STATE OF FLORIDA DEPARTMENT OF HEALTH DEPARTMENT OF HEALTH, PETITIONER, v CASE NO. 2011-10006 CHRISTINA B. PAYLAN, M.D., RESPONDENT. / $e ADMINISTRATIVE COMPLAINT The Petitioner, Department of Health, by and through the undersigned counsel, files this Administrative Complaint before the Board of Medicine against the Respondent, Christina B. Paylan, M.D., and in support thereof alleges: . 1. The Petitioner is the state agency 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, the Respondent was a. licensed physician within the state of Florida, having been issued license number ME 82839, Page 1 of 17 Filed November 16, 2011 3:52 PM Division of Administrative Hearings 3. The Respondent's address of record is 3230 West Kennedy — Boulevard, Tampa, Florida 33609. 4. The Respondent is nat board certified in any specialty. 5. The Respondent practices plastic surgery. ~ 6. At all times material to this Administrative Complaint, the Respondent practiced at her office surgical center, the Institute for Cosmoplatic Surgery (clinic), which is located at 3230 W. Kennedy . Boulevard, Tampa, Florida 33609. 7. The Respondent she advertises that she performs invasive surgical procedures which include but are not limited to: belly button ' insertion, breast augmentation, breast lift, brow lift, buttock enhancement, chin implants, fat transfers, liposuction, weight loss skin reduction, neck lifts, penile enhancements, rhinoplasy and tummy tucks, 8. J.G. was an employee at the Respondent's clinic from sometime in November 2009 through on or about June 11, 2011. 9. On or about May 31, 2011, at the Respondent’s request, J.G. went to the Respondent's home and, at the Respondent's request, 1.G. picked up a written prescription for patient L.B. for the drug Demerol, which was signed by the Respondent. Page 2 of 17 10. Demerol is the brand name for the drug meperidine. Meperidine is an opioid and is prescribed to treat pain. According to Section 893.03(2), Florida Statutes, meperidine 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. Abuse of meperidine may lead to severe psychological or physical dependence. | . 11. On or about May 31, 2011, J.G. had the prescription written for L.B. filled at a pharmacy. 12. On or about May 31, 2011, J.G. returned to the Respondent's home and gave the Demerol to the Respondent or the Respondent's paramour, J.E.A, 13. At all times material to this complaint, J.E.A was the Respondent's patient. 14, The Tampa Police Department (T.P.D.) interviewed patient L.B., on or about June 13, 2011, and she indicated that she has not been prescribed Demerol on or around May 31, 2011. 15. On or about June 9, 2011, T.P.D, executed a search warrant on the Respondent's home. Among the items T.P.D. seized were: Page 3 of 17 used syringes, unused syringes, a sharps container, one bulk bottle of hydrocodone with acetaminophen containing 100 pills, two vials of Demerol 50 ml, two vials of lorazepam, one vial of diazepam 10 mi, naloxone hydrochloride 1 ml, and two prescription pads, ano oD Ta > o 16. A sharps container is a container used for the disposal of medical needles, scalpels and/or intravenous catheters. 17, Hydrocodone with acetaminophen is a drug that is sold under the brand names Vicodin, Lortab and Lorcet. (Acetaminophen is the drug in Tylenol.) Hydrocodone with acetaminophen is an opioid that is prescribed to treat pain. According to Section 893.03(3), Florida Statutes, hydrocodone with acetaminophen is a Schedule III controlled substance | that has a potential for abuse less than the substances In’ Schedules I and If and has a currently accepted medical use In treatment in the United States. Abuse of the substance may lead to moderate or low physical _ dependence or high psychological dependence 18. Lorazepam is prescribed to treat anxiety. According to Section 893.03(4), Florida Statutes, lorazepam is a Schedule IV controlled substance that has a low potential for abuse relative to the substances in Page 4 of 17 Schedule III and has a currently accepted medical use In treatment in the United States. Abuse of lorazepam may lead to limited physical or psychological dependence relative to the substances in Schedule III. | 19. Diazepam, commonly known by the brand name Valium, 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 If and has a currently accepted medical use in treatment in the United States. Abuse of ‘diazepam may lead to limited physical or psychological dependence relative to the substances in Schedule Iit. . 20. Naloxone hydrochloride is a narcotic antagonist and is used for the complete or partial reversal of narcotic depression, including respiratory depression, induced by opioids, including natural and synthetic narcotics, propoxyphene, methadone and certain narcotic-antagonistic analgesics. Naloxone hydrochloride is also used when there is diagnosis of suspected acute opioid overdose. . 