The Issue The issue in this case is whether Petitioner, Latrice J. Walker’s application for certification as a certified nursing assistant should be granted.
Findings Of Fact Petitioner is a 31-year old woman. She is currently employed as a key-holder at Church’s Chicken, where she is a de facto assistant manager. Her duties include handling customers’ credit cards and cash, as well as making drop deposits at a local bank. On or about March 4, 2013, Petitioner completed and submitted a Florida Certified Nursing Assistant Application. The application was received by the Board on March 12, 2013. On page 4 of the application, there is a section entitled “Criminal History.” That section asks of the applicant: “Have you ever been convicted of, or entered a plea of guilty, nolo contender, 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), driving while impaired (DWI) and driving while license suspended (DWLS) are not minor traffic offenses for the purposes of this question.” Petitioner answered, “No”, to the criminal history question. In fact, she had three relevant arrests on her record, to wit: 1) In January 2003, Petitioner was arrested and charged with a violation of section 832.05(2), Florida Statutes (2002), relating to the issuance of a bad check; 2) in April of the same year, Petitioner was arrested and charged with violation of section 812.014(3)(a), Florida Statutes (2002), relating to petit larceny, and section 831.09, Florida Statutes (2002), relating to passing a forged instrument; and 3) on August 8, 2004, Petitioner was arrested and charged with leaving the scene of an accident in violation of section 316.061(1), Florida Statutes (2004), and possession of less than 20 grams of marijuana, a violation of section 893.13(6) (2004). Petitioner entered a plea on the 2002 charges and adjudication was withheld. She was found guilty of the 2004 charges. Petitioner provided two reasons for answering, “No”, to the criminal history question: First, she believed that because adjudication had been withheld she did not need to disclose the arrests. Second, she was holding her six month-old child while preparing the application and may have hit the wrong box on the application form. The testimony concerning her child affecting her typing of the application was not persuasive. Whatever the reason for her response on the application, it is clear Petitioner did not try to hide her criminal past. As early as October 2013, she had requested from the Levy County Clerk of Court information about her convictions so that she could provide that information to the Board. On February 24, 2014, almost one year after submitting her application, the Board sent Petitioner a letter indicating her application was not complete. The letter advised Petitioner that incomplete applications would expire after one year from the “received date.” The letter then identified information that was missing from Petitioner’s application, including the following items: Proof of completion of probation or parole; Proof of completion of fines, restitution, or court-ordered sanctions for each offense; Certificates, counselor letters, and proof of treatment or rehabilitation; Proof of completion of community service; and Proof of completion of pre-trial intervention. It is clear from the Board’s letter to Petitioner that the Board was aware of her criminal convictions as the omissions letter had asked for explanations as to completion of sanctions for each offense. Petitioner went to the Levy County Courthouse and obtained the requested information. She provided the information to the Board as requested. On March 4, 2014, the Board notified Petitioner that additional explanations about each of the offenses were required. Again, Petitioner provided the requested information. On or about June 30, 2015, the Board notified Petitioner that her application for certification was being denied. No one from the Board testified concerning the basis for the denial, but the Notice of Intent to Deny set out the following bases for the denial: That Petitioner was convicted of or entered pleas to a charge of no driver’s license in 2000, worthless checks, petit theft and uttering a forged instrument in 2003, and leaving the scene, resisting arrest, possession of marijuana and petit theft in 2004. The application includes the following question: Have you ever been convicted of, or entered a plea of guilty, nolo contender, 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, driving while impaired (DWI) and driving while license suspended (DWLS) are not minor traffic offenses for the purposes of this question. The applicant answered the question, “NO”. The applicant is in violation of Sections 464.204(1)(a), 464.018(1)(a)(c) and (o), and 456.072(1)(c) and (h), Florida Statutes, by being convicted or