STATE OF FLORIDA

DIVISION OF ADMINISTRATIVE HEARINGS

AGENCY FOR HEALTH CARE )

ADMINISTRATION, )

)

Petitioner, )

)

vs. ) CASE NO. 94-6437

) CHARLES R. THOMPSON, M.D., )

)

Respondent. )

)

RECOMMENDED ORDER

The final hearing in this case was held before Larry J. Sartin, Hearing Officer, on April 23 and 24, 1996, in Pensacola, Florida.

APPEARANCES

For Petitioner: Britt Thomas, Esquire

Agency for Health Care Administration Northwood Centre

1940 North Monroe Street, Legal A Tallahassee, Florida 32399-0792

For Respondent: James M. Wilson, Esquire

Wilson, Harrell & Smith, P.A.

307 Palafox Street Pensacola, Florida 32501

STATEMENT OF THE ISSUE

The issue in this case is whether Respondent, Charles R. Thompson, M.D., 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 as alleged in an Administrative Complaint entered November 3, 1993.

PRELIMINARY STATEMENT

On November 3, 1993, Petitioner, the Agency for Health Care Administration, f/k/a the Department of Business and Professional Regulation, entered an Administrative Complaint alleging that

Respondent, Charles R. Thompson, M.D., had committed a violation of Section 458.331(1)(t), Florida Statutes. Respondent disputed the allegations of the Administrative Complaint and requested a formal administrative hearing.

By letter dated November 15, 1994, Petitioner requested the assignment of a Hearing Officer of the Division of Administrative Hearings to conduct a formal administrative hearing. The matter was designated case number 94-6437 and was assigned to the undersigned.

At the formal hearing Petitioner presented the testimony of David S. Hoffman, M.D. Petitioner also offered the deposition testimony of Jeffrey E. Ehrlich, M.D., Scott D. Greenwood, M.D., and Rose Marie Nye. It was agreed that Dr. Ehrlich's deposition testimony would be taken and filed after the completion of the formal hearing. Petitioner offered five exhibits, including the depositions of Dr. Greenwood and Ms. Nye. All five exhibits were accepted into evidence. Dr. Ehrlich's deposition testimony has been marked as Petitioner's exhibit 6 and is accepted into evidence.

Respondent testified on his own behalf and presented the testimony of David Bell, M.D., and Bruce McCraw, M.D. Respondent's exhibits 1-3 were accepted into evidence.

Two joint exhibits were also offered and accepted into evidence.

The parties filed a Prehearing Stipulation. The Stipulation contains agreed findings of fact. Those findings have been included in this Recommended Order.

A letter dated May 8, 1996 from the court reporter was filed on May 9, 1996. The letter indicated that the transcript of the final hearing was being filed. By agreement of the parties proposed orders were, therefore, required to be filed on or before May 21, 1996.

Both parties filed proposed orders on or before May 21, 1996. A ruling on each proposed finding of fact has been made either directly or indirectly in this Recommended Order or the proposed finding of fact has been accepted or rejected in the Appendix which is attached hereto.

FINDINGS OF FACT

1. The Parties.

   
   

   1. Petitioner, the Agency for Health Care Administration (hereinafter referred to as the "Agency"), is the state agency charged with regulating the practice of medicine in the State of Florida pursuant to Section 20.165, Florida Statutes, Chapter 455, Florida Statutes, and Chapter 458, Florida Statutes. (Stipulated Fact).

      
      

   2. Respondent, Charles R. Thompson, M.D., is, and has been at all times material hereto, a licensed physician in the State of Florida. Dr. Thompson was issued license number ME 0053590. Dr. Thompson's last known address is 8333 North Davis Highway, Pensacola, Florida 32514. (Stipulated Facts).

      
      

   3. Dr. Thompson specializes in internal medicine. Dr. Thompson is not, however, Board certified in internal medicine. (Stipulated Facts).

      
      

   4. At all times relevant to this proceeding, Dr. Thompson was a shareholder/employee of the Hodnette Medical Center Clinic, a/k/a The Medical Center Clinic, P.A. (hereinafter referred to as the Medical Center Clinic"), in Pensacola, Florida.

