£A"d STATE OF FLORIDA DEPARTMENT OF HEALTH DEPARTMENT OF HEALTH, PETITIONER, Vv. CASE NOS. 2005-01806 2000-08846 A. HUSSAM ARMASHT, M.D., 2000-08620 2000-05906 RESPONDENT. a ADMINISTRATIVE COMPLAINT Petitioner, Department of Health, by and through undersigned counsel, files this Administrative Complaint before the Board of Medicine against Respondent, A. Hussam Armashi, M.D., and in support thereof alleges: 1. The Department of Health (“Department”) is the state department charged with regulating the practice of medicine pursuant to Chapters 20, 456, and 458, Florida Statutes. 2, At all times material to this Complaint, Respondent was a licensed physician within the state of Florida, having been issued license number ME 66828. J:\PSU\Medical\Bolivar\cases\Armashi\Armashi AC.1.doc ea:rst so0z ¢ dy HOH 61:S7t SeBe—-Se-Ad 3. Respondent's address of record is 12228 Cortez Boulevard, Spring Hill, Florida 34613. 4. Respondent is board certified in anesthesiology. GENERAL FACTUAL ALLEGATIONS 5. Reflex sympathetic dystrophy (RSD”) is a syndrome involving - pain, stiffness, swelling, and discoloration of the hand. 6. “Trigger point” is the name generally given to a localized area of pain, frequently soft tissue which may have become irritated by the action of weakened or damaged muscles, tendons, and/or ligaments. 7. Fibromyalgia syndrome is generally characterized by pain in numerous trigger points, non-refreshing sleep, and appears to affect the entire body 8. Fascial tissue is a sheet or band of fibrous connective tissue enveloping, separating, or binding together muscles, organs, and other soft structures of the bady. 9. Myofascial pain is a musculoskeletal syndrome characterized by painful areas in trigger points located on muscle tissue and/or the junction of muscle and fascial tissue. J:\PSU\Medical\ Bolivar\cases\Armashi\armashi AC.1.doc Fe'd WOHY 61ST SEI eorst so0z S dy ERE SE SCA S@"d States. Abuse of Fentanyl may lead to severe physical and psychological dependence. 15. Epinephrine is a chemical which narrows blood vessels, opens airways in the lungs, counteracts low blood pressure, and relieves itching and hives. 16. Bupivacaine is an anesthetic agent available in suspension form for intravenous injection that causes loss of feeling in the skin and surrounding tissues. 17. Lidocaine is an anesthetic agent available in suspension form for intravenous injection that causes loss of feeling in the skin and surrounding tissues. 18. Depo-Medrol (methylprednisolone) is an anti-inflammatory corticosteroid available in suspension form for intravenous injection. FACTS REGARDING PATIENT B.K. CASE NO. 2005-01806 19, In or about September 1997, Patient B.K., a female, presented to Respondent for treatment of chronic pain. Respondent treated her with intravenous injections and oral narcotic medication until approximately May 1999. 3:\PSU\Medical\Bollvar\cases\Armashi\Anmasnt AC. L.doc 6a:SsT $o0z ¢ dy HOH Bz:St SHBe—-SE-Ad 20. In or around February 1998, Patient B.K. presented to Respondent in his brother-in-law’s office after normal office hours. Respondent gave her a sheet to cover herself and she kept her underwear on under the sheet. 21. Respondent administered injections to Patient B.K. which produced a euphoric effect, unlike any injection he had previously administered. Respondent kissed Patient B.K. while she sat on the examining table. She rejected this advance and stated that she was married. Respondent replied that he was also married. 22. Patient B.K. lay back on the table as a numbing effect from the injections ensued. Respondent kissed her breasts. She told him not to do this. He urged her to be quiet and told her that she would enjoy it. 23. Respondent removed Patient B.K.'s panties and his own shirt and pants, and rubbed his penis on her vagina. Respondent penetrated her vagina with his penis while Patient B.K. cried. He ejaculated and wiped her off with a towel. Respondent informed Patient B.K. that if she told her husband what had occurred, her marriage would end and she would not get custody of their children due to her addiction to the pain medications Respondent was prescribing for her. 2:\PSU\Mecical\Bollvar\caces\Armashl\Armashi AC.1.doc 98° HOH Best SeBe—-Se-sdy 6a:SsT $o0z ¢ dy 24. At some point in 1998, Respondent moved to a new office. Patient B.K. presented to this office in the evening and was the only patient present in the office. Patient B.K. requested a gown and Respondent replied that he did not have any in the new office. Respondent administered injections and had sexual intercourse with Patient B.K. on the floor. She told him to stop and that he was hurting her. Patient B.K. experienced bleeding due to this intercourse. 