STATE OF FLORIDA

DIVISION OF ADMINISTRATIVE HEARINGS

DEPARTMENT OF PROFESSIONAL REGULATION, ) BOARD OF MEDICAL EXAMINERS, )

)

Petitioner, )

)

vs. ) CASE NO. 84-3794

)

SEYMOUR A. GOSS, M.D., )

)

Respondent, )

)

RECOMMENDED ORDER

Pursuant to notice, the Division of Administrative Hearings, by its duly designated Hearing 0fficer, William R. Cave, held a public hearing in the above- styled case on April 22, 1986 in 0rlando Florida.

APPEARANCES

For Petitioner: Cecilia Bradley, Esquire

Department of Professional Regulation

130 North Monroe Street Tallahassee, Florida 32301

Edward Hill, Staff Attorney Department of Professional Regulation

130 North Monroe Street Tallahassee, Florida 32301

For Respondent: Joe Jacobs, Esquire

305 South Gadsden Street Tallahassee, Florida 32301

Harry Rein, J.D., M.D. 3803 Lake Sarah Drive 0rlando, Florida 32804

BACKGROUND

This cause originally arose out of a fourteen (14) count Administrative Complaint dated September 17, 1984 and filed by Petitioner with Division of Administrative Hearings on October 31, 1984 alleging certain improper conduct by Respondent. Subsequent to a negotiated settlement which the Board of Medical Examiners (Board) rejected, the Petitioner joined by the Respondent requested the Division of Administrative Hearings to relinquish jurisdiction in this case so that the parties could resolve this matter in an informal hearing. The Motion To Relinquish Jurisdiction was Granted by Order entered on October 28, 1985 and the file of the Division of Administrative Hearings was closed. Unable to settle this matter by an informal hearing, Petitioner filed an Amended Administrative Complaint, dated January 13, 1986, with the Division of

Administrative Hearings on January 21, 1986. The Amended Administrative Complaint contained the original fourteen counts plus one (1) additional count. On April 14, 1986 an Order was entered granting Petitioner's Motion To Amend Administrative Complaint and this matter went to formal hearing on the Amended Administrative Complaint. By this Amended Administrative Complaint Petitioner seeks to revoke, suspend or otherwise discipline the license of Seymour A. Goss as a physician in the State of Florida. As grounds therefore, it is alleged:

1. that Respondent had prescribed, dispensed, administered, mixed, or otherwise prepared a legend drug including any controlled substance, other than in the course of the physician's professional practice; (2) that Respondent failed to keep written medical records justifying his course of treatment of the patient including, but not limited to, patient history, examination results and test results; (3) that Respondent failed to perform a statutory or legal obligation place upon a licensed physician; (4) that Respondent committed gross or repeated malpractice or failed 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; (5) that Respondent made deceptive, untrue, or fraudulent representations in the practice of medicine or employed a trick or scheme in the practice of medicine when such scheme or trick fails to conform to the generally prevailing standards of treatment in the medical community; (6) that Respondent prescribed, administered, dispensed, mixed, or otherwise prepared a controlled substance other than in good faith and in the course of his professional practice; and (7) that Respondent exercised influence within a patient-physician relationship for purposes of engaging a patient in sexual activity. This alleged conduct violates Section 458.331(1)(h), (k)(e)(n)(q)(t)and Sections 893.05(1), Florida Statutes; and it is also alleged that he violated Section 458.331(1)(x), Florida Statutes by violating Section 458.329, Florida Statutes.

   
   

   In support of the charges, Petitioner presented the testimony of Seymour A. Goss. Petitioner's Exhibits Nos. 1-4 were received into evidence.

   
   

   Respondent presented the testimony of Margaret McLoughlin (M. M.) 1/ Respondent's Exhibits Nos. 1, 2, and 4 were received into evidence.

   
   

   The parties submitted posthearing Proposed Findings of Fact and Conclusions of Law. A ruling on each proposed finding of fact has been made as reflected in the Appendix to the Recommended Order.

   
   

   FINDINGS OF FACT

   
   

   1. Upon consideration of the oral testimony and documentary evidence adduced at the hearing, the following relevant facts are found:

      
      

   2. The parties stipulated to the following facts: 2/

      
      

      1. Respondent prescribed drugs for M. M. at the times and in the strength and quantities as alleged in paragraph three of the Second Amended Administrative Complaint.

