2 RRL BE RG Rie cae abit “Regal D. Dixo RDDMad oem a ee Sn emi aid STATE OF FLORIDA i a. fy, Cg 7 ef AGENCY FOR HEALTH CARE ADMINISTRATION Eo ” fe JEB BUSH, GOVERNOR DR. RHONDA M aEpowss' SECRETARY” “Olt, ty a September 11, 2001 Ms. Sharyn L. Smith Director and Chief Judge Division of Administrative Hearings The Desoto Building 1230 Apalachee Parkway Tallahassee, Florida 32399-1550 Re: DOH vs. Charles Bolick, Case Number: 01-06210 Dear Ms. Smith: 0 / IS 7 7 4. (a Pursuant to Section 120.57(1), Florida Statutes, please find enclosed two (2) copies of the Agency’s Administrative Complaint in the above-referenced case. Also enclosed are two (2) copies of the Election of Rights form submitted by the Respondent. Counsel does not currently represents the Respondent. 59 SW Hideaway Place, Stuart, Florida 34994 is the Respondent’s current address. Please assign an Administrative Law J udge to conduct formal proceedings pursuant to Section 120.57(1), Flertda Staputes- i Senor Attorney 2727 Mahan Drive « Mail Stop #34 8 Visit AHCA Online at Tallahassee, FL 3230 www fdhe.state fl.us SSE ORME STATE OF FLORIDA DEPARTMENT OF HEALTH DEPARTMENT OF HEALTH Petitioner, vs. . Case No. 2001-06210 CHARLES BOLICK, R.N., Respondent. / ADMINISTRATIVE COMPLAINT COMES NOW, Petitioner, DEPARTMENT OF HEALTH, by and through its undersigned counsel and files this administrative complaint before the Board of Nursing against the Respondent, ‘CHARLES BOLICK, R.N., and in support thereof alleges: 1. Petitioner is the state agency charged with regulating the practice of nursing pursuant to Chapters 20, 456, and 464, Florida Statutes. 2. Pursuant to the authority of Section 20.43(3)(g), Florida Statutes, _. the Petitioner has contracted with the Agency for Health Care Administration to. - provide con : . plaint, investigative and prosecutorial services required by Sea aa aaa nr ARRON AR the Division. of Med including the issuance of emergency orders of suspension or restriction. 3. Respondent is and has been at all times material hereto, a licensed REGISTERED NURSE in the State of Florida, having been issued license number RN 17971 52. AM em SSS TR EAS ete eA a Lt seems 4, Respondent's last known address is 1105 NE Ixora Drive, Jensen Beach, Florida 34957-6117 and/or 59 SE Hideway Place, Stuart, Florida 34994. 5. On or about December 2000, Respondent was employed by All About Staffing, a temporary staffi ing agency, and assigned to work at Raulerson Hospital located at 1797 Highway 441 North, Okeechobee, Florida 34972, as a temporary nurse in the Post Anesthesia Care Unit (“PACU”). 6. While assigned to work a Raulerson Hospital, Respondent was responsible for providing all aspects of nursing care to patients, including the administration of controlled substances, 7. An audit of Respondent's documentation of withdrawal and administration of controlled substances revealed discrepancies in Respondent's handling of controlled substances, Including but not limited to: . a. ‘On or about 12120100, at approximately 8:40 a.m., Respondent ~~ “signed out 100 mg. of Demerol for patient T.H.; Respondent did not document administering the Demero! to patient T.H. or wasting the Demerol. b. "On or about 12/20/00, at approximately 41: 10 am., / Respondent signed out 100 mg. of Demerol for Patient B.J; ~ Respondent documented administering 25 mg. of the Demerol ‘to patient B.J., but d hot document administering or wasting the remaining 75 mg. ofD Demerol. _ On or about 12/20/00, at approximately 2:30 p.m., Respondent signecl out 100 mg. of Demerol! for patient R.K; Respondent did not document administering the Demero! to patient R.K. or wasting the Demerol. a. Se - substances that was ir d. On or about 12/21/00, at approximately 11:15 a.m., Respondent signed out 100. mg. of Demerol for patient W.E; There is no documentation that Respondent administered the Demerol to patient W.E. or wasted the Demerol; The medical records reflect that at approximately 11:10 a.m. no acute distress was noted with patient W.E. and in fact, Patient W.E. was discharged at approximately 11:25 a.m. e. On or about 12/26/00, at approximately 11:30 a.m., Respondent signed out 100 mg. of Demerol for patient P.E.; Respondent did not document administering the Demerol to patient P.E. or wasting the Demerol; The medical records reflect that at approximately 11:25 a.m. patient P.E. was sleeping and that at approximately 11 35 a. m. patient P.E. was _ ~ awake and denied any pain. 8. Demerol is a Schedule II controlled substances pursuant to Chapter 893, Florida Statutes. A substance in Schedule II has a high potential for abuse and has a currently accepted but severely restricted medical use in treatment i in... the United States, and abuse of the substance may lead to severe psychological - or physical dependence. inimal acceptable Standards of Prevailing hursing practice as be 9. The “define ned by Rule 6489-8 0051, Florida Administrative Code, require that anurse accurately 4 contro led ‘substances, and | accurately document. nt_the nded for a . patient, but was s wasted instead. Inaccurate documentation of the administration of controlled substances poses a danger to Ei (ETE aie tl se SM OTR a eo et ms patients, in that it may lead to patients receiving too much or too little of the necessary physician ordered medication. 10. A nurse’s removal of controlled substances for administration to . patients and the subsequent failure to accurately document administering or wasting the controlled substances is a strong indication that a nurse is diverting those controlled substances for his or her own personal use. 11. On or about December 29, 2000, Respondent was referred to the Intervention Project for Nurses (“IPN”), by Gail Gerntrup, BSN, R.N., his supervisor at Ail About Staffing. 12. The IPN program acts as a consultant to the Agency pursuant to Section 456.076, Florida Statutes, for the evaluation and treatment of impaired practitioners. IPN ‘Monitors treatment, if appropriate, conducts random drug screens, and Provides for exchange of information for impaired practitioners among the treatment programs, IPN, the Agency, and the Department. 13. Respondent entered into a monitoring contract with IPN, but dia not follow through | with the monitoring requirements and v was ; dismissed from IPN on ora around June ee 2001. AS Respondent is not currently being monitored by fe ty xpected and required of of licensed nurses in the State of Florida, ~ Count | 14. Petitioner re-alleges and incorporates by reference the allegations of fact contained in paragraphs one (1) through thirteen (13) as if fully stated herein. 15. Based upon the foregoing findings of fact, the Respondent's licensé is subject to discipline pursuant to Section 464.018(1)(j), Florida Statutes, for being unable to practice nursing with reasonable skill and safety to patients by reason of illness or use of alcohol, drugs, narcotics, chemicals, or any other type of material or as a result of any mental or physical condition. . Count I! 16. Petitioner re-alleges and incorporates by reference the allegations of fact contained in paragraphs one (1) through thirteen (13) as if fully stated herein. 17. | Based upon the foregoing findings of fact, the Respondent's license is subject to discipline pursuant to Section 464.018(1)(h), Florida Statutes, by failing to conform to the minimal acceptable Standards of prevailing nursing practice by violation Rule 6489-8. 00(1), Florida Administrative Code, by inaccurate recording, altering or falsifying patient records. Count Ill 18. Petitioner re-alleges and incorporates by reference the allegations of wets. fact. contained i in in paragrephs one et) through thirteen ¢) 3) as if fully Stated herein, 19 controlled substances under chapter 893 for other than legitimate purposes. WHEREFORE, Petitioner respectfully request that the Board of Nursing enter an Order imposing one or more of the following penalties: Revocation or suspension of Respondent's license, imposition of an administrative fine, ing fi indings of fact, the Secretary concludes A that . Respondent is in violation of Section A64 o18(t), Florida Statutes, by oo pting to engage in the | possession, sale or distribution of Ie issuance of a reprimand, placement of the Respondent on probation, costs, and/or any other relief that the Board deems appropriate. Signed this ZEN tay of Robert G. Brooks, M.D. , 200/ Secretary, Department of Health Nancy Snurkowski, hief Attomey On Behalf of the Agency for Health Care Administration Reginald [D4Dixon, Senior Attorney FBN: 0113925 Agency for|Health Care Administration Allied Health Section Post Office Box 14229 Tallahassee, Florida 32317-4229 (850) 414 - 8576 ips COUNSE| spr THE PETITIONER: RDD/rd Por NG uns FILED DEPARTMENT. OF HEALTH D CLERK é paTe__G//of___ Sema er pee one

Docket for Case No: 01-003597PL