to violate, directly or indirectly, assisting in or abetting the violation of, or conspiring to violate any provision of this chapter [Chapter 5, the Medical Practice Act].

"(b) Gross negligence.

"(c) Repeated negligent acts. To be repeated, there must be two· or more negligent acts or omissions. An initial negligent act or omission followed by a separate and distinct departure from the applicable standard of care shall constitute repeated negligent acts.

"(1) An initial negligent diagnosis followed by an act or omission medically appropriate for that negligent diagnosis of the patient shall constitute a single negligent act.

"(2) When the standard of care requires a change in the diagnosis, act, or omission that constitutes the negligent act described in paragraph (1), including, but not limited to, a reevaluation of the diagnosis or a change in treatment, and the licensee's conduct departs from the applicable standard of care, each departure constitutes a separate and distinct breach of the standard of care.

"(d) Incompetence.

"(e) The commission of any act involving dishonesty or corruption which is substantially related to the qualifications, functions, or duties of a physician and surgeon.

"(f) Any action or conduct which would have warranted the denial of a certificate. "

11. Unprofessional conduct under Business and Professions Code section 2234 is conduc1 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. (Shea v. Board a/Medical Examiners (1978) 81 Cal.App3d 564, 575.)

12. Section 2242 of the Code provides in pertinent part that "prescribing ... dangerous drugs as defined in Section 4022 without an appropriate prior examination and medical indication constitutes unprofessional conduct."

Section 2266 of the Code states:

"The failure of a physician and surgeon to maintain adequate and accurate records relating to the provision of services to their patients constitutes unprofessional conduct."

FIRST CAUSE TO REVOKE PROBATION
(Failure to Successfully Complete PACE Program)

14. At all times after the effective date of Respondent's probation in Case No. 09-2006- [75931, Condition 3 stated in pertinent part:

"3. CLINICAL TRAINING PROGRAM. Within 60 calendar days of the effective date ·of this Decision, Respondent shall enroll in a clinical training or educational program equivalent to the Physician Assessment and Clinical Education· Program (PACE) offered at the University of California - San Diego School of Medicine ("Program").

"The Program shall consist of a Comprehensive Assessment program comprised of a two-day assessment of Respondent's physical and mental health; basic clinical and communication skills common to all clinicians; and medical knowledge, skill and judgment pertaining to Respondent's specialty or sub-specialty, and at minimum, a 40 hour program of clinical education in the area of practice in which Respondent was alleged to be deficient and which takes into account data obtained from the assessment, Accusation, and any other "information that the Board or its designee deems relevant. Respondent shall pay all expenses associated with the Clinical training program.

"Based on Respondent's performance and test results in the assessment and clinical education, the Program will advise the Board or its designee of its recommendations for the scope and length of any additional educational or clinical training, treatment for any medical condition, treatment for any psychological condition, or anything else affecting Respondent's practice of medicine. Respondent. shall comply with Program recommendations.

"At the completion of any additional educational or clinical training, Respondent shall submit to and pass an examination. The Program's determination as to whether Respondent passed the examination or successfully completed the Program shall be binding.

"Respondent shall complete the Program not later than six months after Respondent's initial enrollment unless the Board or its designee agrees in writing to a later time for completion.

"Failure to participate in and complete successfully all phases of the clinical training program outlined above is a violation of probation.

"If Respondent fails to complete the clinical training program within the designated time period, Respondent shall cease the practice of medicine within 72 hours after being notified by the Board or its designee that Respondent failed to . complete the clinical training program."

15. Respondent's probation is subject to revocation because he failed to comply with Condition 3, referenced above, by failing to successfully complete the PACE program, as follows:

A. On or about September 29, 2009, respondent began his participation in the full PACE program. His seven day program concluded in March, 2010.

B. Respondent's performance in the PACE program was evaluated by PACE faculty and directors. Both respondent's Phase I and Phase II assessments were deemed unsatisfactory.

C. PACE concluded that respondent showed consistent deficiencies in several clinical competencies~ including (1) inadequate clinical judgment in general medicine; (2) inadequate knowledge in conducting a complete physical examination; (3) poor demonstration of professional boundaries; (4) inadequate knowledge of his own clinical limitations; and (5) lack of insight into his own skills and knowledge, a deficiency which called into question his own professionalism and concern for patient well being.

