STATE OF FLORIDA DEPARTMENT OF HEALTH DEPARTMENT OF HEALTH, Petitioner, Case No, 2011-06682 Vv. EILEEN MARIE RIORDAN, L.P.N., Respondent. . DMINI E INT - COMES NOW, Petitioner, Department of Health, by and through Its undersigned counsel, and files this Administrative Complaint before the Board of Nursing against Respondent, Eileen Marie Riordan, L.P.N., and in support thereof alleges: oe 1. Petitioner is the state department charged with regulating the practice of nursing pursuant to Section 20.43, Florida Statutes; Chapter 456, Florida Statutes; and Chapter 464, Florida Statutes. 2. At all times material to this Complaint, Respondent: was a.” licensed practical nurse (L.P.N.) within the state of Florida, having been issued license number PN 659991. Filed December 9, 2011 3:47 PM Division of Administrative Hearings 3. Respondent's address of record is 3313 Creekridge Rd, Brancion, Florida 33511.. . 4. From on or about August 1, 2008, through on or about August 3, 2008, Tampa General Hospital admitted Respondent under the Baker Act: the law which provides the basis for involuntary examinations of adult persons in Florida who meet specific criteria. 5. On or about August 3, 2008, Respondent voluntarily admitted herself for treatment at St. Joseph’s Hospital, located in Tampa, Florida. 6. Upon Respondent's discharge from St. Joseph's Hospltal on or about August 6, 2008, Respondent's treating physician at the hospital documented the following diagnoses of Respondent: major depressive disorder (severe), general anxiety disorder, history of anorexia nervosa, personality disorder not otherwise specified (NOS), and a Global Assessment of Functioning (GAF).score of 35/65. 7. NOS Is used as a broad-based diagnostic category. The NOS diagnosis indicates that the patient's problems fall into a particular family of disorders (i.e. depressive disorders, anxiety disorders, etc.) but there is not enough information at the time of diagnosis to better specify the type of DOH v. Elleen Marie Riordan, L.P.N. 2 Case No, 2011-06682 J:\PSU\EAU\C, Schell\AC\Nursing\Riordan, Elleen LPN (j after oce).doc disorder or the patient does not meet the criteria of any specific disorder within that category. 8. The Global Assessment of Function (GAF) Test is a rating tool used by mental health professionals. The numeric scale (0-100) is used to subjectively rate the social, occupational and psychological functioning of adults. The first number represents current level of functioning and the second number represents the highest level of functioning in the preceding year. 9. An individual with a GAF score of 35 exhibits some impairment In reality testing or communication (speech is at times illogical, obscure or irrelevant) or exhibits major impairment In several areas such as work or school, familly relations, judgment, thinking or mood. 10. From on or about September 3, 2008, through October 2, 2008, Fairwinds Treatment Center provided in-patient treatment services to Respondent for major depression (severe, recurrent) with suicidal ideation and risk, dysthymia, post-traumatic stress disorder, and anorexia nervosa. 11. Upon release, Fairwinds Treatment Center recommended that Respondent engage in out-patient treatment with her regular psychiatrist, Pamela Powers, M.D. (Dr Powers). DOH v. Elleen Marie Riordan, L.P.N. 3 Case No. 2011-06682 J:\PSU\EAU\C. Schell\AC\Nursing\Riordan, Elleen LPN (j after oce).doc 12. Dr. Powers has treated Respondent since approximately 1993. 13. According to Dr. Powers, Respondent has a long history of anorexia and a history of cutting her skin with sharp objects, the most recent incident being a few months ago when Respondent's father passed away. . 14. Dr. Powers’ current diagnoses of Respondent include major depression (severe, recurrent), eating disorder NOS (partial recovery from anorexia nervosa), and attention deficit disorder. .15. Dr Powers documented that Respondent’s current medications Include: hydrocodone/APAP, clonazepam, alprazolam and Flexeril. 