Vet Board Visits Music
is "Won't Back Down"
- Lyrics below.
OUR
SPEECH FROM FEBRUARY 14, 2008 NOW POSTED BELOW We
attended the scheduled meeting of the Texas State Board of Veterinary
Medical Examiners on October 12, 2006 in Austin, Texas. We both
addressed the Board with scathing 3 minute speeches (board imposed time
limit - speech text below) during the citizen comments portion of the
meeting. We provided the Board with our incoming phone records from
April 7, 2006 that provides indisputable proof that Board Investigator
Dennis Barker lied about calling and interviewing Stempy's human mom,
Cindy Munson (co-author of this website). We also went over grave
concerns that we have with the complaint process and many other
unresolved issues regarding the complaint. Board rules state that the
investigator shall interview the complainant (which is us) as part of
the complaint process. Now that we have given the Board indisputable
proof of the unethical behavior of it's investigator, will the Board
take action? (Update 4/14/07 - Does not look like it. The Board has
still DONE NOTHING.) CINDY MUNSON
SPEECH TO THE BOARD 10/12/06 My
name is
Cindy Munson. My husband and I filed a complaint with the board,
#06-111, in
regards to what we allege was negligent and substandard care that we
believe
resulted in the death of Stempy, our beloved Shih Tzu. We are present
today to
hear the information regarding his complaint as provided for in Board
rule
575.27g. (see handout)(below) Most of you should be familiar with this
case. We
mailed copies of the complaint and appeal to all veterinarian board
members.
The appeal was dismissed on August 3rd 2006.
We
come to the
board today with grave concerns about the complaint process. How is it
possible
that we submit a complaint ABOUT a veterinarian, but yet we are never
allowed
to communicate with the reviewing veterinarians? We are not privy to
the respondent
veterinarian’s reply to our complaint, therefore we are not
allowed to object
or dispute her account of events. The respondent and reviewing
veterinarians
can communicate freely with each other throughout the entire process.
The
complainant, however, is not allowed any contact at all with the
reviewing
veterinarians. That is completely unfair and most certainly is NOT
looking
after the best interest of the patient.
According
to
board rule 575.27c7(see handout)(below), the investigator shall
interview the
complainant. We were never interviewed by the Investigator. According
to an
email from Peter Hartline (see handout)(below), the Investigator claims
to have
called and interviewed me on April 7, 2006. Right now is the first time
I have
EVER spoken to ANYONE with the Board. We have obtained our incoming
phone
records for April 7, 2006. (see handout)(below)These records provide
indisputable proof that the Investigator did not call and interview me
on the
day in question. We could possibly understand the Investigator being
mistaken
about the phone call. What we do not understand or accept is the fact
that the
Investigator then goes on to fabricate a conversation. That changes his
conduct
from mistaken to intentional. This is a very serious situation that
must be
dealt with immediately.
Several
key
issues remain unaddressed.
The
procedure
done on September 27th 2005 was UNAUTHORIZED. Isn’t an
unauthorized procedure
BELOW the minimum standard of care?
Dr.
Thomas did
not have the experience to perform the unauthorized procedure
(according to
Hope, a longtime employee, “That’s the FIRST time
Dr. Thomas has EVER done a
cut like that in 20 years of being a vet.”….as
stated to us on September 27th
2005.). There is NO QUESTION that Stempy should have been referred to a
specialist. Isn’t the failure to refer BELOW the minimum
standard of care? (see
handout)(below)
Dr.
Thomas
provided NO aftercare management that is REQUIRED for
Stempy’s condition.
Proper aftercare management should have been started or recommended
after his
first surgery in November 2003. We provided the opinion of another
Mesquite
veterinarian who always recommends aftercare management. (see
handout)(below)
Isn’t providing ZERO aftercare management BELOW the minimum
standard of care?
My
husband,
Greg, will present the remaining issues. Thank you.
GREG
MUNSON
SPEECH TO THE BOARD 10/12/06
My name is
Greg Munson. I am Stempy’s Daddy.
Dr.
Thomas’
staff DENIED Stempy care on 9-29-05 at 5pm when we called and requested
to
bring him back in because his condition was deteriorating. We were told
specifically, “NO! Do NOT bring Stempy back in. He will be in
pain for 2 or 3
more days.” The clinic stated Stempy would be in pain, yet
Dr. Thomas had taken
Stempy completely OFF of painkillers. She prescribed tranquilizers with
no
analgesia, yet led client to believe he was prescribed a different
painkiller.
This is not BELOW the minimum standard of care?
Dr.
