STATE OF FLORIDA DEPARTMENT OF HEALTH DEPARTMENT OF HEALTH, PETITIONER, v. CASE NO.: 2006-36542 SANDRA ANN LINDSTROM, P.A., RESPONDENT. / ADMINISTRATIVE COMPLAINT Petitioner, Department of Health hereby files this Administrative Complaint before the Board of Medicine against Respondent, Sandra Ann Lindstrom, P.A., and in support states: 1. Petitioner is the state agency charged with regulating the practice of physician assistance pursuant to Section 20.43, Florida Statutes; Chapter 456, Florida Statutes; and Chapter 458, Florida Statutes. 2. At all times material to this Administrative Complaint, Respondent was a licensed physician assistant within the State of Florida, having been issued license number PA 9103823. 3. Respondent's address of record is 4640 Sanibel Way, Bradenton, Florida 34203. 4. Respondent was first licensed as a physician assistant on or about August 3, 2006. 5. At all times material to this Administrative Complaint, Respondent provided no notice to the Department of a supervising physician. 6. Respondent did not file with the Department, before commencing to prescribe, evidence that she had completed a continuing medical education course of at least 3 classroom hours in prescriptive practice, conducted by an accredited program approved by the boards, which course covers the limitations, responsibilities, and privileges involved in prescribing medicinal drugs, or evidence that she had received education comparable to the continuing education course as part of an accredited physician assistant training program. 7. Respondent did not file with the Department, before commencing to prescribe, evidence she had a minimum of 3 months of clinical experience in the specialty area of the supervising physician. 8. On October 31, 2006, an investigator with the Department, operating in an undercover capacity, and using a patient name with the initials RJ, presented to Respondent at Jacksonville Healthcare Systems, Inc., located in Jacksonville, Florida, complaining of mid-back pain. 9. Respondent wrote RJ prescriptions, dated October 31, 2006, for 90 Lorcet 10/650 mg, 30 Flexeril 10 mg, and 120 ibuprofen 800 mg. 10. The prescriptions written by Respondent were signed “Sandra A. Lindstrom, PA,” and contain her physician assistant license number. 11. Lorcet is a brand name for a_ medication -containing hydrocodone and acetaminophen, and is prescribed to treat pain. According to Section 893.03(3), Florida Statutes, hydrocodone, in the dosages found in Lorcet, is a Schedule III controlled substance. 12, At no time prior to writing the prescriptions did Respondent inform RJ that she was a physician assistant. | 13. At no titne prior to writing the prescriptions did Respondent inform RJ that he had a right to see a physician before any medications were prescribed. 14. The prescriptions written by Respondent do not contain the name, address or telephone number of a supervising physician. 15. The prescriptions written by Respondent do not contain Respondent's prescriber number. 16. Section 458.347(7)(g), Florida Statutes (2006), provides that the Board of Medicine may impose any of the penalties authorized under Sections 456.072 and 458.331(2), Florida Statutes, upon a physician assistant if the physician assistant has been found guilty of or is being investigated for any act that constitutes a violation of Chapter 458 or Chapter 456. | COUNT ONE 17. Petitioner re-alleges and incorporates Paragraphs one (1) through sixteen (16) above, as if fully set forth herein. 18. Section 458.331(1)(g), Florida Statutes (2006), provides that failing to perform any statutory or legal obligation placed upon a licensed physician constitutes grounds for disciplinary action. 19. Section 458.347(7)(e), Florida Statutes (2006) provides that upon employment as a physician assistant, a licensed physician assistant must notify the department in writing within 30 days after such employment or after any subsequent changes in the supervising physician. This notification must include the full name, Florida medical license number, specialty, and address of the supervising physician. 20. At all times material to this Administrative Complaint, Respondent provided no notice to the Department of a supervising physician. 21. Respondent violated Section 458.331(1)(g) (2006), Florida Statutes, in that, during all times material to this Administrative Complaint, she failed to provide notice to the Department notice of a supervisory physician, in violation of Section 458.347(7)(e), Florida Statutes (2006). COUNT TWO 22. Petitioner re-alleges and incorporates Paragraphs one (1) through sixteen (16) above, as if fully set forth herein. . 23. Section 458.331(1)(g), Florida Statutes (2006), provides that failing to perform any statutory or legal obligation placed upon a licensed physician constitutes grounds for disciplinary action. 