Findings Of Fact Respondent, Marianne T. Keim, is a licensed veterinarian in the State of Florida, holding license number VM 0005113 (Veterinarian). Respondent's license to practice veterinary medicine is currently under probation and emergency suspension. At all material times, Respondent practiced veterinary medicine in Tampa, Florida. Findings As To Count I Of The Administrative Complaint On August 18, 1994, the Board of Veterinary Medicine entered a Final Order in settlement of five (5) different cases involving allegations against the Respondent. The Final Order adopted a Stipulation of the parties, and was filed with DBPR on August 22, 1995. The Final Order resulted in the placing of Respondent's license to practice veterinary medicine on probation for a period of five (5) years. The Final Order imposed certain conditions on the Respondent's practice of veterinary medicine, and also imposed an administrative fine on Respondent in the amount of $3,000, payable within 180 days from the date the final order was rendered by the Board. The Final Order provides in pertinent part: The Respondent shall, in the future, comply with Chapters 455 and 474, Florida Statutes, and the rules promulgated pursuant thereto. The Respondent shall be placed on probation for five (5) years. The terms of the Respondent's probation are: Compliance with all requirements of this Final Order. Practice veterinary medicine with direct supervision by a Florida licensed veterinarian for not less than forty (40) hours per month. All other practice of veterinary medicine shall be with indirect supervision by a Florida licensed veterinarian. Personally appear before the Board of Veterinary Medicine at the first meeting after probation commences, semiannually, at the last meeting before probation terminates and at such other times as may be requested by the Board. The Respondent shall be notified by the Board staff of the date, time, and place of the Board meeting whereat Respondent's appearance is required. Failure of Respondent to appear as requested or directed shall be considered a violation of the terms of this Order, and shall subject the Respondent to disciplinary action. The direct and indirect supervisor shall be approved by the Board and shall review all aspects of the Respondent's practice of veterinary medicine. In the event the Respondent desires to change monitors, the Respondent shall notify the Board at least ten (10) days prior to the last date that the former monitor will be available. The Respondent shall allow the monitors access to Respondent's patient records, calendar, patient logs, or other documents necessary for the monitor to supervise the Respondent as detailed below. The responsibilities of the indirect monitoring veterinarian shall include the following: Review 25 percent of Respondent's active patient records at least once a month at the Respondent's office for the purposes of ascertain- ing the appropriateness of the Respondent's treat- ment, medication management, and the thoroughness with which her records are kept. The monitor shall go to Respondent's office once every month and shall review Respondent's calendar or patient log and shall select the records to be reviewed. Submit reports to the Board on a quarterly basis, in affidavit form, at least twenty-eight (28) days prior to each applicable Board meeting and each of which shall include: A description of Respondent's practice (type and composition). A statement addressing Respondent's com- pliance with the terms of probation. A brief description of the monitor's relationship with the Respondent. A statement advising the Board of any problems which have arisen. A summary of the dates the monitor went to the Respondent's office, the number of records reviewed, and the overall quality of the records reviewed. Any other reporting requirements. Maintain contact with the Respondent on a frequency of at least once per month. In the event that the monitor is not timely contacted by the Respondent, then the monitor shall report this fact in writing to the Board. The Respondent's monitor shall appear before the Board at the first meeting following commencement of the probation and at such other times as directed by the Board. It shall be Respondent's responsibility to ensure the appearance of her monitor to appear as requested or directed. Failure of the monitor, with- out good cause shown, to appear as requested or directed shall constitute a violation of the terms of this Order and shall subject the Respondent to disciplinary action. The responsibilities of the direct monitoring veterinarian shall include the following: Submit reports to the Board on a quarterly basis, in affidavit form, at least twenty-eight days prior to each applicable