The Issue Whether Petitioner’s application for a license as a Registered Pharmacy Technician should be approved.
Findings Of Fact On May 22, 2008, based on a plea of nolo contendere, Petitioner was adjudged guilty of the offense of Unlawful Sexual Activity with a Minor, a second-degree felony. She was placed on five years of Sexual Offender Probation. The special conditions of Petitioner’s probation included the following: a. Restitution to the victim in the amount of $425.00; b. No contact with the victim; and c. Attend parenting classes. The standard conditions of Sex Offender Probation were imposed upon Petitioner, including: (a) A mandatory curfew from 10 p.m. to 6 a.m.; (b) A prohibition on living within 1,000 feet of a school, day care center, park, playground, or other place where children regularly congregate; (c) Participation in a sex offender treatment program; (d) No contact with any children under the age of 18, unless court approved; and (e) A prohibition on working for pay or as a volunteer at any place that children regularly congregate, including but not limited to any school, day care center, park, playground, pet store, library, zoo, theme park or mall. On October 5, 2009, Petitioner submitted an application for licensure as a Registered Pharmacy Technician. On December 9, 2009, the Board voted to deny Petitioner’s application. A Notice of Intent to Deny reflecting the vote was filed on December 31, 2009. Petitioner testified that she has been a pharmacy technician since 1981. There was no evidence presented, however, indicating that Petitioner has been licensed in Florida as a Registered Pharmacy Technician. Petitioner is currently employed by Randolph Margrave, preparing intravenous medications (IVs) and supplies for administering to patients in their homes. She works in a clean room under a hood in an isolated barrier. She has no contact with the public, and she has no contacts with the patients. Although her position does not require Petitioner to review patient records, she has access to patient records. According to her current employer, Petitioner does an excellent job. Prior to her current position, Petitioner worked in a retail pharmacy from 1981 to 1989. From 1989 to 1999 she worked in the pharmacy department of a hospital. Petitioner’s current employment does not require her to have contact with the public. Petitioner described the circumstances that led to her arrest and subsequent conviction. She testified that she performed oral sex on her daughter’s seventeen-year-old boyfriend. In her testimony, Petitioner stated: My daughter’s boyfriend was very abusive. We got a restraining order against him, and they only granted it for two weeks, temporary. And he threatened me through her. And as it turned out, I made a bad decision. And it was an oral sex one time and . . . [h]e was 17 years old at the time. Petitioner testified that her daughter’s boyfriend was a very mature 17-year-old. Petitioner further testified: And I thought my daughter’s life was being threatened, and it was like making a deal with the devil. And it was a one-time thing and a very bad thing. In a typical retail pharmacy setting, a pharmacy technician is the first point of contact for patients that drop off or pick-up a prescription. A pharmacy technician in a retail setting gathers the patient’s information, enters it into the computer, prepares the label and counts and pours the medication. Pharmacy technicians have access to personal information of the patients that patronize the pharmacy. This information includes but is not limited to the patient’s name, gender, phone number (including cell number), address, allergy information and prescription medication history. Minors may purchase and pick-up medications from a pharmacy. A licensed Registered Pharmacy Technician may practice at any location without restriction.
Recommendation Based on the forgoing Findings of Fact and Conclusions of Law, it is RECOMMENDED: That the Board of Pharmacy enter a final order denying Celeste Donald’s application for licensure as a Registered Pharmacy Technician. DONE AND ENTERED this 30th day of June, 2010, in Tallahassee, Leon County, Florida. S JAMES H. PETERSON, III Administrative Law Judge Division of Administrative Hearings The DeSoto Building 1230 Apalachee Parkway Tallahassee, Florida 32399-3060 (850) 488-9675 Fax Filing (850) 921-6847 www.doah.state.fl.us Filed with the Clerk of the Division of Administrative Hearings this 30th day of June, 2010.
The Issue This is a license discipline case in which the Petitioner seeks to take disciplinary action against a medical doctor on the basis of alleged violations of paragraphs (m), (q), and (t) of Section 458.331(1), Florida Statutes. The violations charged relate to allegations that the Respondent improperly prescribed legend drugs, including controlled substances, and that he failed to keep certain records.
