STATE OF FLORIDA

DIVISION OF ADMINISTRATIVE HEARINGS

FLORIDA STATE BOARD OF NURSING, )

)

Petitioner, )

)

vs. ) CASE NO. 78-259

) PAMELA KAY JOHNSON, L.P.N., )

)

Respondent. )

)

RECOMMENDED ORDER

This case was heard pursuant to notice on March 30, 1977, in Sanford, Florida, by Stephen F. Dean, assigned Hearing Officer, of the Division of Administrative Hearings.

This case was presented upon an Administrative Complaint filed by the Florida State Board of Nursing against Pamela Kaye Johnson, alleging that she had engaged in unprofessional conduct contrary to Section 474.21(1)(b), Florida Statutes, by administering a prescription drug without a doctor's order, and by violating Section 464.21(1)(f), by exhibiting behavior which the Board has reason to believe to due to poor health and which creates an undue risk that the licensee would do undue harm to others.

The Board presented evidence that Pamela K. Johnson had administered Atarax to Herbert Speir without a doctor's order. Johnson presented evidence in her own behalf concerning matters in mitigation.

APPEARANCES

For Petitioner: Julius Finegold, Esquire

1007 Blackstone Building

Jacksonville, Florida 32202

For Respondent: Pamela Kay Johnson appeared

in her own behalf, assisted by her husband, Lewis Johnson

FINDINGS OF FACT

1. Pamela Kay Johnson is a licensed practical nurse licensed by the Florida State Board of Nursing.

   
   

2. The records of Sanford Nursing and Convalescent Center showed that Pamela Kay Johnson either administered Atarax to Herbert Speir without a doctor's order or administered the Atarax to another patient and erroneously charted its administration on Speir's medication chart while she was on duty at the center on November 6, 1977.

3. On the morning of November 8, 1977, after having worked the evening shift and then gone partying with her husband, Pamela Kay Johnson exhibited faintness and physical distress at the staff meeting at the convalescent center. She was examined by the director of nursing at the center, who sent her home and subsequently terminated her when it was discovered that she had mismedicated Speir.

   
   

4. Mr. Lewis Johnson stated that his wife had been treated for convulsive seizures and had been prescribed Phenobarbital and Dilantin by her treating physician, Dr. Merritt. Mr. Johnson stated that his wife had been on this medication since July, 1977, and subsequent to her initial adjustment to the medication had suffered no ill effects from it. When Mr. Johnson arrived home on November 8, Mrs., Johnson was in bed and asleep. He spoke that day with the director at nursing who advised him that she felt Mrs. Johnson needed to see a physician because of her condition. Mr. Johnson took his wife the following day to Watson Clinic in Ocala, Florida, where she was seen by her treating physician, Dr. Merritt. Dr. Merritt conducted tests on Mrs. Johnson and subsequently advised Mr. and Mrs. Johnson that the level of Phenobarbital and Dilantin in her system was consistent with the dosage he had prescribed. After testing, Dr. Merritt reduced the dosage of Phenobarbital. Dr. Merritt could offer no explanation of Mrs. Johnson's reaction to Phenobarbital.

   
   

5. Mrs. Johnson is currently employed with Homemakers Upjohn as a licensed practical nurse. She has not had any other drug reaction since the reduction of the medication.

   
   

   CONCLUSIONS OF LAW

   
   

6. Pamela Kay Johnson is charged with unprofessional conduct and with exhibiting signs of poor physical health which create an undue risk of the persons contrary to Section 464.21 (1)(b) and (f), Florida Statutes.

   
   

7. The record shows that on November 6, 1977, Pamela Kay Johnson either mismedicated Herbert Speir or mischarted administration of medications. In either event, this would constitute the violation of Section 464.21(1)(b), Florida Statutes.

