STATE OF FLORIDA

DIVISION OF ADMINISTRATIVE HEARINGS

GREGORY WAYNE STANCEL, )

)

Petitioner, )

)

vs. ) Case No. 00-1360

) DEPARTMENT OF HEALTH, BOARD ) OF CHIROPRACTIC, )

)

Respondent. )

)

RECOMMENDED ORDER

Robert E. Meale, Administrative Law Judge of the Division of Administrative Hearings, conducted the final hearing in Fort Myers, Florida, on July 26, 2000.

APPEARANCES

For Petitioner: Gregory W. Stancel, pro se

2256 Iris Way

Fort Myers, Florida 33905

For Respondent: Cherry A. Shaw

Senior Examination Attorney Department of Health General Counsel's Office

4052 Bald Cypress Way, Bin A 02 Tallahassee, Florida 32399-1703

STATEMENT OF THE ISSUE

The issue is whether Petitioner is entitled to a passing grade on the chiropractic examination.

PRELIMINARY STATEMENT

By report mailed January 5, 2000, Respondent informed Petitioner that he had failed the physical diagnosis and X-ray

interpretation portions of the practical part of the chiropractic licensure examination administered in November 1999. The report states that the minimum passing score for each portion was 75 and Petitioner scored a 67.7 and 72, respectively. The report states that Petitioner passed the two remaining parts of the chiropractic examination.

By letter dated March 12, 2000, Petitioner challenged the scoring of several items for each portion of the examination that he had failed and requested a formal hearing.

At the start of the hearing, Respondent conceded one point credit for Question 24.

At the hearing, Petitioner called one witness and offered into evidence eight exhibits. Respondent called two witnesses and offered into evidence 17 exhibits. All exhibits were admitted.

FINDINGS OF FACT

1. Petitioner took the November 1999 examination for chiropractic licensure. He passed the written part and the technique portion of the practical part. However, Petitioner failed the physical diagnosis and X-ray interpretation portions of the practical part.

2. The physical diagnosis portion of the examination supplies candidates with a brief case history followed by several questions. Score sheets provide standards for the scoring of responses.

3. Question 3 of the physical diagnosis portion of the examination requires the evaluators to ask the candidate to demonstrate and describe an abdominal examination and explain the significance of a digital rectal examination on the patient, who has complained of cramping, bloatedness, and distention, as well as alternating stool consistency with an irregular pattern of defacation.

4. The evaluators assigned Petitioner no points for his responses to Question 3. For the demonstration of an abdominal examination, Petitioner failed to ensure that the abdominal muscles were relaxed in order to permit a useful examination. Petitioner attempted to listen to the spleen, prior to performing percussion and palpation, but he was not in the left lower quadrant, which is the location of this organ. Petitioner palpated the abdominal area with his fingertips, rather than his palms, and failed to perform deep palpation. Petitioner also failed to outline the liver in his demonstration.

5. The purpose of the digital rectal examination, for this patient, was to detect blood or a palpable lesion. Petitioner incorrectly responded that the purpose of this examination was to perform a prostate examination.

6. Petitioner's misdiagnosis of diverticulitis, in response to Question 8, reflects his limited insight into this patient's condition, for which the correct diagnosis was irritable bowel syndrome, colitis, or spastic colon.

7. Question 17 of the physical diagnosis portion of the examination required a demonstration of the gluteus maximus and peroneus muscles. The evaluators credited Petitioner for the correct demonstration of the gluteus maximums, but not the peroneus.

8. Petitioner incorrectly grasped the patient's calf and ankle, which precluded the isolation of the peroneus. Failing to grasp the metatarsal end of the foot prevented Petitioner from properly isolating the peroneous muscle.

9. At the hearing, Respondent gave Petitioner full credit for his response to Question 24 of the physical diagnosis portion of the examination.

10. Question 3 of the X-ray interpretation portion of the examination required Petitioner to examine two X-ray films, taken two years apart, and render a probable diagnosis. The vast destruction of bone mass suggested a case of neuropathic joint resulting from syphillis, but Petitioner diagnosed post-traumatic joint disease, focusing instead on the patient's physically demanding profession and her age of 37 years. However, the extensiveness of bone destruction over a relatively short period favored the diagnosis of neuropathic joint over Petitioner's diagnosis.

11. Question 5 of the X-ray interpretation portion of the examination required Petitioner to identify the anatomical structures outlined at lumbar-3 on a specific X-ray. Petitioner

    identified the structures as lamina, but they were the pars interarticulares, which are isthmus between the lamina and pedicle.

12. Question 38 of the X-ray interpretation portion of the examination required Petitioner to explain why the neural foramen, as revealed on an X-ray, appeared enlarged. Rather than cite the nondevelopment of the cervical-6 pedicle, Petitioner incorrectly chose neurofibromatosis, despite the failure of the exposed structures to reveal the angularity characteristic of this condition and the absence of any bony structure subject to the process of deterioration resulting from neurofibromatosis.

13. Despite the concession by Respondent on Question 24 on the physical diagnosis portion of the chiropractic licensure examination, Petitioner has failed to prove that he is entitled to additional credit on the physical diagnosis or X-ray interpretation portion of the chiropractic licensure examination that he should have passed either portion of the examination.

    CONCLUSIONS OF LAW

    
    

14. The Division of Administrative Hearings has jurisdiction over the subject matter. Section 120.57(1), Florida Statutes.

15. As an applicant, Petitioner has the burden of proving that he is entitled to additional credit on the chiropracture licensure examination. Department of Transportation v. J. W. C. Company, Inc., 396 So. 2d 778 (Fla. 1st DCA 1981).

16. As noted above, Petitioner has failed to prove that he is entitled to sufficient additional credit as to be entitled to a passing score on either the physical diagnosis or X-ray interpretation portions of the chiropracture licensure examination administered in November 1999.

RECOMMENDATION

It is

RECOMMENDED that the Board of Chiropractic enter a final order dismissing Petitioner's petition.

DONE AND ENTERED this 26th day of September, 2000, in Tallahassee, Leon County, Florida.

ROBERT E. MEALE

Administrative Law Judge

Division of Administrative Hearings The DeSoto Building

1230 Apalachee Parkway

Tallahassee, Florida 32399-3060

(850) 488-9675 SUNCOM 278-9675

Fax Filing (850) 921-6847 www.doah.state.fl.us

Filed with the Clerk of the Division of Administrative Hearings this 26th day of September, 2000.

COPIES FURNISHED:

Joe Baker, Jr., Executive Director Board of Chiropractic

Department of Health

4052 Bald Cypress Way, Bin C07 Tallahassee, Florida 32399-3257

William W. Large, General Counsel Department of Health

4052 Bald Cypress Way, Bin A02 Tallahassee, Florida 32399-1701

Angela T. Hall, Agency Clerk Department of Health

4052 Bald Cypress Way, Bin A02 Tallahassee, Florida 32399-1701

Gregory W. Stancel 2256 Iris Way

Fort Myers, Florida 33905

Cherry A. Shaw

Senior Examination Attorney Department of Health General Counsel's Office

4052 Bald Cypress Way, Bin A02 Tallahassee, Florida 32399-1703

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 must be filed with the agency that will issue the final order in this case.

Docket for Case No: 00-001360

Orders for Case No: 00-001360