The license of La Palma internal medical Dr. Su-Yong Pak was placed on two years' probation and he is prohibited from supervising physician assistants effective Tuesday, according to the state medical board.
According to accusations filed in November 2015 and signed by Kimberly Kirchmeyer, executive director of the Medical Board of California, the discipline stems from Pak's treatment of an 87-year-old patient in July 2009.
The man had suffered a heart attack and was taken to Palomar Medical Center and then Palomar Heights Care Center, both in Escondido. Four days after arriving at the skilled nursing facility, the patient fell while walking to the bathroom and later complained of pain to his right hip.
Two X-rays were taken of the man's hip, and copies were sent via computer to Pak, who looked them over on his Samsung personal computer and/or Hewlett-Packard laptop, according to Kirchmeyer.
The quality of those images was poor, but Pak nonetheless concluded the damage done to the hip was minor, with no break or fracture, writes Kirchmeyer, noting that a broken hip can be very serious and even deadly for elderly patients.
On July 18, 2009, a day after being released from the skilled nursing facility, the patient returned to the emergency room complaining of severe pain to his hip and an inability to walk, Kirchmeyer states. A medical evaluation determined the fellow had suffered from a neck fracture, substantial blood loss and ... a fractured right hip.
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He received surgery, but on July 22, 2009, he was found apneic and pulseless, and cardiopulmonary resuscitation was unsuccessful.
Failing to identify the hip fracture, failing to recognize the poor quality of the X-rays, viewing them on his PC and/or laptop and failing to follow up with better X-rays or a CT scan "constitute extreme departures from the applicable standard of care," Kirchmeyer writes.
In a settlement signed by Pak and Kirchmeyer, the physician agrees to take an education course, have his practice monitored by an independent expert at his own expense, notify every hospital and facility where he has privileges of his suspension, obey all laws and submit quarterly reports.
Violation of his probation could result in the surrender of his medical license, according to the agreement.