STATE OF FLORIDA
DIVISION OF ADMINISTRATIVE HEARINGS
DEPARTMENT OF PROFESSIONAL ) REGULATION, BOARD OF MEDICAL ) EXAMINERS, )
)
Petitioner, )
)
vs. ) CASE NO. 82-147
)
HERBERT F. JOHNSON, M. D., )
)
Respondent. )
)
RECOMMENDED ORDER
Pursuant to notice, an administrative hearing was held before Diane D. Tremor, Hearing Officer with the Division of Administrative Hearings, on June 22 and 23, 1982, in the Hillsborough County Courthouse, Tampa, Florida. The issue for determination at the hearing was both respondent's license as a medical doctor should be revoked, suspended or otherwise disciplined for the reasons set forth in the Administrative Complaint filed on December 21, 1981.
APPEARANCES
For Petitioner: Grover C. Freeman
FREEMAN & LOPEZ
4600 West Cypress Avenue, Suite 410
Tampa, Florida 33607
For Respondent: Howard L. Garrett
GARRETT & GARRETT
518 Tampa Street, Suite 202 Tampa, Florida 33602
INTRODUCTION
By a forty-four count Administrative Complaint filed on December 21, 1981, the Department of Professional Regulation, Board of Medical Examiners charges respondent with violations of Chapter 458.331 and Chapter 893.05, Florida Statutes (1980), and seeks to revoke, suspend or take other disciplinary action against his license as a medical doctor. In summary form, the factual allegations of the Complaint are that respondent prescribed 600 tablets of Percodan and 9,500 tablets of Dilaudid (4 mg. strength) to twenty-six patients between October 30, 1980 and March 26, 1981. More specifically, the Complaint charges that respondent prescribed Dilaudid to fourteen named patients in excessive amounts without adequate medical examinations or medical records to justify such a course of treatment. It is further alleged that such conduct constituted the prescribing, dispensing or administering of a controlled substance other than in the course of professional practice, gross or repeated malpractice or the failure to practice medicine with that level of care, skill
and treatment which is recognized by a reasonably prudent similar physician as being acceptable.
At the hearing, the petitioner presented the testimony of Mary Sue Sutton, an investigator with the Department of Professional Regulation; Lawrence Neufeld, M.D.; Donn L. Smith, M.D., who was accepted as an expert witness in the field of the practice of medicine; the respondent Herbert F. Johnson, M.D.; and William D. Gates, Jr., a narcotics detective with the Tampa Police Department.
Petitioner's Exhibits A through E, which included the deposition of Ronald Dick, an expert document examiner, were received into evidence.
The respondent testified in his own behalf and presented the testimony of Joseph Daniel Faulkner, the executive director of the DWI Counter-Attack School; Kathryn Bowns, a head and neck cancer nursing specialist at the Veteran's Administration Hosital; and Jay S. Reese, M.D.
Subsequent to the hearing, both parties submitted proposed findings of fact and proposed conclusions of law. To the extent that the parties' proposed findings of fact are not contained in this Recommended Order, they are rejected as being either not supported by competent, substantial evidence adduced at the hearing, irrelevant or immaterial to the issues in dispute or as constituting conclusions of law as opposed to findings of fact.
FINDINGS OF FACT
Upon consideration of the oral and documentary evidence adduced at the hearing, the following relevant facts are found:
At all times relevant to this proceeding, respondent Herbert F. Johnson was licensed as a medical doctor in the State of Florida, and practiced in Tampa, Florida. The majority of his practice has been in the field of radiation therapy, oncology and the treatment of cancer patients. In approximately June of 1980, respondent began a general practice in Tampa and continued there until the latter part of March, 1981, when he moved his practice to Bryson City, North Carolina.
On February 26, 1981, Leonard F. Torres, a thirty-one year old man who listed his occupation as an airline technician (radio) with Eastern Airlines, visited respondent's office with complaints of back pains. The respondent's medical records do not reflect that Torres was given a physical examination or that any diagnostic studies were undertaken by respondent to confirm Torres' complaints of back pain. Between February 26, 1931, and March 24, 1981, respondent prescribed 320 tablets of Dilaudid, 4 mg. strength, for Mr. Torres. The medical records indicate that one 4 mg. Dilaudid prescription for 100 tablets was given because Torres was going to be out of the country for 4 to 6 weeks, that another was renewed for 100 tablets because Torres was departing for a period of 4 to 6 months and that another 100 tablet prescription was renewed because Torres did not have the prior prescription filled within the 48 hours allowed for Dilaudid. The medical records prepared by respondent for patient Torres do not justify the prescription of 320 tablets of 4 mg. strength Dilaudid. Proper medical practice requires a physician to attempt to find the systemic origin of a complaint of back pain. This may include the use of x- rays, a myelogram, or referral to an orthopedic surgeon. A physician can not properly treat a patient without knowing what is wrong with the patient.
