Sep 2 2008 14:56 Sep 2 2008 13:53 P. O05 Se ‘a! ae oT aa STATE OF FLORIDA DEPARTMENT OF HEALTH DEPARTMENT OF HEALTH, PETITIONER, CASE NO. 2007-10293 JOSEPH ROSS YATES, M.D., ag-]-7) 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 Respondent, Joseph Ross Yates, 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, the Respondent is and has been a licensed physician in the state of Florida, having been issued license number ME 48700. 3. Respondent's address of record is 5710 SW 34" Avenue, Ocala, Sep 2 2008 14:56 Sep 2 2008 13:53 P. O06 “ae —_ Florida 34474. 4. The Respondent is board certified in Emergency Medicine by the American Board of Emergency Medicine. 5. On or about June 8, 2006, at approximately 12:15 p.m., Patient L.S., a thirty-seven (37) year old female, presented by ambulance to the emergency department at Munroe Regional Medical Center (MRMC) in Ocala, Florida, with complaints of abdominal pain that started the day prior in the left upper quadrant. The emergency nursing record for Patient L.S. noted a past ~ medical history of back problems and a past surgical history of knee surgery. 6. On or about June 8, 2006, at approximately 12:20 p.m., the emergency nursing record for Patient L.S. noted in the initial assessment the patient was in moderate distress, was anxious, and had general abdominal tenderness. . 7, Qn or about June 8, 2006, at approximately 1:10 p.m., Patient L.S. was examined by the Respondent. The Respondent noted Patient L.S.’s abdominal pain started the previous day, was sudden onset, was still present, and was constant and severe. The Respondent ordered a urinalysis, pregnancy test, ultrasound of the gallbladder, and a chest x-ray for Patient L.S. 2 J APSU\Medical\Matthew Casey\Cases\Status 60 Cases\Yates 07-10293\(t) fail to CT ac.doc Sep 2 2008 14:56 Sep 2 2008 13:53 P.O? er _ 8. On or about June 8, 2006, at approximately 2:15 p.m,, the radiologist read Patient L.S,’s gallbladder ultrasound and recommended further evaluation with either a computed tomography (CT) scan of the abdomen or a nuclear medicine hepatobiliary scan. A hepatobiliary scan involves injecting a special radioactive dye into a vein in a patient's arm and the taking of pictures to see whether the gallbladder is working normally. This test can also reveal other problems, such as blocked bile ducts (bile ducts are tubes attached to the gallbladder), 9. On or about June 8, 2006, at approximately 2:50 p.m., the Respondent discharged Patient L.S. from MRMC in a wheelchair after diagnosing her with a urinary tract infection (UTI). The Respondent prescribed Patient L.S. Percocet and Macrodantin, and instructed her to return if she got worse and/or to see her primary care physician as soon as possible. 10. Percocet is a combination of a narcotic (Oxycodone) and a non- narcotic (Acetaminophen) used to relieve moderate to severe pain. Macrodantin (Nitrofurantoin) is an antibiotic used to treat urinary tract infections by stopping the growth of bacteria. 11. On or about June 8, 2006, the Respondent failed to order a complete blood count (CBC) and/or an electrolyte panel including liver enzymes . 3 JAPSU\Medical\Matthew Casey\Cases\Status 60 Cases\Yates 07-10293\(t) fail to CT ac.doc Sep 2 2008 14:56 Sep 2 2008 13:53 P. 08 “wae! Se and an amylase and/or lipase for Patient L.S. prior to discharging her from MRMC. A complete blood count provides a physician with information about the kinds and numbers of calls in the blood, especially red blood ceils, white blood cells, and platelets, which may aid in the diagnosis of a patient. An electrolyte panel is a blood test that measures the levels of minerals and carbon dioxide in a patient's blood. Amylase and/or lipase tests measure the amount of those “enzymes in the blood. Increased amounts of these enzymes may show a patient’s pancreas is damaged and/or not working properly. 