Opinion

White v. State Med. Bd. of Ohio

  • 2024 Ohio 1553
Court
Ohio Court of Appeals
Filed
Apr 23, 2024
Status
Published
On the bench
Luper Schuster
Cited by
2 cases
Authority
More cited than 60.2%

The opinion

[Cite as White v. State Med. Bd. of Ohio, 2024-Ohio-1553.]

IN THE COURT OF APPEALS OF OHIO

TENTH APPELLATE DISTRICT

Mark A. White, M.D., :

Appellant-Appellee, : No. 23AP-587

(C.P.C. No. 22CV-3828)

v. :

(REGULAR CALENDAR)

State Medical Board of Ohio, :

Appellee-Appellant. :

D E C I S I O N

Rendered on April 23, 2024

On brief: Crabbe, Brown & James, Larry H. James, and

Christopher R. Green, for appellee. Argued: Christopher R.

Green.

On brief: Dave Yost, Attorney General, Katherine

Bockbrader, and Melinda Snyder, for appellant. Argued:

Katherine Bockbrader.

APPEAL from the Franklin County Court of Common Pleas

LUPER SCHUSTER, J.

{¶ 1} Appellant, State Medical Board of Ohio (“the board”), appeals from a

judgment of the Franklin County Court of Common Pleas reversing an order of the board

indefinitely suspending the medical license of appellee, Mark A. White, M.D., for at least

one year. For the following reasons, we reverse the judgment of the trial court.

I. Facts and Procedural History

{¶ 2} White is a physician who has been licensed to practice medicine in Ohio since

1997. By notice of opportunity for hearing dated November 10, 2020, the board notified

White that it proposed to take disciplinary action against his license to practice medicine.

The board alleged White engaged in sexual misconduct with a patient, in violation of R.C.

No. 23AP-587 2

4731.22(B)(6), 4731.22(B)(20), and Ohio Adm.Code 4731-26-02(A). White timely

requested a hearing in response to the notice.

{¶ 3} A board hearing examiner held a hearing on the matter on July 29 and 30,

2021. To begin the hearing, White’s counsel conceded that White engaged in sexual

misconduct with Patient 1, as that term is defined in Ohio Adm.Code 4731-26-01. The

evidence at the hearing detailed White’s friendship with Patient 1 and the circumstances of

the sexual misconduct. The board called White as a witness as if on cross-examination, and

he testified to the following facts.

{¶ 4} White, born in 1957, received his license to practice medicine in 1997, and

currently has approximately 3,000 patients for whom he provides medical care. In

approximately 2012, White met Patient 1, who was 20 years old at the time, at a social

gathering for gay African American men. Afterwards they began attending church group

meetings for gay African American men, of which White was a member, and extensively

discussed the challenges of being gay and lack of acceptance in parts of the African

American community. They became very good friends, with White becoming somewhat of

a mentor to Patient 1. White introduced Patient 1 to other older gay African American men,

who understood these issues. White had his first sexual encounter with Patient 1 in

November 2014, prior to Patient 1’s first visit to White’s medical office, which occurred on

June 29, 2015, with Patient 1 seeking treatment for an acute cough.1 White testified that he

had a second sexual encounter with Patient 1, on or about September 4 to 7, 2015, which

was while he was a patient. Patient 1’s last visit to White’s office was in May 2019, a couple

months before Patient 1 committed suicide.

{¶ 5} White was questioned regarding Exhibit V, which he identified as a book that

Patient 1 had sent to Wesley Williams, a mutual friend. White first reviewed the book in

September or October 2020, and he could not believe Patient 1 would make such untrue

statements relating to White. In questioning White, the board’s counsel recited various

passages from the book to elicit his response to those passages. White did not object to this

line of questioning.

1 During the board’s preliminary investigation of White’s misconduct, White indicated his first of two sexual

encounters with Patient 1 was following Patient 1’s first office visit. But after reviewing his personal journal,

White was able to recall the timing of the events more accurately.

No. 23AP-587 3

{¶ 6} White acknowledged his mistake in engaging in sexual conduct with a

patient, and he expressed sorrow for Patient 1’s untimely death. But White also stated he

did not believe that his sexual relationship with Patient 1, concurrent with their physician

and patient relationship, was harmful to Patient 1.

