Received Event (Event Succeeded) Date: é | : SR AR SARA Pages: Remote CSID: 850 414 1989 SEP-@6-2001 16:22 AHCA/LEGAL MEDICAL 858 414 1989 5 RY qe EPARTMENT OF HEALTH, £)QSEPH P. MAGRE, M.D., Complaint before the Board of Medicine (the Board) against Joseph P, Magre,’ M.D. (Respondent) and alleges: medicine pursuant to -gortracted with the Agency for Health Care Administration to provide consumer _ Quality Assurance, councils, or boards, as appropriate, 9/6/01 Time: 4:21 PM 23 Sender: 850 414 1989 SARE pe Raat He A _ STATE OF FLORIDA DEPARTMENT QF HEALTH PETITIONER, (CASE NO. 1999-57862 RESPONDENT. Lorre COMES NOW the Department of Health {Petitioner) and files this Administrative 1, Petitioner is the state agency charged with regulating the practice of Section 20.43 and Chapters 456 and 458, Florida Statutes. Pursuant to the provislons of Section 20,43(3)(9), Florida Statutes, the Petitioner has complaint, investigative, and prosecutorial services required by the Division of Medical coer ere ETT FROMM A oe a es RMT orn Re on wee CRT ORE eR Date: Pages: Remote CSID: 850 414 1989 ee | Received Event (Event Succeeded) 9/6/01 Time: 4:21 PM 23 Sender: 850 414 1989 SEP-@6~-2081 16:22 AHCAYLEGAL MEDICAL 958 414 1989 . 2 Respondent is and has: been at all times material hereto a licensed phiatcan in the state of Florida, having been issued license number ME0024401. Respondents last known address Is P.O. Box 3167, St. Augustine, Florida 32085-3167. 3. Respondent Is board certified In surgery. 4, On or about June 5, 1992, Patient B.H., a 48 year old female, presented to | Respondent at Flagler Hospital (the hospital) in St. Augustine, Florida, and Respondent ipettormed surgaty on Patient BH. to remove her galibladder. , 5. During the surgery, Respondent inserted a Jackson-Pratt surgical drainage tube in the indsion in Patient B.H.'s abdomen after removing the gallbladder. The (surgical drain is used to draw off fluids from the abdomen. Patient BH. was discharged “OR OF about June 13, 1992, In good general condition, but her medical records do not “mention the removal of the surgical drain from the Inclston prior to discharge. 6. On or about November 5, 1996, Patient 8.H, presented to Flagler Hospital. = Emergency Room complaining of severe pain in her abdomen along the right flank, % i . : _ faith ‘che paln having been present for about three (3) weeks, An xcray of Patlent B.H’s. : : abdomen showed what appeared to be a surgical drain in the right upper quadrant of the abdomen. Patient B.H. was refcrred to the Respondent. 7. On or about November 6, 1996 Patient B.H. presented to Respondent in ‘his office. Respondent examined Patient BH. and found her abdomen to be bulging “ahd tender. - Under focal anesthesia, Respondent made an Incision in Patient B.H/s PRE ERE Tr MRE OTR REAR oer rer T OEE REE TERR er me =~ £ * Received Event (Event Succeeded) Date: i Pages: SEP-86~2081 16:23 AHCAYLEGAL MEDICAL 858 414 1989 Remote CSID: ——— 9/6/01 Time: 4:21 PM 23 . Sender: 850 414 1989 850 414 1989 ‘abdomen, explored the area with his finger, found what felt like the surgical drain, then vfemoved the Grain from Patient B.H.'s abdomen. ra 8. ‘After the surgery ta remove the drain from Patlant B.H.'s abdomen, Respondent made a handwritten note in his office files describing the surgery. He “noted he did not tell the patient about the surgical drain or the surgery to remove the “spnroval.” ~ drain because the patient seemed emotionally upset, Respondent wrote at the top of _ the handwritten note “STRICTLY CONFIDENTIAL Not to be sent out without my ‘ 9. Respondent did not inform Patient B.H. that there was a surgical drain iside her abdomen. 10. Respondent did not document in Patient B.H.'s written medical records the * exct that he Informed Patient B.H. that there was a surgical drain Inside her abdomen. 11, Respondent did not inform Patient B.H. that one reason she needed : surgery on or about November 6, 1996, was because Respondent had {eft a surgical "| drain Inside her abdomen during a prior surgery in 1992. ! 12. Respondent did not document in Patient B.H’s written medical records the - .. fact that he informed Patient &.H, that one reason she needed surgery on or about ” November 6, 1996, was because Respondent had left a surgical drain Inside her’ } abdomen during a prior surgery in 1992. 