The New Jersey State Board of Medical Examiners (the "Board") has taken the following actions in April 2009. This information is a summary prepared by the Board Administrative Office staff. Copies of the Orders can be found at www.njmedicalboard.gov under the right-hand pull down menu, "Board Activities," "Monthly Summaries." Requests for certified, true copies should be made in writing directed to William V. Roeder, Executive Director, P.O. Box 183, Trenton, New Jersey 08625.

BLATSTEIN, Marc J., D.P.M.
License #MD001485
Fredericksburg, VA 22408
Ohio College of Podiatric Med, 1983
National Boards

FINAL ORDER OF DISCIPLINE filed April 27, 2009. Dr. Blatstein's New Jersey license to practice medicine was automatically suspended as a result of his license lapsing on October 31, 1993. On or about December 18, 2001, the Virginia Board entered an Order providing for the reprimand of Dr. Blatstein's license together with a monetary penalty of $5,000.00, and the requirement that he complete a Continuing Education course in coding and billing for podiatric services. Thereafter, on or about June 26, 2007, a Judgement in a Criminal Case was entered in connection with Dr. Blatstein's guilty plea to Mail Fraud. Dr. Blatstein was committed to custody for twenty-four months with credit for time served and ordered to pay restitution in the amount of $272,704.05. As a result of Dr. Blatstein's criminal conviction, on or about February 24, 2006, the Virginia Board entered a Consent Order accepting Dr. Blatstin's surrender of license in lieu of further proceedings. The Consent Order stated Dr. Blatstein cannot petition the Virginia Board for reinstatement of his license for at least twelve months from the date of his release from imprisonment. This disciplinary action taken by the Virginia Board provided grounds for the New Jersey Board to take disciplinary actions against Dr. Blatstein's license, in that his license in Virginia had been suspended, and due to his criminal conviction. A Provisional Order of Discipline ("POD") was entered by the New Jersey Board on February 24, 2009, and served upon Dr. Blatstein. The POD was subject to finalization by the Board at 5:00 p.m. on the 30th business day following entry unless Dr. Blatstein requested a modification or dismissal. Dr. Blatstein did not submit a response to the POD. The New Jersey Board ordered Dr. Blatstein's license to practice medicine and surgery in New Jersey suspended until such time as he holds an active, unrestricted license to practice medicine in Virginia. In the event Dr. Blatstein seeks reinstatement of his medical license at any time in the future, he will be required to appear before a Committee of the Board to establish that he is fit to practice medicine, and demonstrate to the Board's satisfaction that he holds an active, unrestricted license in Virginia. EFFECTIVE DATE: April 27, 2009.

CARNEVALE, Norina, M.D.
License #MA022612
20 Lebanon Drive
Brielle, NJ 08730
UMDNJ, 1966
National Boards

FINAL CONSENT ORDER filed April 20, 2009. This matter was opened to the Board upon receipt of information concerning Dr. Carnevale's settlement by Consent Order with the New Jersey Office of the Insurance Fraud Prosecutor("OIFP") of allegations of disability claims fraud. The Board noted that the terms of Dr. Carnevale's Consent Order with OIFP, filed January 22, 2009, found her to have violated N.J.S.A. 17:33A-1, et seq., for which she was fined a $5,000.00 civil penalty. The Board also noted that no criminal charges were brought in this matter. The Board ordered and Dr. Carnevale agreed to be reprimanded for failure to make proper disclosure of a disability condition to an insurance carrier. EFFECTIVE DATE: April 20, 2009.

DARA, Parvez, M.D.
License #MA033292
214 Commons Way, Bldg B
Toms River, NJ 08755-6427
King Edward Medical College, 1973
FLEX Endorsement

