STATE OF FLORIDA
DIVISION OF ADMINISTRATIVE HEARINGS
DEPARTMENT OF PROFESSIONAL ) REGULATION, BOARD OF MEDICAL ) EXAMINERS, )
)
Petitioner, )
)
vs. ) CASE NO. 84-0171
)
ORLANDO C. RAMOS, M.D. )
)
Respondent. )
)
RECOMMENDED ORDER
Pursuant to notice, this cause came on for formal hearing before P. Michael Ruff, Hearing Officer, on May 30, 1984 in Miami, Florida. The appearances were as follows:
APPEARANCES
For Petitioner: Joseph W. Lawrence, II, Esquire
Department of Professional Regulation
130 North Monroe Street Tallahassee, Florida 32301
John Hale, Esquire
Department of Professional Regulation
130 North Monroe Street Tallahassee, Florida 32301
For Respondent: Ellis Rubin, Esquire
265 Northeast 26th Terrace Miami, Florida 33137
This cause commenced upon the filing of an Administrative Complaint by the Petitioner, the Department of . Professional Regulation, Board of Medical Examiners, by which that agency seeks to suspend, revoke, or take other disciplinary action against the Respondent's licensure status as a medical doctor in Florida. The Respondent disputed the factual allegations of that Administrative Complaint and availed himself of his right to a formal hearing before a Hearing Officer pursuant to Section 120.57(1), Florida Statutes. After the cause was set for hearing, on one occasion, it was continued by agreement of the parties, inasmuch as settlement negotiations were proceeding. Thereafter, a five-count amended complaint was filed against the Respondent and the cause ultimately proceeded to trial upon the amended complaint.
In Counts I and II of the amended complaint, it is factually alleged that the Respondent knowingly permitted one Manuel S. Farinas to perform a medical eye examination on Robert G. Wolf on the premises where the Respondent conducted
his medical practice, and allowed Farinas to write prescriptions for medically prescribed eyeglasses using Respondent's prescription blanks. It is alleged that this constitutes a violation of Section 458.331(1)(g), Florida Statutes, in that the Respondent thus aided, assisted, procured and advised an unlicensed person to practice medicine. It is also charged that this is a violation of Section 458.331(1)(w), Florida Statutes, as constituting delegation of professional responsibilities to a person whom the licensee knows or has reason to know is not qualified by licensure to perform those responsibilities.
Counts III and IV involve factual allegations that in March of 1982 the Respondent knowingly permitted Mr. Farinas to perform an eye examination on Dorris B. Bruce, also on the premises of the Respondent's medical practice, and allowed him to write prescriptions for medically prescribed eyeglasses using the Respondent's prescription blanks. Thus, the same statutory violations are alleged against the Respondent in regard to the factual allegations of Counts III and IV.
In Count V it was also alleged regarding both patients, that the Respondent violated Section 458.331(1)(t), Florida Statutes, by failing to practice medicine in that regard with the level of care, skill and treatment recognized by reasonably prudent similar physicians under similar conditions and circumstances.
At the hearing, the Petitioner presented the expert testimony of two witnesses, Dr. Lawrence T. Reese and Dr. John Handwerker, as well as the testimony of Geoffrey Hullman and Robert Wolf. The Respondent testified on his own behalf. The Petitioner offered Exhibits 1 through 10 and the Respondent offered one exhibit. All exhibits were admitted. 1/
The issue to be resolved in this proceeding concerns whether Respondent is guilty of the conduct alleged in the factual allegations in the amended administrative complaint, whether that conduct constitutes violations of the statutory authority upon which the complaint is predicated and, if so, what penalty, if any, is warranted.
Proposed findings of fact and conclusions of law were timely filed by Petitioner and have been considered. To the extent that they are in accordance with the findings, conclusions and views stated herein, they are accepted. To the extent that the proposed findings, conclusions and arguments asserted are inconsistent herewith, they are rejected. Certain proposed findings and conclusions are omitted as not relevant nor as necessary to a proper determination of the material issues presented. To the extent that the testimony of various witnesses is not in accord with the findings herein, it is not credited. See, Sonny's Italian Restaurant v. Department of Business Regulation, 414 So.2d, 1156, 1157 (Fla. 3rd DCA 1982); Sierra Club v. Orlando
Utilities Commission, 436 So.2d 383 (Fla. 5th DCA 1983).
