STATE OF FLORIDA AGENCY FOR HEALTH CARE ADMINISTRATION STATE OF FLORIDA, D . AGENCY FOR HEALTH CARE is 01): ©, ADMINISTRATION, Petifioner, Case No. 2007013432 2007013433 vs. SARASOTA DOCTORS HOSPITAL, INC., d/b/a DOCTORS HOSPITAL OF SARASOTA, Respondent. ADMINISTRATIVE COMPLAINT COMES NOW the Agency For Health Care Administration (hereinafter Agency), by and through the|undersigned counsel, and files this Administrative Complaint against SARASOTA DOCTORS| HOSPITAL, INC., d/b/a DOCTORS HOSPITAL OF SARASOTA (hereinafter Respondent), pursuant to Section 120.569, and 120.57, Florida Statutes, (2007), and alleges: NATURE OF THE ACTION Thig is an action to impose an administrative fine in the amount of two thousand dollars ($2,000.00)) pursuant to Sections 120.569, 120.57, 395.1042, 395.1055 and 395.1065, Florida Statutes (2007). JURISDICTION AND VENUE 1. The|Agency has jurisdiction pursuant to Chapters 395, Part I, and 408, Part II, Florida Statutes (2007). 2. Venne lies pursuant to Section 120.57 Florida Statutes, and Chapter 28-106.207 Florida Administrative Code. EXHIBIT “Ae PARTIES 3. The| Agency is the regulatory authority with regard to hospital licensing and regulation pursuant to|Chapter 408, Part II, Florida Statutes (2007), Chapter 395, Part I, Florida Statutes (2007), and| Chapter 59A-3, Florida Administrative Code, respectively. 4. Respondent is a hospital located at 5731 Bee Ridge Road, Sarasota, Florida 34233, and is licensed under Chapter 395, Part I, Florida Statutes and Chapter 59A-3, Florida Administrative Code, license number 4307. 5. Respondent was issued a license by the Agency to operate a 168-bed hospital (License No. 4307) lbcated at 5731 Bee Ridge Road, Sarasota, Florida 34233, and was at all times material required to comply with the applicable federal and state regulations, statutes and rules. COUNT I 6. The/Agency re-alleges and incorporates paragraphs (1) through (5) as if fully set forth herein. 7. That pursuant to Florida law, every hospital offering emergency services and care shall provide emergency care available 24 hours a day within the hospital to patients presenting to the hospital. Aft a minimum at least one physician shall be available within 30 minutes through a medical staff call roster; initial consultation through two-way voice communication is acceptable for physician presence. Rule 59A-3.255(6)(a)(2), Florida Administrative Code. See also, Section 395).1041(3), Florida Statutes (2007). 8. That on January 10, 2007, the Petitioner Agency completed a complaint survey, complaint number 2007000199, of the Respondent facility. 9. That based upon the review of records and interview, Respondent failed to ensure that emergency ¢are was available and provided 24 hours a day within the hospital to patients presenting to the hospital for one (1) patient, the same being contrary to law. 10. That the Petitioner’s representative reviewed Respondent’s records regarding patient number twenty (20) during the survey and noted the following: a. That the patient was sent to the Respondent’s emergency room on November 11, 2006 for abdominal pain; That the patient was a fifteen (15) year old who fell from a bike and hit the abdomen; That a CT scan was completed on the patient’s abdomen; That the Respondent’s doctor annotated "there does appear to be low density at the med-portion of the spleen. This raises the question of a splenic laceration. Significant blood around the spleen, however, is not identified. A liver laceration is not seen. However, there does appear to be a small amount of blood around the inferior aspect of the liver;" That the emergency room physician requested the on-call surgeon to evaluate the patient and for possible surgery; That the emergency room physician evaluated the patient, stabilized the patient, and the patient was then transported to a hospital in Tampa. 11. That the Petitioner’s representative interviewed Respondent’s staff during the survey who indicated as’ follows: That Respondent’s emergency room physician was not able to treat this patient and called the on-call physician for evaluation and to perform surgery on this patient; That the on-call physician stated that he was not on-call and to call a different 12. f. surgeon; That the emergency room physician then called the second surgeon who stated he also was not on-call; That the emergency room physician then called a third surgeon who also stated he was not on-call; That the emergency room physician then called Tampa General who accepted this patient; That the patient was then transported to Tampa General by helicopter. That