The Issue The primary issue in this case is whether the crimes of which Respondent was convicted are directly related to the practice of medicine. If so, it will be necessary to determine an appropriate penalty.
Findings Of Fact At all times relevant to this case, Respondent Algirdas Krisciunas, M.D., was licensed to practice medicine in the state of Florida. His office was located in Broward County. Petitioner has regulatory jurisdiction over licensed physicians such as Dr. Krisciunas. In particular, the Department is authorized to file and prosecute an administrative complaint against a physician, as it has done in this instance, when a panel of the Board of Medicine has found that probable cause exists to suspect that the physician has committed a disciplinable offense. Exercising its prosecutorial authority, the Department has charged Dr. Krisciunas with one such offense, namely, being tried and found guilty of a crime which directly relates to the practice of medicine. It is an undisputed fact that, on October 13, 2010, in a case styled United States v. Krisciunas, No. 0:10-6007-CR- DIMITROULEAS-001, the U.S. District Court for the Southern District of Florida entered a judgment of conviction which adjudicated Dr. Krisciunas guilty of five counts of unlawfully dispensing oxycodone, a narcotic pain medication, and one count of conspiring to distribute oxycodone. Based on this conviction, the court sentenced Dr. Krisciunas to a term of 97 months' incarceration in a federal prison. At the time of the final hearing in this case, Dr. Krisciunas was serving his sentence in the custody of the U.S. Bureau of Prisons. The crimes of which Dr. Krisciunas was convicted are directly related to the practice of medicine——a fact that Dr. Krisciunas concedes is true. Because it is undisputed that Dr. Krisciunas was convicted of crimes that directly relate to the practice of medicine, the conduct which gave rise to Dr. Krisciunas's conviction is relevant only for the limited purpose of determining the appropriate penalty to be imposed in this proceeding. In this regard, the undersigned finds that the principal events which gave rise to Dr. Krisciunas's conviction occurred on July 13, 2009; August 6, 2009; and September 9, 2009. On each of these dates, Detective William Schwartz of the Broward County Sheriff's Office, working undercover, presented to Dr. Krisciunas as "Bill Rix." During each visit, Dr. Krisciunas gave "Bill Rix" prescriptions for oxycodone and the anxiolytic alprazolam despite the absence of any legitimate medical justification for prescribing these medications. "Bill Rix" (Detective Schwartz) paid Dr. Krisciunas's staff in cash for the drugs, which he received in Dr. Krisciunas's office at the conclusion of each visit.
Recommendation Based on the foregoing Findings of Fact and Conclusions of Law, it is RECOMMENDED that the Board of Medicine enter a final order finding Dr. Krisciunas guilty the offense described in section 458.331(1)(c), Florida Statutes, i.e., being convicted of a crime that directly relates to the practice of medicine. It is further RECOMMENDED that the Board of Medicine revoke Dr. Krisciunas's medical license and impose an administrative fine of $10,000. DONE AND ENTERED this 27th day of June, 2011, in Tallahassee, Leon County, Florida. S JOHN G. VAN LANINGHAM 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 27th day of June, 2011.
The Issue The issue for determination is whether Respondent, a licensed physician, committed a violation of Section 458.331(1)(x), Florida Statutes, as alleged in the Administrative Complaint, and, if so, what disciplinary sanctions should be imposed against his license.
Findings Of Fact Respondent is Grayson C. Snyder, a licensed physician at all times pertinent to these proceedings, holding medical license number ME 0004035. Respondent's last known address is 635 West Central Avenue, Blountstown, Florida 32424-1909. Petitioner is the state agency charged with regulating the practice of medicine pursuant to Section 20.165, Florida Statutes; Chapter 455, Florida Statutes; and Chapter 458, Florida Statutes. On December 29, 1994, the Board of Medicine issued a final order against Respondent. The final order suspended Respondent’s license to practice for at least 6 months, pending his demonstration to the Board that he could practice medicine with skill and safety by undergoing an evaluation by a psychiatrist approved by the Physicians Recovery Network (PRN). The final order also required Respondent’s completion of a period of probation after reinstatement and his payment of an administrative fine in the amount of $5,000 within 30 days of the final order. Respondent has consistently failed to comply with the final order, inclusive of the payment of the $5,000 administrative fine. Other requirements of the final order relating to psychiatric evaluation and completion of a probationary period have also not been met.
