STATE OF FLORIDA DEPARTMENT OF HEALTH DEPARTMENT OF HEALTH, PETITIONER, Vv. CASE NO. 2010-19194 RICHARD HAYS, M.D., RESPONDENT. / 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 the Respondent, Richard Hays, 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 43956. Richard Hays, M.D. Case No. 2010-19194 Filed February 22, 2012 3:06 PM Division of Administrative Hearings Rag 3. Respondent's address of record is 1901 S. John Young Parkway, Suite 103, Kissimmee, Florida 34741. 4. 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 abuse of oxycodone may lead to severe psychological or physical dependence. 5. Oxycontin is a semi-synthetic opiate that contains oxycodone hydrochloride, a Schedule II controlled substance defined in Chapter 893, Florida Statutes, which is indicated for the relief of moderate to severe pain. Oxycontin has a high potential for abuse and has a currently accepted, but limited, medical use in treatment in the United States. Abuse of this substance may lead to severe physical and psychological dependence. 6. Vicodin, Lortab and Lorcet are the brand names for Hydrocodone. Hydrocodone/APAP contains hydrocodone = and acetaminophen, or Tylenol and is prescribed to treat pain. According to Section 893.03(3), Florida Statutes, hydrocodone, in the dosages found in hydrocodone/APAP is a Schedule III controlled substance that has a Richard Hays, M.D. 2 2010-19194 potential for abuse less than the substances in Schedules I and II 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. 7. Xanax is the brand name for alprazolam and is prescribed to treat anxiety. According to Section 893.03(4), Florida Statutes, alprazolam 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. Abuse of alprazolam may lead to limited physical or psychological dependence relative to the substances in Schedule III. 8. Soma is the brand name for carisoprodol, a muscle relaxant commonly prescribed to treat muscular pain. According to Section 893.03(4), Florida Statutes, carisoprodol is a Schedule IV controlled substance that has a low potential for abuse relative to the substances in Schedule II and has a currently accepted medical use in treatment in the United States. Abuse of carisoprodol! may lead to limited physical or psychological dependence relative to the substances in Schedule ITI. 9. Dilaudid is the brand name for hydromorphone and _ is prescribed to treat pain. According to Section 893.03(2), Florida Statutes, hydromorphone is a Schedule II controlled substance that has a high Richard Hays, M.0. 3 2010-19194 potential for abuse and has a currently accepted but severely restricted medical use in treatment in the United States, and abuse of hydromorphone may lead to severe psychological or physical dependence. 10. Ambien is the brand name for the drug zolpidem, prescribed to treat insomnia. According to Title 21, Section 1308.14, Code of Federal Regulations, zolpidem is a Schedule IV controlled substance. Zolpidem can cause dependence and is subject to abuse. 11. Methadone is prescribed to treat pain. According to Section 893.03(2), Florida Statutes, methadone 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 methadone may lead to severe psychological or physical dependence. 12. Rule 64B8-9.013(3), Florida Administrative Code, provides as follows: The Board has adopted the following standards for the use of controlled substances for pain control: (a) Evaluation of the Patient. A complete medical history and physical examination must be conducted and documented in the medical record. The medical record should document the nature and intensity of the pain, current and past treatments for pain, underlying or coexisting diseases or conditions, the Richard Hays, M.D. 4 2010-19194 effect of the pain on physical and psychological function, and history of substance abuse. The medical record also should document the presence of one or more recognized medical indications for the use of a controlled substance. (b) Treatment Plan. The written treatment plan should state objectives that will be used to determine treatment success, such as pain relief and improved physical and psychosocial function, and should indicate if any further diagnostic evaluations or other treatments are planned. After treatment begins, the physician should adjust drug therapy to the Patient medical needs of each patient. Other treatment modalities or a rehabilitation program may be necessary depending on the etiology of the pain and the extent to which the pain is associated with physical and psychosocial impairment. E ific H 13. Respondent prescribed soma, oxycodone, xanax, and lorcet for SH, on the dates and in the strengths and quantities described in the following table: SH Soma Oxycodone Xanax 350 Mg. 15 Mg. ; 2 Mg. 2/23/2010 2/23/2010 2/23/2010 2/23/2010 350 Mg. 15 Mg. 10/650 Mg. 2 Ma. 90 Tablets 180 Tablets 120 Tablets | 60 Tablets 3/23/2010 3/23/2010 3/23/2010 3/23/2010 350 Mg. 15 Mg. 10/650 Mg. 2 Mg. 90 Tablets 180 Tablets 120 Tablets 60 Tablets 4/21/2010 4/21/2010 4/21/2010 4/21/2010 350 Mg. 15 Mg. 10/650 2 Mg. 90 Tablets 180 Tablets 120 Tablets 60 Tablets 5/21/2010 5/21/2010 5/21/2010 5/21/2010 350 Mg. 15 Ma. 10/650 Mg. 2 Mg. 90 Tablets 180 Tablets 120 Tablets 60 Tablets | Richard Hays, M.D. 5 2010-19194 8/12/2010 8/12/2010 8/12/2010 Soma Oxycodone | Lorcet | Xanax 350 Mg. 15 Mg. mCICH Mg. 2 Mg. 6/18/2010 6/18/2010 6/18/2010 6/18/2010 350 Mg. 15 Mg. 10/650 Mg. 2 Mg. 90 Tablets 180 Tablets 120 Tablets 60 Tablets 7/15/2010 7/15/2010 7/15/2010 7/15/2010 350 Mg. 15 Mg. 10/650 2 mg. 90 Tablets 180 Tablets 120 Tablets 60 Tablets 8/12/2010 350 Mg. 15 Mg. 10/650 2 mg. | __ 90 Tablets 180 Tablets 120 Tablets | 60 Tablets 9/9/2010 9/9/2010 9/9/2010 9/9/2010 350 Mg. 15 Mg. 10/650 2 mg. 90 Tablets 180 Tablets 120 Tablets | 60 Tablets 14. The strengths and quantities of soma, oxycodone, xanax and lorcet which Respondent prescribed were potentially lethal and were prescribed without justification or without documenting justification in the medical record of patient SH. 15. Respondent did not refer or did not document a referral for SH to a psychiatrist, an orthopedic surgeon, a physical therapist, or an interventional pain specialist. 16. Respondent did not document or did not perform a complete medical history and physical exam on SH. 17. Respondent did not document or did not determine the following: a. The nature or intensity of SH’s pain; b. Current or past treatments of SH’s pain; Richard Hays, M.D. 6 2010-19194 c. The effect of pain on SH’s physical or psychological function; d. Any history of substance abuse for SH; e. | Whether SH was taking the prescribed medications or whether SH was taking illicit drugs by performing any drug screens by an outside laboratory during the course of treatment; f. Obtaining any diagnostic studies on SH; g. Obtaining any consultations from other specialists on SH; h. Counsel SH on the potential danger of addiction and abuse of the medication being prescribed. 