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David Steenblock Disciplined Repeatedly by California Osteopathic Medical BoardStephen Barrett, M.D.
In January 2008, the Osteopathic Medical Board of California charged David A. Steenblock, D.O. with gross negligence, repeated negligent acts, excessive treatments, failure to maintain adequate records, and falsely representing his credentials. Steenblock operates a clinic in Mission Viejo, California, which claims to "give the maximum amount of recovery possible for stroke and traumatic brain injury." The complaint (shown below) states that he:
Charged a 77-year-old stroke patient more than $26,000 for services that included 87 sessions of hyperbaric oxygen, 84 physical therapy treatments, 20 intravenous treatments, and 8 testosterone injections.
Retained Medicare payments that should have been refunded to the patient.
Failed to document an initial evaluation, any treatment rationale, or the patient's responses to treatment.
Falsely represented that he is board-certified by the American Board of Family Practice, even though he had not been certified by that board since December 1984.
Represented that he is certified by the American Board of Chelation Therapy, even though that board is not recognized by the American Board of Medical Specialties and did not list him among its members.
The clinic's Web site has claimed:
Strokes are caused by a lack of oxygen to a part of the brain. Long term effects are caused by the continued lack of oxygen, the swelling of brain tissue and the accumulation of calcium within the damaged nerve cells. Dr. Steenblock's neuro-rehab program is designed to bring oxygen back to these starved cells, reduce swelling, and provide the nutrients needed to help the cells remove their waste and restore normal metabolic function.
It is true that strokes are caused by lack of oxygen to the brain. However, there is no scientific evidence that increasing oxygen delivery to the brain after an acute episode is over can stimulate cells to regenerate.
In August 2009, the Osteopathic Board concluded that Steenblock had engaged in gross negligence, repeated negligent acts, and excessive prescribing of treatment and had failed to maintain adequate records. The board also concluded that Steenblock had improperly advertised himself as board certified. He was placed on probation for five years, ordered to take courses in medical ethics and recordkeeping, and assessed $25,166.60 for the cost of investigation and enforcement. In 2011, the board filed a petition to revoke Steenblock's probation. The petition stated that in early 2010, Steenblock had notified the board that he had not complied with his probation terms because he had challenged the a prior board decision in San Francisco Superior Court and expected the court would stay his probation until the matter was resolved. However, the court did not issue a stay and, even though the Board notified Steenblock that he was required to comply with probation, he did not make reports, enroll in the required continuing education courses, or pay the $25,166.60. In 2013, the board suspended Steenblock's license for 60 days, ordered him to pay the $25,166 within that time period, and renewed his probation for another five years during which he is required to comply with the terms of the 2009 order.
This was the fourth time Steenblock has been in trouble. In 1991, he was charged with negligence in connection with two patients he had treated. In 1994, the case was settled with a stipulation under which he agreed to serve five years of probation, pay $10,000 for costs, and take extra continuing education courses in pharmacology, medical charting, and ethics. In 1997, Steenblock was charged with violating his probation by not paying the $10,000 assessment and by using three unlicensed "physical therapy assistants" to administer patient services. (In 1997, the employees were convicted of practicing physical therapy without a license.) In 2000, after Steenblock had paid the $10,000 and hired a licensed physical therapist to supervise the others, the board assessed another $3,500 toward costs but decided not to penalize him for "aiding and abetting the unlicensed practice of physical therapy." The proceedings also had the effect of extending his probation for three months.
EDMUND G. BROWN JR.,
Attorney General of the State of California
STEVEN V. ADLER
Supervising Deputy Attorney General
RICHARD D. HENDLIN,
State Bar No. 76742
Deputy Attorney General
110 West "A" Street, Suite 1100
San Diego, CA 92101
P.O. Box 85266
San Diego, CA 92186-5266
Telephone: (619) 645-2071
Facsimile: (619) 645-2061
Attorneys for Complainant
BEFORE THE
OSTEOPATHIC MEDICAL BOARD OF CALIFORNIA
DEPARTMENT OF CONSUMER AFFAIRS STATE OF CALIFORNIA
In the Matter of the Accusation Against:
DAVID STEENBLOCK, D.O.
