Sep 28 2009 15:08 Sep 28 2009 15:03 P. O04 STATE OF FLORIDA DEPARTMENT OF HEALTH DEPARTMENT OF HEALTH, PETITIONER, , vo | CASE NO.: 2004-34359 AKRAM ISMAIL, M.D., RESPONDENT, a 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, Akram | Ismail, M. dD, 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 physician within the State of Florida, having been issued license number ME 64427, DOH v Akram Ismail, MD, Case No 2004-34359 1 Sep 28 2009 15:08 Sep 28 2009 15:03 P.O5 3. Respondent's address of record is 8100 CR “4 Leg-A, Leesburg, Florida 34788, 4. Respondent is board certified in gastroenterology by the | American Board of Medical Specialties and the American Board of Internal Medicine, 5. On or about September 1, 2004, Patient S.M., a 64 year- old male, presented to Lake Surgery & Endoscopy Center CLSEC’) to undergo a colonoscopy. On that date, Respondent performed a colonoscopy on Patient S.M. | 6. At the time Patient S.m. underwent the colonoscopy, he had a history of atrial fibrillation, hypertension, myocardial infarction and tuberculosis and was taking Coumadin, - amitriptyline, Simvastatin, hydrochlorothiazide, atenolol, and naproxen although none of this information is noted in Respondent's medical records, 7. Coumadin is a legend drug indicated for the treatment of thromboembolic complications associated with atrial fibrillation and j is used to reduce the risk of death, recurrent myocardial infarction, and thromboembolic events after myocardial fibrillation. t DOH v Akram Istnail, MD, Case No 2004-34359 2 Sep 28 2009 15:08 Sep 28 2009 15:04 P. O06 8. Amitriptyline is a legend drug used to treat symptoms of depression, . 9. Simvastatin is a legend drug used to treat cholesterol 10. Hydrochlorothiazide is a legend drug used to treat, among other things, hypertension. 11. Atenolol is a legend drug that is used to treat angina and hypertension and to treat and prevent heart attacks, | i2. Naproxen is an over the counter nonsteroidal anti- inflammatory drug. 13. Respondent did not document any history or physical for Patient S.M. in the medical records for the September 4 2004, colonoscopy, 4, Reporiefisopérative-report-reflectsthat~conecious ™ ~-Sedatiorr-was. achieved during the procedure With the assistance ofa certified registered nurse anesthetist (“CRNA”); however, Respondent did not indicate, -What type..of. anesthesia. was administered or the _” dosages Of same. ~_ ba SSM A oy aR aie em - heated eri DOH v Akran Ismail, MD, Case No 2004-34359 Sep 28 2009 15:09 Sep 28 2009 15:04 P.O? 15. Shortly following the colonoscopy, Patient S.M. showed signs of distress and the CRNA followed the American Society of Anesthesiologists protocol in an attempt to stabilize Patient s. M. 16, Following the CRNA‘s attempts, Patient s, M. was transported via ambulance to the emergency department at ‘Leesburg Regional Medical Center and expired shortly thereafter, 17, An autopsy was performed and the cause of death was indicated by the medical examiner as coronary atherosclerotic disease. | 18. Respondent's medical record of the September 1 2004, colonoscopy indicates that Respondent documented a post-operative examination of Patient S.M. wherein he noted that Patent S.M.'s condition met discharge criteria. 19. Respondent's operative report for the September 1, 2004, Colonoscopy on Patient S.M. is not dated and is not signed by Respondent. : | COUNT I 20. Petitioner realleges and incorporates paragraphs one (1) through nineteen (19) as if fully set forth herein, DOH v Akram Ismail, MD, Case No 2004-34359 : 4 Sep 28 2009 15:09 Sep 28 2009 15:04 P. 08 21. Section 458, 331(1)(t), Florida Statutes (2004), provides that the failure 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 constitutes grounds for disciplinary action by | te Board of Medicine. 22. Respondent violated Section 458. S010, Florida Statutes (2004) in one or more of the following ways: a) by failing to perform and/or document a history and Physical for Patient S.M. prior to or in conjunction with the September 1, 2004, colonoscopy; se b) by failing to ‘document the type and dose(s) of anesthesia“ administered -to-Patient-S.M,-during-the-September 1, ~~~" 2004; colonostopy; =~ _¢) _ by failing to sign and date the operative report for . Patient S.M.’s September 1, 2004,.colonoscopy; _ 2 — d) by determining and/or indicating that Patient 5.M.'s post-operative condition met discharge criteria, DOH v Akram Ismail, MD, Case No 2004-34359 5 Sep 28 2009 15:09 Sep 28 2009 15:04 P.09 23. Based upon the foregoing, Respondent has violated Section 458.331(1)(t), Florida Statutes (2004), by 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 circumstances, COUNT II ! 24, Petitioner realleges and incorporates Paragraphs one (1) through nineteen (19) as if fully set forth herein. | 25, ‘Section 458.331(1)(m), Florida Statutes (2004), Provides that failing to keep legible, as defined by department rule in consultation with the board, medical records that identify the licensed physician or the physician. extender: and- Supervising” physician by ~—-Rame-and professional title-who-is- or. ‘are-responsible for-rendering, “~“Ordering,- ‘supervising, or billing for each diagnostic or treatment procedure and that justify the course of treatment of the patient, _. including, but not limited to, patient histories; examination results; test results; records Of digs prescribed, dispensed, or administered; ~and-reperts-of -consultations-and- ‘hospitalizations constitutes grounds for disciplinary action by the Board of Medicine. DOH v Akram Ismail, MD, Case No 2004-34359 6 Sep 28 2009 15:09 Sep 28 2009 15:05 P.10 26. Respondent failed to maintain and/or keep written medical records justifying the course of treatment for Patient S.M. in one or more of the following ways: | a) _ by failing to document a history and physical for Patient SM. prior to or in conjunction with the September. 1, 2004, colonoscopy: | b) by failing to document the type and dose(s) of snesthesa administered. to Patient $.M. during the September 1, 2004, | colonoscopy: Cc) by failing to: sign and date the operative report fr Patient S.M.'s September 1, 2004, colonoscopy; d) by indicating on medical records that Patient S. M. S post- Operative condition met discharge criteria. 27. Based on the foregoing, Respondent violated ‘Section 458.331(1Xm), Florida Statutes (2004), by failing to keep legible 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, DOH v Akram Isinail, MD, Case No 2004-34359 . : : 7 Sep 28 2009 15:10 Sep 28 2009 15:05 P.11 WHEREFORE, 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 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 (mM day of Der tiabey ! , 2006. M. Rony Francois, M. D., M.S. PH, Ph.D. Secretary, Department « of Health DEPARTMENT OF HEALTH Jennifer Forsh EPUTY-CLE ~-~5-Assistant-General Counsel , DOH, Prosecution Services Unit _ Dare equa ~~4052 Bald Cypress Way,.Bin C-65 Tallahassee, FL 32399-3265 Florida Bar # 0344140 850.245.4640, ext. 8140 .850,245.4680 FAX oR CPs : December 8, 2006... a reenrccce . aw a PCP Members: Ashkar, Bearison & Beebe DOH v Akram Ismail, MD, Case No 2004-34359 8g Sep 28 2009 15:10 Sep 28 2009 15:05 P.12 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 ifa hearing is requested, : | NOTICE REGARDING ASSESSMENT OF COST: s 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 i in addition to any other discipline imposed, DOH v Akram Ismail, MD, Case No 2004-34359

Docket for Case No: 09-005302PL