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California Veterinary Medical Board Taking Aim At Three Northern California Track Vets For Prescription Practices

It seems the accusations filed by the California Veterinary Medical Board against Drs. Vince Baker, Jeff Blea and Sarah Graybill Jones were not the first the board made in 2021 based on racetrack practice. In February, the board filed accusation documents against a trio of veterinarians associated with San Francisco Equine. The board claimed it received a complaint in 2017 from the CHRB about Drs. Kim Lewis Kuhlmann, Steven Lee Boyer, and Kenneth Carl Allison prescribing medications to equine patients “per the trainer's instructions, without an examination or medical necessity.”

“The complaint alleged the SFE veterinarians prescribed the medications because the equine patients were entered to race – not to treat any specific condition diagnosed by the veterinarians,” read one accusation document. “The complaint included CHRB veterinarian reports completed by the SFE veterinarians, dated June 2017 through August 2017. The reports showed that the trainers of SFE's equine patients, rather than the SFE veterinarians, made the decisions to prescribe and administer the medications.”

Boyer is accused by the board of negligence, dispensing dangerous drugs without medical necessity, failure to establish a veterinarian-client-patient relationship, failure to keep adequate written records, failure to maintain a prescriber's record in the case of controlled medication, and prohibited veterinary practices. Allison is facing similar charges, with the exception of the controlled medication violation.

Kuhlmann's causes for discipline include negligence, dispensing dangerous drugs without medical necessity, failure to establish a veterinarian-client-patient relationship, prohibited veterinary practices, and purchasing or transferring expired drugs.

Kuhlmann is also alleged to have “manufactured, sold, delivered, held, or offered for sale, drugs that were imitations of commercially available drugs, and therefore misbranded.”

“An extremely large number of compounded drugs were found during the Board inspection,” the document read. “Many of the compounded drugs were commercially obtainable at the same concentrations as ketoprofen, glycopyrrolate, and others.” Kuhlmann also had misbranded drugs and expired drugs, many of which were compounded, according to the board. Those compounds came from Buy-Rite Drugs, Wedgewood Pharmacy, Precision Compounding, US Compounding, Pharmacy Resources Inc., UC Davis, and others.

She's also accused of failing to maintain adequate records for Schedule IV drugs, keeping adequate drug logs, ensuring drugs and biologics were maintained and dispensed legally, or insuring standards for medical waste. Kuhlmann is listed as the licensee manager for the practice, and as such is on the hook for additional requirements regarding overseeing recordkeeping for patients in the practice's care.

The names of the equine patients or human clients were not revealed in the public-facing accusation documents, as is typical in the case of veterinary medical board disciplinary actions.

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While many drugs named in the documents were commonly-recognized, legal therapeutic medication, the documents also called into question the legality of some of the substances the veterinarians allegedly administered or prescribed. Some were not FDA-approved, while others are marketed as supplements but considered by California legal definition to be “dangerous drugs.”

Kuhlmann's document also mentioned the use of Stanozolol, an anabolic steroid sold under the brand name of Winstrol. Unlike testosterone, boldenone, and nandrolone, stanozolol does not naturally occur in horses. Stanozolol is not permitted in a horse's system on race day at any level. At the time of the alleged violations, reported stanozolol administration resulted in a horse being placed on the veterinarian's list for 60 days before being permitted to enter races.

All three could face suspension or revocation of their license, requirement to pay the board's expenses for investigation, and fines of not more than $5,000 per violation.

Settlement conferences are on the books for all three veterinarians for April 29, with pre-hearing conference and hearing dates scheduled afterwards.

According to a spokesman for California's Department of Consumer Affairs, hearing dates for Baker and Graybill Jones have not yet been scheduled.

The post California Veterinary Medical Board Taking Aim At Three Northern California Track Vets For Prescription Practices appeared first on Horse Racing News | Paulick Report.

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CHRB Investigative Reports Add Details to NYRA’s Amended Charges Against Baffert

In a press release Monday, the New York Racing Association (NYRA) announced that it had amended its ongoing Statement of Charges issued against trainer Bob Baffert to include a pair of positive tests for phenylbutazone (bute) in 2019 in California and a subsequent inspection of the trainer's barn which allegedly uncovered an unlocked medication cabinet, improperly labeled medications and the presence of unsecured phenylbutazone paste.

NYRA has charged Baffert with engaging in conduct detrimental to the best interests of racing and has sought to temporarily ban the trainer from its tracks. A hearing on the matter is scheduled to begin Jan. 24.

Dr. Rick Arthur, who was the California Horse Racing Board (CHRB) equine medical director at the time of the 2019 violations, told TDN Monday that barn inspections are “routine” after a post-race medication positive, and that there is no regulatory requirement for drug cabinets to be locked, even though the board strongly encourages medications to be securely stored.

Arthur also explained that the proper labeling of medications is primarily the veterinarian's responsibility, and that a crucial question is: What were the mislabeled drugs?

“If it's Gastrogard tubes out of the box,” said Arthur Monday, pointing to a commonly used ulcer medication, “it's a technical violation, and not a serious one at all. If it was serious, an official warning or complaint would have been filed against either the trainer or the dispensing veterinarian.”

The investigation reports for the barn inspections–obtained through a California Public Records Act (CPRA) request–shed some light on the nature of NYRA's amended complaint but fail to answer the issue of what the mislabeled drugs actually were.

No subsequent warnings or complaints were filed against either Baffert or the attending veterinarian, Dr. Vince Baker, however.

