Opinion

Menkes v. State Med. Bd. of Ohio

  • 159 N.E.3d 900
  • 2020 Ohio 4656
Court
Ohio Court of Appeals
Filed
Sep 29, 2020
Status
Published
On the bench
Brown, J.
Cited by
1 cases
Authority
More cited than 46.1%

The opinion

[Cite as Menkes v. State Med. Bd. of Ohio, 2020-Ohio-4656.]

IN THE COURT OF APPEALS OF OHIO

TENTH APPELLATE DISTRICT

Alan L. Menkes, D.O., :

Appellant-Appellee, : No. 19AP-476

(C.P.C. No. 17CV-3982)

v. :

State Medical Board of Ohio, : (REGULAR CALENDAR)

Appellee-Appellant. :

D E C I S I O N

Rendered on September 29, 2020

On brief: Dinsmore & Shohl, LLP, Eric J. Plinke, and

Daniel S. Zinsmaster, for appellee. Argued: Eric J. Plinke.

On brief: Dave Yost, Attorney General, Katherine

Bockbrader, and Kyle C. Wilcox, for appellant. Argued:

Katherine Bockbrader.

APPEAL from the Franklin County Court of Common Pleas

BROWN, J.

{¶ 1} Appellant, the State Medical Board of Ohio ("board" or "Ohio board"),

appeals from a judgment of the Franklin County Court of Common Pleas reversing the

board's order reprimanding appellee, Alan L. Menkes, D.O. ("Dr. Menkes"). For the reasons

which follow, we affirm in part and reverse in part.

{¶ 2} Dr. Menkes received a license to practice osteopathic medicine and surgery

in Ohio in 1967. In 1990, Dr. Menkes' Ohio medical license expired due to non-renewal. On

July 23, 2015, Dr. Menkes submitted an application to the board seeking to restore his Ohio

medical license.

No. 19AP-476 2

{¶ 3} Dr. Menkes has been employed in a variety of positions throughout his long

career in the medical profession. Since 2013, however, Dr. Menkes has been practicing

telemedicine for his employer, MD Live, Inc. As a telemedicine physician, Dr. Menkes

consults with patients over the phone or by video and is able to diagnose minor conditions,

make recommendations, and provide prescription refills. In 2014 and 2015, Dr. Menkes

sought medical licenses in several states in order to expand his telemedicine practice. Dr.

Menkes noted on his Ohio application for license restoration that he would be practicing

"telemedicine only" in Ohio. (Appellee's Ex. A.)

{¶ 4} The application for license restoration asked Dr. Menkes to list "ALL

states/provinces in which you hold or have held a license to practice medicine and surgery

* * * whether the license is current or not." (Emphasis sic.) (Appellee's Ex. A.) In response

to the question, Dr. Menkes listed his medical licenses in the following states: Arizona,

California, Colorado, Florida, Hawaii, Idaho, Iowa, Michigan, Nevada, New York, Ohio, and

Washington. Dr. Menkes did not list his expired Oregon medical license in his response to

the question. Dr. Menkes also answered "no" to question seven on the application, which

asked whether any "board" had "in any way limited * * * any professional license, certificate

or registration granted" to him. (Appellee's Ex. A.) Dr. Menkes executed an affidavit

averring the statements made in the application were true and complete.

{¶ 5} In 1986, Dr. Menkes was in a motor vehicle accident which caused a

herniated disc in his spine. Dr. Menkes had neurosurgery to attempt to repair the herniated

disc in 1987, but the neurosurgery "went bad." (Hearing Tr. at 55.) As a result, Dr. Menkes

suffers from a permanent condition which causes weakness, muscle atrophy, and tremors

in his hands. The tremors affect Dr. Menkes' "fine grasp control for instrumentation."

(Hearing Tr. at 56.)

{¶ 6} Prior to the motor vehicle accident, Dr. Menkes had been working in

hospitals as an osteopathic intensivist. Dr. Menkes had an insurance policy at that time

termed a "Usual ('OWN') Occupation Policy," which would pay benefits if Dr. Menkes was

"unable to perform the substantial duties of [his] occupation." (Appellee's Ex. I.) Following

the accident and unsuccessful neurosurgery, Dr. Menkes filed a claim under his insurance

policy and began receiving payments. Dr. Menkes explained that although his injury

No. 19AP-476 3

"limited [his] hospital work in invasive procedures," it did "not limit [his] office practice."

