Click here to see the original Texas Medical Board Press Release.

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TMB disciplines 45 physicians at August meeting, adopts rule changes

At its August 26, 2016 meeting, the Texas Medical Board disciplined 45 licensed physicians and issued three cease and desist orders. The disciplinary actions included: ten orders related to quality of care violations, seven orders related to unprofessional conduct, three revocations, seven voluntary surrenders/revocations, three orders related to other states’ actions, four orders related to peer review actions, one order related to criminal activity, two orders related to improper prescribing, one order related to improper supervision or delegation, one order related to violation of Board rules, three
orders related to violation of prior Board order, and three orders related to a Texas Physician Health Program violation.

The Board also took action against a Non-Certified Radiologic Technician.

The Board issued 159 physician licenses at the August meeting, bringing the total number of physician licenses issued in FY16 to 4,093.

RULE CHANGES ADOPTED

CHAPTER 174. TELEMEDICINE

§174.11, On-Call Services
The amendment to §174.11, concerning On-Call Services, amends and adds language referring to Chapter 177 (relating to Business Organizations) and newly adopted Subchapter E titled “Physician Call Coverage Medical Services.”

CHAPTER 177. BUSINESS ORGANIZATIONS

§177.16, (Subchapter C) Physician Assistants
The amendments to 177.16, relating to Physician Assistants, eliminates section (e) and amends section (f) in order to
align with a recent 3rd Court of Appeals decision, which invalidated part of the rule relating to the grandfathering clause
and entities solely owned by physician assistants. Accordingly, the amendments to this section correct sections of the
rule that were invalidated by the 3rd Court of Appeals decision.

§177.18-177.20, (New Subchapter E) Physician Call Coverage Medical Services
New §177.18-177.20, concerning Physician Call Coverage Medical Services, provides physicians guidance and sets forth the minimum requirements relating to on-call services and agreements.

CHAPTER 185. PHYSICIAN ASSISTANTS

§185.2, Definitions
The amendments to §185.2, relating to Definitions, add definitions for “Active Duty” and “Armed Forces of the United
States” and amend definitions for “Military service member”, “Military spouse” and “military veteran.” These
amendments are in accordance with the passage of SB 1307 (84th Regular Session) which amended Chapter 55 of the Texas Occupations Code.

§185.4, Procedural Rules
The amendment to §185.4, relating to Procedural Rules, expands subsection (f), Alternative Licensing Procedure, to include military service members and military veterans. The amendment also includes language allowing the executive
director to waive any prerequisite to obtaining a license for an applicant described in the subsection, after reviewing the
applicant’s credentials. These amendments are in accordance with the passage of SB 1307 (84th Regular Session) which
amended Chapter 55 of the Texas Occupations Code.

§185.6, Annual Renewal
The amendment to §185.6, relating to Annual Renewal, adds new subsection (b)(9) providing that a surgical assistant
who is a military service member may request an extension of time, not to exceed two years, to complete any
continuing education requirements. The amendment also adds new subsection (j) providing that military service
members who hold a license to practice in Texas are entitled to two years of additional time to complete any other
requirement related to the renewal of the military service member’s license. This amendment is in accordance with the
passage of SB 1307 (84th Regular Session) which amended Chapter 55 of the Texas Occupations Code.

§185.7, Temporary License
The amendment to §185.7, relating to Temporary License, changes an incorrect citation, §185.4(d), to the correct
citation, §185.4(c).

§185.8, Inactive License
The amendment to §185.8, relating to Inactive License, adds new language in subsection (d) providing that a licensee
attempting to return from inactive to active status must complete a fingerprint card and return the card to the board as
part of the application, as well as submitting, or having submitted on the applicant’s behalf, a report from the National
Practitioner Data Bank/Health Integrity and Protection Data Bank (NPDB-HIPDB).

CHAPTER 199. PUBLIC INFORMATION

§199.6, Enhanced Contract or Performance Monitoring
New §199.6, concerning Enhanced Contract or Performance Monitoring, delineates the criteria and requirements for the
agency’s identification of and monitoring of certain contracts. This new section is added in accordance with the passage
of SB 20 (85th Regular Session) which amended Chapter 2261 of the Texas Government Code.

CHAPTER 200. STANDARDS FOR PHYSICIANS PRACTICING COMPLEMENTARY AND ALTERNATIVE MEDICINE

§200.3, Practice Guidelines for the Provision of Complementary and Alternative Medicine
The amendment to §200.3, concerning Practice Guidelines for the Provision of Complementary and Alternative
Medicine, corrects an incorrect reference to the “board of medical examiners.”

DISCIPLINARY ACTIONS

QUALITY OF CARE
Adeleye, Victoria M., M.D., Lic. No. N7985, Conroe
On August 26, 2016, the Board and Victoria M. Adeleye, M.D., entered into an Agreed Order requiring her to within one
year complete at least 16 hours, divided as follows: eight hours in polypharmacy and eight hours in medical
recordkeeping. The Board found Dr. Adeleye with respect to one patient, failed to use proper diligence and keep
adequate medical documentation on educating the patient of potential medication risks and failed to coordinate care
with the patient’s pain management physician who was prescribing narcotics.
Becker, Teresa M., M.D., Lic. No. G7036, Houston
On August 26, 2016, the Board and Teresa M. Becker, M.D., entered into an Agreed Order publicly reprimanding Dr.
Becker and requiring her to within one year complete at least 12 hours of CME, divided as follows: eight hours in
evaluation and treatment of alcohol and drug withdrawals and seizures and four hours in risk management. The Board
found Dr. Becker signed off on in-take orders that included a withdrawal watch protocol on which the patient’s vitals
were being monitored. After the patient’s first seizure, Dr. Becker appropriately prescribed Librium, however, she failed to meet the standard of care by failing to place the patient under closer medical supervision and/or transferring him to a
hospital. As a result, the patient suffered additional seizures that were not reported to Dr. Becker, which led to the
patient’s death.
Diaz, Horacio Alberto, M.D., Lic. No. K4408, Laredo
On August 26, 2016, the Board and Horacio Alberto Diaz, M.D., entered into an Agreed Order requiring Dr. Diaz to within
one year complete at least 16 hours of CME, divided as follows: eight hours in diagnosing or treating chest pain or
conditions that may be cardiac in origin, four hours in physician-patient communications and four hours in medical
recordkeeping. The Board found Dr. Diaz failed to properly evaluate one patient and discharged the patient
prematurely.
Fehr, Gregory Brien, M.D., Lic. No. K1813, Mission
On August 26, 2016, the Board and Gregory Brien Fehr, M.D., entered into an Agreed Order publicly reprimanding Dr.
Fehr and requiring him to within one year and three attempts pass the Special Purpose Exam (SPEX); within one year
complete at least 24 hours of CME, divided as follows: four hours in risk management, four hours in ethics, eight hours in
medical recordkeeping and eight hours in procedural sedation; and within 60 days pay an administrative penalty of
$2,000. The Board found Dr. Fehr administered three doses of Propofol that were higher than normal and did not record
in the medical records why they were necessary, did not adequately monitor the patient after administering the doses
and submitted responses to the Board without reviewing the relevant medical records.

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Click here to see the original Texas Medical Board Press Release.