26381 Crown Valley Parkway, #130 Mission Viejo, CA 92691
Osteopathic Physician and Surgeon
License No. 20A4160
Respondent.
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| Case No. 00-2005-001536
ACCUSATION
FILED JAN 30, 2008
Complainant alleges:
PARTIES
1. Donald J. Krpan, D.O. (Complainant) brings this Accusation solely in his official capacity as the Executive Director of the Osteopathic Medical Board of California.
2. On about August 3, 1977, the Board issued Osteopathic Physician and Surgeon License Number 20A4160 to David Steenblock, D.O. (Respondent). The license was in full force and effect at all times relevant to the charges brought herein and will expire on January 31, 2009, unless renewed.
JURISDICTION
3. This Accusation is brought before the Osteopathic Medical Board of California (Board) under the authority of the laws set forth below. All section references are to the Business and Professions Code unless otherwise indicated.
4. Section 3600 states:
"The law governing licentiates of the Osteopathic Medical Board of California is found in the Osteopathic Act and in Chapter 5 of Division 2, relating to medicine.
5. Section 3600-2 states:
"The Osteopathic Medical Board of California shall enforce those portions of the Medical Practice Act identified as Article 12 (commencing with Section 2220), of Chapter 5 of Division 2 of the Business and Professions Code, as now existing or hereafter amended, as to persons who hold certificates subject to the jurisdiction of the Osteopathic Medical Board of California, however, persons who elect to practice using the term or suffix "M.D." as provided in Section 2275 of the Business and Professions Code, as now existing or hereafter amended, shall not be subject to this section, and the Medical Board of California shall enforce the provisions of the article as to persons who make the election. After making the election, each person so electing shall apply for renewal of his or her certificate to the Medical Board of California, and the Medical Board of California shall issue renewal certificates in the same manner as other renewal certificates are issued by it."
6. Section 2234 states in pertinent part:
"The [Board] 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, or assisting in or abetting the violation of, or conspiring to violate, any provision of this chapter.
"(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.
". . . . "
7. Section 2266 provides that the failure "to maintain adequate and accurate records relating to the provision of services to ... patients constitutes unprofessional conduct."
8. Section 2453.5 provides:
"Individuals possessing physician's and surgeon's certificates issued by the Osteopathic Medical Board of California shall not hold themselves out to be board certified unless the board certification has been granted by the appropriate certifying board, as authorized by the American Osteopathic Association or the American Board of Medical Specialties, or is the result of a postgraduate training program approved by the Accreditation Council for Graduate Medical Education."
9. Section 651 provides in pertinent part:
"(a) It is unlawful for any person licensed under this division or under any initiative act referred to in this division to disseminate or cause to be disseminated any form of public communication containing a false, fraudulent, misleading, or deceptive statement, claim, or image for the purpose of or likely to induce, directly or indirectly, the rendering of professional services or furnishing of products in connection with the professional practice or business for which he or she is licensed. A 'public communication' as used in this section includes, but is not limited to, communication by means of mail, television, radio, motion picture, newspaper, book, list or directory of healing arts practitioners, Internet, or other electronic communication.
AppleMark
"(b) A false, fraudulent, misleading, or deceptive statement, claim, or image includes a statement or claim that does any of the following: "( 1) Contains a misrepresentation of fact.
"(2) Is likely to mislead or deceive because of a failure to disclose material facts.
"(3) . . . .
"(4) . . . .
"(5) Contains other representations or implications that in reasonable probability will cause an ordinarily prudent person to misunderstand or be deceived.
"(g) Any violation of this section by a person so licensed shall constitute good cause for revocation or suspension of his or her license or other disciplinary action.
". . . ."
