Findings Of Fact Petitioner, Shaikh Enayetul Karim, sat for the dental licensure examination administered by the Department of Professional Regulation in December 1985. The Petitioner received a failing score of "2.85" for the clinical portion of the examination and a score of "78" on the written and oral diagnosis portion. A passing score on all portions is necessary for licensure. The Petitioner complained of contradictory grading or disparate grades between each of the three examiners for a given procedure. Accordingly, pursuant to Department rules, the Petitioner's objections were reviewed by the Respondent's dental examination consultant as to the following procedures: Procedure 2 - amalgam restoration Procedure 5 - endodontic evaluation (posterior) Procedure 6 - endodontic evaluation (anterior) Procedure 7 - cavity preparation Procedure 8 - onlay wax-up Procedure 9 - pin amalgam preparation Procedure 10 - pin amalgam restoration The Respondent's consultant, Dr. Sue Ellen Hamilton, testified as an expert witness and was one of the three graders on Petitioner's original examination. Upon reviewing the Petitioner's examination and his scores for each procedure, she ultimately agreed with the grade assigned by the three examiners for procedures numbered 2, 5, 7, 8 and 10 above. She questioned the grades for procedures 6 and 9, however, and recommended that those two procedures be regraded by three additional independent graders. Upon these procedures being regraded, the Petitioner's scores still were insufficient to merit a passing score on the clinical portion of the examination. Passing that portion is required to pass the entire examination and to become licensed. Lucinda Ann Richards was accepted as an expert witness in the areas of examination development, evaluation and the administration of examinations. She is an examination development specialist with the Department of Professional Regulation and is a PhD candidate in "testing and measurement," a discipline involving training in the development and implementation of fair examinations which accurately test competency in a field such as dentistry. She established that the examination at issue was developed and administered in accordance with the Department's rules. She particularly described the method of training of examiners to ensure that they grade each procedure tested independently of each other and accord a candidate a fair evaluation, giving a candidate the benefit of the doubt in the case of an answer or procedure in which they feel the scoring thereof is a "borderline" passing or failing situation. She established that the examination is based upon "holistic material," that is, the material for the dental examination is not drawn from one or two schools or methods of dentistry, but rather the material for the examination and the questions and procedures upon which candidates are tested is drawn from all generally accepted schools or methods of dentistry and is graded on the same holistic basis, that is, candidates' answers are accorded passing scores if they are correct under theories or practices of any of the generally accepted schools or methods of dentistry related to the procedure or question posed to the candidate. She established that this holistic grading system is more fair and reasonable for examination candidates who typically are educated at many dental schools in many different states. Fairness of the examination and its grading is additionally ensured by the use of three different independent examiners who each independently grade each question or procedure without consultation with each other. Their grades are then submitted for each procedure and averaged so that the score the candidate obtains is an average score so that the candidate will get the benefit of those examiners who graded a given guest ion or procedure with the maximum grade, a "5" to counter balance an examiner who might have graded the procedure with a "1" or "2." Thus, as established by witness Hamilton, the grades assigned by the three examiners for procedures 2, 5, 7, 8 and 10 were determined upon review to be correct but, as to those grades for procedures 6 and 9 which Ms. Hamilton determined required regrading, it developed that upon regrading of those procedures he was accorded the same grade on procedure 6, but indeed received a lower grade on procedure 9. Thus, ultimately, the Petitioner's grade on the clinical portion of the examination at issue, upon regrading, was still insufficient to accord him a passing score. Contrary to Petitioner's remonstrances before and at hearing, his score was not sufficient so that one additional point would have passed him, even upon regrading his examination. Witness Sue Ellen Hamilton was accepted as an expert witness in the field of practice of dentistry and the evaluation of dental examination candidates. She was examiner number "083" who helped grade the Petitioner's original examination and who participated in the review of that examination, when he protested his score to the Department. She found that all the procedures mentioned above put at issue by the Petitioner except procedures 6 and 9, were graded correctly. For instance, she did agree with the Petitioner in her testimony that he identified the "canals" correctly, but the other mistakes on that procedure amply justified the original grade she and the other examiners accorded him. Procedure 8 was not accorded a passing score upon original grading or upon review by Ms. Hamilton. That procedure involved a wax "onlay" which was "waxed up" higher or modeled with a higher dimension than surrounding teeth. Ms. Hamilton established that this was a serious defect which would result in that tooth being the only tooth touching the opposing teeth in both jaws. Witness Hamilton otherwise in her testimony, amply established that the grades on procedures 2, 5, 7, 8 and 10 were correct as originally scored and that, upon the regrading she felt required on procedures 6 and 9, that the scores upon regrading were correct. She established that as to procedure 2, there was a serious defect involving an "open contact," that is, too much space between the teeth of the model. The Petitioner had been dissatisfied with the variation of the three examiners' comments about this procedure. Two of the examiners had criticized the open contact, and the third examiner noted "proximal contour." Ms. Hamilton established that these examiners' comments do not actually oppose each other in their import. It would not be possible to verify the fact of contact or lack of it by an X-ray "because of variances due to angulation" (see Petitioner's Exhibit 1). Ms. Hamilton established, however, that given that there was an open contact situation in the Petitioner's performance of this procedure, the procedure should have a failing grade without having the candidate redo that restoration because of the fundamental and serious nature of this defect. Concerning procedure 5, the grades given were "3", "5" and "1". Ms. Hamilton agreed with the Petitioner that the canal identification was correct. Even so, the "messial" wall was overextended and slight "pulp horns" were found, on the "lingual" wall. She felt that the grade of "5" accorded by one examiner was overly generous but it should be allowed to balance the grade of "1" given by another examiner so that a fair, holistic evaluation of that procedure was that score originally given, that is, an average of the grades "3", "5" and "1". Accordingly, she recommended no regrading. As another example, upon her review of the Petitioner's response to procedure 6 (grades given were "2", "4" and "3") she found that indeed the preparation was overextended incicsally, as the examiners had found, but she could find no evidence of the under-extension concerning which the Petitioner had been criticized and concedes that maybe examiner number "10" had made an error in making the wrong comment about this procedure. Even so, examiner "10" had given the Petitioner