{¶ 7} White called four individuals to attest to his good character and reputation

within the community. Wesley Williams testified that he was good friends with both White

and Patient 1. He described White as a great person who is dedicated to his community and

Patient 1 as an “impressive young man” in need of a mentor to accomplish his lofty goals.

(July 29, 2021 Tr. Vol I at 109.) Attorney Charles Postlewaite testified to White’s positive

attributes, including his honesty, integrity, and concern for others. Postlewaite described

White as someone involved and respected within his community, and he expressed concern

at the harm that could result if White’s license to practice medicine was suspended.

Businessman, Ernest Sullivan, testified that White continued to serve minorities within

Columbus even when that may not have been the most lucrative career path for him.

Sullivan described White as a caring person who positively impacts his community. Bishop

Melvin Griffin, a local minister, also attested to White’s good character and reputation

within the community.

{¶ 8} Following the hearing, on April 14, 2022, the hearing examiner issued a

report and recommendation with detailed findings of fact, including the finding that White

had sexual contact with Patient 1 when Patient 1 was under his care. Based on these factual

findings, the hearing examiner concluded that White’s conduct with Patient 1 violated R.C.

4731.22(B)(6), 4731.22(B)(20), and Ohio Adm.Code 4731-26-02. The hearing examiner

also recommended the board suspend White’s license for a minimum of one year,

commencing 31 days following the effective date of the order, and fine him $6,000.

{¶ 9} White filed an objection to the hearing examiner’s proposed order. He

requested the opportunity to appear before the board to challenge the hearing examiner’s

recommendation that his license be suspended for a minimum of one year, commencing 31

days following the effective date of the order. He noted the practical difficulty of winding

down his practice in 30 days, considering he has 3,000 patients, and he proposed, as an

alternative punishment, surrendering his license one year after the order is filed. He did

not, however, challenge any factual finding or conclusion of law of the hearing examiner.

No. 23AP-587 4

The filing expressly states: “Respondent understands and respects the findings of the

Hearing Examiner and accepts responsibility for his actions.” (Apr. 19, 2022 Respondent

Mark A. White’s Obj. to Hearing Examiner’s Report at 1.) In sum, White’s objection

challenged the hearing examiner’s recommended penalty but not any finding of fact or

conclusion of law.

{¶ 10} At the board’s May 11, 2022 meeting, White and his counsel addressed the

board. The board’s meeting minutes reflect White’s contrition for his conduct, and his

concern that 30 days would be insufficient time to properly transfer the care of his patients

to other physicians. The board’s meeting minutes indicate that White’s counsel, in

challenging the penalty of a minimum year-long license suspension beginning 30 days after

an order is filed, emphasized White’s contributions to the community and the absence of

any other infraction in his 25-year professional career. White’s counsel reiterated the

request, as made in his objections, that he be given one year to wind down his practice and

then surrender his license. His counsel challenged the hearing examiner’s finding that he

did not have remorse, asserting his monotone voice and straight-forward manner may have

led to this misperception. Otherwise, there is no indication that White, or his counsel,

challenged any finding of fact or conclusion of law reached by the hearing examiner.

{¶ 11} After White and his counsel addressed the board, multiple board members

stated their thoughts and concerns regarding the matter, specifically emphasizing the

profound negative impact White’s conduct had on Patient 1. In particular, board member

Dr. Schottenstein noted that this case presents a good example for why sexual activity

between a licensed physician and a patient is prohibited. He explained that the imbalance

of power makes such activity inherently unacceptable as it is psychologically damaging to

patients. The board voted to adopt the hearing examiner’s report and recommendation,

including the proposed suspension of White’s medical license for a minimum of one year,

commencing 31 days after the entry of the order. On May 11, 2022, the board mailed a copy

of its order to White.

