Findings Of Fact Petitioner took the podiatry licensure examination administered by the Respondent in July, 1989, receiving a grade of 61.3%, with 221 correct answers. A score of 75%, with 270 correct answers, is required to pass the examination for licensure. This podiatry examination was developed by the Bureau of Examination Services in conjunction with consultants who served as "item writers", and Florida licensed podiatrists. Five Florida licensed podiatrists selected items written by the various consultants from a bank of questions available for the 1989 examination. Competent substantial evidence was not introduced on behalf of the Petitioner to establish that the examination was in any way flawed in its preparation or method of selecting the actual questions used on this exam. The Petitioner testified that several questions were misspelled in the examination booklet which he received at the exam site. The actual question booklets used for the July, 1989, exam were introduced in evidence, but the Petitioner failed to establish, by competent substantial evidence, that there were any significant misspellings in these booklets which would in any way impair the fairness or validity of the examination results. It is also asserted by the Petitioner that he was given insufficient time to review his examination in order to identify problems in the grading of the examination, and that the review room was cramped and noisy. The review session was conducted on October 24, 1989, and the Petitioner attended. The review session began at 8:30 a.m. and concluded at 1:00 p.m. on that date, and was conducted in the Respondent's office in Tallahassee, Florida. The Petitioner actually began his review at 8:35 a.m., and completed the review and left the review room at 12:52 p.m. Thus, the Petitioner has failed to establish, by competent substantial evidence, that he lacked sufficient time to complete his review, and has also failed to prove by competent substantial evidence that conditions in the review room deprived him of an opportunity to conduct a meaningful review of his exam. There is a lack of competent substantial evidence in the record to establish that the grades which the Petitioner received on the July, 1989, podiatry licensure examination were incorrect, unfair, or invalid, or that the examination, and subsequent review session, were administered in an arbitrary or capricious manner.
Recommendation Based upon the foregoing, it is recommended that Respondent enter a Final Order dismissing the Petitioner's challenge to the grades he received on the July, 1989, podiatry licensure examination. RECOMMENDED this 7th day of May, 1991 in Tallahassee, Florida. DONALD D. CONN Hearing Officer Division of Administrative Hearings The DeSoto Building 1230 Apalachee Parkway Tallahassee, Florida 32399-1550 Filed with the Clerk of the Division of Administrative Hearings this 7th day of May, 1991. APPENDIX TO RECOMMENDED ORDER, CASE NO. 90-2799 Despite waiting an additional seven days until April 25, 1991, as requested by counsel for the Petitioner in his letter filed on April 19, 1991, no proposed recommended order was filed on behalf of the Petitioner. Rulings on the Respondent's Proposed Findings of Fact: Adopted in Finding 1. Adopted in Findings 2 and 3. Adopted in Finding 3. COPIES FURNISHED: Melvyn G. Greenspahn, Esquire 3550 Biscayne Boulevard Suite 404 Miami, FL 33137 Vytas J. Urba, Esquire Northwood Centre, Suite 60 1940 North Monroe Street Tallahassee, FL 32399-0792 Jack McRay, Esquire Northwood Centre 1940 North Monroe Street Tallahassee, FL 32399-0792 Patricia Guilford Executive Director Board of Podiatry 1940 North Monroe Street Tallahassee, FL 32399-0792
Findings Of Fact The Petitioner is a registered Nurse, and she is registered with a national organization as a respiratory therapist. A respiratory therapist works with patients who have respiratory, spinal, lung, or drug abuse problems. One procedure used by such therapists to determine if a patient is breathing properly is an arterio blood gas test. The petitioner has performed thousands of much tests. Until the Respondent adopted rules pursuant to the Florida Clinical Laboratory Law, there was no requirement for licensure to perform arterio blood gas tests. There is now a special category for licensure as a laboratory technologist in a specialty called "Chemistry-Special" which would qualify an individual to perform such tests, but no other clinical laboratory procedures. The petitioner submitted an application for licensure in the "Chemistry-Special" specialty on September 29, 1977. She did not take the test required by the Respondent, and accordingly her license application has been denied.