18. Respondent did not develop or did not document a treatment plan for SH. a ifi Cw 19. Respondent prescribed soma, oxycodone, xanax and oxycontin for CW, on the dates and in the strengths and quantities described in the following table: Richard Hays, M.D. 7 2010-19194 Soma Oxycodone Xanax | Oxycontin | 350 Mg. 30 Mg. 5 Mg. 80 Mg. 1 Mg. 2 Mg. 2/2/2010 2/2/2010 2/2/2010 2/2/2010 350 Mg. 30 Mg. .5 Mg. 80 Mg. 90 Tablets 120 Tablets 90 Tablets | 60 Tablets | | 3/2/2010 3/2/2010 3/2/2010 3/2/2010 350 30 Mg. 1 Mg. 80 Mg. 90 Tablets 120 Tablets 90 Tablets | 60 Tablets | 3/30/2010 3/30/2010 3/30/2010 3/30/2010 350 Mg. 30 Mg. 1 Mg. 80 Mg. 90 Tablets 120 Tablets | 90 Tablets | 60 Tablets 4/27/2010 4/27/2010 4/27/2010 | 4/27/2010 | 350 Mg. 30 Mg. 1 Mg. 80 Mg. 90 Tablets 150 Tablets 90 Tablets 60 Tablets 5/25/2010 5/25/2010 5/25/2010 5/25/2010 350 Mg. 30 Mg. 1 Mg. 80 Mg. 90 Tablets 150 Mg. 90 Tablets 90 Tablets 6/22/2010 6/22/2010 6/22/2010 6/22/2010 350 Mg. 30 Mg. 2 Mg. 80 Mg. 90 Tablets 150 Tablets 60 Tablets 90 Tablets 7/20/2010 7/20/2010 7/20/2010 7/20/2010 350 Mg. 30 Mg. 2 Mg. 80 Mg. 90 Tablets 150 Tablets 60 Tablets 90 Tablets 8/17/2010 | 8/17/2010 | 8/17/2010 | 8/17/2010 350 Mg. 30 Mg. 2 Mg. 80 Mg. 90 Tablets 150 Tablets 60 Tablets 90 Tablets 9/14/2010 9/14/2010 9/17/2010 9/17/2010 350 Mg. 30 Mg. 2 Mg. 80 Mg. 90 Tablets 150 Tablets 60 Tablets 90 Tablets Richard Hays, M.D. 2010-19194 20. The strengths and quantities of soma, oxycodone, xanax and oxycontin which Respondent prescribed were potentially lethal and were prescribed without justification or without documenting justification in the medical record of CW. 21. Respondent did not refer or did not document a referral for CW to a psychiatrist, an orthopedic surgeon, a physical therapist, or an interventional pain specialist. 22. Respondent did not document or did not perform a complete medical history and physical exam on CW. 23. Respondent did not document or did not determine the following: a. The nature or intensity of CW's pain; b. Current or past treatments of CW's pain; c. The effect of pain on CW’s physical or psychological function; d. Any history of substance abuse for CW; e. | Whether CW was taking the prescribed medications or whether CW was taking illicit drugs by performing any drug screens by an outside laboratory during the course of treatment; Richard Hays, M.D. 9 2010-19194 f. Obtaining any diagnostic studies on CW; g. Obtaining any consultations from other specialists on CW; h. Counsel CW on the potential danger of addiction and abuse of the medication being prescribed. 24. Respondent did not develop or did not document a treatment plan for CW. Facts Specific to CL 25. Respondent prescribed soma, lortab, xanax and dilaudid for CL, on the dates and in the strengths and quantities described in the following table: CL Lortab Xanax Dilaudid Soma 350 Mg. 40/500 1 Mg. 4Mg. 2/24/2010 | 2/24/2010 | 2/24/2010 | 2/24/2010 350 Mg. 10/500 Mg. 1 Mg. 4 Mg. 20 Tablets | 180 Tablets | 120 Tablets | 120 Tablets 3/25/2010 | 3/25/2010 | 3/25/2010 | 3/25/2010 350 Mg. 10/500 Mg. 1 Mg. 4 Mg. 20 Tablets | 180 Tablets | 120 Tablets | 120 Tablets 4/22/2010 | 4/22/2010 | 4/22/2010 | 4/22/2010 350 Mg. | 10/500 Mg. 1 Mg. 4 Mg. 20 Tablets | 180 Tablets | 120 Tablets | 120 Tablets 5/20/2010 | 5/20/2010 | 5/20/2010 | 5/20/2010 350 Mg. | 10/500 Mg. 1 Mg. 4 Mg. 20 Tablets | 180 Tablets | 120 Tablets | 120 Tablets | Richard Hays, M.D. 2010-19194 10 | Soma Lortab Xanax | Dilaudid 350M 10/500 1 Mg. 4 Mg. 3 | Mg. | 6/17/2010 | 6/17/2010 | 6/17/2010 | 6/17/2010 350 Mg. 10/500 Mg. 1 Mg. 4 Mg. 20 Tablets | 180 Tablets | 120 Tablets | 120 Tablets | 7/15/2010 | 7/15/2010 | 7/15/2010 | 7/15/2010 350 Mg. | 10/500 Mg.{ 1Mg. 4 Mg. L 20 Tablets | 180 Tablets | 120 Tablets | 120 Tablets 8/12/2010 | 8/12/2010 | 8/12/2010 | 8/12/2010 350 Mg. | 10/500Mg.| 1Mg. 4 Mg. 20 Tablets _| 180 Tablets | 120 Tablets | 120 Tablets 9/9/2010 | 9/9/2010 | 9/9/2010 | 9/9/2010 350 Mg. 10/500 Mg. 1 Mg. 4 Mg. 20 Tablets | 180 Tablets | 120 Tablets | 120 Tablets | 26. The strengths and quantities of soma, lortab, xanax, and dilaudid, which Respondent prescribed were potentially lethal and were prescribed without justification or without documenting justification in the medical record of CL. 27. Respondent did not refer or did not document a referral for CL to a psychiatrist, an orthopedic surgeon, a physical therapist, or an interventional pain specialist. 28. Respondent did not document or did not perform a complete medical history and physical exam on CL. 29. Respondent did not document. or did not determine the following: Richard Hays, M.D. 2010-19194 11 a. The nature or intensity of CL’s pain; b. Current or past treatments of CL’s pain; c. The effect of pain on CL's physical or psychological function; d. Any history of substance abuse for CL; e. | Whether CL was taking the prescribed medications or whether CL was taking illicit drugs by performing any drug screens by an outside laboratory during the course of treatment; f. | Obtaining any diagnostic studies on CL; g. Obtaining any consultations from other specialists on CL; h. Counsel CL on the potential danger of addiction and abuse of the medication being prescribed. 30. Respondent did not develop or did not document a treatment plan for CL. Richard Hays, M.D. 12 2010-19194 EF 31. DP Respondent prescribed soma, oxycodone, ambien, methadone, and alprazolam for DP on the dates and in the strengths and quantities described in the following table: DP Soma are Ambien | Methadone ria 350 Mg. 30 Mo. 10 Mg. 10 Mg. 2/2/2010 2/2/2010 2/2/2010 1 350 Mg. 10 Mg. 10 Mg. 30 Tablets 25 Tablets | 60 Tablets 3/2/2010 | 3/2/2010 3/2/2010 3/2/2010 3/2/2010 350 Mg. 15 Mg. 10 Mg. 10 Mg. 1 Mg. 30 Tablets | 150 Tablets | 25 Tablets | 90 Tablets | 60 Tablets | 3/31/2010 | 3/31/2010 | 3/31/2010 | 3/31/2010 | 3/31/2010 350 Mg. 15 Mg. 10 Mg. 10 Mg. 1 Mg. 30 Tablets | 150 Tablets | 25 Tablets | 90 Tablets | 90 Tablets 4/28/2010 | 4/28/2010 | 4/28/2010 | 4/28/2010 | 4/28/2010 350 Mg. 15 Mg. 10 Mg. 10 Mg. 1 Mg. 30 Tablets | 150 Tablets | 25 Tablets | 120 Tablets | 90 Tablets 5/25/2010 | 5/25/2010 | 5/25/2010 | 5/25/2010 | 5/25/2010 350 Mg. 15 Mg. 10 Mg. 10 Mg. 1 Mg. 30 Tablets | 180 Tablets | 25 Tablets | 120 Tablets | 90 Tablets | 6/22/2010 | 6/22/2010 | 6/22/2010 | 6/22/2010 | 6/22/2010 350 Mg. 15 Mg. 10 Mg. 10 Mg. 1Mg. 30 Tablets | 180 Tablets | 25 Tablets | 120 Tablets | 90 Tablets 7/20/2010 | 7/20/2010 | 7/20/2010 | 7/20/2010 | 7/20/2010 350 Mg. 15 Mg. 10 Mg. 10 Mg. 1 Mg. 60 Tablets | 180 Tablets | 25 Tablets | 150 Tablets | 90 Tablets 8/17/2010 | 8/17/2010 | 8/17/2010 | 8/17/2010 | 8/17/2010 350 Mg. 15 Mg. 10 Mg. 10 Mg. 1 Mg. 60 Tablets | 180 Tablets | 25 Tablets | 150 Tablets | 90 Tablets 9/14/2010 | 9/14/2010 | 9/14/2010 | 9/14/2010 “| 9/14/2010 350 Mg. 30 Mg. 10 Mg. 10 Mg. 1 Mg. 60 Tablets | 90 Tablets | 25 Tablets | 180 Tablets | 90 Tablets Richard Hays, M.D. 2010-19194 13 32. The quantities of soma, oxycodone, ambien, methadone and alprazolam, which Respondent prescribed, were potentially lethal and were prescribed without justification or without documenting justification in the medical record of DP. 33. Respondent did not refer or did not document a referral for DP to a psychiatrist, an orthopedic surgeon, a physical therapist, or an interventional pain specialist. 