STATE OF FLORIDA DEPARTMENT OF HEALTH DEPARTMENT OF HEALTH, PETITIONER, v. CASE NO. 2002-31138 RICHARD CONLEY, M.D., RESPONDENT. | AD IVE COMPLAINT COMES NOW, Petitioner, Department of Health, by and through its undersigned counsel, and files this Administrative Complaint before the Board of Medicine against Respondent, Richard Conley, M.D., and in support thereof alleges: 1. Petitioner is the state department charged with regulating the practice of medicine pursuant to Section 20.43, Horida Statutes; Chapter 456, Florida Statutes; and Chapter 458, Florida Statutes. 2. Respondent, whose last known address is 3310 Bermuda Isle Circle, #229A, Naples, Florida 34109, was issued Florida medical license number ME 76560 on August 24, 1998. Ta'd 6867 FTP aos WOTTAM THOS 1“YoHs cr:6@ SeGe-TE-NIL Te6 900¢ T unr “ae See’ 3. At all times material to this complaint, Respondent was a licensed physician with the State of Florida. 4, Respondent is board certified in pathology by the American Board of Pathology. 5. Respondent became the primary treating physician for Patient B.H., an 89 year-old female, on or about November 7, 2002, when B.H. was transferred to Cypress Community Care Center (Cypress), a skilled nursing facility in Naples, Florida, from Lee Memorial Hospital in Fort Myers, Florida, where she had been admitted four days carlier for evaluation following a fall in the home. 6. During B.H.’s hospitalization, physician M.N. _ initiated anticoagulation therapy and, at discharge, Physician M.N. ordered Coumadin, an oral anticoagulation agent. Physician M.N. also gave the following order: INR on 11/7/02 and report to Nursing Home Medical Director. INR (International Normalized Ratio) is a laboratory test which is used to monitor anticoagulation therapy. 7. At BH’ admission to Cypress on November 7, 2002, Respondent ordered Coumadin but did not order INR or any other laboratory tests to monitor anticoagulation therapy. JAPSU\Medicalimonies ryan\coacs\eonley\ac,final.doc 2 cad 6867 Pir B58 W2TCaW THOS 1“YOHs EP:6@ SeBe-TA-NNIL Te6 900¢ T unr 8. A reasonably prudent similar physician under similar conditions and circumstances would order INR or another acceptable laboratory test to monitor anticoagulation therapy. 9, Respondent was out of town attending a conference from December 1 through December 8, 2002, and did not arrange for alternative medical coverage for Patient B.H. during this time period. 10. A reasonably prudent physician under similar conditions and circumstances would arrange for alternative medical coverage for the physician’s patients during a planned absence. 11. On December 3, 2007, Cypress staff placed a telephone call to Respondent concerning a large ecchymasis on top of patient B.H.’s right hand. Respondent did not return the call. 12. On December 4, 2002, Cypress slaif contacted the on-call physician and reported the ccchymosls. This physiclan ordered antibiotics, x-ray of the right hand, and transport to a haspital emergency room for evaluation. Patient B.H, was transported that day to Lee Memorial Haspital. 13. The examining physician in lhe emergency room noted that Patient B.H’s hand started swelling on December 2; It was purple; she complained of severe pain, worsening over the last 24 hours; she was started on Coumadin on November 3, 2002, for chronic atrial fibrillation; 4:\PSU\Medical\monica ryan\casct\conley\ac,final.dac a £4"d 6867 Pir B58 W2TCaW THOS 1“YOHs EP:6@ SeBe-TA-NNIL Te6 900¢ T unr ue and the level of the Coumadin and her protime have not bean checked since then. Protime (prothrombin time; PT) is a laboratory test to monitor anticoagulation therapy. 14. Lab testing was performed and the following results were obtained: PT was elevaled at 41.4, INR was elevated at 9.2, and PTT (partial thromboplastin time) was elevated at 82. The examining physician diagnosed Coumadin toxicity, and Patient B.H. was admitted. 15. Section 458.331(1)(t), Florida Statutes (2002), provides that 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 constitutes grounds for discipline by the Board of Medicine. 16, The 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 the following ways: a. __ by failing to order INR or any other acceptable test to monitor anticoagulation therapy for Patient B.H. between November 7 and December 4, 2002; and JAPSU\Medicalimonita ryan\cases\enniry\ad, final.doc 4 Fad 6867 FTP 458 WITTAW TES 1“YoHs fP:6@ SeBe-TEa-NNIe Tr:6 900¢ T une ae b. by failing to arrange for alternative medical coverage for Patient B.H. during Respondent's scheduled absence from December 1 through December 8, 2002. 17. Based on the foregoing, Respondent has violated Section 458,331(1)(t), Florida Statutes (2002), 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 clrcumstances. WHEREFORE, the Petitioner respectfully requests that the Board of Medicine enter an order imposing one or more of the following penalties: permanent revocation or suspension of Respondent's license, restriction of practice, imposition of an administrative fine, issuance of a reprimand, placement of the Respondent on probation, corrective action, refund of -fees billed or collected, remedial education and/or any other relief that the Board deems appropriate. JAPSU\Medical\monisa ryan\cases\wonley'ac, hmal.doe 5 S@"d4 6867 FTP aos WOTTAM THOS 1“YoHs fP:66@ SeBe-TE-NIL cr:6 G00e T unc naar SIGNED this Abe day of C mviny 2005. John 0. Agwunobi, M.D., M.B.A., M.PRH. parlinent off Health tant General Counsel IH Prosecution Services Unit 4052 Bald Cypress Way, Bin C-65 rsp Tallahassee, FL 32399-3265 IL WEALTH Florida Bar # 0570788 oer EPUTY CLERK (850) 414-8126 cern Nigtlur Colima (850) 414-1989 FAX paTe_- Le-o> Reviewed and approved by: DLL Enitials) 25” (date) | PCP: Jomary 21, 2005 PCP MemberS:p1-pehei, ordra, Dyctisss JAPSU\Moedieal\moniea ryanicases\conley\ac, final.doe 6 98° 6867 Pir B58 W2TCaW THOS 1“YOHs FR:6e = SeBe2-TE-NNIE cr:6 G00e T unc Meer “att Richard Conley, M.D., DOH Case No.: 2002-31138 NOTICE OF RIGHTS Respondent has the right to request a hearing to be conducted in accordance with Section 120.569 and 120.57, Florida Statutes, to be represented by counsel or other qualified representative, to present evidence and argument, to call and cross-examine witnesses and to have subpoena and subpoena duces tecum issued on his or her behalf if a hearing is requested. NOTICE REGARDING ASSESSMENT OF COSTS 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. JAPSUNMecical\monica ryanicases\wontey\ac,final.doc 7 28"d 6867 FTP 458 WITTAW TES 1“YoHs FR:6e 3 SeBe-TE-NNIE er:6 S00¢ T unc

Docket for Case No: 05-001983PL