The Issue The central issue in this case is whether Petitioner should be granted additional credit for the responses given during his practical examination for licensure which was conducted during November, 1991, and for which Petitioner entered this challenge.
Findings Of Fact Based upon the testimony of the witnesses and the documentary evidence received at the hearing, the following findings of fact are made: Petitioner, David Sanders, is a candidate for chiropractic licensure. His candidate for licensure number is 200142, and he took the November, 1991, practical examination administered by the Department. Petitioner received a score of 64.0 on the practical examination. Petitioner's score fell below the minimum score for passing, 75.0. Petitioner timely challenged the examination results and claimed that the Department had incorrectly graded Petitioner's responses and performance during the examination. In this case, the practical examination was administered by two examiners who, independently of one another, scored the responses given by Petitioner when presented with two case studies. For Case 1, the scoring was divided into fourteen sections or subsections where the candidate was evaluated and given points based upon the responses given. For the orthopedics section of Case 1, the Petitioner was given a scenario of facts from which he was to determine the appropriate tests to be administered to the patient. Following selection of the tests to be given, Petitioner was required to perform the test. For an inappropriate test, no points were awarded, even if the candidate performed the test correctly. Of the nine tests listed, four were to be chosen and performed. One point was awarded for each appropriate test correctly performed. In response to the orthopedics section, Petitioner selected three appropriate tests to perform. Consequently, the maximum grade, per examiner, he could have received was a score of three. Petitioner received a score of two from one examiner, and a three from the other. The first examiner commented that the Yeomans test was wrong. Since Yeomans was an appropriate test to perform, and Petitioner correctly performed the test, Petitioner should have received a three on that section from that examiner. Under the neurological subsections of Case 1, Petitioner was required to identify, based upon the fact scenario given, four muscles which should be examined and tested. Petitioner only identified three relevant muscles. Consequently, he received a score of three from each examiner. The scoring on this subsection was correct. Under subsection 8 of the neurological portion Petitioner received no credit as he failed to select three appropriate tests and correctly interpret the responses. Accordingly, the scoring on this subsection was correct. The final subsection of the neurological portion was the diagnosis rendered based upon all the findings of the scenario and test results. Since Petitioner rendered an inappropriate diagnosis, no points were awarded. The scoring on this subsection was correct. Case 2 of the physical examination contained nine sections or subsections for which Petitioner could have received credit. The first section of Case 2 required Petitioner to obtain a history from the patient. To achieve a perfect score on this section, the candidate had to inquire into seven or more areas of relevant history. If so, the score for the section would be a four. In this case, Petitioner should have received a four from both examiners regarding the history taken. As it was, Petitioner only received a three from the examiners. In order to receive credit on the physical-selection portion of the test, Petitioner was required to auscultate the heart and lungs, and purcuss the chest. Since he failed to do so, the scoring on this subsection was correct. In connection with subsections 18 and 19 of Case 2, Petitioner failed to receive full credit because he did not indicate an appropriate laboratory test. Had Petitioner requested a SMAC test, full credit would have been given for both subsections. As it was, because Petitioner failed to request a SMAC test, he could not receive credit on either subsection. The scoring on these subsections was correct.
