STATE OF FLORIDA DEPARTMENT OF HEALTH DEPARTMENT OF HEALTH, Petitioner, Vv. CASE NO.: 2014-03373 ARTHUR CHARLES ROSENBLATT, M.D., Respondent. / ADMINISTRATIVE COMPLAINT Petitioner, Department of Health, by and through undersigned counsel files this Administrative Complaint before the Board of Medicine against Respondent Arthur Charles Rosenblatt, 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 medical doctor within the state of Florida, having been issued license number ME 49592. 3. Respondent's address of record is 1623 West Classical Boulevard, Delray Beach, Florida 33445. 4. At all times material, Respondent was working at his private medical practice located at 1623 West Classical Boulevard, Delray Beach, Florida 33445. 5. On or about October 13, 2009, Patient D.R., a forty-five (45) year old female, presented to the Respondent for complaints of severe anxiety and depression, palpitations and dsynpea upon exertion, joint pain, muscle aches, and arthritis. 6. Patient D.R. reported that her medical history included a knee replacement in 2007, and a motor vehicle accident in 1981 which resulted in a comminuted fracture, a lacerated spleen, and a lacerated liver. Patient D.R. indicated that she had previously been prescribed oxycodone! for her pain. 7. On or about October 13, 2009, Respondent diagnosed Patient D.R. with depression, panic disorder, chronic pain, and severe osteoarthritis, Respondent documented that Patient D.R. had a history of pain at a level of 8 out of 10, with 10 being the most severe pain. 1 According to Sectlon 893.03(2), Florida Statutes, oxycodone is a Schedule 11 controlled substance that has a high potential for abuse and has a currently accepted but severely restricted medical use In treatment in the United States, Abuse of oxycodone may lead to severe psychological or physical dependence. 2 DOH v. Arthur Charles Rosenblatt, M.D. 2014-03373 8. Beginning on or about October 13, 2009 through December 9, 2011, Respondent prescribed the following at various times in various combinations, doses, and quantities: methadone’, clonazepam’, oxycodone/APAP’, Avinza5, oxycodone, Kadian®, Ambien’, Ambien C.R.8, emazepam®, Dilaudid!°, Percocet!!, Roxicodone’?, Nuvigil'?, MS-Contin™, 2 Methadone is prescribed to treat pain. According to Section 893,03(2), Florida Statutes, methadone Is a Schedule II controlled substance that has a high potential for abuse and has a currently accepted but severely restricted medical use In treatment In the United States. Abuse of methadone may lead to severe psychological or physical dependence. 3 Clonazepam Is commonly prescribed to treat anxiety. According to Section 893.03(4), Florida Statutes, clonazepam Is a Schedule IV controlled substance that has a low potential for abuse relative to the substances In Schedule HI and has a currently accepted medical use in treatment in the United States, Abuse of clonazepam may lead to limlted physical or psychological dependence relative to the substances In Schedule III. 4 Oxycodone/APAP contalns oxycodone and acetaminophen, or Tylenol. According to Section 893.03(2), Florida Statutes, oxycodone Is a Schedule II controlled substance that has a high potential for abuse and has a currently accepted but severely restricted medical use In treatment In the United States, Abuse of oxycodone may lead to severe psychological or physical dependence. 5 Avinza Is a brand name for morphine, Morphine is prescribed to treat pain, According to Section 893.03(2), Florida Statutes, morphine is a Schedule II controlled substance that has a high potential for abuse and has a currently accepted but severely restricted medical use in treatment in the Unlted States, Abuse of morphine may lead to severe psychological or physical dependence. ® Kadian Is a brand name for extended release morphine sulfate. Morphine 1s prescribed to treat paln. According to Sectlon 893.03(2), Florida Statutes, morphine is a Schedule II controlled substance that has a high potential for abuse and has a currently accepted but severely restricted medical use in treatment in the United States, Abuse of morphine may lead to severe psychological or physical dependence, 7 Ambien is the brand name for the legend drug zolpidem, prescribed to treat Insomnia. ® amblen C.R. is an extended release formulation of Ambien. ° Temazepam Is prescribed to treat insomnia. According to Section 893,03(4), Florida Statutes, temazepam 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 temazepam may lead to limited physical or psychological dependence relative to the substances In Schedule HI. 10 Dilaudid Is the brand name for hydromorphone and Is prescribed to treat paln. According to Section 893.03(2), Florida Statutes, hydromorphone Is a Schedule IJ controlled substance that has a high potential for abuse and has a currently accepted but severely restricted medical use in treatment In the United States, Abuse of hydromorphone may lead