STATE OF FLORIDA DEPARTMENT OF HEALTH DEPARTMENT OF HEALTH, PETITIONER, Vv. CASE NO. 2010-01127 FELICIA SPUZA, 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, Felicia Spuza, 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 26372. 3. Respondent’s address of record is 6101 Dr. Martin Luther King, Jr. Street N., St. Petersburg, Florida 33703. 4, Between February 25, 2009, and December 3, 2009, Respondent treated Patient MG, a then 34 year old male, for pain management. 5. At all times material this complaint, Respondent prescribed the following substances to Patient MG: a.) Soma is 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. . Abuse of Soma may lead to limited physical or psychological dependence relative to the substances in Schedule III. The generic name for Soma is carisoprodol. b.) 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 ITI 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 Il. c. Viagra is used to treat erectile dysfunction (impotence) in men. Viagra relaxes muscles and increases blood flow to particular areas of the body. 6. Patient MG presented to Respondent with a history of a motor vehicle accident on November 17, 2007, and persistent low back pain. Patient MG was also being treated by Dr. JG for pain management during the same time periodopp; 7. On or about February 25, 2009, Patient MG presented to Respondent with complaints of right leg pain and stiffness, history of sleep disorder and attention deficit disorder. 8. On February 25, 2009, Respondent prescribed Soma 350 mg, 90 tablets, and Xanax 1 mg, 90 tablets. 9, Onor about April 6, 2009, Patient MG presented to Respondent with complaints of low back pain with left leg radiculopathy and left shoulder pain. The patient reported that he ran out of Xanax and he had a seizure as a result of missing a dose of Xanax. 10. On April 6, 2009, Respondent prescribed Soma 350 mg, 90 tablets and Xanax 1 mg, 90 tablets. ii. On or about April 30, 2009, Patient MG presented to Respondent with complaints of low back pain with bilateral radiculopathy. Patient MG reported that he ran out of Xanax early and requested an early refill. 12. On April 30, 2009, Respondent prescribed Soma 350 mg, 90 tablets and Xanax 1 mg, 120 tablets. 13. On or about June 8, 2009, Patient MG presented to Respondent with complaints of low back pain with radiculopathy and muscle spasms. 14. On June 8, 2009, Respondent prescribed Soma 350 mg, 90 tablets and Xanax 1 mg, 90 tablets. 15. On or about July 10, 2009, Patient MG presented to Respondent with complaints of anxiety, seizures, numbness in both legs and impotence. 16. On July 10, 2009, Respondent prescribed Soma 350 mg, 90 tablets, Viagra 100 mg, 5 tablets, and Xanax 2 mg, 90 tablets. 17. On or about August 20, 2009, Patient MG presented to Respondent with complaints of seizures when he runs out of Xanax. Patient MG also had complaints of headaches, dizziness, anxiety, and weakness in the legs. | 18. On August 20, 2009, Respondent prescribed Soma 350 mg, 90 tablets, Viagra 100, 6 tablets, and Xanax 2 mg, 60 tablets. 19. On or about September 21, 2009, Patient MG presented to Respondent with complaints of low back pain, left leg pain with radiculopathy, muscle spasms, and seizure following missed dose of Xanax. 20. On September 21, 2009, Respondent prescribed Soma 350 mg, 90 tablets, Viagra 100 mg, 4 tablets, and Xanax 2mg, 60 tablets. 21. On or about October 23, 2009, Patient MG presented to Respondent with complaints of low back and thoracic back pain, depression, and impotence. 22. On October 23, 2009, Respondent prescribed Soma 350 mg, 90 tablets, Viagra 100 mg, 4 tablets, and Xanax 2 mg, 90 tablets. 23. Respondent failed to adequately document her medical records to justify prescribing Soma and Xanax as alleged herein. 24. Respondent inappropriately and excessively prescribed controlled substances to Patient MG. 25. Respondent failed to adequately assess Patient MG's complaints and symptoms. 26. Respondent failed to document coordination of care with other physicians involved with Patient MG's treatment. 27. Respondent failed to refer Patient MG to a psychiatrist for treatment. 28. Respondent failed to evaluate and assess Patient MG’s reports that he ran out of Xanax early. 29. Respondent failed to refer Patient MG to a specialist to address the patient’s complaints of seizures. COUNT ONE 30. Petitioner incorporates and realleges paragraph one (1) through twenty-eight (28), as if fully alleged herein. 31. 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(1)(g), 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. 32. For purposes of Section 458.331(1)(t), 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. . . J 33. Respondent failed to meet the prevailing standard of care in his treatment of Patient MG by doing one or more of the following: a. By inappropriately and excessively prescribing controlled substances to Patient MG; b. By failing to adequately assess Patient MG’s complaints and symptoms; Cc. By failing to coordinate care with other physicians involved with Patient MG's treatment; d. By failing to refer Patient M.G. to a specialist to treat his complaints of seizures; or e. By failing to evaluate and assess Patient MG's reports that | he ran out of Xanax early. 34. Respondent violated Section 458.331(1)(t), 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 MG as alleged herein. COUNT TWO 35. Petitioner realleges and incorporates paragraphs one (1) through twenty-eight (28), as if fully alleged herein. 36. 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. 37. Respondent prescribed, dispensed, or otherwise prepared a legend drug, other than in the course of her professional practice, by inappropriately and/or excessively prescribing the controlled substances without justification, to Patient MG, as alleged herein. 38. 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/or excessively prescribing controlled substances, without justification, to Patient MG, as set forth herein. COUNT THREE 39. Petitioner incorporates and realleges paragraphs one (1) through twenty-eight (28), as if fully alleged herein. 40. 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 limited to, patient histories; examination results; test results; records of drugs prescribed, dispensed, or administered; and reports of consultations and hospitalizations. 41. Respondent failed to keep medical records that justified the course of treatment for Patient MG by doing one or more of the following: a. By failing to adequately document her medical records to justify prescribing controlled substances as alleged herein; or b. By failing to document coordination of care with other physicians involved with Patient MG’s treatment, 42. On or about the dates set forth above, Respondent violated Section 458.331(1)(m), Florida Statutes (2008, 2009), by failing to keep medical records that justified the course of treatment for Patient MG. 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, SIGNED this 22~ ? ay Act 2011. H. Frank Farmer, Jr, MD, PhD, FACP State Surgeon General Yolohda Y. Green, Esq. Assistant General Counsel DOH Prosecution Services Unit >) 4052 Bald Cypress Way, Bin C-65 FILE! HEALTH Tallahassee, FL 32399-3265 DEP AREPUTY CLERK Florida Bar # 0738115 Sheaden. Soto (850) 245-4640, Ext. 8128 CLR 22 20K (850) 245-4681 FAX DA YYG PCP: August 19, 2011 PCP Members: Leon, Elsinatti, Goersch 11 DOH v. Felicia Spuza, M.D. CASE NO. # 2010-01127 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: 14-001020PL