Feb 5 2007 12:3. FEB-@5-2087 12:28 FL. DEPT OF HEALTH 856 i868 1855 on STATE OF FLORIDA DEPARTMENT OF HEALTH DEPARTMENT OF HEALTH, PETITIONER, OT -O0WOT PL v. CASE NO. 2005-64975 CARLOS E. SANTIAGO, M.D., RESPONDENT. ; MINI E Petitioner, the Department of Health, by and through its undersigned counsel, files this Administrative Complaint before the Board of Medicine against the Respondent, Carlos E. Santiago, M.D., and in support thereof states: 1. Petitioner is the state department charged with regulating the practice of medicine pursuant to Section 20.43, Horida 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 ME 50094. 3. The Respondent's address of record is P.O. Box 430980, AO -%-1) Feb 5 2007 12:37 FEB-@5-2087 12:28 FL DEPT OF HEALTH 850 458 1855 P.@6 nN -_ South Miami, Florida 33243. 4. At all times material to this Complaint, Respondent was worked at South Florida Surgical Center (SFSC). 5. Subject had performed a previous surgery on Patient MR for an axillary mass. The mass had been excised twice before by another physician. The mass had returned and Subject informed Patient MR that a fourth (4") surgery would be required. 6. On or about June 17, 2005, Patient MR received an ultrasound, examination, with Doppler, of the veins of the right upper extremity. The ultrasound results were showing everything as normal, no evidence of venous thrombosis. 7. On or about August 25, 2005, Patient MR presented to SFSC and. received a pre-operative diagnosis of large recurrent softball-sized mass in the right axilla (arm pit) suspicious for liposarcoma (cancer). 8. On or about August 25, 2005, Subject again attempted to resect the Mass under Patient MR's right arm. The attempt to resect this mass was unsuccessful and the attempt was abandoned. 9. On or about August 25, 2005, in the afternoon following DOH v. Carlos E. Santiago, Case # 2005-64975 J:\PSU\Medical\Patty\ACs\Santlago 05-64975 (t).doc Feb 5 2007 12:77 FEB-@5-2@07 12:28 Fu DEPT OF HEALTH 854 488 1855 P.8? oo the attempted resection of the right axillary mass by Respondent, Patient MR was unable to extend her right wrist and had a loss of sensation in her right hand. 10. | Respondent felt that Patient MR may have nerve damage and requested a physician at Doctors Hospital in Coral Gables to evaluate Patient MR. 11. On or about August 26, 2005, Subject and this physician performed the following surgery on Patient MR at Doctors Hospital (DH): exploration of axilla; repair of radial and ulnar nerve with operative microscope; removal of axillary mass. 12. During the surgery at DH, it was noted by the DH physician that the radial and ulnar nerves (nerves to the hand) had been completely severed and cauterized during the August 25, 2005 surgery. These nerves were in a very superficial location due to _significant. scarring from_the previous surgical. attempts to resect the mass. _ 13... The physician from DH repaired Patient MR’s right radial and ulnar. nerves and Respondent removed the mass under Patient MR’‘s right'arm. DOH v. Carlos?E. Santiago, Case # 2005-64975 J:\PSU\Medical\Patty\ACs\Santiago 05-64975 (t).doc Feb 5S 200? 12:37 FEB-@S-20087 12:28 FL DEPT OF HEALTH 850 488 1855 P.@8 yN ~ COUNT I STANDARD OF CARE 14. Petitioner adopts and incorporates paragraphs one (1) through thirteen (13) as though fully set forth herein. 15. Section 458,331(1)(t), Florida Statutes (2004), provides: -t) Notwithstanding s. 456,072(2) but as ‘ specified in s. 456.50(2): 1. Committing medical malpractice as defined in s. 456.50. The board shall give great weight to the provisions of s. 766.102 when . enforcing this paragraph. Medical malpractice ‘ shall not be construed to require more than one instance, event, or act. 2. Committing gross medical malpractice. 