Jan 14 2009 13:32 Jan 14 2009 13:91 P.O5 STATE OF FLORIDA DEPARTMENT OF HEALTH DEPARTMENT OF HEALTH, Petitioner, | v. DOH CASE NO.: 2008-02311 CHRISTOPHER CONAVAY,| M.D., Respondent. ADMINI TIVE COMP \ COMES NOW, Petitioner, Department of Health, by and through its undersigned counsel, and files this Administrative Complaint before the Board of Medicine against Respondent, Christopher Conavay, 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, | J:\PSU\Medical\Robert Milne\Cases\CONAVAY 2008-0231 1\Conovay AC 458 331(1)(t)(nim} (m) (Q) (f) FINAL.doc ! : ) pmae 4 2. At all times ji licensed physician within number ME 42102. Jan 14 2009 13:33 Jan 14 2009 13:91 aterial to this Complaint, Respon he State of Florida, having been iss P. O06 | | tL was a ied license | 3. Respondent’s address of record is 2304, Aloma Avenue, Suite 201, Winter Park, Florida 33076. 4, On January 3, 2007, Respondent diagnosed Patient €.P., a thirty three year-old female with fibromyalgia and coccyxdynia (pain in the region of the coccyx), stemming from an old displaced coccyxgeal fracture. 5. Respondent's diagnosis of fibromyalgia and coccyxdynia assumed the truth and accuracy of Patient C.P’s verbal history without verifying her prior history supposedly been diagnosed by her previous treating physicians. 6. On January 3, of an old displaced coccygeal fracture which had 2007, in support of the verbal patient! history that she related to Respondent, Patient C.P. provided Respondent with copies of opoid prescriptions from her prior treating physicians, which had been filled by CVS pharmacy. 7. On January 3, 2007, Respondent's diagnosis was benefit of Patient C.P’s prior medical records from Doctors M.J. without the and J.D. (8. Respondent's January 3, 2007, medical notes fail to show: J:APSU\Medical\Robert Milne\Cases\CONAVAY 2008-02311 \Conovay AC 458 B3L(A)CtK(nn) {m) (Q) (f) FINAL. dee 2 | | } ot Jan 14 2009 13:33 Jan 14 2009 13:32 a) A physical examination of Patient C.P,; b) A history of present illness; c) A listing of clinical impressions; P.O? d) A presence jor absence of a personal or familial substance abuse history; e) An appropriate treatment plan; f) Diagnostic studies. 9, On January 3, - Respondent prescribed for Pati tablets of oxycodone 15 mg to be taken every 4 hours or as breakthrough pain together with 60 OxyContin 80 mg tablets twice daily. ent C.P 160 needed for to be taken 10. Oxycodone and OxyContin (oxycodone with a time release coating designed to deliver analgesia over a 12 hour period) are powerful opioid analgesic Schedule} II narcotic legend drugs controlled i pursuant to Chapter 893, Florida Statute. They have a high potential for abuse and have a currently accepted) but severely restricted medical use i | n treatment in the United States. Abuse of these substances may lead to severe psychological or physical dependence. 3:\PSU\Medical\Robert Milne\Cases\CONAVAY 2008-02311 \Conovay AC 458 331(1)(tXnn):(m) (Q) (f) FINAL.og 3 f i i Jan 14 2009 13:33 Jan 14 2009 13:32 P. 08 ii. On January 3,/2007, Respondent gave: Patient CP, 50 sample Fentanyl patches. 12. A Fentanyl patch is a transdermal delivery system for a high concentration of potent.|Schedule [J narcotic layend drugs controlled pursuant to Chapter 893) Florida Statute, Fentanyl is an opioid agonist, which includes fentanyl, hydromorphone, methadone, | morphine, oxycodone, and oxymorphone. It has a high potential for abuse and associated risk of fatal overdose due to respiratory depression. 