FINDINGS OF FACT
The Respondent is a licensed medical doctor holding license number MEOO17343 issued by the Florida Board of Medical Examiners. He has a general family practice but also states that he specializes in neurology as well. He is not board certified in any specialty. He has had many years of practical medical experience in Cuba and later in the United States. The Petitioner is an agency of the State of Florida charged with regulating and enforcing licensure and the licensure standards for medical doctors in Florida, and enforcing the practice standards embodied in Chapter 458, Florida Statutes.
In October, 1981, the Respondent employed Manuel Farinas to work in his medical office, specifically for the purpose of performing eye examinations and writing prescriptions for eyeglasses. The Respondent had known Manuel Farinas when they were in Cuba and knew that he had experience also in working with contact lenses and fitting contact lenses and eyeglasses. The Respondent was aware that Farinas did not hold a license to practice any of the medical or healing arts in Florida, but was informed by Farinas that he was then studying to take the foreign medical graduate examination which is a prerequisite to licensure. The Respondent set up a separate eye examination room in his medical offices which contained equipment designed specifically to perform eye examinations. Indeed, as established by Petitioner's composite Exhibit 7, Manuel Farinas has not been and is not licensed as a physician or physician's assistant in Florida and holds no license in Florida authorizing practice of medicine in any form.
On March 16, 1982, Dorris B. Bruce, an investigator for the Department of Professional Regulation, went to the Respondent's office to obtain an eye examination. Patient Bruce was examined by Mr. Farinas and was diagnosed as having "hypertension retinopathy." The examination of the "patient" consisted of a cornea examination, an examination for conjunctivitis, the patient's lenses were checked, and a fundus examination was performed. The patient was given a prescription for eyeglasses on the Respondent's prescription blank, which bore his printed name. The blank was unsigned and Respondent's testimony itself establishes that the examination of patient Bruce and the rendering of the prescription for eyeglasses was done exclusively by Manuel Farinas, and Respondent did not examine Dorris Bruce nor supervise the medical care provided by Farinas.
Robert Wolf, an investigator employed with the Department, made an appointment for an eye examination with the Eyeglass Emporium for June 1, 1982. This is a business establishment and opticinary owned by one Geoffrey Hullman. It is located next door to, and in the same building with, the Respondent's medical office. Upon arriving at the Eyeglass Emporium, Mr. Wolf was directed to the Respondent's adjoining medical office where the "patient" completed a patient information form. Mr. Wolf was then taken by one of Respondent's office assistants to the examining room for the eye examination mentioned above. Shortly thereafter, an office assistant entered the room accompanied by a man who was introduced as the doctor who would perform the eye examination. The "doctor" was actually Manuel Farinas. Notations in the medical record prepared on patient Wolf at the Respondent's office (Exhibit 3 in evidence) establish that the patient had a visual eye examination without glasses and was examined for conjunctivitis and also had cornea, lens and fundus examinations. Farinas examined Mr. Wolf by shining a flashlight type device into his eyes, having him read a wall chart, and by having him look through a lens in a machine that flashed charts on the wall until Farinas got the best subjective reading of visual acuity from the patient. The patient was also given a chart to read. Farinas diagnosed the patient as having a mild case of conjunctivitis and gave him a prescription for eyeglasses and a prescription for Vicollirum. Both prescriptions were written on blanks bearing the Respondent's name and office address. Upon completion of the eye examination, the prescriptions were written by Manuel Farinas for patient Wolf and were placed in a folder and given to the patient. The prescriptions were not signed by either Farinas or the Respondent. At no time during the patient's presence in the Respondent's office, did the
Respondent either examine the patient or review and approve the medical prescriptions written for the patient, or supervise the medical examination activities of Farinas. The patient was then directed by Farinas through a door adjoining the Respondent's office to the Eyeglass Emporium to have the prescription for eyeglasses filled.
Investigators for the Petitioner then re-entered the Respondent's office at that time and interviewed Farinas who was still in the room where the patient Wolf had been examined. After identifying themselves as investigators for Petitioner, Farinas was asked for identification. He identified himself as Dr. Manuel Farinas and admitted that he had written the prescriptions for patient Wolf. Respondent entered the room at that point and the Petitioner's employees identified themselves as investigators. In the presence of the Respondent, the investigator elicited statements from Farinas that he had examined patient Wolf and that he had written the two prescriptions for that patient as well as eliciting the statement that he was not licensed. The Respondent did not comment on any of those responses by Farinas at that time. Farinas then produced for Petitioner's investigators documents purporting to show that he had received medical training in Cuba.