to severe psychological or physical dependence. . "1 Percocet Is a brand name for oxycodone/APAP which contains oxycodone and acetaminophen, or Tylenol. According to Section 893.03(2), Florida Statutes, oxycodone Is a Schedule IJ controlled substance that has a high potential for abuse and has a currently accepted but severely restricted medical use in treatment In the United States, Abuse of oxycodone may lead to severe psychological or physical dependence, 22 Roxicodone Is a brand name for oxycodone. According to Section 893.03(2), Florida Statutes, oxycodone is a Schedule II controlled substance that has a high potential for abuse and has a currently accepted but severely restricted medical use in treatment in the United States. Abuse of oxycodone may lead to severe psychological or physical dependence. 13 Nuvigil, also known as armodafinil, Is a wakefulness promoting agent commonly prescribed to treat Individuals with daytime fatique caused by sleep disorders. Armodafinil Is not listed in Section 893.03 but Is a legend drug. 44 MS-Contin is a brand name for controlled release morphine sulfate. Morphine Is prescribed to treat pain. According to Section 893,03(2), Florida Statutes, morphine Is a Schedule 1 controlled substance that has a high potential for abuse and has a currently accepted but severely restricted medical use in treatment in the United States, Abuse of morphine may lead to severe psychological or physical dependence. 3 DOH v. Arthur Charles Rosenblatt, M.D. 2014-03373 hydrocodone/APAP!®, and Dalmane’®.On or about December 22, 2011, Patient D.R. expired from acute combined drug intoxication. 9. With the exception of routine bloodwork, Respondent did not refer Patient D.R. to have any type of diagnostic testing, x-rays, or imaging studies conducted throughout the course of her treatment. 10. Respondent did not refer Patient D.R. to a specialist for further evaluation throughout the course of her treatment. 11. Respondent did not create a written treatment plan with objectives to be used to determine Patient D.R.’s success. 12. Respondent did not obtain a complete medical history of Patient D.R. 13. Respondent did not consistently create or maintain medical records that document all appointments and telephone contacts with Patient D.R., the quantity of medication Respondent prescribed to Patient D.R., that Respondent conducted musculoskeletal or neurologic physical examinations of Patient D.R., whether he determined the location and 15 Hydrocodone/APAP contains hydrocodone and acetaminophen, or Tylenol, According to Sectlon 893.03(2), Florida Statutes, hydrocodone is a Schedule II controlled substance that has a high potential for abuse and has a currently accepted but severely restricted medical use in treatment in the United States. Abuse of hydrocodone may lead to severe psychological or physical dependence. 16 Dalmane Is a brand name for flurazepam, a drug used to treat Insomnla. According to Section 893,03(4), Florida Statutes, flurazepam is a Schedule 1V controlled substance that has a low potential for abuse relative to the substances in Schedule 11] and has a currently accepted medical use in treatment in the United States, Abuse of flurazepam may lead to Ilmited physical or psychological dependence relative to the substances in Schedule J1J. DOH v, Arthur Charles Rosenblatt, M.D. 2014-03373 intensity of Patient D.R.’s pain, or whether pain medication previously prescribed had any effect on Patient D.R.’s pain or function. 14. Portions of Patient D.R’s medical records are illegible, undated, do not contain a patient name or identifier, and are unsigned. 15. Respondent prescribed controlled substances to Patient D.R. inappropriately and in excessive quantities. 16. Respondent prescribed controlled substances to Patient D.R. without medical justification. COUNT I 17. Petitioner re-alleges and incorporates paragraphs one (1) through sixteen (16) as if fully set forth herein. 18. Section 458.331(1)(t), Florida Statutes (2009-2011), subjects a licensee to discipline for committing medical malpractice as defined in Section 456.50, Florida Statutes. Per Section 456.50(1)(g), Florida Statutes (2009-2011), medical malpractice is 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 (2009-2011), provides that the prevailing standard of care for a given healthcare provider shall be that level of care, skill, and treatment 5 DOH v. Arthur Charles Rosenblatt, M.D. 2014-03373 which, in light of all relevant surrounding circumstances, is recognized as acceptable and appropriate by reasonably prudent similar health care providers. 