a passing grade on it and in an abundance of caution, Ms. Hamilton recommended that it be regraded since she felt the preparation did not deserve a failing grade. The regrading of procedure 6, however, did not result in increasing the overall score on the clinical portion of the exam to a passing grade. As to procedures 7 and 8, she found the grades were fair for those procedures and should stand. For instance, as to procedure 7, she found that the "axial walls will not draw," which is a defect determined originally by the examiners. As to procedure 8, she found that the "margins were generously bulky and the over-waxed buccal cusp and distal marginal ridge would cause hyperocclusion." She felt the overly generous grades of "3" and "4" accorded by two of the examiners adequately compensated for the low grade of "1" accorded by the third examiner and felt that the grade was fair as to that procedure also. Procedure 9 has already been discussed and Ms. Hamilton recommended a regrade of that procedure, which was done. She felt the grade of "5" accorded by one examiner was overly lenient, did not sufficiently balance the lower grade of "2" given by another examiner, hence the recommended regrading for reasons more particularly described in Petitioner's Exhibit 1. Finally, as to procedure 10, the pin amalgam restoration, all three examiners accorded the Petitioner a grade of "3." Ms. Hamilton, upon a review of these grades and of the procedure performed by the Petitioner found that the margins were bulky on the "proximal and buccal surfaces." The distal buccal cusp was too narrow. In short, she felt that the grades accorded this procedure were justified to begin with. In summary, as established by Ms. Hamilton, although the Petitioner felt many of the grades were inconsistent and contradictory, it was established that the comments of the examiners were guidelines to show candidates where their procedures differed from the ideal situation. Comments are designed to overlap each other for each procedure so each situation is evaluated as completely as possible. It is difficult, given different aspects and interpretations possible for each procedure to have agreement of all three examiners as to scoring on the same procedure. This is why three examiners were used so as to aim for a holistic evaluation of each procedure and to average the number scores accorded by each examiner so as to accord maximum fairness to the candidate. She and witness Richards established that this was done as to each of the contested procedure grades for the Petitioner. With this type of grading in mind, it was shown that the object of the examination review accorded the Petitioner when he first objected to his grades, is to try to discern if a grade by one examiner is unjustifiably low and is not compensated for by a lenient grade from the other examiner, or examiners, for the same procedure. If one examiner, for instance, accords a grade of "1" for a procedure and other examiner on the same procedure accords a grade of "5", it may be that the grade of "1" is too low but that the grade of "5" is too beneficial to the candidate. Thus, the grades are averaged and the lenient grade is allowed to be averaged with the "too-low" grade, which results in a fair result for the candidate and helps to render the examination as a whole, and each procedure, a fair test of the candidate's overall competence in the field of dentistry. It has thus been established by Respondent's expert witnesses that the examination development and its administration and method of grading was professionally accurate, fairly took into account, and gave candidates the benefit of, their education in various schools or methods of dentistry, was statistically valid and was free of arbitrariness or caprice.
Recommendation Having considered the foregoing Findings of Fact, Conclusions of Law, the evidence of record, and the candor and demeanor of the witnesses, it is, therefore RECOMMENDED that the Petitioner, Shaikh Enayetul Karim, be denied licensure as a dentist in the State of Florida. DONE and ORDERED this 24th day of June, 1987, in Tallahassee, Florida. P. MICHAEL RUFF 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 24th day of June, 1987. APPENDIX TO RECOMMENDED ORDER, CASE NO. 86-2635 The Petitioner Karim did not file Proposed Findings of Fact and Conclusions of Law in this case. The Respondent Department of Professional Regulation did file Proposed Findings of Fact and Conclusions of Law, all of which were accepted. COPIES FURNISHED: Shaikh Enayetul Karim Apartment 30 524 Morris Avenue Elizabeth, New Jersey 07208 Jeffrey H. Barker, Esquire Deputy General Counsel Department of Professional Regulation 130 North Monroe Street Tallahassee, Florida 32399-0750 Van Poole, Secretary Department of Professional Regulation 130 North Monroe Street Tallahassee, Florida 32399-0750 Joseph A. Sole, Esquire General Counsel Department of Professional Regulation 130 North Monroe Street Tallahassee, Florida 32399-0750 Pat Guilford, Executive Director Board of Dentistry Department of Professional Regulation 130 North Monroe Street Tallahassee, Florida 32399-0750
Findings Of Fact Petitioner is licensed by the State of Florida as a Clinical Laboratory Technician. Petitioner applied to the Respondent for licensure as a Clinical Laboratory Technologist with specialties in microbiology, serology, clinical chemistry, hematology, immunohematology and chemistry. On February 11, 1980, Respondent denied Petitioner's application for a technologist's license for the reason that Petitioner does not have the sixty semester hours or HEW exam required under Section 10D-41.25(9) or (10), Florida Administrative Code. Petitioner holds a high school equivalency diploma. Petitioner attended the Manhattan Medical Assistants' School in 1960-1961 and graduated from that school, receiving a diploma as a Laboratory Technologist. When Petitioner attempted to obtain a transcript of his studies at that school, he discovered that the school is no longer in business; and, accordingly, he is unable to obtain a transcript reflecting his studies there. Petitioner does not have a bachelor's degree from an a"credited college or university. Through the years, Petitioner has taken a number of continuing education courses, but these courses have not been affiliated with an accredited college or university. Prior to moving to Florida, petitioner was employed for seventeen years as a Laboratory Technologist at the New Rochelle Hospital Medical Center and was a supervisor of the evening and night shifts at that Center. Petitioner's witnesses testified as to the quality of Petitioner's work as an employee of the Department of Pathology at South Miami Hospital. Petitioner has taken the U. S. Public Health Service proficiency examination in clinical laboratory technology. A satisfactory score on all sections of that examination must be obtained in order to Pass the examination. Petitioner passed each section of the examination except for the hematology section. He attempted to retake the examination but was advised that the March 30, 1979, examination was the last test scheduled by HEW. That examination has been administered on five different occasions between the years 1975 and 1979. There is no information available as to whether the HEW examination will or will not ever be administered again. That examination is not the same as the licensure examination given by the Respondent but can act as a prerequisite, if satisfactorily completed, to the state licensure examination. An approved course of study is available to Petitioner at Miami-Dade Community College. Personnel at that school have advised him that he would receive thirty-two credits for his life's work and that he would be required to take six or seven examinations plus approximately a year's worth of courses. Petitioner does not desire to attend that college even on a part-time basis several times a week, since he is employed at two full-time jobs at this time.
