WILLIAM LeGRANDE COOPER, Appellant, v. STATE BOARD OF MEDICAL EXAMINERS et al., Respondents
L. A. 21190
In Bank
Apr. 28, 1950
217 P.2d 630 | 35 Cal. 2d 242
SCHAUER, J.—The superior court, pursuant to an alternative writ of mandate issued upon the petition of William LeGrande Cooper (hereinafter called petitioner), reviewed disciplinary proceedings theretofore had before respondent Board of Medical Examiners (hereinafter termed the board) and rendered judgment upholding the findings and conclusions of the board as well as its order revoking petitioner‘s license as a drugless practitioner (see State Medical Practice Act,
Petitioner does not deny that he performed the acts which the board and the superior court held to constitute unprofessional conduct. They were: (count 7) the use of the prefix “Dr.,” with certain descriptive language, while holding licenses as a drugless practitioner and as a clinical laboratory technologist, and (count 9) the penetration of tissue incidental to the giving of a blood transfusion at the direction of a qualified physician as well as the recommendation and delivery of aspirin to the patient and the suggested use of massage and liniment by him following the transfusion.1 The superior court, after a hearing but with no other evidence than the transcript and record of the proceedings before the board, found and concluded that the “findings and order of respondent Board revoking petitioner‘s license as a drugless practitioner were . . . supported by the findings of respondent Board; that the findings of respondent Board were, and are, based upon and supported by the weight of the evidence,” and that the proceedings before the board were within its jurisdiction and were conducted “without procedural or prejudicial error or abuse of discretion of any kind.” Judgment was rendered denying the peremptory writ of mandate and recalling the alternative writ theretofore issued.
Petitioner first contends that the trial court erred in not holding that as to count seven the board committed an abuse of discretion (see
An affirmative vote of seven members of the board is required for license revocation (
In Hohreiter v. Garrison (1947), 81 Cal.App.2d 384, 399-401 [184 P.2d 323], it was commented that “Due process requires a fair trial before an impartial tribunal and that requires that the person or body who decides the case must know the evidence, but due process is not interested in mere technical formalism. It is the substance that is determinative of whether due process has been afforded . . . The Supreme Court stated [in Morgan v. United States, 298 U.S. 468, 480 (56 S.Ct. 906, 80 L.Ed. 1288)] . . . ‘The officer who makes the determinations must consider and appraise the evidence which justifies them . . . The “hearing” is the hearing of evidence and argument. If the one who determines the facts which underlie the order has not considered evidence or argument, it is manifest that the hearing has not been given.’ ” In that case it was held that an insurance agent whose license was revoked had not been denied due process by reason of the fact that under the permissive provisions of subdivision (b) of
We are of the view that the Legislature did not, by the provision of subsection (a) of
Moreover, as in the Hohreiter case, petitioner‘s contentions that as to count seven both due process and legislative intention were violated, are further met by the fact that the trial court here was “authorized by law to exercise its independent judgment on the evidence.” (Moran v. Board of Medical Examiners (1948), 32 Cal.2d 301, 308 [196 P.2d 20], and cases there cited.) That court did exercise its judgment upon the evidence and has made its decision, and petitioner has thus been accorded a full and fair judicial hearing which
Petitioner makes no contention that the evidence does not support the findings of fact made by the board, which were in effect adopted by the trial court also, but does urge that such findings do not as to either count seven or count nine support the conclusion of law that petitioner violated the statutory provisions cited by the board in its decision and order revoking petitioner‘s license.
From the findings it appears that at the time of the acts performed by petitioner, upon which the order of revocation is based, he was licensed both as a clinical laboratory technologist under the provisions of chapter 3, division 2, of the Business and Professions Code, and as a drugless practitioner under the provisions of article 7, chapter 5, division 2, of the same code. (Unless otherwise stated, section numbers mentioned hereinafter will refer to the Business and Professions Code.) For “some years prior to the filing of the Accusation” before the board, petitioner and one King “maintained their offices and laboratories in the same premises” in Los Angeles; King “maintained his office as a physician and surgeon and X-ray laboratory in a portion of said premises” and petitioner “maintained his offices and clinical laboratory in another portion of said premises.” A “common receptionist was used” by petitioner and King. “[U]pon the exterior portion of the street entrance to said premises [petitioner] . . . maintained a sign reading as follows: ‘DR. WM. L. COOPER CLINICAL PATHOLOGY.’ ” Also “for some considerable time prior to the filing of the accusation” petitioner and King “caused to be distributed to other clinical laboratories, hospitals and to licentiates in the healing arts a form of order for work to be done or performed . . . [which] contained in the heading thereof the following designations . . .