Findings Of Fact The Respondent is, and has been at all times material to this proceeding, a licensed physician, having been issued license number ME 0026758 by the State of Florida. During 1988 and 1990 the Respondent wrote five prescriptions for a person named V. L. R. The prescriptions were dated 7/9/88, 8/23/88, 9/27/88 11/18/88, and 2/12/90. As of October 22, 1990, the Respondent did not have any medical records in his possession regarding V. L. R. The Respondent has never had any medical records regarding V. L. R. The prescriptions the Respondent gave to V. R. L. included a prescription for 100 tablets of Eskalith CR, 450 milligrams each. Eskalith is a brand name for Lithium. The prescriptions the Respondent gave to V. L. R. also included a prescription for 500 tablets of Lithobid, 300 milligrams each, which is another brand name for Lithium. Before prescribing Lithium, a physician should establish the existence of a mood disorder as a diagnostic basis for the prescription. The diagnosis should be reflected in medical records. When prescribing Lithium, a physician should also monitor the concentration of the drug in the system of the person to whom the drug is prescribed, because the therapeutic level of Lithium is very close to the toxic level of Lithium. If the concentration is too low, the drug is not effective. If the concentration is too high, there can be toxic effects including vomiting, diarrhea, unsteady gait, and the possibility of falling. The prescriptions the Respondent gave to V. R. L. included a prescription for 30 tablets of Ativan, 100 milligrams each. Ativan is a controlled substance which is habit forming. It is a tranquilizer. A physician should not prescribe Ativan without a diagnosis of a sleeping problem or anxiety. The diagnosis should be documented in the medical records of the person to whom the prescription is given. The name of the drug, the dosage, and the times the drug should be taken should all be included in the medical records. The prescriptions the Respondent gave to V. R. L. included a prescription for 100 tablets of Tegretol, 100 milligrams each. Tegretol is an anti-seizure medication that is also used as a mood stabilizer in people who have a major mood disorder. When prescribing Tegretol, a physician should also monitor the concentration of the drug in the system of the person to whom the drug is prescribed, because the drug has the potential for adverse side effects, including inhibition of blood cell production and the production of platelets leading to the risk of infection or bleeding. A physician should not prescribe Tegretol unless a diagnosis of a mood disorder has been made. The diagnosis should be reflected in medical records. A physician should not prescribe Tegretol and Lithobid to the same person unless there have been some difficulties in the treatment of the person and a need for simultaneous prescription of both drugs has been established by the physician. The name of the drug, the dosage, and the times the drug should be taken should all be included in the medical records. The prescriptions the Respondent gave to V. R. L. included a prescription for 100 tablets of Anafranil, 25 milligrams each. Anafranil is a drug prescribed to treat obsessive/compulsive disorder with or without depression. A physician should not prescribe Anafranil without a diagnosis of an obsessive/compulsive disorder. The diagnosis should be documented in the medical records of the person to whom the prescription is given. Any symptoms of depression should also be noted in the medical records. The name of the drug, the dosage, and the times the drug should be taken should all be included in the medical records. When prescribing Anafranil, the physician should monitor the effect of the drug by observation of the person to whom the prescription is given. Such observations should be noted in the medical records. The prescriptions the Respondent gave to V. R. L. included a prescription for 10 tablets of Endep, 25 milligrams each. Endep is a commercial name for amitriptyline, which is an antidepressant. It is used to treat depression. A physician should not prescribe Endep unless a diagnosis of depression has been made. The diagnosis should be included in the medical records. The name of the drug, the dosage, and the times the drug should be taken should all be included in the medical records. The prescriptions the Respondent gave to V. R. L. included a prescription for 15 tablets of Halcion, 25 milligrams each. Halcion is a controlled substance that is used to treat sleeping disorders. A physician should not prescribe Halcion unless a diagnosis of a sleeping disorder has been made and the need for the drug is established. When prescribing Halcion, the physician should monitor the effect of the drug by means of observations of and discussions with the person to whom the prescription was given. The diagnosis of sleeping disorder and the observations and discussions should all be noted in the medical records. The name of the drug, the dosage, and the times the drug should be taken should also all be included in the medical records. The Respondent prescribed quantities of medication that represented a potential danger to V. L. R. The Respondent prescribed excessive or inappropriate quantities of drugs to V. L. R. The Respondent, by providing the prescriptions described above to V. L. R., prescribed legend drugs, including controlled substances, outside the scope of his professional practice.
