Texas State Board of Medical Examiners

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Texas Medical Board
Chapter 178 - Complaints

Complaints
§§178.1-178.8

178.1. Purpose and Scope.
(a) Purpose. The purpose of this chapter is to provide a system of procedures for the
initiation, filing and appeals of complaints that will promote their just and efficient disposition.
(b) Scope. This chapter shall govern the initiation, filing, referral, resolution and appeal
of all complaints before the board.

178.2. Definitions. The following words and terms, when used in this chapter, shall have the following
meanings, unless the context clearly indicate otherwise.
(1) Act--Title 3, Subtitle B, Chapter 151-165, Tex Occ. Code Ann. for
physicians; Title 3, Subtitle C, Chapter. 204, Tex Occ. Code Ann. for physician assistants; Title
3 Subtitle C, Chapter 206, Tex Occ. Code Ann. for surgical assistants; and Title 3, Subtitle C,
Chapter 205, Tex Occ. Code Ann. for acupuncturists.
(2) Address of record--The mailing address of each subject licensee as provided
to the board pursuant to the Act.
(3) Agency--The divisions, departments, and employees of the Texas State Board
of Medical BoardExaminers, the Texas State Board of Physician Assistant BoardExaminers, and
the Texas State Board of Acupuncture Examiners.
(4) Baseless or unfounded--Not based on any evidence or fact.
(5) Board--The appointed members of the Texas State Board of Medical Board
Examiners for physicians and surgical assistants, the Texas State Board of Physician Assistant
Board Assistants for physicians assistants, and the Texas State Board of Acupuncture for
acupuncturists.
(6) Complaint--Information provided to the board that alleges a licensee has
committed a violation of the Act.
(7) Complainant--Any A person, including an individual, a partnership,
association, corporation, or other entity, who initiates a complaint. A complainant may be a
patient, a family member of a patient, a health care professional, or any other person who has
information regarding the possible violation of the Act. A complainant may be anonymous, in

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Chapter 178 – Complaints

which case the complaint will be investigated to the extent that information is provided on which
an investigation can be initiated.
(8) Jurisdictional--A matter over which the board has the authority to investigate
and act upon.
(9) Licensee--A person to whom the board has issued a license, permit,
certificate, approved registration, or similar form of permission authorized by law.
(10) Official Investigation – an investigation conducted by the agency of a
complaint that, after preliminary investigation, has been determined to be jurisdictional and has
been officially filed.
(11) Preliminary Investigation – an investigation conducted by the agency upon
the initiation of a complaint to determine whether the complaint is jurisdictional and whether the
complaint should be filed and an official investigation conducted.
(12) Subject licensee--The licensee against whom a complaint is filed.

178.3. Complaint Procedure Notification.
(a) Methods of Notification. Pursuant to the Act, for the purpose of directing complaints
to the board, the board and its licensees shall provide notification to the public of the name,
mailing address, and telephone number of the board by one or more of the following methods:
(1) displaying in a prominent location at a licensee's place of business, signs in
English and Spanish of no less than 8 1/2 inches by 11 inches in size with the board-approved
notification statement printed alone and in its entirety in black on white background in type no
smaller than standard 24-point Times Roman print with no alterations, deletions, or additions to
the language of the board-approved statement; or
(2) placing the board-approved notification statement printed in English and
Spanish in black type no smaller than standard 10-point 12-pitch typewriter print on each bill for
services by a licensee with no alterations, deletions, or additions to the language of the board-
approved statement; or
(3) placing the board-approved notification statement printed in English and
Spanish in black type no smaller than standard 10-point, 12-pitch typewriter print on each

