STATE OF FLORIDA
DIVISION OF ADMINISTRATIVE HEARINGS
DEPARTMENT OF PROFESSIONAL ) REGULATION, BOARD OF NURSING, )
)
Petitioner, )
)
vs. ) CASE NO. 83-1209
)
ROSA LEE SCOTT, )
)
Respondent. )
)
RECOMMENDED ORDER
Consistent with the Notice of Hearing furnished to the parties by the undersigned on April 12, 1985, a hearing was held in this case before Arnold H. Pollock, a Hearing Officer with the Division of Administrative Hearings, in Jacksonville, Florida on May 20, 1985. The issue for consideration at the hearing was whether the Respondent's license as a registered nurse in the State of Florida should be disciplined because of the alleged misconduct outlined in the Administrative Complaint filed herein.
APPEARANCES
For the Petitioner: Robert D. Newell, Esquire
200 South Monroe Street, Suite B Tallahassee, Florida 32301
For the Respondent: Erin L. Denny, Esquire
1101 Blackstone Building
Jacksonville, Florida 32202 BACKGROUND INFORMATION
By Administrative Complaint dated March 28, 1983, the Petitioner, Department of Professional Regulation, Board of Nursing, charged Respondent, Rosa Lee Scott, with unprofessional conduct departing from or failing to conform to the minimal standards of acceptable and prevailing nursing practice in violation of Section 464.018(1)(f), Florida Statutes (1981). Respondent thereafter submitted an election of rights form on April 11, 1983, in which she disputed the allegations of fact contained in the Administrative Complaint and requested a formal hearing. The file was referred to the Division of Administrative Hearings for appointment of a Hearing Officer on April 20, 1983 and hearing was set in this case for August 12, 1983.
On August 4, 1983, Petitioner moved for a continuance on the basis that the parties anticipated an amicable settlement of the issues and on August 5, 1983, the continuance was granted. The settlement previously mentioned did not materialize and the case was again set for hearing on October 28, 1983.
However, prior to that time Petitioner again moved for a continuance which was granted on October 24, 1983. On March 9, 1984, based on Petitioner's motion to
reset, a hearing was set for May 25, 1984. Because of scheduling considerations, this hearing was rescheduled for June 26, 1984 but on June 22, 1984, counsel for Petitioner again requested a continuance due to the unavailability of a crucial witness. On June 28, 1984, an order continuing the hearing until September 26, 1984 was entered but again, on September 21, 1984, counsel for Petitioner moved for a continuance which was granted on September 25, 1984. At this time the hearing was set for January 23, 1985.
On January 21, 1985, Respondent elected not to dispute the facts alleged in the Administrative Complaint and requested an informal hearing. As a result, on January 25, 1985, the undersigned entered an order relinquishing jurisdiction to the Petitioner, Board of Nursing, and closing the Division of Administrative Hearings' file in this case. However, on April 5, 1985, pursuant to a request by substituted counsel for the Respondent, Petitioner forwarded a letter to the Division of administrative Hearings requesting that a Hearing Officer again be assigned to the case for a formal hearing. Thereafter, on April 12, 1985, the undersigned set the case for hearing on May 20, 1985 and so notified the parties.
At the hearing, Petitioner presented the testimony of Dr. William D. Walklett, a radiologist; Dr. Eileen K. Austin, a registered nurse qualified as an expert in nursing; Ann Halley, Assistant Vice President for Nursing Services for Methodist Hospital; Dr. Rafael A. Perez, Staff Pathologist at Methodist Hospital; Randy Gene Martin, a registered nurse and supervisor of the 11 - 7 shift at Methodist Hospital; Jane G. Headrick, Nursing Supervisor at Methodist Hospital; Edna F. Lockett, a licensed practical nurse employed at Methodist Hospital; and Dr. Daniel B. Nunn, a surgeon practicing at Methodist Hospital.
Petitioner also introduced Petitioner's Exhibits A through I and K. Respondent testified on her own behalf and presented the testimony of Grace E. Davis, daughter of the patient the treatment of whom gave rise to this action; and Dr. Earl T. Cullins, a general surgeon. Respondent also introduced Respondent's Exhibits 1 through 4.
The parties have submittal posthearing proposed findings of fact pursuant to Section 120.57(1)(b)4, Florida Statutes. A ruling on each proposed finding of fact has been made either directly or indirectly in this Recommended Order, except where such proposed findings of fact have been rejected as subordinate, cumulative immaterial, or unnecessary.