34. Respondent did not document or did not perform a complete medical history and physical exam on DP. 35. Respondent did not document or did not determine the following: a. The nature or intensity of DP’s pain; b. Current or past treatments of DP’s pain; c. The effect of pain on DP’s physical or psychological function; d. Any history of substance abuse for DP; e. Whether DP was taking the prescribed medications or whether DP was taking illicit drugs by performing Richard Hays, M.D. 2010-19194 14 any drug screens by an outside laboratory during the course of treatment, f. Obtaining any diagnostic studies on DP; g. Obtaining any consultations from other specialists on DP; h. Counsel DP on the potential danger of addiction and abuse of the medication being prescribed. 36. Respondent did not develop or did not document a treatment plan for DP. Fa Cifi L 37. Respondent prescribed soma, oxycodone, lorcet and xanax for SL on the dates and in the strengths and quantities described in the following table: SL Soma | Oxycodone Lorcet | Xanax | _350 Mg. 30 Mg. 7 10/650 Mg. | _2 Mg. 2/10/2010 2/10/2010 2/10/2010 2/10/2010 350 Mg. 30 Mg. 10/650 Mg. 2 Mg. 60 Tablets 120 Tablets | __60 Tablets 90 Tablets 3/11/2010 ia 3/11/2010 3/11/2010 3/11/2010 | 350 Mg. 30 Mg. 10/650 Mg. 2 Mg. | 60 Tablets 120 ‘Tablets 60 Tablets 60 Tablets 4/12/2010 4/12/2010 4/12/2010 4/12/2010 350 Mg. 30 Mg. 10/650 Mg. 2 Mg. 60 Tablets 120 Tablets | 60 Tablets | 60 Tablets Richard Hays, M.D. 15 2010-19194 Soma Oxycodone Lorcet Xanax 350 Mg. 30Mg. _| 10/650 Mg. 2Mg._ 5/10/2010 5/10/2010 5/10/2010 | 5/10/2010 | 350 Mg. 30 Mg. 10/650 Mg. 2 Mg. 60 Tablets 120 Tablets | 60 Tablets | 60 Tablets 6/9/2010 6/9/2010 6/9/2010 6/9/2010 350 Mg. 30 Mg. 10/650 Mg. 2 Mg. 60 Tablets 120 Tablets 60 Tablets | 60 Tablets 7/20/2010 7/20/2010 7/20/2010 | 7/20/2010 350 Mg. 30 Mg. 10/650 Mg. 2 Mg. 60 Tablets 120 Tablets 60 Tablets | 60 Tablets 8/17/2010 8/17/2010 8/17/2010 | 8/17/2010 | 350 Mg. 30 Mg. 10/650 Mg. 2 Mg. 60 Tablets 120 Tablets 60 Tablets | 60 Tablets 9/14/2010 9/14/2010 9/14/2010 | 9/14/2010 350 Mg. 30 Mg. 10/650 Mg. 2 Mg. 60 Tablets 120 Tablets 60 Tablets | 60 Tablets 38. The quantities of soma, oxycodone, lorcet and xanax, which Respondent prescribed, were potentially lethal and were prescribed without justification or without documenting justification in the medical record of SL. 39. Respondent did not refer or did not document a referral for SL to a psychiatrist, an orthopedic surgeon, a physical therapist, or an interventional pain specialist. 40. Respondent did not document or did not perform a complete medical history and physical exam on SL. 41. Respondent did not document or did not determine the following: Richard Hays, M.D. 16 2010-19194 a. | The nature or intensity of SH’s pain; b. Current or past treatments of SH’s pain; c. The effect of pain on SH’s physical or psychological function; d. Any history of substance abuse for SH; e. | Whether SH was taking the prescribed medications or whether SH was taking illicit drugs by performing any drug screens by an outside laboratory during the course of treatment; f. | Obtaining any diagnostic studies on SH; g. Obtaining any consultations from other specialists on SH; h. Counsel SH on the potential danger of addiction and abuse of the medication being prescribed. 42. Respondent did not develop or did not document a treatment plan for SL. COUNT ONE 43. Petitioner realleges and incorporates paragraphs 1 through 18 as if fully set forth herein. Richard Hays, M.D. 17 2010-19194 44. Section 458.331(1)(q), Florida Statutes (2009)(2010), subjects a licensee to discipline, including suspension, for prescribing, dispensing, administering, mixing, or otherwise preparing a legend drug, including any controlled substance, other than in the course of the physician's professional practice. For purposes of this paragraph, it shall be legally presumed that prescribing, dispensing, administering, mixing, or otherwise preparing legend drugs, including all controlled substances, inappropriately or in excessive or inappropriate quantities is not in the best interest of the patient and is not in the course of the physician's professional practice, without regard to his intent. 45. Respondent prescribed controlled substances inappropriately or in excessive or inappropriate quantities in one or more of the following ways: a. By prescribing the controlled substances, soma, oxycodone, lorcet, and xanax without justification to patient SH , as outlined in paragraphs 14 through 18; b. By prescribing the controlled substances, soma, oxycodone, lorcet and xanax in potentially lethal doses to Patient SH, as outlined in paragraphs 14 through 18. Richard Hays, M.D. 18 2010-19194 46. Based on the forgoing, Respondent violated Section 458.331(1)(q), Florida Statutes (2009)(2010) when he prescribed the controlled substances, , soma, oxycodone, lorcet, and xanax without justification and in potentially lethal doses, to patient SH, as outlined in paragraphs 14 through 18. COUNT TWO 47. Petitioner realleges and incorporates paragraphs 1 through 18 as if fully set forth herein. 48. Section 458.331(1)(m), Florida Statutes (2009)(2010), provides that 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, constitutes grounds for disciplinary action by the Board of Medicine. 