Judges: DONALD D. CONN
Agency: Department of Health
Latest Update: Oct. 28, 1985
Summary: Physician's record keeping, treatment, and care rendered to patient was substandard and failed to timely reveal disease which caused patient's death.
85-2480.PDFSTATE OF FLORIDA
DIVISION OF ADMINISTRATIVE HEARINGS
DEPARTMENT OF PROFESSIONAL ) REGULATION, BOARD OF )
MEDICAL EXAMINERS, )
)
Petitioner, )
)
vs. ) Case No. 85-2480
) WARREN A. CLARK, M.D., )
)
Respondent. )
)
RECOMMENDED ORDER
Pursuant to notice, a final hearing was held October 3, 1985, in Tampa, Florida, before Donald D. Conn, a duly designated Hearing Officer of the Division of Administrative Hearings. The parties were represented as follows:
APPEARANCES
For Petitioner: Joseph Shields, Esquire
Department of Professional Regulation
130 North Monroe Street Tallahassee, Florida 32301
For Respondent: Warren A. Clark, M.D., pro se
94 Yellow Lake Road
New Port Richey, Florida 33553
The Department of Professional Regulation, Petitioner, filed an Administrative Complaint before the Board of Medical Examiners alleging that Warren A. Clark, M.D., Respondent, failed to keep proper medical records and rendered substandard medical care in his treatment of Frank X. Curtis from December, 1983 until his death on June 25, 1984.
At the hearing Petitioner made an ore tenus motion to amend paragraph 3 of the Administrative Complaint to correct a scrivener's error changing the date shown from December 12, 1984 to December 12, 1983, and the motion was granted. Petitioner
introduced three exhibits, and also called Melanie Egan, daughter of Frank X. Curtis, as well as expert witnesses Lawrence Neufelder, M.D. and Charles C. Williams, Jr., M.D.
Respondent
testified on his own behalf. No transcript of the hearing has been filed.
The parties were allowed to submit post-hearing proposed findings of fact pursuant to Section 120.57(1)(b)4, Florida Statutes, but only Petitioner timely filed proposed findings. A ruling on each proposed finding of fact has been made as reflected in the Appendix to this Recommended Order.
FINDINGS OF FACT
At all times material hereto Respondent has been a licensed physician in the State of Florida, having been issued license number ME-0008090.
On December 12, 1983 Frank X. Curtis visited Respondent at his office, complaining of abdominal pain and constipation. Respondent advised Curtis that his symptoms could be indicative of cancer, ordered an upper G.I. series, and diagnosed his condition as a hiatal hernia. Respondent did not recommend any further treatment for Curtis.
Because the abdominal pain and constipation continued, Curtis again saw Respondent on January 3, February 7, February
22 and March 1, 1984. During this time Curtis' weight dropped from 180 lbs. to 155 lbs., and Curtis became increasingly weak.
On March 5, 1984 Respondent admitted Curtis to Community Hospital of New Port Richey with an admitting diagnosis of "partial intestinal obstruction." Curtis underwent a lower G.I. series which revealed a tumor in his intestine. Respondent performed surgery on March 9 to remove the tumor and his post-operative diagnosis of Curtis' condition was carcinoma of the sigmoid colon with metastasis to the liver and small intestine. Curtis was discharged from the hospital on March 18, 1984 but died on June 25, 1984 as a result of the spread of cancer in his
body.
According to expert testimony from Drs. Neufelder and Williams, Respondent failed to maintain proper medical records in the treatment of Curtis which would justify the course of treatment he provided. In their opinion, Respondent also failed
to practice medicine in this case with reasonable care and skill, and in fact his treatment of Curtis was "far below acceptable standards." Specifically, Respondent's office records for this patient reveal no explanation of the reported symptoms of abdominal pain and constipation, and contain almost no patient history or record of any physical examination. A complete medical history and physical exam, as well as blood tests and follow-up should have been initially performed on this patient due to his reported symptoms.
