STATE OF FLORIDA
DIVISION OF ADMINISTRATIVE HEARINGS
STATE OF FLORIDA, DEPARTMENT OF ) PROFESSIONAL REGULATION, BOARD ) OF MEDICAL EXAMINERS. )
)
Petitioner, )
)
vs. ) CASE NO. 83-2304
)
WILLIAM J. LEE, M.D., )
)
Respondent. )
)
RECOMMENDED ORDER
Notice was given and on December 14 and 15, 1983, in Jacksonville, Florida, a formal Subsection 120.57(1), Florida Statutes, hearing was held. This Recommended Order is being entered following the receipt and review of the transcript of proceedings, associated exhibits and the proposed orders of the parties. The last of those proposals was filed on March 19, 1984. The proposals have been utilized to some extent as reflected in the Recommended Order. The rejection of the balance of the proposed Recommended Orders is based upon their immateriality, irrelevance or because they are contrary to the factual treatment of this controversy found in the Recommended Order.
APPEARANCES
For Petitioner: Harry L. Shorstein, Esquire
605 Blackstone Building
Jacksonville, Florida 32202
For Respondent: Kurt Andrew Simpson, Esquire
Costa Verde Plaza
2459 South Third Street Jacksonville Beach, Florida 32250
ISSUES
This case concerns an administrative complaint brought by the State of Florida, Department of Professional Regulation, against Respondent, charging violations of provisions of Chapter 458, Florida Statutes. In particular, it relates to the treatment of the patient Sandra Gilhousen in the placement of an IUD and in the performance of an abortion. Respondent is also charged with misprescription of a controlled substance, Ionamin, for that patient.
Respondent is also charged with misprescription of Ionamin, Demerol and Quaalude for the patient Betty Boling. Finally, Respondent is accused of misprescription of Demerol for the patient Margo Stewart. These allegations are more completely described in the conclusions of law.
FINDINGS OF FACT
William J. Lee, M.D., is a physician licensed to practice medicine in the State of Florida according to licensure by the State of Florida, Department of professional Regulation, Board of Medical Examiners, License No. ME012345.
At all times relevant to this cause, he has held that license and has practiced general medicine and general surgery at Jacksonville Beach, Florida. Dr. Lee is a graduate of Emory University in 1958 and received an M.D. degree from Emory in 1964. His internship was done at the University of Florida, followed by residency and general surgery at the University of Florida from 1965-1968, which was completed at the Duval Medical Center in Jacksonville, Florida, in 1969.
After appropriate service of the subject administrative complaint, Respondent made a timely request for formal hearing pursuant to Subsection 120.57(1), Florida Statutes.
SANDRA GILHOUSEN
On January 5, 1983, Sandra Gilhousen went to the office of Respondent in Jacksonville Beach, Florida, for purposes of the placement or insertion of an IUD. She filled out a patient history information form to the extent as reflected in a copy of that form found in Petitioner's composite Exhibit No. 5, admitted into evidence. That information included home address, employment status, occupation, phone number and age. No information was given or requested on the subject of her past medical history, other than Dr. Lee asking if she suffered any allergies. During the examination process and the subsequent placement of the IUD, the patient indicated that her menstrual cycle had concluded two or three days before, when in fact, she had missed a normal cycle and had suspicion of being pregnant. When the Respondent placed the IUD, there was some seepage of blood indicating to him that the menstrual cycle had just concluded as the patient had indicated. On the other hand, the uterus was enlarged which was consistent with pregnancy. The uterus was found to be mildly boggy upon the placement of the Intrauterine Device. It was the expectation of the patient that the placement of the IUD would cause her to abort the fetus.
No pregnancy test was performed prior to the placement of the IUD and no laboratory work was done. These procedures were not performed, according to Lee, because he believed her when she said she had just concluded menses and she had a healthy appearance. Prior to the placement of the Intrauterine Device, Dr. Lee checked the patient's blood pressure, lungs, masses in the abdominal cavity and for pelvic irregularities. None of the results of these observations were recorded in her records with Dr. Lee. The notations in her record related to the visit simply indicates insertion of IUD and the cost of that service plus the cost of the device. At the conclusion of the procedure, Dr. Lee gave the patient a pamphlet related to the IUD and asked for her to make a return visit to make certain there were no complications.
