KENTUCKY BOARD OF MEDICAL LICENSURE Hurtoourne Office Part Matt Bevin ‘3x0 Whitington Parkway, Suit 18 Preston P. Nunneliey, M.D. Governor au, Kents 40222 resident ‘Riopone (som) 129-7260 van stn FED Jane 8, 2016 FLED oF RecoRD JUN 08 206 David A, Dao, MD. License No. 22439 ae 14657 Shepherdsville Rovd Elizabethtown, KY 42701 RE: Approval to Progress to “Onsite Consultation” Phase Dear Dr. Daot Having reviewed your Amended Agresd Order; a Jeter ffom sour counsel, Clay B. ‘Worthan dated Tune 6 2016; letter from Mary Minobe of CPEP, dated June 1, 2016, ¢ ser sen itinm I, Godfiey, M.D, dated May 11, 2016; and records from the Secretary of Sate Fogg Heaniand Medica Clinic {hereby approve your request to proyress tothe next Phase Sryour Educational Intervention Plan, Preeepted Edueation, during which you must 1+ Meet wit your preceptor, Dr. Godfrey, twice monthlys | Camtinue i review and adéress your learning goals with your preceptor including frypotbetcl ease ciscusson, medical iteratze reviews, and chart reviews/ease-based discussions; ‘+ Continue to submit patent chars to CPEP for reviews and Integrate feedbeck from your preceptor and CPEP into your practice. sincerely, C Wadlirm Brcine to €, WILLIAM BRISCOE, MD. CHAIR, HEARING PANEL A Mary D. Minobe, CPEP. William J. Godttey, M.D. Clay B. Wortham, Esq. UCKY An Eq! Oppartunty Employer EDFILED OF RECORD commonweattaorxenrucky MAR 02 2015 BOARD OF MEDICAI. LICENSURE CASE NO. 917 aan INRE:THE LICENSE TO PRACTICE MEDICINE IN THE COMMONWEALTH OF KENTUCKY HELD BY DAVID A. DAO, MD, LICENSE NO. 22439, 4657 SHEPHERDSVILLE ROAD, ELIZABETHTOWN, KENTUCKY 42701 AMENDED AGREED ORDER Come now the Kentucky Board of Medical Lisensure (the Boar’), acting by and ttrough its Hearing Pane! A, and David A. Dao, MLD. (‘he licensee”), and, based upon theit sutal desire fo allow the license to resume the practice of medicine, hereby ENTER INTO the following AMENDED AGREED ORDER: STIPULATIONS OF FACT ‘The parties stipulate the following facts, which serve asthe factal bases for this Amended Agreed Order: 1. AC all relevant tines, David A. Dao, MD, was licensed by the Board to practice medicine within the Commonwealth of Kentucky. 2. The licensee's media! spcily is Pulmonary Disease. 3. On or about July 30,2003, Sergeant Bill Sivers contacted the Board and advised that the licensee had been anested fr drug-related offenses afer an undercoveriavestgtion 4. In October 2003, the licensee was indicted by the Jefferson County Grand Jury for criminal acts of Teffickng in Controlled Substance, Obtaining Drags by Froad and Deceit, and Unaxthorized Preseribing, Dispensing or Administering of Controlled Substances. 5. On or about Octoser 16, 2003, the Board filed a Complaint and Emergency Order of Suspension agains the licensee’s Kentucky medical license,6. In or around March 2004, the licensee was indicted in Nelson County, Kentucky with igh (8) felony counts of Obtaining Controlled Substances by Fraud and Deceit and eight counts of Complicity to Obtain Controlled Substances by Fraud and Deceit, At or round the same time, the licensee was re-ndicted in Jefferion County, Kentucky with ‘twenty-one (21) felony counts of Trafficking in a Controlled Substance, Obtaining Drugs by Fraud and Deceit, and Prohibited Activities Relating to Controlled Substances. 7. On or about May 11, 2004, the Board issued an Amended Complaint and Amended Emergency Order of Suspension, 8. During the Boar's investigation int the criminal charges against the licensee, the Board Yeamed thatthe licensee had become sexually intrested in a patient who had been refered to his practice, Patient A; during the inal evalustic, the licensee performed a complete physical examination, including a genital examination, for Patient A who had been refered for collapsed lungs and chest pin; shorty afer his ist appointment, the licensee made Patent A his office manager; acording to Patent A, he quit that job ‘because of inappropriate remarks made by the licensee; fer he uit the license pursued him aggressively, finally arranging o provide controlled sutstance prescriptions to him in exchange for sexual acs ths continued for sometime, with Patient A andthe licensee ‘meeting at hotel rooms and some of these meetings were recorded; at some point, the licensee began spliting some of the prescriptions with Pant A. and gave Patint A money to fill the presritions; the licensee also assisted Paint A to fil the controlled substances prescriptions in a variety of names of other persons; police were abe to identify approximately 33 fraudulent preseri ss as part of their investigation; with Patient A's assistance, the police were able to put together a sufficient case to amest the:licensee and bang charges agains him in two counties; around the same time, the licensee was plhced on a conectve action plan by Hardin Memorial Hospital due to disruptive conduct and refered to the Kentucky Physicians Heath Foundation (“te Foundation") fer evaluation and anger management after his amet, the licensee vas ‘ested bythe hospital and ested postive for Utramy/Tramadol; and as esl ofthe dug ‘est results and the criminal charges, the licensee's hospital privileges became suspended on September 13,2003. 