Patient Patti Hendrix first visited respondent's office on February 11, 1981, complaining of headaches and vomiting. The respondent's medical records
reflect that respondent examined her eyes, her throat and took her blood pressure. Along with other medications, respondent prescribed 30 tablets of 4 mg. strength Dilaudid for Miss Hendrix on this first visit. She appeared at respondent's office again on February 15, 20, 27 and March 4, 9, 13 and 25, 1981, and each time respondent prescribed an additional 30 tablets of Dilaudid,
4 mg. strength. The respondent's medical records reflect no further physical examination or diagnostic studies for patient Hendrix's complaints of headaches. On one occasion when she received a prescription for Dilaudid, March 13th, respondent's records note that Miss Hendrix was "totally free of headaches for the last two days." Her other complaints included sinus infection and cold sores or blisters. It is acceptable medical practice to prescribe Dilaudid for headaches only in acute situations after the trial of other medications. A patient suffering acute head pain should be referred to a neurologist.
Danny Springer, age 31, first visited respondent's office on February 27, 1981, complaining of pain in his foot following an earlier surgery. The pain was of an arthritic type. Respondent did order blood tests on this patient, but no radiological or other diagnostic tests were performed. Mr. Springer was prescribed 30 tablets of Dilaudid, 4 mg. strength, on the first visit. The respondent's Medication List for Mr. Springer indicates that 50 tablets of Dilaudid were prescribed on March 2, 100 on March 4 and another 100 on March 10, 1981; for a total of 280 tablets in less than two weeks. Respondent's medical records indicate that Springer was given 100 tablets on March 4 because he was leaving the state for 3 to 5 weeks, and was given another
100 tablets on March 10 because he "lost his medication."
The respondent's Medication List for patient Robert A. Korynas, 21 years of age, indicates that he received four Dilaudid prescriptions from respondent for 100 tablets each, 4 mg. strength, between February 18 and March 23, 1981. This patient complained of back pain on his first visit of February 17, 1981. Respondent found muscle tightness in the patient's back and the medical records reflect that the only physical examination performed was an elevation of the patient's legs. On that first visit, Emperin No. 3 was prescribed. On the following day, February 18, without further notation in the medical records, the patient was prescribed Dilaudid, 4 mg. x 100. Respondent's medical records note that on a March 12th visit, "he is getting the back pain under control." Another 100 tablet prescription for Dilaudid was given the patient. On March 20, 1981, respondent noted that the patient "experienced definite improvement with the use of Robaxin and DMSO," but lost his prescription for Dilaudid. A new prescription was given. The medical records reflect that three days later, on March 23, the patient stated that his prescription was lost last week and "a new prescription was given today for Dilaudid x 100." There is no indication in the medical records of patient Korynas that any diagnostic studies, such as x-rays, were undertaken to define the origin or extent of the patient's alleged back pain.
Patient Charles Goodwin, a 36-year-old truck driver, first visited respondent's office on February 13, 1981, with complaints of pain in his left leg near the site of a steel rod placed there after a fracture. The patient stated that he had been using Dilaudid for control of his pain. The only notation in the respondent's medical records indicating treatment afforded this patient on the first visit were a blood pressure reading of 218/140, and notes that old surgical scars were present on the patient's ankle and that there was no localized tenderness or redness to suggest infection. The patient was given a prescription for 50 tablets of Dilaudid 4 mg. strength, on this first visit. On subsequent visits, the patient's blood pressure was checked and blood lab tests were performed on February 27, 1981. The respondent's medical records
reflect that Dilaudid, 4 mg. strength, was prescribed for Goodwin in doses of
100 tablets each, on the following dates: February 18 and 26, and March 6, 13,
20 and 26, 1981. The patient received a total of 650 tablets of Dilaudid in a period of six weeks, in spite of respondent's notations in the medical records that the patient was advised to take aspirin or bufferin for pain "rather than depending exclusively on Dilaudid" (March 6), that "he is requiring a lot of Dilaudid" (March 13) and "I've advised him at this time to decrease the Dilaudid to one every four hours and after 3 days to start increasing the interval between medications" (March 20).
