A dog dies horribly from a botched Caesarean and then her puppy's body is handed over at Circle K

Complaint: Complaint 20-45
Respondent: Monika Knoblich
Premises: All Creatures Veterinary Services

The complainant took her dog in for a C-section with Knoblich. She tells us that the dog had no health problems prior to the surgery. She says that no blood work was done prior to the procedure and has concerns about the use of Gentocin on the dog. When she went to pick up the dog it turns out that one of the puppies was already dead inside and another was struggling, yet she says Knoblich did not mention the other puppy was also quite likely to die. Her dog started to get quite sick. At a follow-up visit she says Knoblich finally did some blood work and discovered the dog was in acute kidney failure. At this point she took the dog to Southern Arizona Veterinary Specialty and Emergency Center; they concluded after a fashion that the dog either needed to go to California for $10,000 in dialysis or be euthanized. The complainant did not believe the dog would survive the trip and couldn't afford it, so the dog was euthanized. She said that she wanted the sick puppy to survive to carry on her mother's spirit but learned from Jessica (a vet tech) that the puppy had died as well. She says she received the puppy's body in a box during a rendezvous at a local Circle K. She mentions that she wished her own life would end after all this, then also says that the death of the dog ended her breeding business. She asks how Knoblich would feel if someone destroyed her life and her business like that. She would also like a new puppy at Knoblich's expense.

Knoblich's response states that she initially informed the complainant that she should take the dog to another facility for a C-section. She also says that the complainant waited to think about it even though this could have a negative effect. She also says she warned the complainant that her clinic did not have 24-hour staff so the dog would have to go home for monitoring. The C-section was performed and the already-dead puppy was put in the freezer for cremation. She says the surviving mother and dog were sent home with discharge instructions. The mother came back with problems and there was allegedly discussion of going to an emergency service; the puppy came back for a tail docking and dewclaw removal but wasn't eating well. The next day the mother came back in very bad shape. She says she was in touch with a veterinarian at the referral center who had questions about the case; it appears she made incorrect notations in her medical records regarding the Gentocin. Knoblich says that she owes the complainant nothing as she did not fall below the standard of care, but she does admit that she never provided her with the medical records she requested. She also says that Jessica (the tech) is actually very compassionate and the dog was not returned in a cardboard box; she says the dead puppy was returned on the same bed it came in on.

The Investigative Committee had serious concerns regarding the use of the Gentocin. They stated it was not the standard of care, and they also said that the large number of medical records issues meant that there could be bigger problems; they also noted some other medical concerns regarding the case. They also found room to blame the complainant for dilly-dallying about the C-section, as they felt the dead puppies were more likely the result of waiting to perform the C-section. They found several violations ranging from a failure to use current professional and scientific knowledge to a failure to release the dog's medical records. The Board sentenced Knoblich to eight hours of continuing education, a $1000 civil penalty, and required her to reimburse the complainant for $1211.50.

Motions

Investigative Motion: Find violation

Source: January 1, 2020 PM Investigative Committee Meeting
People:
Monika Knoblich Respondent
Roll Call:
Adam Almaraz Aye
Amrit Rai Aye
Brian Sidaway Aye
Cameron Dow Aye
William Hamilton Aye
Violations:
ARS 32-2232 (12) as it relates to AAC R3-11-501 (1) failure to use current professional andscientific knowledge in the administration of gentamicin, and its route of administration,in a patient that had significant risk factors that could potentially lead to toxicity.
ARS 32-2232 (21) as it relates to AAC R3-11-502 (L) (7) for failure to document the dispensing of Clavamox and meloxicam on August 1, 2019 and Entyce on August 5, 201 9; and (7) (b) for failure to document the amount of SQ fluid administered to the dog on August 2, 2019.
ARS 32-2232 (21) as it relates to AAC R3-11-502 (L) (2) for failure weigh the puppy on August 5, 2019 and document it in the medical record; and (4) for failure to perform an exam on puppy on August 5, 2019 and document it in the medical record.
ARS 32-2232 (18) as it relates to AAC R3-11-501 (8) for failure to provide a copy of the dog's medical record to the pet owner in a timely manner.
Result: Passed

