Elawyers Elawyers
Ohio| Change

DEPARTMENT OF HEALTH, BOARD OF MEDICINE vs JACINTA IRENE GILLIS, M.D., 11-005692PL (2011)

Court: Division of Administrative Hearings, Florida Number: 11-005692PL Visitors: 24
Petitioner: DEPARTMENT OF HEALTH, BOARD OF MEDICINE
Respondent: JACINTA IRENE GILLIS, M.D.
Judges: R. BRUCE MCKIBBEN
Agency: Department of Health
Locations: Fort Myers, Florida
Filed: Nov. 03, 2011
Status: Closed
Recommended Order on Friday, February 3, 2012.

Latest Update: Apr. 24, 2012
Summary: Count One. Whether Respondent, Jacinta Irene Gillis, M.D. (hereinafter referred to herein as "Dr. Gillis"), violated sections 458.331(1)(nn) and 458.326, Florida Statutes (2008 and 2009), by: a. Failing to diagnose patient M.G. with intractable pain prior to prescribing a controlled substance under Schedules II-V, as provided in section 893.03, from on or about December 19, 2008 through December 30, 2009; b. By inappropriately or excessively prescribing potentially lethal, highly abused, control
More
11005691AFO



DEPARTMENT OF HEALTH,


Petitioner,


STATE OF FLORIDA BOARD OF MEDICINE

Il: 35

Final Order No. DOH-12-0720-fVt _ QA


vs. DOH CASE NOS.: 2008-20661

2010-01128

DOAH CASE NOS.: ll-5691PL

11-5692PL LICENSE NO.: ME0099298


JACINTA IRENE GILLIS, M.D.,


Respondent.

                                                             !


FINAL ORDER


THIS CAUSE came before the BOARD OF MEDICINE (Board) pursuant to Sections 120.569 and 120.57(1), Florida Statutes, on April 13, 2012, in Jacksonville, Florida, for the purpose of considering the Administrative Law Judge's Recommended Order, Exceptions to the Recommended Order, and Response to Exceptions to the Recommended Order (copies of which are attached hereto as Exhibits A, B, and C, respectively) in the above-styled cause.

Petitioner was represented by Carol Gregg, Assistant General Counsel. Respondent was present but was not represented by counsel.

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 EXCEPTIONS


The Board reviewed and considered the Respondent's Exceptions to the Recommended Order and rejected the exceptions because Respondent failed to clearly identify the disputed portion of the Recommended Order by page number or paragraph; she failed to identify the legal basis for the exception; and did not include the appropriate and specific citations to the record.

FINDINGS OF FACT


  1. The findings of fact set forth in the Recommended Order are approved and adopted and incorporated herein by reference.

  2. There is competent substantial evidence to support the findings of fact.

CONCLUSIONS OF LAW


  1. The Board has jurisdiction of this matter pursuant to Section 120.57(1), Florida Statutes, and Chapter 458, Florida Statutes.

  2. The conclusions of law set forth in the Recommended Order are approved and adopted and incorporated herein by reference.

PENALTY


Upon a complete review of the record in this case, the Board determines that the penalty recommended by the




Administrative Law Judge be ACCEPTED. WHEREFORE, IT IS HEREBY ORDERED AND ADJUDGED:

Respondent's license to practice medicine shall be SUSPENDED until she demonstrates the ability to practice medicine with reasonable skill and safety. Such demonstration of skill and safety shall require Respondent to undergo an evaluation by Florida CARES, or a board-approved equivalent evaluator, document compliance with the recommendations, and personally appear before the Board (Probation Committee) with said evaluation and the evaluator's recommendations.

Respondent's practice shall be evaluated specifically for her practice in pain management. Upon review of the evaluation, the Board shall determine the conditions for reinstatement and may impose additional terms and conditions on Respondent's practice such as a period of probation with term and conditions to be set at the time of reinstatement.

The Administrative Law Judge's penalty regarding the payment of costs is rejected by the Board since the ALJ does not have the legal authority to impose the costs in this matter.

The costs in this matter are within the purview of the Department of Health.

RULING ON MOTION TO ASSESS COSTS


The Board tabled ruling on the Petitioner's Motion to Assess Costs in the amount of $81,278.36, and reserves


jurisdiction in this matter impose the costs at the time Respondent's license to practice medicine is reinstated.

(NOTE: SEE RULE 64B8-8.0011, FLORIDA ADMINISTRATIVE CODE. UNLESS OTHERWISE SPECIFIED BY FINAL ORDER, THE RULE SETS FORTH THE REQUIREMENTS FOR PERFORMANCE OF ALL PENALTIES CONTAINED IN THIS FINAL ORDER.)

DONE AND ORDERED this c{)61/-et-_ day of               

2012.



. Rosenbe

BOARD OF MEDICINE




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 HEALTH 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 Final Order has been provided by Certified Mail to JACINTA IRENE GILLIS, M.D., 12405 Green Stone Court, Fort Myers, Florida 33913; to Bruce McKibben, Administrative Law Judge,


Division of Administrative Hearings, The DeSoto Building, 1230 Apalachee Parkway, Tallahassee, Florida 32399-3060; and by interoffice delivery to Veronica Donnelly, Department of Health,

4052 Bald Cypress

3253 this 23

Way, Bin #C-65, Tallahassee, Florida day of --/1-1/M4-r ----, 2012.

32399-


Deputy Agency Clerk


j -,

- 7011 1570 0001 2472 7407

- - l"lllL&_UQ


Rick Scott

Governor

SteVen L. Harris, M.D., M.Sc.

Interim State Surgeon General


INTEROFFICE MEMORANDUM


DATE:


TO:


FROM:


SUBJECT:

April 19, 2012


Cassandra Pasley, BSN, J.O., Bureau Chief Health Care Practitioner Regulati ·on


Joy A. Tootle, Executive Directo Board of Medicine


Delegation of Authority


This is to advise you that I will be out of the office on Friday, April 2otn, 2012 and I will

,

return back in the office on Monday, April 23rd 2012. Crystal Sanford is delegated to

serve as acting Executive Director for the Board of Medicine. Ms. Sanford can be reached at (850) 245-4132.


Mission Statement: To protect and promote the health of all residents and visitors in the state through organized state and

                                               community efforts, including cooperative agr:eements with counties.


Division of Medical Quality Assurance• Board ofMedicine

4052 Bald Cypress Way, Bin C03 Tallahassee, Florida 32399-3253

Phone: (850) 245-4131 Fax: (850) 488-0596 http://www.doh.state.fl.us/mqa/medieal/indeLbtml





. .

Dite February 19, 2012


Attention Jpy Tootle, Executive Director Board of Medicine

Department of Health 4052 Said Cypress Way Tallahassee, Florida 3,2399


MHllot»f: BO Ru

2,

  • ....

2tl2FEB PH 3: ii

RE: URGENT REQUEST FOR HEARING BEFORE ALL MEDICAL BOARD MEM13ERS PRIOR TO RULING IN BOARD QF MEDICI-NE vs. JACINTA IRENE GILLIS, M.D., DOAH CASE NOS.11-5691Pl AND 1l-5692PL

AN INJUSTICE AND INTENTION DISREGARD TO THE TRUTH EXISTS IN THIS CASE. ANO, I, OR. GILLIS, HAVE BEE DENIED THE RIGHT FOR THE TRUTH TO BE HEARD ANO MY FATE DECIDED.

I AM HUMBLY ASKING THE BQARD TO HEAR ME IN PERSON UP FRONT SO THE DE REPANCIES IN WHAT HA$ BEEN SAID CAN BE CONFRONTED.

THE JUDGE RULED ON ARGUMENTS BASED.ON THE DIAGNOSIS AND TREATMENT

. OF INTRACTABLE PAIN WHEN THE CASES ARE ENTIRELY ABOUT THE DIAGNOSIS

AND TREATMENT OF PATIENTS WITH CHRONIC PAIN. TERMS SUCH AS HISTORY

ANO PHYSICAL WERE SAID TO NOT EXIST DESPITE THEIR PRESENCE. EXCESSIVE WAS COINED INAPPROPRIATELY IN REFERENCING ns USE IN THE APPLICATION OF

MEDICINE.


Law enforcement fraudulently filed criminal allegations and fraudulently filed malpractice allegation against Dr. Gillis. The criminal allegations are presently up for dismissal due to lack of merit. Law enforcement made over 80 fraudulent

c unts without merit about Dr. Gillis' practice habits. The DOH's Attorney, not having any medical background, easily eliminated all counts except 10. The 10 counts left require medical kn<>wledge to determine validity. I am not interested in suing the DOH for damages, and t is this fear that keeps these 10 counts in dispute. I just want my life and livelihood restored. Bottom line is Law


    11079                                                                                   


Enforcement intentionally sought out to destroy me. It's law Enforcement that abused their power. And, it is law enforcement that is underestimatingthe board's ability to detect frau .

THERE IS NO JUSTIFICATION FOR ANY OF THE ALL GATIONS.


Respectfully,


Jacinta Gillis M.O. 12446 Pebble stone ct

Fort Myers, Fl. 33913 CELl-?39 362 6220.


ISSUES RELATED TO CASE 2010-01128/DOAH CASE NO. 11-5692


STATEMENTS ON EACH COUNT ARE NOT SUPPORTED BY INFORMATION IN CHARTS. THE MEDICAL RECORDS CONTAIN INFORMATION CONTRADICTING STATES ALLEGATIONS.

PLEASE REVIEW EACH PATIENTS RECORDS TO CONFIRM OR DISMISS ALLEGATIONS PERTAINING TO DR. GILLIS' CARE FOR EACH PATIENT DISCUSSED.

PATIENT MG IS DISCUSSED IN THIS CASE. COPY OF MEDICAL RECORDS ENCLOSED. COUNT ONE: NOT VALID

  1. Dr. GIilis never diagnosed a Pt. MG with intractable pain. Dr. Gillis

    diagnosed and.treated patient for Chronic Pain.


  2. Pt. MG was titrated down to a lower dose of pain medication while under care of Dr. Gillis. Pt. MG had cJ high tolerance. Pt. MG was taking 400 tablets per


    month of Oxycodone prior to coming to Dr. Gillis. Dr. Gillis had decreased patient down to 240 tablets per month Immediately. Thus, using the term excessive for Pt. MG based solely on numb r without considering patient's baseline and tolerance is Inappropriate. pt. MG had a long history of pain management and surgery since 2007 related to Chronic back pain.

  3. Pt MG was counseled and referred to psychiatry. Patient was seeing an Orthopedic Surgeon that performed his surgery in Nov. 2008 for follow up regularly and patient was seen by a neurologist for issue of seizures during course of care under Dr. Gillis.

d: Dr. Gillis orders UDS when patient presents with clinical signs suggesting that abuse may be occurring. Dr. Gillis has in the past requested patients to do Urine Drug Screens when behavior or presentation is questionable.

COUNTTWO: NOTVALID


THE DEFINITION OF LEGIBILITY IN REGARDS TO MEDICAL PRACTICE IS

CLEARLY DEFINED IN 458.331(m) all of the aspects identified are visible and clear in the medical record. Dr. Gillis and The States Expert, Dr. Gerber, agreed on day 2 of questioning that legibillty was not an issue.

COUNTTHREE: NOTVALID


  1. Pt. MG. never was pres<:ribed an excessive amount or inappropriate amount. Pt. MG baseline dosage for oxycodone was 40% higher prior to coming

    to Dr. Gillis. Under Dr. Gillis' 91re patient was being stabilized on lower doses of medication. Saying excessive without knowing a patients baseline and tolerance is inappropriate.

  2. Pt MG was referred to psychiatry. And Dr. Gillis had an ongoing patient- physician relationship monitoring patient closely_. Patient was advised about how this might benefit him in his care. Patient never went to psychiatry. Patient did receive counseling/education about his medical problems with an retired Orthopedic on site at Dr. Gillis' office. Patient was still seeing Or. Nucci, his Orthopedic Surgeon throughout 2008 and 2009 for ongoing surgical concerns.


  3. Urine Drug Screens were not clinically indicated since patient MG didn't exhibit any signs to indicate abuse was a concern.

  4. Pt. MG was injured in 2()07 and had a long history of physical therapy/occupational therapy, pain management, and was being actively seen by an Orthopedic Surgeon while under care of Dr. Gillis. Pt. was being seen by Dr. Gillis for continued care regarding chronic pain. Psychiatry was recommended by Dr. Gillis since it was felt pati,nt would benefit. Patient never went despite recommendation.

COUNT 4: NOT VALID


  1. No evidence to support excessive existed. Pt. MG tolerance level and baseline dosage was much hiJher in 2008 while under care of a prior pain management specialist that was board certified. Dr.Gillis started patient on a much lower dose than patient was accustomed to.

  2. Urine Drug Screen is nc,t mandatory in the State of Florida but patient must consent to drug screen if requested.

  3. No evidence of excessiveness existed. Pt. MG had long history of chronic back pain since 2007 with sur.gery November 2008 and with prior pain management by a Board Certified Pain Management physician for control of chronic back pain prior to Dr. Gillis ever seeing patie!'lt. Dr Gillis provided patient adequate pain management f()r optimal function at a lower dose than the Board Certified Pain Management Physician did prior to her.


CASE 2008-000661/DOAH CASE NO. 11-5961 -


COUNT ONE: REFERING TO PATIENT RS; Please see medical record.


  1. History and physical d cumented and performed.


  2. In chart information pertaining to questioriing about past surgeries and past medications taken for pc,ln, Patient responded saying he took "Motrin" over the counter. Patients prior treatments under re of other specialist spoken



    about. Patient denied history of pain management as documented in the process. So information related to past treatments and medications were explored with patient RS. Patient RS even provided an Orthopedic Physician name "Dr. Wood" as a physiC!iin that evaluated him in the past. Patient stated he had a MRI of Neck/Shoulder. Records were to be obtained. Please see History and Physical form completed by Dr. Gillis.

  3. Patient filled out patient information form and was asked about medical history including but not limited to allergies, treatments, past medical problems, past medicines used for pain, etc. Dr. Gillis wrote a note in conjunction about encounter with patient and more details on problem presented with and documentation of a physical xam. This supports that an History and Physical Exam was done. And, patient answered questions related to pain to intentionally deceive Dr. Gillis into bellevil"lC he was In some form of discomfort or pain. Dr. Gillis asked patient questions that pertained to patient's pain and patient RS voluntarily provided the information regarding history related to pain. Patient also checked he had neck and back pain on intake form. Patient never told Dr. Gillis he was not in pain. Thu!i, Dr. Gillis had no reason to not believe patient was not telling the truth. Patient c n communicate pain in more ways than one. There are other terms that can be used to describe pain sucb as aching, hurting, feeling bad, describing pain as a pro lem, etc. If a patient is not in pain a patient doesn't answer questions pertaining to pain, don't sign pain management agreements, and don't check boxes that are admissions of pain.

  4. This was patient RS fir5t and last visit i!nd patient described his shoulder pain and limits as they related to him being a carpenter. Pt. RS problem didn't appear to warrant further patn management. Pt. RS was informed to follow up with primary care doctor for future issues and borderline elevated blood

    pressure.


  5. Past and current treatrnents were discussed and documented in chart. Pt. RS took Motrin over the couiiter without relief thus, Percocet was recommended after evaluation and diagnosi on a as needed basis with no refills.


  6. Patient RS described problem with shoulder and movement and he displayed it on physical exam.

  7. Treatment for RS was ocumented. Pt RS was advised to take one tablet up three times a day as needed for pain. Pt RS was informed of blood pressure concerns that could be follow.ed up with primary care doctor.

  8. Patient RS was advised 11fter first visit to follow up with primary care doctor. Patient testified that he asked if he needed to return and Dr. GIilis said there was no need. Pt RS was diagnosed with Chronic Shoulder Pain based on information provided to Dr. Ulis and evaluation of patient.

COUNTTWO


  1. Pt. RS was diagnosed With Chronic Pain, not intractable pain. Chronic pain is a valid reason to treat a pa,lent even acute pain is a valid reason to treat pain. So even if Patient RS suffered from transient pain Percocet would still be an appropriate option. People don't overdose on one tablet every 8 hours.

  2. Chronic Pain is a valid reason to prescribe a pill that has an anti- inflammatory component cory,bined with a pain medicine component. People prescribe Percocet when a toQth is pulled or for a sprain ankle if a person can't weight bear and is on crutche$. Percocet prescribed once every 8 hours is not close to excessive.

  3. Patient was spoken to bout what was tried in the past. Patient stated Motrin was the medication used. Thus a combination pill was a step up for trial purposes. Pt. RS was advised'to follow up with primary care.

  4. Pt. stated he was taking motrin as needed and it was not helping. Thus a pain medicine with combinatjpn therapy was initiated. If he had never tried an anti-inflammatory then that would have been tried solely.

COUNT3


  1. Chronic Shoulder pain is a valid and justifiable diagnosis based on patient's information he provided. Patient stated he has had the pain for a year.


  2. History and Physical w s performed and documented by Dr. Gillis and patient information and pain anagement agreement were completed by Patient RS.

  3. Patient RS complete medical histo as provided by patient directly is in chart.

  4. No urine drug screen w s done since patient had no history to indicate one was indicated at that time. P tient RS was dinically appropriate and thus suspicion for abuse was not applicable.

  5. Pt. RS was diagnosed and treated for Chronic Pain, not "intractable pain". Chronic Pain is a justifiable di,gnosis to treat with pain medication. Chronic Pain is documented and based on thf duration patient proclaimed that problem existed. Intractable would not be an a propriate diagnosis_ for this patient at this time. Therefore, allegations related to Intractable Pain are non-applicable.

COUNT 4 : REFERENCING PATIENT DH CHART


  1. Patient DH has a compl te history and physical documented in chart.

  2. Pt. DH filled out informition form regarding pain problem and elaborately wrote "Severe Lower Back Pain with weakness in knees". Patient DH signed a pain management agreement.

  3. Patient DH stated he had history of treatment with oxycodone and muscle relaxers since a motor vehicle accident two years prior.

  4. Pt. DH was asked to de ribe pain and rate pain. His response confused Dr.Gillis. Dr. Gillis did ask further questions to clarify the confusion which made her suspect that patient had $ me expressive problem or disorder which she clearly documented in the no es. Pt. in retrospect was being evasive. Unfortunately, rating pain is difficult for many to do correctly, thus patients answer was contributed to a mental deficit or lack of education that might have existed. But upon second encc;,unter Dr. Gillis readdressed the pain level issue and asked for clarification anq patient did state that it was zero out of 10 with treatment. And, patient on second visit stated that "treatment was working" for

    f-1


    his pain when asked. Noneth,less, Dr. Gillis felt patient was not a candidate for long term pain management and requested patient not to return. Patient also failed to assist in getting his records to the office in a timely fashion as requested on both visits by Or. Gillis.

  5. Dr. Gillis used the term pain when asking patient questions at all time. Patient voluntarily answered all questions pertaining to pain. Patient expressed that in the past he was treated with oxycodone and mu.scle relaxers without success. Patient DH never denied having pain, despite him claiming he never said the word "pain". Pati nt DH i;pent the entire time providing answers related to pain and extensively wrote out on his patient information sheet that PURPOSE OF VISIT was "Severe low back p ln-weakness in knees". Dr. GIiiis had no basis to accuse patient of lying about pain or problems related to pain. Physicians can be sued for not addressing pain r under treating pain.

  6. Patient DH expressed "tfficulty functioning physically on job secondary to pain. Dr. Gillis asked patient ow the pain was affecting him? He voluntarily answered and never stated hf! did not have pain despite being given many opportunities to do so. If a p rson is not or never was in pain why is the patient providing information in relation to episodes of pain.

  7. Patient DH. was diagno$ed with Chronic Neck and Back Pain and placed on a trial of low dose oxycodone and anti-inflammatories since patient did state he was on oxycodone in the past. If patient had no exposure to pain medication he would·have been prescribe Percocet or vicodin to begin which is an acceptable next step after trying anti-inflammatories alone.

  8. Patient DH records wer:e to be obtained with patient's assistance in providing the correct information. However, since Patients records were not still available on second visit pati nt was reprimanded and requested not to return for further care. Patient was only prescribed one tablet every 6 hours as needed for oxycodone. One tablet for sQmeone in pain every 6 hours as needed is not excessive and there is no case or information supporting that this is a toxic level for even an opiod naive patiept. Pt DH was also given a prescription for Motrin one tablet three times a day.


COUNTS


  1. Pt. DH was diagnosed with Chronic Pain Syndrome. Pt presented with complaints related to neck and back as documented in chart. Pt was not diagnosed with intractable p ln. Chronlc pain and intractable pain are two different things. Intractable pain would be an inappropriate term to use without further Investigation and prior records available. Based on patients history of suffering the term Chronic Pain was applied.

  2. Patient was diagnosed with Chronic Pain which is a justifiable diagnosis to be treated for pain.

  3. Pt. DH attests to the fac::t that in the past he was treated with Oxycodone for some duration after a Motor Vehicle Accident 2 years prior. Pt DH expressed suffering related to working as a laborer. Stiffness was mentioned when patient was asked to elaborate more n pain. Stiffness is a common term used with patients describing their discc:,mfort related to pain and it symbolizes a form of difficulty functioning. Patient was given opportunity to deny pain but never did.

    Instead, patient was eager to elaborate about a dramatic motor vehicle accident and location of pain and history of treatments due to pain and how they helped or didn't help which is all dorumented.

  4. Patient wrote on patient information he was suffering from "severe lower back pain" and he exhibited signs of difficulty when asked to perform various maneuvers. Neither officer could recall the complete physical exam in detail and neither officer was educated to understand the significance behind performing any of the tasks requested. Thus, to mention a few movement an officer can recall and disregard their admission to not remembering all of the exam and its purpose is a sign of bias. They both testified that an exam was done and in fact one officer was requested to disrobe for further evaluation.

COUNT6


  1. Patient DH was diagnosed with Chronic pain syndrome with focus on back and neck which is a valid diagnosis to justify prescribing pain medication.


  2. Patient DH has a compl te history and physical on chart on first visit.


  3. Patient filled out information form an_d provided Dr. Gillis with history related to motor vehicle accident and history of injury for 2 years, with history of treatment with pain medication, etc. On second visit patient provided Dr.Gillis with a Physician name where records were available. Patient DH stlll never denied having pain and continued to fabricate stories to manipulate Dr. Gillis into treating him. However, due to patients unwillingness to comply with Dr. GUils' record request and was asked not to return by Dr. Gillis.

  4. Urine Drug Screen was flOt done since patient DH didn't exhibit any signs of abuse or suspicion related to abuse.

  5. Patient was diagnosed with Chronic pain syndrome prior to being prescribed a controlled subs nce on a trial basis. Patient was advised on second visit for follow up not to return due to lack of cooperation with records. Treatment is on a trial basis and documented response to treatment is always recorded to determin benefit of continued care. Patient DH was determined not to be a candidate for long term care in regards to pain.

In retrospect the end results of both officers treatments were correct. They both attempted to deceive Dr. Gilli . But Dr. Gillis used instinct and good medical decision making to conclude that neither officer was qualified to continue pain management under her care. Dr. GIiiis is not a psychic. There are many patients that undergo exploratory laparotomies before a doctor realizes a patient is malingering. Dr. Gillis diverted abuse within one or two visits without subjecting patient to extreme measures related to both officers fraudulent behavior. If the officers wanted to determine f Dr. Gillis was treating patients for non-medical reason or unethical reasons, all they had to do was deny pain and be honest and watch what happened next. These officers intentionally sought out to en rap Dr. Gillis and when she passed the test they fabricated allegations of malpractice. Is believing a patient's complaints, evaluating and treating a patient based on his complaints malpractice? The board will be subjecting a good, morally sound,

competent physician to an extreme punishment if the board rules to punish Dr.

GIilis for recognizing and diveriting abuse. If the board looks at any physicians O

f ·l.

11088--------------------------------'




reoords you can probably find anything to complain about•• In Doctor Gillis' case a warning to document more would be appropriate and maybe suggesting a course on current treatment in Pain medicine would be more appropriate. But to accuse Dr. Gillis of ca4sing harm or being a danger when not one prescription oould support allegations of excessiveness or lethal dose and there is no history of any patient ever being harmed while under care of Dr. GIiiis would be unjust and excessive. I am a single parent of 2 young children that depend on their mother to be able to maintain her profession. Can the board honestly say that there is any form of malpractice? c:=an the board say that Dr.Gillis' dosages prescribed were dangerous and caused harm? Can the board say that Dr. Gillis prescribed Patient MG and excessive amount of medication when patient MG had a high· tolerance and was on 400 tablets of oxycodone for almost a year prior to Dr. Gillis titrating his medication down. Please review the allegations and look at the records. The medical records confirm all that I am saying. The rumors and stories

related to my case and e en the twisting of words during the hearing were unnecessary. We-should be IQoking at the facts which are evident in each patient's medical- oord. Medical records from all physicians that provided care should be admissible. Please see all enclosed records for Patient M.G.

I am innocent and_ I am prayerful the Medical Board will look at the facts and disregard all the dramatization around my case. I have been subjected to news exposure for no reason. I don't want fame. I want my life back. I want to regain my ability to provide for my family and I want to continue to help the

underserved by providing quality care. I valued my license. I· understand to

practice medicine is a privilege. And, it's a privilege I never took for granted. I live to uphold the Hippocratic Oath to do no harm.


12446 pebble stone court·

Fort Myers, Florida 33913 239 362 6220


y

\


IN 1llE SIXTH JVDICIAL CIRCUIT COURT OF FLORIDA

IN AND FOR PINELLAS COUNTY FLORIDA

Criminal Division Case No.: CRC 11 08815 CFANO

STATEOFFLORJDA,

Plaintiff,

v.

JACINTA OIWS,

Defendanl

---------------·'

MOilON TO DISMISS

COURT APPOINTED


· The Defendant, byand throuqhtheundersigned attorney, hereby moves thisHonorable Court pursuant to Fla.R.Crim.P. §3.190(c)(4) for, to dismiss each count of the infonnation apinst the Defendant in this action and, in suppmt thereof; would show:.

  1. This motion isaccompanied by the affidavil of the Defendant which provides the factual

    basis for this motion.

  2. The Defendant is with four counlS in an action brought by the Statewide Pn>secutor. Such counts include raQketeering. conspiracy to racketeer, and two counts of money laundering. They allege criminal activity in both dtc Sixth mid Twentieth Judicial Circuit.

  3. The two racketeering counts me accompanied with a number of "predicate incidents• which allege that the Defendant engaged insome fonn ofdrugdelivery or in the illegal pn:scription ofdrugs. The drugs alleged to have been illegally distributed comprise oxycodone and methadone.

  4. The Defendant was. at all times relevant to lhis complaint and as established in her

affidavit. a licensed physician havin& satisfied all requiremenlS for such licensure within the State of Florida. As such, it was both her right and herduty to provide and apply appropriate treatment to her patients, including the administration of accepted types and amounts of medication.


S. In her affidavit the Defendant has set forth the nature of her conduct of her medical pmctice inboth lhe6thJudicial Circuit and the20th Judicial Circuit ofFlorida. She hasset forth that she isa qualified and licensed physi who is.bylaw.authorized to prescribe medication to treat her patiems, including the medica1'ons which are alleged to have been •dclivcrecr' or Olherwisc disseminated in this case. She next sets forth that she plCSCribed such medication only after a personal a:eview of each patient's condition, including an interview with each patient, inaccoidance withaccepted medical practice and '1&ndmds. This would include prescn"bing the type. the closase level. and amount and appropriate c:pnditions of refill.

6.Counts Two through Four"1hstantially,if not totally, depend uponthe same facts. Inother words, if the Defendant's affidavit iscorrect that all pRSCrlptions written from her practice aredone so in accordance withthe law and p,opcr medical procedure Jben it is alsoclear that there could be

no conspiracy with a staffmember orother person or entity asalleged in Count Two. It is also clear

that collecting her consultation fees and distribudng the funds to operate her businesses and to pay · fa salary could not be money laundering as set fcxth in Count 1brcc and Count Four.

7.M va-,thcallegationscpfthevariouscountsoftheinfonnationarevagucanduncertain. Patients are referred to by a code nUJDber which is appuently assigned by the State of Florida and not known to the Defendant. On any given day the Defendant would see nmnerous patients so this fonn of charging is not sufficient notice for trial. For the purpose of the MOTION TO DISMISS

lt is not falally significant because the Defendant has affirmatively set forth that each and every

patientofhers was handled lawfully and responsibly. It isalso troubling that theStateof Florida has failed to set forth the specific IJ\eory upon which each so-ailed "predicate incident• was accomplished. In particular, if there was a false or fraudulent prescription, in what manner was it false or lhwdulent? If the Defendal)t is accused of delivay and never had any possession of any


contro11ed substance, what is the theory of how theDefe11dnnt may have "deliver:cd• or conspit:ed to "delive • any controlled substance? Again. the Oefendant'.s affidavi't nffinnativcly sets furlh thal she did not maintain ot petsonally handle any suth cootrotled sobs1ance. E\ten so lhc Slate gtioutd set forth in Its traverse, should they feel the ability lo file one. specilic facts related to each prodk:nte incident in which it is believed d1at tbe Defendant issued a folsc ot f'raudu.lent prescription or that she had any role in the delivery of a controlled. A general denial lacking in speci'fioity i not an ptable traverse under these circumslances. lf' 1hc Stmc cannot do· this the case should. be dismis$Cd.

  1. Since there-are no material dispwed facts and since the undisp1.Ued foots do not establish aprima facie case of guilt against 1he Defendant. the Defendant is cntiiled to aA order of dismissnl and-discharge with respoct to each count of the infommtion.

    WHEREFORE, the Defendant prays this Ht>norablc-Court entc:r an order dismissing aU four

    counts of the infonnation and discharging lbe Defendant with respect to caeh of tl1e allcgntions of


    lhiscase.

    Respectfully submirtoo. Charles E. Lykes. Jr.

    Counsel for Defendant

    1172 Brownell Streel, Suite A Clear.water. Florida 33756-5107

    Phone: 727- 441-Bj0S; FnK: 72-7-442-8562

    Emai : charJe-s@lykcsJaw.com_


    CERTITICATE OJi!SERVICE

    [ HEREBY CERTWY duita true.and accurate copy of the foregoing was served upon:


    Honarablc Bernie McCabe O1.ttce.ofStilte Attorney. Division K Post Office 5028

    Clearwntcr, FL337S8


    Michael W Schmid. Esq Assisuint Statewide Prosecutor

    3507 E. Frontage Road, Suite 200

    Tampa. FLj3607-7013


    Oreg Williams, llsq!

    Office of the Public Defender l42s·o 49111 Street North Cleanvater, Ft 33762

    by (X) regular United States Mail, ( ) hand delivery, ( ) facsimile·to                                    _

    ( ) e m.n&I                                                 and/or( )                                                 _

    tlus ;./1Cl:.Y4.

    or • 20/,Z-



    INTI-IE SIXTH JUDICIAL CIRCUIT COURT OF FLORIDA IN AND FOR PINEl.J..AS COUNTY FLORIDA

    Criminal Division Case No.: CRC 11 088ls CFANO


    STATE OF FLORIDA,

    Plaindff,

    v.

    JAClNTA GILLIS.

    Defendant.

    ----------------''

    AFFIDAVIT


    COURT APPOINTED


    1. I am Jacinta Gillis M.D.. the Affiant an 1he Dcl"cndanl in 1he above-style case all statements made herein are accus,te and truthful and made ormy own personal knowledge.

    2. Al all limes heleln I ha\'lt llcensed physician In the Slate of Florida wllllall riptsand priYiJcga of that office and have been subject to the rules and regulations or all boards and agencies having · sesponsa"billly for such licenses. full lic:cnsed and anctioncd by the Stale of Florida to prac:licc lnterMI MedlciDc and Paia Mllllagemcnt. A copy of my curriculum 11/tae is anacbed as Exhibit I • A copy of 111)' licensing certiflClllc is anacbed • Ex!ubit II.

    3. I solely owned and operaled 2 medical prac1lccs specializing in Internal Medicine and Pain

      Maaagcmcnt. Such racmties wen: fudher wae authorized and rcgislend by the Slaae of Florida to provide

      llabllCllt in the an,a of Pain Manapent and have, al all limes been opemed faithfully lo that mission.

    4. I was the only llc:eased physician pn,viding care and ln:almeftt to all patients for medically ind"ated reason at bolh medical IOCltions lium beginning of praclices up til Ootobcr S. 2010. when such. facilities were dosed dueto complic:atlons resulting ftDm these c:t.gcs.

S.I had nohislory of mal,,..aice or disciplinary actions in regards to my medical license and have always conducled my practice respopsibly and with full repnl for the care of my patlems and m:ccpted medical practices.

  1. I had lhc duty to evaluate. !flagnosc and treat any patient determined to have a medical indication


    forb'l!lllment and have always done ao bly and to the best of my ablllty. In the comse of fulfilling these duties it is always my praclicc witll new patients to rmi=w the prellmlaary d8la taken by my qaliried Slafr, to personally interview each and everypadent with regard for lheirnecds and Ill)'infonnation relevant to tn:alment opdons. to review their medical and incident histoly and to trcat in accordance with the needs

    oftbe patient and accepted medic:al practice and standards. Allbough the"prcdicalc incidents" cledibed in

    the information refer to my patents by code and not by their given names, I am capable orsa,ing without equivocation that each and every patient was properly lnatcd because my pmdice and procedures do not allow •Y cxccptlons to these mlm. If I ever had rason to doubt the niprescntation ora patient regarding their c:ondilian I would mprcss my concerns and resolve any doubt before adminismrin& or prac:ribin& any

    balmenL


  2. I had the duty to prescribe refills on medicatiou to my patients as detennlned to be medically lndicatecl and liavc always done so to the best of Ill)' ability and in accordance wld1 accepted and Slllldard pn,ceclurcs..

8.1 have always followed the Florida Ouldelillcs for theTreatment of Clumlc Pain.

  1. InCbecowse ofmy business I have mainlllincd bank ICCDWlts in legal bakinginstitutions. There exisas no limit ID the number of bank acc:oums a pclSM can possess for business or personal n11110DS. It is not aplast thelaw to own aare dCpllSit box. It is not against the law ID make mubiplo dcposilsor multiple withdraws. It isnot against tho law to purchase ahome with money earned fiont your profession. It'snot aplnst the law to own multiple vehicles purchased with the money eamcd &om your profession. It is not apinsa the law to save your money in a bank or safe deposit box. It Is not against the law to be a minority, eam adegree in medicine. and practice medicine.

  2. I have8'lted in complete compfamce wilh Florida Statute §193.05. I was theonly physician that prescribed medicine In myoffices tom openlq day until October S,2010. Idid not administer. distribute ormix any medic:atians oasiteateither medical pntclice location. No scaff'membcr at either medical location evaluated, diaposed, nr1reated any patient No staff"member pescribed. administiered, dispensed. ormixed any medication tbr any patient seen by me. There wen: no-medicationson site or in possession of any.staff'



    member at c:ithcr medical localion. neprescriber Is lhe pcrlOII who writes tho prescription. bas their named printed and inscribed clearly at top of the prescription and sips their u,natutt at the bottom of lho prescription aulhoriziq the filling of the prmcription.

    1. I cld not acaept walk-ins. and only treated patients ewer theage or40. My patient's average aac

      was SO. My patien1S hid been cllnlcally liable on treatment for at least 6 months or more with no compfacation. AD of my patient's quality of life and funcCioml c:apacity bad improved since beglonlng tra1mell1 under my c:are.

    2. My meclical pnactices wi:re lcpl business entities. All acdvitles eonductecl by me or under my c:oalnll. either on or off said pnmlscs. have been conducted lawfully. My home and offices were...-cbed. Only lepJ itans were found ud taken along with money ft'Om my legal banking Institutions. AU money

    tnnsactians wens clmrly roconied by my banking lnsdtution. I have complied wtih all banking rules and

    regu1aaons at an 1imes.

    13.SinccaDofmyactivilicscmdsincelllactiviticsundertakenbyanymemberofmySlaff'bavobccn legal and proper, it is clear that tt.crc has not been any aclivlty which coulcl be cba,acte11zed as either iaclcdcctl.ig oras part of a conspiracy 10 commit any crime. .

    1. AD oflho income fiommyplBClicc bas bcc:n lcpl, accounted ror,and popcrlydocumentedand

      reported as Income. Such has been qsed to Pl>' lhcJust expenses of my business, to pay wages, and for my

      reported and lawtill income. Aa:onllngly, there can benosustainable chage of money laundering.

    2. I have Im aIons histosy ofholdiag boaonblc positions as a Medi.ell Din=ctar at many State Prisons across the United SlaleS. I also perfonn community service 'WOl'k.

    3. lam a single parenlof two honor roll students. and a community leader. I have committed my Ufc to providing medical care to undeNerved communities II afl'ordable rates. I only lrmt patienls for medically indicated reasons and all patiClds lrCafcd by me have medical ffJCORls supporting lhis fact. Every

      visit and fMllY medication over prmcribed by me Is documcntal 1ft each paticnl's medk:al record and the

      medical indication isprcscnl.

    4. I ant not .-wan, of any p111ient who has either suffered as a result ofan:, imptoper diagnosis or


      1rcat111e11l hy me nor am I aware of any pa1ic1,1 wlto Ms made a rorn,al or infonnar con1plainl aboltt my


      service-,


    5. Further affianl sald1 naught. ·


      STAT110FPLO

      COUNTY OF" ... · )

      °"' rnrs Kc1Far or ,l_1.'!!120.J.1. bc1'oro...,

      ti            

      _. rhe oodersigiied notaty. pc;sonallyappca:;;.,.£/J,>. known·lDme. and who did talre

      an Olllh, to be the·person whose nanie is sub!iilribcd to the above- instrument. and being informed of the·corucn1Sof'said instnrmeiil, acknowledged tbat helshe·volunlnri1)1' ex ted dieSlilnC·farthe uses­ and purposes·htrt;in conlni®d.

      IN WrrNESS WHP.ROOF, [ have hereunto set my h al.



      -11098

      JACINTA L GILLIS M.D.

      12446 Mble Stone Court Fort M,ers, Flori4a,33913

      2393626220

      Elntdl: Medcare200l@ralroo.com

      OBJECTIYE

      Loolllngfor a position In a community In nBd of ,m llllen,111 Medici•• Spedalbl/Hoqlttl/Jst which will accqt and aalst In ,,o,1111d11tWOr to pn,ctlce mdicl,ie ud pro,lde optlm,,,,. mre to

      thne In n•IL ·

      PERSONALST.ATEMENT

      OIi,.

      Look no,/llrlber. This Is notja,t another CYcoming tlCl'OS8 your dall. I""' that•fH/dtll Internal Mallcl11e Pltplci1111 w/11, that spfflal /MnMalltF and wor/c etllk that,ou htwe6en Rlkb,g olll. I 11111 tblll Hoq,/Jalist tl,at not on6' gds along with stq/f w/1, but Is loVlfli by famllla.1 an,a H,:Y co,npetat, aolff/lllmtlna/e H06Jll1allst tJ,at tends to make posltlN lasting

      palilll,ts and ctllleagaa.1Olli a HrY ddlcatell. hart/ workbrg, pl'Oedllre or/aid Internist tbat cm, get dieJob don,. 1lltne maulve trabtlng In JClJ ultlnpand I 11111 act•l6' oneqf few thllt atw ll'llt,Bospllol/stl111tern11l Medlci,ie lral111NL And,Jmt ID I

      would I toM coasllaetl/or a ptaltlon.

      EDUCATION

      Rock blMd High School, Rock bland, IUl11ols College lwp BIBJ-6111


      Mlllml Unlwnlly, Oxford, Obill

      Biology 8111-6/89

      TanasnStale UnlversllJ1, NasbPl/le, Tennasu

      PIT-M•dlclne 6/89,.8/91

      Meharry Hdlcal College, Nash•Hle, Tennessee

      Medical Degree JIJ/91


      Co,,cord Law School Los.Aqelos,Ctdifornla r'year2005




      POST GRADUATE MEDICAL EDUCATION


      Wrig/1( Sttlk UnMnlty.Dayton. Ohio

      General Surgery Internship lhgree 11198

      Letwl I Trt11U11t1 T•m

      Qenen,I Surpry lntffllSJ,/p

      Wrlgl,f State Unlvenlly, Dayton Obio

      2198-5198

      Md111n:, /,f,dical College, Naslmlle, TeMessee

      lnlRIUII Metlldne Resldenq Degrn 2/DJ

      SPECIAL SKILLS

      Jle'1•klUetl In pe,fonnlng betbidf! prot:tllllllG and l"'"lding coufor tl,e crltlctuly Ill d11e lo

      extensive tn,inlng 1111d aper/eta inlnteu/Pe Care Units11nd OIi Acllle Mallclll W111m. &tame trallllag a" Hosp""1Jst in the Jl.tlll'tlUAdlnlllistrtltlonlltAIPln C Yon,,, Mlll'/iwff,oro,Te11nGRefrom 7M to 2/(JJ.


      UCENSESAND CERTIF1C4TIONS

      Unllwl State,Medical Ut:a8e ExulSStq I, II, Ill AtlPtmcell T(aan,a Life Support Completff Jllf)2 Pdildric Al#J,11m:ed Life Support Colnplt!ld 6lfU Abtlnmd Cardiowm:sllll' Life Support Con,ple•d &IS America Joard of Internal Medlclne Eligible UCMSG B•ld In Florida, Nor1lt Carolinll, Iowa

      PROFESSIONAL AFFILIATIONS

      Aln,rican Co/19 of P/,plclas

      Nqllonlll Medical Assoclatloll

      •erlcan Mwllcal Aaodatlon

      POSIDONS HELD

      T,mnasee Prison/or Wo,,,.,n, Nt1Shvllle, Tennasn

      Metflcal Director/Stoff Physician

      JIOJ-8/0J .•-



      11099

      Hi/Jon Heatl RtJ6ional Mdical Center, HIiton Be11d, SC

      /nt:0111p1m Ht!tllth Hospllallst 8/0J-2/04


      _.



      Pal•Olnlc

      Atlllllta, Geor,l11

      Pqln Man.,,,,,1nt Specialist JRN-9/04

      HeoJthCare P,,ttn,n

      LoCIUIITenau

      Well$tar Facilities Atlanta, Georgia

      Stiff/ Phpician & HOlpitallst

      3/04-9/04


      1/llaols CornctkJRal FIIC/lltla

      Wexford Hnldl Ser,/cu Medka/Dittaor S,4/f Phplcian

      9/04-1/0S


      Pabf Ql,rk, Rock Island, Illinois

      Pain Sp«lallst/Pllplcl11n,J/05-9/05

      o,,,IJJC11m Ten11111S

      Brommen lfetlkal C..ter, Bloom/ngton. llllnols

      l(ospllallsl SIOUl/tJS


      Dan/41111u/ Yuge,Lllc11111 TorDnS Horiflln Medical Cellffl', Dbcon, Tennessee Hospltallst

      09/0S - OJM

      Stqffou,Locum Tenons

      P/"'1f/ldd Corndlotu,J F11cllity Malcpl Dlm:tor, Pllllnftdd, lndia1111 02/06-0S/06


      Nallon11I Health Senlt:a Cllnic

      PalnOlnJc

      Pain $peclall.st, Nasl,.Uk, r,nnasa

      06/06- 08/()6


      Hea/dlcan Partnen Loe,,,,. Tenems

      Ket/lie MIMJit:11I C.ta.Rld,l•nd, Washington

      Hosp/lafllf

      09/06 - 01/01


      St»lnd b,patlMt Phy,lt:liul1 IM11111 Tenem

      Aub11m Reglollfl/ Medical Cffller,.lf11burn, Wtablnpn

      HO$pltallst, D1/01- IJ6/01


      M#Cp Melletll Cenler

      Soulx City, Iowa

      M•tf HIik StJtlln1 Locum T•ncn1 B08pltallst

      01/01-fJ8/01


      lbmnatl• MtJtlit:al Cent6r Ell:ttbdhCJty,NC Ddta Loc11111 Tm,1111

      B06pltalbt

      tJ9/01-12/01


      Natlllnal M«llml -'4fllllllla

      Punta Gorda, Flonda

      Horpita/id

      IJ1/0U1/08


      llRMe4JcalGroup

      Palnainlc

      SL Pdusbllrr, Florida

      P11ln Man....-Spedallst

      IJ1/118-l1/08


      r-,

      Dollllr Mdlca/ Clinic St Florida Jntanal M•l lne &

      Pqln Manoge,Mnt Sp«:iallst

      IJI/09-10/10


      HONORS AND AWARDS

      ·Nominated"1,plclon of tM Month cons«:Utively

      Hilton H•d lfegloul Hospllol, South Clll'Ollno 20fJJ


      Various COlllftlllll/ty IAlulersl,lp Aw,mfs on4 Letten

      "ock, hlllnd, /Hlnols 2005

      Patient Choice Award f'or 2009 & 2010


      .

      . .

      . . . .

      . . ...

      .

      -, :. , ..· t: : r : ·

      t • • •


      ••• •

      ====,


      RictScan

      0owrllor


      H. Fa Farmer. Jr.. MD. Pll'D. FACP

      S.. SIQCl!ll Clenenl




      Florida Department of Health

      Attn: caro1B. Klein

      Office of the General Counsel

      Prosecution Services Unit

      4052 Bald Cypress Way, Bin tc-'5

      Tallahassee, FL 32399-3265 .

      RE: Ucense Certification for Jacinta Irene GUiis To Whom It May Concern:

      November 18, 2011

      This Is to certify the following lnfofmatlon, maintained In the 1'800rds of the Department of

      Heallh, for lhe above referenced Health care Practitioner: ·

      PROFESSION:

      LICENSE NUMBER: ORIGINAL CERTIACATION: EXPIRATION DATE:

      CURRENT STATUS OF LICENSt:!

      AGENCY ACTION:

      Medc:al Doctor

      ME892.98

      08/25/'&)07

      01131/2013

      Emerg. Suspens., ACTIVE

      No


      To expedite the verification PR>0'SS, the above fonnat Is the standard format for all healtffl;:are practitioners. If you have quest1011s regarding the status of this license, please cal the cuatcmer Con1aCt Center at (860) 488-0595, option 6.


      Since;r,


      Ucenslng and Auditing Services Unit


      Division of Medical Quality Aaunlnca • Ucanslng and Auditing Savlce8 Unit

      4052 Bald Cypress W11Y, Bin 0.10 • Tallahaaee, FL 32399-3280

      Fu: (850) 246-4791

      Visit m onllne et lloddallheallh.com


      1



      _....

      ....,.)

      ·( 11 URMSDIOAL GROUP, INC.

      &oOO 49TH S"FREET NORTH SUITECO=s

      :PINELi.AS 'PARK. 'FL33782

      , 7.27-.230-9319

      iPATIE·Nt INFORMATION


      NAME: .  . '--- ------

      STREET CITY STATE ZIP CODE

      ADDRESS:-· ------=-:;...;·:..:·'-J .:;.....;.--=--------------------



      HOME:#                     SEX:' FEMALE


      CELL                                    


      WEIGHT: -.Jo0

      OTHER# -------

      HEIGHT: '-' 'f

      MARITAL STATUS: MARRIED DNORCEOWIOOWED


      . SS:#:                                                         DOB:                                                   


      DRIVE S LICENSE#                                                                              STATE:                                       


      OCCUPATION: .·

      C ::'-t<,. u.a:.._.

      EMPLOYER:


      EMERGENCY CONTACT:                              


      ,. ,POSE OFTHIS"VISm

      s-1.· .,.

      I .,,,. / •

      J.J iJ1;1<, ·oWJ-

      PHONE'fl:_ ----------


      WERE YOU IN AN AUTO AC<i:IDENT? YES .

      IF·so,·DATEOFACCIOENT: ·                                    


      COMPANY

      AUTO fNSURANCE INFORMATION:

      ---.,-//,-A -----......------------

      MEDICAL HISTORY: (CHECK ALL THAT APPLY)

      ------_ HEART DISEASE


      ,,,,,.,- NECK/BACK PAIN


      STROKE

      .,,,._HIGH BLOOD PRESSURE FIBROMYALGIA

      DEPRESSION/ANXIETY

      ----LIVER DISEASE

      SINCJS PROBLEMS

      -----LUNG DISEASE .

      ---DIABETES

      CANCER

      ---ASTHMA

      ---.--SEIZURES

      HIGH CHOI..ESTEROL

      ---

      ARTHRms

      KIDNEY·DISEASE

      ---GERO


      ALLERG.IES:

      HOW DID.YOU HEAR ABOUT US?

      PA ENTSIGNA'TURE: ."'- ,t

      ----VASCULAR-DISEASE         

      STOMAC ULCERS


      ----DATE: f:l:12/oJ'

      HEAO ES



      11104

      ...

      2


      ......

      -z_


      - -:


      .•


      ....• ).



      11105


      ....

      ...

      s\7

      i .

      UR M DICAL GROUP, INC•.

      8800 49TH STREET NORTH SUITE #293 PINELLAS .PARK, FL 33782

      727-230-9319

      727-230-4714


      .. '

      . .

      AUTHORIZATION FOR RELEASE OF INFORMATION.


      . .

      I HEREBY AUTHORIZE THE USE OF DISCLOSURE OF MY IDENTIAABLE.HEALTH INfORMATION

      AS DESCRIBED BELOW. I UNDERSTAND THAT THIS AUTHORIZATION.ISVOLUNTARY..


      PATIENT NAME-:-----

                                SS#:

      PERSONS/ORGANIZATION'S PROVIDING THE INFORMATION: PERSON/ORGANTION RECEMNG THE INFO:.

      YOUR CURllEN:r PHYSICIAN INFO BELOW...

      UR MEDICAL GROUP, I .

      88()0 49TH·STREET NORTH #203 Pl ELLAS.P FL 33782

      727-230-9319"

      727-230-47f4


      -..


      'iCIFIC DESCRIP1'10N OF INFORMATION:

      I


      ---

      XRAY REPORTS


      _     ,_MRI REPORTS        

      LAB WORK.

      ---

      NARRA'l"M: REPORTS

      ---

      CT REPORTS

      ---

      PROGRESS NOTES

      ER RECORDS

      ---

      ALL MEDICAL RECORDS.


      I UNDERSTAND THE PATIENT'S REPRESENTATIVE MUST READ A..ND INITiAL THE:FOUOWING. STMTS:

      . .

      I UNDERSTAND THAT THIS AUTH WILL EXPIRE ON

      ------INITIALS

      ---

      I UNDERSTAND THAT I M. AY REVOKE THIS A.UTHO.RI.ZATION AT ANY TIME B. Y NOTIFYING THE.PRACTICE IN. WRITING, BUT IF I DO IT W,ILL MAVF NO-AFFECT.ON ANY ACTIONS TAKEN BEFOR.E THEY RECEIVE THE

      REVOCATION. INITIALS

      i ---


      1,_)ATURE OFPATIENT OR PATIENrs GUARDIAN DATE


      I _11106                                                                                ..



      UR MEDICAL GROUP, INC.

      8800 49TH STREET NORTH #203

      PINELLAS PARK, FL 33782 727-230-9319

      727-230-4714


      CONSENT TO TREAT


      For and in ·consid ration of II the servic s provided to_ you, this form-is a consent that you are authorizing -Dr.·GilJis to provide you with medical.treatment at UR Medical Group·,

      ' Inc. By signing your·name._below you are consent ng to.

      . receive treatmen.t/counselirig at.t e facility named ·above.


      · GUARANTEE OF PAYMENT

      ,.

      . .

      For and in consideration of the services provided- to the patient, I promise·_to pay- UR Medical Group, Inc. for all services rendered to or on behalf of the patient.


      ..

      Signature _


      Date: .,r/ .:,..,/rv


      -11107

      7 \ L,



      . UR MEDICAL GROUP, INC. 8800 49TH STREET NORTH #203

      PINELl.AS PARK,-FL 33782

      727-230-9319

      CHRONIC PAIN AGREEMENT

      The purpose of this agreement Is to protect your access to controlled substances and;to proted our abOity

      to prescribe for you. ,.


      • The long-,tenil use.of such substances as oplolds (narcotic analgesics), be odlazf\tplne tranquilizers, and· .· barbiturate sedatives is controversial because of uncertainty regardi g· the extent to which they provide . · long-term benefit There is also the. risk of an addlctiVe disorder developing or of relapse occurring in

        .person with a prior ad ction. The extent of this risk is not certain.