Between February 4, 1981 and March 26, 1981, patient Norman Clyde Snyder, a 35-year-old construction worker, received from the respondent prescriptions for 570 tablets of 4 mg. Dilaudid. This patient had sustained back injuries in the past and complained of pain. Respondent diagnosed a herniated disc after a physical examination. His prescriptions for Dilaudid from respondent were received on the first visit of February 4 (20 tablets), and again on February 9 (100 tablets), February 13 (100), February 27 (100), February 28 (100), March 9 (30), March 16 (30), March 17 (30), March 23 (30) and March 26 (30). The respondent's notations in the patient's medical records indicate that, on February 13, the patient was going to Oregon for "possible 2 to 4 months," that on March 5, the patient was advised by respondent "to start tapering down on the Dilaudid since he is taking too much at the present time," that on March 9, the patient lost his medication in an automobile accident, that on March 16, respondent advised him "to start tapering rapidly on his medication and stretch out to 8 hours between doses," and that on March 17, the patient's medication was taken out of his jacket at the pool hall."
Phyllis Myers, 37 years old, received from the respondent eight prescriptions for Dilaudid, 4 mg. strength, between February 6 and March 26, 1981, for a total of 600 tablets. She complained of having a history of urinary tract infections with attendant back pain. On her first visit on February 6, 50 Dilaudid tablets were prescribed. The Medication List reflects that another 100 were prescribed on February 11, though the medical records do not reflect that respondent saw her on that date. The respondent's records for this patient indicate that on February 21, the patient advised respondent that she would be in Miami for the next three weeks. She received a prescription for 100 tablets of Dilaudid. On February 27, the patient came in and received another prescription for Dilaudid, 100 tablets. Again, she was to be in Miami for a week and a half. On March 3, the records state that Myers came in and had been robbed of her money and medications in Miami. Again, another prescription for
100 tablets was given, though this is not reflected on the Medication List. Prescriptions for 50 tablets of Dilaudid were given on March 16 and 17, the medical records reflecting that "husband beat pt. and stole medicine." A urinalysis and lab report was obtained by respondent for this patient on March 5, some one month after her first visit and after 350 tablets of Dilaudid had already been prescribed for her.
Dale J. Schepman, a 31-year-old long-distance truck driver, first visited respondent on February 24, 1981, with back pain complaints. Respondent performed a physical examination and found muscle tenderness and tightness and a small inguinal hernia, acute pharyngitis and early tonsilitis. Respondent prescribed 50 tablets of Dilaudid, 4 mg. strength, on this initial visit. The respondent's records reflect that the patient was given additional prescriptions for Dilaudid on February 27 (50 tablets), March 10 (50), March 19 (50) and March
26 (100), for a total of 300 tablets in a one month period. No x-rays or other diagnostic studies were undertaken on this patient by respondent.
Belinda Hagan, a 25-year-old employed by Eastern Airlines, first visited respondent's office on March 9, 1981, complaining of severe headaches and stating that she had used Dilaudid in the past. Respondent's impression was that she had acute frontal sinusitis. Among other medications, respondent prescribed 20 tablets of Dilaudid, 4 mg. strength, on this first visit. The respondent's medical records reflect that the patient returned to his office on March 24, stating that she had been raped on March 18, and was unable to sleep since that episode. She requested Dilaudid to allow her to sleep and relax, and respondent again prescribed 20 tablets. On the following day, March 25, the patient again came into respondent's office, stating that she "lost her medication in the parking lot yesterday." Respondent prescribed another 20 tablets of Dilaudid for her.
Between February 6, 1951 and March 26, 1981, Edward E. Cohran received from the respondent prescriptions for 430 tablets of Dilaudid, 4 mg. strength. This patient, a 44-year-old truck driver, complained of severe back pain, had a herniated disc and was significantly overweight. Respondent did have his medical records from a recent hospitalization. The medical records reflect that on one occasion, respondent was told that the pharmacist would not honor the prescription because it was not timely presented for filling, and that on another occasion, the patient reported that he lost his prescription.
Harry Allen Rockwell, a 41-year-old long-distance truck driver, first visited respondent on February 26, 1981, with pain in his right flank, tenderness in the right side of the abdomen and a history of renal stones. The medical records do not reflect that any laboratory or other diagnostic tests were performed by respondent on that first visit, or any time thereafter. One hundred tablets of Dilaudid, 4 mg. strength, were prescribed by respondent. Some seven days later, patient Rockwell was again prescribed 100 tablets of Dilaudid. While the medical record for March 5th reflects that he was given refills because he "lost all his medication on his last trip out of town," the Medication List indicates that the Dilaudid was "replace[d]" on March 6th.
