STATE OF FLORIDA
DIVISION OF ADMINISTRATIVE HEARINGS
DEPARTMENT OF PROFESSIONAL ) REGULATION, BOARD OF MEDICINE, )
)
Petitioner, )
)
vs. ) CASE NO. 91-0596
)
ALPHONSE DEL PIZZO, M. D. )
)
Respondent. )
)
RECOMMENDED ORDER
Upon due notice, the Division of Administrative Hearings by its duly assigned Hearing Officer, William R. Cave, held a formal hearing in the above- captioned matter on July 22, 1992 in Bradenton, Florida.
APPEARANCES
For Petitioners: Richard A. Grumberg, Esquire
Senior Attorney
Department of Professional Regulation 1940 North Monroe Street, Suite 60
Tallahassee, Florida 32399-0792
For Respondent: J. Allen Bobo, Esquire
Roger Lutz, Esquire
Lutz, Webb, Bobo and Baitty, P. A. One Sarasota Tower
Two North Tamiami Trail Sarasota, Florida 34236
STATEMENT OF THE ISSUE
Whether Respondent's license to practice medicine in the state of Florida should be revoked, suspended or otherwise disciplined.
PRELIMINARY STATEMENT
By an Administrative Complaint dated October 24, 1990 the Petitioner seeks to revoke, suspend or otherwise discipline the Respondent's license to practice medicine in the state of Florida. As grounds therefor, it is alleged that Respondent, in the care and treatment of patients, L. Y. and O. G., violated Section 458.331(1)(m) and (t), Florida Statutes, by failing to keep written medical records justifying the course of treatment of the patients and by failing to practice medicine with that level of care, skill and treatment which is recognized as being acceptable under similar conditions and circumstances.
By letter dated January 24, 1991, the Petitioner referred this matter to the Division of Administrative Hearings for the assignment of a Hearing Officer and conduct of a formal hearing under Section 120.57(1), Florida Statutes. The
matter was originally scheduled for hearing on February 11, 1991 but due to several continuances was not heard until July 22, 1992.
At the hearing, the Petitioner presented the testimony of John Kruse, M. D., Christine Wolf, R. N. and Walter Hughes. Petitioner's exhibits 1 and 2 were received as evidence in this case. Petitioner's exhibit 1 was the deposition of Mark C. Monroe, M. D., received in lieu of his live testimony at the hearing.
Respondent testified on his own behalf. The depositions of David E. Law, M. D., Jose F. Estigarribia, M. D., and George Kozma, M. D., were received as Respondent's exhibits 1, 2, and 3, respectively in lieu of their live testimony at the hearing. Respondent's exhibit 4 was also received as evidence in this case. Joint exhibits 1 and 2 were received as evidence in this case.
Petitioner has stipulated to dismissing all allegations in the Administrative Complaint with the exception of those allegations concerning the issue of the standard of care in the premature extubation and recovery room care of patients, L. Y. and O. G.
A transcript of this proceeding was filed with the Division of Administrative Hearings on August 6, 1992. An Order entered on August 21, 1992 granting an unopposed motion filed by the Petitioner extended the time for the filing Proposed Recommended Orders until September 2, 1992 with the understanding that the time frame for issuing the Recommended Order was waived in accordance with Rule 22I-031(2), Florida Administrative Code (now Rule 60Q- 2.031(2), Florida Administrative Code). A ruling on each proposed finding of fact submitted by the parties has been made as reflected in an Appendix to the Recommended Order.
FINDINGS OF FACT
Upon consideration of the oral and documentary evidence adduced at the hearing, the following relevant findings of fact are made:
At all time relevant to this proceeding, the Respondent was licensed to practice medicine in the state of Florida, having been issued license number 0024212. Respondent is also licensed to practice medicine in the states of Pennsylvania, New York, New Jersey and Illinois.
Respondent is an anesthesiologist who was board certified in 1962, and has had experience as a professor of anesthesiology.
The two cases involving patients L. Y. and O. G. that are in issue in this proceeding arose while Respondent was practicing at Manatee Memorial Hospital in Bradenton, Florida.
