The Issue Whether Petitioner's application for a license as a licensed practical nurse in the State of Florida should be approved.
Findings Of Fact Petitioner is licensed as a practical nurse in Virginia. She has applied for a Florida license as a practical nurse based on her Virginia license. The application for licensure in Florida contains the following questions, to which Petitioner answered "yes": 6.B. In the last 5 years, have you been treated for or had a recurrence of a diagnosed mental disorder or impairment? 7.A. Have you EVER been convicted of, or entered a plea of guilty, nolo contendere, or no contest to, a crime in any jurisdiction other than a minor traffic offense? You must include all misdemeanors and felonies, even if adjudication was withheld. Driving under the influence (DUI) or driving while impaired (DWI) is not a minor traffic offense for purposes of this question. In July 2000, Petitioner was found guilty of simple assault, a misdemeanor, in the Circuit Court of Fairfax County, Virginia. She was fined $300, and ordered to pay costs. Two hundred dollars of the fine were suspended, conditioned upon her good behavior for a period of one year and upon the condition that she have no contact with the victim or the victim's cat. The conviction did not have any connection with Petitioner's work. Rather, it involved an altercation with a woman whose cat was discovered at Petitioner's home. In 2006, Petitioner was attending school at Howard University, taking classes toward her RN degree. She began to have auditory hallucinations and was unable to sleep. At one point, Petitioner went for two days without no sleep whatsoever. At her husband's encouragement, Petitioner sought medical assistance and was admitted to a hospital for inpatient treatment. Petitioner was diagnosed as having bipolar disorder. After one week of inpatient treatment, Petitioner spent a month in Chicago with her brother, who is a licensed psychiatrist, and discontinued her nursing program because it was too stressful. Petitioner did not work for a three-month period as a result of her illness. Since September 2006, Petitioner has been treated at the Adult Behavior Health Center of the United States Army hospital in Fairfax, Virginia. According to the memorandum provided to the Board of Nursing by Odita Asuncion, M.D., her diagnosis was bipolar disorder with psychotic features. Dr. Asuncion described Petitioner as being in remission, and stated that her prognosis is fair with medication and regular follow-up. Petitioner takes Seraquel and Trazadone to control her condition. At the time Dr. Asuncion provided information to the Board of Nursing, Petitioner was also taking Lamictal, a mood stabilizer, but according to Petitioner this medication was discontinued three months before the hearing. While Petitioner claims the auditory hallucinations have ceased, she continues to have problems concerning her ability to sleep. Petitioner currently works at a home health care agency in Virginia. Petitioner presented evidence to show that she has worked for a home health care agency, however, there is no evidence regarding the environment in which she works, the duties she performs, the amount of supervision provided or whether her employer is satisfied with either the quality of her work or her stability on the job. Although she is taking her medication as prescribed at this time, Petitioner does not agree with her diagnosis. Neither does her husband. Petitioner believes that she was sick, sought treatment and is now well, with the exception of still having trouble sleeping.
Recommendation Upon consideration of the facts found and conclusions of law reached, it is RECOMMENDED: That a final order be entered denying Petitioner's application for a license as a practical nurse in the State of Florida. DONE AND ENTERED this 10th day of April, 2008, in Tallahassee, Leon County, Florida. S LISA SHEARER NELSON Administrative Law Judge Division of Administrative Hearings The DeSoto Building 1230 Apalachee Parkway Tallahassee, Florida 32399-3060 (850) 488-9675 SUNCOM 278-9675 Fax Filing (850) 921-6847 www.doah.state.fl.us Filed with the Clerk of the Division of Administrative Hearings this 10th day of April, 2008. COPIES FURNISHED: Theodora Koko Patten 10162 Oakton Terrace Road Oakton, Virginia 22124 Lee Ann Gustafson, Esquire Office of the Attorney General The Capitol, Plaza Level 01 Tallahassee, Florida 32399-1050 Rick Garcia, Executive Director Board of Nursing Department of Health 4052 Bald Cypress Way Tallahassee, Florida 32399-1701 Patricia Dittman, Chair Board of Nursing Department of Health 4052 Bald Cypress Way Tallahassee, Florida 32399-1701 R. S. Power, Agency Clerk Department of Health 4052 Bald Cypress Way, Bin A02 Tallahassee, Florida 32399-1701 Josefina M. Tamayo, General Counsel Department of Health 4052 Bald Cypress Way, Bin A02 Tallahassee, Florida 32399-1701 Dr. Ana M. Viamonte Ros, Secretary Department of Health 4052 Bald Cypress Way, Bin A00 Tallahassee, Florida 32399-1701