Patient Ken Williams, a 31-year-old construction worker, was prescribed 30 tablets of Dilaudid by respondent on his first visit on February 5 and an additional 230 tablets on the following seven visits between February 10 and March 16, 1981. This patient suffered back pain following a 1978 automobile accident, according to respondent's medical records. Other than the performance of manipulation by the respondent, the medical records do not indicate that other diagnostic testing was performed on this patient.
Jackie A. Knecht, 33 years old, first visited respondent's office on February 19, 1981, with complaints of back pains resulting from an injury two years ago. After an examination, respondent found some muscle spasms and evidence of a curvature within the spine. On this first occasion, respondent prescribed 100 tablets of Dilaudid, 4 mg., for the patient. On March 4, 1981, patient Knecht again visited respondent and his notes reflect that the use of DMSO and Norflex
"gives her complete relief. With these results, the patient is planning to taper off her dependence and need for Dilaudid. I've advised her to take 1/2 tablet, rather than a whole tablet as needed."
A prescription for 100 tablets of Dilaudid, 4 mg., was given the patient on March 4th. A similar prescription was given her on March 9th because the
patient told respondent that her purse and medication were lost at the beach. Neither x-rays nor other diagnostic studies were undertaken for this patient.
Eighteen-year-old Susan Burns received five prescriptions for Dilaudid from the respondent between February 26 and March 18, 1981, for a total of 170 tablets, 4 mg. strength. This patient came in with complaints of pain in the right flank which respondent diagnosed as chronic urinary tract infection. On the first visit, she indicated that Dilaudid gave her pain relief and she was prescribed 30 tablets. A urinalysis was not performed until the second visit on March 5, with the result not available until March 7. She was prescribed an additional 30 tablets on March 5, and the Medication List indicates that 30 tablets were prescribed on March 6 as a "replace T for 3/5/81." On March 13, 30 more Dilaudid tablets were prescribed and respondent noted that he would see her again in ten days. Five days later, on March 18, patient Burns visited respondent again. The respondent's medical records note that Burns planned to go to New York for a couple of weeks and that she had noticed further improvement in her symptomatology. A prescription for Dilaudid, 50 tablets, was given her on this occasion. Respondent's notes state "will not see her again."
Dilaudid is a strong, addictive narcotic utilized in some instances to relieve acute pain. It is seven to eight times more potent that morphine and is similar in effect to heroin. Its usage is justified in situations of acute, almost debilitating pain and for terminal illnesses. In those instances, the maximum and safe dosage of Dilaudid, 4 mg. strength, for outpatients is one tablet every six hours. It is best to start a patient on the weakest of analgesics and if Dilaudid is used, the recommended dosage is 2 mg. strength. Because of its highly addictive quality and extreme potency, Dilaudid should be a medication of last choice for the control of pain. It does not cure a condition; it only relieves acute pain. In a noninstitutional setting, it is not good medical practice to prescribe more than 20 to 30 narcotic tablets at one time. The use of strong narcotics is not the proper manner to treat chronic pain. Patients develop a tolerance to the drug and this requires increased dosages, thus resulting in physical and psychological dependence. Addictive drugs should be avoided with chronic conditions.
There are common ploys utilized by "patients" who are abusing or trafficking in narcotics and a physician should be, aware of such signals. These include a request by the "patient" for a specific narcotic, an alleged history of being unable to tolerate other milder drugs and excuses of losing a prescription or having the medication stolen.
A radiation therapist who has treated cancer patients should know about pain and proper medications and procedures for controlling and alleviating pain.
Respondent has been active in an alcohol detoxification and rehabilitation program in Tampa, a service for which he received the "Service to Mankind" award by the Sertoma Club of Tampa. During the years 1972 through 1974, respondent was also actively involved in drug awareness Programs in Tampa.
Respondent did not feel that any of the fourteen patients referred to above manifested symptoms of drug addiction on their first visit. He admits that he would not today have any of the fourteen as patients after the second visit. He further admits that the medical records for these fourteen patients do not justify the prescriptions given for Dilaudid and that the quantities prescribed were so great and so frequent as to be inappropriate.
