STATE OF FLORIDA 9 43 29 PH hi: 56 DEPARTMENT OF HEALTH” : ovisiia Oe , ADMINIS | RAIVE DEPARTMENT OF HEALTH, ) HEARING ) PETITIONER, ) ) " ) CASE NO. 1998-22455 ) LEE R. MAJKA, P.A, ‘ ). RESPONDENT. _+) ) ADMINISTRATIVE NT COMES NOW the Petitioner, Department of Health, hereinafter referred to as “Petitioner,” and files this Administrative Complaint before the Board of Medicine against Lee R. Majka, P.A., 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 456, 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 assistant in the state of Florida, having been issued license number PA 0002120. _Respondent’s last known address is 6484 Ft. Caroline Road, Jacksonville, Florida 32277. 3. Patient A.D. was born on or about September 25, 1995, at Baptist Medical Center (hereinafter “BMC”) in Jacksonville, Florida, at thirty (30) weeks gestation. The patient was hospitalized for approximately six (6) weeks in the neonatal intensive care unit before being discharged home with her parents on or about November 9, 1995. 4. On or about November | 14, 1995, Patient A.D. was examined by her Pediatrician, Dr. Crane, who personally examined the patient and diagnosed her as a “well baby.” 5. During the evening of on or about November 18, 1995, Patient A.D/s. parents, T.D. and J.D., phoned Dr. Crane’s office to report that Patient A.D.'s breathing was erratic and that she had a low temperature of 97 degrees. The time of this call is not documented in the patient’s medical record. 6. Respondent, the on-call physician assistant in Dr. Crane’s office on or about November 18, 1995, returned the parents’ telephone call on or about November 18, 1995. Respondent noted that Patient A.D. was premature, and had a temperature of 97 degrees. He advised the parents that there was no cause for concern, and that it was not necessary to take Patient A.D. to the emergency room. Respondent did not document his recommendations, or the time of his return call, in Patient A.D’s medical record. 7. On or about November 18, 1995, Patient A.D/s parents again called Dr. Crane's office with concerns regarding Patient A.D’s erratic breathing and low temperature. Respondent again advised them that there was no cause for concern. Respondent did not document the second telephone conversation with Patient A.Ds parents in the patient’s medical record. 8. On or about November 18, 1995, Patient A.D.’s parents, unsatisfied with Respondent's advice, demanded that Respondent refer their concerns to the on-call physician, Dr. Laspada. Respondent complied with their request. Dr. Laspada advised the parents to bring Patient A.D. to the office the following morning. 9. The parents of Patient A.D. advised Dr. Laspada that they were going to take A.D. to the hospital, and, at approximately 11:23 p.m., Patient A.D. arrived with her parents at the BMC emergency room. Patient A.D. was admitted to the BMC. Pediatric Critical Care Unit with a diagnosis of Respiratory Syncytial Virus (an RNA- containing virus causing bronchitis and bronchopneumonia in children). As a result of this illness, Patient A.D. suffered extensive brain damage. 10. A reasonably prudent similar physician assistant would have recognized that a température of 97 degrees in a neonate requires immediate evaluation, would have referred the patient to the emergency room for immediate evaluation, and: would have documented the parents’ calls and his recommendations in the patient's chart. 11. Respondent failed to recognize that Patient A.D’s temperature of 97 degrees required immediate evaluation, failed to refer Patient A.D. to the emergency room for immediate evaluation, and failed to appropriately document the patient's complaints and his recommendations in Patient A.D/s chart. COUNT ONE 12. _ Petitioner realleges and incorporates paragraphs one (1) through eleven (11), as if fully set forth herein this Count One. 13. Respondent failed to practice medicine with that level of care, skill, and treatment which is recognized by a reasonably prudent similar physician assistant as being acceptable under similar conditions and circumstances in one or more of the following ways: (1) Respondent failed to recognize that Patient A.D’s temperature of 97 degrees required immediate evaluation; (2) Respondent failed to appropriately assess Patient A.D.'s complaints and symptoms; and (3) Respondent failed to refer Patient A.D. to the emergency room for immediate evaluation. 14. 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 assistant as being acceptable under similar conditions and circumstances. NT TWO 15. Petitioner realleges and incorporates paragraphs one (1) through eleven (11), and paragraph thirteen (13), as if fully set forth herein this Count Two. 16. Respondent failed to keep keep. written medical records justifying the course of treatment of the patient, including, but not limited to, patient histories; examination results; test records; records of drugs prescribed, dispensed, or administered; and reports of consultations and hospitalizations, in that Respondent failed to appropriately document his contact with Patient A.D.’s parents, the time of the calls, and his recommendations made via telephone to Patient A.D.s parents regarding Patient A.D.’s condition on or about November 18, 1995. 17. Based on the foregoing, Respondent violated Section 458.331(1)(m), Florida Statutes, by failing to keep written medical records justifying the course of treatment of the patient, including, but not limited to, patient histories; examination results; test records; records of drugs prescribed, dispensed, or administered; and reports of consultations and hospitalizations. 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 456.072(4), Florida Statutes, and/or any other relief that the Board deems appropriate. SIGNED this_ 2" aay of 2000. Robert G. Brooks, M.D., Secretary LED OEPARTMENT OF HEALTH DEPUTY CLERK Re thryn sp CLERK Nichi R Faron Chief Medical Attorney pate__lo (de [2e0> COUNSEL FOR DEPARTMENT: Kathryn L. Kasprzak Chief Medical Attorney Agency for Health Care Administration P. O. Box 14229 Tallahassee, Florida 32317-4229 Florida Bar # 937819 MRH PCP: October 21, 2000 PCP Members: Ashkar, Murray, Rodriguez

Docket for Case No: 00-004781PL