D. During PACE, respondent recommended many treatments outside the standard of care, including, but not limited to, taking diabetics off their diabetic medication (and instead, prescribing progesterone); refusing to use beta blockers; prescribing testosterone for female ii1continence; recommending progesterone for a patient :with fibromyalgia (without taking a pain history, conducting a physical, or reviewing prior records); telling a lactose intolerant female patient already on a low dairy diet she did not need to take her calcium pills; recommending testosterone for a perimenopausal woman with dysfunctional uterine bleeding; and suggesting an osteoarthritis patient might benefit from an injection of growth hormones.

E. During his oral clinical examination, respondent was presented with six patient scenarios, including headache, thyroiditis, erectile dysfunction, perimenopause with dysfunctional uterine bleeding, postmenopause/osteoporosis, and fibromyalgia. Respondent did not recommend conducting a physical examination for any of the hypothetical patients. When asked about his failure to recommend a physical in any of the cases, respondent explained his belief that physica1s are not needed because he can get all the information he needs from a thorough history.

F. Respondent failed the oral clinical examination.

G. As part of PACE, respondent submitted seven of his randomly selected charts for review by PACE. On or about October 11, 2009, his seven charts were evaluated by a Board Certified physician who is a member of the PACE faculty. At this point in time, respondent had already successfully completed the PACE medical record keeping course as required by his terms and conditions of probation. Each of respondent's 'seven charts had elements' that were deficient, unacceptable, and failed to meet the standard of care, including, but not limited to the following:

1. Respondent's records were not clear;

2. The records were incomplete, in that there was insufficient information provided to determine the appropriateness of care or plans;

3. The patient's name and gender was often missing from the progress notes;

4. Respondent failed to use the SOAP format and failed to include objective symptoms or references to any physical examination;

5. Respondent did not always document an assessment, give a diagnosis, or include a treatment plan;

6. Occasionally, respondent had a diagnosis, but no explanation for how he arrived at it. For example, on one occasion a patient was seen with the main concern of acne. Respondent's chart identified a diagnosis of "Creative ADHD" without any explanation for how he arrived at that diagnosis;

7. Some entries were sparse and inadequate; and

8. The records did not include follow-up plans for monitoring.

H. Respondent told different PACE faculty members that he does not examine his patients or conduct physical examinations in his practice.

I. Respondent told different faculty members that he takes his diabetics off their medicine and instead prescribes progesterone. While at PACE, on or about March 8, 2010, respondent also told a sports medicine patient who happened to be diabetic that the patient should stop taking his medicine and take a type of progesterone.

J. Respondent admitted that he does not follow the standard of care. He stated that he is the only medical practitioner· who truly understands the disease process, and as such, he had no intention of following the standard of care identified by PACE or the Medical Board.

K. Respondent was asked to prepare a research paper demonstrating a scientific basis (evidence based medicine) for his recommended treatment protocols using progesterone. Respondent could not support his theories with scientific evidence. He failed the evidence based medicine project.

L. Following respondent's participation in Phase II of PACE, the clinical education portion, some faculty concluded that respondent is a dangerous practitioner who is not competent to safely practice medicine.

M. Upon review of the entirety of respondent's participation in PACE, PACE directors concluded that respondent failed the PACE Program and that he is not safe to practice medicine. The Medical Board received notice of this conclusion on or about June 1, 2010.

16. Respondent's failure to successfully complete PACE is a violation of the terms and conditions of his probation.

SECOND CAUSE TO REVOKE PROBATION
(Failure to Obey All Laws & Rules Related to the Practice of Medicine - Incompetence)

17. At all times after the effective date of Respondent's probation in Case No. 09-2006- 75931, Condition 7 stated:

"7. Obey All Laws. Respondent shall obey all federal, state and local laws, all rules governing the practice of medicine in California and remain in full compliance with any court ordered criminal probation, payments and other orders."

