In 1984, Joseph R Montante, M.D., of Boulder, Colorado, began using and promoting a bizarre program called Nutrabalance in which misinterpretations of laboratory tests were used to recommend dietary supplements. In 1992, as noted below, the Colorado State Board of Medical Examiners reviewed his care of seven patients and concluded that he had failed to perform and/or document adequate physical examinations and did not adequately document his assessments or treatment plans. The board placed Montante on probation for five years, during which he would be required to have another physician monitor patient charts to ensure that he is practicing medicine according to accepted standards. In 1995, the board amended its order to reduce the number of chart reviews but ordered the practice monitor to comment on whether or not the Nutrabalance reports “constitute a potential threat to patients in that disease or illness may be missed.” Montante was also required to notify patients that he “specializes in nutritional consultations and does not provide primary medical care for other medical problems.”
BEFORE THE STATE BOARD OF MEDICAL EXAMINERS
STATE OF COLORADO
STIPULATION AND FINAL AGENCY ORDER
IN THE MATTER OF THE DISCIPLINARY PROCEEDING REGARDING THE LICENSE TO PRACTICE MEDICINE IN THE STATE OF COLORADO OF JOSEPH R. MONTANTE, M.D., LICENSE NO. 22290.
Respondent.
IT IS HEREBY STIPULATED and agreed by and between Inquiry Panel B (“panel”) of the Colorado state Board of Medical Examiners (“board”) and Joseph R. Montante, M.D. (“respondent”) as follows:
1. Respondent was licensed to practice medicine in Colorado on April.10, 1979, and was issued license No. 22290. which respondent has held continuously since that date.
2. The panel and the board have jurisdiction over respondent and over the subject matter of this proceeding.
3. On or about March 13, 1992, the panel reviewed a report of investigation in case Nos. MB8989088, MB0292004, and MB0292123. The panel found that the investigations disclosed facts which warranted proceeding by formal complaint, as provided in S 12-36-118(5), C.R.S. The panel thereupon referred the complaint in the above referenced cases to the Attorney General.
4. Respondent understands that:
a. He has the right to be represented by an attorney of the respondent’s choice;
b. He had the right to a formal disciplinary hearing pursuant to S 12~36-118(5), C.R.S.;
c. By entering into this stipulation and Final Agency Order (hereinafter, the “Order”), respondent is knowingly and voluntarily giving up the right to a hearing. Respondent neither admits nor denies: the facts in this Order, but for purposes of compromise, relieves the panel of its burden of proof.
d. Respondent is knowingly and voluntarily giving up the right to present a defense by oral and documentary evidence, and to cross-examine witnesses who would testify on behalf of the panel.
5. It is the intent of the parties and the purpose of this Order to provide for a settlement of all facts disclosed by the investigation in Case Nos. MB8989088, MB0292004, and MB0292123, without the necessity of holding a formal disciplinary hearing.
6. Respondent admits and agrees for the purposes of this Order only: In his treatment of patients M.B.; G.W.; D.G; T.B.; J.G.; L.H.; and C.J.; he failed to perform complete physical examinations and/or prepare adequate records with regard to physical examinations of the patient; and he inadequately documented his assessment of the patient’s condition and medical plan for the patient’s care.
7. Respondent admits that the conduct set forth above constitutes two or more acts or omissions which fail to meet generally accepted standards of medical practice, in violation of S 12-36-117(1) (p), C.R.S. of the Medical Practice Act.
8. Based upon the violation found above, the panel is authorized by S 12-36-118(5) (g) (III), C.R.S. to order probation and such conditions upon respondent’s practice which it deems appropriate to assure the respondent is physically, mentally, morally, and otherwise qualified to practice medicine in accordance with generally accepted professional standards of medical practice.
