OCT-18-28R6 gor12 Oct 10 20068 9:05 STATE OF FLORIDA DEPARTMENT OF HEALTH DEPARTMENT OF HEALTH, PETITIONER, Vv. CASE NO. 2006-04126 VANESA LA’SHEA ROBINSON, R.PH., RESPONDENT. | ADMINISTRATIVE COMPLAINT Petitioner, Department of Health, by and through undersigned counsel, files this Administrative Complaint before the Board of Pharmacy against Respondent, Vanessa La’Shea Robinson, R.Ph., and in support thereof alleges: 1. Petitioner is the state department charged with regulating the practice of pharmacy pursuant to Section 20.43, Florida Statutes; Chapter 456, Florida Statutes; and Chapter 465, Florida Statutes. 2, Respondent is, and has been at all times pertinent to this Complaint, a licensed pharmacist pursuant to Chapter 465, Florida Statutes, having been issued license number PS 20171. 3. Respondent's address of record is 1671 Keely Lane, Sarasota, J:\PSU\Medical\LYNNE\a pharmacist pharmacy\Rabinson 06 04126\robinsan 06 04126 eso ac.doc 1 P.a4715 Oct 10 2006 9:03 OCT-18-2886 9:12 P.@6/15 Florida 34232. 4. The Professionals Resource Network (“PRN”), formerly the Physicians Recovery Network, is the impaired practitioners program for the Board of Pharmacy, pursuant to Section 456.076, Florida Statutes. PRN is an independent program that monitors the evaluation, care, and treatment of impaired healthcare professionals. PRN oversees random drug screens and provides for the exchange of information between Department of Health (Department) approved treatment providers and the Department for the protection of the public. Raymond M. Pomm, M.D., a Board-certified psychiatrist and addictionolosist, is the Medical Director of PRN and is charged with responsibility for the oversight of the program and documentation of compliance and noncompliance with PRN monitoring contracts. 5. In or about November 2005, Respondent was employed by HealthSouth as a pharmacist. Based on two episodes of apparent impairment while at work, Respondent was given the opportunity to present a physician's certificate that she was fit for duty as a pharmacist and an appointment for Respondent was scheduled for November 18, 2005, with a Florida licensed physician (provider). J\PSU\Medical\LYNNE\a pharmacist pharmacy\Robinson 06 04126\robinson 06 04126 eso ac.doc 2 Oct 10 2006 9:04 OCT-18-2886 9:12 P.@6715 6. Respondent presented on November 18" to the provider who assessed her as follows: 1. Chronic headaches believe multifactorial likely a component of analgesic rebound headaches as well as tension headaches and intermittent migraines, which are currently not treated with prophylactic therapy and likely over treated with opiates in combination with Benzos and Ambien, which are likely causing some impairment in her ability to function as a pharmacist. There may be an element of substance dependence and/or abuse. The patient has had screening urine done through her office, however these will be positive for Benzo’s and opiates. I would recommend a more intensive evaluation with a psychiatrist substance abuse counselor, which is certified through the professional recovery network in order to determine whether this patient is in fact safe to return to work on her current medications. At this time, I am recommending that she avoid using the Fiorinal and Xanax, but follow up closely with her psychiatrist. Stress reduction techniques with physical therapy t.id. and home exercises on a daily basis including neck range of motion, exercises, heating pad as needed. 2. Cognitive behavioral therapy and marriage counseling consideration and likely the patient will need to have regular drug screens. 7. In December 2005, Respondent was terminated from her position at HealthSouth because she was impaired on the job, having slurred speech and other indicia of impairment. 8. On December 16, 2005, Respondent was evaluated by a Department approved addictionist (Doctor #1), Respondent admitted that J:\PSU\Medical\LYNNE\a pharmacist pharmacy\Robinson 06 04126\robinson 06 04126 eso ac.doc 3 Oct 10 2006 9:04 OCT-18-2886 9:15 P.