The Petitioner established through expert testimony of Dr. Lawrence T. Reese, who is a board certified opthalmologist, with a sub-specialty in retinal muscular disease, that a medical doctor does not receive the appropriate training in a general M.D. degree course of study to qualify him to either perform a thorough eye examination or to prescribe eye-wear for patients. Dr. Reese practices in Dade County, Florida and is affiliated with Parkway Regional Medical Center and Humana Hospital. He holds a voluntary faculty appointment at the University of Miami School of Medicine in Opthalmology. Dr. Reese is aware of the general standard of instruction in opthalmology in a medical school curriculum for the general M.D. degree granting institutions. This instruction, consists of from three to four hours of instruction, and is basically a laboratory study where the medical students examine each others' eyes. Thus, the general medical student who fails to pursue a specialty in opthalmology, receives only a bare minimum amount of training in patient eyecare and examination. A general or family practitioner would thus only have minimal involvement in the area of eye-care. Dr. Reese is aware of the generally prevailing standard of care of general practitioners in Dade County, Florida. Dr. Reese thus established that the extent of eye-care provided by general practitioners in that medical community is to visually look into the patient's eyes as a part of a general medical examination. This is a cursory eye examination at best. The visual examination consists of looking into the patient's eyes with an opthalomoscope in order to get a view of the optic nerves and surrounding fundus. If such a general practitioner/family practitioner examination shows that the patient's eyes appear to be normal, this is the extent of the visual examination performed. If problems are apparent, the general prevailing standard of practice dictates that the general practitioner or family practitioner refer the patient to a board certified opthalmologist.
John Handwerker, M.D., is a licensed medical doctor in the State of Florida who has practiced medicine in Dade County for 33 years. His testimony corroborates that of Dr. Reese. Dr. Handwerker is not aware of any eye-care training provided by medical schools in M.D. degree granting programs. He is aware of the generally accepted prevailing standards of practice of medicine by general and family practitioners in Dade County and established that a family practitioner would not typically perform a refraction of the eyes for the purpose of prescribing eyeglasses. That standard would be the same for a general practitioner even if he has a sub-specialty in neurology, which is not a
relevant sub-specialty to questions of eye-care. This type of practitioner would not have either the training or experience to perform such an examination.
As established by both of these expert witnesses, a person who takes a patient's history, makes an examination of the patient's eyes and prescribes either medication or an optical lens or both, is engaged in the practice of medicine. Both medical experts established that if a licensed medical doctor authorizes an unlicensed person to take the medical history of a patient, perform the eye examination and write prescriptions for medication, or for optical lenses for that patient, and the extent of the licensee's participation in the process is either to merely sign the prescription or at most to review the patient's medical records, then that licensed medical doctor is not properly supervising an unlicensed person and is permitting an unlicensed person to practice medicine.
As established by Dr. Reese, a thorough eye examination would consist of determining if the patient has a family history of eye disease, determining whether the patient is experiencing any particular visual problem, determining the refractive state of the patient's eyes (that is, visual acuity), and would include a check of various eye systems of the patient, such as the pupils and their reaction to light as well as the ocular motor system for eye movement (musculature). Additionally, a properly examined patient, should be checked for visual defects, have a slit lamp examination to determine the medical condition of the eyes (which consists of examining the upper and lower parts of the pupils under the eyelids), the patient's cornea should be checked for material in the eye fluid and in most instances a dilated examination of the pupil should be done to diagnose its condition. When all of these examinations and checks are performed the doctor can then reach a cogent conclusion concerning the overall health of the patient's eyes and make appropriate recommendations concerning care and treatment.
A medical diagnosis that a patient's fundus is normal, cornea is normal and the lens is normal can only be made if the patient's eyes have been dilated. The fundus can be examined without dilating the patient's eyes, although dilation would give increased ability to examine it. Dilation of a patient's eyes is effected by the use of a prescription drug by medical practitioners who are experienced and who practice in the area of eye examinations and eye-care. Both patients Bruce and Wolf were diagnosed by Farinas as having normal fundus, cornea and lenses. But this diagnosis was made without a thorough eye examination because Farinas did not dilate their eyes to adequately check these systems.