found guilty of, or entering a plea of nolo contendere to, regardless of adjudication, a crime in any jurisdiction which directly relates to the practice of nursing assistance or to the ability to practice nursing, and by attempting to obtain a nursing license by bribery, misrepresentation or deceit. No further explanation for denial of Petitioner’s application for certification was stated in the Notice of Intent to Deny or by way of testimony or other evidence at final hearing in this matter. However, one may surmise that the basis for the Board’s denial of the application was: 1) that Petitioner had been found guilty or pled nolo contendere to the enumerated crimes, and 2) that Petitioner attempted to mislead the Board in her application for certification. Petitioner provided evidence as to each of the issues raised in the Board’s Notice of Intent to Deny. Although her memory was clouded as to specifics about each of the incidents due to the passage of time, she admitted each offense and tried to explain the circumstances surrounding them. As to the charges of leaving the scene of the accident, resisting arrest without violence and possession of marijuana, Petitioner explained as follows: She was helping her sister move to a new home. Petitioner was driving the rental vehicle and hit a car in the parking lot of a business. She drove away from the scene. When the police came to her home, Petitioner went into her house. At some point marijuana was found, but Petitioner-–who says she has never done drugs–- claimed it to be her sister’s drugs. Petitioner was arrested. However, she satisfied all of the conditions of probation and made all payments for costs. As to the insufficient funds charge, Petitioner stated that at the time she wrote the check to pay rent for the mobile home she was living in, she had funds in the bank. However, by the time the check was submitted for payment, she had used the existing funds. She admitted the violation and made all payments of restitution and costs. The uttering offense came when she agreed to sign a money order that did not belong to her. She yielded to the influence of nefarious friends with whom she no longer associates. Again, she admitted her culpability and made all necessary restitution to the victim. Petitioner filed her application for certification as a nursing assistant to fulfill a long-time dream of working in health care. She has “changed her ways” and is very desirous of doing positive things in her life. Petitioner’s demeanor and candor at final hearing gave credence to her promise to do better in the future, if given the opportunity. Her testimony was persuasive. However, it is troublesome that Petitioner chose to blame her application errors on the fact that she was holding her child while typing the application. That “excuse” does not ring true and seems an unnecessary reason for not disclosing the crimes. Nonetheless, absent further elucidation by the Board as to exactly why Petitioner’s application was denied, there is no way for Petitioner to further support her challenge to the denial other than as she did at final hearing. The Board did not challenge her reasons; it merely stood by its denial letter without further support or justification.
Recommendation Based on the foregoing Findings of Fact and Conclusions of Law, it is RECOMMENDED that a final order be entered by Respondent, Department of Health, Board of Nursing, granting Petitioner, Latrice J. Walker’s, application for certification as a certified nursing assistant, with appropriate sanctions. DONE AND ENTERED this 16th day of March, 2016, in Tallahassee, Leon County, Florida. S R. BRUCE MCKIBBEN 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 16th day of March, 2016. COPIES FURNISHED: Latrice J. Walker 454 Southwest 10th Circle Chiefland, Florida 32626 Deborah B. Loucks, Esquire Lynette Norr, Esquire Office of the Attorney General The Capitol, Plaza Level 01 Tallahassee, Florida 32399-1050 (eServed) Joe Baker, Jr., Executive Director Board of Nursing Department of Health 4052 Bald Cypress Way, Bin C02 Tallahassee, Florida 32399-3252 (eServed) Ann-Lynn Denker, PhD, ARNP Chair Board of Nursing Department of Health 4052 Bald Cypress Way, Bin C02 Tallahassee, Florida 32399-3252 Nichole C. Geary, General Counsel Department of Health 4052 Bald Cypress Way, Bin A02 Tallahassee, Florida 32399-1701 (eServed)
The Issue Whether Respondent failed to timely file its application for the renewal of its abortion clinic license, as alleged in the Administrative Complaint. If so, may the Agency for Health Care Administration (Agency) fine Respondent for failing to timely file its renewal application. If the Agency is authorized to impose such a fine, should it exercise such authority. If so, what is the amount of the fine it should impose.
