Mesbahi v. Maryland State Board of Physicians
201 Md. App. 315
| Md. Ct. Spec. App. | 2011Background
- Dr. Mesbahi, licensed in Maryland since 1982, operated laser hair removal in her Rockville office; Nazemzadeh and Rahmati, her sisters, assisted without medical licenses; patients alleged injuries from laser treatments and questioned who authorized the procedures.
- DR 00-1 (2002) declared laser hair removal a surgical act, restricting delegation to licensed professionals; Board later imposed sanctions based on this ruling.
- Board charged Mesbahi with aiding unlicensed practice and unprofessional conduct; Nazemzadeh and Rahmati were charged with unlicensed practice of medicine.
- Board investigations included patient complaints (A, B, C), records subpoena, and interviews; Nazemzadeh and Rahmati ceased laser services in 2005; Dr. Mesbahi faced additional allegations.
- ALJ recommended sanctions; Board issued final decision (2009) imposing fines and permanent cease-and-desist against laser hair removal; circuit court remanded (2010) to articulate sanction rationale, which the Board did not fully do under court supervision.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Whether DR 00-1 properly defined laser hair removal as the practice of medicine | Mesbahi argues DR 00-1 is invalid or improperly applied | Board treats DR 00-1 as binding precedent and valid basis | Board reasonably treated DR 00-1 as precedent and used it to define scope of practice |
| Due process: did Board fail to notify about DR 00-1 | Claim of inadequate notice violated due process | Physicians presumed to know the Medical Practice Act; DR 00-1 not required to be re-notified | No due process violation; notice not required beyond availability of DR 00-1 and related materials |
| Must Board prove knowing violation for sanctions | Ignorance of DR 00-1 should excuse conduct | Statutes lack mens rea; strict liability appropriate for regulatory offenses | No mens rea required; strict liability applicable; violation upheld |
| Whether sanctions were arbitrary and capricious | Circuit court found sanctions arbitrary for lack of articulated reasoning | Board did articulate factors; sanctions within agency discretion | Board's sanctions upheld; circuit court’s remand reversed; sanctions affirmed with directions to affirm Board's decision |
Key Cases Cited
- Baltimore City Bd. of Sch. Comm'rs v. City Neighbors Charter Sch., 400 Md. 324 (2007) (declaratory rulings treated as precedents in contested cases)
- United Parcel Serv., Inc. v. People’s Counsel, 336 Md. 569 (1994) (scope of substantial evidence review under APA)
- Finucan v. Maryland Board of Physician Quality Assurance, 380 Md. 577 (2004) (agency expertise afforded deference on legal questions)
- Md. Aviation Admin. v. Noland, 386 Md. 556 (2005) (sanctions review and deference to agency decisions)
- Md. Transp. auth. v. King, 369 Md. 274 (2002) (deference in sanction decisions; broad agency discretion)