STATE OF FLORIDA b 06 3 DEPARTMENT OF HEALTH =p) iB ION OF : he SIRATIVE DEPARTMENT OF HEALTH, ) ARIES . ) PETITIONER, ) 4 . ; vs. ) CASE NO. 1998-11181 ) : BRUCE E. WIITA, M._D., ) , ) ‘RESPONDENT. +) - a) 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 Bruce E. Wiita, 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 0014196. Respondent’s last known address is 3385 Burns Road, Palm Beach Gardens, FL 33410-4328. 3. Respondent is a board-certified urologist. VU YU 4. Patient L.S., an 81-year old male, presented to Respondent for diagnosis and treatment of prostate cancer. Over approximately two years, Respondent treated Patient L.S. and performed a transurethral resection of the prostate, external beam radiation therapy and cryosurgery on the patient. : . - 5. Following the cryosurgery, Patient L.S. had an ongoing problem with stress and incontinence. . ? 6. On or about February 12, 1997, Patient LS. presented to Respondent with concerns about his stress incontinence. At that time, Respondent explained the cure for incontinence, including external devices, collagen injections, and an artificial urinary sphincter. Dr. Wiita advised that the best course would be an external device called a Cunningham Clamp. 7. On or about August 20, 1997, Patient L.S. returned to Respondent for evaluation and follow up and expressed dissatisfaction with the Cunningham Clamp. The patient expressed continued concern about his incontinence and Respondent recommended a series of diagnostic tests to determine the patient’s options for treatment. 8. The patient underwent diagnostic tests and it was determined that his options included an artificial urinary sphincter and medication. 9. On or about September 10, 1997, Patient L.S. retumed to Respondent and advised Respondent that he wanted to have the AMS urinary sphincter inserted. Respondent erroneously dictated into his office progress notes that Patient L.S. wanted to have a penile prosthesis inserted. . / - 10. Following the patient’s office visit, a member of Respondent’s staff called Jupiter Medical Center and scheduled surgery for an AMS penile prosthesis insertion for Patient L.S. based on information in Respondent’s dictated progress notes. UW Y 11. On or about September 19, 1997, Respondent’s physician assistant performed a pre-operative history and physical examination by which he documented Patient L.S.’s history of stress incontinence and the plan to have a urinary sphincter inserted. 12. Also, on or about September 19, 1997, Patient L.S. signed an informed consent at Jupiter Medical Center which indicated the procedure to be performed as “insertion of AMS 800 urinary sphincter.” > . : 13. On or about September 23, 1997, Patient L.S. was admitted to the hospital and prepared for the insertion of a petiile prosthesis, rather than a urinary sphincter. 14, _ Respondent arrived in the operating room after the patient was prepped and under anesthesia. Respondent did not review the patient’s chart, physical examination or history before proceeding with the insertion of the penile prosthesis. 15. Respondent’s operative report indicates a preoperative diagnosis for Patient L.S. as organic impotency and a postoperative diagnosis as organic impotency. 16. As a result of Respondent’s failure to dictate the correct surgical procedure to be performed on Patient L.S. and Respondent’s failure to review the patient’s chart, history and examination prior to surgery, the patient was subjected to an unnecessary surgical procedure. COUNT ONE . 17. Petitioner realleges and incorporates paragraphs one (1) through sixteen (16), as if fully set forth herein this Count One. - 18. 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 failed to dictate the correct procedure to be ee VU ww) performed on Patient L.S. and he failed to take the appropriate precautions prior to performing surgery to insure that he was performing the correct procedure on the patient. ° 19. 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 and circumstances. : COUNT TWO 20. Petitioner realleges and incorporates paragraphs one (1) through sixteen (16), and paragraph eighteen (18), as if fully set forth herein this Count Two. 21. Respondent performed professional services which had not been duly authorized by the patient or client, or his or her legal representative, in that Respondent performed a procedure to insert a penile prosthesis and the patient had signed a consent and authorization for insertion of an AMS 800 urinary sphincter. ‘22. 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 Sections 743.064, 766.103, or 768.13, Florida Statutes... —_ COUNT THREE 23. Petitioner realleges and incorporates paragraphs one (1) through sixteen (16), paragraph eighteen (18), and paragraph twenty-one (21), as if fully set forth herein this Count Three. ; . 4 oe 24. Respondent.failed to keep legible medical records that justify the course of treatment of the patient, in that Respondent erroneausly dictated into his office progress notes that Patient L.S. wanted to have an AMS penile prosthesis inserted and by erroneously indicating in the operative report a preoperative diagnosis for Patient L.S. of organic impotency and a postoperative diagnosis of organic impotency. : 25. 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. WU Nw] WHEREFORE, the Petitioner respectfully requests the Board of Medicine enter an order at 3 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