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Wendy R. Smoker, M.D v. Iowa Board of Medicine

April 24, 2013

WENDY R. SMOKER, M.D., PLAINTIFF-APPELLANT,
v.
IOWA BOARD OF MEDICINE, DEFENDANT-APPELLEE.



Appeal from the Iowa District Court for Polk County, D.J. Stovall, Judge.

The opinion of the court was delivered by: Doyle, P.J.

Wendy Smoker, M.D., appeals from the district court ruling on judicial review affirming the disciplinary action of the Iowa Board of Medicine. REVERSED AND REMANDED.

Heard by Doyle, P.J., and Danilson and Mullins, JJ.

Wendy Smoker, M.D., appeals from the district court ruling on judicial review that affirmed the disciplinary action of the Iowa Board of Medicine. We reverse the decision of the district court and remand to the Board for entry of an order dismissing the disciplinary action against her.

I. Background Facts and Proceedings

Dr. Wendy Smoker is an internationally renowned physician and full professor in the field of neuroradiology. She is the recipient of numerous awards and honors for her extensive work and expertise in her field, and is praised by colleagues for her excellence in the profession and devotion to her work. As a prelude to our review of Dr. Smoker's history of alcohol dependence, we find it important to note there is no dispute her condition has never affected her medical practice.

Dr. Smoker received her undergraduate and medical education at the University of Iowa. In 1978, she was issued an Iowa medical license. In 1982, she began working as an assistant professor at the University of Iowa. In 1986, she took a position as an associate professor at the University of Utah. From 1990 to 2001, Dr. Smoker was a full professor and director of neuroradiology at the University of Virginia.

While she lived in Virginia, Dr. Smoker developed an alcohol dependency. In 2000, she self-reported to the Virginia Board of Medicine and completed a ninety-day inpatient treatment program. She was sober for one year before she had an isolated relapse in September 2001. Dr. Smoker immediately completed a six-week relapse program at the direction of the Virginia Board of Medicine.

In November 2001, Dr. Smoker moved to Iowa to begin her present position as a full professor at the University of Iowa Hospitals and Clinics (UIHC), where she is also the director of neuroradiology. Because she was on the diversion program in Virginia, the Board required her to participate in Iowa's version of the program, the Iowa Physician Health Program (IPHP). Dr. Smoker self-reported to IPHP and entered into a confidential physician health contract for alcohol dependence, which required urine analysis, a worksite monitor, and a psychiatrist.

Dr. Smoker did "very well" with her sobriety but for an isolated relapse in October 2003. She immediately completed a ninety-day treatment program. In light of her relapse, IPHP extended her contract to December 2008.*fn1 She successfully maintained her sobriety*fn2 and the Board released her from her contract in December 2008.*fn3 Upon her release from IPHP, Dr. Smoker continued to attend four Alcoholics Anonymous (AA) meetings each week, had an active AA sponsor, and spoke with her life coach approximately two times each month.

In February or March 2009, one of Dr. Smoker's junior colleagues, staff professor Dr. Jack Kademian,*fn4 reported to Dr. Smoker's supervisor and former workplace mentor under her IPHP contract, Dr. Joan Maley, that he had observed Dr. Smoker intoxicated at a national medical conference in Florida in February 2009.*fn5 Dr. Maley informed Dr. Kademian that Dr. Smoker was "no longer under contract with the IPHP," and took no action on his report.

In September 2009, Dr. Kademian again reported to Dr. Maley that he had observed Dr. Smoker intoxicated, this time at a professional dinner following the UIHC's annual Dolan lecture hosted by the neuroradiology department.*fn6 Again, Dr. Maley did not act on Dr. Kademian's report. One other physician observed Dr. Smoker consuming alcohol at the Dolan event, but did not believe she was intoxicated. The following morning, Dr. Smoker told her department chair Dr. Laurie Fajardo that she had "slipped" and she attended an AA meeting a few hours later. There are no allegations or evidence to suggest Dr. Smoker consumed alcohol after September 2009.

In October 2009, Dr. Kademian reported his observations to the Board. When questioned by IPHP coordinator Deb Anglin,*fn7 Dr. Smoker admitted she had "slipped" a few times, but reported there had been no recent incidents and that she was still working on her program. She declined Anglin's recommendation that she self-report to the Board.

In January 2010, the Board's chief investigator submitted an investigative report in response to Dr. Kademian's complaint against Dr. Smoker. The report's synopsis states, "[t]here are new reports of continued drinking" by Dr. Smoker. The report's narrative states, "Dr. Smoker has been reported to be intoxicated at two social functions and has said she will not self-report." A case history, IPHP Executive Summary, and an IPHP cover email were attached to the report. In February 2010, the Board issued an order requiring Dr. Smoker to undergo a comprehensive physical, neuropsychological, and substance abuse evaluation at Resurrection Health Care in Illinois at her expense. She complied with the order.

During the evaluation, Dr. Smoker stated she had consumed alcohol on two occasions following her release from her IPHP contract in December 2008; namely, she bought a bottle of wine and consumed two glasses of wine at home on September 12, 2009, and she consumed three or four glasses of wine at the UIHC Dolan dinner on September 14, 2009. She had no explanation for why she did it and stated it was a "stupid thing to do." She denied drinking on any other occasion after her release from IPHP. From the evaluation, Resurrection released a comprehensive assessment in April 2010.*fn8 The assessment adduced Dr. Smoker suffered ...

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