It is the recovery room nurse's responsibility to fill out the post anesthesia care unit (PACU) record which documents the patient's course through the recovery room. The record includes notations which track the patient's activity, respiration, blood pressure, consciousness and color. Each category is scored on the basis of 0, 1 or 2. Each individual score is determined by the recovery nurse's observation of the patient and her judgment of the patient's condition at that particular moment.
Ambu-bagging is a procedure whereby a mask with a reservoir bag of oxygen is placed over the nose and mouth of the patient and the bag is squeezed to force air and oxygen into the lungs of patient. Ambu-bagging is used in
situations where the patient is not breathing and the procedure, in effect, breathes for the patient.
PATIENT, L. Y.
L. Y., a 72 year-old female who presented with abdominal pain and was initially evaluated in the emergency room of Manatee Memorial Hospital on March 22, 1988. The emergency room physician, James A. DeRespino, M. D., diagnosed the patient's condition on admission as abdominal pain/rule out perforated viscus. Jose Estigarriba, M. D., the physician called in for consultation on March 23, 1988 by Robert A. Fishco, the attending physician, diagnosed the patient's condition as acute abdomen, peritonitis, possible perforated viscus.
L. Y. was in extremely ill health upon her admission. L. Y. had diabetes, chronic high blood pressure, coronary artery disease, recurrent heart failure, congestive heart failure and a history of pulmonary edema. L. Y. was on multiple medications for her diabetes and cardiovascular disease.
Both Dr. Estigarribia, the patient's surgeon, and Dr. Fishco felt that immediate surgical intervention was necessary to determine and correct the problem.
L. Y. initially refused to have the surgery for approximately 24 hours. However, after talking with Dr. Fishco the patient finally consented to surgery late in the afternoon of March 23, 1988, approximately 24 hours after admission to the hospital.
After the patient consented to surgery, Dr. Estigarribia immediately discussed with the patient the various invasive monitoring techniques and retaining the patient on a respirator after surgery. The patient refused these procedures because of difficulties she had experienced during similar procedures in the recent past.
At this point, Dr. Estigarribia determined that it was best to move the patient to surgery as quickly as possible and dispense with such devices as swan-ganz catheters because he was concerned that she may change her mind and decide against surgery.
The Respondent was first notified of the surgery approximately fifteen minutes prior to L. Y. being transported to the operating room. Respondent saw the patient in the operating room and took a history. Dr. Estigarribia informed the Respondent of the urgent situation and of the patient's refusal to consent to ventilation therapy and invasive monitoring.
Respondent anesthetized the patient using a rapid sequence induction. Dr. Estigarribia then performed an exploratory laparotomy, resection of the small bowel, end-to-end anastomosis, and peritoneal lavage on the patient.
After the surgery was completed but prior to the patient being extubated, Respondent checked the patient's blood pressure (120/70) and pulse rate (90), found the patient's color to be good and her oximetry (oxygen saturation of blood) readings to be satisfactory.
Just prior to extubation, the patient's blood pressure was 140 over 90, her pulse rate 90, her oximetry reading was 96, she was breathing on her own and was conscious to the point of being able to communicate with Respondent by opening her eyes when asked a question.
After making certain that the patient was breathing on her own and was conscious, Respondent extubated the patient while still in the operating room. Shortly thereafter, approximately 10 minutes, the patient was moved to the recovery room.
The patient progressed satisfactorily in the recovery room. The patient's PACU score upon arrival in the recovery room at 10:30 p.m. was 5 out of a possible 10, with consciousness and activity each being given a score 0 by the recovery room nurse and respiration a score of 1. However, within 10 minutes the patient had improved to a total score of 9, with a consciousness and activity each being given a score of 2 and the respiration score remaining at 1. The total score remained at 9 until 12 midnight, approximately one and one-half hours after the patient was delivered to the recovery room. At 12:30 a.m., approximately two hours after her admission to the recovery room, the patient's score dropped to a total of 4 and the patient experienced ventricle fibrillation and expired as a result of this cardiac event at approximately 12:47 a.m.