FINDINGS OF FACT
At all times pertinent to the issues involved herein, Respondent was licensed as a registered nurse in the State of Florida under license number 01271-2.
Respondent has been licensed as a registered nurse in Florida since 1951. Since that time she has taken various continuing education courses in the nursing profession and is up-to-date on her continuing education requirements. She began work as a registered nurse with Methodist Hospital in 1967 and remained there until she was terminated 15 years later in December, 1982.
According to Mrs. Scott the patient in question here, Mrs. Thornton, was first assigned to her care on the morning of November 26, 1982. This was the first day she met her. Respondent came into Mrs. Thornton's room that morning to get the patient up and ready for the day. At this point, Mrs. Thornton said she did not feel well and was very weak. Instead of a bath, she asked merely for a light sponge bath. The patient was wearing a high-neck
"granny flannel" gown which she would not allow the Respondent to remove even to give her the sponge bath. At that time, Mrs. Scott says, Mrs. Thornton had one IV tube connected to an Abbott pump. This IV was connected to the patient's right forearm. Mrs. Scott did not see nor did she know that Mrs. Thornton had a subclavian catheter installed.
Mrs. Scott contends that when she did rounds with Dr. Eye in the afternoon of November 26, he advised her to discontinue the IV in Mrs. Thornton's arm because of puffiness of the arm where the IV was connected. When she went to do that, she states she noticed one suture on the inside of the patient's right arm just above the elbow which was not connected to the IV. She showed this to Dr. Eye, who told her to take it out. As a result, she removed the suture and took out the intravenous tube from the right arm. At this point, she asked Dr. Eye if he wanted to send it to the lab and he said no. As a result, she put the IV set and all other throwaways in the wastebasket. At this point, Dr. Eye gave her an oral order to apply warm compresses to the arm. This order was subsequently reduced to writing.
Mrs. Scott categorically denied having removed a left subclavian catheter from Mrs. Thornton. In fact, because of the gown Mrs. Thornton was wearing, Mrs. Scott denies even knowing that such a catheter had been installed. In any case, she would not have removed it by herself, she says, because she had been taught never to remove a subclavian catheter without someone else being present. She contends the catheter she removed was not a CVP (central venous pressure) catheter, as she subsequently charted by mistake. In that regard, she wrote in her nurse's notes, she says, merely what Dr. Eye had written in his order as to the description of the catheter to be removed. Dr. Eye had indicated in his orders to "D/C central line", which meant to disconnect the central line catheter (here, the subclavian) and because of the tremendous confusion at the nurses' station at the time she wrote her notes, she put in the wrong procedure.
The subclavian catheter in question here was installed by Dr. Nunn, Mrs. Thornton's surgeon, on November 19, 1982.. During the procedure he inserted a 20-gauge catheter into the patient through the left subclavian area. He did not install any other catheter of a similar size.
Somewhat later, he received a call from Mrs. Thornton's physician, Dr. Garcia, regarding the fact that a portion of the catheter was still in the patient and as a result, he performed surgery to remove it. He found a part of the catheter outside the wall of the subclavian vein and the remainder still in the vein. The entire portion of the catheter that was left in the patient was removed and the patient recovered satisfactorily from the surgery.
In this regard, the danger inherent in leaving a piece of a catheter like this one inside a patient is that the broken remains could cause blockage of either a coronary artery, or if in the vein, a venal blockage. A third possibility is that of infection though this is somewhat more remote.
According to Dr. Nunn, there are various causes for a catheter to break. The catheter may be subjected to rough treatment. The catheter itself may be weak. The catheter could be cut by the person removing it when the suture holding it in place is cut, and, although quite unlikely, the catheter might be broken when it is passed through the needle used to insert it. In Dr. Nunn's experience going back to 1955, however, he has never seen an instance where part of a subclavian catheter was left in a patient by accident.
Mrs. Grace E. Davis, Mrs. Thornton's daughter, recalls that on the day Mrs. Thornton was released from the hospital, Mrs. Davis had to wait for her in the waiting room while an additional procedure was accomplished prior to the discharge. As Mrs. Davis recalls, when they got home from the hospital, she asked her mother why they had had to wait and Mrs. Thornton said that it was for the purpose of removing the catheter in her heart through which she was getting nitroglycerin.
