David Stender, D.C. Reprimanded by
the Arizona Chiropractic Board

Stephen Barrett, M.D.


In November 2008, the Arizona State Board of Chiropractic Examiners reprimanded David Stender and ordered him to take 20 hours of continuing education in medical record-keeping, ethics, and critical evaluation of literature. The board's final amended order (shown below) concluded that Stender had:

Paragraph 7 of the board's original order said that Stender had used deceptive and misleading information "to frighten or intimidate prospective patients for marketing purposes." However, this language referring to his intent was removed after Stender asked for reconsideration and threatened to sue the board if the order was not modified.


BEFORE THE ARIZONA STATE BOARD
OF CHIROPRACTIC EXAMINERS

In the Matter of

DAVID STENDER, D.C.,
Holder of License No. 5437
For the Practice of Chiropractic
In the State of Arizona,

Respondent


|
|
|
|
|
|
|
|

Case No. 2008-005

FINDINGS OF FACT, CONCLUSIONS
OF LAW AND NON-DISCIPLINARY
ORDER FOR CONTINUING
EDUCATION1

 

1At its meeting of November 11, 2008, the Board granted Respondent's Motion for Review for the limited purpose of reviewing paragraph 7 of the Findings of Fact. After conducting a review of that paragraph, the Board voted to modify the language contained in that paragraph and issue this Amended Order.

INTRODUCTION

Under A.R.S. § 32-924(F), the Arizona State Board of Chiropractic Examiners ("Board'') held a Formal Interview for David Stender, D.C. ("Respondent") on August 14, 2008. Respondent knowingly and voluntarily appeared before the Board, and was represented by legal counsel, Terrance Woods, Esq. Respondent was properly notified of the Formal Interview and the following allegations against him:

a. May have failed to release a copy of all requested patient records to another licensed physician within ten business days of a written request to do so.

b. May have failed to create and maintain patient records in compliance with [the] law and professional standards.

c. May have billed for services not provided, and/or not documented as provided, and/or not medically necessary or appropriate for patient care. May have failed to properly examine, assess, diagnose and treat or refer patients.

d. May provide substandard care due to an intentional or negligent act, to include conduct, practice or condition that impairs the ability to practice skillfully and safely. Conduct, practice or condition may include, but is not limited to, fear, guilt or bias that impedes the skilled and safe practice of chiropractic.

e. Knowingly making a false or misleading statement to a patient or a third-party payor.

f. Knowingly making a false, or misleading statement, providing false or misleading information, or omitting material in any oral or written communication, including attachments, to the Board, Board staff or a Board representative or on any form required by the Board.

g. May have advertised in a false, deceptive or misleading manner.

h. May have used deceptive and misleading information to frighten or intimidate prospective patients for marketing purposes,

After due consideration and deliberation of the facts and law applicable to this matter, the Board voted to issue the following Findings of Fact, Conclusions of Law and Order.

FINDINGS OF FACT

I. The Board is the duly constituted authority for the regulation and control of the practice of chiropractic in the State of Arizona.

2. Respondent is the holder of License No. 5437 to practice chiropractic in the State of Arizona.

3. Respondent received a written request for copies of records and x-rays for patients A.S. and E.S. dated June 28, 2007. The x-rays were provided. However, the rest of the patient records were not provided. When the requesting physician called Respondent to inquire as to why the full record was not provided, Respondent's staff stated that no records would be sent in response to the request. Respondent has admitted that he and his staff failed to provide a copy of the patient records within the ten (10) days required by law.

4. Respondent failed to document an examination, an x-ray report, clinical impressions, subjective Complaints, objective findings, or a treatment plan for patient’s A.S. and B.S. The history for the patient was minimal and the daily notes for each day were repetitive and generic rather than encounter specific, Respondent also failed to sign or initial each daily record and failed to document the specific area of treatment with a wobble chair.

5. Respondent billed for a CPT code 99203 new patient evaluation and management on March 15, 2007. The patient record does not support the charge because Respondent failed to document a history that met the requirement of that billing code, and there is no documentation of an examination having been conducted or documentation of any clinical decision making that may have been applied.

6. In addition, Respondent's documentation fails to reflect that he properly examined, assessed, diagnosed and treated patient's A.S. and E.S.

7. Further, Respondent advertised in a false, deceptive or misleading manner and used the deceptive and misleading information in his advertisement. Respondent misrepresented information in a publication when he advertised that a study demonstrated that people with untreated subluxation are fifteen (15%) percent more likely to die. The article he referenced did not support that statement, and actually indicated the opposite. Respondent also made false multiple statements regarding the consequence of subluxation and medications that he also misrepresented as being supported by clinics literature. Such statements were represented as "Our vision for the peace of God" and included the misrepresentation that: ''the problem is we live in a community where many of the teachers educating our children, bus drivers driving our children, medical doctor treating our families, police officers holding a gun, politicians protecting our rights, and children sitting next to ours in school are taking drugs, have subluxation, and lead an extremely unhealthy lifestyle. Our schools and community area not really safe"; Ritalin is equated with children carrying guns in school, ''we'' are living in a war zone due to untreated subluxation and medications, any drug will cause some level of adverse effect; and legal medications are the leading cause of death, abuse and drug arrest. The publications that Respondent provided in evidence that these statements are substantiated do not support the statements, and for the most part, are not relevant to the advertised statements.

