STATE OF FLORIDA DEPARTMENT OF HEALTH DEPARTMENT OF HEALTH, ) PETITIONER, vs. } CASE NO. 2000-08413 RONALD MALAVE, 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 Ronald Malave, 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 456, Florida Statutes, and Chapter 458, Florida Statutes. Pursuant to the authority of Section 20.43(3), Florida Statutes, the Petitioner has contracted with the Agericy 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 0058695. Respondent’s last known address is 612 Baywood Court, Lake Mary, Florida 32746. 3. Respondent's area of specialty is psychiatry and he is board certified in psychiatry and geriatric psychiatry. 4. On or about September 2, 1994, Patient JP, then a thirty-four (34) year-old female, presented té Respondent for a second opinion psychiatric evaluation. Patient J.P.'s primary complaint was of severe recurrent depression, dating back to her childhood. Respondent evaluated her on that date. 5. On or about September 6, 1994, Respondent prepared a written report of Patient J.P.'s evaluation in which he diagnosed: Patient J.P. as having "major depression, recurrent, severe dysthymia". His plan of treatment included prescribing Cytomel (a thyroid hormone), Vivactil, and either Ritalin or Dexedrine (stimulants). In addition, Respondent indicated that a cognitive/behavioral approach, in conjunction with pharmacotherapy, may be effective in Patient J.P.'s treatment. 6. Beginning on or about October 5, 1994, and continuing until on or about August 26, 1999, Patient J.P. attended treatment sessions with Respondent approximately every two weeks. The treatment sessions lasted between forty-five (45) minutes and an hour. 7. Patient J.P. attempted suicide twice while under the care of Respondent.. The first attempt occurred at the end of 1995 and Patient J.P. was involuntarily committed (under the Baker Act, Section 394.451, Florida Statutes) to the Winter Park Hospital. Patient J.P. had a tremendous fear of hospitalization and Respondent was aware of this. Respondent overrode the involuntary commitment and had her released from the-hospital-into his care. .--Patient J.P. attempted suicide again near the end of 1998 or the beginning of 1999. Again, Respondent had her released from the hospital back into his care. - 8. During the time in which Patient J.P. was under the care of Respondent, he treated her for multiple personality disorder, attempting to integrate her different personalities, about four (4) or five (5), which she often exhibited during sessions. . Patient J.P. referred to the personality shifts as "lost times" or blackout periods, as she could not recall what occurred during the personality shifts from her core personality. 9. One of Patient J.P.'s alter personalities was "Bridgette", a sixteen (16) year old female. During the course of Respondent's treatment of Patient J.P., which continued for almost five (5) years, Respondent began engaging in sexual acts with Patient J.P. during treatment sessions in which Patient IP. had shifted to "Bridgette". Although Patient J.P. was unable to recall much of what happened during the sessions in which she shifted to "Bridgette", Patient J.P. noticed on numerous visits that when she came out of a session with Respondent, her hair and clothing would be in disarray, her make-up would be smeared, and she would have’ wet underpants. 10. After one of her sessions with Respondent, Patient J.P. noticed that she felt hot and that her underpants were wet. She went home and put the pair of underpants under her bed. Patient J.P. continued to save her underpants following a number of sessions with Respondent. 11. During another one of Patient J.P.'s sessions with Respondent, she "awoke" (shifted back to her core personality) and found herself on the office floor with Respondent on top of her engaged in sexual intercourse. Patient J.P. tried to say something and Respondent "shushed" her and then helped her up from the floor. Patient J.P. then "lost time" and does not recall anything else from the session. She noticed that her underpants were wet after that session and she saved them. 12. ~ On another occasion, Patient J:P- "awoke" during a session to find herself~~ performing oral sex on Respondent. Patient J.P. stood up and Respondent stated, to her "Continue, you're the best." Patient J.P. then "lost time"-and does not recall anything until she "awoke" while driving home. 13. On yet another occasion, Patient J.P. "awoke" during a session and found herself straddling Respondent in his chair and they were engaged in sexual intercourse. Patient J.P. also recalled an occasion standing near Respondent by his desk where he called her "Bridgette" and reached out and touched her breast and buttocks. Patient J.P. then "lost time" again. When she awoke, Patient J.P. realized that they had had sex because her underpants were wet. 14. Patient J.P. was initially reluctant to report the sexual incidents with Respondent as she was confused and was very dependant on him because she trusted him and he kept her out of the hospital. 