Teeth weren't pulled and the state finds a rare case of medical incompetence

Complaint: Complaint 18-16
Respondent: Edwin Kiesel
Premises: Camino Seco Pet Clinic

The complainant, one of Kiesel's longtime clients, brought her cat to him because of significant eye and nose discharge. He suspected it was actually a dental problem that was showing up that way, and that they needed to find and pull the offending tooth. She was advised to buy a Groupon coupon to get 50% off and she did so. They did bloodwork prior to the tooth extraction and identified some early renal dysfunction. Kiesel wanted to wait and do the tooth extraction later because of concerns regarding anesthetic risk in such a situation, so he prescribed a renal diet and a recheck. The next month they came in for what was supposed to be a tooth extraction, but the cat continued to decline, was reexamined and rehospitalized with little information provided. The complainant finally took the cat to another clinic where they found that the teeth were still in place and needed to be pulled.

Kiesel's response states that he in fact didn't pull any teeth and he's not sure where the complainant ever got that idea from. He states that he did anesthetize the cat to examine the mouth but elected not to pull the tooth because subsequent blood work had also showed anemia. Kiesel states that he's happy another veterinarian was able to pull the teeth in question but that he would have had concerns doing the operation based on of the kidney values and anemia.

The Investigative Committee said that Kiesel shouldn't have been such a wimp over the renal values and just went ahead with pulling the teeth. They also said that he did a very bad job of just about everything else, was incompetent, and did a very bad job of keeping records and notes. They also thought he lied to the complainant about pulling the teeth.

Motions

Investigative Motion: Find violation

Source: November 11, 2017 PM Investigative Committee Meeting
People:
David Stoll Respondent Attorney
Edwin Kiesel Respondent
Roll Call:
Adam Almaraz Aye
Amrit Rai Aye
Donald Noah Aye
Robert Kritsberg Aye
Tamara Murphy Aye
Violations:
ARS 32-2232 (22) Medical incompetence; lacked sufficient knowledge or skill to a degree likely to endanger the health of the cat as demonstrated by the inability to intubate the cat or place an IVc atheter. The cat's elevated renal values and anemia did not warrant delaying the tooth extraction.
ARS 32-2232 (21) failure to maintain adequate medicalrecords- extraneous information in the medical records.
ARS 32-2232 (21) as it relates to AAC R3-11-502 (E) no discharge instructions documented in the medical record on July 15, 2017 or July 27, 2017.
ARS 32-2232 (21) as it relates to AAC R3-11-502 (H) (1) no signed authorization was obtained before general anesthesia was administered or surgery was performed.
ARS 32-2232 (21) as it relates to AAC R3-11-502 (H) (3) no surgical monitoring was documented on July 15, 2017 or July 27, 2017,
ARS 32-2232 (21) as it relates to AAC R3-11-502 (L) (2) no weight documented in the medical record on July 15, 2017.
ARS 32-2232 (21) as it relates to AAC R3-11-502 (L) (4) no resultsof an exam documented in the medical record on July 15, 2017.
ARS 32-2232 (21) as it relates to AAC R3-11-502 (L) (6) failure to accurately document treatment provided on June 8, 2017, July 15, 2017 and July 27, 2017;
ARS 32-2232 (21) as it relates to AAC R3-11-502 (L) (7) no documentation in the medical record of the convenia administered to the cat on June 8, 2017.
ARS 32-2232 (21) as it relates to AAC R3-11-502 (L) (7) no documentation in the medical record of the anesthesia administered to the cat on July 27, 2017.
ARS 32-2232 (21) as it relates to AAC R3-11-502 (L) (7) (d) route of administration was not documented in the medical record for convenia on July 27, 2017.
Result: Passed

Board Motion: Schedule informal interview

Source: December 12, 2017 Board Meeting
People:
David Stoll Respondent Attorney
Proposed By: Nikki Frost
Seconded By: Robyn Jaynes
Roll Call:
Christina Bertch-Mumaw Aye
Darren Wright Absent
J Greg Byrne Aye
Jessica Creager Absent
Jim Loughead Aye
Julie Young Absent
Nikki Frost Aye
Robyn Jaynes Aye
Sarah Heinrich Aye
Result: Passed

Board Motion: Find violation

Source: February 2, 2018 Board Meeting
People:
David Stoll Respondent Attorney
Edwin Kiesel Respondent
Proposed By: Darren Wright
Seconded By: Sarah Heinrich
Roll Call:
Christina Bertch-Mumaw Absent
Darren Wright Aye
J Greg Byrne Absent
Jessica Creager Aye
Jim Loughead Nay
Julie Young Aye
Nikki Frost Absent
Robyn Jaynes Nay
Sarah Heinrich Aye
Violations:
ARS 32-2232 (22) Medical incompetence
Result: Passed

