Now 1? 2006 10:04 Nov 17 2006 11:00 P.05 STATE OF FLORIDA DEPARTMENT OF HEALTH DEPARTMENT OF HEALTH, PETITIONER, V. CASE NO. 2005-67004 IRVING HALL, JR, M.D., RESPONDENT, ee ADMINISTRATIVE COMPLAINT Petitioner, Department of Health, by and through undersigned counsel, files this Administrative Complaint before the Board of Medicine against Respondent, Irving Hall, Jr, 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 Statutes; Chapter 456, Florida Statutes; and Chapter 458, Florida Statutes. 2. At all times material to this Complaint, Respondent was a licensed physician within the state of Florida, having been issued license number 6044. 3. Respondent's address of record is 712 39" Street West, Bradenton, Florida 34205. Nov 1? 2006 10:04 Nov 17 2006 11:01 P.O6 4. Respondent is Board certified by the American Board of Pediatrics. 5. On or about April 12, 2001, Patient RR, an eleven year old male, presented to the Respondent of Manatee Pediatrics for a “bowel problem”, having frequent soft, loose stools with blood. At the time of his visit, Patient RR weighed sixty-three pounds and his height was fifty-four inches. Laboratory results only revealed blood in his stool. Patient RR's diagnosis at the time was gastroenteritis (inflammation of the stomach and the intestinal tract). He was given Lactinex and told to return in two weeks, There is no indication he was plotted on a growth chart. 6. Patient RR returned to Respondent's office approximately two weeks later. Patient RR weighed sixty-four pounds. His assessment was moniliasis (infection of the skin or mucous membranes by yeastlike fungi). He was told to drink buttermilk or use Lactinex (/actobaci//us—bacteria from unpasteurized whole milk used to replace good bacteria in the colon) and. to return in.one month. 7. Upon Patient RR’s return, the chart states that his bowels were “much better”. His weight remained at sixty-four pounds. Nov 1? 2006 10:05 Nov 17 2006 11:01 PLO? 8. On or about October 16, 2001, Patient RR visited the Respondent's office with complaints of explosive diarrhea, which was watery in nature despite Patient RR drinking buttermilk and taking Immodium and Lactinex. The report notes that Patient RR lost four pounds in the previous two weeks and had poor weight gain. Laboratory studies indicated that Patient RR had a slightly elevated SGOT (serum olutamic- oxaloacetic transaminase--an intracellular enzyme involved in amino acid and carbohydrate metabolism), mildly low hemoglobin (iron-containing pigment of red blood cells) with borderline low mean corpuscular (blood cell) hemoglobin suggestive of iron deficiency. The October 16, 2001 medical report suggests possible ulcerative colitis (ulceration of mucosa of the colon) and schedules a return visit in seven to ten days. 9, Onor about April 18, 2002, Patient RR at thirteen years of age returns to Respondent's office with no improvement in his bowels and no weight gain during the previous since his previous visit six months before. He only had a two-pound weight gain since his first visit two years earlier. 10, Respondent questioned whether Patient RR had irritable bowel syndrome versus colitis, Giardia (species of protozoa which attach to cells of the intestinal mucosa, absorbing nourishment) or celiac disease Nov TP? 2006 10:05 Nov 17 2006 11:01 P.08 (intestinal malabsorption syndrome characterized by diarrhea, malnutrition, bleeding tendency, and hypocalcemia) and refers him for a barium enema, along with something illegible, 10. Patient RR returns to the Respondent's office approximately twenty months later with no improvement in his symptoms. Patient has bowel movements four to five times a night and eight to ten times a day, everyday. The assessment is ulcerative colitis vs. “Krohn’s” and Patient RR is referred to Dr. McClenathan, a pediatric gastroenterologist. —_, 11. Patient RR, at fourteen years of age, was seen by Dr. McClenathan’s gastroenterology group on or about February 17, 2004. Dr. Reinstein notes in the February 17, 2004 report that Patient RR's family history is significant for an uncle with colitis. His weight is at the third percentile and height is at the twenty-fifth percentile. He is described as emaciated. His stool was positive for blood, which is inconsistent with irritable bowel syndrome. Dr. Reinstein recommends Patient RR undergo an endoscopy (inspection of body organs or cavities by use of the endoscope) and colonoscopy (examination of the upper portion of the rectum with an elongated speculum or a colonoscope) and that Patient RR's symptoms be treated more aggressively. Nov 1? 2006 10:05 Nov 17 2006 11:01 P.Og 12. On or about February 26, 2004, Patient RR underwent an esophagogastroduodenoscopy (inspection of the esophagus, stomach and first part of the small intestine) and colonoscopy with ileoscopy (inspection of the lower three-fifths of the small intestines) and biopsies. The colonoscopy confirmed Patient RR suffered with Crohn’s disease. 13. Patient RR underwent aggressive therapy after his diagnosis of having Crohn’s disease (chronic inflammation of granular tumor involving the end of the ileum). Within nine months, his weight rises to the twenty- fifth percentile. 14, Section 458.331(1)(t), Florida Statutes (2001), provides that the 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 constitutes grounds for disciplinary action by the Board of Medicine. 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 one or more of the following ways: a) Failing to adequately assess Patient RR's condition, despite Now 1? 2006 10:05 Nov 17 2006 11:02 P.10 the presence of voluminous diarrhea and severe failure to thrive, through testing for malabsorption, getting a reticulocyte count (which would indicate bleeding); b) Failing to order abdominal contrasted CT scans; ¢) Failing to order a colonoscopy and/or endoscopy; d) Failing to timely refer Patient RR for consultation to a gastroenterologist for diagnosis of his gastrointestinal problems, despite Patient RR’s complaints and lack of improvement; e) Failing to obtain a complete medical history of Patient RR's family, including, but not limited to, an uncle who suffers from colitis. 16. Based on the foregoing, Respondent has violated Section 458.331(1)(t), Florida Statutes (2001), by failing to practice, medicine within the standard of care which would be recognized by a reasonably prudent medical professional under similar conditions and circumstances. WHEREFORE, 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, Now 1? 2006 10:06 Nov 17 2006 11:02 P.11 placement of Respondent on probation, corrective action, refund of fees billed or collected, rernedial education and/or any other relief that the Board deems appropriate, SIGNED this 23” day of 2006, DEPART FILED DOH Prosecution Services Unit CLERK. ES, 4052 Bald Cypress Way, Bin C-65 ome Tallahassee, FL 32399-3265 9 27% Florida Bar # 0078999 850.245.4640 ext. 8175 850.245.4681 FAX Irving Hall, Jr, M.D. CASE NO, 2005-67004 pcp: 9/22/bb . PCP Members: dakkor beauzeny Behe Now 1? 2006 10:06 Nov 17 2006 11:02 P.12 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.

Docket for Case No: 06-004661PL