Jeb Bush John O. Agwunobi, M.D., M.B.A. Governor Secretary July 31, 2002 @ . _ & py Zs The Honorable Larry J. Sartin ZL Division of Administrative Hearings “ The DeSoto Building 1230 Apalachee Parkway Tallahassee, Florida 32399-1550 RE: DOH v. Robert Treuherz , M.D. DOH Case Number: 2000-10977 DOAH Case Number: 01-3775 PL AS CCbse cl Dear Judge Sartin: Enclosed you will find a Final Order entered by the Board of Medicine in the above- referenced case. If you have any questions about this matter, please do not hesitate to contact our Office at (850) 487-9632. Sincerely, Tim Umeaood Tiffany Underwood, CLA Paralegal to Bruce A. Campbell Senior Attorney TU/tu Enclosure 4052 Baid Cypress Way Bin C-65 « Tallahassee, FL. 32399-3265 Final Order No. DOH-02-0632. SS FILED DATE -MQA STATE OF FLORIDA Departent of Fea! BOARD OF MEDICINE By Agency Cae ay UP Py 4 4 DEPARTMENT OF HEALTH, Petitioner, vs. CASE NO.: 2000-10977 LICENSE NO.: ME00061470 ROBERT R. TREUHERZ, M.D., Respondent. / FINAL ORDER THIS CAUSE came before the Board of Medicine (Board) pursuant to Sections 120.569 and 120.57(4), Florida Statutes, on April 5, 2002, in Ft. Lauderdale, Florida, for consideration of a Consent Agreement (attached hereto as Exhibit A) entered into between the parties in the above-styled cause. Upon consideration of the Consent Agreement, the documents submitted in support thereof, the arguments of the parties, and being otherwise advised in the premises, IT IS HEREBY ORDERED AND ADJUDGED that the Consent Agreement as submitted be and is hereby approved and adopted in toto and incorporated by reference herein. Accordingly, the parties shall adhere to and abide by all the terms and conditions of the Consent Agreement . This Final Order shall take effect upon being filed with the Clerk of the Department of Health. a eyes DONE AND ORDERED this / day of Li + 2002. BOARD OF MEDICINE CERTIFICATE OF SERVICE I HEREBY CERTIFY that a true and correct copy of the foregoing Final Order has been provided by U.S. Mail to Robert R. Treuherz, M.D., 1815 East Commercial Boulevard, Suite 204, Ft. Lauderdale, Florida 33308; to Paul C. Buckley, Esquire, Third Floor Justice Building East, 524 S. Andrews Avenue, Ft. Lauderdale, Florida 33301; and by interoffice delivery to Nancy M. Snurkowski, Chief - Practitioner Regulation, and Lisa Pease, Senior Attorney - Appeals, Agency for Health Care Administration, 2727 Mahan Drive, Tallahassee, Florida 32308-5403, on or before 5:00 p.m., this 6th day of ppAa , 2002. we NO.G/dY Pe ogy STATE OF FLORIDA mo gs DEPARTMENT OF HEALTH : BOARD OF MEDICINE 02 py 6-9 we 4 DEPARTMENT OF HEALTH, Bn Petitioner, DOH CASE NO. 2000-10977 v. ROBERT REICHERT TREUHERZ, M.D. Respondent. ey CONSENT AGREEMENT Robert R. Treuherz, M.D., referred to as the “Respondent,” and the Department of Health, referred to as “Department,” stipulate and agree to the following Agreement and, to the entry of a Finat Order of the Board Of Medicine, referred to as “Board,” incorporating the Stipulated Facts and Stipulated Disposition in this matter. Effective July 1, 1997, Petitioner fs 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 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. mu-4sfuooor. g7y STIPULATED FACTS 1. At all times material hereto, Respondent was a licensed physician in the State of Florida having been issued license number ME 0061470, 2 Respondent was charged by Administrative Complaint fled by the Agency and property served upon Respondent with a violation of Chapter 458, Florida Statutes, and the rules enacted pursuant thereto. A true and correct copy of.the Administrative , ‘ Complaint ts attached hereto as Exhibit A. 3. Respondent neither admits nor denies the allegations of fact contained in the Administrative Complaint. STIPULATED CONCLUSIONS OF LAW 1. Respondent admits that, in his capacity as a licensed physician, he is . Subject to the provisions of Chapters 456 and 458, Florida Statutes, and the jurisdiction of the Department and the Board, 2. Respondent admits that the facts Set forth in the Administrative Compiaint, if proven, would constitute a violation of Chapter 458, Florida Statutes, as alleged in the Administrative Complaint. 