9. On or about Noversber 9, 2004, after a jury trial in Jefferson County, the licensee was convicted on ss (6) felony counts of Obtsning Drugs by Fraud and Deceit. The jay ‘evommende a sentence of two (2) years and eight (8) months on each felony count 10. On or about Janary 6,200, the licensee was sentenced in Jefferson Circuit Couto two ) years aad cight (8) months on each felony conviction. The Court granted te licensee's request for probation and placed the licensee on five (5) years supervised probation. 11,0n or aboot February 17,200, the sense surrendered his iense to practice medicine in the Commonvealth of Kentucky by entering nto an Agreed Order of Surender. 12, Atthe time the Lcense surrendered his Kentucky medial liens, he was awaiting tial on the indents in Nelson County. In April 2005 the Nelson County charges were dismissed, withoxt prejudice, based in part ypon the other felony convictions in Jeferson Couny. 13.n or around May 2007, the licensee completed a clinical sis assessment in the specialty of pulnonology at the Center for Personalized Education for Physicians (CCPEP"). The Assessment Summary included the following information:A. Medical Knowledge ‘During this Assessment, Dr. Dao demonstrated medical knowledge that was ‘outdated and also contained gaps that would not likely be fully explained by his time away from practice. His areas of relative strength included ‘occupational lung disease and pulmonary embolism. Dr. Dao's knowledge of current pharmacology was deficient, He demonstrated some deficits that were surprising based on the common nature ofthe disorders; this was true in the areas of COPD, asthma, and the solitary pulmonary nodule. Other areas of identified need pertained to ly be relatively infrequent, especially in a rural practice, such as pulmonary vasculitis or interstitial lung disease, In the area of critical care, Dr. Dao showed that he lacked! competence with ‘acid-base disorders, ventilator management, —_ventilator-associated ‘pneumonis, and current evaluation and treatment of shock. It will be ‘important for Dr. Dao to address these particular areas prior to resuming practice inthe inpatient setting Dr, Dao's performance in discussions pertaining to procedures was mixed He did well in discussing techniques for bronchoscopy. While he was also able to do this regarding central venous catheter insertion, he was not able to easily discuss potential complications ofthis procedure. His discussion of ‘Swan-Ganz catheter insertion was good, except for a minor point. Dr. Dao ‘Volunteered that transtrachael needle aspiration was a personal limitation, B. Clinical Reasoning During the Assessment, Dr. Dao demonstrated clinical judgment and reasoning that were generally sound, though with some areas for improvement. In most hypothetical eases, he demonstrated the ability 10 ‘gather information in a logical, organized, and complete fashion. While his knowledge deficits sometimes impacted his ability to navigate through the cases, his general approach was logical. At times his formulation of differential “diagnoses lacked the structure that would assist. him in formulating more thorough lists. Dr. Dao requized a moderate amount of ceueing from the consultant to consider certain diagnoses as well as lueatments. In a few instances, Dr. Dao did not recommend plans that seemed adequately aggressive for the scenario, for example, the case of respiraory filure and acidosis; thus it was not clear if he properly perceived the acuity of illness Dr. Dao demonstrated awareness of some of his limitations, and indicated that he would refer to a colleague or referal center in those instances; 4hhowever, it was not clear if he understood the breadth of his limitations. In light ofthe fact that no charts were available for review and the duration of time away from practice, CPEP cannot comment about Dr. Dao’s application of knowledge in practice. D. Documentation Dr. Deo performed acceptably on the SP documentation exercise, indicating that he understands the important components of an adequete ‘note. His documentation was evaluated solely on the basis of notes written at