Oct 6 2006 12:48 Oct 6 2006 12:45 P. O06 Na ‘we! PRACTITIONER REGULATION STATE OF FLORIDA LEGAL DEPARTMENT OF HEAL#FHrrs - | AMIE: 45 DEPARTMENT OF HEALTH, Petitioner, vs” CASE NO. 2004-21769 STEPHEN E. NADEAU, M.D., Respondent. / A NIST E COMP COMES NOW Petitioner, Department of Health, by and through undersigned counsel, and files this Administrative Complaint before the Board of Medicine against Respondent, Stephen E. Nadeau, M.D., and alleges: 1, Petitioner is the state agency 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 hereto, Respondent has been a duly licensed physician in the State of Florida, having been issued license number ME 33898. t DOH v. Stephen &, Nadeau, M.D,; DOH Case No. 2004-21769 J:\PSU\Medical\LYNNE\aa Medical cases\Nadeau, Stephen MD; 2004-21769\AC Nadeau 04-21769.doc S000 | € NYT Oct 6 2006 12:48 Oct 6 2006 12:45 P.O? Nw’ ‘al 3. Respondent's address of record is GRECC (182), Veterans Administration Medical Center, Gainesville, Florida, 32608-1197 4. Respondent is board certified in neurology. 5. Respondent was Patient S.R.’s treating neurologist from 1991 to 2001. Respondent saw Patient S.R. for treatment of migraine headaches and depression. 6. Respondent’s last office visit with Patient S.R., a. then forty-six year old female, was in or about October 2001. 7. In or about November 2001, Patient S.R. moved from the State of Florida to the State of Colorado. 8. On or about November 27, 2002, Respondent dictated a letter to Patient S.R.’s chart which stated Respondent had called in a prescription for Fiorinal #3, 150 tablets for Patient S.R. after speaking with Patient S.R. by telephone. 9. Fiorinal #3 is a schedule III controlled substance regulated under Chapter 893 Florida Statutes, which contains aspirin, butalbital, caffeine, and codine, It is used primarily to relieve complex tension headaches. Fiorinal #3 has a currently accepted medical use in treatment in the United States, and abuse of Fiorina! #3 may lead to moderate or low 2 DOH v. Stephen E. Nadeau, M.D.; DOH Case No. 2004-21769 i APSU\Medical\LYNNE\aa Medical cages\Nadeau, Stephen MD; 2004- P21769\AC Nadeau 04-21769.doc Oct 6 2006 12:48 Oct 6 2006 12:45 P. 08 ue’ al! physical dependence and/or high psychological dependence. 10. On or about December 23, 2002, Patient S.R. contacted Respondent via telephone because of an increase in frequency and change in pattern of her headaches. : 11. Respondent wrote a prescription for Methadone 10 ‘mg, 180 tablets and. called in a prescription for Fiorinal #3, 200 tablets for Patient SLR. 12. Methadone is a schedule II controlled substance regulated by Chapter 893, Florida Statutes. Methadone is a narcotic pain reliever used in the treatment of severe pain. Methadone has a currently accepted medical use in treatment in the United States, and abuse of Methaclone may lead to severe psychological and/or physical dependence. | 13. On or about January 20, 2003, Respondent spoke with Patient S.R. via telephone to provide follow-up care for her migraines. Respondent issued Patient S.R. one prescription for Methadone 10 mg, 180 tablets and one prescription for Fiorinal #3, 1560 tablets with one refill. | 14. On or about February 20, 2003, Respondent spoke with Patient S.R. via telephone and Patient S.R. reported to Respondent that she had destroyed one of the Methadone prescriptions Respondent had: mailed to DOH v. Stephen E, Nadeau, M.D.; DOH Case No, 2004-21769 J:\PSU\Medical\LYNNE\aa Medical cases\Nadeau, Stephen MD; 2004-21769\AC Nadeau; 04-21769.doc Oct 6 2006 12:49 Oct 6 2006 12:45 P.09 “nae ea? her. Respondent issued Patient S.R. a prescription for Methadone 10 mg, 180 tablets. 15. On or about March 22, 2003, Respondent spoke with Patient S.R, via telephone regarding her headache management, sleep. disorder and depression. Respondent issued, and mailed to Patient S.R., two prescriptions for Methadone 10 mg, 186 tablets, and one prescription for Fiorinal #3, 150 tablets with one refill. 16. On or about May 12, 2003, Respondent spoke with Patient S.R. via telephone regarding her headaches, sleep disorder and depression. Respondent issued Patient S.R. one prescription for Fiorinal #3, 150 tablets with one refill, and two prescriptions for Methadone 10 mg, 186 tablets. 17, On or about July 11, 2003, Respondent spoke with Patient S.R. via telephone regarding her headaches, sleep disorder and depression. Respondent issued Patient S.R. one prescription for Fiorinal #3, 150 tablets with one refill, and mailed Patient S.R. two prescriptions for Methadone 10 ma, 186 tablets. 18. On or about September 3, 2003, Respondent spoke to Patient S.R. via telephone regarding her headaches, sleep disorder and depression. DOH v. Stephen E, Nadeau, M.D.; DOH Case No. 2004-21769 J:APSU\Medical\LYNNE\aa Medical cases\Nadeau, Stephen MD; 2004-21769\AC Nadeau 04-21769.doc Oct 6 2006 12:49 Oct 6 2006 12:46 P.10 ~ wa Respondent issued Patient S.R. two prescriptions for Fiorinal #3, 150 tablets and two prescriptions for Methadone 10 mg, 186 tablets. 