         
         

      2. Respondent wrote at least one of the aforesaid prescriptions for

         M. M. during the time that she was being treated as an inpatient at the hospital.

         
         

      3. Dilaudid, Brompton Mixture, Morphine Sulfate, Sublimaze, Valium, Demerol, and Talwin are brand names for drugs containing scheduled controlled substances listed in Chapter 893, Florida Statutes.

      4. Respondent administered approximately 5cc's Sublimaze and/or 5mg Morphine Sulfate to M. M. by I.V. on or about January 26, 1984, prior to her surgery.

         
         

      5. Between at lest January 30, 1984 and February 15, 1984, Respondent kept bottles of injectable narcotics, including Morphine, Dilaudid, and Fentanyl in his motor home and administered these narcotics to M. M.

         
         

      6. The aforesaid drugs were discovered by the Volusia County Sheriff's Officers acting pursuant to a search warrant issued upon an affidavit stating that Respondent had maintained injectable narcotics in his motor home for the purpose of administering them to M. M., that he had inserted a permanent

         I.V. line into M. M. after her discharge from the hospital for the purpose of administering I.V. medication, and that he had administered and/or ordered administration of injectable narcotics inappropriately or in excessive or inappropriate quantities.

         
         

      7. Respondent failed to keep sufficient records to justify his course of treatment of M. M.

         
         

      8. Respondent had a patient-physician relationship with M. M.

         
         

      9. M. M. became dependent upon scheduled controlled substances during the time that Respondent prescribed and/or administered medications to her.

         
         

      10. Respondent was licensed at all times material to the allegations in the Second Amended Administrative Complaint and is currently licensed at this time, possessing license number ME 0011798.

          
          

   3. Respondent is a medical doctor trained in the field of anesthesiology.

      
      

   4. Respondent did not have a private practice at the time he treated M. M. and his practice as a physician had been limited to the practice of anesthesiology.

      
      

   5. Respondent met M. M., a registered nurse (RN) at the Ormond Beach Hospital. at the end of July, 1983 and had been socially involved with M. M. before her accident in November 1983 when she requested the officer at the scene of the accident to call Respondent who then drove her to Ormond Beach Hospital for medical treatment.

      
      

   6. At the time of the accident in November, 1983, when Respondent began to treat M. M., she was not presently under the constant care of another physician but had been prior to that time when needing pain medication.

      
      

   7. As a result of the accident, Respondent referred M. M. to the appropriate specialist for her particular problem. Since Respondent was M. M.'s primary physician and already prescribing pain medications it was each specialist's decision to allow Respondent to continue prescribing pain medication as he saw fit.

      
      

   8. In January, 1984, M. M. was hospitalized for the surgical treatment of carpal tunnel. Her admitting physician at that time was Dr. Mason and Dr. Parikh was the surgeon. Respondent supervised the administration of the anesthesia for surgery and it was understood that Respondent and Dr. Parikh would supply pain medication. Prior to the surgery, Respondent administered, at

      different times, Sublimaze and Morphine Sulfate to M. M. Because of her physical dependency on drugs due to her prior medical condition Respondent did not want any drug withdrawal to occur prior to surgery and create other medical problems.

      
      

   9. Dr. Mason had prescribed medication for M. M. prior to surgery but Respondent was not aware of this prior to administering Sublimaze and Morphine Sulphate.

      
      

   10. Respondent failed to check M. M.'s chart prior to administering the Sublimaze and Morphine Sulfate and failed to tell Dr. Mason or the nurse or note in M. M.'s chart that he had administered those drugs.

       
       

   11. Dr. Mason or the nurse would not have known what medication Respondent had administered to M. M. had they checked her chart but Respondent did record the medication in the anesthesia records of drug administration in surgery.

       
       

   12. Respondent wrote an order in M. M.'s chart which the nurse refused to follow even after Respondent instructed her to follow the order. Subsequently, Respondent learned that Dr. Mason had cancelled Respondent's order for medication but this was after Respondent had administered the Sublimaze and Morphine Sulfate.

       
       

   13. Following the operation, Respondent continued to provide postoperative medication with the approval of Dr. Parikh and Dr. Newfield. Respondent gave M.

