State medical board approves consent order for Dr. Yadav, rejects Cica consent order and denies modification request for Dr. Fales

The Department of Public Health board voted to approve a consent order for Dr. Yadav and rejected a separate consent order for Dr. Cica, and later denied a request to modify the consent order for Dr. Fales during a virtual meeting that covered several disciplinary matters and administrative updates.

Board Chair opened the meeting and identified agenda items, noting a board letter supporting legislation to raise the board’s maximum civil fine to $25,000 and that a Federation of State Medical Boards letter about an FDA caution on compounded drugs (mentioning retratrutide) had been circulated to members.

The board approved the consent order for Dr. Yadav after Attorney Joelle Newton, representing the Department of Public Health, summarized the case. Newton said the record shows a May 20, 2023 incident in which the respondent violated patient‑physician boundaries by engaging with a patient outside a clinical setting and exchanging text messages, and a prior disciplinary action on the physician’s West Virginia license from May 2020 that also involved boundary issues. The consent order submitted to the board included a reprimand, a $5,000 civil penalty, a permanent restriction requiring a chaperone for all female patients, two years of probation with therapy and employer reports, and a prohibition on solo practice. The motion to approve was moved by Doctor Green and carried in a roll call. The recorded vote showed 13 approvals, 1 opposed and 1 recusal; the board certified the consent order as approved.

A separate consent order for Dr. Cica, described by Newton as arising from an April 6, 2021 vaccine exemption letter and subsequent alleged failures to appropriately treat a patient who reported COVID and to keep sufficient medical records, was not approved. The proposed order would have imposed a reprimand, a $5,000 civil penalty and one year of probation with supervisor reports, coursework and record‑keeping conditions. Several board members criticized the penalty and probation length as inadequate given the respondent’s disciplinary history. Doctor Green said the one‑year probation “is not sufficient” and suggested a minimum of two or three years; Doctor Wolf called earlier sanctions and the respondent’s record into question and said, “otherwise, it’s a joke,” urging a larger fine. After discussion the roll call vote resulted in a majority voting not to approve the consent order (with one recusal); the board did not adopt the proposed order.

Later in the meeting the board considered a request from counsel for Doctor Fales to modify an existing consent order so that a retired, board‑certified internal medicine physician or a board‑certified family practitioner could serve as the required practice monitor. Counsel for Fales said independent monitoring would cost more than $7,000 and presented two local physicians as lower‑cost alternatives: one retired internal medicine physician and one board‑certified family physician. Department counsel (Attorney Fezzina) opposed the modification, saying the consent order’s paragraph requiring department consent to any modification remained in effect and that the department would not consent to the proposed replacements; she also said the department had information suggesting the retired physician might be a friend of the respondent, which would conflict with monitoring unit vetting standards. The board voted to deny the modification request by roll call; members said a future request could be presented if the department were to consent.

Votes at a glance

- Approve minutes: approved by acclamation (unanimous)

- Consent order — Dr. Yadav: approved. Motion moved by Doctor Green. Order terms presented by Attorney Joelle Newton: reprimand; $5,000 civil penalty; permanent chaperone requirement for all female patients; two years probation with therapy and employer reports; prohibition on solo practice. Roll call (selected): Ms. Emmett — approve; Dr. Duffy — approve; Dr. Grieco — approve; Dr. Green — recused; Miss Jacqueline — approve; Dr. Katz — approve; Dr. London — approve; Mr. McEnany — approve; Mr. Buzenti — approve; Dr. Risha — approve; Dr. Sauer — approve; Dr. Schwent — approve; Dr. Wolf — no; Dr. Zeman — approve; Dr. Ewen — approve. Outcome: approved.

- Consent order — Dr. Cica: not approved. Department presentation (Attorney Newton) described alleged improper vaccine exemption and failures in treatment and documentation; proposed terms included reprimand, $5,000 civil penalty and one year probation with supervisor reports and coursework. Roll call (selected): Ms. Emmett — do not approve; Dr. Duffy — do not approve; Dr. Grieco — do not approve; Dr. Green — do not approve; Miss Jacqueline — do not approve; Dr. Katz — do not approve; Dr. London — do not approve; Mr. McEnany — do not approve; Mr. Presente — do not approve; Dr. Risha — do not approve; Dr. Rissy — do not approve; Dr. Sauer — do not approve; Dr. Schwint — do not approve; Dr. Wolf — do not approve; Dr. Zeman — recused; Dr. Yuan — do not approve. Outcome: not approved.

- Request to modify consent order — Dr. Fales: denied. Proposal sought to allow a retired board‑certified internal medicine physician or a board‑certified family physician to serve as the practice monitor because the independent monitor would cost an estimated $7,000+. Department counsel stated the department does not consent to the modification; in addition the department reported the family physician candidate lacked board certification. The board voted by roll call to deny the requested modification. Outcome: denied; the chair noted the respondent may bring a future request with department consent.

Discussion and context

Board members repeatedly emphasized public protection and the limits of the board’s authority to change consent orders unilaterally. Attorney Fezzina cited a provision of the contested consent order that requires department consent for any modification and referenced statute citation discussed in the meeting (4‑181a) when explaining the department’s position. Several members said they were unwilling to accept what they viewed as minimal penalties in cases with repeated or serious prior complaints.

The chair also reported that the board’s letter supporting a statutory amendment to raise the board’s small‑claims fine cap to $25,000 had been voted out of the public health committee with a joint favorable report; she said the measure is moving through the legislative process but is not final. The chair drew members’ attention to the FSMB letter about FDA caution regarding compounded drugs that mention retratrutide, saying the Federation’s notice had been circulated for members’ awareness.

The meeting concluded after the votes and routine administrative items; the chair said denied or tabled modification requests can be refiled if the department later agrees to a change.