me Jeb Bush John O. A Governor a if th i at March 12, 2003 The Honorable Larry J. Sartin Division of Administrative Hearings The DeSoto Building 1230 Apalachee Parkway Tallahassee, Florida 32399-1550 RE: DOH v. Henry A. Villegas, M.D. “ DOH Case Number 2000-00760 if > chore DOAH Case Number 01-1480PL 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) 414-8126. Sincerely, gerne Toone ~Taverne Thomas, Compliance Officer for Bruce A. Campbell, Senior Attorney LT Enclosure 4052 Bald Cypress Way « Bin C-65 » Tallahassee, FL 32399-3265 Final Order No. DOH-03-0121-_S -MQA FILED DATE - 2. STATE OF FLORIDA __ Department of Health BOARD OF MEDICINE - Deputy Agency letk C5 7 By: DEPARTMENT OF HEALTH, Petitioner, vs. HENRY A. VILLEGAS, M.D., Respondent . oo / FINAL ORDER THIS CAUSE came before the BOARD OF MEDICINE (Board) pursuant to Sections 120.569 and 120.57(4), Florida Statutes, on December 6, 2002, in Tampa, Florida, for the purpose of considering a Consent Agreement (attached hereto as Exhibit A) entered into between the parties in this cause. Upon consideration of the Consent Agreement, the documents submitted in support thereof, the arguments of the parties, and being otherwise fully advised in the premises, the Board rejected the Consent Agreement and offered a Counter Consent Agreement which Respondent was given 7 days to accept. By letter and explanation, dated January 15, 2003, Respondent accepted the Counter Consent Agreement . The Counter Consent Agreement incorporates the original Consent Agreement with the following amendments: 4. The fine set forth in Paragraph 2 of the Stipulated Disposition shall be increased to $10,000. 2. Within one (1) year from the date the Final Order is filed, Respondent shall document the completion of 50 hours of community service. Community service shall consist of the delivery of medical services directly to patients, without fee or cost to the patient, for the good of the people of the State of Florida. Affidavits detailing the completion of community service requirements shall be filed with the Board’s Probationer’s Committee. 3. Respondent shall receive a letter of concern from the Board. IT IS HEREBY ORDERED AND ADJUDGED that the Consent Agreement as submitted be and is hereby approved and adopted in toto and incorporated herein by reference with the amendments set forth above. Accordingly, the parties shall adhere to and abide by all the terms and conditions of the Consent Agreement as amended. | This Order shall take effect upon being filed with the Clerk of the Department of Health. a —en DONE AND ORDERED this “5 day of FEEL MMS , 2003. BOARD OF MEDICINE Hh arry McPhoefson, Jr., Executive Director endra Vijayanagar, M.D., Chair CERTIFICATE OF SERVICE I HEREBY CERTIFY that a true and correct copy of the foregoing Order has been provided by U.S. Mail to HENRY A. VILLEGAS, M.D., Interlink #1166, P.O. Box 25635, Miami, Florida 33102-5635; to Dustin P. Delany, Esquire, Conroy, Simberg, et al., 3440 Hollywood Boulevard, 2 Floor, Hollywood, Florida 33021; and by interoffice delivery to Ephraim Livingston and Pamela Page, Department of Health, 4052 Bald Cypress Way, Bin #C-65, Tallahassee, Florida 32399-3265 this 17 1 day of Fema , 2003. ; . JcT go 2002 3: 13 JAM FR. CONROYs SIMBERG» GANOH439617912 TO s22280173720 1850 F. 03785 . — 30594 WwURY Ure Garou TY pocouurrgrcRalis r ~ STATE OF FLORIDA DEPARTMENT OF HEALTH DEPARTMENT OF HEALTH, - Petitioner, Vv. DOH Case No. 2000-00760 HENRY A. VILLEGAS, M.D.,. Respondent. CONSENT AGREEMENT Henry A. Villegas, 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 i in this mattar. 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. STIPULATED FACTS 1. At all times material hereto, Respondent was a licensed physician in the State of Florida having been issued license number ME 0045980. 2. Respondent was charged by an Administrative Complaint filed by the Department and properly served upon 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 ia) 737281850 | re 64702 cT ge 2002 3213 J Ar FR, CONROY: SIMBERS Beene eee TPE J aoe eRe Swatt re 30595 3. Respondent neither admits nor denies the allegations of fact contained in the Administrative Complaint for purposes of these proceedings only. STIPULATED CONCLUSIONS OF LAW . 