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STATE OF FLORIDA DEPARTMENT OF HEALTH

DEPARTMENT OF HEALTH,

Petitioner,

v. CASE NO. 2008-15244

RACHAEL GITTENS, M.D.,

Respondent.

ADMINISfRATIVE 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, Rachael Gittens, 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 physician within the State of Florida, having been issued license number ME 86836.

   
   

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3. Respondent's address of record is 224 Pennsylvania Avenue, Freeport, New York 11520.

4. On or about June 10, 2008, Shuman Lucas, an investigator with

the Department, conducted a routine dispensing practitioner inspection at the South Florida Pain Clinic, located at 500 W. Oakland Park Blvd., Wilton

Manors, Florida 33311.

s. Respondent was employed full time by South Florida Pain Clinic

•.. as a dispensing practitioner at the time of the inspection.

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1. Respondent is registered with the Florida Board of Medicine as

   a dispensing practitioner.

2. The investigator discovered thirty-three (33) . patient

   
   

   .:. prescriptions signed by Respondent for various controlled substances.

   
   

3. The investigator reported the following deficiencies:

   
   

   1. No generic drug sign was displayed.

      
      

   2. Several presc, ipttons were dispensed to patients but contained no patient names or addresses.

   3. Several prescriptions were dispensed to patients but were not initialed and dated.

      
      

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   4. Several prescriptions were signed by ResgQnden.t. even though they were not for specific patients.

4. On or about April 18, 2008, Respondent prescribed two hundred and forty (240) tablets of Roxycodone 30mg, thirty (30) tablets pf Mabie 7.5mg and sixty (60) tablets of Valium 10mg to patient AW. On or about May 16, 2008, Respondent prescribed Patient AW two hundred and forty (240) tablets of oxycodone 30mg, thirty (30) tablets of Mabie 7.5mg and ninety (90) tablets of Valium 10mg. There was no documentation showing that Respondent evaluated patient AW. The prescriptions written and dispensed to patient AW by Respondent failed to display the patient's name, address and/or date of issue. The address provided by the patient was fraudulent.

5. Roxycodone is the brand name for a drug that contains oxycodone, and is prescribed to treat pain. According to Section

   ,c.. 893.03(2), Florida Statutes, oxycodone is a Schedule II controlled substance that has a high potential for abuse and has a currently accepted but severely restricted medical use in treatment in the United States, and abuse of oxycodone may lead to severe psychological or physical dependence.

   
   

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6. Mabie is the brand name for Meloxicam, a legend drug that has

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   currently accepted but limited medical use in the United States. Mabie is a nonsteroidal anti-inflammatory drug used to relieve the symptoms of arthritis, primary dysmenorrhea, fever; and as an analgesic, especially where there is an inflammatory component.

7. Valium is the brand name for diazeparn and is prescribed to

   
   

   treat anxiety. According to Section 893.03(4), Florida Statutes, diazepam is a Schedule IV controlled substance that has a low potential for abuse relative to the substances in schedule III and has a currently accepted medical use in treatment in the United States, and abuse of diazepam may lead to limited physical or psychological dependence relative to the substances in Schedule Ill.

8. Oxycodone is commonly prescribed to treat pain. According to

   
   

   , .·. Section 893.03(2), Florida Statutes, oxycodone is a Schedule II controlled substance that has a high potential for abuse and has a currently accepted but severely restricted medical use in treatment in the United States, and

   
   

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   abuse of oxycodone may lead to severe psychological o,r dependence.

   physical

   
   

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   ii COUNT ONE

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9. Petitioner realleges and incorporates paragraphs one (1) through thirteen (13), as if fully set forth herein.

10. Section 458.331(1)(9), Florida Statutes (2007), provides that

    
    

    failing to perform any statutory or legal obligation placed upon a licensed physician constitutes grounds for disciplinary action by the Board of Medicine.