18. Respondent's probation is subject to revocation because he failed to comply with Probation Condition 7, referenced above in paragraph 16, by violating Code section 2234, subdivision (c), incompetence, as follows:

A. Paragraph 15 and its subsections are incorporated herein by reference.

B. Respondent showed a lack of medical knowledge and skill during his participation in PACE, 'and was thus incompetent, in violation of the Medical Practice Act, section 2234, subdivision (d), as described above in paragraph 15, above.

THIRD CAUSE TO REVOKE PROBATION
(Failure to Obey All Laws & Rules Related to the Practice of Medicine - Records)

19. Respondent's probation is subject to revocation because he failed to comply with Probation Condition 7, referenced above in paragraph 16, by violating Code section 2266, through his failure to maintain adequate and accurate medical records, as follows:

A. Paragraph 15 and its subsections are incorporated herein by reference.

B. Respondent failed to maintain adequate and accurate patient records with respect to the seven random charts he submitted to PACE for its review. The inadequate charts violated the Medical Practice Act, section 2266, as described in paragraph 15 (G), above.

FOURTH CAUSE TO REVOKE PROBATION
(Failure to Obey All Laws & Rules Related to the Practice of Medicine - Dishonesty)

20. Respondent's probation is subject to revocation because he failed to comply with Probation Condition 7, referenced above in paragraph 16, by violating section 2234, subdivision (e), by engaging in dishonesty, as follows:

A. Paragraph 15 and its subsections are incorporated herein by reference.

B. On or about August 6, 2010, in response to Complainant's filing of a Petition for Interim Order of Suspension, respondent signed a Declaration under penalty of perjury, which he filed with the Office of Administrative Hearings in support of his opposition to the Petition. Respondent's Declaration contained statements that respondent knew were false, misleading, and dishonest, including, but not limited to the following statements:

1. Respondent declared: "I always advise my patients to check with their primary care doctor before following the treatment."

2. Respondent declared: "I believe in physical examinations. I routinely do appropriate physical exams, which usually includes checking the vital signs, I listen to the heart and lungs, I palpate the thyroid, and I palpate pressure points."

3. Respondent declared that "The allegation that I take diabetics off insulin is false. I do sometimes recommend that certain diabetics could be taken off insulin if laboratory test results reveal the patient is producing large amounts of insulin on his or her own."

4. Respondent declared that he "takes great care to monitor" his patients "closely."

FIRST CAUSE FOR DISCIPLINE
(Gross Negligence)

Patient J.J.2

2To protect patient privacy, patient names are identified by initials only.

21. Respondent is subject to disciplinary action under section 2227 and 2234, as defined by section 2234, subdivision (b), in that respondent was grossly negligent in his care, treatment and management of patient J.J. The circumstances are as follows:

A. On or about May 10, 2005, J.J., a 50 year old woman, sought care and treatment from respondent at his medical office in Rancho Mirage, California. She completed some forms and paid for and obtained numerous lab tests. On one form, she wrote that she had diabetes and hypertension, and she checked. boxes indicating she was frequently incontinent and fatigued. Her list of medications included medicine for diabetes (Glucatrol, Glucophage and Humalog), medication for hypertension (zestril), medication for incontinence (ditropan), and vitamin and ,mineral supplements. She stated her major concerns were her high blood sugars, fatigue) and weight.

B. Respondent's sole meeting with J.J. was on or about May 23, 2005. Respondent had the results of the lab work taken on or about May 10, 2005. In part, the lab work showed the following: J.J.’s triglycerides were dangerously out of range, at 541. (Normal reference range is under 150 MG/DL.) Her glucose was also extremely elevated, at 251. (Normal reference range is 65-99.) J.J.'s insulin level was high at 20. (Normal range is less than 17.) Her ALT level was elevated at 53. ·(Normal ALT range is between 2 and 40 U.L.) Patient J.J.'s DHEA sulfate level was elevated at 178. (Normal is 15-170.) Her testosterone, progesterone, and thyroid levels were all in the normal range.

C. Though respondent spoke at length with J.J., respondent did not conduct a physical examination of the patient or review her medical records from any other medical provider.

