Sajadi v. Kan. Bd. of Healing Arts, 092421 KSCA, 123, 200

CourtCourt of Appeals of Kansas
JudgeBefore BUSER, P.J., HILL and ISHERWOOD, JJ.
Writing for the CourtISHERWOOD, J.
PartiesSeyed Sajadi, M.D., Appellee, v. Kansas Board of Healing Arts, Appellant.
Docket Number200,123

Seyed Sajadi, M.D., Appellee,

v.

Kansas Board of Healing Arts, Appellant.

No. 123, 200

Court of Appeals of Kansas

September 24, 2021

SYLLABUS BY THE COURT

1. The statute governing revocation or suspension of licenses permits the Board of Healing Arts to take disciplinary action against a physician who is dually licensed in another state and who has had disciplinary action taken against them by the proper licensing authority of another state, territory, District of Columbia, or country. K.S.A. 65-2836(j). In determining the appropriate sanction to impose, the Kansas Board of Healing Arts may properly consider all facts and circumstances which gave rise to the sanction in the state where the conduct occurred.

2. Engaging in the practice of the healing arts is a privilege. Accordingly, the Board of Healing Arts is vested with broad discretion in ensuring that the public health, safety, and welfare of Kansans are shielded from the unprofessional and improper practice of medicine. In carrying out that responsibility when sanctioning a physician in accordance with K.S.A. 65-2836(j), the Kansas Board of Healing Arts is not limited to imposition of a sanction which simply mirrors the disciplinary measure taken in the state that acted first.

3. The sanctioning authority governing the Board of Healing Arts is defined and limited exclusively by the law of this state. The Guidelines for the Imposition of Sanctions published by the Board of Healing Arts are simply a resource intended to aid the Board in determining the appropriate sanction in the cases that come before it. They are not mandates and are not intended to constrain the Board from exercising its entire range of authority in any given case.

Appeal from Shawnee District Court; THOMAS G. LUEDKE, judge.

Tucker L. Poling, former general counsel, Courtney Cyzman, general counsel, and Warran D. Wiebe, deputy general counsel, Kansas State Board of Healing Arts, for appellant.

Russell Keller and Mark W. Stafford, of Forbes Law Group, of Overland Park, for appellee.

Before BUSER, P.J., HILL and ISHERWOOD, JJ.

ISHERWOOD, J.

The Kansas State Board of Healing Arts imposed three sanctions against Dr. Seyed Sajadi including public censure, a $5, 000 fine, and limitations on his practice of medicine. The district court affirmed the censure and fine but rescinded the limitations imposed on Dr. Sajadi's medical license. The Board appeals to this court seeking reversal of the district court's order and argues the district court improperly substituted its judgment for that of the Board. Because we find that the Board's decision consisted of sanctions that were reasonable and valid under Kansas law, we reverse the district court's decision rescinding the practice limitations on Dr. Sajadi's medical license.

FACTUAL AND PROCEDURAL BACKGROUND

Dr. Seyed Sajadi is a physician and surgeon licensed to practice medicine in Kansas and Missouri. He had owned and operated clinics in both states under the name of Lipo Body Enhancement, LLC (Lipo Body), where he performed various cosmetic and surgical procedures. Dr. Sajadi's primary office is in Overland Park, Kansas, but he often traveled to Springfield, Missouri, to perform procedures.

In June 2013, Dr. Sajadi performed an abdominal liposuction surgery on Patient 1 at the Springfield, Missouri office of Lipo Body. Dr. Sajadi had three different cell phone numbers and shared at least two of those with Patient 1. He instructed her to text or call after surgery if complications arose. Within a few hours of Patient 1's surgical procedure, Dr. Sajadi was satisfied that her condition was stable, so the doctor left Springfield to return to his home in Overland Park, 2 hours and 40 minutes away. Dr. Sajadi did not have a secondary protocol in place if Patient 1 was unable to reach him. He also had not forged an agreement with local healthcare professionals or hospitals to monitor his patients or provide for their post-surgical care should the need arise. Finally, he did not have admitting privileges at any Springfield area hospitals.

That evening, Patient 1 experienced light-headedness, secreted fluids, and developed pools of blood in her bed. Her husband repeatedly sought to contact Dr. Sajadi at both numbers the doctor had provided but his efforts were fruitless. Dr. Sajadi apparently did not recognize the number for Patient 1's husband, so he declined to answer any of the calls.

After failing to reach Dr. Sajadi, Patient 1 went to an emergency department in Springfield, where healthcare providers diagnosed her with third spacing of fluid following liposuction. The hospital admitted her for observation. About 30 minutes after trying to reach the doctor, Patient 1's husband received a call back from him. Following the conversation with the spouse, Dr. Sajadi contacted the hospital to learn more about Patient 1's condition.

