STATE OF FLORIDA
DIVISION OF ADMINISTRATIVE HEARINGS
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AGENCY FOR HEALTH CARE ADMINISTRATION,
Petitioner,
vs.
NEVILLE CLEMENT JACK,
Respondent.
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) CASE NO. 96-2576
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RECOMMENDED ORDER
Pursuant to notice, the Division of Administrative Hearings, by its designated Administrative Law Judge, David M. Maloney, held a formal hearing in the above-styled case on October 1, 1996, via videoteleconference. The proceeding was
) conducted from facilities in Tallahassee. The court reporter
was in Tampa with the parties and other participants.
APPEARANCES
For Petitioner: Steven Rothenberg, Esquire
Agency for Health Care Administration 9325 Bay Plaza Boulevard, Suite 210
Tampa, Florida 33619
For Respondent: Neville Clement Jack, M.D., Acting Pro Se 6814 Rosemary Drive
Tampa, Florida 33625-3979
STATEMENT OF THE ISSUES
Whether Respondent should be determined to be found in violation of Florida's Medical Practice Act for gross negligence or failure to practice medicine with that level of care, skill, and treatment recognized by a reasonably prudent similar
physician as being acceptable under the circumstances or for
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failure to keep written medical records justifying the course cf
treatment of a patient throughout seven months of her pregnancy? (
If so as to either charge, what is the appropriate discipline to be imposed by the Board of Medicine?
PRELIMINARY STATEMENT
On May 23, 1996, the Agency for Health Care Administration, (Petitioner, "AHCA" or the "agency,") forwarded an Administrative Complaint against Respondent, Neville Clement Jack, M.D., in AHCA Case No. 93-22708 under cover of a letter from a senior attorney in the agency. The Division of Administrative Hearing opened a case file and assigned the matter to the undersigned administrative law judge.
The complaint submitted by the agency seeks discipline from the Board of Medicine to be imposed on Dr. Jack's license to
practice medicine. In addition to factual allegations, the C
complaint contains two counts.
In the first count, Respondent is charged with violating Section 458.331(l)(t), Florida Statutes, for being guilty of gross or repeated negligence or for failure to practice medicine with that level of care, skill, and treatment which is recognized by a reasonably prudent physician as being acceptable under similar conditions and circumstances. In the second, he is charged with violating Section 458.33l(l)(rn), Florida Statutes, for being guilty of failure to keep adequate written medical records justifying the course of treatment of his patient.
Included in the agency's submission is an Election of Rights Form signed by Respondent in which he disputes the
allegations of fact in the Administrative Complaint and requests that the form be considered a petition for a formal hearing pursuant to Section 120.57, Florida Statutes.
The case was noticed for hearing on October 1, 1996, and was heard that day by videoteleconference. Counsel for the agency, Respondent and the witnesses of the parties participated in the proceeding at videoteleconference facilities in Tampa with the undersigned administrative law judge conducting the proceeding from the videoteleconference facilities in Tallahassee at the Division of Administrative Hearings.
The agency submitted a proposed recommended order on October 25, 1996. Respondent did not submit a proposed recommended order.
FINDINGS OF FACT
Petitioner, the Agency for Health Care Administration,
is within the Department of Business and Professional Regulation, together with the Board of Medicine, the regulatory authority charged with regulating the practice of medicine in the State of Florida. Section 20.42 and Chapter 458, Florida Statutes.
Respondent, Neville Clement Jack, M.D., is the holder of a license to practice medicine in Florida, license number ME 0046020.
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While holding license number ME 0046020, Dr. Jack has
) been disciplined twice by the Board of Medicine.
He was first disciplined by a final order dated August
26, 1994. He had been charged by administrative complaint with (
violating Section 458.33l(l)(c), Florida Statutes, in that he had entered a plea of nolo contendere in the Thirteenth Judicial Circuit Court for Hillsborough County to seven counts of petit theft. The plea was based on criminal charges in which he was accused of defrauding Medicaid of $11,227.00 by billing Medicaid for services he had not provided. Dr. Jack did not contest the factual allegations in the administrative complaint. Dr. Jack was fined $2,500.00 and ordered to subject his practice to procedures designed to achieve quality assurance in the practice.