49. Respondent failed to keep legible medical records justifying the course of treatment for Patient SH in one or more of the following ways: a. By failing to document justification for prescribing to SH; Richard Hays, M.D. 19 2010-19194 By failing to document referrals for SH to a psychiatrist, an orthopedic surgeon, a_ physical therapist, or an interventional pain specialist; By failing to document performance of a complete medical history and physical exam on SH; By failing to document the nature or intensity of SH's pain; By failing to document current or past treatments of SH‘s pain; By failing to document the effect of pain on SH’s physical or psychological function; By failing to document any history of substance abuse for SH; By failing to document a treatment plan for SH; By failing to document a medication management agreement on any visits but still prescribing controlled substances; By failing to document a urine drug screen from an outside laboratory on SH; k. By failing to document any diagnostic studies on SH. 50. Based on the foregoing, Respondent violated Section 458.331(1)(m), Florida Statutes (2009)(2010), by failing to keep legible medical records that justify the course of treatment for Patient SH. COUNT THREE 51. Petitioner realleges and incorporates paragraphs 1 through 18 as if fully set forth herein. 52. Section 458.331(1)(t), Florida Statutes (2009)(2010), subjects a doctor to discipline for committing medical malpractice as defined in Section 456.50. Section 456.50, Florida Statutes (2009)(2010), defines medical malpractice 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. 53. Level of care, skill, and treatment recognized in general law related to health care licensure means the standard of care specified in Section 766.102. Section 766.102(1), Florida Statutes, defines the standard of care to mean“. . . The prevailing professional standard of care for a given health care provider shall be that level of care, skill, and Richard Hays, M.D. 21 2010-19194 treatment which, in light of all relevant surrounding circumstances, is recognized as acceptable and appropriate by reasonably prudent similar health care providers... .” 54. Respondent failed to meet the required standard of care in one or more of the following ways: a. _ By prescribing soma, oxycodone, lorcet, and xanax to SH without justification, as outlined in paragraphs 14 through 18; b. By prescribing soma, oxycodone, lorcet and xanax to SH in potentially lethal doses, as outlined in paragraphs 14 through 18; c. By failing to refer SH to a psychiatrist, an orthopedic surgeon, a physical therapist, or an interventional pain specialist; d. By failing to obtain a complete medical history or perform a physical exam on SH; e. By failing to obtain the nature or intensity of SH’s pain; Richard Hays, 2010-19194 22 f. By failing to obtain the current or past treatments of SH's pain; g. By failing to obtain information on the effect of pain on Sh’s physical or psychological function; h. By failing to obtain any history of substance abuse for SH; i. By failing to develop a treatment plan for SH; j. By failing to obtain a urine drug screen from an outside laboratory on SH; k. By failing to review or obtain any diagnostic studies on SH. 55. Based on the foregoing, Respondent has violated Section 458.331(1)(t), Florida Statutes (2009)(2010), by committing medical malpractice. COUNT FOUR 56. Petitioner reincorporates and realleges paragraphs 1 through 18 as if fully set forth herein. 57. Section 458.331(1)(nn), Florida Statutes (2009)(2010), provides that violating any provision of chapters 456 or 458, Florida Richard Hays, M.D. 2010-19194 23 Statutes, or any rules adopted pursuant thereto, is grounds for discipline by the Board of Medicine. 58. Respondent violated Section 458.331(1)(nn) Florida Statutes (2009)(2010) when he violated Rule 64B8-9.013(3), FAC in one or more of the following ways: Richard Hays, M.D. 2010-19194 By failing to document justification for prescribing soma, oxycodone, lorcet and xanax to SH; By failing to document referrals for SH to a psychiatrist, an orthopedic surgeon, a_ physical therapist, or an interventional pain specialist; By failing to document performance of a complete medical history and physical exam on SH; By failing to document the nature or intensity of SH’s pain; By failing to document current or past treatments of SH’s pain; By failing to document the effect of pain on SH’s physical or psychological function; 24 g. By failing to document any history of substance abuse for SH; h. By failing to document a treatment plan for SH; i. By failing to document a medication management agreement on any visits but still prescribing controlled substances; j. By failing to document a urine drug screen from an outside laboratory on SH; k. By failing to document any diagnostic studies on SH. 59. Based on the foregoing, Respondent has violated Section 458.331(1)(nn), Florida Statutes (2009)(2010), by violating Rule 64B8- 9.013(3), FAC. COUNT FIVE 60. Petitioner realleges and incorporates paragraphs 1 through 12 and paragraphs 19 through 24 as if fully set forth herein. 61. Section 458.331(1)(q), Florida Statutes (2009)(2010), subjects a licensee to discipline, including suspension, for prescribing, dispensing, administering, mixing, or otherwise preparing a legend drug, including any controlled substance, other than in the course of the physician’s professional practice. For purposes of this paragraph, it shall be legally Richard Hays, M.D. 2010-19194 25 presumed that prescribing, dispensing, administering, mixing, or otherwise preparing legend drugs, including all controlled substances, inappropriately or in excessive or inappropriate quantities is not in the best interest of the patient and is not in the course of the physician’s professional practice, without regard to his intent. 62. Respondent prescribed controlled substances inappropriately or in excessive or inappropriate quantities in one or more of the following ways: a. By prescribing the controlled substances, soma, oxycodone, oxycontin and xanax without justification to patient CW, as outlined in paragraphs 19 through 24; b. By prescribing the controlled substances, soma, oxycodone, oxycontin and xanax in potentially lethal doses to Patient CW, as outlined in paragraphs 19 through 24. 63. Based on the forgoing, Respondent violated Section 458.331(1)(q), Florida Statutes (2009)(2010) when he prescribed the controlled substances, soma, oxycodone, oxycontin and xanax without justification and in potentially lethal doses, to patient CW, as outlined in paragraphs 19 through 24. Richard Hays, M.D. 26 2010-19194 COUNT SIX 64. Petitioner realleges and incorporates paragraphs 1 through 12 and paragraphs 19 through 24 as if fully set forth herein. 65. Section 458.331(1)(m), Florida Statutes (2009)(2010), provides that 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, constitutes grounds for disciplinary action by the Board of Medicine. 