CPEP, as charts from his former practice were not available, For this reason, no assessment of his ability to manage and organize « complete chart can be made, F, Summary Overall, Dr. Dao's knowledge was outdated and contained gaps. His clinical judgment and reasoning were generally sound, with some areas for improvement. Dr. Dao’s communication skills were good with peers and SP's; although the SP’s had difficulty understanding his accent. His documentation for the SP encounters was adequate. His cognitive finction sereen was within normal limits. It snot clear whether Dr, Dao has a health condition that could impact the practice of medicine. tthe licensee's direction, CPEP developed an Educational Intervention Plan. 14,1In or around October 2007, the licensee completed the “Maintaining Proper Boundaries” program atthe Vanderbilt University Medical Center 15. In or around November 2007, the Panel considered a request by the licensee to reinstate his license and voted to defer action until the licensee completed any evaluation(s) Tecommended by the Kentucky Physicians Health Foundation ("the Foundation”). In ‘dition, the Panel asked the licensee to outline his employment history since 2003 and to provide a detailed work plan, The Panel voted that practice location approval would be a condition required ifthe licensee were ever permitted to resume practice,16.1n or around March 2009, the Foundation refered the icensee to Keystone Center for a psychological assessment, where he received Axis I diagnoses of R/O PTSD and R/O ‘MDD and it was noted Dr. Dao’s objective assessment indicated that he was resistant to being forthright and honest about his sexual relationship with B.C. and indicated ‘an overall pattern of guardedness. This is understandable considering his desire to keep secret the exact nature of his relationship with B.C. During ‘and after the polygraph exam, Dr. Dao disclosed the sexual nature of his relationship with B.C. and appeared over whelmed with emotion. He acknowledged that he possibly disclosed at ths time because he could no longer carry the secret due to the emotional and physical tol t placed upon hhim. Projective testing suggests that Dr. Dao has difficulty processing his feelings and tends toward not being emotionally vulnerable. He can also be interpersonly naive. Physically, Dr. Dao is poorly managing his diabetes and isin need of increased self care and medical management. ‘Several inconsistencies were noted in the records provided. They have been noted throughout the report. For example, according to the Order of ‘Surrender, there was significant evidence that Dr. Dao was engaged in a sexual relationship with B.C. inchuding video surveillance of Dr. Dao with BC. with his “shirt off and pants undone.” Additionally, Dr. Dao éenied drug use as part of the allegations. Yet, his testing indicated otherwise on September 7, 2003. He was positive for Ultram. Finally, even while at Keystone, Dr. Dao denied paying for sex. Yet he indicated that he deducted monies owed to him by B.C. for sexual favors. Dr. Dao denied trading drugs for sex while admitting to prescribing narcotics for B.C. while they engaged in a sexual relationship. Dr. Dao continues to maintain a pattern of {deception that is inconsistent with the level of accountability necessary for a practicing physician, Upon completion of the assessment process, Dr. Dao was encouraged 10 take time to address his traumatic experiences in childhood and as an adult ‘coming to America in 1995. He was encouraged to address his denial and the assault to his integrity related tothe events with B.C. It is the opinion of the assessment team that Dr. Dao is nat safe to practice medicine at this time. This opinion is offered within reasonable certainty and based upon availabe information. 17. Two years later, the licensee retumed to the same evaluator, but at Pine Grove Behavioral Health, where he received an Axis I diagnosis of Mood Disorder NOS and the evaluator reached the following conclusions and recommendations:‘Mary Gannon, MD noted that Dr. Dao “lacked the foundation to navigate iffcult situations, both interpersonally and in a complex profession”. Dr. Gannon noted a need to contro, avoidance, withholding information and ‘magical thinking as problematic. She also opined reinstatement of Dr. Dao's medical license as the primary motivation for therapy. 