13. Respondent prescribed these controlled substances in very high dosages to Patient C.P, despite the fact that he had never met her before and Respondent did so without: a) Reviewing her prior medical records: and checking with her previous physicians whether her treatment was tefminated for substance abuse/diversion; b) Ordering urine toxicology for illicit drug use/ diversion of opioids; | . ¢) Listing T. positives from Patient C.P’s physical they pertained to the affected areas of her hips, examination a knees, lumbar and cervical spine; J:\PSU\Medicall\Rabert Milne\Cases\CONAVAY 2008-02311\Conovay AC 458 331(t)t)(n1) (m) (Q) (Q) FINAL.do 4 pho Jan 14 2009 13:33 Jan 14 2009 13:32 P.09 d) Annotating) the range of motion, crepitus, tenderness, effusion erythema, nodules or stability; f} Documenting in his diagnosis of fibromyalgia at cast eleven -out of eighteen tender points as recommended by the American . College of Rheumatology; g) Ordering radiographs of the affected joints. 14. On or about January 3, 2007, May 14, 2007, June 11, 2007, and June 26, 2007, Respondent issued prescriptions to Patient (.P, for 160 tablets of oxycodone 15 mg to be taken every 4 hours or as needed for breakthrough pain together with 60 OxyContin 80 mg tablets to be taken twice daily On January 3, 2007, in addition to the foregoing, Respondent gave C.P.a box of 50 Fentanyl patches, ~15.. On or hear the dates listed in paragraph fourteen above, Respondent prescribed oxycodone and OxyContin to C.P. in the quantities and dosages described therein, without conducting or documenting one or more of the following: complete medical histories ar physical examinations, the nature and intensity of the patient’s pain, current and past treatments for pain, underlying or cdexisting diseases or conditions, the effect of the pain on physical and psychological function, history of substance abuse, J:\PSU\Medical\Robert Miine\Cases\CONAVAY 2008-0231 1\Conovay AC 458 331(1}¢tXnn)(m) (Q) (f) FINAL.dod 3 ae DS | h Jan 14 2009 13:34 Jan 14 2009 13:92 P.10 the presence of one or more recognized ‘medical indications for the use of a controlled substance and without documenting written treatment plans that state objectives that |will be used to determine treatment success or indicate if any further diagnostic evaluations ‘of other treatments are planned. | 16. On January 3, 2007, Respondent diagnosed Patient C.P. with psoriasis, a skin condition) forming thick silvery scales and itchy, dry, red patches that are sometimes painful. Respondent's medical notes of that date fail to show the presence or absence as well as the location of psoriatic lesions or pitting of the nails which is a classic finding of this condition. 17. On January 3} 2007, Respondent diagnosed Patient C.P, with psoriatic’ arthritis which jis a systemic connective tissue disease, but Respondent's medical notes of that date did not tule out other systemic connective tissue diseases and Respondent failed to order laboratory studies including, but not limited to: , | a) Rheumatoid factor; | b) Antinuclear|bodies; C) Erythrocyte| sedimentation rate; | | T:APSU\Medical\Robert Milne\Cases\CONAVAY 2008-02311\Conavay AC 458 33 1(4)(t)(n1n)| (Mn) (Q) (F) FINAL.dag 6 be li sg Jan 14 2009 13:34 Jan 14 2009 13:93 P.11 d) Complete blood count; e) Serum electrolytes; f) Liver function tests; g) Urinalysis. 18. On January 3,| 2007, Respondent prescribed Methotrexate for the treatment of Patient C.P’s psoriatic arthritis without documenting the fact that Patient C.P had that disorder, Methotrexate is a_ toxic antimetabolite that acts as a folic acid antagonist to interfere with cellular reproduction and ts used in the treatment of psoriasis, certain cancers, and certain inflammatory diseases such as rheumatoid arthritis. | 19, Despite diagnosing psoriatic arthritis Respondent failed to refer Patient C.P. to a rheumatologist for a comprehensive evaluation. 20. Respondent i to order periodic laboratory testing to monitor Patient C.P’s liver and kidney function for serious adverse side affects associated with Methotrexate treatment. 