Dr. Jack was disciplined again by a final order entered
December 13, 1995. In this second proceeding, Dr. Jack was
charged with twelve counts of violating the disciplinary C
provisions of Chapter 458, Florida Statutes. Six of the counts
charged Dr. Jack with failure to practice medicine with reasonable safety, two charged him with medical records violations, one with making deceptive representations in the course of his practice and one with inappropriate prescription of legend drugs. In entering a consent order with the Agency for Health Care Administration, Dr. Jack neither admitted nor denied the charges. The final order disposed of the case by fining him $5,000 and placing him on probation for a two year period effective December 5, 1995. Of the seven cases of patients whose treatment by Dr. Jack led to the twelve counts of violations of the Medical Practice Act in the administrative
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complaint, issued in this second proceeding, three -cases, in part, consist of charges involving failure to respond to telephone calls or pages in a timely manner; three also consist of charges Dr. Jack failed to be present at critical moments in obstetrical care, including delivery, and follow-up or postpartum care. Failure to respond to pages or telephone calls at critical moments of need by an obstetrical patient is at the heart of this case, a case involving prenatal care of A.W., a woman who had entrusted her first pregnancy to Dr. Jack.
In early 1990, Dr. Jack admitted a new patient to his practice of gynecology: A.W. Dr. Jack and A.W. had know each other prior to establishment of their physician-patient relationship because they were members of the same church.
A little more than two years later, when Patient A.W. suspected that she might be pregnant, she made an appointment with Dr. Jack's office.
If pregnant as she suspected, A.W. thought Dr. Jack would be the ideal person to provide her with obstetrical care. She been his gynecological patient for more than two years. In addition, she had known him for some time and had always believed him to be a reputable physician. In fact, she had seen Dr. Jack's name listed in her Humana provider publication as both a gynecologist and an obstetrician.
In addition to thinking Dr. Jack would be an ideal obstetrician for prenatal care and delivering the baby, A. W.,
) knew that if she were pregnant, she did not want the baby to be
delivered a birthing center. She wanted the baby to be delivered at a hospital by a reputable obstetrician. In her mind, Dr. Jack was that obstetrician. He was the obstetrician whom she felt she could trust with a moment extremely important to her and her child-to-be: the baby's birth.
A.W. presented to Dr. Jack's office on May 8, 1992 with indications of pregnancy. Dr. Jack conducted a full physical examination of her, including a sonogram. She was diagnosed as pregnant with an expected delivery date of December 21, 1992.
Dr. Jack accepted A.W. as a prenatal patient. Unbeknownst to A. w., however, Dr. Jack, in May of 1992, did not have privileges at any hospital. He was not able and knew he
was not able, therefore, to deliver A. W.'s baby at a hospital.
It is not clear from the record why Dr. Jack did not have privileges at any of the local hospitals. It may have been because he had been convicted of seven criminal counts of petit theft involving medicaid fraud. It may have been because of the charges in the two cases for which he was disciplined several years later by the Board of Medicine. Whatever the basis for the loss of privileges, however, the fact remains: from the moment A.W. presented in May of 1992 throughout the course of care he provided A.W. while she was pregnant, Dr. Jack did not have privileges at any local hospital at which he could have delivered A.W.'s baby.
At her initial visit the time most appropriate for the information to be communicated to a pregnant woman, A.W. was
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not informed by either Dr. Jack's office staff or Dr. Jack, himself, that Dr. Jack did not have privileges at a local hospital.
Nonetheless, for th·e next few months, A.W.'s pregnancy and prenatal care proceeded uneventfully. Dr. Jack provided
A.W. with appropriate prenatal care, such as checking fetal heart tone, analysis of weight gain, checking growth of the fetus by measuring the patient's abdomen, and performing urinalyses. But, Dr. Jack did not refer A.W. to an obstetrician for the expected delivery. And A.W., not knowing that Dr. Jack could not conduct the delivery at a hospital, made no attempt to contact an obstetrician.
During several of the visits to Dr. Jack's office prior to October of 1996, A.W. made known her intention to have
) the baby delivered at University Community Hospital ("UCH") in discussions with Dr. Jack's staff. It may be that staff members who participated in these discussions thought A.W. had been informed as part of standard office procedure of the lack of Dr. Jack's privileges. But, such procedure had not been followed in the case of A.W. At none of the times A.W. discussed delivery at UCH did the staff inform A.W. that Dr. Jack did not have privileges at UCH or, for that matter, at any other hospital in the area. Neither did Dr. Jack inform her of the status of his privileges at local hospitals.
