Jan 16 2009 11:48 Jan 16 2009 11:47 P.O5 STATE OF FLORIDA | DEPARTMENT OF HEALTH , DEPARTMENT OF HEALTH, ! PETITIONER, : v. CASE NO. 2006-32570 ss KARL MATTHEW HAGEN, M.D, : xy sesponper s) a MINISTRAT MPLAL Petitioner, Department of Health, by and through undersigned counsel, files this Administrative Complaint before the Board of Medicine against Respondent, Karl Matthew Hagen, M.D., and in suppor 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 78524, 3. Suite 288, Ocoee, Florida 34761. Respondent’s address of record is 10000 West Colonia Drive, Jan 16 2009 11:49 Jan 16 2009 11:46 P. O06 4. Respondent is board certified in General Surgery. 5. On or about August 31, 2006, Respondent performed a laparotomy (the surgical opening of the abdomen), colostomy (the opening of some portion of the colon through the abdominal wall to ts outside surface) closure, and left Gophorectomy (excision of an ovary) on Patient G.K,, a seventy-six year old |female. | 6. Patient G.K. wag status post a sigmoid colostomy for perforated diverticulitis (inflammation| of the sac or pouches in the wall of the intestinal tract) prior to the procedure performed on or about August 31, 2006. : 7. There is no documentation in the surgical report on or about | August 31, 2006, or any other medical record that Respondent checked the integrity of the anastomosis (the surgical or pathological connection of two , tubular structures) prior to closing during the surgical procedure. | 8. On or about September 3, 2006, Patient G.K. began having favers, with a temperature ip to 101.5 degrees. | 9. On or about September 5, 2006, at approximately 1140 hours, Patient G.K. underwent a chest x-ray, which revealed bibasal infiltrates and 1 | left pleural effusion. Jan 16 2009 11:49 Jan 16 2009 11:48 P.O? 10. On or about September 7, 2006, at approximately 1049 hours, Patient G.K. underwent] another chest x-ray, which revealed pneumoperitoneum (condition in which air or gas is collected in the peritoneal cavity), with a moderate amount of free air in the diaphragm, and residual bibasilar hypoventilatory changes. 11. On or about September 7, 2006, at about 1939 hours, Patient G.K. underwent a CT scan of the abdomen, which revealed bilateral pleural effusions and areas of lower lobe pneumonia, extensive intraperitoneal ait, leading to suspicion of perforation, and multiple tiny globular foc of air in the anterior pelvis, leading to suspicion for abscess, | 12. On or about September 8, 2006, at approximately 1544 hours, Respondent performed a laparotomy, drainage of pelvic abscess, and sigmoid colostomy on Patient G.K. , 13, Respondent petformed the surgery at least seventeen hours after Patient G.K. underwerit the C.T. scan on or about September 7, 2006. 14. ‘The findings during the procedure revealed necrosis (death of areas of tissue or bone surrounded by healthy parts) of the portion of the anastomosis around the staple line closing the old colostomy stump, fecal | Jan 16 2009 11:49 Jan 16 2009 11:48 P.O8 contamination, and a largejabscess, which was treated with drainage of the abscess and sigmoid colostomy. 15. The surgical report of the September 8, 2006 procedure stated that an area of the colon, from the distal sigmoid colon to the anastomosis in the upper rectal line, was stapled off and discarded, : 16. Respondent’s handwritten surgical note states, however, that the only specimen removed was abscess fluid. 17, There is no doqumentation that the removed area of the colon . was sent to the pathology department. ! 18. On or about September 9, 2006, another physician performed a second look laparotomy on) Patient G.K., which revealed ischemic changes and a dusky appearance throughout the abdomen, including the omentum (a double fold of peritoneum attached to the stomach and connecting it with certain of the abdominal viscera), colon, and small bowel, | 19. Over the next two days, Patient G.K.’s condition deteriorated, with her going into rapid |atrial fibrillation (extremely rapid, incomplete contractions of the atria resulting in fine, rapid, regula, and uncoordinated moverients), developing a worsening septic picture, and multi-organ system failure. Jan 16 2009 11:49 Jan 16 2009 11:48 P.09 20. Onor about September 1i, 2006, Patient G.K.’s life support was withdrawn and she expired. 21. Section 458.33 1(1)(t), Florida Statutes (2006), subjects a doctor to discipline for committing medical malpractice as defined in Section 456.50, Section 456.50, Florida Statutes (2006), defines medical malpractice as the failure to practice medicine in accordance with the level of care, skill, and treatme care licensure, itt recognized in general. law related to health 22. Level. of care, skill, and treatment recognized in general law | related to health care licensure means the standard of care specified in Section 766.102. Section 766.102(1), Florida Statutes (2006), defines the standard of care to mean “ .., The prevailing professional standard of care for a given health care provider shall be that level of care, skill, and treatment which, in fight of all relevant surrounding circumstances, is recognized as acceptable and appropriate by reasonably prudent similar | heaith care providers...” 23. Respondent failed to meet the required standard of care in one or more of the following ways: Jan 16 2009 11:50 Jan 16 2009 11:49 P.10 a. By ang to document any test of the integrity of the anastom Patient G b. By failing hour dela c. By failing sis during the August 31, 2006 surgery of ‘Ke; or to document reasons for an, at least, seventeen y in returning Patient G.K. to surgery; or to send the specimen removed, as reported in the September 8, 2006 surgical note, of Patient G.k, for pathologic examination; or d. By discarding the specimen removed, as reported in the September 8, 2006 surgical note: or €. By failing to resect the area of necrosis, which was seen during the September 8, 2006 surgery of Patient G.K. 24, Based on the foregoing, Respondent has violated ‘Section 458.331(1)(t), Florida Statutes (2006), by failing to practice medicine within the standard of cate which would be recognized by a reasonably prudent medical professional under similar conditions and circumstances, WHEREFORE, Petitio ner 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, placement of Respondent on Probation, corrective action, refund of fees . ; | billed or collected, remedial education and/or any other relief that the Board deems appropriate. Jan 16 2009 11:50 Jan 16 2009 11:49 P.11 Oe fi f SIGNED this UZ ' day of Niche base ___, 2007, CRE rien : He led A i Elana J. Jones LZ | ‘Assistant General.Counsel | . DOH Prosecution Services Unit Fl Eb 4052 Bald Cypress Way, Bin C65 ENT cr HEALTH Tallahassee, FL 32399-3265 Florida Bar # 0078999 de Vehauot! 850.245.4640 ext. 8175 | Om 850.245.4681 FAX | Karl Matthew Hagen, M.D. CASE NO. 2006-32570 pcp: October 12, 2007 | PCP Members: Dr. Leon, Pr. Cline, + Mr. Beebe, Respondent has the nr accordance with Section represented by counsel or ot and argument, to call and ¢ _and subpoena duces tecu requested, Jan 16 2009 11:50 Jan 16 2009 11:49 P.12 OTICE OF RIGHTS ight to request a hearing to be conglucted in 20,569 and 120.57, Florida’ Statutes, to be er qualified representative, to present evidence oss-examine witnesses and: to have subpoena issued on his or her behalf if a hearing is NOTICE REGARDING ASSESSMENT OF COSTS Respondent is placed related to the investigation on notice that Petitioner has incufred costs 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 “mn include attorney hours and costs, discipline imposed. on the Respondent in addition to any other

Docket for Case No: 09-000246PL