Recommendation Based on the foregoing and in accordance with Petitioner's penalty guidelines set forth in Rule 64B-8.001, Florida Administrative Code, it is hereby RECOMMENDED that a Final Order be entered finding Respondent guilty of the violation alleged in the administrative complaint and revoking Respondent's license. DONE AND ENTERED this 2nd day of April, 1998, in Tallahassee, Leon County, Florida. DON W. DAVIS 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 2nd day of April, 1998. COPIES FURNISHED: Carol Lanfri, Esquire Agency for Health Care Administration 2727 Mahan Drive Tallahassee, Florida 32308-5403 Michael Stone, Esquire 116 East 4th Street Panama City, Florida 32401 Marm Harris, Executive Director Department of Health 1940 North Monroe Street Tallahassee, Florida 32399-0750 Angela T. Hall, Agency Clerk Department of Health 1317 Winewood Boulevard, Building 6 Tallahassee, Florida 32399-0700 Pete Peterson, General Counsel Department of Health Building 6, Room 102-E Tallahassee, Florida 32399-0700 Dr. James Howell, Secretary Department of Health Building 6, Room 306 1317 Winewood Boulevard Tallahassee, Florida 32399-0700
The Issue The issue for determination is whether Respondent, a licensed physician, committed violations of Chapter 458, Florida Statutes, as alleged in the Administrative Complaint, sufficient to justify the imposition of disciplinary sanctions against his license.
Findings Of Fact Respondent is Ernesto C. Jaranilla, M.D., a licensed physician at all times pertinent to these proceedings, holding medical license number ME 0065787. Respondent's last known address is 633 Baker Street, Rochester Hills, Michigan 48307. Petitioner is the state agency charged with regulating the practice of medicine pursuant to Chapter 458, Florida Statutes. The State of Michigan Department of Commerce, Board of Medicine, is the licensing authority for the State of Michigan. On or about May 9, 1994, the State of Michigan Board of Medicine issued a final order requiring Respondent to pay a fine of $1,000.00 within 60 days, placed Respondent's license on probation and required him to complete 100 hours of approved continuing education credits. As a result of the action of the Michigan Board of Medicine, Respondent is guilty of having action taken against his license to practice medicine by the licensing authority of the State of Michigan. Respondent did not notify the Florida Board of Medicine within 30 days of the action taken by the State of Michigan against his license to practice medicine. Instead, Petitioner's personnel learned of Respondent's transgression by way of a report from the Federation of State Medical Boards dated April 19, 1996. The report indicated that the Michigan disciplinary action had been terminated by order dated January 26, 1996.
Recommendation Based on the foregoing, it is hereby RECOMMENDED that a Final Order be entered imposing discipline upon Respondent's license in this cases as follows: An administrative fine of $750 for each Count of the Administrative Complaint for a total of $1500. Suspension of Respondent's license to practice medicine in the State of Florida with such suspension to be terminated upon Respondent's payment of the administrative fine, and successful compliance with such other terms and conditions as may be prescribed by the Florida Board of Medicine, inclusive of Respondent's personal appearance before the Florida Board of medicine for presentment of proof of his reinstatement to practice medicine in the State of Michigan and to certify his completion of any Board prescribed course for practitioners who have failed to comply with reporting or other obligations to the Board. DONE AND ENTERED this 8th day of January, 1997, in Tallahassee, Leon County, Florida. DON W. DAVIS 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 8th day of January, 1997. COPIES FURNISHED: Kevin w. Crews, Esquire Agency for Health Care Administration Post Office Box 14229 Tallahassee, FL 32317-4229 E. Jaranillia, M.D. 301 State Street Harbor Beach, MI 48441 Marm Harris, Executive Director Agency for Health Care Administration 1940 North Monroe Street Tallahassee, FL 32399-0770 Jerome Hoffman, Esquire Agency for Health Care Administration 2727 Mahan Drive Tallahassee, FL 32309 Douglas M. Cook, Director Agency for Health Care Administration 2727 Mahan Drive Tallahassee, FL 32308