Recommendation Based upon the foregoing findings of fact and conclusions of law, it is RECOMMENDED: That a Final Order be entered denying Petitioner's application for a technologist's license pursuant to the provisions of The Florida Clinical Laboratory Law. RECOMMENDED this 10th day of October, 1980, in Tallahassee, Florida. LINDA M. RIGOT Hearing Officer Division of Administrative Hearings The Collins Building Room 101 Tallahassee, Florida 32301 (904) 488-9675 Filed with the Clerk of the Division of Administrative Hearings this 10th day of October, 1980. COPIES FURNISHED: Richard N. Krinzian, Esquire 8585 Sunset Drive, Suite 190 Miami, Florida 33143 Morton Laitner, Esquire Dade County Department of Public Health 1350 N.W. 14th Street Miami, Florida 33125 Mr. Alvin J. Taylor, Secretary Department of Health and Rehabilitative Services 1323 Winewood Boulevard Tallahassee, Florida 32301
The Issue As to Case 93-6927, whether Respondent, a licensed physician, violated the provisions of Section 458.331(1)(m), (t), (v), and (dd), Florida Statutes, as alleged in the Administrative Complaint and the penalties, if any, that should be imposed. As to Case 93-6928, whether Respondent violated the provisions of Section 458.319(5), 458.327(1)(a), and 458.331(1)(x), Florida Statutes, as alleged in the Administrative Complaint and the penalties, if any, that should be imposed. As to Case 93-6929, whether Respondent violated the provisions of Section 458.331(1)(x), Florida Statutes, as alleged in the Administrative Complaint and the penalties, if any, that should be imposed.
Findings Of Fact Petitioner is the agency of the State of Florida that regulates the practice of medicine. Respondent is a licensed physician in the State of Florida and has been issued license number ME 0028412 by the Petitioner. CASE NO. 93-6927 On December 12, 1990, Susan D. Bernhardt conducted an inspection for the Florida Department of Health and Rehabilitative Services (DHRS) of an abortion clinic named Miami International Esthetics Center (MIEC). Ms. Bernhardt was hired as a consultant by DHRS to conduct random inspections of MIEC pursuant to a stipulation between DHRS and MIEC. Ms. Bernhardt is a registered nurse and is experienced in surgical procedures. Ms. Bernhardt observed Respondent perform an abortion on a patient at MIEC on December 12, 1990. Also present in the operating room was a nurse anesthetist, to whom Respondent referred as Mr. Martin. Respondent, Mr. Martin, and Ms. Bernhardt were present in the operating room at all times during the procedure. Mr. Martin administered anesthesia and the patient lost consciousness. Shortly after losing consciousness, the patient began making sounds which Ms. Bernhardt described as "crowing noises" and to which Dr. Van Eldik referred to as "stridors". These sounds indicate that the patient's air passages are blocked, a condition that requires prompt action from the physician or from the person administering anesthesia since the condition can be life threatening. Ms. Bernhardt testified that she went to the patient and used her stethoscope to confirm that the patient was having breathing difficulties. She thereafter tilted the patient's head and restored her breathing. The amount of time that lapsed between the time the patient first experienced difficulties breathing and the time Ms. Bernhardt acted was not established. While it is clear that neither Respondent or Mr. Martin 1/ acted to provide the patient with any relief or to assure that her air passages were open so that she could receive adequate oxygen, it is not clear whether the action of Ms. Bernhardt obviated the necessity for either the physician or the nurse anesthetist to act. Consequently, it is found that Petitioner failed to establish by clear and convincing evidence that Respondent failed to properly supervise Mr. Martin by failing to order him to assist the patient when Ms. Bernhardt acted promptly to relieve the patient. Emergency equipment was maintained on a crash cart that was in the operating room during the procedure Ms. Bernhardt observed. As the operating surgeon, Respondent was responsible for making sure that appropriate emergency equipment was readily available. Appropriate emergency equipment would include emergency drugs on the crash cart. Throughout the procedure there were no emergency drugs present on the crash cart. Respondent failed to adequately supervise Mr. Martin to ensure that appropriate emergency equipment was readily available. As part of her inspection of MIEC, Ms. Bernhardt reviewed medical records at the clinic pertaining to patients of the Respondent. Some of the records that were reviewed by her are contained in Petitioner's Exhibit 5. Respondent's records reviewed by Ms. Bernhardt were of overall poor quality. Documentation concerning physical examination was scanty and often failed to include the size of the patient's uterine and a description of the presumptive signs of pregnancy. Anesthesia records were not filled out. Documentation concerning the recovery room period was virtually nonexistent. No vital signs or progress notes were charted. There was no follow-up documentation evidencing a pelvic examination and no notation of patient complaints or symptoms. The records reviewed by Ms. Bernhardt during her inspection did not justify or adequately document the course of treatment for the respective patients. A subpoena was served on Respondent by one of Petitioner's investigators that required him to turn over all medical records pertaining to certain named patients. A similar subpoena was served on Mr. Angel Caso, the owner of MIEC. In response to the subpoena that was served on his client, Respondent's attorney informed the investigator that Respondent did not have any medical records other than those that would have been maintained at the MIEC. In