Jul 18 2005 16:19 JUL-18-2885 16:19 AHCA/LEGAL MEDICAL 856 414 1989 P.@2/24 oo : STATE OF FLORIDA DEPARTMENT OF HEALTH DEPARTMENT OF HEALTH, PETITIONER, Vv. CASE NO. 2004-23678 MICHAEL ROSIN, M.D., RESPONDENT. DMINISTRATIVE 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, Michael Rosin, 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, Florida Statules; Chapter 456, Florida Statutes; and Chapter 458, Florida Statutes. DOH v, Micnaal A, Rosin, " D, 1 Case Number: 2004-2367: JAPSU\Medical\Caral Crega\aCeNPnyscane\rrsin ac og dikk.dor ac cg dick Jul 18 2005 16:19 JUL-18-2885 16:19 _SHEA/LEGAL MEDICAL 856 414 1989 P.@3/24 2. At all times material to this Complaint, Respondent was a licensed physician within the state of Florida, having been issued license number ME 31899. 3. Respondent's address of record is 1966 Hillview Street, Sarasota, Florida 34239. 4. At all times material to this order, Respondent practiced as a dermatologist. Respondent is not board certified in any specialty. 5. Between June of 2000 and continuing through in or about June 2004, Respondent performed biopsies on the following twenty-three (23) patients, determined that all of the patients had basal cell carcinoma, and performed four stages of Mohs surgery on all. Patient. | Biopsy Date | Basal Cell Date of | Stages Of Name Carcinoma Mohs Mohs Diagnosed Surgery | Surgery by Performed Respondent following | _biopsy MA. 12/04/2001 | YES |_ 4 Stages [RHE (11/5/2002 __| YES 4 Stages MB. 4/11/2002 | YES 5/1/2002 4 Stages q a . M.B. 11/20/2003 | YES [4Stages | DOH v. Michael A. Rosin, M.D. 2 Case Number. 200423678 J*\PSL\Medical\Caral Greag\AC's\Physiciane\rosin ac og dKK.dnc ar Cg ok Jul 18 2005 16:19 856 414 1989 P.a4/24 JUL-19-2005 16:20 AHCA/LEGAL MEDICAL [M.B. __[ 2/4/2004 YES 4 Stages D.S.B. 4/9/2002 YES 14/15/2002 ‘3 Stages _ 4/17/2002 __| 1 Stage D.S.B. 4/10/2002 [YES 4/15/2002 _|4 Stages "| F.C. 8/20/2002 _| YES 9/5/2002 4 Stages LE. 10/22/2003 _| YES 11/10/2003 _/4 Stages ___| L.E. 1/13/2004 | YES | 1/14/2004 — [4 Stages EF. 2/12/2004 [YES 4 Stages M.G. 3/17/2004 _| YES 3/24/2004 [4 Stages —__| M.G. [4/9/2004 YES 4/16/2004 | 4 Stages | W.J. | 6/30/2003 | YES {7/3/2003 | 4 Stages W.1J. 1/7/2004 YES 1/8/2004 4 Stages | W.J. 2/18/2004 | YES _|[4 Stages LL. ~_ [12/21/2000 _ | Yes 1/4/2001___| 4 Stages TM, [3/13/2003 | YES 4/2/2003 | 4 Stages O.M. __ [9/4/2003 YES 9/11/2003 | 4 Stages | LR. 6/1/2000 YES 6/13/2000 _|4 Stages N.S. 12/20/2000 | YES Undated 4 Stages following notes regarding [. | 12/20 biopsy [ M.S. [12/20/2000 _ | YES 1/9/2001 _—(| 4 Stages" LS. [10/4/2001 _| YES 10/5/2001 __| 4 Stages R.S. 7/23/2003 | YES 8/7/2003 4 Stages H.S. [8/27/2002 __| YES [9/25/2002 [4 Stages ST. __[ 8/16/2001 | YES 8/23/2001 _| 4 Stages ST. [9/8/2003 YES | 9/12/2003 | 4 Stages [P.T. 11/12/2002 [YES | 11/21/2002 [4 Stages (CT. [ 4/23/2002 __| YES 4/24/2002 4 Stages__| [HT _| 11/06/2003 | Yes 11/12/2003 | 4 Stages i [H.T. 03/30/2004 _| YES 4/2/2004 4Stages_ | 1.W, 11/7/2002 [Yes _| 11/13/2002 [4 Stages J.R.W. 5/7/2001 YES _15/14/2001 | 4 Stages | DOH v, Michael A. Rosin, M.D, 3 Case Number: 2004-23678 4:\PSU\Medical\Caral Gregg\ACs\Physicians\rosin ac 09 dkk.doc ac cg dkk Jul 18 2005 16:19 JUL-18-2885 16:24 AHCA“LEGAL MEDICAL 54 414 1989 P. 524 oN = 6, Respondent's records for the above-described patients indicate that Respondent ciagnosed basal cell carcinoma based on and justified by the biopsies listed above. 