Received Event (Event Succeeded) Date: 3/17/2005 - a Pages: 23 Time: 4:06 PM Sender: 850 414 1989 Duration: 6 min 12 sec Fax Number: Company: Type: Fax Subject: MAR-17-2005 16:04 z. RHCA/LEGAL MEDICAL 858 414 1989 =P. @5 =, STATE OF FLORIDA DEPARTMENT OF HEALTH DEPARTMENT OF HEALTH, PETITIONER, v. CASE NO, 2004-50375 THOMAS P. TOIA, D.C., (. ~ CF GG PL RESPONDENT, _ { el INISTRATIVE COMPLAINT COMES NOW, Petitioner, Department of Health, by and through Its undersigned counsel, and files this Administrative Complaint before the Board of Chiropractic Medicine against the Respondent, Thomas P. Toia, D.C, and in support thereof alleges: 1. Petitioner is the state department charged with regulating the practice of Chiropractic Medicine pursuant to Section 20.43, Florida Statutes; Chapter 456, Florida Statutes, and Chapter 460, Florida Statutes. 3. Acall times material to this Complaint, the Respondent was a licensed chiropractic physician within the State of Florida, having been issucd license number Cl! 2231. Received Event (Event Succeeded) Date: 3/17/2005 Time: 4:06 PM Pages: 23 Duration: 6 min 12 sec Sender: 850 414 1989 Company: Fax Number: Subject: Type: Fax _MAR-17-20@5 16704 AHCA/LEGAL MEDICAL a52 414 1989 3. The Respondent’s address of record is 1655 East Oaklard Boulevard, Fort Lauderdale, Florida 33334. 4. At all times material to this complaint, the Respondent worked ‘as a chiropractor at Advanced Integrated Medical Center, Incorporated, (hereinafter referred to as ALMC) in Ft. Lauderdale, Florida. In addition, he is listed by the Florida Department of State, Division of Corporations, as the Officer/Director of AIMC. 5. On or about Wednesday, November 24, 2004, Patients B.K. and E.K., a husband and wife, presented to AIMC where Dr Bach McComb (hereinafter referred to as Dr. McComb) administered a substance Dr. McComb represented as Botox treatment injections to both patients. 6, Dr. McComb's license to practice osteopathic medicine had been suspended by the Department on April 11, 2003, in case numbers 2002-28615, 2003-03247, 2003-03248, 2003-02806, and 2003-02808. 7. The Order of Emergency Suspension was still in effect at the time Dr. McComb administered the injections, 8. At the time of administration of the purported Botox injections to Patient 8.K. and Patient E.K., Dr McComb acted in violation of the emergency order that suspended his license. Thomas P. Tola, D.C. Case: Nureiver 2004-50375 2 2:\PSU\Medical\William Millet\Cexes\Tuls 2004-50375\ Tole Administrative Comptalnr.doc TE Received Event (Event Succeeded) Date: 3/17/2005 Time: 4:06 PM . , : : ages 23 Duration: 6 min 12 sec Sender: 850 414 1989 Company: Fax Number: Subject. Type: Fax , . MAR-17-2885 16:85 AHCA’LEGAL MEDICAL 852 <14 1989 P.Q? 9. Prior to November 24, 2004, Patients B.K. and E.K. had been treated with Botox injections by Shelley Wolland, D.O. (hereinafter referred to as Dr, Wolland), another associate osteopathic physician at AIMC. 10. On or about March 18, 2002, Dr. Wolland’s license to practice osteopathic medicine was restricted by the Department under an Order of Emergency Restriction of License in case number 2001-21687. 11, The Department prohibited Dr. Wolland from dispensing, administering, or injecting any medication exccpt for those medicines that may be required to sustain a patient’s life in a bona fide medical emergency. 