response to the subpoena that was served on him, Mr. Caso turned over medical records pertaining to 45 patients. These records reflect that the Respondent was their attending physician. Mr. Caso could not be subpoenaed by Petitioner to compel his attendance at the formal hearing because he could not be located. The medical records that were turned over to Petitioner pursuant to subpoena were admitted into evidence as Petitioner's Exhibit 5 as records received by Petitioner during the course of an official investigation. There was no evidence that any other medical records pertaining to these patients exist. The medical records that constitute Petitioner's Exhibit 5 do not justify or adequately document the course of treatment of the respective patients. CASE NO. 93-6928 Section 458.319(5), Florida Statutes, provides, as follows: (5) The licensee must have on file with the department the address of his primary place of practice within the state prior to engaging in that practice. Prior to changing the address of his primary place of practice, whether or not within this state, the licensee shall notify the department of the address of his new primary place of practice. The Petitioner maintains the addresses of physicians by computer. There is no statute or rule that requires a physician to notify the Department in writing as to a change of address, but the Department's policy is to require that address changes be in writing and that the request for a change of address come from the physician. There was no written notification from Respondent to the Petitioner that his business address had changed prior to September 1992. At the time of the formal hearing, Respondent's business address was 102 East 49th Street, Hialeah. His former business address was 4821 West 4th Avenue, Hialeah, Florida. At the times pertinent to this proceeding, Respondent's home address was 14710 Day Pine Avenue, Miami, Florida. As of December 17, 1990, Petitioner had been informed of that address. Petitioner's investigator, Diane Robie, interviewed Respondent at his business address on East 49th Street on August 22, 1991. Respondent had been at this address for approximately eight months as of August 22, 1991. This new business address was reflected by Ms. Robie's report, which was filed with Petitioner on October 8, 1991, but that report did not trigger a change of the business address Petitioner maintained for Respondent in its computers. Respondent's license to practice medicine was scheduled to expire on December 31, 1991. In mid October 1991, the Department of Professional Regulation (Department) mailed a renewal notice to Respondent's former business address on West 4th Avenue. As required by Section 458.319(4), Florida Statutes, the Department routinely mails to the physician a renewal form that the physician must use to renew his license. This mailing takes place 60 days before the physician's license is scheduled to expire. This renewal form is generated by computer and is sent to the mailing address that is on record with the Department and maintained by computer. It was the Department's policy to try to notify a physician at his home address if a renewal notice is returned from a stale office address. There was no evidence that the renewal notice and the renewal form that was mailed to Respondent at his former address in October 1991 was returned to the Department as being an incorrect address. The evidence failed to establish what happened to the renewal notice that was mailed to Respondent in mid-October 1991. There was no further attempt by the Department following the mid-October 1991 mailing to notify the Respondent at his home address or business address that his license was about to expire. Respondent's license expired on December 31, 1991, and his licensure automatically reverted to inactive status pursuant to Section 458.319(3), Florida Statutes. Respondent made no effort to contact the Department until June 1992 at which time his secretary/office manager contacted the Department by telephone and advised that Respondent had not received the renewal documentation. On August 10, 1992, the Petitioner wrote to Respondent at his home address. This was the first written communication between the parties since the mid-October 1991 mailing. Respondent mailed a check in the amount of $500.00 for the renewal of his license to the Department in September 1992. On October 6, 1992, the Department wrote Respondent at his former address on West 4th Avenue and advised that prior to the renewal of his license, Respondent had to pay an additional fee in the amount of $350.00 for the processing of his renewal application and that he would also have to submit proof that he had earned required continuing medical education credits. On February 15, 1993, the Department sent to Respondent a letter at his East 49th Street address that provided as follows: This letter is in response to your (sic) to your submission to renew your Florida medical license which was received in the Board office on 9-15-92. Unfortunately the Board of Medicine cannot comply with your request until the follow- ing is received: $350.00 renewal fee. (in addition to the $500 already submitted) You did not fill out the Financial Respon- sibility portion of the renewal application, therefore, you will need to fill out a new form, and have it properly notarized. Please submit an affidavit for your active practice activities between January 1, 1992, and the present date. Any person applying for reactivation of a license must show either that such licensee main- tained tail insurance coverage which provided liability coverage for incidents that occurred on or after January 1, 1987, or the initial date of licensure in this state, whichever is later, and incidents that occurred before the date on which the license became