D. J.J. purchased a one year "plan" from respondent.

E. Respondent diagnosed J.J. with hypertension, hypothyroidism, diabetes mellitus, hypoadrenalism, fibromyalgia and menopausal syndrome.

F. Respondent failed to document relevant patient hi story (or results of a physical examination or test) to show how he arrived at the diagnoses of hypothyroidism, hypoadrenalism, fibromyalgia, or menopausal syndrome.

G. Respondent failed to appropriately address J.J.'s elevated laboratory levels.

H. Without medical indication, respondent instructed the patient to abruptly discontinue all medications she had been taking, including her diabetic and anti­hypertensive medications.

I. Respondent prescribed numerous drugs to J.J., including progesterone cream, testosterone cream, DHEA, and thyroid medications, all without medical indication.

J. Respondent also instructed the patient to take supplements and follow his low/no carbohydrate diet closely.

K. Respondent failed to counsel his patient about the risks of abruptly stopping her medications and following his treatment plan.

L. Respondent failed to obtain informed consent before commencing his treatment plan.

M. Respondent told, J.J. she did not need to monitor her blood sugars at home.

N. Respondent did not advise J.J. to discuss his recommended treatment with her primary care or regular physician before following his recommendations.

O. Respondent failed to schedule a follow-up appointment and failed to adequately or appropriately follow the patient's response to his treatment.

P. About a week later, J..J. telephoned respondent. She reported her blood sugar was elevated to 344 and she was throwing up. Respondent charted that he spoke to the patient at the end of the day, and her blood sugar was "down" to 214. Within two weeks of Starting respondent's regimen, J.J. became very ill. She had diarrhea, developed fatigue, was still vomiting, had an elevated heart rate, and then was constipated. Respondent did not advise the patient to come in for an evaluation, but told her to stop the thyroid medication. She felt terrible, could not keep food or water down, and had lost 17 pounds. When J.J.'s husband called respondent's office, the dietician told Mr. J. the patient was just "detoxing" and to give her low carb fruits and a laxative. It did not help. On June 8, 2005, J.J.'s husband spoke with respondent. Respondent prescribed suppositories for nausea. Within less than a month, J.J. 's husband had called respondent's office 22 times concerning his wife's deteriorating condition. On respondent's advice, J.J. had colonics. Her condition did not improve. Respondent did not have her come back to the office for an evaluation.

Q. On or about June 20, 2005, J.J.'s husband again spoke with respondent. He conveyed that J.J. was still nauseated and could not keep food or water down. Respondent thought she was possibly impacted and recommended J.J. go to the Emergency Room.

R. J.J. went to her local emergency room at the Inland Valley Medical Center. She was weak, in pain, nauseous, and by this point in time, had lost 30 pounds. She was admitted to the JCU, where she was started on IV fluids, IV insulin and IV antibiotics. J.J. was diagnosed with several serious conditions: acute metabolic acidosis, diabetic ketoacidosis, uncontrolled diabetes mellitus, hepatopathy, acute renal insufficiency, hypokalemia, acute pancreatitis and hyponatremia.

S. J.J. was discharged on June 26, 2005, advised to follow with her primary care physician and continue her insulin.

T. Respondent failed to maintain an adequate and accurate medical chart on patient J.J. His chart entries lack critical information. They contained virtually no history, no assessment or plan. His telephone calls with the patient or her husband were poorly documented, if they were documented at all.

Patient M.P.

22. Respondent is further subject to disciplinary action under sections 2227 and 2234, as defined by section 2234, subdivision (b), in that respondent was grossly negligent in his care, treatment and management of patient M.P. The circumstances are as follows:

A. Patient M.P., a 53 year old man, first sought treatment from respondent's office on December 8, 2006. He completed a form indicating he had diabetes, hypertension, a possible auto immune disease, and that he was hypothyroid. He listed a number of medications that he was taking, including medication for high blood pressure (Diovan), medications for his diabetes (Actos, Glucophage and Lantus), and thyroid medication (Synthroid). Labs were ordered .

B. M.P.'s first patient encounter with respondent was on January 4, 2007, at respondent's medical office. They spoke at length. Respondent did not conduct an appropriate or adequate physical examination of the patient, or any physical examination of the patient.

