GOVERNOR AGENCY FOR HEALTH CARE ADMINISTRATION ; &, 4 | oy, & Jes BUSH RHONDA M. MepoysrM D., FAAFP 4% December 7, 2001 Vo Ta ty ey Gs Lo Larry J. Sartin ) The Honorable Division of Administrative Hearings The DeSoto Building l J 1230 Apalachee Parkway i Tallahassee, Florida 32399-1550 RE: DOH v. Carole Lynne Daniels, M.D. DOH Case Number 1998-11944 DOAH Case Number 005105PL Dear Judge Sartin: Enclosed you will find a Final Order entered by the Board of Medicine in the above- referenced case. If you have any questions about this matter, please do not hesitate to contact our office at (850) 488-4516. Jol njE. Terrel Sanior Attorney JET/cde Enclosure 2727 MAHAN DRIVE, MAIL STOP #439-A TALLAHASSEE, FLORIDA 32308 (850) 414-8126; (888) 240-9931 TOLL FREE P.O. BOX 14229, MAIL STOP 39-A TALLAHASSEE, FLORIDA 32317-4229 (800) 955-8771 TDD; (850) 414-1989 FAX ence pr gees eee ee ee . STATE OF FLORIDA » . BOARD OF MEDICINE Final Order No. DOH-01-0922-"S. fic DEPARTMENT OF HEALTH, : FILED DATE- Department of Heal: Petitioner, By: UC \ - Deputy Agency Clerk vs. : CASE NO.: 1998-11944 LICENSE NO.: ME0065088 CAROLE LYNNE DANIELS, M.D., ~ Respondent. / FINAL ORDER THIS CAUSE came before the Board of Medicine (Board) pursuant to Sections 120.569 and 120.57(4), Florida Statutes, on June 2, 2001, in Dania, Florida, for consideration of a Consent Agreement (attached hereto as Exhibit A) entered into between the parties in the above- styled cause. Upon consideration of the Consent Agreement, the documents submitted in support thereof, the arguments of the parties, and being otherwise advised in the premises, “the Board rejected the Consent Agreement and offered a Counter Consent Agreement which was. accepted by Respondent’s counsel in a letter dated June 8, 2001 (and attached hereto as Exhibit B). The Counter Consent Agreement offered by the Board and accepted by the Respondent incorporates the original Consent Agreement with the following amendment : Respondent shall receive a REPRIMAND. IT IS HEREBY ORDERED AND ADJUDGED that the Consent Agreement as e: submitted be and is hereby approved and adopted in toto and incorporated by reference herein with the amendinent set forth above. Accordingly, the parties shall adhere to and abide by all the terms and conditions of the Consent Agreement as amended. This Final Order shall take effect upon being filed with the Clerk of the Department of Health. we DONE AND ORDERED this ZO — day of , 2001. BOARD OF MEDICINE GASTON ACOSTA-RUA, M.D. CHAIRMAN CERTIFICATE OF SERVICE I HEREBY CERTIFY that a true and correct copy of the foregoing Final Order has been provided by U.S. Mail to Carole Lynne Daniels, | felon. SS 34 Key, Florida 33042-9605; to M.D., 386 Blackbeard Road, Little T Addison J. Meyers, Esquire, P.O. Box 149022, Coral Gables, Florida 33114-9022; and by interoffice delivery to Nancy M. Snurkowski, Chief -. Practitioner Regulation, and Simone Marstiller, Senior Attorney - Appeals, Agency for Health Care Administration, 2727 Mahan Drive, t [ . te Tallahassee, Florida 32308-5403, on or before 5:00 p.m., this . ’ day of , 2001. ; STATE OF FLORIDA DEPARTMENT OF HEALTH BOARD OF MEDICINE - __ DEPARTMENT OF HEALTH, Petitioner, : v. . DOH CASE NUMBER 1998-11944 CAROLE LYNNE DANIELS, M.D. . Respondent. CONSENT AGREEMENT CAROLE LYNNE DANIELS, M.D., referred to as the "Respondent," and the Department of Health, referred to as "Department," stipulate and agree to the following Agreement and to the entry of a Final Order of the Board of Medicine, referred to as "Board," incorporating the Stipulated Facts and Stipulated Disposition in this matter. 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. ST IPULATED FACTS 1. At all times material hereto, the Respondent was a licensed physician in the State of Florida having been issued license number ME 0065088. : 2. The Respondent was charged by an Administrative Complaint filed by the Agency and properly served upon the Respondent with violations of Chapter 458, Florida Statutes, and the rules enacted pursuant thereto. A true and correct copy of the . Administrative Complaint is attached hereto as Exhibit A. 3. Respondent neither admits rior denies the allegations of fact contained in the Administrative Complaint. . STIPULATED CONCLUSIONS OF LAW 1. The Respondent admits that, in her capacity as a licensed physician, she is subject to the provisions of Chapters 456 and 458, Florida Statutes, and the jurisdiction of the Agency and the Board. 