STATE OF FLORIDA DEPARTMENT OF HEALTH DEPARTMENT OF HEALTH, PETITIONER, v. CASE NO, 2010-11362 HOSSEIN FARSAD, M.D., RESPONDENT. ADMINISTRATIVE COMPLAINT Petitioner, Department of Health, by and through its undersigned counsel, files this Complaint before the Board’ of Medicine against Respondent, Hossein Farsad, 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 98132, on or about March 14, 2007. 3. Respondent does not hold any certifications from specialty boards recognized by the Florida Board of Medicine. 4. Respondent's address of record is 1700 Kennedy Causeway, 1009, North Bay Village, Florida 33141. 5. During all times relevant to this complaint, Respondent was practicing at All States of Pain, L.L.C., Pain Management Clinic License Number 182, located at 1580 North West 2™ Avenue, Suite 9, Boca Raton, Florida 33432. 6. During all times relevant to this complaint, Respondent practiced medicine in the area of pain management. He was engaged in the treatment of pain by prescribing or dispensing controlled substance medications. 7. Respondent prescribed one or more of the controlled substance medications oxycodone, Roxicodone, Valium, Restoril, and Soma for the treatment of pain to patients F.B., R.B., M.H., E.M., A.M., M.M., D.P., S.R., C.T., and J.C., at All States of Pain, L.L.C. | 8. Oxycodone is a semi-synthetic opioid that is prescribed to treat pain. Oxycodone is commonly prescribed to treat pain. According to Section 893.03(2), Florida Statutes, oxycodone is a Schedule IT controlled DOH v. HOSSEIN FARSAD, M.D. Case Number 2010-11362 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. 9. Roxicodone is a brand name for oxycodone. Oxycodone is a semi-synthetic opioid that is prescribed to treat pain. 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. | 10. Valium is the brand name for diazepam and is prescribed to treat anxiety. Diazepam is a benzodiazepine. According to Section 893.03(4), Florida Statutes, diazepam is a Schedule IV controlled substance that has a low potential for abuse relative to the substances in Schedule II and has a currently accepted medical use in treatment in the United States. Abuse of diazepam may lead to limited physical or psychological dependence relative to the substances in Schedule HI. DOH v. HOSSEIN FARSAD, M.D. Case Number 2010-11362 11. Restoril is the brand name for temazepam and is prescribed to treat insomnia. Temazepam is a benzodiazepine. According to Section 893.03(4), Florida Statutes, temazepam 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 temazepam may lead to limited physical or psychological dependence relative to the substances in Schedule IIT. . 12. Soma is the brand name for carisoprodol, a muscle relaxant commonly prescribed to treat muscular pain. According to Section 893.03(4), Florida Statutes, carisoprodol 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 carisoprodol may lead to limited physical or psychological dependence relative to the substances in Schedule III. ' 13. At all times material to this complaint, the standard of care required that Respondent obtain complete medical histories, perform complete medical examinations, offer treatment modalities and medication alternatives to controlled substances, utilize risk mitigation strategies to prevent diversion of controlled substances, refer to specialists, and keep DOH v. HOSSEIN FARSAD, M.D. Case Number 2010-11362 legible medical records that justified the course of treatment of patients to whom the Respondent prescribed controlled substances. 14. Respondent breached the standard of care in his care and treatment of patients F.B., R.B., M.H., E.M., A.M., M.M., D.P., S.R., C.T., and J.C. by failing to obtain a complete medical histories, perform a complete medical examinations, offer treatment modalities and medication alternatives to controlled substances, utilize risk mitigation strategies to prevent diversion of controlled substances, refer to specialists, and/or keep legible medical records that justified their courses of treatment, and/or by prescribing inappropriate, excessive, and/or inappropriate combinations of controlled substances. Facts Specific to Patient F.B. 15. From on or about March 30, 2010, through on or about July 1, 2010, Respondent provided care and treatment to patient F.B., a forty-two year old male resident of Point Pleasant, West Virginia, for complaints of back, left hip, left leg, left foot, and right elbow pain. — 16. Patient F.B. presented a suspended driver's license for identification. DOH v. HOSSEIN FARSAD, M.D. Case Number 2010-11362 17. On or about March 30, 2010, patient F.B. indicated that he was not receiving current treatment for his condition. 18. On or about March 30, 2010, patient F.B. indicated that he had never been a patient at a pain management clinic. 19. On or about March 30, 2010, patient F.B. indicated that the current medication prescribed to him for treatment of pain was Percocet 5 mg. twice a day. 20. Percocet is the brand name for a drug that contains 5 mg. of oxycodone and 325 mg. of acetaminophen. Percocet is prescribed to treat pain. | Oxycodone is a semi-synthetic opioid. According to Section 893.03(2), Florida Statutes, oxycodone is a Schedule IL 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. Acetaminophen is a non-narcotic analgesic. 24. On or about March 30, 2010, the Respondent documented that the reason for patient F.B. receiving treatment at All States of Pain, L.L.C. was that patient F.B.’s previous physician would not prescribe opioids. DOH v. HOSSEIN FARSAD, M.D. Case Number 2010-11362 22. On or about March 30, 2010, patient F.B. tested. positive for benzodiazepines, marijuana, and oxycodone on an initial urine drug screen. 23. Respondent obtained reports of imaging and nerve conduction studies of patient F.B. performed in West Virginia. 24. The reports of imaging and nerve conduction studies of patient - F.B. performed in West Virginia identified F.B.’s previous physicians. 25. The Respondent did not obtain complete records from F.B.’s West Virginia physicians identified in the imaging and nerve conduction reports. 26. Patient F.B. was hypertensive during visits to the Respondent. | 27. Respondent did not obtain and document a sufficient medical history for patient F.B. 28. Respondent did not obtain and document adequate physical examinations of patient F.B. 29. Respondent did not refer patient F.B. to specialists for further evaluation. ' 30. Throughout the time of Respondent's care and treatment of patient F.B., Respondent did not sufficiently provide or recommend other treatment modalities to patient F.B. DOH v, HOSSEIN FARSAD, M.D. Case Number 2010-11362 31. Respondent prescribed controlled substances to patient F.B. as follows: [DATE |OXY- |ROXI- |ROXi- | RESTORIL] VALIUM | SOMA CODONE|CODONE|CODONE|15MG. |5MG. | 350 MG. | 30 MG. |30MG. | 15 MG. 3/30/10 | #120 #30 4/29/10 #150 #90___| #60 6/03/10 #180 #90 7/01/10 #180 | #60 #90__| Facts Specific to Patient R.B. 32, From on or about April 1, 2010, through on or about July 1, 2010, Respondent provided care and treatment to patient R.B., a forty- three year old male resident of Lapaz, Indiana, for complaints of neck and low back pain. 33. Onor About April 1, 2010, patient R.B. indicated that he was not receiving current treatment for his condition. 34. On or About April 1, 2010, patient R.B. indicated that the current medications prescribed to him for treatment of pain were “Rockys 30 mg.” six times a day; “Rockys 15 mg.” three times a day; and “Zanex 2 mg.” once a day. 35. Onor about April 1, 2010, the Respondent documented that patient R.B.’s previous clinic closed. DOH y. HOSSEIN FARSAD, M.D. Case Number 2010-11362 36. Onor about April 1, 2010, the Respondent documented that patient R.B. last took medication one week earlier. 37. On or About April 1, 2010, patient R.B. provided a urine specimen for drug screen. . 38. Onor About April 1, 2010, the urine drug screen test did not indicate any positive results. 39. On or About April 1, 2010, Respondent obtained a report of a lumbar spine MRI performed on January 27, 2010, which identified the physician that referred patient R.B. for the test. 40, Respondent did not obtain patient R.B.’s records from the physician that referred patient R.B. for the lumbar MRI performed on January 27, 2010. 