Petitioner: DEPARTMENT OF HEALTH, BOARD OF MEDICINE
Respondent: JOHN L. LENTZ, JR., M.D.
Judges: LISA SHEARER NELSON
Agency: Department of Health
Locations: Destin, Florida
Filed: May 22, 2015
Status: Closed
Recommended Order on Friday, July 8, 2016.
Latest Update: Jan. 27, 2017
Summary: The issues to be determined in this proceeding are whether Respondent, John L. Lentz, Jr., M.D., committed the disciplinary violations charged with respect to seven patients in three Administrative Complaints that have been consolidated for the purpose of hearing. If the facts demonstrate that any of the charged violations have been committed, then the appropriate penalty to be imposed for such violations must be recommended.Petitioner established by clear and convincing evidence that Respondent
Summary: The issues to be determined in this proceeding are whether Respondent, John L. Lentz, Jr., M.D., committed the disciplinary violations charged with respect to seven patients in three Administrative Complaints that have been consolidated for the purpose of hearing. If the facts demonstrate that any of the charged violations have been committed, then the appropriate penalty to be imposed for such violations must be recommended.Petitioner established by clear and convincing evidence that Respondent departed from the standard of care with respect to seven patients, kept inadequate records, and failed to report diagnosis of Lyme disease. Recommend revocation and a fine.
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STATE OF FLORIDA
DEPARTMENT OF HEALTH
DEPARTMENT OF HEALTH,
PETITIONER,
Vv. CASE NO. 2011-15106
JOHN LUTHER LENTZ, JR., 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, John Luther Lentz, Jr., 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 82437.
3. Respondent's address of record is 15200 Emerald Coast
Parkway, St. Maarten Unit 506, Destin, Florida 32541.
4. At all times material to this Complaint, Respondent was Board
certified in Family Medicine.
5. From on or about September 28, 2010, through on or about
February 28, 2012, the Respondent provided medical care and treatment
to patient C.C., a twenty-seven to twenty-eight year old female.
6. On or about September 28, 2010, the Respondent evaluated
patient C.C. for complaints of severe back, buttock, and right leg pain.
7. On or about September 28, 2010, the Respondent, diagnosed
patient C.C. as having chronic fatigue syndrome and chronic pain
syndrome.
8. Onor about September 28, 2010, the Respondent, prescribed
CD57, C3a, C4a, and eosinophilic cationic protein laboratory tests of patient
C.C.’s blood.
9, Respondent did not prescribe an immunoassay test or a
Western blot test for Borrelia burgdorferi for patient C.C.
DOH v. John L. Lentz, M.D.
Case Number 2011-15106 2
10. On or about October 15, 2010, the Respondent diagnosed
patient S.H. with Lyme disease. Lyme disease is an infectious disease
caused by the bacteria Borrelia burgdorferi.
11. At all times material to this Complaint, patient C.C. did not have
objective laboratory test results for the diagnosis of Lyme disease.
12. On or about October 15, 2010, the Respondent diagnosed
patient C.C. with and Babesiosis. Babesiosis is a parasitic disease of the
blood caused by infection with Babesia.
13. Babesia infection is diagnosed by identification of Babesial
parasites in a blood smear or by PCR amplification of Babesial DNA.
14. Respondent did not prescribe a blood smear examination for
Babesial parasites or PCR amplification for Babesial DNA for patient C.C.
15. Atal times material to this Complaint, patient C.C. did not have
objective laboratory test results for the diagnosis Babesiosis.
16. On or about October 18, 2010, the Respondent referred patient
C.C. to a specialist for venous port placement for the administration of
intravenous antibiotic therapy.
17. Beginning on or about October 18, 2010, Respondent
prescribed long term intravenous antibiotic therapy to patient C.C.
DOH v. John L. Lentz, M.D.
Case Number 2011-15106 3
18. | At all times material to this Complaint, Patient C.C. did not have
a medical condition that justified the long term intravenous antibiotic
therapy prescribed by the Respondent.
19. Respondent prescribed inappropriate intravenous antibiotics in
excessive amounts for inappropriate periods of time to patient C.C.
20. Beginning on or about October 18, 2010, Respondent
prescribed oral antibiotic therapy to patient C.C.
21. Atall times material to this Complaint, Patient C.C. did not have
a medical condition that justified the oral antibiotic therapy prescribed by
the Respondent.
22. Respondent prescribed inappropriate oral antibiotics in
excessive amounts for inappropriate periods of time to patient C.C.
23. From on or about October 19, 2010, Respondent prescribed the
anticoagulant heparin to patient C.C.