(Hearing Tr. at 56.)

{¶ 7} Dr. Menkes received a license to practice medicine in Oregon in 1978.

Although Dr. Menkes worked predominantly in California throughout the 1980s, in 1988

Dr. Menkes wanted to cover a colleague's practice in Oregon for a couple of weeks. On

October 20, 1988, Dr. Menkes submitted a document to the Oregon Board of Medical

Examiners1 ("Oregon board") requesting a limitation of his medical license pursuant to

Oregon Revised Statute ("O.R.S.") 677.410. The document stated as follows:

I, ALAN L. MENKES, D.O., in accordance with the provisions

of ORS 677.410, do voluntarily request the following

LIMITATION be placed upon my license:

1. I shall limit my medical practice to that of an office based

practice only.

I understand that this Limitation will remain in force and effect

until terminated by the Board and failure to comply with terms

of this Limitation may be grounds for disciplinary action by the

Board.

(State's Ex. 3.)

{¶ 8} Dr. Menkes explained that the purpose of requesting the voluntary limitation

was "to backup [his] disability." (Hearing Tr. at 75.) Following a hearing, the Oregon board

decided to approve Dr. Menkes' "request for a voluntary limitation under ORS 677.410,

limiting him to office practice only." (Appellee's Ex. F.) Dr. Menkes' Oregon medical license

expired in 1994.

{¶ 9} On April 13, 2016, the Ohio board notified Dr. Menkes it proposed to refuse

to reinstate his medical license or take other disciplinary action against him. The board

further informed Dr. Menkes that his failure to list his Oregon medical license on the Ohio

application for license restoration and his negative answer to question seven on the

application constituted false, fraudulent, deceptive, or misleading statements in violation

of R.C. 4731.22(B)(5).

1 The Oregon Board of Medical Examiners is now the Oregon Medical Board. References to the Oregon

board throughout this decision refer either to the Oregon Board of Medical Examiners or the Oregon

Medical Board interchangeably depending on the relevant timeframe.

No. 19AP-476 4

{¶ 10} On November 14, 2016, the board's hearing examiner conducted a hearing on

the matter. Dr. Menkes explained at the hearing that Misty deBlois, a licensing expert

employed by MD Live, Inc., filled out the state licenses section on the Ohio application using

his curriculum vitae ("CV"). Dr. Menkes could not provide "an exact date when [his CV] was

last completed or updated," but acknowledged that the section of his CV identifying his

various state medical licenses did not contain "the word 'Oregon.' " (Hearing Tr. at 21;

Appellee's Ex. D.) Thus, Dr. Menkes explained his Oregon medical license was

"inadvertently" omitted from the Ohio application "or Misty didn't do it. It wasn't

deliberate. She used it from [his] CV and obviously [he] didn't have it on [his] CV. It wasn't

intentional." (Hearing Tr. at 71.) Dr. Menkes affirmed that he reviewed the application

before submitting it to the board.

{¶ 11} Dr. Menkes explained he answered "no" to question seven on the application

because he had "asked for the [voluntary] limitation and that's how [he] interpreted it. The

[Oregon] Board didn't come up with it. * * * They ratified [his] request to limit [his]

practice." (Hearing Tr. at 50.) Dr. Menkes affirmed that Oregon was "the only state where

[he had] ever entered into a limitation" on his license. (Hearing Tr. at 69.)

{¶ 12} Evidence presented at the hearing demonstrated Dr. Menkes submitted an

application to the Oregon board on November 4, 2014 seeking to reactivate his Oregon

medical license. On January 20, 2015, an Oregon board compliance officer wrote a letter

to Dr. Menkes informing him that if he was "requesting that the Board terminate the 1988

Voluntary Limitation" he needed to "submit a written request stating that and fully explain

what has changed to negate the original need for the Voluntary Limitation." (Appellee's Ex.

F.) Dr. Menkes explained at the hearing that he could not reactivate his Oregon medical

license or remove the voluntary limitation because he could not provide the Oregon board

with "a statement that [he had] returned to [his] condition prior to [his] accident." (Hearing

Tr. at 53.) On May 4, 2016, the Oregon board granted Dr. Menkes' request to withdrawal

his Oregon application for licensure.

