STATE OF FLORIDA DEPARTMENT OF HEALTH cont pe ee 04 SEP DEPARTMENT OF HEALTH, _ ACMIMIGTR, -- PETITIONER, Hep ieee v. CASE NO. 2002-22892 ALAN SALTZMAN, D.O., at al GK OL . (Cv ~YYD RESPONDENT. ooo ADMINISTRATIVE COMPLAINT Petitioner, the Department of Health, by and through undersigned counsel, files this Administrative Complaint before the Board of Osteopathic Medicine against Respondent, Alan Saltzman, D.O., and in support thereof states: 1. Petitioner is the state department charged with regulating the practice of osteopathic medicine pursuant to Section 20.43, Florida Statutes; Chapter 456, Florida Statutes; and Chapter 459, Florida Statutes. 2. Respondent is, and has been at all times material hereto, a licensed osteopathic physician in the State of Florida, having been issued license number OS 4113. 3. Respondent’s last known address is 5345 NW 125" Avenue, Coral Springs, Florida 33076. 4. Onor about January 2, 2002, Patient P.L., a person residing in Norwood, Massachusetts, completed a questionnaire through an Internet site and ordered ninety (90) tablets of Hydrocodone/APAP 10/500. Hydrocodone is a Schedule III controlled substance pursuant to state and federal laws and is used for the treatment of pain. 5. Onor about January 2, 2002, Patient S.M., a person residing in Statesville, North Carolina, completed a questionnaire through an internet site and ordered sixty (60) tablets of Hydrocodone/APAP 5/500. 6. On or about January 2, 2002, Patient B.P., a person residing in Monroe, Louisiana, completed a questionnaire through an internet site and ordered seventy-five (75) tablets of Hydrocodone/APAP 10/325. 7. On or about January 2, 2002, Patient T.P., a person residing in Charlotte, North Carolina, completed a questionnaire through an internet site and ordered ninety (90) tablets of Hydrocodone/APAP 10/325. 8. Onor about January 2, 2002, Patient A.W., a person residing in Lawrence, Kansas, completed a questionnaire through an internet site and ordered sixty (60) tablets of Hydrocodone 10/500. 9. Onor about January 2, 2002, Respondent issued an electronic prescription for ninety (90) tablets of Hydrocodone/APAP 10/500 to P.L. 10. On or about January 2, 2002, Respondent issued an electronic prescription for sixty (60) tablets of Hydrocodone/APAP 5/500 to S.M. 11. On or about January 2, 2002, Respondent issued an electronic prescription for seventy-five (75) tablets of Hydrocodone/APAP 10/325 to B.P. | 12. On or about January 2, 2002, Respondent issued an electronic prescription for ninety (90) tablets of Hydrocodone/APAP 10/325 to T.P. 13. On or about January 2, 2002, Respondent issued an electronic prescription for sixty (60) tablets of Hydrocodone/APAP 10/500 to A.W. 14. At all times material to this Complaint, Respondent's prescriptions for Hydrocodone were not reduced to writing and were kept in an electronic format stored on computer(s). 15. At all times material to this Complaint, Respondent did not conduct a physical examination of patients P.L., S.M., B.P., T.P., and A.W. 16. Atall times material to this Complaint, Respondent did not take the vital signs of patients P.L., S.M., B.P., T.P., and A.W. 17. At all times material to this Complaint, Respondent did not obtain a complete history of patients P.L., S.M., B.P., T.P., and A.W. 18. At all times material to this Complaint, Respondent did not adequately assess patients P.L., SM, B.P., T.P., and A.W.’s complaints and symptoms. 19. At all times material to this Complaint, Respondent did not identify and pursue the appropriate treatment plans for the conditions of patients P.L., S.M., B.P., T.P., and A.W. 20. At all times material to this Complaint, Respondent did not make diagnosis of patients P.L., S.M., B.P., T.P., and A.W. 21. At all times material to this Complaint, there was no face to face dialogue between Respondent and patients P.L., S.M., B.P., T.P., and AW. 22. On or about January 3, 2002, patients P.L., S.M., B.P., T.P., and A.W. received the vials containing the Hydrocodone from the dispensing pharmacy. COUNT I - STANDARD OF CARE 23. Petitioner re-alleges and incorporates paragraphs one (1) through twenty two (22) as if fully set forth herein. 