41. Onor about April 29, 2010, Respondent obtained Kissimmee, Florida pharmacy records showing the name of a physician from whom patient R.B. had obtained prescriptions for controlled substances from on or about September 3, 2009, through on or about November 27, 2009. 42. Respondent did not obtain records from the physician from whom patient R.B. had obtained prescriptions for controlled substances DOH v. HOSSEIN FARSAD, M.D. Case Number 2010-11362 from on or about September 3, 2009, through on or about November 27, 2009. 43. Onor about June 3, 2010, patient R.B. provided a urine specimen for drug screen. 44. Onor about June 3, 2010, the urine drug screen test did not indicate any positive results. 45. Patient R.B. was hypertensive during visits to the Respondent. 46. Respondent did not obtain and document a sufficient medical history for patient R.B. 47. Respondent did not obtain and document adequate physical examinations of patient R.B. _ 48. Respondent did not refer patient R.B. to specialists for further evaluation. 49, Throughout the time of Respondent's care and treatment of patient R.B., Respondent did not sufficiently provide or recommend other treatment modalities to patient R.B. 50. Respondent prescribed controlled substances to patient R.B. as follows: DOH v, HOSSEIN FARSAD, M.D. Case Number 2010-11362 DATE ROXICODONE 30 MG. | RESTORIL 15 MG. 04/01/2010 #180 | #30 04/29/2010 #180 06/03/2010 #180 07/01/2010 #180 Facts Specific to Patient M.H. 51. From on or about April 29, 2010, through on or about July 22, 2010,Respondent provided care and treatment to patient M.H., a forty-one year old male resident of Point St. Lucie, Florida, for complaints of neck and back pain. . . 52. On or about April 29, 2010, patient M.H. indicated that the current medication prescribed to him for treatment of pain was Nucynta 75 mg. three times a day. _ 53. Nucynta is a brand name for tapentado!l. Tapentadol is an opioid and is prescribed to treat pain. Tapentadol is a Schedule II controlled substance under the Controlled Substances Act; however, it is not currently listed in Section 893.03 of the Florida Statutes. 54. On or about April 29, 2010, patient M.H. indicated that he was currently receiving treatment for his condition at “West Palm.” 55. Onor about April 29, 2010, patient M.H. indicated that surgery had been recommended. DOH v. HOSSEIN FARSAD, M.D. Case Number 2010-11362 ) 56. On or about April 29, 2010, patient M.H. tested positive for benzodiazepines on an initial urine drug screen. 57. Respondent obtained medical records of patient M.H from previous physicians for care provided from on or about January 25, 2010 through on or about April 12, 2010. 58. The medical records from previous physicians do not document that patient M.H. had been prescribed benzodiazepines. 59. The medical records from previous physicians identify other physicians from whom patient M.H. had received care. . 60. Respondent did not obtain records from the other physicians from whom patient M.H. had received care. 61. The medical records of patient M.H obtained from previous physicians for care provided on or about April 12, 2010, document that patient M.H. could not explain a urine drug test result positive for hydromorphone. 62. Hydromorphone is the generic for the brand Dilaudid. Hydromorphone is an opioid commonly prescribed to treat pain. According to Section 893.03(2), Florida Statutes, hydromorphone is a Schedule IT controlled substance that has a high potential for abuse and has a DOH v. HOSSEIN FARSAD, M.D. Case Number 2010-11362 currently accepted but severely restricted medical use in treatment in the United States. Abuse of hydromorphone may lead to severe psychological or physical dependence. 63. Patient M.H. was hypertensive during visits to the Respondent. | 64. Respondent did not obtain and document a sufficient medical history for patient M.H. 65. Respondent did not obtain and document adequate physical examinations of patient M.H. 66. Respondent did not refer patient M.H. to specialists for further evaluation. ’ 67. Throughout the time of Respondent’s care and treatment of patient M.H., Respondent did not sufficiently provide or recommend other treatment modalities to patient M.H. - 68. Respondent prescribed controlled substances to patient M.H. as follows: DATE OXYCODONE 30 MG. 04/29/2010 #120 05/27/2010 #120 06/24/2010 #120 07/22/2010 #120 DOH v. HOSSEIN FARSAD, M.D. Case Number 2010-11362 13 Facts Specific to Patient E.M. 69. From on or about April 29, 2010, through on or about May 27, 2010, Respondent provided care and treatment to patient E.M., a thirty-six year old male resident of Greenville, Tennessee, for complaints of low back, hip, and left femur pain. 70. On or about April 29, 2010, patient E.M. indicated that he was not receiving current treatment for his condition. 71. On or about April 29, 2010, patient E.M. indicated that he had never been a patient at a pain management clinic. 72. On or about April 29, 2010, patient E.M. indicated that the facility where he was previously treated went out of business. 73. On or about April 29, 2010, patient E.M. indicated that the current medications prescribed to him for treatment of pain were Roxicodone 30 mg. six times a day; Roxicodone 15 mg. four times a day; and Zanax 2 mg. twice a day. 74. On or about April 29, 2010, Respondent documented that patient E.M. last visited his previous provider two months earlier. DOH v. HOSSEIN FARSAD, M.D. Case Number 2010-11362 14 75. On or about April 29, 2010, patient E.M. tested positive for opiates on an initial urine drug screen. 76. Respondent did not obtain and document a sufficient medical history for patient E.M. 77. Respondent did not obtain and document adequate. physical examinations of patient E.M. 78. Respondent did not refer patient E.M. to specialists for further evaluation. ' 79, Throughout the time of Respondent's care and treatment of patient E.M., Respondent did not sufficiently provide or recommend other treatment modalities to patient E.M. - 80. Respondent prescribed controlled substances to patient E.M. as follows: [ DATE OXYCODONE 30 MG. RESTORIL 30 MG. 04/29/2010 | #120 | 05/27/2010 | #120 #15 Facts Specific to Patient A.M. 81. On or about April 29, 2010, Respondent provided care and treatment to patient A.M., a thirty-one year old female resident of Edon, Ohio, for complaints of low back and mid-back pain. DOH v. HOSSEIN FARSAD, M.D. Case Number 2010-11362 15 82. On or about April 29, 2010, patient A.M. indicated that she was not receiving current treatment for her condition. . 83. On or about April 29, 2010, patient A.M. indicated that she had never been a patient at a pain management clinic. 84. On or about April 29, 2010, Respondent documented that patient A.M.’s visit on that day was her “First time in pain clinic.” 85. On or about April 29, 2010, patient A.M. indicated that she had taken yoga, oxycodone, and Xanax for her pain. 86. On or about April 29, 2010, patient A.M. provided a urine specimen for drug screen. | 87. On or about April 29, 2010, the urine drug screen test did not indicate any positive results. 88. Respondent did not obtain and document a sufficient medical history for patient A.M. 89. Respondent did not obtain and document adequate physical examinations of patient A.M. 90. Respondent did not refer patient A.M. to specialists for further evaluation. DOH v, HOSSEIN FARSAD, M.D. Case Number 2010-11362 Ot, Throughout the time of Respondent’s care and treatment of patient A.M., Respondent did not sufficiently provide or recommend other treatment modalities to patient A.M. ’ 92, Respondent prescribed controlled substances to patient A.M. as follows: DATE OXYCODONE 30 MG._| SOMA 350 MG. 04/29/2010 #90 | #60 Facts Specific to Patient M.M. 93. From on or about April 29, 2010, through on or about June 24, 2010, Respondent provided care and treatment to patient M.M., a thirty- five year old male resident of Boston, Massachusetts, for complaints of neck pain. 94. On or about April 29, 2010, patient M.M. indicated that he was not receiving current treatment for his condition. 95. Onor about April 29, 2010, patient M.M. indicated that he had never been a patient at a pain management clinic. 96. On or about April 29, 2010, patient M.M. indicated that he was not currently prescribed any medication for pain. DOH v. HOSSEIN FARSAD, M.D. Case Number 2010-11362 17 . 97, On or about April 29, 2010, Respondent documented “Last M.D. visit In Boston 2 yrs. ago.” 98. On or about April 29, 2010, patient M.M. tested positive for opiates on an initial urine drug screen. . 