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Medical Board Faulted for Licensing Convicted RapistThis article is mirrored for historical purposes from: http://medscape.com
November 25, 2014
background checks are not required for licensing a physician in almost
a third of the 50 states. The case of William Dando, MD, however, may
make one of those states rewrite its laws.
The Maryland Board of
Physicians (MBOP) licensed Dr Dando in 1996, even though he pleaded
guilty in 1987 to raping in a woman at gunpoint, according to state
records. Last month, the Maryland health department issued a report
that chastised the medical board for glossing over his 1987 conviction.
In his license application, Dr Dando said he had been convicted of
assaulting someone while intoxicated. The MBOP accepted Dr Dando's
explanation at face value without bothering to dig deeper, according to
the report from Inspector General Thomas Russell of the Maryland
Department of Health and Mental Hygiene.
Of course, a criminal
background check at that time would have ferreted out the whole truth,
and presumably caused the board to reject Dr Dando's application. But
even without this tool, Russell said, the board still could have asked
the Florida Department of Corrections about the exact charges against
Dr Dando, who served 3.5 years of a 10-year prison sentence. The MBOP
also apparently ignored later revelations that Dr Dando had misled it
about his crime, said Russell.
In the meantime, Dr Dando
proceeded to rack up complaints to the medical board as well as two
sex-offense charges involving a patient in 2014, which dredged up his
criminal past. He surrendered his medical license this past summer.
Dando was not the first or last physician with a prior felony to slip
through Maryland's vetting process, which requires applicants to
disclose criminal convictions. In 1988, the MBOP granted a license to a
man who did not reveal that he had been convicted of robbery and
second-degree manslaughter. And in 2011, a former Army officer was
licensed after she admitted to a criminal conviction on her
application, but misportrayed it to make herself look less culpable.
requires criminal background checks for nurses, chiropractors,
dentists, and all other healthcare professionals licensed and regulated
by its state boards — all except physicians, that is. That makes it 1
of 16 states that forgo this precaution, according to the Federation of
State Medical Boards (FSMB), which has recommended background checks
"We believe it's very important," said Lisa Robin,
the FSMB's chief advocacy officer. "A criminal record for a physician
may be rare, but it's still very important information as to whether
the physician is professionally and ethically qualified to provide
Whether a state mandates a criminal background
check for physicians depends in part on the "political environment" in
the state legislature, noted Robin.
That can mean who is
lobbying for such a law, and who is lobbying against it. Maryland's own
track record illustrates how a state medical society or medical board
can stand in the way of background check requirements.
part, the MBOP has agreed with Inspector General Russell's criticisms
and recommendations. In a letter to Russell, board chair Devinder
Singh, MD, acknowledged lapses in oversight in Dr Dando's case that
were "contrary to the mission of the board to protect the public."
board has proposed legislation that would require criminal background
checks not only for initial licensure but also for license renewal and
"We're clearly behind the eight-ball on this,"
said Dr Singh in an interview with Medscape Medical News. "I'm happy to
bring criminal background checks into the process.
"This deficiency was highlighted by a single case. It's a troubling case."
Medical Society and Board Once Opposed Background Checks
The Maryland medical board has not always supported criminal background checks.
2006, the research department of the Maryland legislature recommended
rewriting state law to authorize the board to make these inquiries in
light of applicants not self-reporting criminal convictions. The MBOP
registered its reservations, according to Russell's report.
board expressed concern regarding the potential cost and possible
delays in issuing licenses as reasons for not requesting authorization
to do nationwide criminal background checks," Russell stated. The board
also said that the authority to perform these checks wasn't necessary,
given the "likely low number of licenses with positive records."
Table. States That Do Not Require Criminal Background Checks for Licensing Physicians1
1Arizona requires criminal background checks for allopathic physicians, but not for osteopathic physicians.
2Minnesota will begin conducting criminal background checks on medical license applicants, beginning in 2018.