The Del Mar barn inspection identified by the NYRA press release pertains to the one conducted Aug. 16, after the Baffert-trained Eclair (Bernardini) tested positive for bute after finishing 4th at Del Mar Aug. 3. Baffert was fined $1,500. Eclair tested positive with 2.88 micrograms per milliliter (ug/mL) of bute in her system.

According to the report, the investigator found “25 different kinds of medications that are not properly labeled and expired. There is no lock on the medication cabinet however the tack room door has lock capabilities. Dr. Vince Baker advised he would be taking care of the situation.”

According to the report, Baker told the investigator he did not know how Eclair tested positive for bute. “Baffert stated he thinks someone is intentionally giving bute to his horses and mentioned that he would be offering a reward to help solve the case,” the report added.

According to the report, Baker told the investigator he had treated Eclair no later than 10:30 am two days before the race.

Baker also told the investigator that he treated other Baffert runners with bute the following day, but that he “does not believe he inadvertently treated 'Eclair' by mistake,” according to the report.

The CHRB conducted a separate inspection of Baffert's Del Mar barn Aug. 10, after Cruel Intention (Smiling Tiger) tested positive for bute after finishing 3rd at Del Mar July 27 in the Real Good Deal S.

Baffert was fined $500. Cruel Intention tested positive with 0.51 ug/mL of bute in his system.

In light of the Santa Anita welfare crisis the spring of 2019, the CHRB reduced just months earlier the permissible level of race-day bute from 2 ug/mL to a level of non-detect.

Six days prior to the second barn inspection, the CHRB investigator found “expired medications and those that were up to date were properly labeled. There is no lock on the medication cabinet however the door has lock capabilities,” according to the inspection report.

According to the report, Baker told the investigator he treated three of Baffert's horses at the same time with bute, “and does not know why only one horse [Cruel Intention] tested positive for it.”

The two inspection reports can be read here and here.

The post CHRB Investigative Reports Add Details to NYRA’s Amended Charges Against Baffert appeared first on TDN | Thoroughbred Daily News | Horse Racing News, Results and Video | Thoroughbred Breeding and Auctions.

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Blea, Baker Among California Veterinarians Hit With Accusations From Veterinary Medical Board

Three racetrack veterinarians in Southern California are the subjects of formal “accusation” documents from the state's veterinary medical board saying they violated a series of regulations governing their jobs. Dr. Jeff Blea, longtime racetrack practitioner and equine medical director for the California Horse Racing Board, is facing eight causes for discipline; Dr. Vince Baker, practitioner and managing licensee of Equine Medical Center in Cypress, Calif., faces 15 causes for discipline; Dr. Sarah Graybill Jones, a practitioner who works for Equine Medical Center, faces seven causes for discipline.

All three could see their veterinary licenses revoked or suspended, may be required to pay the Board back for reasonable costs of investigation, and/or be ordered to pay fines not exceeding $5,000.

The accusation documents represent the charges filed by the veterinary board. Hearings have yet to be held to determine whether and what disciplinary action may be taken.

The primary focus for much of the accusation documents involves record-keeping, both records of examination and diagnosis ahead of treatment and records of drugs dispensed, including controlled substances in some instances. In several cases, the veterinary medical board accuses the veterinarians of failing to establish a valid veterinary-client-patient relationship (VCPR) per state regulations because it's not clear from existing records that the veterinarians examined horses prior to dispensing medications.

The accusations outline the treatment of racehorses identified only by their initials and in large part, without trainer or owner names attached. The exception seems to be in the accusation document for Baker. As managing licensee of Equine Medical Center, he is considered to have some responsibility for the record-keeping of veterinarians working at the practice. A portion of the accusation document detailed records from other veterinarians at the clinic that seemed to similarly be missing identifying information, examination records, or treatment plans as required by law. In these cases, specific clients (trainers) were mentioned and included Carla Gaines, Doug O'Neill, and Bob Baffert. Baker has long been a key part of the veterinary team treating Baffert's horses, although in the accusation documents the medical board noted it was Jones who administered treatments to two unidentified Baffert horses and later billed the treatments under Baker's name.

The majority of substances listed in the documents are routine and legal therapeutic medications. By the veterinary medical board's legal definition, however, some were considered “dangerous” if they bore the phrase “RX only” on the label. Many, like Lasix, aren't considered by a layperson's definition to be inherently dangerous or exotic. Some of the drugs mentioned however, were also considered by the state to be misbranded because they were produced outside of federal oversight. Thyro-L, the trade name for levothyroxine powder, falls into this category as it is not FDA-approved and was allegedly dispensed by both Baker and Blea. Baker is also accused of using compounded substances from Buy Rite Drugs which were missing best usage dates, as well as Stop Two and EMP Drench, which the board also says fit the state's definition of misbranded drugs.

Some of the records the board considered to be inadequate from Baker's practice were for more tightly-regulated substances like Euthasol and ketamine.

An anonymous tip earlier this year prompted the investigation by the medical board into Blea in February. Blea took over his current role as CHRB equine medical director in June. In Baker's case, the medical board had performed a routine inspection of EMC's mobile unit in August 2019 and noted deficiencies in medical records and drug logs. The board visited the clinic's base in May 2020 and also received an anonymous complaint about Baker and others in February 2021.

Although identifying horse information was excluded in the documents, treatment dates were included. For Blea, they ranged from early 2020 to February 2021. For Baker, the dates ranged from January 2019 to August 2020. For Jones, the dates were concentrated in March 2020.

According to a report from the Los Angeles Times Dec. 23, an emergency hearing in Blea's case is scheduled for Dec. 24. The Times also notes that the position of equine medical director does not require an active veterinary license.

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