19, Respondent fell below the minimum standard of care in his treatment of Patient D.R. in one or more of the following ways: a. by prescribing excessive amounts, and dosages of narcotic pain medications, benzodiazepines, and sedative/hypnotic medications to Patient D.R.; . by prescribing inappropriate combinations of narcotic pain medications, benzodiazepines, and — sedative/hypnotic medications to Patient D.R.; . by failing to obtain a complete medical history of Patient D.R,; . by failing to conduct routine musculoskeletal or neurologic examinations of Patient D.R.; . by failing to refer Patient D.R. for appropriate diagnostic testing; . by failing to refer Patient D.R. to a specialist for further care and treatment; and/or DOH v. Arthur Charles Rosenblatt, M.D. 2014-03373 g. by failing to prepare a treatment plan stating objectives to be used to determine the success of treatment. 20. Based on the foregoing, Respondent violated Section 458.331(1)(t), Florida Statutes (2009-2011). COUNT II 21. Petitioner re-alleges and incorporates paragraphs one (1) through seventeen (17) as if fully set forth herein. 22. Section 458.331(1)(q), Florida Statutes (2009-2011), subjects a licensee to discipline 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 the purposes of the 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 or her intent. 23. Asset forth above, Respondent prescribed a legend drug other than in the course of his professional practice by prescribing excessive 7 DOH v. Arthur Charles Rosenblatt, M.D. 2014-03373 amounts and inappropriate combinations of narcotic pain medications, benzodiazepines, and sedative/hypnotic medications to Patient D.R. 24. Based on the foregoing, Respondent violated Section 458,331(1)(q), Florida Statutes (2009-2011). COUNT III 25. Petitioner re-alleges and incorporates paragraphs one (1) through seventeen (17) as if fully set forth herein. 26. Section 458.331(1)(m), Florida Statutes (2009-2011), 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. 27. Respondent failed to maintain records that justify the course of treatment of Patient D.R. in one or more of the following ways: DOH v. Arthur Charles Rosenblatt, M.D. 2014-03373 . by failing to create or maintain records documenting that Respondent obtained a complete medical history of Patient D.R.; . by failing to create or maintain records documenting that Respondent conducted routine musculoskeletal or neurologic examinations of Patient D.R.; . by failing to create or maintain records documenting whether the pain medications Respondent previously prescribed had any effect on Patient D.R.’s pain or function; . by failing to create or maintain records documenting objective measurements of Patient D.R.’s pain; . by failing to create or maintain records documenting that Respondent referred Patient D.R. for appropriate diagnostic testing; . by failing to create or maintain records documenting, that Respondent referred Patient D.R. to specialist for further evaluation; . by failing to create or maintain medical records which document the quantity of medications prescribed; DOH v. Arthur Charles Rosenblatt, M.D, 2014-03373 h. by failing to create or maintain records for Patient D.R. that are fully legible; and/or i. by failing to prepare a written treatment plan stating | objectives to be used to determine the success of treatment. 28, Based on the foregoing, Respondent violated Section 458,331(1)(m), Florida Statutes (2009-2011). 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. (Signature on following page) 10 DOH vy. Arthur Charles Rosenblatt, M.D. 2014-03373 SIGNED this as day of VlovLWMGTR , 2015. John H. Armstrong, MD, FACS State Surgeon General and Secretary of Health Sora (Corgi Sarah Corrigan Assistant General Counsel DOH Prosecution Services Unit FILED 4052 Bald Cypress Way, Bin C-65 a Tallahassee, Florida 32399-3265 CLERK Angel S Florida Bar Number 85797 ge ng pare NOV 0 32 (850) 245 - 4444 Telephone (850) 245 - 4683 Facsimile E-mail: Sarah.Corrigan@flhealth.gov SEC/sdm PCP: 10/30/2015 PCP Members: Dr. El-Bahri, M.D., Dr. Merle Stringer, M.D., Ms, Goersch, Ms. Mittan . DOH v. Arthur Charles Rosenblatt, M.D. 2014-03373 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. A request or petition for an administrative hearing must be in writing and must be received by the Department within 21 days from the day Respondent received the Administrative Complaint, pursuant to Rule 28-106.111(2), Florida Administrative Code. If Respondent fails to request a hearing within 21 days of receipt of this Administrative Complaint, Respondent waives the right to request a hearing on the facts alleged in this Administrative Complaint pursuant to Rule 28-106.111(4), Florida Administrative Code. Any request for an administrative proceeding to challenge or contest the material facts or charges contained in the Administrative Complaint must conform to Rule 28-106.2015(5), Florida Administrative Code. Please be advised that mediation under Section 120.573, Florida Statutes, is not available for administrative disputes involving this agency action. 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 any other discipline imposed. 12 DOH v. Arthur Charles Rosenbiatt, M.D, 2014-03373

Docket for Case No: 16-005070PL