Maryland State Medical Society (MSMS) voiced similar objections at the
time, calling the proposed requirement for physicians to submit to
fingerprinting and a criminal background check "offensive."
appears to be a solution in search of a problem which does not exist,"
Russell quoted the MSMS as saying. The proposal died in the state
Similar to the medical board, however, the medical society has changed its position.
now we support background checks," said MSMS President Tyler Cymet, DO,
in an interview with Medscape Medical News. "The concept is clear. The
question is how it's done so it's coordinated and not burdensome."
the society wants to avoid, said Dr Cymet, is a system in which
physicians encounter multiple requirements for fingerprinting and
background checks from medical schools, licensing boards, and hospitals.
reversal by the medical board and the medical society on the issue fits
a familiar pattern, said Lisa McGiffert, director of the Safe Patient
Project of the watchdog group Consumers Union.
reforms such as background checks "come about when there is a
high-profile incident in the media," said McGiffert. "They tend to
happen as a reaction, as opposed to pro-action."
outside pressure exerted by a scandal, state medical boards give
physicians the benefit of the doubt on alleged misbehavior, she said.
"There is so much forgiveness along the way."
"It's true, most doctors aren't criminals," said McGiffert. "But it's the board's job to identify those doctors who are."
Red Flags Ignored Along the Way
Dando was a husband, a father of two, and a first-year family medicine
resident in Miami, Florida, in December 1986, when he broke into a
woman's home and raped her while threatening her with a gun. He pleaded
guilty to burglary and sexual assault with a deadly weapon, and in
September 1987, he received a 10-year prison sentence. At the
sentencing, he expressed remorse for his crime.
"I think that
whatever your judgment, it will be less than what I deserve," the
Orlando Sentinel quoted Dr Dando as telling the judge. "Had it been in
another era, it could have meant my life."
The conviction merely
interrupted his medical career, however. After he was released in 1991
for good behavior, Dr Dando managed to enter a residency program at the
University of Maryland Hospital System. However, in 1993, trouble
caught up with him again. The MBOP received a complaint that Dr Dando,
who was not licensed at the time, was abusing controlled substances. He
agreed to receive substance abuse treatment and undergo board
monitoring for 5 years.
It was during that 5-year span that Dr
Dando sought to get licensed in Maryland. He answered "yes" to an
application question about a criminal conviction.
[of 1986] I awoke to the harsh reality that I had a drinking problem,"
he explained in a letter to the MBOP. "During a short leave away from
the hospital [of the residency program,] I became intoxicated and was
accused of assaulting someone. I subsequently turned myself in [and]
made a plea agreement with the state of Florida to undergo alcohol
rehabilitation and a period of incarceration."
In his report, Russell characterized Dr Dando's explanation as "false and misleading."
MBOP issued a license to Dr Dando in September 1996. The next year, the
board was notified by its counterpart in Georgia that it was allowing
Dr Dando to withdraw his application for a license there. The
information received from Georgia suggested that Dr Dando might warrant
registration as a sex offender, but the MBOP apparently did not
reexamine the 1987 conviction, according to Russell's report.
December 2003, the MBOP received a complaint that Dr Dando allegedly
was habitually getting drunk and taking Ritalin (Novartis) and Ambien
(sanofi-aventis) and that he had tried to run over someone with his
car. The board then checked with the Florida Department of Corrections
for more information about Dr Dando's criminal history and received a
fax "clearly outlining what had happened in that case."
board, Russell wrote, "still took no action after receiving this
critical piece of information." It eventually closed the 2003 complaint
about Dr Dando's alleged substance abuse, citing lack of evidence, as
well as a similar one in 2004.
Dr Singh explained the 1997 and
2003 miscues by saying that board staff members failed to present the
information from Georgia and Florida to the board's voting members.
"There was some issue of staff incompetence," he said.
complaint filed in 2005 finally stuck. A woman told the board that Dr
Dando was prescribing excessive amounts of Xanax to her mother even
though he had not examined her in more than a year. Her mother, the
woman said, had had "several acute overdose episodes." In a slow-motion
response that Russell said was characteristic, the MBOP reprimanded Dr
Dando in April 2010 for substandard care, put him on probation for 18
months, and ordered remedial education on controlled substances and
Allegations of Improper Vaginal Exams
Dr Dando's career crashed into a brick wall in 2014.
Maryland medical board in February 2014 received yet another complaint
that he was overprescribing controlled substances, according to
Russell's report. Then, in May, a woman told police that Dr Dando had
performed an "inappropriate vaginal exam" the month before at an urgent
care clinic where he worked.