{¶ 13} On February 9, 2017, the hearing examiner issued a report and

recommendation. The hearing examiner determined that the Oregon voluntary limitation

constituted a violation of R.C. 4731.22(B)(22), and that Dr. Menkes' failure to list his

Oregon medical license on the Ohio application constituted a violation of R.C.

No. 19AP-476 5

4731.22(B)(5). However, as the hearing examiner found Dr. Menkes' explanation for his

response credible, the hearing examiner concluded that Dr. Menkes' negative answer to

question seven did not amount to a violation of R.C. 4731.22(B)(5). The hearing examiner

recommended that the board grant Dr. Menkes' application for restoration of his certificate

to practice osteopathic medicine and surgery in Ohio and reprimand Dr. Menkes for

violating R.C. 4731.22(B)(22) and (5).

{¶ 14} The board adopted the hearing examiner's report and recommendation at its

April 12, 2017 meeting, and issued an order granting Dr. Menkes' application for restoration

of his Ohio medical license and reprimanding Dr. Menkes. Dr. Menkes appealed the board's

order to the common pleas court.

{¶ 15} On July 11, 2017, Dr. Menkes filed a brief in the common pleas court asserting

the board's order was contrary to law and was not supported by reliable, probative, and

substantial evidence. The board filed a brief in response to Dr. Menkes' contentions on

July 20, 2017.

{¶ 16} On July 1, 2019, the common pleas court issued a decision and judgment

entry affirming in part and reversing in part the board's order. The court held that the

board's order reprimanding Dr. Menkes, pursuant to R.C. 4731.22(B)(22), was contrary to

law, as the Oregon board "merely accepted [Dr. Menkes'] request to voluntarily self-limit

his Oregon medical license to an office practice." (Decision at 14.) The court further

concluded the board's order reprimanding Dr. Menkes for having violated R.C.

4731.22(B)(5) was not supported by reliable, probative, and substantial evidence. As such,

the common pleas court affirmed the portion of the board's order restoring Dr. Menkes'

certificate to practice osteopathic medicine and surgery in Ohio and reversed the portion of

the board's order reprimanding Dr. Menkes.

{¶ 17} The board appeals, presenting the following two errors for our review:

[I.] The lower court erred in holding that the public board order

restricting Dr. Menkes' Oregon license did not constitute a

violation of R.C. 4731.22(B)(22).

[II.] The lower court erred and abused its discretion in finding

no evidence of intent to mislead.

No. 19AP-476 6

{¶ 18} In an administrative appeal, pursuant to R.C. 119.12, the common pleas court

must consider the entire record to determine whether reliable, probative, and substantial

evidence supports the agency's order and whether the order is in accordance with law. Univ.

of Cincinnati v. Conrad, 63 Ohio St.2d 108, 110-11 (1980). Reliable, probative, and

substantial evidence has been defined as follows:

(1) "Reliable" evidence is dependable; that is, it can be

confidently trusted. In order to be reliable, there must be a

reasonable probability that the evidence is true. (2) "Probative"

evidence is evidence that tends to prove the issue in question;

it must be relevant in determining the issue. (3) "Substantial"

evidence is evidence with some weight; it must have

importance and value.

Our Place, Inc. v. Ohio Liquor Control Comm., 63 Ohio St.3d 570, 571 (1992).

{¶ 19} The trial court's "review of the administrative record is neither a trial de

novo nor an appeal on questions of law only, but a hybrid review in which the court 'must

appraise all the evidence as to the credibility of the witnesses, the probative character of the

evidence, and the weight thereof.' " (Emphasis sic.) Lies v. Ohio Veterinary Med. Bd., 2

Ohio App.3d 204, 207 (1st Dist.1981), quoting Andrews v. Bd. of Liquor Control, 164 Ohio

St. 275, 280 (1955). The trial court "must give due deference to the administrative

resolution of evidentiary conflicts," although "the findings of the agency are by no means

conclusive." Conrad at 111. The common pleas court conducts a de novo review of questions

of law, exercising its independent judgment in determining whether the administrative

order is " 'in accordance with law.' " Ohio Historical Soc. v. State Emp. Relations Bd., 66

Ohio St.3d 466, 471 (1993), citing R.C. 119.12.

