STATE OF FLORIDA

DIVISION OF ADMINISTRATIVE HEARINGS

DEPARTMENT OF HEALTH, )

BOARD OF MEDICINE, )

)

Petitioner, )

)

vs. ) Case Nos. 98-0785

) 98-0948

DUKE H. SCOTT, M.D., )

)

Respondent. )

)

RECOMMENDED ORDER

Pursuant to notice, these matters were heard on February 23- 25, 1999, in Jacksonville, Florida, before Donald R. Alexander, the assigned Administrative Law Judge of the Division of Administrative Hearings.

APPEARANCES

For Petitioner: John O. Williams, Esquire

Maureen L. Holz, Esquire The Cambridge Center

355 North Monroe Street Tallahassee, Florida 32301

For Respondent: Kelly B. Mathis, Esquire

Michael A. Wasylik, Esquire Suite 1700, SunTrust Building

200 West Forsyth Street Jacksonville, Florida 32202-4359

Joseph P. Milton, Esquire

1660 Prudential Drive, Suite 200

Jacksonville, Florida 32207-8185 STATEMENT OF THE ISSUE

The issue is whether Respondent's license as a medical doctor should be disciplined for the reasons given in the

Administrative Complaints filed on October 17, 1997, and February 2, 1998.

PRELIMINARY STATEMENT

On October 17, 1997, Petitioner, Department of Health, Board of Medicine, issued an Administrative Complaint alleging that while treating three female patients, Respondent, Duke H. Scott, a licensed medical doctor, was guilty of exercising influence within a physician-patient relationship for purposes of engaging in sexual activity, engaging in sexual misconduct in the practice of medicine, and violating a rule or provision within

Chapter 458, Florida Statutes, as proscribed by Sections 458.329, 458.331(1)(j), and 458.331(1)(x), Florida Statutes, and Rule

64B8-9.008, Florida Administrative Code. Those complaints have been assigned Case No. 98-0948. On February 2, 1998, Petitioner filed a second complaint alleging essentially the same conduct on the part of Respondent while treating four other female patients. Those complaints have been assigned Case No. 98-0785. Respondent denied the allegations and requested a formal hearing under Section 120.569, Florida Statutes, to contest the charges.

The complaints in Case Nos. 98-0785 and 98-0948 were referred by Petitioner to the Division of Administrative Hearings on February 12 and 26, 1998, respectively, with a request that an Administrative Law Judge be assigned to conduct a formal hearing. The two cases were consolidated and by Notice of Hearing dated March 3, 1998, a final hearing was scheduled on May 27-29 and

June 1-4, 1998, in Jacksonville, Florida. At the parties' equest, the cases were rescheduled to August 31-September 3, 1998, and then to February 23-26, 1999, at the same location.

During the course of this proceeding, Petitioner voluntarily dismissed the allegations of V. F., one of the patients identified in Case No. 98-0785. In addition, after an evidentiary hearing was conducted on August 31, 1998, the undersigned granted Respondent's Motion to Dismiss the allegations pertaining to patient P. M., also identified in Case No. 98-0785, on the grounds that the doctrine of laches and due process prevented the prosecution of these charges, which dated back to 1979. An order confirming this dismissal was entered on October 15, 1998. Finally, the numerous discovery disputes which arose prior to hearing have been addressed by various preliminary orders.