Findings Of Fact Based upon the evidence adduced at hearing and the record as a whole, the following findings of fact are made: At all times material to the instant case, Respondent operated an abortion clinic located in Dade County, Florida, at 3250 South Dixie Highway, Coconut Grove, Miami, Florida (Coconut Grove Clinic). License number 693 constituted authorization from the Agency to Respondent to operate the Coconut Grove Clinic for the one-year period specified in the license. License number 693 had an effective date of March 22, 1995, and an expiration date of March 21, 1996. On or about December 22, 1995, the Agency sent Respondent the following letter: In reviewing our records, we note that the facility's abortion clinic license expires on 03/21/96. We are enclosing a copy of Form 3130-1000, Licensure Application, which should be completed and returned to this office along with the appropriate licensure fee of $250.00, pursuant to Rule 59A-9.020 Florida Administrative Code, made payable to the Agency for Health Care Administration. Incorrect or incomplete information will not be accepted, and the application will be returned. The application must be received on or before 01-21-96, sixty (60) days prior to the expiration of the current license to comply with section 390.016(1), Florida Statutes. Your attention to this request will facilitate processing your renewal license. The letter was delivered to Respondent on December 28, 1995. The General Manager of the Coconut Grove Clinic, Carmen Penaloza, filled out the Licensure Application and gave it to Respondent's Chief Operating Officer, Dr. Vladimir Rosenthal, for his signature. After Dr. Rosenthal affixed his signature to the Licensure Application, he returned the document to Penaloza for mailing to the Agency. The Licensure Application was completed and signed prior to January 21, 1996. Some time after January 21, 1996, the Agency notified Respondent that it had no record of having received a completed and signed Licensure Application from Respondent.1 Accordingly, Penaloza filled out and Dr. Rosenthal signed another Licensure Application. This completed and signed Licensure Application was received by the Agency on April 25, 1996. On or about May 21, 1996, the Agency issued Respondent License number 0786, authorizing Respondent to operate the Coconut Grove Clinic for the one-year period beginning March 22, 1996, and ending March 21, 1997. On June 3, 1996, the Department issued an Administrative Complaint announcing its intention to fine Respondent $1,000.00 for filing its application to renew its license to operate the Coconut Grove Clinic "ninety-five (95) days late."
Recommendation Based on the foregoing Findings of Fact and Conclusions of Law, it is RECOMMENDED that the Agency issue a final order dismissing the Administrative Complaint against Respondent. DONE AND ENTERED this 10th day of October, 1997, in Tallahassee, Leon County, Florida. STUART M. LERNER 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) 921-6847 Filed with the Clerk of the Division of Administrative Hearings this 10th day of October, 1997.
The Issue The issue in this case is how the Board of Nursing (Board) should discipline the Respondent’s registered nurse license for: pleading guilty to two counts of larceny-grand theft of a controlled substance, which were third degree felonies under section 812.014(2)(c)13., Florida Statutes1/; pleading nolo contendere to possession or use of narcotic equipment, a first degree misdemeanor under section 893.147(1), Florida Statutes; pleading nolo contendere to larceny-petit theft, a second degree misdemeanor under section 812.014(3)(a), Florida Statutes; and failing to report the criminal violations to the Board within 30 days.
Findings Of Fact In April 2014, the Respondent became licensed to practice as a registered nurse in Florida. He holds license RN 9381249. He also has a certified nursing assistant license, which he has held since 2009. From November 2014 until January 2015, the Respondent was working as a registered nurse at Sarasota Memorial Hospital. While working there, he diverted controlled substances for his own use. Specifically, he was putting Percocet pills prescribed for, but not used by, patients in his pocket and taking them later himself for pain. The Respondent was found out, fired, arrested, and charged with criminal violations. In August 2015, the Respondent entered pleas of: guilty to two counts of larceny-grand theft of a controlled substance, third degree felonies in violation of section 812.014(2)(c)13.; nolo contendere to possession or use of narcotic equipment, a first degree misdemeanor in violation of section 893.147(1); and nolo contendere to larceny-petit theft, a second degree misdemeanor in violation of section 812.014(3)(a). The Respondent was sentenced to a 14 month-long drug court program (which included random drug sampling), probation, fees and costs, and was prohibited from practicing as a nurse while he was on probation. Adjudication was withheld. The Respondent did not report his pleas and convictions to the Board in writing. He testified that he thought the Board had sufficient notice because an unidentified representative of the Board was present at the plea hearing and asked the judge to have the Respondent repeat the pleas so they could be properly and clearly recorded for use in a license discipline proceeding, and because he telephoned the Board soon after the incident and was told to stop practicing nursing. The Respondent successfully completed the drug court program and probation, and fulfilled all other conditions of his pleas and sentences. The Respondent acknowledged that his diversion of controlled substances from his place of employment was wrong, a mistake, and showed poor judgement.
