Petitioner: DEPARTMENT OF HEALTH, BOARD OF MEDICINE
Respondent: MANUEL MIGUEL PENA, M.D.
Judges: SUSAN BELYEU KIRKLAND
Agency: Department of Health
Locations: Naples, Florida
Filed: Dec. 13, 2007
Status: Closed
Settled and/or Dismissed prior to entry of RO/FO on Tuesday, January 15, 2008.
Latest Update: Dec. 24, 2024
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STATE OF FLORIDA
DEPARTMENT OF HEALTH
_ DEPARTMENT OF HEALTH,
PETITIONER,
v. CASE NO. 2003-23325
MANUEL MIGUEL PENA, M.D,,
RESPONDENT,
I Tr PLAI
Petitioner, Department of Health, by and through undersigned
counsel, files this Administrative Complaint before the Board of Medicine
against Respondent, Manuel Miguel Pena, 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
ficensed physician: within the state of Florida; having beer issued license
number ME 42699.
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3. Respondent's primary practice address of record is 6370 Pine
Ridge Road, Suite 101, Naples, Florida 34119, |
4. Respondent is Board Certified by the American Board of Plastic
Surgery.
_ 5. On or about June 30, 2003, Patient L.G. (L.G.), a sixty-seven
(67) year old female, presented to the Naples Day Surgery Center (NDSC),
Respondent provided a consultation for a liposuction procedure of the
trunk.
6. On or about July 17, 2003, Respondent recorded a history and
physical of L.G. Respondent wrote that L.G. was a very healthy sixty-seven
| (67) year old woman.
| 7. The records from July 17, 2003, indicated L.G. had her kidney
removed thirty years prior:
8. The records from July 17, 2003, indicated that L.G. did not
smoke.
9. On or about July 22, 1998, Respondent performed a full face
_laser resurfacing on L.G.
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10. In the history and physical from the July 22, 1998 full face laser
resurfacing procedure, Respondent noted L.G. smoked one half of a pack
. Of cigarettes a day.
11. On or about July 22, 2003, L.G. presented to NDSC for the
liposuction procedure.
12. The EKG in Respondent's medical records, taken in preparation
for the procedure, listed a myocardial infarction (a heart attack) of
indeterminate age. | | | | |
13. ‘The liposuction proceeded with no apparent complications.
L.G. was sent to recovery Post procedure.
14, L.G. did not awaken after the procedure. The following
timeline occurred in the recovery room,
a 11:30 am - L.G. remains unresponsive;
b. 12:00 pm -L.G. still no response to verbal commands;
Cc. 12:30 pm - Ephedrine Sulfate 50 mg administered in
L.G/'s left thigh to aid in extubation:
d. 13:00 pm - Respondent called — ordered finger stick;
oe ~7@: . 13:15 pm - L-G: not responding to verbal commands;
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f. 14:00 pm - LG. opening eyes to painful stimuli — will not
turn head to right;
g. 14:30pm - L.G, does not follow verbal commands;
h. 14:50pm ~ Slight dropping noted to left side of L.G’s
mouth. LG. not responding to verbal commands and not
awakening to simple commands, such as hand squeezing. L.G,
was admitted to Intensive Care Unit at Naples Community
Hospital (NCH) for observation and neurological evaluation,
15. A CT scan and MRI were taken of L.G. while at NCH. The
results were an infarction to multiple areas in the left hemisphere ~ total
blockage of the left internal carotid artery, specifically an intra-operative
stroke.
16. . The stroke was likely caused by a cerebral embolus.
17, A Trans Esophageal Echocardiograph (a diagnostic test that
performs an ultrasound of the heart) revealed significant aortic disease
with atherosclerosis. |
18. On or about August 01, 2003, L.G’s family decided to remove
“LG's feeding tubes,
19. LG. was admitted to hospice and later expired.
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20. LG’s history from her past medical records indicated findings
of obesity (Body Mass Index of 33), history of smoking for nine (9) years,
. hyperlipidemia (the presence of excess fat or lipids in the blood), and
adiposity (Loose connective tissue, the main role of which is to store
energy in the form of fat, although it also cushions and insulates the body),
, 21. Clinical and laboratory findings of L.G. indicated severe.
atherosclerotic disease as evidenced by the history of an abdominal aortic
aneurysm and an old myocardial infarction.
22, L.G. was not an appropriate candidate for any major elective
surgery due to her severe atherosclerotic disease, history of smoking,
obesity, and age,
. 23. L.G’s atherosclerotic disease was evidenced by her abdominal
aortic aneurysm and an old inferior myocardial infarction, as shown on the
EKG.
24. The removal of three thousand eight hundred milliliters
(3,800 mi) of fat is a traumatic event in a patient with L.G’s medical history
of atherosclerotic disease, history of smoking, obesity, and age,
25.-—Section 458.331(1)(t), Florida Statutes (2003), provides that
failure to practice medicine with that level of care, skill, and treatment
5
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which is recognized by @ reasonably prudent similar physician as being
acceptable under similar conditions and circumstances constitutes grounds
for disciplinary action by the Board of Medicine.
26. Respondent fell below the standard of care recognized by'a
reasonably prudent similar physician, in one or more of the following ways:
a. By failing to take a proper history and physical;
b. By failing to perform pre-operative testing;
C. By failing to take into account L.G.'s severe atherosclerotic
disease; ,
d. By failing to take into account L.G's history of an
abdominal aortic aneurysm:
e. By failing to take into account L.G’s history of an old
myocardial infarction:
f. —_ By failing to take into account L.G.s age of sixty seven
years;
g. _ By failing to take into account L.G.’s history of smoking;
h, By failing to obtain pre-operative clearance from the
_ ~~"—primary care physician;
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i. By failing to obtain pre-operative clearance from an
internist;
j. By failing to obtain pre-operative clearance from a
cardiologist;
k, By the removal of three thousand eight hundred milliliters
(3,800ml) of fat in light of LG’s medical history of
atherosclerotic disease, history of smoking, obesity, and age.
Based on _the foregoing, Respondent has violated Section
458. 331(1)(t), Florida Statutes, (2003) 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 that the Board of
Medicine enter an order imposing one or more of the following penalties:
" pérmanent 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.
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SIGNED this__>. day of Vel nuues , 2007.
Ana M. Viamonte Ros, M.D., M.P.H.
Secretary of Health
WE
Michael BD. Milnes
Assistant General Counsel
DOH Prosecution Services Unit
4052 Bald Cypress Way, Bin C-65
DEPARTMENT OF HEALTH Tallahassee, FL 32399-3265
CLERK: Rac ee Florida Bar No.: 0857491
DATE Pt (850)245-4640 ext 8136
(850) 245-4680 Facsimile
MDM/tgc
PCP: January 26, 2007
PCP MEMBERS: El-Bahri, Winchester, Long
| Case Name: MANUEL MIGUEL PENA Case No. 2003-23325
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Case Name: MANUEL MIGUEL PENA Case No. 2003-23325
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: 07-005667PL