25. Approximately fifteen to twenty incidents involving sexual touching and/or contact took place between Respondent and Patient B.K. while she in his office and under his care for pain management treatment. She continued to present to Respondent because of both her addiction to pain medication and his threats to tell her husband, causing the break up of her marriage and loss of her children. Respondent also frequently told Patient B.K. that she would go to jail if her drug use was revealed. 26. At some point in 1999, Patient B.K. presented to Respondent for treatment. Respondent administered several injections in the back of her head and back. Patient B.K. remained conscious, but became numb and unable to physically stop Respondent's sexual advances. She told him to stop, but he continued and had sexual intercourse with her while she 6 J:\PSU\Medical\Bolivar\cases\armashi\Armashi AC.1.do¢ 28"d HOH Bz:St SHBe—-SE-Ad 6a:SsT $o0z ¢ dy was under the effect of the injection. Respondent ejaculated in and/or on Patient B.K.’s vagina. 27, Patient B.K. inserted a tampon to prevent leakage of his seminal fluid onto her clothing. She removed the tampon at home, wrapped it in an empty toilet paper roll and placed it in a bag in a closet. 28. Patient B.K. made a criminal complaint of sexual battery against Respondent to the Hernando County Sheriff's Office. She gave them the tampon containing Respondent's seminal fluid. A DNA test on the tampon indicated that the semen matched Respondent's DNA. 29, On or about November 13, 2001, the Hernando County State Attorney's office charged Respondent with sexual battery upon Patient B.K. 30. On or about May 28, 2003, Patient B.K. provided a sworn statement in the criminal case. She told the prosecutor that she did not want the criminal prosecution to proceed because she could not physically or emotionally endure a trial. 31. Onor about May 30, 2003, the prosecutor filed a nol/e prosequi/ in the criminal action against Respondent. J:\PSU\Medical\Bolivar\cases\Armashl\Armashi AC.1.doc 8@"d QOHY Te:S) =6SRe-Se—-ad OT:ST $o00z ¢ dy COUNT ONE 32, Petitioner realleges and incorporates paragraphs one (1) through thirty-one (31) as if fully set forth herein. 33. Section 455.624(1)(u), Florida Statutes (1998), provides that engaging or attempting to engage a patient or client in verbal or physical sexual activity is grounds for disciplinary action by the Department. This statute further provides that “For the purposes of this section, a patient or client shall be presumed to be incapable of giving free, full, and informed consent to verbal or physical sexual activity. 34. Respondent engaged or attempted to engage Patient B.K. in sexual activity outside the scope of professional practice in one or more of the following ways: (a) By kissing Patient B.K. on the mouth while she was under his care for purposes of pain management treatment; (b) By kissing Patient B.K.’s breasts while she was under his care for purposes of pain management treatment; (c) By removing Patient B.K.’s panties while she was under his care for purposes of pain management treatment, 7:\PSU\Medical\Bolivar\cases\Armashi\armashi AC.1.doc Ob:ST so0z S$ dy HOH Te:S? = SBBe-Se-sdd (d) By rubbing his penis against Patient B.K.’s vagina while she was under his care for purposes of pain management treatment, (e) By engaging in sexual intercourse with Patient B.K. while she was under his care for purposes of pain management treatment. 35. Based on the foregoing, Respondent violated Section 455.624(1)(u), Florida Statutes (1998), by engaging or attempting to engage a patient or client in verbal or physical sexual activity. COUNT TWO 36. Petitioner realleges and incorporates paragraphs one (1) through thirty-one (31) as if fully set forth herein. 37. Section 458.331(1)(j), Florida Statutes (1998), provides that the following is grounds for disciplinary action by the Board of Medicine: Exercising influence within a patient-physician relationship for purposes of engaging a patient in sexual activity. A patient shall be presumed to be incapable of giving free, full, and informed consent to sexual activity with his or her physician. 38. Respondent exercised influence within the physician-patient relationship for purposes of engaging Patient B.K. in sexual activity in one or more of the following ways: 1:\PSU\Medical\ Bolivar\cages\Armash!