       M. Morphine but changed to Sublimaze (Fentanyl) 3/ when M. M. developed a sensitivity to Morphine.

       
       

   14. Brompton mixture is a combination of Morphine Sulfate and cocaine in a cherry 4/ base and had been administered to M. M. by Respondent prior to morphine and Sublimaze being administered in an attempt to minimize the need for parenteral medication but her pain was too severe for appropriate amounts of Brompton mixture to work.

       
       

   15. Respondent had no experience in treating a patient with Carpal Tunnel Syndrome or Charcot-Marie-Tooth disease but did have experience in administering medication for pain associated with these diseases as an anesthesiologist.

       
       

   16. Respondent's experience with drug dependency problems was with patients who had overdosed and he had administered medication to bring them out of the overdose.

       
       

   17. After the carpel tunnel surgery in January, 1984, M. M. continued to have an unusual amount of pain. The pain was in the wrist, neck, chest and shoulders. M. M. also had problems with spondylolisthesis and scoliosis.

       
       

   18. M. M. suffered more pain after her surgery than anticipated by Respondent which baffled Respondent; however, he encouraged M. M. to take less medication.

       
       

   19. At times when Respondent was not available, Respondent allowed M. M. to self-administer the medication.

       
       

   20. There was no separate type resuscitation machine at M. M.'s apartment, however, Respondent did have a larynoscope and tubes available which are forms of resuscitation equipment for treating either drug or allergic reaction or drug overdose. There was evidence that in most instances when these

       drugs are administered in the home there is no separate resuscitation type machine available nor would it be in a hospital room, however, it would be available at nurses' stations.

       
       

   21. Narcan, which is used to treat drug overdose, was kept at M. M.'s apartment along with other medication as was medication to treat allergic reaction.

       
       

   22. In February, 1984, after taking narcan and nubain to eliminate any residual narcotics form her system, M. M. was concerned that she might be suffering withdrawal and checked herself into Halifax Hospital.

       
       

   23. A few months later, M. M. was diagnosed as having cancer (Hodgkin's Lymphoma) which has been treated by radiation and chemotherapy and substantially relieved. This condition was not known at the time Respondent was treating M. M., however, it was established as the cause of the extreme pain suffered by M.

       M. during this period.

       
       

   24. M. M. was struck by an automobile at age six (6) and suffered head injuries and is an epileptic.

       
       

   25. Presently M. M. is on Tylenol 4, as needed for pain control, as well as phenobarbitol and valium and has been taking the same or similar drug since she was involved in the accident at age six (6).

       
       

   26. Prior to, and during the patient-physician relationship that existed between Respondent and M. M. between November, 1983 and up until approximately the middle of February, 1984, there was no sexual relationship between them; however, during the patient-physician relationship there existed a close personal relationship but it was always professional. Subsequent to Respondent terminating his treatment of M. M. in February, 1984, sometime around June, 1984, Respondent and M. M. began a sexual relationship. This sexual relationship started before Respondent prescribed medication for M. M. while traveling together, when her regular physician was not available.

       
       

   27. The reasons for drugs being in Respondent's mobile home, which were found there by the Sheriff's Deputy, was due to Respondent being required to remove his personal stock of medication out of the hospital after a hospital employee overdosed. The drugs used by the hospital employee were not Respondent's drugs.

       
       

   28. With the exception of this matter, Respondent is an anesthesiologist with an unblemished record. Respondent has never personally abused narcotics or personally used narcotics of the kind here involved or has he been questioned in this regard by any county, state or federal authority.

       
       

   29. M. M. was an R.N. during the time Respondent was treating her and is now employed as an R.N. by Tallahassee Memorial Regional Medical Center. M. M. has never been charged with any offense relating to narcotics.

       
       

   30. Respondent is presently employed with the Florida Department of Health and Rehabilitative Services and his license as a physician is an absolute requirement for employment in this job.

       
       

   31. Respondent did not prescribe, dispense or administer medication, including controlled substances, to M. M. other than in the course of his professional practice.

   32. Respondent in prescribing, dispensing, and administering medication, including controlled substances, to M. M. did not fail to perform his statutory or legal obligation in good faith and in the course of his professional practice only.

