Home E-Weekly September 12, 2017

Why Was This Pain Management Doc Disciplined?

Published: September 11, 2017

REPORTED PROBLEMS Edwin Kulubya, MD, departed from the standard of care, according to the state medical board.

The Medical Board of California placed a pain management specialist's medical license on probation for 5 years due to his treatment of a 65-year-old female patient who coded after receiving epidural steroid injections and facet injections with propofol in an unaccredited facility.

The board concluded that Edwin Kulubya, MD, an anesthesiologist in Anaheim, Calif., had been grossly negligent, performed repeated negligent acts, and failed to maintain adequate and accurate records. During the probation period, Dr. Kulubya can't perform intravenous sedation for interventional pain procedures nor can he supervise physician assistants or advanced practice nurses, says the medical board order, which details the October 2014 procedure.

Dr. Kulubya performed epidural steroid injections and facet injections with propofol sedation on a female patient. The woman, 65, was conscious at the end of the procedure when the IV and monitors were removed. A brief time later, she went into cardiac arrest. The patient was revived and transferred to a local hospital for follow-up care.

The medical board says facilities where IV sedation is performed must be accredited. In addition, the standard of care for pain management procedures requires having a treatment plan in place, informed consent, and intraoperative and post-op monitoring.

Dr. Kulubya demonstrated "extreme" departures from the standard of care by failing to document the dose of propofol he administered, or the intraoperative and post-op monitoring that was used, according to the medical board. In addition, he didn't keep an independent sedation record and failed to note whether a qualified provider monitored the patient or administered the sedation. There was also no pre-op or PACU record for the case, and no mention of the staff members who took care of the patient in those areas.

Jennifer Sturges, the attorney for Dr. Kulubya, did not respond to a request for comment.

Daniel Cook

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