STATE OF FLORIDA

DIVISION OF ADMINISTRATIVE HEARINGS

DEPARTMENT OF PROFESSIONAL )

REGULATION, )

)

Petitioner, )

)

vs. ) CASE NO. 90-2212

)

GERALD COOPER, M.D., )

)

Respondent. )

)

RECOMMENDED ORDER

Pursuant to notice, a formal hearing was held in this matter before the Division of Administrative Hearings, by its duly designated Hearing Officer, Diane Cleavinger, on June 25, 1991, in Tallahassee, Florida.

APPEARANCES

For Petitioner: Francesca Small

Senior Attorney

Department of Professional Regulation 1940 N. Monroe Street, Suite 60

Tallahassee, Florida 32399-0792 For Respondent: Gerald Cooper, pro se,

STATEMENT OF THE ISSUES

Whether Respondent's license to practice medicine should be disciplined for alleged violations of Chapter 458, Florida Statutes.

PRELIMINARY STATEMENT

On March 1, 1990, the Department filed an Administrative Complaint against Petitioner, Gerald Cooper, alleging that his license to practice medicine should be disciplined for several violations of Chapter 458, Florida Statutes.

Specifically, the Administrative Complaint alleged that Respondent's license should be disciplined for violating Section 458.331(1)(t), Florida Statutes in that he committed gross or repeated malpractice or failed 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 circumstances; Section 458.331(1)(m), Florida Statutes, in that he failed to keep written medical records justifying the course of treatment of Patient D.J.D. including but not limited to patient histories, examination results and test results; and Section 458.331(1)(x), Florida Statutes, in that he violated a provision of Chapter 458, by practicing medicine in Florida while his license was inactive and was in violation of Section 458.327(1)(a), Florida Statutes. Respondent

disputed the allegations of the Administrative Complaint and requested a formal administrative hearing. Respondent's request was forwarded to the Division of Administrative Hearings.

At the hearing, Petitioner offered eight exhibits and the testimony of three witnesses. Petitioner also presented the deposition testimony of Jack F. Kareff, M.D. Respondent testified on his own behalf but did not offer any exhibits into evidence.

Petitioner filed its Proposed Recommended Order on August 1, 1991.

Respondent did not file a Proposed Recommended Order. The Petitioner's proposed findings of fact have been considered and utilized in the preparation of this Recommended Order, except where such findings were not shown by the evidence, or were immaterial, irrelevant, cumulative or subordinate. Specific rulings on the Petitioner's Proposed Findings of Fact are contained in the appendix to this Recommended Order.

FINDINGS OF FACT

1. At all times material to this proceeding, Respondent was licensed as a physician in the State of Florida having been issued licensed number ME 0025012.

   
   

2. On January 1, 1990 Respondent's license to practice medicine in the State of Florida became inactive. Respondent was not aware that his license had become inactive because he had not received the usual notice from the Board that his license was due to be renewed. The notice had been mailed to Respondent's last known address.

   
   

3. At Respondent's own admission, Respondent continued to practice medicine in the State of Florida after his license had become inactive. However, Respondent immediately ceased such practice when he learned that his license was inactive. Respondent's license has never been reactivated.

   
   

4. Given these facts, Respondent's practice of medicine after his license had become inactive constitutes only a minor violation of Section 458.331(1)(x), Florida Statutes. The penalty for such a violation should be minor. Therefore, a letter of reprimand would be appropriate in this case.

   
   

5. In 1984, Dr. Cooper was employed as a staff physician in the emergency room of Tallahassee Memorial Regional Medical Center.

   
   

6. On March 30, 1984, Patient D.J.D., a nineteen year old male, ingested an unknown quantity of the drug Asendin.

   
   

7. Asendin is a tricycline antidepressant drug.

   
   

8. Patient D.J.D. told his roommate what he had done. His roommate called an ambulance. The ambulance transported Patient D.J.D. to Tallahassee Memorial Regional Medical Center (TMRMC) While D.J.D. was being transported to TMRMC, the Respondent, who was on duty in the TMRMC emergency room, gave the paramedics who were treating Patient D.J.D. en route orders by phone to give patient D.J.D.

