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Gonzalez’s medical license remains suspended

Wife's license also suspended
By: Krissi Khokhobashvili, Placer Herald and Press Tribune editor
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Dr. Efrain Gonzalez’s medical license has been suspended, effectively prohibiting the doctor accused of negligence against 15 women from practicing any form of medicine in California.

Administrative Law Judge Karen J. Brandt issued her decision April 25 following an April 19 hearing in Sacramento involving Deputy Attorney General Margaret Phe on behalf of the Medical Board of California and Albert Garcia, representing Gonzalez.

Brandt ordered Gonzalez’s license suspended March 25 in an ex parte hearing, stating in the order that Phe had made a satisfactory showing that “the likelihood of injury to the public if the instant order is not issued outweighs the likelihood of injury to respondent in issuing the order” and, “Serious injury will result to the public before this matter may be heard on regular notice.”

In a 95-page complaint filed by the California Medical Board, 15 former patients outline their experiences at Gonzalez’s Advanced Med Spa cosmetic surgery clinic on Sunset Boulevard. In the summary of her decision, Brandt noted that Gonzalez’s alleged violations of the Medical Practice Act include failing to properly address an infection after placing breast implants in a patient, using Propofol inappropriately during a plastic surgery procedure and performing a breast implant procedure that resulted in breast deformity. She also noted that Gonzalez’s board certification in obstetrics and gynecology had lapsed in 2011, by which time his practice was “exclusively a cosmetic-surgery practice,” and Gonzalez is not board certified in plastic surgery.

Four experts weighed in on the allegations – Debra Johnson, a clinical professor of surgery at UC Davis; Lorne K. Rosenfeld, clinical professor of plastic surgery at UC San Francisco; David Jeffrey Ruderman, board-certified in anesthesiology; and Kevin Nugent, also board-certified in anesthesiology.

Nugent reviewed medical records with regard to one of the 15 patients, in which the patient allegedly went into respiratory arrest during surgery. According to Nugent, “Respondent unsuccessfully tried endotracheal intubation. Respondent then performed a tracheotomy and that patient was transferred to an acute-care facility.” According to Brandt’s decision, Nugent believes Gonzalez is “not qualified by training and experience to provide either conscious or deep sedation,” and “does not have the airway-management skills required for deep sedation.”

Rosenfeld reportedly stated that Gonzalez appears to be “inadequately trained in cosmetic surgery with a poor grasp of the basic principles of art and science.”

At the April 19 hearing, Garcia argued that his client would assent to a practice restriction, in which he would be prohibited from performing cosmetic surgery while still being able to otherwise practice medicine. Brandt decided that argument is not persuasive, as “there is nothing in respondent’s submissions to indicate that he has attained the insight to know when he is practicing beyond his training and competence, or the judgment to ensure that he would self-regulate sufficiently to abide by any conditions that might be imposed.”

In his March 25 declaration, Gonzalez lamented that he had been the subject of much publicity regarding his case, and that he believes the “number of patient cases filed against (him) is the direct result of all this negative publicity.” Brandt struck that argument down, noting that the experts’ declarations and reports were the only evidence upon with the interim suspension order is based.

Gonzalez also asserted in his declaration that because he is the sole financial supporter of his two children, not being able to pursue practicing medicine would cause “irreparable financial damage” to his family. However, Brandt decided that “the financial damage that may be caused to respondent by the issuance of an ISO is far outweighed by the likelihood of injury to the public.”

The interim suspension order was granted, prohibiting Gonzalez from practicing or attempting to practice any form of medicine in the state of California, until an accusation is issued and a decision rendered.

Gonzalez is scheduled to appear in the Office of Administrative Hearings on June 21.

Brandt also ordered the interim suspension of Gonzalez’s wife’s medical license, in an administrative hearing May 1. Brandt determined that Yessennia Candelaria’s license will be suspended until a hearing is held May 24 in Sacramento.

The Placer County District Attorney’s Office has filed charges against Gonzalez and Candelaria as a result of a lengthy investigation led by investigators from the state Medical Board in connection with Franchise Tax Board, the DEA and the District Attorney’s office. The pair was arrested March 15 in connection with the execution of search warrants on Advanced Medical Spa, and their Rocklin home.

The complaint charges Gonzalez with 37 felony counts, including 15 counts of grand theft by false pretenses and 15 counts of mayhem. He is also charged with conspiracy to commit grand theft, conspiracy to disseminate false or misleading information, three counts of conspiracy to practice medicine without a license and conspiracy to operate a clinic without accreditation, according to a press release from the District Attorney’s Office.

Candelaria Is charged in 24 felony counts, including seven counts of grand theft by false pretenses and seven counts of mayhem. She is also charged with conspiracy to commit grand theft, conspiracy to disseminate false or misleading information, three counts of conspiracy to practice medicine without a license and conspiracy to operate a clinic without accreditation. Candelaria is also charged with felony possession and transportation of a controlled substance and a misdemeanor count of being under the influence of a controlled substance.

Both have pleaded not guilty to the charges and will next appear in Placer Superior Court May 29. The couple is represented by Tom Johnson.