Findings Of Fact At all times material to this proceeding, Respondent was licensed to practice medicine in the State of Florida, with license number 0017339. On October 25, 1979 the Commission on Medical Discipline of Maryland, licensing authority for the State of Maryland, revoked Stanley Radvan- Ziemnowicz's (Ziemnowicz) license to practice medicine in the State of Maryland. On August 18, 1981 the commission on Medical Discipline of Maryland denied Ziemnowicz's petition for reinstatement from its order of revocation dated October 25, 1979. On January 3, 1984, the Commission on Medical Discipline of Maryland granted Ziemnowicz a stay of its order dated October 25, 1979 revoking his license to practice medicine in the State of Maryland and placed him on probation. On April 29, 1986 the Commission on Medical Discipline of Maryland entered an order withdrawing the stay of its order dated October 25, 1979 entered on January 3, 1984 and again revoked Ziemnowicz's license to practice medicine in the State of Maryland. Stanley Radvan-Ziemnowicz whose license to practice medicine in Maryland was revoked on April 29, 1986 is the same Stanley Radvan-Ziemnowicz who is the Respondent in this Respondent's license to practice medicine in the State of Maryland has not been reinstated since the entry of the Order by the Commission on Medical Discipline of Maryland, dated April 29, 1986, and Respondent's license to practice medicine in the State of Maryland is currently revoked.
Recommendation Based upon the Findings of Fact and Conclusions of Law recited herein, and there being no mitigating circumstances presented by the Respondent, it is RECOMMENDED that the Board enter a Final Order revoking Respondent's license to practice medicine in the State of Florida. Case No. 87-3183 Respectfully submitted and entered this 4th day of December, 1987, in Tallahassee, Leon County, Florida. WILLIAM R. CAVE 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 4th day of December, 1987. APPENDIX TO RECOMMENDED ORDER IN CASE NO. 87-3183 The following constitutes my specific rulings pursuant to Section 120.59(2), Florida Statutes, on all of the Proposed Findings of Fact submitted by the Petitioner in this case. Rulings on Proposed Findings of Fact Submitted by the Petitioner Adopted in Finding or Fact 1. Adopted in Finding of Fact 2. Rejected as not supported by the evidence in the record in that the order of the Commission of August 18, 1981 denied Respondent's reinstatements to practice medicine. Rejected as not supported by the evidence in the record in that it was the Order of January 3, 1984, that entered the stay and placed the Respondent on probation. Adopted in Findings of Fact 5 and 6. 6.-7 Adopted in Finding of Fact 7. Rulings on Proposed Findings of Fact Submitted by the Respondent The Respondent did not submit any Proposed Findings of Fact or Conclusions of Law. COPIES FURNISHED: Susan Branson, Esquire Department of Professional Regulation 130 North Monroe Street Tallahassee, Florida 32301 Stanley Radvan-Ziemnowicz, M.D. 9400 Old Georgetown Road Bethesda, Maryland 20014 Tom Gallagher, Secretary Department of Professional Regulation 130 North Monroe Street Tallahassee, Florida 32399-0750 Dorothy Faircloth Executive Director Department of Professional Regulation Board of Medicine 130 N. Monroe St. Tallahassee, Florida 32399-0750
The Issue The issue in this case is whether the Respondent’s license to practice as a certified nursing assistant should be revoked or otherwise disciplined based on the charges of unprofessional conduct by stealing from a patient.