      
      

   5. Dr. Thompson has not been the subject of any disciplinary action against his license to practice medicine, other than the subject proceeding, and has had no medical malpractice claims asserted against him.

      
      

2. Patient Number 1, K. M..

   
   

   1. Patient Number 1, K. M., was a 27 year old female. (Stipulated Fact).

      
      

   2. K. M. had a history of severe insulin dependent diabetes mellitus, severe hypertension, blindness due to diabetic retinopathy, and chronic renal failure. K. M. had lost a toe due to gangrene. (Stipulated Facts). She suffered from fluctuating blood sugars, recurring problems with headaches, recurring problems with nausea and vomiting, recurring instances of non- compliance with physicians' orders, recurring episodes or phases of anemia and recurring periods during which she suffered from diabetic ketoacidosis.

      
      

   3. K. M. was also suspected of suffering from coronary artery disease, due to the severity and duration of her diabetes and the resulting peripheeral vascular disease. She was also

      suspected to suffer from diabetic gastroparesis, a condition that affects the function of the stomach and digestive tract.

      
      

   4. Dr. Thompson had become K. M.'s primary treating physician around October of 1989. She had been a patient at the Medical Center Clinic prior to becoming Dr. Thompson's patient.

      
      

3. Emergency Room Visits Prior to September, 1990.

   
   

   1. During the year 1990, K. M. went to the Emergency Department of West Florida Regional Medical Center (hereinafter referred to as "West Florida Regional"), on eight different occasions prior to September 16, 1990.

      
      

   2. On some of the 1990 Emergency Department visits, K. M. presented with symptoms similar to those which she presented with at the time of the hospitalization which is the subject of this proceeding. The symptoms she presented with included headaches, nausea and vomiting, hypertension and manifestations of kidney dysfunction. Dr. Thompson was consulted on three of these occasions.

      
      

   3. K. M. was hospitalized from July 9, 1990 through July 19, 1990. She was under the care of Dr. Thompson during this hospitalization. K. M. was treated for insulin dependent mellitus, nausea and vomiting secondary to probable gastroparesis, hypertension, dehydratin and anemia.

      
      

   4. During K. M.'s July, 1990, hospitalization, she received IV fluids, blood pressure medications, and medication to treat nausea and vomiting and the effects of diabetic gastroparesis. She was discharged in stable condition on July 19, 1990.

      
      

4. K. M.'s Hospitalization in September of 1990.

1. On or about September 16, 1990, K. M. presented to the Emergency Department of West Florida Regional with complaints of headache, nausea and uncontrolled vomiting. K. M. was vomiting blood. (Stipulated Facts).

   
   

2. Dr. Thompson, K. M.'s primary care physician, was consulted by the Emergency Department physician.

   
   

3. Dr. Thompson examined K. M. and noted that she was dehydrated with no diarrhea or edema, had clear lungs and a regular heart rate and rhythm. K. M. had a blood pressure of 218/137. (Stipulated Facts).

4. Dr. Thompson diagnosed K. M. with dehydration, nausea, probably due to chronic renal failure, and possible tear ("Mallory-Weis") to the esophagus due to severe vomiting. (Stipulated Facts). Dr. Thompson's assessment also included the following findings: (a) insulin-dependent diabetes mellitus; (b) hypertension; (c) chronic renal failure secondary to diabetic nephropathy; (d) migraine headaches; (e) mild diabetic ketoacidosis; (f) anemia; (g) poorly controlled blood sugars; and

   (h) tachycardia.

   
   

5. At the time of her admission to West Florida Regional,

   K. M. was critically ill. A component of K. M.'s illness was her volume status. Dr. Thompson admitted K. M. to the Critical Care Unit (hereinafter referred to as the "CCU"), of West Florida Regional, administered Catapres intravenously to lower her blood pressure, and issued orders for intravenous rehydration and insulin therapy. (Stipulated Facts). Dr. Thompson also ordered Bicitra for K. M.'s acidosis. Dr. Thompson's full admitting orders are recited in Respondent's proposed finding of fact 8.

