Oct 10 200? 12:21 OCT-18-2087? 12:82 FL DEPT OF HEALTH 856 488 1855 P.@3 STATE OF FLORIDA DEPARTMENT OF HEALTH DEPARTMENT OF HEALTH, PETITIONER, v. CASE NO. 2005-64527 SHARON T. BEST, P.A., RESPONDENT. ADMINISTRATIVE COMPLAINT Petitioner, Department of Health, by and through undersigned counsel, files: this Administrative Complaint before the Board of Medicine against Respondent, Sharon T. Best, P.A., 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 assistant within the state of Florida, having been issued license number PA 9102701. 3. Respondent's primary practice address of record is 15062 Oak Chase Court, Wellington, FL 33414. 3:\PSU\Medical\MairGx\Cases\Best, Sharon\AC.doc 1 Ma rs OCT-18-2687 12:82 FL DEPT OF HEALTH vee 10 200 "so 408 1855 P.G4 4. On or about June 16, 2004, Patient H.C. (H.C.) presented to Respondent at the Palm Glades Rural Health Associates, Inc., (PGRH) with complaints of constant urination, numbness in the legs, light headedness, constant thirst, and weakness. 5, Respondent ordered a CBC test, Comprehensive Metabolic Panel (CMP) test, Lipid Profile, EKG, and a urine dip. 6. The results of H.C’s urine dip showed: elevated ketone level, elevated glucose level, and a specific gravity (the concentration of particles in the urine) Of 1.005 g/ml (normal range is 1.020 -1.030 g/ml). | 7. | The results of H.C.’s CMP showed elevated glucose levels. 8. Respondent diagnosed H.C. with tachycardia, an increased heart rate, and prescribed Altace, a blood pressure medicine used to treat hypertension. | 9. On or about June 16, 2004, Respondent contacted her supervising physician to present H.C’s case. Respondent's supervising physician was concerned that the patient was suffering from diabetic | ketoacidosis (DKA). Respondent’s supervising physician inquired whether an “accu-check” (a blood sugar-testing device used to test for diabetes) had been performed. Respondent stated that an accu-check had not been performed. J:\PSU\Medical\MarrGx\Cases\Best, Sharon\AC.doc ? Oct 10 200? 12:21 OCT-18-2887 12:82 FL DEPT OF HEALTH 856 488 1855 P85 10. Respondent then attempted to contact H.C, to attempt to have him return ta PGRH for testing and treatment or to refer H.C, to an emergency room for testing and treatment for the possible DKA. Respondent was unable to contact H.C. 11. Diabetic ketoacidosis (DKA) is an emergency condition caused by untreated hyperglycemia (an excessive amount of glucose circulating in the blood) that develops when cells in the body are unable to get the glucose they need for energy. Untreated DKA can lead to coma and death. 12. Symptoms of DKA include, but are not limited to: dehydration, excess thirst, excess urination, drowsiness, general weakness, and increased heairt rate, ketones in the urine, elevated glucose levels, and an abnormally low specific gravity. 13. On or about June 17, 2004, H.C. presented to Glades General Hospital with an admitting diagnosis of severe diabetic ketoacidosis. H.C. was admitted to Glades General Intensive care unit. Shortly after admission to the ICU H.C. developed ventricular tachycardia with unobtainable blood pressure. A code blue was called. 14. On June 17, 2004, at 10:50pm, H.C. was pronounced dead. The final diagnosis is listed in the Glades General medical records as severe J:\PSU\Medical\MarrGx\Cases\Best, Sharon\ac.doc 3 Oct 10 2007 12:22 OCT-18-2087 12:a2 FL DEPT OF HEALTH 856 488 1855 P.@6 diabetic ketoacidosis, acute renal failure, sepsis, obesity, ventricular tachycardia, acute respitory failure, alcohol abuse — unspecified. 15. Section 458.347(7)(g), Florida Statutes, states that the Board of Medicine may impose any of the penalties authorized under Sections 456.072 and 458.331(2) upon a physician assistant if the physician assistant or the supervising physician has been found guilty of or is being investigated for any act that constitutes a violation of chapter 458° or chapter 456. 16. Section 458.331(1)(t), Florida Statutes (2003), provides that failure to practice medicine with that level of care, skill, and treatment which is recognized by a reasonably prudent similar physician assistant as being acceptable under similar conditions and circumstances constitutes grounds for disciplinary action by the Board of Medicine. 17. Respondent fell below the standard of care recognized by a reasonably prudent similar physician assistant, in one or more of the following ways: a. By failing to perform the accu-check test on H.C., and b. By failing to recognize and diagnose H.C’s DKA. 18. Based on the foregoing, Respondent violated Section 458.331(1)(t), Florida Statutes, (2003) by failing to practice medicine with J:\PSU\Medical\MarrGx\Cases\Best, Sharon\Ac.dac 4 OCT-18-2087 12:83 Oct 10 2007 12:22 FL DEPT OF HEALTH 856 488 1855 Pa? that level of care, skill and treatment which is recognized by a reasonably prudent similar physician assistant as being acceptable 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, impasition 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 31% day of August, 2007. Ana M. Viamonte Ros, M.D., M.P.H. Secretary of Health / Cc Gr . Marr Assistant General Counsel OF HEALTH DEPARTME x cer . DOH Prosecution Services Unit CLERK: Raac hau 4052 Bald Cypress Way, Bin C-65 DATE nha led Tallahassee, FL 32399-3265 Florida Bar No.: 131369 (850) 245-4640 Ext. 8145 (850) 245-4680 Facsimile GSM/tgc PCP: June 22, 2007 PCP Members: El-Bahri and Peters J:\PSU\Medical\MarrGX\Cases\ Best, Sharon\AC.doc Oct 10 2007 12:22 OCT-18-2087 12:83 FL DEPT OF HEALTH 856 488 1855 P.@8 Case Name: SHARON T. BEST, P.A. Case No. 2005-64527 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\MarnGX\Cases\Best, Sharon\AC.doc 6

Docket for Case No: 07-004633PL