66. Respondent failed to keep legible medical records justifying the course of treatment for CW in one or more of the following ways: a. _ By failing to document justification for prescribing soma, oxycodone, oxycontin and xanax to CW; b. By failing to document referrals for CW to a psychiatrist, an orthopedic surgeon, a_ physical therapist, or an interventional pain specialist; c. By failing to document performance of a complete medical history and physical exam on CW; Richard Hays, M.O. 27 2010-19194 d. _ By failing to document the nature or intensity of CW's pain; e. By failing to document current or past treatments of CW's pain; f. By failing to document the effect of pain on CW’s physical or psychological function; g. By failing to document any history of substance abuse for CW; h. By failing to document a treatment plan for CW; i, By failing to document a medication management agreement on any visits but still prescribing controlled substances; Hl By failing to document a urine drug screen from an outside laboratory on CW; k. By falling to document any diagnostic studies on Cw. 67. Based on the foregoing, Respondent violated Section 458.331(1)(m), Florida Statutes (2009)(2010), by failing to keep legible medical records that justify the course of treatment for Patient CW. Richard Hays, M.D. 2010-19194 28 COUNT SEVEN 68. Petitioner realleges and incorporates paragraphs 1 through 12 and paragraphs 19 through 24 as if fully set forth herein. 69. Section 458.331(1)(t), Florida Statutes (2009)(2010), subjects a doctor to discipline for committing medical malpractice as defined in Section 456.50. Section 456.50, Florida Statutes (2009)(2010), defines medical malpractice 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. 70. Level of care, skill, and treatment recognized in general law related to health care licensure means the standard of care specified in Section 766.102. Section 766.102(1), Florida Statutes, defines the standard of care to mean“. . . 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 surrounding circumstances, is recognized as acceptable and appropriate by reasonably prudent similar health care providers. . . .” 71. Respondent failed to meet the required standard of care in one or more of the following ways: Richard Hays, M.D. 29 2010-19194 Richard Hays, M.D. 2010-19194 a. By prescribing soma, oxycodone, oxycontin and xanax to CW without justification, as outlined in paragraphs 19 through 24; b. By prescribing soma, oxycodone, oxycontin and xanax to CW in potentially lethal doses, as outlined in paragraphs 19 through 24; C. By failing to refer CW to a psychiatrist, an orthopedic surgeon, a physical therapist, or an interventional pain specialist; d. By failing to obtain a complete medical history or perform a physical exam on CW; e. _ By failing to obtain the nature or intensity of CW's pain; f. By failing to obtain the current or past treatments of CW's pain; g. __ By failing to obtain information on the effect of pain on CW's physical or psychological function; h. By failing to obtain any history of substance abuse for CW; 30 i. By failing to develop a treatment plan for CW; j. By failing to obtain a urine drug screen from an outside laboratory on CW; k. By failing to review or obtain any diagnostic studies on CW. 72. Based on the foregoing, Respondent has violated Section 458.331(1)(t), Florida Statutes (2009)(2010), by committing medical malpractice. COUNT EIGHT 73. Petitioner reincorporates and realleges paragraphs 1 through 12 and paragraphs 19 through 24 as if fully set forth herein. 74. Section 458.331(1)(nn), Florida Statutes (2009)(2010), provides that violating any provision of chapters 456 or 458, Florida Statutes, or any rules adopted pursuant thereto, is grounds for discipline by the Board of Medicine. 75. Respondent violated Section 458.331(1)(nn) Florida Statutes (2009)(2010) when he violated Rule 64B8-9.013(3), FAC in one or more of the following ways: Richard Hays, M.D. 31 2010-19194 By failing to document justification for prescribing soma, oxycodone, oxycontin and xanax to CW; By failing to document referrals for CW to a psychiatrist, an orthopedic surgeon, a physical therapist, or an interventional pain specialist; By failing to document performance of a complete medical history and physical exam on CW; By failing to document the nature or intensity of CW's pain; By failing to document current or past treatments of CW's pain; By failing to document the effect of pain on CW’s physical or psychological function; By failing to document any history of substance abuse for CW; By failing to document a treatment plan for CW; By failing to document a medication management agreement on any visits but still prescribing controlled substances; j. By failing to document a urine drug screen from an outside laboratory on CW; k. By failing to document any diagnostic studies on CW. 76. Based on the foregoing, Respondent has violated Section 458.331(1)(nn), Florida Statutes (2009)(2010), by violating Rule 64B8- 9.013(3), FAC. COUNT NINE 77. Petitioner realleges and incorporates paragraphs 1 through 12 and paragraphs 25 through 30 as if fully set forth herein. 78. Section 458.331(1)(q), Florida Statutes (2009)(2010), subjects a licensee to discipline, including suspension, for prescribing, dispensing, administering, mixing, or otherwise preparing a legend drug, including any controlled substance, other than in the course of the physician’s professional practice. For purposes of this paragraph, it shall be legally presumed that prescribing, dispensing, administering, mixing, or otherwise preparing legend drugs, including all controlled substances, inappropriately or in excessive or inappropriate quantities is not in the best interest of the patient and is not in the course of the physician’s professional practice, without regard to his intent. Richard Hays, M.D. 33 2010-19194 79. Respondent prescribed controlled substances inappropriately or in excessive or inappropriate quantities in one or more of the following ways: a. By prescribing the controlled substances, soma, lortab, xanax and dilaudid without justification to patient CL, as outlined in paragraphs 25 through 30; b. By prescribing the controlled substances, soma, lortab, xanax and dilaudid in potentially lethal doses to Patient CL, as outlined in paragraphs 25 through 30. 80. Based on the forgoing, Respondent violated Section 458.331(1)(q), Florida Statutes (2009)(2010) when he prescribed the controlled substances, soma, xanax, lortab and dilaudid, without justification and in potentially lethal doses, to patient CL, as outlined in paragraphs 25 through 30. COUNT TEN 81. Petitioner realleges and incorporates paragraphs 1 through 12 and paragraphs 25 through 30 as if fully set forth herein. Richard Hays, M.D. 2010-19194. 34 82. Section 458.331(1)(m), Florida Statutes (2009)(2010), provides that 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, constitutes grounds for disciplinary action by the Board of Medicine. 