There is competent substantial evidence in the record to establish facts to show that Respondent's treatment of patient, L. Y. was within that level of care, skill, and treatment recognized as being acceptable under similar conditions and circumstances at the time of extubation and subsequent recovery room care, notwithstanding the testimony of Dr. Monroe and Dr. Kruse to the contrary which was based primarily on the hospital's records and more specifically on the recovery room nurse's scores and notes in the PACU records.
PATIENT, O. G.
Patient, O. G., is a sixteen year old male athlete who sustained a fractured mandible in an athletic event. O. G. was admitted as an emergency case to the Manatee Memorial Hospital on June 9, 1988 with a diagnosis of acute fracture of the mandible and laceration of the mouth.
On June 9, 1988 the patient's attending surgeon performed an open reduction of the right angle of the mandible and the removal of four impacted wisdom teeth. Respondent placed the patient under general anesthesia for the above scheduled procedure.
When the operative procedure ended (at approximately 6:55 p.m.), Respondent remained in the operating room with the patient approximately 30 minutes to assess the patient's post-operative condition.
While still in the operating room the patient exhibited the usual indicators for extubation. The patient's oximetry readings were good, his blood pressure and pulse were good, he was breathing on his own with adequate title volume, he responded when given verbal commands, and was able to lift his head. At this point in time, the patient was having adverse reaction to the tube used by Respondent to maintain the patient's airway. Based on his training and experience as an anesthesiologist, using the above indicators, the Respondent determined that the patient was ready to be extubated. The patient was extubated in the operating room by the Respondent before being transferred to the recovery room.
Upon being delivered to the recovery room, at approximately 7:25 p.m., the patient's condition began to deteriorate. The patient's breathing became shallow and he did not respond to verbal commands. The Respondent had the recovery room nurse remove the blanket covering the patient so that the
Respondent could observe the patient's respiratory pattern and coloration to determine if the patient needed assistance with breathing and to give assistance, if needed. The Respondent had the nurse place the patient on 100% oxygen. Normally, a patient is placed on 40% oxygen.
The patient did not recover from the anesthesia as quickly as the Respondent had anticipated. Notwithstanding the recovery room nurse's testimony as to her observation of the patient's condition as set out in the PACU records, the patient's condition was not so life threatening as to require intervention by the Respondent prior to the time he decided to call in a pulmonologist.
While I do not doubt the competence of the recovery room nurse, the Respondent's testimony that his observation of the patient's condition during this period of time led him to believe that it was not life threatening was more credible. It was the Respondent's observation of the patient's condition that guided him in choosing a conservative procedure in his handling of the patient.
Although Respondent was assisting with other operations in the hospital during this time, he stayed within voice range of the patient and nurse, monitoring the patient's condition and periodically assisting or having the nurse assist the patient in breathing by using an Ambu-bag and when necessary, either the Respondent or the nurse, would suction off blood secretions through the nasal passage. The Respondent chose this conservative procedure of monitoring the patient's condition rather than performing a "blind" intubation through the nasal passage or by cutting the wires holding the patient's jaws shut and intubating through the mouth thinking the patient would respond without the necessity of reintubation. The first procedure would have involve the risk of pushing possible blood clots into the lower portion of the patient's airway, while the second procedure would necessitate that the patient undergo an additional operation.
Eventually, when O. G. failed to respond, Respondent decided to reintubate the patient. However, since the Respondent had decided against a "blind" intubation through the nasal passage or cutting the wires on the jaws to intubate through the mouth, he decided to intubate using a fiber optic bronchoscope in order to visualize the airway and remove any blood clots that may have formed in the upper portion of the airway as a result of the surgery. This procedure would avoid the risk of pushing the blood clots down into the lower part of the patient's airway.
Since Respondent was not a pulmonologist he was not given the privilege at Manatee Memorial Hospital to use a fiber optic bronchoscope. Therefore, Respondent sought the services of David Law, M. D., a pulmonologist on call at the hospital that evening, to perform the reintubation using the fiber optic bronchoscope.
Dr. Law reintubated the patient using the fiber optic bronchoscope. Dr. Law found blood clots in the upper portion of the patient's airway which were removed before attempting the reintubation. The patient was then transported to the Intensive Care Unit and afterwards recovered satisfactorily. Dr. Law opined that he would not have attempted a "blind" nasal reintubation of the patient under the circumstances here because of the possibility of pushing blood clots down into the lower portion of the patient's airway.
