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April 21, 2014

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health care:

California, Nevada take opposite stances when disciplining the same doctor

Nevada doesn’t disclose its response to a doctor who admitted to battery on a woman, California pulled his license

Dr. Sean S. Steele was able to practice medicine in both California and Nevada until last year.

That’s when the California Medical Board revoked his license, based on evidence and testimony from a woman who said he sexually assaulted her in the back of a Mercedes during an evening of drinking in Las Vegas.

According to the official decision, the California Medical Board concluded that Steele had “brutally sexually attacked” the woman and then lied about it under oath. The board called his behavior “unbecoming to a member in good standing of the medical profession, and which demonstrates an unfitness to practice medicine.”

The board revoked Steele’s license, effective April 17, 2012.

In Nevada, however, Steele, an internist, is still licensed and has privileges at University Medical Center, MountainView Hospital, Valley Hospital Medical Center, Summerlin Hospital Medical Center and Centennial Hills Hospital Medical Center, according to the hospitals.

The Clark County District Attorney's office had charged him with felonies, including sexual assault — and then accepted Steele’s no contest plea to a lesser charge of misdemeanor battery.

Later, the Nevada State Board of Medical Examiners issued a “non-public action,” a sanction so negligible that it is not disclosed. A search of the board’s website shows no sanction against Steele.

In other words, there is no public disclosure by the Nevada State Board of Medical Examiners of an incident involving a doctor that was deemed so serious by California authorities that the doctor was prohibited from seeing patients there.

The case raises questions about how closely Nevada monitors its medical professionals. Legislators, members of the Nevada medical community and others have long criticized the Nevada State Board of Medical Examiners’ ability to effectively regulate, investigate and sanction doctors.

Through her attorney, Robert Murdock, the woman declined to comment. The Las Vegas Sun does not name the victims of sexual assaults.

A request to interview Steele was sent by email to his attorney, Russell Iungerich. The attorney did not respond to that request.

Steele is appealing the decision of the California Medical Board on the grounds that his due process rights were violated because Iungerich was ill on the day of the woman’s testimony and therefore she was not cross-examined.

In its ruling, the California Medical Board concluded, “(The victim) is telling the truth and (Steele) lied to the Medical Board investigators, lied in the civil suit and lied under oath in the present proceedings.”

• • •

This is what happened, based on the California Medical Board’s decision as reported in its written findings. Some of the information is graphic:

The couple met through a dating service and had been out on a few uneventful dates. On the night of Sept. 3, 2008, Steele hired a driver to chauffeur the couple in his Mercedes because they planned to be drinking. They went to dinner at Treasure Island where, according to the victim, Steele drank heavily.

From there they went to the Riviera for a comedy show. At some point, the victim said she stopped drinking, but Steele continued.

In the comedy show, Steele was acting “strange, ridiculous, he was drunk and was very loud,” she said.

They left with their driver to go to the Blue Martini Lounge at Town Square. The victim called a friend from the car so she could get picked up at the Blue Martini and end the date.

The couple were in the back of the Mercedes when Steele kissed her. She rejected further advances.

According to the medical board’s ruling, Steele then attacked her. He pinned her down, put his mouth on her breast, began pulling on her jeans and became focused on the woman’s “crotch area.” She screamed for him to stop and began beating him on his head.

The victim, the decision states, said she “felt a pain in her crotch area like someone was cutting at her with a knife.”

She said the car stopped and she jumped out, pulled up her pants and straggled to the nearest open business establishment, an Adult Superstore.

A detective testified that surveillance video from Adult Superstore showed the victim run in the store. "She was extremely disheveled, her jeans were open in the front, and she appeared frantic,” according to the board decision.

Her underwear was missing. She got a ride home and climbed into bed with her clothes on.

For his part, Steele told the California Medical Board that the victim was on his lap and began kissing him. When she pushed off his lap, her pants came down, after which “she became very upset and wanted to get out of the car,” according to board documents that summarized Steele’s testimony. He said he was concerned when she left the car because she was acting “erratic.”

The next morning, she called the police and was transported to University Medical Center Sexual Assault Unit for examination.