99, Respondent did not obtain and document a sufficient medical history for patient M.M. 100. Respondent did not obtain and document adequate physical examinations of patient M.M. 101. Respondent did not refer patient M.M. to specialists for further evaluation. 102. Throughout the time of Respondent’s care and treatment of patient M.M., Respondent did not sufficiently provide or recommend other treatment modalities to patient M.M. . 103. Respondent prescribed controlled substances to patient M.M. as follows: DATE OXYCODONE 30 MG. 04/29/2010 #90 05/27/2010 #120 06/24/2010 #120 DOH v. HOSSEIN FARSAD, M.D. Case Number 2010-11362 Facts Specific to Patient D.P. ’ 104. From on or about April 29, 2010, through on or about June 24, 2010, Respondent provided care and treatment to patient D.P., a fifty-nine year old male resident of Monticello, Kentucky, for complaints of low back pain. 105. On or about April 29, 2010, patient D.P. indicated that he had been receiving treatment for his condition at a pain management clinic; however, it got too expensive. 106. On or about April 29, 2010, patient D.P. indicated that the current medications prescribed to him for treatment of pain were oxycodone 30 mg. five times a day; oxycodone 10 mg. three times a day; and Xanax 2 mg. three times a day. 107. On or about April 29, 2010, Respondent documented patient D.P. last visited the Kentucky clinic four months earlier, 108. On or about April 29, 2010, patient D.P tested positive for opiates on an initial urine drug screen. 109. Patient D.P. was hypertensive during visits to the Respondent. "110. Respondent did not obtain and document a sufficient medical history for patient D.P. DOH v. HOSSEIN FARSAD, M.D. Case Number 2010-11362 111. Respondent did not obtain and document adequate physical examinations of patient D.P. | 112. Respondent did not refer patient D.P. to specialists for further evaluation. 113. Throughout the time of Respondent’s care and treatment of patient D.P., Respondent did not sufficiently provide or recommend other treatment modalities to patient D.P. 114. Respondent prescribed controlled substances to patient D.P. as follows: DATE | ROXICODONE 30 MG. | VALIUM 10 MG. 04/29/2010 | #150 #60 05/27/2010 #180 #60 06/24/2010 #180 #60 Facts Specific to Patient S.R. 115. On or about April 29, 2010, Respondent provided care and treatment to patient S.R., a twenty-four year old male resident of London, Kentucky, for complaints of low back pain. 116. On or about April 29, 2010, patient S.R. indicated that he was not receiving current treatment for his condition. DOH v. HOSSEIN FARSAD, M.D. Case Number 2010-11362 20 117. On or about April 29, 2010, patient S.R. indicated that he had been a patient at “North Dade” pain management clinic before it was closed. 118. On or about April 29, 2010, patient S.R. indicated that the current medications prescribed to him for treatment of pain were oxycodone 30 mg. four times a day; oxycodone 15 mg. two times a day; and Xanax 2 mg. once a day. 119. On or about April 29, 2010, patient S.R. provided a urine specimen for drug screen. | 120. On or about April 29, 2010, the urine drug screen test did not indicate any positive results. 121. On or about April 29, 2010, Respondent documented — that patient S.R. last took medication one week earlier. 122. Respondent did not obtain and document a sufficient medical history for patient S.R. - 123.. Respondent did not obtain and document adequate physical examinations of patient S.R. 124, Respondent did not refer patient S.R. to specialists for further evaluation. DOH v, HOSSEIN FARSAD, M.D. Case Number 2010-11362 ai ' 125. Throughout the time of Respondent's care and treatment of patient S.R., Respondent did not sufficiently provide or recommend other treatment modalities to patient S.R. - 126. Respondent prescribed controlled substances to patient S.R. as follows: DATE OXYCODONE 30 MG. | SOMA 350 MG. 04/29/2010 #90 #60 Facts Specific to Patient C.T. 127. On or about April 29, 2010, Respondent provided care and treatment to patient C.T., a thirty-six year old male resident of Richmond, Kentucky, for complaints of low back pain. 128. On or about April 29, 2010, patient C.T. indicated that he was not receiving current treatment for his condition. 129. On or about April 29, 2010, patient C.T. indicated that he had never been a patient at a pain management clinic. | 130. On or about April 29, 2010, patient C.T. indicated that the current medications prescribed to him for treatment of pain were “Roxicets” 30 mg. eight times a day; and “Roxicets” 15 mg. four times a day. DOH v. HOSSEIN FARSAD, M.D. Case Number 2010-11362 22 131. On or about April 29, 2010, patient C.T. tested positive for benzodiazepines, opiates, and oxycodone on an initial urine drug screen. 132. On or about April 29, 2010, Respondent documented — that patient C.T. had been treated at another clinic for two months which had closed. 133. On or about April 29, 2010, Respondent documented — that patient C.T. last visited his previous clinic two months earlier. | 134. On or about April 29, 2010, Respondent documented _ that patient C.T. had not received any treatment before his previous clinic. 135. Respondent did not obtain and document a sufficient medical history for patient C.T. 136. Respondent did not obtain and document adequate physical examinations of patient C.T, ' 137. Respondent did not refer patient C.T. to specialists for further evaluation. 138. Throughout the time of Respondent's care and treatment of patient C.T., Respondent did not sufficiently provide or recommend other treatment modalities to patient C.T. DOH v. HOSSEIN FARSAD, M.D, Case Number 2010-11362 23 139. Respondent prescribed controlled substances to patient C.T. as follows: DATE OXYCODONE 30 MG. | SOMA 350 MG. 04/29/2010 #120 #60 Facts Specific to Patient J.C. 140. From on or about April 28, 2010, through on or about July 20, 2010, Respondent provided care and treatment to patient J.C., a twenty-six year old male resident of Lighthouse Point, Florida, for complaints of low back pain. 141. On or about April 28, 2010, patient J.C. indicated that he was not receiving current treatment for his condition. | 142. On or about April 28, 2010, patient J.C. indicated that he had never been a patient at a pain management clinic. 143. On or about April 28, 2010, patient J.C. indicated that he was not currently prescribed any medication for pain. 144, On or about April 29, 2010, the Responcent documented that patient 1. was a first time pain clinic patient. ~ 145. On or about April 29, 2010, the Respondent documented that patient J.C. had taken medication prescribed to patient J.C.’s mother. . DOH v. HOSSEIN FARSAD, M.D. Case Number 2010-11362 24 146. On or about April 29, 2010, patient J.C. tested positive for opiates on an initial urine drug screen. ~ 147. Patient J.C. was hypertensive during visits to the Respondent. 148. Respondent did not obtain and document a sufficient medical history for patient J.C. ' 149. Respondent did not obtain and document adequate physical examinations of patient J.C. 150. Respondent did not refer patient J.C. to specialists for further. evaluation. 151. Throughout the time of Respondent’s care and treatment of patient J.C., Respondent did not sufficiently provide or recommend other treatment modalities to patient J.C. 152. Respondent prescribed controlled substances to patient J.C. as follows: DATE OXYCODONE | OXYCODONE SOMA 350 | ROXICODONE 30 MG, 15 MG. MG. 15 MG. 04/29/2010 | #120 #60 05/25/2010 | #120 #30 06/22/2010 | #120 #60 07/20/2010 | #120 #60 DOH v. HOSSEIN FARSAD, M.D. Case Number 2010-11362 25 COUNT I — PT. F.B. 153. Petitioner re-alleges and incorporates paragraphs one (1) through thirty-one (31) as if fully set forth herein. 154. Section 458,331(1)(t), Florida Statutes (2009-2010), provides that committing medical malpractice constitutes grounds for disciplinary action by the Board of Medicine. Medical Malpractice is defined in Section 456.50(), Florida Statutes (2009-2010), 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. For purposes of Section 458,331(1)(t), Florida Statutes (2009-2010), the Board shall give great weight to the provisions of Section 766.102, Florida Statutes (2009-2010), which provides 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. 