BEFORE THE NORTH CAROLINA MEDICAL BOARD. In re: ) ) Shyam Lal Garg, MD ) CONSENT ORDER ) Respondent. )

Transcription

1 BEFORE THE NORTH CAROLINA MEDICAL BOARD In re: ) ) Shyam Lal Garg, MD ) CONSENT ORDER ) Respondent. ) This matter is before the North Carolina Medical Board ( Board ) on information received relating to Shyam Lal Garg, MD ( Dr. Garg ). Dr. Garg admits and the Board finds and concludes that: STATUTORY AUTHORITY The Board is a body duly organized under the laws of North Carolina and is the proper party to bring this proceeding under the authority granted it in Article 1 of Chapter 90 of the North Carolina General Statues and the rules and regulations promulgated thereto. FINDINGS OF FACT 1. On October 16, 1982, the Board issued a license to Dr. Garg to practice medicine, license number During time relevant herein, Dr. Garg practiced in Hampstead, North Carolina. 3. Patients A through G presented to Dr. Garg for care. Dr. Garg s charts for these patients were incomplete and inaccurate and, at times, appear carelessly written. Consent Order Shyam Lal Garg, MD Page 1 of 7

2 4. Dr. Garg s notes contain a paucity of information and at other times irrelevant information. Multiple visits often had no chief complaint listed or history of present illness, or plan of treatment other than to refill medications. Other visits have either no physical examination documented or what appears to be excessive review of systems. When treatment plans are listed they often appear nearly identical from note to note. 5. Dr. Garg prescribes controlled substances. From his records, it is not clear that the medications are medically appropriate. The medical records should contain the continued indication for a given treatment plan, especially those treatment plans that involve the use of high risk and potentially dangerous controlled substances. In addition, if a patient s medical conditions are uncontrolled, the treatment plan should be altered and the change in the plan clearly documented in the medical record. Aberrant drug screens are not addressed, and issues regarding drug abuse or diversion are not addressed. In many instances, the medical record does not reflect that Dr. Garg reviewed the North Carolina Controlled Substance Reporting System (NCCSRS). 6. Dr. Garg s treatment plans typically consist of boilerplate lists of generalities that are at times supplemented with more topical discussions. However, there is little to no discussion about the continued indication for prescribing Consent Order Shyam Lal Garg, MD Page 2 of 7

3 controlled substances, the risks/benefits of such treatment, or alternative treatments. The notes are at times inaccurate. 7. Dr. Garg s medical records do not clearly provide the reader with a narrative and context to explain Dr. Garg s prescribed treatments. While the records do not disclose that Dr. Garg s treatments were harmful, there is little evidence that his treatments were medically indicated. An accurate representation for each office visit, including an appropriate and accurate history, physical examination, and treatment plan that builds support for continued medical care should be documented in the medical record. CONCLUSIONS OF LAW The Board has evidence on which it could conclude that Dr. Garg s conduct, as described above, constitutes unprofessional conduct, including, but not limited to, departure from, or the failure to conform to, the standards of acceptable and prevailing medical practice within the meaning of N.C. Gen. Stat (a)(6), which is grounds under that section of the North Carolina General Statutes for the Board to annul, suspend, revoke, or limit his license to practice medicine and surgery issued by the Board or deny any application he might make in the future. Consent Order Shyam Lal Garg, MD Page 3 of 7

4 PROCEDURAL STIPULATIONS 1. Dr. Garg acknowledges and agrees that the Board has jurisdiction over him and over the subject matter in this case. 2. Dr. Garg knowingly waives his right to any hearing and to any judicial review or appeal of this case. 3. Dr. Garg acknowledges that he has read and understands this Consent Order and enters into it voluntarily. 4. The Board has determined it to be in the public interest to resolve this matter as set forth below. 5. Dr. Garg would like to resolve this matter without the need for more formal proceedings. ORDER NOW, THEREFORE, with Dr. Garg s consent, it is ORDERED that: 1. Dr. Garg is hereby REPRIMANDED for the above-described conduct. 2. Dr. Garg is hereby FINED two thousand dollars ($2,000). The FINE shall be paid within sixty (60) days of the date of this Consent Order. 3. Within six (6) months of the date of this Consent Order, Dr. Garg shall complete ten (10) hours of Category I Continuing Medical Education ( CME ) in each of the following subject areas: medical record keeping and controlled substance prescribing. The CME courses must be pre-approved by the Consent Order Shyam Lal Garg, MD Page 4 of 7

5 Board s Medical Director. Dr. Garg shall submit evidence of the completion of CME courses to the Board s Compliance Department within thirty (30) days of completing the courses. 4. Dr. Garg shall submit to a chart review within one year of the date of this Consent Order. 5. Dr. Garg shall obey all laws. Likewise, Dr. Garg shall obey all rules and regulations involving the practice of medicine. 6. Dr. Garg shall meet with the Board or members of the Board for an investigative interview as such times as requested by the Board. 7. This Consent Order is intended solely for the purpose of resolving the cases at hand and for no other purpose. 8. If Dr. Garg fails to comply with any of the terms of this Consent Order, that failure shall constitute unprofessional conduct within the meaning of N.C. Gen. Stat (a)(6) and shall be grounds, after any required notice and hearing, for the Board to annul, revoke, suspend or limit his license or to deny any application he might then have pending or might make in the future for a license. 9. This Consent Order shall take effect immediately upon its execution by both Dr. Garg and the Board and it shall continue in effect until specifically ordered otherwise by the Board. Consent Order Shyam Lal Garg, MD Page 5 of 7

6 10. Dr. Garg hereby waives any requirement under any law or rule that this Consent Order be served on him. 11. Upon execution by Dr. Garg and the Board, this Consent shall become a public record within the meaning of Chapter 132 of the North Carolina General Statutes and shall by subject to public inspection and dissemination pursuant to the provisions thereof. Additionally, it will be reported to persons, entities, agencies and clearinghouses as required and permitted by law. By Order of the North Carolina Medical Board this the 21st day of April, NORTH CAROLINA MEDICAL BOARD By: Eleanor E. Greene, MD President-Elect Consent Order Shyam Lal Garg, MD Page 6 of 7

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