   30 cc's of Ipecac with water to induce vomiting. The Ipecac was administered but Patient D.J.D. did not vomit.

9. When the paramedics arrived at the hospital at 8:16 p.m., Patient

   D.J.D. was coherent and responded appropriately to questions. He was conscious and was sitting up with his eyes open. Approximately twenty minutes after

   D.J.D. arrived at the hospital, he had a grand mal seizure. Respondent was made aware of the seizure.

   
   

10. Respondent performed an initial evaluation of Patient D.J.D. and wrote orders for an intravenous line, blood and urine analysis. The emergency room nurse did not inform Respondent that D.J.D. was an overdose patient. However, Respondent did not question the ER nurse about Patient D.J.D.'s history.

    
    

11. At approximately 9:00 p.m., Patient D.J.D. had a second grand mal seizure.

    
    

12. Following Patient D.J.D.'s second grand mal seizure, the Respondent administered Valium, Phenobarbital and Dilantin. After the drugs were administered Respondent asked the ER nurse about D.J.D.'s history.

    
    

13. Although Respondent was made aware that Patient D.J.D. had overdosed on Asendin, at no time did he pump or lavage Patient D.J.D.'s stomach or administer charcoal.

    
    

14. Charcoal is used with Asendin overdose patients to absorb the drug from the patient's system. It is usually diluted with sorbitor and pushed into the stomach.

    
    

15. Gastric lavage involves washing the stomach contents out with saline solution.

    
    

16. Dr. Jack F. Kareff, M.D., who has completed a three year residency in emergency medicine and who has been with Humana Hospital Bennett Emergency Department in Plantation, Florida, testified as an expert in emergency medicine. Dr. Kareff was of the opinion that Respondent should have lavaged or pumped Patient D.J.D.'s stomach and/or administered charcoal and that by not doing so, Dr. Cooper failed to practice medicine with that level of care, skill and treatment that is recognized as being acceptable in his treatment of Patient D.J.D.'s overdose.

    
    

17. Respondent stated that he did not lavage Patient D.J.D.'s stomach or administer charcoal since it was not appropriate treatment for a patient who is seizing. Respondent stated that this is difficult to do as the teeth are clenched and it is difficult to force a tube in. However, the evidence showed that Patient D.J.D. had an oral air tube placed by either Respondent or the nurse after his first seizure. In fact, at one point during the treatment of Patient D.J.D., Respondent replaced the patient's airway tube. Such evidence indicates that Respondent's reasoning is not well founded.

    
    

18. Respondent also states that he did not lavage patient D.J.D.'s stomach or administer charcoal because Asendin is absorbed very rapidly. However, the better evidence demonstrated that in the case of an overdose of the tricyclic antidepressants, like Asendin, gastric stasis is accomplished. Therefore, the stomach does not empty as fast as it usually does and the drug may still be in the stomach up to 12 hours after ingestion. The failure of Dr. Cooper to administer such treatment and immediately inquire about the patient's history constitutes a violation of Section 458.331(1)(t), Florida Statutes by falling below the standards of practice of medicine recognized in the community.

19. Dr. Kareff testified that the Respondent failed to keep written medical records justifying the course of treatment of Patient D.J.D. in that the records did not justify Respondent's failure to pump or lavage his stomach and administer charcoal. However, in 1984, a doctor was not required to keep records justifying a course of treatment not given and it is questionable whether practicably speaking such records can be kept. Therefore, Respondent is not guilty of violating Section 458.331(1)(m), Florida Statutes, and Count II of the Administrative Complaint should be dismissed.

    
    

    CONCLUSIONS OF LAW

    
    

20. The Division of Administrative Hearings has jurisdiction over the parties to, and the subject matter of this proceeding. Section 120.57(1), Florida Statutes.