Although it is true that ready-made eyeglasses can be purchased at commercial department stores with or without a prescription, where a patient has visited a medical doctor's office and had his eyes examined and is given a written prescription for glasses, the patient then believes that he has received a proper, competent medical eye examination and is being prescribed glasses for valid medical reasons. Where an inadequately trained or unlicensed person performs visual examinations and writes medical prescriptions for glasses, a patient is being deceived or at least potentially deceived as to the correct assessment of the condition of his eyes. The testimony of the Respondent himself as well as Mr. Hullman, the operator of the Eyeglass Emporium, establishes that Farinas was known and referred to as "Dr. Farinas" during the time he was employed in Respondent's office. Farinas was introduced to Mr. Wolf as "Dr. Farinas" at a time when he was not (and still is not) licensed in Florida.
Both Drs. Reese and Handwerker opined that where a general practitioner with a specialty in neurology permits an unlicensed person to conduct medical examinations and write medical prescriptions for eyeglasses or for medicinal drugs, and the extent of the licensee's contact with the patient is to sign prescriptions or review the patient's medical records, the licensee has failed to conform to generally accepted and prevailing standards of care recognized by reasonably prudent similar physicians under similar conditions and circumstances.
The Respondent is not board certified in opthalmology and has had no residency training or other formal training in opthalmology outside the minimal general training described above, received in the course of preparing for his
M.D. degree. The Respondent maintained that he has extensive experience performing medical visual examinations, but this testimony is not deemed credible because, as revealed by Petitioner's Exhibit 8 in evidence, during the informal proceeding before the Board where Respondent was also testifying under oath, he acknowledged that he had not performed medical visual examinations or refractions and had not written a medical prescription for eyeglasses in over 13 years, thus, his testimony that he has had extensive experience in performing medical visual examinations recently and during the period under consideration in the Administrative Complaint is not deemed credible.
Although Respondent contends that he supervised the practice of Farinas, his testimony conflicts with competent evidence indicating otherwise. The supervision consisted of the Respondent allegedly reviewing the patient's records and signing prescriptions for eyeglasses or drugs written by Farinas. Although expert testimony has established that this does not constitute adequate supervision by a licensed medical doctor, in the case of both patients involved in this proceeding the eyeglass prescriptions were actually never signed. Although use of unsigned prescriptions is not necessarily illegal, it shows that Farinas was not supervised to any significant extent at all in his examination, care and treatment of patients who presented themselves to the Respondent's office for an eye examination. When patient Wolf was in the Respondent's office he was never examined by Respondent, nor was his prescription given him by Farinas ever reviewed by the Respondent, nor did the Respondent review his medical history, which he had provided in writing on a form provided by Respondent's office. Additionally, as established by witness Hullman, that witness returned unsigned prescriptions to the Respondent's office for the Respondent to sign after the prescriptions had already been filled by the opticianry and after the investigation into this matter had commenced. The Respondent signed the previously unsigned prescriptions and returned them to Hullman and thus it is established that at the time the prescriptions were executed and filled, the Respondent did not supervise the prescribing by Farinas nor the examinations to which the prescriptions related, both as to prescriptions of eyeglasses or drugs.
Finally, it should be pointed out that Respondent was aware in April of 1982 that his use of Farinas in performing visual examinations and prescriptions as to eye-care patients was improper because of the visit to his office by Investigator Dorris Bruce. Two months later, however, patient Wolf went to the Respondent's office for an eye examination and was also examined by Farinas and tendered prescriptions by Farinas with no signature, supervision or other review of the procedure performed or prescriptions given by the Respondent. This was some nine months after Farinas first became employed in these capacities at the Respondent's office.
CONCLUSIONS OF LAW
The Division of Administrative Hearings has jurisdiction of the subject matter of and the parties to this proceeding. Section 120.57(1), Florida Statutes (1981).
