STATE OF FLORIDA DEPARTMENT OF HEALTH = DEPARTMENT OF HEALTH, PETITIONER, Vv. WILLIAM JOHN GOGAN, M.D., RESPONDENT. _ ADMINISTRATIVE COMPLAINT Petitioner, Department of Health, by and through undersigned counsel, files this Administrative Complaint before the Board of Medicine against Respondent, William John Gogan, M.D., and in support thereof alleges: 1. Petitioner is the state department charged with regulating the practice of medicine pursuant to Section 20.43, Florida Statutes; Chapter 456, Florida Statutes, and Chapter 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 58162. 3. Respondent's address of record is 701 Northlake Blivd., Suite 208, North Palm Beach, Florida 33408. 1 DOH v. William J. Gogan, M.D.; DOH Case No. 2003-19156 4. On or about July 17, 2003, Respondent prescribed Saizen 5 mg/15iu Vial to Patient N.S., athen 61 year-old male resident of Alabama. 5. Saizen is a legend drug, and a brand name for Somatropin, a human growth hormone used primarily for the long term treatment of children with growth failure due to inadequate secretion of endogenous growth hormone. 6. On or about August 4, 2003, Respondent prescribed Testosterone Cypionate 200 mg/ml (10m!) to Patient N.S. 7, Testosterone Cypionate is a scheduled III controlled substance regulated by Chapter 893, Florida Statutes. It is used to prevent osteoporosis in men who have low testosterone levels. 8. On or about August 4, 2003, Responden prescribed “Saizen 5mg/idiu Vial”, “100 Alcohol swabs Qty 100,” “Novarel (HCG) 10, 0000 units”, “Cyanacobalamin 1000mcg/m! (30 ml)”, and “Sharps container Qty 1” to Patient N.S. 9. Novarel (HCG) is an injectable form of a naturally occurring hormone produced by the placenta. HCG supports the normal development of an egg from the ovary and can induce ovulation. HCG also stimulates the production of androgens in men and progesterone in women. 2 DOH vy. William J. Gogan, M.D.; DOH Case No. 2003-19156 10. Cyanacobalamin is a brand name for an injectable form of Vitamin B12. It helps maintain healthy nerve cells and red blood cells. 41. On or about October 20, 2003, Respondent prescribed “Saizen 5mg/15iu Vial” to Patient N.S. 12. Respondent did not conduct a physical examination of Patient N.S. prior to prescribing any medications to him. 13. Respondent did not determine and/or verify any potential contraindications in Patient N.S. prior to prescribing the above-referenced medications to him. 14. Respondent did not provide any plan of care, follow-up care, or monitoring prior to, or at any time following, his prescribing of medications to Patient N.S. 15. Respondent inappropriately prescribed medications to Patient N.S., by virtue of having prescribed such medication to Patient N.S. without conducting a physical examination on Patient N.S. 16. Respondent failed to practice medicine with that level of care, skill, and treatment which is recognized by a reasonably prudent similar physician as being acceptable under similar conditions and circumstances, when he prescribed medications to Patient N.S. without first conducting a physical examination on Patient N.S. 3 DOH v. William J. Gogan, M.D.; DOH Case No. 2003-19156 17. Respondent failed to keep medical records that justified the course of treatment provided to Patient N.S. by Respondent. COUNT ONE 18. Petitioner realleges and incorporates paragraphs one (1) through seventeen (17) as if fully set forth herein. 19. Section 458.331(1)(m), Florida Statutes (2003), provides that a physician may be subject to discipline for failing to keep legible 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. 20. Rule 64B8-9.003, Florida Administrative Code (FA.C.), establishes the standard of practice for adequacy of medical records and provides that medical records are maintained for purposes of, among other things: 1) establishing a basis for planning patient care and for continuity of care; 2) furnishing documentary evidence of the course of the patient's medical evaluation, treatment and change in condition; and 3) documenting communication between the practitioner responsible for the patient and other health care practitioners. This rule further requires the medical record to contain sufficient information to identify the patient, 4 DOH v. William J. Gogan, M.D.; DOH Case No. 2003-19156 support the diagnosis, justify the treatment, and document the course and results of treatment accurately, by including, at a minimum, patient histories; examination results; test results; records of drugs prescribed, dispensed, or administered; reports of consultations; and copies of records obtained from other health care practitioners. 