Petitioner: DEPARTMENT OF HEALTH, BOARD OF MEDICINE
Respondent: CRAIG E. AMSHEL, M.D.
Judges: SUSAN BELYEU KIRKLAND
Agency: Department of Health
Locations: Tampa, Florida
Filed: Jun. 11, 2010
Status: Closed
Settled and/or Dismissed prior to entry of RO/FO on Friday, April 29, 2011.
Latest Update: Dec. 23, 2024
STATE OF FLORIDA
DEPARTMENT OF HEALTH
DEPARTMENT OF HEALTH,
PETITIONER,
Vv.
| CASE NO. 2007-16072
CRAIG E. AMSHEL, M.D.,
RESPONDENT.
. t /
i
ADMINISTRATIVE COMPLAINT
Petitioner, the Department of Health, by and through its undersigned
counsel, files this Administrative Complaint before the Board of Medicine
against the Respondent, Craig E. Amshel, M.D., and in support thereof
states:
1. | _ Petitioner is the state department charged with regulating the
Practice of medicine pursuant to Section 20.43, Florida Statutes; Chapter
456, ov 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 90042.
J\PSU\Medical\Robert Milne\Cases\amshel 2007-16072\AC 458.331 (1)(t33.doe 1
pO’d = GEFLL LOZ LL une
Se:TT aloz TT unc
APG
3. The Respondent's address of racord is 1901 Haverford Plaza,
#105, Sun City Center, Florida 33573,
4, : Respondent is certified by the American Board of Surgery.
5. : On or about April 14, 2006, Patient S.A. a forty-five (45)
year-old female, was admitted to the Emergency Room of South Bay
Hospital, Tampa Florida, with a pulse of 126, normotensive, with cramps,
abdominal pain, nausea and vomiting.
6. i Abdominal x-rays were consistent with small bowel obstruction.
7, Patient S.A, was admitted by Respondent at 1345 on April 14,
2006, for hydration, correction of electrolytes, decompression of the
intestinal tract by nasal gastric tube and observation. She was placed on
antibiotics, morphine for pain, Phenergan for nausea and Zantac to
decrease he production of stomach acid.
8, | At 2050 on April 14, 2006, Respondent was called because
Patient SA. had 4 pulse of 136; blood pressure of 78/57; Patient S.A, was
anxious and agitated; and had a pain score of 10. Respondent ordered by
telephone a bolus of normal saline and increased the morphine dosage for
pain relief, but did not come to the hospital to re-examine or re-evaluate _
Patient S.A.
i}
1APSU\Medicl\Ropert Milne\Cases\Amshel 2007-16072\AC 458.331(1)(t)3.doc 2
SO‘d BE tkk OlO@ bE une
SF:TT ode TT unc
9, At 0350 on April 15, 2006, Respondent was called again
because Patient S.A.'s pulse was 130 and her blood pressure was now
90/58. Respondent ordered another bolus of normal. saline, a Foley
catheter. and Ativan for sedation, Respondent did not return to the hospital
to re- evaluat Patient S.A, nor did he take her to surgery to explore her
abdomen and ‘her bowel obstruction.
10. At.0625 on April 15, 2006, Respondent was called a third time
because Patient S.A.'s tachycardia (heart rate in excess of 100 beats per
minute) temained unabated. She now had shortness of breath and her
arterial blood gases showed Patient S.A. was acidotic, despite the
correction of her dehydration and electrolyte imbalance.
11, Respondent arrived at South Bay Hospital at 0720 on April 15,
2006, and ordered additional intravenous fluids and sodium bicarbonate.
Respondent also ordered an EKG and had consultations with a cardiologist |
and an anesthesiologist.
12.
At 0745 Patient S.A. experienced respiratory arrest while a
central line was being placed and she was resuscitated.
13. | At 0805 Patient S.A. was taken to the operating room where
JAPSU\Madical\Robert Milne\Cases\Amshel 2007-16072\AC 458,331(1)(t)3.doc 3
90 ‘d BetLL OlO@ bb une
SF:TT ode TT unc
Respondent performed an ileocolectomy (removal of a section of the
intestine at the end of the ileum and beginning of the colon) because there
Was a distended small bowel with obstruction in the distal ileum secondary
to adhesions.
14,
times and eventually expired at 1934 on April 15, 2006,
Postoperatively Patient S.A. went into cardiac arrest several
15. The Final Pathology Report showed multifocal ischemia
(restriction of blood supply at several sections of the intestines) and
pseudomembranous enterocolitis (infection of the colon) with focal
perforation with acute, sub acute and chronic serositis {inflammation of the
inner lining of the abdomen).
