STATE OF FLORIDA

DIVISION OF ADMINISTRATIVE HEARINGS

GRACITA R. ABELLA, M. D., )

)

Petitioner, )

)

vs. ) CASE NO. 79-789

) BOARD OF MEDICAL EXAMINERS, )

)

Respondent. )

)

RECOMMENDED ORDER

This case was heard pursuant to notice by Stephen F. Dean, assigned Hearing Officer of the Division of Administrative Bearings, in Tampa, Florida, on July 25, 1979. This case was presented upon the Petitioner's petition for reinstatement of her license to practice medicine within the State of Florida.

Dr. Abella's petition for reinstatement is an outgrowth of events which culminated in the issuance by the Board of Medical Examiners of a Notice and Summons and Administrative Complaint against Dr. Abella, charging her with unlawfully obtaining a controlled substance, unlawful use of a controlled substance, and being unable to practice medicine with reasonable skill and safety. Following the issuance of the Administrative Complaint, Dr. Abella relinquished her license to practice medicine within the State of Florida, reserving the right to seek reinstatement upon a showing to the Board that she had engaged in a program of rehabilitation and was able to practice medicine with reasonable skill and safety to her patients in accordance with the pertinent laws governing practice within the State. The President of the Board of Medical Examiners acknowledged Dr. Abella's relinquishment of her license and quashed the Board's Order Compelling Mental or Physical Examination and the Administrative Complaint. The full Board subsequently ratified the Order of the Board's President. After a period of rehabilitative therapy, Dr. Abella petitioned the Board for reinstatement of her license to practice medicine. Dr. Abella subsequently withdrew her petition for reinstatement, which was acknowledged by Dr. Benjamin M. Cole of the Board. On March 29, 1979, Dr.

Abella filed the instant petition for reinstatement of her license to practice medicine in the State of Florida. This matter was referred by the State Board of Medical Examiners to the Division of Administrative Hearings to conduct a formal fact-finding hearing with regard to Dr. Abella's qualifications for relicensure.

The issues presented on Dr. Abella's petition for reinstatement are as follows:

1. Whether Dr. Gracita Rodriguez Abella has been rehabilitated; and

   
   

2. Whether Dr. Gracita Rodriguez Abella can practice medicine with reasonable skill and safety and adherence to the laws governing the practice of medicine within the State of Florida.

Prior to the commencement of the formal hearing, the parties stipulated to the identification and introduction into the record of Respondent's Exhibits 1 through 10. Respondent's Exhibits 11 and 12 were identified and subsequently received into evidence during the proceedings. Petitioner's Exhibits 1 and 2 were identified and subsequently introduced into evidence during the proceedings.

APPEARANCES

For Petitioner: Kevin K. Broderick, Esquire

6155 South Florida Avenue Post Office Box 5378 Lakeland, Florida 33803

For Respondent: William Wiley, Esquire

666 Lewis State Bank Building Tallahassee, Florida 32301

FINDINGS OF FACT

1. Dr. Gracita Rodriguez Abella (nee: Rodriguez) graduated from medical school in the Philippines in 1961. She began an internship in the United States at St. Vincent's Hospital, Erie, Pennsylvania, in 1962. Upon completion of her internship in 1963, she began a rotating residency in anesthesiology at Philadelphia General Hospital. Upon completion of her residency in 1966, she practiced anesthesiology at the General Hospital of the District of Columbia for fifteen (15) months. In 1967, she left the United States and returned to the Philippines.

   
   

2. In the Philippines, Dr. Abella practiced as a general practitioner and anesthesiologist on the staff of four hospitals. During this period of time, she never had any complaints lodged against her and did not abuse drugs.

   
   

3. In August, 1973, Dr. Abella returned to the United States. In the interim, Dr. Abella had married, and her husband, Orlando Abella, returned to the United States with her. Dr. Abella practiced as an anesthesiologist at Long Island General Hospital, Brooklyn, New York, from 1973, until 1975. During this period of time she had no complaints lodged against her.