    
    

21. Chapter 458, Florida Statutes, authorizes the Board of Medicine to regulate the practice of medicine. Specifically, Section 458.331, Florida Statutes, provides for the revocation, suspension or other discipline of a physician's license for various violations of Section 458.331(1), Florida Statutes. Section 458.331 states in pertinent part, that a physician may be disciplined for:

    
    

    (m) Failing to keep written medical records justifying the course of treatment of the patient, including, but not limited to, patient histories; examination results; test results; records of drugs prescribed, dispensed, or administered, and reports of consultations and hospitalizations.

    (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.

    (x) Violating any provision of Chapter 458, a rule of the board or Department, or a lawful order of the Board or Department

    previously entered in a disciplinary action.

    
    

22. Section 458.319, Florida Statutes, states in pertinent part:

    
    

    1. The department shall renew a license upon receipt of the renewal application and fee not to exceed $250.

    2. The department shall adopt rules establishing a procedure for the biennial renewal of licenses.

    3. Any license which is not renewed at the end of the biennium prescribed by the department shall automatically revert to an inactive status. Such license may be reactivated only if the licensee meets the other qualifications for reactivation in s. 458.321

23. Section 458.327, Florida Statutes, states in pertinent part:

    
    

    1. Each of the following acts constitutes a felony of the third degree, punishable as provided in s. 775.082, s. 775.083, or

       s. 775.084:

       1. The practice of medicine or an attempt to practice medicine without an active license.

          
          

24. The Department has the burden of proof in a license discipline case and must establish by clear and convincing evidence that Respondent has violated the provisions of Chapter 458, Florida Statutes.

    
    

25. In this case, the Department has established by clear and convincing evidence that Respondent failed to order gastric lavage, charcoal and cathartic therapy for Patient D.J.D. and that by so failing Respondent failed 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 violation contributed to the eventual death of D.J.D. and therefore is a serious violation of Chapter 458, Florida Statutes.

    
    

26. Additionally, the Department established by clear and convincing evidence that Respondent practiced medicine in Florida while his license was on inactive status. Such action violates Section 458.331(1)(x), Florida Statutes by violating Section 458.327(1)(a), Florida Statutes. However, this violation was minimal and should not subject Respondent to more than a letter of reprimand.

    
    

27. The Department failed to present clear and convincing evidence that Respondent failed to keep written medical records justifying the course of his treatment of Patient D.J.D. in violation of Section 458.331(1)(m), Florida Statutes. The statute does not require a physician to keep medical records for treatments not given. Department of Professional Regulation, Board of Medicine

    v. Breesman, 15 F.L.W. D2249 (Fla. 1st DCA Sept. 5, 1990). Therefore, Count II of the Administrative Complaint should be dismissed.

28. Rule 21M-20.001, Florida Administrative Code, provides: Disciplinary Guidelines.

    1. Purpose. Pursuant to Section 2, Chapter 86-90, Laws of Florida, the Board provides within this rule disciplinary guidelines which shall be imposed upon applicants or licensees whom it regulates under Chapter 458, F.S. The purpose of this rule is to notify applicants and licensees of the ranges of penalties which will routinely be imposed unless the Board finds it necessary to deviate from the guidelines for the stated reasons given within this rule. The ranges of penalties provided below are based upon a single count violation of each provision listed; multiple counts of the violations may result in a higher penalty than that for a single, isolated violation. Each range

       includes the lowest and highest penalty and all penalties falling between. The purposes of the imposition of discipline are to punish the applicants or licensees for violations and to deter them from future violations; to offer opportunities for rehabilitation, when appropriate; and to deter other applicants or licensees from violations.

    2. Violations and Range of Penalties. In imposing discipline upon applicants and licensees, in proceedings pursuant to Section 120.57(1) and 120.57(2), Florida Statutes, the Board shall act in accordance with the following disciplinary guidelines and shall impose a penalty within the range corresponding to the violations set forth below. The verbal identification of offenses are descriptive only; the full language of each statutory provision cited must be consulted in order to determine the conduct included.