{¶ 12} On June 6, 2022, White filed an appeal from the board’s order to the trial

court. The next day, he requested an order staying the board’s order, asserting likely

hardship to him and his patients. The trial court granted the stay request. In support of

his challenge to the board’s order, White argued the board’s order was unlawful because

No. 23AP-587 5

the board considered evidence not admitted into the record, because the board disciplined

him based on reasons not included in the violation notice, and because the board failed to

consider his mitigation evidence. The trial court concluded the board violated White’s due

process rights because it considered evidence not admitted into the record, and because it

disciplined him for reasons not charged in the notice of opportunity for hearing. On these

bases, the trial court reversed the board’s order and remanded the matter for further

proceedings. Based on this disposition, the trial court did not analyze or resolve White’s

argument that the board’s order was unlawful because it did not consider his mitigation

evidence.

{¶ 13} The board timely appeals.

II. Assignments of Error

{¶ 14} The board assigns the following two assignments of error for our review:

[I.] The lower court erred in its interpretation of R.C. 119.07

and its holding that the Medical Board did not comply with

R.C. 119.07 and violated Dr. White’s due process rights by

analyzing aggravating factors not expressly enumerated in the

Notice of Opportunity for Hearing.

[II.] The lower court erred in holding that the Board violated

due process by considering evidence that the appellant failed

to object to and that was not prejudicial.

III. Standard of Review

{¶ 15} In reviewing an order of an administrative agency under R.C. 119.12, a

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 (1980).

“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. “Probative”

evidence is evidence that tends to prove the issue in question; it must be relevant in

determining the issue. “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).

No. 23AP-587 6

{¶ 16} The common pleas 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.’ ” 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 common pleas court must give due deference to the administrative agency’s

resolution of evidentiary conflicts, but “the findings of the agency are by no means

conclusive.” Conrad at 111. On questions of law, the common pleas court conducts a de

novo review, 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), quoting R.C. 119.12.

{¶ 17} An appellate court’s review of an administrative decision is more limited.

Pons v. Ohio State Med. Bd., 66 Ohio St.3d 619, 621 (1993). As to factual disputes, the

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

Id.; Blakemore v. Blakemore, 5 Ohio St.3d 217, 218 (1983). An abuse of discretion requires

more than an error in judgment. To find an abuse of discretion, we must conclude that the

trial court’s decision was without a reasonable basis and clearly wrong. Miracle Home

Health Care, L.L.C. v. Ohio Dept. of Job & Family Servs., 10th Dist. No. 12AP-318, 2012-

Ohio-5669, ¶ 18. On purely legal questions, however, an appellate court’s review is plenary.

Big Bob’s, Inc. v. Ohio Liquor Control Comm., 151 Ohio App.3d 498, 2003-Ohio-418, ¶ 15

(10th Dist.).

IV. Discussion

{¶ 18} Because they involve interrelated issues, we discuss together the board’s first

and second assignments of error. In its first assignment of error, the board contends the

trial court erred in concluding the board violated R.C. 119.07 by not including necessary

information in the notice of opportunity for hearing. The board’s second assignment of

error asserts the trial court erred in finding the board violated White’s due process rights in

considering a document not admitted into evidence, Exhibit V. Both of these assignments

of error have merit.

{¶ 19} As a preliminary matter, we note White, in objecting to the hearing

examiner’s report and recommendation, did not raise the issues later presented to the trial

No. 23AP-587 7

court for review. “Generally, a party waives the right to appeal an issue that could have

been but was not raised in earlier proceedings. * * * This principle has been applied in

appeals from administrative agencies.” MacConnell v. Ohio Dept. of Commerce, 10th Dist.

No. 04AP-433, 2005-Ohio-1960, ¶ 21 (when license applicant failed to object to evidentiary

defects before the administrative tribunal, those defects could not be asserted as grounds

for appeal). Because White did not raise these issues in his objections, the board was not

given the opportunity to address them. Thus, White waived his arguments concerning the

notice of opportunity for hearing and the consideration of Exhibit V. And, even if not

waived, the trial court erred in not finding White’s arguments fail on the merits.

{¶ 20} Chapter 4731 of the Revised Code vests the board with broad authority to

regulate the medical profession in Ohio and to discipline physicians for non-compliant

conduct. Griffin v. State Med. Bd. of Ohio, 10th Dist. No. 09AP-276, 2009-Ohio-4849.

