STATE OF FLORIDA

DIVISION OF ADMINISTRATIVE HEARINGS

DEPARTMENT OF PROFESSIONAL ) REGULATION, BOARD OF NURSING, )

)

Petitioner, )

)

vs. ) CASE NO. 88-3603

)

ANN CLAYCOMB, )

)

Respondent. )

)

RECOMMENDED ORDER

Pursuant to notice, the Division of Administrative Hearings, by its duly designated Hearing Officer, William J. Kendrick, held a formal hearing in the above-styled case on December 13, 1988, in Miami, Florida.

APPEARANCES

For Petitioner: Michael A. Mone', Esquire

Department of Professional Regulation

130 North Monroe Street Tallahassee, Florida 323990750

For Respondent: No appearance.

PRELIMINARY STATEMENT

By administrative complaint dated May 22, 1988, petitioner charged that respondent violated the provisions of Section 464.018(1)(f), Florida Statutes. The gravamen of petitioner's charge is the assertion that respondent failed to conform to the minimal standards of acceptable and prevailing nursing practice in the administration of medications while employed at Health South Rehabilitation, Miami, Florida, on December 24, 1987.

At hearing, petitioner called as witnesses: William Brochinsky, Elaine Wood, Beverely Viars, and Diane Robie, accepted as an expert in nursing.

Respondent's exhibits 1 and 2 were received into evidence. Neither the respondent nor anyone on her behalf appeared at hearing, and no evidence was offered on her behalf.

The transcript of hearing was not ordered, so the parties were granted leave until December 23, 1988, to file proposed findings of fact. Petitioner elected to file proposed findings, and they have been addressed in the appendix to this recommended order.

FINDINGS OF FACT

1. Respondent, Ann Claycomb (Claycomb), was at all times material hereto a licensed practical nurse in the State of Florida, having been issued license number 39853-1.

   
   

2. On December 24, 1987, Claycomb was employed as an agency nurse by Alpha Health Care, Inc., and was on assignment to Health South Rehabilitation, a skilled nursing and rehabilitation facility in Miami, Florida. While at the facility on that date, Claycomb worked the morning shift 7:00 a.m. to 3:30 p.m., and was assigned to the skilled nursing floor.

   
   

3. The skilled nursing floor contained 20-25 elderly, though mostly alert patients. At the commencement of Claycomb's shift, it was her responsibility to administer medications to these patients which conformed with that prescribed by their medication administration record (MAR).

   
   

4. Shortly after Claycomb began her rounds, Elaine Wood, the Unit Manager at Health South Rehabilitation, began to receive complaints from patients for what they perceived to be errors in the medicinal drugs administered or attempted to be administered to them by Claycomb. Upon investigation, the following medication errors were discovered.

   
   

   1. Claycomb administered what she believed to be two Tylenol tablets to patient H.B. Following administration, the patient became lethargic and her vital signs deteriorated but later returned to normal. Lethargy is not a side effect of Tylenol.

   2. Although the MAR prescribed two Slow K tablets at 9:00 a.m., and Lilbrax as needed, Claycomb recorded having administered one Slow K tablet and Atarax to patient H.R.

   3. Claycomb dispensed Atarax to patient A.J. at 9:00 a.m. when the MAR prescribed dose to be given at 1:00 p.m. Patient refused medication because given at the wrong time.

      
      

5. In committing the foregoing medication errors Claycomb's practice fell below the minimal standards of acceptable and prevailing nursing practice in the administration of medicinal drugs.

   
   

6. Verification of other complaints received by Ms. Wood could not be verified because, contrary to accepted and prevailing nursing practice, Claycomb did not annotate some patients' MAR upon dispensing medications.

   
   

   CONCLUSIONS OF LAW

   
   

7. The Division of Administrative Hearings has jurisdiction over the parties to, and the subject matter of, these proceedings.

   
   

8. The allegations in this case are that Claycomb violated Section 464.018(1)(f), Florida Statutes. That section authorizes the Board of Nursing to take disciplinary action against a nurse who has been guilty of:

   Unprofessional conduct, which shall include, but not be limited to, any departure from, or failure to conform to, the minimal standards of acceptable and prevailing nursing practice in which

   case actual injury need not be established.

   
   

9. Under existing law, the burden is on petitioner to demonstrate by clear and convincing evidence that respondent violated the provisions of Section 464.018(1)(f), Florida Statutes. Ferris v. Turlington, 510 So.2d 292 (Fla. 1987). Petitioner has sustained its burden of proof.

   
   

10. In arriving at an appropriate penalty in the instant case, consideration has been given to the disciplinary guidelines set forth in Rule 21O-10.011, Florida Administrative Code. Based on a balancing of such guidelines, an appropriate penalty in the instant case is found to be a suspension of Claycomb's license until she can submit proof satisfactory to the Board of Nursing that she can practice nursing safely.

RECOMMENDATION

Based on the foregoing findings of fact and conclusions of law, it is RECOMMENDED that a final order be entered suspending the license of

respondent, Ann Claycomb, until such time as she submits proof satisfactory to the Board of Nursing that she can practice nursing safely.

DONE AND ENTERED in Tallahassee, Leon County, Florida, this 27th day of December, 1988.

WILLIAM J. KENDRICK

Hearing Officer

Division of Administrative Hearings The Oakland Building

2009 Apalachee Parkway

Tallahassee, Florida 32399-1550

(904) 488-9675

Filed with the Clerk of the Division of Administrative Hearings this 27th day of December, 1988.

APPENDIX TO RECOMMENDED ORDER, CASE NO. 88-3603

Petitioner's proposed findings of fact are addressed as follows:

1. Addressed in paragraph 1.

2-4. Addressed in paragraphs 2 and 3.

5 & 6. Addressed in paragraphs 46.

1. Addressed in paragraph 4c.

2. Subordinate or not necessary to result reached.

3. Not necessary to result reached.

4. Not necessary to result reached.

5. To the extent supported by competent proof addressed in paragraph 4. Proposed findings 11a and 11d are based on hearsay which does not supplement or explain any competent proof.

12-15. Not pertinent nor necessary to result reached.

COPIES FURNISHED:

Michael A. Mone', Esquire Department of Professional Regulation

130 North Monroe Street Tallahassee, Florida 32399-0750

Ms. Ann Claycomb

4175 South West 98th Avenue Miami, Florida 33165

Lawrence M. Shoot, Esquire 6011 West 16th Avenue Hialeah, Florida 33012

Judie Ritter, Executive Director Board of Nursing

504 Daniel Building

111 East Coastline Drive Jacksonville, Florida 32201

Bruce D. Lamb, Esquire General Counsel

Department of Professional Regulation

130 North Monroe Street Tallahassee, Florida 32399-0750

Docket for Case No: 88-003603

Orders for Case No: 88-003603