In the medical community a pulmonary physician is the specialist most experienced with the use of a fiber optic bronchoscope, and it would be unusual for a non-pulmonary physician to use a fiber optic bronchoscope under circumstances similar to those occurring with this patient.
There is competent substantial evidence in the record to establish facts to show that Respondent's treatment of the patient, O. G. was within that level of care, skill, and treatment recognized as being acceptable under similar conditions and circumstances at the time of extubation and subsequent recovery room care, notwithstanding the testimony of Dr. Monroe and Dr. Kruse to the contrary which was based primarily on the hospital's records and more specifically on the recovery room nurse's scores and notes in the PACU records.
CONCLUSIONS OF LAW
The Division of Administrative Hearings has jurisdiction over the parties to, and the subject matter of, this proceeding pursuant to Section 120.57(1), Florida Statutes.
Section 458.331(2), Florida Statutes, empowers the Board of Medicine to revoke, suspend or otherwise discipline the license of a physician found guilty of any one of those acts enumerated in Section 458.331(1)(a) through (11), Florida Statutes.
Respondent was initially charged with the violation of Section 458.331(1)(m) and (t), Florida Statutes. However, the Petitioner has stipulated to dismissing all allegations of the Administrative Complaint with the exception of those allegations concerning the issue of standard of care in the premature extubation and recovery room care of the patients L. Y. and O. G. Therefore, the only violation left of which the Respondent is charged is a violation of Section 458.331(1)(t), Florida Statutes, which provides in pertinent part as follows:
(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*.... (E. S. between *)
In a disciplinary proceeding, the burden is upon the regulatory agency to establish facts upon which its allegations of misconduct are based. Balino
v. Department of Health and Rehabilitative Services, 348 So.2d 349 (2 DCA Fla. 1977). The Petitioner must prove the material allegations of the Administrative Complaint by clear and convincing evidence. Ferris v. Turlington, 510 So.2d 191 (Fla. 1987). The Petitioner has failed to prove the material allegations of the Administrative Complaint by clear and convincing evidence and thereby, has failed to sustain its burden in this regard.
Based upon the foregoing Findings of Fact and Conclusions of Law, it is recommended that the Board of Medicine enter a final order dismissing the Administrative Complaint filed in this case.
RECOMMENDED this 15th day of January, 1993, at Tallahassee, Florida.
WILLIAM R. CAVE
Hearing Officer
Division of Administrative Hearings The DeSoto Building
1230 Apalachee Parkway
Tallahassee, Florida 32399-1550
(904) 488-9675
Filed with the Clerk of the Division of Administrative Hearings this 15th day of January, 1993.
APPENDIX TO RECOMMENDED ORDER, CASE NO. 91-0596
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.
Petitioner's Proposed Findings of Fact.
Proposed findings of fact 1, 3, 4, 5, 6, and 9 are adopted in substance as modified in findings of fact 1, 6, 7, 5, 13, and 16, respectively.
Proposed finding of fact 2 is unnecessary.
Proposed finding of fact 7 is neither material nor relevant to the conclusion reached in the Recommended Order.
Proposed findings of fact 8 and 16 go to the credibility of the expert witnesses and are unnecessary as findings of fact.
Proposed findings of fact 10-15 and 17-22 are rejected as not being supported by substantial competent evidence since there is more credible evidence supporting a finding contrary to the findings set forth in these proposed findings of fact.
6. Proposed findings of fact 23, 24-25, 29, 30, 31, 33-35, 39- 42, 39, 40, 41,
42, 43 and 44 are adopted in substance as modified in findings of fact 19, 20,
21, 23, 22, 4, 23, 25 and 5, respectively.
Proposed finding of fact 26 although acceptable is unnecessary.
Proposed findings of fact 27 and 28 go to the credibility of a witness and while they may be accurate they are unnecessary.
9. Proposed findings of fact 32, 36-38, 45-51, 55-71, 73, 75, 77, 78, 80-82, 84, 85, 88-96 are accepted as the testimony of the recovery nurse and the experts who testified in this case and a reflection of the hospital's records, particularly the PACU records upon which the experts relied in given their testimony or opinions. However, they are not necessarily adopted as findings of fact because the more credible evidence is to the contrary. See findings of fact 22-30.
