Sep 22 2008 12:10 SEP-22-2088 12:45 AHCA P.28 STATE OF FLORIDA DEPARTMENT OF HEALTH DEPARTMENT OF HEALTH, PETITIONER, v. CASE NO. 2006-40617 JACK J. COHEN, D.P.M., | RESPONDENT. .-— a N MP COMES NOW, Petitioner, Department of Health, by and through its undersigned counsel, and files this Administrative Compiaint before the Board of Podiatric Medicine against Respondent, Jack J. Cohen, D.P.M., and in support thereof alleges: L. Petitioner is the state department charged with regulating the practice of podiatric medicine pursuant to Section 20.43, Florida Statutes; Chapter 456, Florida Statutes; and Chapter 461, Florida Statutes. 2. At all times material to this Complaint, Respondent was a licensed Podiatric physician within the state of Florida, having been issued license number PO 1663 on August 27, 2001. 3. Respondent's address of record is Miami Beach Foot and Ankle Center, 524 Arthur Godfrey Road, #204, Miami Beach, Florida 33140, 4. On or about November 8, 2006, Patient G.S., a male then fifty (50) years of age, presented to Respondent with complaints of a painful com on the fifth toe of his left foot.” Departrrent of Health v, Jack J. Cohen DPM 1 Case Number 2006-40617 ‘ . 2:\PSU\Allled Heatth\Kathryn Price\Podlatry\Casas\Cohen, J\Cohen6-40617\Cohen6-40617 AC.doc fn Ore f Sep 22 2008 12:10 SEP-22-2088 12:45 AHCA 5. Respondent's record of treatment for Patient G.S, did not include a patient history. 6. At the time that Patient G.S. presented to Respondent on or about November 8, 2006, Patient G.S. also had an overlapping toe on his right foot. G.S. advised Respondent that this condition was not giving him any problems. 7. On or about November 8, 2006, Respondent advised Patient G.S. that the pain in his fifth digit was caused by a bunion and the overlapping of toes 1-4 on the left foot. Respondent noted that procedures were necessary to reverse the conditions on all: - digits. 8. On of about November 8, 2006, Respondent provided a prescription to patient G.S. for Ativan to be taken prior to surgery. 9. On or about November 8, 2006, pre-operative x-rays were taken of Patient G.S/s feet by an employee in Respondent's office by the name of Diane Cosme. 10. Diane Cosme is not licensed or certified as a health care professional by the Department of Health. 1. _ The x-rays taken by Diane Cosme on or about November 8, 2006, did not ~ show markers delineating G.S.'s left foot from the right foot. . 12. The x-rays taken on or about November 8, 2006, show two different oblique ‘views of Patient G.S/s feet. No anterior/posterior (AP) view was taken. 13. An AP x-ray view would have accentuated Patient G.S/s bunion and hallux valgus deformities. 14. On or about November 9, 2006, Patient G.S. presented to Respondent for surgery. Respondent gave Patient G.S. a liquid to drink. Department of Health v, Jack J. Cohen DPM 2 Case Number 2006-40617 J:\PSU\Allled Health\Kathryn Price\Podiatry\Cases\Cohen, J\Cohen6-40617\Cohen$-40617 AC.doc Sep 22 2008 12:10 SEP-22-2088 12:46 AHCA 15. After drinking the liquid, Patient G.S. went to sleep and awoke after the surgery. 16. Respondent’s record of treatment for Patient GS. does not include a prescription for the liquid substance and does not describe the substance. 17, On or about November 9, 2006, Patient G.S. signed a document entitled “Authorization for Minor Surgery” (authorization) in which Patient G.S. authorized Respondent to perform minimal invasion surgery and cutting of skin, tendons, and soft tissue, on toes 1-5, left and 1-2 right. 18. The authorization Respondent used for Patient G.S. did not advise that Respondent would perform any bone-related procedures. 19. On or about November 9, 2006, Respondent performed an osteotomy (removal of a small wedge of bone from the foot or toe) of the proximal phalanx, right and left, bunionectomy (removal of part of the metatarsal head), right and left, and hammertoe correction, second right, and second, third, fourth, and fifth, left. 20. On or about November 9, 2006, Respondent's operative report for the hammertoe procedures described the procedure on the third toe left only. 21, On or about November 9, 2006, Respondent's operative report for the hammertoe procedures did not describe the procedures performed on the second right, “and third, fourth, and fifth left toes. 22. Onorabout November 12, 2006, Patient G.S. presented to Respondent for the first post-operative visit. Patient G.S, complained of pain in both feet. _ Respondent advised Patient. G. a to continue the pain medication. Department of Health v, Jack . Cohen DPM “3 Case Number 2006-40617 J:\PSU\Allled Health\Kathryn Price\Podiatry\Casas\Cohen, J\Cohen6-40617\Cohené-40617 