ORDER OF TEMPORARY SUSPENSION filed April 7, 2009. On March 27, 2009, the Deputy Attorney General of New Jersey filed with the New Jersey Board an Order to Show Cause and Verified Complaint seeking the temporary suspension of the license of Dr. Dara. The emergent action was in response to allegations that five of Dr. Dara's patients had contracted Hepatitis B, most likely from multiple and significant breaches of infection control standards in his office. Those breaches were rampant in an office where imuno-suppressed patients were receiving invasive procedures involving injections, infusions of chemotherapy and blood tests. These conditions were alleged to exist despite notice to Dr. Dara of various lapses dating back to 2002 in the context of violations issued by the Occupational Safety and Health Administration (OSHA), including a citation for a willful violation of OSHA standards in 2008. The Deputy Attorney General alleged Dr. Dara was responsible for permitting the violations to continue unabated through March 2009, and current office conditions achieved after extraordinary efforts on behalf of Dr. Dara and his team of remediation experts have not altered the fundamental flaws that prompted the relief sought. On April 1, 2009, Dr. Dara through his counsel submitted his Answer denying the allegations of the Verified Complaint and asserting six separate defenses. The investigation leading to the filing of this action began on February 24, 2009, when an employee of a physician acting in accord with the Department of Health and Senior Services (the "DHSS") rules, reported two cases of acute Hepatitis B infection in patients who had received treatment in Dr. Dara's office. On March 16, 2009, DHSS and OCHD (the "Ocean County Health Department") learned OSHA had previously received anonymous employee complaints regarding conditions at Dr. Dara's Toms River Office. Those complaints prompted inspections in 2002, 2007, and 2008, and lead to multiple citations related to many breaches in infection control practices. In seeking emergent relief, the Attorney General alleged Dr. Dara had failed to implement adequate infection control procedures resulting in a risk of harm and actual harm to patients. On April 3, 2009, a Committee of the Board (the "Committee") convened. Dr. Dara moved to dismiss the case asserting that the Complaint lacked verification as the Deputy Attorney General signing the certification did not have first hand knowledge of the facts alleged. The Committee denied the Motion, noting that N.J.S.A 45:1-22 requires only that the application be verified and the requirements were satisfied. The Committee members advised Dr. Dara's counsel that they would like to hear from Dr. Dara. Counsel did not object to the Committee asking Dr. Dara to testify, but asked that any examination by the Deputy Attorney General be limited to lines of questions raised by the Board members present. After a brief Executive Session, the Committee called Dr. Dara noting that he was appearing voluntarily and that his testimony was not being compelled by the Board. After Dr. Dara's testimony before the Committee, the Committee entertained closing arguments and went into Executive Session to deliberate. After fully reviewing the record created, including the testimony of Dr. Montana and Dr. Dara, and considering the arguments of counsel, the Committee found Dr. Dara's continued practice palpably demonstrated a clear and imminent danger to the public health safety and welfare. The finding that Dr. Dara's continued practice constitutes a clear and imminent danger rests upon the Committee's determination that his chronic and recurrent failure to have infection control practices in place in his office over a protracted period of time, despite actual notice of deficiencies, reflects manifestly poor judgment that cannot be remedied by merely altering office practices or having a monitor present. Dr. Dara's counsel argued that just as DHSS has permitted Dr. Dara to reopen his office for non-invasive procedures, so too should the Board. Dr. Dara did not demonstrate that the judgement/neglect that have brought him before the Board has been addressed in any meaningful way. The Board ordered the license of Dr. Dara temporarily suspended effective upon oral announcement at the April 3, 2009 hearing, pending plenary hearing on the allegations of the Verified Complaint. Dr. Dara must comply with the ongoing efforts of DHSS to notify his patients of the need to be tested for the presence of Hepatitis B, Hepatitis C and HIV EFFECTIVE DATE: April 7, 2009.

ORDER CONTINUING TEMPORARY SUSPENSION OF LICENSE filed April 8, 2009. This matter was initially heard before a Committee of the Board on April 3, 2009. The Committee entered an Order temporarily suspending the license of Dr. Dara to practice medicine and surgery in New Jersey pending the completion of plenary proceedings in this matter. The Order of the Committee, together with the record from the hearing was presented to the Board on April 8, 2009, for review so as to afford the full Board an opportunity to determine whether to ratify, reject or modify the action taken by the Committee. On that date, the Board heard arguments of counsel, reviewed the Order of the Committee and the record. The Board unanimously voted to ratify and adopt in its entirety the Order of the Committee. The Board concluded that a palpable demonstration had been made that Dr. Dara's continued practice would present a clear and imminent danger to the public health, safety and welfare, and the concomitant conclusion that no measure short of the temporary suspension of Dr. Dara's licence would be sufficient or appropriate in this case. The New Jersey Board ordered and adopted in its entirety the Order of the Committee filed on April 7, 2009. Dr. Dara license to practice medicine and surgery shall continue to be temporary suspended pending the completion of plenary proceedings in this matter or further Order of the Board. Dr. Dara's motion to stay the effect of this Order was also denied. EFFECTIVE DATE: April 8, 2009.