C. During the visit on January 4, 2007, respondent had the results of the lab work he ordered. In part, the results showed the following: M.P. 's triglycerides, total cholesterol, LDL cholesterol and cholesterol to HDLC ratio were high and out of 'normal reference ranges. M.P,'s glucose was also high, at 199 (Normal reference range is 65-99.) His ALT level was elevated at 92. (Normal ALT range IS between 2 and 40 U.L.) Patient M.P.'s DHEA sulfate level was low, at less than 15. (Normal reference range was 25-240.) His testosterone, progesterone, and thyroid levels were all in the normal range.

D. Respondent charted that the patient had "diabetes (recent onset)", and on the next line, wrote "ADHD/severe fibromyalgia/RBS." Below that, respondent wrote his "plan", which was to "d/c [discontinue] diabetic meds." Respondent also had the patient speak with the office dietician about a meal plan and supplements.

E. Respondent failed to document any relevant patient history, or results of any physical examination or testing to show how he arrived at the diagnoses of ADHD, fibromyalgia, or RBS (restless body syndrome.)

F. Respondent failed to appropriately address M.P.'s elevated laboratory levels.

G. Without medical indication, respondent instructed the patient to abruptly discontinue all his diabetic medications and blood pressure medications, except two.

H. Respondent prescribed numerous drugs to M.P., including progesterone, and testosterone, and he increased the dosages of his thyroid medications, all without . medical indication. .

J. Respondent failed to counsel his patient about the risks of abruptly stopping his medications and following his treatment plan.

K. Respondent failed to obtain informed consent before commencing his treatment plan.

L. Respondent did not tell the patient to check with his primary care physician before starting respondent's recommended treatment regimen.

M. Respondent failed to adequately or appropriately follow the patient's response to his treatment. He did not order repeat labs for almost 9 months. He failed to rescreen the patient's Hga1c and did not adequately monitor the patient's blood sugars, but only charted that the blood sugars were "ok." He did not set goal ranges for cholesterol or blood sugars.

N. Respondent continued to treat M.P. through February, 2008. At various times, the patient's lab values were elevated, but these elevations were not addressed by respondent. For example, in September, 2007, respondent .charted that the patient's labs were "ideal", even though his testosterone level was high and outside the normal range. In January, 2008, .M.P. had elevated cholesterol, triglycerides and uncontrolled blood pressure (at 140/90), but respondent failed to address or appropriately respond to these medical conditions that placed the patient at increased risk, particularly in conjunction with his entire treatment regimen.

O. Respondent's chart notes on M.P. are sparse and inadequate.

Patient L.T.

23. Respondent is further subject to disciplinary action under section 2227 and 234, as defined by section2234, subdivision (b), in that respondent was grossly negligent in his are, treatment and management of patient L.T. The circumstances are as follows:

A. Patient L.T., a 36 year old' woman, first sought treatment from respondent at his medical office on July 4, 2007. She completed a form indicating her medical conditions were OCD and anxiety, and that she was taking 60 mg. fluoxetin (Prozac). She was concerned about weight gain, wanted to lose weight, and wanted to go off ' Prozac. Labs had been ordered and respondent reviewed them. The results were all within the normal range.

B. Respondent spoke with L.T. and her husband. Respondent did not conduct an appropriate or adequate physical examination of the patient, nor any physical examination of the patient.

C. Respondent did not review or request the patient's prior treating medical or mental health records.

D. Respondent charted a diagnosis of "ADHD/fibromyalgia/RLS." His chart entry does not explain how he arrived at these diagnoses.

E. Without medical indication, respondent instructed his patient to stop taking the Prozac. He charted "will wean off Prozac", but did not give the patient instructions on how to stop taking the medication.

F. Respondent prescribed numerous drugs to L.T., including progesterone (four times a day), testosterone, and two thyroid medications, all without medical indication.

G. Respondent failed to counsel his patient about the risks of abruptly stopping her Prozac and following his treatment plan.

H. Respondent failed to obtain informed consent before commencing his treatment plan.

1. Respondent failed to advise the patient to discuss with her primary care physician (or other physician who had prescribed the Prozac), that respondent recommended she discontinue taking anti-depressant medication, or that she have this discussion with the physician prescribing Prozac before she followed respondent's instruction to stop taking it.