3. The parties admit that the Stipulated Disposition In this case 's fair, appropriate, and acceptable. STIPULATED DISPOSITION 1. FUTURE CONDUCT, Respondent shall not in the future Violate Chapters 456, 458-and 893, Florida Statutes, or the. rules Promulgated Rursusnt thereto, Prior to ee 1794, Signing this agreement, Respondent shall read Chapters 456, 458, 893 and the Rules of the Board of Medicine, at Section 6488, Florida Administrative Code. 2. FINE. Respondent shall pay an administrative fine in the amount of $5,000 to the Board. Respondent shall pay this fine within six (6) months of its imposition by Final Order of the Board. THE RESPONDENT ACKNOWLEDGES THAT THE TIMELY PAYMENT OF THE FINES IS HIS LEGAL OBLIGATION AND RESPONSIBILITY AND THE RESPONDENT AGREES TO CEASE PRACTICING IF THE FINE IS NOT PAID AS AGREED TO IN THIS CONSENT AGREEMENT, SPECIFICALLY; IF THE RESPONDENT HAS NOT RECEIVED WRITTEN CONFIRMATION THAT THE FULL AMOUNT OF THE FINE HAS BEEN RECEIVED BY THE BOARD OFFICE WITHIN SIX (6) MONTHS OF THE FILING OF THIS FINAL ORDER, THE RESPONDENT AGREES TO CEASE PRACTICE UNTIL SUCH WRITTEN CONFIRMATION IS RECEIVED BY THE RESPONDENT FROM THE BOARD. (SEE EXHIBIT B OF THIS CONSENT AGREEMENT FOR BOARD ADDRESS AND STANDARD TERMS). 3. COST OF INVESTIGATION AND PROSECUTION. Respondent shall pay Costs of Investigation and prosecution in the amount of $2,349.25. Respondent shall pay the costs of investigation and prosecution to the Board of Medicine within six (6) months of its Imposition by Final Order of the Board, 4. CONTINUING MEDICAL EDUCATION, Within one year of the date of the filing of a Final Order In this cause,-Respondent. shall attend ten (10) hours of Continuing Medical Education (CME) in either diagnosing and treating gynecological condition or risk management. 4. QUALITY ASSURANCE CONSULTATION, Within six (6) months of the date of the Final Order of the Board, an Independent, certified risk manager will review Respondent's current Practice. Specifically, this independent consultant shall review the office and recordkeeping procedures employed at Respondent's practice. This consultant will prepare a report addressing Respondent's practice. This report will include suggested improvements of the quality assurance of Respondent's practice. Respondent wil submit this report, as well as documentation that demonstrates his ‘compliance with the suggestions enumerated in the report, to the Board within 270 days of the. date of the Final Order. Respondent shall bear the cost of such consuitation, any necessary or appropriate follow-up consultation and all costs associated with implementing any and alt suggestions, ; . 5. LETTER OF CONCERN. Respondent shall receive a letter of concem from the Board of Medicine. STANDARD PROVISIONS 1, It is expressly understood that this Agreement Is subject to the approval of the Board and the Agency. In this regard, the foregoing paragraphs (and only the foregoing paragraphs) shall have no force and effect unless a Final Order incorporating the terms of this Agreement is entered by the Board. Lome ee oe rd Hs oyeg 2. Respondent is required to appear before the Board at the meeting of the Board where this Agreement is considered, 3. Respondent and the Agency fully understand that this agreement and Subsequent Final Order incorporating same will in no Way preclude additional proceedings against Respondent for acts or omissions not Specifically set forth in the Administrative Complaint attached as Exhibit "A" herein. . 4. Upon the Board's adoption of this Agreement, Respondent expressly waives all further procedural steps, and expressly waives aill Tights to seek judicial review of or to otherwise challenge or contest the validity of the Agreement and the Final Order of the Board incorporating said Agreement. 5. Upon the Board's adoption of this Agreement, Respondent waives the right to seek any attomey’s fees Or Costs from the Agency in connection with this matter, 6. This agreement is executed by Respondent for the purpose of avoiding further administrative action with respect to this cause. In this regard, Respondent authorizes the Board to review and examine all investigative file materiais Conceming Respondent prior to or In Conjunction with consideration of the Agreement. Furthermore, Should this Agreement not be accepted by the Board, it is agreed that presentation to and Consideration of this Agreement and other documents and matters by the Board shai! not unfairly or illegally prejudice the Board or any of its members from further Participation, consideration, or resolution of these Proceedings. SIGNED this 4 day of. Gla, 2002. Aohip &. Cravhege ma - Robert R. Treuherz, M.D. Before me, personally appeared Roloev+ Rtrevherz , whose identity is known to me by (type of identification) and who, under oath, acknowledges that{his)her signature appears above, Swom to and subscribed before me this 4" aay of Felnsary 2002 . NOTARY PUBLIC My Commission Expires: *% & Hemander & My Commission 66810979 WOH Expires Fetcuary 21, 2003 APPROVED this [Ad day aHottg 2002, John 0. Agwunobi, M.D., Secretary By: Nancy M. Snurkowski, Chief Attorney - Practitioner Regulation STATE OF FLORIDA DEPARTMENT OF HEALTH DEPARTMENT OF HEALTH, ) ; PETITIONER, v. CASE NUMBER 2000-10977 ROBERT R. TREUHERZ, M.D., } RESPONDENT. et) ADMINISTRATIVE COMPLAINT COMES NOW the Petitioner, Department of Heaith, hereinafter referred to as “Petitioner,” and files this Administrative Complaint before the Board of Medicine against Robert R. Treuherz, 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 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 0051470. Respondent's last known address is 1815 East Commercial Boulevard, Suite 204, Fort Lauderdale, Florida 33308. 