Board meeting and each of which shall include: A description of Respondent's practice (type and composition). A statement addressing Respondent's compliance with the terms of probation. A brief description of the monitor's relationship with the Respondent. A statement advising the Board of any problems which have arisen. A summary of the dates the monitor went to the Respondent's office, the number of records reviewed, and the overall quality of the records reviewed. Any other reporting requirements. The Respondent's monitor shall appear before the Board at the first meeting following commencement of the probation and at such other times as directed by the Board. It shall be Respondent's responsibility to ensure the appearance of her monitor to appear as requested or directed. Failure of the monitor, with- out good cause shown, to appear as requested or directed shall constitute a violation of the terms of this Order and shall subject the Respondent to disciplinary action. The Respondent shall obtain a second opinion, by a licensed veterinarian approved by the Board with respect to surgeries, excluding normal or routine spays, neuters, croppings and treatment of abscesses. The Respondent shall pay an Administrative Fine of three thousand dollars ($3,000). As Respondent has filed for protection in the United States Bankruptcy Court and has filed a plan of reorganization with said Court, the Respondent shall be allowed one hundred eighty (180) days from the rendition of the Final Order by the Board of Veterinary Medicine, to pay the fine. The fine shall be paid by the Respondent to the Executive Director of the Board of Veterinary Medicine, 1940 North Monroe Street, Tallahassee, Florida, 32399-0750. This time period may be extended by the Board for good cause shown. Any request for extension shall be submitted, in writing, to the Executive Director prior to the expiration of the 180 day time limit, at the address above. Pursuant to the Final Order, on October 19, 1994, Respondent made a required probationary appearance at the Board meeting in Orlando, Florida. When the meeting commenced, Respondent did not appear with her direct or indirect monitor, and the Board found Respondent in violation of the Final Order in that Respondent had not met the terms and conditions of her probation by failing to have her direct and indirect monitor appear for approval at the Board meeting. Respondent had sufficient time to locate a direct or indirect monitor, or to request an extension of time from the Board. At the October 19, 1994 Board meeting, Respondent represented to the Board that she had experienced difficulty in locating qualified, licensed veterinarians willing to accept the responsibilities of serving as her direct and indirect monitors as required by the Final Order. Prior to the conclusion of the Board meeting of October 19, 1994, Dr. Carlos Piniero, a veterinarian licensed in the State of Florida, and practicing in Hillsborough County, appeared and stated his willingness to serve as Respondent's indirect monitor. Respondent further indicated to the Board that she had obtained the consent of Dr. Robert Adey, a veterinarian licensed in the State of Florida, practicing in Winter Haven, Florida, to serve as her direct monitor. Pursuant to the Board's determination that Respondent had violated the terms and conditions of her probation, Respondent was instructed to discontinue her practice of veterinary medicine pending the Board's approval of her direct and indirect monitor as required by the Final Order. The Chairman of the Board, Dr. Bernard Myers, was given the authority to grant temporary approval for Respondent's direct and indirect monitors until the next meeting of the Board. On October 25, 1994, Dr. Robert Adey was temporarily approved by the Board chairman as Respondent's direct monitor, and Dr. Carlos Piniero was temporarily approved by the Board chairman as Respondent's indirect monitor. By letters dated December 22, 24, and 25, 1994, Respondent wrote individually to the seven members of the Board, Dr. Robert E. O'Neil, Dr. Carlos R. Pereira, Dr. Bernard Myers, Dr. Teresa L. Lightfoot, and Dr. Thomas F. Whitley, Ms. Cynthia Lewis, and Mr. Lewis Jennings, informing each individual member of her attempts to comply with the Final Order, as well as her difficulties in complying with the requirements of the direct monitor relationship. In these letters to the individual Board members, Respondent requested a reduction in her direct monitoring requirement from forty (40) hours per month to twenty (20) hours per month. At the next Board meeting on January 4, 1995, Respondent appeared with counsel, and with her direct and indirect monitors. After inquiring of the monitors and Respondent, the