155, Respondent failed to practice medicine with that level of care, skill and treatment, which is recognized by a reasonably prudent similar DOH v. HOSSEIN FARSAD, M.D. Case Number 2010-11362 ; 26 physician as being acceptable under similar conditions and circumstances, in the treatment of patient F.B. in one or more of the following ways: a. b, f. By failing to obtain a complete history of patient F.B.; By failing to perform a complete physical examination; By failing to refer patient F.B. to appropriate specialists; By prescribing excessive and/or inappropriate amounts and/or combinations of controlled substances to patient F.B. without medical justification; By failing to properly utilize risk mitigation strategies to prevent diversion of controlled substances; and By failing to develop an appropriate treatment plan. Based on the foregoing, Respondent violated Section 458.331(1)(t), Florida Statutes (2009-2010), by committing medical malpractice in treating patient F.B. COUNT IT — PT. F.B. 156. Petitioner re-alleges and incorporates paragraphs one (1) through thirty-one (31) as if fully set forth herein. 157. Section 458.331(1)(q), Florida Statutes (2009-2010), subjects a licensee to discipline, including suspension, for prescribing, dispensing, DOH v. HOSSEIN FARSAD, M.D, Case Number 2010-11362 27 administering, mixing, or otherwise preparing a legend drug, including any controlled substance, other than in the course of the physician's professional practice. For purposes of Section 458.331(1)(q), it shall be legally presumed that prescribing, dispensing, administering, mixing, or otherwise preparing legend drugs, including all controlled substances, inappropriately or in excessive or inappropriate quantities is not in the best interest of the patient and is not in the course of the physician’s professional practice, without regard to his or her intent. 158. Respondent prescribed, dispensed, and/or administered controlled substances other than in the course of his professional practice by prescribing, dispensing, and/or administering controlled substances inappropriately, without: regard to the patient’s best interests or in excessive or inappropriate quantities to patient F.B. on the above described dates and in the above described quantities and combinations. 159. Based on the foregoing, Respondent violated Section 458,331(1)(q), Florida Statutes (2009-2010), by inappropriately prescribing excessive and inappropriate quantities of controlled substances to patient F.B. DOH v. HOSSEIN FARSAD, M.D, Case Number 2010-11362 28 COUNT ITI — PT. F.B. - 160. Petitioner re-alleges and incorporates paragraphs one (1) through thirty-one (31) as if fully set forth herein. 161. Section 458.331(1)(m), Florida Statutes (2009-2010), provides that 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 is grounds for discipline. 162. Respondent failed to keep legible medicai records that justify the course of treatment of patient F.B., including, but not limited to, patient histories; examination results; test results; records of drugs prescribed, dispensed, or administered; and reports of consultations and hospitalizations. 163. Based on the foregoing, Respondent violated Section DOH v. HOSSEIN FARSAD, M.D. Case Number 2010-11362 29 458.331(1)(m), Florida Statutes (2009-2010). COUNT IV — PT. R.B. 164. Petitioner re-alleges and incorporates paragraphs one (1) through fourteen (14) and two (32) through fifty (50) as if fully set forth herein, ' 165. Section 458.331(1)(t), Florida Statutes (2009-2010), provides that committing medical malpractice constitutes grounds for disciplinary action by the Board of Medicine. Medical Malpractice is defined in Section 456.50(g), Florida Statutes (2009-2010), 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. For purposes of Section 458.331(1)(t), Florida Statutes (2009-2010), the Board shall give great weight to the provisions of Section 766.102, Florida Statutes (2009-2010), which provides 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. . 166. Respondent failed to practice medicine with that level of care, DOH v. HOSSEIN. FARSAD, M.D. Case Number 2010-11362 30 skill and treatment, which is recognized by a reasonably prudent similar physician as being acceptable under similar conditions and circumstances, in the treatment of patient R.B. in one or more of the following ways: | a. By failing to obtain a complete history of patient R.B.; b. By failing to perform a complete physical examination; c. By failing to refer patient R.B. to appropriate specialists; dd. By prescribing excessive and/or inappropriate amounts and/or combinations of controlled substances to patient R.B. without medical justification; ‘ae, By failing to properly utilize risk mitigation strategies to prevent diversion of controlled substances; and f, By failing to develop an appropriate treatment plan. - 167. Based on the foregoing, Respondent violated Section 458.331(1)(t), Florida Statutes (2009-2010), by committing medicai malpractice in treating patient R.B. COUNT V - PT. R.B. 168. Petitioner re-alleges and incorporates paragraphs one (1) through fourteen (14) and two (32) through fifty (50) as if fully set forth herein. DOH v. HOSSEIN FARSAD, M.D. Case Number 2010-11362 31 ~ 169. Section 458.331(1)(q), Florida Statutes (2009-2010), subjects a licensee to discipline, including suspension, for prescribing, dispensing, administering, mixing, or otherwise preparing a legend drug, including any controlled substance, other than in the course of the physician's professional practice. For purposes of Section 458.331(1)(q), it shall be legally presumed that prescribing, dispensing, administering, mixing, or otherwise preparing legend drugs, including all controlled substances, inappropriately or in excessive or inappropriate quantities is not in the best interest of the patient and is not in the course of the physician’s professional practice, without regard to his or her intent. 170. Respondent prescribed, dispensed, and/or administered controlled substances other than in the course of his professional practice by prescribing, dispensing, and/or administering controlled substances inappropriately, without regard to the patient’s best interests or in excessive or inappropriate quantities to patient R.B. on the above described dates and in the above described quantities and combinations. 171. Based on the foregoing, Respondent violated Section 458.331(1)(q), Florida Statutes (2009-2010), by inappropriately prescribing DOH v. HOSSEIN FARSAD, M.D. Case Number 2010-11362 32 excessive and inappropriate quantities of controlled substances to patient R.B. COUNT VI — PT. R.B. 172. Petitioner re-alleges and incorporates paragraphs one (1) through fourteen (14) and two (32) through fifty (50) as if fully set forth herein. 173. Section 458.331(1)(m), Florida Statutes (2009-2010), provides that 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 is grounds for discipline. _ 174, Respondent failed to keep legible medical records that justify the course of treatment of patient R.B., including, but not limited to, patient histories; examination results; test results; records of drugs DOH v, HOSSEIN FARSAD, M.D. Case Number 2010-11362 33 prescribed, dispensed, or’ administered; and reports of consultations and hospitalizations. 175. Based on the foregoing, Respondent violated Section 458.331(1)(m), Florida Statutes (2009-2010). COUNT VIT -- PT. M.H. 176. Petitioner re-alleges and incorporates paragraphs one (1) through fourteen. (14) and fifty-one (51) through sixty-eight (68) as if fully set forth herein. | 177. Section 458.331(1)(t), Florida Statutes (2009-2010), provides that committing medical malpractice constitutes grounds for disciplinary action by the Board of Medicine. Medical Malpractice is defined in Section 456.50(g), Florida Statutes (2009-2010), 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. For purposes of Section 458.331(1)(t), Florida Statutes (2009-2010), the Board shall give great weight to the provisions of Section 766.102, Florida Statutes (2009-2010), which provides 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 DOH v. HOSSEIN FARSAD, M.D. Case Number 2010-11362 34 acceptable and appropriate by reasonably prudent similar health care providers. | 178. Respondent failed to practice medicine with that level of care, skill and treatment, which is recognized by a reasonably prudent similar physician as being acceptable under similar conditions and circumstances, in the treatment of patient M.H. in one or more of the following ways: a. By failing to obtain a complete history of patient M.H.; b. By failing to perform a complete physical examination; -¢ By failing to refer patient M.H. to appropriate specialists; d: By prescribing excessive and/or inappropriate amounts and/or combinations of controlled substances to patient M.H. without medical justification; e. By failing to properly utilize risk mitigation strategies to prevent diversion of controlled substances; and f. By failing to develop an appropriate treatment plan. 179. Based on the foregoing, Respondent violated Section 458.331(1)(t), Florida Statutes (2009-2010), by committing medical malpractice in treating patient M.H. DOH v. HOSSEIN FARSAD, M.D. Case Number 2010-11362 35 COUNT VIII — PT. M.H. 180. Petitioner re-alleges and incorporates paragraphs one (1) through fourteen (14) and fifty-one (51) through sixty-eight (68) as if fully set forth herein. 