The patient Gilhousen and an acquaintance, Betty Boling, returned to Dr. Lee's office on January 7, 1983. The purpose of the visit was not the return visit contemplated by Dr. Lee related to the IUD. On this occasion, Gilhousen was provided a prescription for Ionamin, a medication which is a controlled substance used for weight control. Prior to being provided this prescription from Dr. Lee for 30 units in 30 milligram amounts, the blood pressure of the patient was taken. A copy of the prescription may be found as Petitioner's Exhibit No. 1, admitted into evidence. At that time, the patient weighed less than on the date of the final hearing in this cause. On the final hearing date, the patient was 5'5" tall and weighed 120 pounds. The patient Gilhousen had been weighed before the prescription was given but the weight is
not recorded in her records held by Dr. Lee. No indication whatsoever is made of the prescription of the Ionamin or of any examination given prior to prescribing that substance. Dr. Lee did not do a full-scale examination, more than blood pressure and weight, when he prescribed the Ionamin, because in his mind he had observed the patient through an examination two days before when he placed the IUD.
A pregnancy test was performed after January 5, 1983, not by Dr. Lee, and Gilhousen had her pregnancy confirmed. She then requested Dr. Lee to perform an abortion, with the understanding that the procedure would have to be done at the convenience of Dr. Lee, in that she did not wish to pay for that service immediately. Dr. Lee was made aware of the results of the pregnancy test prior to subsequently performing the requested abortion. He expected that he would be able to gain the assistance of Betty Boling when he performed that procedure.
After a telephone conversation on the evening of January 14, 1983, Gilhousen went to Dr. Lee's office around 8:30 p.m. for the purpose of having the abortion done. As with the case with the IUD, no written consent was given to have the abortion done. Nonetheless, it was discussed with Dr. Lee and it was the desire of the patient Gilhousen to have the abortion. When Gilhousen arrived, the Respondent was smoking marijuana and asked her if she would be interested in marijuana, hashish or cocaine, which she declined. Dr. Lee was unattended by other staff at this time and throughout the abortion procedure. The patient was taken to a patient examining room and placed on an examining table where the abortion was done by D&C. The room had an operating light, necessary instruments to conclude the procedure, an electrocardiogram, suction devices, epinephrines, IV fluids and emergency drugs. No monitoring equipment was used during the procedure other than checking her blood pressure. Blood pressure had been checked prior to the procedure and Dr. Lee had listened to the patient's heart and lungs and a pelvic examination had been made. The procedure took approximately 40 minutes and the observation was made by Dr. Lee that the pregnancy was in the range of four to five weeks. No pregnancy test or laboratory work was done prior to the termination. Laboratory tests were not done because, according to Dr. Lee, this was Betty Boling's friend who didn't have any money. A pregnancy test was not done because Dr. Lee felt that this was an additional expense not necessary in that he believed the patient when she said that she had been informed of a positive pregnancy test. Missing information through laboratory work included Rh typing and a hemoglobin test. Related to the hemoglobin test, Dr. Lee observed that the patient's outward appearance was acceptable and that the mucous membranes had good color. Dr. Lee recognized the possibility of Rh factor problems in the sense of the mother being negative and the father positive as it might affect the next pregnancy of the patient pertaining to Rh incompatibilities. Again, the Rh testing was not done for financial reasons. Moreover, per Lee, the patient wanted the procedure done on that evening and the patient, as he understood it, did not wish to become pregnant in the future. Being unable to locate Betty Boling to assist, Dr. Lee decided to go forward with the procedure without an attendant being present.
The patient was given Valium to calm her nerves and Dr. Lee utilized Stadol and Phenergan for sedation and as analgesic. Through this combination, the patient was placed in a sort of "twilight condition" on a plane which made her unconscious, but not a deep unconscious state. While giving her this medication, he asked her if she felt "sexually aroused." In Petitioner's Exhibit No. 5, the amounts and types of medication are recorded in the patient's chart and it is noted that the D&C was done and tolerated well. It is also
noted that the patient was picked up by a friend and the charge of the procedure is given. Ergotamine was given to retract the uterus and minimize bleeding. No other information is recorded in the patient's chart.
