wv 'v) PILED STATE OF FLORIDA DEPARTMENT OFHEALTH SO JUN IS PH ue 10 DIVISION OF ADMINISTRATIVE DEPARTMENT OF HEALTH, ) HEARINGS ) . PETITIONER, ) 00-244 a ) oS%O3 v. - y CASE NO. 1997-05883 5 NANJUNDA SWAMY, MD., ) ) RESPONDENT. _) ____) ADMINISTRATIVE COMPLAINT COMES NOW the Petitioner, Department of Health, hereinafter referred to as “Petitioner,” and files this Administrative Complaint before the Board of Medicine against Nanjunda Swamy, M.D., hereinafter referred to as “Respondent,” and alleges: , 1. Effective July 1, 1997, Petitioner is the state agency charged with regulating the practice of medicine pursuant to Section 20.43, Florida Statutes; Chapter 455, Florida Statutes, and Chapter 458, Florida Statutes. Pursuant to the provisions of Section 20.43(3), Florida Statutes, the Petitioner has contracted with the Agency for Health Care Administration to provide consumer complaint, investigative, and prosecutorial services required by the Division of Medical Quality Assurance, councils, or boards, as appropriate. 2 Respondent is and has been at all times material hereto a licensed physician in the state of Florida, having been issued license number ME 0021566. Respondent’s last known address is 3650 SW 24" Avenue Road, Ocala, Florida 34474, . ope are omer ws YW 3. On or about January 24, 1996, patient S.A. was transferred from the county jail and presented to Florida Correctional Institution (FCI) in Lowell, Florida to Respondent who is the Chief Health Officer at FCI. 4. On or about January 24, 1996, patient S.A. had an initial medical and physical evaluation, conducted by a nurse practitioner, who is supervised by Respondent. Respondent reviewed and signed off on the examination and handling of patient S.A., wherein a one centimeter sized firm, mobile lump at the twelve o’clock position was detected in patient S.A.’s left breast. Patient S.A. gave a medical history that included breast cancer in her maternal grandmother. A sonogram and mammogram were ordered to evaluate the lump. ‘ 5. On or about February 5, 1996, patient S.A. underwent a mobile screening bilateral mammogram. The findings were asymmetric density measuring two centimeters, in the upper central aspect of the left breast. 6. On or about February 26, 1996, patient S.A. underwent a bilateral breast sonogram was done with an impression of a solid appearing mass at the twelve o’clock position of the left breast. | | | . 7. Respondent reviewed the results from the mammogram of February 5, 1996 and the sonogram of February 26, 1996, for patient S.A. and signed off for a course of care that was limited to breast self examination by patient S.A. and follow-up if a change occurs and a routine “reevaluation by Respondent’s medical staff in four months. . Respondent did not conduct nor direct another medical personnel to conduct a physical examination of patient S.A. between February 26, 1996 and July 5, 1996. Respondent did not order a follow-up mammogram or sonogram of patient S.A. even though a lump was detectable through palpitation. 9. On or about July 5, 1996, patient S.A. was seen in health services, by a nurse, with markedly swollen and tender left breast with a large mass measuring the size of an orange. 10. On or about July 6, 1996, patient S.A. entered surgery with a clinical diagnosis of abscess left breast, mastitis left breast. Patient S.A. was anesthetized, an incisional biopsy was performed and a specimen was sent to pathology for examination. 11. A pathology report was conducted with a specimen collected from the left biopsy at the twelve o’clock position. The microscopic diagnosis was invasive, poorly differentiated ductal adenocarcinoma. The tumor was described as being composed of a poorly differentiated invasive ductal carcinoma with areas of necrosis and inflammation. . ‘ 12. Patient $.A.’s subsequent treatment consisted of chemotherapy, modified radical left mastectomy and radiation therapy. Treatment was unsuccessful, and patient S.A. died on April 16, 1997. _ COUNT ONE 13. Petitioner realleges and incorporates paragraphs one (1) through twelve (12), as if fully set forth herein this Count One. 13. Respondent fell below the acceptable standard of care by not conducting a biopsy for four months on patient S.A. after a discrete nodule (lump) was found and by failing to refer patient S.A. to a surgeon for a possible biopsy. . | 14. Based on the foregoing, Respondent violated Section 458.331(1)(t), Florida Statutes, by failing to practice medicine with that ievel ‘of care, skill and treatment which is recognized by a reasonable prudent similar physician as being acceptable under similar conditions and circumstances. ee 7 ww WS WHEREFORE, the Petitioner respectfully requests the Board of Medicine enter an order imposing one or more of the following penalties: permanent 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 as provided for in Section 455.624(4), Florida Statutes, and/or any other relief that the Board deems appropriate. SIGNED this 21 day of “ed , 2000. Robert G. Brooks, M.D., Secretary Chief Medical Attorney COUNSEL FOR DEPARTMENT: Kathryn L. Kasprzak Chief Medical Attorney F i D Agency for Health Care Administration DEP. ARTMENT OF HEALTH Tallakoms = Fler ida 32317-4229 . DEPT CLERK ahassee, Florida - : Rp Florida Bar # 937819 CLERK Ubi R Mion Biledi | a ces os a OATE al: ai / PCP: April 21, 2000 PCP Members: Ashkar, Chemey

Docket for Case No: 00-002498