Recommendation On the basis of all of the foregoing, it is RECOMMENDED that the Board of Medicine issue a Final Order in this case to the following effect: Dismissing the charges alleged in Counts One and Two of the Amended Administrative Complaint; Finding the Respondent guilty of a violation of Section 458.331(1)(q), Florida Statutes, as alleged in Count Three of the Amended Administrative Complaint; and Imposing an administrative penalty comprised of (i) an administrative fine in the amount of one thousand dollars ($1,000.00), (ii) a requirement that the Respondent attend one or more continuing education courses on the subject of legal and ethical issues associated with the prescription of controlled substances, and (iii) a public reprimand of the Respondent for the violation described above. DONE AND ENTERED this 28th day of June, 1994, at Tallahassee, Leon County, Florida. MICHAEL M. PARRISH, Hearing Officer Division of Administrative Hearings The DeSoto Building 1230 Apalachee Parkway Tallahassee, Florida 32399-1550 904/488-9675 Filed with the Clerk of the Division of Adminsitrative Hearings this 28thday of June, 1994. APPENDIX The following are the specific rulings on all proposed findings of fact submitted by all parties. Findings submitted by Petitioner: Paragraphs 1 and 2: Accepted. Paragraph 3: Rejected as subordinate and unnecessary details. Paragraph 4: Accepted in substance. Paragraph 5: Rejected as not supported by clear and convincing evidence. (It is clear that the Respondent did not make any records of any such examinations or tests, but it is not clearly established that he did not perform the examinations or tests.) Paragraph 6: Rejected as subordinate and unnecessary details. Paragraph 7: Accepted in part and rejected in part. It is clear that the Respondent failed to keep medical records regarding V. L. R.; it is not clear that he "treated" her or that she was a patient. Paragraphs 8 through 36: Accepted. Paragraphs 37 and 38: Rejected for several reasons, including the following: These two paragraphs are to some extent arguments, rather than proposed findings of fact. The opinions described in these two paragraphs are both based on an assumption that was not proved; the assumption that V. L. R. was a patient who was being treated. There is no clear and convincing evidence that V. L. R. was the Respondent's patient. Paragraph 39: Rejected as an invalid and incorrect opinion. The issuance of a prescription does not always constitute treatment of the person for whom the prescription is written. (A classic example of when prescription writing does not constitute treatment is when a prescription is written for a drug to be used for recreational purposes, rather than for a legitimate medical purpose.) Paragraph 40: Rejected as not supported by clear and convincing evidence. (It is clear that the Respondent did not make any records of any history, psychiatric evaluation, or diagnosis of V. L. R., but it is not clearly established that he did not do those things.) Paragraph 41: Accepted. Paragraph 42: Rejected for several reasons. First, the facts proposed in this paragraph were not established by clear and convincing evidence. (McKenzie's testimony about who wrote the notes was hearsay that would not meet one of the recognized hearsay exceptions; Norwich's testimony about who wrote the notes was limited to an unquantifiable "probably.") Paragraph 43: Rejected for several reasons. First the evidence is insufficient to establish what kind of relationship the Respondent had with V. L. R. Second, there is no clear and convincing evidence of a sexual relationship between the Respondent and V. L. R. Third, there is no clear and convincing evidence that V. L. was a patient of the Respondent. Fourth, any findings about a sexual relationship would be irrelevant because there is no allegation in the Amended Administrative Complaint regarding any sexual relationship. Paragraph 44: Rejected because this opinion is based on at least one fact that was not proved at the formal hearing. Paragraph 45: Accepted. Paragraph 46: First three lines and first word of fourth line are accepted. The reference to the sexual relationship is rejected as not charged and as not proved by clear and convincing evidence. Paragraph 47: Rejected because this opinion is based on at least one fact that was not proved at the formal hearing. Findings submitted by Respondent: Paragraph 1: Accepted. Paragraphs 2 and 3: Rejected as subordinate and unnecessary procedural details. Paragraphs 4 and 5: Rejected as not supported by persuasive competent substantial evidence. Paragraph 6: Accepted in substance. Paragraph 7: Rejected as subordinate and unnecessary details. Paragraphs 8 through 10: Accepted in substance, with some subordinate and unnecessary details omitted. Paragraph 11: Rejected as incorrect dates; the correct dates are 1988 to 1990. Paragraph 12: Accepted in substance. Paragraph 13: Rejected as irrelevant. COPIES FURNISHED: Francesca Plendl, Esquire Senior Attorney Department of Business and Professional Regulation 1940 North Monroe Street, Suite 60 Tallahassee, Florida 32399-0792 Harold M. Braxton, Esquire, and Tania Therese Wong, Esquire Suite 400, One Datran Center 9100 South Dadeland Boulevard Miami, Florida 33156 Jack McRay, General Counsel General Counsel Department of Business and Professional Regulation Northwood Centre 1940 North Monroe Street Tallahassee, Florida 32399-0792 Dr. Marm Harris Executive Director Board of Medicine Department of Business and Professional Regulation Northwood Centre 1940 North Monroe Street Tallahassee, Florida 32399-0792
The Issue The issue is whether the pharmacy permit issued to the Respondent, North Florida Drug Corporation, d/b/a Scottie Discount Drugs, should be revoked or otherwise penalized based on the acts alleged in the Administrative Complaint.