        Because lhese drugs have potential for abuse or diversion, strict accountability Is necessary when use Is prolonged.·For this reason the roSowing -poffcies are agreed to by you, the patient. as consideration for, and a co"dltfon of,·the willingness_of the-physician whose signature appears below to consider the Initial and/or continued prescriptiOn of controlled substances to treat your chronic pain.

        . .

        • All contrQII substances must come from the physician whose signature appears below or, during his or her absen . by the covering physician, unless specific aUlhorization Is obtained for an exception. · . ·

          (Multiple sources (?Sn lead to untoward drug interactions or poor C0Grdination of treatment)

          . . .

        • Allcontrolled substances must be obtained at the same pharmacy, where possible. Should the need arise to change pharmacies, our office must be Informed. The phannacy that you have selected is: \MW k,l,J) • ·. .. PHONE: .· . . _

        • You are expeqted to inf'orm our office of any new medications or medlcial conditions, and of any adver.se effects you experience from any of lhe m tions th t you taket •

        • The·prescribing physician ha$ permission to discuss all·diagnostic and treatment details with

          · dispensing phannacfsts or·other professionals who provide your health care for purposes of

          maintaining accountability._


        • · You may not share; sell, or otherwise pennit others to hawt a to these medcations. .

          -

        • These dr_u s should_ not be stopped abrupUy, as· n ab tinence syndrome will likely_develep.

      .

      • : Unannou·nced urine or serum· toxicology screens ·may be requested, and your cooperation is· required.··


      • Prescriptions and bottles of the medications may be sought by other Individuals with chf:tmlcal dependency and should be closely safeguatued. it is expected that you will take the'high st possible degree of care with your.medication a pr ptlon. They should not be left where others might see or otherwl e have access to tJ:ie!]:1.


      • . Original containers of medications should be brou ht in to each office visit


      • Since the drugs may be hazardous or lethal to a.person who Is not tolerant to their effects, especially a child, you must keep them out of reach of such people. ·


      • eclications may not _re.placed if they are lost, get wet, are d yed.left on an airplane, etc. If your medication has been stolen and you complete a police report regardi g the theft, an · exception may be m e. . · ·


      • Early refills will generally n_ot be given.


        ....



        '.

        . . .

        .."\

        -

        ....

        .

        '

        --....

        '

        •. PMc:riptions may be is&wd early if th physiciasj or patient wffl be cwt of 1DWn When a refil is due. These Piescriptlons Will contain Instructions. tothe pharmacist ttmt they not be filled prtqr1D the appropriate date.· · ·


      • If the responsible·legal auth0rftles haveq tlons ng your treatmenfas might occur, for e>cample, If you were ol:>taini'lg medicaficms at several pharmacies. all conftdentlality Is waived and theSe authol'ities may be given full access to our records ofcootroled substances ·

      nistrado . .

      • It is u rstood that failu to adhere toUtese pollcles iesutin otherapy with .

      controlled substanC8 prascrfbing by this physician or refenaf forfur1her speclaff,y 8SStlSSffl8nt:

      .. Renewals are CC?fflingentt>nkeeping seheduled appoinCm_.. P do JIQt phone for prescriptions after hours ar on weekends. . . • ·


      - It should be understood 1hatany medical treatmentls lnltia Uy a trial, and that continued •.

      prescription is co ngent onev;deoce.otbenefit · · . ·

      . .

      ... The risks and poterilal benefits of these the pre,s are.explained afsewhere'[and you •.

      lhat You have received such explanatiofli

      • You affirm that you have fullright and powerto sign and be-bo nd by- this agreement, and that

      you have read,. undennand, and accept all of Its terms.


      Patient slgnatura:


      ) . Physician Signature:


      · Appmved '1y the AAP.M Stecutive Committee on Aprt 2, 2001,


      ,..


      f . .


      ) • I


      ...

      ..; r

      .


      PATIENT NAME:  --         


      . UR MEDICAL GROUP.,·I.NC.

      s.       

      HISTORY .AND,.PrHYSJCAL FORM


      DATE:

      .··A.-··

      .


      v/r.rrAlLl si.GNS\·

      . --- PU E. I

      HXOF e:- e,f-( _:.,_.LL l

      . D.LNESS: . · •


      I .


      ... .. ,u ,,.


      \ UR MEDICAL GROUP. INC.

      • JACINTA I. GILLIS

      8800 49th Streat lforth , Suite #203, Pinellas Park, Fl 33782

      ·_(727C) 2'30-9319' FAX: (727) 230-4714 . ,


      ..

      ' .

      -en

      •------:--·C:.-, -------1,i. nrc·.

      "

      ·; o .nt:J ... _:

      -

      . . .. .

      .

      • ,. - • ; I


      •. "6'   •·

      = =.Pl-ll-lll!,w.,..,,,,,,..·-,r-•..,,·..1-1-..·..;-

      Refills 1 2 3' 4 . ' . .


      ----;r,_.o

      No Retina Vold Na

      · VALID FO'l CONTROLLED SUBS ANCcS

      ·

      ....

      . _.;_ .-Jj:


      ,•• ..........



      -.

      I


      -··--.

      . : UR MEDICAL GROUP, INC. 1

      9

      .. aaoo 49TH STREET NORTH SUITE #203 ',,\.

      PINELLAS PARK, FL 33782 727-230-9319·


      PATIENT SIGN IN SHEET

      ·oATE DATE

      l> >/• 1 - 16

                      2                                                                               17                                                         


                      3                                       18                       


                       4                                                19                                                      


                       5                                                                                   20                       


             6                  21                       


      7 22

      -'

      ....... 'j               ·8                           23

                       9                                                                               24                                                      


            10                   25                                                      


            11                      26                       


            1·2                               ·27                       


            13                    28                       


                       14                                                                               29                                                   


            15                    30                       

      rot\\


      i

      - ....I'-'


      11112


      ..

      4: : ...

      I I .

      fv.\t\ L\.


      ·1 \'1.-




      '

      i · UR MEl)ICAL GROUP, INC. 1..._.

      8800 49TH STREET NORTH SUITE t°.t03

      PINELLAS PARK, FL 33782

      727 0,,9319

      ATIENT INFORNIATI0N


      .

      STREET CITY STATE· ZIP CODE

      ADDRESS-:                                                                                                                                       


      HOME#                    CELLI                                 


      l

      OTHER# ­


      SEX:

      FEMALE · WEIG..:r: .2.

      o/:


      HEIGHT:

      -/.. 1/

      oJ

      MARITAL:STATUS: -MARRIED ORCED WIDOWED .

            _    

      I I

      SS#: DOB:

      ........_....._

      DRIVER'S LICENSE#: : STATE:

      :>CCU?ATION; /,.,, ,I'   EMPLOYER:


      :MERGENtv CONTACT:                                                        

      -- , . .

      •• 1i ·--- E-OF THIS VISIT:

      PHONE#:                                                  _,

      sf¥ . /, n<- 1-fr=« .- &w ,_/ 41 . I A/:&-tte:1

      /ERE YOU IN AN AUTO ACCID

      YES NO IF SO, DATE OF ACCIDENT:                                   

      ...

      UTD INSURANCE INFORMATION:                                                                                                                             

      COMPANY···


      PMN·'.

      EOICAL HISTORY: (CHECK ALL THAT APPLY}

      . ..

      HEART DISEASE .·

      CLAIM#


      STROKE

      --HIGHBLOOD PRES$URE FIBROMYALGIA DlPRESSiON/ANXJETY

      --SEIZURES .

            KIONEY DISSASE

      ---LIVER 01S1:ASE

      SINUS PROBLEMS

      ---LUNGDISEASE :

      HIGH CHO OL

      -----VASCUlAR DISEASE

      ---DIABETES

      . CANCER .

      ---ASTHMA

      . ARTHRITIS

      ---=-flf!JU>ACHES

      -- GERO :

      ---

      STOMACH ULCERS

      -ERGIES:                                                                             

      W"DID)OU HEAR ABOUT U ?{\

      ,.f . I


      " 1E rt,·'SIQNATURE_: -

      ". DATE:


      _111

      311


      - - - - - - - - - - - - --



      : -.; UR MEDICAL GROUP, INC.· .',--.' .


      --,


      \


      DATE

      ·.;49TH STREET NORTH SUfTE no.,.:.

      2-

      . PINELLAS PARK, FL 33782

      7i7-230-9319

      PATIENT SIGN IN SHEET

      DATE


      2                                      

      16

      17

      p#r 1 ......

      3                                                18


      !

      \

              

                               

      19



      5


                                                             

      20



                       _6


                                                        


      21



      7


                                                     

      22.


      )

      ..-' .

                            8


                                                       


      23


                    9

                                               

      24


                 o

                                      


      25


                      11

                                                      

      28


            12

                         

      27


                      13

      .                                                    


      28



                        14


                                                             

      . -29



                      1-5


                                                        

                   30

                                                        

      --

      .....


      (


      J,

      .    ,/


      11114


      (

      UR MEDICAL GROUP, INC.

      ...._

      \

      I

      8800 49TH STREeT NORTH SUITE #203 PINELLAS PARK, FL 33782

      727-230-9319

      727-230-4714


      AUTHORIZATION FOR RELEASE OF INFORMATION


      I HEREB.Y A. UTHORIZE THE U E OF DISCLPSURE .OF MY IDEN. TtF-IABLE HEALTH INFORMATION

      AS DESCRIBED BELOW. I UNDERSTAND Tl:(AT THIS AUTH9RIZATION IS VOLUNTARY,

      -t-',

      ..... I

      _ .

      PATIENT NAME:

      · ....•

      ..I.f..._

      SSi#:

      ....

      PERSONS/ORGANIZATIONS PROVID.ING THE INFOR. MATION: PERSON/ORGANTION RECEMNG THE INFO:

      YOUR CURRENT PHYSICIAN INFO BELOW...


      SPECIFIC DESCRIPTION OFINFORMATION:

      UR MEDICAL _GROUP, NC.

      aaoo.48TH STREET NORTH aos· .

      . PINELLAS PARK, FL 2

      727-DG-8319

      727.230-4714


      _    . XRAY REPORTS

      ---


      MRIREPORTS


      --.--.LAB WORK

      NARRATIVE REPORTS

      ---

      . CT REPORTS ·

      ---

      PROGRESS NOTES

      EijRECOROS

      ---

      ALL MEDICAL RECOROs· ,


      I UNDERSTAND THE PATIENT'S REPRESENTATIVE MUST READ ANO INl'f!AL THE.FOLLOWING STMTS:


      I UNDERSTAND THAT TH!S AUTH'Wlll EXPIRE ON                  ._INITIALS...       _


      I UNDERSTAND THAT MAY REVOKE THIS AUTHORIZATION AT Af:'Y TIME BY NOTIFYING THE PRACTICE "IN WR_ITING, BUT IF I DO IT WILL HAY.I: NO AFFECT ON ANY ACTIONS TAKEN B F(?RE THEY RECEIVE THE

      REVOCATION. INITIALS &. · <

      ·, . T7     


      SIGNATURE. oF PATIE.NT oR P. At1ENrs·GUAR01AN·

      11115                                                                               ._.



      UR MEDICAL GROUP, INC.

      8800. 49TH STREET NORTH '203

      ·PINELLAS PARK; FL 3 782 ·

      . 727•23o.9319

      CHRONIC PAIN AGREEMENT

      The purpose of lhis agreement is to protect your access to-controlled substances and lo protect our ao,lrJ)' to prescribe for·you. · · .


      The long-term use·of such JUl?5tances as opioids (naicotic; analgesics), benzodiazepine tranquilizers. and barbiturale seda s is controversial because of uncertainty- raganfIng the extent to which _they. provide long-term benefit There Is also the risk of an.addictive disorder developing or of relapse occurring in a person with a prior·addiction. The extent of this risk is certain. . · .. .


      Because these drugs have potential for abuse or diveriion sttict aceountabllity is neoessary when uie ,s prolonged. For lhifi reason the follqwlng policies are agreed to by you, the patient as consideration for. and a condition of, the wlUingness of" the ph lclan wh signature appears. below to consider the initial an /or continued prescription af controUed substances to treat your chronJc pain.. ·


      or·

      • All controlled substances i:nust come from the ph lclan whose signature appears below or. during his_ or her absen . DY- the covering phP,iclan, unless specific authorization Is obtained for an exception. ·

        C lliple sources can lead to untow rd druginteractions poor coorcf111a_d9n of treatrnenl.)

        . . .

        .

        ·• All controlled substances must be obtained at the same pharmacy, where possible. Should th need arise to change PhaRl'iilcies, pur office must be Informed. The pharmacy that you have selecled is: u,.+, rt PHONE: · · .

        . . .

      • You are expected to Inform our offtc:e of any-new medleations or:medql conditions, and or any adverse effects you experien. ce from any of the med.ications that you take. . ' .

      • The prescnbing physician tias permission to discuss au diagno and ireatment details with dispensing pharmacist& or othe essionals who'provfde your health care for purposes of maintaining accountablllty. • ·

      . .

      • You may ot hare, iell, or otherwise permit others to have access to_ these.medications.

      • These drugs should not.be stopped ruptly, s an,.abstinence,syndronte will likely dev iop.


      • Unannouncecl. urine or serum toxicology screens _may be requested, and your·cooperation is required. . ·


        and

      • Prescriptions and boWes of these medication, may be sought by other Individuals with chem.1ca1 dependency and should be closely safeguarded. It is expected that )'ou Wil take the highest possible degree of care with your medication prescription. They.should not be left wriere others.might see or otherwise have access lo them._


      • Or.iginal containers of cations should be brought In to.each office VisiL .


      • · Since the drugs may be hazardous or lethil a:person Who is not toleram to their effects. e cia!IY a child, you must keep them out of reach of such le.

      • Medicati • may not be ref>!aced.If they are last, get wet, are destroyed, left on a ·alrplane. etc. If your medication has-been stolen and youcomplete a police report regarding the theft. an exceP.lion mar be mad . · • ·


      • Early refills will generaur not be given.

        11116


        JU. ·pationlwm ••:of fDwn whenJ- a,.,.::-;

        due. These.prescriptions wll contain Instructions to the pharmacist flat they not be I.Bed pr1or-ti J

        ..

        the ppropriatedate. ..

        •.

        • If the ras legaltlllhorflies have questions c:ancamlng your lraalman might oc:cur, for . example. If.you were obtaining m.._,ns at 8everil ea.al COftfidentlalilY.Is       and.these authorlles may be gry.n lufl access to ourracords of controlled substances

          admlnllbatfon. ·

        • It Is fallura tip dhR to lhese polJcles may rastilt In cessatlan of therapy with

          contronad subStance prescr1blng by1hls phyilclan or referral·far further_speclalt.y assessment

          .• . . ...,..

        • .R ata·contirtg_anton keeping scheduled appob:ltrnents. Please do not phone tor·

          .

          . ' .

          prescrtptlon1 aft.er_ CII waelcanda. . .. · ·

          .

        • It !Should be understo thaany medlc:al treatment Is lnltla Dy a trial, and that continued

      pdon Is entcn _of bineffl · ·

      . .

      • . The risks and Potenllal benaflls of these therapies are explained elsewhere [and you

        acknoNladge that you have received such exptanalloni .

      • You.affirm that you have ruu right and powar ta llgn a.nd·be bouncf by this ag and that

      · yc,u have read, understand, and accept all ls.terms. · . . . ·


      Patient signature:· /j.

      Phyalc:la,, Signature:

      . .

      t ' • •

      Appro 1W the AAPII& t; mittri.an AprfJ 2, 2001.



      • • I


      . '


      .. ·..,:I•,. : .. .


      .., :1 :r:(" ·: . .·. :,,, . • ..

      ::0 <.\1 ,i ,,, :-:.11-'(:l.•.i.:,.":•, 1 : ·:.•

      :::r· '!#; iliC' r• :.SC:• · .,..

      11117

      ....


      ..,,


      .. .

      , ....


      q

      . UR MEDICAL GROUP, INC.

      HISTORY AND PHYSICAL·FORM

      . . I I -

      PATIENT NAME: ]) hi               oAre: 'l/ c/la%'

      ·cH :t!l£fto' J)J ¢!*

      VITALSIGNS: ... PUlSE fCfUf,(> BP. WEIGHT

      ...


      - ..·-JENT MEDICATIONS:

      ·--- '


      ..I


      -

      -11118


      l,f-.;y- - '1, /1.-:trtvv '2..-t Pn"/\lu-.

      .


        J





      UR MEDICAL GROUP, INC;

      HISTORY AND,.PH,.YSICAL FORM


      PATIENT NAME:                                                                

      "" ...

      CHIEFC.OMPLAINT: t'T r .·pl- ,.,,,_, 'ltf= l\o ,.:.:x;.

      . .



      VITAL SIGNS:

      . . i .

      H.X OF PRESENT flt-NESS:.

      -. - o-,.lI,, c-T_)(_·

      ,;,


      ..."..

             : J :

      f:

      f,

      Cl! .....)NT MEDICATIONS:                  

      ;


      .

      > / !' -,-._

      I

      I

      ri::


      1

      f

      -

      -

      c) .

      .

      . ..


      r

      ..

      . . . '

      :


      ...· ·.

      (

      '-· ....


      .....


      UR MEDICAL GROUP. INC.

      J CINTA 1•. GILJJS

      ., .' ••,


      0-93J9. ·FAX: (727) 23M71

      8800 49th S(t7renet North , Sulfa #203, -Plnellas Park;FL 33782

      .;Jt·-··· l 1•

       6 ;,


      )

      r

      ··"'

      <r

      <r


      . .....



      ·

      ,:,

      1 1;0;

      Aat:10l


      ... i- . ,. •

      049

      --


      _.:


      1 .. -,. _Va.,_ •_.

      ......c ?<

      _:a,.·_.... ._.       .      --...u,-·.·..    ..,... C. •• ·- ...... •-' ' •


      .,.'.....'


      '

      UR MEDICAL G-,OUP, INC.

      JACINTA.I. GIWS.

      8800 49th $treat North , Suite 1 03, P.lnalld F>ark, FL 33782

      . ..(727) 230·9319 FAX:"(727) 230-4714


      "'



      . UR MEDICAL GAO.UP; INt.

      <

      ' cs

      . · JACINTA I. GILUS

      ...

      8800 49th Street·North., Suite 1203, Plqellas Park. FL 33782

      . : (727).230-9 19'. ·FAX: (727) 230-4714 ...

      ....., r



      - ..

      . $'=----..-. -­

      . Rafills f ·2 3 ·4

      Na Rallte ·Vaid Mer --r-:!1----


      .

      -••-••►---- .


      i.._ us.- •-.!-t...l..)... •••.p.'.t....,.,...,.,.................. :.,adl,....::.. :• •.:a.:1---.......u.a,it,l'...,.•a.,·,. :..i.;.-,<.,IJ•,;,.,i:':wai.;;.ha,


      . .

      . .. .

      Aun-toRIZA'tjON FOR RELEA.$E OF INF0RMATI8N

      . ,_,,,.,./

      ffEREBYAlllHQRJZE,nteu a:or OFMY1oamRABU:Hf=ALTH TION:,...- ....

      \S e.aow. I UNOatSiANQ THATn-ftS AlJ'l"l,fOR2ATION IS\QJ,SJNT'ARY:. • ,


      SCFl0DB9CRIPT10N OF.INFORMATION:

      ,·:.    .

      - ( _,_lXRAY.REPORJS.

      ,,. NARRI\TIVERSPORIS

      -:--atRl:CORDS

      ....


      . ...,.- ... . . . .. . . ..,. .. . :

      )J;IISlllND'l!IEMrJEMr'S ui,;n-112ADANOINITW-= S1")o(..


      lpRSI"ANO 'ntA.TlfflS.AUTff WILLEXPIREON                                        IM

      . . .

      AHO".fHA.Tl MAY.REVOl<eTHISAUTHORJZA"llON AT ANY11ME Bf N THernt--< •

      ---

      IN'G. so.r IFI DO fT\NIU. AA=ECr:ONACTIOHSTNCENBEFORE; t

      ICAno°N. I.NtTIALS . . . .

      ; . .

      . . .

      . . . . .

      k.,.

      V1J1 q '-ri-.. -- _ .


             bJdM  GUMDWI


      I '

      . _)

      OA!;J-) .. f ·· ,. "·..

      I I '


      .......

      20


      11122



      C:                  


      ;BGHT: ·&9.s-' '

      ·-----

      Al3!A SI 01110RCeD WiDOWl!D • •. •


      ---- . - ·t

      . .. ·- i' ·--

      ';.,..I

      VER:Sucaise  :. . _STATE: .EL....

      08Ml10N: -·                    l     ...L - ""'ill'-'----··.......-- ----

      . 8ENCY ACT. :. /'\ . e --=-- PttONe•:/1 -, C

      :POSEQF.THISVISIT: .: '"1· :- #


      tffl5al & t --.-;


      -----·---·-----:...                       ,;.                                                                  ""!'"                                                ...,...         -:---

      I

      Ale,J/111:.:QJ


      == At.BIA       

      ..

      ,..J\L AU.-THAT APP v . . · .· ·.

      · KSARTDISeASE · ·. Ne.CK/BACKPAIN


      sreJ:>((5.

      -HIQH8C.OOD PRESSURE·

      DePReSsJtlNIANXIEJY

      -SECZURES · '       

      LIVER DISE:ASe

      SINUSPftOBLEMS

      WHG DlseASS·

      HlGHCHO L

      ---DIM,ETES

      CANCER

      . AS1HNA

      -                        

      - Gate. -. STOMACH ULCERS

      _ .t(IDNEY OIS5ASe V.ASOUlAR-DIS51\.SE


      DID.YOU HEAR ABOUT US?.                           ....;_,_··.                              "tlllr.•-f-'-".:"'r -·-·_:....:

      IE:.S:

      ..... .

      -S!GH»:. Re fr.,*:

      -;;- ·.··

      .a,,TE: 71{-,z,ijat ,-------.:..c...·-··· --


      j '

      C.../. l


      19


      5


      .....


      bN°sENTTO TREAT

      For irl on all the s l prpvidedto yo[4 · this fi:>rm_ a:;cqnserlf 1bat )40U are aufhorizfng Dr..Gflfis to · provide yo\,w1tta·niedicaJ trea1ntentat.·· .,ar ..uaa1 t::l:f.!w3 Inc. 8y }roQr:llSfiie -you are nsril'JQ to ...:·

      receive ·· · - st the.facility named above.


      . .

      GUARANTEE OF PAYMENT

      ,.


      ...

      For anc1·m-censicleration o.ffhe services pR)Vided to the · .·.

      . I promiaa io pay--P?l- . ioa;i. ·c., inf,: forall

      · services renden:d to or on behalf of_ e patient


      ...

      . Date:a/1-1.f.a


      I:·


      . ··-....\

      : I

      1 0n


      Mi

      . .

      _. Dollar Medical ainic is fin ndependantl low cost pain managemerat rogrc-m. It the purpos of providing a ordable quar care to·qualified·candidate

      ,llnessess related to pain.

      ;·. pollar Medical Clinic beli

      anagement should be,

      ,I •

      ,1 ..)rtain criteda when me(ii Hy indicated.

      . .

      government funded facili edicare or medicald or o payment.


      - CERTAIN RESTRICTIONS A PLY


      . .

      lSignatur

      I ,, .

      V .-

      sponsored foun edfor


      riate pain ns·meeting


      t accept any

      sformof ··


      . ._.: :-..OQ.


      :llAR--M-E


      ICAL.

      CLI-N.I. .1


      pilrpdse- - csb-wur

      f)Nt!ICllbe ym,. . . . ' ... • . ....., .


      °tjae-long..term uaeof suc*: as-( :ole sadallves ts   bec:au•  ·••IBlt!IJnfJ- banafit. Thma rs alslb·1he·•-d.art-aicl

      di a P.lfot" "(he exrentot.thls dslc

                     lllese dn.lgs havefar .tf9lan;•aflfct unfl- . ary.when -.

      Pf0lonoed. For lhls iassan lhe fo_lloWlng JJOIIC:lel;· ID by -•"- as cotdd&tallon for;

      a CODdi8an of. the't.lillfagnesa,of..1he,ph,a1Qian. · to cansldar1hs.lnlllal •,

      . .

      $.nd/orcoill.inued pnlSCr1pllOn o.l c..ontm. ued d. .i.«. .

      r. l ' •. ·,

      ·· ·- ·.

      • Al conllOllelLsvbsla=es must.-mmeftlm -tabJlteappai81&balp,af or.

      his arherabsence, by the cowdncllh raa; lriaas·-· · .. ·:· adftained.far

      an eica,plloaL · .

      (Mullfple_ can.leacl·to d don of eaq_nant.) .

      • Allc:oi11roled amslance8 mustbe o. . . me··....  ·      8lioukl1h.e .

      need adse1D at--oe pt.an,\aJw..

      be informed. fbal:yqll have

      selected Is: . · · • PHONE:      


      • You .,,.a,cpectad to Inform ourafffceot

        . . ad\lenleelfacb;JOU a,cperiencefmm 11'1)'

        i ·, • •

        . ,_./ •, The p18SCdbfng physician has pannfask,n ISS elldiagnoslk:.

        = dlspanav phannaclsl&crGlher · pravJde your

        mainlalolng-accounfablllly.

        ·• vou·may notshalw, 881L.m:ottiarw1se·

        -+-                               ,

        I'" • •

      • These shOUld not be atopped

      • • Unannouncad udnecirserum' ·

        l9qUltecf.· .


        .; . . . .

        .• 0l1gfnal c:ontainens r:4mediaatian&

        • Since the-drugs may behezardou& or

          espedalfya dllrd.·JOU must kBap

        • MeclicallOns 01'\Y ndtbe repfaced If llltiY your madlcafion baa baan stolen and fO" em,pCfon maybe made. .

          )

        • Early refiHs will generally not Qe gf .


      11126

      svnc:in>lille wit!llkely,develop. ..

      . . .

      yourcx,operaUonls


      on an alrp1ane, em.. If

      iheth an




      • rnav.txt··emlyff'th

        --'--...• due. These ans wilt comaln

        ., the appropriate data. • .

        (_ ..

        s

        -lf).sr wllfbeout." ftown"1lena rafillls

        to the pharmaC(st that not be filled prior to

        . ..

        • If reaponslble legal authorities haYe q·uel;tlonSCli>nCSmfng your

          example, If you were obtaining ti1edlcatiOnS our of

          andthese authorttles mey be gwen-fuff ,.-.,,_

          .

          ant. as might occur, for ··

          obnlfiderdialllY Is wahled

          aubifanoeS'. · ..

        • ltis tftat tfradhereto mli in·. ·_- -· >f pywlfh

          contioUed edbslmideptesc:riblng•by1hlsPh. an·arnsfelndforflirther' i>eaallY -

          . . .

          • Renewals areon tu,epJng

      ---.flo «°'1 .


      • • ••• '♦ ••

      • ftshould W- ll18t aw,  ic  r" · ·. ·· htlnltia-ly a• :tbat - ...· ·. ·:.· :· _;··_·:_ ·

      p,eserlpflon fscanttngentanaiid'enoe.d_ ··· , .. :. · · . ·,'

      Thel."..R..i.l\_D,i_._ _.;:. , •.-,-•ta1DcIIJi"f··U.IV.P'ii'

      . ·-c.u:v.-,t,lX..J.JN,i_lllslJ.:g..l,-Ia,.,." • • .• ;, , .;. •

      aclcnowredge that you htMt ,eoek,edauch ,

      .-.- 1

      J_.: . . . • . ;·

      '• ♦ I • • ·•

      . •: •. You affilrl:t thaf ftJIJ lfghtand. .. to:.ion d briiound'bJ-. Is.;- t;-enc:r" ti t./

      you llave:read. und..ers.tand. and accept alJ f. Rs te.rm. s..

      . ..,

      - s1gne -

      .. .

      ·, · ·

      ♦• ••

      ' ··'j,stpan Sfgnatum: .· '·

      ···--: •••

      ... .... . .. . ·.··


      ·. ,. ..

      proved by the AAPM ExecutNe Committee on ti 2, 2001. . : .

      ·.- ..

      . . :


      ,...


      .' .•


      : t



      - 11127--------

      . . .


      -----    J



      BLVD.

      Pu,.11,.1..1-WM> FL33

      PHO 1 (727)91!t4-8M

      .com.


      .• .

      rI-\ .;.,Iv ·?3t . . •

      PATIENTNAME:_01 - · --G -

      TB: lo2:,.;iq-ar-


      i · .CHIEF COMP

      ! .. .._,

      _S:::J£fr. Q2'.Q........].L ne v f).€>

      'l - tv ::.....L.!d,&., ....:::.:== =--,

      l . VITALSIGNS:_,.-          


      ,.-. ...

      i

      'j ,,,/


      i

      i


      i: • • •


      I=ONS -=--"-= ...;._--

      tNLIJ ,

      fiPd..-. pt;! _/ • I_

      l " - - ;r- . ',

      r] f.l(cV.A--- .,. --J..     j ' ·....

      b 'J.J . ,... . ·1 ·: .

      1. L l-4 (


        ,o

        -DOLLAR MEDICAL CLINIC

        4427PARKBLVD.·

        PINELLAS J>ARK, FL 33781

        PHONE:(941)875-0761 (727),54-8881

        DollarMedical@Yahoo.com


        . - .

        PATIBNTN  : H-- . . DATE:. l - Jc., -el

        CHlEI' c . fi:h-J!a,..,,..,  n        C...

        .                               P.o.o +--

        '.:    rL&. .

        VITALSIGNS:             PULSB                 .BP       

        r  

        HX OF PRBSBNT!LLNBSS:        -tR'!::,------:==i::=::--...--------

             0

        ib



        - 11129

        WBIQHT


        1 '7




        ·•

        MRI

        Patient ame ((} _ '

        '


        _;a,:;...-

        Datel/j

        cq

        PHYSICIAN'S REQ.UFSI'

        t\ I f


        Appointment 'Time & Date ..1-------------4------

        EXAMINATION


        etic Resonance

        0 Compuieriir.ed Tom


        ging- MRI

        by-CT


        Bone

        X,-Ray

        0 Ulmu;ound of _ _._                                                       ,1-------


        I

        ., .I

        (rlease be

        ( ) Ankle ( }·Bniin ( ) Breast

        ( ) C.ervicru Spine

        ( ) Exm:mity

        (.)I<ncc

        ( ) Abdomen

        ( ) Other (Plc:ase


        Righc----

        specific as poaible or circle ow)

        '

        I/Lumbar S inc

        mits ,

        ( )Pelvis

        ( ) Shoul4w

        ( } Thoracic pine

        c ·rrMJ

        ()MR-An' raphy


        pccify) ------'-----


        --- C'onmst----


        . L,\'2,,q

        ·r-·

        .... ..

        ' ,


        _,l


          11130                                                                                      


        --

        :.•t;.:::·.:.



        \..

        ··-

        DOLLAR MEDICAi"' LINIC

        4427 PARK BLVD.

        P.l,NELLAS PARK, FL 33781

        f&ONE:(941)875-0761 (727>'54-8881

        . Dn!lar.M.. CL&.o.m.


        -----·- --···----··          .....,         ----

        CURRRNT MF.DlCA1l0NS-:-- - ----· - --... -.


        i

        ... ,..,

        I


        ...


        I _11131                                                    ----

        .. . .

        ...

        ....


        DOLLAR .MEDICAL CLINIC

        4427 PAR1( BLVI).

        PJN.£1..LAS J"ARK. FL 3378J

        PB0 ('4l)ft75--076J {727)'54..,,881

        l&Ui.-MediC¾ll<a Ylboo-@111

        13


        ..............

        I

        I I


        ···...

        :

        ! ·<.I. ..


        I

        ,. ..,....


        -



        ..

        11132 ..

        I - rf) }'

        M

        . . .


        .. I ,

        '

        I


        .I .

        "


        I mi,"l1Jl{i'•


        . t

        t . •. '·

        •· ,t



        PtJlS9

        w,·

        lfJ' .

        f

        ""' - ..

        '



        ..

        , ., .

        Mtl J7 J M(N,\.l-n' M tl·-<:fr·;J.CIMc. ,L..· Q?. vB<;I_,.

        .,.,.. •...

        f

        VA,rl'n<i<''•'M<><t, @o Pr ::_...;:. ,Ju--•:


        . . .


        DOLLAR MEDICAL CLINIC

        4427 J)ARKBLVD.

        :PINELLAS PARK, FL 33781

        l'HONE:('41)875-0761 (727)954-8881

        !20Jlon\-1cdic @V8boo.cnm ,


        . - .

        PATmNTNAME: G_· _. . : o tt: ;_Io:.::>.

        CHJEi' coMJ'LA ktt-,.. 01rl-.s>-?       

        ev,st.{_ --.--


        ...

        ·

        VITAL SIGNS;             ,..:PULSB                  BP        

        ·-

        . WElGlIT


        :. ....."':._


        HX OP PRESENT ILLNESS:

              -·_0_.._.T....   -_,_....

        <'·

        - ('-'

        ..., ... .


        •.· ...

        ...

        ...... :


        . .

        ,• ,.t;...,,,r l ,_.f,,

        '• ·· ·· .. ,.;..._{;.•-.


        . PHYSICIAN'S

        RBQ.

        PllrictuNamc-M..;._.

        : / J"-U:

                       ft?;.       

        .....,..

        _

        _ o;...... - .              ¥,.:.s

        ,Appoiaune.ntTimc1k Date----------------

        JDCAMINATION

        Mtgnctic RaolW'lce ng - M1U Plain ntrnX-Rar

        m utcrlud Tomoppnr -Cr Bone Min Analysis

        Cl Ultn&ound of-- --:-----------

        lcuc be: u aped& 8' ?°5' lc ot cirde bcknw)

        ( ) Arude. ( ) wmbar Spine

        .rt.In "'' c+--£A.!{ 0 ( ) Orbits

        ( ) Btcaat ( ) Pelvis

        ( ) SpiDc:

        ( } EJ,ucn\ity

        ( } Knee

        ( )Abdomen

        () Sbouldi:c

        ( ) Thon=Spine

        ( )TM.1

        ( )t_-{R-Angiopaphr

        ( ) Other (Please Specify)----------


        - 11135 38


        Patient Comfort A sessment G ide

        )

        Date:

        1. Where fs your pafn?                            -1----------t----------

        1. Circle the words th:at describe your pa


          • .·.,


      r

      t


      throbbing shooting stabbing gnawing


      Circle One occasional


      What time of day Is your pain the l"°'


      1. Rate your pain by circling the number

        No Pain o 1 2 3 4 s s·

        sharp


        tiring


        evening

        penetrating


        numb miserable unbearable


        aln at Its mu'.§l In the last month.



        ._.,./i

        1

        l

        l

        ;

        _j

        l

        'i

        >

      2. Rate your pain by circling the number at best describes your aln at Its tu.It In the last month.

NoPain o 1 2 3 4{E)e 7 a


5, Rate your pain by circling the number at best describes your aln on ayerage In the last month.

No Pain o 1 2 3 4 5 erG} a s· 1 o Pain as bad as yo can imagine

&. Rate your pain by clrcllng the nu'l'ber at bast describes your sin right now.

No Pain O 1 2 3 4 5 6 7 Pain as bad as yo

f

i 7. What makes your pain Qdl[?_(j ' "f-= ;...lf_R     ,;;..;..f;----+----------

i

!

t 9.What treatments or medicines a,. yo

f amount of reJJef Iha treatment or med

I

i

l

i ·•> Vi· q1J,r .

Treatn1ent o Medicine (include . se

  1. b) D B

    t

    1. Tra

      receMng for your pain? lrcle the number to describe the

      Ina provfde(s) you.

      No 0 -1 2 3 4 5 6 7 8 Complete Relief Relief

      No 0 1 2 3 4 5 6 7 8 @ 10 Complete

      Relief Relief

      I

      t c) t--

      No 0 1 2 3 4 5 6 7 8 9 10 Complete

      ;. Treatment or Medicine (include dose

      d)-Tre-atm-en-t o-r M-ed-ici-ne-0n-clu-de-P.+ose-

      Relief Rellef

      No 0 1 2 3 4 5 6 7 B 9 10 Complete

      Relief Relief


      11136


      ---------------. ·-


      1. What aide gttects or IYDJptQmi arey

        experience during the past week·.


        having? Clrcle the num


        r that best describes your

        \...J

        1. Nausea Barely 1

          Noticeable

          234 9 10

          Severe Enough

          - ,c

          to Stop Medicine


          ......· )


        2. Vomiting


        3. Constipation


        4. Lack of Appetite


        5. lired


        6. Itching


        7. Nightmares


        8. Sweating


          1. Oifflculty Thinking


            ). Insomnia


            Barely

            Noticeable


            Barely

            Noticeable

            Barely

            Noticeable

            Barely

            Noticeable

            Barely Noticeable

            Barely Noticeable

            Barely

            Noticeable

            Barely

            Notlceabkt

            Barely

            Noticeable

            1 2 3 4 5 6 7 8 10

            o 1 2 a «IDs 1 s 10

            o 1 2 s 4 s s(& 10

            0 1 2 3 4ef) -- 8 10

            ,2(/]ss1e 10


            1

            2

            3

            4

            5

            6

            7

            8

            9

            10

            "\

            2

            3

            6



            7

            8

            9

            10


            1 4 5 6 7 8 9 10


            1 {(])4 5 6 7 8 9 10

            severe enough

            to Stop Medicine

            Severe Enough

            to Stop Medicine

            Severe Enough

            to Stop Medicine

            Severe Enough

            to Stop Medicine

            severe Enough to Stop Medicine

            severe Enough

            to Stop Medicine

            Severe Enough

            to Stop Medicine

            Severe enough

            to Stop Medicine

            Severe Enough to Stop Medicine


      2. Circle the one number that de9crl s how during the paswt ek gain has Interfered with your:


        1. General Activity


    b.Mood


    1. Normal Work


    2. Sleep


      Does tl\0t 1 2 3 4 5 6 Interfere

      ooesNot 0123456

      Interfere

      OoesNot 01234567

      Interfere

      OoesNot o 1 5 6 ·7

      Interfere

      10 Completely lnter1 es

      10 CompletalY,

      Interferes

      Completely

      Interferes


      Completely

      Interferes


    3. Enjoyrnentof_Ufe

      ooes Not tnterf{lre

      0 1 2 3 4 5 6

      0 1 2 3 4 sle)1

      0 Completely

      Interferes


      Completely

    4. Ability to Concentrate Does ot

      lntertere

      ooesNot o 1 2 3

      Interferes

      10 Completely

    5. Relations with Other Pe ple

    lntenere

    Interferes


    F5375 PN'023 01•


       11137                                                                                      



    (%!:. :

    ",l:


    DOLLAR MEDICAL CLINIC

    "27 PAR.IC BLVD.

    P LAS PARK, FL 33781

    J.>HONE:('41)875-0761 (7Z7)954-8881·

    DollarMc.-dicaj[mvahoo,com


    IO :.z..7


    PATIENTNAME:_·_)d_··----- -0Ao/>5 - / Z. -O   9

    CHJE.P COMPT..AINT                        _.          ._r_.,_.     _


    ...


    I . I

    '

    VITAL SIONS:

    . . .,

    'Pl.JI$E ·gp_. w.EJOHT


    11

    HX OFPRESBNT JL.LNBSS:,    

                    1-   ...;.;..,.s.:..--.-t; r-5.,-.;.,..-1r--

    -»-\8f. . -.

           -


    11138

    .{ijj;:t,i ;:-...,.

    """"


    _ _,.,,.



    ..... .....

    D.OLLARMEDICAL CLINlC ·

    4427 PARI( BLVD.

    IN.ELLAs PARK, FL 33?81 ..

    PBONE2('4J)87S..0761 (727)954..sSSt· .

    llarMedieaJ@yahpn.cgm


    . PA NAMB. :...c;;A---=----·G--4-··- e, -/ 2- --e9

    CHIBF LAINT_·_-t.#..!. - C _!_ -


    . .. . .

    . VITALSIGNS:_·,....._·--        fta\A\ ttiS-. adr""'._ --.

    lDC·OFPRESmrI"ILLNBSS:.                                                                    

    .....'\ ..

    . l

    ·<''

    -- -----'----- . .

    .,

    CCJ.R.RENTMBD1CAnoNS:. ff......, ---- .>:...: _



    I

    I


    .... ·-


    1?

       11139                                                                                      

    .!'


    .....


    .......

    D_OLLAR MEDICAL CLINIC ·

    4427 PARK BLVD•

    PINELLAS PABK, FL 33711· PHONE:('4 )875-o761 (727)954--8881' .

    D llarMedi o-co.m


    ·G·

    . .


    DATE=

    CHIEF COMPLAINT

    ,/4d, .


    .

    \

    · VITALSlGNS:._·,,    ·--                                                                \,i,{\\i)>, [fi  ,7-:  , --. • . '.


    -- ·•..•.

    I

    . . .

    ...

    ..:·a...x, ·oFPRBSENTn.umss:                             

    .


    -----

    . '

    ..,.


    ,\

    ClJRRBNT.MBDrCAnONS:.    

    . .,. --->            _



    I

    I


    . ...


    .. ,...._, .


    1?

    11140                                                                                  


    .,.......

    ..


    C


    oo.com



    ':


    VITAL SIGNS:._·       .

                          WEIQIIT


    HX OF PRESENT ILLNESS:._    .._.,...       

    -1---- q-     

    • tt)

      ll . ..,,.t.,()

      ---1-------t----- I I tt,•


      ....


      ,I

      . . . .. .: .


      cL


      -111·41



      •."' '

      .....

      =\ :


      DOLLAR MEDICAL CLINIC

      4427PARK BLVD.

      PINELLAS PAR.Kt IL 33781

      PBON.E:(941)875-0761(727)954-8881

      ·po1larMcdical@yaboo.com


      CURRBNT ¥BOJCATIONS.:


      _ . ..,,... ..,.......

      I I

      ..

      ·'. · .

      11

        11142                                                                                   


      . 'i

      I

      !

      i

      f ' - .,

      ,.

      .. _...


      .. -- .•

      DOLLAR MEDICAL CLINIC

      -

      4427 PARK BLVD. • ..

      .PINELLAS PARK, FL 33781

      •. PB9NE:(941) 75-0761C7Z7)?S4-8881,: .

      l,.2pQprt.;.f:cdit:ulr@y1:1hoo.co111 • · • •· •

      1· r-.;7r:.


      . ... ._ ...,.._,.

      VTTAL STONS:                 PULS . P _.....       WBJ9HT ., J *

      • I

      ·,· ...-- ..... --- · f. h

      .


      CURR ...



      ·v.


      ,. - -•-·


      ,...


      , J '


      10

      11143



      • - :--::.:. I

    =.:: .


    ...

    i

    I


    '

    .....

    . ! )

    ·<:,_.. ••

    DOLLAR MEDICAL.CLOOC

    4427 PARK:SLVD.

    PINELLAS l'.ARK, FL 3378!

    PBONE:(94l)a75..0761 (727)95U88l

    DglturMcdieajrg)yahoo.c<;)ro


    c.e, Um •.

    --f----i--4-..L-l-- -;._:_-y



    -...)..·.

    . ....

    /

    ' '


    11144 ----- 9


    "

    \•

    . ::fr, ·1_,'·1,0I

    Dollar Meqical Cl_inic Fa.flow Up Evaluation


    Patient Name. . . -1'      _L    

    1

    ·-:· \! -,

    Hello, Row are you doingtoday?J Cf:& 1.e::--


    Is treatment with Medidnt'!t worldqg?--lJ ·

    . Dqt } l--<.f-o"J

    _


    yourmedicines last thewhole·monih? · . · ,

    ff noi; how many days were vou out of your medicine$?                                                                       

    . ArP.vou sleeping better Vo

    ,,..•

    f

    · - '?id you take medlcfnetoday?,..·.,_\(is . -_

    What Is \'OUrpain level on a scale fron, .1 to 10 toctav, wfth 10-belJJB the worst pain? 7·


    ) .

    - - Physical Exam Updates:


    -\. ..

    Assessment/Plan:


    l.i ...


    _ 111451

    ----A - 8


    ...,...

    ,.,.

    .I . : - I ) ··ri;'7= ...,,,,,,,,,

    Patie t poµlfort _A,.Ssessment ·Guide , ; /J',..

    Name: (Y/ - Date:

    1. Where ls your pain?

      L:;..;q .·c..a.

      t»r:==::...;

      · --

    2. Circle the words that describe your pain.

      -- ··.

      throbbing


      sharp tender .'


      . -penetrating.

      nagging

        -            

      gnawing .

      . burning

      exhausting

      ·if g

      numb•


      -      

      unbearable


      Cfrcle one occasional


      What time of day Is your pain the wor,Slt? Circle one.

      afternoon evenino

      . .

    3. Rate your pain by·c1rcDn9 the number that besl dascr1bes·your paln at Its · ln the Int month.

      NC? Pain o 1 2 s 4. 6 6 7 ,<iJ,Q P n as bad as you can'1mag1n

      . ! . . \


      ":

      I

      •-.::::.'.

    4. Rate your pain by cltcllng.tha nun\ber that bEllt deecrfbes your pa\n at ns Jaiw.1n the laat month, No·Pain D 1 2 3 4'1t) G 7 8 9· ,o Pain BS bad as you Imagine

5, Ra e your paln by c1rcling the number that but descr1bes yoor pain Dn avttl91Inthe last month.

.. · No.Pain 0: 1 2 3 ·4 5 ,ci}s· 9 10 Pain as bad as you aan lmag e·


8. Rate·your pain by cltcllng the ni:,mber that beg\ describes your. pain·ripht ngw.

. 1',10 Pain. D, 1 2 3 4 S ettDs 9 10 Pain es bad as you can Imagine

. 7. What makes y r pa 'becfJ{'(Jd/o7.'.. . ,

.

  1. What makes your pain ? zyr,duY/5 · (r.a.L.1

    . .

    s. What treatments or ·madlcloas are you receMng for your.pain Circle the number to describe the

    amount o relief e treaiment or medlcln• proVfcle(s) you. ·

    Treatment or Medicine (Include dose) Relief









    Relief

    b) Qif/tJ'DI?)/ /1 {/ 2,1)) @ No o

    Treatment or Medicine nc.lude dose) Relle1

    ,

    2

    8

    4

    s:

    6

    7

    8

    g_.@:&omplete

    Aeltef

    C)                                                                     

    Trea1ment or Medicine (inolude dose)


    No

    Relief

    ,


    2


    3


    .4


    5


    6


    7

    B

    9 10 Complete .

    Reftef

    d)                                                                  

    No Q

    1


    3

    4

    5

    6

    7

    8

    10 Complete

    a) <Qy,.qtncltru: {"21/0 ):?'f) No o - 2 3 4 5 e 7 8<!)o Compete ·



    '-·

    ) ·Treatment or Medicine (include dose} Relief Relief


    11146

    ... .•:

    ._·.;•.:...\. .

    i.;1

    ··:1:..... . ...;.·: •..

    1. eWkphaetrf.se.nldceeedfuferle11hgotrhnerpfiaffslit:iwmeaekli.re you having? Cir 1,·ttie aurnber lh;t best desorfbee your

      a. Nausea · Barely . A. 1 2 3 4


      - Vomiting

      Noticeable \...'J

      8 9 10

      Severe Enough to Stop Mediclr,e


      1. -Constipation.

        Barely

        Noticeable

        1\..:J

        1 2 3 4 5 8 7 8 9 10

        Severe Enough

        10 Stop Medicine

        Sare!)' O 1 2 3 6 7 8 9 10

        Noticeable

        . Severe Enough

      2. Lack of Appetite


      3. TJred

        Barely

        Noticeable

        Barely

        0 1 2 3 4 5

        6(&>


        9 10

        to stop Medicine

        Severe enough

        to Stop Medicine

        Noticeable

        4e[} 7 8 9 10.

        Severe Enough

        · to Stop Medicine

        1

      4. Itching. Barely o 1 2 ,/7 .· : 7 8 9 1Q

        Noticeable \..,lt

        7

        8

        9

        10

        7

        8

        9

        10


        7


        B


        9


        10·

      5. Nightmares Barely. /;J 1 2 3 4 5 8

        Noticeable < V

      6. Sweating Barely O 1 2 3 4ttf}6

      Noticeable·


      Severe Enough

      10 Stop Medicine

      Severe Enough

      to Stap.MOdlclne

      SMraEnough

      to Stop Medicine

      1. Difficulty Thinking Barely O .1

      Notlcaabte

      r(i)4 S 6


      Enough.

      to,Stop.Medicine·

      J. Insomnia -Barely o. •'1 tf!y4 .s;.,e 7 8 9 •10

      "Noticeable

      .. Severa- h ·.

      to Stop Medlctne

    2. Circle the one number that deacrfb• how during the past week ROID has lntfl'fart;d llfltb your.


... ,

ActM1y,

Dooe

. 0

1

2

8 •

6 6 @ 9 10

Completely

,



Interfere







I


b. MOOd Does.Not O 1 2 3- 4 5· 6 7 9 10 CornpleteJx

Interfere lntarfel'8S

c; Normal Work .. Does Not

Interfere

Doe; Not

Interfere

0 1 2 s .4

0- 1 ©

s@

5

6

7

8

5


6

..,

Is

9 _10


Completely

Interferes .

Completely

  1. Enjoyment of Ute


    Does Not

    · interfere

    .

    0 1 2 3 4 5 6 7 @

    fnterfaras

    Completely

    . . Interferes

  2. Abnity to·Concemrate Doe.s Not

    Interfere

    0 1 2 3 4-f{V7 a ·s 1-0


    Completely

  3. Relaticms with

    Other eople


    Does Not lnterf re

    0 1 2 - 4 5 e@ s fO

    (i)

    lnterleres

    Completely· ·

    Interferes

    PllP&n,CI by llizabl!lh J, Nlbei!al;in, M.0., Clnlc3IChief ptPain Maneowme111, lllltllule for llehabllllallon, Inc. Ffi375 PAl'OZ! 071'118


    11147

    :90577 4


    p



    Blood Pressure Rate:

    - ..


    I


    PUise r Minute:



    . [.

    lf nat ulh¥_.,a111twhicti111.llllldmmare.notwortcl.not I Dopm-111811clnes.ttbaWhllle---7 I\J,e,g_ I

    ----- -i  ·



    Dl6yaatakeymar blday'I'                                            

    ..

    Wllatlll,..-piln.-itx,41ayan a«aleofS.•2.0,.atb Dbllng

    -·':-.:-_..;_


    ·; )_.,._. your... laelded1


    PHYSICAL EXAM UPDATES:

    _...IMWIDISl:7'


    -

    ; ;;:::_:_..11.o,t,,l\


    ASSEsSMENTOPDAlcS: (!J;v· p z-

    "'" ,. ...


    ..


    _11148,

    --- ·-;. '-....'• . '


    7. _


    Dollar Medi f ainic Follow Up Eval chart i'

    DATE:


    B d Pressure Rate: PuJse Per Minum:


    Is '"'8tmant'wlthl:tle mecldnes worfclnrlt



    ?

    f\rS

    :Whklturi..,         dorfta.«tO ·:fO 6=s-


    JtnatbOW..._,


    et.-.....

    WhatkYG&ll"palrll!!gltodarona ... o11-so,.,...m1a11ng

                    -------1

    :"i - ---

    the WOllltt -l:>.. .

    . . .

    PHYSICAL EXAM UPDATES:


    f;

    1Qi,. .

    ASSESSMENT UPDATES:


    . ....



                 .... 6

      11149                                                                                      




    ....

    . DATE Ol<'EXAM: 08/13/2009

    PATJENTNAMEI- 0 M

    ACCOUNT:

    S&X:Male A.Gl:34

    D.A.TE OFBDmf:

    ROSE RADIOLOGY- Boo7 RA.NCH

    The ll'lllglng Cln1eratBootR"INlc:h

    HCIM ofFlodcla's 18tStand-l.lp, "High Fie! Open MRI

    . - 11.W'...w Clulfll'

    MJHRosli.COII ,

    ?liOle: (727) 71! ..31U JR:I (7%7) 711•3111 •


    - "" I


    , ...

    I•

    REftRRJKGP.ln'SlaAN:. ROBBR.TNUCCI,MD

    FLIXIONl.1CCTINSIONLUMD.AR.Sl'Jl'mMRI .

    HISTORY: .Baclcpain. Pleaaeewluate:fbr,pi:naUnstabffity.

    '.)'£CHNIQUE, T2 •.llftcalfledan, • wdl • exhlallion 'Yi&ws aftheluml,ar spine WCRob1ained wit,11 tbep,timtmthe

    ,uintacllwdpt-bells:lngposltian.iD:1he openMIUscanmr. · .

