STATE OF FLORIDA BOARD OF CHIROPRACTIC MEDICINE DEPARTMENT OF HEALTH, PETITIONER, , Vv. CASE NO.: 2011-18561 DAVID MILES GLADSTONE, D.C., RESPONDENT. / ADMINISTRATIVE COMPLAINT Petitioner, Department of Health, by and through its undersigned counsel, files this Administrative Complaint before the Board of Chiropractic Medicine against Respondent, David Miles Gladstone, D.C., and in support alleges: 1. Petitioner is the state department charged with regulating the practice of chiropractic medicine pursuant to Section 20.43, and Chapters 456 and 460, Florida Statutes. 2. At all times material to this Complaint, Respondent was a licensed chiropractic physician within the State of Florida, having been issued license number CH 10173 on or about December 7, 2010. - DOH v. David Miles Gladstone, D.C. 1 Case No. 2011-18561 3. - Respondent's address of record is 5803 NW 151 Street, Miami Lakes, Florida 33014. 4. On-or about January 8, 2011, A.L,, then three years and two months old, was involved in a motor vehicle accident and later that day presented to a clinic where Respondent practiced, with complaints of occasional bilateral cervical pain at severity level 3/10 with 10 being the most severe. 5. Another chiropractic physician practicing at the clinic conducted an initial examination of the patient on January 8, 2011. 6. Palpation yielded negative results for pain, asymmetry, range of motion, trigger points, and edema, and positive results for muscle tension at a grade of 2 on a scale of 1-5, with 5 being the most severe. 7. Cervical range of motion was determined to be all normal. 8. Two orthopedic evaluations yielded negative findings, and two others yielded positive left findings. 9,. Neurological examination results were found to be within normal limits. id. 1 magaeatl tacancic fae i i ; i i . he overall diagnosis for Patient A.L. was carvical sprain/strain. DOH v. David Miles Gladstone, D.C. Case No. 2011-18561 it) 11. The recommended treatment plan consisted of active release technique, chiropractic care, neuromuscular re-education and therapeutic exercise. 12. Treatment began, by another chiropractic physician practicing at the clinic, on January 11, 2011, and consisted of chiropractic adjustment bilaterally at C2, Ti1, and Li, and therapeutic exercises of bicycle, row trainer, lateral trainer, hip flexion, hip extension, lumbar trainer, and core trainer. 13. This treatment regimen was not appropriate for this patient, given her symptoms and/or age. 14. This treatment regimen was not justified for this patient, in terms of both quality and quantity, given her symptoms and/or age. 15. The records do not contain sufficient detailed information to indicate how the therapeutic exercises were performed or for what period of time. 16. Subsequent treatment episodes occurred on January 12, 13*, 21, 26, and 29, April 6, 8, 9*, 13, 19*, and 23, and May 3, 4, 7, 10, and 1i*, 2011. DOH v. David Miles Gladstone, D.C. Case No. 2011-18561 17. Dates designated with an asterisk C*") are occasions when Respondent was not the treating chiropractic physician. On those dates, treatment was provided by another chiropractic physician practicing at the ‘dlinic, 18. The treatment provided to Patient A.L: on every one of these occasions was identical, as set forth above. 19. A letter in the medical file for Patient A.L., dated February 26, 2011, authored by the chiropractic physician/owner of the service facility -where the patient was being treated, stated that the patient had reached maximum medical improvement and that no further treatment for her was necessary. 20. A progress report was completed on April 23, 2011, by Respondent. 21. This progress report indicates that all of the previous objective symptoms had resolved, except for muscle tension, which had improved. 22. A report in the medical record for Patient A.L. prepared on May 11, 2011, by the other treating chiropractic physician, indicated that all symptoms had resolved and that the patient had reached the point of maximum medical improvement and was being released from care. DOH v. David Miles Gladstone, D.C. Case No. 2011-18561 23. This report, and a corresponding billing record, indicates that the patient received a full regimen of treatment on May 11, 2011, despite there being no symptoms documented. Count One — Record Keeping 24, Petitioner re-alleges paragraphs one (1) through twenty (23) as if fully set forth within this paragraph. 