STATE OF FLORIDA DEPARTMENT OF HEALTH DEPARTMENT OF HEALTH, ) 7 PETITIONER, ) ) vs. -) CASE NO. 1999-54955 ) PATRICK GEORGE WATSON, 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 Patrick George Watson; 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’ e-Agency for Health Care Administration to provide consumer r complaint, investigative and prosecutorial s services required byt the Division of Medical Quality 4 Assurance, councils, or boards, as appropiate, 2 BR kos w - =e) 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 0050511. Respondent’s last known address is 8751 North 30" Street, Tampa, Florida 33603. 3. Respondent is board-certified in internal medicine. 4, Patient L.H., a female then age 31, presented to Respondent on September 22, 1994, with complaints of knee pain related to rheumatoid arthritis. Patient L.H. reported that she was taking Relafen, an anti-inflammatory medication. She also reported a medical history of Wolff- Parkinson- White ‘Syndrome (wPw), which was diagnosed at age 15 in Germany. WPW involves an extra ‘conduction pathway i in the heart, such that the normal conduction delay of the atrioventricular node i is bypassed, resulting in supraventricular tachycardia (rapid heart rate that is initiated above the ventricles). It can be treated by medication or by surgical intervention. Patient L.H. advised Respondent that she had taken. a German brand of Inderol (an: anti- tachycardic medication) for WPW. 5. On September 22, 1994, Respondent performed a physical examination of Patient -L.H., but did not prescribe any medication or formulate any plan of treatment, or provide for a . follow-up appointment. Respondent did note that Patient LH. weighed two-hundred-and-forty- six « (246) pounds. 6. On November 7, 1994, Patient L.H. presented to Respondent with complaints of _, Shortness _ of breath, mild palpitations without syncope loss of consciousness), and symptoms worse with stress and tiredness. Respondent performed a physical examination, ordered eboratory studies, and planned for an EKG (electrocardiogram). Respondent also renewed Patient LH” s prescription for Relafen. “ ee ee / i'w) 7. On November 15, 1994, Patient L.H. submitted to the EKG. Respondent interpreted the EKG as being abnormal, but did not seek consultation from a cardiologist or refer Patient L.H. to acardiologist at that time. 8. On November 18, 1994, L.H. presented to Respondent with complaints of chest pain. Respondent performed a physical examination and noted shortness of breath. Respondent prescribed Sotalol (an anti-arrhythmic medication), ordered. a chest x-ray, and referred Patient L.H. for Holter monitor testing. A Holter monitor is a portable EKG device that can be worn for ‘twenty-four hours to monitor heart abnormalities. 9. Respondent’s records for Patient L.H. do not include documentation of the chest x-ray ever being performed. | 10. On November 21, 1994, Holter monitoring was performed by James R. Irwin, M.D., a cardiologist at St. Joseph’s Hospital, Tampa. In his narrative report of the monitoring, Dr. Irwin stated that Patient L.H. had experienced one episode of tachycardia (rapid heart rate) where the heart rate was-150 beats per minute. Dr. Irwin noted further that the patient experienced occasional-to-frequent PVCs (premature ventricular contractions) and corresponding chest pain, and episodes of ventricular arrhythmia. 11. Respondent received the Holter monitor report from Dr. Irwin. Respondent did not seek further consultation from Dr. Irwin in response to the report. “Respondent did not seek consultation from any other cardiologist in response to the report, or refer Patient L.H. to a ‘specialist in cardiology. . 2. On June 30, 1995, Patient L.H. presented to Respondent with complaints of dry cough and problems with her left heel. Respondent’s records for Patient L.H. contain no notes of tw oY any physical examination that date, or mention of her history of WPW. Respondent referred LH. to a podiatrist for further evaluation of her heel. 13. On August 9, 1995, at approximately 7:26 a.m. Patient L.H. suffered a cardiac arrhythmia, lost consciousness and could not be resuscitated, An autopsy was performed ‘that date. The autopsy report was finalized on October 11, 1995, and indicates Wolff-Parkinson- White Syndrome as the cause of death of Patient L.H. COUNT ONE . 14, Petitioner realleges and incorporates paragraphs one (1) through thirteen (13), as if fully set forth herein this Count Two. , 15. Section 458.331(1)(t), F lorida Statutes, provides that the Board of Medicine may take disciplinary action against a licensed medical doctor upon the medical doctor’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. . 16. Resporident violated Section 458.331(1)(t), Florida Statutes with respect to Patient L.H., due to one or more of the following facts: a. Respondent did not seek consultation from a cardiologist or refer Patient L. H. toa cardiologist on November 115, 1994, when ‘Respondent interpreted the results of the patient’s EKG as abnormal, and when Respondent knew of the patient’s history of WPW. b. Respondent did not seek consultation from a cardiologist or refer Patient L-H. to a cardiologist at any time after November 21, 1994, when Respondent knew of the patient’s history of wPw, and knew or reasonably should have known of the patient’s Holter monitoring results. ae EE’ SEEE* SEY TERE ereteneYenerTe""-Sempepmmers - = COUNT TWO 17. Petitioner realleges and incorporates paragraphs one (1) through thirteen (13), as if fully set forth herein this Count Two. . 18. Section 458. 331(1)(m), Florida Statutes, provides that the Board of Medicine may take “disciplinary action against a licensed medical doctor for failing to keep written medical records that justify the course of treatment of the patient, including, but not limited to, patient © owe histories; examination results; test results; records of drugs prescribed, dispensed, or administered; and reports of consultations and hospitalizations. , 19, Respondent violated Section 458.331(1)(m) with regard to Patient LH. due to one or more of the following facts: a. Respondent did not keep medical records to justify the course of treatment of the patient on November 15, 1994, when Respondent interpreted the results of the patient’s EKG as abnormal and knew of the patient’s history of WPW, but failed to seek consultation from a cardiologist or refer Patient L.H. to a cardiologist. b. Respondent did not keep medical records to justify the course of treatment of the patient at any time after November 21, 1994, when Respondent knew of the patient’s history of WPW, and knew or reasonably should have known of the patient’s Holter monitoring results, but | -- failed to seek consultation from a cardiologist or refer Patient L.H. to a cardiologist. 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 i rc) Ww 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 ZO" aay of Ll arch , 2000. COUNSEL FOR DEPARTMENT: Kathryn L. Kasprzak Chief Medical Attorney Agency for Health Care Administration P. O. Box 14229 - Tallahassee, Florida 32317-4229 Florida Bar #0937819 RE/rme PCP: March 24, 2000 ; PCP Members: Winchester, McMillin Robert G. Brooks, M.D., Secretary ‘Kethryn L. (asprz Chief Medical Attomey DEPARTMENT OF Hi DEPUTY CLERK CLERK Vehi R Via: ¢ weer cee teee oe ao eM Ee EET OT RET TEETER en

Docket for Case No: 00-001718