Recommendation Based upon the foregoing Findings of Fact and Conclusions of Law, it is RECOMMENDED that the Board of Nursing enter a final order: finding the Respondent guilty of violating sections 456.072(1)(x) and 464.018(1)(e); reprimanding him; fining him $500; requiring IPN evaluation and treatment, if necessary; and assessing the costs of investigation and prosecution. DONE AND ENTERED this 6th day of February, 2017, in Tallahassee, Leon County, Florida. S J. LAWRENCE JOHNSTON 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 6th day of February, 2017.
Findings Of Fact Upon consideration of the oral and documentary evidence adduced at the hearing, the following facts are found: By an administrative complaint dated December 15, 1978, respondent was charged with unprofessional conduct in violation of Florida Statutes, Section 464.21(1)(b). The respondent timely requested an administrative hearing which was granted. The envelope which contained the request for hearing was mailed from Buffalo, New York, but the return address was 717 Breakers Avenue #3, Ft. Lauderdale, Florida, with the notation "Note: Address Change." All future correspondence was sent to this address, including the notice of hearing dated May 16, 1979. The hearing was scheduled to commence at 9:30 a.m. At approximately 9:50 a.m., the hearing proceeded without the appearance of the respondent. On July 20 and 21, 1978, the respondent Miller was employed as a registered nurse on the 11:00 p.m. to 7:00 a.m. shift at Cypress Community Hospital in Pompano Beach, Florida. At 3:55 a.m. on July 21, 1978, respondent signed out for 75 milligrams of injectable Meperidine (Demerol), a Class II controlled substance, for patient Frank Mantovi, and then walked into the patient's room with the substance. Another registered nurse on duty, Oletta Jones, observed that the patient was sleeping at the time. Nurse Jones called her supervisor, Anita Johnston, and they awakened the patient and inquired whether he had requested or received any medication for pain. He replied in the negative. The patient appeared oriented and alert, and his vital signs were stable and not indicative of receiving 75 milligrams of Demerol. The administration of Demerol was not charted on the patient's medication record, as it should have been had it been administered. Nurses Jones and Johnston then confronted respondent Miller in the nurses' lounge. At first respondent told them that she had administered the Demerol intermuscularly, but then said she had given it by I.V. push. The doctor's order sheet for patient Mantovi contained a notation for 75 milligrams of Demerol administered intermuscularly as needed for pain every three hours. There is nothing to authorize an I.V. introduction of this medication. It is not acceptable or prevailing nursing practice for a nurse to alter the mode of administration prescribed by the physician. After talking with respondent, patient Mantovi's vital signs were again checked. There was no indication that he had received Demerol. Respondent was then asked to leave the hospital. The pupils of her eyes were observed by Nurse Johnston to be of pinpoint size.
Recommendation Based upon the findings of fact and conclusions of law recited above, it is RECOMMENDED that the Board of Nursing find respondent guilty of unprofessional conduct within the meaning of Florida Statutes, 464.21(1)(b), and suspend her registered nursing license for a period of three (3) months. Respectfully submitted and entered this 14th day of August, 1979, in Tallahassee, Florida. DIANE D. TREMOR, Hearing Officer Division of Administrative Hearings Room 101, Collins Building Tallahassee, Florida 32301 (904) 488-9675 COPIES FURNISHED: Jane M. Miller 717 Breakers Avenue #3 Ft. Lauderdale, Florida 33304 Julius Finegold Esquire 1107 Blackstone Building Jacksonville, Florida 32202 Geraldine Johnson, R.N. Coordinator of Investigation and Licensing 111 East Coastline Drive Suite 504 Jacksonville, Florida 32304 ================================================================= AGENCY FINAL ORDER ================================================================= BEFORE THE FLORIDA BOARD OF NURSING IN THE MATTER OF: Jane Marie Miller 717 Breakers Avenue No. 3 Ft. Lauderdale, Florida 33304 CASE NO. 79-212 As Registered Nurse License Number 66021-2 /
The Issue The issue in this case is whether the allegations set forth in the Administrative Complaint filed by Petitioner, Department of Health, Board of Nursing, against Respondent, Zauher Karim, C.N.A., are correct, and, if so, what penalty should be imposed.