Findings Of Fact The Respondent, Tamar Laurent, is a certified nursing assistant (CNA) in the State of Florida having been issued license CNA 43605. This is the first time action has been taken by DOH and the Board to discipline her license. In December 2012 and January 2013, the Respondent was employed by Westminster Towers. While working at Westminister Towers, the Respondent was assigned to care for patient R.G. R.G. was given a cell phone by his son R.G. III. The Respondent picked up the cell phone, which was lying on the floor next to R.G.’s bed, and placed it in the drawer of a nightstand that was for and contained R.G.’s personal items. The Respondent thought the phone belonged to R.G. One week later, she went back into the drawer and took the cell phone to give to her son. While visiting his father, R.G. III realized that the cell phone was missing. R.G. III attempted to find the phone using family location tracking and looking up the call log. The information he uncovered was given to the Orlando Police Department and Westminster Towers. Nicole Daigneault was the director of nursing at the time of the incident. After receiving the information from R.G. III, she initiated an internal investigation and reported the incident as a theft to the Agency for Healthcare Administration. The internal investigation discovered that the Respondent and the Respondent’s son were in possession of the cell phone. The Respondent contacted Detective Osso of the Orlando Police Department. During an interview with Detective Osso, the Respondent admitted to taking R.G.’s cell phone. A few days after the interview, the Respondent retrieved the cell phone from her son and gave it to her attorney to return to R.G. III. During the hearing, the Respondent maintained that she did not know the cell phone belonged to R.G. and that she placed it in his bedside table because she found it next to his bed. This contradicted her own testimony during the hearing, and in the Respondent’s earlier statement to the Orlando Police Department, that she assumed the cell phone belonged to R.G. when she put it in his drawer. The Respondent knew that the cell phone did not belong to her and that she did not have a right to take it. During the hearing, the Respondent stated her supervisor, Rita, gave her permission to take the cell phone if she brought it back the next day. However, Rita Burginia, the supervisor of nursing assistants at the time of the incident, never had a conversation with the Respondent or would never authorize anyone to take the personal property of a patient. After the testimony of Ms. Burginia, the Respondent then claimed she spoke to a different supervisor, also named Rita. Nicole Daigneault can only recall one Rita working at Westminster Towers at that time, Rita Burginia. In any event, the Respondent did not return the cell phone the next day but rather kept it for a few weeks.
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 as charged; and revoking her license to practice as a certified nursing assistant; and assessing costs of investigation and prosecution. DONE AND ENTERED this 11th day of September, 2015, 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 11th day of September, 2015. COPIES FURNISHED: Ana Margarita Gargollo-McDonald, Esquire Department of Health Prosecution Services Unit 4052 Bald Cypress Way, Bin C-65 Tallahassee, Florida 32399 (eServed) Tamar Laurent 1270 Woodman Way Orlando, Florida 32818 Judson Searcy, Esquire Department of Health Prosecution Services Unit 4052 Bald Cypress Way, Bin C-65 Tallahassee, Florida 32399 (eServed) Joe Baker, Jr., Executive Director Board of Nursing Department of Health 4052 Bald Cypress Way, Bin C-02 Tallahassee, Florida 32399-3252 (eServed) Daniel Hernandez, Interim General Counsel Department of Health 4052 Bald Cypress Way, Bin A-02 Tallahassee, Florida 32399-1701 (eServed) COURTESY COPY FURNISHED: Ann-Lynn Denker, PhD, ARNP Chair Board of Nursing Department of Health 4052 Bald Cypress Way, Bin C-02 Tallahassee, Florida 32399-3252
The Issue The issue for determination in this proceeding is whether Respondent committed the acts alleged in the administrative complaint and, if so, what, if any, disciplinary action should be taken against Respondent's license.
Findings Of Fact Petitioner is the state licensing and regulatory agency charged with the responsibility to prosecute administrative complaints pursuant to the laws of the State of Florida. Respondent is now and has been at all times material to this proceeding a licensed physician in the state, holding license number ME 0028480. A Final Order was filed against Respondent in Department of Professional Regulation v. Roger Lopez, M.D., Department of Professional Regulation Case No. 0070692 on August 26, 1988. The Final Order was entered in accordance with the terms of a stipulation executed by Petitioner and Respondent. Respondent's license was suspended for six months, and Respondent was placed on probation from March 5, 1989, through March 4, 1994. Respondent was properly served a copy of the Final Order. Respondent was required by the terms of the Final Order to practice under the direct supervision of a physician approved by the Board of Medicine (the "Board") and to appear before the Probation Committee whenever requested to do so. Respondent violated the terms of the Final Order by failing to appear before the Probation Committee and by failing to name a monitoring physician to supervise him during his probation. By letter dated August 29, 1989, Respondent was requested by the Board to appear before the Probation Committee at its regularly scheduled meeting on September 20, 1989, and to submit a curriculum vitae for a proposed supervising physician. Respondent acknowledged the Board's request in a letter to Petitioner dated August 31, 1989. Respondent failed to appear before the Probation Committee and failed to designate a monitoring physician.