{¶ 20} An appellate court's review of an administrative decision is more limited than

that of the common pleas court. Pons v. Ohio State Med. Bd., 66 Ohio St.3d 619, 621 (1993).

The appellate court is to determine only whether the common pleas court abused its

discretion. Id.; Lorain City School Dist. Bd. of Edn. v. State Emp. Relations Bd., 40 Ohio

St.3d 257, 261 (1988). The term "abuse of discretion" connotes more than an error of law

or judgment; it implies that the court's attitude is unreasonable, arbitrary or

unconscionable. Blakemore v. Blakemore, 5 Ohio St.3d 217, 219 (1983). Absent an abuse

of discretion, this court may not substitute its judgment for that of the administrative

agency or the trial court. Pons at 621. However, on the question of whether the agency's

No. 19AP-476 7

order was in accordance with the law, this court's review is plenary. Kistler v. Ohio Bur. of

Workers' Comp., 10th Dist. No. 04AP-1095, 2006-Ohio-3308, ¶ 9.

{¶ 21} The board's first assignment of error asserts the common pleas court erred in

holding that the voluntary limitation on Dr. Menkes' Oregon medical license was not a

violation of R.C. 4731.22(B)(22). R.C. 4731.22 provides as follows:

(B) The board, by an affirmative vote of not fewer than six

members, shall, to the extent permitted by law, limit, revoke,

or suspend an individual's certificate to practice or certificate

to recommend, refuse to issue a certificate to an individual,

refuse to renew a certificate, refuse to reinstate a certificate, or

reprimand or place on probation the holder of a certificate for

one or more of the following reasons:

***

(22) Any of the following actions taken by an agency

responsible for authorizing, certifying, or regulating an

individual to practice a health care occupation or provide

health care services in this state or another jurisdiction, for any

reason other than the nonpayment of fees: the limitation,

revocation, or suspension of an individual's license to practice;

acceptance of an individual's license surrender; denial of a

license; refusal to renew or reinstate a license; imposition of

probation; or issuance of an order of censure or other

reprimand.

{¶ 22} "The paramount concern in statutory interpretation is the legislative intent

in enacting the statute." State ex rel. Taxpayers for Westerville Schools v. Franklin Cty.

Bd. of Elections, 133 Ohio St.3d 153, 2012-Ohio-4267, ¶ 17. To discern this intent, courts

first review the statutory language, reading words and phrases in context and construing

them in accordance with rules of grammar and common usage. Id. Where the language of

a statute is plain and unambiguous and conveys a clear and definite meaning, there is no

need to apply rules of statutory interpretation. Cline v. Ohio BMV, 61 Ohio St.3d 93, 96

(1991), citing Meeks v. Papadopulos, 62 Ohio St.2d 187, 190 (1980).

{¶ 23} R.C. 4731.22(B)(22) plainly provides that "[a]ny * * * action[] taken by" a

health care licensing agency to "limit[]" an individual's license to practice may be grounds

for discipline in Ohio. "In determining whether the action of a medical board of another

state falls under R.C. 4731.22(B)(22), we ask whether the language of the out-of-state action

No. 19AP-476 8

can reasonably be interpreted as one of the enumerated actions in R.C. 4731.22."

Angerbauer v. State Med. Bd., 10th Dist. No. 17AP-88, 2017-Ohio-7420, ¶ 28, citing Gross

v. State Med. Bd., 10th Dist. No. 08AP-437, 2008-Ohio-6826, ¶ 27-38.

{¶ 24} The Oregon voluntary limitation was a limitation for purposes of R.C.

4731.22(B)(22), as it precluded Dr. Menkes from practicing medicine outside of an office

based setting. See Ohio Adm.Code 4731-13-36(D) (defining a "limitation" as something

which "preclude[s] the certificate holder from engaging in a particular conduct or activity");

Gross at ¶ 36 (stating that a "limitation" under R.C. 4731.22(B)(22) "reasonably may be

construed as referencing an action taken by a medical licensing agency in another

jurisdiction that imposed an enforceable restriction upon the scope or exercise of a person's

medical license"). Accordingly, the issue in the present case resolves to whether the

voluntary limitation resulted from an action taken by the Oregon board.