11. Section 465.025(7), Florida Statutes, provides that a generic drug sign should be in block letters not less than one (1) inch in height which shall read: "CONSULT YOUR PHARMACIST CONCERNING THE AVAILABILTY OF A LESS EXPENSIVE GENERICALLY EQUIVALENT DRUG AND THE REQUIREMENTS OF FLORIDA LAW."

12. South Florida Pain Clinic did not have a generic drug sign conforming to the Florida Statutes.

13. Section 893.04(1)(c), Florida Statutes, provides there shall appear on the face of the prescription or written record thereof for the controlled substance the following information:

    
    

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    1. The full name and address of the person for whom, or the owner of the animal for which, the controlled substance is dispensed.

    2. The full name and address of the prescribing practitioner

       
       

       and the practitioner's federal controlled substance registry number shall be printed thereon.

    3. The name of the controlled substance prescribed and the strength, quantity, and directions for use thereof.

    4. The number of the prescription, as recorded in the prescription files of the pharmacy in which it is filled.

    5. The initials of the pharmacist filling the prescription and

    
    

    the date filled.

    
    

14. The inspection revealed thirty three (33) prescriptions signed by Respondent for multiple patients. Each prescription was missing the patient name and/or address and/or number of the prescription as recorded in the prescription files of South Florida Pain Clinic and/or initials of the pharmacist filling the prescription and the date filled.

    
    

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15. Section 893.07(3), Florida Statutes, provides the record of all

    r controlled substances sold, administered, dispensed, or otherwise disposed

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    of shall show:

    
    

    a) The date of selling, administering, or dispensing.

    Ir b) The correct name and address of the person to whom or

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    for whose use, or the owner and species of animal for

    
    

    
    

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    which the controlled substance was sold, administered, or dispensed.

16. All of the thirty-three (33) patient prescriptions noted to be in

    
    

    violation were missing both the date they were filled at South Florida Pain

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    Clinic and the initials of the physician who filled them.

    
    

17. Based on the foregoing, Respondent violated Section 458.331(1)(9), Florida Statutes, by failing to perform any statutory or legal obligation placed upon a licensed physician by violating Sections

    465.025(7), 893.04(1)(c), and 893.07(3), Florida Statutes.

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    ,,,1, COUNT TWO

18. Petitioner realleges and incorporates paragraphs one (1) through thirteen (13), as if fully set forth herein.

    
    

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19. Section 458.331(l)(m), Florida Statutes (2007), provides 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 name 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

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    I 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.

20. On or about April 18, 2008, Respondent prescribed two

    
    

    hundred and forty (240) tablets of Roxycodone 30mg, thirty (30) tablets pf Mabie 7.5mg and sixty (60) tablets of Valium 10mg to patient AW. On or about May 16, 2008, Respondent prescribed Patient AW two hundred and forty (240) tablets of Oxycodone 30mg, thirty (30) tablets of Mabie 7.5mg and ninety (90) tablets of Valium 10mg. There was no documentation showing that Respondent evaluated patient AW. The prescriptions written and dispensed to patient AW by Respondent failed to display the patient's name, address or date of issue. The address provided by the patient was

    11. fraudulent.

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21. Based upon the foregoing, Respondent has violated Section 458.331(1)(m), Florida Statutes, by failing to keep legible medical records identifying the licensed physician responsible for justifying the course of treatment including the patient histories, examination results and records of drugs prescribed, dispensed, or administered.

WHEREFORE, Petitioner respectfully requests that the Board of

Medicine enter an order imposing one or more of the following penalties: 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 d f 'Y' day of Jo,,/ , 2008.

Ana M. Viamonte Ros, M.D., M.P.H.

: ! State Surgeon General

n y J. Miller, II

Assistant General Counsel

DOH Prosecution Services Unit 4052 Bald Cypress Way, Bin C-65 Tallahassee, FL 32399-3265

Florida Bar# 0028147

(850) 245-4640, E?ct- 8230

(850) 245-4681 FAX

J:\PSU\Medical\Randy\Gases\Gittens, 2008-15244\AC Gittens 08-15244.doc Page 9

Docket for Case No: 11-003150PL