    °"

    FINJ>JNGS, Tlae)(R.Ifmagnvoffhe1umhm:spine hmfladan tocxtm;landcmoutralles110 f!Jbluutiom or spmal IWbala fi:omSJeldai\to lllm!III 10prochlcelJ\Y llplDalinltilbruty. Disc deldcceti.onmd diac&paaoumowintia atU-5 anclLS-Sl· wJth focalprotruded di,as atL4-5 ad l:.5-Sl. 'l'baeappcarmnp.l'OIIIUlait'OG ti,.edmaloa vifMowhm

    .

    'Wflb tbeflmlct \'iew, Motepmmloentllfl111'11il:nmlnal q.ttl.4-5andU-SJ isMled &.

    codemlon v. few11w.en. Nolpinal-.- ormws.-.iclalti.liecl

    IMPRll:SSION:

    l. No fmtabllityfmm fle.'ldo1l to emnalon. No.,anat lbmasla i'am l=iOllto «dmllmn. · · .

    2. Dilc:prc,tnDiom atIA-s and LS-sl wbicll appear DIOft p.mnfucut cm1he exlltiiJafl#I postuft.·R.eaommmct cliDic:aJ COl'ielatianwilhatleattoa to Sae •Cllil caulcl hcatllidgmare tt.:L4d L5 n_...roots;.DIDI'& prom!DQ!dy onihe tior.tcuicm position. • • • •

    . .

    Japprcdatethe opportanlt:7tobeta111Dffl!Cl hi thoeareol"701II" p.uat.

    MANUEL ROS£,MD

    Diploma"', Americc Board of .RadiQloo

    RaclioJo41Specialist. P.A..


    ._,. ..

    I

    ' ,

    M1Udmw

    dd- B/14/09

    dt- I/J.4/09

    .

    .. LO

    This document has n electrohicaDy signed and app ed


    Upright MRI • 1.&T MRI • 16  CT• X,&y•Ultrasound• Mammo• DEXA •

    Ph,slcal Adllnn: ·Blllln!!fP,tyment Adtlteff:

    Rose RON Radiology

    4133 WOOdlands Pkwy P.O. Bc1x 8S0001

    Palm Ha,t,ar, FL 34885 • :Orfando, FL 32885-0304 · •

    .....

    1. i


      22

      11150




      .._,/

      ...&.

      ·.:-•

      :.,.:.;.:.?...-



      Q

      f

      .. ..


      aa,--.,

      .. 1or::..•

      ROSE RADIOLOGY - Boor RANCH

      ThelrnAglng Ctntar•tBoo1.Rlftell

      Harne of Plollda's \stStilnd-Up, 'MIQh Fit/ Opet1MRI

      • .,..,o.a.../t Oa,N

        · ■IIRDsLcDII

        l'•o ('727) ffl JIII 111: (7%'7)711- l


        DA'l'JtOFEXAM: PA'DENTNAME: ACCoUNT: P11p:2.

        08/W2009 GI M


        ..,.. ....,

        OVJl:R.W.,IMPRIIISJON: .

        1. PocaJ pratnllicms attie1.4:-.$ aud LUJ. lMI.AQclffu coul beatfadingtbo aitlljngIA and LS nerve soots. Tltese

          · aric,ear l:D 'bemildlJmme prombMnt whm conipnd la the prt,::,r cum.1rom Odaber, 2001 Recommmd-cli1lica1

          ·

          carrei.tion wi1b dlmlioJa totaeL4and LS acrveniofl.

        2. No,pjllll1teaa,t, armuaes orellhmidngabacmmlity areidcal16ed.

.

    • r apprealatathe opportunlyto bebmlMd in tlaeCDJ"Do£,,.,..patient. ·.

      MANUBLR.OSE, MD

      D!pJamatt, ADMricaoJ3om oflbdiolo&'I'

      Radlolo118pecia&,t,t.A.

      MR/dm.w

      dd- B/l4JD9

      -cit- 111/409


      ).

      <...


      This ocumenthas been.electronicaBy elgned and approYed

      . - _.:i. ,•. "".:.

      : I ••


      .

      ........

      .



      Updght MRI t 1.81'MR! • 18 Slice CT 4 X-Ray Ullnmound •    DEXA • Pain Management & lntarvenllonal

      P/ryslt:al Addtmr. Bll/lnlJIPllplHAddn!s:s:

      Rose Radiology Rose Ra . .

      4'138 WOOdlande PkWY, P.O. Box 850001

      Pam Harbor, FL 34885 Ol1ando, Fl 32885-0304


      t. d

      11151

      .•1 'It I'• n PI Rd(,t•I IIUUI, 01 •u

      ----- 23




      froa:r.entro.1 Iuging Opet

      Central aging II't.gh· F !    

      . .


      PATIENT NUMBER:

      .PAllcNT:

      DAiE OFBlRTH!


      ·ro:3872489


      GI M:

      1996 P.lm/002 -

      ..

      --

      PHYst(lAN:


      DATE: .

      • EXAMINATIQN:

MICHAELP. SPUZA, MD

8/27/2008

MRI OF.THE a,lVICAL spIN!'wmtOVT C: I M'RAST

. iECHNIQUE: TI.W 1tnagi=s along' Wll1\ sag--.r MPGR. lmages.ani:I ,ndel ,, PGR lmagas and ax111·n. and 12W

Images 'Ml'8 obtained lhrvu;h the c:ll!l'Yk:al spine. , •

P.INDINGS! The lnb!M!lrblbraJ discs.1"am O•T-1 thrriugh C2·3 ID ap J Ill" w!tllln narmal llmlts. Nq disc

hemlal'lons an: ldenUfted. The splnaJ cord end theall AC:. appee I within nannal limits. No bony

abnormallfes are lderlffled.

. --··-- .. - ··----

XMPRE!SSIDN: NORMAL MRl OF11ie CERVICAL SPJNE.

lhankyau farlhls referral.

,,.-..-.. •..

. -> - '"-'

,:..,. • . • •• ..-v.. f ' '

•• , I •• ......... • '\ • I


. S1ephen C. Anderson, M.D.

Amer1can of Radlcilogy

T::

. ,Sydcm .. -- - .

o:OSJ/.28/08 f»/28(01


-11152



fAmN'l' NAME: DATJOFEXAM: lW'ER,BiNG PHYSlCIAN: B'iFERltJN.9 OFFICE:

PEIOORMIP AI;

Physicia11s Group, Lt.C '·

\

Mtu:

Non?:Bidaes Ave

T•wnpa,tL

. 8U•'ISH886


Q ,M

1129/0B

VALENIT· Lc.,y

ST m'ERSBURG

. .

.

. . .

MIUSCAN OF Dm L'Ol\Q.Ak SfD:B.!t--

Con,nal seout vie.w exbibita m.ild s=oltosi.s ccnvex. to.the left -- -


··· ·•·

-..

agJ.t!!lf i_maps revcal.wetl-4lliM'l ma!ViQJl-1 ... bral bodi with retention of a. normal

' l0>-d1JtiC curVe of ilnl' ltmlblir 'ipilio. P l'l!b'll-bCJdy)ldlllOW'aipal·- 'morpholo§

. are appt"OJJriate throughout. Con mednilanc and pmvertcbraJ so1t Cissur,s arenormal.·

. .

.

lbnsvc:rao images show the following:·

.

· L1-r.2. t.2•0 7 and U-L4-tbesc disc,are POIJllll,

.

tA-LS.- there is anu1d buJae with cprce dehydration.

to •

--cn ·.:.._ o.t'CJs· .mltd'diao blilp -lt-1:"t _.oftll iot' lu.t·to1b ript.ofthe .·

protrusi ere is·no gnUi t cO!tta.ct

anterior theca1 sac or the ner.vo root . ·

nuatmc-;-Acconlp8n)'iM 'lbts·dls t,u1go·1r a.1ffl,ac,\ blffd. betniJod-uiae «11 w«ll' , -- ··


..aieevea. .. . · . :--

. l1'flRRSSl0N:. (

1•. .·. At 1, there. is m .'lrJigtng with signffl spinal or neural!

·.

. t.lnarrowing. A. N··tbia disc bulge is e..small.disc hemlation•

. .. · t.o ri;ht,,sidad with a.•of the poST,ecjor anmiliJa. ·

-

2. W . tkere is a mild- dis bulge.· }-,· .· ·


-· ·- '•


•.

. . - . -- .,....

. /-J'l ..

Dolll"cl - ed erican Board f Radtology

PJMI1bpm080t300710S3B


.,

/

.J


11153


STATE OF FLORIDA

DIVISION OF ADMINISTRATM HEARINGS DEPARTMENT OF HEALTH,

Petitioner,


v.


DOAH CASE NO. 11-5691PL DOH CASE NO. 2008-20661


DOAH CASE NO. 11·5692PL

DOH CASE NO. 2010-01128


JACINTA IRENE GILUS, M.D.,


Respondent.


PmTIONER'S OBJECTION AND RESPONSE m RESPONDENT'S· EXCEm<>NS0 TQ RECOMMENDED FINAL ORDER

The Department of Health, Petitioner, files this Objection and Response to Respondent's letter to Joy Tootle, Executive Director for the Rorida Board of Medicine to the extent that this letter is deemed to be Respondent's Exceptions to the Recom_mended Final Order (RO) flied by Administrative Law Judge R. Bruce McKibbon (AU), on February 3, 2012, and states:

  1. Rule 28-106.217 Florida Administrative Code (FAC) sets out the requirements for ffling exceptions to recommended orders as follows:

    2s-106.212 Exceptions and Responses

    1. Parties may file exceptions to findings of fact and conclusions of law contained in recommended orders with the agency responsible for rendering final agency action within 15 days of entry of the recommended order except- in proceedings conducted pursuant to Section 120.57(3), F.S. Exceptions shall identify the disputed portion of the recommended order by page number and paragraph,


      --7894------------------------------1




      ! 2.


      shall Identify the legal basis for the exception, and shall indude any appropriate and specific citations to the record.


    2. Exceptions Shall be provided to all parties by facsimile or electronic mall, If number or address Is provided, the day they are filed with the agency.


    3. Any party may file responses to another party's exceptions within 10 days from the date the exceptions were filed with the agency.


    4. No additional time shall be added to the time llmlts for filing exceptions or responses to exceptions when service has been made by mail.


      Whtie this letter was filed with the Agency, it was not served on Counsel


      for Petitioner as required by Rule 28-106.217(2). Counsel for Petitioner received this letter on February 29, 2012, from the Agency.

      1. This letter appears to take exception to the Al.J's recommended order; however, It fails to Identify the disputed portion of the recommended order by page number and paragraph, identify the legal basis for the exception, or lndude any appropriate and specific citations to the record as required by Rule 28-106.217(1).

      2. The Board of Medicine may reject or modify a Recommended Order only as


        allowed In Section 120.57(1)(1), Florida Statutes (2009), which provides as follows:


        (I) The agency may adopt the recommended order as the final order of the agency. The agency in its final order may reject or modify the condusions of law over which it has substantive jurisdiction and Interpretation of administrative rules over which It has substantive jurisdiction. When rejecting or modifying such condusion of law or Interpretation of administrative rule, the agency must state with particularity Its reasons for rejecting or modifying such conclusion of law or. Interpretation of administrative rule and must make a finding that Its substituted conduslon of law or interpretation of administrative rule Is as or more reasonable than that which was rejected or modified. Rejection or modification of condusions of law may not fonn the basis for rejection or modification of


        2

        7895                                                    





        findings of fact. The agency may not reject or modify the findings of fact unless the agency first detennines from a review of the entire record, and states with particularity In the order, that the findings of fact were not based upon competent substantial evidence or that the proceedings on which the findings were based did not comply with essential requirements of law. The agency may accept the recommended penalty In a recQmmended order, but may not reduce or increase It without a review of the complete record and without stating with particularity its reasons for doing so in the order, by citing to the record in

        Justifying the action.

      3. Respondent has asked the Board to reject or mocl1fy not only concluslons Of law, but also findings of fact; however, Respondent has not satisfied the requirements of Section 120.57(1)(1)

      4. The Board and the Administrative Law Judge (AU) have very distinct, but


        equally Important, roles In fonnal administrative hearings. It is the AU's function to consider all the evidence presented, resolve conflicts, assess credlbl!ity of witnesses, draw permissible inferences from the evidence, and reach ultimate findings of fact

        based upon competent substantial evidence. Heifetz v. pept. of Business Regytatton. 475 So. 2d 1277 {Ra. 1st DCA 1985); Goss v. Disbict School Board of St. John's C.Ountv, 601 So. 2d 1232 (Ra. slh DCA 1992); Cenac y. Florida State Board of Accountancy. 399 So. 2d 1013 (Ra. 1981); and Bejarano v. Department of Education. pjyjsion of

        Vocational Rehabllltat;on, 901 So. 2d 891, 892 (Fla. 4th DCA 2005). This is not the province of the Board and is dearly the exclusive purview of the AU. The All in this case

        fulfilled his role and the Respondent's request that this Board make ultimate findings of fact by reaching different facts or altering the facts found by the ALI Is improper.

      5. The Board's role is to review the entire record and the Recommended

        Order, determine whether there Is competent, substantial evidence to support the


        3

           7896 _j


        findings of fact that were made; whether the conclusions of law that are within the Board's substantive jurisdiction are correct; and whether the penalty should be reduced or Increased, based on a review of the entire record and findings that justify such a reduction or increase. Petitioner only reiterates these roles because of the unique exceptions that Respondent asserts regarding adding evidence to the record, adding/altering findings of fact and then changing conduslons of law based on these added or altered findings of fact.

      6. Respondent does not plead with specificity what findings of fact she is taking exception to. All the findings of fact of .the AU are supported by citation and competent substantial evidence.

      7. Respondent does not allege that the AU did not have competent substantial evidence to make the findings of fact. It Is the All's function to consider all

      the evidence presented, resolve conflicts,· assess credlblllty of witnesses, draw

      I .

      permissible inferences from the evidence, and reach ultimate findings of fact based


      upon competent substantial evidence, which this ALJ did.


      3. Respondent argues facts not in evidence. The Board can only consider


      the evidence which was admitted at the hearing.


      Wherefore, Petitioner requests this Board dismiss and not consider Respondent's letter because she failed to plead her exceptions as required by Rule 28-106.217(1) FAC. In the event this Board does not dismiss Respondent's letter, Petitioner requests this Board to sb'lke all documents and statements presented by Respondent In her letter


      4

      7897


      or attached to her letter which were not presented or admitted as evidence at the hearing. Further, Petitioner requests that all Respondent's exceptions be rejected for the reasons set forth above.

      Respectfully submitted,

      Shlrley

      s .44ffi5--

      Assistant General Counsel Florida Bar Number 946311 Department of Health Prosecution Services Unit

      4052 Bald Cypress Way, Bin #C-65 Tallahassee, Florida 32399-3265

      {850) 245-4640 telephone

      {850) 245-4681 Fax


      . Cl:RTIFICATE OF SEBYICE


      I CERTIFY that a copy of Petitioner's Objection and Response to Respondent's "Exceptions" To Recommended Final Order has been furnished to: Jacinta Irene Gillis, M.D., 12446 Pebble Stone Court, Fort Myers, Florida 33913 by U.S. mall and e-mail (medcare2Q01@yahoo.com) this 1st day of March, 2012.


      - 7898 J




      . .

      Date February 19, 2012


      Attention J y Tootle, Executive Director Board of Medicine

      Department of Health 4052 Bald Cypress Way Tallahassee, Florida 3 399


      HcrJlOttlE BOA"Rti

      -...,

      2112 ft;;B 2, IIH 3: SI

      RE: URGENT REQUEST FOR HEARING BEFORE ALL MEDICAL BOARD MEMl:SERS PRIOlt TO RULING IN BOARD OF MEDICI-NE vs. JACINTA IRENE GILLIS, M.O., DOAH CASE NOS. 11-5691PL ANO 1 ·5692PL

      AN INJUSTICE AND INTENTION DISREGARD TO THE TRUTH EXISTS IN.THIS CASE. ANO, J, DR. GILLIS, HAVE BEE DENIED THE RIGHT FOR THE TRUTH TO BE HEARD AND MY FATE DECIDED.

      I AM HUMBLY ASKING THE BQARD TO HEAR ME IN PERSON UP FRONT SO THE DE REPANCIES IN WHAT HA BEEN SAID CAN BE CONFRONTED.

      THE JUDGE RULED ON ARGUMENTS BASED·oN THE DIAGNOSIS AND TREATMENT

      . OF INTRACTABLE PAIN WHEN THE CASES ARE ENTIRELY ABOUTTHE DIAGNOSIS AND TREATMENT OF PATIENTS WITH CHRONIC PAIN. TERMS SUCH AS HISTORY ANO PHYSICAL WERE SAID TO NOT EXIST DESPITE THEIR PRESENCE. EXCESSIVE WAS COINED INAPPROPRIATELY IN REFERENCING ITS USE IN THE APPLICATION OF MEDICINE.

      Law enforcement fraudulently filed criminal allegations and fraudulently filed

      · malpractice allegation against Or. Gillis. The criminal allegations are presently up for dismissal due to laek of merit. Law enforcement made over 80 fraudulent counts without merit about Dr. Gillis' practice habits. The DOH's Attorney, not

      having any medical background, easily eliminate allcounts except 10. The 10 counts left require medical kn wledge to determine validity. I am not interested in suing the DOH for damages, and .it is this feat that keeps these 10 counts in dispute. I just want my life and livelihood restored. Bottom line Is Law


      L1s99

      P_·_'----


      Enforcement intentionally sought out to destroy me. It's Law Enforcement that abused their power. And, it is law enforcement that is underestimating the board's ability to detect frauq,

      THERE IS NO JUSTIFICATION FOR A.NY OF THE ALL GATIONS.


      Respectfully,


      12446 Pebble stone ct


      Fort Myers, Fl. 33913 CELL-139 362 6220.


      ISSUES RELATED TO CASE 2010-01128/00AH CASE NO. 11-5692


      STATEMENTS ON EACH COUNT ARE NOT SUPPORTED BY INFORMATION IN CHARTS. THE MEDICAL RECORDS CONTAIN INFORMATION CONTRADICTING STATES ALLEGATIONS.

      PLEASE REVIEW EACH PATIENTS RECORDS TO CONFIRM OR DISMISS ALLEGATIONS PERTAINING TO DR. GILLIS' CARE FOR EACH PATIENT DISCUSSED.

      PATIENT MG IS DISCUSSED IN THIS CASE. COPY OF MEDICAL RECORDS ENCLOSED. COUNT ONE: NOT VALID

      1. Dr. Gillis never diagnosed a Pt. MG with intractable pain. Dr. Gillis diagnosed and treated patient for Chronic Pain.

      2. Pt. MG was titrated down to a lower dose of pain medication while under care of Dr. Gillis. Pt. MG had high tolerance. Pt. MG was taking 400 tablets per


        L1900 --.1


        month of Oxycodone prior to coming to Dr. Gillis. Dr. Gillis had decreased patient down to 240 tablets per month Immediately. Thus, usfng the term excessive for Pt. MG based solely on number without considering patient's baseline and tolerance is Inappropriate. Pt. MG had a long history of pain management and surgery since 2007 related to Chronic back pain.

      3. Pt. MG was counseled and referred to psychiatry. Patient was seeing an Orthopedic Surgeon that performed his surgery In Nov. 2008 for follow up regularly and patient was seen bv. a neurologist for issue of seizures during course of care under Dr. Gillis.

d Dr. Gillis orders UDS when patient presents with dinical signs suggesting that abuse may be occurring. Dr. Gillis has in the past requested patients to do Urtne Drug Screens when behavior or presentation Is questionable.

COUNTTWO: NOT VALID


THE DEFINITION OF LEGIBILITY IN REGARDS TO MEDICAL PRACTICE IS

CLEARLY DEFINED IN 458.331{m) all of the aspects Identified are visible and clear in the medical record. Dr. Giltis and The States Expert, Dr. Gerber, agreed on day 2 of questioning that leglbillty was not an issue.

COUNT THREE: NOT VALID


  1. Pt. MG. never was prescribed an excessive amount or inappropriate amount. Pt. MG baseline dosage for oxycodone was 40% higher prior to coming to Dr. Gillis. Under Dr. Gillis' re patient was being stabilized on lower doses of medication. Saying excessive without knowing a patients basellne and tolerance is inappropriate.

  2. Pt. MG was referred to psychiatry. And Dr. Gillis had an ongoing patient- physician relationship monitoring patient closely_. Patient was advised about how

    .this might benefit him in his care. Patient never went to psychiatry. Patient did receive counseling/education about his medical problems with an retired Orthopedic on site at Dr. GIiiis' office. Patient was still seeing Dr. Nucci, his Orthopedic Surgeon throughout 2008 and 2009 for ongoing surgical concerns.


    --7901     .




  3. Urine Drug Screens were not clinically Indicated since patient MG didn't exhibit any signs to Indicate abuse was a concern.

  4. Pt. MG was injured in 2007 and had a long history of physical therapy/occupational therapy, pain management, and was being actively seen by an Orthopedic Surgeon while under care of Dr. Gillis. Pt. was being seen by Dr. Gillls for continued care regarding chronic pain. Psychiatry was recommended by Dr. GIiiis since it was felt patitnt would benefit. Patient never went despite

recommendation.


COUNT 4: NOT VALID

  1. No evidence to support excessive existed. Pt. MG tolerance level and baseline dosage was much hl her In 2008 while under care of a prior pain management specialist that was board certified. Dr.Gillis started patient on a much lower dose than patient was accustomed to.

  2. Urine Drug Screen Is nc,t mandatory in the State of Florida but patient must consent to drug saeen if requested.

  3. No evidence of excessiveness existed. Pt. MG had long history of chronlc back pain since 2007 with sur.gery November 2008 and with prior pain management by a Board Certified Pain Management physician for control of chronic back pain prior to Dr. Gillis ever seeing patie,it. Dr Gillis provided patient adequate pain management f9r optimal function at a lower dose than the Board Certified Pain Management Physician did prior to her.


CASE 2008-000661/DOAH CASE NO. 11-5961 .


COUNT ONE: REFERING TO PATIENT RS; Please see medical record.


  1. History and physical dqcumented and performed.


  2. In chart Information pertaining to questioping about past surgeries and past medications taken for pc,ln, Patient responded saying h took "Motrin" over the counter. Patients prior tft!atments under re of other specialist spoken


    - 7902 J


    about. Patient denied history of pain management as documented in the process. So Information related to past treatments and medications were explored with patient RS. Patient RS even provided an Orthopedic Physician name "Dr. Wood" as a physiclJn that evaluated him in the past. Patient stated he had a MRI of Neck/Shoulder. Records were to be obtained. Please see History and Physical form completed by Dr. GIiiis.

  3. Patient filled out patient Information form and was asked about medical history Including but not limited to allergies, treatments, past medical problems, past medicines used for pain, etc. Dr. Gillis wrote a note in conjunction about encounter with patient and more detatls on problem presented with and documentation of a physical xam. This supports that an History and Physical Exam was done. And, patient answered questions related to pain to Intentionally deceive Dr. GIilis into believl111 he was In some form of discomfort or pain. Dr. GIiiis asked patient questions that pertained to patient's pain and patient RS voluntarily provided the information regarding history related to pain. Patient also checked he had neck and back pain on Intake form. Patient never told Dr. Gillis he was not in pain. Thu , Dr. Gillis had no reason to not believe patient was not telling the truth. Patient !;fin communicate pain in more ways than one. There are other terms that can be used to describe pain sucb as aching, hurting, feeling bad, describing pain as a pro lem, etc. If a patient Is not in pain a patient doesn't

    answer questions pertaining lP pain, don't sign pain management agreements,

    and don't check boxes that are admissions of pain.


  4. This was patient RS first and last visit and patient described his shoulder pain and limits as they related to him being a carpenter. Pt. RS problem didn't appear to warrant further pain management. Pt. RS was informed to follow up with primary care doctor for future issues and borderline elevated blood pressure.

  5. Past and current treatments were discussed and documented in chart. Pt. RS took Motrin over the cou11ter without relief thus, Percocet was recommended after evaluation and diagnosi on a as needed basis with no refills.


       7903----------------------------- J



  6. Patient RS described problem with shoulder and movement and he displayed it on physical exam.

  7. Treatment for RS was ocumented. Pt RS was advised to take one tablet up three times a day as needed f-or pain. Pt RS was informed of blood pressure concerns that could be followed up with primary care doctor.

  8. Patient RS was advised Jfter first visit to follow up with primary care doctor. Patient testified that he asked if he needed to return and Dr. Gillis said there was no need. Pt RS was diagnosed with Chronlc Shoulder Pain based on information provided to Or. )Ills and evaluation of patient.

COUNTTWO


  1. Pt. RS was diagnosed With Chronic Pain, not Intractable pain. Chronic pain is a valid reason to treat a pa fent even acute pain Is a valid reason to treat pain. So even if Patient RS suffered from transient pain Percocet would still be an appropriate option. People don't overdose on one tablet every 8 hours.

  2. Chronic Pain is a valid reason to prescribe a pill that has an anti- inflammatory component combined with a pain medicine component. People prescribe Percocet when a toQth is pulled or for a sprain ankle if a person can't weight bear and is on crutcheJ. Percocet prescribed once every 8 hours Is not close to excessive.

  3. Patient was spoken to bout what was tried In the past. Patient stated Motrln was the medication used. Thus a combination pill was a step up for trial purposes. Pt. RS was advised.to follow up with primary care.

  4. Pt. stated he was takin, motrln as needed and it was not hefping. Thus a pain medicine with combinat!pn therapy was initiated. If he had never tried an anti-Inflammatory then that would have been tried solely.

COUNT3


  1. Chronic Shoulder pain Is a valid and justifiable diagnosis based on patient's information he provided. Patient stated he has had the pain for a year.


    7904 J


  2. History and Physical w,s performed and documented by Dr. Gillis and patient Information and pain Tanagement agreement were oompleted by Patient RS.

  3. Patient RS complete medical history as provided by patient directly is in chart.

  4. No urine drug screen wr,s done since patient had no history to indicate one

    •'

    was indicated at that time. Pcttlent RS was clinically appropriate and thus suspicion for abuse was not aP.plicable.

  5. Pt. RS was djagnosed and treated for Chronic Pain, not "Intractable painn. Chronic Pain Is a Justifiable di gnosis to treat with pain medication. Chronic Pain Is documented and based on th',l duration patient proclaimed that problem existed. Intractable would not be an a proprlate diagnosis_ for this patient at this time. Therefore, allegations related to Intractable Pain are non-applicable.

COUNT 4: REFERENCING PATIENT DH CHART


  1. Patient DH has a compt,te history and physical documented in chart.


  2. Pt. DH filled out informitlon form regarding pain problem and elaborately wrote 11Severe Lower Back PaJn with weakness In knees". Patient DH signed a pain management agreement.


  3. Patient DH stated he ha history of treatment with oxycodone and muscle relaxers since a motor vehicle accident two years prior.

    .

  4. Pt. DH was asked to de rlbe pain and rate pain. His response confused Dr.Gillis. Dr. GUils did ask further questions to clarify the confusion which made her suspect that patient had s<>me expressive problem or disorder which she clearly documented in the no es. Pt. in retrospect was being evasive. Unfortunately, rating pain is difficult for many to do correctly, thus patients answer was contributed to a mental deficit or lack of education that might have existed. But upon second encc>unter Dr. GIiiis readdressed the pain level issue and asked for clarification an(t patient did state that it was zero out of 10 with treatment. And, patient on second visit stated that "treatment was working" for

    L19os

    f"'1



    his pain when asked. Noneth,less, Dr. Gillis felt patient was not a candidate for long term pain management and requested patient not to return. Patient also failed to assist in getting his r cords to the office in a timely fashion as requested on both visits by Dr. Gillis.

  5. Dr. Gillis used the term pain when asking patient questions at all time. Patient voluntarily answered all questions pertaining to pain. Patient expressed that In the past he was treate with oxycodone and musde relaxers without success. Patient DH never denied having pain, despite him claiming he never said the word "pain". Patient DH spent the entire time providing answers related to pain and extensively wrote out on his patient information sheet that PURPOSE OF VISIT was "Severe low back pJiin-weakness in knees". Dr. Gillis had no basis to

    accuse patient of lying about pain or problems related to pain. Physicians can be sued for not addressing pain r under treating pain.

  6. Patient DH expressed lfficulty functioning physlcally on job secondary to pain. Dr. GIiiis asked patient ow the pain was affecting him? He voluntarily answered and never stated h did not have pain despite being glven many opportunities to do so. If a p rson is not or never was in pain why Is the patient providing Information in relation to episodes of pain.

  7. Patient DH. was diagno,ed with Chronic Neck and Back Pain and placed on a trial of low dose oxycodone and anti-inflammatorles since patient did state he was on oxycodone in the past. If patient had no exposure to pain medication he would have been prescribe Percocet or vicodin to begin which is an acceptable next step after trying antl-inflammatories alone.

  8. Patient DH records werre to be obtained with patient's assistance In providing the correct information. However, since Patients records were not still available on second visit pati nt was reprimanded and requested not to return for further care. Patient was only prescribed one tablet every 6 hours as needed for oxycodone. One tablet for sQmeone in pain every 6 hours as needed is not excessive and there Is no case or information supporting that this is a toxic level for even an opiod naive patlept. Pt DH was also given a prescription for Motrin one tablet three times a day.


_7906 ,



COUNTS


  1. Pt. DH was diagnosed with Chronic Pain Syndrome. Pt presented with complaints -related to neck and back as documented in chart. Pt was not diagnosed with Intractable p ln. Chronic pain and intractable pain are two different things. Intractable pain would be an inappropriate term to use without further Investigation and prior records available. Based on patients history of suffering the term Chronic Pain was applied.

  2. Patient was diagnosed with Chronic Pain which is a justifiable diagnosis to

    be treated for pain.

  3. Pt. DH attests to the fact that in the past he was treated with Oxycodone for some duration after a Motor Vehicle Accident 2 years prior. Pt DH expressed suffering related to working cts a laborer. Stiffness was mentioned when patient was asked to elaborate more n pain. Stiffness Is a common term used with patients describing their discomfort related to pain and It symbolizes a form of difficulty functioning, Patient was given opportunity to deny pain but never did. Instead, patient was eager to elaborate about a dramatic motor vehicle accident and location of pain and history of treatments due to pain and how they helped or didn't help which is all documented.

  4. Patient wrote on patient information he was suffering from "severe lower back painH and he exhibited signs of difficulty when asked to perform various maneuvers. Neither officer could recall the complete physical exam in detail and neither officer was educated to understand the significance behind performing

any of the tasks requested. Thus, to mention a few movement an officer can

recall and disregard their admission to not remembering all of the exam and its purpose is a sign of bias. They both testified that an exam was done and in fact one officer was requested to disrobe for further evaluat(on.

COUNT6


  1. Patient DH was diagnosed with Chronic pain syndrome with focus on back and neck which is a valid diagnosis to Justify prescribing pain medication.


    1 7907                                               


  2. Patient DH has a complete history and physical on chart on first visit.


  3. Patient filled out information form an_d provided Dr. Gillis with history related to motor vehicle accident and history of injury for 2 years, with history of treatment with pain medication, etc. On second visit patient provided Dr.Gillis with a Physician name where records were available. Patient DH still never denied having pain and continued to fabricate stories to manipulate Dr. Gillis into treating him. However, due to patients unwillingness to comply with Dr.Gillls' record request and was asked not to return by Dr. Gillis.

  4. Urine Drug Screen was not done since patient DH didn't exhibit any signs of abuse or suspicion related to abuse.

  5. Patient was diagnosed with Chronic pain syndrome prior to being prescribed a controlled subs nce on a trial basis. Patient was advised on second visit for follow up not to return due to lack of cooperation with records. Treatment is on a trial basis and documented response to treatment is always recorded to determin benefit of continued care. Patient OH was determined not to be a candidate for long term care in regards to pain.

In retrospect the end results af both officers treatments were correct. They both attempted to deceive Dr. Gilli . But Or. Gillis used Instinct and good medical decision making to conclude that neither officer was qualified to continue pain management under her care. Dr. Gillis Is not a psychic. There are many patients that undergo exploratory laparotomies before a doctor realizes a patient Is malingering. Dr. Gillis diverte abuse within one or two visits without subjecting patient to extreme measures (elated to both officers fraudulent behavior. If the

officers wanted to determine !f Or. Gillis was treating patients for non-medical

reason or unethical reasons, all they had to do was deny pain and be honest and watch what happened next. These officers intentionally sought out to en rap Dr. Gillis and when she passed the test they fabricated allegations of malpractice. Is believing a patient's complaints, evaluating and treating a patient based on his complaints malpractice? The board will be subjecting a good, morally sound,

competent physician to an extreme punishment if the board rules to punish Dr.

GIiiis for recognizing and dive11ting abuse. If the board looks at any physicians Q

f·. (

   7908 --..I


records you can probably find anything to complain about.. In Doctor Gillis' case a warning to document more would be appropriate and maybe suggesting a course on current treatment in Pain rnedtclne would be more appropriate. But to accuse Dr. GIiiis of caqsing harm or being a danger when not one prescription could support allegations of excessiveness or lethal dose and there is no history of any patient ever being harmed whlle under care of Or. GIiiis would be unjust and excessive. I am a single parent of 2 young children that depend on their mother to be able to maintain her profession. Can the board honestly say that there is any form of malpractice? Can the board say that Dr.Gillis' dosages prescribed were dangerous and caused harm? Can the board say that Dr. Gillis prescribed Patient MG and excessive amount of medication when patient MG had a high tolerance and was on 400 tablets of oxycodone for almost a year prior to Dr. GIiiis titrating his medication down. Please review the allegations and look at the records. The medical records confirm all that I am saying. The rumors and stories related to my case and eyen the twisting of wor s during the hearing were unnecessary. We -should be IQoking at the facts which are evident in each patient's medical-record. Medical records from all physicians that provided care should be admissible. Please see all enclosed records for Patient M.G.

I am innocent and_ I am prayerful the Medical Board wlll look at the facts and disregard all the dramatization around my case. I have been subjected to news exposure for no reason. I don't want fame. I want my llfe back. I want to regain my ability to provide for my family and I want to continue to help the underserved by providing quality care. I valued my license. J understand to practice medicine is a privilege. And, it's a privilege I never took for granted. I live to uphold the Hippocratic Oath to do no harm.


12446 pebble stone court"

Fort Myers, Florida 33913 239 362 6220

_7909          _


STATE OF FLORIDA DEPARTMENT OF HEALTH


DEPARTMENT OF HEALTH,

Petitioner,


v. DOH case Number 2008-20661 DOH case Number 2010-01128 DOAH case Number 11-5691PL DOAH case Number 11-5692PL

JACINTA IRENE GILUS, M.D.,

Respondent.


\


MOTION JO RETAIN JURISDICTION TO ASSESS COSTS

IN ACCORDANCE WITH SECTION 456,072{41

The Department of Health, by and through undersigned counsel asks the Board of Medicine for the entry of an Order retaining jurisdiction to assess costs against Respondent for the Investigation and prosecution of this case in accordance with Section 456.072(4), Florida Statutes (2003). Petitioner states the following in support of the request:

  1. At its next regularly scheduled meeting, the Board of Medicine will take up for consideration the above-styled dlsciplinary action and will enter a Final Order therein.

  2. Section 456.072(4), Florida Statutes (2003),1 states as follows:


    In addition to any other discipline imposed through final

    ----

    order, or-

    citation, entered on or after July 1, 2001,

    1 Ch. 2003-416, § 19, Laws of Fla., effr.ctive September 15, 2003, amended Section456.072(4), Florida Statutes (2003), to include the underlined language.


    7974


    _..


    pursuant to this section or discipline Imposed through final order, or citation, entered on or after July 1, 2001, for a violation of any practice act, the board, or the department when there is not board, shall assess costs related to the investigation and prosecution of the case.

    such costs related to the investigation and prosecution include. but are not limited to. salaries and benefits of

    personnel. costs related to the time spent by the attorney and other personnel workjng on the case. and any other expenses incurred by the department for the case. The board. or the department when there is no board. shaH determine the amount of costs to be assessed after its consideration of an affidavit of itemized costs and anv written objections thereto. . . • ( emphasis added)

  3. The investigation and prosecution of this case has resulted in costs in the total amount of $80,181.99, based on the following Itemized statement of costs: 2008-20661 2010-01128

    1. Total costs for Complaints $103.47 $138.69

      b. Total costs for Investigations $11,131.32

      $2,258.89

      c. Total costs for Legal $33,042.58

      $26,197.03

      d. Total costs for expenses $3,261.53

      $4,042.06

      e. Total costs t.or Compliance $6.42

      $0.00


      as evidenced in the attached affidavit. (Exhibit A).

  4. In the event Respondent's ncense is suspended, as is recommended by the Administrative Law Judge, Respondent will no longer be able to practice medicine In Florida until she demonstrates to the Board that she is competent to practice medicine.



    2


    - 7975 --..ill


  5. In order for costs to be assessed against Respondent, under the current case law, the Department is required to obtain an opinion from an outside attorney that the costs incurred are reasonable. This would cause the Department to incur even more costs related to this case.

  6. The Department believes It is unlikely to recoup any of these

    costs until Respondent's license is reinstated.

  7. Petitioner requests that the Board grant this motion and retain jurisdiction to assess costs against Respondent in the event that her Florida medical license is reinstated.

WHEREFORE, the Department of Health requests that the Board of Medicine enter an Order retaining jurisdiction to assess costs against the Respondent in the event that her medical license in Florida is reinstated.

Respectfully submitted,


Shirley eat-es

Assista eneral Counsel Rorida Bar No. 946311 Prosecution Services Unit Department of Health

4052 Bald Cypress Way Bin-C-65 Tallahassee, Florida 32399-3265

(850) 245-4640, Ext. 8147


3


-7976


CERTIFICATE OF SERVICE

I HEREBY CERTIFY that a true and correct copy of the foregoing . Motion to Assess Costs has been furnished via certified mail to Jacinta Ir Gillis, M.D., 12446 Pebble Stone Court, Ft. Myers, FL 33913 this

day of February, 2012.


4

7977                    



,.


AFFIDAVIT OF FEES AND COSTS EXPENDED


STATE OF FLORIDA COUNTY OF LEON:


BEFORE ME, the undersigned authority, personally appeared SHANE WALTERS who was sworn and states as follows:


  1. My name is Shane Walters.


    --

  2. I am over the age of 18, competent to testify, and make this affidavit upon my own personal knowledge and after review of the records at the Florida Department of Health (DOH).


  3. I am the Operations and Management Consultant Manager (OMCM} for the Consumer Services and Compliance Management Unit for DOH. The Consumer Services Unit is where all complaints against Florida health care licensees (e.g., medical doctors, dentists, nurses, respiratory therapists) are officially filed. I have been in my current job

    ·• position for more than one year. My business address is 4052 Bald Cypress Way, Bin C-75 Tallahassee, Florida 32399-3275.


  4. As OMCM of the Consumer Services and Compliance Management Unit, my job duties include reviewing data in the Time Tracking System and verifying that the amounts correspond. The Time Tracking System is a computer program which records and tracks DOH's costs regarding the investigation and prosecution of cases against Florida health care licensees.


  5. As of today, DOH's total costs for investigating and prosecuting DOH case number(s) 2008-20661 and 2010-01128 (Department of Health v Jacinta Irene Gillis, M.D) are EIGHTY-ONE THOUSAND TWO HUNDRED SEVENTY-NINE DOLLARS AND THIRTY-SIX CENTS ($81,279.36).


  6. The costs for DOH case numbers 2008-20661 and 2010-01128 (Department of Health v. Jacinta Irene Gillis, M.D.) are summarized in Exhibit 1 (Cost Summary Report), which is attached to this document.


  7. The itemized costs and expenses for DOH case numbers 2008-20661 and 2010-01128 (Department of Health v. Jacinta Irene Gillis, M.D.) are detailed in Exhibit 2 (Itemized Cost Report and Itemized Expense Report and receipts), which is attached to this document.


7978


1 of2

.....





B) The itemized costs as reflected in Exhibit 2 are determined by the following method: DOH employees who work on cases daily are to keep track of their time in six-minute increments (e.g., investigators

and lawyers). A designated DOH employee in the Consumer Services Unit, Legal Department, and in each area office, inputs the time worked and expenses spent into the Time Tracking System. Time and expenses are charged against a state health care Board (e.g., Florida Board of Medicine, Florida Board of Dentistry, Florida Board of Osteopathic Medicine), and/or a case. If no Board or case can be charged, then the time and expenses are charged as administrative time. The hourly rate of each employee is calculated by formulas established by the Department. (See the Itemized Cost Report)


·g) Shane Walters, first being duly sworn, states that she has read the foregoing Affidavit and its attachments and the statements contained therein are true and correct to the best of her knowledge and belief.


FURTHER AFFIANT SAYETH NOT.

.JJ{k(R , ,Ja:fbp_

Shane Walters, Affiant


State of Florida County of Leon

Sworn to and subscribed before me this \5 day of                   ,ao,12012,

ly known to me.

l


Stamp Commissioned Name of Notary Public:


2of2

L 7979


I

II

""'*** Cost to Date ***** I


Hours

I Costs I

Complaint:

0.101 $41.911

jinvestigation:

II

183.5511 $11,192.881

jLegal:

II

30s.soll $33,073.301

!compliance:

II

o.ooll S6.ool


··········I **********I

Sub Total:

490.0St $44,314.091

!Expenses to Date:

II

II $3,780.311

l!rior Amount:            

jTotal Costs to Date:

I11

                                so.ool

1 I $48,094.401



Page 1 of 1

Complaint Cost Summary

Complaint Number: 200820661


Subject's Name: GILLIS, JACINTA IRENE

- 798opps.doh.state.fl.us/lRMOOTIMETRAK/CSDETL.ASP


2/15/2012


Page 1 of 1


Complaint Cost Summary

Complaint Number: 201001128


Subject's Name: GILLIS, JACINTA IRENE

I

II

***** Cost to

Date***** I

I

I

Hours II

Costs I

!complaint:


1.9011

$114.271

!Investigation:


32.1011

$2,283.311

!Legal:

I

241.soll

$26,197.031

lcom liance:

II

0.0011

so.ool

II **********II **********I

lsub Total:

II

216.1011

$28,594.611

jEx.eenses to Date:

II

II

$4,590.351

jPrior Amount:

II

II

so.ool

jTotal Costs to Date:

II

II

$33,184.961


L7981ws.doh.state.11.us/IRMOOTIMETRAK/CSDETL.ASP 2/15/2012



Mltdlcal Qualty ..            

Dhislonol ***CONFIDENTIAL***

MQb_

Time Tncking System Itemized Cost/Expense by Complaint

Complaint 200820661

Report Date: 02/28/2012 Page I of 16

Record Staff Activity Staff Cost/Expese Cost/Es:pense Cost/Expense Cost/Ellpense Code Type Code Hours Rate Amont Date Code Description

lcoMPLIANCE MANAGEMENT UNIT I

Cost

HCJ3

0.10

$32.13

$3.21

0S/18/2011

123

AUDITFlLE

Cost

HC08

0.10

$32.13

$3.21

05/18/2011

119

REVIEWING FO/CITATIONS & TERM INPUT




SubTotal

56.42




Cost

HA124

0.40

$61.55

$24.62

09/10/2008

25

REVIEW CASE FILE

Cost

HA124

0.50

$61.55

$30.78

09/1M008

4

ROUTINE INVESTJGA

Cost

HAJ24

o.so

$61.55

$30.78

09/11/2008

4

ROUTINE INVESTIGA

Cost

HA73

0.30

$57.62

$17.29

10/06/2010

1

ROUTINE ADMINIST




SubTotal

$103.47




lcoNSUMER SERVICES UNIT

TIVE WORK

TIVE WORK RATIVE DUTIES


Cost

PI31

2.00

$63.52

$127.04

10/24/2008

4

ROUTINE INVESTIGATIVE WORK

Cost

Pl31

1.00

$63.52

$63.52

10/30/2008

4

ROUTINE INVESTIGATIVE WORK

Cost

PI37

4.00

$52.71

$210.84

11/03/2008

9004

UL-ROUTINE INVESTIGATIVE WORK

Cost

PI37

2.00

$52.71

$105.42

11/03/2008

9058

UL-TRAVEL TIME

Cost

Pl37

6.00

$S2.71

$316.26

11/07/2008

9004

UL-ROUTINE INVESTIGATIVE WORK

Cost

Pl37

2.00

$S2.71

$105.42

11/07/2008

9058

UL-TRAVEL TIME

Cost

Pl37

6.00

$52.71

$316.26

11/12/2008

9004

UL-ROUTINE INVESTIGATIVE WORK

Cost

PD7

2.00

$S2.71

$105.42

11/12/2008

9058

UL-TRAVEL TIME

Cost

Pl37

6.00

$52.71

$316.26

11/14/2008

9004

UL-ROUTINE INVESTIOATIVE WORK

Cost

PI37

2.00

$52.71

$105.42

11/14/2008

9058

UL-TRAVEL TIME

Cost

PI31

2.00

$63.52

$127.04

11/17/2008

4

ROUTINE INVESTIGATIVE WORK

Cost

Pl37

6.00

$52.71

$316.26

11/17/2008

9004

UL-ROUTINE INVESTIGATIVE WORK

IINVESTIGATIVE SERVICES UNIT


M

Q0

Florida Department of Health - FOR INTERNAL USE ONLY - itemizedcostexpE t'---

Qualty.a-aac•

D1¥bloftal *** C ON FI D ENT I AL ***

MQA...   ---

Time Tracking System Itemized Cost/Expense by Complaint

Complaint 200820661


Report Date:

02/28/2012







Page2 ofl6

Reeord

Staff

Activity

Staff

Cost/Expense

Cost/Expense

Cost/Expense

Cost/Expense Code


Type

Code

Houn

Rate

Amount

Date

Code

Description


Cost

Pl37

2.00

$52.71

$105.42

11/17/2008

9058

U TRAVEL TIME


Cost

Pl31

3.00

$63.52

$190.56

11/18/2008

4

ROUTINE INVESTIOATIVE WORK


Cost

PI31

2.00

$63.52

$127.04

11/19/2008

4

ROUTINE INVESTIGATIVE WORK


Cost

P137

6.00

$52.71

$316.26

11/20/2008

9004

U ROUTINE INVESTIGATIVE WORK


Cost

Pl37

2.00

$52.71

$105.42

11/20/2008

9058

U TRAVEL TIME


Cost

PI31

7.00

$63.52

$444.64

11/20/2008

4

ROUTINE INVESTIGATIVE WORK


Cost

Pl37

6.00

$52.71

$316.26

11/21/2008

9076

UL-REPORT PREPARATION


Cost

Pl31

2.00

$63.52

$127.04

11/21/2008

4

ROUTINE INVESTIGATIVE WORK


Cost

Pl31

1.00

$63.52

$63.52

12/05/2008

4

ROUTINE INVESTIGATIVE WORK


Cost

Pi31

2.00

$63.52

$127.04

12/08/2008

4

ROUTINE INVESTIGATIVE WORK


Cost

Pill

2.00

$63.52

$127.04

12/09/2008

4

ROUTINE INVESTIGATIVE WORK


Cost

PIJl

0.50

$63.04

$31.52

04/13/2009

4

ROUTINE INVESTIGATIVE WORK


Cost

PI31

1.00

$63.04

$63.04

04/15/2009

58

TRAVEL TIME


Cost

Pl31

2.00

$63.04

$126.08

04/15/2009

4

ROUTINE INVESTIGATIVE WORK


Cost

PI31

1.00

$63.04

$63.04

04/24/2009

4

ROUTINE INVESTIGATIVE WORK


Cost

PI31

1.00

$63.04

$63.04

04/30/2009

4

ROUTINE INVESTIGATIVE WORK


Cost

Pl31

3.00

$63.04

$189.12

05/05/2009

4

ROUTINE INVESTIGATIVE WORK


Cost

Pill

2.50

$63.04

$157.60

05/18/2009

4

ROUTINE INVESTIGATIVE WORK


Cost

Pl31

1.50

$63.04

$94.56

05/28/2009

4

ROUTINE INVESTIGATIVE WORK


Cost

Pl31

2.00

$63.04

$126.08

06/11/2009

4

ROUTINE INVESTIGATIVE WORK


Cost

Pl31

1.00

$63.04

$63.04

06/1612009

4

ROUTINE INVESTIGATIVE WORK


Cost

Pl31

1.00

$63.04

$63.04

06/24/2009

4

ROUTINE INVESTIGATIVE WORK


Cost

PI31

0.50

$63.04

$31.S2

06/2612009

4

ROUTINE INVESTIGATIVE WORK


Cost

Pill

1.00

$63.04

$63.04

06/30/2009

4

ROUTINE INVESTIGATIVE WORK


Cost

Pl31

1.00

$63.04

$63.04

07/29/2009

4

ROUTINE INVESTIGATIVE WORK


Cost

PI41

0.75

$59.26

$44.45

09/21/2010

58

TRAVEL TIME


Cost

Pl41

1.25

$59.26

$74.08

09/21/2010

4

ROUTINE INVESTIGATIVE WORK


Cost

Pl41

J.00

$59.26

$59.26

09/23/2010

4

ROUTINE INVESTIGATIVE WORK


Cost

Pl41

0.75

$59.26

$44.45

09/24/2010

58

TRAVEL TIME


Cost

Pl41

2.00

$59.26

$118.52

09/24/2010

4

ROUTINE INVESTIGATIVE WORK


Cost

Pl31

2.00

$65.23

$130.46

09/30/2010

4

ROUTINE INVESTIGATIVE WORK


Cost

Pl31

2.00

$65.23

$130.46

10/01/2010

4

ROUTINE INVESTIGATIVE WORK


Cost

Pl31

6.00

$65.23

$391.38

10/05/20)0

4

ROUTINE INVESTIGATIVE WORK


00

O'\

Florida Department of Health - FOR INTERNAL USE ONLY - itemizedcostexpt r---...

- --· J

MQA

Madi!; anc:•

DMslonof *** C ON FIDE NTI A L ***

Time Tracking System Itemized Cost/Expense by Complaint

Complaint 200820661


Report Date:

02/28/2012







·pale 3 of16

Record

Staff

ActMty

Staff

Cost/E][pese

Cost/Expense

Cos1/Eipenae

Cost/Expense Code


Type

Code

Boun

Rate

AIIIOUDt

Date

Code

Description


Cost Pl41 1.00 SS9.26 $S9.26 10/0S/2010 S8 TRAVEL TIME

Cost Pl41 9.00 $59.26 $S33.34 1O/OSl.2010 4 ROUTINE INVESTIGATIVE WORK. Cost P131 3.00 $6S.23 $195.69 10/06/2010 4 ROUTINE INVESTIGATIVE WORK. Cost Pl31 3.00 $6S.23 $195.69 10/07/2010 4 ROUTINE INVESTIGATIVE WORK Cost P13l 3.00 $67.81 $203.43 10/27/2010 4 ROUTINE INVESTIOATIVE WORK. Cost Pl3J 6.00 $67.81 $406.86 11/08/2010 4 ROUTINE INVESTIGATIVE WORK. Cost PDl S.00 $67.81 $339.05 11/)2/2010 76 REPORT PREPARATION

Cost Fl70 1.00 $67.81 $67.81 0S/18/2011 JOO SERVICE OF ADMINISTRATIVE COMPLAINTS, SUBPOENJ Cost FI67 l.S0 $67.81 $101.72 0S/18/2011 9100 ·UL-SERVICE OF A.C.'S, SUBPOENAS, NOTICE TO CEASE & Cost Fl67 1.00 $67.81 $67.81 0S/20/2011 76 REPORT PREPARATION

Cost PI31 1.00 $67.81 $67.81 08/18/2011 76 REPORT PREPARATION

Cost PI31 1.00 $67.81 $67.81 08/18/2011 6 SUPPLEMENTAL INVESTlGATlON

Cost PI31 1.00 $67.81 $67.81 08/19/2011 IS PROFESSIONAL CONTACTS

Cost Pl31 1.00 $67.81 $67.81 081.22/2011 6 SUPPLEMENTAL INVESTIGATION Cost PD1 2.00 $67.81 $135.62 08/23/201 l 6 SUPPLEMENTAL INVESTIGATION

Cost Fl70 1.00 $67.81 S67.81 09/02/2011 100 SERVICE OF ADMINISTRATIVE COMPLAINTS, SUBPOENJ

Cost Fl70 1.00 $67.81 $67.81 09/021.2011 76 REPORT PREPARATION

Cost PI31 2.00 $67.81 Sl3S.62 09/07/201 l 43 PREPARE FOR DEPOSITION Cost PI31 s.so $67.81 $372.96 09/08/2011 43 PREPARE FOR DEPOSITION

Cost Pl3l 2.00 $67.81 $135.62 09/12/2011 6 SUPPLEMENTAL INVESTIOATION

Cost Pl31 3.00 $67.81 $203.43 09/15/20)] 44 DEPOSITIONS

Cost Pl3l 1.00 $67.81 $67.81 091.29/2011 6 SUPPLEMENTAL INVESTIGATION Cost OBOS 0.40 $67.81 $27.12 09/30/2011 6 SUPPLEMENTAL INVESTIGATION Cost OHOS 0.80 $67.81 $54.25 09/300011 58 TRAVEL TIME

Cost onos 0.20 $67.81 $13.56 09/301.201 l 100 SERVICE OF ADMINISTRATIVE COMPLAINTS, SUBPOENJ

Cost OHOS 0.40 $67.81 $27.12 10/03/2011 6 SUPPLEMENTAL JNVESTIGATION Cost PIJJ 1.00 $67.81 $67.81 10/14/201 l 6 SUPPLEMENTAL INVESTIGATION Cost Pl31 3.00 $61.19 $183.57 11/30/201 l 47 TRIAL PREPARATION

Cost Pl31 2.00 $61.19 $122.38 12/02/2011 47 TRIAL PREPARATlON

Cost Pl31 8.00 $61.19 $489.52 12/0S/2011 48 FORMAL HEARING

Cost PI31 1.00 S61.19 $61.19 12/07/2011 4 ROUTINE INVESTIGATIVE WORK.