{¶ 25} O.R.S. 677.410 permits an Oregon licensee to request a limitation of their

license, providing as follows:

A licensee may request in writing to the Oregon Medical Board

a limitation of license to practice medicine or podiatry,

respectively. The board may grant such request for limitation

and shall have authority, if it deems appropriate, to attach

conditions to the license of the licensee within the provisions of

677.205 and 677.410 to 677.425. Removal of a voluntary

limitation on licensure to practice medicine or podiatry shall be

determined by the board.

{¶ 26} In contrast to O.R.S. 677.410, O.R.S. 677.205 permits the Oregon board to

"discipline * * * any person licensed * * * under this chapter" by "[p]lac[ing] limitations on

the license." O.R.S. 677.205(1)and (2)(e). See Read v. Oregon Med. Bd., 244 Or.App. 603,

614-15 (2011) (stating that the Oregon board's "authority to discipline licensees derives

from ORS 677.205"); Gambee v. Cornelius, Or. Dist. No. 10-6265-AA (Mar. 31, 2011), citing

O.R.S. 677.205(2) (noting that the "statutes regulating the practice of medicine in Oregon

give the [Oregon] Board authority to suspend, revoke, or place limitations on licensees").

See also O.R.S. 677.190 (setting forth the grounds for disciplinary action in Oregon); O.R.S.

677.200(1) (providing that "any proceeding for disciplinary action of a licensee" in Oregon

begins by filing a "written complaint [with the] Oregon * * * Board"). Ohio does not have a

No. 19AP-476 9

statute, similar to O.R.S. 677.410, which would permit a licensee to voluntarily request a

limitation of their Ohio medical license.

{¶ 27} O.R.S. 677.415 authorizes the Oregon board to "investigate any evidence that

appears to show that a licensee licensed by the board is or may be medically incompetent

* * * guilty of unprofessional or dishonorable conduct or is or may be a licensee with a

physical incapacity or an impairment." 677.415(2). The Oregon board may also order a

"physical or medical competency examination" if it has "reasonable cause to believe that

any licensee is or may be unable to practice medicine or podiatry with reasonable skill and

safety to patients." O.R.S. 677.420(1) and (2).

{¶ 28} The Ohio board contends that the Oregon board's decision to grant Dr.

Menkes' request for the voluntary limitation constituted an action "taken by" the Oregon

board for purposes of R.C. 4731.22(B)(22). However, the Oregon board's administrative

approval of Dr. Menkes' request for the voluntary limitation was not an action taken by the

Oregon board to limit Dr. Menkes' medical license. Rather, Dr. Menkes took the action to

limit his Oregon medical license, and the Oregon board simply responded to Dr. Menkes'

request for the limitation. While O.R.S. 677.205 permitted the Oregon board to take

disciplinary action to limit Dr. Menkes' license, O.R.S. 677.410 permitted Dr. Menkes to

take action to limit his own medical license. The Oregon board informed Dr. Menkes that

the voluntary limitation was "not considered to be disciplinary in nature, and ha[d] not

been reported to the National Practitioner Databank." (Appellee's Ex. B.)

{¶ 29} While R.C. 4731.22(B)(22) does not require that the action limiting a license

consist of disciplinary action, R.C. 4731.22(B)(22) does require that the action be "taken

by" the health care licensing agency, not the licensee. The Oregon board could have taken

other non-disciplinary actions against Dr. Menkes which may have resulted in limitations

on his license, including investigating Dr. Menkes pursuant to O.R.S. 677.415 or ordering

him to submit to an examination pursuant to O.R.S. 677.420. However, the Oregon board

did not take any of the actions it was statutorily authorized to take against Dr. Menkes.

{¶ 30} The board contends that in Angerbauer and Gross this court "upheld Board

orders in bootstrap cases that [took] action based upon a voluntary agreement that was

ratified by another licensing board." (Appellant's Brief at 19.) In both Angerbauer and

Gross an out-of-state health care licensing agency investigated a doctor's medical practice

No. 19AP-476 10

and found that both doctors failed to meet the applicable standard of care. Angerbauer at

¶ 2, 6-7; Gross at ¶ 30. As a result, the doctors and the agencies entered into agreed orders,

which imposed sanctions on the doctors' medical licenses. Angerbauer at ¶ 31; Gross at

¶ 31. The reviewing courts concluded that the agreed orders were "limitations" for purposes

of R.C. 4731.22(B)(22). Angerbauer at ¶ 32; Gross at ¶ 37-38. The Gross court rejected the

doctor's argument that "he simply inactivated his Colorado license in an administrative,

ministerial manner," as the record demonstrated that the Colorado State Board of Medical

Examiners permanently placed the doctor's license on inactive status after it found "that

Dr. Gross failed to meet generally accepted standards of medical practices with regard to

several cases that it reviewed." Id. at ¶ 40.

