Opinion
As a condition of bail on pending criminal charges, the trial court prohibited Dr. Jeffrey Thomas Gray (Gray) from practicing medicine. The bail condition was requested by the Medical Board of
Factual and Procedural Background
Gray is a licensed physician and surgeon, specializing in psychiatry. In a complaint filed May 12, 2004, Gray was charged with felony counts of unlawfully prescribing and possessing a controlled substance. (Health & Saf. Code, §§ 11153, subd. (a) & 11350, subd. (a).) The complaint also charges Gray with misdemeanor counts of possessing child pornography (Pen. Code, §311.11, subd. (a)), possessing a designated controlled substance (Health & Saf. Code, § 11375, subd. (b)(2)), and sexually exploiting a patient or former patient (Bus. & Prof. Code, § 729).
Gray entered a plea of not guilty at his arraignment on May 12, 2004. The trial court reduced bail to $30,000 from the $50,000 specified in the arrest warrant, 1 and ordered Gray to stay away from the alleged victim, a former patient. Without prior notice, the Attorney General appeared for the Medical Board at the arraignment and asked that “as a condition of release on bail that Dr. Gray’s [medical] license be suspended so that he will not be able to prescribe drugs or have access to any kind of patients at all.” The trial court agreed with the Medical Board and entered an order prohibiting Gray from practicing medicine as an additional bail condition. 2 The order also requires Gray to surrender his professional certificates to the Medical Board until the criminal charges are resolved.
Gray filed a petition for a writ of habeas corpus, challenging the bail condition. The trial court issued an order to show cause, held a hearing on July 27, 2004, and ultimately denied the petition, reasoning that public safety is the primary consideration in setting bail. The court noted the matter could have gone before the Medical Board, which presumably possessed greater expertise than the court in assessing a defendant’s competence to practice medicine. The court articulated a concern that the Medical Board faces a dilemma if it commences administrative proceedings to suspend or revoke a medical license while a criminal action is pending, because a determination favorable to the defendant could have a collateral estoppel effect and preclude a criminal prosecution.
After the trial court denied his petition for a writ of habeas corpus, Gray filed a petition for a writ of habeas corpus here, arguing he was deprived of due process and that prohibiting him from practicing medicine is an unreasonable condition of bail. We construed the habeas petition as one seeking a writ of mandate
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Discussion
I. The Trial Court Violated Petitioner’s Due Process Rights When It Suspended His Medical License as a Condition of Bail.
The state may not deprive a person of life, liberty, or property without due process of law. (U.S. Const., 14th Amend., § 1; Cal. Const., art. I, § 7.)
“Due process requires that before one ... is disciplined by deprival or abridgement of the right to engage in his business or profession, he be given reasonable notice of the charges against him, notice of the time and place of a hearing, and thereafter a fair hearing on the charges. [Citations.]”
(Fort v. Board of Medical Quality Assurance
(1982)
In
Smith v. Board of Medical Quality Assurance
(1988)
Although the
Smith
court noted that Smith, a physician, had a vested property interest in his medical license, the court concluded no federal due process rights were at stake because the proceedings at issue—proceedings that at most would result in ordering Smith to take a competency examination—did not immediately jeopardize Smith’s license.
(Smith, supra,
As for the due process analysis under the California Constitution, the
Smith
court noted one “need not establish a property or liberty interest as a prerequisite to invoking due process protections. [Citations.] Instead, the extent to which procedural due process is available depends on a careful
weighing of the private and governmental
Of these four factors, only the governmental interest appears to have been given much weight by the trial court. Little consideration was given to Gray’s private interest in his license or the risk of erroneously depriving Gray of his license. Nor did the court appear to consider the probable value of additional safeguards or the dignitary interest Gray had in receiving notice of the proposed action and the opportunity to present his side of the story. Indeed, Gray was given no advance notice of the Medical Board’s recommendation that his license be suspended. The Attorney General simply appeared at Gray’s arraignment with a motion in hand, giving Gray’s attorney no opportunity to research the issue before arguing against it. The trial court significantly impaired Gray’s freedom to pursue a private occupation without giving him notice, an effective opportunity to confront the charges or witnesses against him, or a full hearing, in violation of his due process rights.
The Medical Board acknowledges a number of procedures are available to immediately suspend a physician’s right to practice. For example, the Medical Board may seek an interim suspension order from its Division of Medical Quality (or an administrative law judge) based upon affidavits showing the licensee has engaged in, or is about to engage in, acts violating the Medical Practice Act. (Gov. Code, § 11529, subd. (a).) The licensee must receive at least 15 days’ notice of a hearing at which witnesses may be called and cross-examined. The required noticed hearing may be avoided if an affidavit establishes by admissible evidence that serious injury would result to the public before a noticed hearing could occur. In such a case, a suspension order may be issued without notice. (Gov. Code, § 11529, subds. (b), (c) & (d).) However, where an immediate license suspension is based on an evidentiary showing by affidavit, the licensee must be given a full hearing within 20 days. (Gov. Code, § 11529, subd. (c).) If an accusation is not filed with the Board within 15 days after the matter is submitted, the order is dissolved. (Gov. Code, § 11529, subd. (f).)
