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Court upholds revocation of oncologist for spreading hepatitis B

A license revocation and $370,000 judgment against an oncologist whose unsanitary office practices caused an outbreak of hepatitis B in his patients were properly ordered, the Appellate Division of the New Jersey Superior Court held December 5

Photo by Matt Hilger

(In the Matter of Dara).

The New Jersey medical board filed a complaint against oncologist Parvez Dara in 2009, accusing him of maintaining unsanitary conditions in his practice and of mishandling toxic substances. One hundred three of Dara’s patients contracted hepatitis B––which is transmitted by exposure to infected bodily fluids—after being treated in his office.

The physician argued that the board had applied a lesser criterion of guilt than the usual “preponderance of the evidence” standard, which requires that the violations were more probable than not. The basis for this argument was the board’s rejection of the ALJ’s recommendations, which the judge had based on the fact that investigators could not draw a definite, concrete connection between Dara’s practice habits and the infections. Instead, the board relied on what it termed “scientific epidemiologic concepts of causal interference.” This, Dara claimed, had created an alternate and impermissibly low standard.

State investigators had discovered egregious lapses on the part of Dara’s office staff: Soiled gloves used for invasive procedures were often not changed and were often used again for procedures intended to be sterile, needles were often taken out of their sterile packaging early; medicines were not properly stored, waste containers of sharp medical tools were not properly handled, records of waste disposal were lacking, and the office lacked written infection control policies.

Medical tests confirmed that 11 of Dara’s patients were infected with a genetically identical strain of hepatitis B, which they had contracted by patient-to-patient infection at his office. After a series of hearings, the board revoked Dara’s license and imposed fines and costs of more than $370,000.

In issuing its decision, the board rejected the finding of an administrative law judge that the state did not possess enough evidence to show that Dara had been the cause of the infections. The board explained the decision by noting that the ALJ, because of his lack of background in medicine, was unable to draw accurate connections that the board members, with their medical expertise, could better understand.

In his appeal, Dara challenged this decision, calling it arbitrary and unsupported by the evidence. The court, however, ruled that, based on longstanding law, the board was entitled to rely on its own expertise. Combining the evidence of sanitary lapses at Dara’s office with the fact that 11 of his patients had contracted an identical strain of hepatitis B, the board’s decision met the standard of “more probable than not.”

Dara also argued that the revocation of his license was overly harsh. However, the court, in affirming the revocation and the $370,000 penalty imposed, noted Dara’s extensive record of negligence.