At final hearing, Petitioner presented the testimony of

B. N., J. P., A. G., C. A., and S. C., all former patients of Respondent; Christopher L. Arnold, the husband of a former patient; Dr. Dick A. VanEldick, a Lake Worth family physician; and Dr. Barbara A. Stein, a Palm Harbor clinical and forensic psychiatrist. Also, it offered Petitioner's Exhibits 1-8. All exhibits were received in evidence. Respondent testified on his own behalf and presented the testimony of Margaret Hightower, a cousin of A. G.; JoAnn Beck and Frances McLaurin, both medical assistants in his office; Linda Morehead, Phyllis Phillips, Jane

Gibson, and Rebecca Pack, all former patients; Debora Scott, his daughter and a former office employee; Dr. Guy T. Selander, a Jacksonville family physician and former president of the Florida Medical Association; Otis Williams, a former janitor in his office; Ann Hamlin, a former employee; Daisy D. Young, his former office manager; Kathryn L. H. Scott, his wife; and Dr. Michael Gutman, a Winter Park psychiatrist. Also, he offered Respondent's Exhibits 1-10. All exhibits were received in evidence except Exhibits 6-8, on which a ruling was reserved.

Exhibits 3 and 4 are the depositions of the ex-husband and brother, respectively, of patient J. P. Finally, the undersigned granted Petitioner's request to take official recognition of Chapters 455 and 458, Florida Statutes, and Chapter 64B8-8, Florida Administrative Code.

The transcript of hearing (three volumes) was filed on

March 22, 1999. Proposed Findings of Fact and Conclusions of Law were filed by the parties on April 5, 1999, and they have been considered by the undersigned in the preparation of this Recommended Order.

FINDINGS OF FACT

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

1. Background

   
   

   1. At all times material hereto, Respondent, Duke H. Scott, was a licensed medical doctor having been issued license number

      ME 0013791 by the Board of Medicine (Board). Until 1998, Respondent practiced as a family physician at 1205 Beach Boulevard, Jacksonville, Florida. Except for the charges raised in this proceeding, there is no evidence that Respondent has ever been involved in a prior disciplinary action.

   2. Based on complaints filed by three former female patients, J. P., B. N., and S. C., Petitioner, Department of Health (Department), prosecuting this matter on behalf of the Board, issued an Administrative Complaint on October 17, 1997, alleging that while treating those patients between the years 1992 and 1994, Respondent improperly exercised influence in the patient-physician relationship for the purpose of engaging those patients in a sexual activity, and he engaged in sexual misconduct in the practice of medicine. Those three complaints are found in Case No. 98-0985.

   3. On February 2, 1998, the Department issued a second Administrative Complaint alleging that during the years 1992 through 1995 Respondent engaged in similar activity with two other female patients, C. A. and A. G. Those two complaints are found in Case No. 98-0785.

   4. Respondent has denied all allegations of misconduct and requested a hearing for the purpose of contesting the charges. Because the parties presented sharply conflicting versions of events, the undersigned has accepted the most credible testimony and resolved those conflicts in the following manner.

2. Respondent's Practice

   
   

   1. Respondent has worked as a family practitioner in Jacksonville, Florida, since the 1960's and has treated thousands of patients over the years. When the events herein occurred, he was employed as a physician by Health South, Inc. (HSI), a large medical organization, until HSI was bought out by another entity.

      
      

   2. In 1992 through 1994, when the alleged misconduct occurred, Respondent's typical day would begin around 5:30 a.m. or 6:00 a.m. when he made "morning rounds" at two local hospitals visiting patients. He then met with his office personnel at

      7:30 a.m., and he began seeing patients shortly thereafter. His work day did not end until the last patient was seen, generally between 6:00 p.m. and 8:00 p.m., depending on the case load. In an average day, Respondent saw no fewer than twenty-five, and as many as sixty, patients.

   3. The regular staff, which numbered five or six, reported to work each morning by 7:30 a.m. Besides the regular staff, Respondent also hired temporary or part-time workers, often former or current patients, to staff the office after 4:00 p.m. so that some of his regular staff could be relieved. Respondent encouraged these part-timers to complete their education, he paid for their books and tuition while they worked in his office, and he arranged their work schedules around their classes. Because of his full work day, it was not unusual for Respondent to meet

      with potential part-timers at the end of the work day in his office to discuss possible employment and what their duties would entail.