   
   

6. The protocol for the CCU included orders for the contemporaneous recording of all intake and output of a patient receiving IV fluids, such as K. M. The protocol also included orders for the taking of vital signs, including pulse, respiration and blood pressure on a frequent and regular basis. The protocol orders were followed for K. M.

   
   

7. K. M. was admitted to the CCU by Dr. Thompson because he believed she would receive more constant nursing supervision and attention than on the regular hospital floor. There was one nurse to every one or two patients on the CCU, a much higher nurse staffing ration than on the regular floor.

   
   

8. On September 17, 1990, Dr. Thompson's physical examination of K. M. revealed that her nausea persisted with some vomiting. The bleeding, however, had decreased. Dr. Thompson's medical records reflect that K. M. refused an upper endoscopy to determine the cause of the bleeding. K. M. also declined Dr. Thompson's suggestion that she could benefit from a blood transfusion. Dr. Thompson also noted no edema. (Stipulated Facts).

   
   

9. At 3:00 p.m., on September 17, 1990, Dr. Thompson ordered Demerol, 25 mg IM or IV every four hours PRN for pain. At 5:55 p.m. Dr. Thompson ordered 14 units of insulin, SQ stat. Dr. Thompson later ordered the following:

   
   

   1. Please begin clear liquids - ADA

   2. SMA-7, CBC in AM

   3. MG SO4 8 mg IV over 6 hrs (in N/S)

   4. Notify Dr. Wayne Miller of admit & location

   5. Stools for blood, X 3

   6. Bicitra 15 cc po BID

      
      

10. On September 18, 1990, Dr. Thompson examined K. M. Dr. Thompson found the following:

    
    

    1. Continues with nausea, vomiting. Some coffee-ground material.

    2. Afebrile, Vital Signs Stable.

    3. Exam--unchanged.

    4. Blood sugars fluctuating 35-400.

    5. Hematocrit down to 22.4 last p.m., 23 this a.m.

    6. Patient refuses transfusion and endoscopy. Will continue to monitor H & H and B.S. If Hematocrit continues to fall, will have to convince to have transfusion and endoscopy.

    
    

11. Based upon Dr. Thompson's examination of K. M. on September 18, 1990, he ordered: (a) Hematocrit and hemoglobin be changed every 8 hours, instead of every 12 hours--call if Hematrocirt goes below 22; and (b) SMA-7, CBC in a.m.

    
    

12. On or about September 19, 1990, Dr. Thompson examined

    K. M. and noted 1+ edema in the hands and feet. Edema is swelling and is an indication that a person is retaining excessive fluids. Dr. Thompson ordered 20 mg. of Lasix, a diuretic, and reduced K. M.'s fluid intake. According to Dr. Thompson's records he also found no S3 Gallup and that her lungs were clear. (Stipulated Facts).

    
    

13. Dr. Thompson's observations of the results of his examination of September 19, 1990, were as follows:

    
    

    1. Patient confused yesterday and this a.m. Still with some dry heaves.

    2. Afebrile--vital signs stable.

    3. Lungs: clear CV: regular rate and rhythm without S3 gallop

    4. Abdomen: positive bowel signs, no increased organomegaly

    5. Extremities: 1+ edema feet and hands

    6. Intate/Output markedly positive

    7. Hematocrit 24.6 this a.m.

       Blood Sugars 100-250

    8. Plan:

       1. Will transfer to floor--watch blood sugars and Hematocrit and Hemoglobin-- as long as stable Hematocrit and Hemoglobin, will try to hold on

          Endoscopy, but if nausea, gagging continue, will need to look at stomach.

       2. Give Lasix and decrease IV fluids.

       3. Check labs in a.m.

    
    

14. Dr. Thompson ordered the following:

    
    

    1. Please transfer to floor, no monitor needed.

    2. Decrease Hematocrit and Hemoglobin checks to every 12 hours.

    3. SMA-18, CBC in a.m.

    4. Lasix 20 mg IV now.

    5. Decrease IV fluids to 100 CCs per hour [down from 150].

    6. Decrease Zantac to 50 mg IV.

    
    

15. After Dr. Thompson examined K. M. on September 19, 1990, he visited briefly with her parents. Dr. Thompson then checked out of the hospital and went home because he was ill. Pursuant to protocol, another physician was to cover for Dr. Thompson.