A.W.'s pregnancy continued to·proceed uneventfully until mid-October.
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On October 16, 1996, A.W., then close to commencement of her eighth month of pregnancy, presented to Dr. Jack with complaints of a urinary tract infection.
Two weeks later, she presented a second time with
symptoms which Dr. Jack diagnosed as a urinary tract infection and for which he prescribed Bactrim.
Dr. Jack saw A.W. for the infection on November 2, 9 and 11, 1992. Following the November 2 office visit, Dr. Jack prescribed Amoxicillin. Following the November 9 visit, he prescribed Amoxicillin again. On November 11, 1992, Dr. Jack ordered a culture to determine the origin of the infection because A.W. was not responding to the prescribed antibiotics.
On one of these visits, little more than one month
prior to the expected delivery of the baby, Aw. was accompanied (
by W.W., her husband. W.W. expressed to Dr. Jack his concern about the antibiotic treatment received by A.W. and asked why she wasn't being hospitalized. W.W. thought his wife should be monitored in a hospital since the infection had lingered so long and seemed serious. W.W. was especially concerned since the infection was occurring while A.W. was experiencing a first-time pregnancy.
The meeting between A.W., W.W., and Dr. Jack lasted twenty minutes. At no time during the meeting did Dr. Jack inform W.W. that he did not have privileges at any hospital.
Nor did Dr. Jack inform W.W. that he was providing prenatal care only and that it was going to be necessary for him and his wife to obtain an obstetrician for the delivery.
On November 13, 1996, A.W. saw Dr. Jack at his office again in order to have performed a sonogram, a procedure standard near the commencement of the last month of a full-term pregnancy.
At the November 13 office visit, the staff informed
A.W. that Dr. Jack "was not delivering right now, so ... he had other doctors who were delivering for him." Tr. 29. This was the first time that A.W. had ever heard or been informed that Dr. Jack did not have hospital privileges and would not be delivering the baby.
When asked whether she wanted the delivery at UCH or
another hospital, A.W., consistent with her earlier discussions with Dr. Jack's staff, answered UCH. In response, Dr. Jack's
) staff told A.W. that an appointment would be made in the first week of December for A.W. to see Dr. Reimer, an obstetrician with privileges at UCH.
Consistent with the default up until November 13, 1992, by Dr. Jack and his staff in informing A.W. of his lack of privileges, Dr. Jack's records do not reflect that he ever informed A.W. that he did not have privileges. Likewise, on the November 13, 1992, when A.W. was finally and for the first time informed of the status of his privileges, Dr. Jack's records do not reflect that A.W. was informed.
In light of the revelation on November 13, 1992, that
Dr. Jack would not be delivering her baby, A.W. accepted the appointment made for her with Dr. Reimer. It was not A.W.'s
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// independent decision, however, to avail herself of Dr. Reimer's
obstetr ical care at this late stage in her pregnancy. The
decision to accept the appointment was thrust upon A.W. by the ( circumstances of the late revelation of the status of Dr. Jack's privileges. A.W made none of the arrangements to see Dr.
Reimer. The arrangements were handled solely by Dr. Jack's staff.
A.W. was told by Dr. Jack's staff that her records were being copied and sent to Dr. Reimer. Contrary to this representation, however, none of A.W.'s records were transmitted to Dr. Reimer's office.
On the day of her appointment with Dr. Reimer during the first week of December, A.W. attempted to see Dr. Reimer but
she could not find his office. She went to Dr. Jack's office
for directions but, by the time she reached his office, the time ( for the appointment with Dr. Reimer had passed. A.W. had an appointment scheduled with Dr. Jack for the upcoming Friday
afternoon, December 4, at 3:30. Dr. Jack's staff made a second appointment with Dr. Reimer for one hour before: 2:30 p.m., the afternoon of December 4.
With the benefit of the new directions, A.W. found Dr. Reimer's office in time for her 2:30 appointment that Friday afternoon. Dr. Reimer's office refused, however, to allow A.W. to see Dr. Reimer because it did not have her prenatal records or any other medical records of hers. A.W. returned to the office in order to obtain the records, herself, and to transport
them back to Dr. Reimer's office. In addition she intended to
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see Dr. Jack for her 3:30 appointment. When she arrived at the
) Dr. Jack's office, however, it was closed. A.W. attempted to reach Dr. Jack by telephone in the hope that his answering service would be able to inform him of the need to return her call, but this attempt, too, proved unsuccessful.