24. At all times material to this Complaint, patient C.C. did not have
a medical condition that justified the Respondent prescribing the
anticoagulant heparin.
25. Respondent inappropriately prescribed heparin to patient C.C.
DOH v. John L. Lentz, M.D.
Case Number 2011-15106 4
26. Respondent did not refer patient C.C. to a specialist in the
diagnosis and treatment of infectious diseases such as Lyme disease and
Babesiosis at any time during Respondent’s care and treatment of patient
CC.
27. The standard of care required Respondent to obtain an
immunoassay test and a Western blot test that provided objective
laboratory test results confirming the presence of Borrelia burgdorferi
antibodies to make an evidence based diagnosis of Lyme disease, obtain
objective laboratory test results identifying Babesial parasites in a blood
smear or by PCR amplification of Babesial DNA to make an evidence based
diagnosis of Babesiosis, refer patient C.C. to an infectious diseases
specialist for evaluation of patient C.C. and, if confirmed, the treatment of
Lyme disease and/or Babesiosis, and not prescribe the intravenous and oral
antibiotics and anticoagulant heparin as prescribed by the Respondent.
COUNT I
28. Petitioner re-alleges paragraphs one (1) through twenty-seven
(27) as if fully set forth herein.
29. Section 458.331(1)(t), Florida Statutes (2010-2011), provides
that committing medical malpractice as defined in Section 456.50, Florida
DOH v. John L. Lentz, M.D.
Case Number 2011-15106 5
Statutes, constitutes grounds for disciplinary action by the Board of
Medicine. The Board shall give great weight to the provisions of Section
766.102, Florida Statutes, when enforcing Section 458.331(1)(t), Florida
Statutes. Medical Malpractice is defined in Section 456.50, Florida
Statutes, 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. Section 766.102, Florida Statutes, 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.
30. Respondent failed to practice medicine with 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 in violation of Section 458.331(1)(t),
Florida Statutes (2010-2011), in the care and treatment of patient C.C. in
one or more of the following ways:
DOH v. John L. Lentz, M.D.
Case Number 2011-15106 6
a. By diagnosing Lyme disease without objective laboratory
test results from immunoassay test and a Western biot
test;
b. By diagnosing Babesiosis without objective laboratory test
results from a blood smear examination for Babesial
parasites or PCR amplification for Babesial DNA;
c. By prescribing surgery for placement of an venous port
for administration of intravenous medication;
d. By prescribing inappropriate and excessive intravenous
antibiotic therapy without medical justification;
e. By prescribing inappropriate and excessive oral antibiotic
therapy without medical justification; and
f. By prescribing the anticoagulant heparin without medical
justification.
31. Based on the foregoing, Respondent has violated Section
458.331(1)(t), Florida Statutes (2010-2011), by committing medical
malpractice.
WHEREFORE, Petitioner respectfully requests that the Board of
Medicine enter an order imposing one or more of the following penalties:
DOH v. John L. Lentz, M.D.
Case Number 2011-15106 7
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 2013
John H. Armstrong, MD, FACS, FCCP
State Surgeon General & Secretary
of Health, State of Florida
stant General Counsel
DOH Prosecution Services Unit
4052 Bald Cypress Way, Bin C-65
Tallahassee, FL 32399-3265
DEPARTMENT OF HEALTH Florida Bar No.: 0901910
DEPUTY CLERK (850) 245-4640 Business
CLERK ainae g aug” (850) 245-4681 Facsimile
ATE
D
John_frickejr@doh.state.fl.us
JBF/sem
PCP Date: August 16, 2013
PCP Members: Dr. Avila, Dr. Averhoff, and Mr. Dyches
DOH v. John L. Lentz, M.D.
Case Number 2011-15106 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 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. John L. Lentz, M.D.
Case Number 2011-15106 9
Docket for Case No: 15-002888PL
Issue Date |
Proceedings |
Jan. 27, 2017 |
Notice of Appeal filed.
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Jan. 12, 2017 |
Petitioner's Response to Respondent's Exceptions to the Recommended Order filed.
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Jan. 12, 2017 |
Respondent's Exceptions to ALJ's Recommended Order of July 8, 2016 filed Pursuant to FAC Sec. 28.106.217(a) filed.
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Jan. 12, 2017 |
Agency Final Order filed.
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Jul. 08, 2016 |
Recommended Order (hearing held January 26 through 29, 2016). CASE CLOSED.
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Jul. 08, 2016 |
Recommended Order cover letter identifying the hearing record referred to the Agency.
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May 10, 2016 |
Lentz Exhibit "A" to Proposed Findings of Fact and Conclusions of Law (filed in Case No. 15-002890PL).