1 believe that fundamentally this remains unchanged and despite Dr. Dao's verbalization that he wants to obtain his license, his investment in therapy was less than ‘enthusiastic and other factors may be the source of his motivation. His choice to travel to Vietnam instead of continuing to address therapeutic issues is conceming. During this evaluation Dr. Dao stated that regaining his medical license was a matter of “family honor.” Despite this statement, his investment appears less than robust. After Dr. ‘Dao stopped treatment with Dr. Gannon in February of 2010, there appeared to be little investment with his new therapist. Dr. Dao said that he did not participate in therapy while in Vietnam and bas only seen Dr. Kaveh ‘Zamanian once since his return to the US and that appears to be in effort to ‘objain a letter in suppor of license re-instatement Dr. Montgomery noted that Dr. Dao appeared to have difficulties with information processing. Neuropsychological screening did not suggest ‘70ss difficulties. However, in reviewing records, it was noted that Dr. Dao tends to have poor decision-making despite his overall level of ability. His choices have resulted in significant consequences over the years yet he continues to function in this manner. He is generally not forthright regarding details of evenis unless challenged and at times he will tell different versions of a story to different interviewers. For example, he initially stated that he volunteered in a hospital Vietnam. Yet, by the end of the week he stated that he worked there. According to the records (8-8-11), hhe informed Dr. Brady that he practiced medicine in Vietnam and was paid $1000 per month. Additionally, notes dated 5/12/09 reference inconsistencies between Dr. Gannon, Dr. Brady and myself regerding Dr. ‘Dao's control of his diabetes and his ability to return to work. Although one ‘might hypothesize that language may play a role in his ability to receive and integrate information, current testing and history do not support language as ‘a major contributor, especially, in ight of his previous success in the United States. In my opinion, Dr. Brady's notes are telling of some of the difficulties Dr. ‘Deo has had interpersonally. As far back as April, 2002, Dr. Brady notes “che would unilaterally chose to do his own thing”. This remains ‘concem to this day and without a high degree of structure and accountability ‘he is at risk for further boundary related practice issues.RECOMMENDATIONS 1. Given that Dr. Dao has not progressed in outpatient therapy to the level expected to practice medicine safely and with the necessary integrity the profession demands, i is our recommendation that he attend a residential program to address his character deficits. Options include, The Professional Enhancement Program at Pine Grove, Sante’ Center for Healing, or the Professional Renewal Center. 2. Dr. Dao will need to complete a polygraph without evidence of deception prior to re-instatement of his license, 3. Dr. Dao will need to complete professional boundacies course if ‘has not done so inthe pat three years, 4. Random urine and polygraph examinations are recommended, >. A highly structured practice plan with a restricted DEA license is necessary ifwhen he is able to return to medical practice. 18, From November 2011 through January 5, 2012, the licensee patcpated in the recommended Profesional Enhancement Program (CPEP") at Pine Grove, where he reevived additonal Axis 1 diagnoses of Occupational Problem (Profesional Srual Misconduct, boundary violations) and Complex PTSD. The Discharge Summary included the following Brit Summary of Overall Progress: Dr. Dao was admitted to the Professional Enhancement Program (PEP) on 11/072011. Dr. Dao’s treatment focused on his vocational sexual misconduct, personality traits, depression and anxiety, trauma, and relational issues with his spouse and family. While at PEP, Dr. Dao received feedback about his lack of awareness around his personality and relational issues and his dificulty taking responsibility for his boundary violations. He struggled with interpersonal relationships, particularly with recognizing how his personality traits inhibited his ability to function and be genuine in felationships with his peers and wife, During his time here he did gain an understanding of his role in unhealthy relationships and was able to take ‘more responsibility for his actions. He also gained and practiced valuable ‘new coping and relational skills. Overall, Dr. Dao gained an awareness of his maladaptive behaviors while in weatment and would benefit from continued work to maintain his progress, to continue to process his vocational sexual misconduct, and to further address his personality traits, Dr. Deo agreed to follow through with discharge plans to seek employment ‘outside of the medical field where he can practice health boundaries and continue to process treetment issues with an outpatient therapist. It was recommended that he return