a aed A hk ml i tin ob A address is 10351 S.W. 89th Street, Miami, Florida 33176-1502. STATEOFFLORDA ARTMENT OF HEALTH “ DEPARTMENT OF HEALTH, OB CASE NO. 97-00012 ) ) PETITIONER, ) ) v. ) ) HUMBERTO A. GOMEZ, 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 Humberto A. Gomez, MD., 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 Statutes; Chapter 455, Florida Statutes, and Chapter 458, Florida Statutes. Pursuant to the authority 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 all times material hereto a licensed physician in the state of Florida, having been issued license number ME 0022756. Respondent’s last known -~. 3, Respondent was initially licensed as a physician in the State of Florida on or about ~ October 18, 1974. Upon information and belief, Respondent specializes in anesthesiology. ws! a WW 4. On February 20, 1996, Patient MS., age 56, was admitted to Cedars Medical Center in Miami, with a primary diagnosis of severe peripheral vascular disease with bilateral occlusion of proximal superficial popliteal arteries, and a secondary diagnosis of chronic obstructive pulmonary disease (COPD). Patient M.S. was scheduled to undergo a right femoral popliteal bypass surgery. Prior to the procedure, no arterial blood gas specimen was drawn to determine a blood gas baseline for Patient M.S. . 5. On February 21, 1996, Dr. Dagoberto J. Garces performed the bypass surgery. Respondent was the anesthesiologist for the procedure. 6. On February 21, 1996, anesthesia was commenced at approximately 9:30 am. Arterial blood gas was read at 10:56 a.m., and included a pH of 7.31, a pCO? of 43, with a -4 Bicarbonate deficit; this initial metabolic acidosis was not corrected until approximately 2:06 p.m., when another blood gas showed a pH of 7.23, pCO2 of 25 and a bicarbonate deficit of -16. _ 7. Respondent utilized a central venous pressure (CVP) catheter, along with a “guide wire”, a device. used to assist in positioning and moving an intravenous catheter. The CVP catheter was inserted by Respondent into Patient M.S.’s right jugular vein. 8. Respondent lost the guide wire in Patient M.S.’s venous system in the course of ‘utilizing the CVP catheter. 9. Following the Procedure, a portable chest x-ray was taken for Patient M.S. The ‘radiology ‘report ‘for the x-ray indicates the following in pertinent part: ‘There is air rin the subcutaneous tissue of the neck and along the right axilla. A pneumothorax with collapse of the ally d parially the viet upper lobe’i is appreciated. A line is visualized overlying the right lateral aspect of the mediastinum. ” The radiologist’ s impression rn was “Tension pneumothorax of at least 60% as described.” Pneumothorax is the presence of air or gas in the pleural cavity. 10. On February 21, 1996, Dr. Garces accordingly proceeded with a second surgery on Patient MLS. to address the pneumothorax. . 11. On February 22, 1996, Patient M.S. underwent further surgery to remove a foreign object that was left in his body following the surgery of the day before, the “guide wire” utilized by Respondent during the first surgery on February 21, 1996. The “guide wire” was found in Patient M.S.’s inferior vena cava. 12. Respondent’s notes in the medical record for February 21, 1996 contain no meaningful detail concerning the insertion of the CVP catheter, and make no mention of either the placement of or failure to remove the guide wire. Respondent’s notes for February 21, 1996 do not indicate that Patient M.S. was monitored during anesthesia for the presence of equal breath sounds on both lungs. COUNT I 13. Petitioner realleges and incorporates paragraphs one (1) through twelve (12), as if fully set forth herein this Count One. . 14, “Section 4582331 (1)(t), Florida Statutes, provides that the Board of Medicine may .take disciplinary action against a licensed physician upon the physician’s 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. 15. Respondent violated Section 458.331(1)(t), Florida Statutes, on February 21, 1996 with regard to Patient M.S., due to one or more of the following facts: , Wo ae a. Respondent did not obtain an arterial blood gas baseline for Patient M.S. prior to ’ commencement of anesthesia; b. Respondent did not monitor the patient during anesthesia for the presence of equal breath sounds on both lungs; c. Respondent lost track of the guide wire in the patient during the surgical procedure; d. Respondent did not document in detail the procedure for insertion of the CVP catheter; e. Respondent did not document the failure to remove the guide wire from the patient; f. Respondent did not advise the patient and/or the patient’s family or representative of the failure to remove the guide wire from the patient; . g. Respondent did not advise the surgeon of the failure to remove the guide wire from the patient. ' COUNT II 16. Petitioner realleges and incorporates paragraphs one (1) through twenty (20), as if fully set forth herein this Count Two. . 17. Section 458. 3310)(m), Florida ‘Statutes, Provides that the Board of Medicine may take disciplinary action against a licensed physician upon the physician’ s failure to keep medical . records that justify the course ‘of treatment of the patient, including, but not limited to, patient histories; ‘examination results test results; records of drugs prescribed, dispensed, or | administered; and report of consultations and hospitalizations. a 18. Respondent violated Section 458.331(1)(m), Florida Statutes, on February 21, 1996 with regard to Patient M. S, due tc to one or more of the following facts: WF a. Respondent failed to document an arterial blood gas baseline for Patient M.S. prior to commencement of anesthesia; b. Respondent failed to document monitoring of the patient during anesthesia for the presence of equal breath sounds on both lungs; c. Respondent failed to document in detail the procedure for insertion of the CVP catheter; d. Respondent failed to document the fact that the guide wire was lost in the patient’s. venous system in the course of the procedure. WHEREFORE, Petitioner respectfully requests the Board of Medicine enter an order imposing one or moré of the following penalties: permanent revocation or suspension of the Respondent’s license to practice medicine; restriction of the Respondent’s practice, imposition of an administrative fine, issuance of a reprimand, placement of the Respondent on probation, the cs assessment of costs related t to the investigation and Prosecution « of this case as Provided for in 7 Section 455. 6244), FE orida Statutes, ‘and/or a any ‘other relief that the Board deems appropriate. SIGNED this fen day of Bat , 2000. ~ Robert G. Brooks, M.D., Secretary » PEAS: hief Medical Attorney ‘COUNSEL FOR DEPARTMENT: Kathryn L. Kasprzak Chief Medical Attomey : DEPARTMENT OF HEALTH Agency for Health Care Administration DEPUTY CLERK | P.0.Box 14229 } CLERK Leb RA Lon Tallahassee, Florida 32317-4229 — Florida Bar # 0937819 | pare. “7-5 “Robe

Docket for Case No: 00-001594