Court Opinion

ID: 9406360
Source: CourtListenerOpinion
Date Created: 2023-06-30 18:05:41.570703+00
Date Added: 2024-06-11T17:20:29.215749
License: Public Domain

2023 IL App (1st) 220371-U

                                         No. 1-22-0371

                                   Order filed June 30, 2023.

                                                                                   First Division

NOTICE: This order was filed under Supreme Court Rule 23 and is not precedent except in the
limited circumstances allowed under Rule 23(e)(1).
_____________________________________________________________________________

                                            IN THE

                             APPELLATE COURT OF ILLINOIS

                                       FIRST DISTRICT

______________________________________________________________________________

SEAN YETMAN, M.D.,                              )     Appeal from the
                                                )     Circuit Court of
               Plaintiff-Appellant,             )     Cook County
                                                )
       v.                                       )
                                                )     No. 2020 CH 6287
ILLINOIS DEPARTMENT OF FINANCIAL AND            )
PROFESSIONAL REGULATION; and CECILIA            )
ABUNDIS, Acting Director of the Department’s    )     The Honorable
Division of Professional Regulation,            )     Eve M. Reilly,
                                                )     Judge Presiding.
               Defendants-Appellees.            )
_____________________________________________________________________________

       PRESIDING JUSTICE LAVIN delivered the judgment of the court.
       Justices Pucinski and Coghlan concurred in the judgment.

                                            ORDER

¶1     Held: The Illinois Department of Financial and Professional Regulation proved its case to
suspend, then refuse to renew, appellant’s medical license, by clear and convincing evidence.
Additionally, appellant failed to show the evidentiary rulings at the administrative hearing were
erroneous or an abuse of discretion. Finally, the sanction imposed was not an abuse of discretion
and appellant’s due process rights were not violated. We therefore affirm the circuit court’s
judgment confirming the Department’s decision to refuse to renew appellant’s medical license.
No. 1-22-0371

¶2     Dr. Sean Yetman appeals from the circuit court’s order confirming the decision of the

Illinois Department of Financial and Professional Regulation (Department), which suspended Dr.

Yetman’s medical license in Illinois and later placed his license in “refuse to renew” status based

on alleged disciplinary action previously taken against Dr. Yetman in Wisconsin. Specifically,

when the Wisconsin Board began to investigate allegations of misconduct brought against Dr.

Yetman, Dr. Yetman agreed to surrender his Wisconsin medical license to avoid formal charges

and a full investigation and hearing by the Wisconsin Board. Dr. Yetman argued to the

Department and the court below that the Wisconsin Board’s actions were not “disciplinary” in

nature for purposes of the Illinois Medical Practice Act of 1987 (Medical Practice Act) (225

ILCS 60/1 et seq. (West 2012)) since the Wisconsin Board did not charge him with misconduct

or investigate the matter further following the settlement. The circuit court subsequently affirmed

the Department’s decision to refuse to renew Dr. Yetman’s Illinois license.

¶3     On appeal, Dr. Yetman argues, in the main, that the Department’s decision concerning

his license must be reversed because the discipline imposed was unduly harsh under the

circumstances, the evidence presented established mitigating circumstances, and the temporary

suspension of his Illinois medical license violated his due process rights and the Medical Practice

Act. In addition, Dr. Yetman argues that the voluntary surrender of his Wisconsin medical

license is not “discipline,” within the meaning of the Medical Practice Act, and therefore, should

not have been considered disciplinary in nature by the Department. For the following reasons, we

affirm the circuit court’s judgment.

¶4                                     I. BACKGROUND

¶5     In June 2001, Dr. Yetman received his medical degree from the College of Physicians

and Surgeons at Columbia University in New York City. Over the next nine years, Dr. Yetman

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No. 1-22-0371

completed his residency, along with fellowship programs in New York and Connecticut. He

obtained his first medical license during that time from the State of New York.

¶6     In August 2010, Dr. Yetman was hired as a staff surgeon at Meriter Hospital, located in

Madison, Wisconsin; however, he was not officially licensed to practice medicine in Wisconsin

until the following May (license No. 55706-20).

¶7                              A. Wisconsin Disciplinary Proceedings

¶8     The following year, questions arose regarding Dr. Yetman’s competency as a doctor after

two of his patients died shortly after he performed cardiac surgery on them.

¶9     The first (more recent) patient (Patient A) was a 77-year-old man who was admitted to

the hospital in August 2011, with congestive heart failure. He required mitral valve repair or

replacement and aorto-coronary bypass surgery. Patient A was then operated on by Dr. Yetman,

who was responsible “for all surgical decisions and technique[s].” During the surgery, Patient A

experienced “considerable bleeding,” and after the surgery, he “continued to bleed from all areas

and died a short time later.”

¶ 10   The second patient (Patient B) was a 61-year-old woman who was admitted to the

hospital in late June 2011, for treatment of acute coronary syndrome. Testing revealed that she

had significant coronary disease and moderate to severe mitral insufficiency. Like the first

patient, Patient B also required mitral valve repair or replacement and bypass surgery. She was

eventually operated on by Dr. Yetman, who was “responsible for all surgical decisions and

technique[s].” Patient B had to return to the operating room five days after her surgery with Dr.

Yetman for chest closure and removal of an intra-aortic balloon pump that had been placed

inside her. She subsequently developed kidney and liver failure and acute respiratory distress

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No. 1-22-0371

syndrome. Eventually, Patient B’s family asked that she not be resuscitated and that she be taken

off life support. Patient B died shortly thereafter.