According to Dr. Earl T. Cullins, who reviewed Mrs. Thornton's medical records, she was in the hospital from November 17 through December 6, 1982. The medical records for that period indicated that the only catheters, IV's, or CVP's in the patient on November 26 may have been an Abbott Intravenous in the right arm and a subclavian catheter on the left side. The records further reveal that Dr. Eye gave verbal orders to disconnect the centerline (catheter) on November 26 and the nurse's notes written by Mrs. Scott indicate that on November 26, a CVP (central venous pressure--centerline catheter) was discontinued by her.
CVP insertions are generally made in the subclavian plane or through the jugular vein, with the subclavian insertion being preferred. The records are, according to Dr. Cullins, somewhat confusing. For example, he cannot tell from the records whether the subclavian catheter was -being used for medication or whether it was covered with a pressure dressing on November 26. In any event, the records do not indicate that the left subclavian catheter was removed. Instead, they show that a CVP line (centerline catheter) was removed. While he feels that they are one and the same, he cannot tell for certain whether or not they are. At no place do the records or nurse's notes refer to the two together or as one and the same.
Dr. Cullins had much to say about the performance of many of the other professionals involved in this case. For example, he described Dr. Eye as a "spastic" personality and questions the order that Mrs. Scott received to "remove the line." Dr. Cullin feels that if there were two lines in place, it cannot be certainly determined from the notes as to which one she removed. He also contends that Dr. Nunn made a mistake when he inserted the subclavian catheter on November 19 by not taking an X-ray after insertion. Another difficulty with the records, according to Dr. Cullin, is in that they reflect the intravenous needle was inserted in the patient's right hand on November 18 and was thereafter moved from hand to hand until November 26 when all drugs, which required two IV's, were stopped. To Dr. Cullin this indicates that even though the records do not specifically show the second line (other than the fact that the intravenous needle is in the right hand) there had to be one from a medical standpoint.
Dr. Cullin is convinced that since the incident took place late in the day, it would not be at all unusual for Mrs. Scott to have mischarted the removal of the intravenous needle from the hand as the CVP needle which is in the only entry relating to removal of any intravenous lines.
Dr. Cullin also states that the medical records, which on November 25 reflect "IV site good", and the fact that on- November 25, the nurse's notes refer to a transfer of the patient from the intensive care unit with the CVP line intact, without any other intravenous lines being mentioned, does not mean that there were no other lines. In short, Dr. Cullin is stating that the records are so confused it is impossible to tell whether there was one, two, or more intravenous lines in Mrs. Thornton on November 26, and which one was removed by Mrs. Scott.
Ms. Ann Halley, Director of Nursing at Methodist Hospital, became aware of the situation involving Mrs. Thornton when she received a phone call from Dr. Nunn, who had installed the catheter and who told her that when he saw Mrs. Thornton that morning for a follow-up check, about a week after her discharge from the hospital, an X-ray showed that a portion of the subclavian catheter he had installed was still in her chest.
Mrs. Thornton was returned to the hospital that afternoon for removal of the remaining piece of catheter, at which time Ms. Halley called for the medical records. when she checked them over, she saw that Respondent was the one who allegedly had removed the catheter. She contacted Ms. Jan G. Headrick, the head nurse on the floor with Mrs. Scott on November 26. Ms. Halley and Ms. Headrick had a discussion with Respondent about the situation during which Respondent admitted she had removed the catheter. In fact, she stated that when she cut the suture, the catheter simply fell out. According to Ms. Halley, Respondent did not actually use the term "subclavian" in regard to the catheter in question. However, in her opinion, there was little indication that Respondent was confused as to which catheter was in issue.
Mrs. Thornton's patient records, as they relate to the catheter issue, were reviewed by Dr. Eileen Austin, a consultant with many years experience in the field of nursing. Dr. Austin concluded that a subclavian catheter had been removed from Mrs. Thornton in part by a nurse and that the remaining portion left in at the time of initial removal was surgically removed.
Her review of the records revealed that three catheters were inserted during the first period of Mrs. Thornton's hospitalization. These were:
An intravenous line inserted in the Patient's right hand on November 18, 1982 initially,
but which was restarted several times and moved from hand to hand until it was finally capped on November 22, 1982. A catheter of this nature is always less than one inch in length and is never anywhere near seven and a half inches
in length.
A sub-clavian catheter inserted on November 19, 1982 which is also inserted in a vein. The purpose of this one appeared, here, too for administering drugs. It is approximately twelve inches in length and was removed, according to the records, by Respon- dent on November 26, 1982.