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May 10, 2016 |
Respondent's Proposed Findings of Fact and Conclusions of Law Pursuant to FAC Section 28-106.215 (filed in Case No. 15-002890PL).
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May 10, 2016 |
Respondent's Proposed Findings of Fact and Conclusions of Law Pursuant to FAC Section 28-106.215 (filed in Case No. 15-002889PL).
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May 10, 2016 |
Lentz Exhibit "A" to Proposed Findings of Fact and Conclusions of Law filed.
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May 10, 2016 |
Respondent's Proposed Findings of Fact and Conclusions of Law Pursuant to FAC Section 28-106.215 filed.
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May 10, 2016 |
Petitioner's Proposed Recommended Order filed.
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Apr. 18, 2016 |
Order Granting Extension of Time.
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Apr. 15, 2016 |
Respondent's Motion for Further Extenson of Time to File Proposed Recommended Orders (filed in Case No. 15-002889PL).
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Apr. 15, 2016 |
Notice of Substitution of Counsel filed.
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Apr. 15, 2016 |
Respondent's Motion for Durther Extension of Time to File Proposed Recommneded Orders filed.
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Mar. 31, 2016 |
Order Granting in Part Joint Motion to Extend the Page Limit for the Proposed Recommended Orders and Extension of Time.
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Mar. 31, 2016 |
Joint Motion to Extend the Page Limit for the Proposed Recommended Orders and Extension of Time filed.
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Mar. 01, 2016 |
Order Granting Extension of Time.
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Mar. 01, 2016 |
Joint Motion for Enlargement of Time to File Proposed Recommended Orders filed.
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Feb. 25, 2016 |
Transcript of Proceedings (not available for viewing) filed. |
Feb. 16, 2016 |
Petitioner's Notice of Filing Certification of Identity of Witness and Confirmation that Oath was Administered (filed in Case No. 15-002890PL).
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Jan. 26, 2016 |
CASE STATUS: Hearing Held. |
Jan. 25, 2016 |
Order Denying Motions in Limine.
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Jan. 21, 2016 |
Respondent's Exhibit "D" to Motion in Limine to Exclude the Testimony of Either One of Petitioner's Experts William Robbins M.D. or Charles Powers M.D. as Duplicative and Cumulative (filed in Case No. 15-002889PL).
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Jan. 21, 2016 |
Respondent's Exhibit "D" to Motion in Limine to Exclude the Testimony of Either One of Petitioner's Experts William Robbins M.D. or Charles Powers M.D. as Duplicative and Cumulative filed.
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Jan. 21, 2016 |
Respondent's Exhibit "D" to Motion in Limine to Exclude the Testimony of Either One of Petitioner's Experts William Robbins M.D. or Charles Powers M.D. as Duplicative and Cumulative (filed in Case No. 15-002890PL).
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Jan. 21, 2016 |
Respondent's Exhibit "B" to Motion in Limine to Exclude the Testimony of Either One of Petitioner's Experts William Robbins M.D. or Charles Powers M.D. as Duplicative and Cumulative (filed in Case No. 15-002890PL).
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Jan. 21, 2016 |
Respondent's Exhibit "B" to Motion in Limine to Exclude the Testimony of Either One of Petitioner's Experts William Robbins M.D. or Charles Powers M.D. as Duplicative and Cumulative (filed in Case No. 15-002889PL).
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Jan. 21, 2016 |
Respondent's Exhibit "B" to Motion in Limine to Exclude the Testimony of Either One of Petitioner's Experts William Robbins M.D. or Charles Powers M.D. as Duplicative and Cumulative filed.
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Jan. 21, 2016 |
Respondent's Motion in Limine to Exclude the Testimony of Either One of Petitioner's Experts William Robbins M.D. or Charles Powers M.D. as Duplicative and Cumulative and Exhibits "A" and "C" thereto (filed in Case No. 15-002890PL).
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Jan. 21, 2016 |
Respondent's Motion in Limine to Exclude the Testimony of Either One of Petitioner's Experts William Robbins M.D. or Charles Powers M.D. as Duplicative and Cumulative and Exhibits "A" and "C" thereto (filed in Case No. 15-002889PL).
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Jan. 21, 2016 |
Respondent's Motion in Limine to Exclude the Testimony of Either one of Petitioner's Experts William Robbins M.D. or Charles Powers M.D. as Duplicative and Cumulative Exhibits "A" and "C" thereto filed.
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Jan. 21, 2016 |
Respondents' Opposition to Petitioner's Motion in Limine Seeking to Exclude Michael Cichon, M.D. as Respondent's Chief Expert Witness (filed in Case No. 15-002890PL).