Board Motion: Offer consent agreement with modified conclusions of law

Source: February 2, 2020 Board Meeting
People:
David Stoll Respondent Attorney
Proposed By: Robyn Jaynes
Seconded By: Sarah Heinrich
Roll Call:
Darren Wright Aye
J Greg Byrne Absent
Jane Soloman Aye
Jessica Creager Aye
Jim Loughead Aye
Nikki Frost Absent
Robyn Jaynes Aye
Sarah Heinrich Aye
Violations:
ARS 32-2232 (11) Gross negligence
Result: Passed

Board Motion: Offer consent agreement

Source: February 2, 2020 Board Meeting
People:
David Stoll Respondent Attorney
Proposed By: Robyn Jaynes
Seconded By: Sarah Heinrich
Roll Call:
Darren Wright Aye
J Greg Byrne Absent
Jane Soloman Aye
Jessica Creager Aye
Jim Loughead Aye
Nikki Frost Absent
Robyn Jaynes Aye
Sarah Heinrich Aye
Result: Passed

Board Motion: Find violation

Source: June 6, 2020 Board Meeting
People:
David Stoll Respondent Attorney
Monika Knoblich Respondent
Proposed By: Robyn Jaynes
Seconded By: Darren Wright
Roll Call:
Darren Wright Aye
J Greg Byrne Absent
Jane Soloman Aye
Jessica Creager Aye
Jim Loughead Nay
Nikki Frost Absent
Robyn Jaynes Aye
Sarah Heinrich Aye
Violations:
ARS 32-2232 (22) Medical incompetence
Result: Passed

Board Motion: Find violation

Source: June 6, 2020 Board Meeting
People:
David Stoll Respondent Attorney
Monika Knoblich Respondent
Proposed By: Robyn Jaynes
Seconded By: Sarah Heinrich
Roll Call:
Darren Wright Aye
J Greg Byrne Absent
Jane Soloman Aye
Jessica Creager Aye
Jim Loughead Aye
Nikki Frost Absent
Robyn Jaynes Aye
Sarah Heinrich Aye
Violations:
ARS 32-2232 (12) Failure to provide a copy of the medical record
ARS 32-2232 (21) Failure to weigh
ARS 32-2232 (21) Failure to perform an exam
Result: Passed

Board Motion: Issue board order

Source: July 7, 2020 Board Meeting
Proposed By: Robyn Jaynes
Seconded By: Sarah Heinrich
Roll Call:
Darren Wright Aye
J Greg Byrne Absent
Jane Soloman Aye
Jessica Creager Aye
Jim Loughead Aye
Nikki Frost Absent
Robyn Jaynes Aye
Sarah Heinrich Aye
Result: Passed

Board Order: Order 20045 MONIKA KNOBLICH, DVM

Source: Order 20045 (July 7, 2020)
Violations:
A.R.S. § 32-2232 (22) Medical incompetence in the practice of veterinary medicine for using the antibiotic, gentamicin, as an abdominal flush as well as the calculation of the dose of gentamicin.
A.R.S. § 32-2232 (12) as it relates to A.A.C. R3-11-501 (8) for failure to provide a copy of the dog's medical record to the pet owner.
A.R.S. § 32-2232 (21) as it relates fo A.A.C. R3-11-502 (L) (2) for failure weigh the puppy on August 5, 2019 and document it in the medical record.
A.R.S. § 32-2232 (21) as it relates to A.A.C. R3-11-502 (L) (4) for failure to perform an exam on puppy on August 5, 2019 and document it in the medical record.
Penalties:
Probation (1 year)
Continuing education (4 hours in medical record keeping)
Continuing education (4 hours in antibiotics)
Civil penalty ($1000)
Reimburse fees ($1211.50)

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.