woe U VU Tk tay STATE OF FLORIDA bow dL AGENCY FOR HEALTH CARE ADMINISTRATION CO Jay on ps BOARD OF OSTEOPATHIC MEDICINE AN eG PM Bhs AGENCY FOR HEALTH CARE ADMINISTRATION, PETITIONER, vs. CASE NO. 93-06650 BEN A. RAINES, D.O., RESPONDENT. / ADMINISTRATIVE COMPLAINT COMES NOW the Petitioner, Agency for) Health Care Administration, hereinafter referred to as "Petitioner," and files this Administrative Complaint before the Board loft Osteopathic Medicine against Ben A. Raines, D.O. hereinafter referred to as "Respondent," and alleges: 1. Petitioner is the state agency charged with regulating the practice of osteopathic medicine pursuant to) Section 20.42, Florida Statutes; Chapter 455, Florida Statutes; and Chapter 459, Florida Statutes. 2. Respondent is and has been at all times material hereto a licensed osteopathic physician in the State of Florida, having been issued license number 0S 0001609. Respondent’s last known address is P.O. Box 3690 Largo, Florida 34645-0690, Facts Relating to Patient K.wW. 3. Patient K.W is a 65 year old male who was on Procardia and Lopid when he called the Respondent’s office on April 20, 1992, asking for a refill of his medication. 4. The Respondent proceeded to take him off both Procardia and Lopid and put him on Clonidine .2 ml. The Respondent failed to; ask Patient K.W. to come in for an examination or re- evaluation, and ask for a medical history or any other medical information from the patient. 5. On April 21, 1992, Patient K.W. called the Respondent complaining of numbness, difficulty holding objects, blurred vision, and muscle spasm about every half hour after taking the medication. The patient was told by the Respondent to keep taking Clonidine and to come in the follow day for a blood pressure check. 6. On April 22, 1992, Patient K.W. arrived at the Respondent’s office for a blood pressure check. It was noted as 150/95. Laboratory examinations were also performed. These examinations revealed(severe abnormalities including; Uric acid at 12.1, cholesterol 256, Iron 201, Hemogoblin 12.9, Hematocrit 37.0, RBC’s 3.71, LDL 174. 7. On April 24, 1992, Patient K.W. called the Respondent’s office stating that his previous symptoms haa dramatically increased, and that his feet were numb. The Respondent instructed him to continue to take Clonidine and that the symptoms would go away pretty soon. 8. A reasonably prudent physician would lnave seen the patient and re-evaluated the patients medical condition before changing his medication. U WU 9. However, the Respondent failed to examine the patient before changing his medication, and failed to take into account the patients complaints about the medications side effects. 10. Patient K.W. discontinued Clonidine on his own and began to take medications that had been previously prescribed. The patient later reported that all side effects had diminished since he had stopped taking the medication given to him by the Respondent. COUNT. ONE 11. Petitioner realleges and incorporates pattagraphs one (1) through ten (10), as if fully set forth herein this Count One. 12. Respondent is guilty of gross or repeated malpractice or failure to practice osteopathic medicine with that level of care, skill, and treatment which is recognized by a reasonably prudent similar osteopathic physician as being acceptable under similar conditions and circumstances in that Respondent failed to advise the patient to visit his office for a re-evaluation of his medical condition. The Respondent also changed the patients medication without a proper medical examination, medical history and or information. 13. Based on the foregoing, Respondent violated Section 459.015(1) (x), Florida Statutes, by gross or repeated malpractice or failure to practice osteopathic medicine with that level of care, skill, and treatment which is recognized by a reasonably prudent similar osteopathic physician as being acceptable under similar conditions and circumstances. U U Facts Relating to Patient H.S. 14. Patient H.S., a sixty-six year old male, presented to the Respondent on May 18, 1992. He had surgery for an open reduction internal fixation of the left elbow. On May 15, 1992, the orthopedic surgeon who performed the operation recommended that Patient H.S. have follow-up care seven to ten days post operative to include an orthopedic referral; removal of staples; and physical therapy. 15. On May 18, 1992, the Respondent told Patient H.S. that he could perform his follow-up treatment and that he would not refer him to an orthopedic surgeon for follow-up care. 16. A reasonably prudent physician would have referred the patient to a proper orthopedic surgeon for follow-up care and treatment, referred the patient for physical therapy, removed the staples within two weeks of the patients procedure, and followed the operating surgeons instructions for follow-up care and treatment. 