/ft..v

STATE OF FLORIDA

DEPARTMENT OF HEALTH

DEPARTM NT OF HEALTH,

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Petitioner,

v. CASE NO. 2009w06520

ALBERT A TONIO TITUS, M.D,,

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RespPndent.

ADMINISTRATIVE COMPLAINT

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Petitipner,. Depa.rtment of Health, by and through its undersigned

counsel flh s this Administrative Complaint before the ;Board of Medicine

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against R$ ponden1 t Albert Antonio Titus, M.D.f and in support thereof

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alleges:

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1. I Petitioner i the state department charged with regulating the

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   practice of: medicine pursuant to Section 20.43 and Chapters 456 and

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   Chapter 45 , Florida Statutes.

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2. 1At all times material to this Compla'int, Respondent· was a

licensed p ysician within· the State of Florida, having been issued license

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number MS 80817.

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3, · iRespondent's address of record is 8340 Collier Blvd., Ste, 203,

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Naples, FL $4114.

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1. IRespondent is not board certified in General Surgery,

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2. !An inguinal hernia, the most common surgical problem of

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   childhood, bccurs when during fetal development, a sac surrounding an

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   infant's normally descending sexual organs (for boys, the testicles into the

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   scrotum) d es not close as tightly as it should, allowing a portion of the

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   intestine toi bulge through the sac•s channel-like opening:. If the sac is left

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   open, a. loqp of bowel or other organ may become trapped, also called

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   1 incarcerate or strangulated. Once stuck, the organ that comes through

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   this very srhall opening can swell and compress the blood supply that is

   
   

   pulled alon9 with it. Without adequate blood supply, the organ stuck in the

   
   

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   hernia sac tjr testis can be damaged or even ischemic and/or gangrenous.

   
   

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3. Inguinal hernia repair is a procedure wherein a surgeon

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   removes afli or part of the sac that comes through the, inguinal ring and

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   closes the opening of the hernia sac, so that the hernia cannot return.

4. bydrocele is a condition wherein fluid collects in a male i.nfant's

   scrotum du to the same inadequate closure. of the sac from the abdominal

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   cavity. i

   
   

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5. Hydrocelectomy is a surgical procedure to remove the collected

   fluid in the membrane surrounding the testes.

   
   

6. On or about February 9, 2009, Respondent performed a right

   
   

   inguinal heirnia repair on Patient C.P., a nineteen (19) r,,onth old infant at

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   Physicians egional Medical Center in Naples, Florida.

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7. \Respondent's.pre-operative evaluation suggests nothing other

   than a roytine right inguinal hernia repair, which does not involve the

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   removal of testis.

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8. iRespondenes pre-operative notes do not mention or describe

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   Patient C.P. testes and do not indicate a normal genitalia.

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9. [Respondent's intra-operative findings suggest . a relatively

   
   

   routii'le hJrnia, with • associated hydrocele without. any

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   circumstantjes that would justify the removal of the right testis.

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   extenuating

   
   

10. !However, the post-operative surgical pathology report reflected

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    the remova of a normal testis, along with the epididymis, vas ·deferens,

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    and fragrr,ent of hydrocele cyst.

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11. Respondent had inadvertently removed Patient C.P,'s right testis

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    during the urgical procedure.

    
    

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12. The remO\ial of a testis during a hernia· repair, without

    
    

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    extenuating circumstances, ls below the applicable standard of care.

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13. 1 Respondent's records do not reflect or document adequ te pre-

    operative ¢,r intra-operative evaluations indentifying the location Patient C.P.'s right testis.

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14. !Respondent did not obtain consent from Patient C.P.'s parents

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    for remova of C.P.'s right testis.

    
    

    COUNT I

15. \Petitioner realleges and inco porates paragraphs one (1)

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    through se enteen (17).as if fully set forth herein.

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16. Section 458.331(1)(m), Florida Statutes (2009), provides

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    that failing to keep legible, as defined by department rule in consultation

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    with the bo rd, medical records that identify the licensed physician or the

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    physician e ender and supervising physician by name ana professional title

    
    

    who is or arie responsibl for rendering, ordering, supervising, or billing for

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    each diagn stic or treatment procedure and that justify the course of

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    treatment qr!

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    the patient, including, but not limited to,: patient histo ies;.

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    examination\ results; test results; records of drugs prescribed, dispensed, or

    
    

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    administer d; an·d reports of consultations and hospitalzi ations1 constitutes

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    grounds foM discipllnary action by the Board of Medicine..