16. Hydrocodone/APAP contains hydrocodone and acetaminophen, or Tylenol and is prescribed to treat pain. According to Section 893.03(3), Florida Statutes, hydrocodone, in the dosages found in hydrocodone/APAP is a Schedule II controlled substance that has a potential for abuse fess than the substances in Schedules I and IT and has a currently accepted medical use in treatment in the United States. Abuse of the substance may lead to moderate or. low physical dependence or high psychological dependence. DOH v. Elleen Marie Riordan, L.P.N. 4 Case No. 2011-06682 J:\PSU\BAU\C. Schell\AC\Nursing\Riordan, Elleen LPN (j after oce).doc 17. Clonazepam is a benzodiazepine commonly prescribed to treat anxiety. According to Section 893.03(4), Florida Statutes, clonazepam is a Schedule IV controlled substance that has a low potential for abuse relative to the substances in Schedule III and has a currently accepted medical use in treatment in the United States. Abuse of clonazepam may lead to limited physical or psychological dependence relative to the substances in Schedule ITI. 18. Alprazolam Is a benzodiazepine prescribed to treat anxiety and is sold under. the trade name Xanax. According to Section 893.03(4), Florida Statutes, alprazolam is a Schedule IV controlled substance that has a low potential for abuse relative to the substances in Schedule ITI and has a currently accepted medical use in treatment in the United States. Abuse of alprazolam may lead to limited physical or psychological dependence relative to the substances In Schedule IIT. 19. Flexeril is a muscle relaxant that contains cyclobenzaprine. Flexeril is not currently a schedule defined drug under Chapter 893, Florida Statutes. DOH v. Elleen Marie Riordan, L.P.N, 5 Case No, 2011-06682 J:\PSU\EAU\C. Schell\AC\Nursing\Riordan, Elleen LPN (j after oce).doc 20. Dr Powers opined that in the future, Respondent may be capable of practicing nursing on a part-time basis in a low-stress environment. 21. On or about June 15, 2011, the Department ordered Respondent to submit to a mental and physical examination to determine her ability to practice nursing with reasonable skill and safety pursuant to the authority granted in Section 464.018(1)(j), Florida Statutes. 22. On or about July 22, 2011, Respondent submitted to a mental and physical examination conducted by Emily E. Lazarou, M.D., a specialist In forensic psychiatry. 23. Dr Lazarou documented that Respondent was confused and gave inconsistent statements throughout the evaluation. Dr Lazarou observed that Ms Riordan exhibited bizarre behavior, poor memory and obvious cognitive impairment. Respondent reported that her current medications Include Xanax, clonazepam, fluoxetine, trazodone, cyclobenzaprine, atenolol and oxycodone/APAP. 24. Fluoxetine is a selective serotonin reuptake inhibitor (SSRI) antidepressant commonly used for the treatment of | major depressive disorder, bulimia nervosa, obsessive-compulsive disorder, panic disorder, DOH v, Elleen Marle Riordan, L.P.N, 6 Case No, 2011-06682 J:\PSU\EAU\C, Schell\AC\Nursing\Riordan, Elleen LPN (j after oce).dac and premenstrual dysphoric disorder (PMDD). Fluoxetine is a legend drug, but not a controlled substance. 25. Trazodone is an antidepressant medication commonly used for the treatment of depression, anxiety disorders and chronic pain. Trazodone is a legend drug, but not a controlled substance. 26. Atenolol is a beta-blocker commonly used for the treatment of chest pain and high blood pressure, Atenolol is a legend drug, but not a controlled substance. 27. .Oxycodone/APAP contains oxycodone and acetaminophen, or Tylenol. According to Section 893.03(2), Florida Statutes, oxycodone is a Schedule II controlled substance that has a high potential for abuse and has a currently accepted but severely restricted medical use in treatment in the United States, Abuse of oxycodone may lead to severe psychological or physical dependence. 28. As part of the evaluation, Respondent submitted to a salivary toxicology screen. 29. Respondent tested positive for amphetamines. 30. Dr Lazarou diagnosed Respondent with opioid dependence, sedative hypnotic dependence with physiologic dependence, rule out (R/O) DOH v. Elleen Marle Riordan, L.P.N. q Case No. 2011-06682 JAPSU\EAU\C. Schell\AC\Nursing\Riordan, Elleen LPN (j after oce).doc amphetamine abuse verses dependence, anorexia nervosa, pain disorder with psychological factors, general medical condition (fibromyalgia), cognitive disorder NOS, mood disorder NOS, borderline personality disorder and a GAF of 50 (indicative of serious symptoms or a serious impairment in social or occupational functioning). 