Findings Of Fact North Florida Drug Corporation, d/b/a Scottie Discount Drugs, currently holds permit No. PH 0004096 as a Community Pharmacy. Respondent is located at 1448 Bakers Square, Macclenny, Florida. On December 24, 1987, Gustave Goldstein, who had been the designated prescription department manager for Respondent, resigned as a pharmacist at the Respondent's location. He notified Frankie Rosier, the owner and operator of the Respondent, that he was leaving and he notified the DPR that he would no longer be the designated prescription department manager. Carl Messina is the relief pharmacist for the Respondent. From the time of Goldstein's resignation, Messina has told Ms. Rosier many times that it is illegal to operate without a prescription department manager. DPR inspected the Respondent's pharmacy in December, 1987, and determined that there was no prescription department manager after Goldstein quit. DPR conducted an inspection of the Respondent's premises on February 16, 1988, and discovered that there still was no prescription department manager employed there. Frankie Rosier was made aware of this deficiency. On February 16, 1988, the official records of DPR showed that no new designation of a prescription department manager had been filed by Respondent and Goldstein was still listed as the prescription department manager by Respondent. On May 22, 1988, DPR again inspected the premises and determined that there was still no prescription department manager. It is important that each permittee have a designated prescription department manager to assure that all required records are kept and that the pharmacy complies with all legal requirements. This is especially important regarding control and accountability for controlled substances. Without a prescription department manager, a non-pharmacist owner, like Ms. Rosier, would and does have access to these controlled substances without any accountability. By Final Order entered and filed with the agency clerk on December 17, 1987, this same permittee was fined and placed on probation for operating a community pharmacy with an expired permit and for obtaining a permit by misrepresentation or fraud or through an error of the department or the board.
Recommendation Based upon the foregoing Findings of Fact and Conclusions of Law, it is RECOMMENDED that the Department of Professional Regulation, Board of Pharmacy, enter a Final Order finding North Florida Drug Corporation, d/b/a Soottie Discount Drugs, guilty of the violations alleged and revoking the community pharmacy permit No. PH 0004096. DONE and ENTERED this 14th day of October, 1988, in Tallahassee, Florida. DIANE K. KIESLING Hearing Officer Division of Administrative Hearings The Oakland Building 2009 Apalachee Parkway Tallahassee, Florida 32399-1550 (904) 488-9675 Filed with the Clerk of the Division of Administrative Hearings this 14th day of October, 1988. COPIES FURNISHED: Michael A. Mone' Staff Attorney Department of Professional Regulation 130 North Monroe Street Tallahassee, Florida 32399-0750 North Florida Drug Corporation Scottie Discount Drugs 1448 Bakers Square Macclenny, Florida 32063 Bruce Lamb General Counsel Department of Professional Regulation 130 North Monroe Street Tallahassee, Florida 32399-0750 Rod Presnell, Executive Director Board of Pharmacy Department of Professional Regulation 130 North Monroe Street Tallahassee, Florida 32399-0750
The Issue Whether Respondent's permit to operate a pharmacy should be suspended or revoked for alleged violations of Sections 465.22(1)(c), 465.18(1)(b), 465.18(2)(b) F.S., and Rule 21S-1.14 F.A.C. At the hearing, Petitioner withdrew Count-I of the Complaint. Respondent's Motion To Dismiss Counts II and III of the Complaint at the conclusion of Petitioner's case in chief was denied.
Findings Of Fact Respondent presently holds and did so hold at the time of the events alleged in the Complaint a permit to operate a pharmacy issued by Petitioner (Stipulation.) Prior to the events alleged in the Complaint, Petitioner's agent, Vernon K. Bell, an inspector, obtained an authentic prescription from another pharmacy that had not been picked up by a customer, for use in investigations of other pharmacies. The prescription was issued by Dr. George A. Fernandez, Miami, Florida, Number 012194, dated December 11, 1975, to Fela Rivias and was for twenty-one tablets of Erythrocin, 250 miligrams. Erythrocin is an antibiotic prescription drug used for various infections (Testimony of Bell, Petitioner's Exhibit 1.) On December 19, 1975, Bell visited Respondent's pharmacy and observed that the door to the prescription area was unlocked. On December 22, 1975, at approximately 3:30 P.M., Reynaldo Santiago, another agent of the Board of Pharmacy, entered Respondent's pharmacy with the prescription referred to in paragraph 2 above that had been given to him by Bell. Santiago gave it to the cashier to be filled. He observed her go to the prescription department, open a door, and place the prescription on a counter. He then observed Hildelisa Hernandez go to the prescription department and start filling the prescription. Thereafter, Ms. Hernandez, accompanied by Mr. Jose E. Valdez, came out of the prescription area and Hernandez gave a pill bottle to the cashier. The cashier in turn gave it to Santiago for the price of $3.95 or $4.00. The bottle contained 21 tablets and a label affixed thereon contained pertinent information as set forth in the prescription that Santiago had given to that cashier, including the name of the drug, doctor, prescription number and name of patient (Testimony of Santiago, Petitioner's Exhibit 2.) Santiago took the bottle of pills outside and then he and Bell re- entered the Pharmacy. Bell identified himself to Mr. Valdez and asked him who was his registered pharmacist and if he had a pharmacist on duty. Mr. Valdez stated that Hal Glass was his pharmacist, but that he had left the store at 2:00 P.M. Bell then asked Valdez if he had filled the prescription which Santiago had taken into the store and, after some hesitation, Bell asked Hernandez if she had filled it. She replied in the affirmative. She stated that she was not a licensed pharmacist in Florida, but had been a pharmacist in Cuba. Bell then wrote a violation and left the store. Neither he nor Santiago recalled seeing a sign indicating that the prescription department was closed on December 22 (Testimony of Bell, Santiago.) Jose E. Valdez testified that although he formerly had two pharmacists at his previous pharmacy, in August or September of 1975 he was forced to cut back to one part-time pharmacist because of the bad economic situation. He conceded that Ms. Hernandez was not a registered Florida pharmacist. He also stated that he was not aware of the rules requiring that the prescription department be locked when no pharmacist was present until this incident occurred and that, in fact, the door to the prescription area had not been locked although a sign indicating that the prescription department was closed had always been used. He further testified that on February 1, 1976, he hired a full-time pharmacist who is present at all times when the pharmacy is open and that the prescription department is now always locked when she is not present.
