STATE OF FLORIDA DEPARTMENT OF HEALTH DEPARTMENT OF HEALTH, PETITIONER, v, CASE NO. 2001-07713 SHIRIN THOBANI, M.D., 5 . OD J DdIO0 FL RESPONDENT. I ADMINISTRATIVE COMPLAINT COMES NOW, Petitioner, Department of Health, by and through its undersigned counsel, and files this Administrative Complaint before the Board of Medicine against Respondent, Shirin Thobani, 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 4 licensed physician within the State of Florida and was issued license number ME 73288. 3. Respondent's address of record is 1931 NW 35" Terrace, Coconut Creek, Florida 33066. 4. Oxycontin is a legend drug as defined by Section 465.003(8), Florida Statutes, and contains oxycodone, 4 Schedule Il controlled substance listed in Chapter 893, Florida. Statutes. Oxycodone is 3 narcotic analgesic indicated for the relief of moderate to moderately severe pain and carries a high potential for abuse. Abuse of Oxycontin may lead to severe physical and psychological dependence. 5. On or about December 28, 2000, Patient W.C., a 39 year-old male, was involved in an automobile accident. 6. On or about December 29, 2000, Patient W.C. presented to Respondent complaining of neck and back pain, left upper eyebrow laceration and loss. of consciousness for a short period of time. 7. On or about December 29, 2000, Patient W.c. indicated no history of psychiatric problems, depression, anxiety, and drug addiction. 8. Patient W.C. also reported a past medical history positive for neck pain and back injuries from prior automobile accidents in June of 1996 and 2000. Patient W.C, further indicated that he had previously been prescribed Oxycontin. 9. Respondent's physical exam of Patient W.C. revealed a laceration of the lef upper extremity, healing weil with muscle strengths 5/5, DTR+2, tenderness on deep palpation with paraspinal muscles spasms in the cervical and lumbosacral area and tenderness in the region of the left Temporomandibular Joint with normal sensory exam. ~ 40. Initial and follow up examination did not reveal numbness or tingling in Patient W.C’s arms or other evidence of symptoms in the arms. 41. On or about December 29, 2000, Respondent prescribed Patient W.C. Oxycontin, 80 mg., twice daily. 12. On or about January 5, 10, and 17, 2001, Patient W.C. presented to Respondent complaining of neck and back pain. 43. On or about January 5, 10, and 17, 2001, Respondent prescribed Oxycontin, 40 mg,, three times daily for Patient W.C. 14. Onor about February 2, 5, 14, 23, and 28, 2001, Patient W.C. presented to Respondent continuing to complain of severe neck and back paln. 15. On or about February 2, 5, 14, 23, and 28, 2001, Respondent either maintained or prescribed Oxycontin, 20-40 mg., UP to three times daily for Patient W.C. 16. On or about March 14, 28, and 30, 2001, Patient W.C. presented to Respondent complaining of neck and back pain. 47, Onor about March 14, 28, and 30, 2001, Respondent maintained Patient W.C. on Oxycontin 40 mg., twice daily. 18. Throughout April of 2001, Respondent physically examined Patient W.C. and maintained him on Oxycontin 40-80 mg. twice daily. 49. Onor about April 12, 2001, although Patient W.C. reported no numbness or tingling in his arms and no objective findings suggested nerve generated symptoms in his arms, Respondent ordered somatosensory evoked potentials (SSEP’s) and other electrodiagnostic studies of Patient W.C’s upper extremities. 20. Onor about May 3, 2001, Respondent diagnosed Patient W.C. with a mild right-sided radiculopathy from the results of the somatosensory studies of Patient W.C’s cervical region. 21. On or about May 9, 14, 23, and 30, 2001, Patient W.C, presented to Respondent complaining of neck and back pain. 22. Onor about May 9, 14, 23, and 30, 2001, Respondent maintained Patient W.C, on Oxycontin, 40 mg., twice daily. 23. From December, 2000, through May, 2001, Respondent did not obtain information about Patient W.C. from his prior treating physicians. 24, From December, 2000, through May, 2001, Respondent did not refer Patient W.C. to a pain management spacialist and/or order a psychiatric consultation. COUNT ONE- STANDARD OF CARE 25, Petitioner realleges and incorporates paragraphs one (1) through twenty- four (24) as if fully set forth herein. 26. Section 458.331(1)(t), Florida Statutes (2002), provides that a physician's license may be disciplined by the Board of Medicine based upon gross OF repeated malpractice or the failure 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. . 27. Respondent failed to practice medicine with that level of care, skill, and treatment which would be recognized by a reasonably prudent similar physician as being acceptable under similar conditions and circumstances by one or more of the following: a. Failure to refer Patient W.C. to a pain management specialist and/or psychiatric consultation after he failed to improve, b, Failure to contact Patient W.C.’s prior treating physicians regarding f his true prior history c. Ordering unnecessary nerve conduction studies. 28. Based on the foregoing, Respondent has violated Section 458.331(1)(t), Florida Statutes, by 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, COUNT TWO-OVERPRESCRIBING 29. Petitioner realleges and incorporates paragraphs one (1) through twenty- four (24) above as if fully set forth In this count. . 30. Sectlon 458,331(1)(q), Florida Statutes (2002), provides that a physician’s license may be disciplined by the Board of Medicine based upon the Respondent's failure to prescribe, dispense, administer, mix or otherwise prepare a legend drug, including any controlled substance, inappropriately or in excessive quantities that [s not In the best interest of the patient. 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. 31. Respondent prescribed Oxycontin to Patient W.C. in excessive or Inappropriate quantities for the period December 29, 2000, through May 30, 2001. 32. Based on the foregoing, Respondent has violated Section 458.331(1)(q), Florida Statutes, by prescribing, dispensing, administering, mixing, or otherwise preparing a legend drug, including any controlled substance, inappropriately or excessively other than in the course of the physician's professional practice. COUNT THREE-MEDICAL RECORDS 33. Petitioner realleges and incorporates paragraphs one (1) through twenty- four (24) above as if fully set forth in this count. 34. Section 458.331(1)(m), Florida Statutes (2001), provides that a physician’s license may be disciplined by the Board of Medicine based upon Respondent's failure to keep legible, as defined by department rule in consultation with the board, medical records that identify the licensed physician or the physician extender and supervising 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. 35. Respondent failed to keep legible medical records that justify the course of treatment of Patient W.C. based upon the following: records do not justify nerve conduction studies, or continuation of Oxycontin medication after failure to improve, or continued treatment without referral for pain management or psychiatric consult. 36. Based on the foregoing, Respondent violated Section 458.331(4)(m), Florida Statutes, by failing to keep legibie, 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. WHEREFORE, the 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 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 24, day of Api | , 2003. John O. Agwunobi, M.D., M.B.A. Secretary, Department of Health Qo" wo Oe ; BSS 7a y ie 7 : we Mins v Assistant General Counsel wt DOH Prosecution Services Unit ce) a 4052 Bald Cypress Way, Bin C-65 Tallahassee, FL 32399-3265 Florida Bar #440817 ~ (850) 414-8126 (850) 414-1989 RCB:ez Reviewed and approved rydtd (initials)2/_ 2 /o> (date) Pcp: es [o3 PCP Members: DOH vs. Shirin Thobani, M.D., Case No. 2001-07713 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 tohave 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. :

Docket for Case No: 05-002310PL