The patient's recovery from the medications in terms of regaining consciousness took longer than might be expected given the amount of medication. Notwithstanding the patient's slow recovery, Dr. Lee left the patient unattended later in the evening for reason that he felt that she was "ready to go home." After leaving the patient unattended, Respondent tried to gain the assistance of Betty Boling to take her home. Boling did not agree. When Dr. Lee returned to his office, which is also his place of residence, visitors came by and he consumed alcohol with those people. He then left a second time to make purchases at a store and when he returned, a Mr. Hobbs, who was a friend of Gilhousen, had arrived to pick the patient up. Hobbs observed Lee staggering and with slurred speech, indications of intoxication. Hobbs and Dr. Lee took Gilhousen to a car and she left with Hobbs.
Gilhousen came back to Dr. Lee's office on January 15, 1983, to pick up her car and asked Dr. Lee if she needed to be prescribed any antibiotics for her post procedural circumstance. He told her that this would not be necessary at present and advised her to monitor her temperature. As reflected in Petitioner's composite Exhibit No. 5, Gilhousen was later seen at Memorial Hospital of Jacksonville related to her post abortion condition and was found to be acceptably recovering. It was noted on the basis of a pelvic sonogram that the abortion had been a success.
Dr. Doris Newell Carson, M.D., a board-certified gynecologist and obstetrician, who practices in Jacksonville, Florida, was qualified as an expert and gave her medical opinion on the quality of the Respondent's performance in treating Ms. Gilhousen. Her testimony was premised upon an examination of the medical records of Dr. Lee pertaining to Sandra Gilhousen. Dr. Carson felt that in the insertion of an IUD, that Dr. Lee should have obtained the history of the patient's medical condition with particular emphasis on menstrual period and allergies because of the possibility of allergic reaction being brought about with the placement of the IUD. Physical examination was necessary to include heart, lungs, and abdomen and examination of the position of the uterus. In addition, it was necessary to take the blood pressure of the patient and to have laboratory work done related to hemoglobin, a gonorrhea culture and pap smear. Dr. Carson also felt that it was necessary to determine pregnancy by test, prior to the placement. All of these matters should be recorded in the patient records, per Dr. Carson. In addition, written permission should have been received prior to the placement of that IUD. Any physician who failed to do these things and document them, would have demonstrated less prudence than a reasonably prudent, similar physician. As established in prior facts found, Dr. Lee failed to record any of these matters and failed to obtain necessary medical history and to have necessary testing and laboratory work up envisioned by Dr. Carson. Her opinion as to what is needed for the placement of the IUD in the patient Gilhousen in order to achieve community standards in the place where Dr. Lee practiced is accepted. Based upon her opinion, Dr. Lee is found to have practiced medicine in the placement of that IUD with less care and skill than a reasonably prudent similar physician in his community would have been expected to give.
Dr. Carson did not feel that Gilhousen, according to the patient's height and weight, needed Ionamin to control the patient's weight. Ionamin, a controlled substance, is a stimulatory drug which has addictive qualities, from Dr. Carson's understanding. The prescribing of the Ionamin on the information
available to Lee was not the act of a prudent, similar physician who might be confronted with the same conditions and circumstances as Dr. Lee was when he prescribed Ionamin for Gilhousen, per Carson. Carson did not feel there was a medically justifiable reason for issuing the prescription of Ionamin. Moreover, Dr. Lee was deficient in the mind of Dr. Carson by not recording the issuance of the prescription in the patient's medical records. Dr. Carson's observations about Ionamin and the quality of Dr. Lee's performance in prescribing Ionamin to Gilhousen on January 7, 1983, are accepted.