Recommendation That a civil penalty in the sum of $250.00 be imposed against Respondent in lieu of suspension or revocation of its permit, for violation of Section 465.18(1)(b), Florida Statutes, and Rule 21S-1.14, Florida Administrative Code DONE and ENTERED this 26th day of April, 1976, in Tallahassee, Florida. THOMAS C. OLDHAM Hearing Officer Division of Administrative Hearings Room 530, Carlton Building Tallahassee, Florida 32304 COPIES FURNISHED: Stanley Kaplan, Esquire 404 Biscayne Building Miami, Florida Seymour M. Litman, Esquire 10 Northwest 14 Avenue Miami, Florida 33125
Findings Of Fact Petitioner filed with the Board of Medical Examiners an application for licensure by examination in 1983. Included with that application were original "affidavits" submitted on Petitioner's behalf by Dr. Borroto and Dr. Velez. Petitioner filed an application for licensure by endorsement in October of 1984. In conjunction with his application for licensure by endorsement, Petitioner submitted photocopies of the "affidavits" submitted with his 1983 application for licensure by examination. These photocopies of Dr. Borroto's and Dr. Velez's "affidavits" were submitted by Petitioner with notarized attestations that the notary had in fact seen the originals. Petitioner knew that this was not true. On December 28, 1984, Dorothy Faircloth, Executive Director of the Board of Medical Examiners (hereinafter "the Board"), sent Petitioner a letter indicating, among other things, that Petitioner had submitted photocopies rather than original letters establishing his five years of licensed medical practice. Furthermore, he was notified that his application would not be complete until the originals were received. The same letter notified Petitioner that all documents to be notarized must be certified as true and correct copies of the original and stated so by the notary. Petitioner was specifically warned that the notary must see the original and copy in order to make the required statement. In January of 1985, Petitioner submitted new affidavits concerning five years of licensed medical practice. On August 2, 1985, Petitioner attended a meeting of the Board's Foreign Medical Graduate Committee (hereinafter "FMGC") in order to address problems with his application for licensure by endorsement. At that meeting, Petitioner failed to satisfactorily address the issues concerning affidavits attesting to his five years of licensed medical practice. The committee voted to recommend denial of Petitioner's application based upon the lack of personal knowledge of the affiants, improper notarization of the purported affidavits and fraudulent notarization of the 1983 affidavits of Dr. Borroto and Dr. Velez. The Board considered Petitioner's application for licensure by endorsement on August 3, 1985, and voted to deny licensure based on the recommendations of the FMGC. An Order to that effect was filed on August 26, 1985. On October 4, 1985, the FMGC reconsidered Petitioner's application, including new affidavits from Dr. Oscar R. Bravo-Campa, Dr. Juan A. Enriquez- Elesgaray and two other licensed physicians. However, the FMGC determined that the new affidavits did not overcome the problems raised during Petitioner's original attempt to obtain licensure by endorsement and voted to reaffirm their previous recommendation. On October 5, 1985, the Board reconsidered Petitioner's application for licensure by endorsement and voted to reaffirm its previous denial. An Order to that effect was filed on March 27, 1986. Dr. Pedro G. Velez's certification dated January 10, 1983, stated that he had personal knowledge of Petitioner's medical practice in Cuba from January 1971 to June 1980. At the final hearing in this cause, Dr. Velez testified that he has known Petitioner personally only since the 1980s and that he did not know him professionally in Cuba at all. Dr. Velez also testified that he left Cuba in 1966 and that he might have met Petitioner when Petitioner was a student in 1964. Dr. Velez further testified that he signed a second letter in behalf of Petitioner. He testified that Petitioner had probably prepared it for his signature and that no one was present when he signed it. Specifically, the notary who attested