STATE OF FLORIDA DEPARTMENT OF HEALTH DEPARTMENT OF HEALTH, PETITIONER, Vv. CASE NO. 2010-06641 MICHAEL MOYER, M.D., RESPONDENT. 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 2:23 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. DEFINITIONS OF CONTROLLED SUBSTANCES 6. | 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. rp Xanax is the brand name for alprazolam and 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 ITI. 8. Soma (muscle relaxant, Schedule IV) 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 III. 9. Valium, which contains diazepam, which is a schedule IV controlled substance under Chapter 893, Florida Statutes. A substance in schedule IV has a low potential for abuse, and a currently accepted medical use in treatment. Abuse of this substance may lead to limited physical or psychological dependence. 10. Dilaudid contains hydromorphone, a Schedule II controlled substance listed in Chapter 893, Florida Statutes, which is indicated for the relief of moderate to severe pain. Abuse of hydromorphone may lead to severe physical and psychological dependence. 11. Demerol is the brand name for meperidine 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. FACTS SPECIFIC TO PATIENT JW 12. Patient JW presented to Respondent for an initial visit on or about August 4, 2008. Patient JW presented with complaints of back and neck pain. Respondent documented that Patient JW was taking Valium and Oxycodone. 13. Patient JW advised Respondent that he was a participant in a research study for anxiety disorder and under the care of a psychiatrist. 14. Respondent prescribed controlled substances to Patient JW without performing a complete examination or documenting in his records that he prescribed the controlled substance. 15. Respondent referred Patient JW for an MRI of the lumbar spine which returned with an impression of normal lumbar spine with no disk herniations. 16. Respondent's medical records reflect that he prescribed to Patient JW multiple prescriptions for excessive amounts of controlled substances as described in the following table: Date of Medication Type of Quantity Prescription | Prescribed Medication 9/4/08 Oxycodone 30 mg Schedule II 120 9/4/08 Valium 10 mg Schedule II 60 10/22/08 Xanax Schedule IV 60 11/5/08 Oxycodone 30 mg Schedule II 120 11/5/08 Valium 10 mg Schedule II 60 12/4/08 Oxycodone 30 mg Schedule II 150 12/4/08 Xanax 2mg Schedule IV 60 1/7/09 Oxycodone 30 mg Schedule II 150 1/7/09 Xanax 2 mg Schedule IV 60 2/4/09 Oxycodone 30 mg Schedule II 150 2/4/09 Xanax 2 mg Schedule IV 75 2/27/09 Oxycodone 30 mg Schedule II 150 2/27/09 Xanax 2 mg Schedule IV 75 4/2/09 Oxycodone 30 mg Schedule II 150 4/2/09 Xanax 2 mg Schedule IV 75 4/2/09 Dilaudid 8mg Schedule II 160 4/7/09 Demerol 50 mg Schedule II 150 4/9/09 Xanax 2 mg Schedule IV 15 4/9/09 Demerol 50 mg Schedule II 36 4/23/09 Demerol 100 mg Schedule II 240 4/23/09 Xanax 2 mg Schedule IV 50 5/21/09 Oxycodone 30 mg Schedule II 150 5/21/09 Xanax 2 mg Schedule IV 60 6/18/09 | Oxycodone 30 mg Schedule II 180 6/18/09 Xanax 2 mg Schedule IV 60 7/15/09 Oxycodone 30 mg Schedule IT 180 7/15/09 Xanax 2 mg Schedule IV 75 7/15/09 Clonazapem 2 mg Schedule IV 60 7/15/09 Soma 350 mg Schedule IV 60 8/20/09 Oxycodone 30 mg Schedule IT 180 8/20/09 Soma 350 mg Schedule IV 60 8/20/09 Xanax 2 mg Schedule II 75 17. Respondent prescribed a high dosage of Xanax in combination with a high dosage of Oxycodone, and Soma despite the fact that Patient JW was a participant in an anxiety disorder research study and under the care of a psychiatrist. 18. Respondent failed to obtain medical records from previous physicians or the physician(s) monitoring Patient JW in the research study. 19. Respondent failed to obtain regular urine drug screens for Patient JW. 20. Respondent failed to refer the patient to other healthcare specialists for treatment. 21. Respondent’s medical records do not contain justification for the high frequency of simultaneous prescriptions of large quantities of Xanax, Oxycodone, and Soma to Patient JW. 22. Respondent prescribed excessive amounts of controlled substances as referenced in the table above without documentation to support the prescriptions. 23. Respondent failed to document his basis for changing Patient JW from Oxycodone to Dilaudid. 24. Respondent failed to document the Patient JW’s complete medication history. COUNT ONE 25. Petitioner incorporates and realleges paragraph one through twenty-four as if fully set forth herein. 26. Section 458.331(1)(t)1, Florida Statutes (2008, 2009), provides that committing medical malpractice constitutes grounds for disciplinary action by the Board of Medicine. Medical Malpractice is defined in Section 456.50, Florida Statutes (2008, 2009), as the failure to practice medicine in accordance with the level of care, skill, and treatment recognized in general law related to health care licensure. 27. For purposes of Section 458.331(1)(t)1, Florida Statutes (2008, 2009), 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, 2009), 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. . . .” 28. Respondent failed to meet the prevailing standard of care by failing to do one or more of the following: a. By prescribing a high dosage of Xanax in combination with a high dosages of Oxycodone and Soma; b. By failing to obtain medical records from previous physicians or the physicians monitoring Patient JW in the research study; c. _ By failing to obtain regular urine drug screens of Patient JW; d. __ By failing to refer the patient to other healthcare specialists for evaluation and treatment; e. By failing to document the patient’s medical records to justify the high frequency of simultaneous prescriptions of large quantities of Xanax, Oxycodone, and Soma to Patient JW; and/or f. By failing to document support for prescription of excessive amounts of controlled substances as referenced in the table above without documentation to support the prescriptions. 29. Respondent violated Section 458.331(1)(t)1, Florida Statutes (2008, 2009), 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 JW. COUNT TWO 30. Petitioner realleges and incorporates paragraphs one through twenty-four as if fully set forth herein. 31. Section 458.331(1)(q), Florida Statutes (2008, 2009), 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. 32. Respondent prescribed, dispensed, or otherwise prepared a legend drug, other than in the course of his professional practice, by inappropriately and excessively prescribing the controlled substances as referenced in the table above. 33. Based on the forgoing, Respondent violated Section 458.331(1)(q), Florida Statutes (2008, 2009), 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 34. Petitioner incorporates and realleges paragraphs one through twenty-four as if fully set forth herein. 35. Section 458.331(1)(m), Florida Statutes (2008, 2009), 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 10 limited to, patient histories; examination results; test results; records of drugs prescribed, dispensed, or administered; and reports of consultations and hospitalizations. 36. Respondent failed to maintain medical records that justified the course of treatment for Patient JW. 37. On or about the dates set forth above, Respondent violated Section 458.331(1)(m), Florida Statutes (2008, 2009), by failing to maintain medical records to justify the treatment for Patient JW. 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, 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. 11 SIGNED this ld day of Dkr 2011. DEPARTNEN OF DEP Angel Sanders CLERK BTL 7 20 YYG PCP: October 14, 2011 H. Frank Farmer, Jr, MD, PhD, FACP State Surgeon General Yolonda 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 PCP Members: Leon, El Sanadi, Levine DOH v. Michael Moyer, M.D., Case Number 2010-06641 12 DOH v. Michael Moyer, M.D. CASE NO. 2010-06641 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. 13

Docket for Case No: 12-001669PL