The Medical Board may also seek a temporary restraining order from a superior court restraining a licensee from practicing his or her profession. (Bus. & Prof. Code, § 125.7.) Like an interim suspension order, a temporary restraining order must be based on affidavits, and it must not be issued without notice to the licensee unless evidence establishes that serious injury would result to the public. (Bus. & Prof. Code, § 125.7, subds. (a) & (b).) If no accusation is filed with the Medical Board within 30 days after the restraining order is issued, the order is dissolved. (Bus. & Prof. Code, § 125.7, subd. (d).)
With both interim license suspensions and temporary restraining orders, therefore,
Another alternative available to the Medical Board is a superior court injunction against a physician if the Division of Medical Quality has reasonable cause to believe that allowing the physician to practice medicine would endanger the public health, safety, or welfare. (Bus. & Prof. Code, § 2312.) Such proceedings are governed by Code of Civil Procedure provisions concerning injunctive relief. (Bus. & Prof. Code, § 2311; Code Civ. Proc., § 525 et seq.)
Although the Medical Board acknowledges these procedures were available to prevent Gray from practicing medicine, it justifies its failure to use them because a decision favorable to a licensee in an administrative proceeding might have collateral estoppel effect in a later criminal prosecution. According to the Medical Board, because there are strict time limits for filing an accusation and holding a hearing after a temporary restraining order is issued or a license suspended, it is likely that the administrative matter would be fully adjudicated before the criminal action is tried. And, when an administrative agency acts in a judicial capacity and resolves disputed factual issues after the parties have had an adequate opportunity to litigate, the administrative agency’s decision may have a collateral estoppel effect in a subsequent criminal trial. (See
People v. Sims
(1982)
Even if a decision of the Medical Board would have a collateral estoppel effect in a later criminal trial,
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this concern cannot justify depriving Gray of his medical license without due process. To be sure, the public safety is paramount, but some measure of due process must be given to a professional license holder before license suspension. The question is what process is due? At a minimum, the suspension must be based on evidence showing an immediate risk to the public. In a proceeding before the Medical Board involving an accusation against a physician, the standard of proof “to revoke or suspend a doctor’s license should be
clear and convincing proof to a reasonable certainty
and not a mere
preponderance of the
evidence.”
(Ettinger v. Board of Medical Quality Assurance
(1982)
Furthermore, one of the procedural options available to the Medical Board—a preliminary injunction prohibiting a physician from practicing medicine during the time criminal charges are pending—does not appear to raise collateral estoppel concerns. There is no requirement that the Medical Board file and adjudicate an accusation after injunctive relief granted pursuant to Business and Professions Code section 2312. The Medical Board dismisses the availability of injunctive relief, however, asserting this “adjunct procedure” affords no greater due process protection than a bail review hearing, which Gray could have pursued. We disagree.
A party moving for injunctive relief bears the burden of showing the harm that would result if a preliminary injunction were not granted.
(Casmalia Resources, Ltd. v. County of Santa Barbara
(1987)
The availability of a bail review hearing does not remedy this procedural infirmity. When a party is granted a temporary restraining order, that party still has the burden of establishing the threatened harm justifying a preliminary injunction. By contrast, an order setting bail is presumed valid, and it is up to the party seeking modification to show good cause. (See Pen. Code, § 1289.) In the case of a defendant arrested without a warrant for a bailable felony offense, bail is set at the scheduled amount for the charged offense unless a peace officer files a declaration under penalty of perjury setting forth the facts justifying an order setting a higher bail. (Pen. Code, § 1269c.) If simply raising the amount of bail requires such a verified showing, then surely an order depriving a defendant of his or her livelihood and professional license requires, at a minimum, a verified showing of imminent danger to the public.
Accordingly, prohibiting Gray from practicing medicine without prior notice, an evidentiary showing, or an opportunity to be heard violated Gray’s due process rights.
II. Bail Conditions Must Be Reasonable.
The Medical Board contends the trial court has authority and discretion to make all appropriate orders relating to bail, with public safety as the primary consideration. This argument requires us
There is no explicit statutory authority for the trial court to do what it did here. Penal Code section 1269c authorizes a magistrate to “set bail on the terms and conditions that he or she, in his or her discretion, deems
appropriate” in the case of a defendant arrested
without
a warrant. In addition, Penal Code section 1270, subdivision (a) authorizes a court to “set bail and specify the conditions” after the court makes the requisite findings that a defendant charged with a
misdemeanor
is not entitled to an own recognizance (OR) release. Here, because Gray surrendered voluntarily pursuant to a warrant setting bail and because he is charged with felony counts, the statutes expressly authorizing bail conditions do not apply. Nevertheless, although the statutory authority is limited, there is a general understanding that the trial court possesses inherent authority to impose conditions associated with release on bail. (See generally
In re McSherry
(2003)
Before legislative amendments to the Penal Code in 1987, the only permissible purpose of bail was to ensure the defendant’s presence in court.