Findings Of Fact The Florida State Board of Nursing filed an Administrative Complaint against Respondent, William Scott Brewer, who holds licensed practical nurse license number 33305-1, seeking to place on probation, suspend or revoke Respondent's license for the following reasons: On or about January 11, 1978, Respondent uttered forged prescriptions at Maitland Rexall 145 South Orlando Avenue, Maitland, Florida, for controlled substances, to-wit: Quaalude (Methaqualone) and Demerol (Meperedime), and received said controlled substances from the pharmacist. On or about January 16, 1978, Respondent uttered a forged prescription at Walgreen Drug Store, Castleberry, Florida, for a controlled substance, to-wit: Percodan (Oxycodone Hydrochloride). On or about January 25, 1978, Respondent uttered a forged prescription at the Liggett Rexall Drug Store located at 4434 Curry Ford Road, Orlando, Florida, and received a controlled substance from the pharmacist to- wit: Quaalude. On the same date and place as alleged in paragraph C, Respondent uttered a forged prescription for a controlled substance, to-wit: Demerol. Respondent requested this administrative hearing, contending that the Administrative Complaint contained disputed issues of material fact. Based upon the evidence presented and the admissions made by Respondent, it is found that on or about January 11, 1978, the Respondent presented to James A. Robinson, a pharmacist, two prescriptions, one for Demerol and one for Quaalude purportedly signed by Lawrence a Bilotta, M.D. Dr. Bilotta denied signing the prescriptions and the Respondent admitted signing Dr. Bilotta's name thereto. Respondent admitted securing the drugs for himself and his friends. Based upon the evidence presented and the admissions made by Respondent, it is found that on or about January 25, 1978, Respondent presented to Fred Martini, a pharmacist, two prescriptions, one for Quaalude and one for Demerol. Said prescriptions were purportedly signed by Lawrence A. Bilotta M.D. Dr. Bilotta denied signing the prescriptions and the Respondent admitted signing Dr. Bilotta's name thereto. The pharmacist filled the prescription for the controlled drug Quaalude, but did not fill the prescription for controlled drug Demerol. The Respondent admitted securing the Quaalude for use for himself and his friends. After the Respondent left the store with the Quaalude the pharmacist notified the authorities. An information was filed against Respondent in the Circuit Court for Orange County, Florida, charging him with violation of Section 893.13(3)(a)(1) , F.S., charging him with the obtaining of a controlled substance by misrepresentation, fraud, forgery, deception or subterfuge. Respondent pleaded guilty to the crime and the court withheld adjudication of guilt and ordered a pre-sentence investigation by the Florida Parole and Probation Commission and a report to the Circuit Judge. Said report, if any, was not filed in evidence. The allegations contained in allegation B, regarding a forged prescription for a controlled substance, Percodan, was not proved. Respondent, William Scott Brewer, testified, that he has not used drugs since January of 1978, and does not intend to again use drugs. This testimony was not refuted by the Petitioner.
Recommendation Suspend the license of Respondent for a period of not more than three (3) years. DONE AND ENTERED this 10th day of August, 1978, in Tallahassee, Florida. DELPHENE C. STRICKLAND Hearing Officer Division of Administrative Hearings Room 530, Carlton Building Tallahassee, Florida 32304 (904) 488-9675 COPIES FURNISHED: Julius Finegold, Esquire 1005 Blackstone Building Jacksonville, Florida 32201 William Scott Brewer Post Office Box 176 Nacotee, Florida 33864 ================================================================= AGENCY FINAL ORDER ================================================================= BEFORE STATE OF FLORIDA BOARD OF NURSING IN THE MATTER OF: William Scott Brewer Box 176Street Nacotee, Florida 33864 CASE NO. 78-778 As a Licensed Practical Nurse License Number 33305-1 /
The Issue The issue for consideration in this case is whether Petitioner should be granted an exemption from the current disqualification to work with health care agencies resulting from the misconduct cited in the Agency's letter of denial dated January 27, 1997.