{¶ 31} Thus, in both Angerbauer and Gross the out-of-state agencies reviewed the

doctors' medical practices and found that the doctors failed to meet the applicable standard

of care. Although the doctors agreed to the orders at issue, the agencies both took actions

against the doctors which culminated in the agreed orders. In contrast, the Oregon board

never investigated Dr. Menkes' medical practice and never found that Dr. Menkes failed to

meet the applicable standard of care. The Oregon board did not impose the voluntary

limitation against Dr. Menkes as a sanction for misconduct.

{¶ 32} Pursuant to our plenary review, we find the Oregon board's administrative

approval of Dr. Menkes' request to voluntarily limit his Oregon medical license was not an

action "taken by" the Oregon board to limit Dr. Menkes' license for purposes of R.C.

4731.22(B)(22). As such, the Ohio board's order reprimanding Dr. Menkes pursuant to R.C.

4731.22(B)(22) was not in accordance with law.

{¶ 33} Based on the foregoing, the board's first assignment of error is overruled.

{¶ 34} The board's second assignment of error asserts the common pleas court erred

in finding no evidence of Dr. Menkes' intent to mislead or deceive the board pursuant to

R.C. 4731.22(B)(5). R.C. 4731.22(B)(5) states that the board may discipline a licensee or

refuse to reinstate a license for "[m]aking a false, fraudulent, deceptive, or misleading

statement * * * in securing or attempting to secure any license or certificate to practice

issued by the board." The statute defines a "false, fraudulent, deceptive, or misleading

statement" as a "statement that includes a misrepresentation of fact, is likely to mislead or

deceive because of a failure to disclose material facts, [or] is intended or is likely to create

No. 19AP-476 11

false or unjustified expectations of favorable results." R.C. 4731.22(B)(5). In order to

discipline a physician under R.C. 4731.22(B)(5), the board must prove that the physician

intended to mislead or deceive the board. Applegate v. State Med. Bd. of Ohio, 10th Dist.

No. 07AP-78, 2007-Ohio-6384, ¶ 12; Mansour v. State Med. Bd. of Ohio, 1oth Dist. No.

14AP-829, 2015-Ohio-1716, ¶ 25 ("Mansour I"); Gipe v. State Med. Bd. of Ohio, 10th Dist.

No. 02AP-1315, 2003-Ohio-4061, ¶ 64; Rajan v. State Med. Bd. of Ohio, 118 Ohio App.3d

187, 194 (10th Dist.1997).

{¶ 35} In the report and recommendation, the hearing examiner cited three reasons

as support for its conclusion that Dr. Menkes intended to mislead or deceive the board

when he failed to list his Oregon medical license on the Ohio application. The hearing

examiner noted that: (1) Dr. Menkes was engaged in the process of trying to remove the

Oregon voluntary limitation earlier in 2015, such that his Oregon license was not a "distant

memory; it had been on his mind recently when his Ohio application was submitted[;]"

(2) the hearing examiner's "belie[f]" that the process of creating a CV is cumulative,

rendering it likely that Dr. Menkes' CV had in the past included his Oregon medical license;

and (3) the "remarkably coincidental" fact that Oregon, the only state where Dr. Menkes

had a limitation on his license, was the license Dr. Menkes failed to list on his application.

(Report & Recommendation at 16.)

{¶ 36} The common pleas court concluded that the hearing examiner's findings were

"not based upon evidence, let alone reliable, probative, and substantial evidence." (Decision

at 20-21.) The court observed that:

[T]he Hearing Examiner's determination was based upon the

Hearing Examiner's "belief" about the process by which [Dr.

Menkes] drafted his CV, the "likelihood" that the Oregon

medical license had been listed in [Dr. Menkes'] CV at some

time in the past, conjecture as to why the CV that [Dr. Menkes]

provided to Ms. deBlois did not list the Oregon medical license,

and the "remarkable coincidence" that, of all [Dr. Menkes']

medical licenses, Oregon was the only medical license with a

limitation.

