DEPARTMENT OF HEALTH Aoelvis,,, #0 He DEPARTMENT OF HEALTH, ) Nag! VE PETITIONER, ) (O-2415 vs. 5 CASE NO. 1999-62290 ROLAND N. ROZAS, M.D., | 5 RESPONDENT: ~ ; Se 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 ROLAND N. ROZAS, 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 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 0040636. Respondent’s last known address is 11880 S.W. 40th Street, Suite 202, Miami, Florida 33175. 3. Respondent specializes in gastroenterology but is not board-certified. - Ue U 4, On or about November 19, 1997, Patient C.Y. presented to Respondent's office with complaints about her varicose veins. Respondent noted that Patient C.Y.'s varicosities were tender and that she was experiencing leg pain. Respondent diagnosed Patient C.Y.'s condition as vericose veins and noted that the plan of treatment would be sclerotherapy (treatment involving the injection of a sclerosing solution into vessels or tissues). 5. On or about November 26, 1997, Patient C.Y. presented to Respondent's office for the first of a series of sclerotherapy treatments. Respondent asked Patient C.Y. if she wanted ~~ ~ an anesthetic for the procedures, but she declined, stating that she breastfed her baby and was concerned about the effect of the anesthetic. 6. Patient C.Y. presented to Respondent's office for sclerotherapy treatments again on or about December 17, 1997, January 28, 1998, and February 18, 1998. On all dates relevant hereto, Respondent did not perform or document the following items: Location of treatment, Usage of sterile technique, Name of substance injected during procedure, Whether compression stockings were placed on Patient C.Y., and/or Whether the patient was instructed to walk following the procedure. gaogre Respondent did not obtain written consent from Patient C.Y. prior to performing the sclerotherapy treatment on any of Patient C.Y.'s treatment dates. ~ 7. On or about March 4, 1998, Patient C.Y. again presented to Respondent's office for sclerotherapy treatment. Patient C.Y. was wearing a shirt, skirt, bike shorts and underpants. Patient C.Y. fell asleep during the procedure. When she awoke, Patient C.Y. noticed that her clothes were not situated or correctly fitted as they had been when the procedure began. Patient C.Y. had not fallen asleep during any of her previous sclerotherapy treatments. U YU 8. On’‘or about March 18, 1998, Patient C.Y. again presented to Respondent's office for sclerotherapy treatment. The office assistant was not present in the office when Patient C.Y. arrived. Patient C.Y. removed her shoes and pantyhose prior to the procedure. Respondent began the procedure and injected sclerosing solution into Patient C.Y.'s veins several times while she was lying face down on her stomach. Patient C.Y. noted that Respondent spent a longer than usual period of time injecting into her calf muscles and that he was rubbing on them more than usual. Respondent then had Patient-G-Y. turn over onto her back. 9. Shortly after turning over onto her back, Patient C.Y. began to feel drowsy and fell asleep. During the procedure, Patient C.Y. could hear Respondent's voice and felt Respondent's mouth around her neck and face, but was physically unable to move. When Patient cy. fully regained consciousness, she noticed that her skirt had been removed, her underpants were pulled down slightly on the left side, her bra was disheveled, and the top button of her jacket had been undone. When Patient C.Y. put her skirt back on, she noticed that it was wet. Respondent advised her that he had accidentally spilled water on her skirt. Patient C.-Y. also noticed that Respondent had covered the window to his office with an examination gown. He advised that he had done that so that no one could look in through the window. He then explained that he was having trouble with his office assistant and offered the job to Patient C.Y. She accepted the employment offer and Respondent told her to be at his office the next day at 9:00 a.m. 10. On her way home from Respondent's office that same day, Patient C.Y. felt a watery discharge from her vaginal area. Upon arriving at home, Patient C.Y. immediately showered. Patient C.Y. was puzzled by what had happened and continued to think about it the rest of the evening. U VU 11. Onror about March 19, 1998, Patient C.Y. reported to Respondent's office at approximately 9:00 a.m.; however, Respondent did not show up at the office. He telephoned Patient C.Y. at the office and told her that she was free to leave at 12:00 p.m. 12. On that same date, Patient C.Y. telephoned her sister and told her what had happened the previous day. After speaking with her sister, Patient C.Y. went to the Jackson Memorial Hospital Rape Treatment Center where she was examined by Valerie Rao, M.D. The examination showed no signs of trauma and no specimens were collected. 