MACHIAVERNA, Frank, M.D.
License #MA039110
1945 Route 33
Neptune, NJ 07754
UMDNJ, 1980
National Boards

FINAL ORDER AND DECISION ADOPTING DECISION OF ADMINISTRATIVE LAW JUDGE filed April 24, 2009, nunc pro tunc: December 3, 2008. This matter was initially opened to the Board with the filing of a Complaint against Dr. Machiaverna on January 31, 2007. Dr. Machiaverna was charged with gross negligence, gross malpractice or gross incompetence which damaged or endangered the life, health, welfare and safety of a person, and for professional misconduct for failing to conduct a physical examination of DW on or about 9:00 p.m. on December 7, 2000, for failing to return to the hospital to conduct a physical examination of DW at or about 12:00 a.m. on December 8, 2000, after being notified twice as to his patient's considerable pain, and for failing to conduct a thorough physical examination of DW at or about 7:00 a.m. on December 8, 2000, upon encountering DW being brought to the hospital's Radiology Department. Dr. Machiaverna was also charged with negligence, malpractice or incompetence, and professional misconduct for failing to conduct a thorough physical examination including a rectal examination of DW shortly after 5:15 p.m. on December 7, 2000. Dr. Machiaverna filed an Answer on February 23, 2007, defending all of his actions with regard to his treatment of DW as being in accordance with accepted standards of medical care for physicians with similar training and background and that he used his best medical judgment at all times. The Board transmitted the contested case to the Office of Administrative Law and a Hearing was conducted for three days in April of 2008, the record closed June 3, 2008, and an Initial Decision effectively dismissing the Complaint was rendered on September 5, 2008. Exceptions were filed by the State on October 3, 2008, Dr. Machiaverna replied on November 5, 2008, and the matter was scheduled for final disposition before the Board on December 3, 2008. After due consideration of the Administrative Law Judge's Initial Decision, transcripts, exhibits, exceptions and arguments of counsel regarding exceptions, the Board adopted as its final decision, the Findings of Fact and Conclusion of Law of the Administrative Law Judge ("ALJ"). The Board found that despite the tragic patient outcome, Dr. Machiaverna's conduct as alleged in the Complaint did not rise to the level of gross or repeated malpractice or professional misconduct and therefore dismissed the case in its entirety. However, the Board also was of the opinion that best practices for a patient presenting with an abdominal issue constitute serial examinations which were not employed by Dr. Machiaverna in the overall management of this case. EFECTIVE DATE: April 24, 2009, nunc pro tunc December 3, 2008.

PAK, Hong Sik, M.D.
License #MA071859
725 Grand Ave., #105
Ridgefield, NJ 07657
SUNY, 1995

CONSENT ORDER OF REPRIMAND filed April 8, 2009. This matter was opened to the Board upon receipt of a report from the Medical Practitioner Review Panel (the "Panel"), detailing findings made by the Panel upon the completion of an investigation concerning Dr. Pak. Specifically, the Panel commenced an investigation upon receipt of a report from Dr. Pak's medical malpractice insurer detailing a payment in the amount of $950,000.00 was made on Dr. Pak's behalf to settle a civil malpractice action brought by patient H.H., wherein it was alleged he failed to properly treat an anaphylactic reaction following an injection. H.H. suffered brain damage and was left a quadriplegic following the incident. During the pendency of its investigation, the Panel reviewed information to include Dr. Pak's office records, hospital records, and testimony offered by Dr. Pak. The Panel concluded that Dr. Pak engaged in gross negligence when providing care to patient H.H. Specifically, the Panel found Dr. Pak committed gross negligence when he attempted to inject the cervical facet joint on two occasions without the benefit of imaging guidance; that he was negligent when he chose to repeat an injection one week after having first injected H.H. without trying other non-invasive measures to attempt to alleviate H.H.'s pain; and that his medical record keeping failed to conform to the statutes and regulations of the Board. The Board adopted the findings and conclusions of the Panel. Dr. Pak did not admit to any findings made by the Board. The Board ordered and Dr. Pak agreed to be reprimanded for having engaged in gross negligence when providing care to H.H. and for failing to maintain patient records in accordance with the statutes and regulations of the Board. Dr. Pak is to pay a penalty in the amount of $5,000.00, of which $2,500.00 of the assessed penalty is to be paid at the time of entry of this Order with the remaining balance to be paid in full within ninety days of the date of entry of this Order. Dr. Pak will be required to attend and successfully complete within six months of the date of entry of this Order a course in medical record-keeping. EFFECTIVE DATE: April 8, 2009.