181. Section 458.331(1)(q), Florida Statutes (2009-2010), subjects a licensee to discipline, including suspension, for prescribing, dispensing, administering, mixing, or otherwise preparing a legend drug, including any controlled substance, other than in the course of the physician's professional practice. For purposes of Section 458.331(1)(q), it shall be legally presumed that prescribing, dispensing, administering, mixing, or otherwise preparing legend drugs, including all controlled substances, inappropriately or in excessive or inappropriate quantities is not in the best interest of the patient and is not in the course of the physician's professional practice, without regard to his or her intent. 182. Respondent prescribed, dispensed, and/or administered controlled substances other than in the course of his professional practice by prescribing, dispensing, and/or administering controlled substances inappropriately, without regard to the patient's best interests or in DOH v. HOSSEIN FARSAD, M.D. Case Number 2010-11362 36 excessive or inappropriate quantities to patient M.H. on the above described dates and in the above described quantities and combinations. 183. Based on the foregoing, Respondent violated Section 458.331(1)(q), Florida Statutes (2009-2010), by inappropriately prescribing excessive and inappropriate quantities of controlled substances to patient M.H. COUNT IX — PT. M.H. 184. Petitioner re-alleges and incorporates paragraphs one (1) through fourteen (14) and fifty-one (51) through sixty-eight (68) as if fully set forth herein. 185. Section 458.331(1)(m), Florida Statutes (2009-2010), provides that 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 DOH v. HOSSEIN FARSAD, M.D. Case Number 2010-11362 37 administered; and reports of consultations and hospitalizations is grounds for discipline. 186. Respondent failed to keep legible medical records that justify the course of treatment of patient M.H., including, but not limited to, patient histories; examination results; test results; records of drugs prescribed, dispensed, or administered; and reports of consultations and hospitalizations. ' 187. Based on the foregoing, Respondent violated Section 458.331(1)(m), Florida Statutes (2009-2010). COUNT X — PT. E.M. 188. Petitioner re-alleges and incorporates paragraphs one (1) through fourteen (14) and sixty-nine (69) through eighty (80) as if fully set forth herein. _ 189. Section 458.331(1)(t), Florida Statutes (2009), provides that committing medical malpractice constitutes grounds for disciplinary action by the Board of Medicine. Medical Malpractice is defined in Section 456.50(g), Florida Statutes (2009), 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. For purposes of Section DOH v. HOSSEIN FARSAD, M.D. Case Number 2010-11362 38 458.331(1)(t), Florida Statutes (2009), the Board shall give great weight to the provisions of Section 766.102, Florida Statutes (2009), which provides 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. 190. Respondent failed to practice medicine with that level of care, skill and treatment, which is recognized by a reasonably prudent similar physician as being acceptable under similar conditions and circumstances, in the treatment of patient E.M. in one or.more of the following ways: a. _ By failing to obtain a complete history of patient E.M.; | b. By failing to perform a complete physical examination; c. _ By failing to refer patient E.M. to appropriate specialists; d. By prescribing excessive and/or inappropriate amounts and/or combinations of controlled substances to patient E.M. without medical justification; e. _ By failing to properly utilize risk mitigation strategies to prevent diversion of controlled substances; and f. By failing to develop an appropriate treatment plan. DOH v. HOSSEIN FARSAD, M.D, Case Number 2010-11362 39 191. Based on the foregoing, Respondent violated Section 458.331(1)(t), Florida Statutes (2009), by committing medical malpractice in treating patient E.M. COUNT XI — PT. E.M. 192. Petitioner re-alleges and incorporates paragraphs one (1) through fourteen (14) and sixty-nine (69) through eighty (80) as if fully set forth herein. 193. Section 458.331(1)(q), Florida Statutes (2009), subjects a licensee to discipline, including suspension, for prescribing, dispensing, administering, mixing, or otherwise preparing a legend drug, including any controlled substance, other than in the course of the physician's professional practice. For purposes of Section 458.331(1)(q), it shall be legally presumed that prescribing, dispensing, administering, mixing, or otherwise preparing legend drugs, including all controlled substances, inappropriately or in excessive or inappropriate quantities is not in the best interest of the patient and is not in the course of the physician’s professional practice, without regard to his or her intent. 194. Respondent prescribed, dispensed, and/or administered controlled substances other than in the course of his professional practice DOH v. HOSSEIN FARSAD, M.D, Case Number 2010-11362 40 by prescribing, dispensing, and/or administering controlled substances inappropriately, without regard to the patient’s best interests or in excessive or inappropriate quantities to patient E.M. on the above described dates and in the above described quantities and combinations. 195. Based on the foregoing, Respondent violated Section 458.331(1)(q), Florida Statutes (2009), by inappropriately prescribing excessive and inappropriate quantities of controlled substances to patient E.M. 196. Petitioner re-alleges and incorporates paragraphs one (1) through fourteen (14) and sixty-nine (69) through eighty (80) as if fully set forth herein. ' 197. Section 458.331(1)(m), Florida Statutes (2009), provides that 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; DOH v. HOSSEIN FARSAD, M.D. Case Number 2010-11362 41 examination results; test results; records of drugs prescribed, dispensed, or administered; and reports of consultations and hospitalizations is grounds for discipline. - 198. Respondent failed to keep legible medical records that justify the course of treatment of patient E.M., including, but not limited to, patient histories; examination results; test results; records of drugs prescribed, dispensed, or administered; and reports of consultations and hospitalizations. 199. Based on the foregoing, Respondent violated Section 458.331(1)(m), Florida Statutes (2009). COUNT XIII — PT. A.M. 200. Petitioner re-alleges and incorporates paragraphs one (1) through fourteen (14) and eighty-one (81) through ninety-two (92) as if fully set forth herein. 201. Section 458.331(1)(t), Florida Statutes (2009), provides that committing medical malpractice constitutes grounds for disciplinary action by the Board of Medicine. Medical Malpractice is defined in Section 456.50(g), Florida Statutes (2009), as the failure to practice medicine in accordance with the level of care, skill, and treatment recognized in DOH v. HOSSEIN FARSAD, M.D. Case Number 2010-11362 42 general law related to health care licensure. For purposes of Section 458,331(1)(t), Florida Statutes (2009), the Board shall give great weight to the provisions of Section 766.102, Florida Statutes (2009), which provides 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. 