An arterial line installed on November 19, 1982 following inser- tion of the sub-clavian catheter described above. The purpose of this line was for the withdrawal
of blood for blood gas determination.
It is called an arterial catheter and the longest one Dr. Austin has ever seen is two and a half inches.
On the basis of the above, it appears obvious that the only one of the three catheters inserted, according to the records, long enough to have been left in the patient, was the subclavian catheter.
A subclavian catheter is inserted into the clavian vessel so that the tip of the catheter is near the heart. It is inserted just below the collarbone.
The records here reflected no reference in the nurse's notes after Mrs. Scott indicated removal of the subclavian catheter except for two references to dry dressings over the entry area.
According to Dr. Austin, the proper procedure for the removal of a catheter is for the nurse to clip the suture holding the catheter to the skin without cutting the catheter. Thereafter, the nurse withdraws the catheter very carefully and, upon complete withdrawal, compares the length of the portion withdrawn with that of the catheter inserted as described in the patient's records. If a piece is broken off inside the patient, the visual examination in this way will reveal that that taken out is shorter than that put in, thereby indicating that some was left in the patient.
Here, according to Dr. Austin, the Respondent failed to exercise proper procedure in two areas: one, she failed to note the length of the catheter inserted so that a comparison with removal could be done and, two, she failed to inspect the tip of the catheter on removal. It should be smooth and round. Anything else indicates that the catheter was broken or cut and part was left therein. This must be immediately reported to the physician.
In Dr. Austin's opinion, a nurse who would remove a catheter and fail to insure the entire item was removed, and thereafter fails to report that it was not all removed, is unprofessional and puts the patient in a life- threatening situation. Further, assuming that the Respondent's sole improper activity was in mischarting the actual catheter removed, as Respondent contends, this could constitute substandard performance itself.
However, the right arterial catheter in Mrs. Thornton was removed on November 20, 1982 at approximately 2:45 a.m. by Randy G. Martin, the hospital supervisor for the 11 - 7 shift that evening. He removed this catheter because the nurse on duty at the time saw that it was bent and there was some concern that it might break or otherwise do harm. At the time of this operation, Mr. Martin noticed that Mrs. Thornton had a subclavian catheter in place. When the arterial catheter was removed, it was measured and examined to see that the edges were good and then saved for the physician to examine the next day. If this arterial catheter was removed on November 20, it could not have been there on November 26, as Respondent says.
Dr. Eye gave certain orders to discontinue all intravenous medication on November 22, 1982. The doctor's orders are as follows:
D/C central line
Per. with other meds this way
Warm heat to rt arm
Penicillin 500 mg-p/o Q.I.D.
Serum theophyllin 6 hours after dose (scratched out)
Room air arterial blood gas Sunday am.
D/C all IV medication
Dr. Eye's orders O.K.'d w Dr. Garcia
Respondent as was stated before, contends she did not remove the subclavian catheter but instead removed the arterial catheter in the right arm, thereafter inaccurately charting its removal as the CVP catheter. She said she did this because she merely quoted the doctor's order.
Thorough consideration of the above evidence admitted both for and against the Respondent, considered in light of the inherent probabilities and improbabilities of the evidence, results in the inescapable conclusion that Respondent did in fact withdraw the subclavian catheter from Mrs. Thornton and, in doing so, failed to insure that the entire catheter was removed. As a result, a 5 to 6 centimeter long piece of the catheter was left in Mrs. Thornton's chest which was surgically removed several days later.
It is neither alleged nor found that Mrs. Scott was responsible for the catheter breaking. However, the evidence is clear that when she removed the catheter she failed to take those steps necessary and dictated by proper nursing procedures to insure that the entire catheter was removed.
An independent examination of Mrs. Thornton's medical records by Dr. Austin, who had no part whatever in the scenario as it was acted at the time in question, revealed that three catheters were inserted in Mrs. Thorton during the period of her initial hospitalization: the subclavian catheter in the left portion of her chest; the arterial catheter in the right arm; and the peripheral catheter in one or both hands from time to time. The arterial catheter was removed by Nurse Martin on November 20, 1982. The peripheral catheter was capped on November 22, 1982. As a result, the only catheter remaining in Mrs. Thornton on November 26, 1982 was the subclavian catheter. when that fact is considered, along with the fact that Mrs. Scott's initial notes, regardless of her current explanation for them, revealed that she removed the CVP catheter (here it should be noted that CVP catheter is, in this case, the same as subclavian catheter), the conclusion is inescapable that she is the individual who removed the subclavian catheter leaving a portion in the patient. There simply is no evidence aliunde Mrs. Scott's own statement that any other catheter remained in the patient on November 26, 1982. This is so notwithstanding the testimony of Mrs. Davis concerning what her deceased aged mother advised happened the day of her discharge. It is difficult to believe that hospital officials would remove a subclavian catheter from Mrs. Thornton on the morning she is released from the hospital and Mrs. Davis' testimony as to that issue is rejected.