3. Committing repeated medical malpractice , as defined in s. 456.50. A person found by the . board to have committed repeated médical ‘ malpractice based on s. 456.50 may not be ‘licensed or continue to be licensed by this State to provide health care services as a . Medical doctor in this state. Nothing in this paragraph shall be construed to require that a physician be incompetent to : practice medicine in order to be disciplined pursuant to this paragraph. A recommended _ Order by an administrative law judge or a final order of the board finding a violation under this paragraph shall specify whether the . licensee was found to have committed "gross medical malpractice," "repeated medical - malpractice," or "medical malpractice,” or any DOH v. Carlos | E. Santiago, Case # 2005-64975 J: \PSU\Medical\Patty\ACs\Santiago 05-64975 (t).doc Feb 5 200? 12:75 FEB-@5-2@87 12:29 FL DEPT OF HEALTH 852 488 1855 P.@9 zoN : oom combination thereof, and any publication by the board must so specify. 16. At all times material to this Complaint, Respondent fell below the standard of care in one or more of the following ways: _a) —_-Inadequately preparing Patient MR for surgery by failing to perform a pre-operative MRI, which would have defined the anatomical relationships among the mass, scar tissue, blood vessels and nerves; -b) ~~ Failing to perform an_ intra-operative nerve stimulation to identify the nerves and avoid injury; c) Failing to identify the ulnar and radial nerves and severing and cauterizing them as blood vessels. 17. _ Based--on-the foregoing, Respondent victated Section 458.331(1)(t), Horida Statutes (2005), by committing medical Malpractice as defined in s. 456.50. _. _ COUNT II ICAL RECOR 18. : Petitioner adopts and incorporates paragraphs one (1) through thirteen (13) as though fully set forth herein. 19. Section 458.331(1)(m), Florida Statutes (2005), provides 5 DOH v. Carlos; E. Santiago, Case # 2005-64975 J:\PSU\Medical\Patty\ACs\Santiago 05-64975 (t).doc Feb 5 200? 12:78 FEB-@5-2087 12:29 FL DEPT OF HEALTH 85a 488 1855 P.10 : o™ that failing to keep legible, as defined by department rule in consultation with the board, medical records that identify the licensed physician or the physician extender and supervising physician by name and. professional title who is or are responsible for rendering, ordering, supervising, or billing for each diagnostic or treatment procedure and 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 Florida Board of Medicine. 20. Respondent failed to keep written medical records justifying his course of treatment of Patient MR, in that Respondent's medical records failed to document the need for a pre-operative MRI to determine the relationship of scars, nerves and the mass under Patient MR's right arm. 21. Based on the foregoing, Respondent violated Section 458.331(1)(m), Florida Statutes (2004), by failing to keep legible medical records that justify the course of treatment of Patient MR. DOH v. Carlos E. Santiago, Case # 2005-64975 J:\PSU\Medical\Patty\ACs\Santiago 05-64975 (t).doc Fep 5 200? 12:24 FEB-@S-2087 12:29 FL DEPT OF HEALTH 854 488 1855 “>~ 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 day of _, 2006. M. Rony Francois, M.D., M.S.P.H., Ph.D. Secretary, Department of Health Patricia Nelson Assistant General Counsel DEPARTMENT OF HEALTH Florida Bar #325790 CLERK: DEPUTY DOH.Prosecution Services Unit DAE OU __ ___ 4052 Bald Cypress Way, Bin C-65 Tallahassee, FL 32399-3265 (850) 245-4640 PHONE (850) 245-4680 FAX oe PNMtID . PCP: October 27, 2006 PCP Members: El-Bahri, Farmer & Dyches DOH v. Carlos E. Santiago, Case # 2005-64975 J:\PSU\Medical\Patty\ACs\Santiago 0S-64975 (t).doc P. 11 Fen 5 200? le:id FEB-@5-2087 12:3a FL DEPT GF HEALTH 850) 488 1855, P.12 pooN NOTICE OF RIGHTS Respondent has the right to request a hearing to be conducted jn 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. DOH v. Carlos E, Santiago, Case # 2005-64975 J:\PSU\Medical\Patty\ACs\Santlago 0S5-64975 (t).doc

Docket for Case No: 07-000607PL