A health care provider who falsely claimed a stroke patient died because of this of the Moderna COVID-19 vaccine at the previous Fountain Valley Regional Hospital is facing disciplinary motion from the Medical Board of California.

Dr. Tam Ky Nguyen, an internal medicine specialist from Garden Grove, was charged by the board in September with gross negligence and failure to take care of adequate records regarding the allegedly erroneous claims and COVID-19-related diagnoses of two other patients at Fountain Valley Regional.

Nguyen previously had his clinical privileges revoked in 2021 after he sent worrying coronavirus messages to officials at Fountain Valley Regional, which UCI Health owned by Tenet Healthcare Corp. in March together with three other Southern California hospitals. had bought.

Reached by phone Wednesday, Oct. 9, Nguyen declined to comment and referred Southern California News Group inquiries to his attorney, who didn’t immediately reply to emails and phone calls.

UCI Health declined to comment on the medical board's allegations because they were made before the acquisition.

“Dr. Tam Ky Nguyen is not and was not an employee of UCI Health,” said spokesman John Murray. “As a resident doctor in his own practice, Dr. Nguyen does not have the privilege to practice or treat patients at UCI Health – Fountain Valley.”

Nguyen, who has been licensed by the medical board since 1996, is allowed to challenge the board's allegations in a hearing much like a trial and presided over by an administrative law judge.

After the hearing, the judge writes a proposed decision, which is forwarded to a panel of doctors for review. The members of the panel are accountable for making the ultimate decision on disciplinary matters and should either accept, modify or reject the advice.

If the medical board's investigation ends in disciplinary motion, Nguyen's license might be publicly reprimanded, placed on probation, suspended or revoked.

The medical board began investigating Nguyen in September 2021 after receiving a report from Fountain Valley Regional alleging he didn’t undergo a psychiatric evaluation and failed to fulfill admission requirements.

The investigation included a review of Fountain Valley area records and interviews with several witnesses who worked with Nguyen.

According to patient records, Nguyen described a 67-year-old woman's diagnosis of COVID-19 pneumonia in July 2021 as a possible adversarial response to the Pfizer vaccine she received two months earlier, the medical board said.

Nguyen allegedly prescribed the girl the antimalarial drug Plaquenil, whose U.S. emergency food and drug approval was revoked in June 2020, well before her hospitalization, since it showed no profit in speeding recovery from COVID-19.

Medical records reportedly indicate that a physician who deals with infectious diseases beneficial that the patient stop taking Plaquenil.

In response, Nguyen allegedly documented that he as a substitute administered Plaquenil for the patient's rheumatoid arthritis, without consulting health workers, at twice the utmost dose.

Nguyen also allegedly advised the girl, who was at high risk for COVID-19, to avoid the coronavirus booster shot, which represented an “extreme deviation” from the usual of care, the medical board said.

In one other case, Nguyen reportedly diagnosed a 58-year-old woman who was hospitalized after a stroke with a sudden adversarial response to the Moderna vaccination. After her death on May 19, 2021, Nguyen listed the reason for death within the documents as respiratory and multi-organ failure from the Moderna vaccine without “evidence or objective information,” which constitutes gross negligence, the medical board said.

Additionally, Nguyen reportedly stated in his medical records that a 66-year-old man admitted to Fountain Valley Regional in July 2021 for pneumonitis, pneumonia, coughing up blood and experiencing flu-like weakness was affected by “possibly… undesirables.” Autoimmune response to COVID-19 vaccination.”

The documents also include a note from Nguyen advising the patient to avoid further COVID-19 vaccinations, the medical board said.

The Alabama Supreme Court issued an unprecedented ruling in February 2024, finding that stored frozen embryos created for in vitro fertilization, often known as IVF, “minor children” under a state wrongful death law.

The impact on the medical community was immediate and acute. Fearing recent civil or criminal liability if embryos were now considered “persons” under Alabama law, IVF clinics needed to make an overnight decision whether to supply patient care or incur that liability. As a result, there are several IVF clinics across the state IVF procedures were immediately suspended. And that most direct effectNaturally, Was on patients.

As Legal and policy researcher on reproductive rights – and girls of childbearing age – we fear that as debates over fetal versus embryonic personality proceed, healthcare providers can be faced with an increasing number of recent situations by which they have to balance legal liability and patient well-being.

These conflicts are already playing out over abortion, but one other looming example stays under the radar: whether a physician will have the ability to honor a patient's end-of-life wishes if she is pregnant.

In many states the reply might be no.

Doctors assess legal liability

The Supreme Court decision Dobbs v. Jackson In June 2022, the elemental right to access abortion care ended, returning the problem of abortion access to the states and reopening political debates about fetal personality. Doctors who treat pregnant patients are actually subject to a patchwork of abortion bans and restrictions vary from state to state.

Many gynecologists navigating this maze now practice with the looming fear of civil or criminal liability in the event that they come into conflict, even unknowingly, with rapidly changing state laws and judicial or prosecutorial interpretations of those laws. These fears should not unfounded: state attorneys general have threatened to prosecute doctors who provide medical care medically essential abortion care or assisting a patient in a state that has a ban on abortion have an abortion performed out of state. In fact, there have been pregnant women criminally charged with miscarriage.