¶ 11   Following those patients’ deaths, Dr. Yetman left Meriter hospital. He did not practice

medicine for five months while he was on “Vacation/Unemploy[ment].” During that time, Dr.

Yetman looked for employment and also submitted a multi-state medical license application to

be licensed in Illinois, Pennsylvania and Massachusetts.

¶ 12   In September 2012, Dr. Yetman accepted a position as a “Clinical Associate in Cardiac

Surgery” and as an “Instructor in Surgery” at Beth Israel Deaconess Medical Center, located in

Boston, Massachusetts. Dr. Yetman worked there until 2016, when he moved to New York with

his family.

¶ 13   Dr. Yetman’s Wisconsin medical license expired on October 31, 2013, while he was

living and working in Massachusetts. Sometime thereafter, the Wisconsin licensing agency

began investigating allegations against Dr. Yetman related to the deaths of Patients A and B (In

the Matter of Disciplinary Proceedings Against Sean M. Yetman, M.D., Respondent, case 13

MED 061.)

¶ 14   In February 2014, the agency’s prosecuting attorney, Arthur Thexton, offered Dr.

Yetman a settlement regarding the disciplinary charges against him. Dr. Yetman accepted the

offer, and as part of the settlement, he signed a stipulation stating that he “denie[d] any

unprofessional conduct, but solely to settle this matter and avoid the expenses and uncertainties

of litigation,” and agreed to the adoption of an order by the Wisconsin Medical Examining Board

(Wisconsin Board). In addition, Dr. Yetman agreed to waive all “applicable rights” under state

and federal law, including rights to a hearing on the disciplinary charges, to petition for rehearing

and to appeal the final order. Finally, the stipulation provided that if it were adopted by the

                                                 -4-
No. 1-22-0371

Wisconsin Board, the final order would be made public and “published in accordance with

standard Department procedure.”

¶ 15   The next month, the Wisconsin Board issued an order stating,

                “[Dr. Yetman denies any unprofessional conduct with respect to the care of either

       Patient A or Patient B. However, because [Dr. Yetman] has left the State of Wisconsin

       and allowed his registration to lapse, in resolution of this matter, [Dr. Yetman] consents

       to the entry of the following Conclusion of Law and Order.”

The Wisconsin order further stated the stipulation that Dr. Yetman surrender his Wisconsin

medical license and his right to renew his registration was accepted by the Board and that if Dr.

Yetman sought to be relicensed in the future, he would have to pay the costs of such

proceedings.

¶ 16                                  B. Illinois Proceedings

¶ 17   In June 2014, after learning of the Wisconsin Board’s action against Dr. Yetman, the

Department filed an administrative complaint against him. The Department also filed a petition

for temporary suspension of Dr. Yetman’s Illinois license (No. 036.131000) pending a formal

hearing on the Department’s administrative complaint. The Department’s complaint alleged that

discipline of Dr. Yetman’s Illinois license was appropriate under sections 22(A)(12) and

22(A)(34) of the Medical Practice Act because he was disciplined by a sister state (i.e.,

Wisconsin) and failed to report it.

¶ 18   The Department supported its allegations with the Wisconsin Board’s order and an

affidavit from Dr. Brian Zachariah, the Chief Medical Coordinator of the Department’s Division

of Professional Regulation. In his affidavit, Dr. Zachariah stated,

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No. 1-22-0371

                “[Dr. Yetman] is not eligible to practice in the State of Wisconsin because the

       Wisconsin Board issued a Final Decision and Order accepting [Dr. Yetman’s] surrender

       of his license to practice medicine due to his alleged unprofessional conduct in the

       treatment of two cardiac surgery patients who died immediately or shortly after

       operations performed by [Dr. Yetman].”

In conclusion, Dr. Zachariah stated, “I am of the opinion within a reasonable degree of medical

certainty that the continued practice of medicine by Sean M. Yetman, M.D. presents an

immediate danger to the safety of the public in the State of Illinois.”

¶ 19   On June 17, 2014, Jay Stewart, the Director of the Department’s Division of Professional

Regulation (Director), held an ex parte hearing on the Department’s petition for temporary

suspension of Dr. Yetman’s license. At the hearing, Dr. Zachariah was asked why he believed

Dr. Yetman’s continued medical practice posed a risk to the people of the State of Illinois. In

response, Dr. Zachariah testified,

                “Well, Dr. Yetman is a cardiovascular surgeon, and he recently, at least as far as

       we know recently, operated on two patients with really significant disastrous outcomes.

       So much so that the state of Wisconsin felt that he was incapable of practicing medicine,

       and when confronted with that charge, he opted to surrender his license, and if he is so

       impaired, so lacking in the requisite judgment, skill and safety to practice in that state, I

       believe he is also incapable of practicing in our state as well.”

Following the hearing, the Director concluded that “the public interest, safety and welfare

imperatively require emergency action to prevent the continued practice of Sean M. Yetman,

M.D., *** in that [his] actions constitute an immediate danger to public,” and issued an order

                                                -6-
No. 1-22-0371

suspending Dr. Yetman’s medical license in Illinois pending administrative proceedings. Dr.

Yetman was notified of the suspension that day.

¶ 20   The Department scheduled an initial hearing on the administrative complaint nine days

later, but Dr. Yetman continued the matter several times. Meanwhile, Dr. Yetman’s Illinois

medical license expired, and he elected to not renew it at that time.