       
       

   33. There was no showing that Respondent had committed gross or repeated malpractice or failed to practice medicine with that level of care and skill as recognized by a reasonably prudent similar physician as being acceptable under similar conditions and circumstances while treating M. M.

       
       

   34. There was no showing that Respondent had made deceptive, untrue or fraudulent representation in the practice of medicine or employed a trick or scheme in the practice of medicine when such scheme or trick fails to conform to the generally prevailing standards of treatment in the medical community while treating M. M.

       
       

   35. The evidence was insufficient to show that Respondent had exercised influence within a patient-physician relationship for purposes of engaging a patient in sexual activity.

       
       

       CONCLUSIONS OF LAW

       
       

   36. The Division of Administrative Hearings has jurisdiction over the parties to and the subject matter of, this proceeding.

       
       

   37. The alleged misconduct of which Respondent is accused purportedly violates Section 458.331(1)(h)(k)(1)(n)(q)(t) and (x); Section 458.329 and Section 893.05(1), Florida Statutes.

       
       

   38. Section 458.331(1)(h)(k)(1)(n)(q)((t) and (x), Florida Statutes provides as follows:

       
       

       (1) The following acts shall constitute grounds for which the disciplinary action specified in subsection (2) may be taken:

       (h) Failing to perform any statutory or legal obligation placed upon a licensed physician.

       * * *

       1. Exercising influence within a patient- physician relationship for purposes of engaging a patient in sexual activity. A patient shall be presumed to be incapable of giving free, full, and informed consent to sexual activity with his physician.

       2. Making deceptive, untrue, or fraudulent representations in the practice of medicine

       or employing a trick or scheme in the practice of medicine when such scheme or trick fails to conform to the generally prevailing standards of treatment in the medical community.

       * * *

       (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 purpose 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. . . .

       * * *

       (x) Violating any provisions of this chapter, a rule of the board or department, or a lawful order of the board or department previously entered in a disciplinary hearing or failing to comply with a lawfully issued subpoena of the department.

       
       

   39. Section 458.329, Florida Statutes provides as follows;

       
       

       The physician-patient relationship is founded on mutual trust. Sexual misconduct in the practice of medicine means violation of the physician-patient relationship to induce or attempt to induce the patient to engage, or to engage or attempt to engage the patient, in sexual activity outside the scope of the practice or the scope of generally accepted examination or treatment of the patient. Sexual misconduct in the practice of medicine is prohibited.

       
       

   40. Section 893.05(1), Florida Statutes in pertinent part provides as follows:

       
       

       A practitioner, in good faith and in the course of his professional practice only, may prescribe, administer, dispense, mix or otherwise prepare a controlled substance, or he may cause the same to be administered by a licensed nurse or an intern practitioner

       under his discretion and supervision only....

   41. In disciplinary proceedings, the burden is upon the regulatory agency to establish facts upon which its allegations of misconduct are based. Balino

v. Department of Rehabilitative Services, 348 So2d 349, (1 DCA Fla. 1977). License revocation proceedings are penal in nature. State ex. rel. Vining v. Florida Real Estate Commission, 281 So2d 487 (Fla. 1973). As such, "the critical matter in issue must be shown by evidence which is indubitably as 'substantial' as the consequences." Bowling v. Department of Insurance, 394 So2d 165, 172 (1 DCA Fla. 1981). Therefore, the evidence which is required to "substantially" support a license revocation must be greater than required to support conventional forms of regulatory action. With the exception of Counts 1, 7, and 11, the Petitioner has failed to meet its burden of proof. Accordingly, grounds for disciplinary action have been established by Petitioner only as to Respondent's failure to keep sufficient written records to justify the course of treatment for M. M.

RECOMMENDATION

Based upon the Findings of Fact and Conclusions of Law recited herein, it is RECOMMENDED that Respondent be found guilty of a violation of Section 458.331(1)(n) Florida Statutes (1983). For such violation, considering the circumstances surrounding the violation, it is RECOMMENDED that the Board issue a letter of Reprimand and impose an administrative fine of $500.00. It is further RECOMMENDED that Counts 1, 2, 4, 5, 6, 8, 9, 10, 12, 13, 14, and 15 be DISMISSED.

Respectfully submitted and entered this 25th day of June, 1986, in Tallahassee, Leon County, Florida.