83. Respondent failed to keep legible medical records justifying the course of treatment for CL in one or more of the following ways: a. _ By failing to document justification for prescribing soma, lortab, xanax and dilaudid to CL; b. By failing to document referrals for CL to a psychiatrist, an orthopedic surgeon, a_ physical therapist, or an interventional pain specialist; c. By failing to document performance of a complete medical history and physical exam on CL; d. _By failing to document the nature or intensity of CL's pain; e. By failing to document current or past treatments of CL's pain; Richard Hays, M.D. 35 2010-19194 k. 84. Based on the foregoing, Respondent violated Section 458.331(1)(m), Florida Statutes (2009)(2010), by failing to keep legible By failing to document the effect of pain on CL's physical or psychological function; By failing to document any history of substance abuse for CL; By failing to document a treatment plan for CL; By failing to document a medication management agreement on any visits but still prescribing controlled substances; By failing to document a urine drug screen from an outside laboratory on CL; By failing to document any diagnostic studies on CL. medical records that justify the course of treatment for patient CL. 85. Petitioner realleges and incorporates paragraphs 1 through 12 COUNT ELEVEN and paragraphs 25 through 30 as if fully set forth herein. 86. Section 458.331(1)(t), Florida Statutes (2009)(2010), subjects a doctor to discipline for committing medical malpractice as defined in Richard Hays, M.D. 2010-19194 Section 456.50. Section 456.50, Florida Statutes (2009)(2010), defines medical malpractice 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. 87. Level of care, skill, and treatment recognized in general law related to health care licensure means the standard of care specified in Section 766.102. Section 766.102(1), Florida Statutes, defines the standard of care to mean“. . . 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 surrounding circumstances, is recognized as acceptable and appropriate by reasonably prudent similar health care providers. .. .” 88. Respondent failed to meet the required standard of care in one or more of the following ways: a. _ By prescribing soma, lortab, xanax and dilaudid to CL without justification, as outlined in paragraphs 25 through 30; Richard Hays, M.D. 37 2010-19194 Richard Hays, M.D. 2010-19194 By prescribing soma, lortab, xanax and dilaudid to CL in potentially lethal doses, as outlined in paragraphs 25 through 30; By failing to refer CL to a psychiatrist, an orthopedic surgeon, a physical therapist, or an interventional pain specialist; By failing to obtain a complete medical history or perform a physical exam on CL; By failing to obtain the nature or intensity of CL's pain; By failing to obtain the current or past treatments of CL's pain; By failing to obtain information on the effect of pain on CL’s physical or psychological function; By failing to obtain any history of substance abuse for CL; By failing to develop a treatment plan for CL; By failing to obtain a urine drug screen from an outside laboratory on CL; 38 k. By failing to review or obtain any diagnostic studies on CL. 89. Based on the foregoing, Respondent has violated Section 458.331(1)(t), Florida Statutes (2009)(2010), by committing medical malpractice. COUNT TWELVE 90. Petitioner reincorporates and realleges paragraphs 1 through 12 and 25 through 30 as if fully set forth herein. 91. Section 458.331(1)(nn), Florida Statutes (2009)(2010), provides that violating any provision of chapters 456 or 458, Florida Statutes, or any rules adopted pursuant thereto, is grounds for discipline by the Board of Medicine. 92. Respondent violated Section 458.331(1)(nn) Florida Statutes (2009)(2010) when he violated Rule 64B8-9.013(3), FAC in one or more of the following ways: a. By failing to document justification for prescribing soma, lortab, xanax and dilaudid to CL; Richard Hays, M.D. 2010-19194 39 Richard Hays, M.D. 2010-19194 By failing to document referrals for CL to a psychiatrist, an orthopedic surgeon, a_ physical therapist, or an interventional pain specialist; By failing to document performance of a complete medical history and physical exam on CL; By failing to document the nature or intensity of CLs pain; By failing to document current or past treatments of CL’s pain; By failing to document the effect of pain on CL's physical or psychological function; By failing to document any history of substance abuse for CL; By failing to document a treatment plan for CL; By failing to document a medication management agreement on any visits but still prescribing controlled substances; By failing to document a urine drug screen from an outside laboratory on CL; k. By failing to document any diagnostic studies on CL. 93. Based on the foregoing, Respondent has violated Section 458.331(1)(nn), Florida Statutes (2009)(2010), by violating Rule 64B8- 9.013(3), FAC. COUNT THIRTEEN 94. Petitioner realleges and incorporates paragraphs 1 through 12 and paragraphs 31 through 36 as if fully set forth herein. 95. Section 458.331(1)(q), Florida Statutes (2009)(2010), subjects a licensee to discipline, including suspension, for prescribing, dispensing, administering, mixing, or otherwise preparing a legend drug, including any controlied substance, other than in the course of the physician's professional practice. For purposes of this paragraph, it shall be legally presumed that prescribing, dispensing, administering, mixing, or otherwise preparing legend drugs, including all controlled substances, inappropriately or in excessive or inappropriate quantities is not in the best interest of the patient and is not in the course of the physician’s professional practice, without regard to his intent. 96. Respondent prescribed controlled substances inappropriately or in excessive or inappropriate quantities in one or more of the following ways: Richard Hays, M.D. 41 2010-19194 a. By prescribing the controlled substances, soma, oxycodone, ambien, methadone and alprazolam without justification to patient DP, as outlined in paragraphs 31 through 36; b. By prescribing the controlled substances, soma, oxycodone, ambien, methadone and alprazolam in potentially lethal doses to patient DP, as outlined in paragraphs 31 through 36. 97. Based on the forgoing, Respondent violated Section 458.331(1)(q), Florida Statutes (2009)(2010) when he prescribed the controlled substances, soma, oxycodone, ambien, methadone and alprazolam without justification and in potentially lethal doses, to patient DP, as outlined in paragraphs 31 through 36. COUNT FOURTEEN 98. Petitioner realleges and incorporates paragraphs 1 through 12 and paragraphs 31 through 36 as if fully set forth herein. 