oo Re Na A Ne MBS A lie oe AMR ensue sede oe Received Event (Event Succeeded) - Date: Pages: * MaR“16“2aaa° 15:@5 15 te: ° 3/16/00 ww ; 7 Time: abet Duration: 3 min 2 sec AHCA P.84 os os . STATE OF FLORIDA 7 DEPARTMENT OF HEALTH OO- | ISG DEPARTMENT OF HEALTH, ) ; ) PETITIONER, ) ) v. ) CASE NO. 1993-17296 ) LAZARO A. HERNANDEZ, M.D., ) ) RESPONDENT. +?) ADMINISTRATIVE COMPLAINT "COMES NOW the Petitioner, Department of Health, hereinafter referred to as “Petitioner,” and files this ‘Administrative Complaint before the Board of Medicine against Lazaro A. Hernandez, M.D., hereinafter referred to as “Respondent,” and alleges: a : Effective uly 1, 1997, Petitioner i is the state agency charged with regulating the practice of medicine pursuant to Section 20, 43, Florida Statutes; Chapter 455, Florida Statutes, and Chapter 458, Florida Statutes. Pursuant to the authority of Section 20. 430), Florida Statutes, the Petitioner has contracted with the Agency for Health Care Administration to provide Quality Assurance, councils, or boards, as appropriate, state “of Florida, having been issued license number ME 0019886. Respondent's last known address is 2309 Dr. Martin Luther King Blvd., Tampa, Florida, 33607-6405. : 3 - Respondent i is Board Certified in Obstetrics & Gynecology. ative and ecutorial servi es required by th the Division of Medical , __ Respond tt is and has been at all times material hereto a licensed physician i in the ope woeie > ree es ee ee Received Event (Event Succeeded) . * ; ; Date: " 3/16/00 ~ . Time: aw Pages: 15 Duration: 3 min 2 sec Mar-1e2a0@" 15:05 AHCA Toe P.05 _ com on 4, On or about January 13, 1992, Patient D.M., a twenty (20) year old female, presented to Respondent for prenatal care. Patient D.M. gave a history-that listed December 4, 1991, as her last menstrual period. Respondent gave Patient D.M. an estimated day of confinement (EDC) of September 11, 1992. 5. On or about March 24, 1992, a pelvic ultrasound examination was performed. Ultrasound revealed an intrauterine pregnancy at approximately 14-16 weeks, consistent with an estimated day of confinement (EDC) of September 11, 1992. | 6. On or about March 26, 1992, Patient D.M. was given a maternal serum alpha- fetoprotein (AFP) test at the Tampa Pathology Laboratory that showed an AFP equal to 4.0. This result is abnormal and indicates that the fetus was at risk for aneural tube defect. 7, Onor about March 31, 1992, Patient was given another matemal serum alpha- fetoprotein test at the University of South Florida; results showed a raised AFP equal to 3.44. This result is abnormal and indicates that the fetus was at risk for a neural tube defect. 8. On or about April 3, 1992, Respondent ordered an amniocentesis. The AFP on ‘the amniotic fluid was 1.88 with absent acetyleholinesterase and a normal 46 XY karyotype. 9. Onor about April 3, 1992, a second ultrasound examination was conducted with results consistent with 17.4 weeks and an EDC of September 11, 1992. 10, On o or t about May 20, 1992, a third ultrasound examination was conducted with e results consistent with 22-24 weeks and an estimated fetal weight of 704 grams. =o _On or Sbout September 4, 1992, Patient DM. wont into spontaneous labor and was admitted to » St Joseph’s Women’ s Hospital a at o or - about 6: 00a. m At the time of admission she was I centimeter dilated, : 50% effaced, and was as having mild contractions every 2 minutes. Received Event (Event Succeeded) . . a Date: © 3/16/00 : Time: ahem Pages: 15 Duration: 3 min2sec " * MeR-i6“3a98 15:05 AHCA 7 . P.06 - oN os Initial evaluation of the fetal monitor tracings revealed a poor beat-to-beat variability with occasional decelerations, ; 12. At or about 9:00 aim. on September 4, 1992, Respondent ruptured Patient D.M.’s membrane and noted the fluid to be clear. Patient D.M. was I centimeter dilated and 80% effaced. 13.. At or about 9:45a.m. on September 4, 1992, Patient D.M. was started on Pitocin to augment labor. . 