17. However, the Respondent failed to follow the operating surgeons instructions for follow up care, failed |to remove skin staples which should have been removed within two weeks of the procedure; refer Patient H.S. to an orthopedic surgeon; and failed to refer Patient H.S. for physical therapy. 18. On June 29, 1992, Patient H.S. was seen by another osteopathic physician who removed the staples immediately, performed x-rays, and referred Patient H.S. to] an orthopedic surgeon. U U COUNT TWO 19. Petitioner realleges and incorporates paragraphs one (1) through eighteen (18), as if fully set forth herein this Count Two. 20. Respondent is guilty of gross or repeated malpractice or failure to practice osteopathic medicine with that level of care, skill, and treatment which is recognized by a reasonably prudent similar osteopathic physician as being acceptable under similar conditions and circumstances in that Respondent failed to; follow the operating surgeons instructions for follow up care, refer the patient for physical therapy, remove skin staples, and refer the patient to an orthopedic surgeon for follow-up care. 21. Based on the foregoing, Respondent violated Section 459.015(1)(x), Florida Statutes, by gross or repeated malpractice or failure to practice osteopathic medicine with that level of care, skill, and treatment which is recognized by a reasonably prudent similar osteopathic physician as being acceptable under similar conditions and circumstances. Facts Relating to Patient R.A. | 22. He was a seventy-three year old male, who had been previously diagnosed with hearing loss associated with presbycusis and tympanic membrane scars. 23. On May 21, 1992, Patient R.A. arrived at the Respondent’s office complaining of eye and ear problems. After an initial examination, the Respondent diagnosed him with possible retinal detachment, presbycusis and tympanic membrane scars. The Respondent WU U noted that the patients left eye was dark and blurry, and he ruled out retinal detachment. 24. A reasonably prudent physician would have determined that the patient needed an immediate referral to a qualified ophthalmologist and would have referred that patient to the appropriate specialist. 25. The Respondent failed to realize the need for quick action on his part and referred the patient to an ophthalmologist eleven days after the initial diagnosis. 26. On June 29, 1992, Patient R.A. was seen by an ophthalmologist who diagnosed him as having cystoid macular edema and probable epiretinal membrane with the problem increasing. The ophthalmologist also noted that Patient R.A. needed to see a retinal specialist. COUNT _ THREE 27. Petitioner realleges and incorporates patagraphe one (1) through twenty-six (26), as if fully set forth herein this Count Three. 28. Respondent is guilty of gross or repeated malpractice or failure to practice osteopathic medicine with that) level of care, skill, and treatment which is recognized by a reasonably prudent similar osteopathic physician as being acceptable under similar conditions and circumstances in that Respondent failed to refer the patient to an adequate specialist within a reasonable amount of time. U U 29. Based on the foregoing, Respondent violated Section 459.015(1) (x), Florida Statutes, by gross or repeated malpractice or failure to practice osteopathic medicine with that level of care, skill, and treatment which is recognized by a reasonably prudent similar osteopathic physician as being acceptable under similar conditions and circumstances. Facts Relating to Patient V.R. 30. Patient V.R. was first seen by the Respondent on January 27, 1992. She was a seventy-year old female, with a known history of diabetes, status post left carotid endarterectomy carotid stenosis, a history of cerebral infarct left temporal lobe, peripheral vascular occlusive disease, history of congestive heart failure and mild C.0.P.D. These conditions had been under control with numerous medications including Lasix 20mg, Potassium 10ml, Glucotrol, Trental, and Lopid. 31. A reasonably prudent physician would) have examined Patient V.R. and then adjusted the course of treatment based on the test results. 32. The Respondent immediately discontinued all of the medications Patient V.R. was taking, and failed to examine Patient V.R. The Respondent also ordered several exams, but) failed to order several basic exams including an EKG, audio test, and chest x-ray. 33. On June 26, 1992 Patient V.R. called the Respondent complaining that her legs were swollen. Patient V.R. was advised by the Respondent to take two Lasix tablets daily and continue with a low fat diet as previously prescribed. 34. On May 26, 1992, Patient vV.R. Respondent’s office complaining of a swollen leg. returned to the The Respondent prescribed Lasix 40 mg and Digoxin .25 qd and told her to return in four months. 35. Patient V.R. was examined by the Respond 1992. The Respondent advised Patient V.R. to rema the low fat diet, even though she only weighed twenty nine pounds. The Respondent congestive heart failure. 36. 