25. Section 460.413(1)(m), Florida Statutes (2010), provides that failing to keep legibly written chiropractic medical records that identify clearly by name and credentials the licensed chiropractic physician rendering, ordering, supervising, or billing for each examination or treatment procedure and that justify the course of treatment of the patient, including, but not limited to, patient histories, examination results, test results, X rays, and diagnosis of a disease, condition, or injury, is grounds for disciplinary action by the Board of Chiropractic Medicine. 26. Section 460.413(1)(ff), Florida Statutes (2010), provides that violating any provision of this chapter or chapter 456, or any rules adopted pursuant thereto, is grounds for disciplinary action by the Board of Mtoe. ral) Chiropractic M DOH v, David Miles Gladstone, D.C. 5 Case No. 2011-18561 27. Rule 64B2-17.0065 (Minimal Recordkeeping Standards), Florida Administrative Code, provides, in pertinent part: (1) These standards apply to all licensed chiropractic physicians and certified chiropractic assistants. These standards also apply to those examinations advertised at a reduced fee, or free (no charge) service. (2) Medical records are maintained for the following purposes: (a) To serve as a basis for planning patient care and for continuity in the evaluation of the patient's condition and treatment. (b) To furnish documentary evidence of the course of the patient’s medical evaluation, treatment, and change in condition. (c) To document communication between the practitioner responsible for the patient and any other health care professional who contributes to the patient's care. (d) To assist in protecting the legal interest of the patient, the hospital, and the practitioner responsible for the patient. (3) The medical record shall be legibly maintained and shall contain sufficient information to identify the patient, support the diagnosis, justify the treatment and document the course and results of treatment accurately, by including, at a minimum, patient histories; examination results; test results; records of drugs dispensed or administered; reports of consultations and hospitalizations; and copies of records or reports or other documentation obtained from other health care practitioners at the request of the physician and relied upon by the physician in determining the appropriate treatment of the patient. Initial and follow-up services (daily records) shall consist of documentation to justify care. If abbreviations or symbols are used in the daily recordkeeping, a key must be provided. (4) All patient records shall include: DOH v. David Miles Gladstone, D.C. Case No, 2011-18561 (a) Patient history, (b) Symptomatology and/or weliness care, (c) Examination finding(s), including X-rays when medically or clinically indicated, (d) Diagnosis, (e) Prognosis, (f) Assessment(s), (g) Treatment plan, and (h) Treatment(s) provided. (6) Once a treatment plan is established, daily records shall include: (a) Subjective complaint(s) (b) Objective finding(s) (c) Assessment(s) (d) Treatment(s) provided, and ~ (e) Periodic reassessments as indicated. (8) Provided the Board takes disciplinary action against a chiropractic physician for any reason, these minimal clinical standards will apply. It is understood that these procedures are the accepted standard(s) under this chapter. 28. Respondent violated Section 460.413(1)(m), and/or Section 460.413(1)(ff), Florida Statutes (2010), and/or Rule 64B2-17.0065, Florida Administrative Code, in one or more of the following ways: a. the records fail to document the course of treatment, and b. the records fail to justify the course of treatment. 29. Based on the foregoing, Respondent violated Section 460.413(1)(m), and/or Section 460.413(1)(ff), Florida Statutes (2010), and/or Rule 64B2-17.0065, Florida Administrative Code, by maintaining DOH v. David Miles Gladstone, D.C. 7 Case No, 2011-18561 insufficient medical records, which is grounds for discipline by the Board of Chiropractic Medicine. Count Two — Financial Exploitation 30. Petitioner re-alleges paragraphs one (1) through twenty-three (23) as if fully set forth within this paragraph. 31. Section 460.413(1)(n), Florida Statutes (2010), provides that exercising influence on the patient or client in such a manner as to exploit the patient or client for financial gain of the licensee or of a third party which shall include, but not be limited to, the promotion or sale of services, goods or appliances, or drugs, is grounds for disciplinary action by the Board of Chiropractic Medicine. 