\Armashi AC 1L.doc ald QOHY Te:S) =6SRe-Se—-ad OT:ST $o00z ¢ dy (a) By kissing Patient B.K. on the mouth while she was under his care for purposes of pain management treatment; (b) By kissing Patient B.K.‘s breasts while sne was under his care for purposes of pain management treatment; (c) By removing Patient B.K.’s panties while she was under his care for purposes of pain management treatment; (d) By rubbing his penis against Patient B.K.’s vagina while she was under his caré for purposes of pain management treatment; (e) By engaging in sexual intercourse with Patient B.K. while she was under his care for purposes of pain management treatment. 39. Based on the foregoing, Respondent violated Section 458.331(1)(j), Florida Statutes (1998), by exercising influence within a physician-patient relationship for purposes of engaging the patient in sexual activity. FACTS REGARDING PATIENT J.W. CASE NUMBER 2005-01806 40. In or about January 2004, Patient J.W. presented to Respondent for pain management of various conditions, including refiex sympathetic dystrophy syndrome. Respondent initially treated Patient J.W. with oral narcotic pain medication. ; 10 3:\PSU\Medical\Bolivar\cases\Armashi\Armashi AC.1.doc Tid QOHY Te:S) =6SRe-Se—-ad OT:ST $o00z ¢ dy 41, Inoor around July 2004, Respondent began to administer nerve block injections to Patient J.W. In or around September or October 2004, Patient J.W. complained to Respondent that these injections had adverse sexual side effects and asked him how this could be resolved. Respondent bent Patient J.W. over the examination table and told her this was a new sexual position. 42. Patient J. W. presented to Respondent again shortly thereafter and became ill and dizzy during the office visit. She leaned forward and Respondent placed his hand on her breasts to lean her back. 43. On or about January 14, 2005, Patient J.W. called Respondent and asked if he would authorize treatment at a near-by hospital so that she did not have to travel to receive his care. Respondent returned her call on or about Saturday, January 15, 2005. He refused to authorize treatment at the hospital and told Patient J.W. to come to his office for treatment. 44, ‘two of Patient J.W.'s friends drove her to Respondent's office. She presented to Respondent at approximately 6:30 p.m. Respondent directed her companions to the waiting room, turned on the television, and he toak the remote control with him, leaving a Spanish cartoon playing at a high volume. 11 3:\PSU\Medical\Bolivar\cases\Armashl\Armashi AC, 1-doc eld HOH ec:St 3 SHBe—-SA-Add TE:Sk so0z g dH 45. Respondent administered intravenous medication and injections to treat Patient 1.W.’s pain. Respondent pulled Patient J.W. between his legs and rubbed his groin against her back. He told Patient J.W. that she was beautiful, raised her shirt and brassiere and kissed her bare breasts. 46. Patient J.W. tried to push Respondent away. He grabbed her left arm, pinned it to the table, and pulled down her pants and panties, exposing her vagina. Patient J.W. jumped up, removed the IV, and fled to the waiting room. 47, Patient J.W. reported Respondent’s conduct to the Hernando County Sheriff’s Office. On or about February 25, 2005, Respondent was arrested and charged with the sexual battery of Patient J.W. COUNT THREE 48. Petitioner realleges and incorporates paragraphs one (1) through eighteen (18) and forty (40) through forty-seven (47) as if fully set forth herein. 49, Section 456.072(1)(u), Florida Statutes (2003) and (2004), provides that engaging or attempting to engage in sexual misconduct as defined and prohibited in Section 456.063(1), Florida Statutes (2003) and 12 J:\PSU\Medical\Bolivar\cases\Armashi\Armashi AC.1.doc £Tl'd HOH ec:St 3 SHBe—-SA-Add TE:Sk so0z g dH (2004), constitutes grounds for disciplinary action by the Board of Medicine. 50. Section 456.063(1), Florida Statutes (2003) and (2004), states as follows: Sexual misconduct in the practice of a health care profession means violation of the professiona! relationship through which the health care practitioner uses such relationship to engage or attempt to engage the patient or client, or an immediate family member, guardian, or representative of the patient or client in, or to induce or attempt to induce such person to engage in, verbal or physical sexual activity outside the scope of professional practice of such health care profession. Sexual misconduct in the practice of a health care profession is prohibited. 