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STATE OF FLORIDA DEPARTMENT OF HEALTH
DEPARTMENT OF HEALTH,
ROBERT L. HOOD, M.D,,
RESPONDENT.
COMES NOW, Petitioner, Department of Health, by and through its undersigned counsel, and files this Administrative Complaint before the Board of Medicine against the Respondent, Robert L. Hood, M.D., and in support thereof alleges:
Petitioner iS the state department charged with regulating the
practice of rnedicine pursuant to Section 20.43., Florida Statutes; Chapter
456, Florida Statutes; and Chapter 458, Florida Statutes.
J t all times material tt> this Complaint, Respondent was a licensed ph rslclan within the State of Florida, having been issued license number ME 65749..
Respondent's address of record is 850 Southeast 59th Street,
Ocala, Florida, 34480.
01n or abOut November 16, 2009, Patient J.L, a twenty (20) year-old female, presented to Respondent at the emergency department of the Munroe Regional Medical Center (MRMC).
Patient J.L. presented with complaints of a fever for eight (8)
days, generallized aches, headaches, tiredness, abdominal pain, vomiting, diarrhea, a coarse cough, recurrent episodes of coughing, episodes of sudden outbursts of coughing, and difflc:ulties sleeping due to coughing
spells. MRMC medical records also note that Patient J.L.'s influenza and pneumonia vaccines were not current.
Respondent provided treatment to Patient J.L. with assistance
from physician's assistant Mr. C.B., who RespQndent su rvlsed.
Patient J.L underwent a hematology laboratory test, which revealed a white blood cell count of 1.7 x 103/ul. Generally, the normal range for a white blood cell count is between 4.8 and 11.8 x 103/ul. A low white blood cell count is a condition called leukopenia.
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Patient J.L's hematology laboratory results also revealed 15% lymphocytes. Generally, the normal range for lymphocytes ls between 20% and 51%.
Patient J.L.'s hematology laboratory results also revealed a platelet cout1it of 77 x 103/ul. Generally, the normal platelet range is between 130 and 400 x 103/ul. A low platelet count is a condition called thrombocytOpenia.
Patient J.L. was treated medications and fluids, however, neither Respondent nor Mr. C.B. ordered a chest x-ray, blood cultures, or a nasopharyng1, al swab to test for H1Nl influenza.
1L Mr. C.B. decided to discharge Patient J.L., with Instructions that she return the folJowlng day to have her "Complete Blood Count rechecked" because her "White blood cells are too low tonight"
Rl$pondent approved the discharge of Patient J.L.
01n or a.bout November 17, 2009, Patient J.L. presented to MRMC with a worsening condition.
Patient J.l. underwent a physical examination, which revealed
wheezing throughout her lungs, generalized rhonchi, decreased breath sounds on both sides, shortness of breath, and respiratory distress. An x·
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ray of Patient J.L's chest tevealed bilateral "dense infiltrates," which are abnormal substances within the lungs.
Upon this second presentation to MRMC, the medical staff's "impression" of Patient J.l. was that she suffered from hypaxic respiratory distress; respiratory failure; bilateral Infiltrates; pneumonia; possibly acute respiratory distress syndrome; severe pancytopenia, pOssibly secondary to oveiwhelming sepsis; hypokalemia; thrombocytopenia; and hypocalcemia.
on or about November 16, 2009, Patient J.L. was diagnosed with HlNl influenza and admitted into the intensive care unit in critical condition at t-1RMC. Due to her worsening condition, Patient J.L required
intubation and mechanical ventilation.
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P-dtient J.L.'s condition continued to' deteriorate. Patient J.L.
developed severe "pulmonary edema,'' which Is the accumulation of fluids
in her lungs, ; nd was placed on dialysis due to renal failure.
Patient J.L. died on December 8, 2009, as a result of cardiac arrest.
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COUNT ONE
Petitioner realleges and incorpqrates Paragraphs 1 through 18, as if fully set forth herein.
Section 458.347(7)(9), Florida Statutes (2009), allows the
Board of Med.icine to impose any of the penalties authorized under Sections
456.072 and 458.331(2), Florida Statutes, upon a physician assistant if the physician assistant or the supervising physician has been found guilty of or is being investigated for any act that constib,Jtes a violation of Chapters 456
or 458, Florida Statutes.
2L Section 458.331(1)(t)1., Florida Statutes (2009), subjects an physician to discipline for committing medical malpractice as defined in Secticm 456.50. ''Medical malpractice" is defined by Section 456.50(1)(g), Florida Statutes (2009), 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."
22.. Section 456.50(1}(e), Florida Statutes (2009), provides that the
"level of carE , skill, and treatment recognized In general law related to health care Hcensure" means the standard of care that is specified in Section 766,102, Florida Statutes, as follows:
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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 sutrounding circumstances, is recognized as acceptable and appropriate by reasonably prudent similar health care providers.
