A- OS STATE OF FLORIDA DEPARTMENT OF HEALTH DEPARTMENT OF HEALTH, PETITIONER, - ow CASE NO, 2012-05977 BORIS TODOROVIC, M.D., RESPONDENT. ADMINISTRATIVE COMPLAINT COMES NOW, Petitioner, Department of Health, by and through undersigned counsel, and files this Administrative Complaint before the Board of Medicine against Respondent, Boris Todorovic, 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 ME 88563. 3. Respondent's address of record is 2020 Isola Bella, Mount Dora, Florida 32757. “4. At all times material to this Complaint, Respondent was board certified by the American Board of Internal Medicine. 5. On or about December 25, 2011, Patient J.H., an eighty-five year old male, presented to the emergency department at Citrus Memorial Hospital with a recent fever of 101.9° F, a non-productive cough for several days, and a partial knee replacement on December 15, 2011. 6. Patient J.H. presented with a history of coronary artery disease with stent and pacemaker, atrial fibrillation, hypertension, hypothyroidism, . and had stopped smoking 25 years previously. 7. Upon presentation, Patient J.H.’s vital signs were recorded as: blood pressure of 114/66, pulse of 83, temperature of 98.5° F, and oxygen saturation of 95% on ambient air. His chest x-ray showed new infiltrates in the Right upper and lower lobes of the lungs. | 8. In the emergency department, Patient 3H. was tentatively diagnosed with hospital acquired pneumonia and treated with Zosyn and Vancomycin, which are antibiotics, and Lovenox. DOH y. TOBOROVIC, M.D., Case Number 2012-05977 Page 2 of 8 9. On or about December 26, 2011, Patient J.H. was admitted into the hospital. Respondent was Patient J.H.‘s attending physician. 10. A pulmonary consultation suggested the possibility of atypical pneumonia and Respondent started Patient J.H. on Zithromax in addition to his other medications. A rapid test for Influenza A/B was negative. 11. On or about December 27, 2011, Patient J.H.’s Oxygen saturation was 92% on 2 liters of oxygen. 12. On or about December 28, 2011, Patient J.H.’s hemoglobin (Hb) was at 10.2 and he had Dyspnea (shortness of breath) on exertion. A normal hemoglobin range for men Is approximately 13.8 to 18.0 g/dL. 13. On or about December 28, 2011, Patient J.H.s oxygen . saturation on ambient air was 86% at rest and 84% with ambulation. With 3 liters of oxygen, his Oxygen saturation was 96%. 14. On or about December 28, 2011, Respondent discharged Patient J.H. home with 3 liters of Oxygen, antibiotic medications, and instructions to follow up with a specifled physician on January 25, 2012 for complete pulmonary function testing. DOH v, TODOROVIC, M.D., Case Number 2012-05977 Page 3 of 8 nc nS 15. On or about December 28, 2011, Respondent failed to adequately assess Patient J.H.’s complaints, symptoms, and_ history including exertional Dyspnea and decreasing Oxygen saturation. 16.. On or about December 28, 2011, Respondent failed to order adequate diagnostic testing of Patient J.H., such as a chest x-ray with or without a CT exam of the lungs. 17. On or about December 28, 2011, Respondent failed to adequately diagnose Patient J.H.’s complaints, symptoms, and history. 18. On or about December 28, 2011, Respondent failed to develop an adequate treatment plan for Patient J.H. induding keeping Respondent in the hospital for further observation and treatment. 19. On or about December 28, 2011, Respondent discharged Patient J.H. in spite of Patient J.H.’s exertional Dyspnea and decreasing Oxygen saturation. 20. A reasonably prudent Internist practicing within the prevailing professional standard of care, under similar conditions and circumstances, would have recognized the severity of the patient's increasing symptomatology related to Dyspnea and Oxygen saturation, would have ordered a chest xray with or without a CT exam of the lungs, would have DOH v. TODOROVIC, M.D., Case Number 2012-05977 Page 4 of 8 diagnosed the patient's condition accordingly, and would have kept the patient in the hospital for observation and further treatment. i. On or about January 2, 2012, Patient J.H. presented again to the emergency department and was diagnased with bilateral pneumonia and congestive heart failure. Patient J.H.’s condition worsened and he died ' on January 8, 2012. 22. Section 458.331(1)(t)1,, Florida Statutes. (2011), subjects a physician to discipline for committing medical malpractice as defined in Section 456.50. “Medical malpractice” is defined by Section 456.50(1)(g), Florida Statutes (2011), 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.” 23. Section 456.50(1)(e), Florida Statutes (2011), provides that the - “evel of care, skill, and treatment recognized in general law related to health care licensure" means the standard of care that is specified in Section 766.102, Florida Statutes, as follows: 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. DOH v. TODOROVIC, M.D., Case Number 2012-05977 Page 5 of & 24, Respondent failed to meet the prevailing standard of care with regard to Patient J.H. in one or more of the following ways: a) ~ By failing to adequately assess Patient J.H.; and/or _ b) By failing to order adequate diagnostic testing of Patient J.H.; and/or ©) _ By falling to adequately diagnose Patient J.H.; and/or d) By failing to develop an appropriate treatment plan for Patient J.H.. 25. Based on the foregoing, Respondent violated Section 458.331(1)(0), Florida Statutes (2011), by failing to practice medicine with that level of care, skill, and treatment which is recognized by a reasonably prudent similar physician as being acceptable under similar conditions and circumstances, 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. DOH v. TODOROVIC, M.D., Case Number 2012-05977 Page 6 of 8 a SIGNED this 19th day of April, 2013. John H. Armstrong, MD, FACS, FCCP State Surgeon General & Secretary of Health, State of Florida aura L. Glenn Assistant General Counsel Fla. Bar No. 0861413 Florida Department of Health Office of the General Counsel 4052 Bald Cypress Way, Bin C-65 FILED , DEPARTMENT OF HEALTH Tallahassee, Florida 32399-3265 DEPUTY ders Telephone: (850) 245-4444 CLERK ey 3 2013 - Facsimile: (850) 245-4684 paTe APR aS ; Email: Laura_Glenn@doh.state.fl.us LLG PCP; 4/19/13 PCP Members: Dr. Avila, Dr. Thomas, Mr. Dyches DOH v. TODOROVIC, M.D., Case Number 2012-05977 Page 7 of 8 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 his 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.

Docket for Case No: 13-003817PL