2. The Respondent admits that the facts set forth in the Administrative Complaint, if proven, would constitute violations of Chapter 458, Horida Statutes, as alleged in the Administrative Complaint. ' 3. Respondent admits. that the Stipulated Disposition in this case is fair, appropriate and acceptable to Respondent. SEPP RREEE Ter- oweeagres t op-orerepaeerr res Ss Aan 4. STIPULATED DISPOSITION 1 FUTURE CONDUCT. The Respondent shall not in the future violate Chapters 456, 458 and 893, Florida Statutes, or the rules promulgated pursuant thereto, . Prior to signing this agreement, the Respondent shall read Chapters 456, 458, 893 and the Rules of the Board of Medicine, at Section 64B8, Florida Administrative Code. . 2. FINE. The Board shall impose an administrative fine in the amount of $5,000.00 against the Respondent. The fine shall be paid by the Respondent to the Board of Medicine within nine (9) months of its imposition by Final Order of the Board. THE RESPONDENT ACKNOWLEDGES THAT THE TIMELY PAYMENT OF THE FINE IS HER LEGAL OBLIGATION AND RESPONSIBILITY AND THE RESPONDENT AGREES TO CEASE PRACTICING IF THE FINE IS NOT PAID AS AGREED To IN THIS CONSENT AGREEMENT, SPECIFICALLY: IF THE RESPONDENT HAS NOT RECEIVED WRITTEN CONFIRMATION THAT THE FULL AMOUNT OF THE FINE HAS BEEN RECEIVED BY THE BOARD OFFICE WITHIN NINE (9) MONTHS OF THE FILING OF THIS FINAL ORDER, THE RESPONDENT AGREES TO CEASE PRACTICE UNTIL SUCH WRITTEN (CONFIRMATION Is RECEIVED BY THE RESPONDENT FROM THE BOARD. (SEE EXHIBIT B, PARAGRAPH 1 OF THIS CONSENT ‘AGREE :NT FOR BOARD ADDRESS "AND. STANDARD TERMS). a en a 3, CONTINUING MEDICAL EDUCATION. Within nine (9) months of the date of the filing of a Final Order in this cause, Respondent shall attend five (5) hours of Continuing Medical Education in emergent cardiac treatment. . Respondent shall submit a written plan to the Chairman of the Board ‘for approval prior to the completion of said continuing education hours and course. The Board confers authority on the Chairman of the Board to approve or disapprove said continuing education hours or course. In addition, Respondent shall submit documentation in the form of certified copies of the receipts, vouchers, certificates, or other papers, such as physician's recognition awards, documenting completion of this medical course within nine (9) months of the Final Order in this matter. All such documentation shall be sent to the Board of Medicine, regardless of whether some or any of such documentation was previously provided during the course of any audit or discussion with counsel for the Department. These hours shall be in addition to those hours required for renewal of licensure. Unless otherwise approved by the Board, said continuing education course shail consist of a formal, live lecture format. 4. RECORDS COURSE, Respondent shall complete the course, "Quality Medical Record Keeping for Health Care Professionals,” sponsored by the Florida Medical Association, or a Board-approved equivalent, within six (6) months of filing of the final order. ceoge-weme cero ort we 5, REIMBURSEMENT OF COSTS, In addition to the amount of any fine noted above, the Respondent agrees to reimburse the Department for any administrative costs incurred in the investigation and preparation of this case, including costs assessed by the Division of Administrative Hearings, if applicable, and by the Board of Medicine Office. Such costs shall not include any attorney's fees incurred by the Agency for the Prosecution of this case. The agreed upon Agency cost to be reimbursed in this case is - _ $773.41. The costs shall be paid by the Respondent to the Board of Medicine within ninety (90) days of its imposition by Final Order of the Board. THE RESPONDENT ACKNOWLEDGES THAT THE TIMELY PAYMENT OF THE COSTS IS HER LEGAL OBLIGATION AND RESPONSIBILITY AND RESPONDENT AGREES TO CEASE PRACTICING IF THE COSTS ARE NOT PAID AS AGREED TO IN THIS CONSENT AGREEMENT, SPECIFICALLY: IF THE RESPONDENT HAS NOT RECEIVED WRITTEN CONFIRMATION THAT THE FULL AMOUNT OF THE COSTS NOTED ABOVE HAS BEEN RECEIVED BY THE BOARD OFFICE WITHIN NINETY (90) DAYS OF THE FILING OF THIS FINAL ORDER, THE RESPONDENT AGREES TO CEASE PRACTICE UNTIL SUCH WRIITEN CONFIRMATION IS RECEIVED BY THE RESPONDENT FROM THE BOARD. (SEE EXHIBIT B, PARAGRAPH E OF THIS CONSENT AGREEMENT FOR BOARD ADDRESS AND STANDARD TERMS. Ope ong mTOR OR croton STANDARD PROVISIONS 1. . It is expressly understood that this Agreement is subject to the approval of the Board and the Agency. In this regard, the foregoing ‘paragraphs (and only the foregoing paragraphs) shall have no force and effect unless a Final Order incorporating -the terms of this Agreement is entered by the Board, 2. Respondent is required to appear before the Board at the meeting of the Board where this Agreement is considered. . . 