9. Respondent’s license to practice medicine in Colorado is hereby placed on probationary status for a period of five years. During the probationary period, respondent agrees to be bound by the terms and restrictions set forth in the paragraphs below
10. Respondent agrees to employ generally accepted medical principles and procedures in his evaluation and treatment of his patients, including the performance of a proper physical examination. Respondent agrees to adequately document his patient’s subjective presentation, his Objective observations of the patient including the results of his physical examination, and adequately explain his assessment of the patient’s condition and his medical plan for the patient’s care. Respondent agrees to order no laboratory test without first determining such test to be medically justified. Respondent agrees to record in the patient’s chart the same diagnoses which uses to support the patient’s billing. Respondent is not precluded from employing holistic evaluations, assessments and plans, but his use of such must be in addition to, and not in lieu of a standard medical approach.
11. Respondent’s medical practice at office and hospital locations in Colorado monitored by a person who is licensed to practice, and is currently practicing, medicine in Colorado. Such person (the “practice monitor”) may be chosen by respondent but must be approved by the panel. The practice monitor shall have no financial interest in respondent’s practice of medicine. Prior to the panel’s approval, the practice monitor shall submit a letter to the panel stating that he. Has read. this Order and understands and agrees to perform his obligations as set forth herein. The following terms and conditions shall apply with regard to practice monitoring;
a. At least once each month, on dates randomly selected by the practice monitor, the practice monitor shall visit all the offices at which respondent practices medicine, and review on a random basis at least 10 charts maintained by respondent. The purpose of this review shall be to determine whether respondent’s medical practice is being conducted in accordance with generally accepted’ standards of· medical practice in Colorado. The practice monitor is authorized to review such other medical records maintained by respondent as the practice monitor deems appropriate to make this determination.
b. The respondent presently holds no privileges within any hospital or medical institution. If the respondent does obtain such privileges within the probationary period, he agrees to notify the board immediately, and shall at that time be subject to a review of his hospital charts.
c. The practice monitor shall submit quarterly. written reports to the panel. The first such report shall be submitted to the panel on the last day of the first full month after the practice monitor has been approved by the Board. All subsequent reports shall be submitted on the last day of each third month thereafter. All reports shall be mailed to the attention of Program Administrator, state Board of Medical Examiners, 1560 Broadway, Suite 1300, Denver, Colorado 80202.
d. The practice monitor’s reports shall include the following: .
1) a description of each of the cases reviewed;
2) the practice monitor’s opinion whether respondent is practicing medicine in accordance with generally accepted standards of medical practice in Colorado;
3) any evidence that respondent is abusing alcohol, or any controlled substance or habit-forming drug.
e. In any instance where the practice monitor believes respondent is not practicing medicine in accordance with generally accepted standards of medical practice in Colorado, he shall immediately report such belief to the panel in writing with
an explanation of the reasons for such conclusion. .f. The panel agrees that, at the request of the respondent, it shall at the end of two years review the need for practice monitoring and reduce or eliminate the requirement if it deems appropriate.
12. Respondent shall nominate the practice monitor within 30 days of the effective date of this Order. It is respondent’s responsibility to ensure that all reports by the .practice monitor are complete and are submitted to the panel on time. A failure of the practice monitor to submit required reports on time may constitute a violation of this. Order by the respondent. If, in the panel’s judgment, the practice monitor fails to perform the functions contemplated by this Order, the panel may require that a new practice monitor assume the responsibilities specified herein. If respondent becomes aware that the practice monitor has ceased to perform the functions contemplated by this Order, respondent shall nominate a new monitor within 30 days.
13. All costs and expenses associated with the practice monitoring required by this Order, and all other costs and expenses incurred by respondent in complying with this Order shall be the sole responsibility of respondent, and shall in no
way be the obligation of the board or panel.
14. Respondent shall obey all state and federal laws during the probationary period ordered herein. If, at any time during the probationary period, respondent does not have in effect a policy of medical malpractice insurance in compliance
with § 13-64-301, C.R.S., respondent shall so notify the Board in writing within three business days.
15. If respondent relocates to another state at any time during the probationary period, respondent shall notify the panel of the change of address within 10 days’ after same is effective. Respondent hereby gives consent to the panel to notify the Board of Medical Examiners, or its counterpart agency, in any state to which respondent relocates, of the existence and terms of this Order.