Proposed finding of fact 52 is accepted but unnecessary since it relates to proposed findings of fact 53 and 54 which are rejected as not being supported by competent evidence in the record. See finding of fact 25.
Proposed finding of fact 72 is rejected as not being supported by competent substantial evidence in the record.
Proposed findings of fact 74, 76, 79 and 83 are adopted in substance as modified in findings of fact 27, 28, 30 and 24-26, respectively.
Proposed finding of fact 86-87 are accepted but unnecessary since there was no showing that patient suffered heart failure and pulmonary edema.
Proposed findings of fact 97-101, 103 and 104 are more a restatement of testimony than findings of fact but see findings of fact 24-26.
Proposed finding of fact 102 deals more with the credibility of a witness but see finding of fact 24.
Proposed finding of fact 105 is rejected, see findings of fact 24-26.
Respondent's Proposed Findings of Fact.
Proposed finding of fact 1 is unnecessary.
Proposed findings of fact 2 - 20 and 22 are adopted in substance as modified in findings of fact 1, 2, 1 & 2, 3, 6, 7,
8, 8, 9, 10, 11, 12, 13, 14, 16, IS, 18, 17, 17 and 18, respectively.
Proposed finding of fact 21 is more of a discussion of the testimony of Drs. Monroe, Kruse and Kozma rather than being stated as a finding of fact and is therefore, rejected.
COPIES FURNISHED:
Richard A. Grumberg, Esquire Senior Attorney
Department of Professional Regulation 1940 North Monroe Street, Suite 60
Tallahassee, Florida 32399-0792
Allen Bobo, Esquire Roger Lutz, Esquire
Lutz, Webb, Bobo and Baitty, P. A. One Sarasota Tower
Two North Tamiami Trail Sarasota, Florida 34236
Dorothy Faircloth Executive Director Department of Professional
Regulation
1940 North Monroe Street Suite 60
Tallahassee, Florida 32399-0792
Jack McRay General Counsel
Department of Professional Regulation
1940 North Monroe Street Suite 60
Tallahassee, Florida 32399-0792
NOTICE OF RIGHT TO SUBMIT EXCEPTIONS
All parties have the right to submit written exceptions to the Recommended Order. All agencies allow each party at least 10 days in which to submit written exceptions. Some agencies allow a larger period within which to submit written exceptions. You should consult with the agency that will issue the final order in this case concerning their rules on the deadline for filing exceptions to this Recommended Order. Any exceptions to this Recommended Order should be filed with the agency that will issue the final order in this case.
=================================================================
AGENCY FINAL ORDER
=================================================================
DEPARTMENT OF PROFESSIONAL REGULATION BOARD OF MEDICINE
DEPARTMENT OF PROFESSIONAL REGULATION,
Petitioner,
DPR CASE NUMBER: 0102302
vs DOAH CASE NUMBER: 91-0596
LICENSE NUMBER: ME 0024212
ALPHONSE DEL PIZZO, M.D.,
Respondent.
/
FINAL ORDER
This cause came before the Board of Medicine (Board) pursuant to Section 120.57(1)(b)10, Florida Statutes, on June 5, 1993, in West Palm Beach, Florida, for the purpose of considering the Hearing Officer's Recommended Order and Petitioners Exceptions to the Recommended Order (copies of which are attached hereto as Exhibits A and B, respectively) in the above-styled cause.
Petitioner, Department of professional Regulation, was represented by Larry G. McPherson, Jr., Attorney at Law. Respondent was present and represented by J. Allen Bobo, Attorney at Law. Upon review of the Recommended Order, the argument of the parties, and after a review of the complete record in this case, the Board makes the following findings and conclusions.
RULING ON EXCEPTION
Petitioner's Exception to the Hearing Officer's Conclusion of Law in Paragraph 34 of the Recommended Order is granted based on the reasons asserted in the written Exception.
FINDINGS OF FACT
Findings of fact set forth in the Recommended Order are approved and adopted and incorporated herein.
There is competent substantial evidence to support the findings of fact.