51. Respondent engaged in or atternpted to engage Patient J.W. in sexual activity outside the scope of professional practice in one or more of the following ways: (a) By kissing her bare breasts while she was under his care for purposes of pain management treatment; (b) By pulling down her pants and panties and exposing her vagina while she was under his care for purposes of pain management treatment. 52. Based on the foregoing, Respondent violated Section 456.072(1)(u), Florida Statutes (2003) and (2004), by committing sexual 13 J:\PSU\Medical\Bolivar\cases\Armashl\Armashi AC.1.doc FTed QOHY co:st 8 S@e-Se-Add TE:Sk so0z g dH misconduct as defined and prohibited in Section 456.063(1), Florida Statutes (2003) and (2004). COUNT FOUR 53. Petitioner realleges and incorporates paragraphs one (1) through eighteen (18) and forty (40) through forty-seven (47) as if fully set forth herein. 54. Section 458.331(1)(j), Florida Statutes (2003) and (2004), provides that the following is grounds for disciplinary action by the Board of Medicine: Exercising influence within a patient-physician relationship for purposes of engaging a patient in sexual activity. A patient shall be presumed to be incapable of giving free, full, and informed consent to sexual activity with his or her physician. 55. Respondent exercised influence within the physician-patient relationship for purposes of engaging Patient J.W. in sexual activity in one or more of the following ways: (a) By kissing her bare breasts while she was under his care for purposes of pain management treatment; (b) By pulling down her pants and panties and exposing her vagina while she was under his care for purposes of pain management treatment. 14 2:\PSU\Medical\Bolivar\cases\Armashi\Armaghi AC.1.doc ST'd HOH fe:st SeBe—-Se-ady ZE:ST $00z ¢ dy 60. Asa result of this conduct, Patient L. Bu. thereafter presented to Respondent with a companion. 61. Approximately one or two months later, Patient L.B. presented to Respondent without an appointment complaining of a severe headache. She was unaccompanied because she did not expect administration of an intravenous sedative. 62. Respondent locked the door of the examination room and administered intravenous sedation to Patient L. Bu. Respondent untied his scrub pants, revealing his white underwear or undershirt. COUNT FIVE 63. Petitioner realleges and incorporates paragraphs one (1) through eighteen (18) and fifty-seven (57) through sixty-four (64) as if fully set forth herein. 64. Section 455.624(1)(u), Florida Statutes (1998) and (1999), provides that engaging or attempting to engage a patient or client in verbal or physical sexual activity Is grounds for disciplinary action by the Department. This statute further provides that “For the purposes of this section, a-patient or client shall be presumed to be incapable of giving free, full, and informed consent to verbal or physical sexual activity. 16 J:\PSU\Medical\Bolivar\cases\Armashi\Armashi AC.1.doc QOHY fe:st SBee-Se—-H4. ZEST soz S$ dy we 65. Respondent engaged or attempted to engage Patient L. Bu. in sexual activity outside the scope of professional practice in one or more of the following ways: (a) By massaging her shoulders and saying she had a beautiful and athletic back while she was under his care for purposes of pain management treatment; (b) By kissing her neck while she was under his care for purposes of pain management treatment, (c) By fondling her breasts while she was under his care for purposes of pain management treatment. 68. Based on the foregoing, Respondent violated Section 455.624(1)(u), Florida Statutes (1998) and (1999), by engaging or attempting to engage a patient or client in verbal or physical sexual activity. COUNT SIX 69. Petitioner realleges and incorporates paragraphs one (1) through eighteen (18) and fifty-seven (57) through sixty-four (64) as if fully set forth herein. 17 3:\PSU\Medical\Bollvar\cases\Armashl\Armashi AC.2.doc dtd OHH Feist S6Be-Se-Add ZEST soz S$ dy 70, Section 458.331(1)(j), Florida Statutes (1998) and (1999), provides that the following is grounds for disciplinary action by the Board of Medicine: Exercising influence within a patient-physician relationship for purposes of engaging a patient in sexual activity. A patient shall be presumed to be incapable of giving free, full, and informed consent to sexual activity with his or her physician. 