(Decision at 21.)

{¶ 37} The common pleas court further concluded that Dr. Menkes' testimony,

denying any intent to mislead or deceive the board, was "the only evidence in the record on

the issue of [Dr. Menkes'] intent, or lack of intent, to mislead the Ohio Medical Board."

No. 19AP-476 12

(Decision at 21.) However, a licensee's intent to mislead or deceive the board "may be

inferred from the surrounding circumstances, such as when a licensee clearly has

information which he fails to disclose in response to a direct question." Coleman v. State

Med. Bd. of Ohio, 10th Dist. No. 06AP-1299, 2007-Ohio-5007, ¶ 12, citing Webb v. State

Med. Bd., 146 Ohio App.3d 621, 628 (10th Dist.2001). Accord Hayes v. State Med. Bd. of

Ohio, 138 Ohio App.3d 762, 770 (10th Dist.2000), citing Krain v. State Med. Bd. of Ohio,

10th Dist. 97APE08-981 (Oct. 29, 1998); Mansour I at ¶ 25. Thus, "[d]irect evidence of

intent is not necessary because intent may be inferred from the surrounding

circumstances." Mansour v. State Med. Bd. of Ohio, 10th Dist. No. 17AP-615, 2018-Ohio-

2605, ¶ 19 ("Mansour II"). The board is under no obligation to believe a doctor's testimony

"den[ying] any intent to deceive." Mansour I at ¶ 27. See D'Souza v. State Med. Bd. of Ohio,

10th Dist. No. 09AP-97, 2009-Ohio-6901, ¶ 17 (noting that the agency, as the finder of fact,

is entitled to believe all, part, or none of a witnesses' testimony); Bhama v. State Med. Bd.,

10th Dist. No. 08AP-488, 2009-Ohio-819, ¶ 34 (stating that the board "is not bound to

accept a version of the facts that it does not find credible where there is other evidence in

the record to the contrary").

{¶ 38} The application for license restoration directly asked Dr. Menkes to list all the

states where he held medical licenses, whether the license was current or not. Dr. Menkes

"knew [he] had a prior license" in Oregon. (Hearing Tr. at 74.) Thus, Dr. Menkes failed to

disclose information he possessed in response to a direct question on the application. See

Bhama at ¶ 35 (finding evidence of intent to deceive as the appellant "clearly knew that she

had been terminated from Clinton Valley and failed to disclose that information in response

to a direct question"); Mansour II at ¶ 25 (finding evidence of intent to deceive as "Dr.

Mansour knew that he had been convicted of domestic violence and failed to disclose that

in response to a direct question"). Although deBlois filled out the state licensure portion on

the application, Dr. Menkes affirmed that he reviewed the application before submitting it

to the board and affirmed that he executed the affidavit averring that all statements in the

application were true and complete.

{¶ 39} The hearing examiner's assumptions regarding Dr. Menkes' CV consisted of

unsupported conclusions and were not entitled to deference. See Ohio Historical Soc. at

471 (holding that an agency's findings of fact "are presumed to be correct and must be

No. 19AP-476 13

deferred to by a reviewing court unless that court determines that the agency's findings * * *

rest upon improper inferences, or are otherwise unsupportable"). However, even if some of

an agency's findings rest "upon improper inferences or unsupported conclusions and

therefore should have been excluded from consideration," an agency's decision need not be

reversed where "the record contains other reliable, probative and substantial evidence."

Douglas Bigelow Chevrolet v. GMC, 10th Dist. No. 02AP-1156, 2003-Ohio-5942, ¶ 40. See

S & P Lebos, Inc. v. Ohio Liquor Control Comm., 163 Ohio App.3d 803, 2005-Ohio-4552,

¶ 30 (10th Dist.) (noting that the "erroneous reliance upon the investigator's report [did]

not require reversal as long as there [was] other reliable, probative and substantial evidence

to support the commission's order"); Abunku v. State Med. Bd. of Ohio, 10th Dist. No. 11AP-

906, 2012-Ohio-2734, ¶ 20 (finding that "even if it was inappropriate for the hearing

examiner to admit the DEA's order to show cause into evidence" the appellant was not

prejudiced "because other reliable, probative, and substantial evidence in the record

prove[d] that appellant violated R.C. 4731.22(B)(24)").