15. On or about August 1999, Patient J.P. contacted an attorney and advised the attorney as to what had occurred during her treatment sessions with Respondent. Patient J.P. turned over approximately ten (10) pairs of underpants, which she had kept from sessions with Respondent, to her attorney. Patient J.P.'s attorney then forwarded the underpants to the LabCorp laboratory in Chapel Hill, North Carolina for DNA analysis. 16. On or about September 24, 1999, Patient J.P. "awoke" to find herself at Respondent's office and, following that visit, discovered that her underpants were again wet. 17. On or about October 4, 1999, Patient J.P.'s attorney sent a letter to Respondent telling him to discontinue his treatment of Patient J.P. and to have no further contact with her. 18. .-On or about October 24,1999 (Sunday), Patient J.P. "lost time" and "awoke" to find herself in Respondent's office. During that time, she remembered Respondent telling her that when he is threatened, he gets vicious. He also told her that this matter could be settled without attomeys. Respondent also told Patient J.P. to have her attorney write a letter stating that there would be no charges filed against him. 19. Onor about October 26, 1999, Patient J.P.'s attorney reported the sexual incidents between Patient J.P. and Respondent to the Volusia County Sheriff's Office. Patient J.P. subsequently turned over three (3) more pairs of underpants from her sessions with Respondent to the Sheriffs Office. The underpants were then sent to the Florida Department of Law Enforcement for analysis to determine the presence of acid phosphatase, spermaztozoa and DNA. . 20. On or about December 30, 1999, LabCorp, the North Carolina laboratory, issued a report on the findings of the analysis conducted on the underpants submitted by Patient J.P.'s attorney. The laboratory confirmed the presence of semen on eight (8) pairs of the underpants, the profiles of which were consistent on five (5) pairs of the underpants (i.e., belonged to the same donor). LabCorp could not identify the donor of the semen as they did not have a DNA profile of any suspects for comparison. Patient J.P.'s husband has had a vasectomy. 21. On or about January 13, 2000, the Volusia County Sheriffs Office forwarded three pairs of Patient J.P.'s underpants to the Florida Department of Law Enforcement (FDLE) laboratory for DNA analysis. 22. On or-about January 20, 2000, detectives from the Volusia County Sheriff's Office obtained a blood sample from Respondent at the Sheriff's Office. 23. On or about January 27, 2000, Respondent's blood sample was forwarded to the . Florida Department of Law Enforcement (FDLE) laboratory for DNA analysis. 24. On or about March 2, 2000, a blood sample from Patient J.P. was also submitted to FDLE for comparative analysis. ~~ | 25. On or about June 6, 2000, FDLE Crime Laboratory Analyst Timothy B. Potree issued a report regarding the DNA comparative analysis of the blood samples submitted by” Respondent and Patient J.P. and the sperm collected from one of the pairs of Patient J.P.'s underpants. The analyst concluded that the "DNA profile obtained from: the sperm fraction matched the DNA profile of Ronald Malave at all loci tested. The frequency of occurrence of this profile for unrelated individuals in the following populations is approximately: "Lin 19 quadrillion Caucasions lin 290 quadrillion African Americans lin- 13 quadrillion Hispanics.” 26. On or about June 8, 2000, a warrant was issued for Respondent's arrest in Volusia County, Florida, charging him with sexual misconduct by a psychotherapist (felony), contrary to Section 491:0112, Florida Statutes. Respondent was arrested on the warrant that same date. . 27. On or about June 12, 2000, an information was filed by the Seventh Judicial Circuit State Attorney's Office charging Respondent with sexual misconduct by a psychotherapist, in violation of Section 491.0112, Florida Statutes. 