the Petitioner’s representative reviewed Respondent’s on-call roster for surgeons covering O¢tober through December 2006 which reflected that the first doctor called by the emergency department physician was the on-call specialist designated as on-call for November 11, 2006, the date in question. That the Petitioner’s representative reviewed Respondent’s records during the survey and 13. noted as fol 4. b. q d. lows: That on December 6, 2006, a memorandum was authored by the chief of staff regarding "EMTALA 'Duty to Respond; That the memorandum reminded physicians to not fail to respond to an evaluation request from the Emergency Department physician; That the memorandum explained that this is an EMTALA violation; That a memorandum dated November 13, 2006 from the Respondent’s Chief Executive Officer to the on-call surgeon who failed to respond on November 11, 2006 indicated, inter alia, that "...regardless of whether he is on-call or not, if the ER (emergency room) requests that he come in and consult on a patient, he should do so;" e. That another response from the Respondent’s medical director was made on January 10, 2007 to the on-call surgeon, who did not respond, concerning this issue and this correspondence was also placed in the physician's personnel record. 14. That the above reflects the Respondent’s failure to ensure that it provides emergency services and care to patients presenting for emergency care twenty-four (24) hours daily in its failure to ensure that necessary on-call services promptly responded to provide requisite care, the same placing patients at risk. 15. That the Agency cited the Respondent facility for the above referenced deficiency. 16. That the above cited deficiency subjects the Respondent facility to the imposition of an administrative penalty in a sum not to exceed ten thousand dollars ($10,000.00) per violation. § 395.1041(5)(a) Florida Statutes (2007). . WHEREFORE, the Agency intends to impose an administrative fine in the amount of $1,000.00 against Respondent, a hospital in the State of Florida, pursuant to § 395.1041(5)(a) Florida Statutes (2007). COUNT II 17. The|Agency re-alleges and incorporates paragraphs (1) through (5) as if fully set forth herein. 18. — That pursuant to Florida law, every hospital offering emergency services and care shall provide emergency care available 24 hours a day within the hospital to patients presenting to the hospital. At a minimum at least one physician shall be available within 30 minutes through a medical staff call roster; initial consultation through two-way voice communication is acceptable for physician presence. Rule 59A-3.255(6)(a)(2), Florida Administrative Code. See also, Section 394.1041(3), Florida Statutes (2007). 19. That on July 23, 2007, the Petitioner Agency completed a complaint survey, complaint number 207007851, of the Respondent facility. 20. That based upon the review of records and interview, Respondent failed to ensure that emergency care was available and provided 24 hours a day within the hospital to patients presenting to the hospital for one (1) of twenty (20) patient records reviewed, the same being contrary to law. 21. That the Petitioner’s representative interviewed Respondent’s staff member on July 23, 2007 who indicated as follows: 4. That patient number twenty (20) presented to the Respondent’s emergency department on September 23, 2006; b. That the patient was a four year old and presented with severe abrasions to the right hand; q. That the patient required a plastic surgeon for surgery to the right hand; d. That Respondent’s emergency room physician called the anesthesiologist to prepare the patient for surgery; 4. That the anesthesiologist refused to respond to the call and come to the hospital as the patient was four years old and would require post-surgical services that Respondent does not provide; f| That the Respondents emergency room physician then called a surgeon from another hospital to treat the patient; g. That the physician from the other hospital agreed to treat the patient; h. That the Respondent hospital stabilized the patient and transferred the patient to the other hospital; |. That Respondent hospital recognized the above as a violation of law and reported the incident to the Agency for Health Care Administration. 