Count I of the Amended Complaint charges that the Respondent has aided, assisted, procured or advised an unlicensed person to practice medicine in violation of Section 458.331(1)(g), Florida Statutes. The Respondent is charged with regard to Count II, with delegating professional responsibilities to a person when the licensee knows or has reason to know that the person is not qualified by licensure or training to perform such responsibilities. These charges are predicated on the factual allegations in the complaint that the Respondent did knowingly permit Manuel Farinas to perform eye examinations on Robert Wolf and Dorris Bruce and to write prescriptions for eyeglasses, and, in the case of patient Wolf, also for medication for conjunctivitis, using Respondent's prescription blanks. The evidence establishes clearly and convincingly that the Respondent employed Manuel Farinas to perform eye examinations and provided examining space within his medical offices for Farinas to perform those examinations. The Respondent was aware that Farinas was not licensed to practice medicine in Florida. Respondent purchased equipment for Farinas to conduct these examinations and authorized him to write prescriptions for eyeglasses on Respondent's prescription blanks. It is clear, given the above Findings of Fact, that Respondent had direct knowledge that Farinas was performing medical eye examinations on his premises.
The evidence and testimony of Petitioner's experts is equally convincing in establishing that the activities in which Farinas engaged, in Respondent's office, including diagnosis of medical problems, determining the condition of the patient's vision, and prescribing eyeglasses do constitute the practice of medicine. Petitioner has thus established the allegations charged in Counts I and II of the Amended Administrative Complaint.
Concomitantly, the Petitioner has also proven the allegations charged in Counts III and IV of the Amended Complaint. The evidence of record clearly establishes that the Respondent was aware of and authorized the medical practice of Farinas. The case of Bach v. Florida Board of Dentistry, 378 So.2d 34 (Fla. 1st DCA 1979) provides that a licensee must be shown to have knowledge of and to have authorized the practice by an unlicensed person, and in the instant proceeding that standard of proof has been met.
Count V of the complaint charges that the Respondent failed to practice medicine with that level of care, skill and treatment recognized by reasonably prudent similar physicians. The testimony of Drs. Reese and Handwerker establish clearly and convincingly that the Respondent's conduct in permitting Farinas to operate in his office in the manner shown in the above Findings of Fact clearly failed to conform to existing community medical practice standards. Not only was the Respondent not qualified himself by training or experience to perform visual examinations and prescribe eyeglasses for patients, he was accordingly not qualified to supervise the activities of an unlicensed person in carrying out these procedures and prescriptions. A medical doctor without specialty training and education in eyecare is not qualified to merely review a medical prescription for eyeglasses or review the patient's medical records and determine whether the unlicensed person who examined the patient has correctly diagnosed the patient's visual problems, or lack thereof, or correctly tested the patient's eyes or correctly prescribed eyeglasses. A
medical doctor without the specialty training and education is inherently not qualified to adequately supervise such an unlicensed person. In the instant case, in point of fact, the Respondent did not perform any level of supervision over Farinas as to the two patients involved, had he even been qualified to do so. The evidence, in short, clearly established that the Respondent is also guilty of Count V of the Administrative Complaint as well.
Having considered the foregoing Findings of Fact, Conclusions of Law, the candor and demeanor of the witnesses, and the pleadings and arguments of the parties, it is, therefore
RECOMMENDED:
That a Final Order be entered finding the Respondent, Orlando C. Ramos, M.D., guilty, as charged in the Amended Administrative Complaint, of violations of Section 458.331(1)(g), Florida Statutes (1981); Section 453.331(1)(w), Florida Statutes, (1981), as well as a violation of Section 458.331(1)(t), Florida Statutes (1981), and that a fine of $2,000 be imposed and the Respondent's license to practice medicine be suspended for a period of three months. It is further recommended that the Respondent's licensure status be probationary for a one year period commencing at the conclusion of the three month's suspension, during which such probationary period his medical practice should be monitored by the Petitioner to ensure that such violations of the Medical Practice Act do not recur.
DONE and ENTERED this 21st day of November, 1984, in Tallahassee, Florida.
P. MICHAEL RUFF Hearing Officer
Division of Administrative Hearings The Oakland Building
2009 Apalachee Parkway
Tallahassee, Florida 32301
(904) 488-9675
Filed with the Clerk of the Division of Administrative Hearings this 21st day of November, 1984.
ENDNOTE
1/ Petitioner's Exhibits 8 and 9 were marked for identification at the hearing but ruling on their admissibility was reserved to allow Respondent time to review the exhibits and file written objections. No objections were filed as to Petitioner's Exhibit 9, which is the deposition of the Respondent taken in another administrative proceeding, or to Petitioner's Exhibit 8 which is Respondent's testimony before the Board of Medical Examiners at the informal hearing. In light of the lack of objections, both exhibits are admitted.