12, On or about June 8, 2006, the Respondent failed to order a CT scan of Patient L.S,’s abdomen and/or a nuclear medicine hepatobiliary scan for Patient L.S prior to discharging her from MRMC, 13. On or about June 8, 2006, the Respondent improperly diagnosed Patient L.S. as suffering from a UTI when the diagnosis was not supported by the patient’s symptoms and/or her lab work including her urinalysis. 14. On or about June 11, 2006, at approximately 12:20 a.m., Patient L.S. was found unresponsive at home and pronounced dead upon arrival in the emergency ‘department at MRMC. An autopsy conducted later that day determined Patient L.S.’s cause of death to be acute hemorrhagic pancreatitis with a finding of peritonitis, Acute pancreatitis is the sudden inflammation of 4 JAPSU\Medical\Matthew Casey\Cases\Status 60 Cases\Yates 07-10293\(t) fail to CT ac.doc Sep 2 2008 14:57 Sep 2 2008 13:54 P.09 ‘ie! : — the pancreas, the organ which produces the hormones insulin and glucagon. Peritonitis is an infection of the lining of the abdominal wall (peritoneum) caused by bacteria or irritating substances. 15. Section 458.331(1)(t), Florida Statutes (2005), subjects a doctor to discipline for committing medical malpractice as defined in Section 456.50. Section 456.50, Florida Statutes (2005), defines medical malpractice as the failure to practice medicine in accordance with the level of care, skill, and treatment recognized in general law related to health care licensure. 16, Level of care, skill, and treatment recognized in general law related to health care licensure means the standard of care specified in Section 766.102. Section 766.102(1), Florida Statutes (2005), defines the standard of care to mean“, . . The prevailing professional standard of care for a given health care provider shall be that level of care, skill, and treatment which, in light of all relevant surrounding circumstances, is recognized as acceptable and appropriate by reasonably prudent similar health care providers. . . .” 17. The Respondent failed to meet the prevailing standard of care in regard to patient L.S, in one or more of the following ways: by failing to order a CBC and/or an electrolyte panel including liver enzymes and an amylase and/or lipase for Patient L.S. prior to discharging her from MRMC; by failing to 5 JAPSU\Medical\Matthew Casey\Cases\Status 60 Cases\Yates 07-10293\(t) fail to CT ac.doc Sep 2 2008 14:57 Sep 2 2008 13:54 P.10 order, a CT scan of Patient L.Ss abdomen and/or a nuclear medicine hepatobiliary scan for Patient L.S prior to discharging her from MRMC; and/or by improperly diagnosing Patient L.S. as suffering from a UTI when the diagnosis was not supported by the patient’s symptoms and/or her lab work | including her urinalysis. 18. Based on the foregoing, the Respondent has violated Section 458.331(1)(t), Florida Statutes (2005), by committing medical malpractice. 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 appropriata, 6 JA\PSU\Medical\Matthew Casey\Cases\Status 60 Cases\Yates 07-10293\(4) fail to CT ac.doe oe Sep 2 2008 14:57 Sep 2 2008 13:54 P.11 al SIGNED this joe day of unt , 2008. i px re, DEPARTMENT Ge HEALTH TY CLER CLERK: pate, 097) (eo: lu: OoF OF MC/mc PCP Date: June 13, 2008 Ana M. Viamonte Ros, M.D., M.P.H, State Surgeon General E10 Matthew Casey Assistant General Counsel DOH Prosecution Services Unit 4052 Bald Cypress Way, Bin C-65 Tallahassee, FL 32399-3265 Florida Bar # 0115320 (850) 245-4640 ext. 8173 - phone (850) 245-4681 - fax PCP Members: Ashkar, Chizner & Beebe 7 JAPSU\Medical\Matthew Casey\Cases\Status 70 cases\¥ ates 07-10293\(t) fail to CT ac.doc Sep 2 2008 14:57 Sep 2 2008 13:54 P.12 al —_ DOH v. Josern Ross YATES, M.D., CASE No. 2007-10293 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. 8 JAPSU\Medical\Matthew Casey\Cases\Stats 60 Cases\Vates 07-10293\(t) fail to CT ac.doc -

Docket for Case No: 08-004345PL