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Kyros v. Rhode Island Department of Health

Superior Court of Rhode Island, Providence

December 13, 2019

DR. WILLIAM KYROS, Plaintiff,
v.
RHODE ISLAND DEPARTMENT OF HEALTH and NICOLE ALEXANDER-SCOTT, MD, MPH, IN HER CAPACITY AS THE DIRECTOR OF HEALTH OF THE RHODE ISLAND DEPARTMENT OF HEALTH Defendants.

          FOR PLAINTIFF: JACKSON C. PARMENTER, ESQ. ANDREW BLAIS, ESQ.

          FOR DEFENDANT: LISA F. BORTOLOTTI, ESQ. JOSEPH K. ALSTON, ESQ. MORGAN A. GOULET, ESQ.

          DECISION

          LANPHEAR, J.

         Before this Court is the appeal of Dr. William Kyros (Dr. Kyros) from a decision of the Rhode Island Department of Health denying his request to be relicensed. Jurisdiction is pursuant to G.L. 1956 § 42-35-15. For the reasons set forth herein, this Court reverses the Rhode Island Department of Health's final decision.

         I

         Facts and Travel

         The Court first chronicles the extensive, decade-long journey Dr. Kyros has endured at the hands of the Rhode Island Department of Health (RIDOH) and the Board of Medical Licensure and Discipline (the Board). That journey has landed the parties here, with Dr. Kyros appealing the Board's denial of his relicensure application.

         Dr. Kyros became a licensed physician in Rhode Island in June 1986. Dr. Kyros's practice of medicine halted in August 2009 pursuant to an "Agreement to Cease Practice" (the Agreement) with RIDOH.[1] Compl. Ex. 16A. Pursuant to the Agreement, Dr. Kyros also agreed to go for an evaluation at the Sante Center for Healing (Sante Center) and have the evaluation report sent to the Board. Id. The Board was to review the report and then "make a determination on final sanctions." Id.

         Dr. Kyros then went to the Sante Center for an evaluation, completing his treatment on August 20, 2009. Appellant Mem. Supp. Appeal Ex. A 3 (Board Decision). The Sante Center recommendation stated that Dr. Kyros may not have been truthful in his evaluations and that he should be monitored when he returns to practice. Id. On August 27 and September 30, 2009, Dr. Kyros's attorney wrote to the Board asking what Dr. Kyros's next steps should be. Id. at 3-4; Appellant Mem. Supp. Appeal Ex. D, E. There is no evidence that Dr. Kyros ever received a response from the Board. Appellant Mem. Supp. Appeal Ex. A 4 and Ex. F 11 (Hr'g Tr. 156).

         Dr. Kyros, on his own accord, began treatment with psychiatrists Dr. Edward M. Brown and Dr. Gene Jacobs for several years. Appellant Mem. Supp. Appeal Ex. A 4. Dr. Brown treated Dr. Kyros in 1991 and 1992 after the first complaint had been made against Dr. Kyros and then again from 2009 to 2011.[2] Id. Dr. Jacobs also treated Dr. Kyros for three-and-one-half years. Id. In 2013, a psychiatric report written by Dr. Jacobs was submitted to the Board. Id.; Appellant Mem. Supp. Appeal Ex. I. He was also evaluated by forensic psychiatrist Dr. Daniel Harrop in August 2013, and Dr. Kyros received a forensic psychiatry report from him. Appellant Mem. Supp. Appeal Ex. A 4. All of these doctors have since stated that Dr. Kyros is fit to return to work. Dr. Kyros and his attorney then met with the Board Administrator, Dr. James McDonald. Id. Dr. Kyros submitted a license application in 2013, which was subsequently denied.[3] Id.

         On December 4, 2013, the Board sent Dr. Kyros a letter notifying him that the investigating committee had made a finding of "Unprofessional Conduct" against Dr. Kyros. Compl. Ex. 10. There is no evidence that the Board ever ratified this finding.[4] The Board did not take any official action against Dr. Kyros for some time, and Dr. Kyros's third attorney continued to contact the Board in an effort to resolve the issues at hand. Appellant Mem. Supp. Appeal Ex. M. On September 8, 2016, Dr. Kyros's attorney proposed a consent order that would allow Dr. Kyros to return to practice, to which he never received a response. Id. On October 13, 2016, Dr. Kyros's attorney sent another letter to the Board noting its lack of response. Appellant Mem. Supp. Appeal Ex. N. His attorney also requested a response regarding the proposed consent order. Id. Nearly a month later, the Board finally responded to Dr. Kyros's attorney stating that the previous letter "did not evidence the requisite insight for the Board to seriously consider [the] request." Appellant Mem. Supp. Appeal Ex. O. Within a week, Dr. Kyros's attorney responded, again requesting approval of the consent order and outlining all of the steps Dr. Kyros had completed since signing the Agreement. Id.

         On March 23, 2017, Dr. Kyros applied to the Board for reinstatement. Appellant Mem. Supp. Appeal Ex. Q. The Board found that application to be incomplete, and Dr. Kyros resubmitted the application on April 13, 2017. Appellant Mem. Supp. Appeal Ex. R, S. That application included evidence that Dr. Kyros had completed all continuing medical education (CME) credits since the Agreement was signed in 2009. Appellant Mem. Supp. Appeal Ex. A (Board Decision 3); Appellant Mem. Supp. Appeal Ex. S, T.

         In response to Dr. Kyros's application, the Board held a Licensing Committee Meeting on September 7, 2017 and subsequently sent a letter to Dr. Kyros stating that the committee voted to have him attend the Sante Center for re-evaluation and to attend the Center for Personalized Education for Physicians (CPEP) to assess his clinical competency to practice psychiatry. Appellant Mem. Supp. Appeal Ex. U. The Board informed him they would reconsider his application once he completed these evaluations. Compl. Ex. 4. Dr. Kyros then sent a demand for a formal hearing on September 18, 2017. Compl. Ex. 22. The Board responded to Dr. Kyros, informing him that he could come to the next licensing committee meeting and that his application for reinstatement had not yet been approved or denied. Compl. Ex. 24. Dr. Kyros, through his attorney, responded that he did not believe he needed to come in for any further discussion and would like for the Board to review his application. Compl. Ex. 26.

         On October 10, 2017, the Board denied Dr. Kyros's application. Compl. Ex. 27. Upon receiving this denial, Dr. Kyros again requested a formal hearing. Compl. Ex. 29. After a hearing, the Board issued its decision regarding Dr. Kyros on November 14, 2018. The Board's Decision required Dr. Kyros to complete a clinical competency assessment at CPEP[5] and follow all of CPEP's recommendations before Dr. Kyros can be relicensed.[6] Appellant Mem. Supp. Appeal Ex. A 9 (Board Decision). Dr. Kyros was also required to keep the Board informed of his progress at CPEP and satisfy all other statutory requirements for licensing. Id. Lastly, the Board required Dr. Kyros to pay a $2000 administrative fee for the cost of the hearing. Id.

         II

         Standard of Review

         This Court has jurisdiction over appeals from the Board's decisions pursuant to the Administrative Procedures Act (APA). Section 42-35-15. "Any person . . . who has exhausted all administrative remedies available to him or her within the agency, and who is aggrieved by a final order in a contested case is entitled to judicial review. . . ." ...


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