Thomas
sent Stempy home wearing a catheter 3 times to wait days for surgery,
including
twice when no radiographs had been done. Upon mentioning this to
world-renowned
veterinarian Dr. Carl Osborne of the University of Minnesota, he states
that
Dr. Thomas’ actions prompts a reply that encompasses
negligence.
In
the
dismissal letter,with regard to diet, Mr. Mathews states that the
reviewers
note that Hills G/D can be used in dogs where one suspects both oxalate
and
struvite stone types and that this diet was appropriate. We believe
that to be
incorrect. Please review the information we will provide (see
handout)(below)
from the Minnesota Urolith Center. It states that where one suspects
both stone
types, the diet for calcium oxalate TAKES PRECEDENCE, therefore Hills
G/D was
the INCORRECT diet. This is not new information. The copyright at the
bottom is
2002. We believe that no diet will work 100% of the time, that is why
AFTERCARE
MANAGEMENT is crucial. Stempy received NO aftercare management.
Isn’t that
BELOW the minimum standard of care?
Mr.
Mathews
states that Dr. Thomas acknowledges that as a solo practitioner, she
often does
not have time immediately after surgery or appointments to fully
complete the
records. Isn’t that very conducive to forgetting crucial
information by the
time she gets around to writing in the records, such as forgetting that
she was
unquestionably told on 11/1/03 of Stempy’s prior seizure
history? Isn’t failing
to notate crucial information in his records BELOW the minimum standard
of
care?
Mr.
Mathews
mentions a postsurgical radiograph. That is incorrect. Look at the
records. Dr.
Thomas NEVER took postsurgical radiographs to verify removal of all
stones.
Postsurgical radiographs are a part of providing a reasonable standard
of care.
Why
didn’t the
Board request the ORIGINAL records? Photocopied records are much less
likely to
expose altered records.
Exactly
what
unauthorized procedure was performed? A urethrostomy would require a
new
permanent opening. There was none. A urethrotomy would require a new
temporary
opening. There was none. What unauthorized procedure would require an
incision
that extended from his anus to his scrotum, with NO new openings made?
We had
only authorized a cystotomy. Period.
How
can all of
these issues not be BELOW the minimum standard of care? We would
appreciate ALL
of the appointed board members responding to these issues in the very
near
future. Thank you.
***NOTE: WE
SENT FOLLOW UP LETTERS ONE WEEK AFTER THE MEETING AND
WE STILL HAVE NOT RECEIVED EVEN ONE RESPONSE TO
ANSWER OUR
QUESTIONS. IT APPEARS THEY JUST DO NOT CARE. THAT IS PATHETIC.***
(Below
is the
text of the handout) Applicable
Board Rules 575.27g
(g)
Report to
the board of dismissed complaints. The executive director or the
director of
enforcement shall advise the board at each scheduled meeting of the
complaints
dismissed since the last meeting. The information will consist of a
summary of
the allegations, investigation conducted, reasons for dismissal, and
file
number.
575.27c7
(7)
After the
licensee’s response to the complaint is received, further
investigation may
be necessary to
corroborate the
information provided by the complainant and the licensee. During the
investigation, the investigator shall interview the complainant. The
investigator
may request additional medical opinions, supporting documents, and
interviews
with other witnesses.
573.23c
(c)
Responsibility of Licensee to Refer a Case. A licensee shall have a
duty to a
client to suggest a referral to a Specialist, or otherwise more
qualified
licensee, in any case where the care and treatment of the animal is
beyond the
licensee's capabilities. A licensee's decision on whether to accept or
continue
care and treatment of an animal, which may require expertise beyond the
licensee's
capabilities, shall be based on the exercise of sound judgment within
the
prevailing standard of care for a licensee faced with the same or
similar
circumstances.
573.23d2
(2)
Complaints
Regarding Failure to Make Proper Referral. Board investigations of
complaints
alleging failure to properly make referrals will include evaluation of
the
training and experience of the licensee, the availability of a
specialist or
more qualified licensee, the timeliness and adequacy of information
provided to
the client regarding the possible need for a referral, the requests of
the
client, and the likelihood that an adverse result could have been
prevented by
a timely referral.
Peter
Hartline
Email
-----
Original
Message -----
From:
Pete
Hartline
To:
Greg &
Cindy Munson
Sent:
Wednesday, May 31, 2006 10:52 AM
Subject:
RE:
RE: Follow Up
Mr..
Munson:
First,
let me
briefly explain the appeal process.