Findings Of Fact At all times pertinent to the issues herein, the Respondent, Agency for Health Care Administration, was the state agency responsible for regulating the certification of nursing assistants and the regulation of the nursing assistant profession in this state. A part of that responsibility is the maintenance of control over those individuals who are qualified by reason of training and character to work with health care agencies in this state. Ms. Ricks has, as one of her responsibilities, the conduct of background investigations of those individuals who seek certification to work with the indicated category of individuals, but whose background contains information of a disqualifying nature. The purpose of this activity is to ensure that individuals in nursing homes, or in other situations where they are served by certified nursing assistants, receive quality care. At the time of employment by nursing homes and other facilities or organizations who utilize nursing assistants, individuals are screened and if determined to be disqualified for some reason, may ask for an exemption from disqualification. When that request is made, Ms. Ricks is asked to conduct an investigation into the individual's background. In the instant case, Petitioner requested an exemption from disqualification. When, after reviewing the file, Ms. Ricks determined it was impossible for her to grant the exemption based on a desk review, she did an informal investigation into his background. In doing so, she determined that Petitioner had been involved in numerous drug-related offenses over a twenty year span from 1975 to 1995. Included in this list of offenses were the following: Jul. 1975 sale & possession of marijuana Aug. 1982 sale & possession of marijuana c. Oct. 1984 possession of marijuana d. Jan. 1985 possession of marijuana e. Jun. 1988 sale & possession of cocaine f. Jan. 1995 possession of marijuana. Prior to preparing her report on the Petitioner's background, Ms. Ricks gave him an opportunity to be heard. He presented to her a copy of the screening report of the Florida Department of Law Enforcement which contained the above-cited criminal record, as well as testimonials from several individuals for whom he has worked in the recent past. Nonetheless, based on the information available for her to consider, Ms. Ricks, as well as her review group, arrived at the consensus that Petitioner had a long history of drug offenses and had admitted to drug abuse. It was also determined that after his arrest in 1995, Petitioner sought rehabilitation and voluntarily entered a half-way house. Notwithstanding those self-efforts, the Agency officials concluded that Petitioner's rehabilitative efforts had not been sufficiently long-standing to demonstrate full rehabilitation. The officials were of the opinion that the nature of Petitioner's offenses and the length of time he was involved in drug abuse, when compared with the relatively short time of his abstinence, showed there had been insufficient time for meaningful rehabilitation. Mr. Larason does not deny his prior record of drug and alcohol abuse. However, he claims he has made a significant change in his life. His record of offenses, he contends, includes no major felonies except for his involvement with the possession and sale of cocaine in 1988, and even since that offense, he has had only one minor marijuana involvement. Petitioner contends he has voluntarily kept himself in a half-way house, primarily because he felt it was good for him, and he didn't want to leave until he felt he was ready. He claims to regularly attend meeting of Alcoholics Anonymous and that he has remained drug free and sober. He has not touched alcohol for almost two years. He believes he has made a major turn-around in his life and now has no use for alcohol. Alcohol was, he believes, the cause of his downfall. He now believes he is stable and wants the exemption so he can get a full-time job in a hospital. Mr. Larason, for the past several years until the Agency's action, has worked in several mental health hospitals in Pinellas County. He asserts that all have indicated they want him back and have offered him employment. He wants to work and contends he will fight all the way for the opportunity to do so in his chosen field because he is of the opinion that work in this chosen profession, health care, will aid him in his own recovery. Since the Agency declined to grant him an exemption from disqualification, he has not been able to work in the health care field but had been gainfully employed by two realtors doing construction work. Both indicate he is an asset to the community and, in their judgment, will remain so. Consistent with those letters is a reference from the nursing agency for which he formerly worked in which his former supervisor opined Petitioner has learned from his past mistakes. Another health care employer indicates that aside from an occasional work lapse due to alcohol, he was a satisfactory employee.