   4. The staff was divided into "front" and "back" staff, which meant they either worked in the front reception area answering the telephone, making appointments, receiving payments, and processing insurance claims, or they worked in the back assisting the doctor when he was seeing patients. As a rule, part-timers worked with the front staff and not with patients.

   5. During the early 1990's, Respondent had a fairly large contingent of patients who were on a weight loss program. After an initial comprehensive examination, these patients would return on a periodic basis at 7:30 a.m. for weight and blood pressure checks and a quick visit with Respondent to check on their progress. They remained fully clothed during follow-up visits. Unless they had a specific problem, the patients rarely saw the doctor for longer than a minute or two, and an assistant was always present to keep the patients moving.

   6. Beginning around 1985 or so, Respondent had a policy of always having a female assistant in the examination room whenever he conducted a pelvic or breast examination on a female patient. Whenever patients were required to disrobe, they were given a paper gown to wear. It was established that a female assistant would remain in the room until the examination was completed. During a pelvic examination, Respondent always wore a rubber

      glove on the hand that was being used for the examination. Finally, Respondent kept detailed patient records, and he would never do a breast examination without documenting this in the patient's chart.

   7. Unlike most modern era doctors, Respondent occasionally made house calls to family members of his patients when unusual circumstances arose. He followed up on concerns personally, and he treated whole families. In terms of his practicing style, Respondent would sometimes hug his patients, male and female, or even give the females a peck on the forehead before they left his office. This conduct was grounded on his care and concern for the patient, and not for sexual gratification. His style of personally caring for patients has become so rare in today's society that some patients might misinterpret this behavior.

3. The Charges

1. Each of the five patients who filed charges with the Department was either represented in a civil action, or signed an affidavit prepared, by the same Jacksonville attorney. Their claims will be discussed separately below.

   1. Patient C. A.

      
      

2. In September 1997, C. A. read an article in a local newspaper regarding a civil lawsuit filed against Respondent and certain other defendants by J. P., S. C., and B. N. Motivated by the fact that she could "help out getting [Respondent's] license taken away," she contacted the attorney who was representing the

   plaintiffs and agreed to sign an affidavit prepared by him. The attorney then mailed it to the Department. She offered no plausible explanation as to why she had waited five years after the alleged misconduct occurred before making a complaint.

3. Respondent's initial contact with C. A. occurred on November 16, 1992, or five years earlier, when she was eighteen years old, after she fell out of a jeep, broke her ankle, and suffered multiple bruises and contusions. Using her parents' health insurance policy, she visited Respondent's office on seven occasions for treatment of her ankle between November 16 and December 30, 1992. She had no complaints regarding his conduct while visiting him for treatment on those occasions.

4. At hearing, C. A. contended that on an undisclosed date in late 1992, at Respondent's invitation, she rode with him to his condominium where they ate a take-out dinner and he mixed her one drink, ostensibly for the purpose of discussing a part-time job at his office. Respondent denied that this occurred. She also claimed that they met several times at his office "after dark," when the office was empty, for "training" sessions. While she felt "uncomfortable" and "weird" in those settings, she conceded that Respondent never raised the subject of sex, never asked her to engage in sexual relations, and never tried to inappropriately touch her.

5. C. A.'s recollection of the alleged events was somewhat hazy. For example, she claimed that Respondent showed her around

   the condominium, but her description of the condominium was inaccurate. She could not recall the specific dates or times that she visited his office, except that it was after 5:30 p.m., when it became dark. She agreed that it was probably between 6:00 and 7:00 p.m., but if this were true, there would still have been patients or staff in the office at that time, as well as the cleaning crew. She also says that on one occasion, she got some basic training on how to take blood pressure; that training, however, was always given by an assistant, rather than Respondent, and in any event, she would have been hired as "front" staff to meet patients rather than assisting the doctor in treating them.

