STATE OF FLORIDA

DIVISION OF ADMINISTRATIVE HEARINGS

DEPARTMENT OF HEALTH AND )

REHABILITATIVE SERVICES, )

)

Petitioner, )

)

vs. ) CASE NO. 94-4916

)

JOSEPH L. RIGGALL, )

)

Respondent. )

)

RECOMMENDED ORDER

Pursuant to notice, this matter was heard in Winter Haven, Florida, before the Division of Administrative Hearings, by its duly-designated Hearing Officer, Daniel M. Kilbride, on January 25, 1995.

APPEARANCES

For Petitioner: Robert P. Daniti, Esquire

Senior Attorney Department of Health and

Rehabilitative Services 1317 Winewood Bouelvard

Tallahassee, Florida 32399-0700 For Respondent: no appearance

STATEMENT OF THE ISSUES

Whether the Respondent's paramedic license should be disciplined based upon alleged violations of Sections 401.411(1)(a) and (k), Florida Statutes.

PRELIMINARY STATEMENT

On July 18, 1994, the Petitioner filed an Administrative Complaint against the Respondent, alleging violations of Chapter 401, Florida Statutes.

Respondent filed a letter, received on August 18, 1994 and requested a formal hearing. At that time, Respondent indicated his residence address was 4920 S.R. 544, Haines City, Florida 33844. This matter was referred to the Division of Administrative Hearings and was set for hearing. Prior to the formal hearing, Respondent was served with requests for discovery, including an Amended First Request for Discovery, to which the Respondent did not respond. Petitioner filed a motion to relinquish jurisdiction on the grounds that Respondent had allowed his paramedic license to expire prior to the date of the formal hearing and had failed to respond to Petitioner's demand for discovery. Since filing his request for hearing Respondent has failed to inform HRS-EMS, the Division of Administrative Hearings, or the hearing officer of any changes to his mailing address. Nevertheless, Respondent did not remain at the address given on his request for an administrative hearing, but moved to 13711 Hatchienha Road,

Haines City, Florida 33844. Moreover, Respondent has moved again or is not claiming mail sent to him certified, return receipt requested. The motion to relinquish jurisdiction was denied at the formal hearing.

At the formal administrative hearing, the Petitioner was prepared and ready to proceed. Respondent, after due notice, failed to appear either in person or through counsel. After waiting an appropriate period of time, the formal hearing was convened and Petitioner presented the testimony of two witnesses.

Petitioner offered a total of seven (7) exhibits which were received in evidence. Official Recognition was taken of Section 20.19 and Chapters 120 and 401, Florida Statutes.

The Petitioner filed a proposed recommended order with the Division on February 3, 1995. Respondent has not filed proposed findings of fact. The Petitioner's proposed findings of fact have been considered and utilized in the preparation of this Recommended Order, except where such proposals were not supported by the evidence or were irrelevant, immaterial, cumulative, or subordinate. Specific rulings on the proposed findings of fact are contained in the Appendix attached hereto.

Based upon all of the evidence, the following findings of fact are determined:

FINDINGS OF FACT

1. Petitioner, HRS, Office of Emergency Medical Services (EMS), is the state agency which certifies and disciplines emergency medical technicians (EMTs) and paramedics in Florida pursuant to Chapter 401, Florida Statutes (F.S.) and Chapter 10D-66, Florida Administrative Code (F.A.C.).

   
   

2. Respondent, Joseph L. Riggall, was initially certified as a paramedic in Florida under Section 401.27 and Rule 10D-66.057, F.A.C., in 1990, and was last recertified by EMS for the biennial period December 1, 1992 through December 1, 1994 pursuant to an application he submitted to the department through its agent on October 25, 1992.

   
   

3. Respondent Riggall has not filed for recertification as a paramedic in Florida subsequent to the automatic expiration of his certification on December 1, 1994.

   
   

4. A paramedic is a medical paraprofessional authorized under Florida law and administrative rules to administer advanced life support treatment with respect to life-threatening medical emergencies. Florida law defines advanced life support to include the use of techniques such as endotracheal intubation, the administration of drugs or intravenous fluids, telemetry, cardiac monitoring and cardiac defibrillation. A paramedic is authorized to perform invasive techniques in order to help save lives threatened by medical emergencies or severe injuries.

   
   

5. As a paramedic, Respondent has a responsibility to the public, HRS-EMS and his employer, Polk County Emergency Medical Services, to perform his patient care duties without being impaired by alcohol, habit forming drugs or controlled substances.

   
   

6. Respondent was employed by Polk County Emergency Medical Services for a period of time, including March 1994.

7. Respondent was arrested on March 14 1994 in Polk County, Florida, on charges of prescription forgery to obtain controlled substances.

   
   

8. HRS-EMS began an investigation of Respondent on March 23, 1994 based upon a complaint.

   
   

9. In early March, 1994, Respondent reported to his shift supervisor that on March 11, 1994, while he was on duty as a paramedic, all of the controlled substances (morphine and Valium) had been stolen and were missing from his ambulance stationed at Fort Meade, Polk County, Florida.

   
   

10. Respondent's supervisor immediately requested that Respondent submit to a drug test at Polk General Hospital. Respondent complied.

    
    

11. Respondent was drug tested at approximately 12:45 a.m., March 12, 1994 at Polk General Hospital.

    
    

12. The results of the tests taken at Polk General Hospital, and submitted to Metpath Laboratory for testing on samples from Respondent's serum and blood revealed a very high level of morphine (opiates) in Respondent's bloodstream. The level of opiates in his blood was greater than 1,999 mcg/1 and confirmed by immunoassay by the testing laboratory.

