7. Based upon the foregoing findings of probable cause of your violations of NCGS 90-187.8(c)(6), and pursuant to Board Rule 21 NCAC 66.0601(h), the Committee issues this letter of reprimand in lieu of sending the matter to a formal contested case hearing….”
On December 7, the NCVMB stated, “Dr. Greene had until December 5 to accept or not accept her Letter of Reprimand. As of today, we have not heard anything back from her.” On December 11, the NCVMB stated, “We just received a letter in the mail today that Dr. Greene has rejected the Letter of Reprimand. It will go to a hearing sometime in the future unless something else is agreed upon.” Then, on December 14, the NCVMB informed me that “Dr. Greene did meet the board’s deadline for rejecting the Letter of Reprimand,” which is a contradiction to what I understood on December 7.
On December 13, I wrote the NCVMB stating if there was any reconsideration given to reduce the finding against Dr. Greene, I would like to have an opportunity to be heard by the board as well. Since I never received a response from the Board, I wrote another on February 4, reinforcing my letter of December 13—again with no response.
I contacted the NCVMB every two weeks from January 8 through March 31 to check on the status of the rejected Letter of Reprimand always being informed that there were no updates or there was nothing to report regarding my case. On April 13, while viewing a private website, I discovered that the Board reconsidered its decision and changed the finding to “No Probable Cause” at their February 11 meeting—even though based on what I had been told, I believed there was nothing transpiring in my case.
Subsequently, I was informed that the board met with Dr. Greene and her attorney on January 26, which turned out to be a very good day for Dr. Greene. Although the wording in the Letter of Reprimand was very specific, including Dr. Greene not returning to the hospital or contacting the hospital veterinarian on duty to oversee Lance’s care, the board made a 180 degree turnaround, changing its decision to No Probable Cause.
My complaints about the actions of the North Carolina Veterinary Medical Board are as follows:
Based on what I was told, I believed that Dr. Greene did not respond within the timeframe allowed during the initial complaint response.
I was informed that Dr. Greene had to accept or reject the Letter of Reprimand by December 5; and when the response was received on December 11, they stated that Dr. Greene did meet the board’s deadline.
Based on what I was told, I believed that there was nothing transpiring with my case. They could have stated that information could not be shared, but to maintain that there were no updates or nothing to report was at best misleading and now feels abusive.
My pleas to be heard if there was any consideration whatsoever in reducing its finding against Dr. Greene were ignored.
The medical board refused my request for a copy of Dr. Steven Marks’ statement, asserting that it was not pertinent to my case. I cannot conceive of another reason for Dr. Marks to write to the board except to make a statement related to Dr. Greene.
The board’s business practices are arrogant, deceptive, and unethical. I have been victimized not only by the untimely death of a loved one, but also by the unfair practices of the North Carolina Veterinary Medical Board.
This posting reflects my opinions and is being supplied for public awareness.
We took our Afghan Hound, AKC Champion Criston Black Market (Lance), who was in excellent health, to North Carolina State College of Veterinary Medicine (NCSU CVM) for a routine procedure. The consultation was held in a room which was marked “Do Not Use.”
The procedure was performed the following day, and Lance unexpectedly passed away the morning he was to be released. We requested a case review, which was conducted by an independent panel at the CVM which stated that Lance’s condition was under-assessed.
Additionally, Dr. Steven Marks, Associate and Medical Director of the NCSU CVM, telephoned us with the preliminary results prior to receiving the NCSU CVM official report. I recorded the call to clarify and review any information that Dr. Marks would provide, and Dr. Marks told us that Lance’s condition was under-assessed by Dr. Greene.
I filed a complaint with North Carolina Veterinary Board (NCVMB) against Dr. Laura de Marchena Greene:
Some of the supporting documentation relative to the complaint that was submitted to the veterinary board included the NCSU CVM case review, the audio conversation with Dr. Steven Marks, and a letter from Dr. Marks who admitted, “While the absence of this documentation in the medical record represents a significant lapse on our part, please note that the necessary test was indeed performed.”
The NCVMB approved a Letter of Reprimand at their July 23 meeting, and the Letter of Reprimand was issued in a letter dated November 25, 2015 to Dr. Greene which stated:
“The Committee’s findings and decision are as follows:
1. At 1:30 a.m. on 10/23/14 you were alerted at home by page from NCSU-CVM that Lance’s temperature was 105.4F. You concluded that he may have aspirated some blood and that his fever was secondary to aspiration pneumonia. While these conclusions were reasonable, they were a clear indication and warning that Lance’s condition was beginning to deteriorate and that a potential critical situation was developing. Although your treatment directions were appropriate (IV fluids and intravenous infusion of ampicillin sulbactam), you erred in not consulting with the overnight veterinarians at the Hospital.
2. At 2:45 a.m. you again were paged by an IMC ward technician notifying you that Lance was displaying increased respiratory effort and cheek puffing. The dog’s respiratory rate was reported to you to be 28 bpm. You requested that the technician obtain a pulse oximetry measurement. That reading was 90%. At this point you suspected that Lance had aspiration pneumonia. This information was additional evidence of Lance’s continued deterioration, thus warranting your presence at the Hospital. At this point:
(a) You failed to immediately return to the Hospital to oversee and manage Lance’s treatment.
(b) You failed to move Lance to the ICU for assessment and treatment. There were simply too many signs indicating his distress for you not to have immediately moved him to ICU.
(c) At a minimum you should have given directions for additional diagnostics and monitoring, including an arterial blood gas; a continuous electrocardiogram; and a chest radiograph. You failed to order those additional diagnostics.
(d) You failed to consult with an overnight veterinarian at the Hospital.
3. At 3:45 a.m. you received a third page at home. The technician notified you that Lance’s temperature had risen to 106.8F and he continued to have increased respiratory effort, although his respiratory rate was 32 bpm. You requested that one of the two overnight veterinarians present in the building evaluate Lance to determine his level of stability. However, you should have immediately returned to the Hospital.
4. You were paged again at 4:00 a.m. The technician informed you of the overnight veterinarian’s findings of Lance’s increased respiratory effort and harsh lung sounds, and the dog had a repeat pulse oximetry measurement of 97%. It was error for you not to have spoken to the overnight veterinarian yourself about this evaluation.
5. You did not return to the Hospital until approximately 5:20 a.m. By then Lance was dying. The Committee is not able to determine whether your personal management of the case at the Hospital from and after 2:45 a.m. would have prevented Lance’s death. Nevertheless, he was your patient, and his continued deterioration required your presence. Without a necropsy the Committee lacks information that might suggest the cause of his death, although it appears aspiration pneumonia is a likely cause.
6. The foregoing findings of errors and omissions in your care and treatment of Lance constitute probable cause of violations of NCGS 90-187.8(c)(6) as acts of incompetence in the practice of veterinary medicine, in at least the following respects:
(a) You failed to consult with an overnight veterinarian at the Hospital about Lance’s condition after being paged on 10/23/15 at 1:30 a.m., 2:45 a.m. and at 4:00 a.m.
(b) You failed to transfer Lance to the Hospital ICU after being paged at 2:45 a.m.
(c) You failed to order additional diagnostics, including an arterial blood gas; a continuous electrocardiogram; and a chest radiograph after being paged at 2:45 a.m.
(d) You failed to return to the Hospital after being paged at 2:45 a.m. and again at 3:45 a.m. to personally manage Lance’s case. You had been sufficiently informed of his signs of distress. His continued deterioration required your presence and personal direction.
Letter of Reprimand