| Complaint: | Complaint 22-55 |
|---|---|
| Respondent: | Karla Lombana |
| Premises: | University Pet Clinic |
The complainant provides a timeline leading to the death of her dog, starting by noting that it's essentially impossible to get a veterinary appointment in Tucson during the coronavirus. As she couldn't get an appointment with her regular vet, she went to University Pet Clinic and saw Lombana when her dog wasn't eating; the complainant had another sick dog in the family at the same time, and as her dog had previous issues with stomach problems, she wasn't overly concerned. Lombana recommended fluids and medicines to help with an upset stomach.
The dog started to do somewhat better, but three days later the complainant noticed that the dog had defecated and had string in the stool; she relates that the string continued inside of him post-defecation so she trimmed it with scissors to show the vet. She examined the string in detail and discovered it was embroidery floss; she notes that a plastic bobbin with embroidery floss had gone missing in the house a month prior, and the assumption was it had slid down a couch or similar. The complainant goes on to note that she watches many veterinary TV shows like "The Incredible Dr. Pol" so she knew this could easily be fatal; she called University Pet Clinic who told her that it was just string and to come in next week.
At the appointment the following Monday, the complainant states she explained everything to Lombana, even showing her a similar plastic bobbin with thread. She stated that the dog was very important to both her family and to another dog as a support dog; she also cites the aforementioned Dr. Pol's TV show to indicate this wouldn't end well for her dog. The dog had a painful abdomen but x-rays showed nothing, so an ultrasound was scheduled; the complainant grew confused about x-rays and ultrasounds as plastic and string likely wouldn't show up on them. She subsequently flew out of town on vacation and left the dog in the care of one of her adult daughters.
Lombana was able to get the dog in for an ultrasound early. One of the complainant's daughters was available and dropped the dog off while the complainant joined in via speakerphone. There they talked with Holly Merker, who informed them that their dog showed evidence of kidney disease. Tthey asked about the string, which Merker knew nothing about; Merker said she was just filling in for the ultrasound and hadn't seen any string. They were told they would have to wait until the next week for the results to determine next steps. Panicked, the complainant says she started calling other vet clinics but none would take her dog for three days.
They were finally offered an appointment at University Pet Clinic for more fluids and nausea medications as the dog continued to decline. At that time Adams, another vet, was present and saw the dog was in big trouble; she stated that the only choice was to operate. She did so but the dog was sent to VSCOT for overnight evaluation. At VSCOT she was told the dog would take several weeks to recover and would be in pain, so she chose euthanasia; she states that she doesn't believe in letting animals suffer horribly, that they're not people and don't understand what's going on.
Follow-up communication with University Pet Clinic was difficult at best. The complainant was unhappy with the care provided and notes they received a welcome card with a discount coupon after the dog had already died. She states the clinic never responded to a letter with her concerns, and a conversation with Adams proved unfruitful. She states that Adams was only part of a clean-up crew for Lombana's mistake, also noting that she followed up with the sonographer and found concerns with the information provided to her. She was apparently offered a settlement by the insurance company contingent on not reporting Lombana to the veterinary board, which she declined.
Lombana's response details that she was a relief veterinarian at University Pet Clinic when the dog first came in. She states that she specifically asked about the possibility of foreign body ingestion, yet was told by the complainant that there could only have been table scraps if that. She says that when she learned the dog wasn't improving she had the dog come back to the clinic, at which point the complainant admitted the dog had eaten some string. She also says the complainant told her the dog had passed the string and didn't mention cutting a portion of it from the anus. She ordered x-rays that were sent out and found no obstructions; she notes that it could have been malpractice for her to operate when a board-certified radiologist found no problems. She also notes that she was able to have an outside ultrasonographer come in quicker than they could arrange an ultrasound at a specialty facility in the area. At that point she was no longer on relief duty and cannot speak to the remainder of the events, but she believes her handling of the case was appropriate.