7, Mohs micrographic surgery is a specialized surgical technique used to treat skin cancer. Mohs surgery is performed in stages, After each stage of Mohs surgery before starting the next stage, Indlvidual layers of cancerous tissue are removed, the excised skin is placed on a slide, and examined under a microscope for the presence of cancer. A physician proceeds to the next stage of surgery for removal of additional tissue when the slide indicates that all the cancer has not been excised, 8. The biopsy slides prepared by Respondent and his staff on the above-described patients are either so poor that no reliable diagnosis can be made from them or the slides do not contain any evidence supporting Respondent's diagnosis of basal cell carcinoma. §. The above-described biopsy slides prepared by Respondent and his staff are so poor and inadequate that a reasonably prudent similar physician under similar conditions and circumstances would not be able to réliably diagnose a patlent with cancer. DOH vy. Micheel A. Rosin, M.D. 4 Case Number: 2004-23676 7\PA\Medical\Carul Greog\acs\prysicans\noain at cg dick.cioe ac og did Jul 18 2005 16:20 _ JUL-1e-288S 16:28 BHCAYLEGAL MEDICAL 856 414 1989 P. 624 10, Further, Respondent’s biopsy slides described above are sO poor and Inadequate that they provide no medical justification for the performance of multiple stages of Mohs surgery on any of the above patients. 11. Respondent’s medical records on the above-described patients are illegible and do not provide adequate justification for the treatment of the patients noted on the above chart. COUNT IT 42. Petitioner reallages paragraphs one (1) through eleven (11) as if fully set forth here. 13. Section 453.331(1)(t), Florida Statutes (2000) (2001) (2002) (2003), provides in pertinent part the following grounds for discipline by the Board of Medicine: Gross or repeated malpractice or the failure to practice medicine with that level of care, skill, and treatment which is tecognized by a reasonably prudent similar physiclan as being acceptable under similar conditions and circumstances. 14. Respondent engaged in the gross and repeated malpractice of medicine and failed to practice medicine with that level of care, skill, and DOH v. Michael A. Rosin, M.D, 5 Case Number: 2004-23678 J:\PSU\Medica!\Carol Gregg\Ac‘s\enysidans\rosin ac: cy dkk. doe au oy UkB Jul 18 2005 16:20 JUL-18-2885 16:21 AHCA/LEGAL MEDICAL 856 414 1989 Pare treatment which is recognized by a reasonably prudent similar physician as being acceptable under similar conditions and circumstances hy repeatedly preparing inadequate biopsy slides, by diagnosing basal cell cardnoma based on slides that are s0 poor that a reliable diagnosis can not be made from them, and by performing four stages Mohs surgery on the above- described patients with inadequate justification or indication of medical necessity. 15. Based on the foregoing, Respondent violated Section 458.331(1)(t), Florida Statutes (2000) (2001) (2002) (2003), by engaging in the gross or repeated malpractice or by failing to practice medicine with that level of care, skill, and treatment which is recognized by a reasonably prudent similar physician under similar conditions and circumstances, by repeatedly diagnosing patients with cancer without adequate justification, by performing surgery on his patients based on his unjustified diagnoses, and by repeatedly performing multiple stages of Mohs surgery on patients without adequate. Respondent's tailure to prepare and keep biopsy slides that justified the diagnoses of cancer, and the fallure