(McSherry, supra,
Bail conditions intended for public protection must be reasonable, however.
(McSherry, supra,
Here, the bail condition Gray challenges is not per se unreasonable. The Medical Board could legitimately achieve the same result through a variety of procedures available to it. What makes the condition unreasonable is that its imposition violated Gray’s right to procedural due process, which the statutory procedures otherwise available to the Medical Board would have guaranteed. Also, unlike the defendant in McSherry, Gray has not been convicted of any crime. Indeed, when the trial court imposed the disputed bail condition, no preliminary hearing had even been held to determine if probable cause existed to try Gray on the charges alleged.
Had a properly noticed hearing been conducted, the trial court could have addressed the Medical Board’s public safety concerns by imposing alternative conditions less restrictive than an outright prohibition on practicing medicine. There is no indication the trial court considered any such alternatives.
The Medical Board justified its recommendation to the trial court based upon Penal Code section 23, which authorizes state agencies that issue professional licenses to appear in any criminal proceeding if the crime charged is substantially related to the qualifications, functions, or duties of a licensee. Among other things, Penal Code section 23 authorizes a state licensing agency to “make recommendations regarding specific conditions of probation . . . .” (Italics added.) The statute does not authorize a licensing agency to recommend bail conditions expressly, nor does it authorize a trial court to suspend a professional license upon the recommendation of a state licensing agency.
The Medical Board neglects to mention the sections of the Business and Professions Code addressing medical license suspensions and other disciplinary measures that may be taken by the Medical Board after a licensee is convicted. (See Bus. & Prof. Code, §§ 2236, 2236.1, 2237, 2239.) The legislative scheme provides that a criminal conviction justifies license suspension or other disciplinary action. (Ibid.) Thus, for example, when a defendant remains incarcerated after being convicted of a felony, the defendant’s license is automatically suspended, although the filing of a felony complaint, information, or indictment does not similarly trigger any automatic or discretionary license suspension. (Bus. & Prof. Code, § 2236.1.) Likewise, a licensee’s conviction of certain other crimes may constitute “unprofessional conduct” justifying discipline, but merely being charged with the same crimes does not constitute unprofessional conduct. (Bus. & Prof. Code, § 2236.) In this action, the Medical Board justifies the bail condition prohibiting Gray from practicing medicine simply because a criminal complaint has been filed. The mere filing of a felony complaint cannot justify license suspension or surrender without an evidentiary showing that failure to take such action would result in serious injury to the public. (See Gov. Code, § 11529; Bus. & Prof. Code, §§ 125.7, 2312.)
In assessing whether the conditions associated with a defendant’s release while awaiting trial are reasonable, our Supreme Court’s decision in
In re York
(1995)
Here, Gray was able to post bail and therefore had a right to be free from confinement. The trial court cannot justify imposing bail conditions in a manner depriving Gray of due process or other constitutional rights on the ground that Gray would otherwise be confined and effectively deprived of those rights. Under the circumstances presented here, it was unreasonable to deprive Gray of his due process rights in connection with his professional license after he was able to post reasonable bail.
Disposition
Let a peremptory writ of mandate issue directing respondent court to vacate its May 12, 2004 order prohibiting Gray from practicing as a physician and surgeon.
McGuiness, P. J., and Poliak, J., concurred.
Notes
Gray surrendered in court as soon as his attorney advised him the arrest warrant issued; his counsel asked the court to recall the warrant and reduce the bail initially set.
The court reduced bail from $50,000 to $30,000 before considering the Medical Board’s request to suspend Gray’s medical license. Therefore, the reduction in bail did not result from Gray’s acquiescence to the condition prohibiting him from practicing medicine.
While habeas corpus is an appropriate vehicle for challenging the legality of bail grants or deprivations (see
In re Catalano
(1981)
In its opposition, the Medical Board claims that Gray misconstrues the nature and effect of the trial court’s order by characterizing it as a license suspension. Instead, according to the Medical Board, the court simply ordered Gray “not to practice medicine during the pendency of the criminal matter . . . .” For purposes of a due process analysis, there is no meaningful distinction between a license suspension and an order prohibiting a licensee from engaging in the profession for which the person is licensed. Apparently, the attorney representing the Medical Board at Gray’s arraignment failed to see a distinction, too, because she argued that the Medical Board was asking the court to suspend Gray’s license.
We express no opinion on whether a decision of the Medical Board favorable to Gray would preclude a subsequent criminal prosecution.