WILLIAM R. CAVE

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 25th day of June, 1986.

ENDNOTES

1/ Initially Margaret McLoughlin was referred to as M. M. in the original pleadings but she appeared and testified as Margaret McLoughlin.

2/ Although Respondent admitted to prescribing the drugs alleged in subparagraph 1(a) and (b), and admitted the basis for the search warrant, he denied that the medications were prescribed inappropriately or excessively.

3/ Fentanyl is misspelled in transcript as "phentenal". 4/ Cherry is misspelled in the transcript as "Sherry".

APPENDIX TO RECOMMENDED ORDER, CASE NO. 84-3794

The following constitutes my specific rulings pursuant to Section 120.59(2), Florida Statutes, on all of the Proposed Findings of Fact submitted by the parties in this case.

Rulings on Proposed Findings of Fact Submitted by the Petitioner

admitted to patient-physician relationship continuing after February, 1983 which is rejected as not supported by substantial competent evidence.

26. Rejected as not supported by substantial competent evidence. 27.-39. Rejected as hearsay uncorroborated by substantial competent

evidence. Additionally, it can't be determined from the record the facts relied on by Dr. Skora in coming to her conclusion or opinion, therefore, little weight can be given to her conclusion or opinions.

40.-42. Rejected as hearsay uncorroborated by substantial competent evidence. Although the matter set forth in Dr. Zaenger's letter (Petitioner's Exhibit No. 2) may be within her range of expertise, she was neither qualified nor accepted as an expert in this area. Additionally, it can't be determined from the record the facts relied on by Dr. Zaenger in coming to her conclusions or opinions, therefore, little weight can be given to her conclusions or opinions.

43. Adopted in Finding of Fact 27 but clarified.

Rulings on Proposed Findings of Fact Submitted by the Respondent

Respondent has presented part of his Proposed Findings of Fact under the heading "Statement of Fact" with unnumbered paragraphs which I have numbered consecutively 1 through 39 and have addressed. The balance of the Proposed Findings of Fact are in numbered paragraphs 1-7 which, for clarity, I have renumbered 40-46.

1-3. With the exception of that portion which states that Respondent is a medical doctor whose practice was primarily in the field of anesthesiology and adopted in Finding of Fact 2, the finding of facts set out in paragraphs 1-3 are rejected as immaterial and irrelevant.

1. Adopted in Finding of Fact 4.

2. Adopted in Findings of Fact 4, 5, 6 and 7 with clarification.

3. Rejected as immaterial and irrelevant.

4. Adopted in Finding of Fact 16.

5. Adopted in Finding of Fact 17.

6. Adopted in Finding of Fact 22 but clarified.

7. Adopted in Finding of Fact 23.

8. Adopted in Finding of Fact 24.

9. Adopted in Finding of Fact 25.

13-15. Adopted in Finding of Fact 26.

1. Adopted in Finding of Fact 27.

2. Adopted in Finding of Fact 27.

3. Adopted in Finding of Fact 28.

4. Adopted in Finding of Fact 29.

20.-39. Rejected as argument or conclusions and not findings of fact.

1. Rejected as conclusion of law.

2. Adopted in Finding of Fact 30.

3. Adopted in Finding of Fact 31.

4. Rejected as not supported by substantial competent evidence.

5. Adopted in Finding of Fact 32.

COPIES FURNISHED:

Cecilia Bradley, Esquire Department of Professional

Regulation

130 North Monroe Street Tallahassee, Florida 32301

Edward Hill, Staff Attorney Department of Professional

Regulation

130 North Monroe Street Tallahassee, Florida 32301

Joe Jacobs, Esquire

305 South Gadsden Street Tallahassee, Florida 32301

Harry Rein, J.D., M.D. 3803 Lake Sarah Drive Orlando, Florida 32804

Dorothy Faircloth Executive Director

Board of Medical Examiners Department of Professional

Regulation

130 North Monroe Street Tallahassee, Florida 32301

Fred Roche, Secretary Department of Professional

Regulation

130 North Monroe Street Tallahassee, Florida 32301

Salvatore Carpino, Esquire General Counsel

Department of Professional Regulation

130 North Monroe Street Tallahassee, Florida 32301

=================================================================

AGENCY FINAL ORDER

================================================================= BEFORE THE BOARD OF MEDICAL EXAMINERS

DEPARTMENT OF PROFESSIONAL REGULATION,

Petitioner,

DPR CASE NO. 0045116

vs. DOAH CASE NO. 84-3794

LICENSE NO. ME 0017998

SEYMOUR A. G0SS, M.D.,

Respondent.