6. C. A. says that she related Respondent's alleged misconduct to her "mom, stepmother, grandmother, and roommate," and to her present husband, whom she met a few months after last seeing Respondent in December 1992. Except for her husband, no one appeared at hearing to corroborate this assertion. As to the husband, his testimony has been discredited as being biased since he was evicted as a tenant from a rental property owned by Respondent. This occurred after he made an unannounced visit to Respondent's home one Sunday afternoon seeking reimbursement for some painting expenses. During that visit, he banged on the door and windows of Respondent's home until Respondent threatened to

   call the police and have him arrested. Because of his animosity towards Respondent, it is fair to suspect that he may have motivated his wife to bring these charges or color her testimony.

7. For the foregoing reasons, the testimony of C. A. has not been credited. Even assuming arguendo that the events described by C. A. occurred, there is less than clear and convincing evidence that Respondent exercised influence within this relationship for the purpose of engaging C. A. in sexual activity, as alleged in the complaint.

   1. Patient A. G.

      
      

8. Like C. A., A. G. read a local newspaper story which detailed the fact that three other patients had filed a lawsuit against Respondent and certain other defendants. She also read that one or more of the actions had been settled for money by the other defendants. After contacting the plaintiffs' attorney, she learned that the statute of limitations barred her from filing a claim. She agreed, however, to sign an affidavit executed by the attorney, who then filed it with the Department.

9. A. G. first visited Respondent in September 1992 to seek assistance in controlling her weight. She was referred to Respondent by her mother, who was also a weight loss patient and a "long time" friend. A. G. continued in the weight loss program for around nine months.

10. In her complaint, A. G. contended that Respondent always asked her to remove her bra, without any attendant being present, while he conducted her follow-up weight loss examinations. Although he never touched her breasts, she complained that she was "uncomfortable" without a top, and that he sometimes positioned himself much closer to her than was necessary. Once, she says he brushed his body against her while examining her eyes and ears. Besides these office visits, A. G. also contended that Respondent approached her to discuss the possibility of her appearing in a scuba diving instruction video he wished to produce. A meeting at his office, however, never materialized.

11. A. G.'s testimony contained many inconsistencies. For example, at one point, she contended that she was asked by Respondent to take off her bra on "every" office visit; she later testified that he asked her to do so on some occasions; she finally testified that this occurred only once. Even then, she conceded that Respondent had never touched her breasts during any office visit. A. G. also recalled Respondent wearing an old fashioned doctor's band with a little silver "thing" on the top of his head. His office staff established, however, that he does not use such a device.

12. The testimony regarding weight checks by Respondent's former office staff was unequivocal that weight patients are fully clothed; that evidence has been accepted as being the most

    credible on this issue. Visits by weight program patients took no more than a minute or two at most, and an assistant was always in and out of the room to ensure that Respondent moved on to the next waiting patient.

13. In 1995, after having not seen him for over two years,

    
    

    A. G. returned to Respondent's office and requested that he give her a medical excuse to cover an unauthorized leave of absence from her job. Although A. G. denied that this occurred, it was established that she had in fact returned to his office in 1995 and was very angry when she left because Respondent refused to give her the work excuse note that she requested.

14. A. G. also testified that she told her confidant and godmother, Margaret Hightower, about Respondent's alleged behavior. Hightower denied, however, that A. G. ever relayed these alleged incidents to her, and testified that A. G. has a reputation for untruthfulness.

15. For the foregoing reasons, the testimony of A. G. has not been credited. Even one of Petitioner's own experts did not find her testimony to be credible. Accordingly, there is insufficient clear and convincing evidence that Respondent improperly exercised influence in his relationship with A. G. for the purpose of engaging in sexual activity, as alleged in the complaint.

    1. Patient J. P.

       
       

16. J. P.'s allegations are rather lengthy and involve a number of office visits beginning in late April 1993 and ending in early May 1994. However, she did not have specific recall of which allegations arose from a particular office visit. During her testimony, she relied on notes she had made over two years later in contemplation of civil litigation. In some cases, her testimony was in conflict with contemporaneous medical and insurance records, or with the testimony of other witnesses. In addition, her testimony was seriously impeached as a result of other matters found in the record. For these reasons, her testimony has not been accepted.