22. That the Petitioner’s representative was provided with information prepared by Respondent to prevent reoccurrence of such an event which included as follows: a. Staff meetings, physician meetings, reviews of the policy and procedures for violations and in-services were conducted; b. The anesthesiologist who had failed to respond to the emergency department’s request for services wrote a letter to the hospital requesting a one year leave of absence which was granted; ¢. That this correspondence predated the Respondent’s correcting this violation; dl. The staff indicated that if the anesthesiologist returns he will be required to be trained in the regulations as well. 23. That the Petitioner’s representative reviewed Respondent’s records regarding patient number twenty (20) and noted as follows: a. That the patient was sent to the Respondent’s emergency department on September 23, 2006; b. That the patient presented with an open hand wound; ¢. That X-rays were completed with no fracture, however, surgery was required; d. That transfer papers reflected that the patient required a pediatric anesthesiologist which was not available at this facility. 24. — That the Petitioner’s representative reviewed Respondent’s records regarding on-call professionals and noted that the identified anesthesiologist was on the Respondent’s on-call list for September 23, 2006. 25. That the above reflects the Respondent’s failure to ensure that it provides emergency services and care to patients presenting for emergency care twenty-four (24) hours daily in its failure to ensure that necessary on-call services promptly responded to provide requisite care, the same placing patients at risk. 26. That the Agency cited the Respondent facility for the above referenced deficiency. 27. That the above cited deficiency subjects the Respondent facility to the imposition of an administrative penalty in a sum not to exceed ten thousand dollars ($10,000.00) per violation. § 395.1041(5)(a) Florida Statutes (2007). WHIEREFORE, the Agency intends to impose an administrative fine in the amount of $1,000.00 against Respondent, a hospital in the State of Florida, pursuant to § 395.1041(5)(a) Florida Statutes (2007). Respectfully submitted this a day of January, 2008. / 4) Thérhds J. Walsh, II Fla. Bar. No. 566365 Counsel for Petitioner Agency for Health Care Administration 525 Mirror Lake Drive, 330G St. Petersburg, FL 33701 727.552.1525 (office) 727.552.1440 (fax) Respondent lis notified that it has a right to request an administrative hearing pursuant to Section 120.569, Florida Statutes. Respondent has the right to retain, and be represented by an attorney in this matter. Specific options for administrative action are set out in the attached Election of Rights. All requests|for hearing shall be made to the Agency for Health Care Administration, and delivered to Agency Clerk, Agency for Health Care Administration, 2727 Mahan Drive, Bldg #3,MS #3, Tallahassee, FL 32308;Telephone (850) 922-5873. RESPONDENT IS FURTHER NOTIFIED THAT THE FAILURE TO REQUEST A HEARING ll DAYS OF RECEIPT OF THIS COMPLAINT WILL RESULT IN AN IN OF THE FACTS ALLEGED IN THE COMPLAINT AND THE ENTRY OF A FINAL ORDER BY THE AGENCY. WITHIN 2 ADMISSIq IH USS. Certi 33324 and CERTIFICATE OF SERVICE REBY CERTIFY that a true and correct copy of the foregoing has been served by ed Mail, Return Receipt No. 7007 0710 0004 0428 90270n January CT se pore Road, Sarasota, FL 34239. Copies furnished to: CT Corpor 2295 Victo: Ft. Myers, (U.S. Mail) Registered Agent Field Office Manager tion System ia Ave., Room 340 lorida 33901-3884 , 2008 to tion System, Registered Agent, 1200 South Pine Island Rd., Plantation, Florida y U.S. Mail to Robert Meade, CEO, Doctors Hospital of Sarasota, 5731 Bee Ridge 4 Ny, Thorhas ¥, Walsh II, Esquire Robert Meade, CEO Doctors Hospital of Sarasota 5731 Bee Ridge Road Sarasota, FL 34239 -S. Mail Thomas J. Walsh, II, Esquire Agency for Health Care Admin. 525 Mirror Lake Drive, 330G St. Petersburg, Florida 33701 (Interoffice) COMPLETE THIS SECTi@aL ON DELIVERY A Signature x = B. Received by ( Printad Name) & Complete items 1, 2, and 3, Also complete item 4 if Restricted Delivery is desired. @ Print your name and address on the reverse so that we can return the card to you. ™@ Attach this card to the back of the mailpiece, or on the front if space permits. 1. Article Addressed to: CT Co poration System Reg. [abe é Ane Te land Ra Plan tatron, FL D. is delivery address different from item Yes It YES, enter delivery address below: C1 No 3.. Service Type C1 Certified Mail 1) Express Mail j CO Registered © Return Receipt for Merchandise _ 7 33 at O Insured Mail = C.0.D. 4, Restricted Delivery? (Extra Fee) O Yes ACOTO 1343 2- 2. Article a ’ 2EO70 13433 (Trans ———————— EO It PS Form 3811, February 2004 Domestic Return Receipt Maeda ¢ tp o Gere se ego

Docket for Case No: 08-000726