99. Section 458.331(1)(m), Florida Statutes (2009)(2010), provides that failing to keep legible medical records that justify the course of treatment of the patient, including, but not limited to, patient histories; Richard Hays, M.D. 2010-19194. 42 examination results; test results; records of drugs prescribed, dispensed, or administered; and reports of consultations and hospitalizations, constitutes grounds for disciplinary action by the Board of Medicine. 100. Respondent failed to keep legible medical records justifying the course of treatment for DP in one or more of the following ways: a. Richard Hays, M.D. 2010-19194 By failing to document justification for prescribing soma, oxycodone, ambien, methadone and alprazolam to DP; By failing to document referrals for DP to a psychiatrist, an orthopedic surgeon, a_ physical therapist, or an interventional pain specialist; By failing to document performance of a complete medical history and physical exam on DP; By failing to document the nature or intensity of DP’s pain; By failing to document current or past treatments of DP’s pain; By failing to document the effect of pain on DP’s physical or psychological function; 43 g. By failing to document any history of substance abuse for DP; h. By failing to document a treatment plan for DP; i. By failing to document a medication management agreement on any visits but still prescribing controlled substances; j. By failing to document a urine drug screen from an outside laboratory on DP; k. By failing to document any diagnostic studies on DP. 101. Based on the foregoing, Respondent violated Section 458,331(1)(m), Florida Statutes (2009)(2010), by failing to keep legible medical records that justify the course of treatment for patient DP. COUNT FIFTEEN 102. Petitioner realleges and incorporates paragraphs 1 through 12 and paragraphs 31 through 36 as if fully set forth herein. 103. Section 458.331(1)(t), Florida Statutes (2009)(2010), subjects a doctor to discipline for committing medical malpractice as defined in Section 456.50. Section 456.50, Florida Statutes (2009)(2010), defines Richard Hays, M.D. 2010-19194 44 medical malpractice 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. 104. Level of care, skill, and treatment recognized in general law related to health care licensure means the standard of care specified in Section 766.102. Section 766.102(1), Florida Statutes, defines the standard of care to mean“. . . 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 surrounding circumstances, is recognized as acceptable and appropriate by reasonably prudent similar health care providers... .” 105. Respondent failed to meet the required standard of care in one or more of the following ways: a. By prescribing soma, oxycodone, ambien, methadone and alprazolam to DP _ without justification, as outlined in paragraphs 31 through 36; b. By prescribing soma, oxycodone, ambien, methadone and alprazolam to DP in potentially Richard Hays, M.D. 2010-19194 | 45 Richard Hays, M.0. 2010-19194 lethal doses, as outlined in paragraphs 31 through 36; By failing to refer DP to a psychiatrist, an orthopedic surgeon, a physical therapist, or an interventional pain specialist; By failing to obtain a complete medical history or perform a physical exam on DP; By failing to obtain the nature or intensity of DP’s pain; By failing to obtain the current or past treatments of DP's pain; By failing to obtain information on the effect of pain on DP's physical or psychological function; By failing to obtain any history of substance abuse for DP; By failing to develop a treatment plan for DP; By failing to obtain a urine drug screen from an outside laboratory on DP; 46 k. By failing to review or obtain any diagnostic studies on DP. 106. Based on the foregoing, Respondent has violated Section 458.331(1)(t), Florida Statutes (2009)(2010), by committing medical malpractice. UNT_ SIXTEEN 107. Petitioner reincorporates and realleges paragraphs 1 through 12 and paragraphs 31 through 36 as if fully set forth herein. 108. Section 458.331(1)(nn), Florida Statutes (2009)(2010), provides that violating any provision of chapters 456 or 458, Florida Statutes, or any rules adopted pursuant thereto, is grounds for discipline by the Board of Medicine. 109. Respondent violated Section 458.331(1)(nn) Florida Statutes (2009)(2010) when he violated Rule 64B8-9.013(3), FAC in one or more of the following ways: a. _ By failing to document justification for prescribing soma, oxycodone, ambien, methadone and alprazolam to DP; Richard Hays, M.D. 47 2010-19194 By failing to document referrals for DP to a psychiatrist, an orthopedic surgeon, a physical therapist, or an interventional pain specialist; By failing to document performance of a complete medical history and physical exam on DP; By failing to document the nature or intensity of DP’s pain; By failing to document current or past treatments of DP’s pain; By failing to document the effect of pain on DP’s physical or psychological function; By failing to document any history of substance abuse for DP; By failing to document a treatment plan for DP; By failing to document a medication management agreement on any visits but still prescribing controlled substances; By failing to document a urine drug screen from an outside laboratory on DP; k. By failing to document any diagnostic studies on DP. 110. Based on the foregoing, Respondent has violated Section 458.331(1)(nn), Florida Statutes (2009)(2010), by violating Rule 64B8- 9.013(3), FAC. COUNT SEVENTEEN 111. Petitioner realleges and incorporates paragraphs 1 through 12 and paragraphs 37 through 42 as if fully set forth herein. 112. Section 458.331(1)(q), Florida Statutes (2009)(2010), subjects a licensee to discipline, including suspension, for prescribing, dispensing, administering, mixing, or otherwise preparing a fegend drug, including any controlled substance, other than in the course of the physician’s professional practice. For purposes of this paragraph, it shall be legally presumed that prescribing, dispensing, administering, mixing, or otherwise preparing legend drugs, including all controlled substances, inappropriately or in excessive or inappropriate quantities is not in the best interest of the patient and is not in the course of the physician’s professional practice, without regard to his intent. 113. Respondent prescribed controlled substances inappropriately or in excessive or inappropriate quantities in one or more of the following ways: Richard Hays, M.D. 2010-19194 49 a. By prescribing the controlled substances, soma, oxycodone, lorcet and xanax without justification to patient SL, as outlined in paragraphs 37 through 42; b. By prescribing the controlled substances, soma, oxycodone, lorcet and xanax in potentially lethal doses to patient SL, as outlined in paragraphs 37 through 42. 