24, Rule 64B15-14.008, Florida Administrative Code, states, in pertinent part: (1) Prescribing medications based solely on an electronic medical questionnaire constitutes the failure to practice osteopathic medicine with that level of care, skill, and treatment which. is recognized by reasonably prudent osteopathic physicians as ‘being acceptable under similar conditions and circumstances, as well as prescribing legend drugs other than in the course of an osteopathic physician's professional practice. Such practice constitutes grounds for disciplinary action pursuant to Sections 459.015(1)(x) and (t), F.S. (2) Osteopathic physicians shall not provide treatment recommendations, including issuing a prescription, via electronic or other means unless the following elements have been met: (a) A documented patient evaluation, including history and physical examination, adequate to establish the diagnosis for which any drug is prescribed. (b) Sufficient dialogue between the osteopathic physician and the patient regarding treatment options and the risks and benefits of treatment. (c) Maintenance of contemporaneous medical records meeting the requirements of Rule 64B15-15.004, F.A.C. 25. Rule 64B15-15.004, Florida Administrative Code, states, in pertinent part: (1) For the purpose of implementing the provisions of subsection 459.015(1)(0), F.S., osteopathic physicians shall maintain written legible records on each patient. Such written records shall contain, at a minimum, the following information about the patient: (a) Patient histories; (b) Examination results; (c) Test results; (d) Records of drugs prescribed, dispensed or administered; (e) Reports of consultations; and (f) Reports of hospitalizations. 26. Pursuant to Section 459.015(1)(x), Florida Statutes (2001), an osteopathic physician’s license is subject to discipline for failure to practice osteopathic medicine with that level of care, skill, and treatment which is recognized by a reasonably prudent similar osteopathic physician as being acceptable under similar conditions and circumstances. 27. Respondent failed to practice osteopathic medicine with that level of care, skill, and treatment which is recognized by a reasonably prudent similar osteopathic physician as being acceptable under similar circumstances, by doing one or more of the following: (a) by failing to perform a physical examination on patients PL, S.M., B.P., T.P., and A.W. prior to prescribing Hydrocodone; (b) by failing to obtain a complete history on patients P.L., S.M., B.P., T.P., and A.W. prior to prescribing Hydrocodone; (c) by failing to make a diagnosis or treatment plan for patients P.L., S.M., B.P., T.P., and A.W. prior to prescribing Hydrocodone; (d) by failing to reduce to writing the prescription for Hydrocodone; (e) _ by failing to take patients P.L.’s, S.M.’s, B.P.’s, T.P.’s, and A.W.'s vital signs; (f) by failing to adequately assess patients P.L., S.M., B.P., T.P., and AW-S complaints and symptoms; (g) by failing to identify and pursue the appropriate treatment plan for patients P.L., S.M., B.P., T.P., and A.W.'s condition; (h) by failing to discuss with patients P.L., S.M., B.P., T.P., and A.W. other available options for pain treatment and the side effects of Hydrocodone; (i) by prescribing medication based solely on an electronic medical questionnaire contrary to the provisions found in Rules 64B15-14.008 and 64B15-15.004, Florida Administrative Code. 28. Based on the foregoing, Respondent violated Section 459.015(1)(x), Florida Statutes (2001), by failing to practice osteopathic medicine with that level of care, skill and treatment which is recognized by a reasonably prudent similar osteopathic physician as being acceptable under similar conditions and circumstances. COUNT II- MEDICAL RECORDS 29. Petitioner re-alleges and incorporates paragraphs one (1) through twenty-two (22) and twenty-five (25) as if fully set forth herein. 30. Section 459.015(1)(0), Florida Statutes (2001), provides that an osteopathic physician’s license is subject to discipline for failure to keep medical records that justify 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. 31. Respondent failed to satisfy the minimum content requirement of medical records because Respondent failed to adequately record patients P.L., S.M., B.P., T.P., and A.W.'s medical history. 32. Respondent failed to satisfy the minimum content requirement of medical records because Respondent's records do not contain any information about examinations or test results done on patients P.L., S.M., B.P., T.P., and A.W. 33. Respondent failed to satisfy the minimum content requirement of medical records because Respondent's records do not contain any reports of consultations. 