Dr. Carson was questioned on the matter of the abortion procedure which was performed on January 14, 1983. In giving her opinion, she was made aware of certain hypothetical facts related to the setting, time of day, nonavailability of a medical attendant, Dr. Lee's leaving the patient unattended, Respondent smoking marijuana and the offering of marijuana and other drugs to the patient, in addition to the matters set forth in the patient's record. In Dr. Carson's mind, a complete physical, including blood pressure, would be necessary prior to the termination; laboratory work, to include hemoglobin, to measure the amount of iron in the blood would be necessary; a CG culture and RH typing; and discussion with the patient as to allergies to medications would be necessary. In addition, a pregnancy test prior to termination would be indicated. The physician would also need a medical assistant in attendance and written permission would be necessary prior to the termination of the pregnancy. Dr. Carson would have used a D&E as opposed to D&C for termination of this early pregnancy and would not have used the form of anesthesia chosen by Dr. Lee. Her choice would have been a local block. Her testimony as to the choice of procedures and type of anesthesia does not lead to the conclusion that his choice of technique and anesthesia is below the level of care acceptable for a reasonably prudent, similar physician in the Jacksonville community. In Dr. Carson's opinion, it was inappropriate for Dr. Lee to smoke marijuana on the night of the abortion before conducting that procedure and to offer marijuana, hashish and cocaine to the patient. Dr. Carson felt that it was necessary to monitor blood pressure, and other vital signs related to pulse and respiration, the amount of flow from the site of the abortion and to give medication for pain as needed. Dr. Carson finds the act of leaving the patient unattended an unacceptable performance by Dr. Lee. Dr. Carson also believed that the patient's medical history, laboratory information and observations related to the physical examination should be recorded in the patient records and they were not. Per Dr. Carson, the failure to do those things she described related to the pregnancy termination would constitute substandard care to the patient, as would his use of marijuana and offering of illegal drugs to the patient. With the exception of Dr. Carson's opinions about the abortion technique, D&C, and type of anesthesia, her perception about appropriate care is accepted. By her description, this substandard care is tantamount to failure to provide care that a reasonably prudent, similar physician in a similar circumstance would have provided and Dr. Lee has not been sufficiently prudent in his treatment of Gilhousen on the date of the abortion, as shown in contrasting his performance as reported and Dr. Carson's idea of acceptable performance.
BETTY BOLING
Betty Boling requested assistance from Dr. Lee to control her weight. This request was made on January 7, 1983. Her blood pressure was checked and her weight taken. No other information was sought from the patient related to her history and no further examination was made of the patient as to her physical condition. Neither of these observations related to blood pressure and weight were recorded in her patient records, a copy of which may be found as
Petitioner's composite No. 2, admitted into evidence. Boling was then prescribed 30 units, 30-milligram Ionamin by Dr. Lee.
The record in this proceeding is left in the posture that the only basis of knowing the true circumstance of the patient Boling related to the need of weight reduction is her comment that she was overweight when she requested the provision of diet medication. This does not sufficiently justify the prescription of Ionamin and promotes the conclusion, based upon Dr. Carson's perception of the Gilhousen situation where Ionamin was prescribed, that there was no medical justification for prescribing Ionamin to Boling and that to do so was substandard care and not the care expected of a reasonably prudent, similar physician in dealing with the Boling case. (The prescription may be found in Petitioner's Exhibit No. 3.)
On July 14, 1981, Dr. Lee prescribed for Betty Boling 30, 50-milligram Demerol units. On August 23, 1981, an additional 20, 50-milligram Demerol units were prescribed for Boling by Lee. On November 1, 1981, an additional 20, 50- milligram Demerol units were prescribed by Dr. Lee for Boling. On December 7 or 8, 1981, an additional 30, 50-milligram Demerol units were prescribed by Dr. Lee for the benefit of Boling. On December 7, 100, 300-milligram Quaaludes were prescribed for Boling by Dr. Lee. Finally, on February 19, 1982, 100 300- milligram units of Quaaludes were prescribed by Dr. Lee. The prescriptions of Demerol and Quaaludes may be found in Petitioner's composite Exhibit No. 3. Prescriptions indicate the basis for prescribing the Demerol was related to pain and the Quaaludes related to sleep. None of these prescriptions or the reason for the prescriptions are indicated in the patient records of Betty Boling, found as part of Petitioner's composite Exhibit No. 2, as a copy. Although Dr. Lee claimed to have conducted a physical examination on the patient before prescribing the Demerol and Quaaludes, that testimony is not believed.
Moreover, Dr. Lee has no specific recollection of why he prescribed the Demarol for the patient as to the exact details. Dr. Lee had on occasion prescribed Demerol for migraine headaches for Boling. Dr. Lee indicated that other analgesic medication given for the migraine headaches had not been successful and that was why Demerol was used for the patient Boling. Dr. Lee's indication that he might not have entered the details of the prescription of Demerol and Quaaludes for Boling in her records on the occasions in question because of her concern that other persons who had access to her patient records not see those entries, is not tenable and is not accepted as fact. Especially in view of the fact that Boling does not have any recollection of such a request.