SubTotal $11,131.32 00

Florida Department of Health - FOR INTERNAL USE ONLY - itemizedcosteicpE t----


M™"_

*** CONFIDE NTI AL***

DMllol\c,f

Medtcal Qvolly .\MWClll!Ce

Time Tracking System Itemized Cost/Expense by Complaint

Complaint 200820661


Report Date:

02/2812012







Page4of16

Record

Staff

Activity

Staff'

Cost/Eipense

Cost/Expense

Cost/Eq,ense

Cost/Expense Code


Type

Code

Houn

Rate

Amonnt

Date

Code

Description











Cost HLI.A7A 0.40

$112.43

$44.97

06/22/2010

115

CONTACT WITH INVESTIGATORS

Cost HLL83A 0.10

$111.56

$11.16

12/16/2010

25

REVIEW CASE FILE

Cost HLL83A 0.40

$111.56

$44.62

12/17/20IO

25

REVIEW CASE FILE

Cost HLL83A 0.10

$111.56

$11.16

12/17/2010

35

TELEPHONE CALLS

Cost HLLB3A 0.10

$111.S6

$11.16

12/20/2010

35

TELEPHONE CALLS

Cost

HLL83A

0.20

$111.56

$2231

)2/20/2010

115

CONTACT WITH INVESTIGATORS

Cost

HLL83A

0.40

$111.56

$44.62

12/20fl0IO

25

REVIEW CASE FILE

Cost

HLL83A

0.10

$111.56

$11.16

12/21/2010

37

REVIEW LE1TER

Cost

HLL83A

0.20

$1) 1.56

$22.31

12/22/2010

3S

TELEPHONE CALLS

Cost

HLL83A

0.20

$1 I1.56

$22.31

12/2212010

46

LEGAL RESEARCH

Cost

HLL83A

0.40

$111.56

$44.62

01/03/2011

35

TELEPHONE CALLS

Cost

HLL83A

0.20

$111.56

$22.31

01/04/2011

llS

CONTACT WITH INVESTlGATORS

Cost

HLL83A

0.10

$11156

$11.16

01/04/201 l

25

REVIEW CASE FILE

Cost

HLL83A

0.10

$111.56

$11.16

01/05/2011

36

PREPARATION OR REVISION OF LETTER

Cost

HLL83A

0.10

$11156

$11.16

01/05/2011

74

MEETINGS WITH DEPARTMENT STAFF

Cost

HLL83A

0.40

$11 J.56

$44.62

011211201 l

2S

REVIEW CASE FILE

Cost

HLL83A

0.10

Sil J.56

$11.16

04/271201 I

70

CONFERENCES WITH LAWYERS

Cost

HLL83A

0.20

$111.56

$22.31

04/271201 I

70

CONFERENCES WITH LAWYERS

Cost

HLL86A

0.20

$lll.S6

S22.31

04/291201 J

70

CONFERENCES WITH LAWYERS

Cost

HLL86A

0.40

$111.56

$44.62

0412912011

70

CONFERENCES WITH LAWYERS

Cost

HLL86A

0.30

$111.56

$33.47

04129/20)1

25

REVIEW CASE FILE

Cost

HLL86A

4.00

Slll.S6

$446.24

04129/2011

81

ESO/ERO

Cost

HLL83A

5.00

Slll.S6

$557.80

0S/02/201 l

81

ESO/ERO

Cost

HLL84B

3.50

$1 IJ.S6

$390.46

05/02/2011

8)

ESO/ERO

Cost

HLL83A

0.20

$llJ.S6

$22.31

05/03/201 l

70

CONFERENCES WITH LAWYERS

Cost

HLL83A

0.10

$) 1156

$1J.16

05/04/2011

60

MISCELLANEOUS

Cost

HLL84B

I.SO

$111.56

$167.34

05/04/201 I

8)

ESO/ERO

Cost

HLL83A

0.10

$111.56

$11.16

05/09/201 I

35

TELEPHONE CALLS

Cost

HLL83A

0.10

$111.56

$11.16

05/09/2011

70

CONFERENCES WITH LAWYERS

Cost

HLLB3A

0.20

$Jtl.S6

$22.31

05/09/2011

114

CONTACT WITH EXPERTS

Cost

HLL83A

0.10

$111.56

$11.16

05/09/2011

11S

CONTACT WITH INVESTIGATORS

!PROSECUTION SERVICES UNIT -


"'

Q0

0\

Florida Department of Health - FOR INTERNAL USE ONLY - itemlzedcosle,qM t--..

*** C ON FIDE NTI AL***

Dhllloftaf

MQ&

Medlc:cil Qvaltr AuurCIIICe

Time Tracking System Itemized Cost/Expense by Complaint

Complaint 200820661

Report Date: 02/28/2012 Page 5 of 16

Record Staff Activity Staff Cost/Expense Cost/Expense Cost/Expense Cost/Expense Code

Type Code Hours Rate Amount Date Code Description

Cast HLI.84B 0.40 Slll.56 $44.62 05/10/201 l SI ESO/ERO Cost HLL848 0.70 Sll l.56 $78.09 05/10/201 l Sl ESO/ERO Cost HLL84B 0.50 $111.56 $55.78 05/10/2011 81 ESO/ERO

Cost HLL83A 1.50 $111.56 $167.34 05/10/2011 70 CONFERENCES Wl1H LAWYERS Cost HLU3A 0.20 $111.56 $22.31 05/10/2011 ll5 CONTACT WITH INVESTIGATORS Cost HLLS3A 0.20 $111.56 $22.31 05/10/2011 115 CONTACT WITH INVESTIGATORS Cost HLLS3A 1.40 $111.56 $156.lS 05/10/2011 25 REVIEW CASE FILE

Cost HLLS3A 0.10 Slll.56 $11.16 05/10/2011 35 TELEPHONE CALLS

Cost HLL83A 0.30 SI l 1.56 $33.47 05/10/2011 115 CONTACT WITH INVESTIGATORS Cost HLL83A 0.40 $111.56 $44.62 05/10/2011 102 REVIEW EXPERT WITNESS REPORT Cost HLL83A 0.40 $111.56 $44.62 05/10/2011 70 CONFERENCES WITH LAWYERS Cost IaL83A 4.00 $111.56 $446.24 05/11/2011 81 ESO/ERO

Cost HU.84B 4.00 $111.56 $446.24 05/11/2011 SI ESO/ERO Cost HLLS3A 4.00 Slll.56 $446.24 05/12/2011 Sl ESO/ERO Cost HLU3A 0.20 $111.56 $22.31 05/13/201 l St ESO/ERO

Cost HLLSlA 0.10 $111.56 $11.16 0S/13/2011 35 TELEPHONE CALLS

Cost HLL83A 0.40 $111.56 $44.62 05/13/2011 70 CONFERENCES WITH LAWYERS Cost HLLS3A o.so $111.56 $89.25 05/13/2011 81 ESO/ERO

Cost HLLS3A 0.10 $111.56 $11.16 05/17/2011 35 TELEPHONE CALLS Cost HLL83A 0.10 $111.56 $11.16 05/17/2011 35 TELEPHONE CALLS

Cost HLLS3A I.IO $111.56 $122.72 05/17/201 l 2S PREPARE OR REVISE ADMINISTRATIVE COMPLAINT

Cost HLLS3A 1.30 $111.56 $145.03 05/17/2011 28 PREPARE OR REVISE ADMINISTRATIVE COMPLAINT Cost HLLS3A 2.50 $111.56 $278.90 05/1812011 28 PREPARE OR REVISE ADMINISTRATIVE COMPLAINT Cost HLL83A 0.20 $1ll.56 $22.31 05/181201 l 115 CONTACT WITH INVESTIGATORS

Cost HLL83A 1.00 $111.56 SI 11.56 05/18/2011 2S PREPARE OR REVISE ADMINISTRATIVECOMPLAINT

Cost HLL83A 0.20 $111.56 $22.31 05/18/2011 114 CONTACT WITH EXPERTS

Cost HLL83A 0.30 $)11.56 $33.47 05/18/2011 115 CONTACT WITH INVESTIGATORS

Cost HLL83A 1.50 $111.56 $167.34 05/1812011 2S PREPARE OR REVISE ADMINISTRATIVE COMPLAINT Cost HLL83A 0.10 $111.56 $11.16 05/18/2011 114 CONTACT WITH EXPERTS

QC)

Cost HLL83A 0.40 $111.56 $44.62 05/18/2011 28 PREPARE OR REVISE ADM1NISTRATIVE COMPLAINT Cost HU.S3A 0.80 $111.56 $89.25 05/18/2011 28 PREPARE OR REVISE ADMINISTRATIVE COMPLAIN' Cost HLLS3A 0.30 $111.56 S33.47 05/18/2011 28 PREPARE OR REVISE ADMINISTRATIVECOMPLAIN" Cost HUAB 0.20 $111.56 S22.31 05/18/2011 SI ESO/ERO


Florida Department of Health - FOR INTERNAL USE ONLY - itemizedcoste,cpt t----

MedlcCII As-an •

DMllond ***CONFIDENTIAL***

Qt.tally


 MQA Time Tracking System

-

Itemized Cost/Expense by Complaint

Complait 200820661


Report Date:

02/28/2012







Page6of16

Record

Staff

Activity

Staff

Cost/E1.pe11H

Cost/litpense

Cost/Expense

Cost/Expense Code


Type

Code.

Houn

Rate

Amount

Date

Code

Description



Cost

HLL83A

1.00

$111.56

$111.56

05/19/2011

28

PREPARE OR REVISE ADMINISTRATIVECOMPLAINT

Cost

HLL83A

0.50

$111.56

$5S.78

0S/19/2011

28

PREPARE OR REVISE ADMINISTRATIVECOMPLAINT

Cost

HLL83A

0.50

$111.S6

$55.78

0S/20/2011

28

PREPARE OR REVISE ADMINISTRATIVECOMPLAINT

Cost

HLL83A

2.50

$111.56

$278.90

05/23/2011

28

PREPARE OR REVISE ADMINISTRATIVE COMPLAINT

Cost

HLL83A

0.20

$111.56

$22.31

05/23/201 I

115

CONTACT WITH INVESTIGATORS

Cost

HLL83A

0.30

$111.56

$33.47

05124/2011

28

PREPARE OR REVISE ADMINISTRATIVE COMPLAINT

Cost

HLL83A

0.30

$111.56

$33.47

05/lSfl0ll

· 74

MEETINGS WITH DEPARTMENT STAFF

Cost

HLL83A

0.10

$111.56

$11.16

0S/25/2011

103

REVIEW SUPPLEMENTAL REPORT

Cost

HLL83A

0.50

Slll.S6

SSS.78

05/2Sl201 I

70

CONFERENCES WITH LAWYERS

Cost

HLL83A

0.10

$111.56

$11.16

0S/2Sl2011

35

TELEPHONE CALLS

Cost

HLL83A

1.00

$111.56

$11l.S6

05/2S12011

28

PREPARE OR REVISE AOMINlSTRA TIVE COMPLAINT

Cost

HLL83A

0.10

$111.S6

$11.16

05125/2011

114

CONTACT WITH EXPERTS

Cost

HLL83A

3.00

$111.56

$334.68

05/25/201 l

28

PREPARE OR REVISE ADMINISTRATIVE COMPLAINT

Cost

HLL83A

0.20

$111.56

$22.31

05/25/2011

103

REVIEW SUPPLEMENTAL REPORT

Cost

HLL83A

0.30

$111.56

$33.47

0S/l5n011

28

PREPARE OR REVISE ADMINISTRATIVE COMPLAINT

Cost

HLL83A

0.30

$111.S6

$33.47

05125/l0ll

28

PREPARE OR REVISE ADMINISTRATIVE COMPLAINT

Cost

HLL83A

1.80

$111.56

$200.81

0S/2612011

28

PREPARE OR REVISE ADMINISTRATIVE COMPLAINT

Cost

HLL83A

2.40

$111.56

$267.74

05/261201 I

28

PREPARE OR REVISE ADMINISTRATIVE COMPLAINT

Cost

HLL83A

0.40

$111.56

$44.62

0S/26/2011

28

PR.EPAllE OR REVISE ADMINISTRATIVE COMPLAINT

Cost

HLL83A

I.SO

Sll 1.56

$167.34

05/26/2011

28

PREPARE OR REVISE ADMINISTRATIVE COMPLAINT

Cost

HLL83A

0.40

SIi 1.56

$44.62

05/27/2011

28

PREPARE OR REVISE ADMINISTRATIVE COMPLAINT

Cost

HLL83A

0.40

$111.S6

$44.62

05fl7/2011

11S

CONTACT WITH INVESTIGATORS

Cost

HLL83A

0.10

$111.S6

$11.16

0S/3ll201 l

35

TELEPHONE CALLS

Cost

HLL83A

0.60

$111.56

$66.94

06/02120ll

89

PROBABLE CAUSE PREPARATION

Cost

HLL83A

0.80

$111.56

$89.25

06/06/20ll

89

PROBABLE CAUSE PREPARATION

Cost

HLL83A

0.10

$111.56

$11.16

06/06/2011

89

PROBABLE CAUSE PREPARATION

Cost

HLLS3A

0.30

$111.56

$33.47

06/06/2011

63

PRESENTATION OF CASES TO PROBABLE CAUSE PANEL

Cost

HLL83A

0.20

$111.S6

$22.31

06/06/2011

28

PREPARE OR REVISE ADMINISTRATIVE COMPLAINT

Cost

HLL83A

0.30

$111.56

$33.47

06/07/2011

70

CONFERENCES WITH LAWYERS

Cost

HLL84B

0.30

$1 I l.56

$33.47

06/07/2011

3S

TELEPHONE CAU.S

Cost

HLL83A

0.10

$111.56

$11.16

06/09/201 I

37

R.EVIEW LE'JTER

Cost

HLL83A

0.30

$111.56

$33.47

06/14/2011

37

REVIEW LETTER

Cost

HLL83A

0.30

$111.S6

$33.47

06/14/2011

70

CONFERENCES WITH LAWYERS

['-

QC)


Florida Department of Health - FOR INTERNAL USE ONLY - ilemlzedcoste)qlE ['- I



*** C ON FI DE NT I A L ***

IN,lllonof

Mecllc:al Qvdity AIM'mice

MQA_

Time Tracking System Itemized Cost/Expense by Complaint

Complaiat 200820661

Report Date: 02/28/.l012 Pa1;7 of16

Record Staff Activity Staff Cost/Expense Cost/Expense Cost/Expense Cost/Expense Code

Cost

HLL84B

0.20

$111.56

$22.31

06/14/l0l l

70

CONFERENCES WITH LAWYERS

Cost

HLL83A

0.30

$111.56

$33.47

06/2212011

41

REVIEW PLEADING

Cost

HLL83A

0.50

$111.56

$55.78

06fl2/2011

70

CONFERENCES WITH LAWYERS

Cost

HLLl3A

0.10

$111.S6

SI1.16

06124/2011

74

MEETINGS WITH DEPARTMENT STAFF

Cost

HLL83A

0.10

$111.56

Sl 1.16

06/2412011

70

CONFERENCES WITH LAWYERS

Cost

HLL83A

0.10

Slll.56

St 1.16

06/241201 I

115

CONTACT WITH INVESTIGATORS

Cost

HL72B

6.00

SI11.56

$669.36

06/2412011

53

PREPARATION OF MOTION TO AVOID STAY/RESPONSE T

Cost

HL72B

7.50

Slll.56

$836.70

06/25/2011

S3

PREPARATION OF MOTION TO AVOID STAY/RESPONSE T

Cost

HL72B

14.00

Slll.56

$1561.84

06/26/2011

53

PREPARATION OF MOTION TO AVOID STAY/RESPONSE 'I

Cost

HL72B

5.50

$111.S6

$613.58

06/27/2011

53

PREPARATION OF MOTION TO AVOID STAY/RESPONSE 1

Cost

HL72B

2.00

$111.56

$223.12

06/2712011

40

PREPARATlON OF OR REVISION OF A PLEADl'NG

Cost

HLL83A

0.30

$1 I l.56

$33.47

06128/2011

60

MISCELLANEOUS

Cost

HLL83A

0.10

$] 1].56

$11.16

07/05/2011

37

REVIEW LETIER

Cost

HL72B

5.00

$111.56

$557.80

07/06/2011

40

PREPARATION OF OR REVISION OF A PLEADING

Cost

HL72B

1.20

$111.56

$133.87

07/07/2011

40

PREPARATION OF OR REVISION OF A PLEADING

Cost

HLL84B

0.30

$111.56

$33.47

07/08/2011

46

LEGAL RESEARCH

Cog

HLL83A

0.20

$111.56

$22.31

07/14/2011

70

CONFERENCES WITH LAWYERS

Cost

HLL83A

0.10

$1ll.S6

Sll.16

07/18/2011

74

MEETINGS WITH DEPARTMENT STAFF

Cost

HLL83A

0.20

SI 11.56

$22.31

07/1912011

ll5

CONTACT WITH INVESTIGATORS

Cost

HLL83A

0.20

$111.56

$22.31

08/01/2011

35

TELEPHONE CALLS

Cost

HLL83A

0.10

$111.56

$11.16

08/02/2011

70

CONFERENCES WITH LAWYERS

Cost

HLL83A

0.20

$111.56

$22.31

08/03/2011

60

MISCELLANEOUS

Cost

HLL83A

0.10

$111.56

Sll.16

08/03/l0ll

70

CONFERENCES WITH LAWYERS

Cost

HLL83A

0.10

$111.56

$11.16

08/04/2011

37

REVIEW LETIER

Cost

HLL83A

1.00

$111.56

$111.56

08/08/2011

25

REVIEW CASE FILE

Cost

lll.L83A

0.10

$111.56

$11.16

08/08/2011

35

TELEPHONE CALLS

Cost

HLL83A

0.10

$111.56

$11.16

08/08/2011

36

PREPARATION OR REVISION OF LE'ITER

Cost

HLL83A

0.40

$111.56

$44,62

08/08/2011

39

PREPARFlRESPONDTO DISCOVERY

Cost

HLL83A

0.10

$111.56

SI1.16

08/08/2011

115

CONTACT WITH INVESTIGATORS

Cost

HLL83A

0.10

$111.56

SI 1.16

08/09/20ll

3S

TELEPHONE CALLS

Type Code Hours Rate Amoant Date Code Descriptioa


Cost

HLL83A

0.10

$111.56

Sll.16

08/10/2011

35

TELEPHONE CALLS

Cost

HLL83A

1.10

$111.56

$122.72

08/10/l0ll

39

PREPARE/RESPOND TO DISCOVERY

Cost

HLL83A

0.20

$111.56

$22.3]

08/11/2011

74

MEETINGS Willi DEPARTMENT STAFF

Q0 Q0

Florida Department of Healh - FOR INTERNAL USE ONLY - itemizedc:ostexpc t----


*** C ON FIDE NTI AL***

DMsloftof

MQA_

Medic.al Quaily A$IIUJCll'lce

Time Tracking System Itemized Cost/E:s:pense by Complaint

Complaint 200820661

Reeord

Type

Staff

Code

Adivity

Hours

Staff

Rate

Cost/Expense

Amount

Cost/Expense

Date

Cost/Ei:peue

Code

Cost/Expease Code

Description

Cost

HLL83A

0.70

$111.56

S78.09

08/11/2011

25

REVIEW CASE FILE

Cost

HLL83A

0.20

Sl 11.56

$22.31

08/15/2011

60

MISCELLANEOUS

Cost

HLU3A

0.10

$111.56

Sll.16

08/15/2011

36

PREPARATION OR REVISION OF LETTER

Cost

HLL83A

0.10

$111.56

SI1.16

08/15/2011

35

TELEPHONE CALLS

Cost

HLL83A

0.10

$111.56

Sl 1.16

08/16/201 l

35

TELEPHONE CALLS

Cost

HLL83A

0.20

Stll.56

$22.31

08/16/2011

35

TELEPHONE CALLS

Cost

HLL83A

0.20

$111.56

$22.31

08/16/2011

11S

CONTACT WITH INVESTIGAlORS

Cost

HLL83A

J.00

$111.56

$111.56

08/16/2011

39

PREPARE/RESPOND TO DISCOVERY

Cost

HLL83A

1.10

Slll.56

S122.72

08/16/2011

39

PREPARE/RESPOND TO DISCOVERY

Cost

HLL83A

0.10

$111.56

Sl1.16

08/16/2011

35

TELEPHONE CALLS

Cost

HLL83A

0.30

$111.56

S33.47

08/16/2011

115

CONTACT WITH INVESTIGATORS

Cost

HLL83A

0.70

$111.S6

$78.09

08/16/2011

39

PREPARE/RESPOND TO DISCOVERY

Cost

HLL81A

1.00

$111.56

$111.56

08/17!2011

70

CONFERENCES WITH LAWYERS

Cost

HLL83A

0.20

$111.56

$22.31

08/17/2011

115

CONTACT WITH INVESTIGATORS

Cost

HLL83A

0.30

$111.56

$33.47

08/17/2011

35

TELEPHONE CALLS

Cost

HLU3A

0.10

$111.56

Sl 1.16

08/17/201 l

35

TELEPHONE CALLS

Cost

HLL83A

0.10

Slll.56

$11.16

08/18!201 I

35

TELEPHONE CALLS

Cost

HLLB3A

0.40

Slll.56

$44.62

08/18!201 l

40

PREPARATION OF OR REVISION OF A PLEADING

Cost

HLL83A

0.10

$111.56

Sl 1.16

08/18(2011

74

MEETINGS WITH DEPARTMENT STAFF

Cost

HLU3A

0.20

$111.56

$22.31

08/18!2011

70

CONFERENCES WITH LAWYERS

Cost

HLL83A

0.10

Sll 1.56

Sll.16

08/18/201 t

40

PREPARATION OF OR REVlSION OF A PLEADING

Cost

HLL83A

0.10

$111.56

Sl 1.16

08/18!201 l

74

MEETINGS WllH DEPARTMENT STAFF

Cost

HLL83A

1.40

$111.56

$156.18

08/19/2011

39

PREPARE/RESPOND TO DISCOVERY

Cost

HLL83A

0.40

$111.56

$44.62

08/19/201 I

2S

REVIEW CASE FILE

Cost

HLL61B

2.60

$111.56

$290.06

08/22/2011

64

LEGAL ADVICE/DISCUSSION - BOARD OFFICE.DEPT STAI

Cost

HLL83A

0.30

$111.56

$33.47

08/22/2011

103

REVIEW SUPPLEMENTAL REPORT

Cost

HLL83A

1.00

$111.56

$111.56

08/23/2011

39

PREPARFJRESPOND TO DISCOVERY

Cost

HLL83A

0.20

$111.56

$22.31

08/23/2011

70

CONFERENCES WITII LAWYERS

Cost

HLL83A

0.30

$111.56

S33.47

08!i3/2011

39

PREPARE/RESPOND TO DISCOVERY

Cost

HLL83A

0.50

$111.56

SSS.78

08/23(2011

70


Report Date: 02128/2012 Pagel ofl6


Cost

HLL83A

0.10

$111.56

$11.16

08/24'2011

115

CONTACT WITH INVESTIGAlORS

Cost

HLL83A

0.10

$111.56

$11.16

08/24!201 I

3S

TELEPHONE CALLS

Cost

HLL83A

l.00

Sil 1.56

St 11.56

08f24f20I I

39

PREPARFIRESPOND TO DISCOVERY

CONFERENCES WITH LAWYERS 0\

00

0\

Florida Department of Health - FOR INTERNAL USE ONLY - ilemizedcoslelq)l t----

*** CONFIDENTIAL ***

DMSlonof

MQA_

     Medleal Qualftr As•anc•       

Time Tncking System Itemized Cost/Expense by Complaint

hportDate:

02/28/2012







P9e9of16

Record

Type

Staff Code

Activity

Hours

Staff

Rate

Cost/Expease

Amount

Co1t/E1pcase

Date

Cost/Expense

Code

Cost/E1peose Code

Description


Cost

HLL&3A

0.20

·$111.56

$22.31

08/24/2011

11S

CONTACT WITH INVESTIGATORS

Cost

HLLB3A

0.30

$111.S6

$33.47

08/2412011

2S

REVIEW CASE FILE

Cost

HLL83A

0.10

$111.56

$11.16

08/24/2011

36

PREPARATION OR REVISION OF LETTER

Cost

HLL&3A

0.30

Sll 1.56

$33.47

08/29/2011

70

CONFERENCES WITH LAWYERS

Cost

lll..L83A

0.20

$111.S6

$22.31

08/29/201 l

3S

TELEPHONE CALLS

Cost

HLL83A

0.10

$111.56

$11.16

08/29/2011

36

PREPARATION OR REVlSlON OF LETTER

Cost

HLL83A

o.so

$111.56

$5S.78

08/29/2011

2S

REVIEW CASE FILE

Cost

HLL83A

0.10

$11l.S6

SI 1.16

08/29/2011

3S

TELEPHONE CALLS

Cost

HLL83A

0.30

Slll.S6

$33.47

08/29/201 l

70

CONFERENCES WITH LAWYERS

Cost

HLL83A

0.10

$111.S6

SI 1.16

08/29/2011

3S

TELEPHONE CALLS

Cost

HLL83A

0.30

$111.S6

$33.47

08/29/2011

11S

CONTACT WITH INVESTIGATORS

Cost

HLL83A

0.30

$ti 1.56

$33.47

08!29/2011

70

CONFERENCES WITH LAWYERS

Cost

HLL83A

0.20

$111.56

$22.31

08/29/2011

llS

CONTACT WITH INVESTIGATORS

Cost

HLL83A

0.60

$111.56

$66.94

08/29/2011

25

REVIEW CASE FILE

Cost

HLL83A

0.10

$111.56

$11.l6

08/30'201 l

36

PREPARATION OR REVISION OF LETTER

Cost

HLL83A

0.30

$111.56

$33.47

08/30'2011

70

CONFERENCES WITH LAWYERS

Cost

HLL83A

0.20

$111.56

$22.31

08/30/2011

46

LEGAL RESEAROI

Cost

HLLS3A

0.30

$111.56

$33.47

08/30/2011

70

CONFERENCES WITH LAWYERS

Cost

HLL83A

0.10

$111.S6

Sll.16

08/31/2011

36

PREPARATION OR REVISION OF LETTER

Cost

HLL&3A

0.10

Sil l.S6

$11.16

09/01/201 l

&8

PROOFING AND SIGNING LETTERS

Cost

HLL83A

0.30

$1l l.S6

$33.47

09/01/201 l

2S

REVIEW CASE FILE

Cost

HLL83A

0.20

$111.S6

$22.31

09/07/2011

35

TELEPHONE CALLS

Cost

HLL83A

0.50

$111.56

$SS.78

09/07/2011

70

CONFERENCES WITH LAWYERS

Cost

HLL83A

0.10

Slll.S6

$11.16

09/07!201 l

35

TELEPHONE CALLS

Cost

HLL83A

0.10

$111.56

$11.16

09/07/201 l

3S

TELEPHONE CALLS

Cost

HLL83A

0.20

$111.S6

$22.31

09/07/2011

3S

TELEPHONE CALLS

Cost

lll..L83A

0.20

$111.56

$22.31

09/07/2011

70

CONFERENCES WITH LAWYERS

Cost

HLL83A

0.50

$11l.S6

SSS.78

09/07/201 l

43

PREPARE FOR DEPOSlTlON

Cost

HLL83A

0.10

$1l l.S6

$11.16

09107/2011

3S

TELEPHONE CALLS

Cost

HLL83A

o.so

$111.S6

$S5.78

09/07/2011

46

LEGAL RESEARCH

Cost

HLL83A

0.90

$111.S6

$100.40

09/07!2011

]15

CONTACT WITH JNVESTIOAlORS

Cost

HLL83A

0.10

$111.S6

$11.16

09/07/2011

3S

TELEPHONE CALLS

Cost

HLL83A

0.30

$111.S6

$33.47

09/07/2011

11S

CONTACT WITH INVESTIGATORS

Complaint 200820661


=

O'\

O'\

Florida Department of Heall! - FOR INTERNAL USE ONLY - ilemizedc:osteicpe t----


*** C ON FIDE NTI AL***

Dl¥llklllof

Medli:GI Q11ally .\sslRGftCtl

MQb_

Time Tracking System Itemiud Cost/Expense by Complaint

Complaint 200820661

Report Date: 02/28/2012 Page 10of16

Type

Code

Hours

Rate

Amount

Date

Code

Description

Cost

HLL83A

0.20

$111.S6

$22.31

09/07/2011

115

CONTACT WITH INVESTIGATORS

Cost

HLL83A

0.20

$111.56

$2231

09/08/2011

43

PREPARE FOR DEPOSITION

Cost

HLL83A

0.30

$tll.S6

$33.47

09/08/2011

74

MEETINGS WITH DEPARTMENT STAFF

Cost

HLL83A

0.10

$111.56

$11.)6

09/08/2011

35

TELEPHONE CALLS

Cost

HLL83A

0.30

$111.56

$33A7

09/08/201 I

70

CONFERENCES WITH LAWYERS

Cost

HLL83A

0.20

$111.56

$22.31

09/08/2011

35

TELEPHONE CALLS

Cost

HLL83A

0.40

$lll.56

$44.62

09/08/2011

115

CONTACT WITH INVESTIGATORS

Cost

HLL83A

0.60

$111.56

$66.94

09/08/201 l

llS

CONTACT WITH INVESTIGATORS

Cost

HLL83A

0.50

$111.56

$5S.78

09/0&rl0ll

70

CONFERENCES WITH LAWYERS

Cost

HLL83A

0.20

$111.56

$22.31

09/08/2011

74

MEETINGS WITH DEPARTMENT STAFF

Cost

HLL83A

0.10

$111.56

$11.16

09/08/201 l

36

PREPARATION OR REVISION OF LETTER

Cost

HLL83A

0.20

$111.56

$22.31

09/0&rl0l I

74

MEETINGS WIIB DEPARTMENT STAFF

Cost

HLL83A

0.10

$111.56

$11.16

09/08/2011

37

REVIEW LETfER

Cost

HLL83A

0.10

$111.56

$11.16

09/09/2011

37

REVIEW LETTER

Cost

HLL83A

0.10

$111.56

Sll.16

09/09/2011

74

MEETINGS WITH DEPARTMENT STAFF

Cost

HLL83A

0.40

$) 11.56

$44.62

09/09/2011

70

CONFERENCES WITII LAWYERS

Cost

HLL83A

0.40

$lll.S6

$44.62

09/09/2011

36

PREPARATION OR REVISION OF LETI'ER

Cost

HLL83A

0.20

$111.56

$22.31

09/12/201 I

ll5

CONTACT WITH INVESTIGATORS

Cost

HLL83A

0.10

$1) 1.56

SI 1.16

09/12/2011

115

CONTACT WITII INVESTIGATORS

Cost

HLL83A

0.30

$111.56

$33.47

09/12/2011

39

PREPARE/RESPOND TO DISCOVERY

Cost

HLL83A

0.50

Slll.56

$55.78

09/12/2011

39

PREPARE/RESPOND TO DISCOVERY

Cost

HLL83A

0.70

$111.56

$78.09

09/13/2011

2S

REVIEW CASE FILE

Cost

HLL83A

4.00

$111.56

$446.24

09/13/201 l

44

DEPOSITIONS

Cost

HLL83A

0.30

$111.56

S33.47

09/13/2011

S8

TRAVEL TIME

Cost

HLL83A

0.40

$111.56

$44.62

09/13/2011

25

REVIEW CASE FILE

Cost

HLL83A

2.50

SI 11.56

S278.90

09/14/2011

58

TRAVEL TIME

Cost

HLL83A

0.10

Slll.S6

SI l.16

09/14/2011

35

TELEPHONE CALLS

Cost

HLU3A

1.80

Sl l I.S6

$200.8)

09/14/201 l

25

REVIEW CASE FILE

Cost

HLL83A

0.20

$111.56

$22.31

09/15/2011

25

REVIEW CASE FILE

Cost

HLL83A

0.30

$111.56

$33.47

09/15/201 l

58

TRAVEL TIME

Cost

HLL83A

0.20

$111.56

$22.31

09/15/2011

115

CONTACT WITII INVESTIGATORS

Cost

HLL83A

2.00

$111.56

$223.12

09/1S/2011

44

DEPOSITIONS

Cost

HLL83A

0.30

Sll l.56

S33.47

09/15/201 l

11S

CONTACT WITH INVESTIGATORS

Record Staff Activity Staff Cost/Espense Cost/Expense Cost/Expense Cost/E:rpense Code


FloridaDepartmentofHeatth - FOR INTERNAL USE ONLY - itemizeclcostexpE t----


***CON FI D E NT I AL ***

Dl'llslond

Medktll QuaBy Auuronce

MQA_

Time Tracking System Itemized Cost/Expense by Complaint

Complaint 200820661

Report Date: 02/28/2012 P 11 of16

Record Staff Activity Staff Cost/Expense Cost/Expense Cost/Expense Cost/Es:pense Code Type Code Houn Rate Amount Date Code Description

Cost HLL83A s.so $111.56 $613.S8 09/15/2011 58 TRAVELTIME

Cost HLL83A 0.20 $111.56 $22.31 09/16/2011 74 MEETINGS WITH DEPARTMENT STAFF

Cost HLL83A 0.10 $111.56 SI1.16 09/22/2011 11S CONTACT WITH INVESTIGATORS Cost HLLBJA 0.40 $111.56 $44.62 09/23/2011 70 CONFERENCES WITH LAWYERS Cost HLU3A 0.20 $111.56 $22.31 09/23tl011 60 MISCELLANEOUS

Cost HLL83A o.so $111.56 $55.78 09/23/2011 25 REVJEW CASE FILE

Cost HLL83A 0.20 $111.S6 $22.31 09/26/2011 70 CONFERENCES WITH LAWYERS

Cost HLL83A 0.20 $111.56 $22.31 09/2612011 74 MEETINGS WITH DEPARTMENT STAFF

Cost HLL83A 1.00 Sll l.56 Slll.56 09/26/2011 28 PREPARE OR REVISE ADMINISTRATIVE COMPLAJNT Cost HLL83A 0.10 Sll l.S6 $11.16 09/26/2011 70 CONFERENCES WITH LAWYERS

Cost HLL83A 0.30 $111.56 $33.47 09/27/2011 70 CONFERENCES WIIB LAWYERS

Cost HLL83A 0.20 $111.S6 $22.31 09/27/2011 3S TELEPHONE CALLS

Cost HLL83A 0.20 $111.S6 $22.31 09/27/2011 70 CONFERENCES WITH LAWYERS Cost HLL83A 0.60 $111.56 $66.94 09/28/2011 2S REVIEW CASE FILE

Cost HLL83A 0.60 $111.56 $66.94 09/28/2011 28 PREPARE OR REVISE ADMINISTRATIVE COMPLAINT Cost HLL83A 0.10 $111.56 $11.16 09/18/2011 74 MEETINGS WITH DEPARTMENT STAFF

Cost HLL83A 0.20 $111.56 $22.31 09/28/2011 70 CONFERENCES WITH LAWYERS Cost HLL84B 0.10 $111.S6 $11.16 09/30/2011 70 CONFERENCES WITH LAWYERS Cost HLI.84B 2.00 $111.56 $223.12 09/30/1011 46 LEGAL RESEARCH

Cost HLL84B 0.10 $111.S6 $11.16 10/03/2011 70 CONFERENCES WITH LAWYERS

Cost HLL61B 1.00 Slll.S6 $111.S6 10/04/2011 60 MISCELLANEOUS

Cost HLL83A 0.10 $11l.S6 $11.16 10/04/2011 115 CONTACT WITH INVESTIGATORS Cost HLL83A 0.20 $111.56 $22.31 10/04/2011 35 TELEPHONE CALLS

Cost HLL83A 0.10 $111.S6 $11.16 10/04/201) 74 MEETINGS WITH DEPARTMENT STAFF

Cost HLL83A 0.30 $111.56 $33.47 10/04tl011 115 CONTACT WITH INVESTIGATORS

Cost HLL83A 0.20 $111.56 $22.31 10/04/2011 36 PREPARATION OR REVISION OF LETTER

Cost HLL83A 0.30 $111.S6 $33.47 10/04/201 l 25 REVIEW CASE'FILE Cost HLL61B o.so $111.56 SSS.78 IO/OS/2011 46 LEGAL RESEARCH

M

Cost HLL83A 0.20 $111.S6 $22.31 10/05/2011 74 MEETINGS WITH DEPARTMENT STAFF Cost HLL83A 0.70 $111.56 $78.09 10/0512011 25 REVIEW CASE FILE

Cost HLL83A 0.90 $)11.56 $100.40 10/05/2011 2S REVIEW CASE FILE

Cost HLLS3A 0.60 $111.56 $66.94 10/0S/2011 70 CONFERENCES WITH LAWYERS

Cost filL83A 1.00 St 11.56 $111.S6 10/05/2011 25 REVIEW CASE FILE


Florida Department of Health - FOR INTERNAL USE ONLY - llemlzedcostexpc t'-



*** C O NF IDEN TI AL***

DIYbklnof

MQ&

Mellcm Quall-,Auurance

Time Tracking System Itemized Cost/Expense by Complaiat

Complai1t 200820661


Report Date:

02/28/2012




P5e l2of16

Record

Staff

Activity

Staff

Cost/Eq,ense

Cost/Expense Cost/Expense Cost/Es:pease Code

Type

Code

Hours

Rate

Amount

Date Code Description

Cost

HLL83A

1.40

$111.56

$156.18

10/0S/2011

25

REVIEW CASE FILE

Cost

1Il.,LS3A

0.10

$111.56

$11.16

10/06/2011

88

PROOFING AND SIGNING LETTERS

Cost

HLL61B

4.00

$111.56

$446.24

10/10/2011

28

PREPARE OR REVISE ADMINISTRATIVE COMPLAINT

Cost

HLL83A

0.20

$11l.S6

$22.31

10/10/201 I

70

CONFERENCES WITH LAWYERS

Cost

HLL83A

0.40

Sil 1.56

$44.62

10/10/2011

70

CONFERENCES WITH LAWYERS

Cost

HLL83A

1.00

Slll.56

$111.S6 ·

10/11/2011

28

PREPARE OR REVISE ADMINISTRATIVE COMPLAINT

Cost

HLLl3A

0.40

SI11.56

$44.62

10/11/l0l I

70

CONFERENCES WITH l.AWYERS

Cost

HLL83A

0.50

$111.56

$5S.78

10/11/2011

28

PREPAllE OR REVISE ADMINISTRATIVE COMPLAINT

Cost

HLL61B

1.50

$102.41

$153.62

10/11/2011

28

PREPARE OR REVISE ADMlNISTRATIVE COMPLAINT

Cost

HLL61B

2.00

$111.56

$223.12

10/12/2011

28

PREPARE OR REVISE ADMINISTRATIVE COMPLAINT

Cost

HLL83A

0.10

$111.56

$11.16

I 0/12/2011

11S

CONTACT WITH INVESTIGATORS

Cost

HLL83A

1.00

$1JJ.S6

SJ I1.56

10/12/2011

70

CONFERENCES WITH LAWYERS

Cost

HLL83A

0.40

$111.56

$44.62

10/12/201 I

28

PREPARE OR REVISE ADMINISTRATIVE COMPLAINT

Cost

HLL83A

0.10

$111.56

SI 1.16

10/12/2011

115

CONTACT WlTII INVESTIGATORS

Cost

HLL83A

0.50

$ll l.56

SSS.78

l0/12/2011

28

PREPARE OR REVISE ADMINISTRATIVE COMPLAINT

Cost

HLL61B

0.30

$111.56

$33.47

10/20/2011

28

PREPARE OR REVISE ADMINISTRATIVE COMPLAINT

Cost

HLL83A

0.10

$111.56

$11.16

10/20/2011

37

REVIEW LETTER

Cost

HLL83A

0.20

SI11.56

$22.31

10/20/2011

70

CONFERENCES WITH LAWYERS

Cost

HLL61B

030

$102.41

$30.72

10/26/2011

60

MISCELLANEOUS

Cost

HLL83A

0.20

$102.41

$20.48

J0/27f.l0ll

35

TELEPHONE CALLS

Cost

HLL83A

0.70

$102.41

$71.69

10/27/2011

62

REVIEW OF CASES FOR PROBABLE CAUSE PANEL

Cost

HLL83A

0.30

$102.41

$30.72

I0/l8/20l I

62

REVIEW OF CASES FOR PROBABLE CAUSE PANEL

Cosl

HLL83A

0.20

$102.41

$20.48

10/28/2011

70

CONFERENCES WITH LAWYERS

Cost

HLL83A

0.40

$102.41

$40.96

10/31/2011

37

REVIEW LETIBR

Cost

HLL83A

0.20

$102.41

$20.48

10/31/2011

90

POST PROBABLE CAUSE PROCESSING

Cost

HLL83A

0.20

$102.41

$20.48

10/31/2011

70

CONFERENCES WITH LAWYERS

Cost

HLL83A

0.20

$102.41

$20.48

10/31/2011

35

TELEPHONE CALLS

Cost

HLL83A

0.40

$102.41

$40.96

10/3 l/2011

37

REVIEW LETTER

Cost

HLL83A

0.20

$102.41

$20.48

10/31/2011

90

POST PROBABLE CAUSE PROCESSING

Cost

HLL83A

0.20

$102.41

$20.48

10/31/201 I

70

CONFERENCES WITH LAWYERS

Cost

HLL83A

0.20

$102.41

$20.48

10/31/2011

35

TELEPHONE CALLS

Cost

HLL83A

0.20

$102.41

$20.48

ll/01/2011

74

MEETINGS WITH DEPARTMENT STAFF

Cost

HLL83A

0.20

$102.41

$20.48

11/02/2011

74

MEETINGS WlnI DEPARTMENT STAFF


Florida Depllf1ment of Health - FOR INTERNAL USE ONLY - ilemizedcostexpi r-----

*** C O NF ID ENT I AL ***

Dl.ionot

Mecleal Qually AssUrcmc•

MQb_

Time Tracking System Itemized Cost/Expense by Complaint

Complaiat 200820661

Report Date: 02/2812012 Page 13 ofl6

Record Staff Activity Staff Cost/Expense Cost/Ei:pense Cost/Expense Cost/Ellpense Code

Type Code Hours Rate Amount Date Code Descript io

Cost

HLL83A

0.30

$102.41

$30.72

11/02/2011

74

MEETINGS WITH DEPARTMENT STAFF

Cost

HLL83A

0.20

$102.41

$20.48

11/03/lOl l

35

TELEPHONE CALLS

Cost

HLL61B

0.30

$102.41

S30.n

11/0312011

40

PREPARATION OF OR REVISION OF A PLEADING

Cost

HLL61B

0.30

$102.41

S3o.n

11/03/l0ll

47

TRIAL PREPARATION

Cost

HLL61B

0.50

$102.41

$51.21

11/0712011

47

TRIAL PREPARATlON

Cost

HLL83A

0.10

$102.41

SI0.24

11/07/l0l1

74

MEETINGS WITH DEPARTMENT STAFF

Cost

HLL83A

0.20

$102.41

$20.48

11/07/l0ll

40

PREPARATION OF OR REVISION OF A PLEADING

Cost

HLL83A

0.20

$102.41

$20.48

11/09/lOll

70

CONFERENCES WITH LAWYERS

Cost

HLUl3A

020

$102.41

$20.48

11/10/l0l l

70

CONFERENCES WITH LAWYERS

Cost

HLL83A

0.20

$102.41

$20.48

I 1/14/l0ll

74

MEETINGS WITH DEPARTMENT STAFF

Cost

HLL83A

0.10

$102.41

$10.24

11/16/2011

74

MEETINGS WITH DEPARTMENT STAFF

Cost

HLL83A

0.10

$102.41

$10.24

I I/16/2011

35

TELEPHONE CALLS

Cost

HLU3A

0.20

$102.41

$20.48

11/16/2011

35

TELEPHONE CALLS

Cost

HLL83A

020

$l02.41

$20.48

11/16/2011

37

REVIEW LETTER

Cost

HLL83A

0.10

$102.41

$10.24

11/16/2011

74

MEETINGS WITH DEPARTMENT STAFF

Cost

HLL83A

0.20

$102.41

$20.48

11/17/lOll

70

CONFERENCES WITH LAWYERS

Cost

HLL83A

0.10

$102.41

$10.24

l l/I7/l01l

35

TELEPHONE CALLS

Cost

HLUl3A

0.10

$102.41

$10.24

11/17/l0ll

36

PREPARATION OR REVISION OF LETTER

Cost

HLL83A

0.10

$102.41

$10.24

11/17/l0l l

35

TELEPHONE CALLS

Cost

HLL83A

0.20

$102.41

$20.48

I1/17/2011

35

TELEPHONE CALLS

Cost

HLLSJA

0.10

$102.41

$10.24

11/17/2011

35

TELEPHONE CALLS

Cost

HLL83A

0.20

$102.41

$20.48

11/17/2011

70

CONFERENCES w1rn LAWYERS

Cost

HLL81A

0.20

$102.41

$20.48

11/17/2011

70

CONFERENCES WITH LAWYERS

Cost

HLL61B

020

$102.41

$20.48

11/17/2011

35

TELEPHONE CALLS

Cost

lll..L61B

0.30

$102.41

$30.72

ll/17/2011

40

PREPARATION OF OR REVISION OF A PLEADING

Cost

HLL6IB

0.10

$102.41

$10.24

11/17/2011

60

MISCELLANEOUS

Cost

HLU3A

0.20

$102.41

$20.48

11/21/2011

74

MEETINGS WITH DEPARl'MENT STAFF

Cost

HLU3A

0.30

$102.41

$30.72

I1/21/2011

35

TELEPHONE CALLS

Cost

HLU3A

o.so

$102.41

$51.21

11/21/2011

40

PREPARATION OF OR REVISION OF A PLEADING

Cost

HLL83A

0.30

$102.41

$30.72

11/21/2011

74

MEETINGS WITH DEPARTMENT STAFF

Cost

HLL83A

0.50

$102.41

SSl.21

11/21/2011

40

PREPARATION OF OR REVISION OF A PLEADING

Cost

HLL83A

0.10

$102.41

$1024

11/21/2011

74

MEETINGS w1rn DEPARTMENT STAFF

Cost

HLL83A

0.20

$102.41

$20.48

11/2l/l011

25

REVIEW CASE FILE


Florida Department of Health - FOR INTERNAL USE ONLY - itemlZedcostelCPI t----



*** CONFIDE NTI AL***

DMllonof

Medical Qua8y Alalfanc:•


 MQA Time Tracking System

--

Itemized Cost/Expense by Complaint

Complaint 200820661

Report Date: 02/28/2012 !3e 14 ofl6

Record Staff Activity Staff Cost/Es.pense Cost/E1:pense Cost/Expense Cost/Expense Code

Type Code Houn Rate Amo•nt Date Code Description

Cost

HLL61B

0.30

$102.41

$30.72

11/21/2011

64

LEGAL ADVICE/DISCUSSION - BOARD OFFICE,DEPT STAl

Cost

HLL83A

0.10

$102.41

$10.24

11/22/2011

37

REVIEW LEITER

Cost

HLL83A

0.80

$102.41

$81.93

11122/2011

40

PREPARATION OF OR REVISJON OF A PLEADING

Cost

HLL83A

0.80

$102.41

$81.93

11/22/2011

40

PREPARATION OF OR REVISION OF A PLEADING

Cost

HLL83A

0.20

$102.41

$20.48

11/22/2011

74

MEETINGS WITH DEPARTMENT STAFF

Cost

HLLB3A

0.20

$102.41

$20.48

11/23/2011

74

MEETINGS WITH DEPARTMENT STAFF

Cost

HLLB3A

030

$102.41

S3o.n

11/23/20ll

70

CONFERENCES WITH LAWYERS

Cost

HLL83A

0.40

$102.41

$40.96

11/23/2011

25

REVIEW CASE FILE

Cost

HLL83A

0.10

$10i.41

$10.24

11/23/2011

60

MISCELLANEOUS

Cost

HLL61B

0.30

$102.41

S3o.n

11/23/2011

64

LEGAL ADVICE/DISCUSSION - BOARD OFFICE,OEPT STAI

Cost

HLL61B

4.10

$102.41

$419.88

11/28/2011

47

TRIAL PREPARATION

Cost

HLL83A

0.10

$102.41

$10.24

1112812011

36

PREPARATION OR REVISION OF LEITER

Cost

HLL83A

0.20

$102.41

$20.48

1112812011

115

CONTACT WITH INVESTIGATORS

Cost

HLL83A

1.30

$102.41

$133.13

11/2812011

47

TRIAL PREPARATION

Cost

HLLB3A

0.20

$102.41

$20.48

11128/201 l

26

PREPAR.E OR REVISE MEMORANDUM

Cost

HLL83A

1.00

$102.41

$102.41

ll/2912011

47

TRIAL PREPARATION

Cost

HLL83A

0.20

$102.41

$20.48

11/29/2011

35

TELEPHONE CALLS

Cost

HLL83A

0.20

$102.41

$20.48

ll/2912011

l15

CONTACT Wl1H INVESTIGATORS

Cost

HLL83A

1.00

$102.41

$102.41

ll/29/20ll

47

TRIAL PREPARATION

Cost

HLL61B

0.20

$102.41

$20.48

11/29/2011

41

REVIEW PLEADING

Cost

HLL83A

S.00

$102.41

$512.05

11/30/2011

47

TRIAL PREPARATION

Cost

HLL83A

0.40

$102.41

$40.96

11/30/2011

115

CONTACT WITH INVESTIGATORS

Cost

HLL83A

2.50

$102.41

$256.03

t 1/30/2011

47

TRIAL PREPARATION

Cost

HLL83A

0.20

$102.41

$20.48

12/01/2011

114

CONTACT WITH EXPERTS

Cost

HLL61B

3.00

$102.41

$307.23

12/02/2011

47

TRIAL PREPARATION

Cost

HLL83A

1.00

$102.41

$102.41

12/03!2011

47

TRJAL PREPARATION

Cost

HLL83A

3.00

$102.41

$307.23

12/04/2011

58

TRAVEL TIME

Cost

HLL83A

2.00

$102.41

$204.82

12/04/201 l

47

TRIAL PREPARATION

Cost

HLL83A

1.00

$102.41

$102.41

12/04/2011

114

CONTACT WITH EXPERTS

°'

Cost

HLL83A

1.S0

$102.41

$153.62

12/04/2011

47

TRIAL PREPARATION

Cost

HLL61B

8.00

$102.41

$819.28

12/04/2011

58

TRAVEL TIME

Cost.