12. According to medical records, Dr Wolland violated this restriction while employed at AIMC. 13. Botox, which contains Botulinum Toxin Type A, is a legend drug, which requires a physician’s prescription for use or administration. It Is indicated for the treatment of strabismus (a visual defect in which one eye cannot focus with the other on an object because of imbalance of the eye muscles) and blepharospasm (spasmodic winking caused by the involuntary contraction of an eyelid muscle) associated with dystonia (abnormal tonicity of tissue), including benign essential blepharospasm or VII nerve disorders in patients 12 ycars of age or older. It is also indicated Thomas P- Tula, D.C. Case Number 2004 50375 a J\PSU\Mevical Willian: Miiler\Cases\Tois 2004-50375 \Tole.Administranve Complaitit.doc Received Event (Event Succeeded) Date: 3/17/2005 Time: 4:06 PM Pages: 23 Duration: 6 min 12 sec Sender: 850 414 1989 Company: Fax Number: Subject: Type: Fax _ MAR-17-2805 16785 AHCA/LEGAL MEDICAL 858 <14 1989 P.@8 for the treatment of cervical dystonia in adults to decrease the severity of abnormal head position and neck pain associated with cervical dystonia. 14. On April 12, 2002, the federal Food and Drug Administration approved use of Botox for the treatment of wrinkles. 15. On or about Friday, November 26, 2004, at 12:00 p.m., the Respondent and his son, Tom Toia, Jr, (hereinafter referred to as Toia), arrived at the residence of Patients B.K. and E.K., in order to treat ther for a suspected reaction to the purported Botox treatments provided to them by Dr. McComb. 16. Toia worked as a self-described “medical technician” at AIMC, although he Is not a licensed healthcare professional. 1% Patients B.K and £.K. were very weak, had difficulty opening their eyes, and felt like they were experiencing severe flu-like symptoms. 18. Toia, in the presence of the Respondent, started an I.V. in both Patients B.K. and E.K. 19, The Respondent then prepared a “Myer’s Solution” by drawing into a syringe approximately twelve (12) units of ascorbic acid, five (5) units of magnesium, one (1) unit of Vitamin C, one (1) unit of Vitamin B complex, and an unknown amount of saline solution using the same needle. ‘Thomas P. ‘fola, D.C, Case Number 2004-50375 a 2:\eSu\Mecical\wiltam Milan\Cases\ Tha 7004-80375\Toa.Anminisranve Campiaint.cin. Received Event (Event Succeeded) Date: 3/17/2005 Time: 4:06 PM Pages: 23 Duration: 6 min 12 sec Sender: 850 414 1989 Company: Fax Number: Subject: Type: Fax . MAR-17-2085 16:85 AHCA/LEGAL MEDICAL 858 414 1989 P.@9 20. ‘Toia, again in the presence of the Respondent, then Injected the “Myers Solution” into Patient E.K’s Lv. 21, The process was then repeated, using the same vials, for Patient B.K. 22. After administration of the “Myer’s Solution,” each patient was administered a 500 cc hag of *Lactated Ringers Solution” via 1.V. by Toia. 23. The entire process took 60 to 90 minutes. 24. By about 8:00 p.m. on November 26, 2004, Patients B.K. and E.K. were very weak and could not move. Family members transported them to the emergency room of Palm Beach Gardens Medical Center. FACTS RELATED TO PATIENT B.K. 25. On or about Novemher 26, 2004, Patient B.K. was examined in the emergency room by Dr. Dennis Egitto, who made referrals to Dr. Charles Schallap, M.D. (hereinafter referred to as Dr. Schallop), for a neurovascular consultation and to Dr. Richard Weinstock, D.O. (hereinafter referred to as Dr. Weinstock), for a consultation due to respiratory failure and a possible botulism reaction to Botox. 26. Onor about November 26, 2004, Dr. Schallop evaluated Patient B.K. pursuant to Dr. Egitto’s referral. ‘Thomas P. Tole, D.C. Case Number 2004-50375 5 JAPSU\MedicalhWiliaen Milter\Casee\Tola 2004-S03745\ soa. administrative Conalaivil.doc Received Event (Event Succeeded) Date: 3/17/2005 Time: 4:06 PM Pages: 23 Duration: 6 min 12 sec Sender: 850 414 1989 Company: Fax Number: Subject: , Type: Fax . MAR-17-2885 16:5 AHCA/LEGAL MEDICAL 27. Dr. Schallop noted that Patient B.K. exhibited symptoms of progressive weakness, breath and dry throat, difficulty clearing secretions, difficulty speaking, droopy eyelids, and flu-like feeling. 