COPIES FURNISHED:
Joseph W. Lawrence, II, Esquire and John Hale, Esquire Department of Professional
Regulation
130 North Monroe Street Tallahassee, Florida 32301
Fred M. Roche, Secretary Department of Professional
Regulation
130 North Monroe Street Tallahassee, Florida 32301
Ellis S. Rubin, Esquire
265 NE 26th Terrace Miami, Florida 33137
Dorothy Faircloth, Executive Director
Board of Medical Examiners
130 North Monroe Street Tallahassee, Florida 32301
=================================================================
AGENCY FINAL ORDER
================================================================= BEFORE THE BOARD OF MEDICAL EXAMINERS
DEPARTMENT OF PROFESSIONAL REGULATION,
Petitioner,
vs. DPR CASE NOS. 0025309, 0025308
9754001, 0024823
ORLANDO RAMOS, M.D., DOAH CASE NO. 84-0171 LICENSE NO. ME 17343
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 February 3, 1985, in Tampa, Florida for the purpose of considering the hearing officer's Recommended Order (a copy of which is attached hereto) in the above-styled cause. Petitioner, Department of Professional Regulation, was represented by Joseph W. Lawrence, II, Esquire; Respondent was present and represented by Atlee W. Wampler, III, Esquire.
Upon on review of the recommended order, 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 hearing officer's findings of fact are hereby approved and adopted in toto.
There is competent, substantial evidence to support the findings of fact.
CONCLUSIONS OF LAW
The Board has jurisdiction of this matter pursuant to
Section 120.57(1), Florida Statutes, and Chapter 458, Florida Statutes.
The hearing officer's conclusions of law, are hereby approved and adopted in toto.
DISPOSITION
Upon a complete review of the record in this case, the Board determines that the penalty recommended by the hearing officer be rejected. Based on the testimony given before the Board, Respondent's apparent lack of candor and failure to recognize that he had violated the Medical Practice Act, and the fact that Respondent is already on probation for a prior violation of the Practice Act, the Board hereby finds that the penalty recommended by the hearing officer would be too lenient and imposes the penalty set forth below. WHEREFORE,
IT IS HEREBY ORDERED AND ADJUDGED that:
Respondent shall pay an administrative fine in the amount of $6,000. Said fine shall be payable to the Executive Director of the Board within thirty
(30) days of the date of this Order.
Respondent's license to practice medicine in Florida shall be suspended for a period of six (6) months.
Respondent's license to practice medicine in Florida shall be placed on probation for a period of five (5) years, concurrent with the term of probation imposed in Case Number 0032751, subject to the following terms and conditions:
Respondent shall make semi -annual appearances before the Board.
Respondent waived confidentiality with regard to investigative reports prepared by the Department during the probation period. Respondent agreed to this condition on the record at the hearing before the Board.
Prior to his appearance at the June meeting of the Board, Respondent shall file a sworn statement stating that he has read and understood the Medical Practice Act, Chapter 458, Florida Statutes.
This Order takes effect upon filing.
Pursuant to Section 120.59, Florida Statutes, the parties are hereby notified that they may appeal this final order by filing one copy of a notice of appeal with the clerk of the agency and by filing the filing fee and one copy of a notice of appeal with the District Court of Appeal within thirty days of the date this order is filed, as provided in Chapter 120, Florida Statutes, and the Florida Rules of Appellate Procedure.
DONE AND ORDERED this 28th day of February, 1985.
BOARD OF MEDICAL EXAMINERS
J. Darrell Shea, M.D. CHAIRMAN
CERTIFICATE OF SERVICE
I HEREBY CERTIFY that a true and correct copy of the foregoing Final Order has been provided by certified mail to Orlando Ramos, M.D., 3017 Flamingo Road, Miami, Florida 33140 and Atlee W. Wampler, III, by regular United States mail to P. Michael Ruff, Hearing Officer, Division of Administrative Hearings, Oakland Building, 2009 Apalachee Parkway, Tallahassee, Florida, 32301; and by hand delivery to Joseph W. Lawrence, II, Esquire, Department of Professional Regulation, 130 North Monroe Street, Tallahassee, Florida 32301, at 5:00 PM this 5th day of March, 1985.