31. The diagnosis of rule’ out (R/O) substance abuse verses substance dependence indicates there are signs and/or symptoms of substance abuse and dependence but further evaluation is necessary to determine which diagnosis applies. 32. Dr. Lazarou opined that Respondent has poor problem solving abilities, poor judgment, poor decision making skills and an inability to cope with stressful situations. 33. Dr Lazarou opined that Respondent is unable to practice nursing with reasonable skill and safety to patients due to her opioid dependence, sedative .hypnotic dependence, amphetamine use, anorexia nervosa, fibromyalgia and/or borderline personality disorder. 34. Dr. Lazarou recommended. that Respondent enter Inpatient treatment for detoxification, utilize non-narcotic pain. management DOH v. Elleen Marie Riordan, L.P.N. 8 Case No. 2011-06682 J:\PSU\EAUAC. Schell\AC\Nursing\Riordan, Elleen LPN ( after oce).doc provisions, engage in psychiatric treatment and participate In the Intervention Project for Nurses (IPN). 35. IPN is the impaired practitioner program for the Board of Nursing pursuant to Section 456.076, Florida Statutes. IPN is a program that monitors the evaluation, care and treatment of impaired nurses. IPN oversees random drug screens and provides for the exchange of information between treatment providers, evaluators and the Department for the protection of the public. 36. Respondent is not currently. enrolled in IPN, 37. Licensed practical nurses are required to assess the condition of their patients and make complex decisions regarding patient care. Mental fitness and emotional stability are essential traits that a licensed practical nurse must possess in order to competently practice nursing. 38. Section 464.018(1)(j), Florida Statutes (2011), provides that being unable to practice nursing with reasonable skill and safety to patients by reason of illness or use of alcohol, drugs, narcotics, or chemicals or any other type of material or.as a result of any mental or physical condition constitutes grounds for discipline of a licensee by the Board of Nursing. DOH v. Eileen Marie Riordan, L.P.N. 9 Case No. 2011-06682 J:\PSU\EAU\C. Schell\AC\Nursing\Riordan, Elleen LPN (j after ace).doc 39, As set forth above, Respondent is unable to practice nursing with reasonable skill and safety to patients due to her opioid dependence, sedative hypnotic dependence, amphetamine use, anorexia nervosa, fibromyalgia and/or borderline personality disorder. 40. Based on the foregoing, Respondent violated Section 464.018(1)(j), Florida Statutes (2011), by being unable to practice nursing with reasonable skill and safety to patients by reason of illness or use of alcohol, drugs, narcotics, or chemicals or any other type of material or as a result of any mental or physical condition. WHEREFORE, the Petitioner respectfully requests that the Board of Nursing 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, refund of fees billed or collected, remedial education and/or any other relief that the Board deems appropriate. DOH vy, Elleen Marte Riordan, L.P.N. 10 Case No. 2011-06682 E\PSU\BAU\C. Schell\AC\Nursing\Riordan, Elleen LPN (j after oce).doc aaa! SIGNED this 2/0 day of Av gust , 2011. H. Frank Farmer, Jr., MD, PhD, FACP State Surgeon General Carla A. Schell Assistant General Counsel DOH Prosecution Services Unit 4052 Bald Cypress Way, Bin C-65 Tallahassee, Florida 32399-3265 Florida Bar Number 0042155 (850) 245 ~ 4640 Telephone (850) 245 — 4683 Facsimile anent cent oe? cate ook cert Me Oe pave PCP; 8/26/11 PCP Members: C. Home & S. Bowen {cs DOH v. Elleen Marie Riordan, L.P.N, Case No. 2011-06682 J:\PSU\EAU\C. Schell\AC\Nursing\Riordan, Eileen LPN Gj after oce).doc ii 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. DOH v. Elleen Marie Riordan, L.P.N. 12 Case No. 2014-06682 : JPSU\EAUAC. Schell\AC\Nursing\Riordan, Elleen LPN (j after oce).doc

Docket for Case No: 11-006251PL