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Ruben Aleman, M.D. v. Texas Medical Board

Texas Supreme Court
573 S.W. 3d 796 (2019)
ELI5:

Sections

Rule of Law:

Under the Texas Medical Practice Act, the Medical Board may only discipline a physician for violating a state law if that violation is connected to the practice of medicine in a manner that is likely to deceive or defraud the public.


Facts:

  • J.S., a patient of Dr. Ruben Aleman, died on July 16, 2011.
  • At the time of the patient's death, Dr. Aleman was not registered with the state's electronic death registration system (TEDR).
  • Because Dr. Aleman was unregistered, the funeral director removed the death certificate from the electronic system ('dropped to paper') and sent a physical copy to Dr. Aleman.
  • Dr. Aleman hand-signed and certified the paper death certificate on July 29, 2011.
  • The local registrar officially certified the paper certificate on August 8, 2011.
  • Dr. Aleman subsequently registered for the electronic system on August 19, 2011.
  • Dr. Aleman attempted to certify the record electronically after registering, but the system prevented him from doing so because the certificate was already official.

Procedural Posture:

  • The Texas Medical Board filed a formal complaint with the State Office of Administrative Hearings (SOAH).
  • The Administrative Law Judge (ALJ) denied Dr. Aleman's motion to dismiss and plea to the jurisdiction.
  • The ALJ issued a Proposal for Decision finding Dr. Aleman violated the Health and Safety Code and the Medical Practice Act.
  • The Texas Medical Board adopted the ALJ's findings and issued an order imposing sanctions.
  • Dr. Aleman filed a petition for judicial review in the state trial court.
  • The trial court affirmed the Board's order.
  • Dr. Aleman appealed to the Court of Appeals for the Third District of Texas.
  • The Court of Appeals affirmed the trial court's judgment.
  • Dr. Aleman filed a petition for review with the Supreme Court of Texas.

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Issue:

Does the Texas Medical Practice Act authorize the Medical Board to discipline a physician for signing a death certificate manually rather than electronically, under the statutory provision prohibiting acts 'connected with the physician's practice of medicine'?


Opinions:

Majority - Justice Lehrmann

No, the Medical Practice Act does not authorize disciplinary action for this conduct because it is not likely to deceive or defraud the public. The Court reasoned that while Dr. Aleman violated the Health and Safety Code by failing to sign electronically, the Medical Practice Act only permits discipline for state law violations if they fall under the specific category of 'unprofessional or dishonorable conduct likely to deceive or defraud the public.' The Court analyzed the statutory text of Section 164.053(a), noting that it lists specific examples of conduct (like drug diversion or false billing) that involve deception or risk to public welfare. The Court concluded that signing a death certificate manually instead of electronically contains the same information and legal effect, and therefore lacks the necessary element of deception or fraud required for the Board to assert jurisdiction. The Court also affirmed that the initial complaint was valid despite lacking personal knowledge by the signer, and affirmed that Dr. Aleman was not entitled to attorney's fees because the State Office of Administrative Hearings lacks the statutory authority to award them.



Analysis:

This decision significantly checks the regulatory power of the Texas Medical Board by enforcing a strict statutory interpretation of their disciplinary authority. It clarifies that the Board cannot sanction physicians for mere administrative or technical violations of state law unless there is a nexus to the specific statutory category of 'deception or fraud' defined by the Legislature. This prevents the Board from using the 'connected with the practice of medicine' catch-all provision to punish benign administrative errors. Additionally, the case clarifies that administrative law judges in this context do not have the inherent power to award attorney's fees as sanctions unless expressly granted by statute.

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