71. Respondent exercised influence within the physician-patient relationship for purposes of engaging Patient L. Bu. in sexual activity in one or more of the following ways: (a) By massaging her shoulders and saying she had a beautiful and athletic back while she was under his care for purposes of pain management treatment; (b) By kissing her neck while she was under his care for purposes of pain management treatment; (c) By fondling her breasts while she was under his care for purposes of pain management treatment. 72. Based -on the foregoing, Respondent violated Section 458.331(1)(j), Florida Statutes (1998), by exercising influence within a physician-patient relationship for purposes of engaging the patient in sexual activity. 18 J:\PSU\Medical\Bolivar\cases\Armashi\Armashi AC.2,doc 8T'd KOHY Ee:st SbGe-Se-Ad ZE:ST $00z ¢ dy FACTS REGARDING PATIENT L. BA. CASE NUMBER 2000-08846 73. On or about June 24, 1999, Patient L. Ba., a thirty-four (34) year-old female, presented to Respondent for treatment of pain related to reflex sympathetic dystrophy (*RSD”) and fibromyalgia syndromes. 74. Respondent’s medical records indicate that he diagnosed Patient L. Ba. with various conditions, including major depression, lower back pain, sacroiliac joint osteoarthritis, myofascial pain, RSD, and fibromyalgia. 5. Respondent began a treatment plan including lumbar paravertebral nerve block injection, sacroiliac joint injection, and trigger point injections. The injections included a mixture of Lidocaine and Depo- Medrol. On one or more occasions, Respondent also administered Versed and Fentanyl to Patient L. Ba. at the time of injection. 76. Respondent treated Patient L. Ba. for approximately nine months. On at least four occasions, Respondent sexually touched Patient L. Ba. after administering an injection, fondling her breasts and vaginal area over her clothes. 77. On or about January 28, 2000, Patient L. Ba. presented to Respondent at approximately 7:30 p.m. Respondent administered 19 J:\PSU\Medical\Bolivar\cases\Armashl\Armashi AC.2.doc el:st so0z S$ dy HOH Pest SeBe—-SA-Ad injections to her back, arm and Jeg which had a much stronger effect on Patient L. Ba. than those administered on previous visits. 78. Respondent fondled Patient L. Ba.’s breasts under her shirt and began to fondle her vaginal area, but she pushed his hand away. Patient L. Ba. left Respondent's office as soon as she recovered from the effects of the medication. On or about February 1, 2000, Patient L. Ba. and her husband reported Respondent’s conduct to the Hernando County Sheriff's Office. , COUNT Vii 79. Petitioner realleges and incorporates paragraphs one (1) through eighteen (18) and seventy-three (73) through seventy-eight (78) as if fully set forth herein. 80. Section 455.624(1)(u), Florida Statutes (1998) and (1999), provides that engaging or attempting to engage a patient or client in verbal or physical sexual activity is grounds for disciplinary action by the Department. This statute further provides that “For the purposes of this section, a patient or client shall be presumed to be incapable of giving free, full, and informed consent to verbal or physical sexual activity. 20 J:\PSU\Medical\Bollvar\cases\Armashi\Anmashl AC.1.doe @2"d HOH Pest SeBe—-SA-Ad el:st so0z S$ dy 81. Respondent engaged or attempted to engage Patient L. Ba. in - sexual activity outside the scope of professional practice in one or more of the following ways: (a) By fondling her breasts while she was under his care for purposes of pain management treatment; (b) By fondling her vagina while she was under his care for purposes of pain management treatment. 82. Based on the foregoing, Respondent violated Section 455.624(1)(u), Florida Statutes (1998) and (1999), by engaging or attempting to engage a patient or client in verbal or physical sexual activity. COUNT EIGHT 83. Petitioner realleges and incorporates paragraphs one (1) through eighteen (18) and seventy-three (73) through seventy-eight (78) as if fully set forth herein. 84. Section 458.331(1)(j), Florida Statutes (1998) and (1999), provides that the following is grounds for disciplinary action by the Board of Medicine: Exercising influence within a patient-physician relationship for purposes of engaging a patient in sexual activity. A patient 21 J:\PSU\Medical\Bolivar\cases\Armashi\Armashi AC.1.doc Te'd QOHY Pre:st SGe-Se-Add el:st so0z S$ dy shall be presumed to be incapable of giving free, full, and informed consent to sexual activity with his or her physician. 