28. Dr. Schallop noted the following impression into the medical record: 29. intravenous fluids, pulmonary and E.N.T. evaluation, and a swallow evaluation. 30. [Patient 6.K.] underwent a botulinum toxin A procedure, periorbital, on November 24, 2004, by Dr. Bach in Fort Lauderdale. She underwent similar procedure approximately 6 to 8 months ago. Since the procedure, she has been experiencing progressive weakness, dysphagia, blurred vision, difficulty clearing her secretions. The patient's husband underwent the same procedure the same day by the same doctor, and he is experiencing similar symptoms. They spoke to thelr doctor and were told that both he and his wife are experiencing similar symptoms as well. The ctiology needs te be better defined, whether this is an adverse reaction or spread of toxin. The patient has not been taking any other medication at this time. They have no fever, no chills. There is no history of neuromuscular disorder. Dr. Schallop considered Patient B.K. critically ill, and ordered Dr. Schallop also nolified AIMC, the Centers for Disease Control, and Florida Poison Control. inomas P, Tol. D.C. Caat Number 2004-50375 JAPA Medical Williaiy Miler\Casea\Toia 2004 -S0375\ Teta Admmnstrative Complainiidus difticulty swallowing, blurred vision, shortness of 850 114 1989 =P. 10 Received Event (Event Succeeded) Date: 3/17/2005 Time: 4:06 PM > , : : ages 23 Duration: 6 min 12 sec Sender: 850 414 1989 Company: Fax Number: Subject: , Type: Fax , . MAR-17-28@5 16:26 AHCA/LEGAL MEDICAL 31. On or about November 27, 2004, Dr. Weinstock evaluatec! Patient B.K. pursuant to Dr. Egitto’s referral. At this time, Patient B.K. had been placed on a respirator due to her inability lo breathe on her own. 32. Dr. Weinstock noted that Patient B.K, had received nearly three times the amount of botulinum toxin A as had Patient E.K. Dr. Weinstock’s impression was respiratory failure, possibly secondary to Botox botulinurn toxin. Dr, Welnstock recommended antitoxin, continued ventilatory support, and a tracheostomy tube if Patient B.K. continued on the respirator to prevent vocal chord damage. 33. As of this date, Patient B.K. remains hospitalized and is in critical condition. FACTS RELATED TO PATIENT E-K. 34. On or about November 26, 2004, Dr. Schallop evaluated Patient E.K. pursuant to Dr. Egitto’s referral. 35. Dr. Schallop noted that Patlent E.K. exhibited symptoms of generalized weakness, dysenteric speech, dysphagia, blurred vision, shortness of breath and dry throat, and difficulty clearing secretions. 36. Dr Schallop noted the following impression into the medical record: ‘Thomas P, Tula, 0.C, Case Number 2004 50375 D J\PSL:\ Metical \Wilkam Miller\Cases\Toia 2001-50375\Tola Acmenstramve Conmilaii.doc 858 414 1989 P.14 Received Event (Event Succeeded) Date: Pages: Sender: Fax Number: Type: 3/17/2005 Time: 4:06 PM 23 Duration: 6 min 12 sec 850 414 1989 Company: Subject: Fax MAR-17-2885 16:06 AHCA’LEGAL MEDICAL [Patient E.K.] underwent chemo enervation with botulinum toxin A in the periorbital muscles for cosmetic reasons on Wednesday, November 24, 2004. He has experienced since Thursday progressive weakness, dysphagia, difficulty clearing secretions, shortness of breath, dystharic speech, and blurred vision. He has no history of neuromuscular disorder. He underwent a similar procedure 6 to 8 months ago with no adverse effects. Patient states that the physician at the clinic injected himself and his significant other, and they are experiencing similar symptoms. The etiology needs to be better defined, adverse reaction/extensive diffusion of the botulinum toxin A. 37. Dr. Schallap considered Patient E.K. critically ill, and ordered intravenous fluids, pulmonary and E.N.T. evaluation, swallow evaluation, and close assessment of Patient C.K/s neuromuscular status. Dr. Schallop also notified the hospital pharmacy, AIMC, and Florida Poison Control 38. On or about November 27, 2004, Dr. Weinstock evaluated Patient E.K. pursuant to Dr. Egitto’s referral. 