=================================================================
CORRECTED AGENCY FINAL ORDER
================================================================= BEFORE THE BOARD OF MEDICAL EXAMINERS
DEPARTMENT OF PROFESSIONAL REGULATION,
Petitioner,
vs. DPR CASE NOS. 0025309, 0025308
9754001, 0024823
ORLANDO RAMOS, M.D., DOAH CASE NO. 84-0171 LICENSE NO. ME 17343
Respondent.
/
CORRECTED 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 February 3, 1985, in Tampa, Florida for the purpose of considering the hearing officer's Recommended Order (a copy of which is attached hereto) in the above-styled cause. Petitioner, Department of Professional Regulation, was represented by Joseph W. Lawrence, II, Esquire; Respondent was present and represented by Atlee W. Wampler, III, Esquire.
Upon review of the recommended order, 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 hearing officer's findings of fact are hereby approved and adopted in toto.
There is competent, substantial evidence to support the findings of fact.
CONCLUSIONS OF LAW
The Board has jurisdiction of this matter pursuant to Section 120.57(1), Florida Statutes, and Chapter 458, Florida Statutes.
2. The hearing officer's conclusions of law, are hereby approved and adopted in toto.
DISPOSITION
Upon a complete review of the record in this case, the Board determines that the penalty recommended by the hearing officer be rejected. Based on the testimony given before the Board, Respondent's apparent lack of candor and failure to recognize that he had violated the Medical Practice Act, and the fact that Respondent is already on probation for a prior violation of the Practice Act, the Board hereby finds that the penalty recommended by the hearing officer would be too lenient and imposes the penalty set forth below. WHEREFORE,
IT IS-HEREBY ORDERED AND ADJUDGED that:
Respondent shall pay an administrative fine in the amount of $5,000. Said fine shall be payable to the Executive Director of the Board within thirty
(30) days of the date of this Order.
Respondent's license to practice medicine in Florida shall be suspended for a period of six (6) months.
Respondent's license to practice medicine in Florida shall be placed on probation for a period of five (5) years, concurrent with the term of probation imposed in Case Number 0032751, subject to the following terms and conditions:
Respondent shall make semi-annual appearances before the Board.
Respondent waived confidentiality with regard to investigative reports prepared by the Department during the probation period. Respondent agreed to this condition on the record at the hearing before the Board.
Prior to his appearance at the June meeting of the Board, Respondent shall file a sworn statement stating that he has read and understood the Medical Practice Act, Chapter 458, Florida Statutes.
This Order takes effect upon filing.
Pursuant to Section 120.59, Florida Statutes, the parties are hereby notified that they may appeal this final order by filing one copy of a notice of appeal with the clerk of the agency and by filing the filing fee and one copy of a notice of appeal with the District Court of Appeal within thirty days of the date this order is filed, as provided in Chapter 120, Florida Statutes, and the Florida Rules of Appellate Procedure.
DONE AND ORDERED this 20th day of March, 1985.
BOARD OF MEDICAL EXAMINERS
J. Darrell Shea, M.D. CHAIRMAN
CERTIFICATE OF SERVICE
I HEREBY CERTIFY that a true and correct copy of the foregoing Final Order has been provided by certified mail to Orlando Ramos, M.D., 3017 Flamingo Road, Miami, Florida 33140 and Atlee W. Wampler, III, Holland & Knight, 1200 Brickell
Avenue, Suite 1100, Miami, Florida 33131; by regular United States mail to P. Michael Ruff, Hearing Officer, Division of Administrative Hearings, Oakland Building, 2009 Apalachee Parkway, Tallahassee, Florida, 32301; and by hand delivery to Joseph W. Lawrence, II, Esquire, Department of Professional Regulation, 130 North Monroe Street, Tallahassee, Florida 32301, at 5:00 PM this 22nd day of March, 1985.
Dorothy J. Faircloth EXECUTIVE DIRECTOR
| Issue Date | Proceedings |
|---|---|
| Mar. 05, 1985 | Final Order filed. |
| Nov. 21, 1984 | Recommended Order sent out. CASE CLOSED. |
| Issue Date | Document | Summary |
|---|---|---|
| Feb. 28, 1985 | Agency Final Order | |
| Nov. 21, 1984 | Recommended Order | Respondent was guilty of allowing unlicensed person to practice medicine and not practicing with reasonable care. $2,000 fine/three-month suspension/one-year probation. |