J. On or about July 20, 2007, the patient called respondent's office, reporting that she had been completely off Prozac for 9 days, she had gained weight, and was concerned about getting depressed. Respondent recommended she increase her progesterone and follow the meal plan.·

K. The patient's obsessive-compulsive symptoms began to spiral out of .control. Her husband reported to respondent's office that she had gone off the Prozac "cold turkey," was gaining weight, having temper tantrums, destroying things, and calling her husband 70 to 80 times a day at work, was impossible to be around, and needed help. In response, and without recognizing the effects of the patient's abrupt, and improper end to her anti-depressants, respondent kept increasing the patient's thyroid medication dosages.

L. Respondent's treatment resulted in the patient becoming increasingly ill, with dizziness, hypertension, weight gain, anger, bloating, elevated cholesterol, and OCD symptoms. On February 6, 2008, the patient left a message for respondent that she had been dizzy since December, when she increased the thyroid medication at his instruction, so she discontinued it on her own.

Patient G.B.

24. Respondent is further subject to disciplinary action under section 2227 and 2234, as defined by section 2234, subdivision (b), in that respondent was grossly negligent in his care, treatment and management of patient G.B. The circumstances are as follows:

A. Patient G.B., an 82 year old woman, first sought treatment from respondent on February 7, 2007. She reported a history of diabetes, hypertension, arthritis, hyperlipidemia, and low sodium.. She listed a number of medications that she was taking, including medications for her high blood pressure (Diovan/HCT, Norvase, and Metoprolol), medications for her diabetes (actos and Glyburide), and medication for her high cholesterol (vitorin).

B. Respondent spoke with the patient. He did not conduct an appropriate or adequate physical examination of the patient, or any physical examination of the patient.

C. Respondent chart reflected that the patient had an elevated blood pressure of 140/80 and weight of 233 pounds.

D. Respondent diagnosed G.B. with ADHD, fibromyalgia, and hypertension.

E. Respondent failed to document any relevant patient history, results of a physical examination, or test showing how he arrived at the diagnoses of ADHD or fibromyalgia.

F. Without medical indication, respondent instructed the patient to abruptly stop taking all diabetic and anti-hypertensive medications.

G. Respondent prescribed topical progesterone and testosterone creams without medical indication.

H. Respondent prescribed G.B. thyroid medication without medical indication.

I. . Respondent failed to appropriately counsel his patient about the risks of abruptly stopping her medications.

J. Respondent failed to obtain informed consent before commencing his treatment plan.

K. Respondent failed to inform the patient of set goals for fasting and post­prandial sugars, and he did not order a follow up HGA1c to evaluate long term sugar control.

L. Respondent did not advise G.B. to discuss his recommended treatment with her primary care or regular physician before following his recommendations.

M. Respondent failed to adequately or appropriately follow the patient's response to his treatment.

N. On or about Match, 2007, during a "telephone appointment;" G.B. told respondent that her blood sugars were elevated to 138; fasting. In response, respondent told the patient, without medical indication, to stop taking the Glyburide for her diabetes. By March, 2008, her blood sugar was reported to be 172. Respondent did not appropriately address her diabetes.

O. Respondent did not follow established laboratory values in providing care and treatment to G.B. Though the patient had supraphysiologic levels of thyroid hormone after following respondent's synthroid regimen for a year, respondent did not advise G.B. to reduce or stop her thyroid replacement medication dosage. In 2008, when the patient's testosterone levels were elevated at 54 (where normal values range from 2-40), respondent did not advise the patient to decrease or stop using the testosterone.

P. Respondent's medical records for patient G.B. were sparse and inadequate.

Patient B.M.

25. Respondent is subject to disciplinary action under section 2227 and 2234, as defined by section 2234, subdivision (b), in that respondent was grossly negligent, in his care, treatment and management of patient B.M. The circumstances are as follows:

A. Patient B.M. was first seen by respondent on or about June 21, 2008. He completed a form indicating he had a history of hypertension, arthritis, a hiatal hernia, GERD, COPD, and emphysema. B.M. was on approximately 10 medications, including hypertensive and cholesterol medications, and Plavix, a blood thinner. Labs were taken.