The Sexual Assault Nurse Examiner testified that a pelvic exam was painful for the woman because she had suffered a 1- to 1 1/2-inch laceration to the clitoral hood. In fact, the victim had a clitoral piercing that had been “torn through the skin.” An ornamental silver ball attached to the piercing was missing. The nurse said the resulting “ragged lacerations” were the largest she had seen in roughly 4,000 cases.

The nurse testified that the medical evidence was consistent with the victim’s testimony.

The California Medical Board documents also relate that Las Vegas Metro Police Detective Lora Cody, who was assigned to the case, listened in while the woman talked to Steele on the phone the morning after the incident. When the woman asked Steele why he attacked her, he was “apologetic” and didn’t remember what had happened, according to Cody’s testimony.

Metro executed a search warrant on Steele’s home and the Mercedes. Metro found a small ornamental silver ball that the victim identified as the jewelry that had been attached to her clitoral ring.

Cody declined to comment for this story.

“(Steele’s) DNA profile is consistent with the DNA found on (the victim’s) breasts and on the silver ball that had been attached to her clitoral ring,” according to the California Medical Board decision.

“(Steele) had no comment concerning how, based on his recitation of the ‘facts,’ (the victim’s) clitoral silver ball could have been found in the back seat of his Mercedes.”

The board concluded that Steele was inconsistent in his statements, specifically about touching the victim’s breasts, between an interview and later testimony.

The victim’s statements, meanwhile, “have remained relatively constant over time and were corroborated by independent evidence.”

The California board said that, after completing a “credibility determination,” there was “no doubt that (the woman) is telling the truth and (Steele) is lying.”

Iungerich, Steele’s attorney, disagrees and attacked the woman’s credibility in an interview with the Sun. “Her story just doesn’t make sense,” he said, adding that the truth would be clear once he was able to cross-examine her.

Iungerich questioned why she took a ride home from the Adult Superstore from a complete stranger after the incident, and also questioned why Steele would leave the decorative ball of the vaginal piercing in the back seat where it could be found by Metro.

The attorney said he was confident that his client would ultimately prevail in the appeal.

The Sun emailed Iungerich various follow-up questions about the case; he did not directly respond.

In its most pointed question, the California Medical Board decision asks, “How did (the victim) sustain her injuries to her clitoral area and how did the silver ball that had been attached to her clitoral ring come to be in the rear seat of (Steele’s) Mercedes?”

The board then answered its own question: “The only reasonable explanation is that provided by (the victim) — respondent brutally sexually attacked her in the back of the Mercedes and bit and pulled on (the victim’s) clitoral ring until it lacerated (the victim) and broke, letting the silver ball fall into the area of the back seat.”

In revoking Steele’s license, the board found the case “extremely egregious” and “the antithesis of what is expected of a licensed physician and surgeon.”

“Physicians and surgeons take an oath to help those in need and to do no harm. Instead, (Steele) savagely attacked (the victim) and is unwilling to admit and address his antisocial behavior.”

The 15-member board, which includes eight physicians, further wrote that because Steele denied excessive use of alcohol on the night in question, “The only reasonable conclusion is that (Steele) suffers from some type of anti-social psychological problem that can unexpectedly lead to extreme violence.

“The only way to ensure public protection is to revoke respondent’s certification so that a similar situation will not spontaneously occur with a patient. This will not only protect the public and patients, it will also serve to protect the reputation of the medical profession; a profession that prides itself, and relies upon, public trust and its members’ integrity.”

California’s unequivocal decision contrasts with Nevada’s.

Douglas Cooper, the executive director of the Nevada State Board of Medical Examiners, said the board “took appropriate action with a non-public action” that allows Steele to continue to practice without any public notification of his offense.

“The only thing we can act on is the misdemeanor battery charge. We don't do criminal investigations,” he said.

“I never did understand why they did what they did,” Cooper said of the California Medical Board. In a later interview, Cooper said the Steele case was still open and that Nevada could act depending on the outcome of the appeal in California.

Dr. Neil Wenger, professor of medicine and the director of the UCLA Health System Ethics Center, reviewed the California Medical Board decision and concluded in an email to the Sun: “Based on the document that you present, it would seem that the behavior demonstrated by the physician is unbecoming of a physician and contrary to the professional standard of a physician. I do not understand why the Nevada medical board would not find this to be the case.”