Lombana also provides her own timeline of events. In many respects it matches that of the complainant, but there are notable differences. She challenges the notion that the complainant discovered the string and called to schedule an appointment, saying she's confident they would have had her come in sooner if she had. She also contests the notion that the complainant described cutting the string from the dog's anus; she states that the dog was a poor candidate for surgery after a week of vomiting and not eating. She also states that she pointed out that the dog could have passed most of the string in the previous three weeks and that the current symptoms are residual; operating in this case would be a very bad idea. She also states that she did mention to Mrcer and the mobile ultrasonographer, Darcie Argentina, that the dog had eaten at least some string. She also challenges the notion that no ER would have seen the dog given his critical condition.
The Investigative Committee said that surgery should have been performed earlier, but that Lombana did everything correctly; neither the x-rays nor the ultrasound found anything (per complainant the consulting radiologist would have allegedly ordered more testing had she known about the string). They point out that x-rays showed no evidence of obstruction until the day Adams actually performed the surgery, so there's nothing to blame Lombana for in the first place. They state that prior to that, there was no evidence to support exploratory surgery. The Committee voted to dismiss but the board found a violation, noting that Lombana could have performed a barium study rather than waiting; Lombana was found guilty of gross negligence and required to take a three-hour continuing education class in gastrointestinal foreign bodies.
| Source: | April 4, 2022 AM Investigative Committee Meeting |
|---|---|
| People: | |
| Karla Lombana | Respondent |
| David Stoll | Respondent Attorney |
| Roll Call: | |
| Robert Kritsberg | Aye |
| Christina Tran | Aye |
| Carolyn Ratajack | Aye |
| Jarrod Butler | Aye |
| Steven Seiler | Aye |
| Result: | Passed |
| Source: | May 5, 2022 Board Meeting |
|---|---|
| People: | |
| David Stoll | Respondent Attorney |
| Proposed By: | Craig Nausley |
| Seconded By: | Robyn Jaynes |
| Roll Call: | |
| Craig Nausley | Aye |
| Darren Wright | Absent |
| J Greg Byrne | Aye |
| Jane Soloman | Aye |
| Jessica Creager | Aye |
| Jim Loughead | Aye |
| Melissa Thompson | Aye |
| Nikki Frost | Aye |
| Robyn Jaynes | Aye |
| Result: | Passed |
| Source: | June 6, 2022 Board Meeting |
|---|---|
| People: | |
| Karla Lombana | Respondent |
| David Stoll | Respondent Attorney |
| Proposed By: | Craig Nausley |
| Seconded By: | Jane Soloman |
| Roll Call: | |
| Craig Nausley | Aye |
| Darren Wright | Nay |
| J Greg Byrne | Absent |
| Jane Soloman | Aye |
| Jessica Creager | Nay |
| Jim Loughead | Absent |
| Melissa Thompson | Aye |
| Nikki Frost | Nay |
| Robyn Jaynes | Aye |
| Violations: | |
| A.R.S. § 322232 (11) Gross negligence; failure to recognize the need for surgical intervention which resulted in a delay that led to major complications in the patient's care. | |
| Result: | Passed |
| Source: | July 7, 2022 Board Meeting |
|---|---|
| Proposed By: | Craig Nausley |
| Seconded By: | Jane Soloman |
| Roll Call: | |
| Craig Nausley | Aye |
| Darren Wright | Absent |
| J Greg Byrne | Absent |
| Jane Soloman | Aye |
| Jessica Creager | Aye |
| Jim Loughead | Aye |
| Melissa Thompson | Aye |
| Nikki Frost | Aye |
| Robyn Jaynes | Absent |
| Result: | Passed |
| Source: | Order 22055 (August 8, 2022) |
|---|---|
| Violations: | |
| A.R.S. § 32-2232(11) Gross negligence: failure to recognize the need for surgical intervention which resulted in a delay that led to major complications in the patient's care. | |
| Penalties: | |
| Probation (1 year) | |
| Continuing education (3 hours in gastrointestinal foreign bodies) | |
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.