21. On May 14, 2007, Respondent prescribed Patient C.P, Xanax 2mg to be taken at bedtime. | 22. Xanax (Alprazolam) is a Schedule IV legend drug controlled pursuant to Chapter 893, Florida Statute. It is used as an anti-anxiety J:\PSU\Medical\Robert Milne\Cases\CONAVAY 2008-02311\Conovay AC 458 331(1)(t){(nn ] {m) (Q) (F) FINAL.dor 7 fro i $i be § Jan 14 2009 13:34 Jan 14 2009 13:93 P.12 agent, has a currently actepted medical use in treatment in the United States, and abuse of the substance may lead to limited physical or psychological dependence. 23. Respondent’s medical notes of May 14, 2007, make no mention i of a physical examination of Patient C.P. 24, On June 11, 2007, Respondent increased Patient C.P’s dosage of Xanax 2 mg to four times a day. His medical notes of that date fail to reflect C.P’s functional status or a physical examination, but reflect the fact that Respondent has made the diagnosis of addiction. The medical notes do not indicate the substance or substances in question. 25. On June i1, 2007, Respondent increased C.P’s dosage of Xanax to four times a day, even though the addictive potenitial of this short acting benzodiazepine increased the high dosage opioid regimen she was already receiving. 26. On diagnosing Respondent failed to refer the risk of a fatal overdose in ‘conjunction with Patient C.P, with addiction on June 11, 2007, her to a substance abuse treatment center. Not only did Respondent fail to do so, he continued to issue, prescriptions for | oxycodone/OxyContin and 3:\PS5U\Medical\Robert Milne\Cases\CONAVAY Xanax in June and July, 2007. ! i i i 2008-02311\Conovay AC 458 331(1)(tX(nn) Km) (Q) (f) FINAL.do 8 fos : ac i Jan 14 2009 13:34 Jan 14 2009 13:93 P.13 27, Patient C.P. expired on August 2,. 2007, from myxoid heart | disease, Other significant findings from Patient C.P’s autopsy of August 3, 2007, reflected a finding off chronic drug abuse. Count One 28. Petitioner reincorporates and realleges paragraphs one through twenty-seven as if fully set) forth herein. 29. Section 458.331(1)(nn), Florida Statutes: (2007), provides that ) violating any provision of Chapters 456 or 458, Florida Statutes (2007), or any rules adopted pursuant thereto, is grounds for discipline by the Board of Medicine. 30. Rule 64B8-9.013(3), Florida Administrative Code (2007), provides as follows: | The Board has adopted the following standards for the use of controlled substances for pain control: (a) Evaluation of the Patient. A complete medical history and physical examination must be conducted and documented in the medical record. The medical record should document the nature and intensity of the pain, current and past treatments for pain, underlying or coexisting diseases or conditions, the effect of the pain gn physical. and psychological function, and history of substance abuse. The medical record also should document the presence of one or more recognized medical indications for the use of a controlled substance. | : | 1:\PSU\Medical\Robert Miine\Cases\CONAVAY 2008-02311\Conovay AC 458 3312(1)(t)(nn);(m) (Q) (A) FINAL. dod 9 [: me H Jan 14 2009 13:35 Jan 14 2009 13:34 P14 (b) Treatment Plan.|The written treatment plan should | state objectives that will be used to determine treatment success, such as pain relief jand improved physical and psychosocial function, and should indicate if any further diagnostic evaluations or other| treatments are planned. After. treatment begins, the physician should adjust drug therapy to the Patient medical needs of each patient. Other treatment modalities or a rehabilitation program may be necessary depending on the etiology of the pain and the extent to which the pain is associated with physical and psychosocial impairment. | 31, On or near the dates listed in paragraph fourteen, above, Respondent violated Rule 64B8-9.013(3), Florida Administrative Code | (2007), by prescribing oxycodone, OxyContin and by giving Patient C.P. a box of 50 Fentanyl patches in the quantities described therein, without conducting or documenting complete medical histories or physical examinations on Patient C/P. and without documenting one or more of the following: the nature