10. Section 725, subdivision (a), provides that "[r]epeated acts of clearly excessive prescribing or administering of drugs or treatment, repeated acts of clearly excessive use of diagnostic procedures, or repeated acts of clearly excessive use of diagnostic or treatment facilities as determined by the standard of the community ... is unprofessional conduct .... "
11. Section 125.3 of the Code states, in pertinent part, that the Board may request the administrative law judge to direct a licentiate found to have committed a violation or violations of the licensing act to pay a sum not to exceed the reasonable costs of the investigation and enforcement of the case.
FIRST CAUSE FOR DISCIPLINE
(Gross Negligence)
12. Respondent is subject to disciplinary action under Code sections 3600, 3600-2 and 2234, for the following conduct:
A. From November 23, 2004 through May 5, 2005, patient C.A., a 77 year-old male who had suffered a stroke, was seen and treated by Respondent at his clinic in Mission Viejo, California, for persistent disability from the stroke. Respondent evaluated patient C.A. and placed him on a treatment regimen of physical therapy, hyperbaric oxygen therapy, intravenous therapy, and testosterone injections.
B. About November 23, 2004, C.A.'s patient records reflect he was seen by an unidentified person at Respondent's office. The records indicate C.A. was to have hyperbaric treatment for 60 days and physical therapy for a similar period of time, but there is no signature. These records do not contain a physical exam or impression.
C. About November 30, 2004, patient C.A.'s records reflect Respondent did a history and physical exam, noted the presence of left-sided weakness, but did not record any diagnosis or impression or a treatment plan.
D. About November 30, 2004, a physical therapist prepared a Plan of Treatment for Outpatient Rehabilitation, listing long-term and short-term goals. There are five Updated Plan of Progress forms for the period between January 3, 2005, and May 5, 2005, which indicate C.A. did not achieve any of the stated goals.
E. Treatment began on November 26, 2004, with C.A. receiving physical therapy and hyperbaric oxygen treatments. Over the ensuing months, C.A. received 87 hyperbaric oxygen treatments, 84 physical therapy treatments, 20 intravenous therapy treatments, and 8 testosterone injections.
F. The progress notes contain only one entry by Respondent, on December 29,2004, regarding C.A. 's response to the treatment. There are no entries addressing the need for continued treatments.
G. The billing records show patient C.A. paid over $26,000 for his treatments. At the beginning of treatment, Respondent offered to bill Medicare and Tricare and reimburse patient C.A. for his out-of-pocket costs. Respondent failed to fully reimburse patient C.A.
13. Respondent is subject to disciplinary action under Section 2234, subdivision (b), in that he committed gross negligence as a result of the following:
A. Paragraphs 12.A through 12.F. are incorporated herein by reference.
B. Respondent failed to document patient C.A.'s ongoing condition and the effects of the hyperbaric oxygen treatment after December 29, 2004, and thus there was no indication, nor any record thereof, for the hyperbaric oxygen treatments that continued to May 2005.
C. Respondent failed to document patient C.A.'s ongoing condition and the effects of the physical therapy treatments, and thus there was no indication, nor any record thereof, for the physical therapy treatments that continued to May 2005.
SECOND CAUSE FOR DISCIPLINE
(Repeated Negligent Acts)
14. Respondent is further subject to disciplinary action in violation of Section 2234, subdivision (c), in that he committed repeated negligent acts as a result of the following:
A. Paragraphs 12.A. through 12.F., l3.A., and 13.B., are incorporated herein by reference.
B. Respondent failed to document during his initial assessments patient C.A.’s condition, diagnoses, rationale for treatment, alternative treatments, and the risks and benefits of the treatments he recommended.
C. The billing records indicate Respondent was received third party payments from Medicare and Tricare, but failed to fully reimburse the patient as he agreed to do at the beginning of treatment.
THIRD CAUSE FOR DISCIPLINE
(Excessive Treatments)
15. Respondent is further subject to disciplinary action in violation of Section 725, subdivision (a), in that he committed repeated acts of excessive prescribing, as set forth in paragraphs 12.A. through 12.F., 13.A., and 13.B., above, which are incorporated herein by reference.