There is no "right" to an appeal of the reviewing
veterinarians' decision. There
is no
Board rule covering an appeal. It
is
done as a courtesy and informally on a case-by-case basis. We are not required to
grant an appeal. Our
reviewing veterinarians are excellent
veterinarians and give each case a thorough review.
We do not reveal the identity of the "appeal
veterinarian." His/her
job is to look at the WRITTEN record
and decide if the initial decision to dismiss the case on the written
record
was appropriate. If
he/she has any
doubt, the case can move forward to a settlement conference. If he/she is satisfied
that the respondent
veterinarian met the minimum standard of care, the dismissal will be
affirmed. Review is
based on the overall
"picture" of the case, and not one individual aspect or event.
You
do not
have the right to talk to the reviewing Board veterinarian. Any attempts to contact
him/her will
terminate the review. Again,
this
review is based on the WRITTEN record.
As
for the
radiographs, the reviewing veterinarians did not see a reason to review
them at
the time, however, we have requested a copy of them from Dr. Thomas,
and they
will be reviewed when they arrive.
If,
in the opinion of the reviewing veterinarian, they reveal important
information
that could influence the reviewer's decision, we will take that into
consideration.
The
interview
of the complainant by the investigator generally consists of a phone
call. This
call was made on April 7, 2006, when
Investigator Barker spoke with Mrs.. Munson.
I
appreciate
your concern with this matter. You
obviously feel strongly about it.
However, I must now ask you to cease sending me
e-mails with new
questions and points of concern. This
also includes phone calls. I
believe
your position has been well stated, and we know what the issues are. Please let the appeal
process proceed. We
will let you know the outcome before the
end of June.
Peter
C.
Hartline
Director
of
Enforcement
Texas
State
Board of Veterinary Medical Examiners
This
message
contains personal thoughts and opinions of the sender and does not
represent
official policy of the Texas State Board of Veterinary Medical
examiners.
Phone
Records of Greg &
Cindy Munson – April 7,
2006
Outbound LD
LD_From_Call_Date
Call_Time
Call_Length_Minutes
Calling_Number
Called_Number
Call_Type
4/7/2006
20:01:36
0
9725265526
2705265265
Domestic
Outbound Local
Local_From_Call_Date
Call_Time
Call_Length
Calling_Number
Called_Number
4/7/2006
9725265526
2145265265
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9725265526
2145265265
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9725265526
9725265526
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2145265265
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9725265526
2145265265
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2145265265
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9725265526
2145265265
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2145265265
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9725265526
2145265265
Inbound Calls
4/7/2006
Local_&/or_LD_Call_Date
Call_Time
Call_Length
Calling_Number
Called_Number
4/7/2006
3255265265
9725265265
4/7/2006
3255265265
9725265265
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2145265265
9725265265
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2145265265
9725265265
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9725265265
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9725265265
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9725265265
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2145265265
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***We
have blacked all numbers
except the area code of
each phone
number for privacy reasons.***
***Austin,
Texas, where the Vet
Board would be calling from, is area code 512.
As
you can see, there
are no
calls from or to area code 512 on the day in question.***
Aftercare
Management – Other Mesquite, TX Veterinarian Minnesota
Urolith Center
Calcium
Oxalate and Struvite Uroliths
College of
Veterinary Medicine at the University of Minnesota
Dogs
can form
calcium oxalate uroliths following successful management of struvite
(magnesium
ammonium phosphate hexahydrate) uroliths, and vice versa. Sometimes
both
struvite and calcium oxalate are present in the same urolith. When this
occurs,
the likelihood of an initial episode of calcium oxalate urolithiasis,
which has
predisposed the patient to infection-induced struvite urolith
formation, should
be considered. In those situations where dogs have documented
occurrences of
both calcium oxalate and struvite urolithiasis, uncontrollable risk
factors
(defective inhibitors of crystal formation and defective inhibitors of
crystal
aggregation) may be present. This scenario creates a therapeutic
paradox in
that control of some risk factors for struvite urolith formation is
opposite to
that recommended for prevention of calcium oxalate urolith formation.
PREVENTION
If
struvite urolithiasis is associated with urease-positive urinary tract
infections, appropriate therapy should be devised to eradicate the UTI
and prevent its recurrence. Eradication of urease-producing pathogens
will prevent recurrence of infection-induced urolithiasis.In addition,
further medical management should be designed to minimize risk factors
associated with calcium oxalate urolith formation.
When considering dietary management, we recommend that emphasis be
placed on minimizing recurrence of calcium oxalate uroliths, since
medical management currently cannot dissolve this type of urolith.