Notwithstanding the risk to health in prescribing Quaaludes continually as recognized by Dr. Lee in his testimony at hearing, he prescribed Quaaludes in 100 units and in a further 100 units 70 days thereafter in the strongest dosage available. The methaqualone or Quaaludes were for purposes of assisting Boling in sleeping and the explanation given by Dr. Lee about the possibility of using more than one tablet per day within the 70 days in which the original 100 tablets had been prescribed is not accepted.
Dr. Carson, after examining the Boling records, did not find any justification in the records for prescribing Demerol and Quaaludes, in the sense of a medical reason for such prescription. As Dr. Carson identified, Demerol is a narcotic analgesic, equivalent to morphine, with 60 milligrams of Demerol being comparable to 10 milligrams of morphine sulfate. Per Carson, Demerol is a drug highly susceptible to abuse, leading to addiction. For that reason, it is not appropriate for migraine headaches in that migraine headaches are repetitive in nature, thereby promoting greater chance of addiction. Demerol is a very potent respiratory depressant and can have allergic manifestations. Demerol and
Quaaludes are Schedule II controlled substances. Quaaludes are a sedative which are used for inducing sleep and might be used for people suffering insomnia.
Quaaludes have high potential for addiction and the substance became a street drug and has, since the time of this case, become illegal in the State of Florida. To use Demerol and Quaaludes together, according to Dr. Carson, would potentiate depression, thereby compounding effects of the drugs taken singularly. Dr. Lee's prescription of the Demerol and Quaaludes as described in the Boling circumstance, related herein, in the mind of Carson represented a failure of Lee to practice medicine with a level of care, skill and treatment recognized by reasonably prudent, similar physicians as being acceptable under similar conditions and circumstances and represented malpractice. It also was a prescription of controlled substance in bad faith not within the course of professional practice. These opinions by Dr. Carson, related to the Demerol and Quaaludes, and the practices of Dr. Lee in prescribing the substances for the patient Boling are accepted.
MARGO STEWART
No testimony was given related to the allegations found in Count Six pertaining to Margo Stewart and that count was abandoned by the prosecution.
CONCLUSIONS OF LAW
The Division of Administrative Hearings has jurisdiction over the subject matter and the parties to this action pursuant to Subsection 120.57(1), Florida Statutes.
Count One in the Administrative Complaint accuses the Respondent of violating Section 458.331(1)(t), Florida Statutes, by committing gross or repeated malpractice or failing to practice medicine with the care, skill and treatment which is recognized by reasonably prudent, similar physician as being acceptable under similar conditions and circumstances and further violating Section 458.331(1)(1), Florida Statutes, by making deceptive, untrue or fraudulent representations in the practice of medicine or employing a trick or scheme in the practice of medicine when such trick or scheme fails to conform to generally prevailing standards of treatment in the medical community. This relates to the treatment of the patient Gilhousen in the insertion of the IUD and the performance of the abortion. It has been shown that the Respondent violated Section 458.331(1)(t), Florida Statutes, by failing to practice medicine with the level of care, skill and treatment which is recognized by reasonably prudent, similar physician as being acceptable under similar conditions and circumstances. Respondent has not been shown to have violated Section 458.331(1)(1), Florida Statutes. For the violation in Count I, Respondent is subject to the penalties set forth in Section 458.331(2), Florida Statutes.
Count Two charges the Respondent with a violation of Section 458.331(1)(q), Florida Statutes, by prescribing a controlled substance other than in the course of the physician's professional practice. That violation has been established related to the controlled substance Ionamin as prescribed on January 7, 1983, for the patient Gilhousen. Respondent has also violated Section 458.331(1)(h), Florida Statutes, by failing to perform a statutory legal obligation placed upon the physician as it relates to his violation of Section 893.05(1), Florida Statutes, by failing to prescribe the Ionamin in good faith and in the course of his professional practice. Respondent has also violated Section 458.331(1)(t), Florida Statutes, related to the prescribing of the Ionamin in that he has failed to practice medicine with the level of care, skill
and treatment which is recognized by reasonably prudent similar physician as being acceptable under similar conditions and circumstances. The proof is insufficient to establish a violation of Section 458.331(1)(1), Florida Statutes, pertaining to deceptive, untrue or fraudulent representations in his practice or the employment of a trick or scheme in the practice of medicine.