114, Based on the forgoing, Respondent violated Section 458.331(1)(q), Florida Statutes (2009)(2010) when he prescribed the controlled substances, soma, oxycodone, lorcet and xanax without justification and in potentially lethal doses, to patient SL, as outtined in paragraphs 37 through 42. COUNT EIGHTEEN 115. Petitioner realleges and incorporates paragraphs 1 through 12 and paragraphs 37 through 42 as if fully set forth herein. 116. Section 458.331(1)(m), Florida Statutes (2009)(2010), provides that 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 Richard Hays, M.D, 59 2010-19194 administered; and reports of consultations and hospitalizations, constitutes grounds for disciplinary action by the Board of Medicine. 117. Respondent failed to keep legible medical records justifying the course of treatment for SL in one or more of the following ways: Richard Hays, 2010-19194 M.D. By failing to document justification for prescribing soma, oxycodone, lorcet and xanax to SL; By failing to- document referrals for SL to a psychiatrist, an orthopedic surgeon, a physical therapist, or an interventional pain specialist; By failing to document performance of a complete medical history and physical exam on SL; By failing to document the nature or intensity of SL's pain; By failing to document current or past treatments of SLs pain; By failing to document the effect of pain on SL’s physical or psychological function; By failing to document any history of substance abuse for SL; 51 h. By failing to document a treatment plan for SL; i. By failing to document a medication management agreement on any visits but still prescribing controlled substances; j. By failing to document a urine drug screen from an outside laboratory on SL; k. By failing to document any diagnostic studies on SL. 118. Based on the foregoing, Respondent violated Section 458.331(1)(m), Florida Statutes (2009)(2010), by failing to keep legible medical records that justify the course of treatment for patient SL. COUNT NINETEEN 119. Petitioner realleges and incorporates paragraphs 1 through 12 and paragraphs 37 through 42 as if fully set forth herein. 120. Section 458,331(1)(t), Florida Statutes (2009)(2010), subjects a doctor to discipline for committing medical malpractice as defined in Section 456.50. Section 456.50, Florida Statutes (2009)(2010), defines medical malpractice 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. Richard Hays, M.D. 52 2010-19194 121. Level of care, skill, and treatment recognized in general law related to health care licensure means the standard of care specified in Section 766.102. Section 766.102(1), Florida Statutes, defines the standard of care to mean“ .. . 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 surrounding circumstances, is recognized as acceptable and appropriate by reasonably prudent similar health care providers. .. .” 122. Respondent failed to meet the required standard of care in one or more of the following ways: a. By prescribing soma, oxycodone, lorcet and xanax to SL without justification, as outlined in paragraphs 37 through 42; b. By prescribing soma, oxycodone, lorcet and xanax to SL in potentially lethal doses, as outlined in paragraphs 37 through 42; c. _ By failing to refer SL to a psychiatrist, an orthopedic surgeon, a physical therapist, or an interventional pain specialist; Richard Hays, M.D. 53 2010-19194 d. By failing to obtain a complete medical history or perform a physical exam on SL; e. By failing to obtain the nature or intensity of SL’s pain; f. By failing to obtain the current or past treatments of SL's pain; g. _ By failing to obtain information on the effect of pain on SL's physical or psychological function; h. By failing to obtain any history of substance abuse for SL; i. By failing to develop a treatment plan for SL; j. By failing to obtain a urine drug screen from an outside laboratory on SL; k. By failing to review or obtain any diagnostic studies on SL. 123. Based on the foregoing, Respondent has violated Section 458.331(1)(t), Florida Statutes (2009)(2010), by committing medical malpractice. Richard Hays, M.D. 2010-19194 o4 COUNT TWENTY 124. Petitioner reincorporates and realleges paragraphs 1 through 12 and paragraphs 37 through 42 as if fully set forth herein. 125. Section 458.331(1)(nn), Florida Statutes (2009)(2010), provides that violating any provision of chapters 456 or 458, Florida Statutes, or any rules adopted pursuant thereto, is grounds for discipline by the Board of Medicine. 126. Respondent violated Section 458.331(1)(nn) Florida Statutes (2009)(2010) when he violated Rule 64B8-9.013(3), FAC in one or more of the following ways: a. _ By failing to document justification for prescribing soma, oxycodone, lorcet and xanax to SL; b. By failing to document referrals for SL to a psychiatrist, an orthopedic surgeon, a physical therapist, or an interventional pain specialist; c. _ By failing to document performance of a complete medical history and physical exam on SL; d. _By failing to document the nature or intensity of SL's pain; Richard Hays, M.D, 2010-19194 55 k. 127. Based on the foregoing, Respondent has violated Section 458.331(1)(nn), Florida Statutes (2009)(2010), by violating Rule 64B8- 9.013(3), FAC. Richard Hays, M.D. 2010-19194 By failing to document current or past treatments of SL's pain; By failing to document the effect of pain on SL's physica! or psychological function; By falling to document any history of substance abuse for SL; By failing to document a treatment plan for SL; By failing to document a medication management agreement on any visits but still prescribing controlled substances; By failing to document a urine drug screen from an outside laboratory on SL; By failing to document any diagnostic studies on SL. WHEREFORE, the 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 the Respondent on probation, corrective action, refund of fees billed or collected, remedial education or any other relief that the Board deems appropriate. SIGNED this__4344_day of lhagact - 2011. H. Frank Farmer, Jr., MD, PhD, FACP State Surgeon General Mt Tan Brown Assistant General Counsel DOH Prosecution Services Unit 4052 Bald Cypress Way, BIN C-65 FILED Tallahassee, FL 32399-3265 DEPARTMENT OF HEALTH Florida Bar #499048 DEPUTY Telephone (850) 245-4640 Taube, Fax (850) 245-4681 pare, O22: 20\' IB/jb PCP Date: August 19, 2011 PCP Members: Leon, El Sanadi, & Goersch Richard Hays, M.D. 57 2010-19194 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. Richard Hays, M.D. 58 2010-19194

Docket for Case No: 12-000746PL