Case Title: Padmanabhan v. Board of Registration in Medicine

Citation: 

Docket Number: SJC-12119

State: massachusetts

Court: Massachusetts Supreme Court

Date: 2017-06-27T00:00:00Z

Document:
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SJC-12119 
 
BHARANIDHARAN PADMANABHAN  vs.  BOARD OF 
REGISTRATION IN MEDICINE & another.1 
 
 
June 27, 2017. 
 
 
Board of Registration in Medicine.  Administrative Law, 
Decision. 
 
 
 The petitioner, Bharanidharan Padmanabhan, appeals from a 
judgment of a single justice of the county court dismissing his 
petition for relief in the nature of certiorari pursuant to 
G. L. c. 249, § 4.  On May 18, 2017, we issued an order 
affirming the single justice's judgment and indicated that this 
opinion would follow.   
 
 
In 2010, Padmanabhan, a medical doctor, was terminated from 
his position at Cambridge Health Alliance, a termination that he 
alleges was based on false claims that he harmed patients and in 
retaliation for certain actions that he took, including 
reporting purported insurance fraud.  Subsequent to his 
termination, the Board of Registration in Medicine (board) 
commenced disciplinary proceedings against him, and referred the 
matter to the Division of Administrative Law Appeals (DALA).2  
Following an evidentiary hearing that spanned eight days, the 
DALA magistrate issued his recommended decision in August, 2015.  
The board subsequently remanded the case to the magistrate, in 
                                                 
 
1 Division of Administrative Law Appeals. 
 
 
2 The parties do not specifically state, and the record 
before us does not appear to indicate, when exactly the Board of 
Registration in Medicine began its investigation of Padmanabhan.  
It issued its statement of allegations against him in July, 
2014.   
2 
 
 
January, 2016, asking the magistrate to elaborate on certain 
parts of his decision and, among other things, to include 
credibility determinations and clarify certain inconsistencies 
in the decision.  In March, 2016, the magistrate issued an order 
indicating that he was preparing a revised recommended decision 
for the board in response to the remand order. 
 
 
Shortly thereafter, Padmanabhan filed a "Renewed Complaint 
in the Nature of a Petition for a Writ of Certiorari" in the 
county court.  In the petition he argued that his due process 
rights had been violated in various ways during the course of 
the board proceedings.  He also argued that the recommended 
decision issued by the magistrate in August, 2015, became final 
in February, 2016, pursuant to 801 Code Mass. Regs. 
§ 1.01(11)(c)(3) (1998), and that his petition thus did not stem 
from, or seek relief from, an interlocutory ruling but rather 
what was, in effect, a final decision of the board.  The board 
moved to dismiss the petition on the basis that the proceedings 
before it had not yet concluded and that it had not yet issued a 
final decision.  The single justice dismissed the petition 
without a hearing.3   
 
 
In his appeal, Padmanabhan continues to argue that the 
magistrate's recommended decision became the board's final 
decision pursuant to 801 Code Mass. Regs. § 1.01(11)(c)(3), and 
that his appeal is thus not interlocutory.  The regulation 
provides that if an agency such as the board "fails to issue a 
final decision within 180 days of the filing or re-filing of [a] 
tentative decision, the initial decision shall become the final 
decision of the [a]gency, not subject to further [a]gency 
review."  In Padmanabhan's view, the magistrate's recommended 
decision, issued in August, 2015, became the board's final 
decision in February, 2016, 180 days after it was issued.  After 
the board received the recommended decision, however, it 
remanded the case to the magistrate for additional findings and 
                                                 
 
3 Padmanabhan previously filed a similar petition for relief 
in the county court in 2014.  In that petition, he sought review 
of the DALA magistrate's denial of his motion to dismiss the 
disciplinary proceedings.  A single justice allowed DALA's 
motion to dismiss the petition on the basis that the 
magistrate's decision was interlocutory, not subject to judicial 
review at that time, and that Padmanabhan would be entitled to 
seek review pursuant to G. L. c. 112, § 64, at the conclusion of 
the disciplinary proceedings before the board.  Padmanabhan did 
not appeal from the dismissal of this earlier petition. 
3 
 
 
clarification, pursuant to 801 Code Mass. Regs. 
§ 1.01(11)(c)(2), and it did so within 180 days of having 
received the recommended decision.  In other words, the remand 
was timely.  In that circumstance, according to the board, when 
it recommits a tentative decision to the presiding officer -- in 
this case the DALA magistrate -- the 180-day period referred to 
in 801 Code Mass. Regs. § 1.01(11)(c)(3) will begin to run anew 
when a revised decision is refiled.  See 801 Code Mass. Regs. 
§ 1.01(11)(c)(2) ("[t]he same procedural provisions applicable 
to the initial filing of the tentative decision shall apply to 
any re-filed tentative decision after recommital").    
 