17. J. P. initially saw Respondent for hormone and thyroid problems, and emotional distress. She was also treated for a knee injury occuring in May 1993. She was a very large woman weighing approximately 272 pounds.

18. The patient had no complaint regarding her first visit. On her second visit on May 18, 1993, however, she claimed that Respondent examined her without an assistant in the room and attempted to undress her by unbuttoning her blouse and unhooking her bra. She also contended that he examined her breasts unlike any other doctor she had ever visited, including doing so while she sat upright on an examination table and rubbing her nipples until they became hard.

19. Although J. P. contended that the purpose of the second visit was for treatment of an injured knee, the record shows that the original purpose of the visit was to review lab tests and to receive a refill for her thyroid medication. There was no indication in the medical records that a breast examination was performed, and the documentary evidence has been accepted on this issue. Even if one was performed, Petitioner's own expert agreed that it was appropriate to examine her breasts while she was sitting up on the examination table and that it was appropriate and necessary to examine and rub her nipples.

20. J. P. also contended that Respondent performed breast examinations on other occasions even though she was being treated for a knee injury. The medical records do not support this assertion. She also contended that on two occasions, she felt an erection when Respondent brushed up against her during an examination. Like many other doctors, however, Respondent routinely carried an otoscope in his pocket, and it is more likely that the patient felt this instrument if in fact Respondent may have accidentally brushed against her.

21. During a pelvic examination conducted on December 15, 1993, J. P. recalled that Respondent insisted that the female assistant, Frances McLaurin, leave the room. McLaurin disputed that this occurred, and her testimony has been accepted on this issue.

22. When asked why she continued to see Respondent despite the foregoing conduct, J. P. stated that she believed that her insurance company would not allow her to change doctors. The record belies this contention in several respects.

23. For the foregoing reasons, it is found that Respondent did not improperly influence his relationship with J. P. for sexual purposes, or engage in sexual misconduct with the patient, as alleged in the complaint.

    1. Patient B. N.

       
       

24. B. N. first saw Respondent in March 1979 when she was eighteen years of age. She continued to see him on approximately thirty-five occasions prior to May 1992. She expressed no complaints regarding his conduct during those visits.

25. In April 1992, B. N. began working as an assistant in Respondent's office. She was terminated in October 1992. A few months later, she was rehired on a part-time basis in the late afternoon. This employment ended on August 19, 1993, when she found a full-time job elsewhere.

26. When she left Respondent's employ, B. N. had a disagreement with Respondent regarding her insurance benefits. This was confirmed by a representative of HSI, who was in charge of health insurance benefits. B. N. was under the impression that Respondent had maliciously and intentionally cut her work hours so that she would not be eligible for insurance. As it turned out, though, Respondent had no control over the provision

    of health insurance to a part-time employee. This bias on the part of B. N. casts doubt on the credibility of her testimony.

27. On May 15, 1992, B. N. claimed that she was disrobed above the waist while no one other than she and Respondent were in the room. She further complained that Respondent touched her forehead while breathing in her ear. She also contended that Respondent stared into her eyes while doing a breast examination, and that he kissed her on the forehead after the examination was completed.

28. Assuming arguendo that the foregoing events occurred, they do not rise to the level of constituting sexual activity or misconduct, as charged in the complaint. For example, Petitioner's expert conceded that it was not inappropriate to stare into a patient's eyes while performing a breast examination. Moreover, the fact that the patient may have felt Respondent's breath while he looked into her ears is not per se an inappropriate activity. Finally, when Respondent gave a female patient a peck on the forehead before she left his office, it was established that this was done out of care and concern for the patient, and not for sexual gratification.