32. Section 460.413(1)(ff), Florida Statutes (2010), provides that violating any provision of this. chapter or chapter 456, or any rules adopted pursuant thereto is grounds for disciplinary action by the Board of Chiropractic Medicine. 33. Rule 64B2-17.005 (Exploitation of Patients for Financial Gain), Florida Administrative Code, provides, in pertinent part: DOH v. David Miles Gladstone, D.C. Case No. 2011-18561 (1) The overutilization of chiropractic services or practice by exercising influence on a patient in such a manner as to exploit the patient for financial gain of a licensee or a third party is prohibited by Section 460.413(1)(n), Florida Statutes. (2) Overutilization of chiropractic services or practice is defined as services or practices rendered, or goods or appliances sold by a chiropractic physician to a patient for financial gain of the chiropractic physician or a third party which are excessive in quality or quantity to the justified needs of the patient. (3) Overutilization occurs when: (a) The written chiropractic records, required to be kept by subsection 460.413(1)(m), Florida Statutes, do not justify or substantiate the quantity or number of chiropractic services, practices rendered, or goods or appliances sold by a chiropractic physician to a patient; (b) A claim or claims for chiropractic serviees, practice, goods or appliances is submitted to that patient or third party payor representing multiple charges for one specific chiropractic diagnostic service or treatment practice, good or appliance. 34. Respondent violated Section 460.413(1)(n), and/or Section 460.413(1)(ff), Florida Statures (2010), and/or Rule 64B2-17.005, Florida Administrative Code, by rendering services that were excessive in quality and/or quantity to the justified needs of the patient. 35. Based on the foregoing, Respondent violated Section 460.413(1)(n), and/or Section 460.413(1)(ff), Florida Statures (2010), DOH v. David Miles Gladstone, D.C. . 9 Case No. 2011-18561 financial exploitation, which is grounds for discipline by the Board of Chiropractic Medicine. Count Three — Standard of Care 36. Petitioner re-alleges paragraphs one (1) through twenty-three (23) as if fully set forth within this paragraph. 37, Section 460.413(1)(r), Florida Statutes (2010), provides that gross or repeated malpractice or the failure to practice chiropractic medicine at a level of care, skill, and treatment which is recognized by a reasonably prudent chiropractic physician as being acceptable under similar conditions and circumstances is grounds for disciplinary action by the Board of Chiropractic Medicine. The board shall give great weight to the standards for malpractice in s. 766.102 in interpreting this provision. 38. Respondent violated Section 460.413(1)(r), Florida Statutes (2010), in one or more of the following ways: a. by providing treatment that was not appropriate for a patient given that patient’s symptoms and/or age, and b. by providing treatment in excess of what was justified for a patient given that patient's symptoms and/or age. DOH v. David Miles Gladstone, D.C. 10 Case No. 2011-18561 39. Based on the foregoing, Respondent violated Section 460.413(1)(r), Florida Statutes (2010), by failing to practice chiropractic medicine at a level of care, skill, and treatment which is recognized by a reasonably prudent chiropractic physician as being acceptable under similar conditions and circumstances, which is grounds for discipline by the Board of Chiropractic Medicine. WHEREFORE, Petitioner respectfully requests that the Board of Chiropractic 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 and/or any other relief that the Board deems appropriate. s7 /, SIGNED this_/“ day of Untebe , 2012. John H. Armstrong, MD — General and Secreta pe Health ae ae Laas Rossitto-Van Winkle, R.N., J. D. Assistant General Counsel . Florida Bar #06139908 Florida Department of Health Office of the General Counsel DOH v. David Miles Giadstone, D.C. : ll Case No. 2011-18561 4052 Bald Cypress Way, Bin C-65 Tallahassee, FL.32399-3265 Telephone (850) 245-4640 ext. 8139 Facsimile: (850) 245-4684 FILED DEPARTMENT OF HEALTH tari_rossitto-vanwinkle@doh.state.fl.us DEPUTY CLERK CLERK Angel Sanders pate OCT 0 2 2012 PCP Date: September 27, 2012 PCP Members: Kevin Fogarty, D.C. and Wayne Wolfson, D.C. DOH v. David Miles Gladstone, D.C. Case No. 2011-18561 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. DOH v. David Miles Gladstone, D.C. 1 Case No. 2011-18561

Docket for Case No: 13-003277PL