24. Section 458.347(4)(e), Florida Statutes (2006), provides that a supervising physician may delegate to a fully licensed physician assistant the authority to prescribe any medication used in the supervisory physician's practice. This authority is subject to certain limitations, among them: a. A physician assistant may not prescribe any medicinal drugs listed in a formulary provided for in Section 458.347(4)(f), which formulary must include controlled substances as defined in Chapter 893, Florida Statutes. b. A physician assistant must clearly identify to the patient that he or she is a physician assistant. Furthermore, the physician assistant must inform the patient that the patient has the right to see the physician prior to any prescription being prescribed by the physician assistant. c. A _ physician assistant must file with the Department, before commencing to prescribe, evidence that he or she has completed a continuing medical education course of at least 3 classroom hours in prescriptive practice, conducted by an accredited program approved by the boards, which course covers the limitations, responsibilities, and privileges involved in prescribing medicinal drugs, or evidence that he or she has received education comparable to the continuing education course as part of an accredited physician assistant training program. d. A physician assistant must file with the Department, before commencing to prescribe, evidence that the physician assistant has a minimum of 3 months of clinical experience in the specialty area of the supervising physician. e A prescription issued by a physician assistant must be written in a form that complies with chapter 499, Florida Statutes (2006), and must contain, in addition to the supervisory physician's name, address, and telephone number, the physician assistant's prescriber number. 25. Before commencing to prescribe, Respondent did not file the following with the Department: a. evidence that she had completed a continuing medical education course of at least 3 classroom hours in prescriptive practice, conducted by an accredited program approved by the boards, which course covers the limitations, responsibilities, and privileges involved in prescribing medicinal drugs, or evidence that she had received education comparable to the continuing education course as part of an accredited physician assistant training program; and b. evidence she had a minimum of 3 months of clinical experience in the specialty area of the supervising physician. 26. On October 31, 2006, Respondent wrote RJ prescriptions for 90 Lorcet 10/650 mg, 30 Flexeril 10 mg, and 120 ibuprofen 800 mg. a. at no time prior to writing the prescriptions did Respondent inform RJ that she was a physician assistant. b. at no time prior to writing the prescriptions did Respondent inform RJ that he had a right to see a physician before any medications were prescribed. c. the prescriptions written by Respondent do not contain the name, address or telephone number of a supervising physician. d. the prescriptions written by Respondent do not contain Respondent's prescriber number. . 27. Respondent violated Section 458.331(1)(g), Florida Statutes (2006), in that she violated Section 458.347(4)(e), Florida Statutes (2006) in one or more of the following ways: a. _ by prescribing a controlled substance, hydrocodone, to Patient RJ; b. by failing to clearly identify to RJ she was a physician assistant; c. by failing to inform RJ that he had the right to see the physician prior to any prescription being prescribed by Respondent; d. by failing to file with the Department, before commencing to prescribe, evidence that she had completed a continuing medical education course of at least 3 classroom hours in prescriptive practice, conducted by an accredited program approved by the boards, which course covers the limitations, responsibilities, and privileges involved in prescribing medicinal drugs, or evidence that she has received education comparable to the continuing education course as part of an accredited physician assistant training program. e. by failing to file with the Department, before commencing to prescribe, evidence that she had a minimum of 3 months of clinical experience in the specialty area of the supervising physician. f. by issuing prescriptions that failed to contain the supervisory physician's name, address, and telephone number, and the Respondent's prescriber number. 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 _¢) | ot day of Zeptanbel , 2012. John H. Armstrong, MD Surgeon General and Secretary of Health ill Stafford Assistant General Counsel DOH Prosecution Services Unit 4052 Bald Cypress Way, Bin C-65 ILED Tallahassee, FL 32399-3265 OEP EPUTY. cen Florida Bar No.: 70394 mae SEP ee (850) 245-4640 ext. 8153 _paTE SEP 25 20@ == (850) 245-4681 FAX william_stafford@doh.state.fl.us PCP Date: September 21, 2012 PCP Members: Dr. Miguel, Dr. Nuss, Ms. Mittan, P.A., and Ms. Goersch 10 DOH vs. Sandra Ann Lindstrom, PA CASE NO.: 2006-36542 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 any other discipline imposed. ii

Docket for Case No: 14-001851PL