CONCLUSIONS OF LAW
The Board has jurisdiction of this matter pursuant to Section 120.57(1), Florida Statutes, and Chapter 458, Florida Statutes.
The conclusions of law set forth in the Recommended Order, as amended by the Board's ruling on Petitioner's Exception, are approved and adopted and incorporated herein.
There is competent substantial evidence to support the conclusions of
law.
DISPOSITION
Upon a complete review of the record in this case, the Board determines
that the disposition recommended by the Hearing Officer be ACCEPTED AND ADOPTED. WHEREFORE,
IT IS HEREBY ORDERED AND ADJUDGED that
The Administrative Complaint filed in this cause hereby is DISMISSED.
This order takes effect upon filing with the Clerk of the Department of professional Regulation.
DONE AND ORDERED this 11th day of June, 1993.
BOARD OF MEDICINE
JAMES N. BURT, M. D. CHAIRMAN
NOTICE OF RIGHT TO JUDICIAL REVIEW
A PARTY WHO IS ADVERSELY AFFECTED BY THIS FINAL ORDER IS ENTITLED TO JUDICIAL REVIEW PURSUANT TO SECTION 120.68, FLORIDA STATUTES. REVIEW PROCEEDINGS ARE GOVERNED BY THE FLORIDA RULES OF APPELLATE PROCEDURE. SUCH PROCEEDINGS ARE COMMENCED BY FILING ONE COPY OF A NOTICE OF APPEAL WITH THE AGENCY CLERK OF THE DEPARTMENT OF PROFESSIONAL REGULATION AND A SECOND COPY, ACCOMPANIED BY FILING FEES PRESCRIBED BY LAW, WITH THE DISTRICT COURT OF APPEAL, FIRST DISTRICT, OR WITH THE DISTRICT COURT OF APPEAL IN THE APPELLATE DISTRICT WHERE THE PARTY RESIDES. THE NOTICE OF APPEAL MUST BE FILED WITHIN THIRTY (30) DAYS OF RENDITION OF THE ORDER TO BE REVIEWED.
CERTIFICATE OF SERVICE
I HEREBY CERTIFY that a true and correct copy of the foregoing Order has been provided by certified mail to Alphonse Del Pizzo, M.D., 727 Key Royale Drive, Holmes Beach, Florida 32417-1231 and J. Allen Bobo and Roger Lutz, Attorneys at law, One Sarasota Tower, Two North Tamiami Trail, 5th Floor, Sarasota, Florida 34236, by U.S. Mail to William R. Cave, Hearing Officer, Division of Administrative Hearings, The DeSoto Building, 1230 Apalachee Parkway, Tallahassee, Florida 32 399- 1550; and by interoffice delivery to Larry G. McPherson, Jr., Chief Medical Attorney, Department of professional Regulation, 1940 North Monroe Street, Tallahassee Florida 32399-0792 at or before 5:00 P.M., this 13th day of August, 1993.
| Issue Date | Proceedings |
|---|---|
| Aug. 16, 1993 | Final Order filed. |
| Mar. 30, 1993 | Respondent's Motion for Continuance filed. |
| Mar. 30, 1993 | Respondent's Motion for Continuance filed. |
| Jan. 15, 1993 | Recommended Order sent out. CASE CLOSED. Hearing held 7/22/92. |
| Nov. 06, 1992 | Order Of Substitution Of Counsel sent out. (Law firm of Lutz, Webb, Bobo, and Baitty is substituted as counsel of record for respondent Alphonse Del Pizzo, and law firm of Holland & Knight is relieved as counsel of record and shall have no further respon |
| Nov. 04, 1992 | (joint) Stipulation for Substitution of Counsel w/(unsigned) Order Approving Substitution of Counsel filed. (From J. Allen Bobo) |
| Sep. 02, 1992 | Petitioner's Proposed Recommended Order filed. |
| Sep. 02, 1992 | Respondent's (Proposed) Recommended Order (unsigned) filed. |
| Aug. 21, 1992 | Order Enlarging Time for Filing Proposed Recommended Orders sent out. |
| Aug. 18, 1992 | (Petitioner) Motion for Enlargement of Time filed. |
| Aug. 06, 1992 | Transcript of Proceedings (Vols 1&2) filed. |