/

FINAL ORDER

THIS CAUSE came before the Board of Medical Examiners (Board) pursuant to Section 120.57(1)(b)(9), Florida Statutes on August 2, 1986 in Orlando, Florida for the purpose of considering the Hearing Officer's Recommended Order in the above-styled cause. Petitioner, Department of Professional Regulation, was represented by Stephanie A. Daniel, Esquire; Respondent was present and represented by Joseph C. Jacobs, Esquire.

During the course of the review of the Recommended Order, the parties entered into an oral stipulation for disposition of the cause. The oral stipulation was presented to the Board and accepted on the record. A stipulation may be accepted at any time during the course of proceedings. Section 120.57(3), Florida Statutes.

WHEREFORE,

IT IS HEREBY ORDERED AND ADJUDGED:

1. The Recommended Order is REJECTED.

   
   

2. Respondent shall relinquish his DEA registration for a period of three

   (3) years.

   
   

3. Respondent shall be REPRIMANDED.

   
   

4. Respondent shall pay an administrative fine in the amount of five hundred dollars ($500.00) to the Executive Director of the Board within thirty

   (30) days of the filing of this Final Order.

   
   

5. Respondent's license to practice medicine in the State of Florida is placed on PROBATION for a period of three (3) years subject to the following terms and conditions:

   
   

   1. Respondent shall personally appear before the Board at the first meeting after his probation begins and at the last meeting before his probation ends and at such other times as requested.

      
      

   2. Respondent shall submit semiannual reports, in affidavit form, the contents of which shall be specified by the Board. The reports shall each include:

      
      

      1. Brief statement of why Respondent is on probation

         
         

      2. Respondent's Practice location

         
         

      3. Describe Respondent's current practice (type and composition)

         
         

      4. Describe Respondent's compliance with probationary terms.

         
         

      5. Describe Respondent's relationship with supervisory/ monitoring physician

         
         

      6. Advise Board of any problems.

      
      

   3. During the term of probation, the Department shall conduct investigations and make semiannual reports detailing Respondent's compliance with the terms and conditions of this probation. On the record at the meeting, Respondent waived confidentiality of these reports as to the Department and the Board.

      
      

   4. If Respondent resides or practices outside the State of Florida continuously for thirty (30) or more days, such time shall not be counted as part of the probationary period. He must immediately notify the Board at the time he leaves the state and when he returns to the state and must keep current residence and business addresses on file with the Board.

Pursuant to Section 120.59, Florida Statutes, the parties are hereby notified that they may appeal this Final Order by filing copy of a Notice of Appear with the clerk of the agency and by filing the filing fee and one copy of a Notice of Appeal with the District Court of Appeal within thirty (30) days of the date this Order is filed, as provided in Chapter 120, Florida Statutes, and the Florida Rules of Appellate Procedure.

This Order takes effect upon filing.

DONE AND ORDERED this 13th day of August, 1987.

BOARD OF MEDICAL EXAMINERS

EMILIO D. ECHEVARRIA, M.D. CHAIRMAN

CERTIFICATE OF SERVICE

I HEREBY CERTIFY that a true and correct copy of the foregoing Final Order has been provided by certified mail to SEYMOUR A. GOSS, M.D., 2922 Miccosukee Road, Apartment #78, Tallahassee, Florida 32308; JOSEPH C. JACOBS, Esquire, 305 South Gadsden Street, Tallahassee, Florida 32301; and by regular U.S. Mail to WILLIAM R. CAVE, Hearing Officer, Division of Administrative Hearings, The Oakland Building, 2009 Apalachee Parkway, Tallahassee, Florida 32301; and by hand delivery to STEPHANIE A. DANIEL, Esquire, Department of Professional Regulation, 130 North Monroe Street, Tallahassee, Florida 32301, at or before 5:00 P.M., this 18th day of August, 1987.

Dorothy J. Faircloth Executive Director

Docket for Case No: 84-003794

Orders for Case No: 84-003794