Recommendation Based on the foregoing, it is RECOMMENDED: That the Board of Chiropractic Examiners enter a final order changing Petitioner's score on the November, 1991, physical examination as noted above in order to recalculate and determine whether or not Petitioner failed the examination through no fault of his own. DONE and ENTERED this 30th day of October, 1992, in Tallahassee, Leon County, Florida. JOYOUS D. PARRISH Hearing Officer Division of Administrative Hearings The DeSoto Building 1230 Apalachee Parkway Tallahassee, Florida 32301 (904)488-9675 Filed with the Clerk of the Division of Administrative Hearings this 30th day of October, 1992. APPENDIX TO CASE NO. 92-2709 RULINGS ON THE PROPOSED FINDINGS OF FACT SUBMITTED BY THE PETITIONER: 1. None submitted. RULINGS ON THE PROPOSED FINDINGS OF FACT SUBMITTED BY THE RESPONDENT: With regard to paragraph 1, with the deletion of the words "on physical diagnosis" in sentence 1, the paragraph is accepted. Paragraph 2 is accepted. Paragraph 3 is rejected as contrary to the weight of the evidence. Paragraph 4 is accepted. Paragraphs 5 through 9 are accepted. COPIES FURNISHED: David Sanders 359 Glenwood Avenue Satellite Beach, Florida 32937 Vytas J. Urba Assistant General Counsel Department of Professional Regulation 1940 North Monroe, Suite 60 Tallahassee, Florida 32399-0792 Jack McRay General Counsel Department of Professional Regulation 1940 North Monroe, Suite 60 Tallahassee, Florida 32399-0792 Diane Orcutt Executive Director Board of Chiropractic Examiners 1940 North Monroe, Suite 60 Tallahassee, Florida 32399-0792
The Issue Whether the Petitioner should receive additional credit on the Physical Diagnosis portion of the Chiropractic Licensure Examination administered May 10 through 13, 2000.
Findings Of Fact Based on the oral and documentary evidence presented at the final hearing and on the entire record of this proceeding, the following findings of fact are made: The Department is responsible for developing, administering, and scoring examinations to test the competence of persons seeking licensure in Florida as chiropractors. Section 456.017(1)(a), Florida Statutes (2000). Dr. Badalamente was a candidate for the chiropractic licensure examination administered May 10 through May 13, 2000. In an Examination Grade Report dated July 12, 2000, the Department advised Dr. Badalamente that he had failed the Physical Diagnosis portion of the examination, having attained a score of 69 points; a passing score on this portion of the examination is 75 points. Dr. Badalamente requested the opportunity to review the questions and his responses on this portion of the examination. In preparation for the examination review, Department personnel reviewed Dr. Badalamente's examination results and computed the score on the examination by hand. The Department found that there was a discrepancy between the computer- generated score assigned to Dr. Badalamente's responses and the hand-calculated score. After further review, the Department determined that one of the examiners had darkened an incorrect "bubble" that resulted in Dr. Badalamente's receiving no credit on one of the tasks when it was clear from the scoring sheet that the examiner intended to give Dr. Badalamente full credit for his response on the task. The Department adjusted Dr. Badalamente's score on the Physical Diagnosis portion of the examination to 73 points. Dr. Badalamente was advised of the amended score when he conducted the post-examination review of his responses, and an Amended Examination Grade Report was issued September 8, 2000, reflecting the corrected score. General information The Chiropractic Licensure Examination, including the examination administered in May 2000, consists of three parts: X-rays, which is a written examination; Physical Diagnosis, which is an oral examination lasting 70 minutes; and Techniques, during which the candidates are required to demonstrate various techniques of chiropractic adjustment. The Physical Diagnosis portion of the examination is a practical examination consisting of a number of "tasks." The examination candidate is given the complaints and other pertinent information about several hypothetical patients and is then required, among other things, to examine each "patient," to determine and administer appropriate tests, to answer questions, and, ultimately, to diagnose the patients' problems. The candidate performs several "tasks" related to each patient. Approximately 30 days before the examination is administered, the Department sends to each examination candidate a Candidate Information Booklet. The booklet contains general information about the examination, including a description of the parts of the examination, sample questions, and a list of references that should be used in preparing for the examination; information about the policies governing administration of the examination; and a description of the scoring procedures, including information about the post-examination review process. Two examiners score each candidate on the Physical Diagnosis portion of the examination, and a videotape of the candidate's responses is made. The examiners are selected in accordance with criteria established by Department rule, and they receive training before they are permitted to score a candidate. Each examiner participates as a trainee in scoring 15 or more examination candidates, and the points assigned by the trainee examiner are compared with those assigned by the regular examiners to determine the accuracy of the trainee's scores. The two examiners score the candidate