Recommendation Based on the foregoing Findings of Fact and Conclusions of Law, it is recommended that the Agency for Health Care Administration enter a Final Order denying Petitioner's request for exemption, without prejudice, at this time. DONE AND ENTERED this 3rd day of September, 1997, in Tallahassee, Leon County, Florida. COPIES FURNISHED: Scott Larason 633 Third Street North Apartment Two ARNOLD H. POLLOCK Administrative Law Judge Division of Administrative Hearings The DeSoto Building 1230 Apalachee Parkway Tallahassee, Florida 32399-3060 (904) 488-9675 SUNCOM 278-9675 Fax Filing (904) 921-6947 Filed with the Clerk of the Division of Administrative Hearings this 3rd day of September, 1997. St. Petersburg, Florida 33701 Thomas W. Caufman, Esquire Agency for Health Care Administration 7827 North Dale Mabry Highway Tampa, Florida 33614 Sam Power, Agency Clerk Agency for Health Care Administration Suite 3431 Fort Knox, Building 3 2727 Mahan Drive Tallahassee, Florida 32308 Jerome W. Hoffman General Counsel Agency for Health Care Administration 2727 Mahan Drive Tallahassee, Florida 32308
The Issue Whether or not on or about May 24, 1978, the Respondent was arrested by officers of the Jacksonville Sheriff's Office, in Jacksonville, Duval County, Florida, and found to be in illegal possession of the controlled substance, to- wit, Pentothal (Sodium Thiopental), injectable, and, therefore, in violation of Subsections 464.21(1)(b) and (d), Florida Statutes. Whether or not on or about May 24, 1978, the Respondent was found to be in possession of several prescription drugs without having obtained a prescription for those drugs, in violation of Subsection 464.21(1)(b), Florida Statutes.
Recommendation It is recommended that the license of the Respondent, Gloria Nesmith Moore Callender, R.N., No. 48527-2, be REVOKED. DONE and ENTERED this 28th day of November, 1978, in Tallahassee, Florida. CHARLES C. ADAMS, Hearing Officer Division of Administrative Hearings Room 101, Collins Building Tallahassee, Florida 32301 (904) 488-9675 COPIES FURNISHED: Julius Finegold, Esquire Geraldine B. Johnson, R.N. 1005 Blackstone Building Department of Professional and Jacksonville, Florida 32202 Occupational Regulation Board of Nursing Ms. Gloria N. M. Callender 6501 Arlington Expressway, 8030 Almar Place Bldg. "B" Jacksonville, Florida 32208 Jacksonville, Florida 32211
The Issue The issue in this case is whether Respondent violated Section 464.018(1)(h), Florida Statutes (1997) (hereinafter, "Florida Statues"), and Florida Administrative Code Rules 59S- 8.005(1)(e)1 and 2, by diverting morphine during his care and treatment of two patients and failing to keep accurate nurse's notes. (All references to rules are to rules promulgated in the Florida Administrative Code in effect on the date of this Recommended Order).
Findings Of Fact Petitioner is the state agency responsible for regulating the practice of nursing. Respondent is licensed as a nurse pursuant to license number RN 2185632. Respondent admitted under oath at the hearing that he committed the acts alleged in the Administrative Complaint. Respondent did not overdose any patient, endanger, or neglect any patient. Respondent diverted morphine during his care and treatment of patients J.G. and R.B. at West Volusia Memorial Hospital on March 24 and 26, 1997. Respondent was addicted to morphine and diverted morphine from the two patients for self- administration. Respondent is guilty of negligent administration of morphine. Respondent self-administrated morphine that was not medically necessary. Respondent failed to keep accurate nurse's notes for patient J.G. Respondent inaccurately recorded the amount of morphine administered to patients J.G. and R.B. Respondent has voluntarily sought aggressive care and treatment for his drug addiction. Respondent is in three rehabilitation programs in Georgia. Respondent is in an intervention program for nurses ("IPN") approved by the State of Georgia pursuant to a prosecution conducted by the appropriate state agency in Georgia. He is also in a nurses anonymous program and a follow-up hospital program. Respondent is also under the regular care of a psychiatrist.