and|intensity of the patients’ pain, current and past treatments for pain, underlying or coexisting diseases or conditions, the effect of the pain on physical and psychological function or history of substance abuse, the presence of one or more recognized medical indications for the use of a controlled substance and without documenting written treatment plans that state objectives that will be used to determine J:\PSU\Medical\Robert Milna\Cases\CONAVAY [2008-0231 1\Conovay AC 458 331(1)(t)(nn) mi) (Q) (f) FINAL doc 10 . ‘ : i} dg, treatment success or indic treatments are planned. Jan 14 2009 13:35 Jan 14 2009 13:34 P.15 ate if any further diagnostic evaluations or other 32. Based on the foregoing, Respondent has violated Section 458,331(1)(nn), Florida Statutes (2007), by violating Rule 6488-9.013(3), Florida Administrative Code (2007). Count Two 33. Petitioner reindorporates and realleges paragraphs one through twenty seven as if fully set forth herein. 34. Chapter wen Florida Administrative Code (2007), as more particularly set fo realleged. h in paragraph 30: herein of is adopted and 35. Section 458.381(1)(t), Florida Statutes. (2007), provides that committing medical malpractice constitutes grounds for disciplinary action by the Board of Medicine. Medical Malpractice is defined in Section 456.50, Florida Statutes (2007), as the failure to practice medicine in| accordance with the level of care, skill to health care licensure. Statutes (2007), the Bog , and treatment recognized in general law related For purposes of Section 458.331(1)(t), Florida rd shall give great weight to the provisions of Section 766.102, Florida Statutes (2007), which provide that the prevailing A:\PSU\Medical\Robert Milne\Cases\CONAVAY 2008-0231 1\Conovay AC 458 331(1)(¢)¢AIN) Cin) (Q) (f) FINAL.dag iF] rit ! ti ‘ 4 ‘ Jan 14 2009 13:35 Jan 14 2009 13:34 P.16 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, : 36. On or near one or more of the dates listed in| paragraph fourteen, above, Respondent failed to practice with the level of care, skill, and treatment which, in light of all relevant surrounding circumstances, is recognized as acceptable jand appropriate by reasonably prudent similar health care providers | by violating Rule 64B8-9.013(3), Florida Administrative Code (2007), in one or more of the following ways: by prescribing oxycodone, OxyContin to Patient CP. in the, quantities described herein, and by giving C.P. a box of 50 Fentanyl patches without conducting or documenting complete medical “histories or physical examinations on Patient C\P. and without documenting one or more of the following: the nature and jintensity of the patient's. pain, current and past treatments for pain, underlying or coexisting diseases or conditions, the effect of the pain on physical and psychological function or history of substance abuse, the presence of one or more recognized medical indications for the use of a controlled substance and without documenting i J:APSU\Madical\Robert Milne\Cases\CONAVAY 2008-02311\Conovay AC 458 F311) r (Q) (f) FINAL.doc {2 Yoke Hhooons Jan 14 2009 13:35 Jan 14 2009 13:94 PL? written treatment plans that state objectives that will be used to determine treatment success or indicate if any further diagnostic evaluations or other treatments are planned. . 37, Respondent failed to practice medicine with that level of care, skill and treatment which is recognized by a reagonably prudent similar physician as being acceptable under similar conditions and circumstances by failing to establish a reasonable doctor-patient relationship with Patient C.P. prior to prescribing the amounts of oxycodone and OxyCantin and by giving Patient C.P’ a box of 50 Fentanyl patches on the dates alleged herein. | 38. 