RAGI, Gangaram, M.D.
License # MA056750
Teanceck, NJ 07666
Ghandi Medical College 01/78

THIS MATTER HAS BEEN STAYED BY SUPERIOR COURT
APPELLATE DIVISION ON FEBRUARY 23, 2009.

ORDER OF SUMMARY DECISION Filed March 9, 2009: This matter was opened to the New Jersey State Board of Medical Examiners ("the Board") upon filing of an Administrative Amended Complaint on October 30, 2008. The Complaint alleged in ten counts that respondent Gangaram Ragi, M.D. a dermatologist engaged in inappropriate and unwarranted touching of the breasts of nine female patients while rendering care for other conditions. The Complaint also alleged in two counts that Dr. Ragi submitted reappointment applications in August and December 2003 and addenda or follow up letters to two hospitals in which he answered "no" to the questions asking has his medical license ever been the subject of a discipline or investigation, even though he entered into a June 11, 2003 Interim Consent Order with the Board regarding the then pending investigation. The 2003 Interim Order, imposed the limitation of an independent monitor being present whenever respondent treated any female patient. The Board also ordered a Second Interim Order filed November 15, 2005, precluding Dr. Ragi from treating female patients. The third Order was a Final Consent Order filed March 16, 2006, imposing a reprimand. Having determined that grounds exist for disciplinary action the Board then proceeded over Dr. Ragi's objection to the prescheduled and noticed mitigation phase of the hearing. In their consideration of the evidence the Board is mindful of the mitigating circumstances presented. They believe that the likelihood of recurrence is low because Dr. Ragi is under a criminal Consent Order and a Board Order which both forbid him from treating any female patients. The Board is also aware that he has hired another doctor in the practice who sees his female patients. It is therefore ordered that Dr. Ragi's license to practice medicine and surgery in the State of New Jersey shall be and is hereby suspended for three years beginning March 16, 2009. The first year of the suspension shall be active, with the remainder to be served as a period of probation. Prior to resumption of active practice in New Jersey, Dr. Ragi must submit to a psychosexual evaluation at his own expense by the J.J. Peters Institute and agree to abide by any recommendation by the evaluators. Dr. Ragi must successfully complete new courses in boundary issues and ethics, pre-approved by the Board; and he is to pay penalties in the amount of $40,000.00, pay $10,000.00 for misrepresentations in the context of his applications, and pay $30,000.00 for the sexual misconduct involving nine patients. Civil penalties must be submitted within 30 days of the effective date of this Order. EFFECTIVE DATE: March 16, 2009.

RUBINO, Barry P., M.D.
License #MA046827
Long Branch, New Jersey 07746-6415
University of Rome,1983
FLEX Endorsement

CONSENT ORDER Filed April 17, 2009. This matter was opened before the Board upon receipt of a report from the Medical Practitioner Review Panel("Panel") detailing the results of the Panel's investigation of information regarding a civil malpractice action brought by L.K. against Dr. Rubino. Specifically, the Panel received information detailing that a payment was made on behalf of Dr. Rubino to settle a civil malpractice action based on allegations that Dr. Rubino failed to timely diagnose testicular cancer. The Panel concluded Dr. Rubino engaged in repeated acts of negligence during the course of treatment of LK; that on LK's office visit on May 11, 2001, Dr. Rubino had information available sufficient to require him to at a minimum have referred LK for an examination by a urologist; and on each visit thereafter until December 2002, constituted independent acts of negligence during LK's visits in March and June 2002 by failing to re-examine the testicular mass. Additionally the Panel found that Dr. Rubino failed to maintain medical records in a manner consistent with the Boards record keeping rule. The Board ordered and Dr. Rubino agreed to be reprimanded for engaging in repeated acts of negligence in the care he provided to patient L.K. and for failing to maintain medical records in a manner consistent with the requirements of the Board's record keeping rule . Dr. Rubino must pay a penalty in the amount of $5,000.00; he is to attend and successfully complete continuing medical education courses acceptable to the Board in medical record keeping and in the diagnosis and treatment of testicular masses, which are to be completed in six months of the date of this Order.
EFFECTIVE DATE: April 17, 2009.