inactive; OR that such licensee MUST SUBMIT A NOTARIZED AFFIDAVIT STATING THAT SUCH LICENSEE HAS NO UNSATISFIED MEDICAL MALPRACTICE JUDGMENTS OR SETTLEMENTS AT THE TIME OF APPLICATION FOR REACTIVATION. After July 1, 1992, you will need to submit copies of at least 40 hours of Category I CME earned between January 1, 1990, and the present date. Five of these hours must be in Risk Management. Also one hour of HIV/AIDS Category I CME needs to be submitted. Once the above items are received, we will proceed with the issuance of an active Florida medical license. (Emphasis is in the original.) Respondent met all requirements for the renewal of his medical license on March 16, 1993, the date on which his license was reactivated. Between January 1, 1992, and March 15, 1993, Respondent engaged in the practice of medicine in the State of Florida without an active license. Case 93-6929 Petitioner filed an Administrative Complaint against Respondent on April 27, 1988, which was subsequently referred to the Division of Administrative Hearings and assigned DOAH Case No. 88-5546. On February 28, 1989, the parties to that proceeding executed a "Stipulation" which settled the dispute. On April 19, 1989, the Board of Medicine entered a Final Order that accepted the Stipulation and ordered the parties to abide by its terms. Pertinent to this proceeding, Paragraph 4 of the Stipulation required the following: 4. Within one (1) year of the date of filing of the Final Order incorporating the terms of this stipulation, Respondent shall complete twenty-five (25) hours of Category I Continuing Medical Education in the areas of Risk Management and/or Medical Records Keeping. Such continuing education shall be in addition to that amount required for renewal of licensure. Category I Continuing Medical Education is a course approved by the American Medical Association as a top level course. In March 1990, Respondent completed a 25 hour course sponsored by Jackson Memorial Hospital in the area of "Medical Records Keeping". Respondent notified Petitioner on March 21, 1990, that he had completed this course. This was the only course that Respondent claimed to have taken in satisfaction of the Final Order entered in DOAH Case 88-5546. This course has not been designated as a Category I Continuing Medical Education course by Jackson Memorial Hospital. The Petitioner advised the Respondent that the course he had taken did not satisfy its order. Respondent thereafter requested that the matter be reviewed by Petitioner's Probation Committee. This request was granted, but the Probation Committee determined that the course was not acceptable. Respondent did not comply with the order until March 16, 1993.
Recommendation Based on the foregoing Findings of Fact and Conclusions of Law, it is RECOMMENDED that the Petitioner enter a final order that adopts the findings of fact and conclusions of law contained herein and which incorporates the following: Find Respondent not guilty of practicing beyond the scope of his competence in violation of Section 458.331(1)(v), Florida Statutes, as alleged in Count One of Case 93-6927. Find Respondent not guilty of practicing below the standard of care in violation of Section 458.331(1)(t), Florida Statutes, as alleged in Count Two of Case 93-6927. Find Respondent guilty of failing to keep proper medical records in violation of Section 458.331(1)(m), Florida Statutes, as alleged in Count Three of Case 93-6927. For this violation, Respondent should be reprimanded, assessed an administrative fine in the amount of $1,000.00, and placed on probation for a period of two years, to run concurrently with any other period of probation imposed on Respondent. Find Respondent not guilty of failing to properly supervise the nurse anesthetist when the patient experienced breathing difficulties in violation of Section 458.331(1)(dd), Florida Statutes, as alleged in Count Four of Case 93- 6927. Find Respondent guilty of failing to ensure that the crash cart was appropriately equipped, thereby failing to properly supervise the nurse anesthetist in violation of Section 458.331(1)(dd), Florida Statutes, as alleged in Count Four of Case 93-6927. For this violation, Respondent should be reprimanded and assessed an administrative fine in the amount of $250.00. Find Respondent guilty of violating the provisions of Section 458.319(5), Florida Statutes, and thereby violating Section 458.331(1)(x), Florida Statutes, by failing to timely notify Petitioner of his change of business address as alleged in Count One of Case 93-6928. For this violation, Respondent should be reprimanded and assessed an administrative fine in the amount of $250.00. Find Respondent guilty of violating the provisions of Section 458.327(1)(a), Florida Statutes, and thereby violating Section 458.331(1)(x), Florida Statutes, by practicing medicine in the State of Florida after his license expired as alleged in Count Two of Case 93-6928. For this violation, Respondent should be reprimanded and assessed an administrative fine in the amount of $1,000.00, and placed on probation for a period of two years, to run concurrently with any other period of probation imposed on Respondent. Find Respondent guilty of violating the provisions of Section 458.331(1)(x), Florida Statutes, by failing to timely comply with an order of the Board of Medicine alleged in Case 93-6929. For this violation, Respondent should be reprimanded and assessed an administrative fine in the amount of $250.00. DONE AND ENTERED this 31st day of January, 1995, in Tallahassee, Leon County, Florida. CLAUDE B. ARRINGTON 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 31st day of January, 1995.
The Issue The issue in this case is whether Petitioner should receive a passing score on the clinical portion of the August 2000 optometry licensure examination.