In court transcripts pertaining to Steele’s appeal before the California Medical Board, Iungerich references Nevada’s leniency: “(T)he situation is that with regard to the question of the public interest in Nevada, there was only a letter of concern issued and not any discipline.”

In the same transcript, California Deputy Attorney General Tessa Heunis also referred to the Nevada State Board of Medical Examiners’ decision, arguing that Nevada’s leniency was a compelling argument against Steele’s California appeal: “(T)he Nevada Medical Board did nothing about — any of these allegations. They didn’t even bother to contact the Complainant. They showed no interest whatsoever. Didn’t speak to her.”

Dr. Benjamin Rodriguez, the chairman of the Nevada State Board of Medical Examiners, confirmed in an email that the board never spoke to the woman.

“The Nevada criminal investigation led to a finding of simple battery, a misdemeanor in Nevada. ... Nevada criminal legal proceedings get deference and recognition by the board,” he said.

Rodriguez did not elaborate on what evidence was presented to the Nevada board, citing privacy laws.

Rodriguez went on to call the California Medical Board’s decision “extreme for non-medically related conduct, unproven in court as indicated by the resulting charge.”

He reiterated that “This case is not related to the practice of medicine, i.e., it appears to have been a consensual relationship, entirely private behavior with no medical nexus, and is a complicated he/she said situation.”

In pleading no contest to a misdemeanor battery charge, Steele paid a $1,000 fine and completed “impulse control counseling,” according to the California Medical Board documents.

More serious criminal charges originally filed, including sexual assault, were dropped. The prosecutor on the case did not respond to requests for interviews.

Clark County District Attorney Steve Wolfson, who was not the district attorney at the time of the plea agreement, said, “I think at first blush the case seems very strong.” But once the woman hired a civil attorney, Wolfson said, “Her position in the case changed. She became less cooperative and less willing to participate in the prosecution.”

The woman was cooperative in the California Medical Board case, however. She traveled to San Diego to testify.

“If a witness changes gears and changes the approach to the case, it makes your otherwise strong case not so strong,” Wolfson said.

The California Medical Board decision states the victim testified she “wanted to get everything over and she had no interest in participating as a witness in the criminal action against respondent.”

Wolfson saw another potential motive: “Perhaps she saw deep pockets and wanted some civil redress for what he did.”

The parties agreed on a civil settlement, which is sealed.

Robert Murdock, the victim’s attorney, replied to Wolfson’s assertion that the victim was seeking “deep pockets.”

“The same deep pockets that paid the district attorney’s income for the past 25 years,” he said, referring to Wolfson’s time in private practice prior to becoming the county’s chief prosecutor. “He should be ashamed of himself. He knows better.”

Murdock, citing a confidentiality agreement signed upon conclusion of the civil case, declined to comment further.

Eugene O’Donnell, a former police officer and prosecutor who is a criminologist at the John Jay School of Criminal Justice in New York City, said the woman was entitled to pursue civil redress, and that it is incumbent on prosecutors to work with imperfect or even unwilling victims and witnesses, no matter how challenging.

That’s because the crime isn’t merely committed against the alleged victim, but against the state, O’Donnell said.

“It's a state matter. We're also the victims here, the people of the state,” he said.

Sun researcher Rebecca Clifford-Cruz contributed to this report.

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  1. I can't say I am surprised. This is not the first professional NV refuses to discipline no matter how heinous the conduct. Dr. Desai (who deliberately poisoned his patients) did not have his license revoked and has yet to brought before the bar of justice. They allow dentists who cheat on their dental school exams to graduate and practice. Regulators, protect the identities of these miscreants to hide their own misdeeds.

  2. The difference is in California you have no rights to due process. Leave it to the liberals at the sun to advocate nailing someone with no trial. This is why, and I am far from a conservative, its bad to have liberals in charge of everything

  3. Having lived (if one can call it "living") in California before making Nevada my home, I assure you that California is very strict in all cases like this one.

    It's one of the very few lessons that Nevada could learn from California.