Findings Of Fact Petitioner is the state agency charged with regulating the practice of nursing assistance, pursuant to chapters 20, 456, and 464, Florida Statutes. At all times material to the Administrative Complaint, Respondent was a certified nursing assistant (C.N.A.) in the State of Florida, having been issued Certificate No. CNA 191405. The certificate was issued on June 27, 2009. At all times material to the Administrative Complaint, Respondent did not hold any other medical licenses or certificates issued by the Florida Department of Health. On October 17, 2010, Respondent submitted a Health Care Clinic Establishment (HCCE) application to the Department of Health for Chantilly Health Research (Chantilly Health) located at 12800 Indian Rocks Road, Indian Rocks, Florida 33774. Chantilly Health was also known as Chantilly Health and Wellness. At all times material to the Administrative Complaint, the address of record listed on Respondent’s C.N.A. certificate was the same location as Chantilly Health. Respondent’s current address of record is 12199 Indian Rocks Road, Largo, Florida 33774. In his application for HCCE license, Respondent listed Dr. Dunja Boljesic as the Designated Qualifying Practitioner. Respondent signed the application as the clinic manager. Dr. Boljesic had retired and was no longer physically present at Chantilly Health at the time of the investigation giving rise to the Administrative Complaint. It is unknown whether Dr. Boljesic currently maintains any ownership or financial interest in Chantilly Health. On November 30, 2010, the Florida Department of Health, Division of Medical Quality Assurance, issued the HCCE license to Chantilly Health, License No. 604026. Chantilly Health was also licensed with the City of Largo as a “Clinic of Doctors,” a health food store, and a dietary supplement store. Respondent had three different filings with the Florida Secretary of State, Division of Corporations (Sunbiz): one for a research company, one for “vitamin,” and one for a health and nutrition clinic. On January 27, 2012, Department investigator Michael Smith approached Respondent at Chantilly Health and told him he had been diagnosed with multiple myeloma. In response to Mr. Smith’s questions regarding his feigned illness, Mr. Smith testified that Mr. Karim informed him that he could draw blood from him and utilize an independent laboratory to obtain additional information about a specific type of cancer. The laboratory testing would neither be done by Respondent nor Chantilly Health, and would cost $195. Mr. Karim denies having offered to draw blood from Mr. Smith, but testified he could draw a small sample to send to an independent laboratory for testing. Respondent had a glucose and hemoglobin meter at Chantilly Health which he used to draw small samples of blood to determine iron and glucose levels. He did not perform these tests on Mr. Smith, primarily since Mr. Smith refused to have any actual tests performed upon him by Respondent. Had he drawn blood from Mr. Smith, Respondent would not have received any direct or indirect financial benefit or remuneration from the third-party laboratory. Respondent advised Mr. Smith that multiple myeloma, a form of cancer, is related to an inflammation in the gastro- intestinal tract as well as suffering from “toxicity.” He offered to help Mr. Smith strengthen his immune system, which would have included a liver detoxification. Respondent offered to have a blood test performed, after which he would devise a holistic plan of detoxification for Mr. Smith. Mr. Smith chose not to have any of these services performed or ordered by Respondent since he was acting as an investigator and not an actual potential customer of Chantilly Health. Mr. Smith asked Respondent if he was a doctor. Respondent stated he was a doctor “in nutrition medicine and no pharmaceuticals.” He handed Mr. Smith two business cards. The cards contained the following language: Card one: Chantilly Natural Health Research, Functional Blood Nutrition & Lipid-profile, Cardio Risk APW IN-Ratio, centres of enzyme research, Functional Medicine and Orthomolecular Medicine research, Board