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 conditions and circumstances when diagnosing Patient C.P, with psoriasis on January 3, 2007, in one or more of the following ways: | a) By failing to show in Respondent's medical notes of that date the presence or absence as well as the location of psoriatic lesions or pitting of the nails which is a classic finding of this condition; J:\PSU\Medical\Robert Milhe\Cases\CONAVAY| 2008-02311 \Conovay AC 458 331(1)(t)(nn) in) (Q) (f) FINAL.dog 13 poe i i } ! | 3 Jan 14 2009 13:36 Jan 14 2009 13:96 PTB b) By failing to otder periodic laboratory tests to monitor Patient C.P's kidney and liver functions while treating Patient C. P. with Methotrexate in order to guard against known adverse’ side effects associated with such treatment, , 39. - 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 conditions and circumstances when diagnosing Patient €.P. with psoriatic arthritis in one or more of the following ways: a) By failing |to rule out other systemic connective tissue , disease in his medical notes; | : b) By failing to order laboratory studies for: i) Rheumatoid factor ii) Antinuclear bodies iit) Erythrocyte sedimentation rate ! iv) Complete blood count V) Serum electrolytes vi) Liver function tests vil) Urinalysis 1:\PSU\Medical\Robert Milne\Cases\CONAVAY) 2008-0231 1\Conovay AC 458 331(1)(t)(an) m) (Q) (f) FINAL. dod a i i ae a ee Jan 14 2009 13:36 Jan 14 2009 13:96 P19 C) By failing to refer Patient C.P. toa rheumatologist for a comprehensive evaluation. | 40. 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 conditions and circumstances by failing to mention a physical examination of Patient C.P. in his medical notes of May 14, 2007, when prescribing Xanax 2mg for Patient C.P. 41. 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 conditions and circumstances on June 11, 2007, when diagnosing Patient C.P with addiction by failing to refer Patient C.P, to a substance abuse treatment center. | 42, 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 conditions and circumstances when, having diagnosed CP. with addiction on June 11, 2007, Respondent increased Patient C.P’s dosage of Xanax 2mg to four times a day despite the addictive potential of|a short acting benzodiazepine increased the risk J:\PSU\Medical\Robert Milne\Cases\CONAVAY 2008-02311 \Conovay AC 458 331(1)(t)(nn) (im) (Q) (A) FINAL.dod 15 mo {i Jan 14 2009 13:36 Jan 14 2009 13:96 P. 20 of a fatal overdose in conjunction with the high dosage Opioid fegimen she was already receiving. 43, 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 conditions and circumstances by prescribing the opioid regime of oxycodone and OxyContin. 44. Respondent fa led 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 when diagnosing Patient -medical records one or more of the following: C.P, with fibromyalgia by failing to note in his a) The ~ of motion, crepitus, tenderness, effusion erythema, no b) At least recommended ¢) An order for radiographs of the affected joints; ules or stability; eleven out of eighteen tender! points as by the American College of Rheumatology; d) A listing of pertinent positives from Patient C.P’s physical examination as they pertained to the affected areas lof her hips, knees, lumbar J:\PSU\Medical\Robert Milne\Cases\CONAVAY, and cervical spine. 2008-0231.1\Conovay AC 488 331(1)(t)(an) (fn) (@) (F) FINAL.dod 16 fig. q i Pan Fa food Jan 14 2009 13:36 Jan 14 2009 13:96 P21 45. Based on the} foregoing, Respondent has violated Section 458.331(1)(t), Florida Statutes (2007), Count Three _— 46. Petitioner reincorporates and realleges paragraphs one through twenty seven as if fully set forth herein. . | 47. Section 458,3B1(1)(m), Florida Statutes (2007), provides that failing to keep legible medical records justifying the course of treatment of the patient, including, but not limited to, patient histories; examination results; test results; tecords of drugs prescribed, dispensed, or administered; and reports of consultations and hospitalizations is grounds for discipline by the Board of Medicine. : 48. On-or near the dates listed in paragraphs fourteen, twenty- three and twenty-four above, Respondent failed to keep legible medical records justifying the course of treatment of Patient CP. by failing to document one ‘or more of the following: a complete medical history or a physical examination. of |Patient C.P.: the nature and intensity of the patient’s pain; current and past treatments for pain; underlying or coexisting diseases or conditions: the effect of the pain on physical and psychological function; history of substance abuse; the presence of one or 1:\PSU\Medica!