to PEP in,19. The licensee retumed to PEP on June 4 and was discharged on June 15, 2012. The Discharge Summary included the following Return to Work Recommendations ‘Pending the approval of the Kentucky Board of Medical Examiners and the Kentucky Physicians Health Foundation Dr. Dao may return to the practice ‘of medicine with appropriate continuous monitoring. Pending approval of the Kentucky Board of Medical Examiners to retum to practice, it is recommended that Dr. Dao sign & contract with the Kentucky Physicians Health Foundation aftercare monitoring and follow — all recommendations and guidelines ofthis contract. Return to the Professional Enhancement Program (PEP) in one year (June 2013) for a Slay reevaluation to assess for further workplace recommendations, It will be his responsibility to call PEP in order to set this up at least 2 weeks prior to entrance. Prior to acceptance of any position Dr. Dao should discuss ‘employment options with his therapist. Once employment in medicine is cobisined, it is recommended that Dr. Dao paticipate in PEP care ‘monitoring. It is Dr. Dao’s responsibility to contact PEP in order to begin this process, Participate in polygraph testing to be completed in one year at PEP upon his return for reevaluation. [Link] or around October 2012, the Panel considered the above information and vod to defer action until the licensee succesfully completed an updated CPEP Clinical Skils Assessment and obtained an Education Plan, if recommended. 21. In or around February 2012, the licensee paticipeted in an updated CPEP Clinical Skis Assessment inthe specialty of pulmonology fom which CPEP found in pat During this Assessment, Dr. Dao demonstrated medical knowledge that was ‘marginally acceptable with gaps in some areas important to practice. His knowledge appeared stronger in topics pertinent to the outpatient setting. His clinical judgment and reasoning were lacking overall, Dr. Dao's communication skills were adequate, with room for improvement, with Simulated Patients (SPs); his communication skills with peers was professional. His documentation for the SP encounters was marginally adequate with the need for improvement, ‘The educational needs identified in this Assessment are listed in Section I. Assessment Findings. Review of a history and physical exam conducted in January 2013 did not reveal any conditions that should affect Dr. Dao's medical practice. Dr. Deo also submitted 9 discharge summary from Professional EnhancementProgram (PEP) pertaining to a June 2012 admission, Some of te diagnoses identified have the potential to impact medical practice andlor were related to previous licensure discipline (boundary violations). His cognitive function sereen results were below expectations. 22. n or around May 2013, the licensee completed a neuropsychological evaluation, which found no Axis I diagnoses, In the Summary and Discussion, the evalustor concluded, in part, ‘The results of the neuropsychological evaluation revealed that, a the time of the testing, Dr. Dao emotionally was free of debilitating anxiety, depression, or psychological turmoil to the extent that it would affect his ability to function in activities of daily living or manage the practice of medicine. [Neuropsychologically, the man is functioning in the Average Range with High Average skills in perceptual reasoning and working memory. His Average performances in processing speed and verbal comprehension still Were within anticipated parameters especially for someone who was born and raised in foreign country with English asa second language, Agxin, diagnostically the results of this evaluation give no evidence of cortical or subcortical dysfunction or cognitive impairment that would impede this gentleman’s ability to retum tothe practice of medicine 1t is recommended that as he retums to the practice of medicine that he follows the recommendations offered in his last visit to the Professional Enhancement Program in 2012. 23. In or around July 2013, CPEP developed an updated Educational Inervention Plan for the licensee in the specialty of pulmonology, which anticipated thatthe licensee would hhave 100% direct supervi 24. nor around August 2013, the Panel considered the above information and voted to defer action on the licensee's petition for reinstatement until he presented an appropriate practice plan. 25. On or about March 14, 2014, the licensee submitted for the Panel's consideration a plan to practice intemal medicine in Elizabethtown, Kentucky, with Dr. liam Godfrey. 10However, because the licensee had presented himself as a pulmonologist and submitted ‘to clinical skills assessments only in the specialty of pulmonology in 2007 and 2013, (CPEP could not comment or approve of his plan to practice internal medicine. 