    
    

16. On or about September 19, 1990, K. M. suffered cardiac arrest and revived. K. M. expired after multiple episodes of cardiac arrest. (Stipulated Facts). K. M. first sustained an acute myocardial infarction at approximately 3:00 p.m. This was the first time that K. M. first evidenced shortness of breath. Three separate Code 3 procedures were administered to K. M. During the Code 3 procedures she received additional fluids.

    
    

17. The autopsy report on K. M. dated September 20, 1990 indicates that K. M. suffered from acture bilateral bronchopneumonia of the lower lobes with severe pulmonary edema and bilateral pleural effusions, severe artherosclerosis, and marked abdominal ascites. The cause of K. M.'s death was an acute myocardial infarction. (Stipulated Facts).

    
    

18. To the extent that K. M. experienced a fluid overload, that condition did not cause the myocardial infarction she suffered. Fluid overload had nothing to do with the myocardial infarction.

    
    

    E. Monitoring K. M.'s Fluids.

    
    

19. K. M.'s condition required that her fluids be monitored. K. M. was receiving rehydration therapy. She was also receiving medication to control her hypertension. These are opposing therapies and, therefore, more strict monitoring was required. While K. M. was dehydrated and needed fluids, the condition of her kidneys caused her to be less able to handle

    fluids. It is preferrable, however, that a patient such as K. M. experience some fluid overload as opposed to being dehydrated.

    
    

20. Nonetheless, if a patient receives and retains excessive fluids it can be detrimental to the patient. For example, a patient that receives and retains excessive fluids may develop pulmonary edema.

    
    

21. Dr. Thompson monitored K. M.'s rehydration progress through "gross methods". Dr. Thompson used physical examination, including listening to K. M.'s heart and lungs with a stethescope and physically and visually checking for swelling or the absence thereof. K. M.'s fluid intake and output was also recorded and reviewed by Dr. Thompson.

    
    

22. K. M.'s intake and output of fluids was monitored and recorded on a continuing basis each day that she was hospitalized, consistent with protocols. Fluid intake was recorded by IV fluid, IV medication and oral consumption. Fluid output was recorded as urine, bowel movements and emesis. Measuring fluid intake and output is not completely accurate.

    
    

23. Dr. Thompson monitored K. M.'s intake and output, he examined K. M. daily, he looked for pulmonary or cardiac signs of fluid overload, he reviewed nurses notes, graphic sheets recording pulse rate, respiration and blood pressure, and reviewed lab results. These items did not suggest that K. M. was experiencing fluid overload. Dr. Thompson was alert for any signs of edema. There was, in fact, no sign of edema until the morning of September 19, 1990, and Dr. Thompson took steps to alleviate what he concluded was mild edema. Until that time, K.

    1. had not evidenced any shortness of breath, which would have suggested pulmonary edema and a possible fluid overload.

       
       

24. Dr. Thompson did not order the use of a Swan-Ganz catheter or a central venous line. These are both invasive devices designed to measure fluids.

    
    

25. Dr. Thompson also did not order daily weighing of K. M. Weighing a patient can provide information about fluids levels by monitoring weight gain.

    
    

26. Dr. Thompson also did not order daily x-rays of K. M.'s lungs to determine if she had fluid in her lungs. Dr. Thompson relied on listening to her lungs with a stethoscope.

    
    

    1. K. M. Experienced Excessive Fluids.

       
       

27. K. M. experienced excessive fluids, or a "fluid overload", while under Dr. Thompson's care. The terms "fluid

    overload" refer to the condition of the body when excessive fluids are retained in the body.

    
    

28. While hospitalized, K. M. received approximately 8,120 cc.'s of fluid in excess of what her intake and output measurements indicated she was excreting. On the second day of her hospitalization, K. M. received three times the amount of fluids she excreted.