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17. !Respondent failed to keep legible medicat records justifying the

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    course of t atment in that Respondent failed to document one or more of

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    the followin :

    
    

    The presence or absence, or any description whatsoever, either pre-operatively or intra-operatively, of Patient C.P.'s testes; ·

    The existence pre-operatively and or intra-operatively, of Patient C.P.'s right testis, and/or;

    
    

    A justification for removing Patient C.P.'s right testis.

    
    

    
    

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18. ased on the foregoing, Respondent has violated Section

    458.331(1)( ), Florida Statutes (2009), by failing to keep medical records

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    which justi the course of his treatment of Patient C.P.

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    ' COUNT II

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19. etitioner realleges and incorporates paragraphs · one (1)

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    through sev nteen (17) as if fully set forth herein.

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20. fection 458.331(1)(p), Flori9a Statutes (2009), provides

    that perforrtjing professional services which ha.ve not been duly authorized by the pati nt or client, or his or her legal representative, except as

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    provided in/ s, 743.064, s.

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    766.103, or s. 768.13, constitutes grounds for

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    disciplinary ction by the Board of Medicine.

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21. !Respondent performed a surgical removal of:Patient C.P.'s right

testis withojut the consent of .Patient C.P.'s parents or legal representative

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which was. tlso not provided for under s. 743.064, s. 766.103, ors. 768.13

Florida Stat tes.

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, 25. 1Based on the foregoing, Respondent has violated Section

458,331(1) p), Florida Statutes (2009), by performing pr,ofessional services

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on Patient .P. which were not authorized by the patient's parents or legal

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representa,ve,

COUNT III  

1. /Petitioner realleges and incorporates paragraphs one (1)

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   through se enteen (17) as if fully set forth herein.

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2. jSection 456.072(1)(bb), Florida Statutes (2009), subjects a

   licensee t9!

   
   

   discipline for performing or attempting to perform h alth care

   
   

   services oni the wrong patient, a wrong-site procedure, a wrong procedure,

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   or an unau horized procedure, or a procedure that is medically unnecessary

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   or otherwis unrelated. to the patient's diagnosis or medical condition.

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3. I Respondent performed a wrong procedure, an unauthorized

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   procedure iand or a procedure that is medically unnec ssary or otherwise

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   unrelated jto the patient1s diagnosis or medical condition· wh.en he

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   inadverteni tly removed' right ingui al repair.

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   C.P.'s right testis during the p.erformance of the

4. Based on the foregoing, Respondent has violated Section

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456 072(1).(bb), Florida Statutes (2009), by performing or attempting to

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perform h alth care services on the wrong patient, a wrong-site procequre,

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a wrong pfocedure, or an unauthorized procedure, or a procedure that is

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medically unnecessary or otherwise unrelated to the patient's diagnosis or

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medical cordition.

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WH REFORE, Petitioner respectfully requests that the Board of

Medicine erter an order imposing one or more of the following. penalties:

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restriction pf practice, :·imposition of an administrative fine, issuance of a

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reprimand,i placement of the Respondent on probationi corrective action,

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refund of rees billed ·or collected, remedial educati·on and/or any other

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relief that he Board deems appropriate.

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Ana M. Viamonte Ros, M.D., M.P.H.

rt A. Milne

State S r n General'

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FILE.J?

DEPAR.TMENT F HEALTH

DEPUTY CLERK

CLERK d ·

DATE /(-/-/'0!:

PCP Date: 4c..../r r:2-..9, .fU){.C.

PCP Members: £.v.. .(y:: u

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A istant General Cou sel

DOH Prosecution Services Unit 4052 Bald Cypress Way, Bin C-65 Tallahassee, FL 32399.;3265

Florida Bar# 622338

(850) 245-4640

(850) 245-4681 FAX

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NO'fICE OF RIGHTS

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:Respqndiel!'flt has the right to request a ;hearing to be conductid I in accordance with Section 120.569 and 120,57, Florida St•tute,, to be represented by counsel or:other qualified representat:ive,. to pr sent evidence and argument, to call and

cross-exantine witne$ses and to have subpoena and subpoena duces t ufTI issued olil his or her behalf if a hearing is requested.

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OTICE RE ARDING ASSESSMENT OF C()STS

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Respdndent is placed on notice that Petitioner: has inQurred

costs relattd· to the 1;1vestigati0n and prosecution: of this.matter.

Pursuant t Section ,s&.072(4), Florida Statutes, the Board shall assess cos related :to the investigation and prct$9Cution: of a disciplina'i matter, Vlhich may include attorney hpurs and costs,

on the R.es ondent in· addition to any other discipline imposede

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Docket for Case No: 12-003654PL