STATE OF FLORIDA DEPARTMENT OF HEALTH DEPARTMENT OF HEALTH, | PETITIONER, Vv. | CASE NO. 2005-67861 AHMAD M. HAMZAH, M.D., RESPONDENT. a | | | ADMINISTRATIV NT COMES NOW, Petitioner, Department of Health, by and through its undersigned counsel, and files this Administrative Complaint before the Board of Medicine against Respondent, Ahmad M. Hamzah, 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 ME 42726, 90 ‘d pr eol BO0e éb If oP: TT 800¢ 4T [Nc 33647, (48) year _ Respondent is board certified in vascular surgery. On or about October 5, 2005, Patient P.B., a then fo | Respondent's address of record is P.O. Box 48793 Tampa, FL -eight ald woman with a history of diabetes mellitus and hypertension and a family history significant for coronary events, was admitted to Brandon Regional Hospital in Brandon, FL for treatrnent of a sliding hiatal hernia. 6. | A hiatal hernia occurs when a portion of the upper part of the stomach moves into the thorax through a tear or weakness |in the | diaphragm. 7, laproscopic Nissen fundoplication to address Patient P.B’s hernia. On or about October 5, 2005, Respondent performed In this procedure, the upper part of the stomach (fundus) is wrapped around the inferior part of the esophagus, preventing the sliding of the fundus t rough the comptomised portion of the diaphragm. That the procedu performed small holes rather than a large, open incision. é0‘d was laproscopically means instruments were introduced tl rough nm pr eol BO0e éb If oP: TT 800¢ 4T [Nc * Dt : © ® 8. | Prior to performing the aforementioned procedure, Respondent did not refer Patient P.B. to a cardiac specialist for pre-operative| cardiac clearance including but not limited to a stress test. Stress tests évaluate arterial blood flow to the heart muscle during exercise as compared to while at rest | . 9, | In exchange for appointment to the staff of Brandon Regional Hospital, Respondent agreed to be bound terms and conditions set out in an appointment agreement with the hospital, as well as the hdspital’s bylaws, rules and regulations, ‘One of these rules or conditions was that Respondent not perform surgical procedures for which he had ndt been granted surgical privileges. 10. On or about October 5, 2005, what surgical privileges Respondent had at Brandon Regional Hospital did not authorize him to perform laproscopic hiatal hernia repair. 11, On or about October 5, 2005, Respondent ordered a post- operative consult and transfer of Patient P.B.’s post-operative care to Pablo Dubon, M.D. 12. Dr. Dubon is a specialist in internal medicine, not a vascular or. thoracic surgeon, like Respondent. 80 ‘d pr eol BO0e éb If 2eitT 800¢ 4T [nc ®@ ® 13. Responsibility for Patient PBs post-operative care was then transferred to Rose Ann Laurance, M.D., who is also an intern st, and Rashid Saba, an osteopath. 14. While Patient P.B. progressed well in the immediat post- operative period, in the late evening hours of October 5, 2005, sh began to experiance complications. She began to suffer from hypotension (low blood pressure), acidosis (an abnormal increase in the acidity of the body's fluids), abnormal arterial blood gases (ABGs), chest pain and difficulty breathing. 15. | Respondent, who had ieft the hospital after PB.’s cafe was transferred to internists, was notified of Patient PBs complications at approximately 12:30 a.m. on or about October 6, 2005. 16. “Respondent approved’ an immediate CT scan (computerized imaging) of P.B.'S abdomen, pelvis and chest and consultation with a pulmonologist.concerning_P.B’'s.ABGs. .. a 17, ‘The CT scan was not completed and the results not relayed to _—Dr...Saba._untilapproximately_5:00_a.m.on. October 62005, They| were then immediately relayed to Respondent, who ordered P.B. transferred to is ; . the surgical intensive care unit. 60 ‘d . Sheol 8008 2b IP 2eitT 800¢ 4T [nc 18. 2 The aforementioned CT scan revealed that Patient PIB. was suffering from a variety of pulmonary cornplications, including a left) pleural effusion (excess fluid’ in the cavity that surrounds the lungs) and/a right pneumothorax (collapsed lung). 19. Respondent arrived at Patient P.B.’s bedside at approxjmately 6:00 am.lon October 6, 2005. He ordered two units packed red blood cells (PRBCs) and placed a tube in the right side of P.B.’s chest to drain excess fluid from her pleural cavity. 20. | Between 6:30 and 7:40 a.m., Respondent ordered more|PRBCs and placed a left-side chest tube and a central line (a catheter placed in a large vein to facilitate introduction of fluids). 21. “At approximately 7:40 am. on or about October 6,|2005, - Patient “PB. was transferred- to the operating room for expldratory laparotomy (incision into the abdomen), 22. ‘During the aforementioned laparotomy, Respondent observed bleeding coming from P.B.’s-liver as well as perforation of the fundus bf her stomach. 23. As Patient P.B’s abdomen was being closed she beg in to experience acute hypotension and bradycardia (slowing of the heart rate). Ol‘d Sheol 8008 2b IP 2h:TT 8002 4T Inf CPR was implanted output through a computer-controlied balloon placad in the heart). 24. 