1. Respondent admits that, in his capacity as 2 licensed physician, he is subject to the provisions of Chapters 456 and 458, Florida Statutes, and the jurisdiction of the Department and the Board. 2, Respondent admits that the facts that gave rise to this case, if proven, would constinute violations of Chapter 458, Florida Statutes. 3. " Respondent admits that the Stipulated Disposition in this case is fair, appropriate and acceptable to Respondent. , sup ULATED DISPOSITION 4, EUTURE:CONDUCT. Respondent shall riot n the future violate Chapters 456, 458 and 893, Florida Statutes, or the rules promulgated pursuant thereto. Prior to signing this agreement, Respondent read Chapters 456 and 458, Florida Statutes, and the Rules of the Board of Medicine; at Chapter 6488, Florida Administrative Code. 2. FINE. The Board shall impose an administrative fine in the amount of two thousand five hundred dollars ($2,500.00) against Respondent. The fine shall be paid by Respondent to the Board of Medicine within ST (6) months of jts imposition by Final Order of the Board. RESPONDENT ACKNOWLEDGES THAT THE TIMELY PAYMENT OF THE FINE IS HIS LEGAL OBLIGATION AND RESPONSIBILITY AND RESPONDENT AGREES TO CEASE PRACTICING IF THE FINE IS NOT PAID AS AGREED TO IN THIS CONSENT AGREEMENT, SPECIFICALLY: IF RESPONDENT oct 38) 2002 | ot Axe ohh, FR CONROY» SIMBERG » GANON4361 7312 TO 5222H017372R 1850 Pe a5783 WAY ENS ENDEROT ONIN sorborr tu pocovM rarenaiio Fe 30596 HAS NOT RECEIVED WRITTEN CONFIRMATION THAT THE FULL AMOUNT OF THE FINE HAS BEEN RECEIVED BY THE BOARD OFFICE WITHIN SIX (6) MONTHS OF THE FILING/OF THIS FINAL ORDER, RESPONDENT AGREES TO: CEASE PRACTICE UNTEL SUCH WRITTEN CONFIRMATION IS RECEIVED BY RESPONDENT FROM THE: BOARD. (SEE ‘EXHIBIT B, PARAGRAPH E OF THIS CONSENT AGREEMENT. FOR BOARD ADDRESS AND STANDARD TERMS). 3. CONTINUING:MEDICAL EDUCATION. Respondent shall attend ten (10) hours of Category I Continuing Medical Education courses in the area of Pediatric Emergency care. Respondent shall submit a written plan to the Chairman of the Probation Committee for course approval prior to the completion of said courses. In addition, Respondent shall submit documentation of completion of these courses in his required reports. These hours shall be in addition to those hours required for renewal ; of licensure. Unless otherwisé approved by the Board or the Chairman of the Probation Committee, said courses shall consist of a formal live lecture format. 4. 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. The agreed upon Agency cost to be reimbursed in this case is an amount agreed between the parties to be the total liability of Respondent, despite actual costs in excess of this amount. ‘The agreed costs are seven thousand dollars. ($7,000.00). The costs shall be paid by the Respondent to the Board of Medicine within CT 3B 2802 30597 ONE (1) year of its imposition by Final Order of the Board or such time as is set by the Board at the time of its consideration of this matter. THE RESPONDENT ACKNOWLEDGES THAT THE TIMELY PAYMENT OF THE COSTS IS HIS 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 ONE YEAR (OR . SUCH TIME AS IS SET BY THE BOARD AFTER CONSIDERATION OF THIS MATTER) 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.) 5. MITIGATING FACTORS: In arriving at this disposition the parties considered the following mitigating factors: Respondent is a physician with no prior discipline, under no “legal restraints” as that tetm is used In Rule 64B8-8.001, FAC, who cooperated in the investigation of this matter, 6. It is expressly understood thet this Agreement is subject to the approval of the Board and the Department. 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. 3:13 AM FR CONROY. SINBERG, GANGN49517912 TO S222"O17372"1850 F-26728 ee ie eet ermine ave we ; SUP emens 3 Ve ERG. GANON4SSBi7912 TO S222Ra17372H1B850 P.ervag OCT 90, 2002 a7 13 lan FR en B BEpsconnon sorcarr bu jucoruifsreaysio r.uy . 