full Board confirmed the approval of Dr. Adey and Dr. Piniero to serve as Respondent's direct and indirect monitors, respectively. The Board did not consider, nor did the Board approve a reduction of the required forty (40) hours per month of direct monitoring of Respondent's practice of veterinary medicine by Dr. Adey. Respondent began her direct monitor relationship with Dr. Adey on October 20, 1994. As agreed to by her direct monitor, Respondent was required to attend Dr. Adey's clinic in Winter Haven, Florida, on each Thursday. From the onset, Respondent experienced difficulty in complying with the terms and conditions of the Final Order with respect to her relationship with her direct monitor, Dr. Adey. Because Dr. Adey practiced in Winter Haven, Respondent was required to travel approximately two hours each way from her office in Tampa, Florida, to Dr. Adey's clinic. Additionally, Dr. Adey restricted Respondent's activities in his clinic and, as a general rule, only allowed Respondent to observe his own practice. Dr. Adey expressed reservations regarding Respondent's abilities as a veterinarian, and accordingly, did not allow Respondent to practice veterinary medicine in his clinic except in very routine cases, and then only under his own observation and supervision, or the supervision of experienced members of his clinic staff. On one occasion, Dr. Adey gave Respondent an assignment on liver disease to complete at her own clinic. Respondent would also on occasion consult by telephone with Dr. Adey; however, Dr. Adey did not at any time monitor Respondent's practice of veterinary medicine at Respondent's Tampa clinic. According to Dr. Adey's records, Respondent was in attendance at Dr. Adey's clinic for approximately 15 hours in October of 1994, for approximately 28 hours in November of 1994, for approximately 32 hours in December of 1994, and for approximately 32 hours in January of 1995. Respondent's travel time, assignment time, or telephone consultation time are not included in the computation of these hours. From October 20, 1994 through the end of January 1995, Respondent missed three of her scheduled days for attendance at Dr. Adey's clinic. Two of the days were cancelled by Dr. Adey, and one day was cancelled by Respondent due to a meeting with her attorney. On January 27, 1995, Dr. Adey wrote a letter to Diane Gossett, an investigator with DBPR, stating that his direct monitor relationship with Respondent was unsatisfactory, and that under the circumstances, he was not able to attain the quality of direct monitoring of Respondent's practice of veterinary medicine that the Final Order of the Board required. On February 8, 1995, Dr. Adey wrote another letter to Diane Gossett expressing his continuing frustration with the direct monitor relationship with the Respondent, and tendering his resignation as direct monitor within ten (10) days. Dr. Adey subsequently agreed to remain as Respondent's direct monitor until March 12, 1995. On March 3, 1995, Respondent wrote to Susie Love, Program Administrator with the Board, expressing dissatisfaction with the inflexibility of the monitor situation, and requesting modifications of the Board's requirements in this regard. Respondent was informed by Susie Love by letter dated March 6, 1995, that approval of a direct monitor to replace Dr. Adey would have to be approved at the next Board meeting by the full Board. No action was taken by the Board with respect to the approval of a new direct monitor prior to the initiation of the emergency suspension proceedings against Respondent's license. The nature of the direct monitoring relationship established by Respondent with Dr. Adey did not satisfy the requirements imposed by the Final Order, in that Respondent did not practice veterinary medicine under the direct monitoring of Dr. Adey, but only was in attendance, and observed Dr. Adey's practice in Winter Haven one day a week. Respondent's indirect monitor, Dr. Carlos Piniero reviewed at least 25 percent of Respondent's records on a regular basis, consulted with Respondent as to her organization and record-keeping, and in this respect, Respondent was in compliance with the Final Order of the Board. Respondent has not paid the $3,000 fine assessed by the Board which was due 180 days from entry of the Final Order. Payment of the fine is overdue. By letter addressed to Susan Foster, Executive Director of the Board, dated December 5, 1994, Respondent requested an extension of time to pay the $3,000 fine. The letter was notarized by Thurston R. Smith also on December 5, 1994. Thurston Smith is a part-time employee of Respondent. The heading of the letter contains the correct business address of Susan Foster at 1940 North Monroe