21. During the search and seizure that occurred on or about June 9, 2011, at the Respondent’s home, T.P.D. observed that there were Page 5 of 17 blood stains In the carpet, as well as blood stained gauzes and used syringes in various locations throughout the home. 22, On or about June 9, 2011, T.P.D. observed that the Respondent had needle tack marks on the inside of her arm. 23. Needle marks, or track marks, are indicative of intravenous drug injections, 24. On or about June 9, 2011, T.P.D. arrested the Respondent and charged her with one ‘count of trafficking in illegal drugs, two counts of possession of a controlled substance and one count of possession of a drug without a prescription. 25, On or about June 21, 2011, the Department provided the Respondent with information on how. to contact the Professional Resource Network (P.R.N.) for a substance abuse evaluation. 26. P.R.N. is a program which evaluates and treats impaired health care practitioners. Impaired practitioners can go to a P.R.N. approved provider voluntarily for evaluations and treatment. P.R.N. evaluates impaired practitioners. for the Department In accordance with Section 456.076, Florida Statutes. Page 6 of 17 27. On or about June 21, 2011, the Respondent stated that she would do whatever P.R.N. recommended, 28. On or about June 27, 2011, P.R.N. asked the Respondent to submit a hair sample or urine sample (or both) for testing as soon as possible. 29. On or about June 29, 2011, P.R.N. asked the Respondent to withdraw from the practice of medicine. 30. The Respondent has continued to practice medicine despite P.R.N.’s request. 31. On or about July 6, 2011, P.R.N. arranged for the Respondent to have an evaluation performed at Healthcare Connections, in Tampa, Florida, on or about July 13, 2011. 32. On or about July 12, 2011, the Respondent informed the Department's investigator that she would voluntarily appear for an evaluation at Healthcare Connections. | 33. On or about July 14, 2011, the Respondent presented at Healthcare Connections for an evaluation and submitted samples for drug testing. Page 7 of 17 34, On or about July 14, 2011, Healthcare Connections recommended that the Respondent undergo an inpatient evaluation. 35. On or about July 14, 2011, the Respondent refused to sign - releases or withdrew her releases for her Healthcare Connections evaluation to be released to the Department or to PRN, (or both), 36. On or about July 14, 2011, the Respondent left Healthcare Connections before an in-patient evaluation was completed. | 37. On or about July 14, 2011, the Respondent indicated that she would be seeking a second opinion at another facility. 38. On or about July 14, 2011, the P.R.N. informed the Respondent that she must have an in-patient evaluation and advised her that she should go to Shands-Vista, 39. On or about July 15, 2011, the Respondent's hair sample tested positive for meperidine. 40. On or about July 19, 2011, the Respondent was practicing medicine. 41. P.R.N. arranged for the Respondent to have an evaluation at Shands-Vista, on or about July 20, 2011, however, the Respondent did not appear during normal business hours. Page 8 of 17 42. Instead, the Respondent arrived at Shands-Vista on or about July 24, 2011, at approximately 2:00 A.M., in the morning. 43, On or about July 21, 2011, the Respondent left the facility without submitting to an evaluation. 44. On or about July 21, 2011, P.R.N. contacted the Respondent and provided the Respondent another opportunity to admit herself for an evaluation at Healthcare Connections, Shands-Vista, located in Gainesville, Florida or Talbot Recovery, located in Atlanta, Georgia, by the close of business on or about July 22, 2011. . 45. On or about July 22, 2011, the Respondent failed to appear at any of the facilities that P.R.N. had recommended. 46. On or about July 22, 2011, P.R.N called the Respondent at her clinic. 47, ; On or about July 22, 2011, the Respondent refused to commit to participating in a_ three-to-five day inpatient evaluation, as recommended by P.R.N. 48. On or about July 25, 2011, the Respondent indicated:again that she would go to an evaluation voluntarily, but she failed to appear. Page 9 of 17 49. On or about July 26, 2011, P.R.N. Informed the Department that the Respondent had failed to comply with P.R.N,’s requests. Based on the Respondent's failure to appear at evaluations, her continual practice of ~ medicine despite P.R.N.’s request that she refrain from the practice of ‘ medicine, and her positive hair test, P.R.N. opined that the Respondent was an immediate and serious danger to the public. 50. On or about July 26, 2011, P.R.N. closed their file on the Respondent. 51. On or about July 26, 2011, the Respondent represented to the Department that she would go voluntarily into an evaluation the following day. | 52. On or about July 27, 2011, the Respondent represented to the Department that she would be in a facility at 1:00 p.m. 53. On or about July 27, 2011, the Respondent failed to provide the Department with confirmation that she had actually arrived at a facility. 54. On or about July 28, 2011, the Respondent represented to the Department that she had reached an agreement with P.R.N. and that she was scheduled to go to an in-patient evaluation at Shands-Vista. Page 10 0f 17 55. On or about July 29, 2011, the Respondent represented to the Department that she would go to Shands-Vista on or about July 31, 2011 for intake. The evaluation was scheduled to start on or about August 1, 2011. 