       (t) Malpractice - From two (2) years probation to revocation or denial, and an administrative fine from $250.00 to

       $5,000.00.

       (x) Violation of law, rule, order, or failure to comply with subpoena - From a reprimand to revocation or denial, and an administrative fine from $250.00 to

       $5,000.00.

    3. Aggravating and Mitigating Circumstances. Based upon consideration of aggravating and mitigating factors present in an individual case, the Board may deviate from the penalties recommended above.

       The Board shall consider as aggravating or mitigating factors the following:

       1. Exposure of patient or public to injury or potential injury, physical or otherwise: none, slight, severe, or death;

       2. Legal status at the time of the offense: no restraints, or legal constraints;

       3. The number of counts or separate offenses established;

       4. The number of times the same offense or offenses have previously been committed by the licensee or applicant;

       5. The disciplinary history of the applicant or licensee in any jurisdiction and the length of practice;

       6. Pecuniary benefit or self-gain inuring to the applicant or licensee;

       7. Any other relevant mitigating factors.

29. Rule 21M-20.011, Florida Administrative Code, provides: Notice of Noncompliance.

    
    

    1. Pursuant to Section 455.225(3), Florida Statutes, the department is authorized to provide a notice of noncompliance for an initial offense of a minor violation if the board establishes by rule a list or minor violations. A minor violation

       is one which does not endanger the public health, safety, and welfare and which does not demonstrate a serious inability to practice the profession.

       1. Violating any of the following provisions of chapter 458, as prohibited by Section 458.331(1)(x), Florida Statutes:

          1. Section 458.327, Florida Statutes, which provides for criminal penalties for the practice of medicine without an active license. A notice of noncompliance would be issued for this violation only if the subject of the investigation met the following criteria: the subject must be the holder of a license to practice medicine at all time material to the matter; that license is otherwise in

       good standing; and that license must be renewed and placed in an active status within 90 days of reverting to inactive status based on failure to renew the license. If the license was in an inactive status for more than 90 days

       and the individual continued to practice, then the matter would proceed under the other provisions of Section 455.225, Florida Statutes.

       
       

30. The evidence did not demonstrate any reason to go outside the disciplinary guidelines in regards to Respondent's violations of Section 458.331(1)(t) and (x), Florida Statutes. However, given that a death was involved in Respondent's violations of Section 458.331(1)(t), Florida Statutes, the financial penalty should be at the high end of the range established in the guidelines.

RECOMMENDATION

Based on the foregoing Findings of Fact and Conclusions of Law, it is: RECOMMENDED:

That the Board of Medicine enter a Final Order finding Respondent guilty of violating Sections 458.331(1)(t) and (x), Florida Statutes, and that Respondent be: 1) reprimanded, 2) fined $4,000.00, and 3) placed on probation for a period of two years. If is further recommended that Count II of the Administrative Complaint be dismissed.

DONE and ORDERED this 1st d ay of October, 1991, in Tallahassee, Florida.

DIANE CLEAVINGER

Hearing Officer

Division of Administrative Hearings The DeSoto Building

1230 Apalachee Parkway

Tallahassee, FL 32399-1550

(904) 488-9675

Filed with the Clerk of the Division of Administrative Hearings this 1st day of October, 1991.

APPENDIX TO CASE NO. 90-2212

1. The facts contained in paragraphs 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22 and 23 of Petitioner's Proposed Findings of Fact are adopted, in substance insofar as material.