Findings Of Fact In August 2000, Petitioner took the optometry licensure examination and failed to pass the clinical portion of the exam. The clinical portion is where the candidate is required to perform certain patient procedures. The student, or candidate, is evaluated in the process of performing those procedures by two examiners. Each examiner grades the candidate independently of whatever score the other examiner may award on a particular procedure. With regard to the contested questions in this matter, Petitioner objected to the awarding of credit by one examiner and failure of the other examiner to grant credit. In the conduct of the clinical portion of the examination, each procedure is performed twice, once for each examiner. The examiners are not permitted to confer as they apply uniform grading standards to a candidate's performance in demonstrating a particular procedure. Additionally, the examiners have been previously subjected to standardization training where they are trained to apply grading standards in a consistent manner. Both examiners in Petitioner's examination were experienced examiners. Where one examiner gives a candidate one score and the other examiner gives a different score, the two scores are averaged to obtain the candidate's score on that question. With regard to Question 1C on the examination, the candidate is required to tell the patient to look at his or her nose. At the same time, the candidate must hold up a finger in a stationary, non-moving manner. By his own admission, Petitioner failed to comply with this requirement in that his hands were moving. With regard to Question 7A, the candidate was required to tell the patient to look at a distant target. Petitioner told the patient to look straight ahead and argued at final hearing that his instruction was adequate for him to assume that the patient was looking at a distant target. Notably, this question on the examination seeks to elicit a candidate's skill at administering a neurological test of the patient's eye and brain coordination and requires that the candidate specifically tell the patient to look at a distant target. With regard to Question 13C, the candidate must perform a procedure designed to detect retinal lesions. The candidate and the examiner simultaneously look through a teaching tube where the candidate is asked to examiner the patient's eye in a clockwise fashion. When told to look at the nine o'clock position of the retina, Petitioner failed to look at the correct position. By his own admission Petitioner stated that since he had to perform the procedure twice, it is possible that he did not perform the procedure correctly for one examiner. Question 34A relates to Tonometry; the measure of intraoccular pressure (IOP) in the eye. Petitioner was not given credit by one examiner because Petitioner rounded the pressure results he observed. He argued that his answer of 12 was acceptable since he had rounded to the result within 0.5mm of what the machine detected in regard to the patient's eye. One of the purposes of this procedure is to determine whether the candidate can accurately read the dial to the machine. Consequently, Petitioner's failure to perform properly with regard to this procedure was appropriately graded.
Recommendation Based upon the foregoing Findings of Fact and Conclusions of Law, it is recommended that a Final Order be entered dismissing Petitioner's challenge to the grade assigned him for the August 2000 optometry licensure examination. DONE AND ENTERED this 23rd day of February, 2001, 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 www.doah.state.fl.us Filed with the Clerk of the Division of Administrative Hearings this 23rd day of February, 2001. COPIES FURNISHED: Jayeshkumar Vallabhbhai Patel, O.D. 1601 Norman Drive, Apartment GG-1 Valdosta, Georgia 31601 Cherry A. Shaw, Esquire Department of Health 4052 Bald Cypress Way, Bin A02 Tallahassee, Florida 32399-1703 Theodore M. Henderson, Agency Clerk Department of Health 4052 Bald Cypress Way, Bin A02 Tallahassee, Florida 32399-1701 William W. Large, General Counsel Department of Health 4052 Bald Cypress Way, Bin A02 Tallahassee, Florida 32399-1701 Dr. Robert G. Brooks, Secretary Department of Health 4052 Bald Cypress Way, Bin A00 Tallahassee, Florida 32399-1701
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 Donald A. Moyant, Petitioner, operates a contractors' exam school in Brandon, Florida, at which he preps builders to take the CILB exam for licensure as contractors. Petitioner took the exam given in June 1985 and received a score of 58.60. A score of 70.00 is required to pass this examination. The only answer that Petitioner questions is the answer he supplied to question No. 2, which related to the number of reinforcing bars required in a concrete slab of given dimensions and spacings of the bars. In Petitioner's solution to the problem he dropped the fractional bar that resulted from dividing the length of the slab by the spacing between bars. The correct solution requires the addition of a bar for this fractional spare. Petitioner's purpose in pursuing this proceeding is to obtain information to use in his Contractors Exam School, Inc. Since he would not have passed the examination even if his solution to question No. 2 had been marked correct, Petitioner is without standing to bring this action because he is doing so on behalf of the school he runs and not to allow him to receive a passing grade.
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
Findings Of Fact At all times pertinent to the issues herein, the FBM, Respondent herein, was the state agency responsible for the licensing of medical doctors in Florida and the regulation of the practice of medicine in this state. Petitioner is a medical doctor licensed by the Board to practice in Florida. The parties stipulated to the following facts, and it is so found: The Florida Board of Medicine employs no specific criteria for the recognition of practitioners as specialists for advertising purposes other than the rule. The Board of Medicine has not reviewed the activities of the ABMS as it relates to its criteria for the recognition of specialists. The FBM has never adopted written standards, policies or guidelines governing the actions of the ABMS or their separately incorporated, financially independent member boards. The ABMS has never petitioned or applied to the FBM to be considered as a recognizing agency pursuant to Rule 61F6-24.001(2)(f), formerly rule 21M-24.001(2)(f). There are no written standards relating to qualifications for "recognizing agencies" as the term is used in the above-mentioned rule. Pursuant to the rule, the FBM designated specialty boards of the ABMS, a private organization, to be recognizing agencies without establishing any written standards or guidelines for the recognition of a physician as a specialist. The ABMS does not, itself, establish specific criteria standards or requirements for the certification of particular physician specialists. The ABMS utilizes guidelines and requirements established by separately incorporated, financially independent bodies known as specialty boards. The FBM has established no written standards, policies or guidelines to which the ABMS must adhere relating to the recognition of individual practitioners as specialists. The FBM has adopted no rules relating to the regulation or recognizing agencies as defined by the rule. The FBM has not established criteria relating to the qualification of non-ABMS organizations as recognizing agencies under the rule. The FBM has no input into the standards employed by the separately incorporated boards. There are no FBM rules requiring ABMS compliance. The FBM has no mechanism for review of the actions of either the ABMS or its separately incorporated boards. Regardless of standards employed by groups which recognize physicians as specialists, if the groups are not member organizations of the ABMS, advertising specialty achievements of these groups is not permitted under Florida law. Petitioner has been licensed as a physician by the FBM since 1976. He has completed a residency program in orthopedics but has