FOURTH CAUSE FOR DISCIPLINE
(Failure to Maintain Adequate and Accurate Records)
Respondent is further subject to disciplinary action under Section 2266, in that he failed to maintain adequate and accurate records of his treatment of patient C.A., as a result of the following:
A. Paragraphs 12.A. through 12.F., 13.A., 3.B., and 14.C. are incorporated herein by reference.
B. Respondent failed to document the effects of treatment at intervals that would support continued treatment.
C. Respondent failed to maintain billing records that would allow patient C.A. and his wife to monitor or investigate the status of third party billing and collections.
FIFTH CAUSE FOR DISCIPLINE
(Any Act Involving Dishonesty or Corruption)
17. Respondent is further subject to disciplinary action under Section 2234, subdivision (e), in that he committed dishonesty as a result of the following:
A. Paragraphs 12.G. and 16.C., are incorporated herein by reference.
B. Respondent falsely represents on his Internet website,
www.strokedoctor.com and in his curriculum vitae, that he is "Board Certified" by both the American Board of Family Practice and by the American Board of Chelation Therapy. In fact, he is not currently certified by the American Board Family Medicine (formerly known as the American Board of Family Practice) and has not been certified by that Board since December 31, 1984. The American Board of Chelation Therapy is, according to Respondent, a "pseudo-board" that is not recognized by the American Board of Medical Specialties (ABMS). In addition, the American Board of Chelation Therapy, which became the American Board of Clinical Metal Toxicology (ABCMT) does not list Respondent among its members.
SIXTH CAUSE FOR DISCIPLINE
(Violating Business and Professions Code Sections 2234(a) and 2453.5)
18. Respondent is further subject to disciplinary action under Section 2234, subdivision (a), in that he violated Section 2453.5, a provision of Chapter 5 of Division 2 of the Business and Profession Code, in that he held himself out to be board certified by both the American Board of Chelation Therapy (a board not recognized by the Osteopathic Medical Board), and by the American Board of Family Practice when, in fact, he has not been board certified by the American Board of Family Practice since December 31, 1984, as more fully set forth above in paragraph 17.B. which is incorporated herein by reference.
SEVENTH CAUSE FOR DISCIPLINE
(Public Communication Containing False, Fraudulent, Misleading, or Deceptive Statement)
19. Respondent is further subject to disciplinary action under Section 651, subdivisions (a) and (g), in that he disseminated or caused to be disseminated a public communication through his Internet website
www.strokedoctor.com containing a false, fraudulent, misleading, or deceptive statement for the purpose of or likely to induce, directly or indirectly, the rendering of professional services or furnishing of products in connection with the professional practice for which he is licensed, as more fully set forth above in Paragraph 17.B.
DISCIPLINE CONSIDERATIONS
20. To determine the degree of discipline, if any, to be imposed on Respondent, Complainant alleges that on about March 21, 1994, in the case entitled In the Mat of the Accusation Against David Steenblock, D.O., before the Osteopathic Medical Board of California, Case No. 91-1, Respondent's license was disciplined for failing to adequately document his examination and treatment of two patients, one of whom was a minor, and for failing to warn the parents of the minor about the possible side effects of a treatment. On or about March 21, 1999, Respondent successfully completed probation and his license was fully restored. That decision is now final and is incorporated herein by reference.
PRAYER
WHEREFORE, Complainant requests that a hearing be held on the matters here alleged, and that following the hearing, the Board issues a decision:
1. Revoking or suspending Osteopathic Physician and Surgeon License Number 20A4160, issued to Respondent David Steenblock, D.O.
2. Ordering Respondent David Steenblock, D.O. to pay the Board the reasonable costs of the investigation and enforcement of this case, pursuant to Business and Professions Code section 125.3;
3. Taking such other and further action as deemed necessary and proper.
DATED: 1/30/08
________________________________
DONALD J. KRPAN, D.O.
Executive Director
Osteopathic Medical Board of California
State of California
Complainant
This page was revised on August 29, 2013.
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