Board Motion: Find violation

Source: February 2, 2018 Board Meeting
People:
David Stoll Respondent Attorney
Edwin Kiesel Respondent
Proposed By: Darren Wright
Seconded By: Sarah Heinrich
Roll Call:
Christina Bertch-Mumaw Absent
Darren Wright Aye
J Greg Byrne Absent
Jessica Creager Aye
Jim Loughead Aye
Julie Young Aye
Nikki Frost Absent
Robyn Jaynes Aye
Sarah Heinrich Aye
Violations:
ARS 32-2232 (21) Failure to document in the medical record
Result: Passed

Board Motion: Find violation

Source: February 2, 2018 Board Meeting
People:
David Stoll Respondent Attorney
Edwin Kiesel Respondent
Proposed By: Darren Wright
Seconded By: Sarah Heinrich
Roll Call:
Christina Bertch-Mumaw Absent
Darren Wright Aye
J Greg Byrne Absent
Jessica Creager Aye
Jim Loughead Aye
Julie Young Aye
Nikki Frost Absent
Robyn Jaynes Aye
Sarah Heinrich Aye
Violations:
ARS 32-2232 (21) Failure to obtain authorization
Result: Passed

Board Motion: Find violation

Source: February 2, 2018 Board Meeting
People:
David Stoll Respondent Attorney
Edwin Kiesel Respondent
Proposed By: Darren Wright
Seconded By: Sarah Heinrich
Roll Call:
Christina Bertch-Mumaw Absent
Darren Wright Aye
J Greg Byrne Absent
Jessica Creager Aye
Jim Loughead Aye
Julie Young Aye
Nikki Frost Absent
Robyn Jaynes Aye
Sarah Heinrich Aye
Violations:
ARS 32-2232 (21) Failure to document in the medical record
Result: Passed

Board Motion: Issue order

Source: March 3, 2018 Board Meeting
People:
David Stoll Respondent Attorney
Proposed By: Darren Wright
Seconded By: Jessica Creager
Roll Call:
Christina Bertch-Mumaw Absent
Darren Wright Nay
J Greg Byrne Aye
Jessica Creager Aye
Jim Loughead Aye
Julie Young Aye
Nikki Frost Aye
Robyn Jaynes Aye
Sarah Heinrich Aye
Result: Passed

Board Order: Order 18018 EDWIN KIESEL, DVM

Source: Order 18018 (March 3, 2018)
Violations:
A.R.S. § 32-2232 (22) Medical incompetence; lacked sufficient knowledge or skill to a degree likely to endanger the health of the cat as demonstrated by the inability to intubate the cat or place an IV catheter and proceeded with the dental cleaning.
A.R.S. § 32-2232 (21) as it relates to A.A.C. R3-11-502 (E) no discharge instructions documented in the medical record on July 15, 2017 or July 27, 2017.
A.R.S. § 32-2232 (21) as it relates to A.A.C. R3-11-502 (H) (1) no signed authorization was obtained before general anesthesia was administered or surgery was performed on July 15, 2017 or July 27, 2017.
A.R.S. § 32-2232 (21) as it relates fo A.A.C. R3-11-502 (L) (4) no results of an exam documented in the medical record on July 15, 2017.
A.R.S. § 32-2232 (21) as it relates to A.A.C. R3-11-502 (L) (b) failure to document in the medical record the amount of the convenia administered to the cat on August 18, 2016.
A.R.S. § 32-2232 (21) as it relates to A.A.C. R3-11-502 (L) (d) failure to document in the medical record the route of administration of the convenia administered to the cat on August 18, 2016.
Penalties:
Probation (2 years)
Continuing education (6 hours in anesthesia)
Continuing education (4 hours in client communication)
Continuing education (4 hours in veterinary ethics as applied to client communication)
Civil penalty ($1750)

The primary source for the above summary was obtained as a public record from the Arizona State Veterinary Medical Examining Board. You are welcome to review the original records and board meeting minutes by clicking the relevant links. While we endeavor to provide an accurate summary of the complaint, response, investigative reports and board actions, we encourage you to review the primary sources and come to your own conclusions. In some cases we have also been able to reach out to individuals with knowledge of specific complaints, and where possible that information will be included here.