not been certified in this specialty by a member board of the ABMS. However, he identifies himself as a diplomate of the American Academy of Neurological and Orthopedic Surgeons on his letterhead on correspondence mailed from his office and on various correspondence sent to Associated Insurance Brokers Claims Management in regard to a patient. Though he claims he did not intend his letterhead identification as a board diplomate to be advertising, he acknowledged such designation enhanced his stature as an orthopedic surgeon and many insurance carriers approve higher patient charges for various specialists. Thereafter, the FBM initiated disciplinary action against Petitioner on the basis that his "advertising" was in violation of rule 61F6-24.001(2)(f), F.A.C. which prohibited false, deceptive or misleading advertising, and which implied those conditions if the advertising stated or implied the physician was formally recognized as a specialist in a medical specialization unless such recognition was by an agency recognized by the ABMS or another FBM approved agency. Petitioner subsequently filed this challenge to that rule. In the interim, a Division of Administrative Hearings Hearing Officer held a formal hearing on the disciplinary administrative Complaint and on December 20, 1993, entered a Recommended Order in which he found that Petitioner had disseminated the alleged letterhead and that constituted advertising. Since the specialty certification was by an agency not recognized by the ABMS or any other approved recognizing agency, Petitioner was in violation of the rule. The FBM was scheduled to act on the Recommended Order at its meeting to be held on February 4 - 6, 1994. Whether such action was taken, or the nature thereof are not known to the undersigned. Dr. Michael Rask, a medical doctor licensed to practice in Oregon, California, Nevada, and Arizona, and certified in orthopedic surgery by an ABMS recognized board, is Chairman of the Board of the American Academy of Neurological and Orthopedic Surgeons, (Academy). The Academy is an educational, nonprofit, eleemosynary society of physicians and surgeons across America located in Las Vegas, Nevada. It has some international members. It is accredited by the American Federation for Medical Accreditation, (Federation), of which Dr. Rask is also the Chairman. The Federation has close to 50 specialty and sub-specialty boards in its membership, 35 of which are also members of the Academy. Membership in the Academy is neither illegal nor inconsistent with the lawful practice of medicine in Florida. Petitioner, Dr. Feldman, has been a member of the Academy since 1980. The Academy has approximately 650 certified members. For certification in orthopedic surgery as a specialty, the Academy requires completion of a five year residency in that service, in addition to 3 years practice experience. Both a written and an oral examination are required. The tests are formulated by the Academy's national examination committee who are members of the Academy. Between 50 and 60 percent of the committee members are also certified by ABMS recognized specialty boards, but Dr. Rask was unable to identify the members without reference to the Academy's archives, which were not available. Failure rate on the examinations runs from 25 to 28 percent and Dr. Rask feels the tests are comparable to those administered by ABMS member boards. The Academy publishes periodic medical journals edited by Dr. Rask as a part of its educational program and certifies continuing medical education courses accepted by both Texas and California as well as, "maybe some others." The Academy specialty board criteria have been approved by the US Department of Labor which, by letter dated December 18, 1984, recognized the Academy as a "bona fide medical specialty board" and indicated its diplomates could be accorded status equivalent to that of ABMS diplomates in their respective fields. Educational organizations have also recognized the Academy including the International College of Surgeons, United States Section. Nonetheless, it has not been recognized by the ABMS nor has any other recognition board sought approval from the FBM during the period between 1980 through April 1993. Since that time, four requests, including one from the American Academy of Neurologic and Orthopedic Surgeons, have been received by the FBM but they have been held in abeyance pending FBM rulemaking activity to develop appropriate criteria for approval. 10. Rule 61F-24.001(2)(f), F.A.C., formerly 21M-24.01, F.A.C., which is challenged in this matter, was adopted by the FBM in 1980 and amended the same year. In 1988 it was again amended to require ABMS recognition of specialty boards which certified individual physicians. At the time of adoption of the rule and of the amendment thereto, the FBM members recognized the organization and purpose of the ABMS and intended it to be the recognition agency for specialty certification as it relates to physician advertising. Dr. J. Lee Dockery has been Executive Vice-president of ABMS since July, 1991. Before that time he was in the private practice of medicine in Florida and a member of the Florida Board of Medicine. The ABMS is a nonprofit private organization not governmentally regulated, incorporated in Illinois. It is made up of 24 separately incorporated and financially independent specialty boards. There are approximately 126 other self-designated boards for the purposes of certification. The ABMS maintains no files on the standards of certification of these self-designated boards. According to Dr. Dockery, these self-designating boards are not accepted by the medical profession. The independent specialty boards within the ABMS framework develop the criteria for admission to the certifying examinations they administer. They also develop the examinations, determine the examinations' validity, score them, and report the passing scores to the individual physicians, along with certificates of qualification. The ABMS, on the other hand, is the agency which approves the establishment of a specialty or sub-specialty and the independent board for that specialty establishes the criteria and requirements for certification in that specialty. The ABMS does not prepare or grade specialty examinations nor does it review the results of the tests. It also does not establish the requirements for admission to specialty examinations. This is done by the individual certifying board. There are uniform standards among the 24 member boards which relate to the completion of required educational programs under which that specialty was approved for authorization purposes. These standards may vary in terms of length of years of training required but not as to the accreditation of that training. All member specialty boards require initial specialty training for sub-specialties in addition to the training for initial certification in the specialty. Once a physician is certified based on the requirements in place at the time, he does not lose that certification if the requirements for certification are subsequently increased. None of the fee paid by physicians to specialty boards is paid to the ABMS. The ABMS does not lobby, though it has, in some cases, given testimony before state medical boards concerning proposed legislation which, it feels, would inappropriately diminish the qualifications for certification, in order to insure the health of the public is protected. There is an organization for osteopathic physicians similar to the ABMS. It is called the American Osteopathic Association. The American Academy of Neurological and Orthopedic Surgeons is not and never has been recognized by ABMS, nor has the American Federation for Medical Accreditation. Using the term "diplomate" of an organization not affiliated with the ABMS is not improper since that term signifies only the passage of an examination and not certification of expertise. Also, placement of a credential in a cirriculum vitae is different from placing it in a letterhead. The issue is how the placement is to be used. Whereas the former has limited application, the latter may be widely disseminated.