   
   

8. The testimony of fellow-workers, her nursing director, and her husband indicate Mrs. Johnson's error on November 6 appears to be the proximate result of her reaction to Phenobarbital which she was taking in the amounts prescribed by her physician for the treatment of seizures. Her reaction was anomalous because she had taken the drug several months without adverse reaction. Mrs. Johnson appears to be a conscientious and responsible young woman who would not intentionally assume her nursing duties when her faculties and judgment were impaired. The fact that she committed the medication or charting error as a result of over-medication and that this over-medication was not intentional mitigates her violation of Section 464.21(1)(b), Florida Statutes.

   
   

9. The fact remains, however, that Mrs. Johnson has a medical problem and that if she does not take the medication she may suffer a seizure and that if she takes the medication, she may have a recurrence of her adverse reaction.

RECOMMENDATION

The facts presented in this case indicate that the Board should not take any disciplinary action, but that the Board should take action to insure that the public interest is protected. Based upon the foregoing findings of fact and

conclusions of law, the Hearing Officer recommends that the Florida State Board of Nursing suspend the license of Mrs. Pamela Kay Johnson as a licensed practical nurse until July, 1978, the date Dr. Merritt indicated that she could cease taking the medications and not be subject to further seizures. In addition, the Hearing Officer would recommend that Board suspend the recommended suspension upon being satisfied that Mrs. Johnson's health does not constitute an undue risk to the public.

DONE and ORDERED this 4th day of May, 1978, in Tallahassee, Florida.

STEPHEN F. DEAN

Hearing Officer

Division of Administrative Hearings

530 Carlton Building Tallahassee, Florida 32304

COPIES FURNISHED:

Julius Finegold, Esquire 1007 Blackstone Building

Jacksonville, Florida 32202

Pamela Kay Johnson 1670 Morrell Drive

Lakeland, Florida 33801

Geraldine B. Johnson, R.N. State Board of Nursing

6501 Arlington Expressway - Bldg B. Jacksonville, Florida 32211

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AGENCY FINAL ORDER

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BEFORE THE FLORIDA STATE BOARD OF NURSING

IN THE MATTER OF:

Pamela K. Stauffer D. Johnson

308 E. 13th Street Docket No. 78-259 Sanford, Florida 32771

As a Licensed Practical Nurse License Number 38370-1

/

ORDER

This matter came on for deliberation and final action by the Florida State Board of Nursing on the 26th day of June, 1978, in the Board of Construction Industry Conference Room, 6501 Arlington Expressway, Building B, Jacksonville, Florida 32211.

The Board, having reviewed the entire record, including all pleadings, exhibits admitted into evidence, the transcript of hearing proceedings, the Findings of Fact, Conclusions of Law and Recommended Order of the Hearing Officer, adopts the Findings of Fact and Conclusions of Law of the Hearing Officer and IT IS THEREFORE:

ORDERED AND ADJUDGED that the license practical nurse license number 38370-

1 of the Respondent, Pamela K. Stauffer D. Johnson, be suspended until the Board receives a report from Dr. Merritt indicating that it is no longer necessary for the Respondent to take medications and not be subject to further seizures. Following such a report that the licensee be placed on probation for a period of one year with the following terms and conditions:

1. That the Respondent shall forthwith return license number 38370-1 and current annual renewal receipt issued to practice nursing as a licensed practical nurse to the Florida State Board of Nursing.

   
   

2. That the Respondent refrain from violation of any law, Federal, State or Local.

   
   

3. That the Respondent inform, in writing, the Florida State Board of Nursing immediately of any change of address or change of employment.

   
   

4. That the Respondent provide this office with a written report from her physician every three (3) months of her progress in her treatment.

   
   

5. That the Respondent request her employer to provide the Board with an evaluation of her nursing performance every three (3) months during the period of this probation.

The failure to comply with the terms of said probation shall be deemed a violation.

DONE AND ORDERED this 7th day of July, 1978, at Jacksonville, Florida.

FLORIDA STATE BOARD OF NURSING

BY:

Dorothy C. Stratton, R.N. President

BOARD SEAL

ccs: Pamela K. Stauffer D. Johnson

308 E. 13th Street Sanford, Florida 32771

Julius Finegold, Esquire

Docket for Case No: 78-000259

Orders for Case No: 78-000259