Recommendation Based upon the foregoing Findings of Fact and Conclusions of Law, it is RECOMMENDED that the Board enter a Final Order finding Respondent guilty of violating Section 464.018(1)(h) and Rules 59S-8.005(1)(e)1 and 2, suspending Respondent's license for two years from the date of this Recommended Order, and placing Respondent on probation for two years from the end of the suspension period. The terms of probation shall include a requirement that Respondent successfully complete the IPN program in Georgia and hospital follow-up program. DONE AND ENTERED this 18th day of June, 1998, in Tallahassee, Leon County, Florida. DANIEL MANRY Administrative Law Judge Division of Administrative Hearings The DeSoto Building 1230 Apalachee Parkway Tallahassee, Florida 32399-3060 (850) 488-9675 SUNCOM 278-9675 Fax Filing (850) 921-6847 Filed with the Clerk of the Division of Administrative Hearings this 18th day of June, 1998. COPIES FURNISHED: Marilyn Bloss, Executive Director Department of Health Board of Nursing 4080 Woodcock Drive, Suite 202 Jacksonville, Florida 32207 Angela T. Hall, Agency Clerk Department of Health 1317 Winewood Boulevard Building 6, Room 136 Tallahassee, Florida 32399-0700 Joseph S. Garwood, Esquire Agency for Health Care Administration 1580 Waldo Palmer Lane Post Office Box 14229 Tallahassee, Florida 32308-4229 Joseph Webb, pro se 2169 Turner Church Road McDonough, Georgia 30252
Findings Of Fact Maurice Hedge, M.D., is licensed by the Board of Medical Examiners of the State of Florida as a medical doctor and was so licensed at all times relevant hereto. Mrs. Renate Hall was a patient of Respondent from late 1977 until early 1979 during which time she saw him approximately bi-monthly. During this period Mrs. Hall, who was born in Germany and came to America as the wife of a U.S. serviceman, was widowed, out of work, and in poor financial circumstances. Respondent was very gallant, often kissed Mrs. Hall's hand and stroked her arm or hair when she came to his office. Several times he offered to take her to dinner, which offer she did not accept. He did not bill her for the visits. Her last visit to Respondent's office was to have her son's flu virus treated. After examining Mrs. Hall's son, Respondent came out of the examining room and told Mrs. Hall to come into his office while he wrote a prescription. He closed the door to the office, came close to Mrs. Hall, grabbed her breasts and made moaning and groaning sounds. She pushed him away and departed the office, very upset; never to return. No evidence was presented that Respondent is or was in any way mentally impaired. During the period 6-29-79 through 4-17-80 Respondent called in 12 prescriptions to Walgreen's Drug Store, Cocoa, for Class IV controlled substances, Fastin, Talwin, Valium and Premarin for patient Mabel DeVoe (Exhibit 6). A lady known at Walgreen's as Mabel DeVoe picked up these prescriptions. Mabel DeVoe and Geneveive Hodge, the wife of Respondent, are the one and the same person. Exhibit 20 is a list of prescriptions written by Respondent for his wife for controlled substances, primarily Fastin and Talwin, during the first nine months of 1980. These prescriptions were filled at Campbell's Pharmacy, Rockledge, Florida. In the affidavit of Mabel DeVoe (Exhibit 7) she states that she works for Dr. and Mrs. Hodge, and picked up prescriptions made out to Mabel DeVoe and turned the drugs over to Mrs. Hodge. The fact that Respondent was writing prescriptions for Fastin and Talwin for Geneveive Hodge at the same time he was calling in prescriptions for Fastin to be issued to Mabel DeVoe, either a fictitious person or an alias for Mrs. Hodge, shows an intent to deceive by Respondent while participating in this charade. During an audit of Respondent's controlled substances record by the Federal Drug Administration inspectors some two thousand tablets of controlled substances dispensed by Respondent were unaccounted for. Respondent stated to the inspector that most of these unaccounted-for drugs had been dispensed by him rather than administered. When advised of the shortages Respondent made no effort to show that these drugs had been administered, by providing the patients' records to whom he may have administered the drugs. In view of Respondent's admission that these drugs had been dispensed by him, his argument at the hearing that these missing drugs may have been administered and the inspector would have so found had he reviewed all of Respondent's patient records, is without merit. Linda Lomax has been known in police circles in Cocoa and the vicinity for the past ten years or longer as a drug abuser. At various times until late 1980 she was addicted to Demerol. She was successful many times in going to the emergency rooms of hospitals complaining of back pain, earache, and other problems and getting prescriptions for Demerol and other controlled substances. She has a criminal record for assault with a deadly weapon and forgery