29. On August 10, 1993, Respondent performed a pelvic examination on B. N. after she presented complaints of pain in her lower left quadrant which was enhanced during sexual relations. She was diagnosed with inflammation of the cervix and a bacterial infection of the uterus and vagina. B. N.

    complained, however, that she felt pressure to her clitoris during the pelvic examination, and she was asked inappropriate questions of a sexual nature by the doctor.

30. As to the first contention, Petitioner's own expert established that given the complaints presented by the patient, it was appropriate for a doctor to touch the clitoris during a pelvic examination, particularly if the patient had complained of pain during sex. As to the inappropriate questions, the same expert testified as to the legitimate medical reasons for the inquiries made by Respondent.

31. B. N. further contended that Respondent performed the vaginal examination without a glove. In light of the more credible evidence presented by his medical assistants on this issue, and Respondent's own testimony to the contrary, this assertion has been rejected.

32. In summary, there is insufficient clear and convincing evidence that Respondent exercised influence within his relationship with B. N. for the purpose of engaging in sexual activity, or that he engaged in sexual misconduct with the patient.

    1. Patient S. C.

    
    

33. S. C. was a twenty-year-old female when she first saw Respondent as a patient in August 1993. She was taken to see Respondent on August 18, 1993, by her mother, who was also a patient. At that time, she complained of shortness of breath and

    anxiety. During the comprehensive initial examination, S. C. was asked by a member of the staff to remove her blouse, but not her bra, and she was given a paper gown to wear.

34. During the comprehensive examination, Respondent checked the patient's groin areas for nodes, and he felt the femoral pulses. Although S. C. felt uncomfortable when this occurred, she did not think it was inappropriate. According to Petitioner's expert, this was acceptable conduct on the part of Respondent since there were medical reasons for checking a femoral pulse. S. C. also noted that Respondent cupped her breast while listening to her heart with a stethoscope. However, he never rubbed, caressed, or otherwise fondled her breast, and

    S. C. never indicated this made her feel uncomfortable or was inappropriate.

35. S. C. was unemployed during this period of time and was looking for a job. At the same time, Respondent needed someone to replace a part-timer (B. N.) who was leaving the next day. Accordingly, he asked her to return later that day to discuss possible employment.

36. When S. C. returned, the office floors were being buffed by the clean-up crew, and it was too noisy to discuss a job. Respondent suggested that they go to his nearby condominum, sometimes used as a rental or loaned to friends, where his wife was cleaning and restocking the unit. This was confirmed by his wife, who was waiting for him at the condominium. On the way to

    the condominium, S. C. suggested they stop to eat dinner. Since Respondent had already eaten with his wife, he suggested they return to his office on the assumption that the cleaning of the floors was completed. When they returned, one member of the clean-up crew was still present.

37. While in the office, S. C. mentioned that she was having trouble breathing through her nose. Respondent gave her a medication for allergic rhinitis. S. C. recalled that he also performed a quick nasal inspection, and while doing so, Respondent's groin area came into contact with her hands and that he had an erection. She later amended her testimony to state that his groin area came into contact with her knee. At no time, however, did Respondent ever say a word about engaging in sex.

38. Assuming that the above scenario occurred, an accidental brushing up against the patient does not constitute sexual misconduct. Even if S. C. may have felt something brush up against her knee, it is more likely that she felt his otoscope, which he routinely carried in his pocket.

39. S. C. accepted the offer of employment, but she left for Miami shortly thereafter, where her father lived, and she never returned to work for Respondent.

40. In light of the foregoing, it is found that there is less than clear and convincing evidence to indicate that Respondent exercised influence within the patient-physician relationship for the purpose of engaging S. C. in sexual

    activity, or that he engaged in sexual misconduct with her, as alleged in the complaint.

    CONCLUSIONS OF LAW

    
    

41. The Division of Administrative Hearings has jurisdiction over the subject matter and the parties hereto pursuant to Sections 120.569 and 120.57(1), Florida Statutes.