¶ 21                                  1. Motion to Dismiss

¶ 22   In September 2014, Dr. Yetman moved to dismiss the Department’s complaint against

him, arguing, in the main, that the Wisconsin Board’s order was non-disciplinary, within the

meaning of the Medical Practice Act, and therefore, did not meet the criteria for discipline under

the relevant sections of the Act. Dr. Yetman attached to the motion copies of his resume and an

unsigned letter from Mr. Thexton containing the Wisconsin settlement offer. That letter stated

the Wisconsin Board’s case advisor recommended that Dr. Yetman be disciplined but also noted

that Mr. Thexton was “authorized to offer a settlement” that would allow Dr. Yetman to avoid

“formal discipline.”

¶ 23   In response, the Department argued that the Wisconsin Board’s order satisfied the

statutory requirements to impose discipline on Dr. Yetman’s Illinois license and that the agreed

stipulation entered into between him and the Wisconsin Board constituted “disciplinary action”

for purposes of the Medical Practice Act.

¶ 24   Dr. Yetman replied that (1) the “surrender” of a medical license was not considered

discipline under the Wisconsin statute, (2) the surrender was an action taken by Dr. Yetman, not

by the Wisconsin Board, (3) relevant caselaw supporting the Department’s position only applied

if the sister state’s order was “silent” as to whether it was imposing discipline, which was the

                                                -7-
No. 1-22-0371

case here, and that (4) the Department’s “reason for discipline” was not related to the Act’s

purpose.

¶ 25    In November 2014, the Administrative Law Judge (ALJ) denied Dr. Yetman’s motion to

dismiss the Department’s complaint against him, relying primarily on Gross v. Department of

Financial & Professional Regulation, 2011 IL App (1st) 103101. The ALJ concluded that, under

Gross, which will be discussed in more detail below, the surrender of Dr. Yetman’s Wisconsin

license was “disciplinary,” within the meaning of the Medical Practice Act, that the Wisconsin

Board would have regarded the same action as disciplinary if it had been taken by a sister state’s

licensing board, and that the license surrender was akin to a plea of nolo contendere where Dr.

Yetman did not admit to any wrongdoing but accepted the consequences that would have

followed had the charges brought against him been proven.

¶ 26                                     2. Vacatur Motion

¶ 27    In December 2018, Dr. Yetman moved to vacate the temporary suspension of his Illinois

medical license, arguing the suspension violated the Medical Practice Act and his due process

rights because he posed no “immediate danger” to the public and was denied a “pre-deprivation

hearing,” among other reasons. 1 Dr. Yetman supported the vacatur motion with his resume,

letters from medical disciplinary authorities in Massachusetts and New York stating those states

declined to discipline his licenses based on the Wisconsin Board’s order, a new affidavit from

Mr. Thexton stating the Wisconsin Board’s order “did not constitute discipline under Wisconsin

law,” and copies of unpublished Illinois court decisions LaBrot v. Illinois Department of

Financial and Professional Regulation, 2018 IL App (4th) 160938-U and Cadogan v. Division of

        1
          Dr. Yetman’s motion to vacate the temporary suspension of his license was never ruled on;
instead, the temporary suspension remained in effect until the final administrative decision was issued on
September 16, 2020.
                                                   -8-
No. 1-22-0371

Professional Regulation, 2013 IL App (1st) 122160-U. Although those decisions are

unpublished, Dr. Yetman claimed the doctrine of collateral estoppel applied such that he could

rely on the decisions to support his claims, as will be discussed more below.

¶ 28                                  3. Motions in limine

¶ 29   In August 2019, the Department filed two motions in limine. The first motion sought to

bar Dr. Yetman’s arguments based on the LaBrot and Cadogan cases as those decisions were

issued before January 2021, were unpublished and therefore nonprecedential. The second motion

sought to bar Dr. Yetman from presenting arguments based on Mr. Thexton’s most recent

affidavit because, according to the Department, the affidavit contained inadmissible hearsay

statements since Dr. Yetman was offering them as evidence to prove the truth of the matter

asserted.

¶ 30   In response, Dr. Yetman argued, in the main, that LaBrot and Cadogan could be

considered under the doctrine of collateral estoppel and that Mr. Thexton’s affidavit was

admissible under the Illinois Administrative Procedure Act since the affidavit was evidence “of a

type commonly relied upon by reasonably prudent men in the conduct of their affairs,” an

exception for otherwise inadmissible hearsay evidence. Finally, Dr. Yetman argued that fairness

required admission of Mr. Thexton’s affidavit, even if it consisted of inadmissible hearsay

statements, since the Department was allowed to admit Dr. Zachariah’s affidavit.

¶ 31   The ALJ granted the Department’s motions in limine and issued a decision

recommending that Dr. Yetman’s license be “removed from indefinite suspension status” and

“placed in refuse to renew status.” In reaching its decision, the ALJ found that collateral estoppel

did not apply because Dr. Yetman was trying to cite LaBrot and Cadogan as “binding

precedent,” rather than on the basis of claim preclusion. Additionally, Mr. Thexton’s affidavit

                                                -9-
No. 1-22-0371

could not be relied upon since it was being offered for the “truth of the matter asserted,” not to

lay the foundation for business records, like the Department did with the affidavit of Dr.

Zachariah.

¶ 32   Furthermore, the ALJ found that the Wisconsin Board’s order constituted “disciplinary

action,” within the meaning of the Medical Practice Act, under the Gross decision and applicable

Wisconsin statutes. Additionally, disciplining Dr. Yetman’s Illinois license was consistent with

the purpose of the Medical Practice Act, i.e., to safeguard the public, even though his license had

already expired. The ALJ gave little weight to the fact that other states declined to discipline Dr.