At hearing, A.W. described her predicament on the afternoon of December 4, 1992, in the ninth month of her pregnancy and little more than two weeks from the expected birth of her child, in response to the question, "[h]ow were you feeling on that day?"
A bit heavy [and in slight discomfort] and I just knew it was three weeks I hadn't seen a doctor, and I knew I had to see somebody if Dr. Reimer didn't see me ...
(Tr. 32.)
) December 5, 1992
In the early morning of December 5, A.W.'s slight discomfort of the day before had become abdominal pain. At approximately 7 a.m., A.W. made the first telephone call of many calls she made throughout the day to Dr. Jack's office. As the day wore on with no response from Dr. Jack, the pain grew worse. Finally at 5 p.m., Dr. Jack returned the call. Over the telephone, Dr. Jack diagnosed A.W.'s condition as false labor.
After the diagnosis by telephone, the abdominal pain continued to grow worse until it became excruciating. At approximately 8:50 p.m., A.W. reached Dr. Jack by telephone and told him that she wanted to go_ to the hospital. At this moment of A.W.'s worsening condition and what certainly sounded from
A.W.'s description of symptoms to be a serious situation, Dr. Jack responded by telling her to call Dr. Reimer.
In response to a question on direct examination about whether Dr. Jack had met the standard of care in this case, the agency's expert witness, Dr. Pierre Bouis, testified, that to meet the standard of care an obstetrician not able to deliver must "do everything possible to make sure that the patient is cared for by an appropriate facility and/or physician." (Tr. 140.)
Without the required standard of care, that is without any assurance whatsoever of being cared for by an appropriate physician, A.W. presented to the emergency room at UCH at 9:00
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p.m. She asked the attendants to call Dr. Reimer. Dr. Reimer was called but because he had not seen A.W. and did not have any of her records, he declined to come to the hospital.
Nurses at UCH examined A.W. Observing that her abdomen was very hard and unable to detect a fetal heart tone, the nurses called Dr. Commedore, the emergency on-call obstetrician for UCH. Dr. Commedore admitted A.W. to UCH and conducted an examination. There were no fetal heart tones. Furthermore, after conducting ultrasound at bedside and other diagnostic procedures, Dr. Commedore detected no fetal movement.
Dr. Commedore diagnosed A.W. as having suffered abruptio placenta, premature separation of a normally implanted placenta. Abruptio placenta places an unborn child in great jeopardy because of loss of oxygen in the baby's bloodstream.
A Cesarean section was performed after the failure of
) inducement of labor. Dr. Commedore delivered a stillborn baby boy.
An autopsy revealed the stillborn child to have no congenital abnormalities, a normal three vessel umbilical cord and lungs with congestion and meconium aspiration. Abruptio placenta suffered on December 5, 1992, a day spent by A.W. beginning at 7 in the morning until 5 p.m. that evening trying to contact Dr. Jack, had caused the stillbirth of the child of
CONCLUSIONS OF LAW
The Division of Administrative Hearings has jurisdiction over the parties and the subject matter of this proceeding.
Since the agency seeks revocation of Dr. Jack's license, it must prove the violations with which he is charged by clear and convincing evidence. Ferris v. Turlington, 510 So.2d 292, (Fla. 1987).
In this case, the agency has proven by clear and convincing evidence that Dr. Jack has violated Section 458.33l(l)(m), Florida Statutes, the provision of the practice act governing medical records.
The "medical records" violation could not be clearer. There is no record in any of A.W.'s prenatal records kept by Dr. Jack or his office that A.W. was ever informed of the status of
) Dr. Jack's privileges and that he would not be able to deliver
A.W.'s baby at a hospital. Even on the day that A.W. was informed by Dr. Jack's staff, November 13, 1992, (as proven by A.W.'s testimony), that he was not delivering at a hospital, there is no record that the information was provided A.W. In the absence of a record prior to November 13, 1992, it may be presumed that A.W. was not informed until then of the status of Dr. Jack's privileges. The presumption is found to be fact. by virtue of A.W.'s testimony that she was not so informed until November 13, 1992. On that date, A.W. was on the verge of entering her last month of pregnancy, a very late date in her prenatal care to reveal to her a fact so important in the conduct of her relationship with the obstetrician or obstetricians necessary to treat her both prenatally, at birth and postpartum.