202. Respondent failed to practice medicine with that level of care, skill and treatment, which is recognized by a reasonably prudent similar physician as being acceptable under similar conditions and circumstances, in the treatment of patient a.m. in one or more of the following ways: a. By failing to obtain a complete history of patient A.M.; b. By failing to perform a complete physical examination; _¢. By failing to refer patient A.M. to appropriate specialists; d. By prescribing excessive and/or inappropriate amounts and/or combinations of controlled substances to patient A.M. without medical justification; e. By failing to properly utilize risk mitigation strategies to prevent diversion of controlled substances; and DOH v. HOSSEIN FARSAD, M.D. Case Number 2010-11362 43 f. By failing to develop an appropriate treatment plan. - 203. Based on the foregoing, Respondent violated Section 458.331(1)(t), Florida Statutes (2009), by committing medical malpractice in treating patient A.M. COUNT XIV — PT. A.M. 204. Petitioner re-alleges and incorporates paragraphs one (1) through fourteen (14) and eighty-one (81) through ninety-two (92) as if fully set forth herein. | 205. Section 458.331(1)(q), Florida Statutes (2009), subjects a licensee to discipline, including suspension, for prescribing, dispensing, administering, mixing, or otherwise preparing a legend drug, including any controlled substance, other than in the course of the physician's professional practice. For purposes of Section 458.331(1)(q), it shall be legally presumed that prescribing, dispensing, administering, mixing, or otherwise preparing legend drugs, including all controlled substances, inappropriately or in excessive or inappropriate quantities is not in the best interest of the patient and is not in the course of the physician’s professional practice, without regard to his or her intent. DOH v. HOSSEIN FARSAD, M.D. Case Number 2010-11362 44 206. Respondent prescribed, dispensed, and/or administered controlled substances other than in the course of his professional practice by prescribing, dispensing, and/or administering controlled substances inappropriately, without regard to the patient’s best interests or in excessive or inappropriate ‘quantities to patient A.M. on the above described dates and in the above described quantities and combinations. 207. Based on the foregoing, Respondent violated Section 458.331(1)(q), Florida Statutes (2009), by inappropriately prescribing excessive and inappropriate quantities of controlled substances to patient A.M. COUNT XV — PT. A.M. _ 208. Petitioner re-alleges and incorporates paragraphs one (1) through fourteen (14) and eighty-one (81) through ninety-two (92) as if fully set forth herein. | 209. Section 458.331(1)(m), Florida Statutes (2009), provides that 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 DOH v. HOSSEIN FARSAD, M.D. Case Number 2010-11362 45 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 is grounds for discipline. 210. Respondent failed to keep legible medical records that justify the course of treatment of patient A.M., including, but not limited to, patient histories; examination results; test results; records of drugs prescribed, dispensed, or administered; and reports of consultations and hospitalizations. 211. Based on the foregoing, Respondent violated Section 458,331(1)(m), Florida Statutes (2009). COUNT XVI -- PT. M.M. 212. Petitioner re-alleges and incorporates paragraphs one (1) through fourteen (14) and ninety-three (93) through one hundred and three (103) as if fully set forth herein. 213. Section 458.331(1)(t), Florida Statutes (2009-2010), provides that committing medical malpractice constitutes grounds for disciplinary action by the Board of Medicine. Medical Malpractice is defined in Section DOH v, HOSSEIN FARSAD, M.D, Case Number 2010-11362 46 456.50(g), Florida Statutes (2009-2010), 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. For purposes of Section 458.331(1)(t), Florida Statutes (2009-2010), the Board shall give great weight to the provisions of Section 766.102, Florida Statutes (2009-2010), which provides 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. 214. Respondent failed to practice medicine with that level of care, skill and treatment, which is recognized by a reasonably prudent similar physician as being acceptable under similar conditions and circumstances, in the treatment of patient M.M. in one or more of the following ways: a. _ By failing to obtain a complete history of patient M.M.; b. By failing to perform a complete physical examination; | c. By failing to refer patient M.M. to appropriate specialists; d. By prescribing excessive and/or inappropriate amounts and/or combinations of controlled substances to patient M.M. without medical DOH v. HOSSEIN FARSAD, M.D, Case Number 2010-11362 47 justification; | e. _ By failing to properly utilize risk mitigation strategies to prevent diversion of controlled substances; and f. By failing to develop an appropriate treatment plan. 215. Based on the foregoing, Respondent violated Section 458.331(1)(t), Florida Statutes (2009-2010), by committing medical malpractice in treating patient M.M. 216. Petitioner re-alleges and incorporates paragraphs one (1) through fourteen (14) and ninety-three (93) through one hundred and three (103) as if fully set forth herein. 217. Section 458.331(1)(q), Florida Statutes (2009-2010), subjects a licensee to discipline, including suspension, for prescribing, dispensing, administering, mixing, or otherwise preparing a legend drug, including any controlled substance, other than in the course of the physician's professional practice. For purposes of Section 458.331(1)(q), it shall be legally presumed that prescribing, dispensing, administering, mixing, or otherwise preparing legend drugs, including all controlled substances, inappropriately or in excessive or inappropriate quantities is not in the best DOH v. HOSSEIN FARSAD, M.D. Case Number 2010-11362 48 interest of the patient and is not in the course of the physician's professional practice, without regard to his or her intent. 218. Respondent prescribed, dispensed, and/or administered controlled substances other than in the course of his professional practice by prescribing, dispensing, and/or administering controlled substances inappropriately, without regard to the patient’s best interests or in excessive or inappropriate quantities to patient M.M. on the above described dates and in the above described quantities and combinations. | 219. Based on the foregoing, Respondent violated Section 458.331(1)(q), Florida Statutes (2009-2010), by inappropriately prescribing excessive and inappropriate quantities of controlled substances to patient M.M. COUNT XITI — PT. M.M. 220. Petitioner re-alleges and incorporates paragraphs one (1) through fourteen (14) and ninety-three (93) through one hundred and three (103) as if fully set forth herein. 221. Section 458.331(1)(m), Florida Statutes (2009-2010), provides that failing to keep legible, as defined by department rule in consultation with the board, medical records that identify the licensed physician or the DOH v. HOSSEIN FARSAD, M.D. Case Number 2010-11362 49 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 is grounds for discipline. 222. Respondent failed to keep legible medical records that justify the .course of treatment of patient M.M., including, but not limited to, patient histories; examination results; test results; records of drugs . prescribed, dispensed, or administered; and reports of consultations and hospitalizations. 223. Based on the foregoing, Respondent violated Section 458.331(1)(m), Florida Statutes (2009-2010). COUNT XIX — PT. D.P. 224. Petitioner re-alleges and incorporates paragraphs one (1) through fourteen (14) and one hundred and four (104) through one hundred and fourteen (114) as if fully set forth herein. DOH v. HOSSEIN FARSAD, M.D. Case Number 2010-11362 50 225. Section 458.331(1)(t), Florida Statutes (2009-2010), provides that committing medical malpractice constitutes grounds for disciplinary action by the Board of Medicine. Medical Malpractice is defined in Section 456.50(q), Florida Statutes (2009-2010), 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. For purposes of Section 458.331(1)(t), Florida Statutes (2009-2010), the Board shall give great weight to the provisions of Section 766.102, Florida Statutes (2009-2010), which provides 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. 