Yetman’s medical license based on the Wisconsin order because there was little to no

information about “the standard of review utilized, the totality of evidence reviewed, or the

statutes relied upon to decide [those] respective courses of action” taken by those states. Finally,

the ALJ considered factors in aggravation and mitigation. While the ALJ found there were no

mitigating factors, the ALJ found there were a number of aggravating factors, including the

seriousness of multiple offenses and violations of the Medical Practice Act (namely, the deaths

of Patients A and B and Dr. Yetman’s failure to report his Wisconsin license suspension and

stipulation to the Department).

¶ 33                                  4. ALJ Hearing

¶ 34   Th ALJ held a formal hearing on the Department’s complaint against Dr. Yetman,

beginning on September 17, 2019.

¶ 35   At the hearing, Dr. Yetman argued, in the main, that the Wisconsin Board’s order was not

“disciplinary” for purposes of the Medical Practice Act, and even if it was, imposing further

discipline on his Illinois license would be unduly harsh since the temporary suspension of his

license was “more than enough” discipline to satisfy the Act’s purpose. Dr. Yetman submitted a

                                               - 10 -
No. 1-22-0371

third letter from another state (Pennsylvania) that declined to discipline his license based on the

Wisconsin Board’s order.

¶ 36   The Department submitted an official copy of the Wisconsin Board’s order and

stipulation. Both were authenticated by Beth Crampton, the Records Custodian of the Division of

Legal Services and Compliance for the Wisconsin Department of Safety and Professional

Services.

¶ 37                                  5. ALJ’s Decision

¶ 38   In October 2019, the ALJ issued a decision recommending that Dr. Yetman’s Illinois

medical license be “removed from indefinite suspension status” and “placed in refuse to renew

status.” In reaching his decision, the ALJ found that the action taken in Wisconsin was

disciplinary in nature and that disciplining Dr. Yetman’s Illinois license was consistent with the

Medical Practice Act’s purpose, notwithstanding that Dr. Yetman’s license had expired and Dr.

Yetman’s testimony that he had no intention of renewing it. The ALJ noted the Act’s language

was discretionary in that it permitted the Department to take any disciplinary action it deemed

appropriate, and that the Department was not “bound to mimic” either the discipline imposed by

the Wisconsin Board or the lack of discipline imposed by other states. Finally, the ALJ found

that Dr. Yetman’s “offense” was serious because (1) he could no longer practice medicine in

Wisconsin and (2) he failed to notify the Department of Wisconsin’s discipline which “deprived

the citizens of Illinois from timely knowing” that he could not practice medicine in Wisconsin.

The ALJ found these constituted factors in aggravation while he also found there was no

evidence of factors in mitigation in the record.

¶ 39                           6. Medical Disciplinary Board’s Decision

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No. 1-22-0371

¶ 40   In November 2019, the Department’s Medical Disciplinary Board issued a decision

adopting the ALJ’s recommended decision. Dr. Yetman moved for rehearing, renewing his

earlier arguments. The Department responded and Dr. Yetman replied, both renewing their

earlier arguments mentioned above.

¶ 41   In September 2020, the Director issued a final administrative decision denying Dr.

Yetman’s motion for rehearing. The Director also adopted the Medical Disciplinary Board’s

decision.

¶ 42                           7. Instant Action for Administrative Review

¶ 43   In October 2020, Dr. Yetman filed the instant complaint for administrative review against

the Department and its acting director in the circuit court of Cook County. The parties filed

memorandums in support of their respective positions, each setting forth similar arguments to

those mentioned above. On July 28, 2021, the circuit court entered an order affirming the

Director’s decision. In reaching its conclusion, the court found that the decision was “neither

against the manifest weight of the evidence nor clearly erroneous.”

¶ 44   Dr. Yetman moved to reconsider the court’s ruling, arguing that the court did not make

sufficient findings on the issues. Dr. Yetman also argued, for the first time, that the case should

be remanded to the Department so that it could consider “new evidence” concerning the

dispositions of the two medical malpractice cases brought against him by Patients A and B. Last,

Dr. Yetman argued that the Department should be required to remove from its website any

mention of his temporary license suspension to avoid the appearance that he had been

“sanctioned twice.” To support his motion, Dr. Yetman attached a jury verdict form finding that

he was not “negligent in his care and treatment” of Patient A on the date of surgery, as well as a

dismissal order and a release stating that the case involving Patient B settled for $20,000.

                                               - 12 -
No. 1-22-0371

¶ 45   In response, the Department argued, in the main, that Dr. Yetman’s new evidence was

untimely and “neither material or relevant.” Specifically, the administrative review hearing was

conducted more than a month after the jury verdict in Patient A’s case was entered, thus making

the evidence untimely. Additionally, the evidence was not relevant because the “outcome of civil

cases does not and cannot affect whether the Wisconsin Order is discipline under Illinois law, or

whether [Dr. Yetman] failed to report it.” Finally, the Department asserted that Dr. Yetman’s

argument regarding the removal of his temporary license suspension from the Department’s

website was improper as it was raised for the first time in a motion to reconsider.

¶ 46   Dr. Yetman replied that the Medical Board should be allowed to decide for itself the

effect of the dispositions in the medical malpractice cases and that the dispositions established

“mitigating circumstance[s]” in that they showed no patient was harmed.

¶ 47   In March 2022, following arguments from the parties, the circuit court denied Dr.

Yetman’s motion to reconsider. The court concluded that the “new evidence” failed to meet the

standards for either a motion to reconsider or remand as the jury verdict was issued before the

administrative hearing, and therefore did not constitute “new evidence,” and the dismissal order

was not “material” since the settlement of Patient B’s case did “not show a lack of harm to the

patient and, in fact, show[ed] quite the opposite.” This appeal followed.