HLL61B

2.00

$102.41

$204.82

12/04/2011

47

TRIAL PREPARATION

Cost

HLL61B

2.00

$102.41

$204.82

12/04/2011

47

TRIAL PREPARATION

"'

Florida Department of Health - FOR INTERNAL USE ONLY - itemlzedcostexpe °t '-


*** C O NF ID ENT I AL ***

Dlvlllon ol

M4!dir;ol Ql,alily As$Sance

MQA..... -

Time Tracking System Itemized Cost/Expense by Complaint

Complaint 200820661


Report Date:

02/'28/2012







P!!§e JS ofl6

Record

Staff

Activity

Staff

Cost/Expense

Cost/Expense

CostJEspense

Cost/Expense Code


Type

Code

Houn

Rate

Amount

Date

Code

Description


Cost

HLL83A

1.00

$102.41

$102.41

12/0512011

47

TRIAL PREPARATION


Cost

HLL83A

8.00

$102.41

$81928

12/0512011

48

FORMAL HEARING


Cost

HLL83A

1.00

$102.41

$102.41

12/05/2011

47

TRIAL PREPARATION


Cost

HLL61B

9.00

$102.41

$921.69

12/05/2011

48

FORMAL HEARING


Cost

HLL61B

1.00

$102.41

$102.41

12/05/2011

47

TRIAL PREPARATION


Cost

HLL.61B

2.00

$102.41

$204.82

12/05/2011

47

TRIAL PREPARATION


Cost

HLL.61B

8.00

$102.41

$819.28

12/061'201 l

48

FORMAL HEARING


Cost

HLL83A

3.00

$102.41

$307.23

12/07/2011

58

TRAVEL TIME


Cost

HLL61B

8.00

$102.41

$819.28

12/07/2011

58

TRAVEL TIME


Cost

HLL83A

0.20

$102.41

$20.48

12/08/2011

60

MISCELLANEOUS


Cost

HLL83A

0.10

$102.41

$10.24

12/14/2011

49

REVIEW TRANSCRJPTS AND PREPARE

RECOMMENDED C

Cost

HLU3A

0.30

$102.41

$30.72

12/15/2011

49

REVIEW TRANSCRJPTS AND PREPARE

RECOMMENDED C

Cost

HLL83A

0.20

$102.41

$20.48

12127/2011

37

REVIEW LETTER


Cost

HLL83A

0.20

$102.41

$20.48

01/04/2012

70

CONFERENCES WITH LAWYERS


Cost

HLU3A

0.50

$102.41

$5121

01/04/2012

60

MISCELLANEOUS


Cost

HLL84B

0.20.

$102.41

$20.48

01/0412012

70

CONFERENCES WITH LAWYERS


Cost

HLL83A

6.50

$102.41

$665.67

01/10!2012

49

REVIEW TRANSCRIPTS AND PREPARE

RECOMMENDED C

Cost

HLL83A

1.50

$102.41

$153.62

01/1212012

49

REVIEW TRANSCRIPTS AND PREPARE

RECOMMENDED C

Cost

HLL83A

3.00

$102.41

$30123

01/17/2012

49

REVIEW TRANSCRIPTS AND PREPARE

RECOMMENDED C

Cost

HLL85B

0.20

$102.41

$20.48

01/17/2012

49

REVIEW TRANSCRIPTS AND PREPARE

RECOMMENDED C

Cost

HLL83A

2.00

$102.41

$204.82

01/18/2012

49

REVIEW TRANSCRIPTS AND PREPARE

RECOMMENDED C

Cost

HLL83A

1.40

$102.41

$143.37

01/19/2012

49

REVIEW TRANSCRIPTS AND PREPARE

RECOMMENDED C

Cost

HLL61B

0.30

$102.41

$30.72

02/03/2012

60

MISCELLANEOUS


Expense

HLL83A



$28.88

09/22/2011

131400

OOURT REPORTING


Expense

HLL61B



$159.50

09/28/2011

131400

COURT REPORTING


Expense

HLL83A



$731.12

10/04/2011

131400

COURT REPORTING


Expense

HLL83A



$1,475.32

01/09/2012

131400

COURT REPORTING


Expense

HL34B



$270.00

05/17/2011

131630

EXPERT WITNESS


Expense

HL34B



$135.00

0S118/2011

131630

EXPERT WITNESS


Expense

HL34B

Sl,200.00

12/07/2011

131800

EXPERT WITNESS FEES

Expense

HL34B

$1,200.00

12/05/2011

131800

EXPERT WITNESS FEES

Expense

HW3A

$6.82

06/13/2011

133100

LEGAL & OFFICIAL ADVERTISEMENTS

Expense

HLL83B

$29.50

09/09/2011

230012

PRJNTING COMMERCIAL

\0


Flor1d8 Department of Health - FOR INTERNAL USE ONLY - itemizedcostexpl t'-


DMsloftcl

Medltal QflClltr Aaurance

***CONFIDENTIAL*** Time Tracking System

Itemized Cost/Expense by Complaint

Complaint 100820661


Report Date:

02/28/2012







Page 16of16

Record

Staff

Activity

Staff

Cost/Expense

Cost/Expense

CostJEs.pense

Cost/Expense Code


Type

Code

Houn

Rate

Amount

Date

Code

Description


Expense

HLL83A

$11.2S

09/28/2011

230012

PRINTING COMMERCIAL

Expense

HLL83A

$35.2S

10/12/2011

230012

PRINTING COMMERCIAL

Expense

Expense

HLL83A

HL:34B

$20.62

$136.77

11/09/2011

12/05/2011

230012

261010

PRINTING COMMERCIAL

TRAVEL- EMOLOYEE - IN FLA

Expense Expense

Expense Expense

HLLS3A HL34B HL34B

HLL61B

$221.50

$142.22

$144.03

$232.53

12/07/201 l

12/05/2011

12/05/2011

12/07/201l

261010

261010

261010

261010

TRAVEL - EMOLOYEE - IN FLA TRAVEL - EMOLOYEE - IN FLA TRAVEL- EMOLOYEE- IN FLA TRAVEL - EMOLOYEE - IN FLA


SubTotal $39,253.61


Total Cost/Expense $50,494.81



Florida Department or Health - FOR 1.NTERNAL USE ONLY - ltemlzedcostexpl

I

Mecllcd Quality As$9'anc

-----l DMslonaf *** C O NF IDE NT I AL***

\0

\0 MQA_

Time Tncking System

Itemized Cost/Expense by Complaint

QC Complaint 201001128

Report Date: 02/28/l012 P!!e I ofll

Record Staff Activity Staff Cost/E,:pense Cost/Expense Cost/Expense Cost/Expense Code Type Code Hours Rate Amoat Date Code Description


lcoNSUMER SERVICES UNIT


Cost HAS0 0.40

$61.04

$24.42 02/2212010 37 REVIEW LETTER

Cost HA50 0.50

$61.04

$30.52 02/2312010 25 REVIEW CASE FIL

Cost HA50 0.40

$61.04

$24.42 03/24/2010 4 ROUTINE INVESTI

Cost HAI7 0.10

$61.04

$6.10 05/03/2010 1 ROUTINE ADMINI

Cost HA73 0.30

$57.62

$)7.29 10/06/2010 I ROUTINE ADMINI

Cost HA73 0.20

$57.62

$11.52 05/24/2011 I ROUTINE ADMINI


SubTotal

$138.69

!INVESTIGATIVE SERVICES UNIT



Cost HAS0 0.40 $61.04 $24.42 01!15/2010 78 INITIAL REVIEW AND ANALYSIS OF COMPLAINT


E

GATIVE WORK STRATIVE DUTIES STRATIVE DUTIES STRATIVE DlITIES


Cost TI127 0.50 $65.23 $32.62 05/11/2010 4 ROUTINE INVESTIGATIVE WORK

Cost

Tl127

0.20

$65.23

$13.05

05/18/2010

4

ROUTINE INVESTIGATIVE WORK

Cost

T1127

0.50

$65.23

$32.62

07/15/2010

4

ROUTINE INVESTIGATIVE WORK

Cost

Tl127

1.00

$65.23

$65.23

07/21/2010

4

ROUTINE INVESTIGATIVE WORK

Cost

Tll27

0.50

$65.23

532.62

10/04/2010

4

ROUTINE INVESTIGATIVE WORK

Cost

T1127

6.00

$65.23

$391.38

10/05/2010

4

ROUTINE INVESTIGATIVE WORK

Cost

TI127

2.00

$65.23

$130.46

10/0S/2010

SI

TRAVELTIME

Cost

TI124

I.SO

$80.64

$)20.96

10/05/2010

58

TRAVEL TIME

Cost

Til24

6.00

$80.64

$483.84

10/05/2010

5

ROUTINE INSPECTION

Cost

Tl127

1.00

$65.23

$65.23

10/06/2010

4

ROUTINE INVESTIGATIVE WORK

Cost

Til24

0.30

$80.64

$24.19

10/06/2010

15

PROFESSIONAL CONTACTS

Cost

Tll27

0.50

$65.23

$32.62

10/0712010

4

ROUTINE INVESTIGATIVE WORK

Cost

Tll27

1.00

$67.81

$67.81

10/27/2010

76

REPORT PREPARATION

Cost

Tl127

2.00

$67.81

$135.62

10/28/2010

76

REPORT PREPARATION

Cost

Fl70

1.00

$67.81

$67.81

05/18/2011

100

SERVICE OF ADMlNISTRATIVE COMPLAINTS, SUBPOENI

Cost

Fl67

1.50

$67.81

Sl0l.72

OS/18/2011

9100

UL-SERVICE OF A.C.'S, SUBPOENAS, NOTICE TO CEASE &


----.l

OhlSIN of

*** C ON F IDEN TI AL***

Medk:ot QuaJily Alunanc:e

Time Tracking System

MQA_


Itemized Cost/Expense by Complaint

Complaint 201001128


=J)Ort Date:

02!18/2012







P5e2 ofll

Record

Staff

Aeti-vity

Staff

Cost/Expense

Cost/Expense

Cost/E•pense

Cost/Expense Code


Type

Code

Hours

Rate

Amount

Date

Code

Description


Cost

Tll27

0.50

$67.81

$33.91

05/19/2011

6

SUPPLEMENTAL INVESTIGATION

Cost

Cost

Fl67

Tll27

1.00

o.so

$67.81 .

$67.81

S67.Sl

$33.91

05/20/2011

05/31/2011

76

6

RE.PORT PREPARATION

SUPPLEMENTAL INVESTJGATION

Cost

Pl31

2.00

$67.81

$135.62

08/29/2011

6

SUPPLEMENTAL INVESTIGATION

Cost

OHOS

0.40

$67.SI

$27.12

09/30/2011

6

SUPPLEMENTAL INVESTIGATION

Cost

01105

0.80

$67.81

$54.25

09/30/2011

58

TRAVEL TIME

Cost

01105

0.20

$67.81

$13.56

09/30/2011

100

SERVICE OF ADMINISTRATIVE COMPLAINTS, SUBPOENJ

Cost

01105

0.40

$67.81

$27.12

10/03/2011

6

SUPPLEMENTAL INVESTIGATION

Cost

Tll27

1.00

$67.81

$67.81

10/03/2011

6

SUPPLEMENTAL INVESTIGATION


SubTotal $2,258.89


!PROSECUTION SERVICES UNIT                                                                                                                        


Cost HLL52A 0.20 $111.56 $22.31 10/11/2010 78 INITIAL REVIEW AND ANALYSIS OF COMPLAINT Cost HLL83A 0.30 $111.56 $33.47 12/1612010 25 REVIEW CASE FILE

Cost HLL83A 0.60 $111.56 $66.94 12/17/2010 25 REVIEW CASE FILE Cost HLL83A 0.20 $111.56 $22.31 12122/2010 25 REVIEW CASE FILE

Cost HLLBJA 0.10 $111.56 $11.16 01/04/2011 115 CONTACT WITH INVESTIGATORS

Cost HLL83A 0.20 $111.56 $2231 01/04/201 I 25 REVIEW CASE FILE Cost HLL83A 0.10 Sll 1.56 $11.16 0I/OS/2011 35 TELEPHONE CALLS

Cost HLL83A 0.20 $111.56 $22.31 01/18/2011 115 CONTACT WITH INVESTIGATORS Cost HLL86A 0.30 $lll.S6 $33.47 04/29/2011 25 REVIEW CASE FILE

Cost HLL86A 2.00 $111.56 $223.12 04/29/2011 81 ESOIE.RO

Cost HLLBJA 4.00 SI 11.56 $446.24 05/02/2011 St ESO/ERO Cost HLL84B 3.50 $111.56 $390.46 05/02/2011 81 ESO/ERO

Cost HLLBJA 0.20 $111.56 $22.31 05/03fl011 70 CONFERENCES WITH LAWYERS Cost HLL83A 0.10 $111.56 $11.16 0S/04fl011 37 REVIEW LETTER

Cost HLL83A 0.20 · $111.56 $22.31 05/06/2011 70 CONFERENCES WITH LAWYERS Cost ID..U!3A 0.10 Slll.56 $11.16 05/09/20.11 114 CONTACT Wini EXPERTS

Cost HLL84B 0.40 $111.56 $44.62 05/10/2011 81 ESQ/ERO Cost HLJ..84B 0.70 $111.56 $78.09 05/10/2011 81 ESO/ERO

Cost HLL84B 0.50 $111.56 $55.78 05/10/2011 81 ESO/ERO


*** CON FIDE NTI AL***I

DMllond

=

QC

Medical Qualty Assurance

MQb_


Time Tracking System Itemized Cost/Expense by Complaint

= tport Date: 02/28/2012 Pa;e3 ofll

= Complaint 201001128

Record Staff Adivity Staff Cost/Expense Cost/Expense Cost/Expense Cost/Expense Code

Type Code Hoan Rate Amount Date Code Description

Cost

HlL83A

0.20

$111.56

$22.31

05/10/2011

115

CONTACT WITH INVESTIGATORS

Cost

HLL83A-

0.10

St 11.56

$11.16

05/l0/2011

114

CONTACT WITH EXPERTS

Cost

HLL83A

0.30

$111.56

$33.47

05/10/2011

102

REVIEW EXPERT WITNESS REPORT

Cost

HLL83A

0.40

$111.56

$44.62

05/10/2011

25

REVIEW CASE FILE

Cost

HLL83A

4.00

$111.56

$446.24

05/11/2011

81

ESO/ERO

Cost

HLL84B

4.00

$111.56

$446.24

05/11/2011

81

ESO/ERO

Cost

HLL83A

3.40

$111.56

$379.30

05/12/2011

81

ESO/ERO

Cost

HLL83A

0.20

$111.56

S22.:31

05/13/2011

81

ESO/ERO

Cost

HLL83A

0.70

$111.56

$78.09

05/13/2011

81

ESO/ERO

Cost

HLL83A

0.20

SI11.56

$22.31

05/17/2011

70

CONFERENCES WITH LAWYERS

Cost

HLIAB

0.20

$111.56

$2231

05/18/1011

81

ESO/ERO

Cost

HLL83A

0.50

$111.56

$55.18

05/19/2011

28

PREPARE OR REVISE ADMINISTRATIVE COMPLAINT

Cost

HLL83A

0.10

Sil 1.56

Sll.16

05/19/2011

115

CONTACT WITH INVESTIGATORS

Cost

HLL83A

0.60

$111.56

$66.94

05/19/2011

28

PREPARE OR REVISE ADMINISTRATIVE COMPLAINT

Cost

HLL83A

0.10

$111.56

$11.16

05/19/2011

35

TELBPHONE CALLS

Cost

HLL83A

0.50

$111.56

$55.18

05/19/201 l

28

PREPARE OR REVISE ADMINISTRATlVE COMPLAINT

Cost

HLL83A

0.40

$111.56

$44.62

05/19/2011

115

CONfACT WITH INVESTIGATORS

Cost

HLL83A

1.00

Sll l.56

SI 11.56

05/19/2011

28

PREPARE OR REVISE ADMINISTRATIVE COMPLAINT

Cost

HLL83A

0.60

$111.56

$66.94

05/191201 l

28

PREPARE OR REVISE ADMINISTRATIVE COMPLAINT

Cost

HLL83A

3.00

St 11.56

$334.68

05/20/2011

28

PREPARE OR REVISE ADMINISTRATIVE COMPLAINT

Cost

HLL83A

0.30

$111.56

$33.47

05/20/2011

114

CONTACT WITH EXPERTS

Cost

HLL83A

2.00

$111.56

$223.12

05/2012011

28

PREPARE OR REVISE ADMINISTRATIVE COMPLAINT

Cost

HLL83A

0.10

$111.56

$11.16

05'20/2011

114

CONTACT WITH EXPERTS

Cost

HLL83A

2.00

$111.56

$223.12

05/20/2011

21

PREPARE OR REVISE ADMINISTRATIVE COMPLAINT

Cost

HLL83A

0.30

$111.56

$33.47

05120/2011

28

PREPARE OR REVISE ADMINISTRATIVE COMPLAINT

Cost

HLL83A

0.60

$111.56

$66.94

05/23/2011

28

PREPARE OR REVISE ADMINISTRATIVE COMPLAINT

Cost

HLL83A

2.00

$111.56

$223.12

05/23/2011

28

PREPARE OR REVISE ADMINISTRATIVE COMPLAINT

Cost

HLL83A

0.40

$111.56

$44.62

0512312011

28

PREPARE OR REVISE ADMINISTRATIVE COMPLAINT

Cost

HLL83A

1.60

St l1.56

$178.50

05/23'201I

28

PREPARE OR REVISE ADMINISTRATIVE COMPLAINT

Cost

HLL83A

1.30

$11l.56

$145.03

05124/2011

28

PREPARE OR REVISE ADMINISTRATIVE COMPLAINT

Cost

HLL83A

2.10

$111.56

$234.28

05/24/2011

28

PREPARE OR REVISE ADMINISTRATIVE COMPLAINT

Cost

HLL83A

0.90

$111.56

$100.40

05/2412011

28

PREPARE OR REVISE ADMINISTRATIVE COMPLAINT

Cost

HLL83A

o.so

SIIU6

$55.78

05/24/2011

25

REVI£W CASE FILE


C ON FI D E NT I A LI

DM&loft ot *** "**

QC Medk:ol Quollly Asswance

=                                                 

= MQA_ Time Tracking System

Itemized Cost/Expense by Complaint

Complaint 101001128

!port Dale: 02/.28/'2012 Page 4ofll

Record Staff Activity Staff Cost/Expense Cost/Expense Cost/Expense Cost/Expense Code

Type Code Honn Rate Amount Date Code Description

Cost

HLL83A

0.50

Sil 1.56

$55.7S

05/24/201 I

25

REVIEW CASE FILE

Cost

HLU3A

0.10

SIi 1.56

$11.16

05/25/2011

103

REVIEW SUPPLEMENTAL REPORT

Cost

HLU3A

1.00

Slll.56

Sl 11.56

05/25/2011

2S

PREPARE OR REVISE ADMINISTRATIVE COMPLAINT

Cost

HLL64A

0.30

Sll 1.56

$33.47

05/251201 l

70

CONFERENCES WITH LAWYERS

Cost

HLL83A

0.30

$111.56

$33.47

0Sf26/2011

28

PREPARE OR REVISE ADMINISTRATIVE COMPLAINT

Cost

HLLS3A

0.50

$11 l.56

$55.1&

06/02/201 I

89

PROBABLE CAUSE PREPARATION

Cost

HLLS3A

0.80

$111.56

$89.2S

06/06/201 l

S9

PROBABLE CAUSE PREPARATION

Cost

HLL83A

0.30

$111.56

$33.47

06/06f201 I

89

PROBABLE CAUSE PREPARATION

Cost

HLL83A

0.30

Slll.56

$33.47

06/06/2011

70

CONFERENCES WITH LAWYERS

Cost

HLLS3A

0.30

$111.56

$33.47

06/06/l0t 1

63

PRESENTATION OF CASES TO PROBABLE CAUSE PANEL

Cost

HLL83A

0.60

Sil 1.56

$66.94

06/06/2011

28

PREPARE OR REVISE ADMINISTRATIVE COMPLAINT

Cost

HLL83A

2.50

$111.56

$278.90

06/07/2011

28

PREPARE OR REVISE ADMIN1STRATIVE COMPLAINT

Cost

HLL83A

0.90

$111.56

$100.40

06/07/2011

28

PREPARE OR REVISE ADMINISTRATIVE COMPLAINT

Cost

HLLS3A

0.10

$111.56

SJl.16

06/07/2011

35

TELEPHONE CALLS

Cost

HLLS3A

0.10

$111.56

$1l.16

06/09/2011

37

REVIEW LETTER

Cost

HLL83A

0.10

$111.56

Sl 1.16

06/21/2011

70

CONFERENCES WITH LAWYERS

Cost

HLLS3A

0.20

$111.56

$22.31

06/22/2011

70

CONFERENCES WITH LAWYERS

Cost

HLLS3A

0.20

$111.56

$22.31

06/24/2011

74

MEETINGS WITH DEPARTMENT STAFF

Cost

HLL83A

0.20

$111.56

$22.31

06/28/'201 I

41

REVIEW PLEADING

Cost

HLL83A

0.30

Slll.56

$33.47

06/28/'2011

60

MISCELLANEOUS

Cost

HLL83A

0.10

Slll.56

$11.16

06/28/2011

70

CONFERENCES WITH LAWYERS

Cost

HLL83A

0.20

$111.S6

$22.31

06130/20ll

70

CONFERENCES WITH LAWYERS

Cost

· HLLS3A

0.10

$111.56

$11.16

07/0S/2011

60

MISCELLANEOUS

Cost

HLL83A

0.20

Slll.56

$22.31

07/07/201 l

70

CONFERENCES WITH LAWYERS

Cost

HU83A

0.20

$111.56

$22.31

07/14/2011

70

CONFERENCES WITH LAWYERS

Cost

HLLS3A

0.10

SI I1.56

$11.16

08/01/2011

35

TELEPHONE CALLS

Cost

HLU3A

0.10

Sl 11.56

Sll.16

08/02/2011

70

CONFERENCES WITH LAWYERS

Cost

HLL83A

0.20

SllJ.56

$22.31

08/03/2011

60

MISCELLANEOUS

Cost

HLL83A

0.10

SI11.56

SI t.16

08/03/2011

70

CONFERENCES WITH LAWYERS

Cost

HLL83A

1.00

Sll l.56

$111.56

08/05/201)

25

REVIEW CASE FILE

Cost

HLLSJA

0.40

Slll.56

$44.62

08/08/'2011

39

PREPARE/RESPOND TO DISCOVERY

Cost

HLL83A

1.00

$111.56

Sll 1.56

08/10/2011

39

PREPARE/RESPOND TO DISCOVERY

Cost

HLLS3A

0.10

$11l.56

$11.16

08/10/2011

74

MEETINGS WITH DEPARTMENT STAFF


I

Dl'llslon of *** C O NF ID E NT I AL ***

QC Medical Qualty Assurance

=                                                 

= MQA_ Time Tracking System

Itemized Cost/Expense by Complaint

Complaint 101001128

Date: 02/28/2012 Pale 5 of JI

Type

Code

Honn

Rate

Amoant

Date

Code

Descriptioll

Cost

HLL83A

0.20

$111.56

$22.31

08/llflOll

74

MBETIN.OS WITH DEPARTMENT STAFF

Cost

HLL83A

0.80

$111.56

$89.2S

08/11/2011

25

REVIEW CASE FILE

Cost

HIL83A

0.10

$111.56

$11.16

08/lSfl0ll

60

MISCELLANEOUS

Cost

HLL83A

1.30

$111.56

$145.03

08/15/2011

25

REVIEW CASE FILE

Cost

HLL83A

0.10

$111.S6

$11.16

08/16/2011

115

CONTACT WITH INVESTIGATORS

Cost

HLL83A

0.10

$111.56

$11.16

08/16/2011

114

CONTACT WITH EXPERTS

Cost

HLL83A

0.40

$111.56

$44.62

08/16/2011

39

PREPARF/RESPOND TO DISCOVERY

Cost

HLL83A

0.20

$111.56

$22.31

08/17/2011

35

TELEPHONE CALLS

Cost

HLL83A

0.10

$111.56

$11.16

08/17/2011

36

PREPARATION OR REVISION OF LETTER

Cost

HLL83A

0.10

$111.S6

$11.16

08/17/2011

37

REVIEW LEITER

Cost

HLL83A

0.20

$111.S6

$22.31

08/lBfl0ll

3S

TELEPHONE CALLS

Cost

HLL83A

0.40

SI 11.56

$44.62

08/IBfl0I I

40

PREPARATION OF OR REVISION OF A PLEADING

Cost

HLL83A

0.10

$111.56

SI1.16

08/18/2011

74

MEETINGS Wl1ll DEPARTMENT STAFF

Cost

HLL83A

0.20

$111.56

$22.31

08/18/2011

70

CONFERENCES WITH LAWYERS

Cost

HLL83A

0.10

$111.S6

Sll.16

08/18/2011

40

PREPARATION OF OR REVISION OF A PLEADING

Cost

HLL83A

0.10

SIi 1.56

Sll.16

08/18/l0ll

74

MEETINGS WITH DEPARTMENT STAFF

Cost

HLL83A

1.30

$111.56

$145.03

08/19/l0l l

39

PREPARE/RESPONDTO DISCOVERY

Cost

HLL83A

2.50

$111.S6

$278.90

08/22/2011

39

PREPARFJRESPONDTO DISCOVERY

Cost

HLL83A

2.00

$111.56

$223.12

08/23/201 l

39

PREPARE/RESPOND TO DISCOVERY

Cost

HLL83A

0.50

$111.S6

$S5.78

08/2l/201 l

70

CONFERENCES WITH LAWYERS

Cost

HLL83A

0.10

$111.56

$11.16

08/24/2011

74

MEETINGS WITH DEPARTMENT STAFF

Cost

HLL83A

0.20

$111.S6

$22.31

08/24/2011

70

CONFERENCES WITH LAWYERS

Cost

HLL83A

1.10

$111.56

$122.72

08/24/2011

39

PREPARE/RESPOND TO DISCOVERY

Cost

HLL83A

0.30

Sll 1.56

$33.47

08/24/2011

25

REVIEW CASE FILE

Cost

HLL83A

0.10

$111.56

$11.16

08/26/2011

60

MISCELLANEOUS

Cost

HLL83A

0.20

$111.56

$22.31

08/29/2011

35

TELEPHONE CALLS

Cost

HLL83A

0.30

$111.56

$33.47

08/29/2011

70

CONFERENCES WITH LAWYERS

Cost

HLL83A

0.30

$111.56

$33.47

08/29/2011

70

CONFERENCES WITH LAWYERS

Cost

HLL83A

0.20

$111.56

$22.31

08/29/2011

11S

CONTACT WITH lNVESTIGATORS

Cost

HLL83A

0.40

SI11.56

$44.62

08/29/2011

2S

REVIEW CASE FILE

Cost

HLL83A

0.20

$111.56

$22.31

08/30/2011

35

TELEPHONE CALLS

Cost

HLL83A

0.20

$111.56

$22.31

08/30/2011

46

LEGAL RESEARCH

Cost

HLL83A

0.10

$111.56

SI 1.16

08/31/2011

39

PREPARE/RESPOND TO DISCOVERY

Record Staff Activity Staff Cost/Expense Cost/Expense Cost/Expense Cost/Expense Code


*** C ON FI D ENT I A L ***I

l>Mllon of

=

00

MedlcGI Qvalty A$Mnance

=

MQb_


Time Tracking System Itemized Cost/Expense by Complaint

Complaint 101001118

Date:

02/28/2012 Pale 6of11

Record

Staff

Activity

Staff

Cost/Expense

Cost/lspense

Cost/Expense

Cost/Expense Code

Type

Code

Hoan

Rate

Amount

Date

Code

Description

Cost

HLL83A

0.30

$111.56

S33.47

08/31/2011

74

MEETINGS WITH DEPARTMENT STAFF

Cost

HLL83A

0.20

$111.56

S22.3l

09AH/2011

74

MEETINGS WITH DEPARTMENT STAFF

Cost

HLL83A

t.00

SI I l.56

Stl 1.56

09/07/2011

43

PREPARE FOR DEPOSITION

Cost

HLL83A

0.30

Slll.56

$33.47

09/08/2011

35

TELEPHONE CALLS

Cost

HLL83A

0.20

Slll.56

$22.31

09/08/201 l

70

CONFERENCES Wl11I LAWYERS

Cost

HLL83A

0.40

Sllt.56

S44.62

09/08/2011

25

REVIEW CASE FILE

Cost

HLL83A

0.10

SJ 11.56

$11.16

09/09/2011

74

MEETINGS WITH DEPARTMENT STAFF

Cost

HLL13A

0.10

$] lt.56

$11.16

09/12120ll

35

TELEPHONE CALLS

Cost

HLL13A

0.40

SI I 1.56

$44.62

09/12/2011

39

PREPARE/RESPOND TO DISCOVERY

Cost

HLL13A

7.50

$111.56

$836.70

09/1212011

58

TRAVEL TIME

Cost

HLL83A

0.50

Sil 1.56

$55.78

09/12/2011

39

PREPARF/RESPOND TO DISCOVERY

Cost

HLL6JB

7.00

$111.56

S780.92

09/12/2011

58

TRAVEL TIME

Cost

HLL61B

3.00

$111.56

S334.68

09/12/2011

43

PREPARE FOR DEPOSITION

Cost

HLL83A

0.70

$111.56

S78.09

09/1312011

25

REVIEW CASE FILE

Cost

HLL83A

0.30

$11 t.56

$33.47

09/13/2011

58

TRAVEL TIME

Cost

HLL83A

0.40

$111.56

$44.62

09/13/201l

25

REVIEW CASE FILE

Cost

HLL61B

7.00

$111.56

$780.92

09/131201 l

44

DEPOSITIONS

Cost

HLl..618

2.00

Stll.56

$223.12

09/13/201 l

43

PREPARE FOR DEPOSmON

Cost

HLL83A

0.50

$111.56

$55.78

09/14/2011

39

PREPARE/RESPOND TO DISCOVERY

Cost

HLL83A

0.30

$111.56

S33.47

09/14/2011

58

TRAVEL TIME

Cost

HLL83A

2.50

$111.56

S278.90

09/14/2011

44

DEPOSITIONS

Cost

HLL83A

0.30

$111.S6

$33.47

09/14/2011

58

TRAVEL TIME

Cost

HLL618

3.00

SI I 1.56

$334.68

09/14/2011

44

DEPOSITIONS

Cost

HLL618

4.00

Slll.56

$446.24

09/1412011

58

TRAVEL TIME

Cost

HLl..618

2.00

$111.56

$223.12

09/14/2011

29

REVIEW ADMINISTRATIVE COMPLAINT

COst

HLL6lB

2.00

$1)1.56

$223.12

09/15/'l0ll

43

PREPARE FOR DEPOSITION

Cost

HLL61B

3.00

$1] l.56

$334.68

09/15/2011

44

DEPOSITIONS

Cost

HU.618

6.00

$111.56

$669.36

09/15/'l0I I

58

TRAVEL TIME

Cost

HLL83A

0.60

$] Jl.56

S66.94

09/19/2011

25

REVIEW CASE FILE

Cost

HLL83A

0.10

$111.S6

SI1.16

09/1912011

36

PREPARATION OR REVISION OF LETTER

Cost

HLL83A

0.20

Slll.56

$22.31

09/21/2011

74

MEETINGS WITH DEPARTMENT STAFF

Cost

HLL83A

0.20

$111.56

S22.31

09/22/2011

37

REVIEW LETTER

Cost

HLL83A

0.20

Sl 11.56

S22.31

09/23/2011

74

MEETINGS WITH DEPARTMENT STAFF

(.H


ICjl() -t.A·edk:al Qually Asmance

=  

=MQA_

,ort Date: 02/28/2012 Record Staff

Type Code


Activity Hours


Staff

Rate


*** CONFIDE NTI AL***

Time Tracking System

Itemized Cost/Expense by Complaint

Complaint 201001128


Cost/Expense Cost/Expense Cosf/Espease

Amount Date Code


Cost/Expease Code Deseriptioo


Page 7of 11

Cost Cost Cost Cost Cost Cost Cost Cost Cost Cost

Cost Cost Cost Cost Cost

Cost Cost Cost

Cost Cost Cost Cost Cost

Cost

Cost Cost Cost Cost Cost Cost Cost Cost Cost

HLL&3A HLL83A HLL83A HLL83A HLL83A HLL83A HLL83A HLL83A HLL83A HLL83A HLL83A HLL83A HLL83A HLL83A HLL83A HLL84B HLU4B HLL84B HLL83A HLL83A HLL83A HLL83A HLL.61B HLL83A HLL83A HLL83A HLL83A HLL83A HLL83A HLL83A HLL83A HLL83A HLL83A

0.60

0.60

1.00

1.00

0.20

1.00

0.)0

0.60

0.90

0.20

0.20

0.80

0.50

1.00

0.10

0.10

2.00

0.10

1.00

1.00

0.20

0.40

o.so

0.10

0.50

0.30

o.so

0.50

0.80

0.10

0.30

0.80

LOO

Slll.56

$111.56

$111.S6

$111.56

$111.56

$11l.S6

$111.S6

$111.56

$111.56

SlJl.56 St 11.56

St I1.56

Stlt.56 Sl1l.56

$1I1.56

$111.56

$11156

$111.56

Sil 1.56

St 11.56

$111.56

$111.S6

$111.56

$111.56

$111.56

$111.56

Slll.S6 Stll.56 SltJ.56 Sl11.S6

Sllt.56 Sit 1.56

Sltl.S6

$66.94

$66.94

Sil 1.56

Sllt.56

$22.31

SI 11.56

Stt.16

$66.94

$100.40

$22.31

$22.31

S89.25

$55.18

Slll.56 Sll.16

$11.16

$223.12

$11.16

$111.56

$111.56

$22.31

$44.62

S5S.78

$11.16

SSS.78 S33.47

$55.78

S55.78 S89.25

$11.16

$33.47

$89.25

Slll.56

09/23/2011

09/23/2011

09/2612011

09/26/2011

09/26/2011

09/26/2011

09/26/2011

09/27/2011

09/27/2011

09127/2011

09127/2011

09/27/2011

09/27/2011

09/28/2011

09/28'2011

09/30/2011

09/30/2011

10/03/2011

10/04/2011

10/04/2011

10/04/2011

10/04'2011

10/05/2011

10/0512011

10/0S12011

10/05'2011

10/06/.2011

10/06/2011

10/06/2011

10/0612011

10/06!2011

10/06/2011

10/0712011

2S

25

25

25

70

28

70

40

30

70

41

25

114

60

37

70

46

70

70

46

70

45

64

74

46

74

28

46

46

88

28

25

25

REVIEW CASE FILE REVIEW CASE FILE REVIEW CASE FILE REVIEW CASE FILE

CONFERENCES WITH LAWYERS

PREPARE OR REVISE ADMINISTRATIVE COMPLAINT CONFERENCES WITH LAWYERS

PREPARATION OF OR REVISION OF A PLEADING PREPARE AMENDED AIC

CONFERENCES WITH LAWYERS REVIEW PLEADING

REVIEW CASE FILE CONTACT Wim EXPERTS MISCELLANEOUS REVIEW LEITER

CONFERENCES WJTH LAWYERS LEGAL RESEARCH CONFERENCES WITH LAWYERS CONFERENCES WITH LAWYERS LEGAL RESEARCH CONFERENCES WITH LAWYERS

PREHEARING MOTION/CONFERENCE CALL

LEGAL ADVICFJDISCUSSION - BOARD OFFICE.DEPT STAl MEETINGS WITH DEPARTMENT STAFF

LEGAL RESEARCH

MEETINGS WllH DEPARTMENT STAFF

PREPARE OR REVISE ADMINISTRATIVE COMPLAINT LEGAL RESEARCH

LEGAL RESEARCH

PROOFING AND SIGNING LETIERS

PREPARE OR REVISE ADMINISTRATIVE COMPLAINT REVIEW CASE FILE

REVIEW CASE FILE


*** C ON FIDE NTI AL***I

DMtlanof

=

QC

Meclcal Qvolly Assuronce

=

MQA_


Time Tracking System Itemized Cost/Expense by Complaint

UI

Complaint 201001128

:port Date: 02/28/2012 Page 8of 11

Record Staff Activity Staff Cost/Expense Cost/Expense Cost/Expense Cost/Expense Code

Type Code Houn Rate Amount Date Code Description

Cost HLL83A 0.10 $111.56 Sll.16 10/07/2011 70 CONFERENCES WITH LAWYERS Cost HLL83A 0.20 $111.56 $22.31 10/07/201 I 114 CONTACT WITH EXPERTS

Cost HLL83A 0.20 $111.56 $22.31 I0/'07!201 I 28 PREPARE OR REVISE ADMINISTRATIVE COMPLAINT Cost HLL83A 0.10 Slll.56 $11.16 10/11/2011 37 REVIEW LETIER

Cost HLL83A 0.20 SI 11.56 $22.31 10/11/2011 102 REVIEW EXPERT WITNESS REPORT Cost HLL83A 0.20 $111.56 $22.31 10/11/2011 70 CONFERENCES WITH LAWYERS Cost HLL83A 0.20 $111.56 $22.31 10111/2011 25 REVIEW CASE FILE

Cost HLL.61B 3.00 $111.56 $334.68 10/12/2011 28 PREPARE OR REVISE ADMINISTRATIVE COMPLAINT Cost HLL83A 1.50 $111.56 $167.34 10/12/2011 70 CONFERENCES WITH LAWYERS

Cost HLL83B 1.50 $111.56 $167.34 10/13/201 I 30 PREPARE AMENDED NC

Cost HLl.61B 0.50 $111.56 $55.78 10/13/2011 28 PREPARE OR REVISE ADMINISTRATIVE COMPLAINT

Cost HLL83A 020 $1 l l..S6 $22.31 10/18/2011 70 CONFERENCES WITH LAWYERS

Cost HLL61B 0.30 $111.56 $33.47 10/20/2011 28 PREPARE OR REVISE ADMINISTRATIVE COMPLAINT Cost HLL83A 020 $111.56 $22.31 10/20/2011 70 CONFERENCES WITH LAWYERS

Cost HLL83A 0.80 $102.41 $81.93 10/27/201 I 62 REVIEW OF CASES FOR PROBABLE CAUSE PANEL Cost HLL83A 0.30 $102.41 $30.72 10/28/201 l 62 REVIEW OF CASES FOR PROBABLE CAUSE PANEL Cost HLL83A 0.10 $102.41 $10.24 10/28/2011 70 CONFERENCES WITH LAWYERS

Cost HLL83A 0.20 $102.41 . $20.48 10/31/2011 90 POST PROBABLE CAUSE PROCESSING Cost HLL83A 0.20 $102Al $20.48 10/31/2011 90 POST PROBABLE CAUSE PROCESSING Cost HLL83A 0.20 $l02.41 $20.48 11/01/20ll 74 MEETINGS WITH DEPARTMENT STAFF Cost HLL83A 0.20 $102.41 $20.48 11/02/2011 74 MEETINGS WITH DEPARTMENT STAFF

Cost HLL61B 0.30 $102.41 $30.72 11/03/2011 40 PREPARATION OF OR REVISION OF A PLEADING

Cost HLL61B 0.30 $102.41 $30.72 11/03/2011 47 TRIAL PREPARATION Cost HLL83A 0.)0 $102.41 SI0.24 ll/0412011 37 REVIEW LETIBR.

Cost HLL83A 0.10 $102.41 $10.24 11/04/2011 36 PREPARATION OR REVISION OF LETTER

Cost HLL61B o.so $102.41 $51.21 11/07/2011 47 TRIAL PREPARATION

Cost HLL83A 0.20 $102.41 $20.48 11/07/2011 60 MISCELLANEOUS

Cost HLL83A 0.20 $102.41 $20.48 I I/07!2011 35 TELEPHONE CALLS

Cost HLL83A 0.30 $102.41 $30.72 11/07!2011 70 CONFERENCESWITHLAWYERS

Cost HLL83A 0.10 $102.41 $10.24 11/'08!2011 74 MEETINGS WITH DEPARTMENT STAFF

Cost HLL83A 0.40 $102.41 $40.96 ll/09/2011 37 REVIEW LETTER

Cost HLL83A 0.30 $102.41 $30.72 11/10/2011 70 CONFERENCES WITH LAWYERS Cost HLL83A 0.10 $102.41 $10.24 11/15/2011 60 MISCELLANEOUS


*** C ON FIDE NTI A LI

Dl\'blonof ***

QC MedlcGI Qva,Dy Asiur onc

=                                                

= MQA_ Time Tncking System

Itemized Cost/Expense by Complaint

Complaint 201001118

eport Date: 02/28/2012 P9e9ofJ1

Record Staff Activity Staff Cost/Expense Cost/Expense Cost:/lxpense Cost/Expense Code

Type Code Ho11rs Rate Amoant Date Code Description

Cost HW3A 0.10 $102.41 SI0.24 11/1612011 36 PREPARATION OR REVISION OF LETTER Cost HLL83A 0.10 $102.41 $10.24 l 1/1612011 35 TELEPHONE CALLS

Cost HLL83A 0.20 S102.41 $20.48 IJ/1612011 37 REVIEW LETTER

Cost HLL83A 0.10 $102.41 $10.24 ll/1612011 74 MEETINGS WITH DEPARTMENT STAFF Cost HLL83A 0.20 $102.41 $20.48 11/1712011 70 CONFERENCES WITH LAWYERS

Cost HLL83A 0.20 $102.41 $20.48 11/1712011 70 CONFERENCES WITH LAWYERS Cost HLL81A 0.20 $102.41 $20.48 11/17/2011 70 CONFERENCES WITH LAWYERS Cost HIL83A 0.20 $102.41 $20.48 11/21/2011 35 TELEPHONE CALLS

Cost HLL83A o.so $102.41 SS1.21 11/2112011 40 PREPARATION OF OR REVISION OF A PLEADING

Cost HLL83A 0.50 $102.41 $51.21 11/2112011 40 PREPARATION Of OR REVISION OF A PLEADING Cost HLL83A 0.10 $102.41 $10.24 11/21/2011 74 MEETINGS WITH DEPARTMENT STAFF

Cost HLL83A 0.10 $102.41 $10.24 11/21/2011 25 REVIEW CASE FILE

Cost HLU3A 0.20 $102.41 $20.48 11122/20 ti 74 MEETINGS WITH DEPARTMENT STAFF Cost HLL83A 0.10 $102.41 SI0.24 11122/2011 36 PREPARATION OR REVISION OF LEITER

Cost HLL83A 2.00 $102.41 $204.82 11/22/2011 40 PREPARATION OF OR REVISION OF A PLEADING Cost HLL83A 0.20 $102.41 $20.48 11/23/2011 74 MEETINGS WITH DEPARTMENT STAFF

Cost HLL83A 0.20 $102.41 $20.48 l 1123/2011 36 PREPARATION OR REVISION OF LETTER Cost HLL83A 0.10 $102.41 SI0.24 11/23/2011 60 MISCELLANEOUS

Cost HLL83A 0.10 $102.41 $10.24 11/231201l 70 CONFERENCES WITH LAWYERS Cost HLL83A 0.10 $102.41 Sl0.24 11128/2011 35 TELEPHONE CALLS

Cost HLL83A 6.00 $102.41 $614.46 11/28/2011 47 TRIAL PREPARATION

Cost HLL83A I.SO $102.41 $153.62 11/29/2011 47 TRIAL PREPARATION

Cost HLL83A O.lO $102.41 $I0.24 11/29'201) 74 MEETINGS WITH DEPARTMENT STAFF

Cost HLL83A 0.80 $102.41 $81.93 11/30/2011 47 TltIAL PREPARATlON

Cost HLL83A 0.60 $102.41 $61.45 12/01/2011 47 TRIAL PREPARATION Cost HLL83A 6.00 $102.41 $614.46 12/01/2011 47 TRIAL PREPARATION Cost HLL83A 0.70 $102.41 $71.69 12/0112011 47 TRIAL PREPARATION

Cost HLL83A 0.20 $102.41 $20.48 12/01/2011 114 CONTACT WITH EXPERTS

Cost HLL83A 7.80 $102.41 $798.80 12/02/2011 47 TRIAL PREPARATION Cost HLL83A 1.00 $102.41 $102.41 12/031201 l 47 TRIAL PREPARATION Cost HLU3A 3.00 $102.41 $307.23 12/04/2011 58 TRAVEL TIME

Cost HLL83A I.SO $102.41 $153.62 12/0412011 114 CONTACT WITII EXPERTS Cost HLL83A 0.50 $102.41 $51.21 12/04/2011 47 'TRIAL PREPARATION


*** CON F IDE NT I A LI

DMlklnal ***

QC  MedlcGI Qualiy Ass-nee      

=                                                

= MQA_ Time Tracking System

Itemized Cost/Expense by Complaint

---..l

Complaint 201001118

eport Date: 01128/2012 P!§e lOofll

Type

Code

Hoars

Rate

Amoant

Date

Code

Description

Cost

HLL83A

3.00

$102.41

$307.23

12/0512011

47

TRIAL PREPARATION

Cost

HLL83A

0.50

$102.41

$51.21

12/06/2011

47

TRIAL PREPARATION

Cost

HLL83A

6.00

$102.41

S614.46

12/06/2011

48

FORMAL HEARING

Cost

HLL83A

3.00

Sto2.41

$307.23

12/07/2011

58

TRAVEL TIME

Cost

HLL83A

0.10

$102.41

SI0.24

12/1412011

49

REVIEW TRANSCRIPTS AND PREPARE RECOMMENDED C

Cost

HLL83A

3.30

$102.41

$337.95

1212712011

49

VIEW TRANSCRIPTS A'ND PREPARE RECOMMENDED C

Cost

HLL83A

0.10

$102.41

$10.24

01/0312012

37

REVIEW LETIER

Cost

HLL83A

1.00

$102.41

$102.41

01/03/2012

49

REVIEW TRANSCRIPTS AND PREPARE RECOMMENDED C

Cost

HLL83A

0.50

$102.41

$51.21

01/04/2012

60

MISCELLANEOUS

Cost

HLL83A

0.10

$102.41

$10.24

01/06/2012

37

REVIEW LETTER

Cost

HLL83A

0.50

$102.41

$51.21

01/1012012

49

REVIEW TRANSCRIPTS AND PREPARE RECOMMENDED C

Cost

HLL83A

5.00

$102.41

$512.05

01/1212012

49

REVIEW TRANSCRIPTS AND PREPARE RECOMMENDED C

Cost

HLL83A

3.00

$102.41

$307.23

01/13/2012

49

REVIEW TRANSCRJPTS AND PREPARE RECOMMENDED C

Cost

HLL83A

5.00

$102.41

$512.05

01/1712012

49

REVIEW TRANSCRIPTS AND PREPARE RECOMMENDED C

Cost

HLL858

0.20

$102.41

$20.48

Ol/1712012

49

REVIEW TRANSCRJPTS AND PREPARE RECOMMENDED C

Cost

HLL83A

6.00

$102.41

$614.46

01/18/2012

49

REVIEW TRANSCRJPTS AND PREPARE RECOMMENDED C

Cost

HLL83A

4.00

$102.41

$409.64

Ol/1912012

49

REVIEW TRANSCRIPTS AND PREPARE RECOMMENDED C

Expense

HLL83A



$28.87

09/2212011

131400

COURT REPORTING

Expense

HLL61B



$159.51

09/2812011

131400

COURT REPORTING

Expense

HLL83A



$731.13

10/04/2011

131400

COURT REPORTING

Expense

HLL83A



Sl,475.32

01/0912012

131400

COURT REPORTING

Expense

HL34B



$945.00

05/17/201 l

131630

EXPERT WITNESS

E,tpense

HL34B



$270.00

10/11/2011

131800

EXPERT WITNESS FEES

Expense

HL348



$1,200.00

12/07/201 l

131800

EXPERT WITNESS FEES

Expense

Hl..348



$1,200.00

12/051201 t

131800

EXPERT WITNESS FEES

Expense

HLL83A



$6.82

06/1312011

133100

LEGAL&. OFFICIAL ADVERTISEMENTS

Expense

HLL83A



St J.25

09128/2011

230012

PRINTING COMMERCIAL

Expense

HLL83A



$3S.25

10/12/2011

230012

PRINTING COMMERCIAL

Expense

HLL83A



$20.63

Jl/09/2011

230012

PRINTING COMMERCIAL

Expense

HLL83B



$29.50

09/0912011

230012

PRINTING COMMERCIAL

Expense

Hl.348



$136.78

12/051201 l

261010

TRAVEL - EMOLOYEE - IN FLA

Expense

HLL83A



$221.50

12/07/2011

261010

TRAVEL- EMOLOYEE - IN FLA

Record Staff Activity Staff Cost/Expense Cost/Expense Cost/Expense Cost/Expense Code


I

OMllon.al

QC

=                                               

=

Medico! Qqality Assurance


QC :port Date: 02/28/2012

Record Staff


Activity


Staff

*** CON FI DE N T I AL ***

Time Tracking System

Itemized Cost/Expense by Complaint

Complaint 201001128


Cost/Expense Cost/Expense Cost/Expense Cost/Expense Code


Page Jl ofll

Type

Code

Hoan

Rale

Amount

Date

Code

Description

Expense

HL34B



$142.22

12/05/2011

261010

TRAVEL - EMOLOYEE- IN FLA

Expense

HL34B



$144.04

12/05/2011

261010

TRAV£L - EMOLOYEE - IN FLA

Expense

HLL61B



$232.53

12/07/2011

261010

TRAVEL - EMOLOYEE - IN FLA




SubTotal

$33.187.38






Total

Cost/Expense

$35,584.96




gM _

Iex:,


Oftof "** CON FI D E NT I A L "**

lo'ledk:al QvGlily ..

Time Tracking System Itemized Expense by Complaint

Complaint 201001128


Report Date: 02/17/2012 Page I of 1

E1:pense Expense Expense

Staff Code Date Amount Code Expense Code Description

!PROSECUTION SERVICES UNIT


HLL83A

09/22/2011

$28.87

13)400

COURT REPORTING

HLL.61B

09/28/2011

· $159.51

131400

COURT REPORTING

HLL83A

10/04/20\1

$731.13

131400

COURT REPORTING

HLL83A

01/09/2012

$1,475.32

131400

COURT REPORTING

Hl.34B

05/17/2011

$945.00

131630

EXPERT WITNESS

Hl.34B

10/11/201 l

$270.00

131800

EXPERT WITNESS FEES

HLL83A

06/13/2011

$6.82

133100

LEGAL & OFFICIAL ADVERTISEMENTS

HLL83A

09/28/2011

$11.25

230012

PRINTING COMMERCIAL

HLU3A

10/12/201 l

$35.25

230012

PRINTING COMMERCIAL

HLL83A

11/09/2011

$20.63

230012

PRINTING COMMERCIAL

HLL83B

09/09/2011

$29.50

230012

PRINTING COMMERCIAL

HL34B

12/05/2011

$136.78

261010

TRAVEL· EMOWYEE - IN FLA

HLL83A

12/07/2011

$221.50

261010

TRAVEL - EMOWYEE - IN FLA

HL34B

12/05/2011

$142.22

261010

TRAVEL - EMOLOYEE - IN FLA

HL34B

12/05/2011

$144.04

261010

TRAVEL - EMOWYEE - IN FLA

HLL.61B

12/07/2011

$232.53

261010

TRAVEL - EMOLOYEE - IN FLA


SubTotal $4,590.35

Total E1:penses $4,590.35


1


Bay Park Reporting

-4010 W. Slate Stteet

Tampa, Fl. 33609

.·!tt.t11;

l°!:GAi'.i?t,,LAruw !

Phone:813--490-0003

Fu 813-831-1599

11 Sfp 26 Ii 9: 39



Robert Bobek

DepL of Health - Prosecution Seniices 4052 Bald Cypress Way, BIN C-65 Tallahassee. FL 32399-3265

Invoice #33678

                Tenn&                   

Net30


i

Job I Number

RePGl'lar

I

Order Shlnnad

I

ShlnaadVla

j

091\5/2011 I 3612

Sal\llyDavil

I

I

USMai

l

Contract Number

Cua

I 050601

DOH n. GUI depo St Pete

!Description Price Qty I Amount)

Detective Robert Osterland 1 30pm

Appearance - First Hour - Deposition


SA John Beuth 2:30pm

$ 47.25

1.00 S4725

$47.25

Appearance - Additional Hours - Oeposllion (0.5 Hours}

$ 21.00

1.00

S 10.50

S 10.50


Amount Due;

Paid:

$ 57.75

$0.00


       BaJanceCue:         $57.75

       PaymentD :                10/2212011


ft\

1r·so10                           _




BAY PARK REPORTING . - LAt•••U

1875 N. BELCHER ROAO !RJ.l.11.: I.':.,• ..:.lid " 1•m

      INVOICE        I

Invoice No. Invoice Date Job No,

SUITE 102 L GAL

(7,EARWATER, FL 3376S

'-'rllone:'27·724·6091 Fax:727•nS-S749 11 OCl -1 AH 9: Ii.