2. The facts contained in paragraph 24 of Petitioner's Proposed Findings of Fact were not shown by the evidence.

COPIES FURNISHED TO:

Francesca Small Senior Attorney

Department of Professional Regulation

1940 North Monroe Street Suite 60

Tallahassee, Florida 32399-0792

Gerald Cooper 2114 Owens Street

Tallahassee, Florida 32301

Dorothy Faircloth Department of Professional

Regulation

1940 North Monroe Street Suite 60

Tallahassee, Florida 32399-0792

Jack McRay General Counsel

Department of Professional Regulation

1940 North Monroe Street Suite 60

Tallahassee, Florida 32399-0792

=================================================================

AGENCY FINAL ORDER

=================================================================

DEPARTMENT OF PROFESSIONAL REGULATION BOARD OF MEDICINE

DEPARTMENT OF PROFESSIONAL REGULATION,

Petitioner, DPR CASE NUMBER: 89-04035 0097686

-vs- DOAH CASE NUMBER: 90-2212 LICENSE NUMBER: ME 007919

GERALD COOPER, M.D.,

Respondent.

/

FINAL ORDER

This cause came before the Board of Medicine (Board) pursuant to Section 120.57(1)(b)10, Florida Statutes, on February 7, 1992, in Fort Lauderdale, Florida, for the purpose of considering the Hearing Officer's Recommended Order (a copy of which is attached hereto as Exhibit A) in the above-styled cause.

Petitioner, Department of Professional Regulation, was represented by Randolph

1. Collette, Attorney at Law. Respondent was not present or represented.

   
   

   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

   
   

   1. Paragraph 4 of the findings of fact contains statements which the Board finds are not findings of fact, but are conclusions of law and a recommendation on penalty. Those statements are rejected and the Board adopts as the finding of fact the following:

      
      

      Given these facts, Respondent's practice of medicine after his license had

      become inactive constitutes a violation

      of Section 458.331(1)(x), Florida Statutes.

      
      

   2. All of the other findings of fact set forth in the Recommended Order are approved and adopted and incorporated herein.

      
      

   3. There is competent substantial evidence to support the findings of fact.

CONCLUSIONS OF LAW

1. The Board has jurisdiction of this matter pursuant to Section 120.57(1), Florida Statutes, and Chapter 458, Florida Statutes.

   
   

2. The last sentence of Paragraph 7 of the conclusions of law is rejected on the basis that it is not supported by evidence or the law.

   
   

3. In all other respects, the conclusions of law set forth in the Recommended Order are approved and adopted and incorporated herein.

   
   

4. There is competent substantial evidence to support the conclusions of

law.

PENALTY

Upon a complete review of the record in this case, the Board determines

that the penalty recommended by the Hearing Officer be ACCEPTED and ADOPTED. WHEREFORE,

IT IS HEREBY ORDERED AND ADJUDGED that

The Respondent is guilty of violations of Section 458.331(1)(t) and (x), Florida Statutes. Count II of the Administrative Complaint is DISMISSED. Accordingly,

1. Respondent's license to practice medicine is REPRIMANDED.

   
   

2. Respondent shall pay an administrative fine in the amount of $4,000 to the Board of Medicine, Department of Professional Regulation, within 30 days of the date this Final Order is filed.

   
   

3. Respondent's license to practice medicine in the State of Florida is placed on PROBATION for a period of 2 years, subject to the following terms and conditions:

1. Respondent shall comply with all state and federal statutes, rules, and regulations pertaining to the practice of medicine, including Chapters 455, 458, and 893, Florida Statutes, and Rules 21M, Florida Administrative Code.

   
   

2. Respondent shall appear before the Probation Committee at the first meeting after said probation commences, at the last meeting of the Probation Committee preceding termination of probation, and at such other times requested by the Committee. Respondent shall be noticed by Board staff of the date, time and place of the Board's Probation Committee meeting whereat Respondent's appearance is required. Failure of the Respondent to appear as requested or directed shall be considered a violation of the terms of this Order, and shall subject the Respondent to disciplinary action

   
   

3. In the event Respondent leaves the State of Florida fora period of thirty (30) days or more, or otherwise does not engage in the active practice of medicine in the State of Florida, then certain provisions of Respondents probation (and only those provisions of said probation) shall be tolled as enumerated below and shall remain in a tolled status until Respondent returns to active practice in the State of Florida. Respondent must keep current residence and business addresses on file with the Board. Respondent shall notify the

   Board within ten (10) days of any changes of said addresses. Furthermore, Respondent shall notify the Board within ten (10) days in the event that Respondent leaves the active practice of medicine in Florida.