SOSS, Murray C., D.O.
License #MB022418
7600 Woodbine Avenue
Philadelphia, PA 19151-2721
Phila Coll of Osteo Med, 1967
Reciprocity

FINAL ORDER OF DISCIPLINE filed April 24, 2009. Dr. Soss' New Jersey license lapsed on June 30, 1993, which resulted in the automatic suspension of his license to practice medicine and surgery in New Jersey. On or about September 12, 2007, the Pennsylvania Osteopathic Board entered into a Consent Agreement and Order with Dr. Soss, which provided a two year suspension of his license, to be stayed and served as probation for at least two years with certain terms and conditions, and pay a civil penalty in the amount of $39,159.00. More specifically, the Pennsylvania Board determined Dr. Soss engaged in the practice of Osteopathic medicine on an expired license and failed to provide proof of medical professional liability insurance for the period of August 2002 to January 2007. The disciplinary action taken by the Pennsylvania Board provided grounds to take disciplinary action against Dr. Soss' license to practice medicine and surgery in New Jersey, in that his Pennsylvania license to practice medicine had been suspended. A Provisional Order of Discipline ("POD") was entered by the New Jersey Board on February 24, 2009, and served upon Dr. Soss. The POD was subject to finalization by the Board at 5:00 p.m. on the 30th business day following entry unless Dr. Soss requested a modification or dismissal of the stated Findings of Fact or Conclusions of Law. Dr. Soss' did not submit a response to the POD, and the Board determined that further proceedings were unnecessary and that the POD should be finalized without change. The New Jersey Board ordered Dr. Soss' license to practice medicine and surgery in New Jersey suspended until such time as he holds an active, unrestricted license to practice medicine in Pennsylvania. In the event Dr. Soss seeks reinstatement of his New Jersey license at any time in the future he will be required to appear before a Committee of the Board to establish that he is fit to practice medicine in New Jersey, and to demonstrate to the Board's satisfaction that he holds an active unrestricted license in Pennsylvania. EFFECTIVE DATE: April 24, 2009.

SPAL, Mark B, D.P.M.
License #MD002138
Randolph, New Jersey 07669
Des Moines Univ, 1991
National Boards

FINAL CONSENT ORDER Filed April 20, 2009. On May 9, 2008, Dr. Spal through his counsel was served with an Order to Show Cause that was filed with the Board alleging multiple violations, including but not limited to indiscriminate prescribing; gross and repeated negligence; professional misconduct; misrepresentation; and improper record keeping. Dr. Spal filed an Answer denying the alleged violations of the Verified Complaint. On May 22, 2008, an Interim Consent Order was filed resolving the pending Order to Show Cause for the Temporary Suspension of Dr. Spal's license to practice podiatry. That Order required him to surrender his CDS registration until the resolution of this matter. Having reviewed the entire record, including Dr. Spal's records and statements, the Board found Dr. Spal improperly documented his patient records; improperly prescribed CDS to three patients; and misrepresented his treatment of certain patients. Dr. Spal seeking to avoid the cost and time of a plenary hearing of the allegations in this matter and the Board finding the disposition to be adequately protective of the public health safety and welfare, ordered and agreed that the license of Dr. Spal to practice podiatric medicine in New Jersey is hereby suspended for two years, with an active suspension of four months beginning May 22, 2008, with the remainder to be served as a period of probation without restriction. Dr. Spal must successfully complete a Board approved course in the proper prescribing of CDS and provide proof to the Board; his billing records are to be audited for the entire term of probation; pay penalties in the amount of $5,000.00; and cease and desist from treating chronic pain conditions in his podiatric patients unless he is employed in an institution where Board-approved regular supervision of his prescribing practices is provided. EFFECTIVE DATE: May 22, 2008.