For the violations established, the Respondent is subject to the penalties set forth in Section 458.331(2), Florida Statutes.
Count Three charges that Respondent in the Gilhousen matter failed to obtain the written permission to terminate the pregnancy as required by Section 390.001(4), Florida Statutes, and of conducting the procedure in a facility that was not approved for the abortion in contravention of Section 390.001(1)(b), Florida Statutes. The necessary permission was not obtained. It has not been shown that the place where the abortion was done does not meet the requirement of approved facility within the meaning of the statute. Respondent is also accused in Count Three of failing to maintain a record indicating the reason for the termination, the period of gestation at the time of the procedure or to file any such record with the Department of Health and Rehabilitative Services, as required by Section 390.002(1), Florida Statutes. This statute has been violated. For failing to obtain the written permission to perform the abortion and to comply with requirements of recording and filing, Respondent has violated Section 458.331(1)(h), Florida Statutes, by failing to perform statutory and legal obligations placed upon the Respondent. For that violation, he is subject to the penalties set forth in Section 458.331(2), Florida Statutes.
Count Four accused the Respondent of sexually assaulting the patient Gilhousen on the date of the abortion and by doing so, violating Section 458.329, Florida Statutes, by committing sexual misconduct in the practice of medicine and for that reason violating Section 458.331(1)(h), Florida Statutes, by failing to perform statutory legal obligations placed upon the physician and of violating Section 458.331(1), Florida Statutes, by exercising influence within the patient-physician relationship for purposes of engaging the patient in a sexual activity. These violations alleged in Count Four were not proven.
Count Five charges the Respondent with violation of Section 458.331(1)(q), Florida Statutes, by prescribing a controlled substance other than in the course of a physician's professional practice; violating Section 458.331(1)(h), Florida Statutes, by failing to perform a statutory or legal obligation placed upon the physician as related to violation of Section 893.05(1), Florida Statutes, by failing to prescribe the controlled substance in good faith and in the course of his professional practice; violating Section 458.331(1)(1), Florida Statutes, by making deceptive, untrue or fraudulent representations in the practice of medicine or employing a trick or scheme in the practice of medicine when such trick or scheme fails to conform to the generally prevailing standards of treatment in the medical community and violating Section 458.331(1)(t), Florida Statutes, by committing gross or repeated malpractice or the failure to practice medicine with the level of care, skill or treatment which is recognized by reasonably prudent, similar physician as being acceptable under similar conditions and circumstances. This pertains to the prescription of the substances Demerol, Quaalude or methaqualone and Ionamin to Boling on the dates set forth in the findings of fact. With the exception of the violation of Section 458.331(1)(1), Florida Statutes, all allegations as set forth in Count Five have been proven. For these violations, the Respondent is subject to the penalties set forth in Section 458.331(2), Florida Statutes.
Count Six, related to the patient Margo Stewart, was abandoned by the prosecution. Consequently, the proof was not made.
Based upon a full consideration of the facts found and the conclusions of law reached, it is
That a final order be entered which finds the Respondent guilty of Counts One, Two, Three and Five and dismisses Counts Four and Six. The final order should impose a penalty of revocation in view of the gravity of these violations.
DONE AND ENTERED this 1st day of June 1984, in Tallahassee, Florida.
CHARLES C. ADAMS
Hearing Officer
Division of Administrative Hearings The Oakland Building
2009 Apalachee Parkway
Tallahassee, Florida 32399-1550
(904) 488-9675
FILED with the Clerk of the Division of Administrative Hearings this 1st day of June 1984.