Certified Fellow of American Association of Integrative Medicine, Board Certified Am Anti-Aging & Regenerative Med, Board Certified American Alternative Medicine, Reg/Lic: Washington, D.C., West Virginia, DC . . .; WV . . . dr. karim, www.chantillyhealth.com Card two: Chantilly Natural Health Research, Functional Blood Nutrition & Lipid-profile, Cardio Risk APW IN-Ratio, z.karim, centres of enzyme research, Functional Medicine & Orthomolecular Medicine Research, Board Certified & Fellow of American Association of Integrative Medicine, Board Certified, Am Anti-Aging & Regenerative Med, Board certified American Alternative Medicine, Reg/Lic: Washington, D.C., West Virginia, Florida . . . www.chantillyhealth.com www.chantillyhealth.us The cards also displayed a logo that read “American Association of Integrative Medicine, The Medical Society for the 21st Century,” and contained a logo of a staff with two snakes entwined, commonly known as a “caduceus.” Respondent testified he applied for all the board certifications listed on his business cards and that he provided these credentialing associations with documentation of his credentials and transcripts. None of these board certifications are related to a Florida license held by Respondent. In January 2013, Mr. Smith returned to Chantilly Health and observed a certificate on the wall with Respondent’s name and the initials “M.D.” following his name. The initials “M.D.” commonly refer to “medical doctor.” Respondent is not licensed as a medical doctor in Florida. Respondent is not licensed as a naturopathic physician in Florida. Respondent admitted to Mr. Smith that he refers to himself as a doctor on his business cards and on the internet. He says he uses the term “doctor” to mean a doctor of oriental medicine. Respondent is not licensed as an acupuncturist in Florida. Respondent admitted giving information about Vitamin E supplements to Mr. Smith. Respondent admitted having a glucose meter and a hemoglobin meter at Chantilly Health. Respondent admitted performing blood glucose level screenings at Chantilly Health. Respondent testified that he performed hemoglobin tests at Chantilly Health to look at hematocrit iron levels and cholesterol levels. Respondent testified that he advised individuals on whom he performed blood glucose level screenings to “cut down” on their sugar intake. Respondent admitted telling individuals on whom he performed hemoglobin tests to increase their liver intake by once a week. Respondent admitted he should not use the term “doctor” in Florida. Respondent testified that he had never been licensed as a medical doctor in any state. Petitioner submitted into evidence in lieu of live testimony, the deposition transcript of Victor Mendez, C.N.A., who is accepted as an expert in nursing assistance based upon his credentials and experience. He testified as to the standard of care and scope of practice for C.N.A.s. A C.N.A. is restricted to working under the direct supervision of a licensed practical nurse or registered nurse. The job of a C.N.A. is to observe and assist patients. A C.N.A. is not permitted to prescribe any type of supplement or medication when performing his or her duties. A C.N.A. is not permitted to recommend vitamins or supplements even if they are available without a prescription, and may not recommend changes in dietary intake. According to Mr. Mendez, C.N.A.s are not permitted to run diagnostic tests, diagnose patients, evaluate diagnoses, or recommend treatments. Mr. Mendez observed that Chantilly Health was set up much like a medical office with a seating or waiting area, the credentials displayed, Respondent’s attire (personalized surgical scrubs), and the products displayed. Mr. Mendez noted that the type of surgical scrubs worn by Respondent were more akin to those worn by physicians in a health care setting than those worn by non-medical health care staff. Mr. Mendez opined that Respondent telling Mr. Smith he was suffering from “leaky gut” was a diagnosis of an individual’s condition which is clearly outside the scope of practice of a C.N.A. Likewise, Respondent’s offer both to conduct blood tests and create