to make and keep Slides justifying each stage of Mohs surgery performed constitutes gross or DOH V. Michael A. Rosin, M.D, 6 Case Number: 2004-23678 7-\PSU\Medical\Caral Gragg\aCs\Physiclans\rosin ac co dkk.doc an cg dee Jul 18 2005 16:20 JUL-18-2885 16:21 AHCA/LEGAL MEDICAL 856 414 1989 repeated malpractice of medicine or failure 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. COUNT II 16. Petitioner reallages paragraphs one (1) through eleven (11) and incorporates them as if fully set forth here. 17. Section 458.331(1)(m), Florida Statutes (2000) (2001) (2002) (2003), provides the following grounds for discipline by the Board of Medicine: 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 who 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 limited to, patient histories; examination results; test results; records of drugs Prescribed, dispensed, or administered; and reports of consultations and hospitalizations. 18. Respondent falled to keep legible medical records justifying his course of treatment of his patients in violation of Section 458.33 1(1)(m), DOH y, Michael A Rosn, M.D. 7 Cae Number: 2004-2458 JAPSU\Medical\Carn! Gregg yaCs\Physicians\rosin ac 0g ditk.tlac ac eg dkk P.ae/24 Jul 18 2005 16:21 JUL-18-2885 16:21 AHCA/LEGAL MEDICAL 856 414 1989 P.@o/24 oo, Florida Statutes (2000) (2001) (2002) (2003), in that the biopsy slides prepared by Respondent were inadequate for accurate documentation for diagnoses and failed to justify Respondent’s course of treatment. 19, Based on the foregoing, Respondent ‘has violated Section 458.331(1)(m), Florida Statutes (2000) (2001) (2002) (2003), by failing to keep legible medical records that justify his course of treatment of the above-described twenty-three (23) patients. WHEREFORE, the Petitioner respectfully requests that the Board of Medicine enter an order imposing one or more of the following penalties: permanent revocation of 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. SIGNED this _/2t day of. 2005. John. Agwunobi, M.D., M.B.A., M.P.H. Secretary, Department of Health DOH v. Michael 4 Rosin, M.D. 8 Case Number: 2004-23678 J.-\FSU\medicanyCarol Gragg\ACe\Physielans\rosin ac cg dkk.doc ae 9 dk Jul 18 2005 16:21 JUL-18-2885 16:22 AYCACLEGAL MEDICAL 856 414 1989 P. 18/24 Deo Kirke Diane K. Kiesling Attorney Supervisor Litigation Florida Bar #0233285 —~—— DOH Prosecution Services Unit 4052 Bald Cypress Way, Bin C-65 Tallahassee, FL 32399-3265 (850) 487-9685 (850) 414-1989 FAX Carol L. Gregg Assistant General Counsel riLED DOH Prosecution Services Unit DEPARTMENT OF HEALTH 4052 Bald Cypress Way, Bin C-65 EPUTYO,ERK Tallahassee, Fl. 32399-3265 CLERIK Dyunptthion Florida Bar # 181515 OATE PJos (850) 488-3357 (850) 414-1989 FAX Reviewed and approved by: = (initials) ih Jog tate PCP: July |, 2005 PCP Members: Gordon Ondra,MD. ond Ronold Dyches DOK v. Michael & Rosin, M1). 9 Case Number: 2004-23678 J:\PSU\Modical\Carol Gregg\ac's\physidans\rosin ac uy dkkdoc ac og dkk Jul 18 2005 16:21 JUL-18-2085 16:22 AHCA ARCA LEGAL MEDICAL 856 414 1989 P.1i/24 Michael Rosin, DOH Case No. 2004-23678 NOTICE OF RIGHTS Respondent has the right to request a hearing to be conducted in accordance with Section 120.569 and 1720.57, 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 ahd costs, on the Respondent in addition to any other disclpline imposed. DOH v. Michael A. Rosin, M.D. 10 Case Number: 2004-23678 3:(PSU\Medical\Garol Gragg\ACs\Physidane\rosin a¢ og dke.doc ar 6g rikk

Docket for Case No: 05-002576PL