STATE OF FLORIDA DEPARTMENT OF HEALTH DEPARTMENT OF HEALTH, PETITIONER, v. CASE NO. 2008-27065 MICHAEL MOYER, M.D., RESPONDENT. eae | ADMINISTRATIVE COMPLAINT Petitioner, Department of Health, by and through its undersigned counsel, files this Administrative Complaint before the Board of Medicine against Respondent, Michael Moyer, M.D., and in support thereof alleges: 1. 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, Respondent was a licensed physician within the state of Florida, having been issued license number ME 61609. Filed May 11, 2012 2:03 PM Division of Administrative Hearings 3. | Respondent’s address of record is 7823 Shane Ct., Orlando, Florida 32822. 4. Respondent is board certified in Family Medicine. 5. On about December 9, 2008, a Costco Pharmacy reported to the Metropolitan Bureau of Investigation (MBI) that Respondent was inappropriately prescribing excessive amounts of controlled substances to patients. 6. The MBI conducted an_ investigation of Respondent's prescribing practices when prescribing controlled substances. At all times material to this Complaint, Patient KM was a confidential informant in the MBI investigation. DEFINITION OF CONTROLLED SUBSTANCES 7. 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. 8. Xanax is the brand name for alprazolam, which is prescribed to treat anxiety. According to Section 893.03(2), 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 and abuse of the substance may lead to limited physical or psychological dependence relative to the substances in Schedule IIT. 9. 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 III and has a currently accepted medical use in treatment in the United States, and abuse of carisoprodol may lead to limited physical or psychological dependence relative to the substances in Schedule ITI. 10. Lortab is the brand name for a drug that contains hydrocodone and is prescribed to treat pain. According to Section 893.03(3), Florida Statutes, hydrocodone, in the dosages found in Lortab, is a Schedule ITI controlled substance that has a 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. FACTS SPECIFIC TO PATIENT KM 11. From March 10, 2009, until June 17, 2009, Patient KM presented to Respondent for treatment for chronic pain. 12. On or about March 10, 2009, Patient KM presented to Respondent for an initial visit and reported complaints of neck and back pain, and a history of a fall from a table in 2004. Patient KM also reported a history of pain management treatment. 13. Respondent conducted an examination of Patient KM. Respondent performed a straight leg test and the patient denied having pain in her legs. However, Respondent documented in his medical records that the patient had ‘mild pain’ in the legs during the straight leg test. 14. Respondent touched the patient’s back and the patient denied having pain in her back. However, Respondent documented in his records “cervical, thoracic and lumbosacral tenderness on palpation.” 15. On or about March 10, 2009, Respondent prescribed to Patient KM Lortab 10/500 mg, 90 tablets and Soma 350 mg, 60 tablets. 16. On or about April 7, 2009, Patient KM presented to Respondent for a follow-up visit with complaints of neck and back pain. The patient reported muscle spasms and insomnia. She also reported taking Xanax from a friend for anxiety. Respondent failed to address the patient's disclosure that she consumed another patient’s medication. 17. Respondent conducted an examination of Patient KM. Respondent instructed the patient to touch her toes. When the patient touched her toes, Respondent said, “Ohh, Man.” 18. Patient KM requested that Respondent write a prescription for Xanax 30 or 60 tablets in her name. Patient KM also told Respondent that she did not intend to take the Xanax, rather she intended to give the Xanax to a friend. 19. Respondent prescribed to Patient KM Lortab 10/500 mg, 90 tablets, Soma 350 mg, 60 tablets and Xanax 2 mg, 30 tablets. 20. On or about May 12, 2009, Patient KM presented to Respondent for a follow-up visit. LC accompanied Patient KM during the visit. Patient KM reported complaints of exacerbation of neck and back pain, muscle spasms, and insomnia. 21. Patient KM also reported that she took a friend’s Oxycodone and requested a change in her medication to include Oxycodone. 22. Respondent did not address the patient's reported use of controlled substances which were prescribed to another patient. 