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Jan. 21, 2016 |
Respondents' Opposition to Petitioner's Motion in Limine Seeking to Exclude Michael Cichon, M.D. as Respondent's Chief Expert Witness (filed in Case No. 15-002889PL).
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Jan. 21, 2016 |
Respondents' Opposition to Petitioner's Motion in Limine Seeking to Exclude Michael Cichon, M.D. as Respondent's Chief Expert Witness filed.
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Jan. 21, 2016 |
Respondent's Notice of Filing Respondent's Exhibit and Witness List (filed in Case No. 15-002890PL).
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Jan. 21, 2016 |
Respondent's Notice of filing Respondent's Exhibit and Witness List filed.
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Jan. 21, 2016 |
Respondent's Notice of Filing Respondent's Exhibit and Witness List (filed in Case No. 15-002889PL).
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Jan. 19, 2016 |
Petitioner's Notice of Filing Petitioner's Exhibit and Witness Lists filed.
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Jan. 19, 2016 |
Petitioner's Notice of Filing Respondent's Responses to Petitioner's First Request for Admissions and Omnibus Supplemental Response to Petitioner's First Request for Production filed.
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Jan. 19, 2016 |
Joint Pre-hearing Stipulation filed.
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Jan. 19, 2016 |
Motion in Limine to Exclude Expert Witness Testimony of Michael J. Cichon, M.D filed.
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Nov. 19, 2015 |
Petitioner's Third Notice of Taking Deposition Duces Tecum (of Kerry Clark) filed.
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Nov. 12, 2015 |
Petitioner's Second Notice of Taking Deposition Duces Tecum (of Michael Cichon, MD) filed.
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Nov. 12, 2015 |
Petitioner's Second Notice of Taking Deposition Duces Tecum (of Kerry Clark, M.D) filed.
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Oct. 30, 2015 |
Notice of Hearing (hearing set for January 26 through 29, 2016; 9:00 a.m., Central Time; Destin, FL).
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Oct. 23, 2015 |
Notice of Taking Deposition Duces Tecum in Lieu of Live Testimony (of Kim Riley-Mansfield) filed.
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Oct. 23, 2015 |
Notice of Taking Deposition Duces Tecum in Lieu of Live Testimony (of Kim Riley-Mansfield) filed.
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Oct. 22, 2015 |
Corrected Petitioners Notice of Taking Deposition Duces Tecum (Corrected as to title of deponent only) Clark filed.
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Oct. 22, 2015 |
Petitioner's Notice of Taking Deposition Duces Tecum (of Michael Cichon, M.D) filed.
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Oct. 22, 2015 |
Petitioner's Notice of Taking Deposition Duces Tecum (of Kerry Clark, M.D) filed.
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Oct. 21, 2015 |
Amended Petitioner's Notice of Taking Deposition (of MC) filed.
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Oct. 21, 2015 |
Amended Petitioners Notice of Taking Deposition (of Patient CC) filed.
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Oct. 21, 2015 |
Amended Petitioner's Notice of Taking Deposition (of Colleen Taylor) filed.
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Oct. 19, 2015 |
Notice of Unavailability of Respondent's Counsel for Depositions Due to Personal Family Emergency filed.
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Oct. 19, 2015 |
Notice of Unavailability of Respondent's Counsel for Depositions Due to Personal Family Emergency (filed in Case No. 15-002889PL).
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Oct. 19, 2015 |
Notice of Unavailability of Respondent's Counsel for Depositions Due to Personal Family Emergency (filed in Case No. 15-002890PL).
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Oct. 13, 2015 |
Joint Response to Order Continuing Hearing filed.
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Oct. 06, 2015 |
Petitioner's Amended Notice of Scrivener's Error filed.
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Oct. 06, 2015 |
Order Continuing Hearing and Addressing Pending Motions (parties to advise status by October 16, 2015).
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Oct. 05, 2015 |
CASE STATUS: Pre-Hearing Conference Held. |
Oct. 05, 2015 |
Petitioner's Notice of Taking Deposition (of Patient C.C.) filed.
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Oct. 05, 2015 |
Petitioner's Notice of Taking Deposition (of Coleen Taylor) filed.
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Oct. 05, 2015 |
Petitioner's Notice of Taking Deposition (of M.C.) filed.
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Oct. 02, 2015 |
Petitioner's Amended Notice of Scrivener's Error filed.
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Oct. 01, 2015 |
Petitioner's Notice of Scrivener's Error filed.
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Oct. 01, 2015 |
Petitioner's Notice of Scrivener's Error filed.
