STATE OF FLORIDA DEPARTMENT OF HEALTH DEPARTMENT OF HEALTH, Petitioner, v. DOH Case No. 2015-19773 SAYED ARIF ALI JAFFERY, M.D., Respondent. / ADMINISTRATIVE COMPLAINT Petitioner, the Florida Department of Health (hereinafter “Petitioner’), files this Administrative Complaint before the Florida Board of Medicine (hereinafter the “Board”) against Respondent, Sayed Arif Ali Jaffery, M.D. (hereinafter “Respondent”), 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, and Chapters 456 and 458, Florida Statutes. 2. Atall times material hereto, Respondent was a licensed physician within the state of Florida, having been issued license number ME 91784. 3. Respondent's address of record is 109 Trotter Road, Egg Harbor Township, New Jersey 08234. 4. Atall times material hereto, Respondent was a licensed physician within the state of New York, having been issued license number 229371. 5. The licensing authority regulating the practice of medicine in the state of New York is the State Board for Professional Medical Conduct, located within the New York Department of Health (hereinafter the “New York Board”). 6. | Onor about June 4, 2015, the New York Board and Respondent agreed to, and entered into, a Stipulation and Application for an Interim Order of Conditions (hereinafter the “Stipulation and Application”). 7. The Stipulation and Application, among other things, precluded Respondent from practicing medicine in New York state or in any other setting or jurisdiction where Respondent's practice is predicated upon his New York state medical license. 8. Onor about June 9, 2015, the New York Board adopted the terms of the Stipulation and Application and entered an Interim Order of Conditions. 9. The Interim Order of Conditions effected a suspension of Respondent's license or authority to practice medicine in the state of New York. DOH v. Sayed Arif All Jaffery, M.0., DOH Case Number 2015-19773 Administrative Complaint 2 10. The Interim Order of Conditions constitutes action against Respondent's license or authority to practice medicine jin the state of New York. 11. Section 458.331(1)(b), Florida Statutes (2014), subjects a licensee to discipline for having a license or the authority to practice medicine revoked, suspended, or otherwise acted against, including the denial of licensure, by the licensing authority of any jurisdiction, including its agencies or subdivisions. The licensing authority's acceptance of a physician's relinquishment of a license, stipulation, consent order, or other settlement, offered in response to or in anticipation of the filing of administrative charges against the physician's license, shall be construed as action against the physician‘s license. 12. Based on the foregoing, Respondent violated Section 458.331(1)(b), Florida Statutes (2014), by having his license or his authority to practice medicine in the state of New York suspended and/or otherwise acted against by the licensing authority of the state of New York. WHEREFORE, Petitioner respectfully requests the Board 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 DOH v. Sayed Arif Ali Jaffery, M.D., DOH Case Number 2015-19773 Administrative Complaint 3 administrative fine, issuance of a reprimand, placement of Respondent on probation, corrective action, refund of fees billed or collected, remedial education, and/or any other relief the Board deems appropriate. SIGNED this 26™ dayof_ . AW GUST 2016. FILED Department Of Health Deputy Clerk CLERK 9 Angel Sasdens DATE AUG 29 2016 ee _DATE AUG 29 OO PCP: August 26, 2016 Celeste Philip, M.D., M.P.H. State Surgeon General and Secretary Geoffrey M. —— Esq. Assistant General Counsel Florida Bar No. 0010325 Department of Health Prosecution Services Unit 4052 Bald Cypress Way, Bin C-65 Tallahassee, Florida 32399-3265 Telephone (850) 245-4640, ext. 4661 Facsimile (850) 245-4684 E-mail Geoffrey.Christian@flhealth.gov Attorney for Petitioner PCP Members: G. Ei-Bahri, M.D.; J. Orr, Jr, M.D.; Ms. B. Goersch DOH v. Sayed Arif Ali Jaffery, M.D., DOH Case Number 2015-19773 Administrative Complaint DOH V. SAYED ARIF ALI JAFFERY, M.D. DOH CASE NUMBER 2015-19773 QTICE 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. A request or petition for an administrative hearing must be in writing and must be received by the Department of Health within 21 days from the day Respondent received this Administrative Complaint, pursuant to Rule 28-106.111(2), Florida Administrative Code. If Respondent fails to request a hearing within 21 days of receipt of this Administrative Complaint, Respondent waives the right to request a hearing on the facts alleged in this Administrative Complaint pursuant to Rule 28-106.111(4), Florida Administrative Code. Any request for an administrative proceeding to challenge or contest the material facts or charges contained in this Administrative Complaint must conform to Rule 28-106.2015(5), Florida Administrative Code. Mediation under Section 120.573, Florida Statutes, is not available to resolve this Administrative Complaint. 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 of Medicine shall assess costs related to the investigation and prosecution of a disciplinary matter, which may include attorney hours and costs, on Respondent in addition to any other discipline imposed. DOH v. Sayed Arif Ali Jaffery, M.D., DOH Case Number 2015-19773 Administrative Complaint 5

Docket for Case No: 17-002557PL