Findings Of Fact Respondent's name was one of about three hundred on a list of public accountants certified in Florida for whom, at the close of the initial period following institution of the requirement, petitioner had no record of the taking of continuing professional education courses or of the passing of a written professional examination. As a result, petitioner mailed respondent a form letter advising him of the situation, in February of 1977. Receiving no reply, petitioner mailed a second letter to respondent on April 28, 1977, stating that he "ha[d] failed to comply with F.S. 473.111(4) and Rule 21A-15" and that his suspension had been recommended to petitioner for that reason. On May 11, 1977, respondent visited petitioner's offices in Gainesville and spoke to George Thomas McCall, at the time petitioner's coordinator for continuing professional education. Mr. McCall gave respondent three reporting forms on which respondent proceeded, without reference to any notes, to list various titles in the column styled "Name of Course or Program," filling in corresponding blanks in columns for the dates of the courses, for their sponsors and for "Credit Hours Claimed." Petitioner's exhibit No. 1. Douglas H. Thompson, Jr., petitioner's executive director, asked Jean P. Finegold, Mr. McCall's successor, to attempt to verify that respondent had taken the continuing professional education courses he had listed. Ms. Finegold wrote respondent requesting documentation. Petitioner sent this letter by certified mail, but it was returned unclaimed. Ms. Finegold also wrote each of the four institutions listed by respondent as sponsors of continuing professional education courses that he had taken. The United States Department of Labor, listed by respondent as the sponsor of 48 hours of course work he had taken in the auditing and accounting category, never replied to Ms. Finegold's inquiry. Because respondent had indicated, on the reporting form for 1974, that he took courses named "Estate Planning" and "Banking" sponsored by the Florida Institute of Certified Public Accountants (FICPA), Ms. Finegold wrote FICPA asking, inter alia, for verification of respondent's attendance at those courses. Respondent listed no other courses sponsored by FICPA on any of the reporting forms. Under the supervision of FICPA's assistant Director, John Scharbaugh, Vicki Ware researched the FICPA's records without finding the course names "Banking" or "Estate Planning." Later, after an extended telephone conversation between respondent and Mr. Scharbaugh, the FICPA verified that respondent had attended "Income Taxation of Estates and Trusts" on January 10, 1974; Basic Concepts in Estate Planning" on January 11, 1974; "Workshop on Fiduciary Income Tax Returns" on December 14, 1973; "Seminar on Bank Audits, Accounting, Taxes and Regulations" (Seminar) on November 16, 1973; and another course on May 17 and 18, 1973. The three more recent courses "each qualify for eight hours of other CPE credit," composite exhibit No. 8, deposition of Jean P. Finegold, as did the seminar. The other course "Management Advisory Services Conference" is the course respondent referred to on his 1974 reporting form as "Computer Advisory," mistakenly indicating sponsorship by Florida State University rather than by the FICPA. In response to Ms. Finegold's inquiry, the American Institute of Certified Public Accountants (AICPA) indicated that the AICPA had offered no courses entitled "Capital Investments--Long Term Debt," "Tax Reform Act of 1975" or "Tax Course," and Rex B. Cruse, Jr., director of the Continuing Professional Education Division of the AICPA, executed an affidavit to that effect. Composite exhibit No. 7, deposition of Jean P. Finegold. Respondent had indicated on his 1974 and 1976 reporting forms that he had taken courses with such names, sponsored by the AICPA. A subsequent search of the AICPA's bad debt file revealed that respondent had ordered self-study materials for courses named "Capital Structure and Long-Term Objectives," "Ins and Outs of IRS Practice and Procedures" and "Tax Reduction Act of 1975," but respondent "did not officially complete the courses by returning examinations. . .for grading." Composite exhibit No. 6, deposition of Jean P. Finegold. Otha L. Brandon, a certified public accountant in Memphis, Tennessee, first engaged respondent's services in 1975. On four or five occasions thereafter, respondent was in Memphis for orientation and instruction in auditing certain types of accounts, including assignments from the Environmental Protection Agency (EPA). Toward the end of 1976, Mr. Brandon entered into a contract with the EPA to audit construction grants to certain municipalities, including eight Florida cities. He hired respondent to perform the Florida audits. On January 3, 1977, Mr. Brendon wrote respondent directing him to go ahead with the work. At the time, Mr. Brandon contemplated completing the job in mid-February, thinking he would send additional manpower to Florida to assist respondent. Unassisted, respondent made submissions to Mr. Brandon on the last of the eight cities in July or August of 1977. Mr. Brandon allocated approximately nine thousand dollars ($9,000.00) to the Florida portion of the project. Upon receipt of respondent's work, people in Mr. Brandon's office revised the reports to make them conform to EPA regulations and directives. This was taken into account when Mr. Brandon paid respondent in excess of seven thousand two hundred dollars ($7,200.00) for his services. Respondent has been a certified public accountant in Florida since 1972.
Recommendation Upon consideration of the foregoing, it is RECOMMENDED: That petitioner suspend respondent's certificate for three (3) years. DONE and ENTERED this 9th day of February, 1979, in Tallahassee, Florida. ROBERT T. BENTON, II Hearing Officer Division of Administrative Hearings Room 530, Carlton Building Tallahassee, Florida 32301 (904) 488-9675 Filed with the Clerk of the Division of Administrative Hearings this 9th day of February, 1979. COPIES FURNISHED: James S. Quincey, Esquire 226 South Main Street Gainesville, Florida 32602 Thomas B. Calhoun, Esquire 3656 Shamrock Way Tallahassee, Florida 32308