16, Section 458.331(1)(t), Florida Statutes (2005), 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 to mean the failure to practice medicine in accordance
with the level of care, skill, and treatment recognized in general law related:
to health care licensure, For purposes of Section 458,331(1)(t), Florida
Statutes, te Board shall give great weight to the provisions of Section
766.102, Florida Statutes, which provide that the prevailing professional
2:\PSU\Medical\Robert Milne\Cases\Amshel 2007-16072\AC 458.331(1)(t)3.doe 4
L0‘d estlL olog LL unr
Se:TT aloz TT unc
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, | Respondent failed to practice medicine with that level of care,
skill and treatment which is recognized by a reasonably prudent similar
physician under similar conditions and circumstances, in one or more of the
foliowing ways:
| a) By failing to recognize that the initial conservative
treatment plan to observe Patient S.A’s small bowel obstruction should
have been revaluated at 2050 on April 14, 2006, when S.A’s vital signs
began to deteriorate in that despite hydration, Patient S.A.’s blood pressure
was dropping, her pulse was becoming more rapid, and her pain had
increased;
| b) By failing to consider that the changes in S.A.'s vital signs
suggested @ worsening of her condition, probably secondary to ischemic
bowel or perforation and possible toxemia;
¢) By failing to timely return to the hospital to re-examine
and re-evaluate $.A.’s condition;
|
J:\PSU\Medical\Robert Milne\Cases\Amshe! 2007-16072\AC 458.331 (1)()3.doc 5
80 ‘d . BetLL OlOe LE unr
9e:TT ode TT unc
d) By failing to timely explore S.A’s abdomen on an emergent
basis.
18. Based on the foregoing, Respondent violated Section
498.331(1)(0), Florida Statutes (2005), by failing to practice medicine with
that level of care, skill, and treatment which is recognized by a reasonably
prudent similar physician as being reasonable under similar conditions and
circumstances.
WHEREFORE, the Petitioner respectfully requests that the Board of
Medicine | enter an order imposing one or more of the following penalties:
imposition of an administrative fine, issuance of a reprimand, corrective
action, remedial education and/or any other relief that the Board deems
appropriate.
|
|
|
!
|
UAPSU\Medical \Robert Milne\Cases\Amshel 2007-16072\AC 458.331(1){(t)3.dac 6
6O'd PESLL OlOe Lb une
9e:TT ode TT unc
SIGNED this_S_ day of Mae , 2009.
Ana M. Viamonte Ros, M.D., M.P.H,
State Surgeon General,
Department of Health
tyr Robert A. Milne
Assistant General Counsel
DOH Prosecution Services Unit
4052 Bald Cypress Way, Bin C-65
Tallahassee, FL 32399-3265
Florida Bar No.: 622338
| (850)245-4640
(850) 245-4681 Facsimile
PCP: Naw y, LL5
PCP Members: Cin Linn
ra BEPARTMENT OF HEALTH
| mares a DEPUTY CLERK
fee SLERK:
| DATE _.5-//-0 F
|
Craig E. Amshel, M.D., Case No, 2007-16072
|
J:\PSU\Medical\Robert Milne\Cases\Amshel 2007-16072\AC 458,331(1)(t)3.doc 7
Old . PEtLL OlOe Le une
9¢:TT oOTde TT unc
Docket for Case No: 10-003184PL
Issue Date |
Proceedings |
Jun. 21, 2011 |
Respondent, Craig Amshel, M.D.'s Motion to Continue filed.
|
Apr. 29, 2011 |
Order Closing File. CASE CLOSED.
|
Apr. 29, 2011 |
Joint Motion to Relinquish Jurisdiction filed.
|
Apr. 27, 2011 |
Petitioner's Designation of Page/Line Objections to Testimony Being Filed in Lieu of Live Testimony filed.
|
Apr. 27, 2011 |
CASE STATUS: Pre-Hearing Conference Held. |
Apr. 26, 2011 |
Amended Notice of Hearing (hearing set for April 28, 2011; 9:00 a.m.; Tampa, FL; amended as to hearing date).
|
Apr. 26, 2011 |
Second Amended Unilateral Pre-hearing Stipulation filed.
|
Apr. 25, 2011 |
CASE STATUS: Pre-Hearing Conference Held. |
Apr. 25, 2011 |
Respondent, Craig E. Amshel, M.D.'s Page/Line Designation of Objections to, or Matters to be Redacted from, Video Deposition of Armand Katz, M.D., Dated April 14, 2011, filed.
|
Apr. 25, 2011 |
Amended Unilateral Pre-hearing Stipulation filed.
|
Apr. 25, 2011 |
Unilateral Pre-hearing Stipulation filed.
|
Apr. 22, 2011 |
Respondent, Craig E. Amshel, M.D.'s Proposed Pre-hearing Stipulation filed.
|
Apr. 22, 2011 |
Respondent, Craig E. Amshel, M.D.'s Motion to Prohibit Testimony Referencing Prior Lawsuits and/or Department of Health Investigations and/or Board Certification filed.
|
Apr. 21, 2011 |
Letter to Judge Harrell from Edward Copeland regarding one day required for trial filed.
|
Apr. 20, 2011 |
Order Granting Motion for Official Recognition.
|
Apr. 18, 2011 |
Motion for Official Recognition filed.
|
Apr. 11, 2011 |
Notice of Taking Videotaped Trial Deposition (David Stein M.D.) filed.
|
Apr. 11, 2011 |
Amended Notice of Video Deposition for Use at Final Hearing filed.