   
   

4. In the event that Respondent leaves the active practice of medicine in this state for a period of thirty days or more, the following provisions of the probation shall be tolled:

   
   

   1. The time period of probation shall be tolled.

      
      

   2. The provisions regarding supervision whether direct or indirect by another physician, included in paragraphs f through h below

      
      

   3. The provisions regarding preparation of investigative reports detailing compliance with this Order. See paragraph j below.

   
   

5. In the event that Respondent leaves the active practice of medicine for a period of one year or more, the Probation Committee may require Respondent to appear before the Probation Committee and demonstrate his ability to practice medicine with skill and safety to patients prior to resuming the practice of medicine in this State.

   
   

6. Respondent shall not practice except under the indirect supervision of a physician fully licensed under Chapter 458 who has been approved by the Board or its Probation Committee. Absent provision for and compliance with the terms regarding temporary approval of a monitoring physician, as provided below, Respondent shall cease practice and not practice until the Probation Committee or the Board approves a monitoring physician. Respondent shall have the monitoring physician with Respondent at the first probation appearance before the Probation Committee. Prior to approval of the monitoring physician by the Committee, the Respondent shall provide to the monitoring physician a copy of the Administrative Complaint and Final Order filed in this case. Failure of the Respondent or the monitoring physician to appear at the scheduled Probation Committee meeting shall constitute a violation of this Order. Prior to the approval of the monitoring physician by the Committee, Respondent shall submit to the Committee a current curriculum vitae and a description of the current practice from the proposed monitoring physician. Said materials shall be received by the Board office no later than fourteen days before Respondent's first scheduled probation appearance. The attached definition of a monitoring physician is incorporated herein. The responsibilities of the monitoring physician shall include:

1. Submit quarterly reports, in affidavit form, which shall include:

   1. Brief statement of why physician is on probation.

   2. Description of probationer's practice.

   3. Brief statement of probationer's compliance with terms of probation.

   4. Brief description of probationer's relationship with monitoring physician.

   5. Detail any problems which may have arisen with probationer.

   Respondent shall be responsible for ensuring that the monitoring physician submits the required reports.

   
   

2. Report to the Board any violations by the probationer of Chapter 455 and 458, Florida Statutes, and the rules promulgated pursuant thereto.

1. The Board shall confer authority on the Chairman of the Board's Probation Committee to temporarily approve Respondent's supervisory/monitoring physician. In order to obtain this temporary approval, Respondent shall submit to the Chairman of the Probation Committee the name and curriculum vitae of the proposed supervisory/monitoring physician. This information shall be furnished to the Chairman of the Probationer's Committee by way of the Board of Medicine's Executive Director, within 48 hours after Respondent receives the Final Order in this matter. This information may be faxed to the Board of Medicine at (904)

   487-9622 or may be sent by overnight mail or hand delivery to the Board of Medicine at the Department of Professional Regulation, 1940 North Monroe Street, Suite 60, Tallahassee, Florida 32399- 0750. In order to provide time for Respondent's proposed supervisory/monitoring physician to be approved or disapproved by the Chairman of the Probation Committee, Respondent shall be allowed to practice medicine while approval is being sought, but only for a period of five working days after Respondent receives the Order. If Respondent's supervisory/monitoring physician has not been approved during that time frame, then Respondent shall cease practicing until such time as the supervisory/monitoring physician is temporarily approved. In the event that the proposed supervisory/monitoring physician is not approved, then Respondent shall cease practicing immediately. Should Respondent's supervisory/monitoring physician be approved, said approval shall only remain in effect until the next meeting of the Board or the Probation Committee. Absent said approval, Respondent shall not practice medicine until a monitoring/supervising physician is approved.