8. As a mitigating factor, the Board found that Respondent had presented evidence in the form of an audit and that he had taken pro-active steps to remedy the Findings of substandard recordkeeping and unsupported billing. Respondent also testified that he had modified his advertising practices to eliminate the false and deceptive aspects of his advertisement as. noted in paragraph 7.

CONCLUSIONS OF LAW

1. Based on the Findings of Fact, the Board found there is sufficient evidence to conclude that your conduct may constitute unprofessional conduct under A.R.S. § 32-924(A)(5) ([u]nprofessional or dishonorable conduct of a character likely to deceive or defraud the public or tending to discredit the profession);

2. Based on the Findings of Fact, the Board found there is sufficient evidence to conclude that your conduct may constitute unprofessional conduct under A.A.C. R4-7-9~2(5) ([f)ailing to create and maintain a patient record that includes the patient's health history, clinical impression, examination findings, diagnostic results, x-ray films if taken, x-ray reports, treatment plan, .and notes for each patient visit, The notes for each patient visit shall include the patient's name, the date of service, the chiropractic physician's findings, all services rendered, and the name or initials of the chiropractic physician who provided services to the patient);

3. Based on the Findings of Fact, the Board found there is sufficient evidence to conclude that your conduct may constitute unprofessional conduct under A.A.C. R4-7-9-02 (7) ([f]ailing to release a C\copy of all requested patient records under subsection (5), including the original or diagnostic quality radiographic copy x-rays, to another licensed physician, the patient, or the authorized agent of the patient, within 10 business days of the receipt of a written request to do so. This subsection does not require the release of a patient's billing record to another licensed physician.);

4. Based on the Findings of Fact, the Board found there is sufficient evidence to conclude that your conduct may constitute unprofessional conduct under A.R.S. § 32-924(A)(13) ([a]dvertising in a false, deceptive or· misleading manner).

ORDER

Based upon the above Findings of Fact and Conclusions of Law, IT IS HEREBY ORDERED:

1. Chiropractic License No. 5437 issued to Respondent to practice chiropractic in the State of Arizona shall be issued a NON-DISCIPLINARY ORDER FOR CONTINUING EDUCATION for the unprofessional conduct described above.

2. The terms and conditions for Continuing Education are as follows:

a. Respondent shall take and complete eight (8) hours of continuing education In record keeping that. is preapproved by Board staff and provide Board staff with. satisfactory proof of attendance within fifteen (15) days after completing the course{s). Respondent shall commence taking the eight (S) hours of continuing education in record keeping within one (1) months from the effective date of this Order and shall complete the eight (8) hours of continuing education in recordkeeping within three (3) months of the effective date of this Order. The eight (8) hours of continuing education it record keeping are in addition to the mandatory hours of continuing education required of Respondent;

b. Respondent shall take and complete four (4) hours of continuing education in ethics that is preapproved by Board staff and provide Board staff with satisfactory proof of attendance within fifteen (15) days after completing the course(s). Respondent shall commence taking the four (4) hours of continuing education in. ethics within one (1) months from the effective date of this Order and shall complete the four (4) hours of continuing education in ethics within three (3) months of the effective date of this Order.: The four (4) hours of continuing education in ethics are in addition to the mandatory hours of continuing education required of Respondent;

c. Respondent shall take. and complete eight (8) hours of continuing education in critical evaluation of literature that is preapproved by Board staff and provide Board staff with satisfactory proof of attendance within fifteen (15) days after completing the course(s). Respondent shall commence taking the eight (8) hours of continuing education in critical evaluation of literature within three (3) months from the effective date of this Order and shall complete the eight (8) hours of continuing education in critics) evaluation of literature within four (4) months of the effective date of this Order. The eight (8) hours of continuing education in critical evaluation of literature are in addition to the mandatory hours of continuing education required of Respondent;

d. Respondent shall bear all direct and indirect costs of complying with this Order, including but not limited to the costs of the continuing education, Board staff time in monitoring compliance and any other applicable practice monitor.

3. This Order shall become effective as of the date stated below.

DATED this 25 day of November, 2008.

ARlZONA STATE BOARD OF
CHIROPRACTIC EXAMINERS  

By ____________________________
P. Dianne Haydon, D.C., Chairperson
Arizona State Board of
Chiropractic Examiners

NOTICE: This Order constitutes a formal decision and order of the Board. If the Respondent desires to challenge the Order, Respondent shall file a written motion for rehearing with the Board's Executive Director within thirty (30) days after service of the Order. Service of the Order is effective on personal service or five days after the date of mailing to Respondent. Under A.A.C. R4-7-305(C), the motion for rehearing must state with specificity the grounds for rehearing. Failure to file a motion for rehearing or review bas the effect of prohibiting judicial review of the Board's Order, according to A.R.S. § 41-1092.09 (B) and A.R.S. § 12-904 et seq.

COPY of the foregoing mailed by
U.S. Certified mail (return receipt requested)
"this 25 day of November 2008

Certificate No. _________________ to:

David Stender, D.C.
6595 N. Oracle #135
Tucson, AZ 85704
Respondent

COPY of the foregoing mailed
this 25 day of November 2008

M. Brent Peugnet, Esq.
Broening, Oberg, Woods & Wilson, P.C.
1122 East Jefferson St
P.O. Box 20527
Phoenix, Arizona 85036-0527
Attorney for Respondent

Melissa Cornelius
Assistant Attorney General
1275 W. Washington, CIV/LES
Phoenix, Arizona 85007
Attorney for the State

This page was posted on April 4, 2012.

Links to Recommended Companies