56. The Respondent's in-patient evaluation at Shands-Vista was to last four to seven days. 57. The Respondent was schedule to chéck-in and start the intake process at Shands-Vista on or about July 31, 2011, however, she falled to appear. 58. On or about August 1, 2011, the Respondent appeared for her intake and the beginning of her evaluation. . 29. On or about August 1, 2011, the Respondent was seen by Scott Teitelbaum, M.D. (Dr. Teitelbaum) at Shands-Vista. 60. Dr. Teitelbaum is a P.R.N. approved addiction psychiatrist and is also the Chief of the Division of Addiction Medicine at the University of Florida, College of Medicine. 61. On or about August 1, 2011, the Respondent had bruises on both of her arms. The Respondent explained the bruises were due to her injecting herself with weight loss medication. Page 11 of 17 62. On or about August 1, 2011, the Respondent acknowledged testing positive for Demerol, but explained that she had been prescribed Demerol by a physician. 63. On or about August 1, 2011, the Respondent refused to allow the Dr. ‘Teitelbaum to contact the physician who prescribed her the Demerol. 64. On or about August 2, 2011, the Respondent went into Dr. Teitelbaum’s office while he was with another patient and interrupted him. | . . 65. On or about August 2, 2011, the Respondent asked to leave Shands-Vista. 66. On or about August 2, 2011, the Respondent was asked to wait for her afternoon appointment, but she refused. 67, On or about August 2, 2011, the Respondent called law enforcement to Shands-Vista. Law enforcement inquired whether the Respondent was being held against her will. 68. On or about August 2, 2011, law enforcement consulted with Dr. Teitelbaum and elected to hold the Respondent involuntarily because Page 12 of 17 they were concerned the Respondent was a danger to herself or others (or both). 69. On or about August 2, 2011, the Respondent was instructed to complete her evaluation, but the Respondent refused to participate in any testing, 70. On or about August 2, 2011, based on her refusal to participate In her evaluation, the Respondent was released from Shands-Vista. 71. On or about August 2, 2011, Dr. Teitelbaum opined that based on the Respondent's dangerous drug related behaviors, impaired judgment and significant mood lability, the Respondent could not practice medicine "with reasonable skill and safety. 72, On or about August 2, 2011, P.R.N. concurred with Dr. Teltlebaum’s opinion that the Respondent was an immediate and serious danger to the public. 73. Section 458.331(1)(s), Florida Statutes (2010-2011) provides that a physician is subject to discipline for being unable to practice medicine with reasonable skill and safety to patients by reason of illness or use of alcohol, drugs, narcotics, chemicals, or any other type of material or as a result of any mental or physical condition. Page 13 of 17 74. The Respondent is unable to practice medicine with reasonable’ skill and safety to patients by reason of. illness or use of alcohol, drugs, narcotics, chemicals, or any other type of material or as a result of any mental or physical condition in one or more of the following ways: a On or about June 9, 2011, controlled substances and methods of administration were found at the Respondent's home. . On or about June 9, 2011 the Respondent had needle track marks on her person. » On or about August 1, 2011 the Respondent had needle track marks on her person. . From on or about June 27, 2011 through on or about August 2, 2011, the Respondent failed to go to evaluations or failed to complete evaluations. . On or about July 26, 2011, P.R.N, opined that the Respondent was an immediate and serious danger to the public. » On or about August 2, 2011, Scott Teitlebaum, M.D., opined that based on the Respondent’s dangerous drug related Page 14 of 17 behaviors, impaired judgment and significant mood labillty, the Respondent could not practice medicine with reasonable skill and safety, 75, Based on the foregoing, the Respondent violated Section 458.331(1)(s), Florida Statutes, (2010-2011) by being unable to practice medicine with reasonable skill and safety to patients by reason of Illness or use of alcohol, drugs, narcotics, chemicals, or any other type of material or as a result of any mental or physical condition. 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 Réspandent’s ticense, restriction of practice, imposition of an administrative fine, issuance of a reprimand, Page 15 of 17 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 3a day of August _, 2011. H. Frank Farnier, Jr., MD, PhD, FACP State Surgeon General DEPARTMENT OF HEALTH race Kim, Assistant General Counsel DEPUTY CLERK : . . ; DOH Prosecution Services Unit ouernOrad Sos 4052 Bald Cypress Way, Bin C-65 pave AUG 23 Tallahassee, FL 32399-3265 Florida Bar # 31096 (850) 245-4640, Ext, 8187 PHONE (850) 245-4681 FAX PCP: August 23, 2011 ; PCP Members: Levine Leen, Zachariale Page 16 of 17 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. Page 17 of 17

Docket for Case No: 11-005891PL