COPIES FURNISHED:
Harry L. Shorstein, Esquire 605 Blackstone Building
Jacksonville, Florida 32202
Kurt Andrew Simpson, Esquire Costa Verde Plaza
2459 South Third Street Jacksonville Beach, Florida 32250
Dorothy Faircloth Executive Director
Board of Medical Examiners
130 North Monroe Street Tallahassee, Florida 32301
Fred Roche, Secretary
Department of Professional Regulation
130 North Monroe Street Tallahassee, Florida 32301
=================================================================
AGENCY FINAL ORDER
================================================================= BEFORE THE BOARD OF MEDICAL EXAMINERS
DEPARTMENT OF PROFESSIONAL REGULATION,
Petitioner, DOAH CASE NO. 93-2304 DPR CASE NO. 0031724
WILLIAM J. LEE, M.D., LICENSE NO. 12345,
Respondent.
/
FINAL ORDER OF
THE BOARD OF MEDICAL EXAMINERS
This cause came before the Board of Medical Examiners (Board) pursuant to Section 120.57(1)(b)(9), Florida Statutes, on October 12, 1984, in Ft.
Lauderdale, Florida, for the purpose of considering the hearing officer's recommended order (a copy of which is attached hereto) and the exceptions filed thereto in the above-styled cause. Petitioner, Department of Professional Regulation, was represented by Harry L. Shorstein, Esquire, Respondent William
Lee, M.D., was represented by Kurt Andrew Simpson, Esquire. Upon review of the recommended order, the exceptions submitted by Respondent, the argument of the parties, and after a review of the complete record in this case, the Board makes the following findings and conclusions.
FINDINGS OF FACT
The exceptions to the recommended order posed by Respondent are rejected in that they would require the Board to reweigh the evidence presented. This the Board may not do. In the absence of circumstances requiring the special expertise of the Board, the hearing officers findings of fact are binding upon the Board when those facts are based on competent substantial evidence. Johnston v. Department of Professional Regulation, So.2d , q
F.L.W. 1942 (1st DCA, Op. filed September 13, 1984, Case No. AX-322).
The hearing officer's findings of fact are approved and adopted in toto and are incorporated by reference herein.
There is competent substantial evidence in the record to support the Board's findings of fact.
CONCLUSIONS OF LAW
The hearing officer's conclusions of law are approved and adopted in toto and are incorporated by reference herein.
There is competent substantial evidence in the record to support the Board's conclusions of law.
PENALTY
1. Upon a review of the complete record in this case, the Board determines that the penalty recommended by the hearing officer be reduced from revocation. Therefore, it is hereby
ORDERED AND ADJUDGED that Respondent's license to practice medicine be revoked; however, such revocation be stayed and Respondent's license be suspended for five years during which time Respondent shall obtain annually 100 hours of continuing medical education in surgery in Category 1 of courses approved by the American Medical Association, or their equivalent, and may obtain further medical training through an approved surgical fellowship or its equivalent. Upon compliance with the terms of this order and a demonstration by Respondent that he can practice with reasonable skill and safety pursuant to Section 458.331(3), F.S., Respondent's license to practice medicine shall be reinstated. Respondent may request reinstatement of his license after three years of the five year suspension have run. The suspension in this case shall run concurrently with the suspension imposed in Department of Professional Regulation v. Lee DOAH Case No. 83-803. DPR Case No. 10108.
Upon reinstatement, Respondent shall be placed on probation for a period of five years during which time Respondent shall obtain annually 50 hours of continuing medical education, in Category 1 of courses approved by the American Medical Association, or their equivalent, shall appear before the Board semiannually and shall meet other conditions of probation as the Board deems appropriate, including waiver of confidentiality with regard to investigative reports prepared by the department during the probation. This Order takes effect upon filing.
Respondent may appeal this Final Order within 30 days of its filing pursuant to Section 120.68, Florida Statutes and the Florida Rules of Appellate Procedure.
DONE AND ORDERED this 24 day of December 1984.
BOARD OF MEDICAL EXAMINERS
RICHARD J. FEINSTEIN, M.D.
| Issue Date | Proceedings |
|---|---|
| Dec. 25, 1984 | Final Order filed. |
| Jun. 01, 1984 | Recommended Order sent out. CASE CLOSED. |
| Issue Date | Document | Summary |
|---|---|---|
| Dec. 24, 1984 | Agency Final Order | |
| Jun. 01, 1984 | Recommended Order | Revocation indicated for doctor who performed abortion without written consent and without assistant and for wrongfully prescribing narcotics. These are unacceptable standards. |