separately, without communicating with one another, in accordance with written standards for each task. These standards are provided to the examiners prior to the examination, and the Department conducts a "standardization" before each administration of the examination. During the "standardization," each task on the Physical Diagnosis portion of the examination is discussed with the examiners, together with the correct answers. Examiners may ask questions, and the examination is discussed thoroughly. The goal of the "standardization" is for each examiner to assign a candidate the same score for the same task. The two examiners on any given examination rarely assign the candidate different scores on the same task. When it does happen, usually one examiner has missed something that the candidate did or misunderstood something that the candidate said. When this occurs, it is classified as a scoring error, and the videotape is reviewed. If the videotape reveals that one examiner heard or saw something that the other examiner did not see or hear, the Department changes the "incorrect" score to reflect the candidate's response as recorded on the videotape, although the "incorrect" score is changed only when the error would change the candidate's overall grade on the examination. The points assigned by the two examiners for each task on the Physical Diagnosis portion of the examination are averaged, and the sum of the average points for each task is the candidate's overall score on this portion of the examination. The two examiner's scoring Dr. Badalamente's performance on the Physical Diagnosis portion of the examination met the criteria established in the Department's rules and participated in the required training and standardization sessions. Dr. Badalamente's challenge After Dr. Badalamente's post-examination review of the scores assigned to his responses on the Physical Diagnosis portion of the examination, he challenged the scoring of his responses in Tasks 3, 11, 14, 17, 21, and 25. The examiners grading Dr. Badalamente's performance on the Physical Diagnosis portion of the examination were Examiner 23, who has served as an examiner for the chiropractic licensure examination for approximately 10 years, and Examiner 62, who was serving as an examiner for the first time. Task 3 Task 3 dealt with physical examination procedures, and the candidate was required to perform and describe the physical abdominal examination of a patient and to state the significance of "rebound tenderness." The task was worth a total of four points, and full credit was to be given only if the candidate correctly demonstrated and described an abdominal examination and responded correctly to the question; partial credit was to be given if the candidate either correctly demonstrated and described an abdominal examination or responded correctly to the question. Examiner 23 assigned Dr. Badalamente a score of "B" for this task, which was partial credit of two points; Examiner 62 assigned Dr. Badalamente a score of "C" for this task, which was full credit of four points.1 Dr. Badalamente responded to the specific question about rebound tenderness by stating that rebound tenderness in the lower right quadrant indicated "appendicitis." This answer, while correct for the lower right quadrant of the abdomen, was incorrect because Dr. Badalamente limited his response to only one area of the abdomen, rather than considering the entire abdomen. The Department could reasonably expect a candidate to respond to the question with the general answer of irritation or inflammation in the abdominal area. Three of the reference sources listed in the Candidate Information Booklet state that rebound tenderness is indicative of peritoneal inflammation, which could result from several different causes, including, but not limited to, appendicitis. In explaining her rationale for giving Dr. Badalamente full credit for Task 3, Examiner 62 noted on her scoring sheet that Dr. Badalamente stated during his physical examination of the patient that he was looking for inflammation.2 The decision of Examiner 62 to give Dr. Badalamente full credit for this task was within the discretion of the examiner. Task 11 Task 11 dealt with orthopedics. The candidate was given a hypothetical patient's symptoms and was required, first, to select four tests that should be performed in diagnosing the problem and, second, to identify the conditions suggested by positive responses to these tests. The task was worth a total of six points, and full credit was to be given only if the candidate chose four correct tests and gave four correct responses to the second part of the task; partial credit was to be given for three correct tests and responses and for two correct tests and responses; no credit was to be given for fewer than two correct tests and responses. Both Examiner 23 and Examiner 62 assigned Dr. Badalamente a score of "C" for his answer, which was partial credit of four points, indicating that Dr. Badalamente had given three correct tests and responses. Dr. Badalamente correctly identified the four tests that should be performed on the patient. In response to the question requiring him to identify the condition that would be suggested by a positive response to the piriformis test, Dr. Badalamente stated that a positive result would indicate a "piriformis problem." Dr. Badalamente's response was incorrect because it was a mere restatement of the obvious rather than the more specific, and correct, answer that it indicated a spasm of the piriformis muscle or sciatica.3 Task 14 Task 14 dealt