Dec 8 2006 14:37 Dec 8 2006 15:33 ‘er STATE OF FLORIDA DEPARTMENT OF HEALTH DEPARTMENT OF HEALTH, PETITIONER, Ve ; CASE NO, 2002-27414 TOD JOSEPH FUSIA, M.D, RESPONDENT, ee | AD V Petitioner, Department of Health, by and through undersigned counsel, files this Administrative Complaint before the Board of Medicine against Respondent, Tod Joseph Fusia, 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 71010. 3. Respondent's address of record is 2822 W. Virginia Avenue, Tampa, Florida 33607. f — Dec 8 2006 14:37 Dec § 2006 15:33 P. 06 ~ we 4, Respondent is Board certified by the American Board of Urology. 5. Onor about October 11, 2002, Patient A.G., a fifty-three year- old male, was admitted to St. Josephs Hospital in Tampa, Florida, with a chief complaint of right renal mass. The impression of the Respondent on that date was a likely carcinoma of the kidney. 6. Respondent consulted with Patient A.G, and his wife in or around October 2002 regarding A.G.'s medical options regarding, treatment of the right kidney carcinoma. 7. After this consultation, Patient A.G. was scheduled for a robotically assisted laparoscopic right radical nephrectomy (kidney removal) on October 11, 2002, utilizing the micro surgical da Vinci system. | 8. Respondent was the primary surgeon for Patient A.Gs robotically assisted laparoscopic right radical nephrectomy. 9. On or about October 11, 2002, Patient A.G. was taken to the operating room for a robotically assisted laparoscopic radical right nephrectomy. 10. During Patient A.G.'s surgical procedure, Respondent was assisted by another surgeon (hereinafter Assistant Surgeon). Dec 8 2006 14:37 Dec § 2006 15:33 P.O? nl ww! 11. The procedure was started on Patient AG. with an infraumbilical (abdominal wall near the navel) incision and obtaining peritoneal (through the lining of the abdominal wall) access. 12.. The 8mm robotic ports (for withdrawing fluid from the cavity) were placed in the usual fashion for a robotic right nephrectomy for Patient AG. 13. | During Patient A.G/’s surgical procedure, two additional 12 mm accessory ports were placed in his mid abdomen and the right lower abdomen without difficulty. 14. The da Vinci Robotic system was placed without difficulty and Respondent began to mobilize the right half of the colon to expose Patient AG's right kidney. | 15. During Patient A.G.’'s surgical procedure, the Assistant Surgeon operated his instruments with a two dimensional field of vision. 16. During Patient A.G.'s surgical procedure, Respondent relied on a three dimensional field of view to identify the vessels to be stapled. 17. Respondent identified during the procedure what was thought to be Patient A.G_s right renal vein and right renal artery. Dec 8 2006 14:38 Dec 8 2006 15:33 P. 08 ed ‘ae 18. Respondent identified Patient A.G.’s right ureter, which he mobilized and transected. 19. Respondent gave Assistant Surgeon instructions to transect the right renal artery and right renal vein with a stapler. ‘20. Respondent attempted to dissect the kidney, but there was significant scarring of the ligament involving the liver and the kidney. , 21, After two hours of no progress, Respondent decided to convert the procedure to an open nephrectomy. 22, After exploration, Respondent determined they transected Patient A.G.s inferior abdominal aorta and vena cava instead of the right renal artery and right renal vein. 23, When the error was discovered, a vascular surgeon was immediately called to the operating room to repair Patient A.G.’s vena cava and the aorta. 24. Postoperatively Patient A.G. remained stable until 11:00pm on or about October 11, 2002. 25. Patient A.G’s condition continued to deteriorate and Respondent assisted in further surgical intervention on or about October 13, 2002. Dec 8 2006 14:38 Dec 8 2006 15:33 P.09 ~ ww 26. Despite further surgical intervention, Patient A.G, passed away on October 13, 2002. 27. Patient A.G’s death certificate listed the immediate cause of death as “sequela of intraoperative trauma to abdominal aorta and inferior vena cava in the course of laparoscopic nephrectomy.”, or as a result of damage to the abdominal aorta and inferior vena cava during the laparoscopic nephrectomy. 28. Section 458,331(1)(t), Florida Statutes (2002), provides that 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 meet the required standard of care by failing to properly identify parts of the patient A.G/s anatomy and/or by _transecting/dissecting or by instructing the assistant surgeon to transect and/or dissect vessels which were in fact the vena cava and aorta. 30. Based on the foregoing, Respondent has violated Section 458.331(1)(t), Florida Statutes (2002), by failing to practice medicine Dec 8 2006 14:38 Dec 8 2006 15:34 P.10 el! within the standard of care which would be recognized by a reasonably ‘ee prudent medical professional under similar conditions and circumstances, WHEREFORE, 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 Respondent on probation, corrective action, refund of fees billed or collected, remedial education and/or any other relief that the Board deems appropriate. J | SIGNED this Zs day of 2006. , M.S.P.H,, Ph.D. of Health DEPARTMENT OF HEALTH EP . : CLERK: Airy OLERK DOH Prosecution Services Unit pare_9°2.'7- a4 4052 Bald Cypress Way, Bin C-65 Tallahassee, FL 32399-3265 Florida Bar # 0078999 850.245.4640 ext. 8175 850.245.4681 FAX Tod Joseph Fusia, M.D, CASE NO, 2002-27414 PCP: 9/22/ol Dec 8 2006 14:38 Dec 8 2006 15:34 P.11 New’ al? PCP Members: beck kor, Beanion. beebe. 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.

Docket for Case No: 06-004983PL