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State strips ex-USC medical school dean of license, citing 'an appalling lack of judgment'

State strips ex-USC medical school dean of license, citing 'an appalling lack of judgment'
Dr. Carmen Puliafito. (Los Angeles Times)

The state agency that regulates physicians on Friday ordered USC’s former medical school dean stripped of his license to practice medicine, citing “an appalling lack of judgment” in his use of drugs and association with a circle of addicts and criminals while leading the major institution.

The Medical Board of California announced that it was adopting the findings of an administrative law judge who heard days of testimony this spring from Dr. Carmen Puliafito and other witnesses. The decision does not go into effect for 30 days, and Puliafito has the option to appeal. His attorney, Peter Osinoff, did not respond immediately to a request for comment.

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During the hearing, the Harvard-trained ophthalmologist and his attorney said he suffered from bipolar disorder and a “hypomanic” state that poisoned his judgment and skewed his understanding of how his behavior would be viewed by others. They argued that Puliafito has been in recovery about a year and should be allowed to practice medicine under supervision.

But the administrative law judge, Jill Schlichtmann, rejected that argument. The judge said that while Puliafito had “made some important strides ... the evidence did not establish that his rehabilitation has progressed to the point that would justify allowing his continued licensure, even on a restricted basis.”

She also said Puliafito's “testimony lacked insight and was inconsistent with one who has fully accepted responsibility for his misconduct.” Even during the hearing, Schlichtmann said, Puliafito “continued to minimize his misconduct and his testimony lacked complete candor, raising ongoing concerns about his honesty and his rehabilitation.”

The decision comes a year after The Times detailed his drug use and partying, prompting the state’s investigation and its accusation that the former dean used methamphetamine and heroin, smoked methamphetamine within hours of seeing patients and provided drugs to criminals and addicts. The judge said the evidence did not rise to “a clear and convincing” level that the ex-dean used drugs the same day he practiced medicine.During the proceeding, Puliafito denied supplying street drugs to them.

Deputy Atty. Gen. Rebecca Smith argued at the hearing that Puliafito cared only about himself and recounted the chaos of Puliafito’s last few years, placing the blame at his feet as images of the ex-dean consuming drugs were projected onto a white screen for the judge to see. He provided drugs to a young prostitute, Sarah Warren, and her underage brother, and misled authorities about her Warren’s condition and history of drug use when the woman overdosed in his Pasadena hotel room, she argued.

In her decision, Schlichtmann particularly criticized Puliafito’s response to Warren’s overdose.

“His failure to seek appropriate treatment for [Warren] when she suffered an overdose and his misstatements to medical personnel constitute shocking behavior by a physician,” the judge wrote.

Osinoff attacked the state’s evidence during the hearing, particularly the three witnesses who made allegations about Puliafito providing drugs to other people. He pointed out that on the first day of the trial, Warren and her brother were excused from testifying after their attorney cited their 5th Amendment right against self-incrimination. They provided declarations with their allegations to the court.

Another witness for the state, karaoke deejay Don Stokes, repeatedly gave conflicting accounts, veering during the same testimony from denying he ever saw Puliafito smoke methamphetamine to acknowledging it. In an audio interview played for the court, Stokes said Puliafito was the source of drugs at several parties he attended. He testified he had been drinking before the interview and before he gave the state a sworn declaration, and said he couldn’t recall Puliafito providing drugs to others.

In her decision, the judge found that Puliafito improperly prescribed “dangerous drugs” to Warren and her teenage brother and “provided alcohol and marijuana” to him.

Puliafito testified for hours, apologizing to his colleagues, students and family for harming them. He also said he was sorry for damaging the reputation of USC’s Keck School of Medicine and the integrity of the medical profession.

And he also apologized to Warren for enabling her addiction through his financial support, even though during his mania he believed he was rescuing her from a life of drugs and prostitution, his attorney said previously.

“I was supposed to be a beacon of morality and judgment, and I fell flat on my face after decades of doing the right thing,” Puliafito said. “I’m not placing blame on anyone except myself. At the core of this I forgot that I was a physician 24/7. I failed to recognize that and did things outside the workplace that were wrong.”

The Medical Board said that a USC investigation launched after The Times report on Puliafito found “unprofessional and belligerent conduct,” but no “evidence of compromised patient care” while he served as dean. USC declined to comment Friday.

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