Received Event (Event Succeeded) Date: 4/15/03 Time: 3:20 PM Pages: 11 Sender: 850431755555 Remote@ 3107 277850431¢58555 attoRNEY GENERALS OFFICE > 9216847 NO.176 = Bad ? ” ~ ww, & STATE OF FLORIDA t DEPARTMENT OF HEALTH { . | DEPARTMENT OF HEALTH ; —— sf a { . () > - (Od) Petitioner WS. CASE NUMBER: 1999-62114 LLOYD WRIGHT, D.C., Respondent. ADMINISTRATIVE COMPLAINT Petitioner, Department of Health, hereinafter referred to as "Petitioner’, files this Administrative Complaint before the Board of Chiropractic Medicine against LLOYD WRIGHT, hereinafter referred to as "Respondent”, and alleges: —L._-Petitioner is the state agency charged with regulating the practice of chiropractic medicine pursuant to Section 20.43, Chapter 456 (formerly Chapter 455, Part Il, Flarida Statutes) and Chapter 460, Florida Statutes. 2. Respondent is, and has been at all times material hereto, a licensed chiropractor in the State of Florida, having been issued license number CH 0002775. Respondent's last known address is 801 W. Granada Blvd. Suite 301, Ormond Beach, Florida 32174-5940, 3. Onor about April 13, 1999, Patient SW presented to Respondent with complaints of back pain resulting from a slip and fall accident that occurred on or about April 10, 1999. Patient SW continued under Respondent's care until on or about Jime 21, 1999. 4, During Patient SW’s initial visit, on or about April 13, 1999, Respondent indicated in the chiropractic medical records that a course of conservative care was a A 1 Received Event (Event Succeeded) Date: 4/15/03 Time: 3:20 PM Pages: 11 Sender: 850431755555 Remote 7518; 29c850437¢589595 — arToRNEY GENERALS OFFICE > 9216847 NO. 176 5. During the course of Respondent’s treatment of Patient SW, Respondent ordered and/or conducted multiple diagnostic tests, including but not limited to, somatosensory evoked potentials (SSEP) and nerve conduction velocities (NCV). 6. On or about April 30, 1999, Respondent ordered the SSEP and NCV tests. Respondent ordered three different NCV tests: NCV-Motor and F-wave, NCV-sensory, and H- reflex. The total amount billed for this testing was one thousand five hundred and ninety-five dollars ($1595.00). 7. Respondent signed a typed form on or about Apri) 30, 1999, that stated “Rationale for Diagnostic Study”. That form indicated: “The patient’s complaints have lasted more than four weeks since onset of treatment.” 8. Respondent did not treat the patient for four weeks before ordering the SSEP and NCYV tests; Respondent had only treated the patient three times, on April 13,1999, on April 20, 1999 and on April 21, 1999, before ordering the tests on April 30, 1999. 9. Respondent did not give Patient SW an adequate trial of conservative treatment prior to ordering the SSEP and NCV tests. 10. Respondent did not indicate, in Patient SW’s chiropractic medical records, the rationale for or necessity of obtaining multiple diagnostic tests, including but not limited to SSEP and NCV, before determining whether or not Patient SW would respond to conservative treatment. 11, Respondent provided Patient SW with appropriate conservative treatment modalities throughout the course of his treatment. Respondent treated Patient SW with manipulation, hot and cold packs, electrical muscle stimulation, and traction. Received Event (Event Succeeded) Date: Pages: Remote@S1B;29q850431558955 — artoRNEY GENERALS OFFICE > 9216847 4 4/15/03 Time: 3:20 PM 11 Sender: 850431755555 y C 12. Respondent did not change his treatment approach as a result of the multiple diagnostic studies, including but not limited to SSEP and NCV in that Respondent continued the Sathe treatment modalities throughout his care. 13, Onor about June 21, 1999, Respondent typed a Case Summary. 14. In that Case Summary, Respondent stated that a possible consultation with a neurologist was indicated. Respondent did not refer Patient SW for a neurological consultation. 15. In the Case Summary, Respondent also indicates that the prognosis for Patient SW was good and that Patient SW should be re-evaluated in four to six weeks. 16, Respondent did not justify in his medical records why multiple diagnostic testing was necessary $0 early in Patient SW’s treatment when the results of the tests did not change Respondent’s plan of care. On or about April 13, 1999, Respondent planned a course of conservative care and on or about June 21, 1999, Respondent planned to continue conservative care for an additional four to six weeks. 17. Respondent exercised influence over Patient SW for financial gain by engaging in overutilization by ordering excessive tests, including but not limited to SSEP and NCV, before those tests were indicated or necessary, 18. Respondent exercised influence over Patient SW for financial gain by engaging in overutilization by ordering excessive diagnostic tests, including but not limited to SSEP and NCV, without justifying, in his chiropractic medical records, the need for those tests before determining Patient SW’s response to conservative treatment. 