These balancing acts occur even when pregnant patients find themselves in emergency situations.

A study from January 2024 details these conflicts in 13 states. After the Dobbs decision, gynecologists were found to delay clinical look after pregnant patients – even in emergency situations – out of fear of liability under the brand new unclear state laws.

Living will and exclusion of pregnancy

The abortion and IVF examples illustrate the tense and unsure legal landscape that medical professionals must navigate in time-critical and emergency situations. In short: There are not any rules and the chance is great.

We anticipate that physicians can be forced to weigh these same uncertainties and risks in probably the most traumatic situation: treating a patient who has no hope of survival. In such situations, physicians typically seek to bear in mind any pre-expressed end-of-life wishes the patient could have, similar to those contained herein Advance Directives. These instructions may include: Decisions about life-sustaining treatments and designation of 1 Healthcare representative.

Simply put, living wills are a way for patients to inform their families and doctors how they would really like to be treated medically in the event that they later grow to be incapacitated, similar to in a coma. All 50 states plus Washington DC recognize the validity of patient directives.

But not once you're pregnant. As of early 2024, greater than half of the US states will have laws on the books which robotically invalidate an incapacitated patient's previously expressed end-of-life wishes if the patient is pregnant. Law professor John Krause refers to those as “pregnancy restrictions” and notes that they exist in no less than 30 states. In some states, these cancellations of living wills only apply on Point of fetal viability or possibility of live birth. However, in 12 states, these advance directives are considered “pregnancy exclusions.” They occur at every stage of pregnancy.

That signifies that even when a pregnant patient previously had a written, notarized advance directive stating that she didn’t need to depend on organ support if she was unlikely to ever get well, a physician may very well be required under 30 state laws to disregard it fulfilling those desires and keeping her alive to sustain the pregnancy. And in 12 of those states, this requirement would apply even when the pregnancy was not viable. These exclusions would essentially require physicians to proceed organ preservation care in order that the pregnant patient's body may very well be used as an incubator for a fetus.

Currently, there are few reported cases of pregnant patients' living wills being revoked, although there are some heartbreaking examples.

A highly publicized case from 2014 detailed, like Marlise MuñozA Texas woman who was 14 weeks pregnant when she was declared brain dead was kept on life support for 3 months, although she and her family had clearly expressed a desire to not proceed her life artificially.

The reason? The hospital in Texas said this was the case prohibited by the Texas Living Will Act Because Muñoz was pregnant and so they had an obligation to preserve the lifetime of the fetus, they weren’t allowed to show off life support.

However, we suspect that scenarios like that of the Muñoz family could occur should not sufficiently reported. Families in crisis often won’t pursue legal options or make their trauma public. We also expect these situations to grow to be more common in a post-Dobbs world as physicians proceed to grapple with emerging uncertainties and fears of legal liability related to end-of-life look after pregnant patients.

Legislative labyrinths

It is evident that advance directives should not exempt from the personality debate, as the first goal of pregnancy exclusions is to guard the lifetime of the fetus.

Just as abortion restrictions vary from state to state, so do advance directive laws. The laws are extremely complex and sometimes require an intricate compilation of varied sections of state law. Therefore, even when a patient has an advance directive, it is probably going that few understand that these pregnancy exclusions even exist, let alone that they’re fully relevant.

Additionally, many states haven’t yet brought their advance directive laws into compliance with their abortion laws.

Arkansas, where Abortion is currently banned at any point in pregnancy provides an illustrative example.

When it involves end-of-life care, Arkansas law stipulates that physicians “shall” act in accordance with a certified patient’s health guidelines.

However, if the patient is pregnant, Arkansas law requires that the The same guideline mustn’t be followed “as long as it is possible for the fetus to develop to live birth with continued life-sustaining treatment.”

An Arkansas doctor attempting to respect a pregnant patient's advance directive and terminate organ-preserving care—and thus the pregnancy—would due to this fact be faced with quite a few questions: When is it “possible” for a fetus to become live birth? could? Is this an issue of clinical fetal viability, which in line with the American College of Obstetricians and Gynecologists is extremely case specific? impossible to “definitely explain”? And how does a physician reconcile Arkansas' abortion ban with the advance directive law, which apparently allows treatment to be withheld until “the fetus can develop to the point of live birth”?

Specific advance directives

Recent abortion and IVF cases have highlighted how medical decision-making is consistently changing and what this implies for medical care. Given this shifting terrain, it’s unimaginable to predict with any degree of certainty how policies regarding end-of-life look after a pregnant person can be interpreted, even within the few states that allow it for patients Express your wishes within the event of pregnancy.

However, it might be a sensible practice for pregnant patients – or those that may sooner or later grow to be pregnant – to try to know the complexities of their state's laws and create a transparent and specific advance directive that directly addresses their wishes within the event of pregnancy enters pregnancy.