This includes the authority to impose a wide range of sanctions, pursuant to R.C. 4731.22,

ranging from reprimand to revocation. “The discretion granted to the board in imposing a

wide range of potential sanctions reflects the deference due to the board’s expertise in

carrying out its statutorily granted authority over the medical profession.” Demint v. State

Med. Bd. of Ohio, 10th Dist. No. 15AP-456, 2016-Ohio-3531, ¶ 63. In setting the

appropriate sanction for violations alleged and proven, the board may consider mitigating

and aggravating circumstances, including uncharged misconduct. Macheret v. State Med.

Bd. of Ohio, 188 Ohio App.3d 469, 2010-Ohio-3483, ¶ 28 (10th Dist.). See Froehlich v.

Ohio State Med. Bd., 10th Dist. No. 15AP-666, 2016-Ohio-1035, ¶ 31 (finding medical

review board may consider aggravating circumstances, including uncharged misconduct,

when considering the appropriate sanction against the physician); Urban v. Ohio State

Med. Bd., 10th Dist. No. 03AP-426, 2004-Ohio-104, ¶ 17 (noting the board may consider

aggravating and mitigating circumstances in deciding on the appropriate penalty for

physician misconduct).

{¶ 21} Pursuant to R.C. 119.07, the board must provide notice to a party and the

notice “shall include the charges or other reasons for the proposed action, the law or rule

directly involved, and a statement informing the party that the party is entitled to a hearing

if the party requests it within thirty days of the time of service.” This statute is consistent

with principles of due process. It is axiomatic that “[d]ue process entitles an individual to

No. 23AP-587 8

fair notice of the precise nature of the charges to be brought forth at a disciplinary

proceeding.” Applegate v. State Med. Bd. of Ohio, 10th Dist. No. 07AP-78, 2007-Ohio-

6384, ¶ 23, citing Althof v. Ohio State Bd. of Psychology, 10th Dist. No. 05AP-1169, 2007-

Ohio-1010, ¶ 19. But due process is not violated unless the individual is actually disciplined

for activities not mentioned in the hearing notice. Id. “Thus, due process does not preclude

a disciplinary body from considering uncharged misconduct in determining a suitable

sanction.” Macheret at ¶ 27.

{¶ 22} Here, the notice of opportunity for hearing provided to White stated the

following reasons as bases for possible discipline:

In the course of your practice, you undertook the treatment,

provided care and/or prescribed medications to Patient 1, as

identified in the attached Patient Key. (Key is confidential and

shall be withheld from public disclosure.)

On or about September 3, 2020, you admitted to a Board

Investigator that you engaged in sexual conduct with Patient

1 on two occasions. You further stated that you first engaged

in sexual conduct with Patient 1 on or about September 4 to 7,

2015, Labor Day weekend. You further stated that you again

engaged in sexual conduct with Patient 1 in or around January

2017. The patient record documents that you provided

medical care from on or about June 29, 2015 to May 14, 2019,

to Patient 1 which was concurrent with the two times you

acknowledged engaging in sexual conduct with the patient.

(Nov. 10, 2020 Notice of Opportunity at 1.)

{¶ 23} The notice further indicated that White’s alleged conduct violated R.C.

4731.22(B)(6), 4731.22(B)(20), and Ohio Adm.Code 4731-26-02. Pursuant to R.C.

4731.22(B)(6), the board may discipline a licensee for the licensee’s “departure from, or the

failure to conform to, minimal standards of care of similar practitioners under the same or

similar circumstances, whether or not actual injury to a patient is established.” And,

pursuant to R.C. 4731.22(B)(20), the board also may discipline a licensee for violating any

rule adopted by the board. As pertinent here, Ohio Adm.Code 4731-26-02(A), states “a

licensee shall not engage in sexual misconduct with a patient.” For the purpose of this rule,

“ ‘[s]exual misconduct’ means conduct that exploits the licensee-patient relationship in a

sexual way, whether verbal or physical, and may include the expression of thoughts,

No. 23AP-587 9

feelings, or gestures that are sexual or that reasonably may be construed by a patient as

sexual.” Ohio Adm.Code 4731-26-01(H). This includes sexual interaction. Id. Thus, the

notice informed White of the basis for the proposed action, including the alleged

misconduct and the specific statutes and rule that the conduct violated.