If
uroliths
should recur despite control of risk factors, they
may be removed
non-surgically by voiding urohydropropulsion, if detected early.
Uroliths
removed by voiding urohydropropulsion should be quantitatively
analyzed. If
attempts at non-surgical urolith removal are unsuccessful, surgery
remains the
most reliable way to remove active uroliths from the urinary tract. We
emphasize, however, that surgery may be unnecessary for clinically
inactive
uroliths.
Further
references:
Lulich JP,
Osborne CA, Unger LK, et al: Nonsurgical removal of urocystoliths by
voiding
urohydropropulsion. In Journal of the American Veterinary Medical
Association.
Vol 203, pp. 660-663, 1993
Osborne CA, et
al.: Canine and Feline Urolithiases: Relationship of Etiopathogenesis
to
Treatment and Prevention. In Canine and Feline Nephrology and Urology,
Osborne
and Finco 1995, pp 798-888.
Osborne CA:
The Management of Recurrent Urolithiasis In Patients with a History of
Calcium
Oxalate and Struvite Urolith Formation. In Partners In Practice, Hill's
Pet
Nutrition pub. Vol V, No. 1, 1992.
Osborne CA, et
al.: Canine Urolithiasis. Small Animal Clinical Nutrition 4th ed.,
2000, pp.
605-688.
©2002
Regents of the
University of Minnesota. All rights reserved.
4/14/07
- Read
the statements above in bold. Dr. Thomas did the exact opposite. She
did NOT have him on the diet for calcium oxalate
urolithiasis. He was on the WRONG diet for TWO
years. If she had bothered to do the required aftercare management and
taken quarterly - or at least twice yearly - radiographs, she could
have caught the new stones forming early enough to have removed them NON-SURGICALLY!!!!!!!!!!!!!!!
THIS
IS UNFORGIVABLE!!!
STEMPY
IS NO LONGER WITH US BECAUSE OF HER
FAILURE TO DO THIS!!
The Board said she met the
minimum
standard of care. Hmmm. Now, we are not vets, but we think it should be
pretty obvious that she MOST
CERTAINLY DID NOT MEET THE
MINIMUM STANDARD OF CARE. WHY
IS THE
TEXAS VET BOARD PROTECTING GUILTY
VETS? Do
your damn job !We
also attended the February 8, 2007 Board meeting. We attended
the June 2007 Board meeting as well. Our speeches are below: Cindy Munson Speech –
June 14, 2007 In
case you have forgotten, my name is Cindy Munson.
Greg Munson Speech – June
14, 2007 I
believe all of you know who I am, but just in case – my name
is Greg Munson.
Cindy Munson Speech -
10/11/07 We need to set the
record straight. Mr. Helmcamp sent each
of the Board members an email or letter in mid July with my
husband’s name as
the subject. We requested a copy of this correspondence. We
don’t believe we
received the same correspondence each of you received, but we will
address it
anyway. You
told him
you would call and even shook his hand. There was a day when a
man’s word and
handshake was as good as gold. What’s your problem, Dr.
Lastovica? Sounds like
your tattling excursion with Dewey left out relevant facts and got
other facts
completely wrong. th wedding anniversary. One of the Shih
Tzu pups was to be a
gift for their anniversary. Dr. Lastovica advertises to be open until
noon on
Saturday. His clinic had closed early. He was out of town. Not that it
would
have done any good if his assistant had not closed early because she
would not
have been able to give vaccinations with out him present, that
is….unless she
practices without a license. My in-laws didn’t get to take
one of the pups
home. Greg Munson Speech - 10/11/07 Dr. Johnsen, You did a
final
analysis of Stempy’s case on July 9th, 2007. In that
analysis, you state that
you will not entertain anymore dialogue from us on this matter. Sir, we
have
NEVER been allowed to have ANY direct dialogue with you regarding
Stempy’s
case, so it’s pretty obvious to us that you are never going
to grow a
conscious, and certainly not while writing your analysis. That would be us, Dr.
Johnsen. When the
stories don’t match between the
complainant and licensee, you need to talk to both parties. You took
time to
speak with the licensee, veterinary specialists, and other private
practitioners,
but yet you have no time to EVER talk with the complainant? How can you
claim
to put yourself in the owner’s shoes when you NEVER EVEN TALK
TO THEM?!? This
is just downright shameful. Your method is not just, nor is it fair. She
was in over
her head. She should have referred Stempy to a specialist. It was not
within
the “penumbra of her treatment plan.” She had no
“treatment plan.” We were very
explicit and clear about what she had our permission for to perform. 