“DR. C. V. KING
X-RAY-RADIUMDR. WM. L. COOPER
CLINICAL PATHOLOGY”
It was held (count seven) that petitioner‘s use of the prefix “Dr.” preceding his name on the doorway constituted a violation of
It will be noted that the declarations of both
It is noted that count seven of the accusation as filed with the board also charged that petitioner had violated
The facts forming the basis of count nine are as follows: One Dr. Couturier, a licensed osteopathic physician and surgeon, decided to treat one of his patients, named Toros, who was suffering from “a condition of eyeritis,” by “blood transfusions for the purpose of eliminating a latent infection,” and requested petitioner to perform the transfusions. Toros requested that the transfusions take place on a Friday afternoon or a weekend. On August 11, 1944, and again on August 25, 1944, petitioner, at Dr. Couturier‘s request, administered a transfusion to Toros at the latter‘s residence in Los Angeles. At the time of the second transfusion Dr. Couturier was at his residence at Lake Arrowhead, some 100 miles from Los Angeles. Shortly after the second transfusion the patient “complained of suffering pains in his back and . . . legs,” and petitioner thereupon directed the patient‘s wife to “procure some liniment and apply the same by massaging the legs of” the patient. Toros became worse and petitioner then delivered “six capsules” of aspirin to the wife “with directions as to how to administer the same.”
It was held that the above acts by petitioner “constituted the practicing of a system or mode of treating the sick or afflicted by treating and prescribing for an ailment, disease or disorder for which . . . [petitioner] was not licensed as provided in Section 2141,” already quoted herein, and rendered petitioner “guilty of unprofessional conduct as provided” in
Petitioner urges that he was not treating Toros as his own patient, but was merely performing, under the direction of a licensed physician and surgeon, a “routine procedure” authorized by his certificate as a clinical technologist. We are satisfied that this argument lacks merit. The definition of “clinical laboratory technologist,” contained in
Petitioner also attempts to compare the giving of a blood transfusion to the piercing of tissue to withdraw blood as specimen for a test (see King v. Board of Medical Examiners (1944), supra, 65 Cal.App.2d 644). Although it would appear from the King case and from
It may further be noted that we have not discovered in the 850-page transcript herein, nor has either party pointed out any testimony, or cited any law (other than the code sections discussed hereinabove), to the effect that a technologist is or is not authorized to or customarily does or does not administer blood transfusions, either independently or under the supervision of a licensed physician or surgeon.
It is urged by the state that, independently of any other acts, unprofessional conduct is established by the evidence showing that petitioner recommended a massage with liniment and, in accordance with the previous instructions of Dr. Couturier, delivered the six aspirin capsules to the patient; countering, on behalf of petitioner, it is argued that no license is needed or is violated by such simple acts. We conclude that since the recommendation of the massage and liniment and the delivery of the aspirin were related to and formed a part of the treatment of the patient in connection with the giving of the blood transfusions, and since the administering of a blood transfusion clearly was beyond the scope of any license held by petitioner and was an unlawful act, it is unnecessary to consider whether the finding of unprofessional conduct would have been supported by the evidence as to the liniment and massage and aspirin standing alone.
Petitioner‘s final contention is that the penalty of revocation of license is so disproportionate to the offenses held to have been committed by him, as to amount to an abuse of discretion on the part of the board.
“(e) The court shall enter judgment either commanding respondent [board] to set aside the order or decision, or denying the writ. Where the judgment commands that the order or decision be set aside, it may order the reconsideration of the case in the light of the court‘s opinion and judgment and may order respondent to take such further action as is specially enjoined upon it by law but the judgment shall not limit or control in any way the discretion legally vested in the respondent.”
The board made a single order of license revocation based on its findings and conclusions that both count seven and count nine had been violated. Inasmuch as we hold that the findings do not support the conclusion of unprofessional conduct as to count seven, and since license revocation is in any event a drastic penalty, and, furthermore, in consideration of the fact that we have no means of knowing whether the board itself would have imposed so severe a penalty for violation of count nine alone, we are of the view that the judgment should be reversed with directions to the trial court to set aside the order and send the matter back to the board for reconsideration of the penalty. (See
The judgment is reversed and the trial court is directed to enter judgment commanding respondent board to set aside its order of revocation and further directing the board to reconsider the case and redetermine its order in the light of this court‘s opinion and judgment.
Gibson, C. J., Shenk, J., Traynor, J., and Spence, J., concurred.
EDMONDS, J.—I cannot agree that the decision of the superior court upon the record of the hearing held by the Board of Medical Examiners excused the failure of the admin-
Despite the statement of the majority, such a holding is not in accordance with the purpose of the Judicial Council of California as stated in its tenth biennial report commenting upon its proposed statute which subsequently became section 11517. The recommendation of the council was that the decision of an administrative agency, “in every case,” should be made “by someone familiar with the proceedings and before whom an opportunity to argue the case is afforded . . . .” (P. 24.) (Emphasis added.) Certainly the new procedure enacted in 1945 does not sanction a procedure whereby one-half of the board acts as a hearing officer and the other members reach a decision upon a record of the testimony taken by the “hearing group.”