A formal complaint was filed with the Missouri State Board of Registration for the Healing Arts (Missouri Board) as a result of Dr. Sajadi's care and treatment of Patient 1. In March 2018, the doctor entered into a settlement agreement with the Missouri Board to resolve the incident involving Patient 1. The agreement included stipulated facts detailing the events which prompted the disciplinary action taken against Dr. Sajadi. The sanctions imposed by the Missouri Board included a public reprimand and an order for Dr. Sajadi to successfully complete an agency approved course on communication.

A month later, the Kansas Board of Healing Arts (the Board) received a Disciplinary Alert from the Federation of State Medical Boards and learned that Dr. Sajadi was sanctioned in Missouri for "Conduct/Practice Which Is Or Might Be Harmful/Dangerous to the Health of the Patient/Public." The Board issued a Summary Order finding that Dr. Sajadi violated K.S.A. 65-2836(j) when the Missouri Board took disciplinary action against him. The Board imposed a public censure and $10, 000 fine. Dr. Sajadi requested a hearing before the full Board seeking reconsideration of the Summary Order.

The Board conducted an administrative hearing in response to the doctor's request, and Dr. Sajadi testified in order to better explain the underlying facts of the incident with Patient 1. Additionally, Dr. Sajadi's attorney provided the Board with a copy of the settlement agreement between the doctor and the Missouri Board. The Board concluded that the facts contained within the agency record, including Dr. Sajadi's hearing testimony, demonstrated that the doctor engaged in itinerant surgery in a manner that endangered patient safety.

The Board issued a Final Order outlining the sanctions it deemed appropriate, including a public censure and a $5, 000 fine. The Board also imposed these limits on Dr. Sajadi's Kansas license to practice medicine and surgery: "Licensee shall make arrangements to be physically present to attend to the patient, if needed, within 20 minutes notice (initial contact) at all times during the first 24 hours following any surgical procedure conducted by Licensee. For the purpose of this requirement, '20 minutes' refers to the total time to travel to the local location at which the Licensee has admitting privileges.

"Prior to conducting any surgical procedure, Licensee must have a written protocol in place that provides for appropriate backup coverage in the event the Licensee cannot be immediately reached in the first 24 hours following the surgical procedure and/or if Licensee unexpectedly becomes unavailable during that time period. Such protocol must be communicated to and agreed to by the patient prior to the date of surgery.

"Licensee shall not conduct any surgical procedure unless Licensee has admitting privileges with a hospital within 20 miles of the location at which the surgical procedure is conducted."

Dr. Sajadi petitioned the district court to review the Board's Final Order and argued that the order was unreasonable, arbitrary, and capricious under K.S.A. 77-621(c)(8). The court concurred that the doctor violated K.S.A. 65-2836(j) based on the disciplinary action taken by the Missouri Board. It upheld the Board's sanctions of public censure and a $5, 000 fine but agreed with Dr. Sajadi that the practice limitations the Board placed on his medical license were unreasonable and eliminated that sanction. The court's conclusion stemmed from its belief that (1) the sanction imposed by the Board should align with that imposed in the state where the issue originated; (2) in imposing sanctions the Board should adhere to those set out in the Board's Guidelines for the Imposition of Disciplinary Sanctions; and (3) the Final Order issued by the Board should not be more onerous than the Summary Order.

The Board timely appeals.

ANALYSIS

THE PRACTICE LIMITATIONS THE BOARD IMPOSED AGAINST DR. SAJADI'S KANSAS MEDICAL LICENSE WERE SUPPORTED BY SUBSTANTIAL COMPETENT EVIDENCE AND WERE NEITHER ARBITRARY NOR CAPRICIOUS.

We review the Board's decision for substantial evidence and reasonableness.

"Judicial review and civil enforcement of any agency action . . . shall be in accordance with the Kansas judicial review act." K.S.A. 65-2851a(b); see Ryser v. Kansas Bd. of Healing Arts, 295 Kan. 452, 458, 284 P.3d 337 (2012). Under the Kansas Judicial Review Act (KJRA), this court considers this appeal from the district court as if the doctor's petition for review of the Board's Final Order had originally been filed with this court. See Hanson v. Kansas Corporation Comm'n, 58 Kan.App.2d 82, 91, 464 P.3d 357 (2020).

On appeal, the burden of proving the invalidity of the agency action rests with the party asserting such invalidity. K.S.A. 77-621(a)(1); Golden Rule Ins. Co. v. Tomlinson, 300 Kan. 944, 953, 335...

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