STATE OF FLORIDA DEPARTMENT OF HEALTH DEPARTMENT OF HEALTH, Petitioner, v. . DOH Case No. 2007-30311 MATTHEW J. KACHINAS, 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 Respondent, Matthew J. Kachinas, 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 licensed medical doctor within the state of Florida, having been issued license number ME 65595. 3. Respondent's address of record is 6122 S. Tamiami Trail, Sarasota, Florida 34231. 8002 T 0 AWW 4. Patient Ms. K.M. was evaluated at Florida Perinatal Associates on or about December 13, 2005, and was found to be pregnant with a dichorionic (separate placenta) diamniotic (separate sac) twin gestation of twelve weeks four days. 5. A non-septated cystic hygroma (internal cyst containing fluid without separate compartments) was noted for twin A. . 6. Amniocentesis was performed and the result for twin A was 47,XY,+21 and consistent with a male fetus with Down Syndrome. At the time of the amniocentesis, several fetal anomalies were noted for twin A, including a non-septated cystic hygroma, a short femur, an absent nasal bone, and a cardiac anomaly. 7. The fetal anatomy survey for twin B was normal. 8. Ms. K.M. decided that she would seek a selective fetal reduction and was evaluated by Respondent at Premier Institute for Women’s Health. A selective feticide was done on or about January 13, 2006. 9. When Ms. K.M. returned to Florida Perinatal Associates, on or about January 24, 2006, an ultrasound revealed that the remaining live fetus was the one with the congenital anomalies and Down Syndrome. Respondent had performed the feticide on the normal twin B. J:\PSU\Medical\DIANE\kachinas\Kachinas AC 2007-3031 1.doc 2 10. On or about January 27, 2006, Ms. K.M. returned to the Respondent for termination of pregnancy of the fetus with the congenital anomalies. 11. The standard of care for selective termination of pregnancy requires that the correct fetus be identified prior to the feticide. Several ways exist to correctly identify the correct fetus, including the position of the fetus in relationship to the mother, differentiation by gender, and use of ultrasound findings. | 12. Respondent failed to identify the position of twin A in relationship to the mother, even though the ultrasound from Florida Perinatal Associates states that twin B is located toward the maternal right. 13. Respondent failed to clearly differentiate the sex of the fetuses by ultrasound even though twin A (the affected one) was a male and twin B was a female. ~~-~44, -Respondent failed to identify the affected twin by ultrasound even though the affected twin had multiple anomalies including a cystic “hygroma, shortened long bones, and possible A-F canal, whereas twin B’s ultrasound was normal. 3:\PSU\Medical\DIANE\kachinas\Kachinas AC 2007-3031 1.doc 3 15. Respondent failed to meet the standard of care by failing to perform a thorough ultrasound examination in order to identify the correct fetus. 16. Respondent did not document his attempts to identify the sex or multiple anomalies previously reported for twin A. COUNT ONE 17. Petitioner realleges and incorporates paragraphs one (4) through sixteen (16) as if fully set forth herein. 18. 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. 19. 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 J:\PSU\Medical\DIANE\kachinas\Kachinas AC 2007-30311.doc 4 recognized as acceptable and appropriate by reasonably prudent similar health care providers. wee 20. Respondent failed to meet the prevailing standard of care in regard to patient Ms. K.M. in one or more of the following ways: a. By failing to identify the position of twin A in relationship to the mother, even though the ultrasound from Florida Perinatal Associates states that twin B is located toward the maternal right; b. By failing to clearly differentiate the sex of the fetuses by ultrasound even though twin A (the affected one) was a male and twin B was a female; c. By failing to identify the affected twin by ultrasound even though the affected twin had multiple anomalies including a cystic hygroma, shortened long bones, and possible A-F canal, whereas twin B’s ultrasound was normal; --d:--~ By failing-to perform-a thorough ultrasound examination _ in order to identify the correct fetus; . “e. =By failing to document his attempts to identify the Sex or multiple anomalies previously reported for twin A; f. By performing a feticide in the non-affected fetus. J:\PSU\Medical\DIANE\kachinas\Kachinas AC 2007-30311.doc . 5 21. Based on the foregoing, Respondent has violated Section 458.331(1)(t), Florida Statutes (2005), by committing medical malpractice. COUNT TWO 22. Petitioner realleges and incorporates paragraphs one (1) through sixteen (16) as if fully set forth herein. . 23. Section 458.331(1)(m), Florida Statutes (2005), provides that failing to keep legible, as defined by department rule in consultation with the board, medical records . . . that justify the course of treatment of the patient, including, but not limited to, patient histories; examination results; test results; records of drugs prescribed, dispensed, or administered; and reports of consultations and hospitalizations constitutes grounds - for disciplinary action by the Board of Medicine. 24. Respondent failed to document his attempts to identify the sex or multiple anomalies previously reported for twin A. 25. Based on ‘the ~foregoing, ‘Respondent: -has -violated--Section 458.331(1)(m), Florida Statutes (2005), by failing to keep legible, as defined by department rule in-consultation with the board, medical records . .. that justify the course of treatment of the patient, including, but not limited to, patient histories; examination results; test results; records of J:\PSU\Medical\DIANE\kachinas\Kachinas AC 2007-30311.doc 6 drugs prescribed, dispensed, or administered; and reports of consultations and hospitalizations. 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 appropriate. SIGNED this _2¢% day of aa , 2008. Ana M. Viamonte Ros, M.D., M.P.H. Secretary of Health - tex Diane K. Kiefline DEPARTMENT OF Er Dian Assistant Géneral Counsel ty CLERK 0 PS DOH-Prosecution Services Unit CLERK: os 4052 Bald Cypress Way-Bin C-65 mT STS Tallahassee, Florida 32399-3265 Florida Bar # 233285 (850) 245-4640 (850) 245-4681 fax per: 4-45.08 PCP Members: g-{. Bahai, Beakison, Aone Matthew J. Kachinas, M.D. DOH Case No. 2007-30311 J:\PSU\Medical\DIANE\kachinas\Kachinas AC 2007-30311.doc 7 Matthew J. Kachinas, M.D. DOH Case No. 2007-30311 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. 3:\PSU\Medical\DIANE\kachinas\Kachinas AC 2007-3031 1.doc 8

Docket for Case No: 09-004680PL

Orders for Case No: 09-004680PL