OCT-22-2087 18:13 Oct 22 2007 9:57 STATE OF FLORIDA DEPARTMENT OF HEALTH DEPARTMENT OF HEALTH, PETITIONER, v. CASE NO. 2006-35409 ANTONIO J. RAMIREZ, D.O., RESPONDENT. ote: / ADMINISTRATIVE COMPLAINT COMES NOW Petitioner, Department of Health, by and through its undersigned counsel, and files this Administrative Complaint before the Board of Osteopathic Medicine against Respondent, Antonio J. Ramirez, D.O., and in support thereof alleges: 1. Petitioner is the state department charged with regulating the practice of osteopathic medicine pursuant to Section 20.43, Florida Statutes; Chapter 456, Florida Statues; and Chapter 459, Florida Statutes. 2. At all times material to this Complaint, Respondent was a licensed osteopathic physician within the State of Florida, having been issued license number OS 6618. JAPSU\MedicalBlake\Osteo\4 Ca\Ramirez,A.2006-35409(x).dac Lol hig Oct 22 2007 9:57 OCT-22-2087 18:13 3. Respondent's address of record is 812 West Oak Street, Kissimmee, Florida 34741. 4, On or about February 16, 2004, Patient A.M., a then fifty-six (56) year-old female, presented to Osceola Regional Medical Center in Kissimmee, Florida with complaints of abdominal pain. 5. On or about February 16, 2004, Patient A.M. underwent a CT scan ef: her abdomen with contrast. The physician who read the CT scan--~--- reported the following impression, “1. Findings consistent with acute appendicitis with...significant inflammatory changes in the right lower quadrant are present, Associate fluid suggests the possibility of ' perforation. 2, Associated ileus, suggested peritoneal inflammation.” 6. On or about February 17, 2007, Patient A.M. was admitted to Osceola Regional Medical Center. 7. On or about February 17, 2007, Respondent performed a consultation on Patient A.M. In the consultation report Respondent diagnosed Patient A.M. with acute abdomen and perforated appendicitis. 8. Respondent planned to perform a diagnostic laparoscopy, possible laparoscopic appendectomy, and possible open appendectomy on Patient A.M. JAPSU\Medical\Blake\Ostco\ACs\R amirez.A.2006-35409(x),doc ? Oct 22 2007 9:58 OCT-22-2087 14:14 9. On or about February 17, 2007, Respondent performed a- laparoscopic appendectomy with peritoneal drainage on Patient A.M. The procedure was uneventful. 10. Following the surgical procedure, Patient A.M.’s care was being managed by Respondent and a Hospitalist. 11. Following the surgical procedure, Patient A.M. was given parental and oral fluids in conjunction with. ardisietics. 12. On or about February 18, 2004, Patient A.M. was noted to have abdominal distention with diminished bowel sounds. 13. On or about February 19, 2004, Patient A.M.’s progress notes stated that Patient A.M. continued to have abdominal distention with diminished bowel sounds. Despite this problem, Patient A.M. was discharged from Osceola Regional Medical Center on or about February 20, 2004, 14. On or about February 22, 2004, Patient AM’s husband contacted Respondent and told Respondent that Patient A.M. was having bad constipation. Respondent advised Patient A.M.’s husband to take Patient A.M. to the Emergency Room. JAPSU\Medical\Blake\Osteo\ACs\Ramirez. A. 2006-35409(x).doc a Oct 22 2007 9:58 OCT-22-2087 18:14 14. On or about February 23, 2004, Patient A.M. was found deceased in her home by her husband. 15. An autopsy performed by the Orange County Medical Examiner concluded that Patient A.M. died from complications of paralytic ileus due to reported peritonitis status post appendectomy. 16. Paralytic ileus is condition where food is unable to pass through the intestine which may causezmeintestinal blockage. 17, Respondent failed to meet the standard of care in his postoperative management of Patient A.M. 18. Section 459.015(1)(x), Florida Statutes (2003), provides that the failure to practice osteopathic medicine with that level of care, skill, and treatment which is recognized by a reasonable prudent similar osteopathic physician as being acceptable under similar conditions and circumstances, constitutes grounds for discipline py the Board of Osteopathic Medicine. 11. Respondent failed to practice osteopathic medicine with that level of care, skill, and treatment which is recognized by a reasonably prudent similar osteopathic physician, in one or more of the following ways: JAPSU\Medical\Blake\Osteo\ACs\Ramirez.A.2006-35409(x).doc 4 Oct 22 2007 9:58 OCT-22-2087 18:14 P.@9 a) by failing to address Patient A.M.’s continued abdominal distention of postoperative ileus with postoperative x-rays to confirm the diagnosis; b) by failing to aggressively pursue parental replacement of fluid and electrolyte deficiencies known to contribute to paralytic ileus; or c) _ by failing to make sure Patient A.M. was seen by a physician awed a seam: Ct “alter Patient A.M.’s husband called Respondent on or. about February 22, 2004. 12, Based on the foregoing, Respondent has violated Section 459.015(1)(x), Florida Statutes (2003), by failing to practice osteopathic medicine with that level of care, skill, and treatment which is recognized by a reasonably prudent similar osteopathic physician as being acceptable under similar conditions and circumstances. WHEREFORE, Petitioner respectfully requests that the Board of Osteopathic 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, JAPSU\Medical\Blake\Osteo\ACs\Ramirez.A,2006-35409(x).doc 5 Oct 22 2007 9:59 OCT-22-2087 14:14 P.18 refund of fees billed or collected, remedial education and/or any other relief that the Board deems appropriate. SIGNED this Sh day of haut ___, 2007. th V_27M.P.H. pare SLA DOH Prosecution Sesviees Unit 4052 Bald Cypress Way, Bin C-65 Tallahassee, FL 32399-3265 Florida Bar No. 0570788 (850) 245-4640, ext. 8114 850) 245-4682 FAX PCP: August: [0 a0? PCP Members: Kado € OL 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. JAPSU\Medical\Blake\Osteo\aCs\Ramirez,A,2006-35409(x).doc a

Docket for Case No: 07-004796PL