| Complaint: | Complaint 21-48 |
|---|---|
| Respondent: | Carmen McGee Yeamans |
| Premises: | Animal Medical and Surgical Center |
| Related: | 21-45, 21-46, 21-47 |
Disclosure: This complaint is one of four reported by the website founder and directly led to the creation of this site.
This complaint is one of several relating to a particular set of events (see related cases). In this particular complaint Yeamans is mentioned as the dog's neurologist at AMSC.
The complainants tell us that their dog had initially been seen by Cuddon, a neurologist at AMSC. The dog had suffered a back injury and been given steroids by a neurologist at a different clinic (Knowles at Veterinary Neurological Center) and subsequently had a stroke that led to seizures. Cuddon was trying to control the seizures but was only available, on average, two out of every four weeks; the other two weeks he was in Costa Rica. He apparently left AMSC and went back to Australia, but AMSC allegedly neglected to inform the complainants of that; they instead kept seeing a new neurologist, Yeamans, expecting Cuddon to return and assist with the dog's progress. The complainants say that Yeamans was not an adequate replacement.
They have a variety of concerns with Yeamans. They note that while they have experience with teaching hospitals, Yeamans deferred nearly all communication to Sarah Sterling, a resident at AMSC; indeed they state that Yeamans only spoke with them twice about the dog's health in detail, once to recommend euthanasia at the end of his life. They state that Yeamans, Sterling, and staff were broadly unavailable and could not be reached for days at the start of the dog's final health problem, when zonisamide dosages were being adjusted on an ad-hoc basis by 1st Pet Mesa; they received no reply whatsoever and only Schnier (21-47) was able to get a response from Yeamans. They also note that during one hospitalization at AMSC, an emergency veterinarian, Hennigan, offered to discharge the dog with a set of small diazepam syringers. They elected to wait for Yeamans to perform a neurology consult and she later sent the dog home with a prescription for human diazepam rectal syringes costing hundreds of dollars per item; the dog apparently seized again while they were waiting for the prescription to be filled (!). It appears that Yeamans allegedly also either disagreed with much of Cuddon's recommendations or took credit for other recommendations that Cuddon and the complainants had come up with themselves. They claim that Cuddon was attempting to wean the dog off of many of his numerous medications but Yeamans seemed to show little interest in the dog's quality of life overall.
They also claimed that Yeamans did a poor job of managing the side effects of the dog's medications, claiming that the dog could barely stand up on the prescribed dosages; unlike Cuddon, Yeamans seemed to not take the matter seriously, and Sterling, the resident, apparently suggested the dog may just be tired or blamed it on a brain abnormality (this would not seem to fit the timeline provided). On one occasion they say Yeamans was shocked that the dog could walk as well as he was, but the complainants state that it was also the only time she had seen the dog without massive doses of additional medications to prevent cluster seizures. They also have concerns that Yeamans was unaware of potential interactions between zonisamide and phenobarbital, noting that there are pharmacological mechanisms that could make zonisamide be metabolized more slowly as the dog's phenobarbital was reduced; they say they mntioned this to AMSC staff and were ignored. They note that their only assistance in helping the dog eventually came from their primary veterinarian, Jill Patt, at Little Critters Veterinary Hospital; they lost all faith in AMSC at scheduled a visit with a neurologist at Midwestern University but the dog died before the appointment. They also claim that Yeamans laughed at them when they asked if she could perform an MRI to assess the dog's neurological condition prior to euthanasia (something requested by the complainants and also mentioned by Schnier in his response to 21-47).
Yeamans' response states that the dog had been under her practice's care for "progressive seizure disorder and meningoencephalitis of unknown origin" (the complainants were never told there was any suspicion of meningoencephalitis, and neurologists Knowles and Cuddon both concluded the seizures were the result of a stroke based on MRI imaging). She also says that Meredith at 1st Pet reached out to her as the complainants "did not understand the severity" of the dog's condition. She does concede that zonisamide could have triggered IMHA but it's a rare complication and not outside the standard of care. Lastly, she says that she doesn't dispense injectable diazepam herself as it's a bad idea and makes her very uncomfortable because it's a controlled substance (contrary to Hennigan at the same facility who was apparently willing to do so without a problem). She also says the size of the rectal syringe for humans that she prescribed is smaller than the dog's normal feces (not mentioning that this would have to be given in the throes of a full-body seizure). She also says that she did not in fact laugh at the complainants when an MRI was suggested; she only thought the dog was a poor candidate for transfer and had concerns that the dog should be euthanized. She ends by mentioning the dog's various health problems that made her task very difficult. Apparently contradicting herself, she mentions the dog's "previous diagnosis with cerebral infarct causing secondary seizures" yet at the beginning of her response said the dog had "progressive seizure disorder and meningoencephalitis of unknown origin."
The Investigative Committee described the possible side-effect of zonisamide as obscure, stating that no veterinarian would knowingly prescribe a drug to make a dog sick (the response for 21-47 is quite enlightening as this dog had been given a page and a half of medications by various veterinarians; he was practically a living chemistry set). They also said that multiple qualified veterinarians had been seeing the dog and it was not Yeamans' responsibility to monitor the dog when under the care of other veterinarians (this appears to ignore the concern that most of the dog's problems stemmed from the drugs prescribed by her clinic for neurological reasons). They also said the size of the rectal syringe was appropriate and the complainants only felt it a concern because the dog "vocalized"; they cite Yeamans saying the needle was smaller than the dog's poop, not discussing the effects of the dog thrashing around in a seizure while administering it.
It should be noted during all this that Yeamans wasn't even a boarded neurologist, though she did have some specialist neurology training in the UK. Years later it appears that she has still not become a boarded veterinary neurologist either in the US or in Europe. As of this writing (2023) she apparently works at a BluePearl clinic in Overland Park, Kansas, where she's putting brain implants in pets to attempt to control their seizures. A quick check of Google reviews for her new employer seems to show at least a few one-star reviews for their neurological services.
| Source: | April 4, 2021 PM Investigative Committee Meeting |
|---|---|
| People: | |
| Carmen McGee Yeamans | Respondent |
| David Stoll | Respondent Attorney |
| Roll Call: | |
| Adam Almaraz | Aye |
| Amrit Rai | Aye |
| Brian Sidaway | Aye |
| Cameron Dow | Aye |
| Result: | Passed |
| Source: | May 5, 2021 Board Meeting |
|---|---|
| People: | |
| David Stoll | Respondent Attorney |
| Proposed By: | Robyn Jaynes |
| Seconded By: | Jessica Creager |
| Roll Call: | |
| Darren Wright | Aye |
| J Greg Byrne | Aye |
| Jane Soloman | Aye |
| Jessica Creager | Aye |
| Jim Loughead | Aye |
| Nikki Frost | Aye |
| Robyn Jaynes | Aye |
| Sarah Heinrich | Absent |
| 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.