    
    

29. On the morning of September 19, 1990, a nurse caring for K. M. telephoned Dr. Thompson and expressed concern to Dr. Thompson over the amount of fluids K. M. was receiving. It was after this telephone call that Dr. Thompson noted K. M.'s edema and ordered a reduction in her fluids and that she be given Lasix, a diuretic.

    
    

30. Although K. M. did not have any signs of fluid overload until the morning of September 19, 1990, the results of her autopsy indicate that she had begun suffering a fluid overload one or two days earlier. The autopsy also revealed that K. M. had bilateral pneumonia. This condition was not detected by Dr. Thompson during his clinical assessment of her.

    
    

    1. Did Dr. Thompson Fail to Adequately Monitor K. M.'s Fluid Level?

    
    

31. The evidence failed to prove that there is a single, standard method of monitoring the fluid status of a patient such as K. M.

    
    

32. The physicians called as witnesses by the Agency all agreed that Dr. Thompson failed to adequately monitor K. M.'s fluid levels. All three physicians disagreed, however, about the method of monitoring that should have been employed.

    
    

33. The physicians called as witnesses by Dr. Thompson all agreed that Dr. Thompson's efforts to monitor K. M.'s fluid levels were adequate.

    
    

34. The explanations provided by the Agency's witnesses of their opinions as to Dr. Thompson's treatment were inadequate to support a finding that the opinions as to Dr. Thompson's treatment provided by Dr. Thompson and his witnesses were inaccurate.

    
    

35. The weight of the evidence failed to prove that Dr. Thompson deviated from the appropriate standard of care by failing to adequately monitor K. M.'s condition.

36. The weight of the evidence failed to prove that Dr. Thompson failed to practice medicine with an acceptable level of care, skill, and treatment which a reasonably prudent similar physician recognizes as acceptable under similar conditions.

    
    

    CONCLUSIONS OF LAW

    
    

37. The Division of Administrative Hearings has jurisdiction of the parties to and the subject matter of this proceeding. Section 120.57, Florida Statutes (1995).

    
    

38. The Agency announced at the commencement of the formal hearing that it would not be seeking the suspension or revocation of Dr. Thompson's license. Therefore, the burden of proof was placed on the Agency to prove by the "greater weight of the evidence" the charges against Dr. Thompson. Section 458.311(3), Florida Statutes.

    
    

39. Section 458.311(1), Florida Statutes, authorizes the Board of Medicine to take disciplinary action against a physician upon proof of any of several acts. In this matter, the Agency has charged that Dr. Thompson has committed a violation of Section 458.331(1)(t), Florida Statutes.

    
    

40. Section 458.311(1)(t), Florida Statutes, defines the following violation for which discipline may be imposed:

    
    

    (t) Gross or repeated malpractice or 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. . .

    .

    
    

41. Although the Administrative Complaint filed against Dr. Thompson alleged other factual reasons for the charge against him, those charges were reduced at the final hearing and based upon the allegations of the Agency's proposed recommended order to the following particulars:

    
    

    The Respondent practiced medicine below the standard of care in that Respondent failed to monitor Patient Number 1/s . . . fluids and failed to detect her fluid overload in a timely manner.

    
    

42. The greater weight of the persuasive evidence in this case failed to prove that Dr. Thompson's treatment of K. M. constituted gross or repreated malpractice. The greater weight of the persuasive evidence in this case also fail to prove that Dr. Thompson 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.

RECOMMENDATION

Based upon the foregoing Findings of Fact and Conclusions of Law, it is

RECOMMENDED that the Agency for Health Care Administration enter a Final Order dismissing all charges in the Administrative Complaint entered against Charles R. Thompson, M.D.

DONE and ENTERED this 1st day of July, 1996, in Tallahassee Florida.

LARRY J. SARTIN, 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 1st day of July, 1996.

APPENDIX TO RECOMMENDED ORDER, CASE NO. 94-6437

The parties have submitted proposed findings of fact. It has been noted below which proposed findings of fact have been generally accepted and the paragraph number(s) in the Recommended Order where they have been accepted, if any. Those proposed findings of fact which have been rejected and the reason for their rejection have also been noted.

