STATE OF FLORIDA DEPARTMENT OF HEALTH DEPARTMENT OF HEALTH, PETITIONER, Vv. CASE NO. 2015-28802 GRIT ARMSTRONG ADLER, M.D., RESPONDENT. / ADMINISTRATIVE COMPLAINT Petitioner, Department of Health, by and through its undersigned counsel, files this Administrative Complaint before the Board of Medicine against the Respondent, Grit Armstrong Adler, M.D., and in support thereof alleges: 1. Petitioner is the state agency charged with regulating the practice of Medicine pursuant to Section 20.43, Florida Statutes; Chapter 456, Florida Statutes; and Chapter 458, Florida Statutes. 2. At ail times material to this Complaint, Respondent was a licensed medical doctor in the State of Florida, having been issued license number ME 107892. Page 1 of 7 3. Respondent's address of record is 11310 Thonotosassa Road, Thonotosassa, Florida 33592. 4. Respondent is board certified in diagnostic radiology by the American Board of Radiology. 5. On or about October 27, 2015, Patient I.D. presented to Respondent for a scheduled thrombectomy of the right upper arm AV fistula: 6. Over the course of the procedure, Respondent administered four (4) doses of Fentany! via a sheath in the fistula. 7. After the final dose of Fentanyl, Patient I.D. complained of nausea. Shortly thereafter, he stopped responding to questions and showed signs of overdose. 8. Respondent administered a dose of Romazicon in an attempt to counteract the effects of the Fentanyl. 9. Romazicon is a benzodiazepine antagonist and acts as an antidote for the sedative Versed. . 10. Narcan is the correct antidote for Fentanyl overdose. 11. The standard of care required Respondent to administer Narcan, the correct antidote for a Fentanyl overdose. Page 2 of 7 DOH v Gril Armstrong Adler. M.D. Case 2015-28802 12. Respondent failed to adequately document the thrombectomy, including the method of administering the Fentanyl. COUNT ONE Violation of Section 458.331(1)(t) 13. Petitioner realleges and incorporates paragraphs one (1) through eleven (11) as if fully set forth in this count. 14. Section 458.331(1)((1), Florida Statutes (2015), subjects a licensee to discipline for committing medical malpractice as defined in Section 456.50, Florida Statutes. Section 456.50(1)(g), Florida Statutes (2015), states medical malpractice means the failure to practice medicine in accordance with the level of care, skill, and treatment recognized in general law related to health care licensure. Section 766.102, Florida Statutes (2015), provides that the prevailing standard of care for a given healthcare 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. 15. Respondent failed to meet the prevailing standard of care in regard to Patient LD. by administering the incorrect antidote to a Fentanyl overdose. Page 3 0f7 DOH v. Grit Armstrong Adler. MD, Case #2015-28802 16. Based on the foregoing, Respondent has violated Section 458.331(1)(t), Florida Statutes (2015), by committing medical malpractice. COUNT TWO Violation of Section 458.331(1)(m) and/or Section 458.331(1)(nn) 17. Petitioner realleges and incorporates paragraphs one (1) through twelve (12) as if fully set forth in this count. 18. Section 458.331(1)(m), Florida Statutes (2015), subjects a licensee to discipline for failing to keep legible, as defined by department rule in consultation with the board, medical records that identify the licensed physician or the physician extender and supervising physician by name and professional title who is or are responsible for rendering, ordering, supervising, or billing for each diagnostic or treatment procedure and that justify the course of treatment of the patient, including, but not limited to, patient histories; examination results; test results; ‘records of drugs prescribed, dispensed, or administered; and reports of consultations and hospitalizations. 19. Section 458.331(1)(nn), Florida Statues (2015), provides that violating any provision of Chapter 458 or 456, or any rules adopted Page 4 of 7 DOH v. Grit Armstrong Adler. M.D. Case 42015-28802 pursuant thereto constitutes grounds for disciplinary action by the Board of Medicine. 20. Chapter 64B8-9.003(d)(3), Florida Administrative Code (2015), provides that medical records shall contain sufficient information to identify the patient, support the diagnosis, justify the treatment and document the course and results of treatment accurately, by including, at a minimum, patient histories; examination results; test results; records of drugs prescribed, dispensed, or administered; reports of consultations and hospitalizations; and copies of records or reports or other documentation obtained from other health: care practitioners at the request of the physician and relied upon by the physician in determining the appropriate treatment of the patient. 21. Respondent failed to create and/or maintain adequate, legible medical records that justify the course of treatment of Patient I.D. and/or satisfy the requirements of Chapter 64B8-9.003(d)(3), Florida Administrative Code (2015), by failing to adequately document the performance of the thrombectomy, including the method of administering the Fentanyl. Page 5 of 7 DOH v, Grit Armstrong Adler. M0. Case #2015-28802 22. Based on the foregoing, Respondent violated Section 458.331(1)(m), Florida Statutes (2015), and/or Section 458.331(1)(nn), Florida Statutes (2015). 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 lp day of 2017. DEPARTMENT OF tay DOH Prosecution Services Unit cuERx ang DEPUTY cen 4052 Bald Cypress Way, Bin C-65 pave JAN 0 9 OUT Tallahassee, Florida 32399-3265 a Florida Bar Number 0085797 (850) 245 - 4444 Telephone (850) 245 - 4683 Facsimile _SEC/ PCP; 01/06/2016 PCP Members: Steven Rosenberg, M.D.; Donald Mullins Page 6 of 7 DO! v Grit Armstrong Adler. M.D. Casc #2015-28802 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. A request or petition for an administrative hearing must be in writing and must be received by the Department within 21 days from the day Respondent received the 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 the Administrative Complaint must conform to Rule 28-106.2015(5), Florida Administrative Code. Please be advised that mediation under Section 120.573, Florida Statutes, is not available for administrative disputes involving this agency action. 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. Page 7 of 7 DOH v, Grit Armstrong Adler, M.D. Case #2015-28802

Docket for Case No: 18-004821PL