The respondent's stated reason for continuing to see these fourteen patients and continuing to prescribe Dilaudid for them is that he was asked to do so by Detective Gates with the narcotic division of the Tampa Police Department. Respondent testified that he had discussions with Detective Gates over a four to five week period in late February and early March, 1981, that several patients were discussed, that Gates never asked respondent who his other patients were but that Gates did tell him to keep treating and issuing prescriptions to "all his patients." The undersigned does not find this testimony to be credible.
Detective Gates first met respondent on March 25, 1981, in respondent's office. While there is conflicting evidence regarding the subject matter of the discussion between respondent and Detective Gates, it is concluded that respondent was not instructed to continue to issue Dilaudid prescriptions to all his patients. Even if he were so instructed, it would not be good medical practice to follow such instructions.
Respondent closed his office and his medical practice in Tampa on March 26, 1981. He moved to Bryson City, North Carolina and opened an office for medical practice there on April 1, 1981. Respondent knew as early as the first weekend of February, 1981, that he would be closing his Tampa office and moving to North Carolina.
CONCLUSIONS OF LAW
The respondent has been charged with violations of Chapter 458.331(1)(n),(q) and (t), Florida Statutes. Section 458.331 sets forth the grounds for which disciplinary action may be taken against a licensee, and subsections (n),(q) and (t) provide as follows:
(n) Failing to keep written medical records justifying the course of treatment of the patient, including, but not limited to, patient histories, examination results, and test results.
* * *
(q) Prescribing, dispensing, administering, mixing, or otherwise preparing a legend drug, including any controlled substance, other than in the course of the physician's professional practice. For the purposes of this paragraph, it shall be legally presumed that prescribing, dispensing, administering, mixing, or otherwise preparing legend drugs, including all controlled substances, inappropriately or in excessive or inappropriate quantities is not in the best interest of the patient and is not in the course of the physician's professional practice, without regard to his intent.
* * *
(t) Gross or repeated malpractice or
the failure to practice medicine with that level of care, skill, and treatment which
is recognized by a reasonably prudent similar physician as being acceptable under similar conditions and circumstances. The board shall
give great weight to the provisions of s.
768.45 when enforcing this paragraph.
The facts of this case, as set forth above, clearly establish that respondent violated Section 458.331(1)(q) and (t) Florida Statutes. Respondent prescribed 4,880 Dilaudid tablets, 4 mg. strength, to fourteen patients over a six-week period. Not one of these patient's physical condition justified the prescription of this highly addictive drug in such excessive amounts. While the medical records for these patients reveal complaints of pain from the patients, there is no valid medical explanation for the administration of such large dosages of Dilaudid. Respondent failed to perform radiological or other diagnostic studies and to make any reasonable effort to determine the systemic cause of the patients' pain. His prescription of Dilaudid did not constitute treatment of the patients' illnesses, and the frequency and excessive amounts prescribed constituted a failure to practice medicine with that level of care, skill and treatment recognized by reasonably prudent, similar physicians as acceptable under similar circumstances and conditions.
Respondent had to realize that these fourteen individuals were either abusing or trafficking in these narcotics. In situations of acute pain, the proper dosage of 4 mg. strength Dilaudid for patients outside an institutional setting would be four tablets a day or 28 tablets a week--one tablet every six hours. Had these patients actually been using the medication prescribed by respondent, the daily dosage taken could have been as high as 33 tablets (patient Rockwell), as indicated by the following table:
Patient | Number of Tablets Prescribed | 1981 From | To | Approximate Daily Dosage |
Torres | 320 | 2/26 | 3/24 | 12 |
Hendrix | 240 | 2/11 | 3/25 | 6 |
Springer | 280 | 2/27 | 3/10 | 23 |
Korynas | 400 | 2/18 | 3/23 | 12 |
Goodwin | 650 | 2/13 | 3/26 | 15 |
Snyder | 570 | 2/4 | 3/26 | 11 |
Myers | 600 | 2/6 | 3/26 | 12 |
Schepman | 300 | 2/24 | 3/26 | 10 |
Hagan | 60 | 3/9 | 3/25 | 4 |
Cohran | 430 | 2/6 | 3/26 | 9 |
Rockwell | 300 | 2/26 | 3/6 | 33 |
Williams | 260 | 2/5 | 3/16 | 7 |
Knecht | 300 | 2/19 | 3/9 | 16 |
Burns | 170 | 2/26 | 3/18 | 8 |
TOTAL | 4,880 |
It was unreasonable and unprofessional for respondent to have accepted the alleged excuses of many of these patients that they lost their prescriptions or medications or that they needed a large number of tablets because they were going out of town. In many instances, as reflected in the findings of fact above, those patients who allegedly told the respondent that they would be away from the Tampa area for a period of time actually returned to the respondent's office within a week and were issued yet another large prescription for Dilaudid. Several of these patients were long-distance truck drivers or construction workers and the administration of such excessive amounts of narcotics to them could have been life-threatening to themselves and others.