B. Though respondent charted the patient's weight, blood pressure, and pulse, he failed to obtain or chart a respiratory rate, pulse oxygenation, or peak flow. Respondent failed to take an adequate history and- failed perform an adequate physical or any physical examination. He also failed to request or obtain the patient's prior treating records.

C. Though the patient's .initial cholesterol levels were at goal range on the medication he was taking, and respondent acknowledged the patient's blood pressure was "a little high," respondent advised the patient to stop all medications.

D. During the course of treatment, respondent prescribed progesterone and DHEA, and recommended supplements.

E. Respondent failed appropriately counsel his patient about the risks of stopping his medications or stopping them abruptly.

F. Respondent failed to obtain informed consent before commencing his treatment plan.

G. Respondent knew or should have known the patient had a history of a potential stroke and should not have been off his medications.

H. Following respondent's treatment and recommendations, the patient's cholesterol, LDL, HDL levels rose. He developed facial numbness.

I. Respondent's records regarding patient B.M. were sparse and inadequate.

Patient D.W.

26. Respondent is further subject to disciplinary action under section 2227 and 2234, as defined by section 2234, subdivision (b), in that respondent was grossly negligent in his care, treatment and management of patient D.W. The circumstances are as follows:

A. D.W., a 65 year old man, first sought treatment from respondent on or about July 27, 2006. He reported he had diabetes and hypertension, and that his blood sugar was consistently in the 200s. At the time, he was taking approximately 15 different prescription medications prescribed by other physicians.

B. Respondent spent a few hours speaking with D.W. He did not, however, prepare adequate chart notes reflecting his time with the patient. Nor did respondent chart conducting a physical examination.

C. Respondent charted diagnosis of ADHD and severe fibromyalgia. He also noted the patient was a diabetic on insulin and that he had asthma and high cholesterol.

D. Respondent failed to document any relevant patient history, results of a physical examination, or test showing how he arrived at the diagnoses of ADHD or "severe fibromyalgia."

E. Respondent recommended that the patient stop taking most of the medications he was on, including insulin.

F. Without medical indication, respondent prescribed testosterone, progesterone, and thyroid medications for the patient.

G. Respondent failed appropriately counsel his patient about the risks of stopping his medications or stopping them abruptly.

H. Respondent failed to obtain informed consent before commencing his treatment plan.

1. Respondent failed to advise the patient to discuss the treatment plan with his primary care physician before following respondent's recommendation that he stop his insulin and the other medications respondent suggested he stop.

J. At one point, on or about October 17, 2006, D.W. called respondent reporting he had a rash for about two weeks and had had diarrhea for three to four weeks. Respondent attempted to manage the patient over the phone. The symptoms persisted. On or about October 31, 2006, respondent finally recommended the patient be seen the next day.

K. Respondent failed to maintain adequate medical records regarding his care and treatment of D.W.

SECOND CAUSE FOR DISCIPLINE
(Repeated Negligent Acts)

27. Respondent is subject to disciplinary action under section 2227 and 2234, as defined by section 2234, subdivision (c), in that Respondent was repeatedly negligent in the care, treatment and management of patients J.J., G.B., M.P., L.T., B.M., .and D.W., as described above in paragraphs 21 through 26, which are incorporated by reference herein.

THIRD CAUSE FOR DISCIPLINE
(Incompetence)

28. Respondent is further subject to disciplinary action under section 2227 and 2234, as defined by section 2234, subdivision (d), in that Respondent has demonstrated incompetence, as follows:

Paragraphs 15, 17, and 21 through 26 are incorporated by reference .

B. Respondent showed a lack of skill and knowledge through his acts and omissions during his participation in PACE, from September, 2009 through March, 2010.

C. Respondent was incompetent in the care, treatment and management of patients J.J., G.B., M.P., L.T., B.M., and D.W. , as described above in paragraphs 21 through 26, which are incorporated by reference herein.