ZAHL, Kenneth, M.D.
License #MA056413
Morris Township, NJ 07960
Columbia Univ., 1981
National Boards

FINAL DECISION AND ORDER filed April 24, 2009. This matter was opened before the Board upon receipt of an Initial Decision dated December 17, 2008, by Administrative Law Judge ("ALJ") Gerson. ALJ Gerson's decision examined evidence presented during five days of hearing and one day of argument on Motions. The ALJ concluded cause existed for the imposition of disciplinary sanctions against Dr. Zahl on the first count of a four count Verified Complaint filed by the Attorney General ("AG") against Dr. Zahl on January 25, 2006. The first count of the Complaint alleged Dr. Zahl failed to comply with a prior Board monitoring Order which required any procedures Dr. Zahl performed or services he provided be observed by a practice monitor with the bills for such services reviewed by a billing monitor; that Dr. Zahl created false patient records for the services; and that he falsely responded to an investigative demand issued by the AG regarding compliance with the monitoring order. Count II alleged Dr. Zahl failed to comply with a Board Order to pay attorneys fees, which was withdrawn by the AG. Count III alleged failure to timely provide records and billing information to the monitor which was dismissed following argument on a Motion for Summary Decision. Count IV alleged repeated violations of the Monitoring Order in that, Dr. Zahl's continued to bill a particular CPT code for fluoroscopies by each spinal level imaged rather than by spinal region, contrary to the decision of the monitor. Following argument on February 1, 2007 on a Motion for Summary Decision, the ALJ reserved decision and left the motion unresolved. However, the ALJ did not determine the motion or resolve Count IV at the conclusion of the proceedings. Although Dr. Zahl's license had already been revoked as a result of the Zahl I proceeding, the ALJ determined that he had jurisdiction to hear this matter involving allegations regarding a revoked licensee, particularly considering that a practitioner's revoked status is subject to reinstatement, and he concluded that the Board will continue to maintain jurisdiction. Based solely on the findings and conclusions on Count I of the Complaint, the ALJ determined, inter alia, that Dr. Zahl violated the Consent Order for monitoring as to all 55 procedures, and that his conduct warranted a six month suspension of license followed by a year of stringent billing monitoring. He further recommended that imposing a suspension on a license already revoked is redundant, and that these findings of culpability should be taken into account upon any application for reinstatement. The cost of prosecution and attorneys fees, as well as a civil penalty of $10,000.00 were also recommended by the ALJ. The Attorney General filed her exceptions, in which she argued that the Board should consider and decide the Motion for Summary Decision as to Count IV, apparently overlooked and undecided by the ALJ, and that the sanctions imposed should be modified. Following a request by Dr. Zahl for an extension of time to file exceptions in this matter, which was granted, Dr. Zahl filed a Brief in which he raised multiple exceptions to the ALJ's findings regarding the credibility of many of his witnesses and to the ALJ's findings regarding Dr. Yulo's credibility; that the ALJ did not oversee the hearing properly and should not be afforded the usual deference as this decision was late and incomplete; and that Count IV should have been dismissed via Summary Judgment. Dr. Zahl also included within his exceptions an acknowledgment that his response to the Demand for Statement Under Oath was inaccurate and presented what he termed "mitigation." The Attorney General forwarded her reply to Dr. Zahl's exceptions. Dr. Zahl's responses to the exceptions by the Attorney General were filed and this matter was set down for oral argument upon the exceptions. The Board reviewed the extensive record including six days of hearing transcripts, testimony of twelve witnesses and voluminous exhibits, and considered the written exceptions of the parties, oral argument and was satisfied that cause existed to adopt the proposed findings of facts and conclusions of law set forth in the Initial Decision with some modification. Based on the multiplicity of violations found, Dr. Zahl's status as a second offender and that the offenses occurred while he practiced solely due to a court ordered stay of revocation of his license conditioned on his satisfaction of any and all reporting requirements imposed by the Board, it was determined that cause also existed to modify the recommendations made by the ALJ regarding sanctions to be imposed. As announced on the record orally on March 11, 2009, and made effective thereafter five days following service of this Order upon Dr. Zahl, the Board ordered the findings of Fact and Conclusions of Law in the Initial Decision adopted with modifications. The Attorney General's Motion for Summary Decision was granted on Count IV of the Complaint. The Board determined that Dr. Zahl's failure to comply with the Order of the Board entered by Consent as to Count IV constituted professional misconduct and failure to comply as a Board licensee to cooperate by complying with duly entered Board Orders; that the Conclusion of Law of the ALJ as to Count I, that Dr. Zahl violated the Consent Order as to all 55 procedures was modified to include the specific statutory and regulatory violations; and that Dr. Zahl's failure to comply with the Consent Order constituted professional misconduct, a failure to the duty to cooperate, and constituted the use of deception or misrepresentation. The Board ordered the license of Dr. Zahl to practice medicine and surgery in New Jersey revoked. Dr. Zahl was assessed and ordered to pay costs in the amount of $100,000.00, within thirty days of entry of this Order or to pay over time with interest set by the rules of Court; and pay penalty in the amount of $50,000.00, within thirty days of entry of this Order or pay over time to include interest set by the rules of Court. In the event Dr. Zahl fails to make payment within thirty days as ordered or fails to make payments in accordance with any schedule of payments that may be found to be acceptable by the Board, he will be considered to be in default of his monetary obligation to the Board and any balance then owed to the Board will be considered to be immediately due in full, and a Certificate of Debt for the full amount of penalties and cost then owing. EFFECTIVE DATE: April 29, 2009.