The Agency's Proposed Findings of Fact

1. Accepted in 2.

2. Accepted in 3.

3. Accepted in 6-7.

4. Accepted in 14.

5. Accepted din 14-15 and 18.

6. See 16 and 19.

7. Hereby accepted.

8. Accepted in 8.

9-10 Accepted in 18.

1. Accepted in 32.

2. Hereby accepted.

3. Accepted in 34-36.

4. Accepted in 35.

15-16 Not supported by the weight of the evidence.

17 Accepted in 33. 18-19 Accepted in 32.

1. Hereby accepted.

2. Not supported by the weight of the evidence.

3. See 26.

4. Accepted in 27.

5. Hereby accepted.

6. See 20.

26-27 Not supported by the weight of the evidence.

28 Accepted in 40.

29-30 Accepted in 41. The last sentence of proposed finding of fact 30 is not supported by the weight of the evidence.

31 See 42.

32-33 Accepted in 25.

34 See 25 and 42-43.

1. Accepted in 25 and 27.

2. See 27 and hereby accepted.

3. Accepted in 29.

4. Not supported by the weight of the evidence.

5. Accepted in 30 and 43.

6. Accepted in 32.

7. Accepted in 26. 42-43 Accepted in 43.

44-50 Not supported by the weight of the evidence.

Dr. Thompson's Proposed Findings of Fact

1. Accepted in 2-4 and hereby accepted.

2. Accepted in 9.

3. Accepted in 7-8.

4. Accepted in 10-11 and hereby accepted.

5. Accepted in 12-13 and hereby accepted.

6. Accepted in 14-16 and 18.

7. Accepted in 17.

8. Accepted in 19 and hereby accepted.

9. Accepted in 21 and hereby accepted. 10-11 Accepted in 21.

1. Accepted in 22.

2. Accepted in 23.

3. Accepted in 24.

4. Accepted in 26 and hereby accepted.

5. Accepted in 27.

6. Although generally correct, this charge was dismissed by Petitioner.

7. Accepted in 35 and hereby accepted.

8. Accepted in 28 and hereby accepted.

9. Accepted in 29 and hereby accepted.

10. Accepted in 30.

11. Statement of the issues. Paragraph 22(a) was dismissed by Petitioner.

12. Hereby accepted.

13. Accepted in 35.

14. See 34-36. Restatement of previously proposed findings.

15. Accepted in 37-39.

16. See 44-49. These proposed findings constitute an accurate summary of testimony.

17. See 45-49. These proposed findings constitute an accurate summary of testimony.

29-30 These proposed findings constitute an accurate summary of testimony.

1. See 45-49. These proposed findings constitute an accurate summary of testimony.

2. These proposed findings constitute an accurate summary of testimony.

33-34 These proposed findings are generally correct but are irrelevant.

35-36 These proposed findings constitute an accurate summary of testimony.

1. See 45-49. These proposed findings constitute an accurate summary of testimony.

2. These proposed findings constitute an accurate summary of testimony and argument.

3. These proposed findings are a repeat of previous proposed findings.

4. Hereby accepted.

5. Accepted in 36.

6. These proposed findings are a repeat of previous proposed findings.

7. Hereby accepted.

44 See 45-49.

COPIES FURNISHED:

Britt Thomas, Esquire

Agency for Health Care Administration Northwood Centre, Suite 60

1940 North Monroe Street Tallahassee, Florida 32399-0792

James M. Wilson, Esquire

307 Palafox Street Pensacola, Florida 32501

Dr. Marm Harris, Executive Director Agency for Health Care Administration

Board of Medicine

1940 North Monroe Street Tallahassee, Florida 32399-0792

Douglass M. Cook, Director

Agency for Health Care Administration 2727 Mahan Drive

Tallahassee, Florida 32308

Jerome W. Hoffman, Esquire 2727 Mahan Drive

Tallahassee, Florida 32309

NOTICE OF RIGHT TO SUBMIT EXCEPTIONS

All parties have the right to submit written exceptions to this 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 contact the agency that will issue the final order in this case concerning agency 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.