42. Because Respondent is subject to the imposition of an administrative fine, as well as the suspension or revocation of his professional license, Petitioner bears the burden of proving by clear and convincing evidence that the allegations in the complaint are true. See, e.g., Nair v. Dep't of Bus. and Prof. Reg., 654 So. 2d 205 (Fla. 1st DCA 1995). Clear and convincing evidence has been defined as evidence of "such weight that it produces in the mind of the trier of fact a firm belief or conviction, without hesitancy, as to the truth of the allegations sought to be established." Slomowitz v. Walker, 429 So. 2d 797, 800 (Fla. 4th DCA 1983).

43. The two complaints allege that, as to patients J. P.,

    
    

    B. N., S. C., C. A., and A. G., Respondent violated Section 458.331(1)(j), Florida Statutes, by exercising influence within the patient-physician relationship for the purpose of engaging in sexual activity; that as to patients J. P., B. N., and S. C., he violated Section 458.329, Florida Statutes, and Rule 64B8-9.008, Florida Administrative Code, by engaging in sexual misconduct in the practice of medicine; and that as to each of the five

    patients, he violated Section 458.331(1)(x), Florida Statutes, by violating a Board rule or a provision within Chapter 458, Florida Statutes.

44. There is less than clear and convincing evidence to sustain the charge that Respondent violated the foregoing statutes and rule. This being so, the complaints in Case Nos. 98-0785 and 98-0948 should be dismissed, with prejudice.

45. On August 31, 1998, an evidentiary hearing was conducted for the purpose of considering Respondent's Motion to Dismiss various allegations in the complaints. On October 15, 1998, the undersigned entered a preliminary order granting Respondent's Motion to Dismiss the allegations raised by patient

    P. M. in Case No. 98-0785 on the ground the doctrine of laches and due process prevented the prosecution of those charges, which dated back to 1979, or some twenty years ago. That ruling is incorporated by reference into this Recommended Order for final disposition by the Board.

46. Petitioner's objection to the admissibility of Respondent's Exhibits 6-8 is sustained.

RECOMMENDATION

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

RECOMMENDED that the Board of Medicine enter a final order dismissing the two complaints, with prejudice.

DONE AND ENTERED this 4th day of May, 1999, in Tallahassee, Leon County, Florida.

COPIES FURNISHED:

John O. Williams, Esquire Maureen L. Holz, Esquire The Cambridge Center

355 North Monroe Street Tallahassee, Florida 32301

Kelly B. Mathis, Esquire Michael A. Wasylik, Esquire

DONALD R. ALEXANDER

Administrative Law Judge

Division of Administrative Hearings The DeSoto Building

1230 Apalachee Parkway

Tallahassee, Florida 32399-3060

(850) 488-9675 SUNCOM 278-9675

Fax Filing (850) 921-6847 www.doah.state.fl.us

Filed with the Clerk of the Division of Administrative Hearings this 4th day of May, 1999.

Suite 1700, SunTrust Building

200 West Forsyth Street Jacksonville, Florida 32202-4359

Joseph P. Milton, Esquire

1660 Prudential Drive, Suite 200

Jacksonville, Florida 32207-8185

Robert M. Ervin, Jr., Esquire Melissa F. Allaman, Esquire Post Office Drawer 1170

Tallahassee, Florida 32302-1170

Tanya Williams, Executive Director Board of Medicine

1940 North Monroe Street Tallahassee, Florida 32399-0750

J. Harding Peterson, III, General Counsel Department of Health

2020 Capital Circle, Southeast Bin A02

Tallahassee, Florida 32399-1701

NOTICE OF RIGHT TO SUBMIT EXCEPTIONS

All parties have the right to submit written exceptions within 15 days from the date of this Recommended Order. Any exceptions to this Recommended Order should be filed with the Board of Medicine.

Docket for Case No: 98-000785

Orders for Case No: 98-000785