Jul 27 2006 10:33 Jul 2? 2006 10:31 P. 02 STATE OF FLORIDA DEPARTMENT OF HEALTH ‘DEPARTMENT OF HEALTH, PETITIONER, v. CASE NO. 2003-28728 KENNETH COURINGTON, M.D., RESPONDENT. / 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 the Respondent, Kenneth Courington, 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 44655. 3. Respondent’s address of record is 2335 Tamiami Trail North, Suite 501, Naples, FL 34103. JAPSU\Modicalrving Levine\AC\Courington 03-28738 ac.doc 9002 | € AVA Jul 27 2006 10:33 Jul 2? 2006 10:31 P.03 4, — Respondent is board certified in surgery. 5. On or about June 23, 2000, Patient M.T., a forty (40) year old male, was riding his bicycle when he was hit by a motor vehicle. 6. Patient M.T. was transferred to Naples Community Hospital (NCH) emergency room via ambulance, and was examined by emergency room physicians who diagnosed acute multi-trauma, including a fractured pelvis and right tibia. An abdomen/pelvic CT demonstrated an attenuation (reduction in thickness) involving the left rectus abdominis muscle as well as a hematoma in the intra-abdominal musculature, Patient M.T. was admitted. 7. On or about June 24, 2000, at NCH, Respondent performed a history and physical examination and ordered a bowel regime, 8, Respondent's diagnosis included major ‘trauma with the following injuries: a) forehead and skull soft tissue injury with stellate laceration, avulsion and subcutaneous hematoma; b) left frontal fracture with small epidural hematoma; c) left orbital and nasal fractures; d) left elbow, soft tissue injury; e) left hand fracture and abulstionis; f) fractured pelvis with peritoneal hematoma; and, Q) open right tibial fibula displaced fragmented fracture. JAPSU\Medical\Irving Levine\AC\Courington 03-28738 ac.doe Jul 27 2006 10:34 Jul 27 2006 10:32 P. O04 9. Despite these signs, including pelvic trauma and rectal bleeding, Respondent did not perform a rectal examination on Patient M.T. 10. From about June 24", to about July 5, 2000, Patient M.T. | suffered an ileus (blockage of the intestine), scrotal edema and abdominal and left lower extremity swelling. 11, During this time period, Patient M.T. also suffered rectal _ bleeding which is repeatedly documented in the nursing notes. 12. On or about July 4, 2000, a pelvic CT scan was ordered which revealed air and subcutaneous tissues consistent with possible necrotizing fascitis, 13. On or about July 5, 2000, Patient M.T. was transferred to Tampa General Hospital where he underwent an immediate exploratory laporotomy, diverting loop colostomy, and incision and debridement of perineum flanks and scrotum. Patient M.T. was diagnosed with necrotizing fascitis of the perineum due to rectal tear. 14. Additionally, Patient M.T’s infection required numerous (about 10) surgical debridement and irrigation procedures as well several (about 6) skin grafts and complete surgical reconstruction of his scrotum. 15. During the hospitalization at NCH, Respondent failed to perform an appropriate rectal examination on Patient M.T. JAPSU\Medical\Irving Levine\AC\Courington 03-28738 ac.doc Jul 27 2006 10:34 Jul 27 2006 10:32 P.O5 16. Respondent failed to document a justification for his failure to perform an appropriate rectal examination on Patient M.T. COUNTT 17. Petitioner realleges and incorporates paragraphs one (1) through sixteen (16) as if fully set forth herein. 18. Section 458.331(1)(t), Florida Statutes (1999-2000), provides that 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 constitutes grounds for disciplinary action by the Board of Medicine. 19. 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 in one or more of the following ways: a) by failing to perform an appropriate rectal examination on Patient M.T.; b) by failing to appropriately diagnose Patient M.T’s rectal tear. 20. Based on the foregoing, Respondent has violated Section 458.331(1)(t), Florida Statutes (1999-2000), by failing to practice medicine with that level of care, skill, and treatment which is recognized by a JAPSU\Medicalrving Levine\AC\Courington 03-28738 ac.doc Jul 27 2006 10:34 Jul 27 2006 10:32 P. O06 reasonably prudent similar physician as being acceptable under similar conditions and circumstances, COUNT IT 21. Petitioner realleges and incorporates paragraphs one (1) through sixteen (16) as if fully set forth herein. 22. Section 458.331(1)(m), Florida Statutes (1999-2000), provides that 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 constitutes grounds for disciplinary action by the Board of Medicine, 23. Respondent failed to keep legible medical records justifying his treatment of Patient M.T. by failing to document a justification for not performing an appropriate rectal examination on Patient M.T. 24. Based on the foregoing, Respondent violated Section 458.331(1)(m), Florida Statutes (1999-2000), by 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. JAPSU\Medical\irving Levine\AC\Courington 03-28738 ac.doc Jul 27 2006 10:34 Jul 27 2006 10:32 P.O? 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 3/_ day of May , 2006, M. Rony Francois, M.D., M.S.P.H., Ph.D, Secretary, Department of Health FILED By: Irving Levine aaa! ty GinzAcTn Assistant General Counsel CLERK Shumoa Melon DOH-Prosecution Services Unit oR Rela - 4052 Bald Cypress Way-Bin C-65 TE SIRO Tallahassee, Florida 32399-3265 Florida Bar # 0822957 (850) 245-4640, ext 8128 (850) 245-4680 fax PCP: Mag AG, Leos PCP Members: g/_ Bahri, 10 ry Faron mo JAPSU\Medical\irving Levine\AC\Courington 03-28738 ac.doc Jul 27 2006 10:35 Jul 27 2006 10:33 P. 08 OTI F RIGHT: 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, TICE REGARD SSE T 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. IAPSU\Medical\Irving Levine\AC\Courington 03-28738 ac.doe

Docket for Case No: 06-002705PL