with range of motion, and the candidate was required to demonstrate and describe hip internal rotation and hip flexion. The task was worth a total of four points, and full credit was to be given only if the candidate correctly performed two demonstrations of range of motion; partial credit was to be given if the candidate correctly performed one demonstration. Both Examiner 23 and Examiner 62 assigned Dr. Badalamente a score of "A" for the task, indicating that neither of his demonstrations was performed correctly, and he received no points for this task. Dr. Badalamente performed both of the range-of-motion demonstrations with the patient standing. This was incorrect because range of motion for hip internal rotation and hip flexion are to be performed with the patient supine or sitting.4 Task 17 Task 17 dealt with dermatomes and sensory tests, and the candidate was required to name all the dermatome patterns that should be tested, given the patient's symptoms, and to demonstrate the dermatome selected by the examiners. The task was worth a total of four points, and full credit was to be given only if the candidate correctly named all of the dermatome patterns and correctly demonstrated the selected dermatome; partial credit was to be given if the candidate either named all of the dermatome patterns or correctly demonstrated the selected dermatome. Both Examiner 23 and Examiner 62 assigned Dr. Badalamente a score of "A" for this task, indicating that he neither correctly named the dermatome patterns nor correctly demonstrated the dermatome, and he received no points for this task. Dr. Badalamente stated that, given the patient's symptoms, he would test the L5 and S1 dermatomes. The correct answer is the L4, L5, and S1 dermatomes, and Dr. Badalamente, therefore, failed to name one of the three dermatome patterns that should be tested. On the second part of Task 17, Dr. Badalamente was asked to trace the pattern of the L3 dermatome. The L3 dermatome runs from the lateral aspect of the thigh across the medial portion of the thigh to the inner thigh, past the patella. Dr. Badalamente failed to trace the entire length of the dermatome, indicating only the portion of the dermatome that runs on the lateral aspect of the thigh. Task 21 Task 21 dealt with diagnostic imaging. There were two questions in Task 21, and the first question required the candidate to specify the changes the candidate would make to correct underexposure of the X-ray film.5 The task was worth a total of four points, and full credit was to be given only if the candidate correctly answered both of the questions; partial credit was to be given if the candidate correctly answered one of the questions. Both Examiner 23 and Examiner 62 assigned Dr. Badalamente a score of "A" for the task, indicating that he failed to answer either of the two questions in Task 21 correctly, and he received no points for this task. Dr. Badalamente responded to the first question on Task 21 by stating that he would increase kVp and decrease MAS. Dr. Badalamente conceded at the hearing that, if this were his answer, it was incorrect. Task 25 Task 25 dealt with ancillary procedures, and the candidate was required to name three contraindications for the use of cryotherapy. The task was worth a total of two points, and full credit was to be given only if the candidate correctly named three contraindications; partial credit was to be given if the candidate correctly named one or two contraindications. Both Examiner 23 and Examiner 62 assigned Dr. Badalamente a score of "A" for the task, indicating that none of the contraindications he named was correct, and he received no points for this task. Dr. Badalamente named hemorrhage, infection, and malignancy as three contraindications for cryotherapy. None of these three conditions are contraindications for cryotherapy; cryotherapy is a recognized treatment for hemorrhage and infection and is also used to treat some kinds of malignancies.
Recommendation Based on the foregoing Findings of Fact and Conclusions of Law, it is RECOMMENDED that the Department of Health enter a final order dismissing the petition of Leonard Badalamente challenging his score on the Physical Diagnosis portion of the Chiropractic Licensure Examination administered May 10 through 13, 2000. DONE AND ENTERED this 21st day of August, 2002, in Tallahassee, Leon County, Florida. PATRICIA HART MALONO 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 21st day of August, 2002.
Findings Of Fact Petitioner took the podiatry licensure examination administered by the Respondent in July, 1989, receiving a grade of 66.9%, with 241 correct answers. A score of 75%, with 270 correct answers, is required to pass the examination for licensure. This podiatry examination was developed by the Bureau of Examination Services in conjunction with consultants who served as "item writers", and Florida licensed podiatrists. Five Florida licensed podiatrists selected items written by the various consultants from a bank of questions available for the 1989 examination. Competent substantial evidence was not introduced on behalf of the Petitioner to establish that the examination was in any way flawed in its preparation or method of selecting the actual questions used on this exam. There is a lack of competent substantial evidence in the record to establish that the grades which the Petitioner received on the July, 1989, podiatry licensure examination were incorrect, unfair, or invalid, or that the examination, and subsequent review session, were administered in an arbitrary or capricious manner.