73240 10/4/2011

lob Date case No.

9/15/2011 U-004058l

Case Name

611090 I


Shiricy Bates, E5q.

FLOR.IDA D::PARiMENT OF HEALTH, PROSECUTION Sl:RVJCES UNJi

4052 BALO CYPRESS WAY

SIN #C·65

TAL HASSEE, FL 32399·3265

PT ORIGINAL& ONE COPY OF D'EPOSffiON:

"BEUTri

TRANSCRll'T ORIGINAL & ONE COP'!' OF OEPOSmON: ROBERT OSTERLAND

B&W Exhibits•

UPS Ground• s&H •1

ACHA vs Gillis q,3 s-srl

Payment T• _

Net30


39.00 Pages @ 3.57 139.ll

33.00 Pages C 3.57 117.81

100.00 @ 0.52 52.00

9.97 9.97

TOTALDUE >>> $319.01


'""""'Reminder Our Valued Olents•••••

we have offices located in Tampa,

Clea,water, St. Pete and New Port Richey.

..,..,-=::.-..,,:f_frln,a,,m,,.l.d,e,.o.,_..._,,,a1aieu,.,_,,th..e

You also can set ycur deposltroos, hearings, videos, etc.

la noau .,. 1 ra,,NCl8ftaedmur

anywhere In North America by simply ca111ng our office.

,d'theSt•teCltiqfPlnanaaJ IMt ._Cllllq rfoht to .-.fNaddUfcm the ctmllvct.Pcrlodi,:po-,lrlUl/ts". rm(/or


·:-:::- ...

[ ::: r--


rlt't!St' dt!ur1;/i boll!HII fW"lillli Cllkt rt!tltrtl IL'if/1 /Jlfl'lllC'tll

:n:-:. I

J-.

Shirley , eW

flORIIMiafPAS!MfNTOF HEALTH, PROSECUTION

SERVIc:$ UNJl:;3

4052 a'iLo CYPRESS WAY

SIN #C·65

TALLAHASSEE, Fl 32399•3255


KemltTo: BAY PARK REPORTING

1875 N. BELCHER ROAD

SUITE 102

CLEARWATER, FL 13765

lnvaice No. Lnvolce Date Total Due


lob No.

BUfD

Case No.

case Name

73240

10/"1/2011

$ 319.01


611090

BAY PARI< 11·004058L ACHA v.9 GIBis


· 8011                                              _




l


.2


3


5


.',

8


10


11


12

l l

STATE OF FLORIDA.

DIVISION OF ADMINISTRATIVE HEARINGS I

DOAH CASE NO:.ll-004058PL/ll-004062

DOH CASE NO: 2008-20661/2010-01128


DEPARTMtNT OF HEALTH,

Petitioner,


JACINTA IRENE GILLIS, M.O.,


Respondent.

---------------'


DEPOSITION OF: ROBERT OSTERLA O


LJ


14 TAKEN ·ay:


lS

DATE:

16


J7 TIME:


18

PLACE:


20


21


u REPORTED BY:


23


24


PETITIONER


SEPTEMBER 15, 2011 COMMENCING AT 1:30 P.M.

DEPARTMENT OF HEALTH INVESTIGATIVE OFFICE SEBRING BUILDING, 3RD FLOOR

525 MIRROR LAKE DRIVE, SUITE 310A

ST. PETERSBURG, FL 33101.


SANDRA DAVIS CAMP PROFESSIONAL REPORTER NOTARY PUBLIC

STATE OF FLORIDA AT LARGE



ARGUS BAY PAJU( UPOR.TING (813} 49O-0DO3


w 8012




l

1

I

STATE OF E'LORlDJ:\ l

DIVISION OF ADMINISTRATIVE HEARINGS

OOAH CASt NO: 1l-0040 8PL/ll-00 40 62 OOH CASE NO: 2008-20661/2010-01128


DEl?;&.RTMENT Of" HEiAl.,T\\,

6 Petitioner,

"T vs.

a JACINTA IRENE GILLIS, M.D.,

·-------''

9 Respondent.


10


-'I:,

OJ"'

-

..

r.­

o,

fr:

r

..'


l2 DEPOSITION OF: JOHN BEUTH


lJ


l4 TAKEN SY:


PET-CTI ONER


l !,


16


DATE: SEPTEMBER 15, 2011

ti TIME: COMMENCING AT 1:30 ?.M.


18

PLACE:


20


21


22 REPORTED BY:


23


DEPARTMENT OF HEALTH INV&STIGATIVE OFFICE SEBRING BUILDING, 3RD FLOOR

525 MIRROR LAKE DRIVE, SUITE 310A ST. PETERSBURG, FL 33101.


SANDRA DAVIS CAMP PROFESSIONAL REeORTER NOTARY PUBLIC

STATE OF FLORIDA AT LARGE


25

ARGUS BAY PARK REPORTING (813) 490-0003


- 8013




MARTINA REPORTING SERVICES

Courtney BulRiln1f,'"Suite 201

2089 First Street

.:HA i I.. . , f.:,·L,\i. •ll Ft. Myers. Florida 33901

lf ;. (239) 334-8545 • Fax (239) 332•2913

11 oc·r - Pii 1: 06 ,

(. BOIE< ROBERT )

FLORIDA DePARTMeNT OF HEALTH

j                         

40e2 8ALC CVflRESS WAV SIN C-00

AU..AHASSEE. Fl 32399-1265

l'U:A9t. nl'rtRfiNC ceNU"40ER

Wri£h RF.Ml'TTINO

DEPARTMENT OF ...EALTI, VS

JACINTA GILLIS CONTRACT#972310001

11..0D4058F'L. 11-004082PL,200B-20e81 REPORTER: AMBROBlO

911312011 OEPO OF: OR. JA.ClNTA GIWS

•. rsu ..

10/1#/11

10/11/11

TN-.EN: 2295 VICTORIA AVE, FT. MYERS APP FEE Q $42 1ST HR. SSS.80 ADD. , 10:00 - 2:15 ( 9113111 )

APP. FEE C S421ST HR. Sll.60AOO.

10:00 - 12:20 ( 9114/11 )

· ·

/

-

1: I

: 4'!

02.40

ORIGINAL & ONE C S4.14 EXHIBITS

UPS GROUND SERVICE

POST A.GE & HANOUNG

t27B PGS)

®' p/4

' . " -..2 ....-.----:,,..;,,,..

!-;J IYOO .

.

Ot.lf-: ,,,._Q

1,150.92

48.10

ORIGINAL uo, A 4'+ I C. 7

_..

1,482.2\_ge

CHARGES

REFERENCE

DATETAKEN

WE ACCEPT ALL MAJOR CREDIT CARDS

ORIG. WLL BE SENT Al=TER READING


10#:

- 1_5!L--

-            

1.482.25 .


DEPA.'Q.TMEN'l' OF HF'.JU,'t'H

vs

· DR. JACIN'l'A GILLIS

---------- /


CASE NO: ll-PL-004058

11-PL-004062

2008-20661

2010-01128

lii

'

I


AE'FIDAVIT


STATE OF FLORIO.A}

COUNTY Of LEE)


I certify that$ 5.96 is the exact lJJ11ount of postage eo·send the Original Transcript to Robert Bobek, 4052 Bald Cypress Way, Bir. C-65, Tallahassee, Fl. in the above-styled case.


DATED this 3RD day of OCTOSER, 2011.







l STATE OF FLORIDA -

It

l:?

DIVISION OF ADMINISTRATIVE HEARINGS -

  1. -i


  2. DEPARTMENT OF HEALTH, )

Petitioner } OOAH CASE NOS. 11-004058'Pi.

4 VS. ) 11-oo,06lfL

) O'\

5 JACINTA IRENE GILLIS, MO. ) DOH CASE NOS. 2008-20661

                                                                        ) 2010-01128


DEPOSITION OF: JACINTA IRENE GILLIS, M.D.


DATES TAKEN:

TIME:.

September 13 and September 14, 2011

10:00 AM

E1LACE TAKEN: Department of Health

Investigative Office

2295 Victoria Avenue, Room 346A

Fort Myers, Florida 33913


BEHALF OF:

REPORTER:

The Department of Realth


Sandra Ambrogio Court Reporter and Notary Public in a_nd for the State of Florida at Large.



--8016


MARTINA ijEPORTING SERVICES

Courtney Building, Suite 201

Fore Myers, lorida 33901

(239) 334-6545

FAX (239) 332-2913


- .



MARTINA REPORTING SERVICES

Courtney EJlldlng,•Sulle 201

2069 First Street

Ft. M ars, Florida 33901 (23.9).3.3..4-:. 45 .. Fax (239) 332-2913

STATEMENT DA'Tc

1/08!1012

INVOK:E NUMBER

. : ,



108880

I

Wl-!e,.,

.,.J PL.J;ASE r11::Fl:F!Cl'JCETHIS 11,:YOtCE NUt.•Jrc:l'e

Pl:'.IITilHG

WE ACCEPT ALL MAJOR CREDIT CARDS

DATETAICEN REFERENCE CHAIIGES


1{ ... Cit PL

l I ..!;)-/&'Iil.

fl ),...

I

,ya .•:· : :;t -:-·: -=-•• f .. _ =- I =-r

•F::::,..t! -·:; =:,: !': . - Q=:. :..:,

.,.: • .J :: . ; : ' -=


TOTAL BALA•,CE

CUE


._8017                                                   .


  • l

""-·

J:1.1 D.


DIV!SION

STl\TE OF FLORIDA 10/1 JJJt

OF ADMINISTRATIVE HEARINGS '"'9 [:J f2:

t•·1.•,.. I

r;:

ADi-f1i1l's'f Nor

DEPARTMENT OF BEALTH, BOARD }

OF M11'....DICINE:, )

)

Hf Ararr,G!As'rtv1.­



Respondent..

)



Petitioner,


)


vs.


JACIN'J'i\


IRENE GILI.IS,


M.D.,

) case Nos.

)

)

11-5691:l?L

11 5692PL

) VOiiOME I OF III

) PAGES 1 1s,


TRANSCRIPT OF KEAAING PROCEEDINGS


Before the Honorable Bruce McKibben, 1'dm,1.nistrative Law J.udge, at a hearing in tha above-styled action, held at the Office .of the

Judges of Compens tion Claims, Fort Myers,


Flc,rida, on D1:1cember 5th and 6th, 2011.


MARTINA REPORTING SER.VICES

Courtney Building, Suite 201

J

2069 First Street ,

Fort Myers, Flo-rida 3390\ 1"5)

(239) 334-6545 -.:::6'1.F \J

F X (239) 332-29 3

-8018                                               

I



.STATE OF FLORIDA

DIVISION OF ;\DMINISTRATIVE


DEPARTMENT OF e3ALTH, BOARD

OF MEDICINE,

Pelitioner,

vs.


JACINTA IRENE GILLIS, M.D.,


Respondent.

)

)

l

)

)

) case Nos. 11-S691PL

) 11-569? L

)

) · VOt.OME II OF III

)) PAGES 195-392


TV:.NSCRTPT OF HEARING PROCEEDINGS


Before the Honorable Bruoa McKibben, Administrative Law Judge, a.t a hearing in the. ove-.styled action, held at the Office of the

Judges of Compensation Clatms, For.t Myers,

Florida, on Decembe.r 5th and 6Lh, 2011.


..



MARTINA REPORTING SERVICES

Courtney Building, 'suite 201 2069 First street

Fort Myers, Florida 33901

{239) 334-&545

FAX (239) 332-2913


DEP TMENT OF HEALTH, BOARD

OF MEOI CI NE 1


PeliLioner,


vs.

"JACINTA lRE'NE GILLIS, ·M.D.,


Respondent.

)

)

)

)

)

) case Nos. 11-5691Pt

) 11 •5692PL

)

) VOLUME III OF III

)} PAGES 393-SSS


lBAN§CRIPT OF HEARING PRQCEEDIBGS


Before the Honorable Bruce McKibben, Administrative Law J.udge, at a hearing in the

above-styled action, held at the office of the

Judges of Cornpens.at.i.on Claims, Fort. Myers,


Florida, on December 5th and 6th, 20ti.



-8020


MARTINA REPORTING SERVICES

Yf5)

Courtney Building, Suite 201 2069 First Street ,

'Fort Myers, Florida 33901

(2391 334-6545 -.:::9 1.r" 1J

FAX l239) 332-2913


*** CO NF ID E N T I A L ***

Time Tracking System Itemized Expense by Complaint

Complaint 200820661


Report Date: 02/17/2012 Page 1 of 1


Staff Code


Expense Date

E:1pense Amount


Expense

Code Expense Code Description

HLL83A

09/2212011

$28.88

131400

COURT REPORTING

HLL61B

09/28/2011

$159.50

131400

COURT REPORTING

HLL83A

10/04/2011

$731.12

131400

COURT REPORTING

HLL83A

01/09/2012

$1,475.32

131400

COURT REPORTING

Hl.34B

05/17/2011

$270.00

131630

EXPERT WITNESS

Hl.348

05/18/2011

$135.00

131630

EXPERT WITNESS

HLL83A

06/13/2011

$6.82

133100

LEGAL & OFFICIAL ADVERTISEMENTS

HLL83B

09/09/2011

$29.50

230012

PRINTING COMMERCIAL

HLL83A

09/28/2011

SI 1.25

230012

PRINTING COMMERCIAL

HLL83A

10/12/201 l

$35.25

230012

PRINTING COMMERCIAL

HLL83A

11/09/2011

$20.62

230012

PRINTING COMMERCIAL

Hl.34B

12/05/2011

$136.77

261010

TRAVEL - EMOLOYEE - IN FLA

HLL83A

12/07/2011

$221.50

261010

TRAVEL - EMOLOYEE - IN FLA

HL34B

12/05/2011

$142.22

261010

TRAVEL - EMOLOYEE - IN FLA

HL34B

12/05/2011

$144.03

261010

TRAVEL - EMOLOYEE - IN FLA

HLL61B

12/07/2011

$232.53

261010

TRAVEL - EMOLOYEE - IN FLA

!PROSECUTION SERVICES UNIT



S•bTotal $3,780.31

Total Expenses 53,780.31


Florida Department of Health · - FOR INTERNAL USE.ONLY -- itemizedexpense



Bay Park Reporting

-4010 w. Slate Street

Tampa, Ft. 33609

Phon :813-490-0003

Fax: 813-831-1589



Robert Bobe1t

DepL ofHealth - Prosecution Se lces 41052 Bald Cypress Way, BIN c-65 Tallahassee. FL 32399-3265

Invoice #33678

              Tenns                 

Net 30



Job I Number

Re11ortar

I

Order Shln-.t

I

Shin-dVla

I

Cl91t51Z011 I 3812

Sal\dy Cavil

I

I

US Mail

I

Contract Number

Cue

I 050801

OOH vt1. Gills dapo St Pe1e

l


IOe&cnptlon Price Qty Amount 1

Detective Robert Osterland 1:30pm

Appearance - First Hour - Deposition


SA John Beuth 2:30pm

$47.25

1.00 S4725

$47.25

Appearance - Additional Hoc.,rs - Deposition (0.5 Hours}

$ 21.00

1.00

S 10.50

S 10.50


Amount Due;

Paid:

S 57.75

$0.00


                                                 567.75  

       Pa     entDue:               1DI2212011  


-8022

......



q

BAV PARK REPORTING

1875 N. BELCHER ROAD

urre 102

,LEARWATE FL 33765

hone:727-724-6091 Fax:727•725-871119 11 OCT - 1 AH 9: I

INVOICE-

Invoice Na.

Invoice Date

1

Job No,


73240

10/4/2011

6ll090

.,

      lob Date

Ce!Se No.


Shirley Bates, Esq.

FLORIDA D:PARTMENT OF HEALTH, PROSECUTION SERVICES UNIT

"1052 BALO CYPRESS WAY

BIN #C-65

TALLAHASSEE, FL 32399-3265

;,,. ORIGINAL & ONE COPY OF DEPOSITION:

'J/1S/2011


ACHAvs Gillis


Net JO

U-00-1058L

Case Name


!if//_!

N BEUTrl

TRANSCRIPT ORIGINAL&. ONE COPY OF DEPOSmON:

ROBERT osrERLANO

8&.W Exhibits •

UPS Ground. s&H •l


'*••Reminder for Our valued Clients•••"'"' We have offices located ln Tampa, Clearwater, St. Pete and New Port Rlehey.

You also can set your depositions, hearings, videos, etc,

anywhere 1n North America by Simply calling aur office.


=:

Tax ID:

. ·• .......

f); ,-

39.00 Pages @ 3.57 139.23

33.00 Pages 3.57 117.81

100.00 tt 0.52 52.00

9.97 9.97

TOTALDUE >>> $319.01


Phone: 950-2"'15-4&10 !"ax:BS0-2'4S-41680

·n-: .

._I

Shirley EW

fLORI'6B:PA&fMENT OF.HEALTH, PROSECUTION

SERVIces UNJ:l;::

-4052 Bil.O CYPRESS WAY

BIN #C•6S

TAUAHASSEE,Fl 32399•3265


ar<emltTo: BAV PARK REPORTING 1875 N. BELCHl:R ROAD SUITE 102

CLEARWATE , FL 33765

tnvoice No. Invoice oa te Tntal Due


Job No.

8U[O

case No. case Name

732-40

10/4/2011

$ 319.01


611090

8AY PARK

1MJ04058L

ACHA vs GIiiis

._8023                                              



1


l 2 J


5


fj

,

8


9


11


12


13


l!t


I 1


11


zo


2!


23


24


8024



STATE OF FLORIOA

DIVISION OF ADMINISTRATIVE HEARINGS

DOAH CASE NO: ll-004058PL/11-004062 DOH CASE NO: 2008-20661/2010-01128

-:_: -,...

DEPARTMENT OF HEALTH,

Petitioner,

vs.

JACINTA IRENE GILLIS, M,D,,

---------------'

---------·-·--------------

DEPOSITION OF: ROBERT OSTERLAND

Respondent.

TAKEN BY:

PEiTITIONER

DATE:

S&PT MBER 15, 2011

TIME:

COMMENCING AT 1:30 P.M.

PLACE:

DEPARTMENT OF HEALTH INVESTIGATIVE OFFICE SEBRING BUILDING, 3RC FLOOR

525 MIRROR LAKE DRIVE, SUITE 310A

ST. PETERSBURG, FL 33701.

REPORTED BY:

SANDRA DAVIS CAMP PROFESSIONAL REPORTER NOTARY PUBLIC

STATE OF FLORIDA AT LARGE

ARGUS BAY AU UPORTXNG (813) 490-0003

1



STATE Of eLORIDA

DIVISION OF ADMINISTRATIVE HEARINGS

DOAH CASt NO: ll-0040 8FL/ll-004062 OOH CASE NO: 200B-20661/2010-0ll28


- ::-

-t./) -.

!! DEE>ARTMENT Of' tteALTl\,

I.:",'"\ -

T'.l .,r.-.

, Petitioner,

OJ c.:


, vs.


a JACINTA IRE.NE GILLIS, M. D.,

--;·:.·.

-..

.1:.-

01

r,.

·..

.,....

,


10


11


12,

---------------'


Respondent.

DEPOSITION OF: JOHN BEUTH


ll


14


15


16


\'7


18


l !I


20


21


22


23


TAKEN BY:


DATE: TIME: PLACE::


REPORTED BY:


PET"CTIONER


SE TEMBER 15, 2011 COMMENCING AT 1:30 ?.M.

DEPARTMENT OF HSALTH INVESTIGATIVE OFFICE SEBRING BUILDING, 3RD FLOOR

525 MIRROR LAKE DRIVE, SUITE 310A

ST. PETERSBURG, FL 33101.


SANDRA DAVIS CAMP PROFESSIONAL REeORTER NOTARY PUBLIC

STAT6 OF FLORIDA AT LARGE



ARGUS BAY PARlt REPORTING (813) 490-0003


..._8025-------------------------1




MARTINA REPORTING SERVICES

Courtney Buffb1 uite 201 2069 First Street

ltt..·..i I,. , • • :'... ,\i . •!I Ft. Myers. Florida 33901

Lf I.A. (239} 334-6545 • Fax (239) 332·2913

(. ,, oc·t -- Pii 1: oG )


.: ENT OF HE/11.TH

40!5.2 BALO CYPRESS WAV SN C-m.1

ALLAHASSEE, FL 3:ngg..s2e5

) ltdtA.91. ilP.Pl'.AtNC OICE NUMUO'I

W,-tEN IIFMITTINO

DEPARTMENT OF ,-.EAi.TH VS

Jf.CINTAGIWS CONTRACT 72310001

g/13/2011

11-0D4058PL. 11-004062PL,2008-20Ge1 REPORTER: AMBROGIO

OEPO OF: CR. Jl.CINTAGIWS

TAh'EN: 2295 VICTORIA.AVE, FT. MYERS

APP. FEE@S421ST HR. $33.BOAOO.

10:00- 2:15 ( Q/13/11 )

APP. FEE O M21ST HR, $33.80ADD.

1 D:00 - 12:20 ( 9/14/11 )

. .

161.20

ORIGINAL & ONE C S4 .14

EXHIBITS

UPS GROUND SERVICE

POSTAGE &HANDLING

t:278 PGS)

' .,

t. l 11100

92,40

er:,'. ,4

,.

",-.2 - ar-C11-01:S'"

1,150.92

ou:mo

·- --

48.10

(ORIGtNAL.l

uo·. A Lit.I- ( C. -,

1.482.2l,ge

1

ORIG. 'MLL aESENT AFTER READING

1,482.25

CHARGES '

REFERENCE

DATE TAKEN

WE ACCEPT ALL MAJOR CREDIT CARDS

;


8026-






I,

DEPARTMENT OF HF.AL'l'H

vs

---------------'

DR. JACINTA GILLIS

CASE NO: ll-PL-004058

ll-PL-004062

2008-20661

2010-01128

AFFIDAV!'r

STATE OF FLORIDA,


COUNTY OF LEE)

I certify that $ 5. 96 is the

t:o send the Original Transcript to Robert Bobek, 4052 Bald Cypress W y, Bin C-65, Tallahassee, Fl. in the above-styled case.

e,-;act amount of post:age

DATED this 3RD day of OCTOBER, 2011.



--8027--·-· -·- -        



  1. STATE OE' FLORIDA

    I

    --

    .'.

    "

    P. '

    -;,

    :::t:

    DIVISION OF ADMINISTRATIVE HEARINGS

    2

    _R,

    ..... l


    1. DEPARTMENT OF HEALTH,

      Petitioner

    2. vs.


      OOAH CASE NOS.

      .d- r:: _-:

  2. ..

::_t, ;::-

t

11-0040SSt>t ,:

1l.-00406 L


  1. JACINTA IRENE GILLIS, MD.

6


DOH CASE NOS.

°'

2008-20661

2010-01128

...:.•



DEPOSITION OF: JACINTA IRENE GILLIS, M. D.


DAT S TAKEN: September 13 and Septemoer 14, 2011

TIME:. 10:00 AM

PlJI..CE TAKEN: Department of Health

Investigative Office

2295 Victoria Avenue, Room 346A

Fort Myers, Florida 33913


BEHALF OF:

REPORTER:

The Department of Realth

Sandra Ambrogio court Reporter and Notary Public in and for the State of Florida at Large.



--8028


MARTINA PORTING SERVICES

Courtney Bui.lding, Suite 201

Fort Myers, Florida 33901

(239) .334-6545

FAX (239) 332-2913


         I






MARTINA REPORTING SERVICES

Courtney lldlng;-Suite 201

2069 First Street

Fl. Myers, Florida 33901

.,w,..e"::,.., ,

:- ;;:ss ... ,

STATEl4ENT DAl&

1J06"t.!U12

INVOICE NUMBER

088 (J

(2-39).3.3.4-..6$45 .. Fa)( (239) 332-2913


115-ll603-i lJ3




_) PLEASE FCE:Ftl'!E U TH'S INYOICE 11:Ul. k:FI

Wl-tl:t.1 Rr:.'.IITTING

{ -!:f(/1d-f)4

I ft"1".

"QJMIJ loJ,i;oQJ.4.MJ

TOT AL BALANCE

. - -

JUE

WE ACCEPT ALL MAJOR CREDIT CARDS

DATETAK&N

REPERENCE

CHAflG&S


'; - .J:! . :1:= ::..L:i-, ;3

:..:-··.T . Ji..L - C





;J.vc/< . t3.o&, L,c

,r 1:/:,1 PL-




'I

B.OID ... DI{ · l

(!,,1,-\Jt-Q...,'1) - Sc=t.i

.r."(J s tJ o•

' .,;,111.

,;,1,a.



._8029                                          _



STl TE OF FLORIDA Ill'!J

{;,.lg

· II e-

.. ...... , ,ft;_

"-•J..,/

DIV!SION OF ADMINISTRA'l'IVE

HEn"A-nI Nt-.:S i;UJ ... qp

:\ '.-,'.,.1..,..,

'·Di',:Ji,ts'f N OF

12: I

DEPARTMENT OF HEALTH, BOARD

OF J.G:DICIN'E,


Pelitioner,


VS,.

) fff4R/Ntf lv£

)

)

)

)

) Case Nos. 11-S6-91PL

) 11 S692PL

JAClN'J'J\ IRENE GILt.IS, M.D., . )

Respondent.

)


} ).

VOI.,UME I OF I I I

PAGES l··l94.


TRANSCRIPT OF HEARING PBQCEEDIN'GS


Before the Honorable Bruce McKibben, Adm.1nistra':ive Law J.udge, at a hearing in the above-styled action, held at the Office of the Judgas of Compe1wation Claims, Fort Myers,

Florida, on Dgcember 5th and 6th, 201,.



-8030

,

JARTlNA REPORTING SERVICES

Courtney Suilding, Suite 201

)=-,

2069 First Streat

Fort Mye:rs, Florida 33901 f5) '

(239) 334-6545 :::;/ \ 11..r U

FAX (239} 332-29 3


l

l


STATE OF FLORIDA

DIVISION OF ADMINISTRATIVE


01-.:J:IJ'.R'I'ME T OF HEALTH, BOARD )

OF MSDICIME, )

PeLitioner, I

)

vs. } Case Nos. 11-5691PL

) 11-569?PL

JACINTA IRENE GILLIS, M.O., I

} ·VOLUME II OF III

Respondent. ) PAGES 195-392

                                                                              )


:z:R .NSCRIPT OF HEARING PROCEEDINGS


Before the Hono able Bruce McKibben, Administrative Law Judge, a.t a hearing in the. abCJve-styled action, held at the Office of the Judges of Compensation Claims, Fort Myers, Florida, on December 5th and 6Lh, 2011.


MARTINA REPORTING SERVICES

Courtney Building, 'suite 201

2069 First Street

Fort Myers, Florida 33901

(239) 334-6545

fP.X (239) 332-2913

I



DEP TMENT OF HEALTH, BO.\RD

PeliLioner, )



I

:,;

)




}

Case Nos. 11 5691PL


·'

)

11-5692PL



OP' MEDICil E,


vs.

ACINT IRENE GILLIS,·M.D.,

Respondent.


)

)

) ·I I


)

) VOLUME III OF l I

)) PAGES 393-SSS


TRANSCRIPT OF HEARING PROCEEDINGS


Before the Honorable Bruce McKibban, Administrative Law Judge, at a hearing in the above-styled action,- held at the office of the

Judges of Compensation Claims, Fort Myers,

Florida, on December 5th and 6th, 2011. r



-8032

MARTIN RE:PORTING SERVIC S

J.'-fB)

Courtney Building, Suite 201 I,

2069 First Street ,

"Fort Myers, Florida 3390\

(239) 334-6545 l.r' 1J

FAX (239) 332-2913



FLORIDA DEPARTMENT OF STATE

_ , I ,· •- it-'., 1

-- '

-· Jir .. I

Kurt S. Browning, Secretary of State :t · . ... . • ;: 22

Division of Library and lnformalionSe ces!,• l •> t'.,1

Administrative Code Unit

The Gray Sullding - SOOS. Broncugh Street, Suite101 - Tallahassee, Fl 32399..0250 • (850)245-6270

Siled to

DEPARTMENT OFHEALTH PROSECUTION SERVICES UNIT 4052 BALD CYPRESS WAY

BIN-CBS TAll.AHASSEE.Fl32399-326$ Attn: ALYSON MOTES


Ac OL!nt: .1014_7 _ lnvo!ce Qat : 6/1_012011 lnv91c,.N .1:nP..,nJ.

P.O.# Publicetlon In Florida Administrative Weekly # units seach Extension

1 · Volume:37/22 P es:154 1544 105 1.24 _ 1 JO

2 Volum.e: 712lPa_glJl_ af¥1 67 1.24 S83.08

Invoice# must appear on an chel;ks and coriespondence. Please pay balance due: S213.28

'F.e.1,0. number. --.- ••• Nel Oue - 15 days. No Oiseount -·

UFrr L :m.:r,••. :.-  • f,:5tJ

w·-r· . :,, .. , '-/t3/!.c.

l/, I '-/-:,/11

...


  • • I

ool\Jt,JP,. n

1 "

I:?> l OQ

. -'i -,<>S'-ol-OIS': I :3. fu'l

1:,.,. :, -0:1-01 01 = '31- LJL/

b'l- !l-.03-01- 9: , :lQ


TO INSURE PROPER CREDIT, PLEASE RETURN THIS PORTION.

Department of State - Division of Administrative Services - Bureau of Planning, Budget and Financial Services

RA Gray Bldg - 500 s. Bronough s 4th Fl, - Tallahassee, Fl. 32399-0250

Account: 10147 Invoice Date: 6110/2011 Number: 123D33

Amount Due: $213.28

S1a1t1 Agencies - Joumlll Tranr.ler toAcco11111 Code: 45-60-2.572001-45400100-GO BFObj 019000 Bf C81001903

Org Coda f EO :454001202Cl0 7X Objecl 019032 Catag0ry; 001903

For .Ac:coun1ng UN Only: Ob;ecl Code: 011l032 C.l 001903 ARGl: 16300 GI.' 67100

Samas Ac;munt CodeNelldor 64-50-2°352001-64400101H)O


-8033                                            





l'olr11r1d1. Numb,r 22, Jr,11e ), 1011

C sw11:..n.ulll cccwy/uipl!Jalc_i.::l1.'tlri11gi101JS . for lnfottnnilon,


Surgeon C',eaeral'i; findings or an immedin_tc and scrioUJ

i:ull (850):?4S-216l.Tl1ii1pu\lli1: 1101ice f11lr1ll61111: rcqLJiren1e11

ufl.5 CfR 9.30.

DF:PARTME;i..'T OF' HEAi.TH

,:k- \ Nol.ice of Em 'llty Actiun

On M:iy 111, 2011. Stotc Surgcoa General, issued an Order or Emcrg1:ncy Su,pcnsion Order .\Yilh TC!\lll'd tu Im: liccmsc ur Jaeinra lmu: Gillis, M.D. .License 4ME 99.:?9"i:. This Em1."f1ll:11C)" Suspc:nsfon Onk.-r w,s pri:itica1ed upoo the Stale Su'¥con G..:nerul', limlints uf un immetliuLc mad s.:nous J.1,1sQr 10 1hc: P'Jblic: he;1lth, Sl'fety ancl welrnre p11r.s1JMI 10

&x:cions 456.073(3) nnd 120.69(6), Florida Swtutcs. nw Sune

Su11,:co11 Gc I dclcrminc,L tlmi tlias summary procedure Wllll

fair under1hc ci 1,ms1nnccs, in 1hat lhcre was oo ollacr mr:thod

a,•aihtblc 10 aclcquati:ly pm1cet she p11blic


Nu1i ol"Enll:rg.:r111yAc1ion

danger- to lhc: public heahb.. arcty IID welfare pur:n'tml t Scctiaos 456.07.lCA) and 120.60(6), Florida Sum,ti:s. 1 he Stille SurgCOll Gcllffl!l ,h::terminctl tfflll. th.is summary J>h)Cl:dU.R .,.,,,n; fair imder the:circunu.1anm,, in tliuL there wll.S no ulbcr 1111:thud available: loadequately prg11.-cl Im: public.

!:. \\ N ice ornl'l,ern,:11q, ,;\etion

On May 20. 201 l, Stall! Surgt.:un General. issued lllt Order o Emcrvcrn:y Susp n io11 Otuer wlt11 rc:gar<I ti;, the license o Lallh:I Mt.:Clclhil\, ltN, LiC&."1191: RN 3140832. Tl1111

ncy S 1\liicm Order was predicutca upon tbc 11Lc:

Surgeon. Gcni:r.il'!i iindin,:s or an immooiale .and acnollli

danger w the public health, safoly Dnd we:lliw p11 t 10 Section., 456.07lt8) ond 120.60(6), Florida S1al1111:s. Tbe Stole Surgeon Ocneml dclcm,incd Lhot this summary pruc:cchm: was lair umk:r ttiv t.:ircunutane1.-s. in 1b.-i11hcrt: was no 011\et rnethl'Kl B\'llalabl 10 .uk:qualely proll:<:1 tlu: public.

'1' On iay 20, 2011, Stutc Su11cun Gcnml, issued au Order j' \\ Notice ofF.n,crgenc:y Actinn

Li_liina Emcr.1i1cncy Si.!SpCnsiun rder wiO, r ,t I 10 the lice11i;e OIi fay 20, 2011, Slate Sllrgcon Gmcral, issm.:d on_Onlcr or o1 Juy A. Prt'!on,. R.N. License #Il;'I; -;820fC:"2.. The lltlletgel\cy Suspei\Rion Ot-der wilh repn.l to \he ltccn._e of m1mem orcl1: _1ha1 L11e en'M!11Jtmcy Sus 1151on ol L1ccmsc Jumic L.Ynn Phillips. C.1'.A. Lic1.11St.: 4CNA 171611')•• rtll'i be htied and yo11r hcen. c lie rc1rwatcd. Emergency Sw.-ptnsic>n Ordor was pn:dic:ucu upun the: Statc

.-Jf \\ Noli.cc on:m ncy Action

- . - Surgi:oit GCtl"-'l'lll'S fiadi111,1s o( au immedl:lle :u1d i;erlous d:Jngcr 10 I.he public hi::lllh, !Wft.:ly and welfare pursumt lo

On May 23. lOI I; Slttlc Surgeon Cii:-m:ral, iiiSUcd m Onl -r ur.

Eincrgcncy S1u;pmi;ion Order with regnnl lo U,..: lict:nl'C o( D11UalJ Wnyni., S 11c1:r. R.111.. l.ic;ea,se #RN 'J1R210L 'lllii l:mert,:Cl\CY Suspen5io11 Order was predictlrecl upon 1hc !;1111e

Sec1iu11.S 456.073(8) a1xl 110.C,()(6), Floridn S1orut- The State Sur,...:1-111 CA.'ncr.il d1.1cnnined c.b,'\I dus s1nnin1ry p,oc:edl,re wus fair under the cireumsianccs., in that lb wa 110 other mclbud

awil.ahle ln ade(luatrly protect lhe public.

S11r on llrneral'!; findi11as of nn im1n ime and scnc,us                                                                                            

danger tc:i 1h1? public. htallh, J:ifcly und wctnm: pWSur£nt IO Scc1ions-156.07l(S) Gnd 120.60(6), l"lorida St1m1ti.s, Tll\: SUllc: Surgeon G11nc111l dc:lcnnmc:d llutL this 1111m1t111 • pruccdurc was luir un kr the cirtul11lllunci:i1. in 1lm1 1heri: wns 110 11th1:r n 1hod nvailnbk: 10 •'11:tJ li:ly pro,tc:I lhe public

y,,. '' Nntice or ITmef!cncy Aclion

I \\ · Nu•ice ufE11 r"e.1cy Ac:tl(ln

On M11y ::io, JUI I, S1111e Sm.1,-cm1 (ierien1t, ii-Sued nil Order or E1111.211i:n.;y s,.11 mn Oru1,1r 1vilh n..-wird In Ilic lic:cm11,t: ur U11icsia1 A. Jenkins, C.N.A. l,icense #CNA 1590R3. Thiili

1-:mergcncy Surpcnsfon Order ww. JH'CMiic:ati:d upon I.be Slate

S11rsemt Ocncral'i. findil1g5 af an immadi111c and serious dang;.-r Ln lhc _public hcallh, A filly ilhd wc-Jforc plllliWLlll lo

or

011 M:1y 24. '2011. Sl:11e Sosuco11 (rcr1erul, issi1cd a•• Order or Scc1ion,; 4S6.073 ) nnd 120.60(6), F1oricln S1.uu . The: Sa11r.: tmergcncy SU$pcnsion Order with regard 10 the lice of Surgeon Gcnc:ral dctcmtincd. lhat lhis dllmnuuy J>IIWCULIN wus lbc:hcllo Rae Stu.1111, C.N.A. License flCNA I12035. Thi, , filir una-r lhc ci umwanc:r11, in lhul lhcrt: w1,s nu uthi:r ro11lh(ld Emergency Su!lpC11&ion Order w:a prcdicuu:d u.poo lhc Slutc a,-uilabk 10 adcqunlcly prulL'CI lbc publit'.

Surgeon Gcnc l's lindin ua imn..:Ji:1111 ood ou

danger to lhc public hc111th, aul'i:1y and welfare pur&1t:n11 10 \\ Notice of Emergency Action

S«liuns 4S6.073{8) and 120.60(6), _flotiJo S1111utes. The S1:1.10 On May :?0. 11111, Staie Sur-.;eoo General, .,o;,u,;,d :in Order of i:;.., 0011 General <letonnined 1h:it 1l11s. sumnLi1y pr4>ecdul\? Wll!'i Bmerg y !:luspell$ion Order wilh segnrd 10 the license of Ciir_ under Lheicirc:11mli&ll11Cl!!i. ill thnl 1here was noother mcd1o<I CaraL 'lbylor, LP.N. License #PN 134293 I. This Emcrg.cncy av:ulable 10 «[U:ttel)· prntec1 1hc pubhc. Suspem;\on Order wa.,; predicaCcd IIJIOO lhc Stoic Slirg1.--011

-- -· · · - - --- Ocncral's rtndings or wi innrmlilltc·and scrioW1 danger ttl 1h1: J_ Nolicc ofEruc;rgt.·ncy Acliun public h1.'llltb, safety 1111J welfare pursua111 tu Sccbuns 1J On May 24, 2011, Siatc Surgeon General, issued un_Onfcr or 4515.073(8) tmd J:!0.60(6), Florida Sllltutei1, The S11.11c SulJJCUII

Emc!ll!cncy Suspension Order will! n:gard tu du: hCL"llSc of

April Nicole Crumpton, C.N.A. Ll ,_-nsc #CNA 711180. Thi:.

Emcrgi:m.:)' Suspension Order Wll!I pn:dic:mr.:d upun thi: Sm1c:


Scc:Liun XJl • Misccllaoeoos 1 3


_8034-                                               _



Florida Adn1i11i..,l'Olfr1t m:ekly l'r1l111nd7, 1\'1unbf!r 12, J111w J, 1911

I

.e.

I

'

Gcr11:ral de1em,incd thnt lhis sum1nklj' procedure wns fuir

under die e1rcumsl11n«S. in 11\al lberc Wt\.'I nn athcr method

:M1ilnble ro adequately protc\:l &bi: public.

*

\l Nuth:&:off.mergency Action

On May 20, 201 l. Sw.k SurJ;:Ctlll CJ1:ncml, i sucd un Order ur

f.nu:rgency Sw.pcrmon Ordi:r with l'l:,anl li, Lhc license ofl

laric DwuhrL. L,P.N. Lii:cim: Nl'N 51536 ll. Thhi l!m" cucy Swpcni;iu11 t>rdi:r wa,; llrcdic111ed upon lhc Stai SIIJ'i4lon G1:11eral\ finding,, 1,f 11n imn1<.,li111c 1111d :.1:1iu11s d,,nsi:r 10 the p1.1blil: 111:ahh, i1tfcty :md wclfu ptir.mmit Ill Sections 4!-r,.07=1,(>"!) nntl 120.<.0(6), Florida Sm111111s. llie St:ue Surgeon Ch:nen1I di:11?m1incd Ihm this w1D111nry procedure Wll!i rair 1111dcr the circums1:1111:cs, i11 th:11 thl!re w11 na olhcr method nv:,ilahlc- 1n ndcquntcly prull,'CI 1hc public.


FISH A D WIL.OLIFI CONSERVATION

COMMISSIO

,W/1.11..ABll.lTY OF GRA.\'T rU l>S

Tlw fhmd:1 1:ish 11nd Wildlife Cooliel"\'nliun ul111111is..,;io11 is t1t:(.'C.'Jllu111 :ipplkntions for grant rundirll' ll1M1 l1 tht Bo111ing l11lrar.1n1crure Qranl (1310) Prugrum fur lisul y1."Dr lOll•IJ. The deadline for rccci\·inu applica1iu1 is S:00 p.m., Augu:,it

19. 2011. /\pplicalions m:\:ivci.l aA.:r the d.:odlinc will bt.:

lnelii;ihlc ro, eansid -nttiun.

'I he Hin Progn:im is funded li'om 1he US 1-'i,h 1md \Vildlift: Si:rvice for the con51Ntlloa 1111<1 renovnti11n nf tic-up rnc1liliei for traosicnl bu.111.:n 111 \'Cl!:CIR 26 feet or more in lcmt:.d1. lnfmmauon ou 1he 1m.1 Program. Pmgrwn. Guidcliui:lt, and

Ri:,1uQ;I for A1l!llic:11io115 and ClorilM.111ion 11r A1,plii:a1i01111

Rc,1 1irc:111entli nre :.wailabh: al bl1p:l/www,myfwc,caml h.n:tti1111fho:i1ing-granl-programs1bigpi,

E1mail qucs1ions to ingp@myrwc.cpm or phone

CK50)4&ll-SC,OO.


DF.PAR1MENT OF FIN,\l"'fCIAL SF.R,'lCES

NOTICE TO ALL POUCYMOI.OERS, CRED110RS, A!\U CLAIMANTS J IAVll\'(i BUSINESS \VlTH S1.iMINOl.li CASUALTY lNSURA NCF. COMPANY.

IN THE CIRCUIT t.'OURT OF THF. SECOND JUDICIAL CIRCUIT. IN ANO FOR 1.t:ON COUNTY, FLORIDA

CASE NO.: 2011-CA-OOIJ().l

In Re; The Reccivcr.ihip uf Sl!MINOI.E C/\SUALTY INSlJlv\NCE COMPAXY, 1:1 1:1orid,1 cnrporu1ian.

NO'l'ICI-: TO AI.L POLICYHOLDEKS, CKF.OITORS, AND ('I.AIMANTS HAVING UUlilNHS.t; WITH SEMINOLE C' ASU/\LTY INSURAN<.: C.:OMPANV.

'l'ou are hereby notified that by onkr,,r tlte Clrcuil Coun orlllc

Second Judicial Circuil, in 11n,J for l..co11 Co1.S1ly, Florida, cruered she 15th day ur M11rcl1, :!O11. tile Dcp:irlmmt ot'

l'1n:111ci11I Scr'\'iec: or 1t11: S1a11: of 1-IOfid:i \\'llli aJlpaintcd 11s

Ri.i:c:i,•er or SEMINOLE C.:ASUAl.fV INSlJRA CE

C"OMl'AN\' and was onk:n:-' 111 liq11ida1e lhl: :u.scts lacal in

1-loridn of said c:nmplllly.

Polh;yholders. claimants, creditors, .imJ uihc:r persc,ns in 1his Stalt Ir.win cl:ii1115 agai11st 1111: .ssscts of SEMINOLE CASUAi.TV INSURANCE COMPANY. sh:ill present such

i:launs ta the Rc:cci,-cron or bcfun, 11:59'. IJ r,m. Qn Man:h I ,

lOl 2. or such claims shull b,.: rUl\lv.ir barred.

Rl..'tjuc.'SIS ror fonns for the pn.-scnllltion or suet, clnim nnd u1q11ldes. conccming tbi!i Rcceiwn;hip should be addrc!iscd lo: lne L>ivision or lleluili1u1ion n11d Liquida11on (If the: Florida llc-:r,:irtment or 1:in:incial Services. Rccdver for SEMINOL C-ASUi\LTY rNSURANCE COMPANY, -POil om.cc Bo 110,

Tallohasscc:, Florida 31302-01IO, Addiliona.l infonnn1iou m.1y he found at: W\V\\ 1.0orid:,i11surJncerc« ivcr.org.


NOl'i<.'.I! TO Al.I. POLICYHOLDERS, <.:Rf:t>ITORS, ANO CLAl -IAN1'S I IA\IING BUSINESS WITI I Af.QUICAP INj:;URJ\NCE COMPANY

IN TH CIRCUIT COURT OP THI! SLiCOND JUDICIAL

ClRClfiT, [N AND fOJl LcON couNr V. FLOR.IDA

CAS!l ,-.0.: 201 I..CA-11494

In Re; T\1c: l'tcceiv rship of Al:QCIL'AP INSlJRANCE

COMPANY, 11 1::-1urida corpomtion.

NOTICE TO ALL l'Ol,ICVI-IOLDERS, CIU:DITORS, A1'1D CLAlMANTS fVMNU UlJSIN.ESS WITH AJ;.QIJIC"AI'

JNSURANC!l COMPA?\-'V

'r'uu arc bcl':by natific:d 1hm by()fder of Ille Cir l1il Court aflht Si:cund Judic:i:al Circuil, in and lur Li:on C.'ounay, Florida. mtc:n:d 1h 7th dny or Morch, 2011. 1h1: Oe1,at1mcnL of

1:in11nclal Services or thl." S1.11c of Moridn \\'a.'i appoint.:d 11s

R.1:1:.:sver of AF.QUICAP INSURANCI ('OMl'A!\."Y and was

ordered to liquidalt: the assc1s laa1tcd in Florida uf •:.id

c:ompany.

rolicyholdcr.s. claimants, cr.c:di1ors, and Other 11crs1J11S in this St:uc ha,·ing i:laimli agobtSI lhe or AEQUICAP INSURANCE COMPA.'IY. shall present 111ch claim lo the: Rcceivcton orbcfon: 11:59:59 p.m, on March 7, 2012, or i.uc:tl cl:iims sh11ll be lon:vtr barred.

1teq11esu far fomm ror tltc pn:sc111atlon of ,ucl! claims md inquiries concerning this Rc.-ceivcrship ihould. be uddrc:ssc:d to: The DMt.ion of R11l111bili1111lon wiJ fJq_uido1ion of lbe r-tonda Dcpanm1.."11t vi' financial Sc:rviccs. Rccch·c:r rur Al:QUICAI' INSURAJ\CE C.:OMrANY. l'llst Office Doii llO, 'l'allah:l$$ell, Floridu 32302-0110. Additional infonmniun n1,1y be (Q\100 a1: www.11uriJai11wr ni:crccei,-cr.ocg.


1S44 Scc•ion Xll • .'.\'1.isccllanCOlls


8035                                                     




Florida ,1dnllnlftra1l11e Weekly H1l111ne .'1. Numbtt 1J, June JO, 201I


Any person \\hol;c sub1tanlial intcn:&I arc affccti:d may danrcr to lhc public health, saf -ty 111d wclfan: pursuanl 10 request a hearing pursunnt to Scciion 120.569, Florida StalUleli, Section,; 456.073(&) and nO.Afl(.6\, Florido Sta1utn. The S1111e '"ithill 21 cl11ys L1l'publicu1ion Llfthis notii:e. Failure 111 requL'Sl a SUl!(!On Cicnt:r.u d1:1.crmincd that chis summary procl:dun: \\11:i

!waring wlthin Che upplicablc timt.: period !ohail constilutr a rair under the eircunl5t:lnces. in ll1at there Wr:15 no othl!r mctllod

, 11iver nf lhe right l(l II lumring, Q11CS1fons l1:£ardin1;: \ht CPI Ll\'lilabh.: IU adet11tall.-ly prulcet lhc public.

ev11l11a1io11 pro1:i:ss should be direcli:d to Su51ln Chl n ill · · ... · · ..:. •···-------- -

l K,'i0114:t-:!161 or by sendi11&: llll email: .,/; If :'l.olice ofli111ergency Action

S11r.an,Gogi:in der.:;ra1e.ll.us. ? On lay 26. 2011. State Surgeon Cic:ncral. is5ued 1111 Orck:r cf Emer1,1 - Suspension Orckr it11 regard 10 dw licti\SC or

DE,.\RT)IJ,:NT Of HEALl'tl

....JL ( "llolh:c 1.1fEmcrgL'11C)' Action

7'l On Mny '!.7, '.!OIi. Suite Surgeon General, issuud an Order of Emergency Suspcnsi011 Order with regard to the license. or Slac)· 1'ot'I Tibbcus, LP.N., License /fPN S11) 66'.!. This

Emcrgt1K.')' Susp1.-nsion Ord1.-r ,vu prL·dicaic:d upon the Stale S111¥1.-on G erars findings or ll1I immediate 1111d serious dance,- tc, the p11bllc htahh. s.1fe1Y a11d \\eltare pnrsuam to

.Sec1lnns ,m,,<l73t8> nnd I J0,60(6). Florida Slmu1es. Tlle State Surgec,n (kncral detcnnined that 1hill summary procedure Wll.$ fair under the tircumsltmces. in lhnt there wru; na nther methnd u,•uilobh: 10 «dcquatcly protccI the public.

\£.. \ Hmergency ACdon •

.,,._ OC'J .\.lay 27. 2011. State.: SUf'l!Wl'I Oi:ncral. issu -d an Order o( l:imeraency Suspension Urrler wlll1 rcprd 10 lhe license or Urenda O11rhn111, R .N., Lir:,:nse IIRN 1>16()32-1. This Emc 111:y

Su nsion Order was predi®ted upon 1he Scnte Surgeon General's· lindingi; nr lln itnmedlnte nnd serious dnnger 10 1hc public h lth, safe:!)' and welrari: pursuanl to Section!

-ISG.073(81 and 120,60(6). Florida Sl:11u1cs. The Slate Surgeon Oenr.:r.tl dr.:1cnnined that 1his suinmlll) pr edure was fair

Alben l Petl?rs, CN.A. l.ic11nse ;IQ.A 18 1)6. This F.mer 111.,'l' Suspension Order \\::IS predicaled upon the Staie Surgeon (.ieneral's tindinas nr nn immedln1c and scrlaus danger 10 lhc public: health, sarciy und wclrarc pursuant lo Scclions 456.07.l(IJ} and l:?0.604(h. flcirida SlatulK. T11c·s1a1e Surgeon Gcncrul determined Lhat 1his summary procedure ¥1'111 fuir under the circumsl:lnccs, in th11t 1hcrc wu na other method nvailubl 10 aib.1m1t1.-I)• pru1 1 the public;,


\,. ;o..Olice off.merr,t:ncy Action

On Mi'IY 26, 2011, Stale Sur;eon General. iss11ed an Order nf Emcr1eney Suspen,ion Order with rcy:inl to the license uf ShcillJh MarjlLl Rolla. R.N., a.k,q,. Slu:illah Ro11an. R.N., License #C'lA 9250805. This Eme11cncy Suspi:Miun Order was predi\:aled llpUII Ilic S\illt Sur i:un Oers«al's lindi11gs of aC'l immcdi<llll and 11CriCl\1!1 dlU'Cl1r lv I.he p11blk: hr.:.tllh, s1:1f11I) und

, el fare pwsualll 10 Sec1ions 4S6.07318) and IJ0.60(6}. 1-'lorida

SlllLUll!S. 111e Slate SW11,eon Oeneral dc1em1ined that lhif. summary procedure '-''115 fair under the cireumilnnces, irs 1h01. chere was nn n1her melhnd :iwilable ICJ ndequ:uely protect che public.-.

under lite cin:umsraraces. in tl1a1 lhcre was no othtr me11tocl . DEPARTMENT Or F'IN,\S'CIA L SERVICES

:w;illnbli: 10 adequo1c:ly protect 1he puhllc.