13. Respondent did not obtain Patient B.H.'s informed consent prior to the "surgery performed November 6, 1996, to remove the drain from her abdomen. Te oon RR Si cemcataduaemameathasadl depmacacace cRteieee ait Fee ORR ARE CRETE CTR CERI tan Date: Pages: Received Event (Event Succeeded) ot Time: 4:21 PM Sender: 850 414 1989 * Remote CSID: 850 414 1989 hn RE SAN SAR NORMAN! EE IN ARR es eae SEP-B6-2001 16:23 RHCA/LEGAL MEDICAL 858 414 1989 14. Respondent did not document in Patient 8.4/5 written medical records the fact that he obtained Patient B.H.s informed consent prior to the surgery to remove the - ‘ srgical drain performed November 6, 1996. 15. After removing the drain in his office, Respondent reexamined Patient BH. “and found that her abdominal pain and swelling persisted. Respondent admitted — Patient B.H. to the hospital on or about November 6, 1996, and sha was taken to the “hospital operating room where Respondent performed surgery to drain the abcess on ber abdominal: wall, 16. Patlent B.H. recovered after the abdominal surgery and was eventually ischarged from the hospital on or about November 12, 1996. . 17. Respondent did not document in Patient B.H2s written hospital records each as the history and physical examination, operative report, or discharge summary : the fact that he removed a surgical drain from Patient B.H.s abdomen, : 18. Respondent did not document in Patient B.H’s written hospital records such as the history and physical examination, operative report, or discharge summary : ; Was a factor in the patient's condition. COUNT ONE 19. Petitioner realleges and Incorporates paragraphs one (1) through eighteen (18), as if fully set forth herein this Count One. : : thie fact that the surgical drain left inside the patient's abdomen during surgery In 1992 2 reese TOPCO RRR + STORET epee EO Se REMERON ETE Pn Received Event (Event Succeeded) Date: 9/6/01 Time: 4:21 PM Pages: 9 23 Sender: 850 414 1989 Remote CSID: 850 414 1989 H i i : e . SEP-86-2001 16:24 AHCA/LEGAL MEDICAL 856 414 1989 20. Respondent failed to practice medicine with that level of care, skill, and ‘Yeatment which Is recognized by & reasonably prudent similar physician as being ‘depeptable under similar conditions and circumstances, in that Respondent failed to do get : one or more of the following: (a) Inform Patient B.H. that there was & surgical drein inside her abdomen; (b)inform Patient B.H. that one reason she needed surgery on or about November 6, 1996, was because Respondent had left a surgical dreln Inside her abdomen during a prior surgery in 1992; (c) obtain Patient B.H’s Informed consent ptior to the surgery performed November 6, 1996, to remove the drain fram her abdomen; or (d) use a hospital operating room to perform surgery to remove the drain from Patient. B.H’s abdomen on or about November 6, 1996, rather than performing the surgery in Respondent's office. 21. Based on the foregoing, Respondent violated Section 458.331(1Xt), i i & & ; : Florida Statutes, by committing gross or repeated malpractice or by falling to practice "medicine with that level of care, skill, and treatment which Is recognized “by 3 reasonably prudent similar physician as being acceptable under similar conditions: end *, Circumstances. LUBE Hee oir Fe AN A be ABB ‘ I SMe HEEB BRE Oe PIE AR EE Received Event (Event Succeeded) Date: Pages: ad Time: 4:21 PM Sender: 850 414 1989 Remote CSID: 850 414 1989 “3 authorized by the patient or cllent, SEP-86-2081 16:25 RHCA/LEGAL MEDICAL 85@ 414 1989 : COUNT TWO 22. Petitioner realleges and incorporates paragraphs one (1) through eighteen - a, and paragraph twenty (20), as if fully set forth herein this Count Two. 23. Respondent performed professional services which had not baen duly or his or her legal representative, in that Respondent — en by the patient or client, ‘performed surgery on Patient 8.H, on or about N ain from her abdomen without first obtaining the patient’s informed consent. lovember 6, 1996, to remove & surgical 24. Based on the foregaing, Respondent violated Section 458,331(1})(p),