Received Event (Event Secor , ; Date: _ 1/26/00 Time: 4:2 Pages: 13 Duration: 4 min 29 sec Sree ee Fax:850-414-1989 "Jan 26 00 16:27 P0613 _ . *, ; woe Ne! - STATE OF FLORIDA te DEPARTMENT OF HEALTH DEPARTMENT OF HEALTH, ) ) 6 O Ye, 5 PETITIONER, ) ) v. ) CASE NO. 1997-04831 ) MELVIN A. MACKLER, M.D., ) ) RESPONDENT. _) ee ) Se ADMINISTRATIVE COMPLAINT 2 COMES NOW the Petitioner, Department of Health, hereinafter teférred to as “Petitioner,” ‘and files this Administrative Complaint before the Board of Medicine against Melvin A. Mackler, M.D., hereinafter. referred to as “Respondent,” and alleges: 1, Effective July 1, 1997, Petitioner is the state agency ‘charged with regulating the practice of medicine pursuant to Section 20.43, Florida 2 Statutes; Chapter 455, Florida Statutes, and Chapter 458, Florida Statutes. Pursuant to the provisions of Section 20.43(3), Florida Statutes, the Petitioner has contracted with the Agency for Health Care Administration to provide consumer complaint, investigative, and prosecutorial services required by the Division of Medical Quality Assurance, councils, or boards, as appropriate. 2. Respondent is and has been at al times material hereto a licensed physician in the state of Florida, having been issued license number ME 0015250. Respondent’s last known address is 7330 SW 62™ Place, Miami, Florida 33143. 3. Respondent is Board Certified in Urology. : Received Event (Event Sueceed ‘ Date: _ 1/26/00 Time: 4:2 Pages: 13 Duration: 4 min 29 sec Sr A Fax:850-414-1989 “Jan 26 00 16:28 =~ P0713 _ 4. On or about August 16, 1996, Patient C.E.H. a seventy-two (72) year old female with a history of metastatic melanoma presented to a medical oncologist at South Miami Hospital with fever and complaints of left flank pain. 5. The oncologist ordered a work-up, including CT (computerized tomography) seans of Patient C.E.H.'s abdomen, which revealed a probable metastasis to her left adrenal gland. 6. On about August 27,1996, Patient C.E.H., was referred to Respondent at South Miami Hospital by her medical oncologist for excision of an adrenal metastases from a primary melanoma of the vulva. . oo - 7. Patient C.E.H.’s surgery was scheduled for August 27, 1996, oy 8, On or about August 27, 1996, Patient C.E.H. was taken to the Operating Room (OR) for surgery. At the beginning of the surgery, Patient! C.E.H. was placed in the right flank position and under adequate general anesthesia. The right flank was prepped and draped as a "sterile field. A curved incision was made and carried down through the skin and subcutaneous tissue. The right kidney and area of the right adrenal were explored and there was no evidence of any metastatic disease and the incision was closed. 9. Respondent did not have consent to operate on the right flank of Patient CEH. . 10. Following the surgery on the right flank, Patient C.E.H. was placed in the left flank elevated position and an incision was made and carried down through the skin and subcutaneous tissue. The left kidney and area of the left adrenal were explored and the metastatic Jesion i in the left adrenal ‘gland was identified and excised with blunt and sharp dissection. Patient C.E.H. tolerated the procedure well and: was moved to the recovery room. Received Event (Event ory ‘ Date: , 1/26/00 Time: 4:2 Pages: 13 Duration: 4 min 29 sec Sr A Fax 850-414-1989 7 "Jan 26 "00 16:28 = P.08/13 _ . NY NY 11. Thereafter, Patient C.E.H. developed a right pneumothorax from the exploration, which extended her hospital stay and Patient C.E.H. was discharged on September 5, 1996 without incident. | . | . 12. The adrenal gland is a retroperitoneal gland, which is only visualized by radiological means, like with a CT Scan. Respondent’s preoperative notes do not indicate that he ever reviewed the prior CT scan. . 13. A reasonably prudent physician under similar conditions and circumstances would have reviewed prior x-rays and/or CT scans to determine the location of the pathology before going irito the OR and before operating. Respondent’s pre-operative notes do not indicate that he ever reviewed Patient C.E.H.’s x-rays or CT seans prior to going to the OR or while in the OR. 14. Respondent fell below thé standard of care by not gaining prior consent to operate on the right flank of Patient C.E.H. oe 15. Respondent fell below the standard of care by not reconfirming the diagnosis of left adrenal metastasis and by not doing so performed a right adrenal metastasis. 16. Respondent failed to keep written medical records justifying the course of treatment in that he faited'to document a complete history by not reviewing the x-rays and/or'CT scans *~ ” prior to surgery. . 17. Respondent failed to keep written medical records justifying the course of treatment in that he failed to document that he reconfirmed the diagnosis prior to going to surgery. Received Event (Event Sueceedrt , ‘ Date: 1/26/00 Time: 4:2 Pages: ° 13 Duration: 4 min 29 sec Sper enn ES Fax:850-414-1989 Dewrinwn 26°00 16:28 ~—- P0913 _ COUNT ONE 18. Petitioner realleges and incorporates paragraphs one (1) through eighteen (17), as if fully set forth herein this Count One. 19. Respondent is guilty of 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 in that he failed to review the prior x-rays of Patient C.E.H.; failed to gain consent to operate on the right flank and failed to confirm the diagnosis of left adrenal metastasis prior to going to suigery. 20. Based on the foregoing, Respondent violated Section 458.331(1)(t), Florida Statutes, by failing 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. Col IO 21. Petitioner realleges and incorporates paragraphs one (1) through cighteen (17) and paragraph nitieteen (19) as if fully set forth herein this Count Two. ) oo te 22. Respondent is guilty of failing to keep appropriate written medical records justifying the course of treatment of Patient C.E.H. as they do not contain a complete history as they do not indicate that the Respondent ever reviewed the x-rays prior to going to surgery, nor do they indicate that Respondent reconfirmed the diagnosis prior to going to surgery. 23, Based on the foregoing, Respondent violated Section 458, 331(1)(m), F lorida Statutes, fuiting to keep written medical records justifying the course of treatment of the patients, including, , s . . .

Docket for Case No: 00-000438