\Robert Milne\Cases\CONAVAY|2008-0231 1\Conovay AC 458 331(1)(t)(nin) (mn) (Q) (f) FINAL.coc 17 _ NQOA a £ Jan 14 2009 13:37 Jan 14 2009 13:36 P. 22 more recognized medical lindications for the use of a controlled substance _or written treatment plans that state objectives’ that will be used to determine treatment success or indicate if any further diagnostic evaluations or other treatrnents are planned. : ‘49, Based on the foregoing, Respondent has violated Section 458,331(1)(m), Florida Statutes (2007). Count Four ‘50. Petitioner reincorporates and realleges paragraphs one through twenty-seven and thirty ag if fully set forth herein, 51. Section 458.3B1(1)(q), Florida Statutes (2007), provides as follows: prescribing, dispensing, administering, mixing, or otherwise } preparing a legend drug, Including any controlled substance, other than in the course of the physician's professional practice is grounds for discipline by the Board of Medicine. For purposes of this paragraph, legally presumed that prescribing, dispensing, administering, otherwise preparing legend drugs, including all controlled it shall be mixing, or substances, inappropriately or in excessive or inappropriate quantities is not in the best interest of the patient and is not in the course. of the professional practice, without regard to his intent. physician’s 2:\PSU\Medical\Robert Milne\Cases\CONAVAY| 2008-0231 1\Conovay AC 458 331(1)(t)(nn) in Q FINAL.dod 18 i 4 i go RE Jan 14 2009 13:37 Jan 14 2009 13:56 PL 23 32. On or near lone or more of the dates listed in paragraph fourteen, above, Resporident prescribed oxycodone and Oxycontin and gave Patient C.P. Fentanyl patches in the quantities listed therein inappropriately or in excessive or inappropriate quantities and outside the course of his professional practice by doing sO in one or more of the following ways: : (a) By prescribing|these controlled substances inappropriately and.in excessive amounts; i (b) By prescribing|these controlled substances inappropriately and in excessive amounts in violation of | rule 6488-9.013, Florida Administrative Code. : 53. Based on the foregoing, Respondent has violated Section 458,.331(1)(q), Florida Statutes (2007). Count Five . 24. Petitioner reindorporates and realleges paragraphs ane through twenty-seven as if fully set forth herein. | 55. Section 456.072(1)(ff), Florida Statutes (2007), provides that the following is grounds for discipline by the Board. of Medicine: J:\PSU\Medical\Robert Milne\Cages\CONAVAY 2008-02311\Conovay AC 458 331(1)(t)(nn) (n) (Q) (f) FINAL. doc 19 { ! 4 ye i} Engaging in a patter Jan 14 2009 13:37 Jan 14 2009 13:56 PL 2d n of practice when prescribing medicinal drugs or controlled substances which demonstrates a lack of reasonable skill or i Safety to patients, a violation of any provision of this chapter, a violation of the applicable practice act, or a violation of any rules adopted this chapter or the applicable practice act of the prescribing i Notwithstanding Section 456.073(13), the depattment may pursuant to practitioner. initiate an investigation and establish such a pattern from billing records, data, or any other information obtained by the department. 