VOY “pd | p oe o oO NS “ eo STATE OF FLORIDA ‘se SO BOARD OF RESPIRATORY CARE DEPARTMENT OF HEALTH, Petitioner, vs. Case No. 03-01804 RENE RIVERA, Respondent. / ADMINISTRATIVE COMPLAINT COMES NOW Petitioner, Department of Health, (hereinafter “Petitioner’) by and through its undersigned attorneys and files its Administrative Complaint against Respondent, RENE RIVERA, (hereinafter “Respondent”) and alleges: NATURE OF THE ACTION 1. This is an action to impose administrative penalties and assess costs related to the investigation and prosecution of the allegations against Respondent pursuant to Sections 456.072 and 468.365, Florida Statutes. JURISDICTION AND VENUE 2. This tribunal has jurisdiction pursuant to Sections 120.569 and 120.57, Florida Statutes. 3. Venue shall be determined pursuant to Rule 28-106.207, Florida Administrative Code. PARTIES 4. Effective July 1, 1997, Petitioner is the state agency charged with regulating the practice of respiratory therapy pursuant to Section 20.43, Florida Statutes, and Chapters 456 and 468, Part V, Florida Statutes. 5. At all times material hereto Respondent has been licensed as a registered respiratory therapist, having been issued license number RRT 5058 on April 9, 1997. 6. Respondent's last known address is 206 Old Bay Lane, Kissimmee, Florida 34743 COUNT! 7. Patient AP was admitted to Osceola Regional Medical Center on September 13, 2002 for a coronary artery bypass graft. 8. AP had a history of diabetes, hypertension, obesity, hyperlipidemia and tobacco abuse. 9. Post-surgery, AP was diagnosed with acute respiratory failure. 10. On or about September 14, 15 and 16, 2002, Respondent provided respiratory therapy to AP. 11. On September 15, 2002, AP was extubated and placed on 40% venti mask. 12, Pursuant to standing orders, AP’s oxygen was weaned down to 61/m nasal cannula. 13. Some time after 6:00 p.m., AP’s oxygen saturation dropped below 90% and the oxygen was increased back to 40%. 14. Around 9:00 p.m., AP’s oxygen saturation decreased, and the oxygen was increased to 50%. Respondent documented AP’s oxygen saturation at 91% at 11:00 p.m. 15. Around 3:00 a.m. on September 16, AP’s oxygen saturation dropped again and AP was placed on a non-rebreather mask with a 61/m nasal cannula. This combination would generate 100% inspired oxygen. 16. An arterial blood gas drawn at 4:00 a.m. was not within normal limits and indicated a life-threatening situation. 17. From 4:00 a.m. to 7:00 a.m., AP’s oxygen saturation was in the range of 73% to 81% as recorded by the nurse. 18. AP’s pulmonologist was called and he ordered BiPaP at 5:00 a.m. for AP. 19. Respondent did not attempt to set up BiPaP until 6:00 a.m., at which time AP's oxygen saturation was 73% as reported by the nurse. 20. Oxygen saturation of 73% is a life-threatening oxygen saturation. 21. AP was a high-risk patient that needed aggressive respiratory therapy. AP was suffering from hypoxemia and was uncooperative. 22. Respondent did not set up BiPaP. 23. Respondent left AP’s room and had no further part in AP’s care. 23. Respondent did not call AP’s pulmonologist to report the life-threatening oxygen saturation level or his failure to set up BiPaP. 24. Respondent did not wait for further orders after his unsuccessful attempt to set up BiPaP as ordered or make any attempt to follow-up with the nurse and prepare new orders for AP, 25. Respondent did not advise the attending nurse of the necessity and urgency of the patient to use BiPaP or be reintubated. 26. Respondent should have expected AP to be intubated before the end of his shift. 27. Respondent failed to record an oxygen saturation on AP after 5:00 a.m. 28. Respondent is subject to discipline for violating Section 468.365(1)(f), Florida Statutes, for unprofessional conduct, including departing from or failing to conform to acceptable standards related to the delivery of respiratory care services. COUNT Il 29. Petitioner realleges and incorporates by reference the allegations in paragraphs 7 through 28 above. 30. Respondent is subject to discipline pursuant to Section 468.365(1)(0), Florida Statutes, by failing to deliver respiratory care services with that level of care, skill and treatment which is recognized by a reasonably prudent respiratory care practitioner or respiratory therapist with similar professional training as being acceptable under similar conditions and circumstances. CLAIM FOR RELIEF WHEREFORE, Petitioner respectfully requests the BOARD OF RESPIRATORY CARE to enter an order imposing one or more of the following penalties pursuant to Section 456.072, Florida Statutes and Rule 64B32-5.001, Florida Administrative Code: a. Revocation or suspension of Respondent's license: b. Restriction of Respondent's practice; c. An administrative fine; d. A reprimand; e. Probation; and/or f. Any other penalty the Board deems appropriate. Dated this 12 day of { Lug rot , 2003. Respectfully submitted, CHARLES J. CRIST, JR. Attorney General FILED DEPARTMENT OF HEALTH DEPUTY CLERK cuerK AN on hon Coduman DATE. g \ \4 \ 03 PL-01 The Capitol Tallahassee, Florida 32399-1050 (850) 414-3300 PCP: Johnson, Waggoner DATE: August 7, 2003 NOTICE OF HEARING RIGHTS AND ASSESSMENT OF COSTS RESPONDENT IS HEREBY NOTIFIED THAT HE/SHE HAS THE RIGHT TO REQUEST AN ADMINISTRATIVE HEARING PURSUANT TO SECTIONS 120.569 AND 120.57, FLORIDA STATUTES. SPECIFIC OPTIONS FOR ADMINISTRATIVE ACTION ARE SET OUT IN THE ATTACHED EXPLANATION OF RIGHTS. ALL REQUESTS FOR HEARING MUST BE MADE WITHIN 21 DAYS OF RECEIPT AND SENT TO LEE ANN GUSTAFSON, SENIOR ASSISTANT ATTORNEY GENERAL, DEPARTMENT OF LEGAL AFFAIRS, PL-01 THE CAPITOL, TALLAHASSEE, FLORIDA 32399-1050. RESPONDENT iS PLACED ON NOTICE THAT PETITIONER HAS INCURRED COSTS RELATED TO THE INVESTIGATION AND PROSECUTION OF THIS MATTER. PURSUANT TO SECTION 456.072(4), FLORIDA STATUTES, THE BOARD SHALL ASSESS COSTS RELATED TO THE INVESTIGATION AND PROSECUTION OF A DISCIPLINARY MATTER, WHICH MAY INCLUDE ATTORNEY HOURS AND COSTS, ON THE RESPONDENT IN ADDITION TO ANY OTHER DISCIPLINE IMPOSED CERTIFICATE OF SERVICE | HEREBY CERTIFY that a true and correct copy hag been served by certified mail, return receipt requested to RENE RIVERA, 206 Old Bay Lane, Kissimmee, Florida 34743 and by U.S. Mail to Gregory A. Fencik, Esquire, Haliczer Pettis, 225 East Robinson Street, Orlando, Florida 32801 this LA day of , 2003 F:\Users\ADMIN\LEE\RESPIRATORY CARE \Rivera AC.wpd

Docket for Case No: 03-004231PL