Sep 22 2009 15:36 Sep 22 2009 15:32 P. O04 Nw STATE OF FLORIDA DEPARTMENT OF HEALTH DEPARTMENT OF HEALTH, i PETITIONER, | v. CASE NO. 2004-34104 MIGUEL A. BURGOS, M.D., RESPONDENT. ADMINISTRATIVE COMPLAINT COMES NOW, Petitioner, Department of Health, by and through its undersigned counsel, and files this Administrative Complaint before the Board of Medicine against Respondent, Miguel A. Burgos, 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 65264. | 3. Respondent's address of record is 5804 Lake Underhill Road, Orlando, Florida 32807. eo : JNPSU\Medical\ Matthew Casey\Cases\Status 70 cases\Burgos 04-341 04\ag (w):& (nn) delegpereie coc . Doty : : cols? {al Sep 22 2009 15:36 Sep 22 2009 15:32 P.O5 w lw 4. The Respondent is board certified in family practice by .the American Board of Family Practice. | 5. At all times pertinent to this cause, Respondent employed at least one licensed physician assistant (PA) while working at Integrated Health Center of America (IHCA). | 6, At all times pertinent to this cause, Respondent was the supervising physician of record for Harry Hindi, a prescribing PA 7 On or about October 1, 2004, Harry Hindi, PA, wrote a prescription for thirty (30) one- milligram Klonopin (Clonazepam) tablets cand for thirty (30) one-milligram Lorazepam tablets for Patient E.G, at THCA. 8. Klonopin (Clonazepam) is a Schedule IV controlled substance under Chapter 893, Florida Statutes. Klonopin Is a benzodiazepine used to treat seizure disorders and panic attacks. Benzodiazepines act on the brain . and central nervous system to produce a calming effect. A substance listed in Schedule IV has a potential for abuse less than the substances contained in Schedule III and has a currently accepted medical use in treatment in the United States. Abuse of a Schedule IV substance may lead to limited physical dependence and/or psychological dependence relative to drugs or’ other substances in Schedule IT. }: APSU\Medical\M atthew Casey\Cases\Status 70 casesBurpos 04-341 OA\ag i) & ) delegate | revised.doc Sep 22 2009 15:37 Sep 22 2009 15:32 P. O06 ad ww! 9, Lorazepam, an anti-anxiety medication, is 4 Schedule IV controlled substance under Chapter 893, Florida Statutes. Lorazepam is also a benzodiazepine. A substance listed in Schedule 1V has. potential for abuse less than the substances contained in Schedule in and has a currently accepted medical use in treatment in the United States, Abuse of a Schedule IV substance may lead to limited physical dependence and/or psychological dependence relative to drugs or other substances in Schedule IL , : 10. Rule 64B8-30.008 of the Florida. Administrative Code provides that: (1) Physician assistants approved to prescribe medicinal drugs under the provisions of section 458.347(4)(e) or 459,022(4)(e), Florida Statutes, are not authorized to prescribe the following medicinal drugs, in pure form or combination: Do, (a) Controlled substances, as defined in Chapter 893, F.S. (b) Antipsychotics. (c) General, spinal or epidural anesthetics. . -(d) Radiographic contrast materials. (e) Any parenteral preparation except insulin and epinephrine. Parenteral includes: intravenous, subcutaneous, intramuscular, and any route other than the alimentary canal: however, it does not include topical or mucosal application, Noone in this formulary prohibits a physician assistant from administering 4 parenteral. drug under the direction or supervision of the supervising physician. (2) A supervising physician may delegate to a prescribing physician assistant only such authorized medicinal drugs as are used in the supervising physician’s practice, not listed in subsection (1). 3 ; J:\PSU\Medical\Matthew Casey\Cases\Status 70 cases\Burgos 04-341 04\ac (w) & (nn), delegate-revised.doc t Sep 22 2009 15:37 Sep 22 2009 15:32 P.O? “ ww (3) Subject to the requirements of this subsection, Sections 458.347 and 459.022, F.S., and the rules enacted thereunder, drugs not appearing on this formulary may be delegated by a supervising physician to a prescribing physician assistant to prescribe. (4) Nothing herein prohibits a supervising physician) from delegating to a physician assistant the authority to order medicinal drugs for a hospitalized patient of the supervising physician, nor does anything herein prohibit 4 supervising physician from delegating to a physician assistant the administration of a medicinal drug under the direction and supervision of the physician. 