26. 1n ot around April 2014, the Panel chose to defer action on the licensee's request to reinstate his medical license until he retumed to CPEP and completed an assessment in Internal Medicine and obtained an education plan, ifrecommended, 27. In or around August 2014, the licensee returned to CPEP and completed an assessment in ‘outpatient intemal medicine. CPEP noted thatthe licensee had net practiced medicine in ‘the United States since 2005 and that he hed not practiced in a primary care or intemal ‘medicine setting outside of residency training. Although the liceasee had participated in ‘two different intemal medicine review CMEs in the prior 36 months, he still demonstrated significant deficiencies which may be difficult to remediate. Overall, (CPEP found that the licensee “demonstrated a very limited fund of knowledge in ‘outpatient and inpatient internal medicine with broad-based end significant deficiencies in the majority of areas covered.” It was noted that he demonstrated “significant and ‘broad deficiencies in areas common to primary care,” his knowledge of health ‘maintenance was “globally inadequate,” and he demonstrated unasceptable knowledge of basic physical examinations and medications. The licensee demonstrated inadequate clinical judgment and reasoning, his thought processes were slow and disorganized. In ‘one case he omitted a pulmonary condition fom a differential diagnosis ~ this was noted to be especially conceming because the licensee isa pulmonologi 28. In or around November 2014, CPEP developed an Educational Intervention Plan for the licensee in the practice of outpatient internal medicine, The Educational InterventionPlan requires that the licensee have 100% direct supervision fom his Preceptor, Dr Wiliam Godttey, during all outpatient intemal medicine paint encounters for an indeterminate period of time, CPEP does not recommend tha th licensee be allowed to practice in higher acuity inpatient setng without first completing a residency program, ven his demonstrated deficiencies in managing emergent scenarios and in treatment planning, 29.0n or about Apel 16,2015, the Pane agreed to allow the licensee to resume the practice of medicine pursuant othe terms and condition st forth n an Agreed Order, [Link] December 2015, CPEP issued Progress Report [in egard to the licensee's education plan and sted Dr, Dao demonstrated compliance with and dedication to his Plan during this reporting period. To progres with his Pan ths report is being provided to the KBML for their consideration in determine ‘fr, Dao may procecd to End of Day Review, which isthe next stepin the Point of Care Experience Dr. Dao’s preceptor, Dr. Godfey, has submited a write report detailing his 100% supervision of Dr Dao one day each week for a period of 3-4 months and stating that he believes that De. Dao is ready to proceed tothe next phase of his esucation plan requiring end of day review, 31. The licensee's Agreed Order required, in part, that “upon competion ofeach phase ofthe Educational Inerventon Plan, the licensee SHALL obain the Panel's writen approval Prior to proceeding with subsequent portion ofthe Educational Intervention Plan” 32, On February 18,2016 the licenses appeared before the Panel and acknowiedged that he had violated the Agreed Onder because he and his preceptor, Dr. Godley, had proceeded to the next phase of is Educational Intervention Plan without the Panels approval. RIPULATED CONCLI LAW ‘The pares stipulate the following Conclusions of Law, which serve asthe legal bases for this Amended Agreed Order 1. The Hoensee's Kentucky medical lisense is subject to regulation and diseptne by the Board 2. Based upon the Stipulations of Fac, the license bas engaged in conduct which violates ‘the provisions of KRS 311.595(4, (8), (9) ~a illustrated by KRS 311.597(1)~ (13) and (21), Accordingly, there are legl grounds for te paties to enter into this Amended Agreed Order 3, Pursuant to KRS 311.591(6) and 201 KAR 9:08, the parties may allow the licensee to resume the practic of medicine pursuant to ths Amended Agreed Order. AMENDED AGREED ORDER Based upon the foregoing Stpulatons of Fct and Stiplsted Conclsions of Law, and, based upon their mutual desire to allow the licensee to resume the practice of medicine, the ities hereby ENTER INTO the following AMENDED AGREED ORDER: 1. The license to practice medicine in the Commonwealth of Kentucky held by David A. Deo, MD., is RESTRICTEDILIMITED FOR AN INDEFINITE PERIOD OF TIME, effective immediatly ypon the fling ofthis Amended Agreed Onder, 2 During the effective period