Recommendation Based upon the foregoing, it is recommended that Respondent enter a Final Order dismissing the Petitioner's challenge to the grades he received on the July, 1989, podiatry licensure examination. RECOMMENDED this 7th day of May, 1991 in Tallahassee, Florida. DONALD D. CONN Hearing Officer Division of Administrative Hearings The DeSoto Building 1230 Apalachee Parkway Tallahassee, Florida 32399-1550 Filed with the Clerk of the Division of Administrative Hearings this 7th day of May, 1991. APPENDIX TO RECOMMENDED ORDER, CASE NO. 90-2803 Despite waiting an additional seven days until April 25, 1991, as requested by counsel for the Petitioner in his letter filed on April 19, 1991, no proposed recommended order was filed on behalf of the Petitioner. Rulings on the Respondent's Proposed Findings of Fact: Adopted in Finding 1. Adopted in Findings 2 and 3. COPIES FURNISHED: Melvyn G. Greenspahn, Esquire 3550 Biscayne Boulevard Suite 404 Miami, FL 33137 Vytas J. Urba, Esquire Northwood Centre, Suite 60 1940 North Monroe Street Tallahassee, FL 32399-0792 Jack McRay, Esquire Northwood Centre 1940 North Monroe Street Tallahassee, FL 32399-0792 Patricia Guilford Executive Director Board of Podiatry 1940 North Monroe Street Tallahassee, FL 32399-0792
The Issue The issue in this case is whether Kenneth D. Stahl, M.D. ("Dr. Stahl" or "Petitioner"), is entitled to an award of attorneys' fees and costs to be paid by the Department of Health, Board of Medicine ("Department" or "Respondent"), pursuant to section 57.105, Florida Statutes (2014).1/
Findings Of Fact Review of the record indicates that, at the time the Administrative Complaint was filed at DOAH, the following facts were known by Respondent, as later stated in the Findings of Fact of the Final Order of the underlying case: In February 2011, Patient C.C., a 52-year-old female, was admitted to Jackson Memorial Hospital ("JMH") with a diagnosis of perforated appendicitis. She also had a perirectal abscess. Her records indicate that she was treated with percutaneous drainage and a course of intravenous antibiotics. She was discharged on March 4, 2011. On June 22, 2011, Patient C.C. presented to the JMH Emergency Department complaining of 12 hours of abdominal pain in her right lower quadrant with associated nausea and vomiting. Shortly after her arrival, she described her pain to a nurse as "10" on a scale of one to ten. A computed tomography ("CT") scan of Patient C.C.'s abdomen was conducted. The CT report noted that the "the uterus is surgically absent," and "the ovaries are not identified." It noted that "the perirectal abscess that was drained previously is no longer visualized" and that the "appendix appears inflamed and dilated." No other inflamed organs were noted. The radiologist's impression was that the findings of the CT scan were consistent with non-perforated appendicitis. Patient C.C.'s pre-operative history listed a "total abdominal hysterectomy" on May 4, 2005. Patient C.C.'s prior surgeries and earlier infections had resulted in extensive scar tissue in her abdomen. Patient C.C. was scheduled for an emergency appendectomy and signed a "Consent to Operations or Procedures" form for performance of a laparoscopic appendectomy, possible open appendectomy, and other indicated procedures. Patient C.C. was taken to surgery at approximately 1:00 a.m. on June 23, 2011. Dr. Stahl was the attending physician, and notes indicate that he was present throughout the critical steps of the procedure. The Operative Report was dictated by Dr. Eddie Manning after the surgery and electronically signed by Dr. Stahl on June 23, 2011. The report documents the post-operative diagnosis as "acute on chronic appendicitis" and describes the dissected and removed organ as the appendix. Progress notes completed by the nursing staff record that, on June 23, 2011, at 8:00 a.m., Patient C.C. "denies pain" and that the laparoscopic incision is intact. Similar notes indicate that at 5:00 p.m. on June 23, 2011, Patient C.C. "tolerated well reg diet" and was waiting for approval for discharge. Patient C.C. was discharged on June 24, 2011, a little after noon, in stable condition. On June 24, 2011, the Surgical Pathology Report indicated that the specimen removed from Patient C.C. was not an appendix, but instead was an ovary and a portion of a fallopian tube. The report noted that