The woman said that Dr Dando,
unaccompanied by a chaperone and not wearing gloves, asked if what he
was doing with his finger "hurt or felt good," according to Russell's
summary of the police report. The woman tearfully asked Dr Dando to
stop, which he did, and then she refused a proffered hug. Police said
they had interviewed another patient who told a similar story about an
improper vaginal exam.
Dr Dando was charged in a state court
with "perverted or unnatural practice" and another crime that amounts
to nonconsensual sexual contact. He pleaded not guilty, according to
court records. Articles published on May 29 in the Baltimore Sun and
the Orlando Sentinel on the charges also broke the news that Dr Dando
had served time for rape in Florida.
At this point, the board
moved quickly. In June, it suspended Dr Dando's license after
concluding that public health and safety "require emergency action."
Among its findings was the 1987 rape conviction. Two months later, Dr
Dando wrote a letter to the MBOP stating that he was voluntarily
surrendering his license to avoid further prosecution on allegations of
misconduct with two patients. The board accepted his offer in September.
prosecutors immediately dropped the criminal charges stemming from the
alleged exam room misconduct in April, citing Dr Dando's surrender of
his license as one of their reasons, the Baltimore Sun reported.
Dando still faces a civil lawsuit filed by a West Virginia woman who
alleges that he fondled her in the exam room. That case is scheduled
for trial in April 2015. He also is battling a wrongful death suit
filed by family members of a patient who died of a narcotics overdose
Brad Roegge, Dr Dando's attorney in the pending lawsuit
on the alleged fondling, told Medscape Medical News that he had no
comment on his client's legal and regulatory troubles and that he would
advise him not to comment as well. There was no response to an
interview request delivered to an address listed for Dr Dando in court
College Pranks vs Crimes of Moral Turpitude
MBOP's Dr Singh said that the medical board that licensed Dr Dando in
1996 and failed to act on tell-tale information afterward is not the
same board that supports criminal background checks in 2014. In fact,
he said, the board began to make an about-face in 2012, when it
required applicants to document any application answers on criminal
convictions and other matters of professional fitness.
criminal background checks will tighten the licensing process even
further, said Dr Singh. The key to collecting comprehensive records
from every state is tapping into the database of the Federal Bureau of
Investigation's (FBI's) National Crime Information Center. A medical
board must be authorized by its state legislature to access the
database; the proposed legislation in Maryland would give the MBOP this
connection. It also requires license applicants to supply the
fingerprint needed to unlock the FBI's data vault.
proposed legislation addresses the concern of physicians such as Dr
Cymet of the MSMS that physicians might be background-checked to death.
Maryland would subscribe to a new FBI program called Rap-Back that
would keep the state medical board continually apprised of any arrests
or convictions after a physician has submitted to an initial background
check and received a license.
Dr Singh hopes the bill will be introduced and passed in the Maryland General Assembly next year.
the proposed legislation, the board would retain a moderate degree of
discretion in deciding whether a criminal conviction should disqualify
someone from holding a medical license. Factors to consider include the
person's age at the time of the crime, the person's work history since
then, and employment and character references. Dr Singh said the board
might choose to license a physician who was convicted of drunk driving
at the age of 18, but who since then has been a model of sobriety. "Or
he might have stolen a fraternity statue while he was in college and
gotten a misdemeanor," said Dr Singh.
Such lesser infractions on
the order of college pranks, said Dr Singh, contrast sharply with
crimes of moral turpitude. This term refers to inherently vile and
depraved conduct that, in the words of one legal case, "shocks the
One commonly cited example of moral
turpitude is rape. Dr Singh said he doubts whether his medical board
would take much time to deliberate on a convicted rapist, especially
since licensing such a person could "destroy the public's confidence in
"Rape is obviously a heinous crime," he said,
"and is considered a crime of moral turpitude, and is clearly a ground
for denial of license.
"The board would probably decide that no discussion is needed."
Medscape Medical News © 2014 WebMD, LLC
Citation: Medical Board Faulted for Licensing Convicted Rapist. Medscape. Nov 25, 2014.