@?7/71s she was currently on Fiorinal with codeine prescribed by Steven Gupta, M.D., an internist in her area. | 9. During this December 16” evaluation Respondent also confirmed that Vadimir Eirismann, M.D. prescribed to her and she was using Restoril, Remeron and Xanax 2 mg Q.H.S. for sleep disturbance. 10. During this December 16" evaluation, Respondent provided a drug screen that tested urine positive for Benzodiazepines, Oxazepam and Alprazolam, consistent with her prescribed medications. 41. Doctor #1 provided the following diagnosis of Respondent: “axis I - Iatrogenic Dependence to Opiates and Benzodiazepines Secondary to Migraines and Sleep Disturbance. No evidence of Addictive Behavior. Panic Disorder; Axis II - Deferred; Axis III History of Migraine, Sleep Disturbance, Etiology unknown; Axis IV Moderate; Axis V GAF of 80.” 12. Restoril is a schedule IV controlled substance accord ing to Chapter 893 Florida Statutes that is a benzodiazephine hypnotic agent. It is used to treat for sleep. A medication in schedule IV has a low potential for abuse relative to the substances in schedule III and has a currently accepted medical use in treatment in the United States. Abuse of the substance may lead to limited physical or psychological dependence 3:\PSU\Medical\LYNNE\a pharmacist pharmacy\Robinson 06 04126\robinson 06 04126 eso ac.doc 4 Oct 10 2006 9:04 OCT-18-2886 9:15 P.@6715 relative to the substances in schedule II. 13. Alprazolam (a/k/a Xanax) is a schedule IV controlled substance according to Chapter 893 Florida Statutes that is a benzodiazepine class of central nervous system-active compounds. Used for the treatment of anxiety disorders. A medication in schedule IV has a low potential for abuse relative to the substances in schedule III and has a currently accepted medical use in treatment in the United States. Abuse of the substance may lead to limited physical or psychological dependence relative to the substances in schedule ITI. 14. Valium is a schedule IV controlled substance that is a benzodiazepine derivative used to treat anxiety disorders. A medication in schedule IV has a low potential for abuse relative to the substances in schedule III and has a currently accepted medical use in treatment in the United States. Abuse of the substance may lead to limited physical or psychological dependence relative to the substances in schedule III. 15, Remeron is a legend drug used for the treatment of major depressive disorder. 16. Doctor #1 recommended Respondent obtain outpatient psychiatry and counseling for detoxification and he informed her that “she J:\PSU\Medical\LYNNE\a pharmacist pharmacy\Robinson 06 04126\robinson 06 04126 eso ac.doc 5 OCT-18-2886 @9'13 vee 10 2008 “ P.@9/15 should not practice as a pharmacist if she uses an opiate or barbiturate for migraine until the PRN clears her to work.” 17. On or about January 10, 2006, Respondent was contacted by - PRN and given options for an inpatient pain evaluation with two licensed physicians. | Respondent chose to do an outpatient with another Department approved provider, (board certified by the American Society of Addiction Medicine) (hereinafter Doctor #2) and to have her psychiatrist monitor her detoxification from the Benzodiazepines. 18. At this time, Respondent was also advised that PRN needed to clear her before she returned to work as a pharmacist. Respondent was told to stop working as a pharmacist. 19. On or about January 10, 2006, Respondent contacted Doctor #15 office. A licensed clinical social worker (LCSW) in Doctor #1’s office returned the call and spoke with Respondent. The LCSW recorded that Respondent sounded very impaired, slurred her words and became confused about what she was saying and not being able to remember names. 