AC,coc Sep 22 2008 12:10 SEP-22-2008 12:46 HCA P.23 23. On or about November 14, 2006, Patient G.S. presented to Respondent for a second post-operative visit. Respondent noted that “patient presents with a foul odor eminating (sic) from sub 2, 3, and 4 toes left...” 24. Respondent started Patient G.S. on soaks of Betadine and vinegar four times a day and prescribed Augmentin, an antibiotic, 25. On or about November 14, 2006, Respondent's record of treatment noted that Respondent performed a culture of Patient G.S’s foot. 26. No laboratory report of the culture taken on or about November 14, 2006, was included in Patient G.S/S record of treatment, 27. Onor about November 16, 2006, Patient G.S. presented to Respondent for a post-operative visit, ) 28. On or about November 16, 2006, Respondent noted in the record of treatment for Patient G.S. that the patient was in a lot of pain and unable to sleep at Night. Respondent noted that the wounds were open, swollen and purulent. 29. On or about November 16, 2006, an employee in Respondent's office by the name of Diane Cosme took x-rays of Patient G.S’s feet, 30. The xrays taken by Diane Cosme: did not show markers delineating Patient G.S/s left foot from the right foot. 31. The x-rays taken by Diane Cosme did not include AP views of Patient G.5's feet. 32. On or about November 16, 2006, Respondent noted in the record of treatment that the x-rays showed narmal bone healing. Department of Health v. Jack J. Cohen DPM ‘ 4 Case Number 2006-40617 2:\PSU\Allied Health\Kathryn Price\Podlatry\Cases\Cohen, J\Cahené-40617\Cohené-40617 AC.doc Sep 22 2008 12:11 SEP-22-2008 12:46 AHCA 33, On or about November 16, 2007, Respondent provided a copy of the record of treatment to Patient G.S. and/or Patient G.S’s wife. Respondent took the records back and indicated that he had to make changes. 34, On or about November 16, 2006, Respondent wrote a referral letter in ‘which Respondent noted that Patient G.Ss wife requested a referral to a hospital for management of any underlying potential infection. 35. On or about November 17, 2006, Patient G.S. was hospitalized at Mount Sinai Medical Center. G.S. was admitted to the hospital with a severe infection in the " left foot and a milder infection in the right foot. There was.early necrotizing fasciitis with compartment syndrome and abscess extending to the ankle on the left foot, 36. On or about November 17, 2006, hospital laboratory results for Patient G.S, ‘indicated that G.S. had Staphylococcus aureus (MRSA) and Streptococcus agalactiae (Group B). 37. Patient G.S, remained hospitalized for 16 days and underwent surgeries to drain the abscesses of both feet as well as fasciotomies for compartment syndrome on the left foot, and several I and D procedures, as well as the placement Of an external device for management of the osteotomies. COUNT ONE 38. Petitioner re-alleges and incorporates paragraphs 1-37 as if fully set forth in this count. | 39. Section 461.013(1)(s), Florida Statutes (2006) provides that the failure to practice podiatric medicine at the level of care, skill and treatment which is recognized by a reasonably prudent podiatric physician as being acceptable under Department of Health v. Jack J. Cohen DPM : 3 Case Number 2006-40617 TA\PSU\Allied Heatth\Kathryn Price\Podlatry\Cases\Cohen, J\Cohen€-40617\Cohen6-40617 AC.doc Sep 22 2008 12:11 : P.2 SEP-22-2088 12:46 AHCA similar conditions and circumstances, constitutes grounds for disciplinary action by the board of podiatric medicine. 40. Respondent failed to practice podiatric medicine at the level of care, skill and treatment which is recognized by.a reasonably prudent podiatric physician as being acceptable under similar conditions and circumstances, in ‘one or more of the following ways: a. By failing to advise Patient G.S. that he would undergo bone-related procedures; and/or b. By failing to advise Patient G.S. of the liquid substance that Respondent gave G.S, to drink on or about November 9, 2006; and/ or c. By allowing an unlicensed individual, Diane Cosme, to perform Trays on Patient G.S.; and/or d. By failing to take x-rays that clearly indicated Patient G.S’s left foot from his tight foot; and/or €. By failing to take pre-operative x-rays that exposed an AP view which would show Patient G.S’s bunion and hallux valgus deformities; and/or f. -By failing to advise Patient G.S. of the results of the culture taken on or about November 14, 2006, 41. Based on the foregoing, Respondent violated Section 461.013(1)(s), Florida Statutes (2006), by Respondent's failure to practice podiatric medicine at the level of care, skill and treatment which is recognized by a reasonably prudent podiatric physician as being acceptable under similar conditions and circumstances, Department of Health v. Jack J. Cohen DPM , 6 Case Number 2006-40617 7\PSU\Allied Health\Kathryn Price\Podiatry\Cases\Cohen, A\Cohen6-40617\Cohen6-40617 AC.doc Sep 22 2008 12:11 SEP-22-2088 12:47 AHCA UNT (@] 42, Petitioner re-alleges and incorporates paragraphs 1-37 as if fully set forth in this count. 