    
    

13. Respondent admitted to the use of prescription opiate medication on March 11 and 12, 1994 while on duty as a paramedic.

    
    

14. As a result of the drug testing of Respondent conducted the evening of March 11 and continuing the morning of March 12, 1994, and Respondent's arrest on March 14, 1994 on other charges related to improperly obtaining controlled substances or prescription medications, the Polk County EMS Medical Director rescinded Respondent's ability to function under the medical director's medical license. Furthermore, Respondent's employer, Polk County EMS, suspended Respondent without pay from his position as a paramedic with Polk County. Subsequently, Polk County EMS discharged Respondent, after providing a pre- determination conference, on August 26, 1994.

    
    

15. HRS-EMS issued an Administrative Complaint, dated July 18, 1994, charging Respondent with a violation of EMS statutes, in particular Section 401.411(1)(a) and (k), Florida Statutes by having tested positive to controlled substances while on duty as a paramedic for Polk County EMS, March 12, 1994.

    
    

16. HRS-EMS has adopted an "impaired" EMTs or paramedics policy and program pursuant to Rule 10D-66.0571, F.A.C.. While the administrative complaint tracks the department's impaired practitioner's rule and provided notice to Respondent relative to the rule, Respondent failed to take advantage of this beneficial program.

    
    

17. Under the impaired practitioner's rule of HRS-EMS, a paramedic who becomes impaired as a result of drug or alcohol use or addiction may avoid administrative sanction by performing voluntary activities including those listed in the department's administrative complaint against Respondent.

    
    

18. Respondent reported for duty as a paramedic while taking a level of controlled substances which impaired his ability to safely provide care to patients.

    CONCLUSIONS OF LAW

    
    

19. The Division of Administrative Hearings has jurisdiction over the parties and subject matter in this case. Subsection 120.57(1), and Section 120.60, Florida Statutes.

    
    

20. The conduct of Respondent as set forth in findings of fact above constitutes grounds for discipline pursuant to Section 401.411(1)(a) and (k), Florida Statutes, in that Respondent, while performing duties as a paramedic with his employer, had taken a level of controlled substances which impaired his ability to provide care to patients.

    
    

21. Moreover, Respondent has failed to avail himself of the impaired practitioner program adopted by HRS pursuant to Rule 10D-66.0571, F.A.C..

    
    

22. Respondent has failed to keep HRS, the division or the hearing officer informed of his correct, current mailing address during the pendency of this proceeding and has thereby acted in a way inconsistent with maintaining his rights to an administrative hearing.

    
    

23. Respondent has failed to recertify as a paramedic and did not appear at the administrative hearing January 25, 1995. Each of these constitutes a waiver of Respondent's right to be present at the administrative hearing held in this matter.

    
    

24. Based upon the foregoing findings of fact and conclusions of law, a penalty is appropriate under Section 401.411(7), Florida Statutes. The violation is egregious in that Respondent has jeopardized patient health and safety. His certification should be revoked.

    
    

25. Respondent has not taken substantial action to correct his violation of Section 401.411(1)(k), Florida Statutes. The maximum administrative fine authorized pursuant to Section 401.411(7) is, therefore, appropriate.

RECOMMENDATION

Based on the foregoing, it is RECOMMENDED as follows:

1. The paramedic certification of Respondent be revoked and an administrative fine of one thousand ($1,000) dollars for the violation of paramedic certification requirements be imposed. It is further

RECOMMENDED that should Respondent reapply for certification as a paramedic or EMT in Florida, he be required to submit to, and successfully complete, the conditions set forth in Rule 10D-66.0571(2), Florida Administrative Code, and pay the administrative fine recommended above, prior to recertification.

DONE and ENTERED this 15th day of February, 1995, in Tallahassee, Florida.

DANIEL M. KILBRIDE

Hearing Officer

Division of Administrative Hearings The DeSoto Building

1230 Apalachee Parkway

Tallahassee, Florida 32399-1550

(904) 488-9675

Filed with the Clerk of the Division of Administrative Hearings this 15th day of February, 1995.

APPENDIX

The following constitutes my specific rulings, in accordance with section 120.59, Florida Statutes, on proposed findings of fact submitted by the parties.

Petitioner's proposed findings of fact.

Accepted in substance: paragraphs 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11 (in

part), 19, 20, and 21.

Rejected as subsumed or covered in the Preliminary Statement: paragraphs 12, 13, 14, 15, 16, 17, 18, and 22.

Respondent has not submitted proposed findings of fact.

COPIES FURNISHED:

Robert L. Powell, Agency Clerk Department of Health and Rehabilitative Services

1323 Winewood Boulevard

Tallahassee, Florida 32399-0700

Kim Tucker, Esquire Department of Health and Rehabilitative Services 1323 Winewood Boulevard

Tallahassee, Florida 32399-0700

Robert P. Daniti, Esquire Emergency Medical Services Department of HRS

1317 Winewood Boulevard

Tallahassee, Florida 32301

Joseph L. Riggall 13711 Hatchienha Road

Haines City, Florida 33844

NOTICE OF RIGHT TO SUBMIT EXCEPTIONS

All parties have the right to submit written exceptions to the Recommended Order. All agencies allow each party at least 10 days in which to submit written exceptions. Some agencies allow a larger period within which to submit written exceptions. You should consult with the agency that will issue the final order in this case concerning their rules on the deadline for filing exceptions to this Recommended Order. Any exceptions to this Recommended Order should be filed with the agency that will issue the final order in this case.

Docket for Case No: 94-004916

Orders for Case No: 94-004916