{¶ 40} The common pleas court failed to address the hearing examiner's finding

regarding Dr. Menkes' attempt to remove the Oregon voluntary limitation in early 2015.

The evidence of Dr. Menkes' communications with the Oregon board in late 2014 and early

2015 consist of letters sent from the Oregon board to Dr. Menkes and Dr. Menkes' own

testimony at the hearing. Furthermore, Dr. Menkes testified at the hearing that other state

licensing agencies asked him about the Oregon voluntary limitation when he sought

licensure in those states. Dr. Menkes explained that Florida asked him about the Oregon

voluntary limitation in 2013, and that Idaho asked him about the Oregon voluntary

limitation "[p]robably in 2014." (Hearing Tr. at 70.) Dr. Menkes received his Florida

medical license in 2013 and received his Idaho medical license in 2015. (Appellee's Ex. A.)

Based on these experiences, Dr. Menkes affirmed that he knew other state agencies "had

questions about that [Oregon voluntary] limitation prior to applying for a license in Ohio."

(Hearing Tr. at 70.)

{¶ 41} Thus, reliable, probative, and substantial evidence in the record established

that Dr. Menkes had communicated with other state health care licensing agencies about

his Oregon medical license between six months and two years prior to submitting his Ohio

application for license restoration. The evidence of Dr. Menkes' recent communications

No. 19AP-476 14

about his Oregon medical license was evidence of surrounding circumstances which

supported the board's conclusion that Dr. Menkes intentionally omitted his Oregon medical

license from the Ohio application. See Instanbooly v. Ohio State Med. Bd., 10th Dist. No.

04AP-76, 2004-Ohio-3696, ¶ 18 (finding evidence of a doctor's intent to deceive or mislead

the board where the doctor answered "no" to an application question asking whether any

board had filed a complaint against her, but the record demonstrated that the Michigan

state medical board had filed an "administrative complaint" against her "one year and four

months prior to her filling out the Ohio renewal application"); Applegate at ¶ 20-21 (finding

evidence of intent to mislead where the doctor asserted that his negative answer to an

application question asking whether he had ever been a defendant in a medical negligence

action resulted from "inattention," but the board found it "unlikely that Applegate would

forget the February 1991 malpractice action - - it was the first malpractice action filed

against him, it was settled for a significant amount, and it occurred only two years prior" to

the time he submitted his license application).

{¶ 42} Dr. Menkes also explained at the hearing that, when he read question seven

on the application, his "interpretation" of the question was "has any Board in any way

limited; and [his] response was [he] limited [his Oregon medical license] voluntarily. And,

therefore, the answer 'no' [was] true and correct in [his] understanding." (Hearing Tr. at

78.) Such evidence bolsters the board's conclusion regarding Dr. Menkes' intent, as the

testimony demonstrates that Dr. Menkes thought about his Oregon medical license when

deciding how to answer another question on the application.

{¶ 43} The common pleas court reversed the board's order finding a violation of R.C.

4731.22(B)(5) based on Dr. Menkes' testimony denying any intent to deceive or mislead the

board and the hearing examiner's unsupportable conclusions. The common pleas court's

ruling arbitrarily ignored other reliable, probative, and substantial evidence in the record

of surrounding circumstances which supported the board's conclusion that Dr. Menkes

acted with intent to mislead or deceive the board. As such, the common pleas court abused

its discretion by reversing the portion of the board's order reprimanding Dr. Menkes for a

violation of R.C. 4731.22(B)(5).

{¶ 44} Based on the foregoing, the board's second assignment of error is sustained.

No. 19AP-476 15

{¶ 45} Having overruled the board's first assignment of error, but having sustained

the board's second assignment of error, we affirm in part and reverse in part the judgment

of the Franklin County Court of Common Pleas and remand the case to that court for

proceedings in accordance with law and consistent with this decision.

Judgment affirmed in part and reversed in part;

case remanded.

LUPER SCHUSTER and BRUNNER, JJ., concur.

_________________

This is a copy of a public record, reproduced as it was published. It is not legal advice, and it may not be the version a court would rely on. Check the official source before you cite it.

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