J:,_ Notic.:ufEm.: nt)' Actioo

On ·l&)• 27, :?OIi, Siu.le Surgeon General, is.sued 11n Order of E111cl'¥.:m.:y SuSpL-nsion Ordi:r wilh regard 10 the li nsc or Amanda Lynn 1cCourt, R. .. Li i:nsc 1'R.',' 9227686. This Emergenc)' SIISpi:nsiun Order was pn:dicated upon 1hc: Suite S11rgeo11 Otnernl's lindi11gs of an un111edlAt aud striuus dancer 10 the public hnld,. sn1 · and "-elf.ire pursuant 10 Sec1kllls -1,6.073(1!) and ll0.60(6), Ploridn SumUC$. The SM1e Siugeon General determined lh;it lhis summary procedure w:is I.air under the circumslunccs, in tha1 lhc:rc was no other mclhod availobh:- lO1H11.-quatLiy protc L lite public.


...JL_\\ Notice M t-:mer1ei1c)' Actia11

r-On ·lay 27, :?OIi. St11tt Surt,'t:On Gi:neral, issued an Order or F.111r:rgc11cy S11spc11sion Order wi1h n:prd to Ille llcense or Victori.'\ Marie Howell, R.N., License /iR,\! 9l6180I!, 1'his Miugenc)• Sllipcnslon Order \Viii predicated 11po,1 the S1a1e SUJICM Cener:i1's findings of nn lmn1edi:11e and setious

NOTICE TO AI.L f'Ol.lCVHOI.DF.RS, CR.EDITORS. ANO CLAIMANTS HAVING Bt.:S ESS WITH AEQUICAP INSL:RANCE COMPANY

IN THE CIRCUIT COURT OF THE SECOND JUDICIAi.. CIRCUIT, IN ,\ D FOR LEO COl n•, FLORIDA CASF.1'O.: JOI 1-CA-<)494

In Re: The Recel11ershlp of Al!QL:ICAr INSURANC"E

<:O:-.wA;,,:V.11 11lorlda <.'OrJX!rnlion.

SOl'lCE TO ALL POLICYHOLDERS. CREDITORS, AND C.'LAIMANTS IIA\'l G BUSIN'l!SS \VITI I AEQUICAP 1:--.SUltA"CT CO IP,\;,.,Y

You are hereby nolili.:d Lhat by order or the C ircuil Coun

of 1l1e. Sec:oncl Judicial Circuit. in1111d for L.con County, PloridR. entered the 7th ct.,r of March. 2011, 1he Dcp11n1nen1 or Fll,:imial Services or ,he s1111e or Florid:a w115 al)IIOlniecl :as Receiver or AF.QUIC,\P t St:RANCF. COMrANY and was

ordeml to Hquidate the m; m located in Floridll of said

company.


Secllon Xii - Mii,cellaneous 1621


._8036                                                         




:>RACTITIO"!Er: F; GULAl'IOH

OPr.RFun·u.L Iii·!: l Sec1reftawy of Staite

2011 SEP -9 llmitk8'8of Library & Information Services

Administrative Code

Tallahassee, FL 32399-0250

Tc: Department or Health

Prosecution Services Unil.

4052 Bald CypreS& Way, Bin C-85

T111llahas1oeG, FL 32391)..3265


Invoice Number:

This lm'llici: Kamlw mwa appc:v o:1 all c!iecbor co11csp011dcncc reaardin_g 1h19 11n-oia!.


Invoice O.te: 09107M1




Cosl

Unit

Amount


h ot Section 893.03, F.S. 9 end 20\0


.,,.• i ,l.,t. . -1;.' '

ise Shannon 2.45-4640 eit 8148• -

,:. .7:'7 t' -•_,• , f • I• I -.


-. " I·



8.75


$35.00



1,00

$24.00

0



  • cl'



.

/q.rr



- 't,.)




Certified copy ea 2007, 200a, 20

Pages copied


Request•d by De

FEIO#'


4


24

. Remittance Addreu:

Staie of Florida Agencies please piy by Journal Transfer to SAMAS Account Code

45-60-2,572001-45400100,00

BF Categorv 001903

                0Bl)at'm'flnt of State, R.A.G"' Bl_di 500 8 Brono ·h S:-. TallahaNee. FL )2399-0250                 




8037_---_·-_----_•-_-

Cu&torner Copy

Org CIKle: - - - 46-<C0-') 20,..200

DOS AQcour.Ung VH_ Only:

EO:·•

TX

Obj.a'at Cod9: , --

1.lti3e

....

ARGL'· '- : ·

,, co

_·:;- .,.'..GL:

67100

--·_--·---.-._-_--------


PRAcrm:n:::• 1.::1.;m.Ml9cretary of State

OPERAT?O I.'\L lJ IT

Divisaon of Library & lnformatlon Services

2011 SEP 28 AH 8: 25 Administrative Code

Tallahassee, FL 32399-0250


To: Department or Health Prosecution Ser,ices Unit


Invoice Number:


20-1464

Ml52 Bald Cypress Way Bin c.s

Tallahassee, Florida 32399-3265

111,ui..-.: Numbrr muAappmr 11n Dll m«bor

i:altCliJll111dc:ncc:ll!pl'(li"l: lh inm


Invoice Date:


09123111



Z


5


Cosl er Unit

Amount



ps_u


8.75


S17.50


I




, ...

- . ·,;" t.00

Vzif,,

. -,.,)


-;t.OQI :.>

.b.cr a:P. -:ef-:gt.S"



S5.00



-

. .


            ..

certified Copies of Rule 6488-9.013, F.A.C.

in effect 10-19-2003 to 10·16-2010 and

  • •\.. :,._ •. '

10-1'7-2010 to lhG present

Pages cople(j


Requested by Denise A. Shannon: ·


FE.IOI# ----


_, , ,

Total Amount Due: • S22.50


Please pay this invoice within 15 days and return the remittance copy with your payment If you have questions concerning this invoice. please call 850-245-6270


Remittance Address:

                  De artment of State, R.A.Gra Bid 500 S. Bronou h Street, Tallahassee, FL 32399-0250                  


Stale of Florida Agiancles please pay by Joumal Transfer lo SAMAS Account Code

45-60-2·5720D1--15400100.00

BF Cateaorv 001903


w8038


Cwtomer Copy


COS Accounting U88 Only:

Org.Code:

45-40-01-20-200

EO:

7X

Object Code:

019035

ARGL

1 00

Gl:

67100



;: t '"•

PRACTITIOHEr..P1n:u!_

t 1iW'1',f

20 blvM6

State

btm15 1(,formation Services Administrative Code

Tallahassee, FL 32399-0250

To: Department of Heelth Prosecution Services Unit


Invoice Number:


ac-14&&

4052 Bald Cypres& Way, c.55

Tatlahass-ee. Flofida 32399-3265

This br,oice Kumber must appear CII\ 1111 .:h\"tltS cir

COITCSJK)llilentc Tl!prdina lhis ilwair:;


lnvolse Date:


10/12/11



0;

Desel'i Ion

Cost per Unit

Amount


6


Cflrtified copy cf Sections 20.43, 456.003,





8,75


$52.60


456.072, 4!8.307. 458.309, and







458,331, Florida Statutes.


'.

l,)



18

Pages Copied


1 ... ·.•.

Requested by Denise Shannon

  • I I


.r'


10

I


II

?ft_

$18.00



  • , " I


I I• ''. '•--•



I ·• I •


Slate of Florl'da Agenciu please pay by Journal Transfer to SAMAS Account COde

45-60-2-572001-45400100-00

BF Ca 001903



L:,_8039                                              

Cuato1ner Copy

Org. Code: . .

45-40.01-20-200

OOS·AcicounUn; Use Only.

EO:

7X

Object Code:

01903_5

ARGL:

16300

GL:

97100


I

PRA.cnr,fll,•:-:r ,.. _

OPn 1lJi MI "$. ctretary of State

ZOI I HOlDJ-gis;,;y- ':'t Library & Information Services

·3 Sidministrative Code


To Department of Hisallh

Tallahassee, FL 32399..0250

Prosecution Services Unit

Offtee oJ the General Counsel 4052 Bald Cypress Way. Bin #C-65

Invoice Number: 20-1468

Thi, l11rnl..'1 Nun'b•'t 11111,;t ;qlpl:'ilt 1111,111 ,:he.:ks ur

oom'l)»1Kk11te i111lhls in•·oicc

11J09/11


  1. Cerfnied Copy of Rule-64B8-8.001, FAC,

    Eff. Feb. ,a. 2009 lhrough Dec. 21, 2009

  2. Cenlfied Copy of 5ecli0n 458.326, FS.,

(Years 200B and 2009 Flori Jutes)

15 Pages CertJned

Attn: Carol B. Klein

{850)245,4640 ext. 8116


?su

11//fe,/J/

. , II I


8.75


6.75


1.00


Amount


cost per Unil

!Y.75


$17.50


$15.DD



. ]j


FEID#


Remittance Address:

                De artment of State. R.A.Gra   , 500 S. Brono Tallahassee FL 32399-0250


State of Florldei Agencies pleose pav by Journal Trsnsrer lo SAMAS Account Cocle

45,50-2-572001-45400100-00

BF Caleoot\' 001903


  • 8040


Cuslamr Ccipy


DOS Aecounllng Use Only:

o.g_cade:

45-41)..()1-20-200

EO;

tX

Object Code:

01lil035

ARGL:

18300

GL:

67100



- ..

•• I • ·-.;,.d

,..

FLORIDA DEPARTMENT OF STATE _: .,1,...

11 1

Kurt S. Browning, S•cretary of State ,. ,, h • ;: 2 2

Division cf Library and lnforrnalionsaliilce ,; 1 .J • 11

Administrati'ie Code Unit

The Gray Building - 500 S. Bronougtl Street, Suite101 -Tallahassee, FL $2399-0250. (850)245-8270

8[1ed ID

DEPARTMENT Of HEALnt PROSECUTION SERVICES UNIT 4052 BALO CYPRESS WAY

BIN-C66

TAU.AHASSEE, Fl 32399-3265

Allri: Al.YSON MOTES


Account: 10147 Invoice Date: 6/10/2011 nVQ .J.f'.!l. .wi-"l 1.033

. P.O.# . Publication inFiortcia"Aciniimsirative Weekly # units $each E,ctenalon

1. . VQIUme:37/22 P es:1543.1544 ···

105 ··-· ii4 $1w..iq

2 Volume:37/23 PcJQes:1621 67 1.24 S83.08

Invoice# must apoaar on all rhec:k1 and c0tresponoe1,ce. Please pay bali,nc;e due.: $213.28

F.E,1,0, number; ••• Net Due -15 days. No Oiscount -

_,,_: p,5<.)


l.•,. I

·, '-/ 3/41_.

"/,--:1/11


-

Dc.:>N Pt }l

. • I ••

  1. lOQ

    f:;> 4-:a -9,5"-oJ-o>S: I :J. 4:7&/­

    hy- = -o.ro,;,,.-o,-,= r 3 1 4<.{

    b'l- !l-O -c)1-oqv:- - :io


    TO INSURE PROPER CREDIT, PLEASE RETURN THIS PORTION.

    Department of State - Division or Administrative Services - Bureau of Planning, Budget and Financl81 Services

    R.A. Gray Bldg - 500 S, Bronough St, 4th Fl. -Tallahassee, Fl. 32399-0250

    °'"

    Account: 10147 Invoice Date: 611012011 Number; 123033

    Amount Due: $213.28

    s1a1c AgencleS- Journal Tian1,fer IO Account Code: 4S-S0.2.S7200\.45400100.C0 BF Oti; CU9000 BF Cat 001903 COIie f E0 :45409120200 7X Object· 019032 Category: 001903

    For in;Use Only: O ect Code: 018032 Cal. 01>1903 ARGL: 16300 G 67\00

    Samas Al.cclunt CodeNendor 84-50-2·35200Ui4400100-o0


    so41                          _..


    I

    c. Fl,11idn Ad111i11is1,ntfre Wcek{I• vulmne .i1. ,Vr,mber 21, Ju11e J, 2011 !

    u1c.ll,u>.'Sv n:1aryloipl 1111c_d ri111,1huus,:/. l or i11fonnnti0n, cull (850)l4S-:mH. TI1i puNic 1101ic:e lullil lhe requireme111.\ urt5 <.'1.,R 930.


    .4'

    DEPARTl\lF:. 'T OF HE \l,TH

    \I Notice ol'Emc ney At:Liua

    On by I K, 2011. Stille Surgeo11 General, inucd :in Order or l:mcrgcr.cy Su.;pcnsion Ordi:r lfil.h rci:ird 10 I.he lii:cm;c) uf Jncinra ln."TIC Gillis. M.D• .License lfME 9929llc. This Enic CBC)' S111pcnifo11 Onlcr pt1:dic.1tecl 11poa1 the Stole Surgeon G&:11crul's nniJinp ur UII i111mellia1c orl<l s,:rious

    ilru1t;1:r 10 uu: public health. Sfrciy aad wclrnrc purs11a111 1c,

    Slit:tiuns -156,073(S) and 120.6(1(6), l;loridn SM111os. rhc 8une Suruco,1 Oencml dcicnnim:d ,,m, tins suminnry p1·Gccdure wa.,q fair u11dcr the circ:11msl:111i:cs. in ih11t there was no other ml!thod avolhtblc ·to u-dc.qu.au-:ly-pm-le-c1.tl1e-pu-blic--------

    \I. Nolie<: or E.n1c:rui:t1c!' Ac1iu11

    .Surseon Cil!flml'i; findinss of no immediate and serious danger 10 the public ht-alth, s.1fcly .:Ill wclf'urc pu_ 1111n1 to Scc1inn.,; 456.073(11) and l:!0.60(6), Flonda St:11uti:s. lhc S1all: Surscon GcDCrol determined that rhu swnmory proccd1&n: \'\'lib rair under &lie c:ifl'11nu.ton -s. in llwl IJlL'rc was no Ulhl!r mud1ud available l{I adcqu111c:ly prali..-ct lh.: publi1:•


    / t\ N,"iceorl!niert1e11cy Ac1ion

    On Mav 20. 201I. SLale Su u11 <.itm:r.il. iss11c:d 11n Ocllt.=r or cm m;y Sui.pern;1011 Order wi1b rc: lld '" 1hc licc,,se r La11i<:l McClellan. ltN. License IIRN 3140832. Th1J f.mcs-gcncy Swipcm,ion (ltd« was prcdicDtcd \lposl \he Sllllc Surgeoo . Ckncr:il's findings c,f an immcdiale .and scricm

    d:inger 10 tJ,c 1,ubllc hl:81th, sofcl)' 11nd wclrarc pursuant lo Sections 456.073(8) and ll0.60(6), Flurida Staluk-s. The Stn&c Sw-gcon General dclcrmincd 1h:11 lhis summ:uy proccdun: \VIIII ruir und1,1r thi: c1n.um;t;tn f, in Iba lhe11! wu no 01her 1ni?lhad available- 1e1 dcquatcly pro1 -c:1 Uw public,

    1' Oa loy 20, 1011. State Sull!c:un Ckucntl. is:.utd a,1 Order J- l\ Nncico of F.n,crgcncy Aclion

    Li.fling llmi:rg ni.-y Susfl'lnsiun r,.11:r wi1h r nl 10 ti lice,, On M:L)' 20. 2011. sane surgeon General. im11:d 11n.Order or

    ot Ju A. Pres!on, R.N. L1ceme #It:-; :8211k42._ 1 he Hmerieitc)' SUS1'Cni1ion Order with reglll'II 10 Ille bcen.sc or o.= 11nment orrll!r\altni lhe em_ergc11ey Susr nsion of Llc:cnA? Jumic Lynn Phillips. C,}l:.A. Lii:wtw 4CNA 17161:.'9. Th,, ne11fted nnd ym1r ltc:ensc be rcm.°"alcd. Emcf!cncy Sib-pension Order \WS pn:dic:aled upon lh1.: Slate

    \\ Nuti.cc ul' Emcry1mcy Acliun

    . ·- Surgc.:on G<:&Wntl's fimliucs uf 1111 inun,31lfa1e aud Kl!riaus

    On Ma,· 23. 101I: SLate Swgcun Cleni:rul, ii;sued an Onh:r ur Emcr C)' Su!!p ion Order with rcgwd 10 the lic\:nst uf D ualJ W,1Ym: SJl'lnci:r, R.N .. l.ic;e11sc #RN tJ\1!21(11. 1"hiJ l:111ery1111cy Suspensio11 Order was prcdic:ired upnn lhc S111te Surg.eon Cieneral'5 flndings of an i1n01cdiau: and serious danger to LIie Jlllblic health, afc.:Ly und wdt\m: puisoont to Sections -15<i.073(8) nnd 120.60(6), Florida Slltllll\lS. Thi.: Sl1111: S11rg(:On Gcn1:111 dc:1cnnim:d lhlll this 1111n11n11 · pruccdurc wai. lilir und ·r the cirt:un1Stunc1?a-. in 1ha11bcl'I: was 110 11th,:r nll:tl 11v11ihlbh: 1<111d1.'\l l,:ly prt>ll:CI the Pltblic

    da r tolhc rublic: hc:lllh, sufi.:ty und wclrurc pm1:111un1 10 Sec1iun, 456.073(8) 11ml 120.Ci0(6), Horida S1orute.."t. The State S111p:d11 Gcncr:il dt.·1<:r,nincd 1U:&t ll1is s11mrr,1ry procadure wns rnir under the clrcumManccs, in ,hat lhrrc wu no olhcr method available Lo adequately protect tile public.


    ,, Nulicc ofElllllrit ICY Ac:iic,n

    On May :?O, 2tm, s..,rc: Surgeon Oener:al, i uc:d n11 C')rdcr or l:tncrJ;l."n.:y S 1.:m.ion Ordl:r with n.-gRrd u, lhu lieet1M: • f U11itsill A. Jenkins, C.N.A. l,ic:en #CNJ\ 1sqoR3. Tlm;

    Hmerycncy IL pcn!lim1 Order WIili lll'Cdica.lcd upon 1l1c Saale Surscc,n General' findings or mn immediate and S<?rious

    V,, l\ Nmite of F.nicrscncy Action dangt..-r lo the public health, r y and wclfun: punuun1 lo

    ") 011 Mil}' 24, 201 I. S1;11 Sufj;con CicncrJI, i,;sucd un Order oi' Section,; 456.0'73(8) and 120.60(6), Florida Sta1u1a. The Sunc Emergency Suspension Order with regard 10 1hc liccn5e or SutJcon General dclCrmincd thal this aummury procciJun: was

    10"' \\

    or

    !ttichcllc Kac Stu.Prl, C.N.A. Liccmsc IICNA 112035. This fair undi..-r I.he c:in:u1m111111rS, in tJ1ul then: was nu ulh.:r mctlmd Erm:rgcncy Suspcitsion Order w:is pmlicmcd upon the Sn11c: available 10 adcqu:11cly pn>ll.'tl lhc public.

    Surgeon Gcnt,:n\l's fu,din!J!i :,a iauncJiml.' :mcl s1:riuus

    °"

    J an1c:r lo 1h1: p11bfo: hc:uhl1, saf'-1Y a11d wclllirc purs11:tn1 Nnticc ofEmcrgtncy Aetion

    S<.'\:tiu11s 456.073(8) nnd 120.60(6). tlorida S1.i111.1e l'he S1,11c 0 ,, May 20. :!(I11. Staie Sui-geoo General, i. sucd Order of

    S11rr,-«ir1 Oencrnl di:tennined 1h:i1 rluf.sunnn:111• prQCcdun? wm. F.mergeric:y Suspemion Order with regard o1 the license of

    ti11t under tl1e-circum&1n11ce., 111 th:it 1here w no Other mc1hnd C:ara L. tbylor, LV.S. 1.iccnsc #PNI ?931. This Emergency

    avail.able 10 untdyprotect the pubhc. S115J"1emion Order w:is predicated upon I.he SCulc SuisL-on

    - ·- ···. ---· Oc:rtcrul"s fllldirigs of an immcdialc and 1Cria11s dungcr lo sh

    J; \\ Nolkc arEmcrscncy A.:liUII public hcallh, safCl)I :inJ wclr:m: pursu:ml IU &-ruuni

    1J On fl.lay 24. 2011, State Surscon General, iUucd uo Onk.-r of 4S6.U73(8) uml 120.60(6), Flomka S1a1u1cs. The Slat Surg1:u11 Emergency Suspension Order wilh n:gard 1u the liCL'llSC.: or

    April Nicole Crumpton, C.N.A. LiL'C'n .: #CNA 781ll0. Tlti:,; llmc1¥1:nC)' SWlp\,"11!SiU11 OnlLT was pn:dil:nll!d upiln tbc S1:11c


    _8042,





    Floritlll Admu,ittrati1•, U ck(I• 1,;,1,,me J7, ,,·11n1b r 21, J11ue J, MIi

    ...

    '

    -

    I

    G.:a\.:r:•I d 1cm1incd lh31 lJlis summary procedure wos foir

    under 1he esrcurt1$l11ntts. in th:11 11,cre wlt't n(I other method

    :1\·:lilnbl>! 1011dequn1cly pro11. 11h11 public.

    l\. No1k1: of l:met.1:e11cy ,\c;ki-n

    On 1ny 20, 2011. Sialc S1tty1.'\111 G11ncral, is. ucd on Onk.-r ur l mergcncy S11i.pcasiL'll Unl.:r wilh r1111w 10 11, UcClliC o( Li:i.t Mam: Owul:u. L.P.N, Lici:rt c .lll'N SIS36l2. This l!mcrt ncy Suspcmion Onl.:r w11-. (lrcdii:n1cJ upon the: iilnlc Sutpn General'<, itntlir\ lf Ill\ imn1cilia1c uncl s11rio11$ dnmu:!r· to 1hc

    R\.'\:vivi:r or SEMINOLE CASUAl.l"V INSUR,\ CE

    C'llMl'ANY and was onleml lt1 liquidate tllC 11.'i!'il.'Ul locat d in

    1-loridn ot'snid company.

    Poli1:yholdc1's, clnhnan1s, aediLUB, and uthi.,r 1,enmni; in lhis S1111e havini; claims 11g:ii11st the assets of SF..\-1111:0LE CASUAI.T\' INSUKANCE COMPANY. 11li:lll prcsenl sucb du11ns lo lhc Rc-ccivcron orb\.of"on: II:S9·59 p.n1. on Man:h !(\, 2012, Ill' Mich clui1ns stuill l,1; fo ver h:irred.

    Rcque lS for fonns for lhe pn.-scmatiun uf •c:b cl:iimi. and

    mqltiri!& neeming 1bili Rcci.:iv hip tibl\uld be addrcucd to:

    pa,bli hi:allh, 11foty :md welfare punnllml Il-l

    Scclinns

    The Uivislon or Rchabilihiliun atad Liquid.111011 of the Florida

    4Sh.07 l IUICI l:?OJ.0(6), Flcridb S111111tes. the St:1.te Surycon l)ep:ann1c11t of rin:m.cial Scrvll!CS. Receiver lor SEMINOL

    (h,-nrr11I d111"•1111incd lhni this wmnuu-y procedure Willi fair . C'ASU,\LTY INSURANCE COMl'AN'I', Post Office Bux 110,

    inllkr llie circumstancn, iu that 1h1.tt wru; no glhcr mcthud 11v:1ilnhle 1n :uk:qu111.ely protecl the p11blic.

    •·

    FISH A. D WILDLlFI!'.. CONSERVATION COMMISSlO

    ,WAIL\AII.JTY Of GRANT l'U l)S

    Tbc l·luntla Fish nncl Wildlife Cunlil:rv11llu11 Cu111n11si,i11n is 11\.1:qmug :ipplicaiirons for pnl fundint througl1 ti Bo111in5

    1nrras.1nictu,c Oram tBIO) Pro,n•m rur f"lllcal )'l:Dr :!.011•13.

    The riendline fM rccci\-in appli liuM ci S:0O p.m.• t\ugU!,l IV, 2011. ArJllii:ationi. n:i:(:ivi:d llf\cr thl.! dtadlinc- will bi: ineligihle for consid1.-ntliLlJI.

    lhe 1:1 lG Progmm is fumh:d from the US ri h and Wikllifi:

    Service ror me cons1rucli<m 1t1td ie110\'lltia1l nf 1ic•UJ1 rcililics

    for lransicnt bumcrs III vcMcls 26 fcc:I 11C mori: in l1:ns,l1. lnformaliun un 1he IJl(l l'mgram. Progmm. Guidi:lin :ind R\.'(IUQI far Apr,llc:11ion5 on4 Clarif!Ql,iun uf Applica1io1l!I R¢41 1in:mm1 nrc nvailabh: al bltp:f/www.myfwc.com/ bc,a1.i11 boa1ing-iranl•pr -'bi1&p/,

    Email qu ions 10 b1gp',e.-myrwc.cu111 or phone

    t1!50)41Stc-S6<>0.


    DF.PA!l.TMENT OF FINANCli\l SKflVICES

    NOTICE TO ALL POLICVI-IOI.OF.RS. CREDITORS. A,:,.:o CLAIMANTS IIAVli,..'Ci BUSINESS WlTH Sl:Ml OI.H CASUALTY INSURAN(;E COMPANY.

    IN 1'HE. ClRCUIT C:OURT OF THE SECOND JUDICIAL CIRCUIT. IN AND 1:oR 1.1·:0N COUNT\', FLORIDA

    CA £ NO.: 2011-l'A-tllNl6•N

    In Re.: 'I'he Rt>ccivcrship "r SEMINOI.F. CASUALTY

    INSlJRANCE COMPAXY.11 l=loridacCJrl)\iralian.

    NO'l'ICF. TO /\l.L POLICYHOLDERS, CltF.011'0RS. AND C'l.,\IMANTS HAVlNCi UUSINF.SS WITH SEMINOLE CASUALTY lNSURANCL: COMl'ANY,

    You :are hereby notified lhal by cmh:r uf1hc Circuil Coun oflhc S..cond Judicial Circuil, in 1inJ for l.i:011 Counay, Florida. entered 1hc ISlh day of Mun:11, :?011, 1he Oep:artmc:nL ol'

    f1n:111c1al Services or thl.' Sui• of l-1orid:i w:u appoin1cd as

    ·rallahaHCC, florida. l230l-OI IU. A.ddilicnal infonnalion m:.y

    be round a1: wwwJloriJ:1i11sur:mcercc:eivcr.org.


    NOTIC.:l! TO Al.I. POLICYHOLDERS, <.:RijDITORS, ANO

    <.:LAL'vlANTS IIA\llNG BUSINESS Wl11 I Al;;QUICAP IN8URANCE COMPANY

    IN TH CIRCUIT COURT OF TIU: ScC.-OND JUDlClAL Cl R.C:Ul'r, lN ,\ND FOR Ll!ON COUN IV. FLORIDA

    CASI:. NO.: :!01l..C:A-049-i

    In Ril; 11111 kecci\·crmip of AEQL:IC:AP INSURANCE COMPANY, t1 Florida corporation.

    NOTICE TO ALL l'Ol,lCVHOLDERS, CREDITORS, AND CLAIMANTS HJWIN<i UUSINESS WITH AEQUIC'AP INSURANCE COMrAi-.-Y

    ur

    You arc hereby nolilic:d 111111 by ()l'derofmc Circui1 Cumt 01'1lle &:cond Judicial Circ11i1. in and lbr Lco11 (.'011my, Flarida. mlcn:d 1111: 7tl1 dny or March, :?Ol l. 1hr: f)4:i,anmcn1 of finonclal Services of thi: S1a1e of Horida \lt'IL"i ;ippointcd al! iver of AEQUICAP JNSUltANCH ( '0 M 11ANY ond Wllll ordered 10 liquid1nc tl1t assets locaicd in Fh.1rida s:ahl

    con1pa11y.

    Policyholders. claimanlll, c:n,ditun, and oihcr persona in lhi11 Smlc h11\'lng dailml apulSI 1he :155Cl5 of AEQUICAP INSURANCE COMPANY. shall present lillCh claim¥ lo 1hc: Receiver. on. or before 11:59:59 p.m. on Marcil 7, 2012, uuucn cl:limi,; stusU be lorl:\'Cr \xln-ed.

    R ue5U for rorms for 1h1: pr.:SCttlilliC)lt 01 &ucll claima and

    inquiries concerning !hi& llet:civetShip $1lauld b aJdrc:sscd 10: The Oi,·ision of Rchubilhalioo UJ1II Liquidalion of the Flund;i Depanmcn1 or Finam.:i,,I Services, Rccci,w ror Al:QUICAl1 INSURANCI! COMrANY. ros1 Office Box l lO. Tallnhasl!ec, Floridu 32302-0110. AdJi1ionnl infcmnatiun 1n y \Mt found a1: www.lluridai11 "ral\Cl!l'CCCn"Cr_arg.


    1544 Section XII• M dlun.cous


       8043                                                    



    I


    Fir,rlda ,1dmillistra1l, Weekly 1-'nlumi: 37, Numbttr lJ, Jum: 10, WI I

    I

    Any person \\-hOliC s11bs1aJ1tial intcn:.sl!i are alfcctcd may dan!!cr lO the publir heah.h. s::i.rc1y and \\'clflll'l! pursuant to

    n:quc5111 hi:-aring purwnnl 10 Section 120.569, Florid11 S!atu1es.. SectiOlls 4 .073(Sl 1111d 1 0.60(61, Florida Statutes. The Stue

    , ithin 21 cluys 1,1f p11blicu1ion ur1his notice. Ftlilure 111 re11uL'Sl a Surg '()D Cicnend dctcnnin<.'ll lha1 ahi!l summary proceduJt ,\IIS arint within 1hc 11pplic:t1bk: time pc:riod i.httll comlilutc II fair under the circumstances, in lluu the was no ather method

    \v11iver nf the rieh1 tl'I a 111.mring. Q11eslinn!- l'l? rdiny !hi: CPI availabh: tu lldl:t1ua1..:ly protect am: public.

    C\011l uatio11 process should be directc:d ,u Susan Goggin ill · · .,._,,                                                     .,_

    lll"iDj245.:?161 or by e11dlng 11n en1all: ti,,, II !\ociceoft::merien · Ac1ion

    S11r.an.Go£i:i11@dci,.sta1e.t1.us. ? On :,..lay 26.2011. State Surgeon General. issued an Order or

    Einergenc)' Suspension Ordtr with r<:gard 10 the lic,:nse of

    DEP.\RT.:\IF.N1'0F H£,\Ll'H

    ..JL JI \lolice of Emcrgi:nc)' Aclion

    On Mny 27, 20ll. State Surgeon Ocnrrial. issued an Order or Emi:rgcncy Suspension Order "'ilh n:prd to the license or Stucy l'\ocl Tibbetts, l.P.K, License flPN S 1 6(i:!, This

    E1m.-rgc-11cy Sus -n.sion Ordi:r Wllll pn:dic.atcd upon 1hc Stal Sur,c.-on Gcncrnl's lindinjS or an immediate and serious danter 10 tlte public health. Hfet)' and ,,etfare p1irs11nn1 10 Sec1lons ,m,.073(8) t1nd I l0.60(6), J;lorida Siatutes. nu Staie Surgeon (icncrrd demmined lhnt 1hi :-umma,y pmcedure was fnir under the drcumstances. in that thm was no other methnd U\•ailabh: lO adc:qua1cl)' pro1c:C\ !hi: public.


    \£. \\ 1-:fMC&ency Acdc,11 .

    or

    ..,,._ On .M11y 27. 2011. S&a11: Sur Gc:m.-r.il. issued an Order ul' limeri,>ency Suspension Order wilh regard 10 1t1e licenso llrenda Ou,liam, R.N.. Li,;..:nsc IIRN 1)16932.f. ll1is Emcri."- lcy Susp!nsion Order • was pB'dicaled upon lhe Sl11te Surgeon Oenernl·s· findings i:if nn lnlmedliu,e rmd serious dnnger 10 lhe public hl::llth, safety and welfare: pursuant . ID Scetioos

    <ISG.073(1) and 120.60(61. Florida St:11u1cs. The Sutic: Suryc:on Oen ral detennincd that 1his SU1nm11ry pro..edurc was rair umter the circumSla11ces. in 1ha1 there was rto other nKllhod

    :lYnllnble 10:u:tequa1cly proiect 1he p111lllc.

    t£. 1 1 ·NuLicc ofErncrgt!IIC)' Aclil.lll

    On Mn)• 27, 2011, State Surgeon Cknc:ral, issued 1111 Order of Em..:Q1L't11:y Slll!pcnsion Ord r with n:l!llf'd 10 tin: license of Amunda Lynn !vlcCourt, R.:"\., Lii:1:nsi: ltR. 9.J276BG. Tlii E.1111:r&ency Susp.:nsiun Order was pr.:dicatcd upon lhl: S1t11 S1•rte0n Geneml"s lindings of 1111 immediate and serlou danpr 10 the public htahh, sa ty Md ·elfnre pursua,n 10 Sec1ians -156.0T.\!BI a11d t:!0.60((,), Florida Stan11es. Tlle Stale Sutgl!on Gnmil delcm,ined 111111. lhis sununary procedure wns

    fair u11dcr !he '-'itcumstam:es, in thnl there was no other ml:lhcd available 10 ad..:quutt:ly pro«ceL I.ht: public.


    \\ M<1tice c,ft'.n1 e11ey Aclia11

    'jt-on 1ey 27. :2011. Stu.Ir Surg n Gc:ner.d, issued an Order af l nieraency Suspe11si011 Order wl1h regard 10 11,e license or

    Victoria Marie llowell, R.N., Llecnse flRN 9l61808. ,.his

    mergenq• Sli&pensrM Order \\'11$ prediCllled 11pon 1he Staie

    !iurgc:nn Gener:d's lindinp Gf nn i111media1e olld serious

    A.lbett t.. Petcn. C.N.A. License :/0'.A 18S6'>6. This F.mergency Suspension Order \\as p,eclicoted upcm ,he Stale Surgeon Gencral·s f111dl11as of 1111 immedlnte and serlollli danger 10 lhc public health, safety and welrarc punuant lo Sec:110115 4:S&.07.l!S) m1d ll0.60(61, Florida. Slalutes. The Slllle Surgeon Oemmil ddcnnincd Lhat lhis summlll}' pnKCdurc W11S fair under lhc tin:umstanca, in lh111 there wus noother mi:-thoJ awilabl lO adcquati:ly pro&L'l.1 lbc: public.


    l,. :!1.otlc:e ()f f.mergcncy ActIOI,

    Oft hy 26, :?Ol I. State SurQeo11 General. issued an Order of Emergency Suspension Ord r ,\ith regard to the license of Sheillah :\1arilu Rolla. R.N.. 11.k.it, Sht:illah Rouan.. R.N_ Li«-nse ilC A 9250805. This Em1:11cm:y Smp..:nsion Order was prooicaled llpoll Ilk:SllllC Surg1:un Gcni!ral'S findings of en itnm..:l.lint11 und Hcrious dunai;cr Lu 11¥: publil.: h.:allh. s1di.1 and welfare pursuant to Sections•IS6.07348)and 120.60(6). Plurlda Stawtt$. Tile Slllle Suf8eGII Oel\Cl'lll dc1c?nnlned lllai 1h s11mn11vy procedure was fair under the circum.slmlCes. iB tilat 1hefc was nn other melhod 1vnll11ble to adequately protect the publit'.


    1n:l'AR'l'i\lltNT 01-" FlNASCIAL SERVICES

    NOTICE 1·0 ALL l'OLlC:VHOL.DERS., CREDITORS. ,\ND CLAIMANTS 1-lAVrNG Bl'Sl)JESS WITH ,\EQUICAP INSL:RA!'IICE COMPANY

    rN THE CIRCUIT COURT Of THE SECOND JUDICIAL

    CIRCUIT, rN A:>:D FOR LEON COlll\TY, FLORIDA

    CASE l\'O.: :?011-CMl 94

    In Re: The Receh,ershill of A Ql:ICAP 1,-:sLJR.ANC:E

    COMPAt-:Y. n 1-'lorid. rporntion.

    c,1·IcE TO ALL POLICYHOLDllR.S. CREDITORS, ANO C:LAIMANTS IIA\'l G BUSINUSS \\IITII AEQUICAP U1,SU1tA!l:C'P. C01'1PA!\JY

    You arc hereby notifh:d lha, by order or lhe Circuit Co11r1 of1he Second Judicial Circuit. in a11d ror Leon Count}'. Plorkle., entel'C!d the 7th d11y of Mnrch. JOI I. 1be Ocpnn111et11 or

    Fina11cial Services of 1he S1211e of florid:a was appointed as Receiver or ,\EOUIC,\P tNSl)RANCE COMPANY and \'f8S

    ordmd to liquidate the mets located in Florida or said company.


    Section XII - Mii;cellaneoui; ICt:?I


       8044                                              


    I

    nn

    PRAcrmom::, t.EGUl.Arliecretary of State

    OPEllATin !!\L

    Div1saon of Library & Information Services

    201I SEP 28 AH 8: 25 Administrative Code

    Tallahassee, FL 32399-0250

    To: oepartmenlofHeallh

    Prosecution Services Unit

    "1052 Bald Cypress Way Bin C-5 Tallahassee, Florida 32399-3265


    2


    5

    Certl11ed COpies Of R\l!e 64B8-9.013, F.A..C.

    in effect 10-19-2003 to 10-16-2010 an,!l ..

    f ·--- , '

    Invoice Number: 20-1464

    Thi=; lmo r f\:11 lffllllluppnron• i:hL,cbar i:a cru:e 1\.-prdi"' 1hi1 in'n'lit;c

    Invoice Date: 09(23111

    10-17-2010 lo the present.

    Pages copied

    ,E.: :;,._::"C


    Cos!. r IJnil

    Amounl


    t?..l!


    8.75


    S'17.50

    ·;·:·· • .. · - . ·". .. 0


    S5.0D


    - OOJ ;J_


    &er. -., ,/-:o/.S


    I I

    Requested by Denise A.. Shannon:-· ·

    t • 'O I I r •


    FElO#.                                    


    ·,,, ·I,!'.''

    •: i •.


    .· , ,

    P'ease pay tn1s invoice within, 5 days and return the remittance copy with your payment If you have questions concerning this 1nvo:ce. please call BS0-24:)-62 /0.


    Remittance Address!

                     De artment of State, R.A.Gra Bid , 500 s. Bronou h Street, TallahaSMe, FL:32399--O25O               


    Ir 8045

    Cullilomer Copy

    .


    State of Flar1da Agen0ies pleas• pay by Journal Transfer lo SAMAS Account Code

    5-60·2-572001-454001O0-0O

    BF Cateaorv 001903

    DOS Accounllng Uu Only:

    Org.Code: 4>40-01-20-200

    EO:

    JX

    Object Code:

    019035

    ARGL:

    18300

    Gt.!

    67100


    1.

    'fl'

    PRACHTIOHEiP ..911_

    OPlRAT!OI' l ' c;fielc_t-cl;iu,iAyr·ioott State

    ZOl I OCT b1vmf llb"'18Jslftformation Services

    Administrative Code

    Tallahassee, FL 32399-0250


    To: Oepanment of Health Proseculion Services Unit 4052 Bald Cyprea5 Way, C-65

    Tallehassee. Florida 32399-3265


    Invoice Number: ZD-1465

    This ln,-oi.e1'umber lll\lSl llpp!.'111 Oil llll i:h k$111'

    COllttpoudcna:n:gard1n9 lhi!i mvo!cc

    Invoice Date: 10112111



    Cost

    Unil

    Amount


    ections 20.43. 456.003,




    8.75


    552.50

    458.309, and





    tatutes.

    ...

    L)




    ''- ·-·


    IO

    I

    1.00

    II

    lr1I

    518.00

    6 Certified ccpy of S 456.072, 458.307. 458,331, Florida S

    1 B Page& Copied


    .

    Requested by De


    ··l, . ._..


    ' •. I

    l.


    ··►·



    Fl:10#


    State of Florida Agencies please pay by Joumel Transfe, to SAMA$ Account Code

    45-50-2-572001-45'400100-00

    BF Cal 001903

    DOS Ac;cOuntlng.Use,Only.

    Org. Code:

    45-410-01·20-200

    EO!

    7X

    Object Code:

    01903.$

    ARGL:

    18300

    enoo·

    Gt.;

    _

                   De  rtment Bf State R.A.Gra·   Bid•   500·5: Bronou  h:Street  Tallah  e. FL. 2399-025ll         




    • 8046

    Customer Copy






    . PRAcnr,01.•:r. -

    0Pnu it:l tJ atetary of State

    3

    20/ I N0't01 y)51¥f t Library & Information Services

    · dministrative Code

    Tallahassee, FL 32399-0250


    Tll:

    Depar1ment or Haallh

    Prosecuth:m Services Unit


    Invoice Number:


    20-1468



    orr.ce or the General counsel

    Thi ln nl,-.i NW111bi, ,1...s1 I

    ur,.tll ..:1I.It


    4052 Bald C ress Way, Bin #C-85

    cor1 'llc<1 n:ll,W'llinJ. lhls mYOite



    ll'IYoice Date:


    11/09/11

    o.


    Ceecrl Ion


    Cost e, Ufll

    Amount



    1


    C8'1iflad Copy or Rule 64B8-8.001, F'AC.


    8.75



    58.75


    Eff. Feb. 18. 2009 lhrough Dec. 21, 2009




    2


    15

    Ceriffted Copy1)r Section 4Sll.326, FS.,

    (Veers 200B and 2009 Flori \ !,Utas) Pages Cel'lifled

    Attn: Catd 8. Klein

    {850)245-4640 ext 8116

    t'Su

    .u

    ;- .

    l)·


    I

    .s.15


    1.00


    I

    S17.50


    S15.00


    1VN,,/Jl

    FEIO#

    $41.25

    Remittance Address:

                   De artment of State, R.A.Gra Bid• 500 S. Bronou h Street, Tallahanee, FL 32399-0250              


    Stale of Floridii Agencies pleose pay by Journal Transfer to SAMAS Account Code 45-&0-2572001-45400100-00

    BF CateaOI\' 001903



    DOS Accounting Use Only:

    Org•.Cade:

    45-40-01-20-200

    EOl

    7X

    Object Cede:

    019035

    AR GL:

    16300

    . Gl.:

    67100

    Customer Copy

    · 8047                  ·-:_-···-·····---



    -  ..


    'RACTntO ER r. GULAl'ION

    CPr.R1-1in• ,'.L 11•·!!: Secretary of State

    201t SEP -9 Qi)titlC81Jof Library & Information Services

    Admlnistrative Code

    Tallahassee. Fl 32399-0250


    To: Oepanment of Health Prosecution SeNicea Unil

    4062 Bald Cypress. way, Bin c.es

    TallahasliCIG, FL 32399-3265


    Invoice Number: 2Q..1458

    This lnwi c l\amb:r mU.'11 lll)pcar o:i all dici:b Of

    concsponlleel:t1t!l)ldiag lhu 1n,-ur.c:.


    Invoice Date: 09'07/11



    a.

    Oescri lion

    C &I

    Unit

    Amount


    4


    Certified copy eact, ot Section 893.03, F.S.

    2007, 200&, 2009 and 2010

    Page$ copied


    t:'1 J.; :. it

    Requested by Denise Shannon 2.45-4640 ext 8148





    ,i>s,0


    8.75


    S35.0D


    24

    1.00

    $24.00


    ,-. 7,., .. ' . - · .



    -,


    •.

    't/'I.







    41, II


    /qi,,



    Remittance Address:

                    Cepanmrmt of State, RA.Gray Bldg c S Src-r:o-..igh Swet. ie•lshD"8. FL !2S99•0250                


    State of Florida Agencies pleaae pay by Journal Tniinsfer to SAMAS Account Code

    45- 2-572001-45400100-00

    &F Cato1.1orv 001903


    8048


    Customer Copy

    --:_-                



    DOS Ai:caunltng UN On1v

    ONJ Con: ..

    14Mo-:,•-2 ,_z,:,

    rro:.

    11

    0Dia,;. Cod&: · •·

    o, :;.!g

    ..

    A'P.GL.:.

    6\t::)

    G!..:

    571C'.)


    STATE OF FLORIDA

    DEPARTMENT OF HEALTH


    DEPARTMENT OF HEALTH,


    PETITIONER,

    v.


    CASE NO.: 2008-20661


    JACINTA IRENE GIWS, M.D.,

    RESPONDENT.


    ADMINISTRATIVE COMPLAINT

    COMES NOW, Petitioner, Department of Health, by and through Its undersigned counsel, and files this Administrative Complaint before the Board of Medicine against Respondent, Jacinta Irene GIiiis, M.D., and In support thereof alleges:

    1. Petitioner Is the state agency charged with regulating the practice of medicine pursuant to Section 20.43, Florida Statutes; Chapter 456, Florida Statutes; and Chapter 458, Florida Statutes.

    2. At all times material to this Complaint, Respondent was a licensed physician within the State of Florida, having been issued license number ME 99298.


      9205

      1


      Piled Auguat 11, 2011 3158 PM DiviaioD of AdminitrativeHearing




    3. Respondent's address of record IS 12446 Pebble Stone Court, Fort Myers, Florida, 33913.

      ' .

    4. At all times material to this cause between lune 2008 and

      December 2008, Respondent treated patfents R.S., D.H., M.N., and A.W.

    5. The Department of Health (Department) Initiated an Investigation of Respondent based on an undercover Investigation conducted by the PJnellas County Sheriffs Office (PCSO).

    6. It was alleged that Respondent was Issuing prescriptions for controlled substances to undercover agents of the PCSO without conducting adequate phystcal examinations.

    7. The types of controlled substances In quest:IOn that were

      presalbed by Respondent are listed as follows:

      1. OXyeddone (opioid) Is commonly prescribed to treat pain. According to Section 893.03(2), Florida Statutes, oxycodone Is a SChedule II controlled substance that has a high potential for abuse and has a curre tly accepted but severely restrtc.ted medlcal use In treatment in the United St.ates. Abuse of oxycodone may lead to

        severe psythologfcal or physical dependence.


        9206

        ...,

        -- 2





        .J


      2. Percocet (opioid) Is the brand name for the formulation of

        oxycodone and acetaminophen and is prescribed to treat pain.

      3. Alprazolam {benzodlazepine} is often sold under the· brand name Xanax, and is prescribed to treat anxiety. According to Section 893.03(4), Rorlda Statutes, alprazolam ls a Schedule IV controlled substance that has a low potential for abuse relative to the substances In Schedule III and has a currently accepted medical use

        in treatment In the United States. Abuse of the substance may lead

        to limited physical or psychological dependence relative to the

        substances in Schedule III.

      4. Carlsoprodol, commonly known by the brand name Soma, is a muscle relaxant prescribed to treat muscular pain. According to Sectlon 893.03{4), Florida Statutes, carlsoproclol Is a Schedule r.v

        controlled substance that has a low potential for abuse relative to the

        substances In Schedule III and has a currently accepted medical use In treatment in the United States. Abuse of carisoprodol may lead to limited physical. or psychologlcal dependence .relative to the substances In Schedule Ill.


        3

        .._9207                                               _



        ,I


    8. In medidn , a proper medical assessment indudes the patient's pr:ior medical history, prior pain management treatment history, intensity of pain, factors that make the pain worse or alleviate the pain, the pain's Intensity and location, verification of prior controlled substance prescriptions including the date and quantity of the last prescription received, name of the previous treating physician, name and address of the pharmacy where the last controlled substance prescriptions were filled together with all relevant contact information and verification of all the foregoing by the physician personally contacting the previous pharmacy and treating physician, together with the reason for the referral, and verification for the reasons of referral with the prior treating physician.

      FACTS SPECIFIC IO R,S,

    9. On or about August 27, 2008, R.S. presented to Respondent

    with complaints of back and shoulder paln.

    10.. Respondent's medical records show that she presalbed Percocet 10/325, ninety (90) pllls to R.S.

    1. Respondent did not obtain any medical documentation, records,

      or correspondence from any·other physician of R.S.


      9208



      . )


    2. Respondent did not perform_ a thorough and complete medical

      assessment of R.S.

    3. Respondent did not accurately and completely document performing a complete medical assessment of R.S. or accurately and completely document any medical justification for not doing so.

    4. Respondent did not review medlcal records from other

      physicians, pharmacists, or health care professionals of R.S.

    5. Respondent did not accurately and completely document

      revl lng any medical records from other physicians, . pharmacists, or

      '

      health care professionals of R.S., or accurately and completely document any medical Justification for·not doing so•.

    6. Respondent did not communicate with R.S.'s previous

      physicians, pharmacists, or health care professionals.

    7. Respondent did not aa:urately and completely document communicating with R.S.'s previous physicians, pharmacists, or health care professionals, or aa:urately and completely document any Justification for

      · not doing so.

    8. Respondent did not perform a urine drug screen.


      5

      .._9209




    9. Respondent did not accurately and completely document performing a urine drug screen, or accurately and completely document

      Justification for not doing so.

    10. Respondent's medical record did not adequately provide justification for the prescribing of Percocet as described In paragraph ten

      (10) to R.S.


      EACTS $PECIFIC IQ P-H,

    11. From on or about August 4, 2008 to on or about August 27, 2008 D.H. presented to Respondent with complaints of back and neck pain.

    12. Respondent's medical records show she prescribed one hundred twenty (120) pills of oxycodone thirty (30) mg. and ninety (90) pills of Motrln six hundred (600) mg. on August 4, 2008.

    13. Respondent's medical records show she prescribed one hundred twenty (120) pills of oxycodone thirty {30) mg. on August 2 , 2008. .

    14. Respondent did not obtain any medical documentation, records, or correspondence from any other physician of D.H.

    15. Respondent did not perform a complete and thorough medical

      assessment of patient D.H.



      6

      .......9210



      ·•·

      . l


    16. Respondent did not accurately and completely document performing a complete medical assessment, or accurately and completely document any medical justification for not doing so.

    17. Respondent did not obtain or review prior medical records from any other physician, pharmacist, or health care professional.

    18. Respondent did not accurately and completely document

      reviewing any medical records from any other physician, pharmadSt, or

      . health. care professional or accurately and completely document any medical justification for not doing so.

    19. Respondent did not obtain a urine drug screen.

    20. Respondent did not prOVlde justification In the medic.al records for prescribing oxycodone 30 mg as described In paragraphs twenty two

      (22) and twenty three (23).

      FACTS SPECIFIC TO M,N,

    21. From on or about June 23, 2008 through on or about November 10, 2008 M.N. presented to Respondent with complaints of lower back, left knee and right shoulder pain.

    22. On or about June 23, 2008 Respondent prescribed sixty (60) p111s of xanax 1 mg. and two hundred ten (210) pllls of oxycodone 30 mg.


      7

      _9211                   


    23. On or about July 18, 2008 Respondent presalbed thirty (30) pllls of amoxidllin five hundred (500) mg, and two hundred ten (210) pills of oxycodone 30 mg.

    24. On August 13, 2008 Respondent prescribed one hundred eighty

      (180) pills of oxycodone 30 mg.

    25. On September 10, 2008 Respondent prescribed two hundred

      ten (210) pills of oxycodone 30 mg.

    26. On October 7, 2008 Respondent prescribed one hundred eighty

      {180) pills of oxycodone 30 mg.


    27. On· November 10, 2008 Respondent prescribed one hundred

      fifty (150) pills of oxycodone 30 mg.

    28. Respondent did not perform a thorough and oomplete physical examination of M.N.

    29. Respondent did not obtain a urine screen of M.N.

    30. Respondent did not perform a complete and thorough medical assessment of M.N.

    31. Respondent did not accurately ·and completely document performing a complete medical assessment of M.N., or accurately and completely document any medical justification for not doing so.



      8

      .._9212



    32. Respondent did provide justification in the medical record

      for prescribing Xanax to M.N.


    33. R ndent did not provide justification In the medical record

      for prescribing oxyc.odone thirty (30) mg. to M.N.

      FACTS SPECIFIC IQ A.  

    34. From·on o about lune 20, 2008 through on or about October 28, 2008, A.W. presented to Respondent with pain shooting down the arms and hands.

    35. On or about June 20, 2008 Respondent prescribed thirty (30)

      . '

      pills of Zoloft 50 mg., and one hundred fifty (150) -pills of oxycodone 30

      mg.


    36. On or about lune 27, 2008 Respondent prescribed sixty (60) pills of Xanax 1 mg. and sixty {60) pills of Soma 350 mg.

    · 47. On or about July 16, 2008 Respondent prescribed thirty (30) pills of Zoloft 50 mg. and one hundred eighty {180) pills of oxycodone 30 mg.

    1. On or about September 29, 2008, Respondent prescribed one hundred eighty (180) pRls of oxycodone 30 mg.·and sixty (60) pllls of Advil 400 mg.·


      9

      _9213 _



      . l


    2. On or about October 28, 2008 Respondent presalbed two

    hundred (200) pills ·of oxycoctone 30 mg. and sixty (60) pills of Advil 400 mg.