| Jul. 31, 1992 | Post-Hearing Order sent out. |
| Jul. 22, 1992 | Respondent's Notice of Filing filed. |
| Jul. 22, 1992 | CASE STATUS: Hearing Held. |
| Jul. 22, 1992 | (Respondent) Notice of Taking Deposition filed. |
| Jul. 21, 1992 | (3) Notice of Taking Deposition filed. (From J. Allen Bobo) |
| Jul. 20, 1992 | (Petitioner) Notice of Filing Respondent`s Admissions to Petitioner`s Request for Admissions filed. |
| Jul. 20, 1992 | Amended Notice of Hearing (as to time only) sent out. (hearing set for 7-22-92; 9:00am; Bradenton) |
| Jul. 13, 1992 | (2) Notice of Taking Deposition Duces Tecum filed. (From J. Allen Bobo) |
| Apr. 21, 1992 | Notice of Hearing sent out. (hearing set for July 22-23, 1992; 9:00am; Bradenton) |
| Apr. 06, 1992 | (Petitioner) Response to Order of Continuance filed. |
| Mar. 20, 1992 | Order of Continuance sent out. (motion for continuance granted; parties shall reply by 4-6-92) |
| Dec. 04, 1991 | Fifth Notice of Hearing sent out. (hearing set for March 31, 1992; 1:00pm; & April 1, 1992; 9:00am; Bradenton). |
| Dec. 02, 1991 | (Petitioner) Status Report filed. |
| Aug. 26, 1991 | Order Granting Continuance sent out. (Hearing cancelled; Status report due). |
| Aug. 23, 1991 | Respondent`s Motion for Continuance Affidavit of Respondent, Alphorns Pizzo, M.D. filed. (From J. Allen Bobo) |
| Aug. 07, 1991 | Amended Order Granting Continuance sent out. (Hearing reset for Aug. 30, 1991; 9:00am; Bradenton). |
| Jul. 19, 1991 | Order Granting Continuance sent out. (hearing rescheduled for Aug. 30, 1991; 9:00am; Bradenton). |
| Jul. 16, 1991 | Respondent's Motion for Continuance & cover letter to AHP from A. Bobo filed. |
| May 24, 1991 | Order Granting Continuance sent out. (hearing rescheduled for July 25, 1991; 9:00am; Bradenton). |
| May 23, 1991 | Joint Motion for Continuance filed. |
| May 15, 1991 | Notice of Taking Deposition to Perpetuate Testimony filed. (From Richard A. Grumberg) |
| Apr. 24, 1991 | Notice of Serving Answers to Respondent's Expert Interrogatories to Petitioner filed. (From Richard A. Grumberg) |
| Apr. 12, 1991 | Notice of Service of Respondent's Answers to Petitioner's First Set of Interrogatories; Respondent's Response to Petitioner's First Requestfor Production; Notice of Service of Respondent's Response to Petitioner's First Request Ad missions filed. (from J. |
| Mar. 28, 1991 | (Respondent) Notice of Service of Respondents First Set of Expert Interrogatories to Petitioner; Respondent Alphonse Del Pizzo, M.D. First Set of Expert Interrogatories to Petitioner Department of Professional Regulation filed. |
| Mar. 14, 1991 | Notice of Serving Petitioners First Set of Request for Admissions, Request for Production of Documents and Interrogatories to Respondent; Petitioners First Set of Request for Admissions, Interrogatories and Request for Production of Documents to Responden |
| Feb. 14, 1991 | Notice of Hearing sent out. (hearing set for May 29-31, 1991: 9:00 am: Bradenton) |
| Feb. 12, 1991 | Joint Response to Initial Order filed. |
| Jan. 31, 1991 | Initial Order issued. |
| Jan. 24, 1991 | Agency referral letter; Administrative Complaint; Election of Rights;(DPR) Notice of Appearance (from R. Grumberg) filed. |
| Issue Date | Document | Summary |
|---|---|---|
| Jun. 11, 1993 | Agency Final Order | |
| Jan. 15, 1993 | Recommended Order | Insufficient evidence to prove violation of Section 458.331(t). |