21. Respondent's medical records regarding Patient N.S. insufficiently documented and did not justify the course of treatment of Patient N.S. 22. Respondent's records did not include the following: a) Assessments and/or related reports for planning the care of Patient N.S., or for continuity in the evaluation of the condition and treatment of Patient N.S.; b) The name of Patient N.S/s primary physician; c) Alan of care for Patient N.S.; d) Verification or substantiation of the blood pressure, weight or height of Patient N.S.; e) Physical and/or medical examination results, and Patient N.S.'s medical history; or f) Reports of consultations and/or hospitalizations. 5 DOH vy. William J. Gogan, M.D.; DOH Case No. 2003-19156 23. Based on the foregoing, Respondent violated Section 458.331(1)(m), Florida Statutes (2003), and Rule 64B8-9.003, FA.C., by failing to keep legible medical records that justify the course of treatment of Patient N.S. COUNT TWO 24. Petitioner realleges and incorporates paragraphs one (1) through seventeen (17) as if fully set forth herein. 25, Section 458.331(1)(q), Florida Statutes (2003), provides that a physician may be subject to discipline for prescribing, dispensing, administering, mixing, or otherwise preparing a legend drug, including any controlled substance, other than in the course of the physician's professional practice. For the purposes of this paragraph, it shall be legally presumed that prescribing, dispensing, administering, mixing, or otherwise preparing legend drugs, including all controlled substances, inappropriately or in excessive or inappropriate quantities is not in the best interest of the patient and is not in the course of the physician's professional practice, without regard to his or her intent. 26. Respondent inappropriately prescribed Saizen, Testosterone Cypionate; Novarel (HCG), and Cyanacobalamin to Patient N.S. by failing to 6 DOH v. William J. Gogan, M-D.; DOH Case No. 2003-19156 conduct a physical examination on Patient N.S. prior to prescribing these medications to him. 27. Based on the foregoing, Respondent violated Section 458.331(1)(q), Florida Statutes (2003), by prescribing, dispensing, administering, mixing, or otherwise preparing a legend drug, including any controlled substance, other than in the course of the physician's professional practice, by virtue of inappropriately prescribing Saizen, Testosterone Cypionate; Novarel (HCG); and Cyanacobalamin to Patient N.S. COUNT THREE 28. Petitioner realleges and incorporates paragraphs one (1) through seventeen (17) as if fully set forth herein. 29, Section 458.331(1)(t), Florida Statutes (2003), provides that a physician may be subject to discipline for failing to practice medicine with that level of care, skill, and treatment which is recognized by a reasonably prudent similar physician as being acceptable under similar conditions and circumstances. 30. Respondent failed to practice medicine with that level of care, skill, and treatment which is recognized by a reasonably prudent similar physician as being acceptable under similar conditions and circumstances, 7 DOH v. William J. Gogan, M.D.; DOH Case No. 2003-19156 when he prescribed Saizen,; Testosterone Cypionate; Novarel (HCG); and Cyanacobalamin to Patient N.S., in one or more of the following ways: a) b) c) d) e) f) h) 31. Respondent failed to establish a doctor-patient relationship with Patient N.S.; Respondent failed to perform a physical examination of Patient N.S..: Respondent failed to verify Patient N.S.’s medical information; Respondent failed to verify Patient N.S.'s need for Saizen; Testosterone Cypionate; Novarel (HCG); and Cyanacobalamin,; Respondent failed to verify Patient N.S/s vital signs, such as height, weight, and blood pressure, Respondent failed to establish a plan of care for Patient N.S.; and Respondent failed to maintain medical records for Patient N.S. consistent with the standards established by Rule 64B8-9.003, FA.C. Based on the foregoing, Respondent has violated Section 458.331(1)(t), Florida Statutes (2003), by failing to practice medicine with that level of care, skill, and treatment which is recognized by a reasonably 8 DOH v. William J. Gogan, M.D. DOH Case No. 2003-19156 prudent similar physician as being acceptable under similar conditions and circumstances. 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 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. s 5 Signed this 2! _ day of [tans — _ 2004. John O. Agwunobi, M.D., M.B.A., M.P.H. Secretary, Department of Health DEPARTMENT OF HEALTH Assistant General Counsel DEPUTY CLERK Florida Bar No.: 0394572 CLERK Nit sees Colones DOH, Prosecution Services Unit DATE Dae: 4052 Bald Cypress Way, Bin # C-65 —————$—$_— Tallahassee, FL 32399-3265 850.414.8126 Business 850.414.1991 Facsimile LAQP/sw Reviewed and approved by: D cK {initials) 1 lio Joy (date) PCP irepruary 21, 2005 PCP Members: El-Bahri, Coto, Dyches 9 DOH v. William J. Gogan, M.D.; DOH Case No. 2003-19156 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 INV 1 te OR eee eee OOOO 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. 10 DOH v. William J. Gogan, M.D.; DOH Case No. 2003-19156

Docket for Case No: 05-001636PL