Professional discipline action; General duty negligence under the Public Health Code; MCL 333.16221(a); In re Sangster; Standard of care; Failure to visualize/document pressure ulcers; Negligent supervision of a physician assistant (PA); MCL 333.17047, MCL 333.17049(2); Competent, material, & substantial evidence; Procedural due process; Adequate notice of charges; Hardges v Department of Soc Servs; History & physical (H&P); Board of Medicine’s Disciplinary Subcommittee (DSC); Administrative law judge (ALJ)

Holding that competent, material, and substantial evidence showed respondent-physician failed to discover and document a patient’s pressure injuries and negligently supervised a PA, the court affirmed the sanctions imposed by the DSC. Respondent, serving as medical director at a skilled nursing facility, examined an elderly patient (AH) admitted after hospitalization for sepsis. Nursing records at admission documented coccyx and left-heel pressure wounds, but respondent’s H&P stated, “No rashes or ulcers,” and a PA’s progress notes misidentified a heel wound and lacked detailed descriptions. After a hearing, the ALJ found violations of general duty under MCL 333.16221(a) for failing to visualize/document the wounds and for negligent supervision of the PA, but no “incompetence,” and recommended sanctions. The DSC adopted the proposal. On appeal, the court rejected respondent’s argument that the evidence did not support a standard-of-care violation, concluding that the testimony of Dr. K “and the documentary evidence clearly constituted ‘competent, material, and substantial evidence’ supporting the conclusion that respondent violated the standard of care.” It likewise rejected the challenge to negligent supervision, finding the progress notes, along with Dr. K’s “testimony and report, constituted competent, material, and substantial evidence supporting the ALJ’s conclusion that respondent failed to properly supervise the PA.” Addressing due process, the court rejected the claim of inadequate notice, explaining that “any reasonable person would know that petitioner was advancing a claim of negligent supervision in its complaint,” and noting the ALJ correctly concluded negligent supervision was properly raised.