CONCLUSIONS OF LAW
The Division of Administrative Hearings has jurisdiction over the parties and the subject matter of these proceedings.
In the Administrative Complaint, Respondent is alleged to have violated Section 464.018(1)(f), Florida Statutes (1981), by demonstrating unprofessional conduct which departed from or failed to conform to the minimal standards of acceptable and prevailing nursing practice.
This statutory provision indicates that:
The following acts shall be grounds for disciplinary action set forth in this section:
* * *
(f) Unprofessional conduct, which shall include, but not be limited to, any departure from, or the failure to conform to, the minimal standards of acceptable and prevailing nursing practice, in which case actual injury need not be established.
Here, the evidence clearly shows that the Respondent removed a subclavian catheter from a patient entrusted to her care and in doing so left a portion of the catheter in the patient's body. There is no indication, as was stated above, that the Respondent caused the catheter to break or was in any way responsible for the breakage. Respondent's lack of professionalism is demonstrated in her failure to take proper measures after withdrawal of the catheter to insure that the entire item had been removed. Competent evidence revealed that she should have examined the catheter upon removal to see that the end was round and smooth; that she should have measured it to insure that the length of the piece removed was equal to the length of the instrument inserted; and having once done that and determined that it was not, she should have notified the physician immediately. Here, she failed to take any of these steps and her failure to do so clearly constituted unprofessional conduct and a failure to conform to the minimal standards of acceptable and prevailing nursing practice.
Having once concluded that Respondent is guilty as alleged in the Administrative Complaint, the question then remains as to what action should be taken to adequately discipline Respondent's license while at the same time providing sufficient corrective action to protect the interests of the public. The evidence is free of any indication that Respondent has previously been disciplined for substandard performance or any other violation of the statute or rules governing the practice of nursing. In addition, the evidence also appears to be almost exclusively documentary in nature. Respondent has spent 15 years in the practice of nursing and has apparently conducted herself satisfactorily during that time. As such, and in light of the circumstances here, it would be inappropriate to revoke her license for this one instance of sub-professional performance.
Nonetheless, Respondent must be impressed with the fact that the nursing profession cannot tolerate performance which falls below the minimum standards set by the profession for the conduct of its practitioners. Therefore, same substantial action must be taken.
RECOMMENDED ACTION
Based on the foregoing Findings of Fact and Conclusions of Law, it is, therefore:
RECOMMENDED that Respondent's license as a registered nurse in the State of Florida be suspended for ninety (90) days and that she thereafter be placed on probation for a period of two (2) years under such terms and condition as are dictated by the Board of Nursing.
RECOMMENDED this 27th day of August, 1985, at Tallahassee, Florida.
ARNOLD H. POLLOCK
Hearing Officer
Division of Administrative Hearings Oakland Building
2009 Apalachee Parkway
Tallahassee, Florida 32301 904/488-9675
FILED with the Clerk of the Division of Administrative Hearings this 27th day of August, 1985.
COPIES FURNISHED:
Robert D. Newell, Esquire ROBERT D. NEWELL, JR., P.A.
200 South Monroe Street, Suite B Tallahassee, Florida 32301
Erin L. Denny, Esquire 1101 Blackstone Building
Jacksonville, Florida 32202
Judie Ritter, Executive Director Board of Nursing
Department of Professional Regulation
Room 514, 111 East Coastline Drive
Jacksonville, Florida 32202
Fred M. Roche, Secretary Department of Professional
Regulation
130 North Monroe Street Tallahassee, Florida 32301
Salvatore A. Carpino, Esquire General Counsel
Department of Professional Regulation
130 North Monroe Street Tallahassee, Florida 32301
=================================================================
AGENCY FINAL ORDER
=================================================================
STATE OF FLORIDA DEPARTMENT OF PROFESSIONAL REGULATION
BOARD OF NURSING
DEPARTMENT OF PROFESSIONAL REGULATION,
Petitioner,
vs. DPR CASE NO. 0030851
DOAH CASE NO. 83-1209
ROSA LEE SCOTT,
Respondent.