85. Respondent exercised influence within the physician-patient relationship for purposes of engaging Patient L. Ba. in sexual activity in one or more of the following ways: (a) By fondling her breasts while she was under his care for purposes of pain management treatment, (b) By fondling her vagina while she was under his care for purposes of pain management treatment. 86. Based on the foregoing, Respondent violated Section 458.331(1)(j), Florida Statutes (1998) and (1999), by exercising influence within a physician-patient relationship for purposes of engaging the patient in sexual activity. FACTS REGARDING PATIENT R.V. CASE NUMBER 2000-08620 87. On or about October 7, 1999, Patient R.V., a thirty-year-old female, presented to Respondent for treatment. She was referred by her psychiatrist for pain management. 88. Respondent diagnosed Patient R.V. with fibromyalgia and chronic lower back pain and began a treatment plan including trigger point 22 3:\PSU\Medical\ Bolivar\cases\armashi\Armashi AC.L.doc cee'd QOHY Pre:st SGe-Se-Add el:st so0z S$ dy injections. Respondent administered injections containing a mixture of Lidocaine, epinephrine, Depo-Medrol and Fentanyl. 89. On or about Patient R.V.’s second visit, Respondent instructed her to remove her brassiere in order to administer the injections. Patient R.V. also had to remove or lower her pants. Respondent never had an attendant in the room during these sessions, never gave her a gown or provided any other means for her to cover herself, and would remain in the treatment room and watch her while she undressed. 90. Respondent sexually touched Patient R.V. numerous times after administering the injections. On one or more occasions, Respondent fondled Patient R.V.’s bare breasts, rubbed her vaginal area, stroked her hair, and told her she was beautiful. He also pressed his erect penis against her back. 91. Respondent asked Patient R.V. to wear “t-back” panties when she presented for the injections and informed her that he preferred pink panties. Patient R.V. often presented for injections and medication refills on a weekly basis. Respondent would see Patient R.V. without an appointment and/or after hours for the injections. 23 J;\P5uU\Medical\ Bolivar\cases\Armashi\Armashi AC.1.doc Fe'd PLIST soz S$ 4dy HOH Sé:STt = SHBe—-SE-Ad 92, Patient R.V. continued to present to Respondent until approximately May 2000. COUNT NINE 93. Petitioner realleges and incorporates paragraphs one (1) through eighteen (18) and eighty-seven (87) through ninety-two (92) as if fully set forth herein. 94. Section 455.624(1)(u), Florida Statutes (1999), provides that engaging or attempting to engage a patient or client in verbal or physical sexual activity is grounds for disciplinary action by the Department. This statute further provides that “For the purposes of this section, a patient or client shall be presumed to be incapable of giving free, full, and informed consent to verbal or physical sexual activity. 95. Respondent engaged or attempted to engage Patient R.V. in sexual activity outside the scope of professional practice in one or more of the following ways: (a) By fondling her breasts while she was under his care for purposes of pain management treatment; 24 1:\PSU\Medical\Bolivar\cases\Armashl\Armashi AC.1L.doc Fed QOHY Se:st S6@e-Se-Ady PLIST soz S$ 4dy (b) (c) (d) (e) 96. By stroking her hair and telling her she was beautiful while she was under his care for purposes of pain managernent treatment; By asking her to wear “t-back” panties to office visits while she was under his care for purposes of pain management treatment; By telling her he liked pink panties while she was under his care for purposes of pain management treatment; By pressing his erect penis against her back while she was under his care for purposes of pain management treatment. Based on the foregoing, Respondent violated Section 455.624(1)(u), Florida Statutes (1999), by engaging or attempting to engage a patient or client in verbal or physical sexual activity. 97. COUNT TEN Petitioner realleges and incorporates paragraphs one (1) through eighteen (18) and eighty-seven (87) through ninety-two (92) as if fully set forth herein. 98. Section 456.072(1)(u), Florida Statutes (2000), provides that engaging or attempting to engage in sexual misconduct as defined and 25 1:\PSU\Medical\Bolivar\cases\Armashi\Armashi AC.1.doc HOH Se:st SHBe—-SE-Ado PLIST soz S$ 4dy prohibited in Section 456.063(1), Florida Statutes (2000), constitutes grounds for disciplinary action by the Board of Medicine. 