Petitioner: DEPARTMENT OF HEALTH, BOARD OF MEDICINE
Respondent: LEONARD WALKER, M.D.
Judges: LARRY J. SARTIN
Agency: Department of Health
Locations: Fort Pierce, Florida
Filed: Aug. 08, 2000
Status: Closed
Settled and/or Dismissed prior to entry of RO/FO on Tuesday, December 5, 2000.
Latest Update: Dec. 25, 2024
FILED
00 AUS -8 PM u: 0G
4 DIVISION] Gr
STATE OF FLORIDA ADMINISTRATIVE
DEPARTMENT OF HEALTH EARINGS
DEPARTMENT OF HEALTH, )
PETITIONER 5 | 53
00-32
v. ) CASE NOS. 1998-18603 & 1999-52960
)
LEONARD WALKER, M.LD., )
7 )
RESPONDENT. )
ee
ADMINISTRATIVE COMPLAINT
COMES NOW the Petitioner, Department of Health, hereinafterireferred to as “Petitioner,”
and files this Administrative Complaint before the Board of Medicine against Leonard Walker,
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 provisions 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 0021417. Respondent's last known address is
Ne] No) |
161 S. Camelia Ct., Vero Beach, Florida 32963. At all times relevant herein, Respondent was
employed by and practiced at Lawnwood Regional Medical Center.
FACTS PERTAINING TO PATIENT J.H.
3. On/or about December 18, 1997, Patient J.H. was treated at Lawnwood Regional
Medical Center (Lawnwood) emergency room for complaints of shortness of breath and a
productive cough of yellow sputum, fever and chills. |
4. Dr. Salehi's differential diagnosis indicated pneumonia, asthma or chronic obstructive
pulmonary disease. Dr. Salehi recommended further evaluation and testing.
5. On or about December 22, 1997, while a patient at Lawnwodd, Patient J.H. underwenta
\
bronchoscopy ordered by Dr. Lloyd which revealed bronchitis. Dr. Lloyd performed bronchial
washings and a biopsy from Patient J.H.'s right middle lobe.
6. In his capacity as a pathologist, Respondent reviewed and interpreted | the
specimens obtained by Dr. Lloyd and reached the following diagnosis:
DIAGNOSIS: 1., 2., 3. BIOPSIES, LUNG WASHINGS CELL
BLOCK AND CYTOLOGY SMEARS, LUNG BRUSHING CYTOLOG
LARGE CELL (NON OAT-CELL) CARCINOMA.
7. Onor about January 26, 1998, Patient J.H. was readmitted to Lawnwood by Dr. Lioyd.
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8. During this admission, Patient J.H. came under the care of Dr. Ioannou who concurred
with the diagnosis of large cell carcinoma by Respondent and performed a right middle lobectomy
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and right upper lobectomy.
9. Intra-operatively, Dr. Ioannou did not find any cancer in either lung, but performed the
bilateral lobectomies based on the Respondent's pathology report of large cell carcinoma.
Caan )
10. Subsequent pathology report by another pathologist states a diagnosis of metaplastic
(abnormal) epithelial cells with atypicality and a few markedly atypical cells, but no malignancy.
11. Patient J.H. was discharged from Lawnwood after being ddvised that all of the cancer
had been removed. Patient J.H. was never told that he in fact did not have cancer.
12. On or about February 12, 1998 a pathology report from the University of Miami
regarding a right middle lobe biopsy of the tissue removed from Patient J.H. stated:
Minute strips of highly dysplastic bronchial epithelium :
present. Recommend further studies if clinically indicated.
13. Another outside review dated February 6, 1998, by an internationally known
pathologist, Dr. Eugene Mark, at Massachusetts General Hospital indicated a diagnosis of:
“Metaplastic epithelial cells with atypicality and a few markedly atypical cells.”
14. On or about June 3, 1999, the materials and slides rélating to Patient J.H.| were
reviewed by another expert, a board certified pathologist acting at the request of the Agency. He
specifically examined the bronchial biopsy diagnosed by Respondent as Large Cell Carcinoma.
This expert found instead that "the very small amount of tissue on the slides reviewed is indeed
atypical . . . but does not nearly reach the level warranting a diagnosis of carcinoma and probably
represents an exaggerated inflammatory response. Unfortunately the patient underwent a
bilobectomy on the basis of the diagnosis and no tumor was found." |
15. Respondent practiced medicine below the acceptable standard of care by diagnosing
Patient J.H. with large cell carcinoma, resulting in unnecessary surgery; when he in fact had
atypical epithelial cells, as confirmed by expert review.