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Oct. 01, 2015 |
Joint Motion for Telephonic Status Conference and to Continue Final Hearing filed.
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Sep. 30, 2015 |
Petitioner's Motion to Compel Better and Complete Answers to Petitioner's First Requests for Production and First Sets of Interrogatories Dated June 1, 2015 filed.
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Sep. 28, 2015 |
Petitioner's Notice of Taking Deposition Duces Tecum filed.
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Aug. 24, 2015 |
Amended Notice of Hearing (hearing set for November 17 through 20, 2015; 9:00 a.m., Central Time; Destin, FL; amended as to Dates and Venue).
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Aug. 17, 2015 |
Order Granting Continuance and Re-scheduling Hearing (hearing set for November 10 through 13, 2015; 9:00 a.m., Central Time; Destin, FL).
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Aug. 14, 2015 |
Joint Motion for Continuance filed.
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Jul. 28, 2015 |
Notice of Taking Deposition in Lieu of Live Testimony (Patient C.H.) filed.
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Jul. 28, 2015 |
Notice of Taking Deposition in Lieu of Live (of S.H.) filed.
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Jul. 09, 2015 |
Petitioner's Amended Notice of Taking Deposition Duces Tecum (of John Lentz, Jr., amended as to time only) filed.
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Jul. 07, 2015 |
Notice of Taking Deposition in Lieu of Live Testimony (of Joel Rosenstock, M.D.) filed.
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Jul. 06, 2015 |
Petitioner's Notice of Taking Deposition Duces Tecum (of John Lentz, Jr.) filed.
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Jun. 18, 2015 |
Petitioner's Notice of Scrivener's Error filed.
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Jun. 17, 2015 |
Notice of Appearance of Co-counsel (Sarah Corrigan) filed.
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Jun. 17, 2015 |
Notice of Appearance of Co-counsel (Chad Dunn) filed.
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Jun. 09, 2015 |
Petitioner's Notice of Unavailability filed.
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Jun. 05, 2015 |
Order of Pre-hearing Instructions.
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Jun. 05, 2015 |
Notice of Hearing (hearing set for September 29 through October 2, 2015; 9:00 a.m., Central Time; Destin, FL).
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Jun. 05, 2015 |
Order Accepting Qualified Representative.
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Jun. 05, 2015 |
Order of Consolidation (DOAH Case Nos. 15-2888PL, 15-2889PL, and 15-2890PL).
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Jun. 03, 2015 |
(Proposed) Order Granting Respondent's Application for Permission to be Represented by Out of State Attorney Jacques G. Simon Pursuant to F.A.C. Sec.28-106.106 and Fla. Bar Reg. 4-5.5(c)(2) filed.
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Jun. 03, 2015 |
Affidavit of Jacques G. Simon, Esq., In support of Respondent's Request for permission to be Represented at the Hearing before The Division of Administrative Hearings (DOAH) by qualified Representative, out of state attorney Jacques G. Simon pursuant to F.A.C. Sec. 28-106.106 and Fla. Bar. Reg. 4-5.5(c)(2) filed.
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Jun. 03, 2015 |
Respondent's Request for permission to be Represented at the Hearing before The Division of Administrative Hearings (DOAH) by qualified Representative, out of state attorney Jacques G. Simon Pursuant to F.A.C. Sec.28-106.106 and Fla. Bar.Reg.4-5.5(c)(2) filed.
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Jun. 03, 2015 |
Certificate of Service Regarding Respondent's Application to be Represented by Qualified Representative Pursuant to F.A.C. Sec. 298-106.106 and Fla. Bar Reg. 4-5.5(c)(2) filed.
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Jun. 03, 2015 |
Letter to Judge Nelson from Jacques Simon regarding representing Respondent filed.
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Jun. 01, 2015 |
Notice of Serving Petitioner's First Request for Admissions, First Request for Interrogatories and First Request for Production to Respondent filed.
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Jun. 01, 2015 |
Joint Response to Initial Order filed.
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May 27, 2015 |
Motion to Consolidate Actions filed.
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May 26, 2015 |
Initial Order.
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May 22, 2015 |
Administrative Complaint filed.
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May 22, 2015 |
Election of Rights filed.
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May 22, 2015 |
Agency referral filed.
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Orders for Case No: 15-002888PL
Issue Date |
Document |
Summary |
Jan. 10, 2017 |
Agency Final Order
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Jul. 08, 2016 |
Recommended Order
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Petitioner established by clear and convincing evidence that Respondent departed from the standard of care with respect to seven patients, kept inadequate records, and failed to report diagnosis of Lyme disease. Recommend revocation and a fine.
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