11. Harry Hindi, PA, violated Rule 64B8-30.008 of the Florida Administrative Code, by writing prescriptions for Klonopin and Lorazepam for Patient E.G. on or about October 1, 2004, while the Respondent was his supervising physician of record. : 12. On or about January 5, 2005, the Respondent met ‘with investigators from the Department of Health and told them that he did not know his physician assistants could not prescribe controlled substances. The Respondent further indicated he thought his physician assistants could write and sign prescriptions for non-narcotics such as Xanax and Valium. COUNT ONE , 13. Petitioner realleges and incorporates paragraphs one (1) through twelve (12) as if fully set forth herein. 4 ‘JAPSU\MedicalMatthew Casey\Cases\Status 70 cases\Burgos 04-34104\ac (w) & (nn).delegate}reviged.doc j Sep 22 2009 15:37 Sep 22 2009 15:33 P. 08 ~ ww 14, Section 458. 331(1)(W), Florida Statutes (2003), provides that delegating professional vesponsibilities to a person when the licensee delegating such responsibilities knows of has reason to know that such person is not ‘qualified by training, experience, of licensure to perform them constitutes grounds for disciplinary action by the Board of Medicine. 15. Respondent improperly delegated professional responsibilities to his PA, Hindi, that were ‘outside Hindi’s scope permitted by law when Hindi inappropriately prescribed controlled substances even though it is expressly written in Rule 64B8-30.008 of the Florida Administrative Code that physician assistants shall not prescribe controlled substances. 16. Based on the foregoing, Respondent has violated section 458. 331(1)(w), Florida Statutes, (2003), by delegating professional responsibilities to a person when the licensee delegating such responsibilities knows or has reason to know that such person is not qualified by training, experience, or licensure to perform them. | COUNT TWO 17. Petitioner realleges and incorporates paragraphs one Q) through twelve (12) as if fully set forth herein. 18. Section 458.331(1)(nn), Florida Statutes, (2003), provides that violating any provision of this chapter or chapter 456, or any rules adopted 5 JAPSU\Medical\Matthew Casey\Cases\Status 70 cases\Burgos 04-34 104\ac (ww) & (nn) delega e-revised. doc Py Sep 22 2009 15:37 Sep 22 2009 15:93 P.09 ~~ weed pursuant thereto constitutes grounds for disciplinary action by the Board of Medicine. 19. Section 458.347(3), Florida Statutes (2003), provides that a supervising physician must be qualified in the medical areas in which the PA is to perform and shall be individually responsible and liable for the performance and the acts and omissions of the PA. : 20, Respondent's PA, Hindi, practiced outside his scope permitted by law when he inappropriately prescribed controlled substances even though it is expressly written in Rule 64B8- -30,008 of the Florida Administrative Code that physician assistants shall not prescribe controlled substances. : 21. The Respondent, as Hindi’s supervising physician, improperly and/or implicitly delegated to Hindi the prescribing of controlled substances “on or about October 1, 2004, in violation of Rule 64B8-30.008, FA.C. 22. Based on the foregoing, the Respondent has violated Section 458,.331(1)(nn), Florida Statutes, (2004), by violating any provision of this chapter or chapter 456, or any rules adopted pursuant thereto by being individually responsible for Hindi prescribing controlled substances and/or by improperly and/or implicitly delegating to Hindi the prescribing of 6 t J:\PSU\Medical\Matthew Casey\Cases\Status 70 cases\Burgos 04-34 104\da(w) & (nn) seeeutre ; 4 hous if Sep 22 2009 15:38 Sep 22 2009 15:93 PTO v w cantrolled substances an or about October 1, 2004, in viotation of Rule 64B8-30,008, FAC,. | WHEREFORE, Petiticner respectfully requests that the Board of Medicine enter an order impasing one or more of the following penalties: permanent revocation or suspension of Respondent's ficense, 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. SIGNED this_|74 day of Ortsber _, 2007. Ana M. Viameonte Ros, M.D., M.P. H. State Surgeon General fmatthew Casey Assistant Genera! Counsel DOH Prosecution Services Unit 4052 Bald Cypress Way, Bin C-65 | Tallahassee, FL 32399-3265 _ Florida Bar #0115220 850.245.4640 ext. 8173 - phone 850.245.4681 - fax MC/me PCP; October 12, 2007 PCP Members: Leon, Cline & Beebe 7 ' JAPSU\Medival\Matthew Casey\Casesliintus 76 cases\Hurgos 04-341 0d\ac (wy & (nn) Selegate-reviged. doc ae i Sep 22 2009 15:38 Sep 22 2009 15:93 P.11 ‘ee! . ead DOH vy. Miguel A. Burgos, M.D., Case #2004-34104 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 iis placed on notice that Petitioner has incurred costs related to the investigation and prosecution ofthis 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 routes costs, on the Respondent in addition to any other discipline imposed. i 8 JAPSU\Medical\Matthew Cagey\Cages\Status 70 cases\Burgos 04-34 104\n¢ (Ww) & (nn) sti ; Dodi { ag : co4G ‘

Docket for Case No: 09-005218PL