of this Amended Agreed Order the licensee's Kentucky medicel Heese SHALL BE SUBJECT TO THE FOLLOWING TERMS AND CONDITIONS until further order ofthe Pant 4 The licensee's practice of medicine is EXPRESSLY RESTRICTED/LIMITED to the practice of internal medicine in an outpatient office-based environment, and he SHALL NEITHER practice in an inpatient setting (including but notlimited to nursing homes) NOR provide any treatment for conditions outside of the specialty of internal medicine, unless and until approved to do so by the Panel; ». The licensee SHALL NOT perform any act which would constitute the “practice ‘of medicine,” as that term is defined in KRS 311.550(10), unless and until the Panel or its Chair has approved, in writing, the specific practice location at which hae will practice medicine. ‘The decision whether to approve a particular practice location lies in the sole discretion of the Panel or its Chair. In determining ‘whether to approve a particular practice location, the Panel or its Chair will particularly consider whether there will be appropriate supervision of the licensee, ‘and may also consider the nature ofthe practice, including the licensee's proposed ‘duties and hours to be worked, In approving such practice location, the Panel or its Chair may include specific conditions/testritions to ensure patient safety and ‘may require additional conditions end/or restrictions as a condition of it granting approval fora new practice location. The parties agree thatthe Panel or its Chair ‘must approve any change in practice location forthe licensee in writing and prior to the licensee commencing the practice of medicine at any location(s); i. ‘The licensee is hereby approved to and SHALL ONLY practice internal ‘medicine one (1) day each week atthe office-based outpatient practice of| William J. Godfiey, MD., 914 West Dixie Avenue, Elizabethtown, Kentucky 42701; . The licensee SHALL comply with and shall successfully complete all requicements of his CPEP Educational Intervention Plan, at his expense and as. directed by CPEP, a copy of which is attached; |. The licensee SHALL TAKE ALL NECESSARY STEPS, including the execution ‘of waivers and/or releases to ensure that CPEP provides timely written reports to the Panel outlining his compliance with the Educational Intervention Plan. The licensee SHALL further ensure that CPEP shall notify the Board immediately if the licensee should fail to comply with the Educational Intervention Plan or practices medicine in a manner that creates a danger or tsk of danger to the health or safety of patients or the public; ‘Upon completion of each phase ofthe Educational Intervention Plan, the licensee SHALL oblain the Panel or Panel Chair's written approval prior to proceeding ‘with subsequest portions of the Educational Intervention Plan. The licensee SHALL ensure that the Panel or Panel Chair is provided with all written evaluation reperts by CPEP and a written (or in person) report from William J. Godftey, M.D, in order to make a fully informed decision at each interval; If deemed necessary and appropriate by CPEP, the licensee SHALL SUCCESSFULLY COMPLETE the Post-Education Assessment, at his expense ‘and as directed by CPEP; and “4{The licensee SHALL NOT violate any provision of KRS 311.595 and/3r 311.597. 3. The licensee expressly agrees that if he should violate any term or condition of this ‘Amended Agreed Order, the licensee's practice will constitute an immediate danger to the public health, safety, or welfare, as provided in KRS 311.592 and 13B.125. The partes further agree that ifthe Board should receive information thet he has violated any ‘erm or condition ofthis Amended Agreed Order, the Panel Chair is authorized by law to enter an Emergency Order of Suspension or Restriction immediately upon s finding of probable cause that a violation has occurred, after an ex parte presentation of the relevant facts by the Board's General Counsel or Assistant General Counsel. Ifthe Panel Chair should issue such an Emergency Order, the parties agree and stipulate that a violation of any term or condition ofthis Amended Agreed Order would render the licensee's practice ‘an immediate danger to the health, welfare and safety of patients and the geveral public, pursuant to KRS 311.592 and 13B.125; accordingly, the only relevant quesion for any ‘emergency hearing conducted pursuant to KRS 138.125 would be whether the licensee violated a term or condition ofthis Amended Agreed Order. 