Mar 10 2008 17:32 Mar 10 2008 16:32 P. O04 STATE OF FLORIDA DEPARTMENT OF HEALTH DEPARTMENT OF HEALTH, PETITIONER, Yy. CASE NO. 2003-20072 SITARAMAIYER SESHADRI, M.D. RESPONDENT. ADMINISTRATIVE COMPLAINT COMES NOW, Petitioner, Department of Health, by and through its undersigned counsel, and files this Administrative Complaint before the Board of Medicine against. the Respondent, Sitaramaiyer Seshadri, 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. ~ Respondent's address of record is 2841 Tamiami i Trail, Port Charlotte, Florida 33952. J:APSU\Medical\Michael Milnes\AC Mike\Seshadri, Sitaramaiyer AC.doc ~-4/. Mar 10 2008 17:32 Mar 10 2008 16:32 P.O5 @ 3. At all times material to this Complaint, Respondent was a licensed physician within the State of Florida, having been issued license number ME 39902. 4, Respondent is board certified — in Geriatric Medicine, Rheumatology and Internal Medicine. 5. Onor about May 3, 2000, Patient B.D. (B.D.) presented to the Charlotte Regional Medical Center Emergency Room (ER) with complaints of diffuse pain in the upper arms and back. The pain initiated when B.D. lifted her infant child. 6. - On or about May 3, 2000, after arrival to the ER, B.D. had a Syncopal episode. 7, Onor about May 3, 2000, B.D. was lifted out of a wheelchair and Placed on a stretcher by an ER nurse. After being placed on the ‘stretcher B.D. again complained of severe shoulder and arm pain. 8 On or about May 3, 2000, it was noted in the record that movement of B.D.'s arms caused severe and excruciating pain. 9. During the ER visit and hospitalization dated May 3, 2000, a thoracic spine, cervical spine, CT scan of the head, and chest x-ray was obtained. No shoulder x-rays were ordered in spite of B.D.’ complaints of severe pain in her shoulders and arms. J:\PSU\Medical\Michael Milnes\AC Mike\Seshadri, Sitaramaiyer AC.doc Mar 10 2008 17:32 Mar 10 2008 16:32 P. O06 10. On or about May 4, 2000, B.D.'s attending physician requested a consult by Respondent due to an elevated CPK. 11. Respondent's Consultation Note remarks that 8.D. complained of a lot of aches.and pains; ‘mainly in the shoulders and. arms as well as her hands. 12. Respondent noted that the examination could not be completed because B.D. stated she was unable to move her arms due to pain. 13. On-or about May 4, 2000, Respondent's diagnoses were acute myalgia and arthralgia mainly affecting the upper part of the body with high CPK. Respondent's records state the exact etiology was unclear. 14. "Respondent ordered a laboratory workup including a follow-up of the CPK, viral titers, hepatitis profile, and thyroid profile. Respondent never followed up these exams even though B.D was in the hospital for four more days. 15. Onor about May 4, 2000, Respondent did not order any x-rays of B.D.'s shoulders or arms. 16. On or about May 8, 2000, photographs were taken of B.D.’s upper arms revealing axtensive bruising of the medial aspect of both arms. B.D. was released from the hospital the same day. J:\PSU\Medical\ Michael Milnes\AC Mike\Seshadri, Sitaramaiyer AC.doc Mar 10 2008 17:32 Mar 10 2008 16:32 P.O? 17. On or about May 22, 2000, B.D. presented to Respondent's office and was re-evaluated per her complaints of severe pain in the shoulders and arms. Respondent's physical examination of B.D. noted atrophy of the deltoid muscles in both arms and decreased range of motion in both shoulders. 18. Onor about May 22, 2000, Respondent ordered x-rays of B.D.’s shoulders. The x-ray of the left shoulder reported dislocation and fractures with separation. The x-ray of the right shoulder reported a fracture dislocation of the right humerus. Upon notification of the results of the x- rays Respondent advised B.D. to go to the ER. , 19. On or about May 22, 2000, B.D. presented'to the ER and was evaluated by Dr. Davis. X-rays were obtained and revealed bilateral . shoulder dislocations anteriorly with greater tuberosity fragments. 20, On or about May 22, 2000, a review of the initial chest x-ray from B.D.'s initial ER visit on May 3, 2000 revealed both shoulders were dislocated. The chest x-ray was taken prior to the radiology technicians moving B. Ds: 5 arms. 21. On or about May 23, 2000, B.D. was referred to an orthopedic surgeon and underwent Bilateral open reductions of both shoulders. 3:\PSU\Medical\Michael Milnes\AC Mike\Seshadri, Sitaramaiyer AC.doc Mar 10 2008 17:32 Mar 10 2008 16:32 P. 08 92. Section 458.331(1)(t), Florida Statutes (1999), provides that - 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_cireumstances, constitutes grounds for disciplinary action by the Board of Medicine. 23. Respondent failed 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 circumstances, by one or more of the following: (a) By not completing @ physical examination on May 4, 2000, on a patient complaining of severe pain in the arms; (b) By not ordering shoulder x-rays on May 4, 2000, when B.D. complained of not being able to move either arm due to severe pain; (c) © By not reviewing all documents from the ER on May 4, 2000, which included a chest x-ray of B.D. that indicated the dislocated. shoulders. 24. Based on the foregoing, Respondent violated Section 458.331(1)(t), Florida Statutes (1999), by failing to practice medicine with that level of care, skill, and treatment which is recognized by a reasonably I:\PSU\Medical\Michael Milnes\AC Mike\Seshadri, Sitaramaiyer AC.doc : 5 | Mar 10 2008 17:33 Mar 10 2008 16:33 P.09 ‘prudent similar physician as being acceptable under similar conditions and circumstances. | 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 O&Leloew 2006. Board deems appropriate. SIGNED this Byrd day of M.-Rony Francios, M.D., M.S.P.H., Ph.D. Secretary, Department of Health DEPARTMENT OF HEALTH hAke ¢/. DEPUTY : , cure: £2 gn Michael D. Milnes DATE, ‘olde a Assistant General Counsel DOH Prosecution Services Unit Oe 4052 Bald Cypress Way, Bin C-65 Tallahassee, FL 32399-3265 Florida Bar # 0857491 (850) 245-4640 ext 8136 (850) 245-4680 Facsimile MDM/tig pep: 4-2A-Ol PCP Members: f.l-rkr , Dontes , + Lena) J:\PSU\Medical\Michael Milnes\AC Mike\Seshadri, Sitaramaiyer AC,doc Mar 10 2008 17:33 Mar 10 2008 16:33 P.10 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\ Michael Milnes\AC Mike\Seshadri, Sitaramaiyer AC.doc ‘ . |

Docket for Case No: 08-001207PL