28. Respondent's conduct in engaging in sexual acts with Patient J.P. during her treatment sessions for multiple personality disorder constitutes sexual misconduct in the practice of medicine. Respondent inappropriately exercised influence within a patient-physician relationship for the purpose of engaging a patient in sexual activity in that Respondent took advantage of Patient J.P.'s psychiatric condition and performed inappropriate acts which were sexual in nature-and which- were not performed for any. legitimate medical or therapeutic purpose. . . ) 29. Section 458.329, Florida Statutes, states that the physician-patient relationship is founded on mutual trust. Sexual misconduct in the practice of medicine means violation of the physician-patient relationship through which the physician uses said relationship to induce the patient to engage, or to engage or attempt to engage the patient, in sexual activity outside the scope of the practice or the scope of generally accepted examination or treatment of the patient. Sexual misconduct in the practice of medicine is prohibited. 30. Rule 64B8-9.008, Florida Administrative Code, states in part that sexual contact with a patient is sexual misconduct, which includes verbal or physical behavior which may reasonably be interpreted as romantic involvement with a patient regardless of whether such involvement occurs in the professional setting or outside of it, may reasonably be interpreted as intended for the sexual arousal or gratification of the physician, the patient or any third party or r may be reasonably interpreted as being sexual. COUNT ONE 31. Petitioner realleges and incorporates paragraphs one (1) through thirty (30), as if fully set forth herein this Count One. 32. Respondent exercised influence within a patient-physician relationship for purposes of engaging a patient in sexual activity, in that Respondent engaged in sexual acts with Patient J.P. during psychiatric treatment sessions in which she had "shifted" to one of her alter personalities. 33. Based on the foregoing, Respondent violated Section 458.331(1)(j), Florida Statutes, by exercising influence within a patient-physician relationship for purposes of engaging a patient in sexual activity. A patient shall be presumed to be incapable of giving free, full, and informed consent to sexual activity with his or her physician COUNT TWO 34. Petitioner realleges and incorporates paragraphs one (1) through thirty (30) and thirty-two (32), as if fully set forth herein this Count Two. _ _ _ 35. Respondent violated any provision of Chapter 458, Florida Statutes, a rule of the board or department, or-a lawful order of the board or department previously entered in a disciplinary hearing or failed to comply with a lawfully issued subpoena of the department, in that Respondent violated the express prohibition against sexual misconduct stated in Section 458.329, Florida Statutes, and Rule 64B8-9.008, Florida Administrative Code in his actions with Patient J.P. , 36. Based on the foregoing, Respondent violated Section 458.331(1)(x), Florida Statutes, by violating any provision of Chapter 458, Florida Statutes, a rule of the board or department, or a lawful order of the board or department previously entered in a disciplinary hearing or failing to comply with a lawfully issued subpoena of the department. COUNT THREE 37. Petitioner realleges and incorporates paragraphs one (1) through thirty (30), thirty-two (32), and thirty-five (35), as if fully set forth herein this Count Three. 38. Respondent failed to practice medicine with that level of care, skill, and treatment which is recognized by a reasonably prudent similar physician as being acceptable under similar conditions and circumstances, in that Respondent engaged in sexual conduct with Patient J.P. during the course of a psychiatric treatment session in which he was supposed to be treating her ; for multiple personality disorder. 39. Based on the foregoing, Respondent has violated Section 458.331(1)(t), Florida Statutes, by failing to practice medicine with that level of care, skill, and treatment which is recognized by a reasonably prudent similar physician as being acceptable under similar conditions and circumstances. 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, placément of the Respondent on probation, the assessment of costs related to the investigation and prosecution of this case as provided for in Section 456.072(4), Florida Statutes, and/or any other relief that the Board deems appropriate. SIGNED this >” Gay ot_esspeaset , 2000. Robert G. Brooks, M.D., Secretary hief Medical Attorney COUNSEL FOR DEPARTMENT: Kathryn L. Kasprzak Chief Medical Attorney Agency for Health Care Administration P. O. Box 14229 Tallahassee, Florida 32317-4229 Florida Bar #0937819 KLK/Amk PCP: August9, 2000 _. PCP Members: Ashkar, Glotfelty, Rodriguez PATIENT INDEX RONALD MALAVE, M.D. Case No. 2000-08413 Patient J.P. Jane Polkinghorne Please refer to all patients by initials. Patient names and records are confidential. >

Docket for Case No: 00-003851PL