of prescriptions. In July 1980 Ms. Lomax was apprehended by the police in Rockledge on the basis of a warrant issued in Melbourne for the offense of using forged prescriptions. She was accosted in a drug store while attempting to get drugs on a forged prescription. When the policeman identified himself as such she immediately asked to leave the drug store to "talk". Without ever being placed under arrest by the police, without promises of leniency, of police dropping of charges or other inducement Ms. Lomax asked if the police were interested in learning who committed recent drug related robberies and when the policeman said "Yes" proceeded to tell him about prior unsolved robberies in the area and of a forthcoming planned robbery. The information given by Ms. Lomax proved reliable. She also knew the drug abusers who were getting drugs from which doctor and agreed to assist in getting evidence against these doctors. Ms. Lomax subsequently was introduced to John Spanogle, an investigator for Petitioner, and agreed to assist in getting evidence against Respondent. She had gone to Respondent's office in mid-June 1980 and had obtained Demerol without a physical examination and without a medical reason for having the drug. She had received information from other drug abusers that she could get Demerol from Respondent. When Respondent asked her during the June visit who sent her to him she told him Karen Schaffer and Karen Pritchard. After giving her a prescription for Demerol, Respondent told her to come back. On this visit she stole some blank prescription pads from Respondent's office. Ms. Lomax's next visit to Respondent was in mid-July 1980 and on this visit she presented him with a prescription for 50 Demerol she had forged on one of the blanks she had stolen and told him the pharmacist would not fill it. Respondent tore up that prescription and issued her a valid one for 50 Demerol. During these visits Respondent kissed Ms. Lomax and called her "Baby". When Ms. Lomax told Spanogle the substance of her visit to Respondent he asked if she would return with a "bugging" device on her person, to which she agreed. On July 30, 1980, Ms. Lomax visited Respondent's office carrying a radio transmitter in her purse which was monitored and recorded by Spanogle and the police. At this visit Ms. Lomax told Respondent's nurse that she had an earache. When she met Respondent in the examining room he greeted her with a kiss on the mouth. She told him she didn't have an earache but wanted something for sleep. He asked if Valium would be okay. She said "Yes". When he asked if she wanted 24 or 30 she replied "30". After the greeting kiss Respondent unzipped the front of her dress and played with her breasts. She showed him bruises on her leg and he lifted her dress and remarked that she had sexy underwear and good-looking legs. Her testimony of the events that transpired on this July 30 visit is corroborated by the transcript of the tape of the conversation between Respondent and Ms. Lomax (Exhibit 13). Respondent again agreed to take care of the prescription she had forged from the stolen prescription pad. She made an appointment to return 5 August and left with the prescription. At a prearranged meeting place she turned over prescriptions for 30 Valium, 5 mg. and 24 Dalwane, 30 mg. (Exhibit 8) to Spanogle. On 5 August 1980 Ms. Lomax again visited Respondent's office carrying a "bugging" device. During this visit she was kissed several times by Respondent. They discussed his sexual exploits, or rumors thereof, with other patients. Respondent unzipped his pants to expose his penis and asked Ms. Lomax to look at it and touch it, and he kissed and fondled her breasts. No other physical examination was performed. Ms. Lomax told Respondent she wanted something to help her sleep. While in the office Respondent gave her a Valium injection and upon her departure he gave her prescriptions for 60 Librium, 10 mg. and 24 Nodular, 300 mg. These prescriptions were delivered to law enforcement officers by Ms. Lomax and were admitted into evidence as Exhibit 9. On 12 August 1980 Ms. Lomax made a final visit to Respondent's office again carrying a "bugging" device through which their conversation could be monitored and recorded. During this visit Respondent again fondled and kissed Ms. Lomax's breasts, unzipped his pants and requested oral sex from Ms. Lomax, which she declined. She complained that some of the drugs he gave her last time were ineffective and that she wanted something stronger. Also, she wanted something to keep her awake for the night job she was going to start and sleeping pills so she could sleep during the daytime. She stated she preferred Valium over Librium. When she left the office she had prescriptions for 50 Talwin, 50 mg.; 50 Valium, 5 mg.; 30 Ionamin, 30 mg.; and 50 Dalmane, 30 mg., which she delivered to law enforcement officers (Exhibit 10). On none of these visits was she billed by Respondent for medical services.
