STATE OF FLORIDA - - DEPARTMENT OF HEALTH DEPARTMENT OF HEALTH, PETITIONER, wi . CASE NUMBER: 2011-12129 _ RONALD LORIN SHAW, M.D., \ RESPONDENT. ; / ADMINISTRATIVE COMPLAINT . Petitioner, Department of Health, by and through its undersigned counsel, filles this Complaint before the Board of Medicine against _ Respondent, Ronald Lorin Shaw, M.D., and in support thereof alleges: he . Petitioner Is the state department charged with regulating the practice of medicine pursuant to Section 20.43, Florida Statutes; Chapter: 456, Florida Statues; 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 44966, . 3 At all times material to this Complaint, Respondent was Board certified in Family Medicine, 4, Respondent's ‘address of recofd Is 202 North Park Avenue, Apopka, Florida 32703-4148. 5. From on or about December 5, 2008, to on or about September 15, 2010, Respondent had a physiclan-patient relationship with patient F.W., a then seventy-eight to seventy-nine year old woman. 6. Onor about December 5, 2008, Respondent diagnosed patient F.W. with hypertension. 7. On or about December 5, 2008, Respondent prescribed lisinopril and hydrochlorothlazide to patient FW. 8, Lisinopril is an angiotensin-converting enzyme (ACE) inhibitor used In the treatment of hypertension. , °9, Hydrochlorothlazide is a diuretic that inhibits the ability of the kidneys to retain water. 10. On or about December 15, 2008, laboratory bload analysis of patient F.W. revealed a glomerular filtration rate (GFR) of 52 (reference ‘range >59) and creatinine of 1.03 (reference range 0.57 to 1.00). 11. On or about March 13, 2009, Respondent examined patlent EM, following a closed shoulder dislocation approximately four days — earlier. DOH v. Ronald Lorin Shaw, M.D. Case Number 2011-12129 - - 12. On or about March 13, 2009, patient F.W.’s oxygen saturation in room alr was 89%. Normal oxygen saturation in room air is 95% to 100%. . 13. On or about March 13, 2009, ?, Respondent prescribed Vicodin to patient F, W. 14. Vicodin is a cambination of hydrocodone and acetaminophen ” prescribed to treat pain. 15. On or about April 1, 2009, laboratory blood analysts of patient FW. revealed a glomerular filtration rate (GFR) of 52 (reference range >59) and creatinine of 1.02 (reference range 0.57 to 1.00). 16. On-or about April 7, 2009, Respondent documented that patient FW. had chronic kidney disease (CKD), Stage III; hypertension; an impaired fasting glucose: and secondary osteoarthritis of the forearm. 17. On or about April 7, 2003, ‘Respondent prescribed a Medrol 4 ma. Dosepak to patient F.W. 18. On or about April 14, 2009, Respondent discontinued patient . ) F.W.'s Vicodin prescription and prescribed colchicine and Indocin to patient FLW. 19. Colchicine Is used for the treatment of gout, ‘DOH v. Ronald Lorin Shaw, M.D. Case Number 2011-12129 20. Indocin is-a non-steroidal antl-Inflanimatory. drug used for the ~ .treatment of pain and swelling. 21. On or about April 14, 2009, patient F.W.’s oxygen saturation in ° room air was 92%. 22, On or about May 7, 2009, Respondent changed patient F.W.'s - prescription for Indocin to ibuprofen 800 mg. three times a day, as needed. 23. Ibuprofen is a non-steroidal antl-inflammatory drug used for the treatment of pain and swelling. | 24, On or about August 21, 2009, Respondent evaluated patient F.W, for pre-operative clearance for elective shoulder surgery. . 25. On or about August 21, 2009, patient F.W.’s oxygen saturation in room air was 90%. 26. ‘On or about August 25, 2009, laboratory blood analysis of . patlent F.W, revealed a glomerular filtration rate (GFR) of 17 (reference range >59) and creatinine of 2. 70 (reference range 0.57 to 1.00). ‘27, Respondent was aware of the August 25, 2009, laboratory blood analysis of patient F. W. prior to patlent F.W.’s shoulder surgery and gave medical clearance for patient F.W. to undergo surgery. DOH v. Ronald Lorin Shaw, M.D, Case Number 2011-12129 28. Respondent did .-not discontinue patient F.W.'s — anti- inflammatory medications before surgery. 