Street, Tallahassee, Florida, 32399. Respondent did not personally mail or fax the letter to Susan Foster, or request a return receipt. Dr. Lawrie Glickman, a friend of Respondent's testified that he believed the letter was among several items of mail he posted for Respondent. Thurston Smith testified that he believed the letter was among several items he faxed to DBPR for Respondent. Susan Foster did not receive the December 5, 1994, letter from Respondent by mail or by fax. DBPR has established normal and acceptable business procedures for processing incoming correspondence. In accordance with DBPR's normal business procedures, mailed or faxed letters addressed to the Board's Executive Director, Susan Foster, would routinely be opened and delivered to her office. Ms. Foster was personally familiar with Respondent, and also with the Board's actions relating to Respondent. Ms. Foster had received correspondence from Respondent on several other occasions, and had also received telephone calls from Respondent on several occasions. Any communication received by Ms. Foster from Respondent requesting an extension of time to pay a fine would, in the normal course of DBPR's procedures, have been brought to the Board's attention by Ms. Foster. A second handwritten letter from Respondent dated December 19, 1994, addressed to Susan Foster at the DBPR office in Tallahassee, also requested an extension of time to pay the $3,000 fine. The handwritten letter states that this is Respondent's second request for extension of time. Dr. Glickman testified he mailed and faxed this letter. Susan Foster did not receive the second letter. Respondent did not personally inquire of Susan Foster as to the status of Respondent's request for extension of time, nor did Respondent request that Ms. Foster place this matter on the agenda of the Board's next meeting on January 4, 1995. Respondent appeared, with counsel, at the next Board meeting on January 4, 1995; however, neither Respondent nor her counsel raised the issue of an extension of time in which to pay the fine with the Board. The Board did not consider, or approve an extension of time for Respondent to pay the $3,000 fine imposed by the Final Order. Respondent has not complied with the terms and conditions of the Final Order entered by the Board. Respondent did not satisfy the forty (40) fours per month of required direct monitoring of her practice of veterinary medicine. Respondent did not pay the $3,000 fine imposed by the Board within 180 days as required by the Final Order. Respondent's efforts in this regard do not constitute substantial compliance with a lawful order of the Board. Findings As To Counts II And III Of The Administrative Complaint On or about October 25, 1994, Mrs. Amy Armstrong inquired of Respondent as to performing a declaw procedure (also known as an onychectomy) on Mrs. Armstrong's six-month old English Springer Spaniel, Tilly. Mrs. Armstrong was concerned because her dog was digging in the yard, and scratching inside the house. Mrs. Armstrong was also concerned that her dog's digging and scratching would upset her landlord, and that she would be financially responsible for the damages caused by the dog. Mrs. Armstrong had initially contacted Respondent because Respondent's clinic advertised low-cost rates, and Mrs. Armstrong had been satisfied with Respondent's spay and neuter procedures previously performed on Mrs. Armstrong's cat and another dog. Mrs. Armstrong again called Respondent's clinic in mid-November 1994, and spoke with Daryl Dunnisch a member of Respondent's clinic staff regarding the declawing procedure. In late December of 1994, Mrs. Armstrong called again and Respondent personally discussed the declawing procedure with her. Respondent informed Mrs. Armstrong that the procedure required the dog to be anesthetized, but that the procedure should not be complicated for a young dog, that the recovery period would be a few days during which the dog would be sedated, and that the procedure should solve the digging and scratching problems Mrs. Armstrong was experiencing. Respondent also offered Mrs. Armstrong the alternative of filing down the dog's nails. Respondent's records reflect that Mrs. Armstrong was forewarned of the severe pain the dog would experience, as well as the lengthy recovery period. Respondent quoted Mrs. Armstrong a price of $65.00 for the declawing procedure. Mrs. Armstrong did not represent to Respondent or to a member of Respondent's office staff that she would euthanize the dog unless the declawing procedure were performed, but stated that she would need to consider other options about keeping the dog. As to this issue, the testimony of Mrs. Armstrong is deemed more credible. In regard to the declawing of