Moreover, the constitutional right to be “heard by counsel” has been held to mean the effective right to presentation of the case by counsel addressing auditory faculties of a jury. (Messer v. State, 120 Fla. 95 [162 So. 146].) The word “hearing” is stated to mean “the listening to the arguments of counsel on both sides if oral arguments are made. . . .” (West Chicago Park Commissioners v. Riddle, 151 Ill.App. 487.) To hear does not mean to read.
It cannot be said that the failure of the board to comply with
It seems clear that the Legislature, in fixing the requirements for a hearing and decision by the Board of Medical Examiners and other administrative agencies enumerated in
For these reasons, I would reverse the judgment and direct the trial court to issue a writ of mandate commanding the respondent board to set aside its order of revocation and to hear and consider, in accordance with the statutory requirements, all evidence pertinent to the issues presented by the charges against Dr. Cooper.
CARTER, J.—I dissent.
The majority opinion holds that members of an administrative board may join to make the necessary quorum in deciding a case before it although they were not present at the hearing and thus did not hear the witnesses testify. It is reasoned that such is not necessary for due process if the absent members read the evidence and that the statute does not require it; that “to hear” means only to examine the evidence. I do not question the due process holding, but the statute here by express terms requires the deciding board members to receive the evidence from the witnesses by their auditory and visual faculties.
It should first be noted that this is not a case where a hearing officer made findings and a decision, which were adopted by the board. There was a hearing officer present to conduct the
It is no answer to suggest, as does the majority opinion, that, inasmuch as petitioner had a hearing in the trial court, he is not injured, for he was entitled to a determination by the board which had initial jurisdiction. If they had seen and heard the witnesses, they might have imposed a lesser penalty than license revocation.
I cannot agree that the giving of the transfusions was a violation of the law. Petitioner had nothing to do with the diagnosis, medical instruction or treatment of the patient. All that was done by a licensed physician and surgeon, who requested that petitioner perform the mere mechanical act involved in a transfusion. Petitioner was only carrying out the medical orders of a licensed physician. It will be noted that the statute (
“Aside from the proposition that nurses in the surgery during the preparation for and progress of an operation are not diagnosing or prescribing within the meaning of the Medical Practice Act, it is the legally established rule that they are but carrying out the orders of the physicians to whose authority they are subject. The surgeon has the power, and therefore the duty, to direct the nurse and her actions during the operation.” [Emphasis added.]
Practicality and common sense must be employed when these statutes are interpreted. Many common practices may be noted which, while technically a violation of the Medical Practice Act, are not so considered. Take, for example, the case of the playground supervisor, or school teacher, who renders first aid to her charges, such as the removal of a splinter which calls for a penetration of tissue; the manicurist who cuts fingernails (tissue); the barber who cuts hair (tissue); the nurse, or even a mere office attendant employed by a doctor who gives hypodermic injections for the prevention of various diseases, or in treatment of different ills, diseases or conditions, where the doctor is not in the same room, or even in the immediate vicinity. While all of the above mentioned acts are technical violations of the Medical Practice Act, reason and common sense tell us that the Legislature in adopting the Medical Practice Act did not intend that any of these acts should constitute a crime.
It would seem to me that the doctor who gives the orders to a person in the category of appellant is equally guilty, if appellant is guilty, of unprofessional conduct. He, too, must be cognizant of the limitations of the license held by such a drugless practitioner or laboratory technician. Nurses and laboratory technicians are taught to give hypodermics, and the intricacies of giving transfusions, and yet, under the holding of this case, are guilty of unprofessional conduct if they
I would, therefore, reverse the judgment with direction to the trial court to grant the writ of mandate prayed for by petitioner.
Respondents’ and appellant‘s petitions for a rehearing were denied May 25, 1950. Edmonds, J., Carter, J., and Spence, J., voted for a rehearing.
Notes
Section 2394: “The use of drugs or what are known as medicinal preparations by the holder of a drugless practitioner‘s certificate in or upon any human being or the severing or penetrating of the tissues of any human being by the holder of a drugless practitioner‘s certificate in the treatment of any disease, injury, or deformity, or other physical or mental condition of the human being, except the severing of the umbilical cord, constitutes unprofessional conduct within the meaning of this chapter.”
Section 1205 (before 1949 amendment): “As used in this chapter, ‘clinical laboratory’ means any place, establishment or institution organized and operated for the practical application of one or more of the fundamental sciences by the use of specialized apparatus, equipment and methods for the purpose of obtaining scientific data which may be used as an aid to ascertain the presence, progress and source of disease.”
In 1949 the following sentence was added to section 1205: “A duly licensed clinical laboratory technologist or clinical laboratory technician may perform venipuncture or skin puncture for test purposes, upon specific authorization from any person licensed under any provisions of law relating to healing arts.”
Section 1288: “It is lawful for any person conducting or operating a clinical laboratory to accept assignments for tests from any person licensed under any provision of law relating to the healing arts.”
“(a) Suspending judgment.” “(b) Placing him upon probation.
“(c) Suspending his right to practice for a period not exceeding one year.
“(d) Revoking his certificate.
“(e) Taking such other action in relation to disciplining him as the board in its discretion may deem proper.”