The agency has also proven clearly and convincingly that Dr. Jack has violated Section 458.33l(l)(t), Florida Statues.
The standard of care by an obstetrician unable to deliver a patient's baby requires the obstetrician to do "everything possible to make sure that the patient is cared for by an appropriate facility or physician." (Tr. 140).
Dr. Jack did not meet the standard of care in this case. Not only did he not inform A.W. and her husband that he would not be able to deliver their baby at a hospital, he made no arrangements to make sure that she was cared for at an appropriate facility or by an appropriate physician. His staff,
under his direction, also failed to make the necessary
) arrangements. While they made two appointments with Dr. Reimer, A.W., ultimately, was not seen by Dr. Reimer because Dr. Jack's office did not transfer or make her records available to Dr.
Reimer.
Arrangements should have been made for Dr. Reimer's office to see A.W. long before the first week of December, two to three weeks from the expected delivery date. That the baby could have been born prematurely, in which case a hospital delivery would have been necessary, does not ever seem to have crossed Dr. Jack's mind.
Furthermore, after a day of increasing pain until the
pain became excruciating in the early evening hours of December
s, 1992, Dr. Jack was given information by the patient at 8:50
) p.m. that indicated his earlier diagnosis of false labor was
incorrect and that the medical situation of A.W. and her baby had become serious. Dr. Jack's only response was to tell A.W. to call Dr. Reimer, an obstetrician whom Dr. Jack had never contacted either in person, by phone, or through records delivery, about A.W.'s pregnancy. At the very least, if Dr.
Jack referred prenatal patients to Dr. Reimer for obstetrical care, Dr. Jack should have called Dr. Reimer, himself, when he knew A.W.'s prenatal condition had become serious.
Dr. Jack's failure to see that A.W. was cared for at delivery in an appropriate facility by an appropriate physician far exceeds his failure to contact Dr. Reimer the evening of
) December 5. Dr. Jack's office was closed on December 5, 1992,
during hours when an appointment had been made for A.W., the day
before she suffered abruptio placenta, the same day she had (
tried to see Dr. Reimer but was unable to because of Dr. Jack's office staff's failure to deliver her records. Perhaps A.W.'s baby would have been saved had A.W. been examined by either Dr. Reimer or Dr. Jack the day before the placenta's premature separation occurred. On the state of this record, we will never know. But, what is known, is that Dr. Jack closed his office when he had an appointment with A.W., his staff failed to deliver her records to Dr. Reimer's office, Dr. Jack failed to return calls the afternoon of Friday, December 4, 1992, and failed to return A.W.'s increasingly frantic calls throughout the day of Saturday, December 5, 1992 until the early evening of that day.
It is true that abruptio placenta, a condition that ( was not caused by Dr. Jack's care, was the cause of the
stillbirth of A.W.'s baby. What is not known, however, is what would have been the outcome of her pregnancy had Dr. Jack at any of numerous times during his prenatal care of A.W., met the standard of care imposed on him in this case. The opportunity to attempt to meet that standard of care presented itself on many occasions to Dr. Jack during the course of his treatment of
A.W. It presented itself at her initial visit when pregnant, at any of the many visits for prenatal care, thereafter, until November 13, 1992. It presented itself on the afternoon of Friday, December 4 when Dr. J.ack closed his office despite the appointment with A.W., and throughout the day of December 5,
until 8:50 p.m., when Dr. Jack knew the situation was serious
,"") and he answered with the lamest of responses, directing A.w., then in dire need of care, to call Dr. Reimer.
It may be that Dr. Jack's failure to assure A.W. had an obstetrician was not the proximate cause of her baby son's stillbirth. It cannot be determined on the basis of this record. But Dr. Jack's failure is a link in a chain of events that led to tragedy. If that link had been removed from the chain, and abruptio placenta had still resulted in the stillbirth of A.W. and W.W.'s child, at least they would know that their child's stillbirth was the result of an act of nature rather than the result of Dr. Jack's abysmal failure to practice medicine with even minimal skill and safety.