¶ 48                                          II. ANALYSIS

¶ 49   The Director’s decision, which adopted the ALJ’s recommendations, is an administrative

decision and judicial review is governed by Administrative Review Law (735 ILCS 5/3-101 et

seq. (West 2018)). Crittenden v. Cook County Commission on Human Rights, 2012 IL App (1st)

112437, ¶ 40. In reviewing a final administrative decision, we review the Director’s decision, not

the ALJ’s or circuit court’s decision. Id. “The standard of review depends on the question

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No. 1-22-0371

presented; this court reviews factual questions under the manifest weight of the evidence

standard, questions of law de novo, and mixed questions of law and fact under the clearly

erroneous standard.” Masood v. Division of Professional Regulation of Department of Finance &

Professional Regulation, 2023 IL App (1st) 220657, ¶ 47. Because Dr. Yetman does not

challenge on appeal any of the Director’s factual findings, however, the manifest weight standard

of review does not apply in this case.

¶ 50                                     A. Disciplinary Action

¶ 51   Turning the merits of the case before us, we first address Dr. Yetman’s argument that the

Department erroneously determined that the Wisconsin Board’s order was a “disciplinary

action,” within the meaning of section 22(A)(12) of the Medical Practice Act.

¶ 52   Initially, the parties disagree about the appropriate standard of review. Dr. Yetman asserts

the de novo standard applies to this issue since it requires us to interpret statutes, whereas the

Department asserts that the clearly erroneous standard applies to the issue since it involves the

application of section 22(A)(12) of the Medical Practice Act to the undisputed facts in this case.

We agree with the Department that the clearly erroneous standard applies in reviewing the

Department’s decision. See Gross, 2011 IL App (1st) 103101, ¶ 13 (reviewing the Department’s

decision that applied section 22(A)(12) of the Medical Practice Act to undisputed facts for clear

error). “An agency decision is clearly erroneous only where a review of the record leaves the

court with a ‘definite and firm conviction that a mistake has been committed.’ ” Oleszczuk v.

Department of Employment Security, 336 Ill. App. 3d 46, 50-51 (2002) (quoting United States v.

United States Gypsum Co., 333 U.S. 364, 395, 68 S. Ct. 525, 542, 92 L. Ed. 746, 766 (1948)).

¶ 53   Section 22(A) of the Medical Practice Act provides, “[t]he Department may revoke,

suspend, place on probation, reprimand, refuse to issue or renew, or take any other disciplinary

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or non-disciplinary action as the Department may deem proper with regard to the license or

permit of any person issued under this Act, including imposing fines not to exceed $10,000 for

each violation” upon 44 different grounds. 225 ILCS 60/22(A) (West 2012). One of those

grounds provides, as relevant here, that the Department may take disciplinary action based on

“[a]dverse action taken by another state or jurisdiction against a license or other authorization to

practice as a medical doctor, ***, a certified copy of the record of the action taken by the other

state or jurisdiction being prima facie evidence thereof.” 225 ILCS 60/22(A)(12). Furthermore,

“[t]his includes any adverse action taken by a State or federal agency that prohibits a medical

doctor *** from providing services to the agency’s participants.” Id.

¶ 54   After reviewing the record in this case, we cannot say the Department’s decision that the

Wisconsin Board’s order constituted “disciplinary action” was clearly erroneous. In reaching our

decision, we find Gross to be dispositive of the issue. In Gross, this court considered whether an

agreed order by the State of Colorado placing the plaintiff-doctor’s medical license on permanent

inactive status qualified as “disciplinary action” for the purpose of imposing reciprocal discipline

on the doctor’s Illinois license under section 22(A)(12) of the Medical Practice Act. Gross, 2011

IL App (1st) 103101, ¶ 2. The court ultimately held that, even though the Colorado Board did not

impose discipline on the doctor (since it settled with the doctor), the Department did not commit

clear error in concluding that the Colorado Board had taken “disciplinary action” against the

doctor’s license, within the meaning of the Medical Practice Act. Id. ¶ 24. The court’s holding

was based on three facts that it determined satisfied section 2 of the Medical Practice Act: (1) the

Colorado Board’s action that placed the doctor’s license in inactive status qualified as “practice

modification” since it restricted him from practicing in Colorado; (2) the Colorado Board would

regard the action as disciplinary under Colorado law if another state’s board took similar action

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No. 1-22-0371

against the doctor; and (3) the parties expressly agreed that their “agreed order” “had the same

force and effect as an order entered after formal disciplinary hearing.” Id. ¶¶ 18-20.

¶ 55   Finally, the Gross court observed that the parties’ agreed order was similar to a plea of

nolo contendere because the doctor did not admit that he committed the charged misconduct but

“accepted, as a consequence of the charges, a restriction on his license that precluded him from

actively practicing in Colorado.” Id. ¶ 21. And, under the Medical Practice Act, the Department

may discipline a physician based on “[a] plea of guilty or nolo contendere.” Id. ¶ 22 (citing 225

ILCS 60/22(A)(3) (West 2008)). While the Gross court found that section of the Medical

Practice Act did not “directly apply,” the court found it “indicates that the Department will treat

a failure to contest charges in other states as grounds for disciplining a physician in Illinois.”

Gross, 2011 IL App (1st) 103101, ¶ 22.

¶ 56   Similarly, here, the Wisconsin Board’s order clearly modified Dr. Yetman’s practice

since it accepted both the surrender of Dr. Yetman’s license and his waiver of his right to renew

his license, facts that were noted by the ALJ. Second, the Wisconsin Board would regard the

action as disciplinary under Wisconsin law if a sister state’s board took similar action against Dr.