3. Respondent and the Agency fully understand that this jomnt a agreement and subsequent Final Order incorporating same will in no way preclude additional proceedings against Respondent for acts or omissions not specifically set forth in the Administrative Complaint attached as Exhibit "A" herein. 4. Upon the Board's adoption of this Agreement, Respondent expressly waives all further procedural steps, and expressly waives all rights to seek judicial review of or to otherwise challenge or contest the validity of the Agreement and the Final Order of the Board incorporating said Agreement. 5. Upon the Board’s adoption of this Agreement, the parties hereby agree that each party will bear his own attorney's fees and costs resulting from Prosecution or -- defense of this matter. Respondent \ waives the right to seek any attomey's fees or costs : from the Aagenoy| in n connection with this matter. 6 5 2 ret 6. This agreement is executed by the Respondent for the purpose of avoiding further administrative action with respect to this cause. In this regard, Respondent authorizes the Board to review and examine all’ investigative file materials concerning , Respondent prior to or in conjunction with consideration of the Agreement. Furthermore, should this joint Agreement not be accepted by the Board, it is agreed that presentation to and consideration of this Agreement and other documents and matters by the Board shall not unfairly or illegally prejudice the Board or any of its members from further participation, consideration, or resolution of these proceedings. — pe ee Exhibit B STANDARD TERMS APPLICABLE TO CONSENT AGREEMENTS The following are the standard terms applicable to all Consent Agreements, " including supervision and monitoring provisions applicable to licensees on probation. A. PAYMENT OF FINES. Unless otherwise directed by the Consent Agreement, all fines shall be paid by check or money order and sent to the Board address as set forth . . in paragraph E, below. The Board office does not have the authority to change terms of payment of any fine imposed by the Board, — B. COMMUNITY SERVICE AND CONTINUING EDUCATION UNITS. Unless other wise directed by the Consent Agreement, all community service requirements, continuing education units/courses must be completed, and documentation of such completion submitted to the Board of Medicine at the address set forth below in paragraph E, WITHIN ONE YEAR OF THE DATE OF THE FINAL ORDER. C. ADDRESSES. The Respondent must keep current residence and practice addresses on file with the Board. ‘The Respondent shall notify the Board within ten (10) days of any changes of said addresses. Furthermore, if the Respondent's license is on probation, the Respondent shall notify the Board within ten (10) days in the event that, . the Respondent leaves the active © practice of medicine in Florida, PTET SEE Weer Dz COSTS. Pursuant to Section 458.331(2), Florida Statutes, the Respondent shall pay all costs necessary to comply with the terms of this Consent Agreement. Such costs include, but are not limited to, the cost of preparation of Investigative Reports detailing compliance with the terms of the Consent Agreement, obtaining supervision or monitoring of the practice, the cost of quality assurance reviews, and the Board's administrative cost directly associated with the Respondent's probation. E. BOARD ADDRESS. Unless otherwise directed by the Board office, all fines, . reports, correspondence and inquires shall be sent to: Board of Medicine, 4052 Bald Cypress Way, Bin #C-3, Tallahassee, Florida 32399-1731, Attn: Final Order _ Compliance Officer. bid od jd. ol ll ee SIGNED this § _ day of fe HA aren , 2001. Carole Lynne Daniels, M.D. Before me, personally appeared Cyyo el iu) whose identity is. known to me by _ FLeewyA DL: {type of identification) and who, under oath, acknowledges that his/her signature appears above. Sworn to and subscribed before me this 4g day of Few 200 | 2001. . a ie, KRISTYNE A. WILSON Wr BQ WY COMMISSION FCC Ta77=0 : pee ; Ap 27, 2002 sae RES: Ape z7, 2002 NOTARY PUBLI . My Commission Expires: ey Practitioner Regulation-Legal Tt . STATE OF FLORIDA © - DEPARTMENT OF HEALTH DEPARTMENT OF HEALTH, =) . oEntHONE,. Mo _ } CASE NO. 1998-11944 CAROLE LYNNE DANIELS, M.D., } . RESPONDENT. et”) ADMIN E.COMPLAINT COMES NOW the Petitioner, Department of Health, hereinafter referred to as “Petitioner,” and files this Administrative Complaint before the Board of Medicine against Carole Lynne Daniels, 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 456, : Florida Statutes, and Chapter 458, Florida Statutes. Pursuant to the provisions of Section 26 .