a treatment plan was outside the scope of a C.N.A.’s license. Petitioner also presented the expert testimony of Philip N. Styne, M.D., through a transcript of his deposition taken in lieu of live testimony at the final hearing. Dr. Styne was presented as an expert in the fields of internal medicine and gastroenterology. Dr. Styne has been licensed as a medical doctor in Florida since 1979, and is board certified in internal medicine and gastroenterology. He is also the medical director of Digestive Health Clinical Informatics and Liver Services for Florida Hospital. Based upon Dr. Styne’s credentials and experience, the undersigned accepts him as an expert for purpose of offering opinion testimony in this matter. Dr. Styne provided a description of what characterizes multiple myeloma, the disease feigned by Mr. Smith during his investigation of Respondent. Dr. Styne testified that multiple myeloma is treated by chemotherapy, an allogeneic or autologous blood or bone marrow transplant, or a combination of these. Detoxifying the liver is not an accepted form of medical treatment in his opinion. If a patient presented himself to Dr. Styne suffering from multiple myeloma, he would seek a referral to a board-certified oncologist, an internist who specializes in the treatment of cancer. He would make the referral since multiple myeloma is not particular to his specialty, and because it is usually a lethal disease. On December 30, 2013, Respondent submitted a copy of John Daidone’s registered nursing license to Petitioner along with his request for a hearing before the Board of Nursing. Respondent wrote on the copy of the license that Mr. Daidone had supervised him since February 2003. Respondent has only held a C.N.A. license since June 26, 2009. Mr. Daidone testified on behalf of Petitioner at the hearing. He has been licensed as a registered nurse in Florida since around 1990. After presenting a detailed description of his work experience, Mr. Daidone testified he had never supervised Respondent. Mr. Daidone was originally referred to Respondent when he needed a blood test performed. Respondent pricked Mr. Daidone’s finger to draw blood which he examined under a microscope. Respondent advised Mr. Daidone that he was suffering from mycoplasma pneumonia and gave him some supplements to treat his condition. Mycoplasma pneumonia is an infection of the lungs caused by bacteria of a similar name. Respondent gave Mr. Daidone a signed document stating he had the disease and signing it “Z. Karim, N.D.” The abbreviation N.D. stands for naturopathic doctor. Respondent also attached a Chantilly Health business card to the document listing him as an M.D. Mr. Daidone last spoke with Respondent about two months prior to the final hearing, at which time Respondent asked him to say he had supervised Respondent. When testifying, Respondent claimed that Mr. Daidone had signed Respondent’s name on the document with the initials “M.D.” after it. Respondent stated he may have signed a blank piece of paper that Mr. Daidone completed at a later time. Respondent further testified that Mr. Daidone must have picked up a business card from Chantilly Health and photocopied it to the document he created at a later time. Respondent admitted he kept his business cards in the lobby of Chantilly Health in an area accessible to the public. Mr. Daidone could not recall whether he or Respondent typed the letter, or whether it was his handwriting or that of another person appearing on the letter. Mr. Daidone candidly admitted he has problems with his recall and memory. In January 2013, Respondent was issued a Uniform Unlicensed Activity Citation by the Florida Department of Health for practicing medicine in violation of chapters 456 and 458, Florida Statutes. Respondent entered into a Settlement Agreement in that matter in which he neither admitted nor denied the facts alleged in the citation, and paid $4,754.11 (representing a fine of $1,000.00 and costs of $3,754.11) to resolve the citation. Respondent also agreed not to violate any provision of chapter 456 or any Florida statute or rule related to the practice of any health care profession.