Yetman because Wisconsin law in effect at the time (which is similar to current Wisconsin law

in effect) provided that “adverse action” included “the surrender of a credential, whether or not

accompanied by findings of negligence or unprofessional conduct.” Wis. Admin. Code § Med

10.02(2)(q) (2012). Third, while the parties did not expressly agree that the stipulation “had the

same force and effect as an order entered after [a] formal disciplinary hearing,” as was the case

in Gross, Dr. Yetman’s stipulation was similar to a plea of nolo contendere because Dr. Yetman

denied “any unprofessional conduct” but agreed to the stipulation to avoid formal charges

brought against him.

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No. 1-22-0371

¶ 57    Because the facts here were substantially similar to those in Gross, we likewise conclude

that the Director did not commit clear error in concluding that the Wisconsin Board’s order

constituted “disciplinary action,” within the meaning of the Medical Practice Act. Id. ¶ 24.

Moreover, since Illinois law supports our conclusion, we need not address the other authorities

cited by the Department to support its argument that no clear error occurred.

¶ 58                                    1. Thexton Affidavit

¶ 59    Dr. Yetman, nevertheless, argues that the Wisconsin Board’s order is not a “disciplinary

action” based on Mr. Thexton’s affidavit, which he argues, should have been admitted by the

ALJ because it was the type of evidence ”commonly relied upon by reasonably prudent men in

the conduct of their affairs,” thereby overcoming traditional hearsay exclusions.

¶ 60    In response, the Department argues that the ALJ properly declined to admit Mr.

Thexton’s affidavit as inadmissible hearsay evidence because Dr. Yetman intended to rely on the

affidavit for the truth of the matter asserted in order to “to vacate the Temporary Suspension

Order.” Specifically, Dr. Yetman intended to rely on Mr. Thexton’s statements in his affidavit

that:

                “The stipulation resulted in the Final Decision and Order by the Wisconsin

        Medical Examining Board, which I drafted, that accepted the surrender of the license, but

        the resulting order did not impose discipline on Dr. Yetman under Wisconsin law. This

        was my intent at the time, and the intent of the Board.”

We agree with the Department that the affidavit was properly excluded.

¶ 61    The rules adopted by the Department for administrative proceedings provide, inter alia,

that “[t]he rules of evidence and privilege as applied in civil cases in the circuit courts of this

State shall be followed.” Additionally, “[e]vidence not admissible under those rules of evidence

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No. 1-22-0371

may be admitted, however, except when precluded by statute, if it is of a type commonly relied

upon by reasonably prudent men in the conduct of their affairs.” 68 Ill. Adm. Code 1110.220(a)

(2018). “Hearsay” is a “statement, other than one made by the declarant while testifying at the

trial or hearing, offered in evidence to prove the truth of the matter asserted.” Ill. R. Evid. 801(c)

(eff. Jan. 1, 2011). In general, this type of evidence is inadmissible due to its lack of reliability

and the inability of the opposing party to confront the declarant, unless such evidence falls within

an exception to the hearsay rule. Crittenden, 2012 IL App (1st) 112437, ¶ 62.

¶ 62    An administrative agency’s decision regarding the conduct of its hearing and the

introduction of evidence is properly governed by an abuse of discretion standard and will not be

reversed unless there is demonstrable prejudice to the party.” Wilson v. Department of

Professional Regulation, 344 Ill. App. 3d 897, 907 (2003). In the case at bar, the Director’s

decision to not admit Mr. Thexton’s affidavit did not constitute reversible error.

¶ 63    Here, Dr. Yetman sought to rely on Mr. Thexton’s affidavit “to vacate the Temporary

Suspension Order” based on Mr. Thexton’s statement that no discipline was imposed on Dr.

Yetman by the Wisconsin Board’s order. Because Dr. Yetman wanted to rely on Mr. Thexton’s

statement for the truth of the matter asserted (i.e., that no discipline was imposed), the affidavit

constituted inadmissible hearsay evidence under Illinois law. Although Dr. Yetman argues that

Mr. Thexton’s affidavit was admissible as the type of evidence “commonly relied upon by

reasonably prudent men in the conduct of their affairs,” he has not shown that the Department

would not have been prejudiced by the admission and the Department’s inability to cross-

examine Mr. Thexton.

¶ 64    Furthermore, the record demonstrates that the Department would have been prejudiced by

its inability to cross-examine Mr. Thexton had his affidavit been admitted. For example, Mr.

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Thexton’s affidavit stated that the Wisconsin Board’s order “did not impose discipline on Dr.

Yetman under Wisconsin law,” but it did not indicate whether Mr. Thexton was referring to

formal or informal disciple (or neither). Based on the stipulation that Dr. Yetman agreed to in

order to avoid formal charges brought against him, it would appear that Mr. Thexton was

referring to formal disciple not being imposed on Dr. Yetman. Without being able to cross-

examine Mr. Thexton, however, the parties can only offer speculation as to what type of

discipline was (or was not) imposed. Likewise, if Mr. Thexton’s affidavit had been admitted to

prove that no discipline was imposed on Dr. Yetman, this would have substantially prejudiced

the Department since the Department would not have been able to cross-examine Mr. Thexton to

clarify apparent contradictions between his affidavit and the stipulation.