|
Apr. 11, 2011 |
Amended Notice of Taking Deposition Duces Tecum filed.
|
Mar. 31, 2011 |
Order on Motion for Protective Order.
|
Mar. 31, 2011 |
CASE STATUS: Motion Hearing Held. |
Mar. 31, 2011 |
Defendant, Craig Amshel, M.D.'s Motion for Protective Order as to "Trial Video" of Petitioner's Expert, Armand Katz, M.D. filed.
|
Mar. 30, 2011 |
Notice of Taking Deposition (s) Duces Tecum (Armand Katz, M.D.) filed.
|
Mar. 30, 2011 |
Notice of Taking Deposition (s) Duces Tecum of Christian Birkedal, M.D. (to be produced) filed.
|
Mar. 30, 2011 |
Defendant, Craig Amshel, M.D.'s Supplemental Motion for Protective Order as to "Trial Video" of Petitioner's Expert, Armand Katz, M.D. filed.
|
Mar. 28, 2011 |
Cross-Notice of Videotape Deposition and Notice of Video Deposition for Use at Final Hearing filed.
|
Mar. 22, 2011 |
Order Granting Continuance and Re-scheduling Hearing (hearing set for April 27 and 28, 2011; 9:00 a.m.; Tampa, FL).
|
Mar. 22, 2011 |
Notice of Taking Deposition Duces Tecum filed.
|
Mar. 17, 2011 |
CASE STATUS: Pre-Hearing Conference Held. |
Mar. 14, 2011 |
Motion for Status Conference filed.
|
Mar. 11, 2011 |
Notice of Cancellation of Depoaition Ad Testificandum (of A. Smallwood) filed.
|
Mar. 09, 2011 |
Amended Notice of Hearing (hearing set for April 5 and 6, 2011; 9:00 a.m.; Tampa, FL; amended as to hearing location).
|
Mar. 09, 2011 |
Order Granting Motion to Change Venue.
|
Mar. 01, 2011 |
Motion to Change Venue filed.
|
Feb. 23, 2011 |
Notice of Taking Telephonic Deposition Ad Testificandum filed.
|
Feb. 22, 2011 |
Notice of Taking Deposition Ad Testificandum filed.
|
Jan. 25, 2011 |
Notice of Taking Telephonic Deposition Ad Testificandum filed.
|
Jan. 11, 2011 |
Order Granting Continuance and Re-scheduling Hearing (hearing set for April 5 and 6, 2011; 9:00 a.m.; Orlando, FL).
|
Jan. 10, 2011 |
Joint Motion for Continuance of Final Hearing filed.
|
Nov. 24, 2010 |
Notice of Taking Deposition Ad Testificandum filed.
|
Nov. 24, 2010 |
Notice of Taking Deposition Ad Testificandum filed.
|
Sep. 23, 2010 |
Notice of Serving Petitioner's First Request for Interrogatories filed.
|
Aug. 16, 2010 |
Notice of Appearance as Co-counsel (filed by Y. Grenn).
|
Aug. 12, 2010 |
Order Re-scheduling Hearing (hearing set for January 20 and 21, 2011; 9:00 a.m.; Orlando, FL).
|
Aug. 10, 2010 |
Notice of Appearance (filed by Richard Womble).
|
Aug. 09, 2010 |
Letter to Judge Harrell from R. Womble requesting a status conference filed.
|
Aug. 02, 2010 |
Order Granting Continuance (parties to advise status by August 9, 2010).
|
Aug. 02, 2010 |
Order Denying Motion to Dismiss.
|
Jul. 28, 2010 |
Notice of Filing Expert Opinion of Dr. Armand Katz.
|
Jul. 27, 2010 |
CASE STATUS: Motion Hearing Held. |
Jul. 27, 2010 |
Notice of Filing Petitioner's Exhibit "A" in Support of its Response to Respondent's Motion to Dismiss Petitioner's Administrative Complaint.
|
Jul. 26, 2010 |
Respondent's , Craig E. Amshel, M.D., Motion to Dismiss Petitioner's Administrative Complaint filed.
|
Jul. 09, 2010 |
Motion for Status Conference filed.
|
Jun. 23, 2010 |
Order of Pre-hearing Instructions.
|
Jun. 23, 2010 |
Notice of Hearing (hearing set for August 12 and 13, 2010; 9:00 a.m.; Orlando, FL).
|
Jun. 18, 2010 |
Joint Response to Initial Order filed.
|
Jun. 18, 2010 |
Notice of Appearance (filed by R. Womble, L. Lytle).
|
Jun. 11, 2010 |
Initial Order.
|
Jun. 11, 2010 |
Notice of Appearance (filed by R. Milne).
|
Jun. 11, 2010 |
Election of Rights filed.
|
Jun. 11, 2010 |
Administrative Complaint filed.
|
Jun. 11, 2010 |
Agency referral filed.
|
|
CASE STATUS: Pre-Hearing Conference Held. |
|
CASE STATUS: Pre-Hearing Conference Held. |
|
CASE STATUS: Motion Hearing Held. |