================================================================= AGENCY FINAL ORDER

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

STATE OF FLORIDA

AGENCY FOR HEALTH CARE ADMINISTRATION BOARD OF MEDICINE

AGENCY FOR HEALTH CARE ADMINISTRATION, BOARD OF MEDICINE,

Petitioner,

AHCA CASE NO: 92-12982

v. DOAH CASE NO: 94-6437

LICENSE NO:ME 0053590

CHARLES R. THOMPSON, M.D.,

Respondent.

/

FINAL ORDER

THIS MATTER was heard by the Board of Medicine (hereinafter Board) pursuant to Section 120.57(1)(b)10., Florida Statutes, on August 2, 1996, in Orlando, Florida, for consideration of the Hearing Officer's Recommended Order (Attached as App. A) in the case of Agency for Health Care Administration, Board of Medicine

1. Charles R. Thompson, M.D. At the hearing before the Board, Petitioner was represented by Larry G. McPherson, Jr., Chief Medical Attorney. Respondent was not present and was represented by James M. Wilson, Esquire. Upon consideration of the Hearing Officer's Recommended Order after review of the complete record and having been otherwise fully advised in its premises, the Board makes the following findings and conclusions:

   FINDINGS OF FACT

   
   

   1. The Hearing Officer's Recommended Findings of Fact are approved and adopted and are incorporated herein by reference as the Findings of Fact of the Board in this cause.

      
      

   2. There is competent, substantial evidence to support the Board's findings herein.

      
      

      CONCLUSIONS OF LAW

   3. The Board has jurisdiction over the parties and subject matter of this case pursuant to Section 120.57 and Chapter 458, Florida Statutes.

      
      

   4. The findings of fact set forth above do not establish that Respondent has violated Section 458.331(1)(t), Florida Statutes as charged in the Administrative Complaint.

      
      

   5. The Conclusions of Law of the Recommended Order are approved and adopted and incorporated herein with the following amendment: that the Hearing Officer's recommendation to dismiss this matter on page fifteen (15) of the Recommended Order should be directed to the Board of Medicine rather than the Agency for Health Care Administration.

DISPOSITION

Based upon the Recommended Findings of Fact and Conclusions of Law of the Hearing Officer, the Board hereby determines that pursuant to Rule 59R-8, Florida Administrative Code, the penalty recommended by the Hearing Officer is appropriate as set forth in the Recommended Order.

WHEREFORE, it is found, ordered and adjudged that the Respondent is not guilty of violating Section 458.331(1) (t), Florida Statutes, and the Administrative Complaint filed in this matter is hereby DISMISSED.

This Final Order becomes effective upon its filing with the Clerk of the Agency for Health Care Administration.

NOTICE

The parties are hereby notified pursuant to Section 120.59(4), Florida Statutes, that an appeal of this Final Order may be taken pursuant to Section 120.68, Florida Statutes, by filing one copy of a Notice of Appeal with the Clerk of the Agency for Health Care Administration and one copy of a Notice of Appeal with the required filing fee with the District Court of Appeal within thirty (30) days of the date this Final Order is filed.

DONE and ORDERED this 6th day of September, 1996.

BOARD OF MEDICINE

MARY KATHRYN GARRETT, M.D. CHAIRMAN

CERTIFICATE OF SERVICE

I HEREBY CERTIFY that a true and correct copy of the foregoing Final Order and its attachments have been forwarded by US Mail to Charles R. Thompson, M.D., 8333 North Davis Highway, Pensacola, Florida 32514, James M. Wilson, Esquire, P.O. Drawer 13430, Pensacola, Florida 32591-3430, Larry J. Sartin, Hearing Officer, Division of Administrative Hearings, The DeSoto Building, 1230 Apalachee Parkway, Tallahassee, Florida 32399-1550 and by hand delivery to Larry G. McPherson, Jr., Chief Medical Attorney, Agency for Health Care Administration, 2727 Mahan Drive, Building 4, P.O. Box14229,Tallahassee,Florida32317 on this 12th day of September, 1996.

Marm Harris, Ed.D. Executive Director

Docket for Case No: 94-006437

Orders for Case No: 94-006437