1992. She complained of gas pains when walking right leg. Patient V.R. was referred to a vascula 37. The vascular surgeon diagnosed Patient venus thrombosis of both lower extremities, bilate femoral artery occlusion and_ status post ent on June 29, in on Lasix and one-hundred and also diagnosed her with Patient V.R. was seen again by the Respondent on July 2, and pain in her r surgeon. V.R. with deep ral superficial left carotid endarterectomy. Patient V.R. was started on Coumadin. The vascular surgeon also recommended a weekly prothrombin time, and non invasive venous studies to confirm the diagnosis of deep vein thrombosis. 38. time, non invasive venous studies, and follow up v 39. into the patients treatment plan. The Respondent failed to integrate these r The vascular surgeon recommended a weekly prothrombin isits. ecommendations UO U COUNT FOUR 40. Petitioner realleges and incorporates paragraphs one (1) through thirty-nine (39), as if fully set forth herein this Count Four. 41. Respondent is guilty of gross or repeated malpractice or failure to practice osteopathic medicine with that level of care, skill, and treatment which is recognized by a reasonably prudent similar osteopathic physician as being acceptable under similar conditions and circumstances in that Respondent removed the Patient from all medications with no apparent medical justification. The Respondent also failed to properly examine the patient, failed to adapt the course of treatment based on the patients test results, and failed to follow the specialists recommendations for treatment. 42. Based on the foregoing, Respondent violated Section 459.015(1)(x), Florida Statutes, by gross or repeated malpractice or failure to practice osteopathic medicine with that level of care, skill, and treatment which is recognized by a reasonably prudent similar osteopathic physician as being acceptable under similar conditions and circumstances. Facts Relating to Patient I.H. | 43. Patient I.H. an eighty-four year old female, visited the Respondent on September 16, 1991, complaining of weakness, dizziness, and fatigue. A note was made on her records to obtain a chest x-ray and a mammogram, however there is no documentation of the tests being performed. U U 44. A reasonably prudent physician would have followed-up on whether or not the appropriate examinations had been performed. 45. On February 24, 1992, Patient I.H.’ s daughter called the Respondent complaining that her mother, Patient I.H. was coughing, dizzy, and was having difficulty breathing. The Respondent prescribed Rondec and Digoxin over the phone with no follow up examination. In addition the Respondent failed to document the phone call on the Patient’s medical records. The Respondent also discontinued all of Patient I.H.’s previous medicat 46. A reasonably prudent physician would have examined the patient before changing the course of would have changed the course of treatment based on ions. appropriately treatment, and test results. A prudent physician would have also documented all phone calls dealing with the patient on her medical records. COUNT FIVE 47. Petitioner realleges and incorporates paragraphs one (1) through fourty-six (46), as if fully set forth herein this Count FIVE. | 48. Respondent is guilty of gross or repeated failure to practice osteopathic medicine with that malpractice or level of care, skill, and treatment which is recognized by a reasonably prudent similar osteopathic physician as being acceptable under similar conditions and circumstances in that Respondent failed to follow-up on examinations that were needed but never performed, and failed to re-evaluate the patient before changing her course of treatment. 10 49. Based on the foregoing, Respondent violated Section 459.015(1)(x), Florida Statutes, by gross or repeated malpractice or failure to practice osteopathic medicine with that level of care, skill, and treatment which is recognized by a reasonably prudent similar osteopathic physician as being acceptable under similar conditions and circumstances. WHEREFORE, the Petitioner respectfully requests the Board of Osteopathic Medicine enter an Order imposing one or more of the following penalties: revocation or suspension of the Respondent’s license, restriction of the Respondent’s practice, imposition of an administrative fine, issuance of a reprimand, placement of the Respondent on probation, the assessment of costs related to the investigation and prosecution of this case, other than costs associated with an attorney’s time, as provided |for in Section 455.227(3), Florida Statutes, and/or any other relief that the Board deems appropriate. SIGNED this ow day of bree , 1996. Douglas M. Co FILED AGENCY FOR WEALTH CARE ADIINISTRATION wo EPUTY CI dentipre ey vate_U-3 96 11 COUNSEL FOR AGENCY: Francesca Plendl Senior Attorney Agency for Health Care Administration 1940 North Monroe Street Tallahassee, Florida 32399-0750 Florida Bar #765996 FP/nb PCP: February 29, 1996 Perez and Hand 12

Docket for Case No: 00-000436