39, At this lime, Patient t.K. was being intubated and placed on a respirator duc to his worsening condition. Dr. Weinstock’s impression was Botox reaction causing respiratory failure, aspiration, and dysphagia. 40. Dr Weinstock also recommended a tracheostomy tube If Patient E.K, continued on the respirator to prevent vocal chord damage. Thomos P, Tala, D.C, Case Number 71K}4°50375 8 J:\PSU\Medicol\ William Miller\Caees\! 019 2004-50875\ Tula Administrative Complaint-doc 858 «14 1989 P.12 Received Event (Event Succeeded) Date: 3/17/2005 Time: 4:06 PM Pages: 23 Duration: 6 min 12 sec Sender: 850 414 1989 Company: Fax Number: Subject: Type: Fax . MAR-17-2085 16°46 AHCA’LEGAL MEDICAL 8528 414 1969 41. As of this date, Patient E.K. remains hospitalized and is in critical condition. COUNT ONE 42. Petitioner realleges and incorporates paragraphs one (2) through forty-one (41) as if fully set forth herein. 43. Sectlon 460.413(1)(r), Florida Slatutes (2004), provides that failing to practice chiropractic medicine at a level of care, skill, and treatment which is recognized by a reasonably prudent chiropractic physician as being acceptable under the circumstances constitutes grounds for disciplinary action by the Board of Chiropractic Medicine. 44. The Respondent failed to practice chiropractic medicine at a level of care, skill, and treatment which is recognized by a reasonably prudent chiropractic physician as being acceptable under the circumstances in one or more of the following ways: a. By prescribing, dispensing, or administering “Myer’s Solution” and “Lactated Ringers Solution” to Patients BIC. and E.K., b. By failing to completely examine and evaluate Patien*s B.K. and E.K. before administering treatment, and/or c. By failing to create any medical records or notations regarding the treatment provided to Patients B.K. and E.K. dnomas P. lola, D.C. Casa Number 2004-50375 9 J:A\PSU\Medical\wilham Miler\Cases\Tola 2004-50375 \Tols, Aoministratve Complamitdoc P.13 Received Event (Event Succeeded) Date: 3/17/2005 Time: 4:06 PM Pages: 23 Duration: 6 min 12 sec Sender: 850 414 1989 Company: Fax Number: Subject: Type: Fax _ MAR-17-2885 16:26 AHCA/LEGAL MEDICAL 858 <14 1989 I 45. Based on the foregoing, Respondent has violated Section 460.413(1)(r), Florida Statutes (2004), by failing to practice chiropractic medicine at a level of care, skill, and treatment which Is recognized by a reasonably prudent chiropractic physician as being acceptable under the circumstances. COUNT TWO 46. Petitioner realleges and incorporates paragraphs one (1) through forty-one (41) as if fully set forth herein. 47. Section 460.413(1)(ff), Florida Statutes (2004), provides that violating any provision of Chapter 460 or Chapter 156, or any rules adopted pursuant thereto constitutes grounds for disciplinary action by the Board of Chiropractic Medicine. 48. Section 456.072(1)(p), Florida Statutes (2004), provides that delegating or contracting for the performance of professional responsibilities by a person when the licensee delegating or contracting for performance of such responsibilities knows, or has reason to know, such person is not qualified by training, experience, and authorization when required to perform them constitutes grounds for disciplinary action by the Board of Chiropractic Medicine. Thomas P This, 0.0. Cane Number 2004-50375 10 J\PSU\Mecical\wiliam Miller\Cases\Tola 2006-50375) Tote Adranist alive Con iulaistLdus 14 Received Event (Event Succeeded) Date: 3/17/2005 a Time: 