23. Patient KM told Respondent that she intended to share any Xanax prescribed to her with LC. Nonetheless, Respondent prescribed the Xanax to Patient KM. 24. On or about May 12, 2009, Respondent prescribed to Patient KM Oxycodone 30 mg, 120 tablets, Xanax 2 mg, 30 tablets, and Soma 350 mg, 60 tablets. 25. On or about June 17, 2009, Patient KM presented to Respondent for a follow-up visit. She reported complaints of neck and back pain. Respondent conducted a cursory examination of Patient KM. 26. On or about June 17, 2009, Respondent prescribed to Patient KM Lortab 10/500 mg, 90 tablets and Soma 350 mg, 60 tablets. COUNT ONE 27. Petitioner incorporates and realleges paragraph one through twenty-six as if fully set forth herein. 28. Section 458.331(1)(t)1, Florida Statutes (2008), provides that committing medical malpractice constitutes grounds for disciplinary action by the Board of Medicine. Medica! Malpractice is defined in Section 456.50, Florida Statutes (2008), 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. 29. For purposes of Section 458.331(1)(t)1, Florida Statutes (2008), the 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, Florida Statutes (2008), which provides that 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. . . .” 30. Respondent failed to meet the prevailing standard of care by failing to do one or more of the following: a. _ By failing to justify prescription of Xanax to Patient KM; and/or b. By failing to refer the patient for alternative treatment such as surgical consultation, physical therapy, and massage therapy; and/or c. By failing to change Patient KM to a longer acting medication; and/or d. By prescribing excessive doses of Oycodone, Xanax and Soma to Patient KM. 31. Respondent violated Section 458.331(1)(t), Florida Statutes (2008), by failing to practice medicine with the level of care of a reasonably prudent similar physician as being acceptable under similar conditions and circumstances in the treatment of Patient KM. COUNT TWO 32. Petitioner realleges and incorporates paragraphs one through twenty-six as if fully set forth herein. 33. Section 458.331(1)(q), Florida Statutes (2008), 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. 34. Respondent prescribed, dispensed, or otherwise prepared a legend drug, other than in the course of his professional practice, by inappropriately and: excessively prescribing Oxycodone, Soma and Xanax to Patient KM as alleged herein. 35. Based on the forgoing, Respondent violated Section 458.331(1)(q), Florida Statutes (2008), when he prescribed, any controlled substance, other than in the course of his professional practice by inappropriately and excessively prescribing the controlled substances as set forth in the table above. COUNT THREE 36. Petitioner incorporates and realleges paragraphs one through twenty-six as if fully set forth herein. 37. Section 458.331(1)(m), Florida Statutes (2008), subjects a licensee to discipline for 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 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. 38. Respondent failed to maintain medical records that justified the course of treatment for Patient KM as follows: a. By documenting that Patient KM had pain on occasions when the patient denied pain; and/or b. By prescribing Xanax and failing to document justification for the prescription; and/or c. By failing to document the medical records to support prescription of Oxycodone, Xanax and Soma to Patient KM. 39. On or about the dates set forth above, Respondent violated Section 458.331(1)(m), Florida Statutes (2008), by failing to maintain medical records to justify the treatment for Patient KM. 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 Respondent's license, restriction of practice, imposition of an administrative fine, issuance of a reprimand, 10 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. signe this (4 — day of _(InZele~ 2011. FILE DEPARTMENT OF HEALTH DEPUTY CLERK CLERK Angel Sanders DATE @CT 17 ont YYG PCP: October 14, 2011 PCP Members: El Sanadi, Levine H. Frank Farmer, Jr, MD, PhD, FACP State Surgeon General Y. Green, Esq. Assistant General Counsel DOH Prosecution Services Unit 4052 Bald Cypress Way, Bin C-65 Tallahassee, FL 32399-3265 Florida Bar # 0738115 (850) 245-4640, Ext. 8128 (850) 245-4681 FAX DOH v. Michael Moyer, M.D., Case Number 2008-27065 11 DOH v. Michael Moyer, M.D. CASE NO. 2008-27065 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. 12

Docket for Case No: 12-001668PL