226. Respondent failed to practice medicine with that level of care, skill and treatment, which is recognized by a reasonably prudent similar physician as being acceptable under similar conditions and circumstances, in the treatment of patient D.P. in one or more of the following ways: a. _ By failing to obtain a complete history of patient D.P.; _ b. By failing to perform a complete physical examination; DOH v. HOSSEIN FARSAD, M.D, Case Number 2010-11362 51 ‘c. By failing to refer patient D.P. to appropriate specialists; d. By prescribing excessive and/or inappropriate amounts and/or combinations of controlled substances to patient D.P. without medical justification; e. By failing to properly utilize risk mitigation strategies to prevent diversion of controlled substances; and _f. By failing to develop an appropriate treatment plan. 227. Based on the foregoing, Respondent violated Section 458.331(1)(t), Florida Statutes (2009-2010), by committing medical malpractice in treating patient D.P. COUNT XX ~ PT. D.P. 228. Petitioner re-alleges and incorporates paragraphs one (1) through fourteen (14) and one hundred and four (104) through one hundred and fourteen (114) as if fully set forth herein. 229. Section 458.331(1)(q), Florida Statutes (2009-2010), subjects a licensee to discipline, including suspension, for prescribing, dispensing, administering, mixing, or otherwise preparing a legend drug, including any controlled substance, other than in the course of the physician's professional practice. For purposes of Section 458.331(1)(q), it shall be DOH v. HOSSEIN FARSAD, M.D. Case Number 2010-11362 52 legally presumed that prescribing, dispensing, administering, mixing, or otherwise preparing legend drugs, including all controlled substances, inappropriately or in excessive or inappropriate quantities is not in the best interest of the patient and is not in the course of the physician’s professional practice, without regard to his or her intent. 230. Respondent prescribed, dispensed, and/or administered controlled substances other than in the course of his professional practice by prescribing, dispensing, and/or administering controlled substances inappropriately, without regard to the patient’s best interests or in excessive or inappropriate quantities to patient D.P. on the above described dates and in the above described quantities and combinations. 231. Based on the foregoing, Respondent violated Section 458.331(1)(q), Florida Statutes (2009-2010), by inappropriately prescribing excessive and inappropriate quantities of controlled substances to patient D.P. COUNT XXI — PT. D.P. . 232. Petitioner re-alleges and incorporates paragraphs one (i) through fourteen (14) and one hundred and four (104) through one hundred and fourteen (114) as if fully set forth herein. DOH v. HOSSEIN FARSAD, M.D. Case Number 2010-11362 53 233. Section 458.331(1)(m), Florida Statutes (2009-2010), provides that 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 is grounds for discipline. 234. Respondent failed to keep legible medical records that justify the course of treatment of patient D.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. 235. Based on the foregoing, Respondent violated Section 458.331(1)(m), Florida Statutes (2009-2010). DOH v. HOSSEIN FARSAD, M.D, Case Number 2010-11362 54 COUNT XXII — PT. S.R. 236. Petitioner re-alleges and incorporates paragraphs one (1) through fourteen (14) and one hundred and fifteen (115) through one hundred and twenty-six (126) as if fully set forth herein. 237. Section 458.331(1)(t), Florida Statutes (2009), provides that committing medical malpractice constitutes grounds for disciplinary action by the Board of Medicine. Medical Malpractice is defined in Section 456.50(g), Florida Statutes (2009), 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. For purposes of Section 458.331(1)(t), Florida Statutes (2009), the Board shall give great weight to the provisions of Section 766.102, Florida Statutes (2009), which provides . 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. 238. Respondent failed to practice medicine with that level of care, skill and treatment, which is recognized by a reasonably prudent similar physician as being acceptable under similar conditions and circumstances, DOH v. HOSSEIN FARSAD, M.D, Case Number 2010-11362 55 in the treatment of patient S.R. in one or more of the following ways: a. By failing to obtain a complete history of patient S.R.; b. By failing to perform a complete physical examination; c. _ By failing to refer patient S.R. to appropriate specialists; d. By prescribing excessive and/or inappropriate amounts and/or combinations of controlled substances to patient S.R. without medical justification; e. By failing to properly utilize risk mitigation strategies to prevent diversion of controlled substances; and ff. By failing to develop an appropriate treatment plan. 239. Based on the foregoing, Respondent violated Section 458,331(1)(t), Florida Statutes (2009), by committing medical malpractice _ in treating patient S.R. | COUNT XXIII — PT. S.R. 240. Petitioner re-alleges and incorporates paragraphs one (1) through fourteen (14) and one hundred and fifteen (115) through one hundred and twenty-six (126) as if fully set forth herein. 241. Section 458.331(1)(q), Florida Statutes (2009), subjects a licensee to discipline, including suspension, for prescribing, dispensing, DOH v. HOSSEIN FARSAD, M.D. Case Number 2010-11362 56 administering, mixing, or otherwise preparing a legend drug, including any controlled substance, other than in the course of the physician's professional practice. For purposes of Section 458.331(1)(q), it shall be legally presumed that prescribing, dispensing, administering, mixing, or otherwise preparing legend drugs, including all controlled substances, inappropriately or in excessive or inappropriate quantities is not in the best interest of the patient and is not in the course of the physician's professional practice, without regard to his or her intent. 242. Respondent prescribed, dispensed, and/or administered controlled substances other than in the course of his professional practice by prescribing, dispensing, and/or administering controlled substances inappropriately, without regard to the patient’s best interests or in excessive or inappropriate quantities to patient S.R. on the above described dates and in the above described quantities and combinations. 243. Based on the foregoing, Respondent violated Section - 458.331(1)(q), Florida Statutes (2009), by inappropriately prescribing excessive and inappropriate quantities of controlled substances to patient SR. DOH v. HOSSEIN FARSAD, M.D. Case Number 2010-11362 57 COUNT XXIV — PT. S.R. . 244. Petitioner re-alleges and incorporates paragraphs one (1) through fourteen (14) and one hundred and fifteen (115) through one hundred and twenty-six (126) as if fully set forth herein. — 245. Section 458.331(1)(m), Florida Statutes (2009), provides that 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 is grounds for discipline. 246. Respondent failed to keep legible medical records that justify the course of treatment of patient S.R., including, but not limited to, patient histories; examination results; test results; records of drugs prescribed, dispensed, or administered; and reports of consultations and hospitalizations. DOH v. HOSSEIN FARSAD, M.D. Case Number 2010-11362 : 58 247. Based on the foregoing, Respondent violated Section 458.331(1)(m), Florida Statutes (2009). COUNT XXV ~ PT. C.T. 248. Petitioner re-alleges and incorporates paragraphs one (1) through fourteen (14) and one hundred and twenty-seven (127) through one hundred and thirty-nine (139) as if fully set forth herein. 249. Section 458.331(1)(t), Florida Statutes (2009), provides that committing medical malpractice constitutes grounds for disciplinary action by the Board of Medicine. Medical Malpractice is defined in Section 456.50(g), Florida Statutes (2009), 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. For purposes of Section 458.331(1)(t), Florida Statutes (2009), the Board shall give great weight to the provisions of Section 766.102, Florida Statutes (2009), which provides 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. 