   
   

4. In 1975, Dr. Abella left Long Island General Hospital and went Lo the Jewish Hospital, Brooklyn, New York. After six months, she left the Jewish Hospital in Brooklyn, New York, and began work as an anesthesiologist at St. Mary's Hospital, Brooklyn, New York. During this time, she began to abuse Demerol. Her physical symptoms were noted by other members of the staff, who reported her abuse of drugs to her supervisor. Dr. Abella's employment was terminated in April of 1977. During this period, Dr. Abella was using drugs while on duty. She was at that time using approximately 100 mg. of Demerol per day.

   
   

5. Between her discharge from St. Mary's Hospital in April and May of 1977, Dr. Abella did not work. In May of 1977, Dr. Abella joined two other physicians in Leesburg, Florida, in the Mid-Florida Anesthesiology Group. During this period she was drug-free and remained so until her husband arrived in Florida. Dr. Abella's husband caused her a great deal of difficulty,

   harassing her while on duty, making threats to turn her in because of her use of drugs in New York, and physically abusing her. Dr. Abella began using Demerol again, which was discovered quickly by her associates who talked her into going

   to Gainesville for treatment at Shand's Teaching Hospital, University of Florida, Gainesville, Florida. She received treatment at Shand's and was discharged drug-free, returning to practice in Venice, Florida, with a group of physicians beginning to set up a practice. During the period of her practice in Venice, she commuted from Leesburg, Florida. Again, her husband began to harass her, and Dr. Abella again began taking Demerol. She was arrested on April 14, 1977, for forging a Demerol prescription and again for the same offense on April 17, 1977. Upon her second arrest, Dr. Abella was held in the county jail. She remained incarcerated until after her plea of nolo contendere and being placed on probation by the court, and her subsequent transfer from the county jail to Bowling Green Treatment Facility near Orlando. After Dr. Abella left Bowling Green, she went to the Chronic Alcoholic Rehabilitation Program (CARP) in West Palm Beach, where she worked essentially as a nurse in the admitting section.

   
   

6. In July of 1978, while working at CARP, she was observed by staff members to be under the influence of a drug. She subsequently admitted having taken Nembutal from CARP supplies to assist her in sleeping after having had an automobile accident in which she severely injured her face. Dr. Abella testified that this was the only time she had used drugs since her arrest in April of 1978.

   
   

7. Because of her unlawful use of controlled substances, an administrative complaint was filed against her by the Board of Medical Examiners in April of 1978. Dr. Abella surrendered her license voluntarily on April 24, 1978. She applied for relicensure in July, 1978; however, because of the incident involving Nembutal, she withdrew that earlier petition.

   
   

8. The testimony of Dr. Abella and the assessment of various counselors reflect that her drug involvement has been directly related to her inability to cope with her role as a physician and with her husband's expectations of her as a wife. While her testimony tends to diminish the pressures placed upon her by her husband, she is intellectually aware of those pressures her husband has placed upon her. Because of her cultural and religious background, Dr. Abella has been reluctant to accept a civil dissolution of her marital relationship. Dr. Abella's testimony shows her acceptance of the civil dissolution of her marriage as a means of resolving the conflicts with her husband; however, she has not instituted proceedings because of her current probationary status with the court and her unlicensed status as a physician.

   
   

9. Dr. Abella is currently working six and one-half days a week in two separate jobs as a medical assistant and is the primary source of support for her children.

   
   

10. The record shows that Dr. Abella needs continuing treatment to assist her in resolving the problems underlying her drug usage; however, she cannot reasonably attain this treatment while working six and one-half days a week to support herself and her children. Furthermore, without the added income of her salary as a physician, she lacks the financial independence necessary to support herself and her children, and obtain such treatment.