34. Based on the foregoing, Respondent violated Section 459,015(1)(0), Florida Statutes (2001), and Rule 64B15-15.004, Florida Administrative Code, by failing to keep legible, as defined by department rule in consultation with the board, medical records that identify the licensed osteopathic physician or the osteopathic physician extender and supervising osteopathic physician by name and professional title who is or are responsible for rendering, ordering, supervising, or billing for each diagnostic or treatment procedure and that justify 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 III — INAPPROPRIATE PRESCRIBING 35. Petitioner re-alleges and incorporates paragraphs one (1) through twenty-two (22) and twenty-four (24) through twenty-five (25) as if fully set forth herein. 36. Pursuant to Section 459.015(1)(t), Florida Statutes (2001), an osteopathic physician's license is subject to discipline for: prescribing, dispensing, administering, supplying, selling, giving, mixing, or otherwise preparing a legend drug, including all controlled substances, other than in the course of the osteopathic physician's professional practice. 37. At all times material to this Complaint, Respondent inappropriately prescribed Hydrocodone to patients P.L., S.M., B.P., T.P., and A.W. because Respondent: (a) (b) (c) (d) failed to perform a physical examination on Patient 3.R patients P.L., S.M., B.P., T.P., and A.W. prior to prescribing Hydrocodone; failed to obtain a complete history on patients P.L., S.M., B.P., T.P., and A.W. prior to prescribing Hydrocodone; failed to make a diagnosis or treatment plan for patients P.L., S.M., B.P., T.P., and A.W. prior to prescribing Hydrocodone; failed to reduce to writing the prescription fr Hydrocodone; (e) (g) (h) (i) failed to take patients P.L., S.M., B.P., T.P., and A.W.'s vital signs; failed to adequately assess patients P.L., S.M., B.P., T.P., and A.W.’s complaints and symptoms, failed to identify and pursue the appropriate treatment plan for patients P.L., S.M., B.P., T.P., and A.W.'s condition; failed to discuss with patients P.L., S.M., B.P., T.P., and A.W. other available options for weight loss and the side effects of Hydrocodone; prescribed medication based solely on an electronic medical questionnaire contrary to the provisions found in Rules 64B15-14.008 and 64B15-15.004, Florida Administrative Code. 38. Based on the foregoing, Respondent violated Section 458.331(1)(t), Florida Statutes (2001), by inappropriately prescribing Hydrocodone to patients P.L., S.M., B.P., T.P., and A.W. other than in the course of the osteopathic physician’s professional practice. WHEREFORE, Petitioner respectfully requests that the Board of Osteopathic Medicine enter an order imposing one or more of the following penalties: permanent revocation or suspension of Respondent’s license, restriction of practice, imposition of an administrative fine, issuance of a reprimand, placement of the Respondent on probation, corrective action, refund of fees billed or collected, remedial education and/or any other relief that the Board deems appropriate. SIGNED this_23°° day of Feber aed 2004. John O. Agwunobi, M.D., M.B.A. Secretary, Department of Health Florida Bar No. 647871 DOH Prosecution Services Unit 4052 Bald Cypress Way, Bin C-65 Tallahassee, FL 32399-3265 850.410-3466 850.414.1991 FAX Reviewed and approved by: _@?c_. (initials) 121'5/03 (date) pcp; Feb- 26, 2oatt PCP Members: Wg pdt arckrren Alan Saltzman, D.O., DOH Case No. 2002-22892 Alan Saltzman, D.O., DOH Case No, 2002-22892 04 SEP 28 AMII: 53 DIVISION . Respondent has the right to request a hearingAGOINBERA! conducted in accordance with Section 120.569 and 120.87/NGS Florida Statutes, to be represented by counsel or other qualified representative, to present evidence and argument, to call and cross-examine witnesses and to have subpoena and subpoena duces tecum issued on his or her behalf if a hearing is requested. NOTICE OF RIGHTS bo NOTICE REGARDING ASSESSMENT OF COSTS Respondent is placed on notice that Petitioner has incurred costs related to the investigation and prosecution of this matter. Pursuant to Section 456.072(4), Florida Statutes, the Board shall assess costs related to the investigation and prosecution of a disciplinary matter, which may include attorney hours and costs, on the Respondent in addition to any other discipline imposed.

Docket for Case No: 04-003495PL