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Chapter 178 – Complaints

registration form, application, or written contract for services of a licensee with no alterations,
deletions, or additions to the language of the board-approved statement.
(b) Approved English Notification Statement. The following notification statement in
English is approved by the board for purposes of these rules and the Act: NOTICE
CONCERNING COMPLAINTS, Complaints about physicians, as well as other licensees and
registrants of the Texas State Board of Medical BoardExaminers, including physician assistants,
acupuncturists, and surgical assistants may be reported for investigation at the following address:
Texas State Board of Medical BoardExaminers, Attention: Investigations, 333 Guadalupe,
Tower 3, Suite 610, P.O. Box 2018, MC-263, Austin, Texas 78768-2018, Assistance in filing a
complaint is available by calling the following telephone number: 1-800-201-9353, For more
information, please visit our website at www.tsbme.state.tx.us.
(c) Approved Spanish Notification Statement. The following notification statement in
Spanish is approved by the board for purposes of these rules and the Act: AVISO SOBRE LAS
QUEJAS, Las quejas sobre médicos, así como sobre otros profesionales acreditados e inscritos
en la Junta de Examinadores Médicos del Estado de Texas, incluyendo asistentes de médicos,
practicantes de acupuntura y asistentes de cirugía, se pueden presentar en la siguiente dirección
para ser investigadas: Texas State Board of Medical BoardExaminers, Attention: Investigations,
333 Guadalupe, Tower 3, Suite 610, P.O. Box 2018, MC-263, Austin, Texas 78768-2018, Si
necesita ayuda para presentar una queja, llame al: 1-800-201-9353, Para obtener más
información, visite nuestro sitio web en www.tsbme.state.tx.us.
(d) Figures 1 and 2 are samples of the type print referenced in subsection (a) of this
section.

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NOTICE CONCERNING COMPLAINTS

Complaints about physicians, as well as other
licensees and registrants of the Texas State Board of
Medical BoardExaminers, including physician
assistants, acupuncturists, and surgical assistants
may be reported for investigation at the following
address:

Texas State Board of Medical BoardExaminers
Attention: Investigations
333 Guadalupe, Tower 3, Suite 610
P.O. Box 2018, MC-263
Austin, Texas 78768-2018

Assistance in filing a complaint is available by
calling the following telephone number:

1-800-201-9353

For more information please visit our website at
www.tmb.state.tx.uswww.tsbme.state.tx.us

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AVISO SOBRE LAS QUEJAS

Las quejas sobre médicos, así como sobre otros
profesionales acreditados e inscritos en la Junta de
Examinadores Médicos del Estado de Texas,
incluyendo asistentes de médicos, practicantes de
acupuntura y asistentes de cirugía, se pueden
presentar en la siguiente dirección para ser
investigadas:

Texas State Board of Medical BoardExaminers
Attention: Investigations
333 Guadalupe, Tower 3, Suite 610
P.O. Box 2018, MC-263
Austin, Texas 78768-2018

Si necesita ayuda para presentar una queja, llame al:

1-800-201-9353

Para obtener más información, visite nuestro sitio
web en www.tmb.state.tx.uswww.tsbme.state.tx.us.

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Chapter 178 – Complaints

178.4. Complaint Initiation.
(a) A complainant may initiate a complaint by submitting the information concerning the
complaint to the board. This information should include at a minimum:
(1) The name and contact information of the complainant;
(2) The name of the licensee against who the complaint is filed;
(3) The time and place of the alleged violation of the Act; and
(4) If applicable, the name and birth date of the patient who the physician has
allegedly harmed.
(b) The board may file a complaint on its own initiative.
(c) The identity of a non-testifying complainant, as well as the complaint itself, is part of
the investigative information gathered by board employees and shall remain confidential.
Confidentiality shall be waived only by a written statement of the complainant specifically
waiving confidentiality or by the complainant testifying in a contested case hearing.
(d) A peer review committee, licensee, and all other groups named in §§160.003,
204.208, 205.304, and 206.159 of the Act shall report relevant information to the board relating
to the acts of the licensee in this state if, in their opinion, that licensee poses a continuing threat
to the public welfare through the licensee's continued practice. The report shall include a
narrative statement describing the time, date, and place of the acts or omissions on which the
report is based; and it shall be made to the board as soon as possible after the threat risk is
identified and the relevant information can be assembled.

178.5. Complaint Evaluation. Preliminary Investigation of a Complaint.
(a) Once a complaint has been received by the board, agency staff shall conduct a
preliminary investigation an initial screen of the complaint within 30 days. If the complaint
alleges a violation of the standard of care, the staff member conducting the preliminary
investigation an initial screen of the complaint shall be a licensed health care provider in Texas.
(b) As part of the preliminary investigation evaluation of each complaint, the following
minimum additional evidence will be gathered:
(1) The history of the subject licensee collected and maintained by the board; and
(2) The history of the subject licensee maintained by the National Practitioner's
Data Bank.