13. Later that same day, Patient C.Y. reported the incident to the Miami-Dade Police Department at the Kendall station. At the police station, Patient C.Y. spoke with Detestive L. Velken. 14. On or about March 20, 1998, at approximately 12:30 a.m., Detective Velken accompanied Patient C.Y. to her residence. There, Patient C.Y. provided the detective with the clothing she had worn on the date of the incident which included a skirt, a pair of pantyhose, a pair of underpants and a jacket. The items were impounded as evidence. . 15. On or about March 30, 1998, Patient C.Y. provided Detective Velken with additional written information regarding the incident with Respondent on March 18, 1998, which included the following details: Lights were turned off, a smock was put over the window of the examining room; as I started to wake up I felt very cold and shaky. The doctor rubbed my feet and removed the smock from the window and laid it on top of me. I felt friction on my vigina [sic] and vulva. My bra was pulled up over my breasts. J felt them being grabbed and squeezed. The top button of my jacket was unbuttoned; My underwear was down/lower on the left side. 16. Patient C.Y. subsequently discovered that she was pregnant. Cn U 17. Onror about May 8, 1998, Patient C.Y. presented at the Eve Medical Center in Miami, Florida where she underwent a procedure to terminate the pregnancy. The products of conception and two tubes of blood were turned over to Detective R. Baena, of the Miami-Dade Police Department, who impounded the specimens as evidence. 18. On or about June 17, 1998, the products of conception and blood were submitted to the Miami-Dade Police Department Crime Laboratory Bureau for DNA analysis. 19. Onor about February-1;-1999, detectives from the Metro-Dade Police Department ~~ collected saliva samples from Respondent and subsequently submitted them to the Crime Lab for DNA analysis. . 20. Toby Wolson, a forensic biologist with the Miami-Dade Police Department Crime Lab conducted a DNA comparison of the products of conception from Patient C.Y., a blood stain of Patient C.Y., and the oral swab standard from Respondent. According to Mr. Wolson's Report dated October 6, 1999, the DNA profile of Respondent was consistent with the paternity profile of the products of conception at all nine polymorphic loci chosen for comparison. Mr. Wolson concluded that Respondent "cannot be excluded as the father of the child." For the nine loci, the Probability of Paternity was 99.9%. 21. Section 458.329, Florida Statutes, states that the physician-patient relationship is founded on mutual trust. Sexual misconduct in the practice of medicine means violation of the physician-patient relationship through which the physician uses said relationship to induce the patient to engage, or to engage or attempt to engage the patient, in sexual activity outside the scope of the practice or the scope of generally accepted examination or treatment of the patient. Sexual misconduct in the practice of medicine is prohibited U UY 22. Patient C.Y. did not consent at any time to engaging in sexual acts with Respondent. Respondent engaged in sexual misconduct outside the scope of generally accepted examination and treatment in his care and treatment of Patient C.Y. 23. Respondent exercised influence within a patient-physician relationship for the purpose of engaging a patient in sexual activity. A patient shall be presumed to be incapable of giving free, full, and informed consent to sexual activity with his or her physician. 24. The following were not-included in Respondent's medical record for Patient C.Y., ~*~ regarding a history and physical examination: Position, pattern or size of varicosities, Past treatment of varicosities, ” Complications or prior conditions of the venous system, Family history of venous , or other, disease, and/or The presence of disease processes which exacerbate venous disease. enoep Patient C.Y.'s medical records do not reflect that pre-treatment photographs were taken of the varicosities, that informed consent was obtained, or that any educational materials were provided to the patient. 25. Respondent failed to properly assess and adequately diagnose Patient C.Y.'s complaints in that he did one or more of the following: a. Failed to adequately explore the patient's complaints of pain by referring her for a specialized consultation and testing, including duplex ultrasound evaluation and photoplethsmography of the venous system; b. Failed to gather or record information regarding aching, swelling, itching, leg ulcers, burning, heaviness, cramps, throbbing or restless legs; and/or c. Failed to recognize contraindications, such as breastfeeding, to sclerotherapy treatment. COUNT ONE 26. Petitioner realleges and incorporates paragraphs one (1) through twenty-five (25), as if fully set forth herein this Count One. . 