to his signature was not present. Dr. Pedro G. Velez clearly had no personal knowledge that Petitioner was licensed to practice or did practice medicine in Cuba from January 1971 through June 1980. The certification completed by Dr. Esperanza Arce-Nunez, regarding Petitioner's five years of licensed medical practice and submitted by Petitioner to the Board in 1985, was not notarized as an affidavit. Dr. Arce-Nunez testified that she could not remember anything about seeing Petitioner in a practice setting in 1971, one of the years covered by her certification. In fact, her only personal knowledge of Petitioner's practice of medicine in Cuba occurred in 1977. Dr. Oscar R. Bravo-Campa testified that he coincided with Petitioner during annual medical rotations in Havana every year. He also testified that he could not remember when or where he saw Petitioner in a practice setting during the nine years covered by his affidavit, which specifically stated that he had contact with Petitioner in a practice setting three times a year in addition to rotations every year between 1971 and 1980. In fact, his only personal knowledge of Petitioner's practice of medicine in Cuba occurred in 1977. Dr. Ignacio Coro initially testified that he knew Petitioner for six years. In fact, Petitioner has resided in this country for approximately six years, since June of 1980. Dr. Coro subsequently claimed to know Petitioner longer than six years, about thirteen years. Although Dr. Coro's certification claimed he saw Petitioner in a practice setting twice a year from 1971 to 1980, he testified that he saw Petitioner only once in 1980. Dr. Coro could not remember seeing Petitioner in a practice setting during 1973. Dr. Coro further testified that the clarification statement, dated September 20, 1985 and attached to his September 9, 1985 affidavit, was included because Petitioner specifically requested it, and he did not know where the document was typed. The certification prepared by Dr. Juan A. Enriquez-Elesagaray and submitted by Petitioner did not contain a notarization. Petitioner testified that the letters dated September 20, 1985 and signed by Dr. Esperanza Arce-Nunez, Dr. Oscar R. Hravo-Campa, Dr. Ignacio Core, and Dr. Juan A. Enriquez- Elesgaray were each composed by the individual doctors. However, the letters are almost identical as to their wording, punctuation mistakes and misspellings. Petitioner testified both that he received his medical degree in 1971 and in 1977. Petitioner further testified that he allowed his application to be notarized by someone who did not witness his signature. Dorothy Faircloth, Executive Director of the Board, testified that the Board initially had concerns about Petitioner's application, specifically because he submitted affidavits with attestations stating that the notary had seen the originals. The Board doubted the veracity of such a statement because the originals were in the Board's possession. Ms. Faircloth also testified that the change in the Board's certification forms that took place subsequent to 1983 was an attempt to clarify and emphasize the Board's previous requirement that affiants have actual knowledge, by determining the basis and frequency of such knowledge. Petitioner took his blank application (except for Petitioner's signature) to Dr. Luis Manuel Rodriguez Molina who prepares licensure application documents for Cuba doctors seeking licensure in Florida. Molina translated and/or filled in all documents, obtained signatures, and then later had his son notarize those documents even though none was actually signed in the presence of his son, the notary public. When he submitted it to the Board, Petitioner knew that he had not signed his application in front of a notary public, and, therefore, Petitioner's affidavit portion of his application was knowingly false. The purported "personal knowledge" of each affiant and witness testifying as to Petitioner's five years of actual practice is that each between the years of 1971 and 1980 saw Petitioner at the equivalent of medical association meetings. These meetings were, however, also attended by students. Only Dr. Elesgaray could testify that he saw Petitioner in a practice setting twice each year.
