Physician Sentenced to Two Years in Death of Patient

Dr. Ralph J. W. Small, a Northridge physician, on Friday was ordered to prison for two years for the 1978 death of a woman at his former cosmetic surgery clinic in Orange County. Kim Plock, a 33-year-old mother of three, died during surgery of respiratory and cardiac arrest.

Santa Monica Superior Court Judge Raymond Choate re-sentenced Small on a 1979 plea of no contest to involuntary manslaughter after ruling that Small had violated terms of a probation sentence.

Small was supposed to practice medicine only under the supervision of another doctor, but testimony at the six-day hearing showed that he opened offices in Northridge and Newhall without supervising physicians.

When he gets out of jail, the 37-year-old physician will not be able to practice medicine in California. Last month, the state Board of Medical Quality Assurance voted to revoke Small’s medical license effective Aug. 26.

The board concluded that Small failed to honor the probation conditions it set for him after it found the ear, nose and throat specialist guilty of gross negligence and incompetence in his treatment of Plock and numerous other patients.

In Orange County, Small had enjoyed a flourishing cosmetic surgery practice at a walk-in clinic in Santa Ana. Plock’s death during breast enlargement surgery touched off an investigation of his practice that culminated in the Orange County district attorney charging him with 41 criminal counts, including murder, assault, unlawful practice of medicine, grand theft and false advertising.

In a controversial plea bargaining agreement, Small pleaded no contest to involuntary manslaughter, the other charges were dropped and he was placed on five-years’ probation.

The court adopted the medical board’s limits on Small’s practice. While on probation, he not only was to work only under a supervising physician, but also was confined to practicing ear, nose and throat medicine.

After agreeing to the rules, Small in 1981 left Orange County and began practicing at the Lake View Medical Center in Lake View Terrace.

Small’s latest day in court was prompted by the medical board’s discovery last year that he also had been operating an office in Newhall without its knowledge since 1982. Small also opened an office in a Northridge bungalow in 1984.

In addition, he advertised in the Yellow Pages for medical specialties--plastic and reconstructive surgery, pediatrics and dermatology--which he had been forbidden to practice, the board said.

Small testified that he tried to observe the terms of his probation, but that board officials in Los Angeles provided him with conflicting and confusing advice on how to do that.

Choate agreed that the board’s supervision of Small had not been ideal. But the judge said that Small had broken the board’s rules when he “let his ambitions and lack of self-discipline take over.”