4, The licensee understands and agrees that any violation of the terms of this Amended Agreed Order would provide a legel basis for additional disciplinary action, including: revocation, pursuant to KRS 311.595(13), ain may provide « lepal bus prosecution. SO AGREED on this 24 day Oh Fabs FOR THE LICENSEE: 1sFORTHE BOARD: CWILLIAM BRISCOE, MD. CHAIR, HEARING PANEL A TEANNE K DIAKOV General Counsel Kentucky Board of Medical Licensure 310 Whitington Pareway, Suite IB Louisville, Kentucky 40222 “al. (502) 829-7150, 16CP. EPS P Ss EDUCATIONAL INTERVENTION PROGRAM. EDUCATION PLAN, Developed November 2014 for David A. Dao, M.D. [NATIONALLY RECOGNIZED * PROVEN LEADER * TRUSTED RESOURCE ‘720 8, Colorado Boulevard, Suite 1100-N Deaver, Colorado 80246 ‘Phone: 303-577-3232 Far: 303-577.3241 ‘[Link] “Ts doamonl ood onlrs ee eonlonss end iced fr be ecava use ef CPE, Paraben, and aiomed rofl ovewcrpanlzan).s pvepd unc plea rv, aareiin vak pro yde wee ‘3 prvi byl, Use dca wou wien euhzten ten CPEP ey rit, you ta eed ‘is eounont mom, plone conta CPEP immedi.Edveation Plan Davd A. Dao, MD. Appendix A Appendix B Appendix C & Page 20f 19 EDUCATION PLAN OVERVIEW Itroduction and Plan Desiga Individesl Leeraing Goals ‘© Specific areas of educational need Pesformance Objectives (Modules A and B) © Self-study, CME, Preceptor Meetings Initiation ofthe Plan and Preceptor Approval ‘© Determining the start of activities Education Notebook ‘+ Preceptor Approval Process Paticipation and Monitoring * Participation Expectations ‘Evaluation Process Deration APPENDICES: Practice Profile Federal Regulations of Privacy of Individually identifiable Health Information Glossary and Educational Terms‘Béucation Plan David [Link], MD. Page 3 of 19 |. INTRODUCTION Dr. Dao has not practiced inthe United States since 2005. His previous practice experience was in pulmonology. ‘Dr. Dao hes not precticed in a primary cre or interoal medicine seting outside ‘of residency tsining. Due to the dificulie in ideaifying a preceptorhip in pulmonology, Dr. Dao presested to CPEP for a clinical skills Addendum in intemal medicine in Angust 2014, ‘which identified areas of educational need. The development of this Education Plan (Plan) was based on those needs. The Plan was also based on dats gathered by CPEP and information obisined from Dr. Dao. The purpose ofthis Plan is to provide a framework in which Dr. Dao ‘an address his educational neods in outpatient intemal medicine. For a complete history of Dr. Dao"s CPEP activites, see his August 2014 Assessment Report (oleae dato November 7, 2014), Important to Note: ‘During his Assessment, Dr. Dao demonstrated a significant numberof educational needs related to outpatient internal medicine. It is CPEP’s opinion that an attempt at supervised remedial ‘education in th area of outpatient internal medicine may be appropriate for Dr. Dao. However, ‘based on the information that Dr. Duo provided to CPEP, it appeared that he participated in two different internal medicine review Continuing Medical Education (CME) activities in the past 36 ‘months and sll had mumerous knowledge deficiencies recognized during the Addeodum, which suggests that he may have difficulty remediating ‘Educational programs developed by CPEP cannot provide the same rigor or level of supervision 5 a residency program, and CPEP cannot guarantee that Dr. Dao will be able to access the ‘educational resources needed for him to successfully address his educational needs ouside of a residency setting. Areas such os Dr. Dao's clinical judgment and reasoning can be challenging to remediate and may requir time to ensure success. In light of the extent of the deficiencies identified, any remediation would requize interest by the Boacd, extensive resources, and fll commitment by Dr. Deo. CPEP recognizes that decisions about licensing or privileging are ‘made a the local level and based on many factors other than the Assessment. A glossary of Educational Intervention terms is enclosed. FOCUS OF PLAN ‘Outpatient [nteral Medicine: This Plan adresses Dr. Dao's practice of outpatient intemal medicine. If areas of educational need other than those addressed in this Plan are identified while Dr. Dao is participating in the Plan, CPEP will notify the referring organization and Dr, Dao and determine ifthe educstional needs can be addressed within the context ofthis Plan. Inpatient Intemal Medicine: Based on Dr, Dao's performance during the Addendum, in particular his deficiencies in managing emergent hypothetical scenarios and in treatment planning, Dr. Dao did not demonstrate ability to safely practice in a higher-acuty inpatient setting. ‘Tie Gouret end colons ev cunflonl md lio fr be excuse oo a CPEF, Patcoan a wind rofesonlvon cmineabn), 2a pega ude peal ev, ey ver redo belo os Fermi by lon. Ue x dacoque wiht witenaxboraion fen CPEP sei prised you hae rch is ‘ocala coi PEP ned,