· 23. Respondent failed to meet the prevailing standard of care in regard to Patient J.L. during her initial presentation on or about November 16, 2009, in ()ne or more of the following ways:
, Respondent failed to adequately evaluate Patient J.L.
and/or her symptoms;
, Respondent failed to admit Patient J.L. for observation despite her presenting complaints and/or the persistence of her complaints;
Respondent failed to conduct a chest x-ray of Patient J.L.;
Respondent failed to obtain any blOO(i cultures from Patient J.L. to determine the existence of an Infection;
Respondent failed to obtain a nasopharyngeal swab from
Patient J.L. to test for H1N1 Influenza;
Respondent failed to evaluate Patient J.L. for sepsis despite her presenting complaints and the persistence of her complaints;
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ResPondent failed to adequately assess Patient J.L.'s
hematology laboratory results;
Respondent failed to conduct an adequate follow-up evaluation after reviewing Patient J.L.'s hematology laboratory results, in particular her white blood count, percentage of lymphocytes, and platelet count;
Respondent failed to adequately review Patient J,L,'s
medical chart;
Respondent approved the discharged Patient J.L.; and/or
Respondent failed to adequately supervise his physician's
assistant, Mr. C.B.
Based on the foregoing, Respondent has violated Section 458.331(1)(t)L, Florida Statutes (2009), by committing medical malpractice.
COUNTTWO
Petitioner realleges and incorporates Paragraphs 1 through 18,
as if fully set forth herein.
Section 458.331{1)(dd), Florida Statutes (2009), allows the Board of Medicine to impose disdpline against a physician for failing to
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adequately supervise the activities of those physician assistants, paramedics, emergency medical technicians, -advanced registered nurse practitioners, or anesthesiologist assistants acting under the supervision of the physician,,
R1espondent was the supervising practitioner of physician's assistant Mr. C.B.
Respandent and Mr. C.B. treated Patient J.L. upon her
presentation Ito the MRMC on or about November 16, 2009.
Respondent failed to adequately supervise Mr. C.B. on or about November 115, 2009; regarding one or all of the following activities performed by Mr. C.B.:
a.. The evaluation of Patient J,L, and/or her symptoms;
Failing to admit Patient J.L. for observation despite her presenting complaints and/or the persistence of her complaints;
Failing to conduct a chest x-ray of Patient J.L.;
Failing to obtain any blood cultures from Patient J.l. to determine the existence of an infection;
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Failing to obtain a nasopharyngeal swab from Patient J.L.
to test for H1Nl influenza;
Failing to evaluate Patient J.L. fot sepsis despite her presenting complaints and the persistence of her complaints;
Failing to adequately assess Patient J.L.'s hematology
laboratory results;
The decision to discharge Patient J.L.; and1or
Failing to conduct an adequate follow up evaluation after reviewing Patient J.L.'s hematology laboratory results, in particular her white blood count, percentage of
lyrhphocytes1 and platelet count.
Based on the foregoing, Respondent violated Section 458.331(1)(dd), Florida Statutes (2009), by failing to adequately supervise the activities of those physician assistants, paramedics, emergency medical technicians, advanced registered nurse practitioners, or anesthesiologist assistants acting under the supervision of the physician.
WHEREIFORE, the Petitioner respectfully requests that the Board of Medicine enter an order imposing one or more of the following penalties:
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J:IPSUIMe<1icoJ\OovlnlCa<0s\Hood. Robert L., M.D\HoodAC,doc
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.
SIGNE:D this )2,-¥r' day of _"3_,vt_Wl TIM , 2010.
tate Surgeon General
Gavi D. Burg
Ana M. Viamonte Ros, M.O., M.P.H.
gdb
Assistant Genera Counsel DOH Prosecution Services Unit
4052 Bald Cypress Way, Bin C-65 Tallahassee, FL 32399-3265
Florida Bar# 013311
(850) 245-4640
(850) 245-4681 FAX
PCP Date: November 12, 2010
PCP Members: Leon, Bearison, Goersch
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J:IPSU\Modical\Qal'iolCa.ses\Hood, Rob<l1 L., M.D\HoodAC.do-c
DOH vs. RobertL Hood, M.D. Case No.: 2010a02675
NOTICE OF RIGHTS
Respondent has the right to request a hearing to be conducted in accordance with Section 120.569 and 120.57, Florida Stat.utes, to be represented by counsel or other qualified representative, to present evidence and argument, to call and cros&-ex:amine witnesses and to have subpoena and subpoena duces tecun11 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 ta1 Section 456,072(4), Florida Stat ute s1 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 any other discipline Imposed,
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