COUNT ONE
16. Petitioner realleges and incorporates paragraphs one (1) through fifteen (15), as if fully
set forth herein this Count One.
17. Respondent practiced medicine below the acceptable jstandard of care, in
Respondent misdiagnosed patient J.H. with large cell carcinoma of the lungs causing the patie
undergo unnecessary surgery. |, Respondent failed to practice medi¢ine with at a level of
recognized by a reasonably prudent physician as being acceptable under similar circumstances
that
nt to
care
18. Based on the foregoing, Respondent violated Section 458.33 1(1)(t), Florida Statutes, by
failing to practice medicine with that level of care, skill and treatment which is recognized by a
reasonably prudent physician as being acceptable under similar circumstances.
FACTS PERTAINING TO PATIENT RW,
19. On or about January 29, 1997, while a patient at Lawnwood, Patient R.W. underwent a
biopsy of the colon with a preoperative diagnosis of multiple colon polyps.
20. Respondent examined the tissue and made a diagnosis of:
1) Ellipse of skin/subcutaneoussoft tissue, site unspecfed-od organized
cutaneous scar
2) Segment of ¢olon with:
Familial polyposis with numerous randomly distributed sysplat
villoglandular/adenomatouscolonic polyps
Focal intermurally infiltrating well differentiated adeno: cinomaarising from the
base of the largest polyp with infiltration to, but not through, the underlying
muscularis
Large-bloc microsections of drainage area fat tissue negative for lymph nodes
No mucosal polypoid structure noted closer than 10.0 om to either the proximaljor
distal surgical plane of excision.
UW VY
21. On or about June 3, 1999, the Agency’s expert submitted his opinion after reviewing
the case. He opined that Respondent’s diagnosis of invasive carcinoma could not be sustained by
the tissue reviewed. He expressed concer for the patient because the patient may be subjected to
chemotherapy and given an incorrect diagnosis of cancer with a guarded prognosis. The expert also
found this type of error to be particularly disturbing “since the pitfall of glandular pseudo-
inclusions due to sectioning artifact should be well recognized by an experienced pathologist.”
22. Respondent practiced medicine below the acceptable standard of care by misdiagnosing
Patient R.W. with adenocarcinoma.
COUNT TWO
23. Petitionerrealleges and incorporates paragraphs one (1) through two (2) and paragraphs
nineteen (19) through twenty-two (22), as if fully set forth herein this Count Two.
24. Respondent practiced medicine below the acceptable| standard of care, in |that
Respondent misdiagnosed Patient R.W. with invasive carcinoma when no cancer was present.
Respondent failed to practice medicine with at a level of care recognited by a reasonably prudent
physician as being acceptable under similar circumstances.
25. Based on the foregoing, Respondent violated Section 458.33 1(1)(t), Florida Statutes, by
failing to practice medicine with that level of care, skill and treatment which is recognized by a
reasonably pnident physician as being acceptable under similar 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, im dsition of an administrative
‘Pp P ipa
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fine, issuance of a reprimand, placement of the Respondent on probation, the assessment of casts.
related to the investigation and prosecution of this case as provided fer in Section 455.624(4),
or
Florida Statutes, and/or ern other relief that the Board deems appropriate
SIGNED this Loh day of
_—y
COUNSEL FOR DEPARTMENT:
Kathryn L. Kasprzak
Chief Medical Attorney
Agency for Health Care Administration
P. O. Box 14229
Tallahassee, Florida 3231 7-8229
Florida Bar # 937819
DKK/dk
PCP: June 26, 2000
PCP Members: Cerda, Woods, Pardue
lene , 2000.
Robert G. Brooks, M.D., Secretary
F LED
OE ARTY cLERK
CLERK °
DATE __telavloo
Docket for Case No: 00-003253PL
Issue Date |
Proceedings |
Dec. 05, 2000 |
Order Closing File issued. CASE CLOSED.
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Nov. 30, 2000 |
Notice of Appearance (filed by C. Lanfri via facsimile).
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Nov. 30, 2000 |
Motion for Continuance, Alternatively, Motion to Relinquish Jurisdiction (filed by Respondent via facsimile).
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Nov. 28, 2000 |
Letter to L. Walker from D. Kiesling In re: responses to discovery due December 1, 2000 (filed via facsimile).
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Nov. 21, 2000 |
Order Granting Motion to Withdraw as Counsel for Respondent issued.