30598 7. Respondent. shal! appear before the Board at the meeting of the Board ~ where this Agreement is considered. Respondent, in conjunction with the consideration of this Agreement by the Board, shall respond to questions under oath from the Boa rj ~ Board Staff or Department Staff, Respondent shall be prepared to explain the circumstances involved in this matter and what measures have been taken to prevent a recurrence. However, Respondent shall offer no evidence, testimony or argument that disputes or contravenes any stipulated fact or conclusion of law. 8. Should this Agreement be rejected, no statement made in furtherance of this Agreement by Respondent may be used as direct evidence against Respondent in any proceeding; however, such statements may be used by the Petitioner for impeachment purposes. . — . 9. Respondent and'the Department fully understand that this joint Agreement 7 and subsequent Final Order- incorporating same will in no way preclude additional . proceedings by the Board or the Department against Respondent for acts or omissions not specifically set forth in the Administrative Complaint. 10. 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. oe 11. Respondent waives the right to seek any attorney's fees or costs from the Department in connection with this matter. 3 ‘ 3 449617912 TO S222n017397281858 P.e87a3 OCT 36.2002 3:14 AM FR CONROY» SIMBERG, GANO? 2322 ver <3 cuue abtcia noe GUNKRYUT OS IMIBE RG TBHNUN ybry 30599 12. This Agreement is executed by Respondent for the purpose of avoiding further administrative action’ with respect to this quse. In this regard, Respondent authorizes the Board to review and examine. all investigative file materials conceming 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 Hegally prejudice the Board or any of its members from further participation, consideration or resolution of these proceedings. PeCcUAVMI (CS feRUILID FOF Neen eee en ne reeTEEE SITE Sinn nestonsenne samme een nae nace! ‘ : . : 9cT 90° 2002 3:14 AM FR Cot SY, SIMBERG, GANON4S617912 TO 22nai7a72k1esea P.e9vag- . Ge Ew Ue Fete tee ee oe 2 SELLE LA ae ont SIGNED this 23 day of OCTOBER 2002. . ey HENRY #. VILLEGAS,@1.D. STATE OF FLORIDA RPepvelhe oF Costa Bien: COUNTY OF SAN CARLOS ; Before me, personally appeared HEN Albttere Utleas whase identity is Known to me by _ SOA ¥2, eats (type of identification) and . who, under oath, acknowledges that his/her signature appears above. - Sworn to and subscribed before me this 22.3 da My Commission expires: do ae expires” BBOGADAY ROTASIA : APPROVED this Gay of Mopreete 2002. oe John Agwunobi, M.D. . : Secretary, Department of Health Mrs S- By: Wings S. Benton Deputy General Counsel 30600 EXHIBIT B STANDARD TERMS APPLICABLE TO CONSENT AGREEMENTS | The following are the standard terms applicable to all Consent Agreements, Woes including supervision and monitoting provisions applicable to licensees on probation. A. all fines shall be paid by check or money order and sent to the Board address set forth In paragraph E, below. The Board office does not have the authority to change the terms of - ‘payment of any fine imposed by the Board. B. otherwise directed by the Consent Agreement, any 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 IMPOSING . SUCH REQUIREMENTS. Cc ADDRESSES. Respondent must keep current residence and practice addresses on file with the Board, Respondent shall notify the Board within ten (10) days of any changes of sald addresses. Furthermore, If Respondent's license is on probation, Respondent shall notify the Board within ten (10) days in the event that Respondent leaves the active practice of medicine in Florida. D. COSTS. Pursuant to Section 458.331(2), Florida Statutes, Respondent shall pay all costs necessary to comply with the terms of this Consent Agreement. Such costs include, but are not limited to, the costs of preparation of Investigative Reports detalling PAYMENT OF FINES. Unless otherwise directed by the Consent Agreement, ©. COMMUNITY SERVICE AND CONTINUING EDUCATION UNITS. Unless . 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 costs - Giredty. associated with Respondent's probation. E, BOARD ADDRESS: Unless otherwise dracted by the Board office, all fines, 7 reports, correspondence and inquiries shail be sent to: Board of Medicine, Client Services Unit, 4052 Bald Cypress Way, Bin # C03, Tallahassee, Florida 32300- . 1753, Attn: Medical Compliance Officer. 