{¶ 24} The board’s violation findings align with this notice. Based on the evidence

presented at the hearing, the hearing examiner found that White engaged in sexual activity

with Patient 1 once during their physician-patient relationship. The hearing examiner

concluded that White’s conduct with Patient 1 violated R.C. 4731.22(B)(6), 4731.22(B)(20),

and Ohio Adm.Code 4731-26-02. Based on this conclusion, the hearing examiner also

recommended the board suspend White’s license for a minimum of one year, commencing

31 days following the effective date of the order, and fine him $6,000. The board voted to

adopt the hearing examiner’s report and recommendation, including the proposed

suspension of White’s medical license for a minimum of one year, commencing 31 days

after the entry of the order. Thus, the board only disciplined White for violations charged

in the notice of intent—namely, for his conduct in violation of R.C. 4731.22(B)(6),

4731.22(B)(20), and Ohio Adm.Code 4731-26-02. Insofar as the board considered other

facts and circumstances in determining the appropriate sanction, including further details

of White’s relationship with Patient 1, White’s degree of remorse for his misconduct, and

the harm to Patient 1, that consideration was within the board’s discretion and did not

demonstrate any deficiency in the notice of opportunity for hearing. See Macheret,

Froehlich, and Urban. Thus, we agree with the board that the trial court erred in

concluding the board violated R.C. 119.07 and due process principles by disciplining him

for uncharged conduct.

{¶ 25} We also agree with the board that the trial court erred in concluding the board

violated White’s due process rights by considering an exhibit that had been excluded from

evidence. Patient 1 sent Exhibit V, a book titled “Mante Means Courage,” to Wesley

Williams, who gave it to White after Patient 1’s passing. Williams believed that Patient 1

had authored the book. At the hearing, White denied many of the statements relating to

him made in the book. The board initially moved to admit Exhibit V into evidence but later

withdrew this motion. In her report and recommendation, which was adopted by the

No. 23AP-587 10

board, the hearing examiner quoted the following passage in Exhibit V regarding a sexual

encounter between White and Patient 1:

I was I’m embarrassed at myself and at my body. I couldn’t

look at Dr. White in the eyes, or anyone. Aside from feeling

dirty, I wanted to go to sleep -- for I had not slept, but had been

up, throughout the night, staring at the night, and at the walls,

and listening to it, the night, and the walls, as they settled, into

the earth, which I tried to do, settle into the couch. When I

arrived at my dorm, when it was, perhaps, for the first time that

day, morning, and I’d stepped out of the truck and around it

and onto the sidewalk, and looked at Dr. White, somehow, and

he’d grinned, like a robber, whom I could not take back my

belongings from, and turned away from him, the robber, and

swiped, and gone inside.

(Apr. 14, 2022 Report & Recommendation at 10-11.)

{¶ 26} White argued, and the trial court agreed, that the board violated his due

process right by relying on contents of Exhibit V, particularly the above-quoted passage, in

reaching its decision. The flaw in this reasoning is passages of Exhibit V, including the

above-quoted passage, were read into the record during White’s questioning. There was no

objection to the recitation of these passages during White’s questioning. And White does

not allege that the hearing examiner relied on any passage of Exhibit V that was not read

into the record. Although Exhibit V was not admitted into evidence in its entirety, no

passage of that book read into the record was stricken or otherwise excluded from the

record. See State v. Blackburn, 10th Dist. No. 88AP-73, 1988 Ohio App. LEXIS 4002, *10

(Sept. 29, 1988) (“although the trial court’s ruling precluded admission of the exhibits, it

had no effect on the testimony offered relative to those exhibits”). Thus, there was no error

in the board citing those passages as part of its decision on the matter. Consequently, the

trial court erred in concluding the board violated White’s due process in relying on contents

of Exhibit V.

{¶ 27} Based on the foregoing, we sustain the board’s first and second assignments

of error.

No. 23AP-587 11

V. Disposition

{¶ 28} Having sustained the board’s first and second assignments of error, we

reverse the judgment of the Franklin County Court of Common Pleas and remand this

matter to that court for further proceedings consistent with law and this decision.

Judgment reversed;

cause remanded.

JAMISON and BOGGS, 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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