56. Between the dates fisted in paragraphs fourteen, twenty-one and twenty-four above, Respondent engaged in a pattern of practice when prescribing medicinal drugs or controlled substances to the herein that demonstrated one or more of the following: Patient C.P. a lack of réasonable skill or safety to patients, a violation of any provision of chapters 456 or 458, Florida Statues (2007), or any rules adopted pursuant thereto, by issuing the prescriptions listed in paragraph fourteen above: (a) Without cond ucting or documenting ¢omplete m edical history or physical examination on Patients C.P., and without. documenting one or more of the following: the nature and intensity of the pat 7:\PSU\Medical\Robert Milne\Cases\CONAVAY 2008-0231 1\Conovay AC 458 331(1)(t)(rn)}dm) (Q) (f) FINAL.dog ent’s pain; current and past treatments for 20 Jan 14 2009 13:37 Jan 14 2009 13:56 P. 25 pain; underlying or coexisting diseases or conditions; the effect of the pain on phys cal and psychological function or history of substance abuse; the presence of one or more recognized medical indications for the use of a controlled substance; and without documenting written treatment plans that) state objectives that will be used to determine treatment success or indicate if any further diagnostic evaluations or other treatments are planned; (b) Without keepi course of treatment ng legible medical records that justify the of Patient C.P., by failing to documeht one or more of the folidwing: complete medical history or physical examinations on Pa I patient’s pain; curre or coexisting diseas physical and psycho tient C.P.; the nature and intensity of the nt and past treatments for pain; underlying es or conditions; the effect of the pain on ogical function; history of substance abuse; the presence of ong or more recognized medical indications for the use of a contrdlled substance; or written treatment! plans that state objectives that will be used to determine treatment J:APSU\Medical\Robert Milne\Cases\CONAVAY 2008-0231 1\Conavay AC 458 331(1)(t)(nin} (mm) (Q) (fF) FINAL.doc F | 4 rai success or indicate if any further diagnostic evaluations or other treatments are planned. Jan 14 2009 13:38 Jan 14 2009 13:97 P. 26 57. Based on the foregoing, Respondent has violated Section 456.072(1)(ff), Florida Statutes (2007), WHEREFORE, the Board of Medicine enter following penalties: pe Petitioner respectfully fequests that the an order imposing one or more of the rmanent 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. 1:\PSU\Medical\Robert Mitne\Cases\CONAVAY 2008-02311 \Conovay AC 458 331(1)(X(nn) (m) ® (Ff) FINAL. dog Hi 4p fg i tt i : a SIGNED this oii DEPARTMENT OF HEALTH PUTY CLE CLERIC FS paTe__\U: 2708 PCP Members: Leon, Rose PCP: October 10, 2008 Christopher Conavay, M.D., Case No. 2008-02311 J:\PSU\Medical\Robert Mibe\Canes\CONAVAY} 204 Jan 14 2009 13:38 Jan 14 2009 13:97 P.2? Ana M. Viarjonté Ros, M.D., M.PH. eneral : Assistant General Counsel Florida Bar # 622338 DOH Prosecution: Services Unit 4052 Bald Cypress Way-Bin C-65 Tallahassee, Florida 32399-3265 (850) 245-4640 Office (850) 245-4681 Facsimile nberg ! f us 2008-0231 1\Conovay AC 458 aazcaygien) i @ (f) FINAL, doc | | | i : , 2008. Christopher Conavay, M.D., Case No, 2008} Respondent has conducted in accordance with Section 12) Florida Statutes, to be NOTICE OF RIGHTS Jan 14 2009 13:38 Jan 14 2009 13:97 P. 28 02314 .569 and 120.57, the right to or san hearing to be lior other qualified represented by counst 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 bo Respondent is pla costs related to the in { ed on notice that Petitionér has incurred estigation and prosecution of this matter. ation of a Pursuant to Section 456.072(4), Florida Statutes, the tion shall assess costs related to the investigation and prosec disciplinary matter, which may include attor ey hours nd costs, on the Respondent in addition to any other di icipline imposed. rene J:\PSU\Medical\Robert Milne\Cages\CONAVAY f { \ P008-02311\Conovay AC 458 331 H (nn) r @ {i FINAL.Goc 24

Docket for Case No: 09-000210PL