250. Respondent failed to practice medicine with that level of care, DOH v. HOSSEIN FARSAD, ™.D. Case Number 2010-11362 59 skill and treatment, which is recognized by a reasonably prudent similar physician as being acceptable under similar conditions and circumstances, in the treatment of patient F.B in one or more of the following ways: a. By failing to obtain a complete history of patient C.T.; b. By failing to perform a complete physical examination; c. _ By failing to refer patient C.T. to appropriate specialists; d. By prescribing excessive and/or inappropriate amounts and/or combinations of controlled substances to patient C.T. without medical justification; e. By failing to properly utilize risk mitigation strategies to prevent diversion of controlled substances; and —f, By failing to develop an appropriate treatment plan. 251. Based on the foregoing, Respondent violated Section 458.331(1)(t), Florida Statutes (2009), by committing medical malpractice in treating patient C.T. | COUNT XXVI — PT. C.T. 252. Petitioner re-alleges and incorporates paragraphs one (1) through fourteen (14) and one hundred and twenty-seven (127) through one hundred and thirty-nine (139) as if fully set forth herein. DOH v. HOSSEIN FARSAD, M.D. Case Number 2010-11362 60 253. Section 458.331(1)(q), Florida Statutes (2009), subjects a licensee to discipline, including suspension, for prescribing, dispensing, administering, mixing, or otherwise preparing a legend drug, including any controlled substance, other than in the course of the physician's professional practice. For purposes of Section 458.331(1)(q), it shall be legally presumed that prescribing, dispensing, administering, mixing, or otherwise preparing legend drugs, including all controlled substances, inappropriately or in excessive or inappropriate quantities is not in the best interest of the patient and is not in the course of the physician's professional practice, without regard to his or her intent. 254. Respondent prescribed, dispensed, and/or administered controlled substances other than in the course of his professional practice by prescribing, dispensing, and/or administering controlled substances inappropriately, without regard to the patient's best interests or in excessive or inappropriate quantities to patient C.T. on the above described dates and in the above described quantities and combinations. 255. Based on the foregoing, Respondent violated Section 458.331(1)(q), Florida Statutes (2009), by inappropriately prescribing DOH v. HOSSEIN FARSAD, M.D. Case Number 2010-11362 61 excessive and inappropriate quantities of controlled substances to patient CT, COUNT XXVIII — PT. C.T. 256. Petitioner re-alleges and incorporates paragraphs one (1) through fourteen (14) and one hundred and twenty-seven (127) through one hundred and thirty-nine (139) as if fully set forth herein. . 257. Section 458.331(1)(m), Florida Statutes (2009), provides that 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 is grounds for discipline. | 258. Respondent failed to keep legible medical records that justify the course of treatment of patient C.T., including, but not limited to, patient histories; examination results; test results; records of drugs DOH v, HOSSEIN FARSAD, M.D, Case Number 2010-11362 62 prescribed, dispensed, or administered; and reports of consultations and hospitalizations. 259. Based on the foregoing, Respondent violated Section 458.331(1}(m), Florida Statutes (2009). | ~ COUNT XXVIII ~ PT. J.C. 260. Petitioner re-alleges and incorporates paragraphs one (1) . through fourteen (15) and one hundred and forty (140) through one hundred and fifty-two (152) as if fully set forth herein. 261. Section 458.331(1)(t), Florida Statutes (2009-2010), provides that committing medical malpractice constitutes grounds for disciplinary action by the Board of Medicine. Medical Malpractice is defined in Section 456.50(g), Florida Statutes (2009-2010), 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. For purposes of Section 458.331(1)(t), Florida Statutes (2009-2010), the Board shall give great weight to the provisions of Section 766.102, Florida Statutes (2009-2010), which provides 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 DOH v. HOSSEIN FARSAD, M.D. Case Number 2010-11362 63 acceptable and appropriate by reasonably prudent similar health care providers. . 262. Respondent failed to practice medicine with that level of care, skill and treatment, which is recognized by a reasonably prudent similar physician as being acceptable under similar conditions and circumstances, in the treatment of patient F.B in one or more of the following ways: a. _ By failing to obtain a complete history of patient J.C.; b. By failing to perform a complete physical examination; c. By failing to refer patient J.C. to appropriate specialists; d. By prescribing excessive and/or inappropriate amounts and/or combinations of controlled substances to patient J.C. without medical justification; e. By failing to properly utilize risk mitigation strategies to prevent diversion of controlled substances; and ’ f, By failing to develop an appropriate treatment plan. 263. Based on the foregoing, Respondent violated Section 458.331(1)(t), Florida Statutes (2009-2010), by committing medical malpractice in treating patient J.C. DOH v. HOSSEIN FARSAD, M.D. Case Number 2010-11362 64 COUNT XXIX — PT. J.C. 264. Petitioner re-alleges and incorporates paragraphs one (1) through fourteen (15) and one hundred and forty (140) through one hundred and fifty-two (152) as if fully set forth herein. 265. Section 458.331(1)(q), Florida Statutes (2009-2010), subjects a _ licensee to discipline, including suspension, for prescribing, dispensing, administering, mixing, or otherwise preparing a legend drug, including any controlled substance, other than in the course of the physician's professional practice. For purposes of Section 458.331(1)(q), it shall be legally presumed that prescribing, dispensing, administering, mixing, or otherwise preparing legend drugs, including all controlled substances, inappropriately or in excessive or inappropriate quantities is not in the best interest of the patient and is not in the course of the physician’s professional practice, without regard to his or her intent. 266. Respondent prescribed, dispensed, and/or administered controlled substances other than in the course of his professional practice by prescribing, dispensing, and/or administering controlled substances inappropriately, without regard to the patient’s best interests or in DOH v. HOSSEIN FARSAD, M.D. Case Number 2010-11362 65 excessive or inappropriate quantities to patient J.C. on the above described dates and in the above described quantities and combinations. 267. Based on the foregoing, Respondent violated Section 458.331(1)(q), Florida Statutes (2009-2010), by inappropriately prescribing excessive and inappropriate quantities of controlled substances to patient J.C. COUNT XXX — PT. J.C. 268. Petitioner re-alleges and incorporates paragraphs one (1) through fourteen (15) and one hundred and forty (140) through one hundred and fifty-two (152) as if fully set forth herein. 269. Section 458.331(1)(m), Florida Statutes (2009-2010), provides that 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 DOH v. HOSSEIN FARSAD, M.D. Case Number 2010-11362 66 administered; and reports of consultations and hospitalizations is grounds for discipline. 270. Respondent failed to keep legible medical records that justify the course of treatment of patient J.C., including, but not limited to, patient histories; examination results; test results; records of drugs prescribed, dispensed, or administered; and reports of consultations and hospitalizations. 271. Based on the foregoing, Respondent violated Section 458.331(1)(m), Florida Statutes (2009-2010). . WHEREFORE, 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. DOH v. HOSSEIN FARSAD, M.D. Case Number 2010-11362 67 A) yi SIGNED this 2.4” day of ./¢ Zofew , 2013. ve John H. Armstrong, MD, FACS Surgeon General & Secretary FILED DEPARTMENT OF HEALTH DEPUTY CI Fla. Bar No. 0901910 CLERK: ; Rated Florida Department of Health . 10 feesire Office of the General Counsel pare OF Ii-s 4052 Bald Cypress Way, Bin #C65 Tallahassee, FL 32399-3265 Telephone: (850) 245-4444 Facsimile: (850) 245-4684 PCP Date: 10/25/13 PCP:Members: Georges El-Bahri, M.D., Merle Stringer, M.D. and Carolyn Pardue | DOH v. HOSSEIN FARSAD, M.D. Case Number 2010-11362 68 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. HOSSEIN FARSAD, M.D. Case Number 2010-11362 69

Docket for Case No: 14-001649PL