4:06 PM Pages: 23 Duration: i Sender: 850 414 1989 Company: 6 min 12 sec Fax Number: Sublet. Type: Fax ject: ——__e_—_———— CT _ MAR-17-2085 16:07 AHCA/LEGAL MEDICAL 852 414 1989 =P. 15 49. The Respondent violated Section 456.072(1)(p), Florida Statules (2004), when, as operator of AIMC, he allowed McComb, whose license to practice osteopathic medicine was suspended on April 11, 2003, to practice at AIMC. Because the suspension, which Is public record, was in full force and effect, McComb was not authorized to practice at AIMC. 50. Based on the foregoing, Respondent has violated Section 460.413(1)(f1), Florida Statutes (2004), by violating section 456.072(1)(p), Florida Statutes (2004). OUNT THREE Si. Petitioner realleyes and incorporates paragraphs one (1) through forty-one (41), forty-seven (47), and forty-eight (48) as if tully set forth herein. 52. The Respondent, as operator of AIMC, Violated Section 456.072(1)(p), Florida Statutes (2004), when he allowed Wolland, whose license the Department had placed a restriction against dispensing, administering, or injecting any medication except for those medicines that may be required to sustain a patient's life in a bona fide medical emergency, on March 18, 2002, to practice at AIMC. Because the restriction, which |s public record, was in full force and effect, Wolland was not authorized to practice in the manner shc practiced al AIMC. Thomas &, Tola, D.C. Case number 2004-50375 ! TAPSU\Medleal\Wiltiam muuar\Cases\Tole 2004:50075\Tola. Administrative Complaint.doc Received Event (Event Succeeded) er Date: 3/17/2005 Time: 4:06 PM Pages: 23 Di ion: i Sender: 850 414 1989 Compan : Smaeess Fax Number: Subje . Type: Fax me . MAR-17-2825 16:87 AHCA/LEGAL MEDICAL 858 414 1989 = P.16 53. Based on the foregoing, Respondent has violated Section 460.413(1)(ff), Florida Statutes (2004), by violating section 456.072(1)(pi, Florida Statutes (2004). COUNT FOUR 54, Petitioner realleges and incorporates paragraphs one (4) through forty-one (41) and forty-seven (47) as it fully sct forth herein. 55. Section 456.072(1)(j), Florida Statutes (2004), provides that aiding, assisting, procuring, employing, or advising any unlicensed person or entity to practice a professiun contrary to Chapter 456, the chapter regulating the profession, OF the rules of the department or the hoard constitutes grounds for disciplinary action by the Board of Chiropractic Medicine. 56. The Respondent violated Section 456.072(1)(j), Florida Statutes (2004), when he aided, assisted, procured, employed, or advised Toia, an unlicensed individual, to: a. Dispense or administer “Myer's Solution,” a legend drug, to Patients B.K, and E.K., b. Dispense or administer “Lactated Ringers Solution,” a legend drug to Patients B.K. and E.K., and/or c. Start and/or administer an 1.V. in Patients B.K. and E.K. Thumas P. Tela, D.C Cose Number 2004-04/S 12 JAPBU\Medical Wiliam Millor\Csees\Tola 2004-50975\ Tole. Administrative Comnpiaint.dec 16 Received Event (Event Succeeded) Date: 3/17/2005 Time 4:06 Pages: 23 nin 12 Sender: 850 414 1989 Company Smnveess Fax Number: Subject. Type: Fax meet ay . MAR-1'7-2685 16:87 AHCA/LEGAL MEDICAL Q50 114 1989 P17 57, Based upon the foregoing, the Respondent has violated Section 460.413(1)(ff), Florida Statutes (2004), by violating Section 456.071(1)(i)s Florida Statutes (2004). COUNT FIVE 58. Petitioner realleges and incorporates paragraphs one (1) through forty-one (41) as if fully set forth herein. 59, Section 460.413(1)(P), Horida Statutes (2004), provides, infer alia, that any prescribing, dispensing, or administering medicinal drug, except as authorized by Section 460.403(9)(c)2, Florida Statutes, constitutes grounds for disciplinary action by the Board of Chiropraciic Medicine. 