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(c) During this preliminary investigation initial evaluation period, the agency staff may
make reasonable efforts to contact the complainant concerning the complaint. Any additional
information received from the complainant will be added to the information maintained on the
complaint.
(d) During this preliminary investigation initial evaluation period, the subject licensee
may be given the opportunity to respond to the allegations against him. If the subject licensee is
given this opportunity, the response must be received within the time prescribed by agency staff.
Any additional information received from the subject licensee will be added to the information
maintained on the complaint.
(e) At the conclusion of the preliminary investigation 30-day initial screening period,
agency staff shall determine whether a complaint is jurisdictional and whether there is probable
cause to justify further investigation.
(f) If a complaint is determined to be non jurisdictional, the complaint may be referred to
another government agency for investigation.
(g) If a complaint is determined to be non jurisdictional, the complainant will be notified
of this decision.

178.6. Complaint Filing.
(a) If the preliminary investigation shows that a complaint is determined to be
jurisdictional and that there is probable cause to justify further investigation, the complaint will
be filed with the agency and an official for investigation shall be conducted.
(b) Once a complaint has been filed, a priority will be assigned to the complaint as
provided in Sec. 154.056 (a)(1) of the Act.
(c) Once a complaint is filed, the subject licensee and the complainant will be notified of
the filing of the complaint.
(d) After a complaint has been filed, the complaint will be investigated as provided in
Chapter 179 of this title (relating to Investigations), to include the appropriate referral to Expert
Physician Reviewers, an expert panel as provided in Chapter 182 of this title (relating to Use of
Experts).
(e) Complaints received based on information and facts that have previously been or are
currently being investigated will not warrant additional investigation.

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178.7. Complaint Resolution.
(a) After sufficient information and evidence has been gathered, a determination will be
made as to whether the information and evidence gathered indicate that a violation of the Act has
occurred.
(b) If the information and evidence gathered indicate that a violation of the Act has
occurred, the investigation will be referred for an Informal Show Compliance and Settlement
Conference (ISC)Proceeding. This hearing must be scheduled not later than the 180th day after
the complaint has been filed, unless good cause is shown for scheduling the meeting after that
date. Once the ISC informal Show Compliance Proceeding is scheduled, the complaint shall be
governed by Chapter 187 of this title (relating to Procedural Rules).
(c) If the information and evidence gathered is insufficient to support that a violation of
the Act has occurred, the investigation will be referred to a disciplinary committee of the board
for evaluation. If the disciplinary committee of the board determines there is insufficient
evidence to support that a violation of the Act has occurred, the case will be recommended to the
board for the dismissal of the complaint. If the board approves the disciplinary committee of the
board's recommendation, the complaint will be dismissed.
(d) If a complaint is dismissed, a letter shall be sent to the complainant explaining the
reason for the dismissal.
(e) If the complaint is dismissed, a letter shall be sent to the address of record of the
subject licensee informing him of the dismissal. The board may inform the subject licensee of
any recommendations that may improve the subject licensee's practice.
(f) If the complaint is determined to be baseless or unfounded, the complaint shall be
dismissed, and a letter shall be sent to the address of record of the subject licensee informing him
that the complaint was dismissed due to the fact that it was baseless and unfounded.

178.8. Appeals.
(a) Initiation. Following the receipt of the notice of dismissal of a complaint, the
complainant may file an appeal of the dismissal to of his complaint with the board. To be
considered by the board, the appeal must:
(1) be in writing;

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(2) be received within 60 days of the mailing of the notice of dismissal of the
complaint; and
(3) list the reason(s) for the appeal. The appeal should provide sufficient
information to indicate that additional review is warranted.
(b) Review of an Appeal. Appeals Valid appeals will be considered by a disciplinary
committee of the board. Upon review of an appeal, subject to the approval of the board, a
disciplinary committee of the board may determine any of the following:
(1) The investigation should remain closed;
(2) Additional information needs to be obtained before a determination on the
appeal can be made;
(3) Additional information needs to be obtained before a determination can be
made as to whether a violation of the Act occurred; and
(4) The case should be referred to an ISC Informal Show Compliance Proceeding
for a determination.
(c) Personal Appearances. The complainant has the right to personally appear before a
disciplinary committee of the board. This appearance must be scheduled through agency staff.
This appearance may be limited in time and scope by the chair of the disciplinary committee of
the board that the appeal is before.
(d) Notice. The complainant shall be notified of the Board's decision concerning the his
appeal.
(e) Appeals Limited. Only one appeal shall be allowed for each complaint.

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