STATE OF FLORIDA DEPARTMENT OF HEALTH DEPARTMENT OF HEALTH, PETITIONER, | v. CASE NO. 2009-12171 ANDREW ALEXANDER LAWRENCE, M.D., RESPONDENT. / . ADMINISTRATIVE COMPLAINT Petitioner, Department of Health, by and through undersigned counsel, files this Administrative Complaint before the Board of Medicine against Respondent, Andrew Alexander Lawrence, M.D., and in support thereof alleges: | i. 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 90031. J:\PSU\Medical\Bates Shirley\Lawrence 2009-12170\AC (t)(m).doc Filed August 8, 2012 2:52 PM Division of Administrative Hearings 3. Respondent's address of record is 3513 Seaboard Avenue, Midland, Texas 79707. 4. At all times material to this Complaint, Respondent was board certified by the American Board of Emergency Medicine. 5. On or about December 18, 2008, Patient T.P. presented to Respondent at the Lake City Medical Center emergency department with complaints of clamminess, dizziness, inability to stand, left head pain, left arm numbness, nausea and vomiting 6. Onor about December 18, 2008, Respondent did not document whether or not Patient T.P.’s onset of pain was gradual or sudden. 7. Onor about December 18, 2008, Respondent did not document - what level of pain Patient TP. was experiencing. | 8. On or about December ~ 18, 2008, Respondent failed to document a complete neurological exam. . 9. Onor about December 18, 2008, Respondent failed to perform an appropriate physical exam. . 10. On or about December 18, 2008, Respondent failed to. obtain a neurological consultation. J:\PSU\Medical\Bates Shirley\Lawrence 2009-12170\AC (t)(m).doc 2 11. On or about December 18, 2008, Respondent failed to admit Patient T.P. to the hospital. . 12. On or about December 18, 2008, Respondent failed. to adequately diagnose Patient T.P’s condition. | 13. On or about December 18, 2008, Respondent discharged — Patient T.P. with a diagnosis of dizziness and instructions for vomiting, headache, viral illness and chest pain. TP. was discharged in a wheelchair. 14. Onor about December 19, 2008, Patient T.P. presented to the emergency department at Shands Hospital in Gainesville, Florida with _complaints of dizziness and vomiting. 15. On or about December’ 19, 2008, a CT scan with contrast of Patient T.P’s head revealed dissection of the left vertebral artery. | 16. On or about December 19, 2008, Patient T.P. was diagnosed with an acute left cerebellar stroke. COUNT ONE 17. Petitioner realleges and incorporates paragraphs one (1) through sixteen (16) as if fully set forth herein. J:\PSU\Medical\Bates Shirley\Lawrence 2009-12170\AC (t)(m).doc 3 i8. Section 458.331(1)(t), Florida Statutes (2008), subjects a doctor to discipline for committing medical malpractice as defined in Section 456.50. Section 456.50, Florida Statutes (2008), defines medical malpractice as the failure to practice medicine in accordance with the level of care, skill, and treatment recognized in general law related to health care licensure. 19. 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 (2008), 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 light of all relevant surrounding circumstances, is | recognized.as acceptable and appropriate by reasonably prudent similar health care providers... .” | 20. Respondent failed to meet the prevailing standard of care in regard to patient T.P. in one or more of the following ways: | a. By failing to document whether or not Patient T.P.’s onset of pain was gradual or sudden; and/or J:\PSU\Medical\Bates Shirley\Lawrence 2009-12170\AC (t)(m).doc 4 2. b. By failing to document what ievel of pain Patient T.P. was experiencing; and/or c. By failing to document a complete neurological exam; and/or d. By failing to perform an appropriate physical exam; and/or e. By failing to obtain a neurological consultation; and/or f. By failing to admit Patient T.P. to the hospital; and/or g. By failing to adequately diagnose Patient T.P.’s condition. Based on the foregoing, Respondent has violated section 458.331(1)(t), Florida Statutes (2008), by committing medical malpractice. - 22. COUNT TWO | - Petitioner realleges and incorporates paragraphs one (1) through sixteen (16) as if fully set forth herein. 23. Section 458.331(1)(m), Florida Statutes (2008), sets forth grounds for disciplinary action by the Board of Medicine for failing to keep legible medical records that justify the course of treatment of the patient, including, but not limited to, patient histories; examination results; test J:\PSU\Medical\Bates Shirley\Lawrence 2009-12170\AC (t)(m).doc 5 results: records of drugs prescribed, dispensed, or administered; and reports of consultations and hospitalizations. 24. Respondent failed to maintain medical records that justify the course of treatment of Patient T.P. in one or more of the following ways: a. By failing to document an adequate patient history: and/or b. By failing to document whether or not Patient T.P.’s onset of pain was gradual or sudden; and/or c. By faiting to document what level of pain Patient T.P. was experiencing; and/or | d. | By failing to document a complete neurological exam. 25. Based on the foregoing, Respondent “violated Section 458.331(1)(m), Florida. Statutes (2008), by failing to keep legible medical records that justify the course of treatment of Patient T.P., including, but not limited to, patient histories; examination results; test results; records of drugs prescribed, dispensed, or administered; and reports of consultations and hospitalizations. , WHEREFORE, Petitioner respectfully requests that the Board of Medicine enter an order imposing one or more of the following penalties: J:\PSU\Medical\Bates Shirley\Lawrence 2009-12170\AC (t)(m).doc 6 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. SIGNED this 12" day of March, 2010. Ana M. Viamonte Ros, M.D., MPH State Surgeon General DEPARTMENT OF HEALTH EPUTY CLE CLERK: im paTE___ IIo fZoL0 SLB PCP: Ashkar, S. Rosenberg, Levine PCP Members: 3/12/2010 J:\PSU\Medical\Bates Shirley\Lawrence 2009-12170\AC (t)(m).doc Shirley |/ Bates Assistant General Counsel - DOH Prosecution Services Unit - 4052 Bald Cypress Way, Bin C-65 Tallahassee, FL 32399-3265 Florida Bar # 946311 (850) 245-4640, Ext. 8244 (850) 245-4681 FAX

Docket for Case No: 12-002630PL