 
We agree in the circumstances presented here that the 
board's decision was not yet final when Padmanabhan filed his 
petition in the county court, and that his attempt to have 
review at that juncture was premature.4  We note as well that 
when the board issues a final decision, the appropriate avenue 
to seek review is by a petition pursuant to G. L. c. 112, § 64, 
not via a petition for relief in the nature of certiorari, as 
Padmanabhan filed here.  See, e.g., Picciotto v. Appeals Court 
(No. 2), 457 Mass. 1002, 1002, cert. denied, 562 U.S. 1044 
(2010), and cases cited ("certiorari relief designed to correct 
errors not otherwise reviewable by motion or by appeal" 
[quotation and citation omitted]).  The single justice, in 
short, did not err or otherwise abuse his discretion in 
dismissing the petition. 
 
 
Although Padmanabhan's argument regarding finality is 
ultimately unavailing, we are not unsympathetic to his 
situation.  The board issued its statement of allegations 
against him in July, 2014, almost three years ago, and 
                                                 
 
4 The circumstances here differ from those presented in 
McGuiness v. Department of Correction, 465 Mass. 660 (2013), 
where we also considered 801 Code Mass. Regs. § 1.01(11)(c)(3).  
In that case, a Civil Service Commission (commission) vote on 
whether to adopt a DALA magistrate's findings of fact and 
recommended decision resulted in a two-to-two tie.  See id. at 
662.  We concluded that the tie vote amounted to a "failure to 
make a final decision" and, pursuant to 801 Code Mass. Regs. 
§ 1.01(11)(c)(3), resulted in the magistrate's decision becoming 
the final decision of the commission by default.  See id. at 
666.  In doing so we noted that the commission "did not fail to 
act for want of effort; it did not act because it could not, 
given the voting deadlock."  Id.  Here, however, the board did 
act. 
4 
 
 
Padmanabhan claims that his medical career has essentially been 
in limbo ever since.  We do not condone the lengthy disciplinary 
process to which Padmanabhan has been subjected.  Indeed, we 
have serious concerns about the potential for repeated 
recommitals and, in turn, repeated re-settings of the 180-day 
clock pursuant to 801 Code Mass. Regs. § 1.01(11)(c)(2), and to 
the elongated process that could result.  In this case, as it 
turns out, the DALA magistrate issued his amended recommended 
decision in August, 2016, while this appeal has been pending, 
and the board has since adopted that decision and suspended 
Padmanabhan's license.5  For Padmanabhan, therefore, it appears 
that the end of the administrative process is imminent.  He now 
has the opportunity to pursue judicial review of the final 
decision of the board, which he may do pursuant to G. L. c. 112, 
§ 64.  In that appeal, he will be free to raise issues related 
to the procedural aspects of the disciplinary process and the 
length of time that process took in his case.6 
 
 
For these reasons, we affirmed the judgment of the single 
justice. 
 
 
Bharanidharan Padmanabhan, pro se. 
 
Samuel M. Furgang, Assistant Attorney General, for Board of 
Registration in Medicine & another. 
                                                 
 
5 In January, 2017, while this appeal was pending, 
Padmanabhan filed an "Emergency Injunction" in this court asking 
for a stay of any further proceedings before the board.  The 
board opposed the attempt to prohibit it from issuing a final 
decision.  A single justice denied the motion.  
 
 
Counsel for the board stated at the oral argument of this 
case that the board has since adopted, with some modifications, 
the magistrate's amended recommended decision but that, at that 
point, the board had not yet determined whether to impose 
discipline.  According to papers subsequently filed by 
Padmanabhan, the board issued an order of indefinite suspension 
on May 11, 2017, effective thirty days from that date. 
 
 
6 In addition to the concerns expressed above, we also are 
troubled by the fact that counsel for the board was unsure of 
the practical consequences of Padmanabhan's situation (e.g., 
whether he can effectively practice medicine, and get paid to do 
so, pending the board's decision).  It behooves the board to 
understand its own disciplinary process and the effect of that 
process on those subject to it.