29. On or about September 1, 2009, patient FW. underwent shoulder surgery. “30. Following shoulder surgery, patient F.W. developed resplratory and kidney failure, 31.) The standard“of care required that Respondent not prescribe medications that were potentially harmful to patient E.W.s renal function or were potentially harmful in the in quantities, doses, and for the periods of time prescribed; that Respondent recognize that patient F.W. was at high risk for surgery; that Respondent discontinue antl-inflammatory medications. when patlent F.W.’s renal function was worsening; that Respondent not provide medical clearance for surgery performed on Septémber 1, 2009; and that Respondent refer patient F.W. to nephrology, pulmonary, and pain management specialists for evaluation. COUNT I 32. Petitioner re-alleges and Incorporates paragraphs one (1) ° through thirty-one (31) as If fully set forth herein. DOH y. Ronald Lorin Shaw, M.D. Case Number 2011-12129 33, Section 458.331(1)(t), 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(g), Florida Statutes (2008-2009), as the fallure to practice medicine . in accordance with the level of care, skill, and treatment recognized in “general law related to health care licensure. For purposes of Section, 458,.331(1)¢t), Florida Statutes (2008-2009), the Board shall give great weight to the provisions of Sectlon 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. 34, Respondent falled: to practice medicine with that level of care, - skill and treatment, which Is recognized by reasonably prudent similar - physicians as being acceptable under simltar conditions and circumstances, in the treatment of patient F.W. In one or more of the following ways: a. By presctibing medications that were potentially harmful to patient F.W,’s renal function that were inappropriate, DOH v. Ronald Lorin Shaw, M.D, Case Number 2011-12129 and/or prescribed In an inappropriate manner, and/or in : excessive or inappropriate quantities; b. By prescribing antl-inflammatory medications to patient F.W. that were inappropriate, and/or prescribed in an Inappropriate manner, and/or tn excessive ‘or inappropriate quantities; Cc. By inappropriately prescribing colchicine to patient F.W., ‘and/or prescribing colchicine In an Inappropriate manner, and/or in excessive or inappropriate quantities; d. __By falling to adequately assess patient F.W.’s abnormal laboratory test results; a e. | By falling to timely obtain laboratory tests to evaluate ; patient F.W.’s renal function; . ~ f. By falling to discontinue ant-inflammatory medications when patient F.W.’s renal function was worsening; . . g By failing to recognize that patient FW. was at high risk for surgery; h By providing medical clearance for F.W.’s surgery; DOH v. Ronald Lorin Shaw, M.D. Case Number 2011-12129 ne By falling to discontinue anti-inflammatory medications | prior to F.W.'s surgery; By placing patient F.W. at risk for severe drug reactions; By failing to refer patient F.W to a specialist in nephrology; , oO | By falling to refer patient 'F.W. to specialist in pulmonary medicine; By falling to- refer patient F.W. to a specialist in pain management; and/or . By failing to provide an appropriate treatment plan, -35. Based on the foregoing, Respondent violated Section 458.331(1)(0), Florida Statutes (2008-2009), by committing medical malpractice. COUNT IE 36. Petitioner re-alleges and incorporates paragraphs one (1) through thirty-one (31) as if fully’ set forth herein. 37. Section 458,.331(1)(m), Florida Statutes (2008-2009), sublets a licensee to discipline for failing to keep legible, as defined by department rule in consultation’ with the board, medical records that identify the DOH v. Ronald Lorin Shaw, M.D." Case Number 2011-12129 Case Number 2031-12129 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. On or about the dates set forth above, Respondent failed to keep medical records that justified the course of treatment of patient F.W,, | including, his failure to document the bases for not referring patient F.W. to specialists for nephrology, pulmonary, and pain management evaluations; and the bases for prescribing medications, including anti- | . inflammatory drugs, In the manner, dosages, and quantities, in which they were prescribed, and his fallure to discontinue them prior to surgery when patient F.W.’s renal function was worsening. 39. Based on ‘the ‘foregoing, Respondent Violated Section 458.331(1)(m), Florida Statutes (2008-2009), by falling to keep medical records that justified the course of treatment of patient F.W. DOH v, Ronald Lorin Shaw, M.D. ) 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 the 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 _|°__ day.of Apri __, 2013. John-H. Armstrong, MD, FACS, FCCP State Surgeon General & Secretary of Health ; J J John B. Fricke, - ; . Assistant General Counsel FILED ‘DOH Prosecution Services Unit DEPARTMENT OF HEALTH 4052 Bald Cypress Way, Bin C-65 CLERK Aopelsomn =~ Tallahassee, FL_ 32399-3265 DATE APR 2 2 2013 Florida Bar #0901910 SS430(F8n " . Telephone (850) 245-4444 * Fax (850) 245-4684 , Email: john_) frickejt@doh. state. e-fl us JBF/jrs PCP Date: 04/19/2013 PCP Members: Dr. Avila, Dr. Thomas, Mr. Dyches DOH v. Ronald Lorin Shaw, M.D, Case Number 2011-12129 . . “LO 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 y. Ronald Lorin Shaw, M.D. Case Number 2041-12129 . ii:

Docket for Case No: 14-004478PL