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. ised Hgts 4 2, Respondent is and has been a at alt times material hereto a licensed 4 physician in the state of Florida, having been Issued license number ME 0065088, _ Respondent's fast known address Js 386. Blackbeard Road, Little Torch key, Florida 33042-9605, ett eo enerr” 3. Respondent specializes in emergency medicine and is not board certified. 4, On or about March 21, 1997, Patient M.C,, a 67 yéar old female with a history of hypertension and smoking, presented to the emergency room (ER) of the Lower Florida Keys Health System facility with coniplaints of chest pain, difficult breathing, and_ a dry cough fasting one week. - Respondent examined, evaluated and treated Patient M.C. in the ER. 5. Respondent examined Patient M.C. and ordered a complete blood count, a chest x-ray, sputum culture, and an electrocardi jogram (EKG), but failed to document . _ these tests in her medical records. The EKG ‘ordered by Respondent showed results consistent with a cardiac ischemia (insufficient supply of blood to the heart) and indicated a possibly developing myocardial infarction (heart attack). 6. Respondent interpreted Patient M.C’s EKG as showing non-acute changes, and diagnosed M.C. as suffering from asthmatic bronchitis. Based on this diagnosis, Respondent discharged Patient M.C. with a prescription for antibiotics and asthma medication. 7. On or about March 23, 1997, Patient M.C. again presented to the emergency oom with complaints of continuing and increased chest pain, and was diagnosed by another Physician as suffering from a severe myocardial infarction. Patient M.C. was : admitted to the hospital's Intensive Care Unit. 8. On or about March 24, 1997, Patient M C's condition deteriorated, and she expired shortly after her transfer to Baptist Hospital. | NCTE — Teg “= ROTRRE~tennr omen paperenmmnmennmrmenT EE Peer ors 9. Respondent's medical records do not document the results of the diagnostic tests that were ordered, and fail to justify Respondent's discharge of Patient M.C. on or _ about March 21, 1997, « f+ 10. Based on Patient M.C’s symptomis and the EKG, a reasonably prudent similar physician would have admitted Patient M.C. to the hospital on or about March 21, ‘1997, : for further evaluation and treatment for a potential cardiac problem. C NE 11. Petitioner realleges and incorporates paragraphs one (1) through ten (40), . a _as if fully set forth herein this Count One. ; 12. Respondent failed to keep written medical records justifying the course of treatment of Patient M.C., in that Respondent's medical records: fail to document the results of the diagnostic tests that were ordered; and fall to justify Respondent's discharge of Patient M.C. on or about March 21, 1997. 13. Based on the foregoing, Respondent violated Section 458.331(1)(m), Florida Statutes, by falling to keep written medical records justifying 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. - COUNT TWO 14. Petitioner realleges and Incorporates paragraphs one 0) tioigh ten (10) and paragraph twelve (12) as if fly set forth rein this Count Two. REE ree We peers eee ere genet ape eee pepe pn one meee _ 415. Respondent practiced’ medicine below the standard of care, In that Respondent: failed to interpret the EKG adequately; failed £6 recognize Patient M.C’s acute cardiac disease; and failed t6admit Patient M.C. to the hospital on or about March 21, 1997, for further evaluation and treatment for a potential cardiac problem. 16. Based on the foregoing, Respondent has violated Section 458,331(1)(t), Florida Statutes, by failing to practice medicine with that fevel of care, skill, and | treatment which Is recognized by a ‘reasonably prudent similar physician as being ; acceptable under similar conditions and circumétances.. ra : 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 land 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 AiMA_ day of —QuyA___. 2000. Robert G. Brooks, M.D., tary Kathryn L. Kasprzak Chief Medica! Attorney arta eer sae aE =o Pm can fae" oem EE eH: COUNSEL FOR DEPARTMENT - Kathryn L. Kasprzak Chief Medical Attorney « “> --- Agency for Health Care Administration P. O. Box 14229 Tallahassee, Florida 323 17-4229 Florida Bar #0937819 Kik/jet/nrb PCP: August 28, 2000 _ > PCP Members: Cerda, El-Bahri, Rodriquez

Docket for Case No: 00-005105PL