20. During this telephone conversation, the LCSW repeated Doctor #1's name at least three (3) times to Respondent, as she could not J:\PSU\Medical\LYNNE\a pharmacist pharmacy\Robinson 06 04126\robinson 06 04126 eso ac.doc 6 Oct 10 2006 9:05 OCT-18-2686 9:14 P.ig/15 remember his name. 21. Further, the LCSW again told Respondent about that PRN had to approve her return to work as a pharmacist. 22. Respondent acknowledged to the LCSW that she understood she was not to practice (as a pharmacist) without PRN approval, but that she was doing so anyway. 23. The LCSW telephoned PRN and advised that Respondent . sounded very impaired on the telephone and Doctor #1s office was concerned about Respondent’s behavior. 24. On or about January 13, 2006, Respondent contacted PRN stating she was on her way to an evaluation in Sunrise, Florida, but had forgotten the name of the evaluator. Respondent's voice was slurred; she sounded confused and asked if PRN could tell her. PRN had been previously advised that Respondent was to see Doctor #2 who is in Miami, not Sunrise. 25. PRN received another telephone call from Doctor #1’s office stating that Respondent had called Doctor #1s office that same day to inquire of the name of the person whom Respondent was to be seeing that day. J:\PSU\Medical\LYNNE\a pharmacist pharmacy\Robinson 06 04126\rohinson 06 04126 eso ac.dac ? OCT -1p-2ee Botta Oct 10 2006 9:05 otis 26. During this call to Doctor #1’s office, Respondent told the LCSW that she was working, even though PRN had advised her not to work. 27, Respondent did not complete the “outpatient” evaluation with Doctor #2 on January 13, 2006 as PRN recommended an “inpatient” evaluation. 28. Respondent was working as recently as March 16, 2006, as a Prescription Department Manager for a pharmacy located in Sarasota Florida, despite PRN’s direction (and per her agreement) to refrain from practicing as a condition of PRN participation. 29. Section 465.016(1)(m), Florida Statutes (2005), provides that being unable to practice pharmacy with reasonable skill and safety by reason of illness; use of drugs, narcotics, chemicals, or any other type of material; or as a result of any mental or physical condition, constitutes grounds for disciplinary action. 30. Respondent has demonstrated an inability to practice pharmacy _ with reasonable skill and safety by her dependence on Opiates and /or benzodiazepines and/or her slurred speech and/or her inability to comprehend directions to obtain an appropriate evaluation. 3:\PSU\Medical\LYNNE\a pharmacist pharmacy\Robinson 06 04126\robinson 06 04126 eso ac.doc 8 Oct 10 2006 9:05 OCT-18-2686 9:14 P.12/15 31. Based on the foregoing, Respondent has violated Section 465.016(1)(m), Florida Statutes (2005), by being unable to practice pharmacy with reasonable skill and safety by reason of use of drugs, narcotics, chemicals, or other type of material, including alcohol. WHEREFORE, Petitioner respectfully requests that the Board of Pharmacy 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, refund of fees billed or collected, remedial education and/or any other relief that the Board deems appropriate. SIGNED this lb aay of July, 2006, M. Rony Francois, M.D., M.S.P.H., Ph.D, Secretgry, Department ves DEPART: ain we 7 Lftine A. QuinbyPerinock Cemehl cf ERR cAtty Assistant General Counsel ee fot, ( DOH Prosecution Services Unit Oa Ds 4052 Bald Cypress Way, Bin C-65 Ee Tallahassee, FL 32399-3265 Florida Bar # 0394572 850.245.4640 ext. 8160 850.245.4681 FAX J:\PSU\Medical\LYNNE\a pharmacist pharmacy\Robinson 06 04126\robinson 06 04126 eso ac.doc 9 Oct 10 2006 9:06 OCT-18-2886 9:15 P.13/15 PCP: 7.10.06 PCP Members: Salem & Parrado VANESA LA‘SHEA ROBINSON, R.Ph; Case # 2004-38375 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 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. J:\PSU\Medical\LYNNE\a pharmacist pharmacy\Robinsen 06 04126\robinson 06 04126 eso ac.doc 10

Docket for Case No: 06-003911PL