Recommendation Based on the foregoing Findings of Fact and Conclusions of Law, it is RECOMMENDED that the Board of Nursing enter a final order: Adopting the Findings of Fact and Conclusions of Law; Finding that Respondent violated section 464.204(1)(b), Florida Statutes, by intentionally violating section 456.072(1)(o) and (m), Florida Statutes, as alleged in the Administrative Complaint; and Revoking Respondent’s certificate to practice as a certified nursing assistant. DONE AND ENTERED this 5th day of December, 2014, in Tallahassee, Leon County, Florida. S ROBERT S. COHEN 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 5th day of December, 2014. COPIES FURNISHED: Thomas W. Caufman, Esquire David M. Greene, Esquire Quintairos, Prieto, Wood and Boyer, P.A. 4905 West Laurel Street, Suite 200 Tampa, Florida 33607 (eServed) Yolonda Y. Green, Esquire Ana M. Gargollo-McDonald, Esquire Lauren A. Leikam, Esquire Prosecution Services Unit Department of Health 4052 Bald Cypress Way, Bin C-65 Tallahassee, Florida 32399-3265 (eServed) Joe Baker, Jr., Executive Director Board of Nursing Department of Health 4052 Bald Cypress Way, Bin C-02 Tallahassee, Florida 32399 (eServed) Jennifer A. Tschetter, General Counsel Department of Health 4052 Bald Cypress Way, Bin A-02 Tallahassee, Florida 32399-1701 (eServed) Lavigna A. Kirkpatrick, BS, RN, Chair Board of Nursing Department of Health 4052 Bald Cypress Way, Bin C-02 Tallahassee, Florida 32399
Findings Of Fact Upon consideration of the oral and documentary evidence adduced at the hearing, the following relevant facts are found: The respondent Eunice Lyles Nicholson is 53 years of age and has been a registered nurse since 1947. She moved to Florida in 1970 and went to work for Jess Parrish Memorial Hospital, where she remained until February of 1977. Since that time, she has been employed in private nursing jobs and at the Titusville Nursing and Convalescent Center. At all times relevant to the incidents which are the subject of the Administrative Complaint, respondent was the charge nurse for the second floor of Jess Parrish Memorial Hospital. Her employee evaluations at the Hospital between 1970 and 1976 were "very good" overall. On or about December 2, 1979, respondent destroyed an ampule containing 100 mg of Demerol, a controlled substance, in the presence of another nurse. She did not sign for the destruction at this time. Later, when the nurse who witnessed the event was out, respondent requested another nurse to sign the document stating that she had witnessed the destruction. It is not acceptable or prevailing nursing practice to request one who did not actually witness the event to sign a document stating that she had witnessed the destruction of a controlled substance. Between February 4, 1977, and February 17, 1977, a period of time in which the Hospital was busier than normal, various discrepancies, inconsistencies and insufficiencies were -noted in the charts and records of approximately six patients under respondent's care. These included incomplete and insufficient nurses notes on the patients' charts; failure to chart the administration of controlled susbstances on the patients' medical record; discrepancies between the nurse's notes, the patient's medication record and the narcotic control record; and the administration of medication at more frequent intervals then called for by the physician's orders. It was respondent's testimony that the charting errors were not intentionally made. She could not explain the errors and could only recall that the Hospital was very busy during that period of time. There was no evidence that any patient was harmed by the charting errors or that there was any similarity in the errors found. There was no evidence that respondent converted any controlled substance to her own use. On or about February 17, 1977, respondent was the head nurse on the 7:00 A.M. to 3:00 P.M. shift. After respondent left this shift, it was noticed that there were two extra ampules of Demerol 75 in the narcotic cart. Respondent was called at home and notified of the discrepancy. She returned to the Hospital. Rather than making an attempt to determine the reason for the narcotic count being incorrect, respondent simply destroyed the two extra ampules. Witnesses observed this event. It is the responsibility of the nurse in charge of each shift to account for, reconcile and verify the inventory of controlled substances with the narcotic records before she leaves her shift. The reason for the discrepancy was never determined.
Recommendation Based upon the findings of fact and conclusions of law recited above, it is recommended that the Board: find the respondent guilty of unprofessional conduct in violation of Florida Statutes, 464.21(1)(b); and impose a six-month suspension of respondent's registered nursing license; and suspend the enforcement of the suspended license and place the respondent on probation for a period of one (1) year. Respectfully submitted and entered this 5th day of September, 1979, in Tallahassee, Florida. DIANE D. TREMOR, Hearing Officer Division of Administrative Hearings Room 101, Collins Building Tallahassee, Florida 32301 (904) 488-9675 COPIES FURNISHED: Julius Finegold 1107 Blackstone Building 233 East Bay Street Jacksonville, Florida 32202 Carl Wasileski Post Office Box 1286 150 Taylor Street Titusville, Florida 32780 Geraldine Johnson Board of Nursing 111 Coastline Drive East, Suite 504 Jacksonville, Florida 32202 ================================================================= AGENCY FINAL ORDER ================================================================= BEFORE THE FLORIDA BOARD OF NURSING IN THE MATTER OF: Eunice Rae Lyles Nicholson 1813 Lilac Circle Titusville, Florida 32780 CASE NO. 79-623 As a Registered Nurse License Number 53804-2 /
