The California Medical Board receives about 10,000 complaints per year, resulting in the opening of about 1,000 investigations. The Medical Board’s Central Complaint Unit, or CCU, receives, initially screens and routes all complaints. Complaints that may identify a violation of the California Medical Practice Act, which can include gross negligence, misconduct, criminal convictions, other license discipline, or competency issues, are referred onward to the DCA Division of Investigation Health Quality Investigation Unit (DCA HQIU) or to the Board’s Complaint Investigation Office, or CIO. DCA HQIU is comprised of sworn peace officers, who can carry a firearm, make arrests, and enforce laws. The Medical Board’s Complaint Investigation Office is staffed by analysts and non-sworn investigators.

Cases involving allegations of quality of care violations, such as gross negligence, multiple instances of negligence, or recordkeeping violations, may be reviewed by a medical consultant. The Medical Board of California has expert medical reviewers and District Medical Consultants. These physicians typical review medical records obtained from care providers to determine if the standard of care was not met, warranting further investigation by the Board. Further review can include a Board interview of the physician who is the subject of the investigation and additional review of the case by medical experts.

Medical Board of California investigations may be triggered by mandatory reporting. An “805 Report” is a report made to the Medical Board of California required by California Business and Professions Code section 805. 805 reports are made by peer review bodies, primarily medical or professional staff of health care facilities. An 805 reports is required if a physician’s staff privileges are denied, terminated or revoked, or restricted for a total of 30 days or more, for a disciplinary cause or reason. Since an 805 report identifies a medical disciplinary cause or reason, the Medical Board of California investigates such reports in order to possibly bring an accusation for quality of care violations, misconduct, impairment, or another cause.

Medical Board investigations of a physician’s quality of care may be first revealed by a Medical Board request for patient records to a provider, such as a hospital, clinic or individual physician. Under Business and Professions Code section 2225.5, a physician who does not turn over patient records to the California Medical Board within 15 days of receiving a request from the Board with a patient written authorization, shall be assessed a fine of $1,000.00 per day the production is late up to $10,000.00, unless the delay is excused for good cause. Unfortunately, if medical records are requested from a hospital or former employer, the physician may not receive notice that the Board has requested records and therefore is examining the patient records.

Another Medical Board mandated report is the Criminal Action Reporting Form, or the “802.1 Report“. Physicians are required to report the filing of an “information” (a criminal complaint document in court) or indictment charging a felony, or a conviction for a misdemeanor or a felony, within 30 days. These reporting requirements extend to allopathic physicians, osteopaths, podiatrists and physician assistants under Business and Professions Code section 802.1. Once an 802.1 report is sent to the Medical Board, the Board typically sends a confirming letter and refers the report of a criminal filing or conviction to investigations. After a Board investigator obtains court and police documents, the investigator will typically contact the physician in person, by phone or by mail, to set up an interview. In certain cases, such as suspected drug abuse or mental impairment, investigators may show up unannounced at a physician’s workplace or home to ask questions, request a drug and alcohol test, or to ask a physician to voluntarily submit to medical and/or psychiatric examinations.

If asked by the Medical Board, a physician has the obligation to sit for an investigation interview within 30 days of being notified of the request. This rule is found in Business and Professions Code section 2234(g), which gives the Board authority to punish as unprofessional conduct the failure to sit for an interview within 30 days of notification. The physician can and should bring an attorney to an investigator interview. Interviews are usually recorded. Relevant documents may be shown to the physician during the interview. Interviews may be held with one or more investigators, accompanied by a medical expert reviewer physician, and even attended by a Deputy Attorney General.

Once an investigation if is completed, which is often after an interview has concluded, the investigator may send a letter to the investigated physician either closing the investigation or indicating that the case has been referred to the Attorney General’s office for possibly disciplinary action. If the investigation has revealed cause for discipline, the Board may serve the physician with an accusation.

Our team of attorneys at Ray & Bishop, PLC, has a deep fund of knowledge and experience, and extensive experience, in defending physicians before the Medical Board of California. A Medical Board investigation is a critical stage which can determine whether a Medical Board case leads to discipline or is closed without action. Contact Ray & Bishop, PLC, to see how we can assist you with your Medical Board of California investigation.