16. If respondent has complied with all the terms and conditions ordered herein, at the expiration of the period of probation including any extension of the period of probation · required by this paragraph, the panel shall terminate the probation. However, the period of probation ordered herein shall be extended by any period of ‘time during which:
a. Respondent is not engaged in the clinical practice of medicine in Colorado;
b. Respondent is not being monitored as required by the terms of this Order; or
c. Respondent ‘is not in compliance with the terms of this Order.
17. Respondent shall notify the administrator of any hospital where he obtains privileges, and any employer or partner, of the terms and conditions of this Order. Respondent shall provide a copy of a this document to all such persons within 10 . days after the effective date of this document or within 10 days after ,respondent obtains new or additional privileges, employers or-partners. The board is obligated by § 12~36-118(13), C.R.S. to notify any hospital in which the respondent has clinical privileges of the existence of this Order.
18. This Order of the panel entered pursuant to stipulation shall constitute a board order for purposes of S 12-36-117(1) (u), C.R.S., and shall have the same force and effect as an order entered after a formal disciplinary hearing pursuant to § 12-36-118(5)(9·), C.R.S.
19. Respondent agrees that if the panel possesses reason~ able grounds to believe that respondent has failed to comply with any conditions imposed by this Order, the panel may summarily suspend respondent’s license to practice medicine in Colorado until such time as the respondent complies with such conditions.
20. Any violation of this Order shall also constitute unprofessional conduct as defined by § 12-36-117(1) (u), C.R.S., and upon proof of a violation, the board may discipline respondent in accordance with § 12-36-118, C.R.S. This Order shall be admissible as evidence at any hearing held to determine whether a violation of this Order or the Medical Practice Act has occurred.
21. If, after a hearing, a violation of this Order, the Medical Practice Act, or both are proven, the board may take into consideration the facts admitted by respondent herein, as well as the terms and conditions of this Order, prior to making an order authorized by § 12-36-118(5) (g) (III), C.R.S. If the alleged violation is determined not to have been proven, no disciplinary action shall be taken by the board and this Order shall continue in full force and effect. The pendency of any disciplinary action pursuant to this Order shall not affect any obligation of respondent to comply with the terms of this Order, and the requirements of this Order shall continue in effect throughout any such disciplinary proceeding.
22. This Order shall be a public record in the custody of the board.
23. This Order shall take effect on acceptance and signature by the panel.
______________________________
Joseph R. Montante, M.D.
4730 Table Mesa Dr. Ste A
Boulder, CO 80303
Subscribed and sworn to before me in the county of
Boulder, State of Colorado, this 27th day of July 1992.
1992 .
_____________________
Christine Weyer
NOTARY PUBLIC
My Commission expires: 3/1/95
THE FOREGOING Stipulation and Final Order is approved and effective this 21 day of August 1992.
FOR THE COLORADO STATE BOARD OF MEDICAL EXAMINERS
INQUIRY PANEL B
______________________
Gilbert Herman
APPROVED AS TO FORM:
FOR THE RESPONDENT
______________________
RICHARD F. SCHADEN
Attorney for Respondent
1655 Walnut St, #301
Boulder, CO 80302-5435
FOR THE BOARD OF MEDICAL EXAMINERS
GALE A. NORTON
Attorney General
RAYMOND T. SLAUGHTER
Chief Deputy Attorney General
TIMOTHY M. TYMKOVICH
Solicitor General
MERRILL SHIELDS
Deputy Attorney General
LINDA L. SIDERIUS
First Assistant Attorney General
____________________________
ROBERT N. SPENCER, 8801*
Assistant Attorney General
Regulatory Law Section
Attorneys for the Colorado state Board of Medical Examiners
110 Sixteenth street, 10th Floor
Denver, Colorado 80202
Telephone: (303) 620-4159
Counsel of Record
AG Alpha No. RG ME DLGNJ
AG File No. E9208801.104