30602" ° 30603 STATE OF FLORIDA _ DEPARTMENT OF HEALTH DEPARTMENT OF HEALTH, - ) PETITIONER, } : v. } CASE NO. 2000-00760 HENRY A. VILLEGAS, M.D., } RESPONDENT. } "8 ADMINISTRATIVE COMPLAINT Av Lye COMES NOW the Petitioner, Department of Health, hereinafter referred to as “petitioner” and files this Administrative Complaint before the Board of Medicine against Henry A. Villegas, M.D., hereinafter referred to as “Respondent,” and alleges: 4... 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 in the state of Florida, having been issued license number ME 0045980. 30604 Respondent's last known address is 14711 Southwest 112" Terrace, Miami, Florida "33196. 3, Onor about January 11, 1998, Patient C.M., then an 11-year old female, presented to the emergency room of Baptist Hospital, Miami, Florida, with a three-day history of temperature up to 105, sore throat, dark brown urine with decreased urine output, and decreased appetite. Patient C.M. was currently taking Duricef, prescribed by her primary care physician, Howard G. Scott, M.D., for her sore throat two days previously. Patient CM's vital signs in the emergency room revealed her to be febrile up to a temperature of 101.5 with the admission blood pressure of 144/81, and a follow up — blood pressure of 159/94. Nurse’s notes for Patient C.M. indicate that she was - “weaving when walking,” and “slow to answer questions.” - 4. Respondent examined Patient C.M. and ordered laboratory evaluation of her urine and blood. Significant positives for the blood laboratory studies indicated a creatinine phosphokinase (CPK) of 375,000 with high limits of normal to be 269; a lactate dehydrogenase (LDH) of 10,000 with high limits of normal to be 180. Significant positive for the urine laboratory studies indicate a large amount of blood; greater than 300 milligrams per DL of protein; positive nitrates; moderate casts; and 10 to 20 red blood cells per high power field. 5. Respondent did not order any electrolyte, blood/urea/nitrogen, or creatinine studies. 6. Respondent diagnosed Patient CM. with tonsillitis and abnormal liver function. den aene mae ete eee et amtetnatinen e m cn are Benen b eamemnetbeamtint aa “3, Respondent then sent Patient C.M. home with a recommendation for increased oral fluids, bland diet and follow up with her primary physician. 8. On or about January 12, 1998 Patient CM. presented to her primary care’ “physician, Howard G. Scott, M.D. Dr. Scott examined Patient C.M.-and advised her to immediately go to the emergency room of Miami Children’s Hospital with the same previously described symptoms. Electrolyte studies of Patient C.M. were drawn which indicated a blood/urea/nitrogen level of 36 with a high limit being 22, and a creatinine of 3.4 with a high level being 1.0. 9. ‘Patient C.M. was examined and admitted to Miami Children’s Hospital by Felix Ramirez-Seljas, M.D., with a diagnosis of acute renal failure secondary to rhabdomyolis (destruction of skeletal muscle). Patient C.M. underwent three weeks of peritoneal dialysis and was discharged on February 2, 1998. COUNT ONE 40. Petitioner realleges and incorporates paragraphs one (1) through nine (9), as if fully set forth herein this Count One. 7 i. 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 sirnilar conditions ‘and circumstances in the treatment of Patient CM. © based upon one or more ‘of the following: (a) falling to recognize signs and symptoms associated with acute renal failure, including fever up to 105, hypertension, grossly bloody urine and significantly higher CPK and LDH levels; 30605 ; . ” (b) falling to perform appropriate kidney function tests such as -blood/urea/nitrogen and creatinine levels; (c) failing to refer Patient C.M. to a pediatric nephrologist, (d) failing to recognize the implications ‘of forcing fluids in a renal: Insufficient patient. 42. Based on the foregoing, Respondent 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. 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 Wersay of fot __-__. 2001. "Robert G. Brooks, M.D., Secretary DEPARTMENT OF HEALTH DEPUTY CLERK Nancy M. Snurkowski , CLEAK eli p. kenon Chief Attorney, Practitioner Regulation DATE 3/24 30607 en ns nent ch Stetina ln a ae eth men ticin Oe ee ete teh Lan ob & COUNSEL FOR DEPARTMENT: Robert Byerts Senior Attorney . Agency for Health Care Administration P, O. Box 14229 ‘Tallahassee, Florida 32317-4229 Florida Bar # 937819 KLK/rcb : PCP: March 23, 2001 PCP Members: El-Bahri, McMillin, Long

Docket for Case No: 01-001480PL