The complainant's dog hadn't been eating or drinking which was very out of character.
She took her dog to Ishak on a Friday, and he recommended keeping the dog overnight.
Her daughter called the next day and was told that they could potentially come get
the dog that afternoon. If the dog would eat food, he thought the dog would be ready
to come home. When they arrived, the dog was too drugged to function much less eat.
The complainant went on Monday to bring the dog home even in his still-drugged state.
Ishak's response was that he examined the dog and recommended an initial workup that
yielded a potential diagnosis of pancreatitis and disc disease. He recommended
referral to a specialist in Phoenix or Tucson but was declined, so he did the best
he could and ordered some additional testing. He again recommended transfer to a
24-hour facility but was declined. He also spoke with the complainant's daughter
(a veterinary technician) and suggested an ACTH test for Addison's based on the dog's
history. According to Ishak the dog began to improve and was released in good shape,
being alert, bright and responsive.
The Investigative Committee came down rather hard on Ishak, perhaps because he'd been
in the system before and was already considered a known bad dude. They felt the ACTH
test was unnecessary and done only to make money, and they also felt that the pain
management Ishak used was grossly inadequate. They also pointed out that the records
say the dog was ambulatory, but the complainant stated the dog was too drugged to move.
It's rare that an Investigative Committee would believe a complainant over a vet's own
medical records, but it appears they did in this case. I'm not sure if it's because the
daughter was a veterinary technician, if they simply had their mind made up about Ishak
because of past history, or what's exactly going on here.
The criticism of running an ACTH test also seems odd. Addison's
is a difficult disease to diagnose and often masquerades as a variety of other diseases
in terms of symptoms. The atypical form is anecdotally almost impossible for the typical
vet out there to catch. So,
if we're to believe that Ishak is a barely-competent veterinarian already on a watch
list and trying to refer the case out anyway, maybe he was just being cautious instead
of predatory. Also recall that it was the complainant's veterinary technician daughter
who approved that one, so maybe it didn't seem so crazy if you were there?
A.R.S. § 32-2232(22) Medical Incompetence in the practice of veterinary medicine for performing. diagnostics without medical justification indicating that Respondent lacked sufficient knowledge; inappropriate use of hydromorphone for pain control where the method of administration left large windows of pain present; and pain medication was not dispensed at discharge in or around August 21, 2017.
A.R.S. § 32-2232(18) for Violating the Board’s Order in Case Nos. 15-77 and 15-103 by extracting teeth and/or performing surgery during two anesthetic procedures involving a dog and a cat on December 18, 2017, and December 29, 2017, respectively, where the Board’s Order restricted Respondent from performing any and all surgeries indefinitely including soft tissue, orthopedic, and oral surgeries, including dental extractions.
A.R.S. § 32-2232(12) as it relates to A.A.C. R3-11-501(1) for failure to provide professionally acceptable procedures for not recognizing the dog's paresis on discharge on December 21, 2017, and again on December 22, 2017, when dropped off for euthanasia where medical records stated dog was ambulatory
A.R.S. § 32-2232(12) as it relates to A.A.C. R3-11-501(8) for failing to provide copies of medical records within 10 days of the pet owners request
A.R.S. § 32-2232(21) as it relatesto A.A.C. R3-11-502(F) for failure to obtain signed authorization from the pet owner before euthanasia was performed
A.R.S, § 32-2232 (11} Gross incompetence; A.R.S. § 32-2232 (12) as it relates to R3-11-501 (3);
A.R.S. § 32-2232 (22) Medical incompetence in the practice of veterinary medicine; and administrative violation of A.R.S. §°32-2233 (B) (3).
A.R.S. § 32-2232 (11) Malpractice, gross negligence and gross incompetence
A.R.S. § 32-2232 (22) Medical incompetence in the practice of veterinary medicine.
Penalties:
Respondent is prohibited from performing any veterinary services with the exception of the following: Euthanasia procedures that are not based upon his diagnosis but rather on a diagnosis made by another veterinarian or at an owner's request;
Respondent is prohibited from performing any veterinary services with the exception of the following: Pre-vaccination examinations; vaccinations; blood draws related to heartworm, FIV/FeLV tests and other Snap tests that are performed in-house; microchipping; nail -trims; anal gland expressions; and providing/dispensing heartworm preventive care if appropriate testing had occurred and/or medical records from another provider indicate the medication is appropriate.
Respondent is prohibited from performing any veterinary services with the exception of the following: Write prescriptions and/or dispense heart worm prevention and flea and tick control medications and may send out fecal exam tests fo external labs, with the understanding that the owner must be instructed to follow up with their regular veterinarian in connection with any abnormal findings or results.
Respondent must refer clients to another licensed veterinarian if resulis from anytests are posilive/abnormal.
These practice restrictions shall remain in place for a minimum of ten (10) years. Respondent may petition the Board for modification annually.
Respondent is prohibited from performing any veterinary services beyond those authorized under this Consent Agreement.
A.R.S. § 32-2232(22) Medical Incompetence in the practice of veterinary medicine for performing. diagnostics without medical justification indicating that Respondent lacked sufficient knowledge; inappropriate use of hydromorphone for pain control where the method of administration left large windows of pain present; and pain medication was not dispensed at discharge in or around August 21, 2017.