Recommendation Based upon the foregoing Findings of Fact and Conclusions of Law, it is, RECOMMENDED that a Final Order be entered denying Petitioner's application for licensure by endorsement. DONE and RECOMMENDED this 13th day of January, 1987, at Tallahassee, Florida. LINDA M. RIGOT, Hearing Officer Division of Administrative Hearings The Oakland Building 2009 Apalachee Parkway Tallahassee, Florida 32301 (904) 488-9675 Filed with the Clerk of the Division of Administrative Hearings this 13th day of January, 1987. COPIES FURNISHED: Dorothy Faircloth, Executive Director Board of Medical Examiners 130 North Monroe Street Tallahassee, Florida 32301 Ramon S. Santos, Jr., Esquire 1000 Ponce de Leon Boulevard, Suite 303 Coral Gables, Florida 33134 M. Catherine Lannon, Esquire Allen R. Grossman, Esquire Department of Legal Affairs The Capitol, Suite 1601 Tallahassee, Florida 32301 Fred Roche, Secretary Department of Professional Regulation 130 North Monroe Street Tallahassee, Florida 32301 Wings S. Benton, General Counsel Department of Professional Regulation 130 North Monroe Street Tallahassee, Florida 32301
Findings Of Fact At all times relevant hereto, respondent, Paul D. French, was a licensed medical doctor having been issued license number ME 0010248 by petitioner, Department Professional Regulation, Board of Medicine (DPR or Board). He has practiced medicine since at least 1968 but the date of issuance of his license is not of record. He was board certified in family practice from 1978 until 1986 when his certification expired. Respondent presently resides at 7114 Southgate Boulevard, Suite 9, North Lauderdale, Florida. On August 21, 1985, the Medical Licensure Commission (Commission) for the State of Alabama filed a complaint against respondent alleging that he had violated certain statutory provisions governing the conduct of medical doctors in that state. Two days later, the Commission temporarily suspended respondent's license to practice medicine. After a hearing was conducted on September 25, 1985 the Commission entered an order on October 11, 1985 revoking his medical license. As grounds, the Commission found that urine and blood tests performed on respondent revealed the presence of alcohol and meperidine, a Schedule II controlled substance with highly addictive properties, and that this violated a prior restriction on his license. Certified copies of these documents were introduced into evidence as petitioner's exhibit 1. Armed with the above information, the Board filed an administrative complaint against respondent on February 10, 1986 charging that Dr. French had violated Subsections 458.331(1)(b) and (s), Florida Statutes (1985), by having had his medical license revoked by another state and with being unable to practice medicine with reasonable skill and safety due to his use of alcohol and drugs or because of a mental or physical condition. The issuance of the complaint prompted Dr. French to initiate this proceeding. On April 21, 1987, the Board filed an order of emergency suspension wherein it suspended Dr. French's license "until such time as (respondent) can demonstrate satisfactorily that he is able to practice medicine with reasonable skill and safety to his patients." That order still remains in effect. Testifying by deposition on behalf of the Board was Dr. Roger A. Goetz, who is director of the Florida Medical Foundation's practitioner recovery network and an expert in the evaluation and treatment of impaired physicians. Doctor Goetz's deposition was taken in September 1987. According to Dr. Goetz, respondent was then unable to safely practice medicine "unless he was very carefully and almost continually supervised." Doctor Goetz opined further that, as a prerequisite to respondent returning to the practice of medicine, he be required first to have "a period of stabilization in his life followed by a reevaluation months from now." At that time, Dr. Goetz found a decrease in respondent's I.Q. and "some cognitive disability." The amount of decrease in I.Q. and the nature and extent of the cognitive disabilities are not of record. In any event, the expert was unsure if this was caused by alcohol abuse or by a cerebral aneurysm suffered by respondent in the mid or late 1960's. However, Dr. Goetz did not rule out an increase in mental capacity in the future and respondent's eventual return to medical practice. The witness suggested that, after a year, Dr. French be given a short period of retraining, a mini-residency or some other form of evaluation to determine if he could function as a physician. No evidence was offered to refute this recommendation. Respondent denies using any alcohol or drugs at the present time, and this was corroborated by Dr. Goetz who said the evaluations conducted in 1987 "did not indicate any usage." Doctor French desires to reenter the medical profession and agrees to several restrictions, such as becoming recertified in family practice, submitting to random testing for drugs and alcohol, and if necessary, being supervised by another physician. He has not practiced medicine in the state since August 1985 when he closed his West Palm Beach office. As to the cognitive disability, respondent denied that he lacks the necessary physical skills to practice medicine pointing out that he practiced medicine for many years after suffering an aneurysm over twenty years ago.
Recommendation Based on the foregoing findings of fact and conclusions of law, it is RECOMMENDED that respondent be found guilty of violating Subsections 458.331(1)(b) and (s), Florida Statutes (1985), and that his license remain suspended until he successfully completes a Board prescribed short period of retraining or a mini-residency, and he demonstrates through a Board prescribed reevaluation that the mental and/or physical impairments that existed in mid- 1987 have been resolved. Also, respondent should be required to submit to random blood/urine testing for such period of time as the Board deems appropriate. DONE AND ENTERED in Tallahassee, Leon County, Florida, this 10th day of November, 1988. DONALD R. ALEXANDER Hearing Officer Division of Administrative Hearings The Oakland Building 2009 Apalachee Parkway Tallahassee, Florida 32399-1550 (904) 488-9675 Filed with the Clerk of the Division of Administrative Hearings this 10th day of November, 1988.