43. Section 461.013(1)(I), Florida Statutes (2006), provides that failing to keep written medical records justifying the course of treatment of the patient, including, but not limited to, patient histories, examination results, and test results, constitutes grounds for disciplinary action by the Board of Podiatric Medicine. 44. Respondent failed to keep written records justifying the course of treatment of Patient G.S., in one or more ‘of the following ways: a. By failing to include a patient history in the record of treatment for Patient G.S.; and/or b. By failing to take x-rays of Patient G.Ss feet that delineated the right foot from the left; and/or C. By failing to take pre-operative x-rays that exposed an AP view which, would show Patient G.S.’s bunion and hallux valgus deformities; and/or d. By failing to identify in the medical. record the Substance Patient G.S. was. given to drink on-or about November 9, 2006; and/or €. By failing to include in the operative report on or about November 9, 2006, a description of the hammertoe correction procedures performed on the second right, and third, fourth, and fifth left toes; and/or f. By failing to include in the record of treatment of Patient G.S. the results of the culture taken on or about November 14, 2006: _ Department of Health v, Jack J. Cohen DPM 7 - Case Number 2006-40617 . JAPSU\Allied Heatth\Kathryn Price\Podiatry\Cases\Cohen, J\Cohen€40617\Cohené-40617 AC. doc Sep 22 2008 12:12 SEP-22-2088 12:4? AHCA P.2? 45. Based on the foregoing, Respondent violated Section 461.013(1)(0), Florida Statutes (2006), by falling to keep written medical records justifying the course of treatment of the patient, including, but not limited to, patient histories, examination results, and test results, constitutes grounds for disciplinary action by the Board of Podiatric Medicine. ) | COUNT THREE 46. Petitioner re-alleges and incorporates paragraphs 1-37 as If fully set forth in this count. | 47, Section 461.013(1)(v), Florida Statutes (2006), provides that delegating . professional responsibilities to a person when the licensee delegating such responsibilities knows or has reason to know that such person is not qualified by training, experience, or licensure to perform them, constitutes grounds for disciplinary action by the Board of Podiatric Medicine. 48. Respondent knew, or had reason to know, that Diane Cosme, who took x-- rays of Patient G.S/s feet, was not qualified by training or experience to perform podiatric x ray services, 49. Respondent delegated to Diane Cosme, & person not qualified by training - or experience to perform podiatric x-ray services, the performance of x-Tays on Patient G.S/s feet on or about November 8 and 16, 2006. 49. Based on the foregoing, Respondent violated Section 461.013(1)(v), Florida Statutes (2006), by delegating professional responsibilities to Diane Cosme, a person not qualified by training or experience to perform podiatric x-ray services, Department of Health v, Jack]. Cohen DPM 8 Case Number 2006-40617 . : TAPSU\Allied Health\Kathryn Price\Podlatry\Cases\Cohen, J\Cohen6-40617\Cohené-40617 AC.doc Sep 22 2008 12:12 SEP-22-2088 12:47? AHCA when Respondent knew or had reason to know that Diane Cosme is not qualified by training, experience, or licensure to perform podiatric x-ray services. WHEREFORE, the Petitioner respectfully requests that the Board of - Podiatric 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 22: / Hey of Septomte tu , 2007, Ana M. Viamonte Ros, M.D., M.P.H. State Surgeon General g) 4 Wee rine By: Kathryn E, Pri DEPARTMENT OF TH Assistant General Counsel _DBRUTY Ge he DOH Prosecution Services Unit CLERK: 4052 Bald Cypress Way, Bin C-65 a — Tallahassee, Fl. 32399-3265 Florida Bar # 850860 (850) 245-4640 VOICE (850) 245-4683 FAX PCP: September 20, 2007 - PCP Members: Strickland, Frisch Department of Health v. Jack J. Cohen DPM . 9 Case Number 2006-40617 . 7:\PSU\Allied Health\Kathryn Price\Podiatry\Cases\Cohen, J\Cohen6-40617\Cohensé-40617 AC.doc Sep 22 2008 12:12 SEP-22-2088 12:48 AHCA P.29 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. Department of Health v. Jack J. Cohen DPM 10 Case Number 2006-40617 2:\PSU\Allled Health\Kathryn Price\Padlatry\Cases\Cohen, J\Cohené-40617\Cohané-40617 AC.doc

Docket for Case No: 08-004749PL