A.R.S. § 32-2232(18) for Violating the Board’s Order in Case Nos. 15-77 and 15-103 by extracting teeth and/or performing surgery during two anesthetic procedures involving a dog and a cat on December 18, 2017, and December 29, 2017, respectively, where the Board’s Order restricted Respondent from performing any and all surgeries indefinitely including soft tissue, orthopedic, and oral surgeries, including dental extractions.
A.R.S. § 32-2232(12) as it relates to A.A.C. R3-11-501(1) for failure to provide professionally acceptable procedures for not recognizing the dog's paresis on discharge on December 21, 2017, and again on December 22, 2017, when dropped off for euthanasia where medical records stated dog was ambulatory
A.R.S. § 32-2232(12) as it relates to A.A.C. R3-11-501(8) for failing to provide copies of medical records within 10 days of the pet owners request
A.R.S. § 32-2232(21) as it relatesto A.A.C. R3-11-502(F) for failure to obtain signed authorization from the pet owner before euthanasia was performed
A.R.S, § 32-2232 (11} Gross incompetence; A.R.S. § 32-2232 (12) as it relates to R3-11-501 (3);
A.R.S. § 32-2232 (22) Medical incompetence in the practice of veterinary medicine; and administrative violation of A.R.S. §°32-2233 (B) (3).
A.R.S. § 32-2232 (11) Malpractice, gross negligence and gross incompetence
A.R.S. § 32-2232 (22) Medical incompetence in the practice of veterinary medicine.
Penalties:
Respondent is prohibited from performing any veterinary services with the exception of the following: Euthanasia procedures that are not based upon his diagnosis but rather on a diagnosis made by another veterinarian or at an owner's request;
Respondent is prohibited from performing any veterinary services with the exception of the following: Pre-vaccination examinations; vaccinations; blood draws related to heartworm, FIV/FeLV tests and other Snap tests that are performed in-house; microchipping; nail -trims; anal gland expressions; and providing/dispensing heartworm preventive care if appropriate testing had occurred and/or medical records from another provider indicate the medication is appropriate.
Respondent is prohibited from performing any veterinary services with the exception of the following: Write prescriptions and/or dispense heart worm prevention and flea and tick control medications and may send out fecal exam tests fo external labs, with the understanding that the owner must be instructed to follow up with their regular veterinarian in connection with any abnormal findings or results.
Respondent must refer clients to another licensed veterinarian if resulis from anytests are posilive/abnormal.
These practice restrictions shall remain in place for a minimum of ten (10) years. Respondent may petition the Board for modification annually.
Respondent is prohibited from performing any veterinary services beyond those authorized under this Consent Agreement.
A.R.S. § 32-2232(22) Medical Incompetence in the practice of veterinary medicine for performing. diagnostics without medical justification indicating that Respondent lacked sufficient knowledge; inappropriate use of hydromorphone for pain control where the method of administration left large windows of pain present; and pain medication was not dispensed at discharge in or around August 21, 2017.
A.R.S. § 32-2232(18) for Violating the Board’s Order in Case Nos. 15-77 and 15-103 by extracting teeth and/or performing surgery during two anesthetic procedures involving a dog and a cat on December 18, 2017, and December 29, 2017, respectively, where the Board’s Order restricted Respondent from performing any and all surgeries indefinitely including soft tissue, orthopedic, and oral surgeries, including dental extractions.
A.R.S. § 32-2232(12) as it relates to A.A.C. R3-11-501(1) for failure to provide professionally acceptable procedures for not recognizing the dog's paresis on discharge on December 21, 2017, and again on December 22, 2017, when dropped off for euthanasia where medical records stated dog was ambulatory
A.R.S. § 32-2232(12) as it relates to A.A.C. R3-11-501(8) for failing to provide copies of medical records within 10 days of the pet owners request
A.R.S. § 32-2232(21) as it relatesto A.A.C. R3-11-502(F) for failure to obtain signed authorization from the pet owner before euthanasia was performed
A.R.S, § 32-2232 (11} Gross incompetence; A.R.S. § 32-2232 (12) as it relates to R3-11-501 (3);
A.R.S. § 32-2232 (22) Medical incompetence in the practice of veterinary medicine; and administrative violation of A.R.S. §°32-2233 (B) (3).
A.R.S. § 32-2232 (11) Malpractice, gross negligence and gross incompetence
A.R.S. § 32-2232 (22) Medical incompetence in the practice of veterinary medicine.
Penalties:
Respondent is prohibited from performing any veterinary services with the exception of the following: Euthanasia procedures that are not based upon his diagnosis but rather on a diagnosis made by another veterinarian or at an owner's request;
Respondent is prohibited from performing any veterinary services with the exception of the following: Pre-vaccination examinations; vaccinations; blood draws related to heartworm, FIV/FeLV tests and other Snap tests that are performed in-house; microchipping; nail -trims; anal gland expressions; and providing/dispensing heartworm preventive care if appropriate testing had occurred and/or medical records from another provider indicate the medication is appropriate.
Respondent is prohibited from performing any veterinary services with the exception of the following: Write prescriptions and/or dispense heart worm prevention and flea and tick control medications and may send out fecal exam tests fo external labs, with the understanding that the owner must be instructed to follow up with their regular veterinarian in connection with any abnormal findings or results.
Respondent must refer clients to another licensed veterinarian if resulis from anytests are posilive/abnormal.
These practice restrictions shall remain in place for a minimum of ten (10) years. Respondent may petition the Board for modification annually.
Respondent is prohibited from performing any veterinary services beyond those authorized under this Consent Agreement.
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.