Background
Plastic surgeon Geoffrey S. Kim owned an office-based surgery center where two patients experienced cardiac arrest during breast augmentation procedures. After the first patient went into asystole in August 2019, Kim waited approximately five hours to contact emergency medical services. She never regained consciousness and died fourteen months later. Kim had previously stipulated with the Colorado Medical Board that his treatment of her constituted substandard care, but he was later convicted of attempted reckless manslaughter based on the incident.
Ten days after the first patient’s death, a second patient experienced an asystolic arrest during surgery. Although an anesthesiologist called for help and a nurse repeatedly asked whether she should call 911, EMS was never summoned. After the patient regained consciousness, Kim allowed her fiancé to drive her to a hospital. His records omitted a shockable rhythm and any transportation discussion and described the asystole as lasting twenty to thirty seconds, while the anesthesiologist’s records documented four minutes. An administrative law judge found three violations of the Medical Practice Act, and the Board adopted those findings and revoked Kim’s license.
The Court’s Holding
The Colorado Court of Appeals affirmed the Board’s order. It held that the Board properly relied on Kim’s felony conviction even though his criminal appeal had been pending during the administrative proceedings. An agency cannot disregard an existing conviction unless a court invalidates it, and Kim could not use the licensing proceeding to collaterally attack the conviction. The earlier stipulation did not bar discipline based on the later conviction because the conviction had not existed when the parties entered the stipulation.
The court also held that substantial evidence supported the findings that Kim provided substandard care to the second patient and repeatedly failed to make essential record entries. Expert testimony established that a reasonably prudent physician would ensure EMS was summoned after an asystolic arrest and would arrange ambulance transportation. The evidence also supported findings that Kim failed to document the patient’s shockable rhythm, the duration of the asystole, and her purported refusal of ambulance transportation.
The court rejected Kim’s due process, equal protection, and patient-autonomy arguments. The complaint gave adequate notice that his failure to summon EMS was at issue; the nurse and anesthesiologist were not similarly situated to Kim; and the Colorado Patient Autonomy Act did not excuse his undocumented account of the patient’s transportation preference. Given Kim’s multiple statutory violations, felony conviction, and the first patient’s death, revocation was not manifestly excessive.
Key Takeaways
- A medical licensing board may discipline a physician based on an existing felony conviction without waiting for completion of the direct appeal, unless the conviction has been invalidated or set aside.
- A prior disciplinary settlement does not bar a later charge based on a conviction that did not exist when the settlement was executed.
- Expert testimony and contemporaneous medical records provided substantial evidence that failing to summon EMS, permitting private transportation after cardiac arrest, and omitting essential clinical details violated accepted medical standards.
Why It Matters
The decision confirms the broad authority of Colorado’s Medical Board to protect public safety through discipline based on a physician’s criminal conviction and subsequent patient-care violations. It also underscores that a physician cannot use an administrative licensing appeal to relitigate the constitutional validity of an underlying criminal judgment.
For medical professionals, the opinion highlights the importance of ensuring emergency services are actually summoned after a cardiac arrest and of accurately documenting critical events, recommendations, and patient refusals. A patient’s asserted preference does not eliminate the physician’s standard-of-care obligations, particularly when that preference was not contemporaneously documented.