FOURTH CAUSE FOR DISCIPLINE
(Prescribing Drugs without Appropriate Prior Examination & Medical Indication)

29. Respondent is further subject to disciplinary action under section 2227 and 2234, as defined by section 2242, subdivision (c)) of the Code in that Respondent prescribed dangerous chugs to patients G.B., M.P., L.T., B.M., and D.W.) without an appropriate prior examination and without medical indication, as described above in paragraphs 21 through 26, which are incorporated by reference herein.

FIFTH CAUSE FOR DISCIPLINE
(Failure to Maintain Adequate and Accurate Medical Records)

30. Respondent is further subject to disciplinary action under sections 2227 and 2234, a defined by section 2266 of the Code) for failing to maintain adequate and accurate records, as follows:

A. Paragraphs 15, and 21 through' 26 are incorporated by reference.

B. Respondent failed to maintain adequate and accurate records on patients G.B. , J.J., B.M., M.P., L.T., and D.W) and on the patients whose records he provided to PACE.

SIXTH CAUSE FOR DISCIPLINE
(Dishonesty)

31. Respondent is further subject to disciplinary action under sections 2227 and 2234, defined by section 2234, subdivision ( e) of the Code, by committing acts of dishonesty) as follows:

A. On or about August 6, 2010, in response to Complainant's filing of a Petition for Interim Order of Suspension, respondent signed a Declaration under penalty of perjury, which was filed in support of his opposition to the charges alleged in the Petition for Interim Order of Suspension. Respondent's Declaration contained statements that respondent knew were false and dishonest, including, but not limited to the following statements:

1. Respondent declared: "I always advise my patients to check with their primary care doctor before following the treatment."

2. Respondent declared: "1 believe in physical examinations. I routinely do appropriate physical exams, which usually includes checking the vital signs, I listen to the heart and lungs, I palpate the thyroid, and I palpate pressure points."

3. Respondent declared that "The allegation that I take diabetics off insulin is false. i do sometimes recommend that certain diabetics could be taken off insulin if laboratory test results reveal the patient is producing large amounts of insulin on his or her own.

4. Respondent declared that he ''takes great care to monitor" his patients "closely."

SEVENTH CAUSE FOR DISCIPLINE
(General Unprofessional Conduct)

32. Respondent is subject to disciplinary action pursuant to Section 2234, in that respondent engaged in general unprofessional conduct as demonstrated above in paragraphs 15, 21-26, and 31, which are incorporated by reference herein.

FACTORS IN AGGRAVATION

33. Through the disciplinary process as part of the Board's Decision issued February 5, 2009, arid effective March 9, 2009, in In the Matter of the Accusation Against Michael Edward Platt, MD, Case No. 09-2006-175931, respondent was disciplined, in part, for failing to conduct adequate physical examinations prior to recommending treatment to his patients, and for recommending and prescribing testosterone for the treatment of incontinence in women, both of which are outside the standard of care. Despite discipline for these acts and omissions, respondent continued to engage in the same misconduct.

34. As part of the Board's Order of Discipline issued in In the Matter a/the Accusation Against Michael Edward Platt, MD, Case No. 09-2006-175931, respondent was required to attend PACE on medical record keeping. Respondent completed the PACE medical record keeping course prior to his participation in the full PACE Program. Despite his completion of the medical record keeping course, respondent continued to maintain inadequate and inaccurate medical records as found by the PACE faculty during the random examination of his charts in September 2009, as described above in paragraph 15.

PRAYER

WHEREFORE, Complainant requests that a hearing be held on the matters herein alleged, and that following the hearing, the Medical Board of California issue a Decision:

  1. Revoking or suspending Physician's and Surgeon's Certificate Number G23729, issued to Michael E. Platt, M.D.
  2. Revoking, suspending or denying Michael E. Platt, M.D., the authority to supervise physician's assistants, pursuant to section 3527 of the Code;
  3. Ordering Michael E. Platt, M.D., to pay the costs of probation monitoring; should he be placed on probation; and,
  4. Taking such other and further action as deemed necessary and proper.

LINDA K. WHITNEY
Executive Director
Medical Board of California
Department of Consumer Affairs
State of California
Complainant

This page was revised on April 2, 2012..

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