14. At or about 11:35 am. on September 4, 1992, Pitocin was stopped due to decelerations and contractions getting too close. There was no change in the degree of Patient D.M.’s dilation (still about 1 centimeter). ° 15. At or about 1:20 p.m. on September 4, 1992, Pitocin was restarted and Patient D.M. was now 2 centimeters dilated, 80% effaced, with a vertex presenting at a —1 station and’ contractions were occurring about every 2-3 minutes. 16. At or about 1:50 p.m. on September 4, 1992, there was a significant deceleration and the beat-to beat continued to be poor. 17. At or about 2:00 -2: 30 p.m. on September 4, 1992, contractions became 1 minute apart. ‘There | was a a large deceleration and the Pitocin v ‘was discontinued at 2: 45 p.m. The cervix : “was 1-2 centimeters dilated and 20% effaced non-reassuring fetal heart rate tracing. At tthe time of delivery, the a amniotic uid was noted to > be meconium n stained a (he first fecal a aischarge of a A newborn). Date: © Pages: : Received Event (Event Succeeded) - “1992, when Pa 3/16/00 * Time: 3: M 15 Duration: 3 min 2 sec * MpR-16-2aaa 15:06 AHCA 7 ° P.O? om om 19, The infant (Patient E.M.) was a depressed 1,800 gram male who was assigned APGAR’s of 2 and 7 atl and 5 minutes respectively, and subsequently remained in the hospital until November 9, 1992. , 20. On or about November 9, 1992, Patient E.M. was discharged with a final diagnosis of: 1. Term birth, living child, small for gestational age. 2. Intrauterine growth retardation. 3. Prenatal asphyxia with meconium. 4. Staining of the amniotic fluid. 5. Shock. 6, Hypoglycemia. 7. Respiratory distress syndrome. 8. Probable congenital pneumonia with significant pulmonary hypertension. 9, Patent ducts arteriousus. 10. Hepatomegaly, significant. 11. Thrombocytopenia, significant. 12. Oliguria secondary to acute renal tubular necrosis secondary to severe prenatal asphyxia. 13. Hyperbilirubinemia of the newborn. 14. Seizure disorder secondary to severe underfusion with evidence of cystic changes to the brain. 15. Mild atelectasis. 16. Bilateral nasal lacrimal duct obstruction. 21. Respondent failed to properly monitor Patient D.M.’s pregnancy. Patient E.M. was at significant risk for intrauterine growth retardation and placental insufficiency problems based on abnormal maternal serum alpha- fetoprotein (AFP) test with no evidence of neural tube defect and. a normal karyotype. 22. There is no evidence that Respondent evaluated fetal growth through measu ‘at P Patient DM,’ $ prenatal visits. 23. ~ There were no o ultrasounds performed c on . Patient D M. afer on or r about May 20, still in ‘the second trimester. 24. Respondent failed to appropriately monitor the development of the fetus during the third trimester. Received Event (Event Succeeded) Date: 3/16/00 Time: Bib Pages: 15 Duration: 3 min 2 sec * meR-16“20a8" 15:26 AHCA mo - P.28 . cn “—™ 25, Respondent failed to properly monitor Patient D.M.’s pregnancy and fetal, development despite of abnormal test results, including abnormal ‘maternal serum alpha- fetoprotein test. , 26.. 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. WHEREFORE, the Petitioner respectfully requests the Board of Medicine enter an order imposing one or more of the following penalties: permanent revocation or suspension‘ of the Respondent’s license, restriction of the Respondent’s practice, imposition of an administrative fine, issuance of a reprimand, placement of the Respondent on probation, the assessment of costs related to the investigation and prosecution of this case as provided for in Section 455,624(4), Florida Statutes, and/or any other relief that the Board deems appropriate. SIGNED this Lee day of Lagu » 1999. Robert G. Brooks, M.D., Secretary FILED DEPARTMENT OF HEALTH Lary G, McPhergoA, Jr. EPUTY CLERK Chief Medical Attorney sofia DATE__. At Date: * Pages: fe--e Received Event (Event Succeede+t ~ 3/16/00 Time: 3:08PM 15 Duration: 3 min2 sec MAR-16-2008 15:06 AHCA Boteisss 8 c™ on COUNSEL FOR DEPARTMENT: Larry G. McPherson, Jr. Chief Medical Attorney Agency for Health Care Administration P. O. Box 14229 Tallahassee, Florida 32317-4229 Florida Bar # 788643 RPC/blt PCP: August 11, 1999 PCP Members: Skinner, Glotfelty, Chemey P.@9

Docket for Case No: 00-001159