¶ 65   For the reasons set forth above, we conclude that the ALJ did not abuse its discretion in

refusing to admit Mr. Thexton’s affidavit. We decline to address Dr. Yetman’s remaining

arguments that the affidavit was improperly admitted because (1) the ALJ was unfamiliar with

Wisconsin law, and (2) the ALJ admitted two of the Department’s affidavits, which, according to

Dr. Yetman, was improper, as those arguments are not legally developed and are thus subject to

forfeiture. See Express Valet, Inc. v. City of Chicago, 373 Ill. App. 3d 838, 855 (2007) (noting

that a reviewing court is entitled to have the issues on appeal clearly defined with pertinent

authority cited and cohesive legal arguments presented as the appellate court is not a depository

in which the appellant may dump the burden of argument and research).

¶ 66                                  2. LaBrot and Cadogan cases

¶ 67   Dr. Yetman also argues that the ALJ should have considered the unpublished LaBrot and

Codogan decisions as controlling authority based on the doctrine of collateral estoppel. Illinois

Supreme Court Rule 23(e)(1) (eff. Feb. 1, 2023) provides that an unpublished order issued before

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January 1, 2021, “is not precedential except to support contentions of double jeopardy, res

judicata, collateral estoppel or law of the case.” “An unpublished decision can be cited for

collateral estoppel purposes when a party seeks to use matter from the unpublished decision to

establish certain facts or issues in the present case, provided that the elements of collateral

estoppel are otherwise met.” Moruzzi v. CCC Services, Inc., 2020 IL App (2d) 190411, ¶ 40.

Collateral estoppel applies only if (1) the issue decided in the prior litigation is identical to the

one presented in the current case, (2) there was a final adjudication on the merits in the prior

case, and (3) the party against whom estoppel was asserted was a party, or was in privity with a

party, to the prior litigation. Id.

¶ 68    Dr. Yetman maintains that each element is satisfied here because (1) the issues in LaBrot

and Cadogan are nearly identical to the present issue, namely, whether sanctions on an Illinois

license based on a sister state’s discipline serves the Medical Practice Act’s purpose of protecting

the health and welfare of Illinois citizens, (2) the prior adjudications were final judgments on the

merits, and (3) the Department was either a party to or in privity with the parties in LaBrot and

Cadogan. We disagree. While those cases involved similar issues to those before us, they were

not identical. Both cases contained different facts and issues, including different sister states,

different disciplines imposed, different doctors, and different alleged violations and misconduct.

¶ 69    For example, in the LaBrot case, there were mitigating factors like the doctor’s

unblemished 36-year career as a chiropractor, his community service record, and perhaps most

importantly, the fact that no harm to a patient had been alleged. LaBrot, 2018 IL App (4th)

160938-U, ¶ 47. In light of those mitigating circumstances, the LaBrot court held the aggravating

factors did not justify the sanctions imposed against the doctor. Id. ¶ 49. Likewise, in Cadogan,

there were several mitigating factors present and the primary issue was whether the sanctions

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imposed were unduly harsh in relation to the alleged misconduct of reporting violations in

violation of the Medical Practice Act. Cadogan, 2013 IL App (1st) 122160-U, ¶ 33. Because the

sister state already had its own reporting requirements, the Cadogan court ultimately held the

sanctions imposed on the physician were too severe under the circumstances. Id. The facts in

LaBrot and Cadogan, however, drastically differed from those before us. Here, Dr. Yetman was

accused of serious harm to Patients A and B and there were no mitigating factors. To suggest the

issues in LaBrot and Cadogan were identical to those here would be to lump all challenges to

license modifications based on a sister state’s discipline in the same category, and we decline to

do.

¶ 70                                  B. “Refuse to Renew” Status

¶ 71   Next, Dr. Yetman raises a number of challenges to the propriety of the sanction imposed

by the Director. See Masood, 2023 IL App (1st) 220657, ¶ 82 (reviewing the propriety of a

particular sanction imposed by the Director for an abuse of discretion). “The Director abuses his

or her discretion when a sanction is imposed that is (1) overly harsh, arbitrary or unreasonable in

view of the mitigating circumstances or (2) unrelated to the purpose of the statute.” Id.

Furthermore, as the reviewing court, we must defer to the administrative agency’s expertise and

experience in determining what sanctions are appropriate to protect the public interest. Id.

¶ 72   After reviewing the record in this case and deferring to the Director’s expertise and

experience, as we must, we cannot say that the Director abused her discretion when she placed

Dr. Yetman’s license in “refuse to renew” status. The Director here relied on, among other

things, the seriousness of Dr. Yetman’s alleged violations concerning his two former now

deceased patients, the harm to those patients and the public, and the fact that he had no record of

success since both patients died after Dr. Yetman performed surgery on them in the beginning of

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his career. Since Dr. Yetman settled Patient B’s case, there was no determination of the facts

underlying that patient’s death for the Director to consider. While Dr. Yetman argues the

settlement demonstrated a lack of harm to Patient B, we agree with the circuit court that it

showed “quite the opposite.” As set forth above (supra ¶ 44), Dr. Yetman settled Patient B’s case

against him for $20,000. This suggests that Patient B was harmed in some way; otherwise,

presumably, Dr. Yetman would not have settled the matter. At the very least, the settlement is

not evidence of no harm against the patient, as Dr. Yetman has suggested.

¶ 73   Furthermore, it bears noting the Director found that Dr. Yetman’s failure to report the

voluntary surrender of his Wisconsin license to Illinois deprived Illinoisans from knowing that

Dr. Yetman could no longer practice medicine in Wisconsin. By placing Dr. Yetman’s license in

refuse to renew status, the Director kept him from practicing medicine in Illinois until he

provided the Department with proof that he posed no significant risk the public. This was an

appropriate safeguard to prevent further harm to the public given the seriousness of the alleged

violations. Last, the record reveals there was no mitigating evidence presented at Dr. Yetman’s

hearing for the Director to consider.