    
    

11. Dr. Abella has taken medical courses during the past year to maintain her professional competency.

    
    

12. The physicians with whom Dr. Abella is now working recommend her for relicensure. Dr. Potash of the Airport Medical Clinic indicates his willingness to employ Dr. Abella if she is relicensed. The Airport Medical Clinic is

    primarily engaged in the administration of employment physicals and the treatment of job-related injuries.

    
    

13. Dr. Abella has stipulated to specific restrictions on her license to practice medicine in the State of Florida, and to a probationary period established by the Board.

    
    

14. Although Dr. Abella is presently drug-free, her ability to remain so and to meet the professional responsibilities of the practice of medicine and the responsibilities of being a mother, and to deal with the trauma of a disillusionment proceeding cannot be predicted. However, they are hurdles which she must overcome without returning to drug usage in order to reestablish her professional credibility. While it is inappropriate to anticipate her response, it is prudent to institute a probationary period to protect the public, should the Board determine that Dr. Abella be relicensed.

    
    

    CONCLUSIONS OF LAW

    
    

15. Dr. Abella was qualified for licensure by the State of Florida and was so licensed prior to the surrender of her license in April of 1978. She is qualified now to practice medicine within the State of Florida except for her past history of inability to cope with certain personal problems, resulting in her unlawful use of controlled substances.

    
    

16. The evidence presented outlined the Petitioner's personal and professional background. Additional evidence was specifically presented relating to her unlawful use of controlled substances and its causes. One can reasonably conclude from the evidence presented that Dr. Abella's drug problem was specifically related to her inability to cope with her professional role and her husband's expectations of her role as a wife and mother. Dr. Abella has gained an intellectual understanding of the problems underlying her drug addiction and accepts her responsibility for it. She is currently engaged in a very heavy work schedule. She is currently living with her children and her husband, and has remained drug-free. However, it is noted that Dr. Abella is not working as a physician and has not resolved the role conflicts within her marriage. These facts do not mitigate against her relicensure, but they do indicate the necessity of establishing clear probationary guidelines and maintaining the probationary status for a sufficient period of time to ensure that Dr. Abella has resolved the crises which contributed to her drug addiction in the first instance.

    
    

17. It is appropriate to note that the Board of Medical Examiners has no authority over a registrant's spouse, and that it is contrary to public policy to "require" or "encourage" a registrant to dissolve a marital relationship. The emphasis must be on a successful resolution of the problems from Dr. Abella's standpoint, and not the manner of their resolution. The Board does have a legitimate interest in monitoring its registrant's mode of practice when past history has indicated the registrant has practiced under conditions contrary to the safety and well-being of the public at large.

RECOMMENDATION

Based upon the foregoing Findings of Fact and Conclusions of Law, and considering the Stipulation entered into by Dr. Gracita Rodriguez Abella and the proposed findings of fact submitted by the parties, the Hearing Officer recommends that the Board of Medical Examiners relicense the Petitioner under the provisions of said Stipulation, extending the period of probation until such

time that the Board is satisfied that Dr. Abella can practice without supervision outside a controlled or structured environment, and until the Petitioner has resolved her personal crises centering on her professional and personal roles. Further, the Hearing Officer would recommend that Paragraph 8 of the Stipulation, calling for individual and/or group therapy and/or counseling on an outpatient basis during the period of probation be specifically implemented, and that the Petitioner accept unannounced periodic urine screening as an integral part of her probation.

DONE and ORDERED this 5th day of September, 1979, in Tallahassee, Leon County, Florida.

STEPHEN F. DEAN, Hearing Officer Division of Administrative Hearings Room 101, Collins Building Tallahassee, Florida 32301

(904) 488-9675

COPIES FURNISHED:

William B. Wiley, Esquire

666 Lewis State Bank Building Tallahassee, Florida 32301

Kevin K. Broderick, Esquire 6155 South Florida Avernie Post Office Box 5378 Lakeland, Florida 33803

Docket for Case No: 79-000789

Orders for Case No: 79-000789