| Complaint: | Complaint 18-49 |
|---|---|
| Respondent: | Jeffrey Steurer |
| Premises: | Southwest Veterinary Surgical Service |
| Related: | 18-50 |
The complainants state that their dog had a knee injury that had previously been treated elsewhere by Lirtzman. Radiographs existed of the knee from prior to the surgery two years earlier as well as from just a few months ago. The complainants- state that the x-rays show the changes in the knee over the years. Steurer examined the dog and diagnosed a complete rather than partial tear and recommended surgery. The complainants were told that x-rays would be done prior to anesthesia and surgery. The complainants say they Steurer called them in surgery to tell them that he suspected valley fever or neoplasia rather than the original diagnosis and a bone biopsy was performed instead. It turns out a valley fever test completed later was also positive. The complainants were concerned about the misdiagnosis and resulting impact of surgery on the dog as well as upward revisions to estimates on the day of the surgery. They state that if Steurer had just read the x-rays and done a valley fever test all of this could have been avoided. (It's particularly interesting as a search for the complainants seem to suggest that one is an ophthalmologist and the other is an optician, so it's not as though they would be totally ignorant.)
Steurer's response details the dog's medical history and his exam prior to recommending TPLO surgery. He states that based on this exam the primary differential diagnosis was a complete tear of the cranial cruciate ligament that could be corrected with surgery. The preoperative bloodwork apparently has some anomalies but none that Steurer considered significant at the time. He also says that the dog was uncooperative and had to be anesthetized to take preoperative x-rays; he notes a lesion on these radiographs and suspected either valley fever or neoplasia. He also sent the x-rays off to IDEXX for a review and called Dixon, the practice owner, who also said to cancel the TPLO operation. (I suspect there's more to Steurer's response, but I don't think we got it in the records.)
The Investigative Committee worked their typical magic on this one. They pointed out that there had been changes on the radiographs. They also said that it's up to the veterinarian whether or not anesthesia was required for the x-rays and that the dog was going to have surgery anyway. They also said that a bone biopsy would have been required in any event as valley fever tests for bone lesions are often suspect and only a biopsy could rule out cancer. They do ignore that the valley fever titer in this case did come back positive so the biopsy wouldn't have been necessary in this particular situation, and they also do not seem to discuss the possibility that the dog could have been presumptively treated for valley fever as opposed to neoplasia.
For another interesting case where a human doctor and a veterinary doctor collide at Southwest Veterinary Surgical Service, check out 21-16. In that case, despite generous discounts, they took their dog elsewhere for the second run.
| Source: | April 4, 2018 AM Investigative Committee Meeting |
|---|---|
| People: | |
| David Stoll | Respondent Attorney |
| Jeffrey Steurer | Respondent |
| Roll Call: | |
| Christina Tran | Aye |
| Mary Williams | Aye |
| Robert Kritsberg | Aye |
| Ryan Ainsworth | Aye |
| Result: | Passed |
| Source: | May 5, 2018 Board Meeting |
|---|---|
| People: | |
| David Stoll | Respondent Attorney |
| Proposed By: | Christina Bertch-Mumaw |
| Seconded By: | Jessica Creager |
| Roll Call: | |
| Christina Bertch-Mumaw | Aye |
| Darren Wright | Aye |
| J Greg Byrne | Aye |
| Jessica Creager | Aye |
| Jim Loughead | Aye |
| Julie Young | Aye |
| Nikki Frost | Aye |
| Robyn Jaynes | Aye |
| Sarah Heinrich | Aye |
| Result: | Passed |
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.