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Nov. 07, 2000 |
Letter to B. Glick from J. Pellett In re: documents to be attached to deposition transcript (filed via facsimile).
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Nov. 06, 2000 |
Motion to Withdraw as Counsel for Respondent (filed via facsimile).
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Nov. 03, 2000 |
Third Addendum to Response to Request to Produce (filed via facsimile).
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Oct. 31, 2000 |
Second Addendum to Response to Request to Produce filed. |
Oct. 25, 2000 |
Notice of Cancellation of Deposition of M. Hussain (filed via facsimile).
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Oct. 25, 2000 |
Ltr. to J. Pellett from M. Felder In re: M. Arnall unable to attend deposition filed.
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Oct. 25, 2000 |
Notice of Cancellation of Deposition of M. Arnall, M. Kiker (filed via facsimile).
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Oct. 25, 2000 |
Deponent, Dr. Arnall`s Objection to Subpoena Duces Tecum (filed via facsimile).
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Oct. 24, 2000 |
Notice of Cancellation of Deposition of M. Nadji (filed via facsimile).
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Oct. 24, 2000 |
Order Granting Continuance and Re-scheduling Hearing issued (hearing set for January 8 and 9, 2001; 10:00 a.m.; Fort Pierce, FL).
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Oct. 24, 2000 |
Copy of Letter to Monica Felder from Jon Pellett (filed via facsimile).
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Oct. 19, 2000 |
Letter to Judge Sartin from J. Pellett Re: Request for Subpoenas (filed via facsimile).
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Oct. 19, 2000 |
Respondent`s Notice to Produce at Deposition (filed via facsimile).
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Oct. 19, 2000 |
Subpoena Duces Tecum (filed via facsimile).
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Oct. 19, 2000 |
(Respondent) Notice of Taking Deposition Duces Tecum (filed via facsimile).
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Oct. 19, 2000 |
(2) Subpoena Duces Tecum filed.
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Oct. 19, 2000 |
(Respondent) Notice of Taking Deposition Duces Tecum (filed via facsimile).
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Oct. 19, 2000 |
(4) Subpoena Duces Tecum (filed via facsimile).
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Oct. 19, 2000 |
(Respondent) Notice of Taking Deposition Duces Tecum (filed via facsimile).
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Oct. 19, 2000 |
(2) Subpoena Duces Tecum (filed via facsimile).
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Oct. 19, 2000 |
(Respondent) Notice of Taking Deposition Duces Tecum (filed via facsimile).
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Oct. 18, 2000 |
Joint Motion for Continuance (filed via facsimile).
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Oct. 11, 2000 |
Notice of Filing Petitioner`s First Set of Interrogatories, Requests for Admissions and Request for Production (filed via facsimile).
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Sep. 25, 2000 |
Notice of Appearance and Substitution of Counsel (filed by J. Pellett via facsimile).
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Sep. 13, 2000 |
Respondent`s Second Request to Produce and Additional Request for Public Records (filed via facsimile). |
Sep. 13, 2000 |
Notice of Serving Interrogatories (filed via facsimile). |
Aug. 31, 2000 |
Order Granting Motion to Extend Time to File Motions in Opposition to the Administrative Complaint issued.
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Aug. 17, 2000 |
Order of Pre-hearing Instructions issued.
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Aug. 17, 2000 |
Notice of Hearing issued (hearing set for November 20 and 21, 2000; 9:30 a.m.; Fort Pierce, FL).
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Aug. 15, 2000 |
Response to Initial Order (filed by Petitioner via facsimile).
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Aug. 14, 2000 |
Motion to Extend Time to File Motions in Opposition to the Administrative Complaint (filed via facsimile).
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Aug. 14, 2000 |
Request to Produce and in the Alternative Public Records Request (filed via facsimile).
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Aug. 14, 2000 |
Notice of Filing (filed via facsimile).
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Aug. 14, 2000 |
Ltr. to Judge L. Sartin from C. Hunter In re: request for subpoenas (filed via facsimile).
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Aug. 10, 2000 |
Initial Order issued. |
Aug. 08, 2000 |
Motion to Extend Time to File Motions in Opposition to the Administrative Complaint filed.
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Aug. 08, 2000 |
Administrative Complaint filed.
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Aug. 08, 2000 |
Request for Formal Hearing filed.
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Aug. 08, 2000 |
Notice of Appearance (C. Howard) filed.
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Aug. 08, 2000 |
Request to Produce and in the Alternative Public Records Request filed.
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Aug. 08, 2000 |
Agency referral filed.
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