60. Section 460.403(9)(c), Florida Statutes (2004), states: (c)1. Chiropractic physicians = may adjust, manipulate, or treat the human body by manual, mechanical, electrical, or natural methods; by the use of physical means or physiotherapy, including light, heat, water, or exercise; by the use of acupuncture; or by the administration of foods, food concentrates, food extracts, and items for which a prescription Is not required and may apply first aid and hygiene, but chiropractic physicians are expressly prohibited from prescribing oF administering to any person any legend drug except as authorized under subparagraph 2., from performing any surgery except as stated herein, or from practicing obstetrics. ‘Thomae P. Toia, 9... Case Number 2004 50375 13 J:\PSU\Medical\witham Millet\Cages\Tola 2004-50375\1 018 Aamintsirative Complaint.doc 17 Received Event (Event Succeeded) Date: Pages: Sender: Fax Number: Type: 3/17/2005 Te ro 23 : 706 PM 850 414 1989 company: 6 min 12 sec Fax Subject: MAR-17-2005 16:08 AHCA/LEGAL MEDICAL rn 85@ 414 1989 P18 2, Notwithstanding — the prohibition against prescribing and administering legend drugs under subparagraph 1., or 5. 499.0122, pursuant to board rule chiropractic physicians may order, store, and administer, for emergency purposes only at the chiropractic physician's office or place of business, prescription medical oxygen and may also order, store, and administer the following topical anesthetics:in aerosol form: a. Any — solution consisting of 25 percent ethyichtoride and 75 percent dichlorodifluoromethane. b. Any solution consisting of 15 percent dichlorodifluoromethane. and 85 percent trichloromonofluoromethane. However, this paragraph does not authorize a chirupractic physiclan to prescribe medical oxygen as defined in chapter 499. 61. The Respondent prescribed, dispensed, and/or administered the follawing to Patients B.K. and E.K.: a. “Myer’s Solution,” a legend drug, and b. “Lactated Ringers Solution,” a legend drug. 62. Based on the foregoing, Respondent has violated Section 460,413(1)(p), Florida Statutes (2004), by prescribing, dispensing, oF administering a medicinal drug, not authorized by Section 460,403(9)(c)2, Florida Statutes. Thomas P Toia, 0.C. Case Number 2004 50375 J:\PSU\Medical (william Milier\Cases\ Toia 2004-50375\ lola Admiiiibstrative Complaint.dos 18 Received Event (Event Succeeded) Date: 3/17/2005 Ti Pages: 23 ime: 4:06 PM Sender: 850 414 1989 Duration: 6 min 12 sec Fax Number: Company: Type: Fax Subject: _ MAR-17-20@5 16:28 AHCA/LEGAL MEDICAL OO 858 <114 1989 COUNT SIX 63. Petitioner realleges and incorporates paragraphs one (1) through forty-one (41) as if fully set forth herein. 64. Section 460.413(1)(t), Florida Statutes (2004), provides that practicing or offering to practice beyond the scope permitted by law or accepting and performing professional responsibilities which the licensee knows or has reason to know that she or he is not competent to perform constitules grounds for disciplinary action by the Board of Chiropractic Medicine. 65, The Respondent practiced beyond the scope of his license as permitted by law when he proscribed, dispensed, and/or administered “myer’s Solution” and “Lactated Ringers Solution,” legend drugs, to Patients B.K, and E.K. 66. Based on the foregoing, Respondent has violated Section 460.413(1)(t), Florida Statutes (2004), by practicing beyond the scope permitted by law and accepting and performing professional responsibilities which the Respondent knew or had reason to know that he was not competent to perform. “Thomas P. Tola, D.C. Case Nuuiber 2004 5 ws J:\Pou\Medica\ Wiliam ‘Miler Cases\Toin ot VE0a75 van. Adiminisuative Comploint.doc 19 Received Event (Event Succeeded) Date: Pages: Sender: Fax Number: Type: _ MAR-17-2885 16:08 3/17/2005 Time re : :06 PM 23 Duration: 850 414 1989 Company: 6 min 12 sec Subject: Fax AHCA/LEGAL MEDICAL $< 858 414 1989 =P, 28 COUNT SEVEN 67. Petitioner realleyes and incorporates paragraphs one (1) through forty-one (41) as if fully set forth herein. 