27. Respondent exercised influence within a patient-physician relationship for purposes of engaging a patient in sexual activity, in that Respondent engaged in sexual conduct with Patient C.Y. while she was unconscious. 28. Based on the foregoing, Respondent violated Section 458:331(1)Q), Florida ~*- Statutes, by exercising influence within a patient-physician relationship for purposes of engaging a patient in sexual activity. A patient shall be presumed to be incapable of giving free, full, and informed consent to sexual activity with his or her physician. COUNT TWO 29. Petitioner realleges and incorporates paragraphs one (1) through twenty-five (25), and twenty-seven (27), as if fully set forth herein this Count Two. 30. Respondent violated any provision of Chapter 458, Florida Statutes, a tule of the board or department, or a lawful order of the board or department previously entered in a disciplinary hearing or failed to comply with a lawfully issued subpoena of the department, in that Respondent violated the express prohibition against sexual misconduct stated in Section 458.329, Florida Statutes, in his actions with Patient C.Y. 31. Based on the foregoing, Respondent violated Section 458.331(1)(x), Florida Statutes, by violating any provision of Chapter 458, Florida Statutes, a rule of the board or department, or a lawful order of the board or department previously entered in a disciplinary hearing or failing to comply with a lawfully issued subpoena of the department. COUNT THREE 32. Petitioner realleges and incorporates paragraphs one (1) through twenty-five (25), twenty-seven (27), and thirty (30), as if fully set forth herein this Count Three. 33. Respondent failed 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 Respondent did one or more of the following: failed to conduct an adequate patient history-and physical examination of Patient C.Y.; failed to make a ~~~ and adequate assessment and diagnosis of Patient C.Y.'s condition; performed sclerotherapy treatment on a patient where it was contraindicated; failed to place compression stockings on Patient C.Y. following the treatment and to instruct her on their use; failed to instruct Patient C-Y. to walk following the treatment procedure; and failed to refer Patient CY. toa specialized consultant for further testing. 34. Based on the foregoing, Respondent has 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. COUNT FOUR 35. Petitioner realleges and incorporates paragraphs one (1) through twenty-five (25), twenty-seven (27), thirty (30), and thirty-three (33), as if fully set forth herein this Count Four. 36. Respondent performed professional services which had not been duly authorized by the patient or client, or his or her legal representative, in that Respondent failed to obtain written consent from Patient C.Y. before performing sclerotherapy treatments on her. WD Nw 37. Based on the foregoing, Respondent violated Section 458.331(1)(p), Florida Statutes, by performing professional services which have not been duly authorized by the patient or client, or his or her legal representative, except as provided in s. 743.064, s. 766.103, or s. 768.13. COUNT FIVE 38. Petitioner realleges-and-incorporates paragraphs one (1) through twenty-five (25), ~~ twenty-seven (27), thirty (30), thirty-three (33), and thirty-six (36), as if fully set forth herein this Count Five. | . 39. Respondent failed to record one or more of the following: a medical history; a physical examination; an accurate diagnosis; a treatment plan; the location of the injections; the type of drug or solution administered; the appearance of the varicosities; past treatment of varicosities; complications or previous conditions of the venous system; family history of venous, or other, disease; and/or presence of disease processes which exacerbate venous disease in the medical record for Patient C.Y. 40. Based on the foregoing, Respondent violated Section 458.331(1)(m), Florida Statutes, by failing to keep legible, as defined by department rule in consultation with the board, medical records that identify the licensed physician or the physician extender and supervising physician by name and professional title who is or are responsible for rendering, ordering, supervising, or billing for each diagnostic or treatment procedure and 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 reports of consultations and hospitalizations. U UY 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 _/ 7 Phy of Z/ wh , 2000. Robert G. Brooks, M.D., Secretary COUNSEL FOR DEPARTMENT: Kathryn L. Kasprzak : Chief Medical Attorney D Agency for Health Care Administration . P.O. Box 14229 DEPARTMENT OF HEALTH Tallahassee, Florida 32317-4229 ce a Florida Bar #0937819 . , KLK/kank | DATE_S AQ PCP: May 19, 2000 PCP Members: Ashkar, Murray, Rodriguez

Docket for Case No: 00-002413