CONSENT AGREEMENT BETWEEN - State Medical Board of Ohio ...

Matter of Kyle Elliott Hoogendoorn, D.P.M. Page 27
Testimony and January 31, 2005, Report of Dr. Chelimsky
58. Dr. Chelimsky testified that Dr. Hoogendoorn had performed procedures that were beyond
the scope of practice of a podiatric physician. Dr. Chelimsky testified that chemoneurolytic
and trigger point injections require the exercise of judgment based on medical knowledge.
Dr. Chelimsky further testified that they require an individual assessment of each patient
because trigger points vary in location from patient to patient, the risks are different from
patient to patient, “and the agent choice will vary from one patient to the next.”
Dr. Chelimsky further testified that they cannot be performed without a need for complex
observations or critical decisions. Finally, such procedures “require repeated medical
assessments to look at the results of the injection as far as pain is concerned, and also to
make sure there hasn’t been a serious complication.” (Tr. at 1634, 1657-1665)
Finally, Dr. Chelimsky testified concerning Dr. Hoogendoorn’s performance of injection
procedures that his opinion does not change if Dr. Hoogendoorn had been performing these
injections as a fellow because “that would imply he’s training to perform it, eventually.
* * * The point of a fellowship program is to train somebody to do what they’re
eventually going to do.” (Tr. at 1648-1649)
Testimony of Dr. Bressi
59. Dr. Bressi believes that it had been appropriate for Dr. Hoogendoorn to administer trigger
point and chemoneurolytic injections in the context of his pain fellowship. Dr. Bressi
testified: “For podiatry it is extremely important that they get a handle on chronic pain
because * * * many, if not the bulk, of their problems deal with pain in the feet. But not all
the pain in the feet comes from the feet, and they have to be familiar with generalized
systems.” (Tr. at 2320-2323, 2479-2480)
60. Dr. Bressi testified that trigger point injections “could be catastrophic if you’re not
careful.” For example, “in the thoracic area you have to watch that you don’t go too deep
because you can collapse a lung[.]” Further, “[y]ou don’t want to get a [blood] vessel.
You can have a seizure or somebody can stroke.” Dr. Bressi further testified that either
Dr. Leak or Dr. Griffin had to have been in the room with Dr. Hoogendoorn at first to show
him how they are done and observe his performance. After that, they would not necessarily
have to be in the room with him. (Tr. at 2480-2482)
Dr. Bressi further testified that, in his opinion, Dr. Hoogendoorn had been competent to
perform trigger point injections and chemoneurolytic injections under the supervision of
Dr. Leak or Dr. Griffin. (Tr. at 2486)
61. Dr. Bressi testified that, in his opinion, Dr. Hoogendoorn had not practiced medicine
without a certificate by performing injections under the supervision of Dr. Leak or
Dr. Griffin. Dr. Bressi testified that the basis of that opinion was that Dr. Hoogendoorn
had been in a fellowship at the time he engaged in those activities. (Tr. at 2486-2487)