99. Section 456.063(1), Florida Statutes, states as follows: Sexual misconduct in the practice of a health care profession means violation of the professional relationship through which the health care practitioner uses such relationship to engage or attempt to engage the patient or client, or an immediate family member, guardian, or representative of the patient or client in, or to induce or attempt to induce such person to engage in, verbal or physical sexual activity outside the scope of professional practice of such health care profession. Sexual misconduct in the practice of a health care profession is prohibited, 100. Respondent engaged in or attempted to engage Patient R.V. in sexual activity outside the scope of professional practice in one or more of the following ways: J:\PSU\Medical\Bollvar\casas\Armashi\Armashi AC.1.doc 92°d (a) By fondling her breasts while she was under his care for purposes of pain management treatment; (b) By stroking her hair and telling her she was beautiful while she was under his care for purposes of pain management treatment; (c) -By asking her to wear “t-back” panties to office visits while she was under his care for purposes of pain management treatment; 26 QOHY 9e:57 SBGe-Se-AHdy SI:ST soz S$ dy (d) By telling her he liked pink panties while she was under his care for purposes of pain management treatment, (e) By pressing his erect penis against her back while she was under his care for purposes of pain management treatment. 101. Based on the foregoing, Respondent violated Section 456.072(1)(u), Florida Statutes (2000) by committing sexual misconduct as defined and prohibited in Section 456.063(1), Florida Statutes (2000). COUNT ELEVEN 102. Petitioner realleges and incorporates paragraphs one (1) through eighteen (18) and eighty-seven (87) through ninety-two (92) as if fully set forth herein. 103. Section 458.331(1)(j), Florida Statutes (2000), provides that the following is grounds for disciplinary action by the Board of Medicine: Exercising influence within a patient-physician relationship for purposes of engaging a patient in sexual activity. A patient shall be presumed to be incapable of giving free, full, and informed consent to sexual activity with his or her physician. 104. Respondent exercised influence within the physician-patient relationship for purposes of engaging Patient R.V. in sexual activity in one or more of the following ways: 27 1:\PSU\Medical\Bolivar\cases\Ammashi\Armashi AC.1.doc de'd QOHY 9e:57 SBGe-Se-AHdy ST:ST $o0z ¢ dy (a) (b) (d) (e) 105. By fondling her breasts while she was under his care for purposes of pain management treatment; By stroking her hair and telling her she was beautiful while she was under his care for purposes of pain management treatment; | By asking her to wear “t-back” panties to office visits while she was under his care for purposes of pain management treatment; By telling her he liked pink panties while she was under his care for purposes of pain management treatment; By pressing his erect penis against her back while she was under his care for purposes of pain management treatment. Based on the foregoing, Respondent violated Section 458.331(1)(j), Florida Statutes (2000), by exercising influence within a physician-patient relationship for purposes of engaging the patient in sexual activity. WHEREFORE, Petitioner respectfully requests that the Board of Medicine enter an order imposing one or more of the following penalties: permanent revocation or suspension of Respondent's ‘license, restriction of 28 J:\PSU\Medical\Bolivar\cases\Armashi\Armashi AC.1.doc 82"d HOH 92:57 SHBe-Se-Ado SI:ST soz S$ dy practice, imposition of an administrative fine, issuance of a reprimand, placement of Respondent on probation, corrective action and/or any other relief that the Board deems appropriate. SIGNED this _/! day of __M#ch , 2005. John ©. Agwunobi, M.D., M.B.A., M.P.H. Secretary, Department of Health FILED DEPARTMENT OF HEALTH r DEPUTY CLERK Maus Wo Keo Casper CLERK J focus Colmar Maura M. Bolivar DATE 3~1Y-05 Assistant General Counsel eS ek oe DOH Prosecution Services Unit 4052 Bald Cypress Way, Bin C-65 Tallahassee, FL 32399-3265 Florida Bar No. 0295840 (850) 414-8126 (telephone) (850) 414-1989 (facsimile) MMB: jes Reviewed and approved by: o (initials) 2 los (date) PCP: march 11, 2005 PCP MemberSizi-pahri, McCoy, Dyches 29 7:\PSU\Medical\Bolivar\cases\Armashi\Armashl AC.1.doc 6e°d OHH 92:57 S8@e-Se-Add SI:ST soz S$ dy

Docket for Case No: 05-001231PL