3. Respondent is Board Certified in Internal Medicine. 4. On or about March 20, 1998, Patient 0.D., a twenty-three (23) year old : female, presented to Respondent for an initial visit for an evaluation of constipation. . During this initial visit, Respondent pefformed a pap smear on Patient 0.D., which revealed a descriptive diagnosis of ASCUS (Atypical Squamous Cells of Undeterm'ned Significance). : 5. ~ Respondent failed to schedule Patient O.D. for a. follow-up pap smear and/or did not refer her to a gynecologist for further evaluation after receiving the results of the March 20, 1998 pap smear. 6. Respondent's medical records for Patient O.D. do not Indicate that Respondent informed the patient of the March 20, 1998 pap smear results. 7. On or about May 6, 1999, Patient 0.D. presented to Respondent and : another annual pap smear was performed. This pap smear revealed a descriptive diagnosis of ASCUS (Atypical Squamous Cells of Undetermined Significance). 8. - Respondent failed to schedule Patient O.D. for a follow-up pap smear and/or did not refer her to a gynecologist for further evaluation after receiving the _Tesults of the May 6, 1999 pap smear. ; 9. Respondent’s medical records for Patient ©.D. do not indicate that — Respondent informed the patient of the May 6, 1999 pap smear results. 10. On or about October 13, 1999, Patient O.D. presented to Respondent with complaints of heavy menstrual periods and painful abdominal cramps. Respondent referred Patient 0.D. to a gynecologist for further evaluation. 2 | 79 Qe 11. On or about October 18, 1999, Patient 0.D. was examined by the gynecologist..A pelvic ultrasound subsequently revealed a left ovarian cyst. : 12. On or about December 14, 1999, the gynecologist performed a hysteroscopy, dilatation and curettage (D & C) and cervical biopsy on Patient O.D. The " pathology report regarding the biopsy revealed carcinoma. 13. -Patient 0.D. subsequently underwent a hysterectomy. 14. Petitioner realleges and incorporates paragraphs one (1) through thirteen (13), as if fully set forth herein this Count One. 15. 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: a) failed to appropriately follow-up Patient O.D.’s pap smear that was taken on or about March 20, 1998; and/or b) failed to appropriately follow-up Patient O.D.’s Pap smear that was taken on or about May 6, 1999. 16. Based on the foregoing, Respondent violated Section 458.331(1)(t), Florida Statutes, by falling to practice medicine with that level of care, . skill, and treatment which is recognized by a reasonably prudent similar physician as being a acceptable under similar conditions and circumstances. 1800 OUNT TWO 17. _ Petitioner realleges and incorporates paragraphs one (1) through thirteen (13) and paragraph fifteen (15) as if fully set forth herein this Count Two. "18. Respondent falled to keep medical records that justify the course of treatment of the patient, in that Respondent: a) failed to document in the medical records an assessment and/or course of treatment with regards to Patient O.D.’s pap smear results; and/or b) failed to document In the medical records that he informed Patient O.D, of the March 20, 1998 or May 6, 1999 pap smear results. 19. Based on the foregoing, Respondent violated Section ssnsouaym/ Florida Statutes, by failing to keep legible, as defined by department rule in consultation with the board, medical records that identify the licensed physician or the physician extender and supervising physician by name and professional title wha is or are responsible for rendering, ordering, supervising, or billing for each diagnostic or treatment procedure and that justify the course of treatment of the patient, Including, but not fimited to, patient histories; examination results; test results; records of drugs prescribed, dispensed, or administered; and reports of consultations and hospitalizations. 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 456.072(4), Florida Statutes, and/or any other relief that the Board deems appropriate SIGNED this AL day of A 2001. Robert G. Brooks, M.D., Secretary Nancy M. Snurkowski Chief Attorney .« Practitioner Regulation COUNSEL FOR DEPARTMENT: Kristy Johnson Senior Attorney Agency for Health Care Administration P. O. Box 14229 . Tallahassee, Florida 32317-4229 FILED Florida Bar #144282 DEPARTMENT OF HEALTH K3/bwk PCP: August 24, 2001 cen £ fq diy PCP Members: ATE q wl (Oj Georges El-Bahri, M.D. Laurie Davies, M.D.

Docket for Case No: 01-003775PL