¶ 74    Based on the above factors that were relied on by the Director in imposing this sanction,

we find the sanction imposed on Dr. Yetman was reasonable and served the Medical Practice

Act’s purpose to protect the public. Accordingly, we find no abuse of discretion occurred.

¶ 75                                    C. License Suspension

¶ 76   Finally, Dr. Yetman argues that the temporary suspension of his Illinois medical license

violated his due process rights because he was denied proper notice and a pre-deprivation

hearing. As set forth above, the Director imposed a temporary suspension on Dr. Yetman’s

license pending the final hearing.

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¶ 77   The Department asserts, and we agree, that Dr. Yetman’s challenge to the temporary

license suspension is moot. An issue on appeal is moot if no actual controversy exists or if events

have occurred that make it impossible to grant the complaining party effectual relief. Fisch v.

Loews Cineplex Theatres, Inc., 365 Ill. App. 3d 537, 539 (2005). Generally, courts will not

consider moot or abstract questions or render advisory decisions. Id. at 540. Since the temporary

suspension, Dr. Yetman’s license has been indefinitely suspended and placed in “refuse to

renew” status. Moreover, Dr. Yetman has not identified in his briefs any effectual relief that we

can grant him from the temporary suspension.

¶ 78   Mootness aside, we cannot say that Dr. Yetman’s due process rights have been violated

by the temporary suspension of his medical license. “Administrative proceedings are governed

by the fundamental principles and requirements of due process of law.” Sharma v. Division of

Professional Regulation of Department of Financial & Professional Regulation, 2023 IL App

(3d) 220095, ¶ 18. An administrative hearing comports with due process if the parties are given

(1) the opportunity to be heard, (2) the right to cross-examine adverse witnesses, and (3)

impartiality in ruling on the evidence. Id. A court, however, will only find a due process

violation if there is a showing of prejudice. Id. Because a claimed due process violation presents

a question of law, our review is de novo. Id.

¶ 79   Dr. Yetman contends that his due process rights were violated because “[t]here was no

extraordinary or emergency situation” that justified a pre-hearing suspension of his license. We

disagree. The Department’s authority to temporarily suspend a physician’s license lies within

section 37(d) of the Medical Practice Act. That section provides, “[t]he Secretary, after

consultation with the Chief Medical Coordinator or Deputy Medical Coordinator, may

temporarily suspend the license of a physician without a hearing, simultaneously with the

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institution of proceedings for a hearing provided under this Section if the Secretary finds that

evidence in his or her possession indicates that a physician’s continuation in practice would

constitute an immediate danger to the public.” 225 ILCS 60/37(d) (West 2012). Additionally,

“[i]n the event that the Secretary suspends, temporarily, the license of a physician without a

hearing, a hearing by the Medical Board shall be held within 15 days after such suspension has

occurred and shall be concluded without appreciable delay.” Id.

¶ 80   Here, the Director held an ex parte hearing on the Department’s petition for temporary

suspension of Dr. Yetman’s license. The Director ultimately concluded that “the public interest,

safety and welfare imperatively require emergency action to prevent the continued practice of

Sean M. Yetman, M.D., *** in that [his] actions constitute an immediate danger to public.”

Before reaching that conclusion, the Director heard testimony from Dr. Zachariah, the Chief

Medical Coordinator, who opined as to why he believed Dr. Yetman posed a risk to the public.

Dr. Zachariah testified that the allegations against Dr. Yetman were serious, and serious enough

that Dr. Yetman “opted to surrender his license” in Wisconsin. Moreover, as set forth, the

Department scheduled an initial hearing on the administrative complaint nine days after the ex

parte hearing, within the Medical Practice Act’s 15-day time period, but Dr. Yetman

subsequently continued the matter several times (see supra ¶ 20).

¶ 81   The foregoing shows that the Director complied with the Medical Practice Act’s

requirements in temporarily suspending Dr. Yetman’s license pending the final administrative

hearing. While Dr. Yetman contends the Department should have first conducted an

investigation to determine if he was even practicing medicine in Illinois, that is not what the law

requires. Moreover, Dr. Yetman was granted a full hearing nine days later, but he chose to

continue the matter. To the extent Dr. Yetman asserts he posed no immediate danger to the

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public of Illinois since he never practiced in the state, this ignores that Dr. Yetman could have

practiced in Illinois if he chose to do so as long as his license remained in effect. In other words,

the public was at risk as long as Dr. Yetman’s Illinois medical license remained active.

¶ 82   In sum, we conclude that the Director did not commit clear error in concluding that the

Wisconsin Board’s order constituted “disciplinary action,” within the meaning of the Medical

Practice Act, since the order modified Dr. Yetman’s ability to practice medicine in Wisconsin.

Additionally, the ALJ’s evidentiary rulings did not amount to an abuse of discretion and Dr.

Yetman’s due process rights were not violated. To the extent we did not address some of Dr.

Yetman’s numerous arguments on appeal, it is because they are so poorly set out that they fail to

merit further attention and are subject to forfeiture. In re Estate of Parker, 2011 IL App (1st)

102871, ¶ 47; Express Valet, Inc., 373 Ill. App. 3d at 855.

¶ 83                                   III. CONCLUSION

¶ 84   Based on the foregoing, we affirm the judgment of the circuit court confirming the

Director’s decision to refuse to renew Dr. Yetman’s Illinois medical license.

¶ 85   Affirmed.

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