Recommendation Based upon the foregoing Findings of Facts and Conclusions of Law, it is RECOMMENDED that Petitioner should enter a Final Order finding Respondent guilty of the allegations in the Administrative Complaint, issuing a reprimand, imposing an administrative fine in the amount of $5,000, suspending Respondent's license until March 4, 1994, and requiring Respondent to demonstrate to the Board no later than March 4, 1994, his ability to practice medicine with the skill and safety required under applicable statutes and rules. DONE and ENTERED this 23rd day of October 1991, in Tallahassee, Leon County, Florida DANIEL MANRY 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 Administrative Hearings this 23rd day of October, 1991.
The Issue The issue in this case is whether the Petitioner’s application for relicensure as a mental health counselor should be granted or denied.
Findings Of Fact The Petitioner was licensed as a psychologist in the State of New Jersey from May 14, 1979, until May 29, 1996. While so licensed, the Petitioner engaged in private practice as a psychologist in New Jersey where he engaged individual, family, and group therapy. On October 16, 1995, the Petitioner’s license to practice psychology in New Jersey was suspended pursuant to a Consent Order. The suspension was based on allegations of extensive insurance fraud perpetrated by the Petitioner during the course of his practice of psychology in New Jersey. Following the suspension of his license, the Petitioner continued to practice psychology in New Jersey by continuing to see patients and continuing to provide therapy. On May 28, 1996, the Petitioner pled guilty to one count of conspiracy and to one count of theft by deception in New Jersey Superior Court, Criminal Division. The criminal charges to which the Petitioner pled guilty resulted from the Petitioner’s having engaged in a scheme in his psychology practice whereby he would submit claims for payment to insurance companies, and would receive payments for those claims from insurance companies, for patients he did not see and/or for treatments he never rendered. The criminal court that convicted the Petitioner ordered the Petitioner to pay restitution in the amount of $2,793,656.70 and sentenced the Petitioner to a prison term of five years and six months. Ultimately, the Petitioner was required to serve only seven months in prison. The Petitioner has repaid a substantial amount of the restitution, but he still owes approximately $600,000.00 in unpaid restitution. On May 29, 1996, the New Jersey State Board of Psychological Examiners issued a Final Order which, among other things, revoked the Petitioner’s license to practice psychology in New Jersey. On June 27, 1996, the Superior Court of New Jersey in Case No. C-225-96 issued a Final Order and Judgment and Permanent Injunction against the Petitioner. That order permanently enjoined the Petitioner from engaging in the practice of psychology in any setting and also ordered the Petitioner to reimburse the patients he had treated while his license was suspended. On May 25, 1994, the Petitioner was advised by letter that he had successfully completed the requirements to be eligible for licensure in Florida as a mental health counselor. Shortly thereafter the Respondent received his license to practice as a mental health counselor in Florida. The Petitioner was licensed in Florida as a mental health counselor from mid-1994 until July 16, 2001. On July 16, 2001, the Florida Board of Clinical Social Work, Marriage and Family Therapy and Mental Health Counseling entered a Final Order revoking the Petitioner’s license to practice mental health counseling in Florida. The revocation order was based on an Administrative Complaint which alleged that the Petitioner had violated Sections 491.009(2)(b) and 491.009(2)(c), Florida Statutes, by reason of the revocation of his New Jersey license to practice psychology, and by reason of his criminal conviction in New Jersey of a crime that directly related to the practice of mental health counseling. The profession of psychologist and the profession of mental health counseling are comparable professions.2 The Petitioner has not completed a minimum of three semester hours or four quarter hours of graduate level coursework on the subject of substance abuse. The Petitioner has not completed a minimum of three semester or four quarter hours of graduate level coursework on the subject of legal, ethical, and professional standards.
Recommendation Based on the foregoing Findings of Fact and Conclusions of Law, it is RECOMMENDED that the Florida Board of Clinical Social Work, Marriage and Family Therapy, and Mental Health Counseling enter a final order denying the Petitioner’s application for licensure as a licensed mental health counselor. DONE AND ENTERED this 28th day of June, 2005, in Tallahassee, Leon County, Florida. S MICHAEL M. PARRISH 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 28th day of June, 2005.