Respondent admits that his medical records in this case were inadequate, but contends that his treatment under the circumstances at the time, and not in hindsight, was adequate. However, considering all of the evidence presented, Respondent's treatment of Curtis from December 12, 1983 until he was hospitalized on March 5, 1984 was not adequate and did not demonstrate the level of skill and care reasonably expected of medical doctors in this state. The level of care and treatment provided while Curtis was hospitalized was adequate and met acceptable standards.
CONCLUSIONS OF LAW
The Division of Administrative Hearings has jurisdiction over the parties and subject matter in this case. Section 120.57(1), Florida Statutes.
Sections 458.331(1)(n) and (t), Florida Statutes, authorize the Board of Medical Examiners to take license disciplinary action against a licensed physician for:
(n) Failing to keep written medical records justifying the course of treatment of the patient, including, but not limited to, patient histories, examination results, and test results.
(t) Gross or repeated malpractice or the failure to practice medicine with that level of care, skill, and treatment which is recognized by a reasonably prudent similar physician as being acceptable under similar conditions and circumstances. The board shall give great weight to the provisions of Section 768.45 when enforcing this paragraph.
Section 768.45, Florida Statutes, sets forth the accepted standard of care required of health care providers, including medical doctors, as "that level of care, skill and treatment which is recognized by a reasonably prudent similar health care provider as being acceptable under similar conditions and circumstances."
Petitioner has met its burden of proof in this case by proving through clear and convincing evidence that Respondent violated the above-cited provisions. Balino v. Department of Health and Rehabilitative Services, 348 So. 2d 349 (Fla. 1st DCA 1977) Bowling v. Department of Insurance, 394 So. 2d 165 (Fla. 1st DCA 1981). Not only were Respondent's medical records of his treatment of Frank X. Curtis totally inadequate, but his treatment of Curtis during the three month period prior to his hospitalization was also unacceptable. Petitioner is therefor authorized to take disciplinary action as prescribed in Section 458.331(2), Florida Statutes. See Azima v. Department of Professional Regulation, 473 So. 2d 761 (Fla. 1st DCA 1985).
Although the record does not reflect any prior disciplinary action against Respondent, the penalty recommended should be severe in light of the fact that the violations proven were not just in record keeping. Rather, the treatment and care/ rendered to Frank X. Curtis was also substandard and failed to timely reveal the nature of the disease which lead to his death shortly after his hospitalization.
RECOMMENDATION
Based upon the foregoing, it is recommended that Petitioner issue a Final Order suspending Respondent's license for a period of five (5) years.
DONE and ENTERED this 28th day of October, 1985, at Tallahassee, Florida.
DONALD D. CONN
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 28th day of October, 1985.
APPENDIX
Rulings on Petitioner's Proposed Findings of Fact:
1-3 Rejected as findings of fact but included in introductory material to this Recommended Order.
4 Adopted in Findings of Fact 2, 3, 4. 5-6 Adopted in Finding of Fact 5.
7 Adopted in Finding of Fact 6.
COPIES FURNISHED:
Joseph Shields, Esquire Department of Professional
Regulation
130 North Monroe Street Tallahassee, Florida 32301
Warren A. Clark, M.D.
94 Yellow Lake Road
New Port Richey, Florida 33553
Fred Roche, Secretary Department of Professional
Regulation
130 North Monroe Street Tallahassee, Florida 32301
Salvatore A. Carpino, Esquire Department of Professional
Regulation
130 North Monroe Street Tallahassee, Florida 32301
Dorothy Faircloth, Executive Director Board of Medical Examiners
130 North Monroe Street Tallahassee, Florida 32301
Docket for Case No: 85-002480
Orders for Case No: 85-002480
| Issue Date |
Document |
Summary |
|
Aug. 15, 1986 |
Agency Final Order
|
|
|
Oct. 28, 1985 |
Recommended Order
|
Physician's record keeping, treatment, and care rendered to patient was substandard and failed to timely reveal disease which caused patient's death.
|