1:05 p.m. | ; experienced cardiac arrest. Unsuccessful efforts to resuscitat ®} @ ‘initiated. Raspondant consultad a cardiac surgeon, who an intra-aortic balloon oump (a device that increasas tardiac Patient P.B. was transferred to intensive care at approximately on October 6, 2005. Approximately ten minutes later she again and stabilize her continued until approximately 2:20 p.m. the same day). when she was pronounced dead. 25. through twenty-four (24), as if fully set forth herein, 26. failing to” perform’ any ‘statutory or légal Obligation placed upon’ a ‘i | physician ig grounds for discipline by the Board of Medicine. legal obligation when he- violated his: appointment agreement with | --the—bylaws;—tules and—regulations- of --.Brandon Regional Hospi COUNT ONE (1) Petitioner realleges and incorporates paragraphs on Section. 458.331(1)(g), Florida Statutes (2005), provides that -On-or about October 5, 2005, Respondent failed to perform a - and | by performing.a laproscopic Nissen repair on Patient P.B. for which he did not have surgical privileges. Lk *d Sheol 8008 2b IP 2eitT 800¢ 4T [nc 28, 458,331(1 legal obligation. 29, ® e ‘Based on the foregoing, Respondent has violated (9), Florida Statutes (2005), by failing to perform a statu ory or | | COUNT TWO ‘Section 458.331(1)(t), Florida Statutes (2005), provides that committing medical malpractice constitutes grounds for disciplinary jaction by the Board of Medicine. Medical Malpractice is defined in Section 456.50, Florida Statutes (2005), to mean the failure to practice medicine in accordance with the level of care, skill, and treatment recognized in general law related to health care licensure. For purposes of 4$8.331(1)(t), Florida Statutes (2005), the Board shall give great weight to the provisions-of Section 766.102, Florida Statutes, which provide that the “prevailing” professional standard of caré fora given health care” provider shall be that level of care, skill, and treatment which, in light of all relevant surrounding. circumstances, is reeognized-as.acceptable and appropriate by reasonably prudent similar-health care providers.” ~ 30. professional standard of care in one or more of the following ways: él‘d Respondent failed to practice medicine within the prevailing Sheol 8008 2b IP BRITT 800¢ 4T [1c ee. ® a. By not obtaining or documenting appropriate) cardiac clearance for Patiant P.B., including but not limited to a strass test, prior to her October 5, 2005 surgery. b. On or about October 5, 2005, by transferring] Patient P.B.'S post-operative care to an internist or internists rather than [another thoracic surgeon. 2006, by Gc At approximately 12:30 a.m. on or about October 6, delegating management of Patient P.B.’'s post-operative complications to an internist or internists instead of immediately raporting to the hog 31 498.331(1 by failing pital to take responsibility for her care, Based on the foregoing, Respondent has violated ection )(t), Florida Statutes (2005), by committing medical malpractice i to practice medicine in accofdance with the level of car , Skill, and treatment which, in light of all relevant surrounding circumsta ces, is recognized as.-acceptable.and. appropriate. by reasonably prudent similar ‘health care providers, ieee eed stump) er eee om a ee ns _WHEREFORE, the Petitioner respectfully requests that: the Board of Medicine enter an order imposing one or more of the following Bld gp eOl 8008 éb IP BRITT 800¢ 4T [1c penalties: restriction of practice, imposition of an administrative fine, issuance of a reprimand, placement of the Respondent on pr bation, corrective action, refund of fees billed or collected, remedial éducation and/or any other relief that the Board deems appropriate, SIGNED this $= day of © \ ene be | M. Rony Frangois, M.D., M.S.PH., |Ph.D. Secretary, Departrnent of Health FILE ~ cena ua Sid HEALTH “25. 9 Ron Freeman PLEAS AGAgsistant General Counsel | DATEL EM UIOLe “© nay_prosecution Services Unit 4052 Bald Cypress Way-Bin C-65 Tallahassee, Florida 32399-3265 | Fiorida Bar # 736171 (850) 245-4640 (850) 245-4681 fax “PCP: December 8, 2006 PCP Members: Ashkar, Bearison, & Beebe Plod SP eOl 8008 2b IP Br:TT 800¢ 4T Inf if | : i ‘ : 8 NOTICE GF 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 inqurred costs related to the investigation and prosecution of this Pursuant to Section 456.072(4), Florida Statutes, the Board shall assess casts 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. Gl ‘d SP eOl 8008 2b IP Br:TT 800¢ 4T Inf ** Transmit Cont. Report *™* Pid Jul 16 2008 fi4:55 [Fares her mee [ore [Toe Ponfwre | mh | fT Line isjbusy. SUCEGSETE Ta "SORIEYET TEL © 59-7) UIE & At sah 9 HRY aaoTALG Dopnoasos Tal bop i ge } fereaatedt gr orton: SRIINIPPE PAMEE oi OY) SiG SUGAGE A = a Sx Praows sooeeenmans ou Zpary oaia Tesodt emo) ae suOROHAsar eTqe pias arent phone mau 3) PREY PSUTRIS WHOL s9pn TenuePyETD Ff IH) RoAMEZLM Eo Aver fara ¥ iv] won 3H 30 UORUORUAeOP PezvotpneCy| “Aqua aaszauppa panied pea ie 6) paevep H — — sd somo Po mr] Uo sont : 379A054 Ssvatd C) ATASMaSVd (] LNSWWOO BEvaid C) MAIN YO; G INISWN fy 89b-Sh2(0S8) JeQUINN xb s.19puEg 19829-6002 ‘zu OrOb-Sbz (058)