19. On or about October 24, 2003, Respondent spoke with Patient S,R. via telephone regarding her headaches, sleep disorder-and depression. Respondent issued Patient S.R. two prescriptions for Methadone 10 mg, 248 tablets and two prescriptions for Fiorinal #3, 150 tablets. 20. On or about December 15, 2003, Respondent spoke with Patient 5.R. via telephone regarding her headaches, sleep disorder and depression, Respondent issued Patient S.R. two prescriptions for Fiorinal #3, 150 tablets and -two prescriptions for Methadone 10 mg, 248 tablets. 21. On or about February 9, 2004, Respondent spoke with Patient S.R. via telephone regarding her headaches, sleep disorder and depression. Respondent issued Patient S.R. two prescriptions for Methadone 10 mg, 248 tablets and two prescriptions for Fiorinal #3, 150 tablets. 22. On or about April 2, 2004, Respondent spoke with Patient S.R. via telephone regarding her headaches, sleep disorder and depression. Respondent issued Patient S.R. two prescriptions for Methadone 10 mg, 248 tablets and two prescriptions for Fiorinal #3, 150 tablets. DOH v. Stephen E, Nadeau, M.D.; DOH Case No, 2004-21769 : :\PSU\Medical\_LYNNE\aa Medical cases\Nadeau, Stephen Mb; 2004-21769\AC Nadeau 04-21769.doc Oct 6 2006 12:49 Oct 6 2006 12:46 P.11 Nee! Nall 23. On or about May 28, 2004, Respondent spoke with Patient S.R. via telephone regarding her headaches, sleep disorder and depression. Respondent issued Patient S.R. two prescriptions for Methadone 10 mg, 248 tablets and two prescriptions for Fiorinal #3, 150 tablets. | | 24. On or about July 20, 2004, Respondent spoke with Patient S.R. via telephone regarding her headaches, sleep disorder and depression. Respondent issued Patient S.R. one prescription for Fiorinal #3, 150 tablets with one refill and two prescriptions for Methadone 10 mg, 248 tablets. 25, On or about September 13, 2004, Respondent spoke with Patient S.R. regarding her headaches, sleep disorder and depression. Respondent issued Patient S.R. one prescription for Fiorinal #3, 150 tablets with one refill and.one prescription for Methadone 10 mg, 240 tablets, 26. On or about November 7, 2004, Respondent spoke with Patient S.R. via telephone and was advised by Patient S.R. that she had been hospitalized on a psychiatric service with a diagnosis of bipolar affective disorder and had been treated with lithium. Respondent issued Patient S.R. one prescription for Fiorinal #3, 150 tablets with one refill and one prescription for Methadone 10 mg, 310 tablets. DOH v, Stephen &. Nadeau, M.D.; DOH Case No, 2004-21769 . J:\PSU\Medical\LYNNE\aa Medical cases\Nadeau, Stephen MD; 2004-21769\AC Nadeau 04-21769.doc Oct 6 2006 12:49 Oct 6 2006 12:46 P.12 aa! Nad 27. Respondent prescribed narcotic medications and/or controlled substances to Patient S.R. who was residing out-of-state, without performing a physical examination on Patient S.R., for a period of approximately three years. 28. Section 458.331(1)(t), Florida Statutes (2004), provides that gross or 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, constitutes grounds for disciplinary action by the Board of Medicine. | 29. 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 circumstances when Respondent. continued to prescribe narcotic and/or controlled substance “medication to Patient S.R. who was no longer living in the State of Florida, based solely on Respondent’s telephone conversations with Patient 5.R. and without performing any physical examination on Patient §.R. for a period of approximately three years. ? DOH v. Stephen E, Nadeau, M.D,; DOH Case No. 2004-21769 J:\PSU\Medical\LYNNE\aa Medical cases\Nadeau, Stephen MD; 2004-21769\AC Nadeau 04-21769.doc Oct 6 2006 12:50 Oct 6 2006 12:46 P.13 ~ wo, 30. Based on the foregoing, Respondent violated - Section 458.331(1)(t), Florida Statutes (2004), 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. WHEREFORE, Petitioner respectfully requests 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 Respondent's practice, imposition of an administrative fine, issuance of a reprimand, placement of Respondent on probation, and/or any other relief that the Board deems appropriate. SIGNED this Z] day of. Tcl 2006, M, Rony Francois, M.D., M.S.P.H., Ph.D. Secretary, Department of Health CLE " CREP hepa eke Assistant General Counsel le 31-6 lo ' Prosecution Services Unit mene 4052 Bald Cypress Way, Bin C-65 Tallahassee, Florida 32399-3265 Florida Bar No. 0394572 850.245.4640 850.245.4681 Fax | LAQP/sw DOH v. Stephen E. Nadeau, M.D., DOH Case No, 2004-21769 J:\PSU\Medical\ YNNE\aa Medical cases\Nadeau, Stephen MD; 2004-21769\AC Nadeau o4-23769. doc Oct 6 2006 12:50 Oct 6 2006 12:47 P14 ee’ Ned we Reviewed and approved by: Coe (initials) 4/71 2 (date) PCP: /-73-O% PCP Members: eon + Gaeraar 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 C Respondent is placed on notice that Petitioner has incurred costs related to the investigation and prosecution of this. matter. ‘Pyursuant: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. 9 DOH v. Stephen E. Nadeau, M.D.; DOH Case No, 2004-21769 J:\PSU\Medical\LYNNE\aa Medical cases\Nadeau, Stephen MD; 2004-21769\AC Nadeau 04-21769.doc

Docket for Case No: 06-003863PL