The disciplinary guidelines of the Board of Medicine, found at 59R-8.001, Florida Administrative Code, provide a range of penalties for violations of paragraphs (m) and (t) of subsection (1) of Section 458.331, Florida Statutes. The range includes license revocation and suspension, as well as probation, reprimand and a fine. The Board may deviate from the range of penalties, however, after consideration as aggravating or mitigating the following factors:
Exposure of patient or public to injury or potential injury, physical or otherwise: none, slight, severe or death;
Legal status at the time of the offense; no restraints, or legal restraints;
The number of counts of separate offenses established;
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The number of times the same offense or offenses have previously been committed by
the licensee ...; (
The disciplinary history of the licensee in any jurisdiction and the length of practice;
Pecuniary benefit or self-gain inuring to the ... licensee;
Any other relevant mitigating factors. Rule 59R-8.001(3), Florida Administrative Code.
51. Dr. Jack's failure to practice with that level of care, skill and treatment recognized by a reasonably prudent physician under similar circumstances in this case supports revocation of his license. In addition, there are aggravating circumstances in this case established by the rules of the Board of Medicine. Dr. Jack's violation exposed A.W. to considerable
injury, pain and emotional trauma. Id., paragraph (a). The
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violations of the Practice Act in this case in light of Dr.
Jack's disciplinary history supports revocation. Id., paragraph (e). Dr. Jack received a pecuniary benefit by providing prenatal care to A.W. and not telling her early on in the course of the care that he did not have hospital privileges. Had he done so, she would have likely selected for prenatal care and delivery of the baby an obstetrician with hospital privileges.
Based on the foregoing, it is, hereby,
If the Board should choose a penalty less severe than revocation, Dr. Jack should be prohibited from practicing obstetrics, including the provision of prenatal care, for the remainder of his practice as a physician licensed by the Board of Medicine.
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ClvID M. MALONEY
Administrative Law Judge
Division of Administrative Hearings The DeSoto Building
1230 Apalachee Parkway
Tallahassee, Florida 32399-1550
(904) 488-9675 SUNCOM 278-9675
Fax Filing (904) 921-6847
Filed with the Clerk of the Division of Administrative Hearings this 24th day of December, 1996.
Steven Rothenberg, Esquire
Agency for Health Care Administration 9325 Bay Plaza Blvd., Suite 210
Tampa, Florida 33619
Neville Clement Jack, M.D. 6814 Rosemary Drive
Tampa, Florida 33625
Dr. Marm Harris
E ecutive Director
Agency for Health Care Administration Board of Medicine
1940 North Monroe Street Tallahassee, Florida 32399-0792
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NOTICE OF RIGHT TO SUBMIT EXCEPTIONS
All parties have the right to submit written exceptions within (
15 days from the date of this recommended order. Any exceptions to this recommended order should be filed with the agency that will issue the final order in this case.
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| Issue Date | Proceedings |
|---|---|
| Mar. 10, 1997 | Final Order received. |
| Jan. 30, 1997 | Amended Recommended Order sent out. |
| Dec. 24, 1996 | Recommended Order sent out. CASE CLOSED. Hearing held 10/01/96. |
| Dec. 02, 1996 | (Petitioner) Notice of Change of Address received. |
| Oct. 25, 1996 | Petitioner`s Proposed Recommended Order; Notice of Filing received. |
| Oct. 18, 1996 | Transcript of Proceedings received. |
| Oct. 09, 1996 | Letter to DMM from B. Lawson Re: Petitioner`s and Respondent`s Exhibits; Exhibits received. |
| Oct. 01, 1996 | CASE STATUS: Hearing Held. |
| Sep. 25, 1996 | (Petitioner) Notice of Filing; Petitioner`s Motion to Take Official Recognition received. |
| Sep. 13, 1996 | (Petitioner) Notice of Filing; (Petitioner) Notice of Taking Deposition In Lieu of Live Testimony (filed via facsimile) received. |
| Aug. 06, 1996 | (Petitioner) Notice of Serving Petitioner`s First Set of Request for Admissions, Interrogatories, and Request for Production of Documents received. |
| Jun. 19, 1996 | Notice of Hearing sent out. (hearing set for 10/1/96; 10:00am; Tampa) |
| Jun. 17, 1996 | (Petitioner) Notice of Filing received. |
| Jun. 11, 1996 | Joint Response to Initial Order received. |
| May 31, 1996 | Initial Order issued. |
| May 28, 1996 | Agency referral letter; Administrative Complaint; Election of Rights received. |
| Issue Date | Document | Summary |
|---|---|---|
| Mar. 06, 1997 | Agency Final Order | |
| Dec. 24, 1996 | Recommended Order | Revocation recommended, Physician treating pregnant woman failed to inform her that he did not have hospital privileges and could not deliver baby. |