19. Respondent exercised influence over Patient SW for financial gain by engaging in overutilization by ordering excessive diagnostic tests, including but not limited to SSEP and NCV, Received Event (Event Succeeded) Date: 4/15/03 Time: 3:20 PM Pages: 41 Sender: 850431755555 Remote (SID; 29g850437¢ 58555 at TORNEY GENERALS OFFICE > 9216847 NO. 176 | S : me without justifying, in his chiropractic medical records, how his treatment approach would be or was modified as a result of the findings from the diagnostic tests. 20. Rule 64B2-17.005, Florida Administrative Code (new 4-1-80) defines overutilization and states: (2) Overutilization of chiropractic services or practice is defined as services or practices rendered, or goods or appliances sold by a chiropractic physician to a patient for financial gain of the chiropractic physician or a third party which are excessive in quality or quantity to the justified needs of the patient. (3) Overutilization occurs when: . (a) The chiropractic records, required to be kept by subsection 460.413(1)(m), Florida Statutes, do not justify or substantiate the quantity or mumber of chiropractic services, practices rendered, or goods or appliances sold by a chiropractic physician to a patient; (>) A claim or claims for chiropractic services, practice, goods or appliances is submitted to that patient or third party payor representing multiple charges for one specific chiropractic diagnostic service or treatment practice, good or appliance. ; ; 21. 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 similar circumstances in that Respondent ordered excessive diagnostic tests, including but not limited to SSEP and NCV prematurely, before determining the effectiveness of his treatment approaches. 22. In the chiropractic medical records Respondent maintained for Patient SW, Respondent failed to justify the course of treatment in that he failed to document the necessity of diagnostic tests, including but not limited to SSEP and NCV so early in the treatment of Patient SW, before determining Patient SW’s response to conservative treatment, Received Event (Event Succeeded) Date: 4/15/03 Time: 3:20 PM Pages: 1 Sender: 850431755555 Remote SoS ;-297850431258§55 — attoRNEY GENERALS OFFICE > 9216947 NO. 176 bo. 3 v 23. In the chiropractic medical records Respondent maintained for Patient SW, Respondent failed to justify the course of treatment in that he failed to document how his treatment approach would be or was modified as a result of the findings of the diagnostic tests. COUNT ONE 24. ‘Petitioner realleges paragraphs one (2) through twenty-three (23) as if fully set forth herein this Count One. 25. Based on the foregoing, Respondent violated Section 460.413(1Xn), Florida Statutes (1998 Supp.), exercising influence on the patient or client in such a manner as to exploit the patient or client for financial gain of the licensee or a third party which shall include, but not be limited to, the promotion or sale of services, goods or appliances, or drugs. COUNT TWO 26. Petitioner realleges paragraphs one (1) through twenty-three (23) as if fully alleged herein this Count Two. 27. Based on the foregoing, Respondent violated Section 460.413(11), Florida Statutes (1998 Supp.), gross or repeated malpractice or the failure 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 similar conditions or circumstances. . COUNT THREE 28. Petitioner realleges paragraphs one (1) through twenty-three (23) and paragraphs as if fully set forth herein this Count Three. 29, Based on the foregoing, Respondent violated Section 460.413(1)(m), Florida Statutes (1998 Supp.), failing to keep legibly written chiropractic medica! records that identify Received Event (Event Succeeded) Date: 4/15/03 Time: 3:20 PM Pages: 1 Sender: 850431755555 Remote foSi2; 2980434298355 attoRNEY GENERALS OFFICE > 9216847 NO.176 clearly by name and credentials the licensed chiropractic physician rendering, ordering, supervising, or billing for each examination or wreatment 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. WHEREFORE, Petitioner respectfully requests the Board of Chiropractic Medicine to enter an order imposing one or mote of the following penalties: revocation or Suspension of Respondent’s license, restriction of Respondent's practice, imposition of an administrative fine and costs, issuance of a reprimand, placement of Respondent on probation, and/or any other relief that the Board deems appropriate. SIGNED this ky day of an Wah , 2002, John O. Agwunobi, M.D., M.B.A. Secretary, Department of Health BY: A M. Snurkowski, Chief Attorney ° DOH Bureau of Health Care Practitioner Regulation-Legal OUNSEL FOR PETITIONER: cen ED y Gatlaff, Attomey ba ja, Bar. No.: 49446] CLERK Yeh; Ker DOH Bureau of Health Care DATE o2, Practitioner Regulation-Legal 4052 Bald Cypress Way, Bin #C-65 Tallahassee, Florida 32399-3265 Telephone: (850) 922-2283 Case No. CH 1999-62114 (Wright) PCP: Vogel, Hoffman DATE: July 21, 2000 6

Docket for Case No: 06-003026PL