STATE OF FLORIDA DEPARTMENT OF HEALTH myoen em ee ad Oh SEP 28 AMIE SI DEPARTMENT OF HEALTH, yin PETITIONER, : v. CASE NO. 2002-18568 ALAN SALTZMAN, D.O., iy d 2 4 ] ( L- RESPONDENT. ee 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 t 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, On June 27, 2002, Patient J.R., an employee of the Federation of State Medical Boards, completed a questionnaire through an Internet site known as pillstore.com (“Internet site”). +» 5, Atall times material to this Complaint, Patient J.R. informed the Internet site that he had not completed a physical exam with blood tests within the last year, that he was six (6) feet tall and weighed one-hundred eighty five (185) pounds. 6. On June 27, 2002, Patient J.R. ordered ninety (90) pills of 120 mg Xenical Capsules. Xenical is a legend drug pursuant to state and federal jaw and it is used in the treatment of obesity. 7. On June 27, 2002, Respondent approved the order of Xenical placed by Patient J.R. 8. On or about June 27, 2002, Respondent issued an electronic prescription for Xenical. The prescription for Xenical was transmitted electronically to the dispensing pharmacy. 9, At all times material to this Complaint, Respondent's prescription for Xenical was not reduced to writing. | 10. At all times material to this Complaint, Respondent did not conduct a physical examination of Patient J.R. 11. At all times material to this Complaint, Respondent did not take the vital signs of Patient J.R. . 12, At all times material to this Complaint, Respondent did not obtain a complete history of Patient J.R. 13. At all times material to this Complaint, Respondent did not adequately assess Patient J.R.’s complaints and symptoms. 14, At all times material to this Complaint, Respondent did not identify and pursue the appropriate plan and treatment for the condition of Patient J.R. i5. At all times material to this Complaint, Respondent did not make a diagnosis of Patient J.R. « 16. At all times material to this Complaint, there was no dialogue between Respondent and Patient J.R. 17. At all times material to this Complaint, Respondent did not discuss with Patient J.R. the other available options for weight loss and did not inform Patient J.R. of the potential side effects of Xenical. : 18. The prescription for Xenical was filled and dispensed by Ancona Drug Solutions (“Ancona”), 1450 N. US Highway 1, Suite 400, Ormond Beach, Florida 32174. » 19, On or about July 2, 2002, Patient J.R. received a vial from Ancona containing the Xenical Capsules. The label on the vial identified Respondent as the prescribing physician. COUNT I - STANDARD OF CARE BYYVIN! 2 OV ae eee eee eee 1) 20. Petitioner re-alleges and incorporates paragraphs one (1) through nineteen (19) as if fully set forth herein. 21. 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. 22. 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. 23. 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. 24, 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 Patient J.R. prior to prescribing Xenical; (b) by failing to obtain a complete history on Patient J.R. prior to prescribing Xenical; | (c) by failing to make a diagnosis or treatment plan for Patient J.R. prior to prescribing Xenical; (d) by failing to reduce to writing the prescription for Xenical; (e) _ by failing to take Patient J.R.’s vital signs; (f) by failing to adequately assess Patient J.R.’s complaints and symptoms; (g) by failing to identify and pursue the appropriate treatment plan for Patient J.R.’s condition; (h) by failing to discuss with Patient J.R. other available options for weight loss and the side effects of Xenical; (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. “25. 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 * 26, Petitioner re-alleges and incorporates paragraphs one (1) through nineteen (19) and twenty-two (22) as if fully set forth herein. 27. 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. i, 28. Respondent failed to satisfy the minimum content requirement of medical records because Respondent's records failed to record Patient J.R.’s medical history. . 29. Respondent failed to satisfy the minimum content requirement of medical records because Respondent’s records to not contain any information about examinations or test results done on Patient J.R. « 30. Respondent failed to satisfy the minimum content requirement of medical records because Respondent’s records to do not contain any reports of consultations. i 31. 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 32. Petitioner re-alleges and incorporates paragraphs one (1) through nineteen (19) and twenty one (21) through twenty two (22) as if fully set forth herein. 33. Pursuant to Section 459.015(1)(t), Florida Statutes (2001), an osteopathic physician’s license is subject to discipline for: prescribing, dispensing, supplying, selling, or giving a legend drug other than in the course of the osteopathic physician's professional practice. 34, Pursuant to Section 459.015(1)(t), Florida Statutes (2001), it is legally presumed that inappropriately or in excessive or inappropriate quantities is not in the best interest of the patient and is not in the course of the osteopathic physician’s professional practice, without regard to his or her intent. +, 35. At all times material to this Complaint, Respondent inappropriately prescribed Xenical to Patient J.R. because Respondent: (a) failed to perform a physical examination on Patient J.R. prior to prescribing Xenical; (b) _ failed to obtain a complete history on Patient J.R prior to prescribing Xenical; (c) (d) (e) (f) (9) (h) (i) failed to make a diagnosis or treatment plan for Patient J.R. prior to prescribing Xenical; failed to reduce to writing the prescription for Xenical; failed to take Patient J.R.’s vital signs; failed to adequately assess Patient J.R.’s complaints and symptoms; failed to identify and pursue the appropriate treatment plan for Patient J.R.’s condition; failed to discuss with Patient J.R. other available options for weight loss and the side effects of Xenical; 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. » 36. Based on the foregoing, Respondent violated Section 458.331(1)(t), Florida Statutes (2001), by inappropriately prescribing Xenical to Patient J.R. 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 93° day of _Febwary , 2004. John O. Agwunobi, M.D., M.B.A. Secretary, Department of Health aie [i DEPAS yest oxenileadbaen AS ma DATE alaszlot 4 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: O72 _(initials) his o> (date) PCP: Fb. lw, 200% PCP Members: Hanke arkrres Alan Saltzman, D.O., DOH Case No, 2002-18568 Alan Saltzman, D.O., DOH Case No. 2002-18568 ro i fm n 04 SEP 28 AMIN: 52 NOTICE OF RIGHTS ABIVIS 4 al Respondent has the right to request a hearing: OB Lee a conducted in accordance with Section 120.569 and 120.57, 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 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. PATIENT INDEX ! a Py : 4 Tove Dad! DOH v. Saltzman; Case No. 2002-18568 04 SEP 28 AMIN: 52 Patient J.R. Bet ADMINISTRAT vi HEARINGS Please refer to all patients by initials. Patient names and records are confidential.

Docket for Case No: 04-003497PL