    SO. Respondent did not perform a urine screen during the time she treated A.W. even though high dose opiates were prescribed.

    1. Respondent did not provide justification In the medical records for prescribing oxycodone 30mg as desaibed in paragraphs forty five (45) and forty seven (47) through forty nine (49).

    2. Respondent did not provide justiflcatton In the medical records for prescribing Xanax to A.W. as there is not an adequate discussion of anxiety disorder In the record.

    3. Respondent did not provide Justification in the medical records

      for pr scriblng Soma to A.W. as described Jn paragraph forty six (46).

      CQUNTONE

    4. Petitioner reincorporates and re-alleges paragraphs 1 through

      fifty three (53) as lf fully set forth herein.

      55. Section 458.331{1)(nn), Florida Statutes (2007, 2008, 2009),

      provides that violating any provision of Chapters 456 or 458, Florida


      _

      10

      9214


      )


      Statutes, or any rules adopted pursuant thereto Is grounds for discipline by the Board of Medicine.

      56, Rule 6488-9.013(3), Florida Administrative Code


      (2007,2008,2009} provides as follows: The Board has adopted the

      following standards for the use of controlled substances for pain control:

      1. Evaluation of the Patient. A complete medical history and physical examination must be conducted and documented ln the medical record. The medical record should document the nature and Intensity of the pain, current and past treatments for pain, underlying or coexisting diSeases or c.onditions, the effect of the pain on physical and psychological function, and 'history of substance abuse. The medical record also should document the presence of one or more recognized medical Indications for the use of a controlled substance.

      2. Treatment Plan. The written treatmert plan should state objectives that w.lll be used to determine treatmen_t success, such as pain relief and Improved physical and psychosocial function, and should Indicate if any further diagnostic evaluations or other treatments are planned. After treatment begins, the physician should adjust drug therapy to the Individual medical needs of each patient


        _

        l1

        ._9215


        Other treatment modalities or a rehabilitation program· may be necessary depending ·on the etiology of the pain and the extent to which the pain Is assodated with physical and psychosocial impairment.

      3. Informed C.Onsent and Agreement for Treatment. The physician should discuss the risks and benefits of the use of controlled substances with the patient, persons designated by the

        patient, or with the patient's surrogate or guardian If the patient ls incompetent. The patient should receive prescriptions from one

        · physician and one pharmacy where possible. If the patient Is

        determined to be at high risk for medication abuse or have a history of substance abuse, the physician should employ the use of a written

        agreement between physician and patient outlining patient responslbilltles, including, but not limited to:

        1. Urine/serum medication levels screening · when

          requested;



          _9216

        2. Number and frequency of all prescription refills; and

        3. Reasons for which drug therapy may be

          discontinued (i.e., violation of agreement}.


          12 _



          .l


      4. Periodic Review. At reasonable intervals based on the Individual circumstances of the patient, the physician should review the course of treatment and any new Information about the etiology of the pain. Continuation or modification of therapy should depend on the physician's evaluation of the patient's progress. If treatment

        · goals are not being achieved, despite medication adjustments, the

        physician should reevaluate the appropriateness of continued treatment. The physician should monitor patient compliance In medication usa and related treatment plans.

      5. Consultation. The physician should be willing to refer the

        patient as necessary for additional evaluation and treatment in order to achieve treatment objectives. Special attention should be given to those pain patients who are at risk for misusing their medications and those whose Hvlng arrangements pose a risk for medication misuse or diversion. The management of pain In patients with a history of substance abuse ·or with a comorbld psychiatric disorder requires extra care, monitoring, and documentation, and may require consultation with or referral to an expert In the management of such patients.


        _

        13

        _9217


        . _} _j


      6. Medical Records. The physician is required to keep

        accurate and complete records to lndude, but not be_ limited to:

        1. · The medical history and physical examination, Including history of drug abuse or dependence, as appropriate;

    2.

    Diagnostic, therapeutic, and laboratory results;


    3.

    _ Evaluations and consultations;


    4.

    Treatment objectives;


    S.

    6.

    Discussion of risks and benefits;

    Treatments;


    7. -

    Medications (tnclucllng date, type, dosage,

    and

    quantity prescribed);


    1. Instructions and agreements; and

    2. ·Periodic reviews.

    Records must remain current and be maintained in an

    accesslble manner and readily available for review.

    1. Respondent violated Rule 64B8-9.013(3), Florida Administrative Code (2007, 2008, 2009) in one or more of the following ways:

      1. by falling to conduct a complete medieal history and


        physical examination of R.S., D.H., M.N., or A.W.;


        .._9218                                               

        _J


      2. by falling to explore other treatmert modalities or


        rehabilitation for R.S., D.H., M.N., or A.W.;


    2. Based on· the foregoing, Respondent has violated Section 458.331(1)(nn), Florida Statutes (2007, 2008, 2009), by violating Rule 64B8-9.013(3), Florida Administrative Code {2007, 2008, 2009).

      COUNTTWO

    3. Petitioner reincorporates and realleges paragraphs 1 through


      fifty three (53) as If fully set forth herein.


    4. Chapter 6488-9.013(3), Aorida Administrative Code {2007, 2008, 2009) as more particularly set forth in paragraph fifty six (56) is adopted and re-alleged as If fully set forth herein.

      61. Section 458.331(1Xm), Florida Statutes (2007, 2008, 2009) provides: falling to keep legible, as defined by department rule In consultatlon with the board, medical records that identify the Ucensed physician or the physician extender and supervising physician by name a professional title who· Is or are responsible for rendering, ordering, supervising, or bllllng for each diagnostic or treatment procedure and that justify the course of treatment of the patient, Including, but not limited to,


      15

       9219




      patient histories; examination results; test results; records of drugs prescribed, dispensed, or administered; and reports of consultations and hospitalizations and a·violation thereof constitutes grounds for disciplinary

      action by the Board.


      ·52. Respondent failed to keep 1egible medical records Justifying the

      course of treatment for patients R.S., D.H., M.N., or A.W. in one or more of

      the following ways:


      1. by falling to keep medical records that Justified the course of treatment of R.S., by failing to record the Justification for prescribing Percocet as described in paragraph ten (10).

      2. by falling to keep medical records that justified the course of treatment of D.H., by falling to record the Justification for prescribing oxycoclone thirty (30) mg. as described in paragraphs twenty two and twenty three (23).

      3. by falling to keep medical records that justified the course of treatment of. M.N., by failing to record the justification for presalbing Xanax or oxycodone thirty (30) mg. as described In paragrap s thirty two (32) through thirty seven (37).


        16

        _9220 --



        :,


      4. by fai ing to keep medical records that justified the course of treatment of A.W., by falling to record the justification for prescribing oxycodone thirty (30) mg., Xanax, or Soma as described in paragraphs forty five (45) through forty nine (49}.

    1. Based on the foregoing, Respondent. violated Section 458.331{1)(m), Florida Statutes {2007, 2008,2009) by falling to keep legible medical records that Justify the course of treatment for patient R.S. and/or patient D.H. and/or patient M.N. and/or patient A.W., Including, but not limited to patient lstorles, examination results; test suits; records of drugs prescribed, dispensed, or administered; and reports of consultations and hospitalizations.

      COUNT THREE

    2. Petitioner reincorporates and realleges paragraphs 1 through

    fifty three (53).


    65. Section 458.331(1){q), Florida Statutes (2007, 2008 2009), subjects a licensee to discipline for prescribing controlled substances Inappropriately or in excesslVe or inappropriate quantities.

    1. Section 458.331(1)(q) states the following acts constitute grounds for disciplinary action:


      17

       9221

      )


      Prescribing, dispensing, administering, mixing, or otherwise preparing a legend drug, induding any controlled substance, other than in the course of the physician's professtonal practice. For the purposes of this paragraph, It

      shall be fegafly 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 nd Is not in the course of the physician's professional practice, without regard to his or her Intent.

    2. Respondent prescribed controlled substances other than in the course of her professional practice by prescribing controlled substances Inappropriately or excessively to R.S, D.H., M.N., or A.Win one or more of the following ways:

      1. by prescribing controlled substances without an adequate

        medical assessment of R.S., O.H., M.N., or A.W.;

      2. by prescribing oontrolled substances without an adequate

        physical examination of R.S., D.H., M.N., or A.W.


        18

        9222,


      3. by prescribing controlled substances without ordering urine drug saeening to R.S., D.H., M,N., or A.W.;

      4. by prescribing Xanax to M.N. or A.W. without an

        adequate discussion of anxiety disorder.

    3. Based on the foregoing, Respondent has viola Section

      458.331{1)(q), Rorlda .Statutes {2007, 2008, 2009).

      COUNT FOUR

    4. Petitioner reincorporates and re-alleges paragraphs 1 through

      fifty three (53) as If fully set forth herein.


    5. Olapter 6488-9013(3), Florida Administrative Code, as more particularly set forth In paragraph flfty six (56) herein is adopted and realleged as If fully set forth herein.

    71■- Section 458.331(1)(t), Florida Statutes (2007, 2008, 2009), subjects a licensee to dlsclpllne for committing medical malpractice as defined in Section 456.50, Florida Statutes. Section 456.SO, Florida Statutes {2007, 2008, 2009) defines meclical malpractice as the failure to practice medicine in accordance wtth the level of care, skill, and treatment recognized in general law related to health care llcensure.


    19

    9223


    '

    ..

    . l

    '


    1. For purposes of Section 458.331(1}(t), Florida Statutes, the Board .of Medicine shall give great weight to the provisions of Section 766.102, Florida Statutes (2007, 2008, 2009) which provide that the prevailing professional standard of care for a given health care provider

      shall be that level of care, skill, and treatment which, In light of all relevant surrounding circumstances, is recognized as acceptable and appropriate by reasonably prudent similar health care providers.

    2. Respondent failed to practice medicine with that level of care, skill, and treatment which is recognized by a reasonably prudent slmllar physician as being acceptable under similar conditions and cira,mstances in tre-1ng R.S., D.H., M.N., or A.W. in one or more of the following ways:

      1. by prescribing controlled substances inappropriately or In excessive or inappropriate amounts t:o R.S., D.H., M.N., or A.W. ;

      2. by falling to note in the medical records in prescribing Xanax that M.N. or A.W. was suffering from an anxiety disorder;

      3. by faUing to order urine drug screening to R.S., D.H.,

        M.N. or A.W. in light of the dosages of controlled substances prescribed;


        20

           9224,                                               





      4. by faffing to how In the medical record the justification

        for prescribing controlled substances to R.S., D.H., M.N., or A.W.,


      5. by iling to perform a complete physical examination on

        R.S., D.H., M.N., or A.W.,


      6. by prescrlbJng controlled substances to R.S, D.H., M.N., or A.W., in quantities and dosages as previously outlined, without Just1flcat1on.

      7. by failing to perform a complete medical assessment- of

        R.S., D.H., M.N., or A.W.

    3. Based on the- foregoing, Respondent has violated Section

    458.331(1)(t), Florida Statutes (2007, 2008, 2009).


    WHEREFORE, Petitioner respectfully requests that the Board of Medicine enter an order imposing one or more of the following penalties: permanent revocation or suspension of Respondent's license, restriction of

    practice, Imposition of an administrative fine, issuance of a reprimand;


    placement of the Respondent on probation, corrective action, refund of fees billed or collected, remedial education and/or any other relief that the Board deems appropriate.


    21

    _9225 _



    SIGNED this <. P  


    day of

    JVfUt..-.              


    2011.


    H. Frank Farmer, Jr., M.O., Ph.D., State Surgeon General Department of Health



    FILED

    DEPARTMENT OF HEALTH

    DEPUTY CLERK

    CLERK fYllel Sanders

    DATE JUN O 7 ?.011


    RJB/das


    PCP Members: Mullins & Tucker

    PCP: June 6, 2011

    Robert J. Bobek

    Assistant General Counsel Florida Bar # 434337

    DOH Prosecution Services Unit 4052 Bald Cypress Way•Bin c..65

    Tallahassee, Florida 32399-3265

    (850) 245-4640 Office

    (850) 245-4681 Facsimile



    22

    _9226, _


    STATE OF FLORIDA

    DEPARTMENT OF HEALTH


    DEPARTMENT OF HEALTH,


    PETITIONER,

    v. 1/-'lo PL

    CASE NO.: 2010-01128


    JACINTA IRENE GIWS, M.O.,

    RESPONDENT.


    APNINIStRATIYE COMPLAINT

    COMES NOW, Petitioner, Department of Health, by and through

    its undersigned counsel, and flies this Administrative Complaint

    · before the Board of Medldne against Respondent, Jacinta Irene Gfffis,

    M.o., and In suppart thereof alleges:

    1. Petitioner Is the state agency charged with regulating the practice of medicine pursuant to Section 20.43, Florida .Statutes; Oiapter 456, Rorida Statutes; and Chapter 458, Florkla Statutes.


      _ 9162

      1


      Fi.1114 AUV\&81: 1l., 2011 4122 PK D:l.v:ldoza ol! lldllb d.u at i ,re lle ari :DIJ


      . I


    2. At all times material to this Complaint, Respondent was a ltcensecJ physician wlthfn the State of Florida, having been Issued license number ME 99298. ·

    3. Respondent's address of record Is 12446 Pebble Stone

      Court, Fort Myers, Rorida, 33913.


    4. At aH times material to this cause between December

      2008 and January 2, 2010, Respondent treated patient M.G.

    5. The Department of Health (Department) began an

    investlgatton of Respondent based on a complaint received by a

    physician who had completed a compulsory medical examination of

    M.G.


    1. The reporting physlda Indicated that a prior ng

      physician other than Respondent may have addicted M.G. to

      narcotics; however, Respondent mnttnued to maintain M.G.s' narcottc usage.

    2. The types of controlled substances In question that were pr scrlbed by Respondent are llsted as follows:

      1. Oxycodone {opioid} Is comm·on1y prescribed to treat

        pain. According to SectJon 893.03{2), Rorlda St:at.\Jtes,


        2 .

        --9163



        . I


        Oxycodone is a Schedule n controlled substance that has a high potential for abuse and has a currently accepted but severely restricted medical use In treatment in the United States. Abuse of Oxycodone may lead to severe psychologlcal

        or physical dependence

      2. Oxycontin Is a seml•synthetic opiate that contains oxycodone hydrochloride, a Schedule II controlled substance defined in Chapter 893, Florida Statutes, which ls lndleated for

        the relief of moderate to severe pain. Oxycontin has a high potential for abuse and has a rrently accepted, but limited, · medical use In treatment In the United States. Abuse of this substance may lead to severe physlcal and psychological dependence.

      3. Valium, which contains dlazepam, ts a SChedule J.V controlled substance, pursuant to Section 89-3.03(4), Florida Statutes. Diazepam ts Indicated for the management of anxiety · disorders or for the short-term relief of the symptoms of anxiety. It may be habit forming and can lead to psychologtcal and physical dependence.



        3


        9 164 1



    3. In medicine, a proper medlcal assessment lndudes the patient's prior medical history, prior pain managemert treatment history, Intensity of pain, factors that make the pain worse or alleviate the pain, th.e pain's lntenSity and location, verification of prior controlled substance prescriptions Including . the date and quantity of .the last presaiptlon received, name of the previous treating physician, name and address of the pharmacy where the last controlled substance prescriptions were filled together with all relevant contact Information and verification of all the foregoing by

      , the physldan personalty contacting the previous pharmacy and treating physician, together with the reason for the referral, and verification for the reasons of referral with the prior treating· physician.

    4. On or abQUt ber 19, 2008 patient M.G. presented

      to Respondent with pain down his left: leg and buttocks.

    5. Respondert's mecllcal. records and M.G.'s patient profile from Bay Life Phannacy a·nd G & H Pharmacy _l lcate that Dr. GIiiis


      4


      .._9165,                           _


      'l


      prescribed the following controlled substances for M.G. on the dates

      and In the quantities described In the following table:



      Oxyoont:in

      40 .,

      O&yaodone

      30q

      Oxyoodcme UAP 10•650 IIIJ

      C>ayaontin

      so •v

      Dianpu

      CValiua>

      10 ■a

      12/19/08

      120 Pilla

      12/19/08

      240 Dille



      12/18/08

      30 ail.la

      1/16/09

      120 m.lla

      1/11/09

      HOp111a



      1/11/09

      30 m.lla

      1/22/0I

      120 'Dill•









      2/2/D9

      . JD eilla

      2/13/09

      120 pil.l,a





      3/12/09

      120 nil1.a





      6/12/09

      60 Dill.





      6/12/90

      60 s,illa





      6/11/09

      60 m.11





      7/9/09

      120 m.ll.a

      7/1/09

      240 'Dill•




      8/6/09

      120 a.ill.a

      116/0t

      HO Dill

      8/6/09

      'm.l.la





      8/H/09

      40 Dill.a



      919/09

      120 Dilla

      9/t/09

      HO Dil l





      10/'I/Ot

      240Dilla


      10/7/09

      120 Dil.l.a



      11/4/09

      240 Dill•



      11/(/09

      150 Dilla


      12/2/09

      240 m.lla


      12/2/0t

      120 P:l.118



      1:Z/30/08

      240 Dilla


      12/30/09

      120 Dill



    6. Respondent's assessment of M.G. failed to adequately assess M.G.'s condition by not requiring any urine drug saeens, by



      5


      . 9166

      1


      . J


      not requesting or reviewing prior medlr.al records regarding previous medieatlon use or history of opioid prescribing and/or by not performing a thorough physlcal or cllnlcal examination of M,G,

    7. The medical records did not contain meclcal Justfflcatlon

      for· the prescriptions oxvm,tln, . oxycodone, or dlazepam as

      described In paragraph ten (10),


      COUNJQHE

    8. Petitioner reincorporates and re-alleges paragraphs 1

      through twelve {12) as If fully set forth herein.

    9. Section 458.331(1Xnn), Florida Statutes (2008, 2009), provides that violating any provlslon of Chapters 456 or 458, Florida statutes, or any rules adopted pursu nt thereto Is grounds for cftsctpllne by the Board of Medicine.

    10. Rule 6488-9.013(3), Florida Administrative Code

      (2008,2009) provtdes as follows:


      The Board has adopted the foNowlng standards for the use of controlled substances for pain control:

      1. Evaluation of the Patient. A complete medical history and phystcal examination must be conducted and

        6

        _.9167             _




        documented In the medical record. The medical record should document the nature and intensity of the pain, current and past treabnents for pain, undertylng or coexisting diseases or conditions, the effect of the pain on physical and psychologleal function, and hfstory of substance abuse. The medical record

        also should document the presence of one or more recognized medical indications for the use of a controlled substance.

      2. Treatment Plan. The written treatment plan should state objectives that wlll be used to determine treatment success, such as pain relief and Improved physical and psychosocial function, and should Indicate If any further

        diagnostic evaluations or other treatments are planned. After

        treatment begins, the physician should adjust drug therapy to the lndMdual medical needs of each patient Other treatment modaHties or a rehablDtation program may be necessary depending on the etiology of the pain and the extent to which the pain Is associated with physical and psychosodal

        impairment.


        7


        , 9168 1                                                                                                      _




        . )


      3. Informed Consent and Agreement for Treatment The physician should discuss the risks and benefits of the use of controUed substances with the patient, persons designated by the patient, or with the patient's surrogate or guardian If the patient ts Incompetent. The patient should recetve presatptlons from one physician and one pharmacy where

        posslbte. If the patient is determined to be at high risk for medication abuse or have a history of substance ab.use, the physician should employ the use of a .written agreement between physician and·patient outlining patient responslblllttes, lndudlng, but not llmltecl'to:

        1. Urine/serum medication levels screening .when

          requested;

          z. Number and frequency of all prescription

          reftlls; and

          3. Reasons for which drug therapy may be

          discontinued (i.e., violation of agreement).

      4. Periodic Review. M.- reas >nable Intervals based on the Individual circumstances of the patient, the physician should


        8


         9169             _..


        . I


        review the course of treatment and any new Information about the etiology of the pain. Continuation or rnodfflcation of therapy should depend on tile physldan's evaluation of the

        patient's progress. If treatment goals are not being achieved,

        · despite medicatton adjustments, the physldan should reevaluate the appropriateness of continued treatment. The physician should monitor patient compliance In medication usage and related treatment plans.

      5. Consultation. The physician should be wDHng to

        refer the patient as necessary for additional evaluation and treatment In order to achieve treatment objectives. Special attention should be given to those pain patients who are at risk

        for misusing their medications and those whose llvtng arrangements pose a risk for medication misuse or diversion. The management of pain in patients with a history of substance abuse or with a amorbid psychiatric disorder requires extra care, monltortng, and documentation, and may require consuitatlon with or referral to an expert in the management of such patients.


        9

        .  9170                                               



      6. Medical Records. The physician Is required to keep

        accurate and complete records to lndude, but not be llmlted to:

        1. The medtcal history and physlcal examination, indudlng history of drug abuse or dependence, as appropriate;

        2. Diagnostic, therapeutic, and laboratory

          results;


        3. Evaluations and consultatlons;

        4. Treatment objectives;

        5. DISCUSSlon of risks and benefits;

        6. Treabnents;


        7. Medications {lnduding date, type, dosage,

          and·quantity presaibed);


        8. Instructions and agreements; and

        9. Periodic reviews.


          Records must remain current and be maintained In

          an accesslble manner and readHy available for review,


          10

          _9171 _


          . )


    11. On or about December 19, 2008 Respondent violated

      Rule 64B8-9.013(3}, Florida Aclmtnrstratlve Code, In one or more of the following ways:

      1. by falHng to conduct a complete medical history and phySlcal examlnatlon of M.G.

      2. by failing to .refer M.G. to either a board certified pain spedallst or someone wtth specialized treatment In chemical dependency;

        c} by falling to explore other b'eatment modalities or

        rehabiDtation.


    12. Based on the foregoing, Respondent has violated Section 4S8.331(1Xnn), Florida Statutes (2008,2009) by violating Rule 64B8- 9.013(3), Florida Administrative Code (2008, 2009).

      COUNTU,,Q

    13. Petitioner reincorporates and re-aJleges paragraphs 1

      through twelve (12), fourteen (14), and fifteen (15) as If fuUy set

      forth hereJn.


      11

      .._9172,                           _


    14. On or about January 16, 2009 Respondent violated Rule

      ·6488-9.013(3), Florida Administrative· Code, In one or more of the following ways:

      1. by falling to conduc.t a complete medical hlst.ory and

        physical examination of M.G.

      2. by falling to refer M.G. to either a board certified


        pain specJaUst or someone with specialize.d

        chemical dependency;

        treatment In


      3. by failing to explore other treatment modalities or

    rehabllltatio .


    20, Based on the foregoing, Respondert has violated Section 4SB.331(1)(nn), Florida Statutes (2008,2009) by violating Rule 64B8- · 9.013(3), Florida Administrative Code (2008, 2009).

    CQUNTTHREE

    1. Petitioner reincorporates and re-alleges paragraphs 1 through twelve (12), fourteen (14), and fifteen {15) as If fully set

      . .

      forth herein.


      12

      ._9173                     _


    2. On or about February 13, 2009 Respondent violated Rufe 64B8-9.013(3), Florida Administrative Code, In one or more of the following ways:

      1. by falling to conduct a complete medlcal history and

        physka examJnatlon of M.G.

      2. by falling to refer M.G, to etther a board certified pain spedallst or someone with spe_dallzed treatment · In chemical dependencyi

      3. by faHlng to explore other treatment modalities or rehabJllt.ation.

    3. Based on the foregoing, Respondent has VIQlated Section 458.331(1Xnn), Florida statutes (2008,2009} by Violating Rute 6488- 9.013(3), Aorlda Administrative Code (2008, 2009). ·

      COUNTFQUR

    4. Petitioner reincorporates and re-alleges paragraphs 1 through twelve (12), fourteen (14), and fifteen (15} as If fully set

      forth herein.


      13

      .._9174,                          _

      . ., . \


    5. On or about March 12, 2009 Respondent violated Rule 6488-9.013{3), F1orkla Administrative Code, In one or more of the following ways:

      1. by falling to conduct a complete medical history and physical examlnatlon of M.G.

      2. by falling to refer M.G. to either board certified pain specialist or someone with speclaRzecl treatment In chemical dependency;

      3. by faUlng to explore other treatment modalities or rehabHitatlon.

    6. Based on the foregoing, Respondent has violated Section 458.331(1Xnn), Florida Statutes (2008,2009) by violating Rule 64B8- 9.0i3(3), Florida Administrative Code (2008, 2009).

      COUNTBYJ .

    7. PetJtloner reincorporates and re-alleges paragraphs 1 through twelve (12}, fourteen (14), and fifteen (15} as lf fuDy set forth herein.


      14

      9175           _


      J


    8. On or about lune 12, 2009 Respondent violated Rule 64B8-9.013{3), Rorlda Administrative Code, In one or more of the following ways:

      1. by falHng to conduct a complete medical history and

        physical examination of M.G.

      2. by falling to refer M.G. to either a board certified pain specialist- or . someone with spedalzed treatment in chemka dependency;

      3. by falhng to explore other treatment modalities or rehabilitation.

    9. Based on the foregoing, Respondent has violated Section 458.331{1Xnn), Florida Statutes (2008,2009) by vlolating ·Rule 6488- 9.013(3}, Rorfda Administrative Code (2008, 2009).

      COUNT SIX

    10. Petitioner relmx>rpprates and re-alleges paragraphs 1


      . '

      through .twelve (12), fourteen (14), and fifteen (15) as if fully set

      forth herein.


       9176


    11. On or about July 9, 2009 Respondent violated Rule 64B8-

      9.013(3), Florida Administrative Code, in one or more of the following

      ways:


      1. by faUlng to conduct a complete medical history and

        physical examination of M.G.

      2. by falling to refer M.G. to etther a board certified pain spedallst or someone With speclallzed treatment Jn chemical dependency;

        c·)

        by faJIJng to explore other t modalities or

        rehabilitation.


    12. Based on the foregoing, Respondent has violated Section 458.331(l)(nn), Aorfda Statutes (2008,2009) by violating.Rule 6488- 9.013(3), Florida Aclmfnlstrative Code {2008, 2009),

      CQVNJRvm

    13. Petitioner reincorporates and re-alleges paragraphs 1

      through twelve (12), fourteen {14), and fifteen (15) as If fully set

      forth herein.


      15

      ·9177                                                     


      )


    14. On or about August 6, 2009 Respondent violated Rule 6488-9.013{3), Florida Administrative Code, in one or more of the followlng ways:

      a} by falling to conduct a complete medical hlstOry all(I

      physical examination of M.G.

      1. by faillng to refer M.G. to either a board certified pain specialist or someone with specialized treatment In chemical dependency;

      2. by falling to explore other treatment modalltles or rehabllltation. ·

    15. Based on the foregoing, Respondent has violated Section 458.331(1)(nn), Florida Statutes (2008,2009) by violating Rule 6488- 9.013(3), Florida Administrative Code (2008, 2009).

    COUNT EIGHT

    · · 36. Petitioner reincorporates and re-allege$ paragraphs 1 through twelve (12), fourteen {14}, and fifteen (15) as If fully set forth herein.


    17

    . 9178,                                              


    1. On or about September 9, 2009 Respondent violated Rule 64B8-9.013(3), Aorida Administrative Code, In one or more of the following ways:

      1. by falling to conduct a complete medical history and physical examination of M.G.

        b} by falling to refer M.G. to either a board certitled pain spedallst or someone wlth speclallzed treatment In

        chemtcat dependency;


        c) by faffing to explore other treatment. modalltles or

        rehabilitation.


    2. Based on the foregoing, Respondent has violated Section 458.331(1Xnn), Florida Statutes (2008,2009) by violating Rule 6488- 9.013(3), Florida AdmlnlStratlve Code (2008, 2009).

      COUNT NINE

    3. Petitioner reincorporates and re-alleges paragraphs 1 through twelve (12), fourteen {14), and fifteen (15) as If fully set forth herein.


      11


      l ..

      ·' l


    4. On or about October• 7, 2009 Respondent violated Rule 6488-9,013(3), Florida Administrative Code, in one or more of the followtng ways:

      1. by falllng to conduct a complete medlcal history and

        physicar examination of M.G.

        b} by failing to refer M.G. to either a board certified pain specialist or someone with speclaltzed treatment In chemical dependency;

        c) by falling to explore other treatment modalltles or

        rehabilitation.

    5. ·Based on ttie foregoing, Respondent has violated Section 458.331(1Xnn), Florida Statutes (2008,2009) by violating Rule 6488- 9.013{3), Florida Administrative Code (2008, 2009).

      CQUNTJIN

    6. Petitioner rel corporates and re-alleges paragraphs 1

      through twelve (12), fourtee (14), and fifteen (15) as If fully set

      forth herein.


      1.9-


    7. On or about November 4, 2009 Respondent violated Rule

      6468-9.013(3), Florida Administrative Code, In one or more of the following ways:

      1. by falling to conduct a complete medical hlStory and

        physical examination of M.G.


      2. by falllng to refer M.G. to either a board certified pain speclallst or someone with specialized treatment In chemlcal dependency;

    c} by falllng to explore other. treatment modalities or

    • rehablntatlon. ·


    '14. Based on the foregoing, Respondent has violated Section

    458.331(1)(nn}, Florida Statutm (2008,2009) by violating Rule 6488-

    9.013(3), Florida Administrative Code (2ooe; 2009).

    COUNT ELEVEN

    4S. Petitioner reincorporates and re-alleges paragraphs 1 through twelve (12), fourteen (14), and fifteen (15) as If fully set . forth herein.


    zo

    _9181                     _


    ·'


    1. On or about December 2, 2009 Respondent vlolated Rule 64B8-9.013{3), Aorlda AdmintstratJve Code, In one or more of the following ys:

      1. by falling to conduct a complete medical history and

        physlral examination of M.G.

      2. by falling to refer M.G. to either a board certified pain spedallst or someone with speclallzed treatment in chemical dependency;

      3. by fallng to explore other treatment modalltles or rehabilitation.

    2. Based on the foregoing, Respondent has vtolated Section 458.331(1Xnn), Florkm Statutes (2008,2009) by violating Rule 6488- 9.013(3), Florfda Administrative Code (2008, 2009).

      CQUNTJWELYI

    3. Petitione·r reincorporates and re-alleges paragraphs l


      through twelve (12), fourteen (14), and fiflEen (15) as If fully set

      forth herein.


      21

      _9182


    4. On or about Decem 30, 2009 Respondent violated Rule 64B8-9.013(3), Florida Administrative Code, tn one or more of

      the foHOWlng ways:


      1. by falling to conduct a complete medical history and

        phystcaJ examination of M.G.

      2. by faling to refer M.G. to efther a board certified pafn spedaNst or someone with specialized treatment In chemical dependencyi

      3. by falllnQ to explore other treatment modalltJes or

    rehabilitation.

    so. Based on the foregoing, Respandent has vfolated Section

    458.33i(l)(nn), Rorida Statutes (2008,2009) by violating Rule 6488·

    9.013(3), Florida Administrative Code (2008, 2009).

    COUNT THJBUEN

    1. Petitioner relncorrx>rates and re-alleges paragraphs 1

      through twelve {12), and fifteen·(15) as If fully set forth herein.

    2. Section 458.331(1Xm), Aorlda Statutes ·(2008, 2009)

      . Provi es: falling to keep leglble, as defined by deparbnent rufe In


      consultation with the board, medlcal records that Identify the licensed


      22

      .._9183,                         _


      _I


      physician or the physician extender and supervising physlclan by name and professional title who ls or are responsible for rendering, ordering, supervising, or bllllng for· each dlagnostlc or treatment procedure and that Justify the course of treatment of the patient,

      Including, but not limited to, patient histories; examination results;·

      test results; records of drugs presa1bed, dispensed, or admJriistered; and -reports of consultations and hospltalzations and a violation thereof constitutes grounds for disciplinary action by the Board.

    3. Respondent failed to keep medical records on or about December 19, 2008, that justified the course of treatment for M.G., by faffing to• record the ,iustiflcatlon for prescribing oxycontln , oxycodone or dlazepam as described In paragraph ten (10),

    4. Based on the foregoing, Respondent has violated Section

      458.331(1)(m), da Statutes (2008, 2009) by falling to keep legible medical records that justified the .course of treatment for M.G., by not indudlng one or more of the following: a complete patient meclcal history and physical examination, lncludlng history of drug abuse or dependence, as approprla ; cf11gnostlc, therapeutic, and laboratory results; evaluations a d consultations; examination


      Z3


      9184.




      .. ,.

      I .J


      results, test results, records of drugs prescribed, dispensed, o,r administered; or reports of consultations and hospltallzations.

      COUNT fOURTEEN

    5. Petitioner reincorporates and re-alleges paragraphs one

      {1) through twelve (12), fifteen (15).and fifty-two (52) as If fully set

      forth herein.

    6. Respondent failed to keep mecfical records on or about January 16, 2009, that justified the course of treatment for M.G., by falling to record the justification ror prescribing oxycontln , oxycodone or dlazepam·as described In paragraph ten (10).·

    7. Based on the foregoing, Respondent has violated Section 458.331(1)(m), Florida Statutes (2008, 2009) by falling to keep leglbre medical records that Justified the course of treatment for M.G., -by not Including one or more of the followtng: a complete patient medical history and physical examination, lndudlng history of drug abuse or dependence, as appropriate; diagnostic, - erapeutlc, and laboratory results; evaluations and consultatlons; examination results, test results, records of drugs prescribed, dispensed, or administered; or reports of consultations and hospltallzatlOns.


    _9185,


    COUNT FlfiEEN

    SB. Petitioner relncorporams and re-alleges paragraphs one

    (1) through twelve {12), fifteen (15) and tlfty-two {52) as If fully set

    forth herein.

    59. Respondent failed to keep medlcal remrds on or about February 13, 2009, that jUstlfled the course of treatment for M.G., by falling to record the justification for prescribing oxveontln ,

    .

    oxycodone or dlazepam as desalbed In paragraph ten (10).

    .

    O, Based on the foregoing, Respondent has violated Section 458.331(1){m), Florida Statutes (2008, 2009) by falling to keep legible medical records that justified the course of treatment for

    M.G., by not Including one or more of the following: a complete

    patient medical history and physical examlnatk>n, lndudlng history of drug abuse or dependence, as appropriate; diagnostic, therapeutic, and laboratory results; evaluations and consultatlons; examination results, test resuhs, records of drugs prescribed, dispensed, or administered; or reportsd mnsultations and hospitalizations


    25

     9186           _




    ...

    l


    COUNTSIXTEEN

    .

    1. Petitioner relnmrporates and re-alleges paragraphs one

      (1) through Ive (12), fdteen (15) and fifty-two (52) as If fully set .

      forth herein.

    2. Respondent failed to keep medlcal records on·or about March 12, 2009, that Justified the course of b'eatment for M.G., by falling to record the justlflr.atton for prescribing oxycontln , oxycodone or dlazepam as described In paragraph ten (10).

    3. Based on the foregOlng, Respondent has violated Section 458.331{1)(m), Florida Statutes (2008, 2009) by faHing to keep legible medlcal records that justified the course of .treatment for

      M.G.,· by not lnclud1ng one or more of the following: a complete.

      '

      patient medical history and physical examination, Including history of drug abuse or dependence, as appropriate; diagnostic, therapeutic, and laboratory results: evaluations and cxmsultat1ons; examination results, test results, records of drugs· prescribed, dispensed, or admlnlstered; or relJ(lts of consultations and hospltallzatlons.


      26

       9187            _



      CQUNI SEVENTEEN

    4. Petitioner reincorporates and re-alleges paragraphs one

      (1) through twelve (12), fifteen (15) and fifty-two (52) as If fuHy set

      forth herein.

    5. Respondent falfed to keep medical records on or about June 12, 2009, that justlf1ed the oourse of ent for M.G., by falHng to record the Justification for prescribing oxyc:ontln , oxycodone or dlazepam as desalbed In paragraph ten (10).

    6. Based on the foregoing, Respondent has violated Section

      458.331{1Xm), FlorJda Statutes (2008, 2009) by failing to keep legible medical records that Justified the course of treatment for M.G., by not lndudlng one or more of the followlng: a cnmplete patient mecllcaf history and physlc:al examination, including history of drug abuse or dependence, as appropriate; diagnostic, therapeutic, and laboratory results; evaluations and a>nsultatlons; examination results, test results, records of drugs prescribed, dtspensed, or administered; or reports of consultations and hospltallzatlons.


      27


      . 9188



      .1


      COUNT IJGHTEEft

    7. Petitioner reincorporates and re--alleges paragraphs one

      {1) through twelve {12), fifteen (15) and fifty-two (52) as If fully set

      forth herein.

    8. Respondent failed to keep medical records on or about July 9, 2009, that Justified the course of treatment for M.G., by falling to record the Justification for prescribing oxyccntln , oxycodone or dlazepam as desalbed In paragraph ten {10),

    9. Based on the foregoing, Respondent has violated Sec.tion 458.331(1)(m), Florida Statutes {2008, 2009) by falling to keep legible medical records that justified the course of treatment .for M.G., by not Including one or more of the following: a complete patlerit medical history and physical examination, Including history of

      drug abuse or dependence, as appropriate; diagnostic, therapeutic, and laboratory results; evaluations and consultations; examination results, test results, records of drugs presalbed, dispensed, or administered; or reports of consultations and hospitalizations.


      2B

       9189



      COUNT NJNEJEEN

    10. Petitioner reincorporates and re-alteges paragraphs one

      (1) through twelve (12), fifteen (15) and fifty-two (52) as If fully set

      forth herein.

    11. Respondent faHed to keep mecllcal records on or about August 6, 2009, that Justified the course of treatment for M.G., by falling to record the Justification for presa lblng oxycontln , oxycodone or dlaz m as described In paragraph.ten (10),

    12. Based on the foregoing, Respondent has violated Section 458.331(1)(m), Florida Statutes (2008, 009) by faffing to keep legible medical re.cords that justified. tile course of treatment for M.G., by not tncludtng one or more of the folkrNlng: a canplete

      patient medk:al history and physical examination, inducting history of

      . .

      drug abuse or dependence, as appropriate; diagnostic, therapeutic,

      . .

      and laboratory results; evaluations and consultations; examination

      results, test results, records <Y drugs prescribed, dispensed, or admlnl ; or reports of co_nsultatkms·and hospitalizations.


      29

      9190


      COUNTTWENll


    13. Petitioner reincorporates and re-alleges paragraphs one ( 1) through twelve {12), fifteen (15) and fifty-two (52) as lf fully set forth herein.

    14. Respondent falled to keep medical records on or about September 9, 2009; that Justified the course of ent for M.G., by falling to record the Justlficatloo r prescribing oxycontin , oxycodone or dlazepam as described In paragraph ten (10).

    15. Based on the foregoing, Respondent has violated Section

      · 458.331(1)(m), Aorida Statutes (2008, 2009) by falling to keep legible medical records that Justified the course of treatment for M.G., by not Including one or more of the foltowlng: a complete patient medical history and physical examination, inducllng hrstory of drug abuse or dependence, as appropriate; diagnostic, therapeutic, and laboratory results; evaluations and consultations; examfnatlo results, test results, recolds of drugs presaibed, dispensed, or administered; or reports Qf consultations and hospitalizations.


      30

      9191            _


      COUNT JWENJY•QNI!

    16. Petitioner reincor s and re-alleges paragraphs one (1} through twelve (12), fifteen (15) and fifty-two (52) as if fully set forth herein.

    n. Respondent failed to keep medical records on or about

    . October 7, 2009, that Justified the course of treatment for M.G., by

    failing to record the Justification for prescr1blng oxycontln ,


    oxycodone or dlazepam as described. In paragraph ten (10•)

    1. Based on the foregoing, Respondent has violated Section 458.331(1Xm), Florida statutes (2008, 2009) by falling to keep legible medical records that justified the course of treatment for M.G., by not lndudlng one or more of the following: a complete

      patient rnedlcal history and physical examination, lnducllng history of drug abuse or dependence, as appropriate; diagnostic, therapeutic, and laboratory results; evaluations and consultations; examination results, test results, recqrds of drugs prescribed, dispensed, or· administered; or reportsd consultations and hospltaHzattons.


      31

         9192.                          _


      g)UNTJWENU•TWO

    2. Petitioner reincorporates and re-alleges paragraphs one.

      1. through twelve (12), fifteen (15) and fifty-two (52) as If fully set forth herein.

    3. Respondent failed to keep medical records on or about

      November 4, 2009, that justified the course of treatment for M.G., by falling to record the Justification for prescrib1ng oxycontrn , oxycodone or dlazepam as desalbed In paragraph ten (lD)

    4. Based on the foregoing, Respondent has violated section. 458.331{1Xm), Ftorlda Statutes (2008, 2009) by f lllng to keep legible medical records that Justified the course of treatment for M.G., by not lndudlng one or more of the foJlowlng: a complete patient medical history and physical examination, Including history of drug abuse or dependence, as appropriate; diagnostic, therapeutic, and laboratory results; evaluations and consultations; examination

      results, test results;. records o·f drugs prescribed, dispensed, or


      administered; or reports of consultations and hospitalizations.


      32.

      9193,                                               


      CQUNTJWEND·IHREE

    5. Petitioner reincorporates and re-alleges paragraphs one

        1. through twelve (12), fifteen (15) and fifty-two (52) as If fully set

      forth herein.


    6. Respondent failed to keep medical records on or about December 2, 2009, that justified the course of treatment for M.G., by falling to record the Justification · for presalbing oxva>ntin , oxvcodone or dlazepam as described In paragraph ten (10).

    7. Based on the foregoing, Respondent has Violated Section

      458.331(1){m), Florida Statutes {2008, 2009) by falllng to keep

      )eglble medical records that justified the course of treatment for M.G., by not Including one or _more- of the following: a complete patient medical history and physical examlnatlOn, Jndudlng history of drug abuse or dependence, as appropriate; diagnostic, therapeutic,

      and laboratory results; evaluations and consultations; examination

      results, test results, records of drugs prescribed, dispensed, or

      administered; or reports of consultations and hospitalizations.


      ._9194 -


      .t


      CQUNITWENTY-FOUR

    8. Petitioner retncorporates and re-alleges paragraphs one (1} through twelve (12), fifteen (15) and fifty-two (52) as if fully set forth herein.

    9. Respondent failed to keep medical records on or about December 30, 2009, that Justified the course of trea ment for M.G., by falling to .record the Justification for prescribing oxycontln , oxycodone or dlazepam as described In paragraph ten (10).

    10. Based on the foregoing, Respondent has violated Section

      458.331(1)(m), Florida Statutes {2008, 2009) by falling to keep legibte medical records that Justified the course of treatment for M.G., by not lndudlng one or more of the following: a complete patient medical history and physical examination, lndudfng history of drug abuse or dependence as appropriate; dagnostle, therapeutic,

      and laboratory results; evaluatlons and consultations; examination results, test results, records of drugs prescribed, dispensed,. or administered; or reports of consul tions and hospltallzatlons.


         9195,                                             



      COUNT JWENTY·fIYE

    11. Petitioner reincorporates and re-alleges paragraphs one

      (1) through twelve (12) as If fully set forth herein.


    12. Chapter 6488-9.013(3),Florida Administrative Code (2008-2009), as more particularly set forth In paragraph fifteen (15) herein is adopted and re-alleged as If fully set forth.

    90. _Section 458.331(1Xt), Rorlda Statutes (2008, 2009), subjects a licensee to disclpllne for c:9mmltting medical malpractlc:e as defined In Section 456.50, Florida Statutes. Section 456.50, Florida Statutes (2008, 2009) defines medical malpractice as thefailure to practice medicine In aca>rdance with the level of care, skfll, and treatment recognized In general law related to health care llcensure.

    1. For pUrposes of Section 458.331(1)(t), Florkla Statutes, the Board shall . give great weight to the provisions of. Section 766.102, Florida Statutes {2008, 2009) which provide that the prevaDing professional standard of care for a given health care provider shall be that level of care, skill, and treatment which, 111 tight


      35


      ......9196,

      .• I )


      of all relevant surrounding circumstances, Is recognized as acceptable

      and appropriate by reasonably prudent similar health care providers.

    2. Respondent failed to practice medicine wrth that level of care, skill, and treatment which Is remgnlzed by a reasonably prudent slmllar physician as being acceptable under slmllai' conditions

      and circumstances In treating M.G. in one or more of the following

      ways:


      1. by presalbing controlled substances Inappropriately

        or In excessive and/or Inappropriate amounts;

      2. by fallng to document in the medical record the Justification for presalblng oxycontln or oxycodone or dlazepam In the doses or quantities as described In paragraph ten (10)

        above;


        c} by falling to confirm whether M.G. presented to a psychiatrist or psychologlst after the Initial referral;

        ·. ·d) by failing to document In the medcal records whether there was·any follow-up .by M.G. after an inltfal referral to a psychiab'lst or psychologist.


        9197           _



        i

        _J


        1. by falDng to order urine drug screening in light of

          the prescribing of controlled substances to M.G.


        2. by failing to record In the medical record any evidence of thorough physk:al examinations or by faling to fully assess the patient.

        3. by faltng to conduct a complete and thorough physical examination of M.G.

    3. Based on the foregoing, Respondent has violated Section 458.331(1)(t), Florida Statutes (2008, 2009).

      COUNT JWENJY-SJX

    4. Petitioner reincorporates and re-alleges paragraphs 1

    through twelve (12) as If fully set forth herein.

    95. Section 458.331(1)(q), Florida Statutes (2008, 200.9) subjectsa licensee to discipline .for presaiblng controlled substances inappropriately or In excessive or inappropriate quantities.

    1. Sec.tfon 458.331(1Xq) states the following ac:ts constitute

      grounds for disciplinary action:


      Presaiblng, dispensing, administering, mbdng, or

      otherwlSe preparing a legend drug, Including any controlled


      37

      1

      9198



      _l .l


      substance, other than In the course of the physician's professional practice. For the purposes 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 ts not In the best Interest of the patient and fs not In the course of the physician's professional practice, without regard to his or her Intent.

    2. Respondent prescribed conlrolled substances other than

      In the murse of her professional practk'e by prescribing controlled

      ···--· . ·-·

      substances inappropriately or exces-stvely In one or more of the

      follOWing ways:

      1. by prescribing controlled substances Without an

        adequate medical assessment of'M.G.;

      2. by prescribing controled substances without an adequate physical examination of M.G.;

        .

      3. by presa'lblng controlled substances without

        dlsasssing or- attempting alternative pain management

        modalltles;


        ......9199

        311


        .I


        1. by presalbing controlled substances Without ordering urine drug screening.

        2. by prescrlbtng controUed substances to M.G. without justification as outlined in paragraph ten (10).

  1. Based on the foregoing, Respondent violated Section

458.331(1)(q), Rotlda Statutes {2008, 2009).


WHEREFORE, the Petitioner respectfully requests that the · Board of Medicine enter an order Imposing one or more of the followfng penalties: permanent revocation or suspension of Respondent's license, resbictlun of practice, imposition of an

administrative fine, Issuance cl a reprimand, placement of the Respondent on probation, corrective action, refund of fees billed or collected, remedial education and/or any other rellef that the Board

deems appropriate.


   9200.                         _


SIGNED this 1-iL day of UI\(_ 2011.



FILED DEPARTMENT OF HEA\.Tti

. DEPUTY CLERK

CLERI( Angel Samifrs

DATE JUN O 7 ?01 . ·


RJB/das

H. Frank Farmer, Jr., M.D., Ph.D.,

State Surgeon General

· -        

Robert J. Bobek

Assistant General Counsel

Florida Bar # 434337

DOH Proseculion Services Unit 4052 Bald Cypress 'Way-Bin C-65 Tallahassee, Florida 32399-3265

(850) 245--4640 Offl0:!

(850) 245-4681 Facsimile


PCP Members: •""'llins -1 1c.teka-­

1

PCP: Jt4r, (. Aolf


4D

_9201                   


Docket for Case No: 11-005692PL
Issue Date Proceedings
Apr. 24, 2012 (Agency) Final Order filed.
Feb. 03, 2012 Recommended Order (hearing held December 5-6, 2011). CASE CLOSED.
Feb. 03, 2012 Recommended Order cover letter identifying the hearing record referred to the Agency.
Feb. 01, 2012 Response to Department of Health's Post Recommendation Order Statement of Facts filed.
Jan. 19, 2012 Petitioner's Proposed Recommended Order filed.
Jan. 09, 2012 Transcript of Proceedings Volume I-III (not available for viewing) filed.
Jan. 03, 2012 (Respondent's) Post Order Recommendation filed.
Dec. 15, 2011 Undeliverable envelope returned from the Post Office.
Dec. 08, 2011 Respondent's Proposed Exhibits (exhibits not available for viewing)
Dec. 05, 2011 CASE STATUS: Hearing Held.
Dec. 01, 2011 Notice of Transfer.
Nov. 29, 2011 Joint Pre-hearing Stipulation filed.
Nov. 28, 2011 Petitioner's Separate Pre-hearing Statement (filed in Case No. 11-005692PL).
Nov. 22, 2011 Amended Notice of Hearing (hearing set for December 5 and 6, 2011; 9:00 a.m.; Fort Myers, FL; amended as to hearing location).
Nov. 21, 2011 Order Re-scheduling Hearing (hearing set for December 5 and 6, 2011; 9:00 a.m.; Fort Myers, FL).
Nov. 21, 2011 Notice of Ex-parte Communication.
Nov. 17, 2011 Petitioner's Motion to Re-schedule Final Hearing (filed in Case No. 11-005692PL).
Nov. 16, 2011 Letter to Judge Kirkland from J. Gillis regarding an objection filed.
Nov. 15, 2011 Notice of Ex-parte Communication.
Nov. 15, 2011 Order of Pre-hearing Instructions.
Nov. 15, 2011 Notice of Hearing (hearing set for December 29 and 30, 2011; 9:00 a.m.; Fort Myers, FL).
Nov. 10, 2011 Response to Administrative Complaints and Supportive Materials filed.
Nov. 07, 2011 Joint Response to Order Re-opening and Consolidating Cases filed.
Nov. 07, 2011 Joint Response to Order Re-opening and Consolidating Cases filed.
Nov. 07, 2011 Amended Administrative Complaint (filed in Case No. 11-005692PL).
Nov. 07, 2011 Amended Administrative Complaint filed.
Nov. 03, 2011 Order Re-opening and Consolidating Cases (DOAH Case Nos. 11-5691PL, 11-5692PL).
Nov. 03, 2011 Motion to Re-open DOAH Case filed. (FORMERLY DOAH CASE NO. 11-4062PL)
Oct. 04, 2011 Order Relinquishing Jurisdiction and Closing Files.
Sep. 27, 2011 Motion for Denial of Postponement filed.
Sep. 27, 2011 Motion to Relinquish Jurisdiction filed.
Sep. 08, 2011 Notice of Taking Deposition Duces Tecum in Lieu of Live Testimony (Detective R. Osterland) filed.
Sep. 08, 2011 Notice of Taking Deposition Duces Tecum in Lieu of Live Testimony (Special Agent J. Beuth) filed.
Sep. 08, 2011 Amended Notice of Taking Duces Tecum (as to location only) filed.
Aug. 31, 2011 Subpoena Duces Tecum (J. Gillis, M.D.) filed.
Aug. 24, 2011 Notice of Serving Petitioner's First Request for Production, First Request for Interrogatories, and First Request for Admissions to Respondent filed.
Aug. 22, 2011 Order of Consolidation (DOAH Case Nos. 11-4058PL and 11-4062PL).
Aug. 22, 2011 Order of Pre-hearing Instructions.
Aug. 22, 2011 Notice of Hearing (hearing set for October 17 through 19, 2011; 9:00 a.m.; Fort Myers, FL).
Aug. 18, 2011 Joint Response to Initial Order filed.
Aug. 12, 2011 Notice of Appearance as Co-counsel (filed by S. Bates).
Aug. 12, 2011 Notice of Appearance (filed by R. Bobek).
Aug. 11, 2011 Election of Rights filed.
Aug. 11, 2011 Administrative Complaint filed.
Aug. 11, 2011 Agency referral filed.

Orders for Case No: 11-005692PL
Issue Date Document Summary
Apr. 23, 2012 Agency Final Order
Feb. 03, 2012 Recommended Order Dr. Gillis failed to properly diagnose, treat, and medicate patients; recommend suspension of license and payment of costs and fees.
Source:  Florida - Division of Administrative Hearings

Can't find what you're looking for?

Post a free question on our public forum.
Ask a Question
Search for lawyers by practice areas.
Find a Lawyer