   
   

2. In view of the need for ongoing and continuous monitoring or supervision, Respondent shall also submit the curriculum vitae and name of an alternate supervisory/monitoring physician to be approved by the Board or its Probation Committee. Such physician shall be licensed pursuant to Chapter 458, Florida Statutes, and shall have the same duties and responsibilities as specified for Respondent's monitoring/supervising physician, during those periods of time when Respondent's monitoring/supervisory physician is temporarily unable to provide supervision. Prior to practicing under the indirect supervision of the alternate monitoring physician or the direct supervision of the alternate supervisory physician, Respondent shall so advise the Board in writing. Respondent shall further advise the Board in writing of the period of time during which Respondent shall practice under the supervision of the alternate monitoring/supervisory physician. Respondent shall not practice unless he is under the supervision of either the approved monitoring/supervisory physician or the approved alternate.

   
   

   1. Respondent shall submit quarterly reports in affidavit form, the contents of which shall be specified by the Board. The reports shall include:

1. Brief statement of why physician is on probation.

2. Practice location

3. Describe current practice (type and composition)

4. Brief statement of compliance with probation terms.

5. Describe relationship with monitoring/supervisory physician.

1. During this period of probation, semi-annual investigative reports will be compiled by the Department of Professional Regulation concerning Respondent's compliance with the terms and conditions of probation and the rules and statutes regulating the practice of medicine.

   
   

2. Respondent shall pay all costs necessary to comply with the terms of the Order issued based on this proceeding. Such costs include, but are not limited to, the cost of preparation of investigative reports detailing compliance with the terms of this Order, the cost of analysis of any blood or urine specimens submitted pursuant to the Order entered as a result of this proceeding, and administrative costs directly associated with Respondent's probation. See Section 458.331(2), Florida Statutes.

This order takes effect upon filing with the Clerk of the Department of Professional Regulation.

DONE AND ORDERED this 25th day of February , 1992.

BOARD OF MEDICINE

ZACHARIAH P. ZACHARIAH, M.D. CHAIRMAN

NOTICE OF RIGHT TO JUDICIAL REVIEW

A PARTY WHO IS ADVERSELY AFFECTED BY THIS FINAL ORDER IS ENTITLED TO JUDICIAL REVIEW PURSUANT TO SECTION 120.68, FLORIDA STATUTES. REVIEW PROCEEDINGS ARE GOVERNED BY THE FLORIDA RULES OF APPELLATE PROCEDURE. SUCH PROCEEDINGS ARE COMMENCED BY FILING ONE COPY OF A NOTICE OF APPEAL WITH THE AGENCY CLERK OF THE DEPARTMENT OF PROFESSIONAL REGULATION AND A SECOND COPY, ACCOMPANIED BY FILING FEES PRESCRIBED BY LAW, WITH THE DISTRICT COURT OF APPEAL, FIRST DISTRICT, OR WITH THE DISTRICT COURT OF APPEAL IN THE APPELLATE DISTRICT WHERE THE PARTY RESIDES. THE NOTICE OF APPEAL MUST BE FILED WITHIN THIRTY (30) DAYS OF RENDITION OF THE ORDER TO BE REVIEWED.

CERTIFICATE OF SERVICE

I HEREBY CERTIFY that a true and correct copy of the foregoing Order has been provide by certified mail to Gerald Cooper, Md. S. 2114 Owens Street, Tallahassee, Florida 32401, and Robert Woolfork, Attorney at Law, 317 East Park Avenue, Tallahassee, Florida 32301 by U.S. Mail to Diane Cleavinger, Hearing Officer, Division of Administrative Hearings, The DeSoto Building, 1230 Apalachee Parkway, Tallahassee, Florida 32399-1550; and by interoffice delivery to Larry G. McPherson, Jr., Chief Medical Attorney, Department of Professional Regulation, 1940 North Monroe Street, Tallahasee, Florida 3239-0792 at or before 5:00 P.M., this day of , 1992

Docket for Case No: 90-002212

Orders for Case No: 90-002212