inflammatory cells were seen. Surgery to remove an ovary is an oophorectomy and surgery to remove a fallopian tube is a salpingectomy. On Friday, June 24, 2011, Dr. Nicholas Namias, chief of the Division of Acute Care Surgery, Trauma, and Critical Care, was notified by the pathologist of the results of the pathology report, because Dr. Stahl had left on vacation. Dr. Namias arranged a meeting with Patient C.C. in the clinic the following Monday. At the meeting, Patient C.C. made statements to Dr. Namias regarding her then-existing physical condition, including that she was not in pain, was tolerating her diet, and had no complaints. Dr. Namias explained to Patient C.C. that her pain may have been caused by the inflamed ovary and fallopian tube or may have been caused by appendicitis that resolved medically, and she might have appendicitis again. He explained that her options were to undergo a second operation at that time and search for the appendix or wait and see if appendicitis recurred. He advised against the immediate surgery option because she was "asymptomatic." The Second Amended Administrative Complaint alleged that Dr. Stahl performed a wrong procedure when he performed an appendectomy which resulted in the removal of Patient C.C.'s ovary and a portion of her fallopian tube instead. The Final Order concluded that the evidence did not clearly show that the wrong procedure was performed. It concluded that it was more likely that exactly the right procedure was performed on Patient C.C. That is, it was likely that an oophorectomy and salpingectomy were the right procedures to remove the inflamed organs and address the abdominal pain that caused Patient C.C. to present at the JMH emergency room, but that the right procedure was initially denominated incorrectly as an "appendectomy," as a result of patient history and erroneous interpretation of the CT scan.
The Issue Whether the Petitioner is entitled to be licensed as a physician assistant.
Findings Of Fact Petitioner sat for the physician assistant licensure examination administered by Respondent October 6 - 9, 1995. Petitioner passed all portions of the examination except for the “Clinical Exam” part of the examination. Because he did not pass the Clinical Exam, Petitioner failed the licensure examination. Thereafter, Petitioner requested the opportunity to review the scoring of his examination and the video that was made of the performance. Petitioner was given ninety minutes for that review. The clinical exam required the candidate to physically examine “patients” with stated vital signs and presenting symptoms. The “patients” were healthy models. The candidate's examination of each patient was closely viewed by two examiners who separately graded various components of the candidate’s performance. The performance was video taped. The video tape included audio so that the verbal instructions to the candidate and the candidate's explanation of his examination could be heard. The Petitioner challenged the scoring of 17 components of the examination. Upon review of Petitioner’s challenge, Respondent gave him additional credit for 10 of the challenged components. That additional credit raised his score from 425 to 500, still short of the 600 points needed for a passing grade. Respondent established that Petitioner was given all the credit he deserved for his performance on the clinical examination. Even if Respondent had given additional credit for all 17 components he challenged, the Petitioner would not have achieved a passing score. This test was not arbitrary or capricious. The questions used were consistent with the instructions given the candidates and similar in nature to those used in other clinical examinations. Petitioner failed to establish that he was entitled to additional credit for his performance on the Clinical Exam portion of the physician assistant licensure examination.
Recommendation Based on the foregoing Findings of Fact and Conclusions of Law, it is RECOMMENDED that Respondent enter a final order dismissing Petitioner’s challenge to the scoring of his performance on the clinical exam portion of the physician assistant examination administered in October 1995. DONE AND ENTERED this 11th day of June, 1997, in Tallahassee, Leon County, Florida. CLAUDE B. ARRINGTON 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 11th day of June, 1997