/
FINAL ORDER
Respondent, Rosa Lee Scott, holds a Florida license Number 01271-2 as a registered nurse. Petitioner, Department of Professional Regulation, filed an Administrative Complaint against Respondent on March 29, 1983, seeking suspension, revocation, or other disciplinary action against the license.
Respondent disputed the material facts contained in the Administrative Complaint and requested a formal hearing. The formal hearing was duly held before the Honorable Arnold H. Pollock, Hearing Officer for the Division of Administrative Hearings on May 20, 1985.
This cause came before the Board on October 3, 1985, in Miami, Florida for final agency action. The Petitioner was represented by William Furlow, Esquire. The Respondent was present at the public meeting. The Board has reviewed the entire record in the case, including the transcript and exhibits.
FINDING OF FACT
The Board accepts and adopts the Findings of Fact contained in the Recommended Order.
CONCLUSIONS OF LAW.
The Board accepts and adopts the Conclusions of Law contained in the Recommended Order.
PENALTY
The Board rejects the Hearing Officer's recommended penalty because the record fails to establish the standard of care at Methodist Hospital for the removal of subclavian catheters by nurses. Moreover, the severity of the incident as established by the record neither warrants suspension nor is consistent with previous cases in which the Board has suspended licenses. It is therefore ORDERED that:
The license of Respondent is hereby placed on PROBATION for a period of one year, subject to the following terms and conditions:
The Respondent shall not violate any Federal or State law, nor any rule or order of the Board of Nursing.
During the probation Respondent shall report any change in residence address, any change of name, any change in employer or place of employment, or any time she is arrested. These events will be reported immediately (and in any event within ten working days) by certified mail to the Board of Nursing, Probation Section, 111 Coastline Drive East, Suite 504, Jacksonville, Florida 32202.
While employed as a nurse, Respondent shall be responsible for causing reports to be furnished by her employer to the Board; these reports shall set out Respondent's current position, work assignment, level of performance, and any problems. The reports shall be submitted every three months as scheduled by the Board probation section. If employed other-wise than as a nurse, Respondent shall report the position, employer and place of employment to the Board probation section on the scheduled quarterly dates. If not employed, Respondent shall so notify the Board probation section on the scheduled quarterly dates.
Any deviation from the requirements of this probation with- out the prior written consent of the Board shall constitute a violation of this probation.
Upon a finding of probable cause that a violation of this probation has occurred, Respondent's license to practice nursing shall be subject to immediate and automatic suspension pending Respondent's appearance before the next Board meeting (or such other meeting as mutually agreed by the licensee and the Department). Respondent will be given notice of the hearing and an opportunity to defend.
The probationary period shall automatically terminate at the end of the prescribed time, but only if all terms and conditions have been met. Otherwise, the probation shall be terminated only by Order of the Board upon proper petition of the Respondent supported by evidence of compliance with this Order.
Pursuant to Section 120.59, Florida Statutes, the parties are hereby notified that they may appeal this final order by filing one copy of a Notice of Appeal with the clerk of the Department of Professional Regulation, and by filing the filing fee and one copy of a Notice of Appeal with the District Court of Appeal within thirty days of the date this Order is filed.
This Order shall become effective upon filing with the clerk of the Department of Professional Regulation.
DONE AND ORDERED this 18th day of November, 1985.
Sandra S. Bauman, Chairman Florida Board of Nursing
CERTIFICATE OF SERVICE
I HEREBY CERTIFY that a true and correct copy of the forgoing Order has been sent to Rosa Lee Scott, 6164 Spira Street, Jacksonville, Florida 32209, to Erin L. Denny, Esquire, 1101 Blackstone Building, Jacksonville, Florida 32201 and to the Division of Administrative Hearings, Oakland Building, 2009 Apalachee Parkway, Tallahassee, Florida 32301, by United States mail, at or before 5:00 p.m., this 18th day of November, 1985.
Judie Ritter, Executive Director
| Issue Date | Proceedings |
|---|---|
| Aug. 27, 1985 | Recommended Order (hearing held , 2013). CASE CLOSED. |
| Issue Date | Document | Summary |
|---|---|---|
| Nov. 18, 1985 | Agency Final Order | |
| Aug. 27, 1985 | Recommended Order | Nurse failed to conform to minimum standards constituting unprofessional conduct and misconduct which supports license discipline. |