ORDER filed April 27, 2009. This matter was opened before the Board upon the Board's receipt of a Motion for Sanctions filed on February 3, 2009, by Dr. Zahl. The Motion was heard on February 1, 2007, at which time Dr. Zahl argued that the Deputy Attorney General ("DAG") assigned to the case, had destroyed evidence gathered through a Demand for Statement Under Oath. Specifically, Dr. Zahl alleged the DAG destroyed medical records, operative reports, x-ray films and schedules Dr. Yulo attached to the Statement Under Oath and sent via mail in late December of 2005. Dr. Zahl further alleged that Dr. Yulo kept no inventory of what he sent and that Dr. Yulo acknowledged at a deposition on November 1, 2007, that he had destroyed a folder of the procedures and schedules and any other medical records that he had taken from Dr. Zahl's office. The Administrative Law Judge ("ALJ") denied Dr. Zahl's motion informing him that it was premature, that there was no showing at this point that the DAG had informed Dr. Yulo to destroy records or had any responsibility for those actions, that there was nothing showing that the records were "crucial records" to this matter, and further indicated that Dr. Yulo's destruction of records might be beneficial to him. Following denial of Dr. Zahl's motion, the Court on February 1, 2007, instructed Dr. Zahl that while his proofs were insufficient at that point, he would have the opportunity after the testimony of Dr. Yulo, the only witness who could establish Dr. Zahl's arguments, to renew his application for sanctions. On February 3, 2009, at the extended time for the filing of exceptions from the Initial Decision of the ALJ, Dr. Zahl renewed his motion for sanctions, disqualification or recusal of the prosecuting DAsG and the dismissal of the matter to the Board. At the Oral argument hearing on March 11, 2009, Dr. Zahl alleged that the DAsG failed to reveal all discovery to him including records received from Dr. Yulo and that another DAG secured "perjured" testimony from Dr. Yulo as to whether he had received a subpoena. As to the records, although Dr. Zahl acknowledged that copies of records were eventually supplied to him, he asserted that the originals (actually copies of records Dr. Yulo took from Dr. Zahl's office) had never been located, and that the night before a deposition of Dr. Yulo was held, the DAG forwarded to him "marked up" or "work copies" of some of the records (schedules) which she indicated she had located. The Board determined that whether or not Dr. Yulo received a subpoena appears to be immaterial to any of the substantive issues in this case, and that nothing had been presented by way of impeachment or otherwise to demonstrate that the DAsG were responsible for the testimony regarding the subpoena. Dr. Zahl offered no evidence or facts which would support any allegation that any of the DAsG destroyed documents or kept documents away for him. In order to prevail on his Motion for sanctions, Dr. Zahl needed to demonstrate that he was unduly prejudiced by a failure of the State to produce evidence to him in this matter. Dr. Zahl asserted that he was entitled to a spoliation inference, however, he did not meet his burden in support of his application as he had not satisfied the elements necessary to sustain a claim of spoliation. Based on these circumstances there had been no demonstration of spoliation of any evidence, nor any foundation for the disqualification, recusal, monetary sanctions, adverse evidential inferences or dismissal of the charges sought by Dr. Zahl in this matter. The Board ordered Dr. Zahl's Motion for sanctions denied. EFFECTIVE DATE: March 11, 2009.

THE NEW JERSEY STATE
BOARD OF MEDICAL EXAMINERS

William V. Roeder
WVR/jj Executive Director