STATE OF FLORIDA DEPARTMENT OF HEALTH DEPARTMENT OF HEALTH, Petitioner, Vv. DOH CASE NO.: 2008-13434 JORGE O. WEKSLER, 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, Jorge O. Weksler, M.D., and in support thereof alleges: 1. Petitioner is the state agency 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 not board certified in Orthopaedic Surgery. 3. At all times material to this Complaint, Respondent was a licensed physician within the State of Florida, having been issued license number ME 55145. Filed November 14, 2012 12:53 PM Division of Administrative nearinds | | 4. At all times material to this Complaint, Respondent's address of record was 7315 Hudson Avenue, Hudson, Florida 34667-1158. 5. On or about August 25, 2005, Patient JLR, a 58+year-old female, presented to the Gulf Coast Orthopedic Center (“Gulf Coast”) at the above-mentioned address in Hudson, Florida, complaining of lower back pain and bilateral leg pain. 6. Open Patient JLR’s presentation to Gulf Coast, Mr. KC, advanced registered nurse practitioner associate at Gulf Coast, evaluated Patient JLR and offered an initial impression of lumbar spine pain with symptoms of radiculopathy, rule out lumbar disc disease and spinal stenosis. 7. KC set forth a treatment plan to have Patient JLR undergo an MRI scan and x-rays of the lumbar spine, a nerve conduction evaluation, and evaluation by a surgeon. 8. The Gulf Coast radiology MRI report dated August 25, 2005, revealed no disc bugle or significant central spinal stenosis and patent neural foramina at the L3-4 level; loss of disc hydration, disc bulge, spondylosis, bilateral facet arthroplasty, and bilateral foramina stenosis at the L4-5 level; and patent neural foramina at the L5-S1 level. 9. Neural foramina are spaces between the vertebrae where nerve roots exit the spinal canal. These spaces sometimes narrow (stenosis), causing irritation to the nerve. The term “patent” describes unobstructed neural foramina. 10. On or about August 29, 2005, Patient JLR presented to Respondent at Gulf Coast for an evaluation. At that time, Dr. AB reviewed the August 25, 2005, diagnostic images and diagnosed a laminectomy defect at L5-S1 foraminal narrowing at the L3-4, L4-5, and L5-S1 degenerative facet syndrome at the L4-5 and L5-Si scar tissue at L4-5 and L5-S1 and nerve impingement at the L3-4 and L4-5. 11. Dr AB set forth a course of treatment to have Patient JLR undergo diagnostic facet injections on the left L4-5 and L5-S1 assuming Patient JLR obtained relief, subsequently undergo bilateral L4-5 and L5-S1 microsurgical debridement of the facet joints with rhizolysis. 12. facet joints are the articulations or connections between the vertebrae in the spine that enable the bending or twisting movements of the spine, which may become inflamed secondary to injury or arthritis and cause pain and stiffness. Rhizolysis is a surgical procedure that utilizes radiofrequency to produce an irreversible destructive lesion of the medial branch nerve, which blocks the passage of painful messages from the affected facet joint to the rest of the central nervous system. 13. On or about September 14, 2005, Patient JLR presented to Dr. KG, Respondent's associate at Gulf Coast, for the diagnostic facet injections on the left L3-L4 4-5 and L5-S1. Dr. KG diagnosed bilateral facet joint syndrome at L3-4, L4-5 and L5-S1. 14. On or about September 15, 2005 Respondent's impression of JLR’s: August 25, 2005 X-ray was that of foraminal narrowing at L3/L4, L4/L5 and L5/S1, and his impression of her August 25, 2005 MRI was that the axial views indicated foraminal narrowing of 13/L4, L4/L5, L5/S1 and nerve impingement at L3/L4 and L4/L5. 15. On or about September 15, 2005, Patient JLR presented to Respondent at Gulf . Coast, and underwent bilateral microsurgical debridement with rhizolysis of the facet joints at the L3-4, L4-5, and L5-S1 levels, together with arthrotomy and thermocoagulation of the dorsal rami innervating the facet joints at the L3-4, L4-5, and L5-S1 levels. 16. Arthrotomy with thermocoagulation of the dorsal rami is the incision into the joint in order to congeal the tissues of the branches of the spinal nerves. COUNT ONE 17. Petitioner realleges and incorporates Paragraphs 1 through 16, as if fully set forth herein. 18. Section 458.331(1)(t), Florida Statutes (2005), subjects a physician to discipline for committing medical malpractice as defined in Section 456.50, Florida Statutes. Medical malpractice is defined in Section 456.50, Florida Statutes, as the failure to practice medicine in aacordance with the level of care, skill, and treatment recognized in general law related to health care licensure. For purposes of Section 458.331(1)(t), Florida Statutes (2005), the board shall give great weight to the provisions of Section 766.102, Florida Statutes (2005), which provide that 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. 19. Respondent failed to meet the prevailing standard of care in regard to Patient JLR in one or more of the following ways: a. Respondent inappropriately diagnosed bilateral facet joint syndrome based on the diagnostic facet injections on the left L3-L4 L4-5 and L5-S1 and the x-ray and MRI dated August 25, 2005; b. | Respondent inappropriately diagnosed bilateral facet joint syndrome at L3-L4 L4-5 and L5-Si when there had been no evaluation performed of the facet joints on the right involving facet injections at L3-L4 L4-5 and L5-S1. c. By performing microsurgical debridement with rhizolysis of the facet joints at the right L3-4, L4-5, and L5-S1i levels when respondent had not proven that the L3-4, L4-5 and L5 facet joints on the right-hand side were contributing to this patient's symptomatology. 20. Based on the foregoing, Respondent has violated Section 458.331(1)(t)1., Florida Statutes (2005), by committing medical malpractice. COUNT TWO 21. Petitioner realleges and incorporates Paragraphs 1 through 15, as if fully set forth herein. 22. Section 458.331(1)(m), Florida Statutes (2005), subjects a physician to discipline for failing to keep legible, as defined by department rule in consultation with the board, medical records that identify the licensed physician or the physician extender and supervising physician by name and professional title who is or are responsible for rendering, ordering, supervising, or billing for each diagnostic or treatment procedure and that justify the course of treatment of the patient, including, but not limited to, patient histories; examination results; test results; records of drugs prescribed, dispensed, or administered; and reports of consultations and hospitalizations. 23. Respondent failed to keep legible medical records of Patient JLR in one or more of the following ways: a. By failing to adequately justify the procedure performed on or about September 21, 2005. 24. Based on the foregoing, Respondent has violated Section 458.331(1)(m), Florida Statutes (2005), by failing to keep legible medical records medical records that identify the licensed physician or the physician extender and supervising physician by name and professional title who is or are responsible for rendering, ordering, supervising, or billing for each diagnostic or treatment procedure and that justify the course of treatment of the patient, 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, the Petitioner 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 the 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 14™ day of September, 2011. Florida Bar # 622338 DOH Prosecution Services Unit 4052 Bald Cypress Way-Bin C-65 Tallahassee, Florida 32399-3265 (850) 245-4640 Office DEPARTMENT OF HEALTH DEPUTY CLERK cLerK Angel Sanders (850) 245-4681 Facsimile DATE SEP 1 4 2011 PCP: September 14, 2011 PCP Members: Leon, Zachariah, Levine DOH vs. Jorge O. Weksler, M.D. DOH CASE NO.: 2008-13434 DOH vs. Jorge O. Weksler, M.D. DOH CASE NO.: 2008-13434 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.

Docket for Case No: 12-003661PL