Findings Of Fact Dr. Lawrence A. Hall is licensed by the Florida State Board of Dentistry and the Hearing Officer has jurisdiction over the Respondent and the offenses alleged. During the time periods alleged Respondent smoked marijuana in the office after office hours in company with employees including a 16-year-old employee. During the time periods alleged Respondent wrote numerous prescriptions in the names of employees for controlled substances or drugs to be used for his personal use or for the use of his wife or friends. These drugs consisted of Eskatrol, Dexadrine, Dexamyl, Percodan, and Quaalude and were taken by Hall during office hours while he was performing work on dental patients. Some of these drugs made Respondent nervous and irritable and adversely affected his practice of dentistry. During the period between March, 1974 and July, 1975 Hall habitually used controlled substances add drugs. On many occasions he would be late getting to the office for morning appointments and late returning from lunch for afternoon appointments. Occasionally he would fail to come to the office at all and scheduled appointments would have to be cancelled - usually after the patient had appeared for the appointment. Hall wrote prescriptions for his wife and for his employees for controlled substances and drugs for uses not related to the practice of dentistry. These drugs consisted of amphetamines, Quaalude, and Percodan, and were often picked up from the pharmacy by one of his office employees not named in the prescription. Hall knew that his federal narcotics license did not authorize him to write prescriptions for drugs not intended for use in the practice of dentistry. Amphetamines are listed as Class II controlled substances in Chapter 893 F.S. On one occasion, while treating a small child, Hall became exasperated, threw a syringe across the room, then ran out of the office to jog around the adjacent shopping center for about 15 minutes to regain his composure. On another occasion a patient reacted adversely to an anesthetic and was thereafter properly treated by Hall to restore her breathing to normal. The dental procedure for which the anesthetic was given was then performed satisfactorily. The patient involved remained a patient of Hall until she moved to a location too far away to continue to use Hall as her dentist. She was satisfied with the dental treatment received from Hall. Hall sought help in his personal and drug related problems from his minister. No evidence was presented that Hall performed unsatisfactory dental work. To the contrary, all evidence presented in this regard was to the effect that Hall's dental work was above average. At the time of the hearing and for some months prior thereto Hall was not taking drugs.
The Issue The issues are those promoted by an administrative complaint brought by the State of Florida, Department of Professional Regulation, against the Respondent, Charles McArthur. In particular, it is alleged that the Respondent practiced pharmacy in the state of Florida with an expired license, in violation of Subsection 465.015(2)(b), Florida Statutes (1981).
Findings Of Fact Respondent, Charles McArthur, is a pharmacist licensed by the State of Florida. His license number is 0012091. On June 20, 1983, Respondent attempted to renew his pharmacy license issued by the state of Florida on a bi-annual basis. He attempted this renewal by appearing in person before officials with the State of Florida, Board of Pharmacy, entitled to grant renewal. That renewal was denied based upon the fact that the Respondent was unable to provide verification of the requisite continuing education credits necessary for relicensure. As a consequence, on June 21, 1983 Respondent's active pharmacy license expired, leaving the Respondent with an inactive pharmacy license. For the period June 21, 1983 through July 20, 1983 Respondent practiced pharmacy with an inactive license. During that time frame, Thomas Hannah, an investigator with the State of Florida, Department of Professional Regulation, visited the Respondent in the pharmacy in which Respondent was practicing in Tallahassee, Florida. He observed the Respondent practice pharmacy and noted the presence of the expired active Florida pharmacy license. On that occasion, Hannah told the Respondent that he was operating without a current license. On the following day, July 20, 1953, Respondent paid the appropriate fees and made proof of the requisite continuing education credits and his active pharmacy license was re-issued. Subsequent to that date Respondent has held an active pharmacy license issued by the State of Florida. In view of the Respondent's practice of pharmacy with an inactive license from the period of June 21, 1983 through July 20, 1983, Respondent was charged with the present offense and requested, and was granted, a formal Subsection 120.57(1), Florida Statutes, hearing. In dealing with other recalcitrant licensees who have not renewed their licenses in the time allotted, the Board of Pharmacy, prior to February, 1980 sent a list to Board inspectors within one or two weeks following the due date of renewal and those inspectors contacted the licensees to ascertain whether the licensees had renewed their pharmacy licenses. If they found that the individual pharmacist did not renew his license that person was given an opportunity to fill out an application, to pay the fee, and to present his continuing education credits to the investigator. Persons who were not entitled to renew due to problems with the continuing education credits were told that they were delinquent, and practicing with a delinquent license was a violation of law. Those persons were given the opportunity to take leave of absence from their active pharmacy practice. Around February, 1980 due to the re- organization of the State of Florida, Department of Professional Regulation, insufficient work force was available to carry out this process of checking on the topic of the delinquent license renewals, and this sequence of inactivity continued until approximately December, 1981. During this period actions were not brought against pharmacists for failure to timely renew a license to practice pharmacy, within the meaning of Section 465.015(2)(b), Florida Statutes, provided they renewed licenses within one year of the appropriate renewal date. In December, 1981 the practice changed and the pharmacists would be prosecuted for failure to timely renew a license to practice pharmacy and continuing to practice with an expired license. This change in policy position which occurred in December, 1981 was not shown in the course of the hearing to be a matter noticed for the benefit of the practicing pharmacists in the State of Florida.