68. Sectlon 460.413(1)(m), Florida Statutes (2004), provides that failing to keep legibly written chiropractic medical records that identify clearly by name and credentials the licensed chiropractic physician rendering, ordering, supervising, or billing for each examination or treatment procedure and that justify the course of treatment of the patient, including, but not limited to, patient histories, examination results, test results, X rays, and diagnosis of a disease, condition, or Injury constitutes grounds for disciplinary action by the Board of Chiropractic Medicine. 69. The Respondent failed to create any medical records or notations regarding the treatment provided to Patients B.K. and E.K. at thelr home on November 26, 2004. 70. Based on the foregoing, Respondent has violated Section 460.413(1)(m), Florida Statutes (2004), by failing to keep legibly written chiropractic medical records that identify clearly by name and credentials the licensed chiropractic physician rendering, ordering, supervising, or billing for each examination or treatment procedure and that justify the Tnemas P. Tola, D.C, Case Number 2004-50375 16 J:\PSUNMedicanW ila Miller\Cases\Tota 2004-505 7o\ (ola Acimb isu ative Comploint.doc 20 Received Event (Event Succeeded) Date: 3/17/2005 Ti Pages: 23 ime: 4:06 PM Sender: 850 414 1989 Duration: 6 min 12 sec Fax Number: Company: Type: Fax Subject: MAR-17-2005 16:99 AHCA/LEGAL MEDICAL 858 414 1989 course of treatment of the patient, including, but not limited to, patient histories, examination results, test results, X rays, and diagnosis of 4 disease, condition, or Injury related to Patients B.K. and E.K. on Novembe” 26, 2004. WHEREFORE, the Petitioner respectfully requests that the Board of Chiropractic Medicine enter an order Imposing one or more of the following penaltics: permanent revocation or suspension of Respondent's ficense, 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. Thomes P, Toit, D.C, Case Nummer 2004-50275 v7 J\PSU\Medical\Wition Milier\Cases\Tud 2004-50375\Tola Administrative Complaint.dec Received Event (Event Succeeded) —— eee —— Date: 3/17/2005 Time: 4:06 PM Pages: 23 Duration: 6 min 12 sec Sender: 850 414 1989 Company: Fax Number: Subject: Type: Fax : MAR-17-26@5 16:09 AHCA/LEGAL MEDICAL 858 414 1989 P.22 De 2005. SIGNED this__® day of __ Sey John O, Agwunobdi, M.D., M.B.A., M.P.H. Secretary, Department of Health William F Miller Assistant General Counsel ; DOH Prosecution Services Unit 4052 Bald Cypress Way, Bin C-65 DEPARTMENT OF HEALTH Tallahassee, FL 32399-3265 F _ Sea EPUTY ELK Fondo ar #0421080 cuneN Colman (850) 414-1991 FAX pare /~ OS ~OS Reviewed and approved by: DLL (initials) /2/2z/av (date) PCP: 7-57-08” PCP Members: Kiedy 4 Leikgon, PC 2 P. Tola, 0.0. case Number 2004-50375 ; | ; Tipe \Modleatvutam Miller\Cases\Toie 2004-50375) ra. Acheanistradve Complaint.dor 22 Received Event (Event Succeeded) Date: 3/17/2005 Time: 4:06 PM Pages: 23 ,' Duration: i Sender: 850 414 1989 Com om : Smaesse Fax Number: Subject... Type: Fax “es MAR-1°7-2885 16:@9 AHCA’LEGAL MEDICAL ‘ Thomas P. Toia, D.C. Case Number 2004-50375 NOTICE OF RIGHTS Respondent has the right to request a hearing to be 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 shail 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. ‘Thomas P. Tia, D.C. Case Number 2004-50375 9 JOPSU\Meuical\William Milte\Cosez\Toia 2004-5U475\ Tha. Adm isb'ative Compiaint.doc 23 re BSG 14 1989 P23 TOTAL P.23

Docket for Case No: 05-000999PL