Another patient was an eighteen-year-old girl. Respondent's medical records specifically note that several patients were relying too heavily on Dilaudid. He allegedly advised them to taper off on their use of Dilaudid, but continued to prescribe this narcotic to them. Respondent's utter and callous disregard for the medical and/or psychological welfare of these patients is further
indicated by the fact, as illustrated by the table above, that many (nine of the fourteen) were prescribed Dilaudid during the last week of respondent's practice in Florida, when he knew he would not be able to provide follow up care or supervision for them.
It is concluded that the evidence in this case clearly establishes that respondent failed to practice medicine with that level of care, skill and treatment recognized by a reasonably prudent, similar physician as being acceptable under similar conditions and circumstances, in violation of Section 458.331(1)(t), Florida Statutes. The evidence further demonstrates that respondent prescribed a controlled substance, Dilaudid, in such excessive and inappropriate quantities as to be not in the best interest of the patient and not in the course of respondent's professional practice, in violation of Section 458.331(1)(q), Florida Statutes.
The respondent's defense of reliance upon the request of a law enforcement officer in continuing the prescription of Dilaudid to these fourteen patients is without merit. Not only does the undersigned find a lack of credibility on the part of the respondent regarding his alleged conversations with Detective Gates, such a defense, even if true, would be irrelevant to guilt of Section 458.331(1)(q), Florida Statutes, which specifically disregards the physician's intent in prescribing excessive or inappropriate quantities of controlled substances.
The petitioner failed to demonstrate that the respondent failed to keep medical records justifying the course of treatment of the patient, as prohibited by Section 458.331(1)(n) Florida Statutes. While this provision is subject to different interpretations, it is concluded that the gravamen of the offense is the failure to keep written medical records. Here, the medical records did not justify the prescriptions of Dilaudid to the named fourteen patients, and this fact constitutes evidence of other violations as discussed above. However, the respondent did maintain written records for each patient and recorded therein the patient histories and the results of the examinations and tests performed. Hence, a violation of Section 458.331(1)(n), Florida Statutes, has not been established.
Finally, the Administrative Complaint factually alleges that respondent prescribed 600 Percodan tablets and 9,500 Dilaudid tablets to approximately twenty-six patients between October 30, 1980 and March 26, 1981. Other than the 4,880 tablets of Dilaudid prescribed to the fourteen patients specifically named in the Complaint, as discussed earlier, the petitioner failed to adduce competent substantial evidence with regard to the remaining Dilaudid tablets or the drug Percodan.
Based upon the findings of fact and conclusions of law recited herein, it is RECOMMENDED that respondent be found guilty of violating Section 458.331(1)(q) and (t), Florida Statutes, and that his license to practice medicine in the State of Florida be revoked.
Respectfully submitted and entered this 10th day of November, 1982.
DIANE D. TREMOR, Hearing Officer Division of Administrative Hearings The Oakland Building
2009 Apalachee Parkway
Tallahassee, Florida 32301
(904) 488-9675
Filed with the Clerk of the Division of Administrative Hearings this 10th day of November, 1982.
COPIES FURNISHED:
Grover C. Freeman, Esquire Freeman & Lopez
Suite 410
4600 West Cypress Avenue Tampa, Florida 33607
Howard L. Garrett, Esquire Garrett & Garrett
Suite 202
518 Tampa Street Tampa, Florida 33602
Samuel R. Shorstein Secretary
Department of Professional Regulation
130 North Monroe Street Tallahassee, Florida 32301
Dorothy Faircloth, Executive Director Board of Medical Examiners
130 North Monroe Street Tallahassee, Florida 32301
| Issue Date | Proceedings |
|---|---|
| Nov. 10, 1982 | Recommended Order sent out. CASE CLOSED. |
| Issue Date | Document | Summary |
|---|---|---|
| Nov. 10, 1982 | Recommended Order | Respondent prescribed excessive doses of narcotics to patients when he should have known better. Recommend revocation of license. |