her dog, Mrs. Armstrong also contacted another veterinarian, Dr. Robert Titus, at the Kingsway Animal Clinic, Brandon, Florida, to whom Mrs. Armstrong had, on occasion, previously taken her pets. Mrs. Armstrong inquired of the cost of the declawing procedure. Dr. Titus does not perform declawing procedures on healthy dogs, and told his staff to quote Mrs. Armstrong a price in excess of $285 to discourage her from seeking the procedure. After considering the price quoted by Respondent, Mrs. Armstrong made an appointment with Respondent to perform the declawing procedure on January 12, 1995. A declawing procedure on a healthy dog is not a normal or routine surgical procedure. This surgical procedure, which is more complicated in an animal with nonretractible claws, involves the removal of the third phalange, which is either a total or subtotal removal of the nail and the complete nail bed along the bone. The procedure results in severe pain in the dog which usually lasts for two or three weeks during which the dog should be medicated and closely examined for possible infection. Declawing of a healthy dog is rarely performed, although one text, General Small Animal Surgery, edited by Ira M. Gourley, D.V.M. and Philip B. Vaseur, D.V.M., which is an accepted treatise used in the practice of veterinary medicine, states that an onychectomy on a healthy dog is indicated to prevent digging or property damage. Performing an onychectomy is not completely prohibited under all circumstances in the practice of veterinary medicine. Under the terms and conditions of the Final Order, Respondent was restricted from performing any surgery other than "normal and routine spays, neuters, croppings and treatment of abscesses" without obtaining a second opinion by a licensed veterinarian approved by the Board. The Final Order did not, however, require Respondent to abide by the second opinion. Respondent consulted by telephone with her direct monitor, Dr. Adey, regarding performing the declawing procedure. Dr. Adey strongly advised Respondent against performing the procedure. After "shouting out" his objection to the procedure, Dr. Adey, nonetheless, reviewed with Respondent the appropriate incisions to be made in performing the surgery. Dr. Adey did not forbid Respondent from performing the surgery because he did not believe that as Respondent's direct monitor he had the authority to do so. Respondent also discussed the declawing procedure with her indirect monitor, Dr. Piniero. Dr. Piniero advised Respondent that he did not believe in performing a declawing procedure on a healthy dog, and that in his opinion, such surgery was indicated only when there was a medical basis for the procedure, such as a cancer or a tumor present in the paw. Despite the advice of her direct and indirect monitors, Respondent on January 12, 1995, performed an onychectomy on Mrs. Armstrong's dog. Dr. Piniero was present at Respondent's clinic when Respondent began the operation; however, Dr. Piniero did not supervise, or otherwise participate in the surgery, and left before the surgery was completed. Respondent had not previously performed an onychectomy. The surgery on the Armstrong dog lasted more than two hours. Following the surgery, the Armstrong dog remained at Respondent's clinic. The next day, January 13, 1995, Amy Armstrong called Respondent and was informed that her dog was doing well, but would be in severe pain for a while and that the recovery period would be approximately two weeks. On January 14, 1995, Mrs. Armstrong's husband visited the dog at Respondent's clinic. The dog's paws were heavily bandaged, but the dog was able to ambulate at that time. On Sunday, January 15, 1995, the Mr. Armstrong brought the dog home. At the time the dog was released, Respondent prescribed an antibiotic, Keflex, for the dog. Mrs. Armstrong spoke to Respondent by telephone, and was told to bring the dog back the following Wednesday or Thursday, to change the bandages. Respondent also informed Mrs. Armstrong that there would be additional charges for the care of the dog in excess of the original price of $65.00 for the surgical procedure. Mrs. Armstrong did not agree to the additional charges. When the dog returned home, Mrs. Armstrong became very upset. The dog was in severe pain, and could not ambulate. That evening Respondent called Mrs. Armstrong to check on the dog. Mrs. Armstrong expressed her concern for the dog's painful condition, and Respondent suggested the dog be given aspirin or Ascriptin. On Monday morning, January 16, 1995, Mrs. Armstrong observed a thick substance which she believed to be blood oozing through the dog's heavy bandages. Mrs. Armstrong became extremely concerned. She took the dog back to Dr. Robert Titus, at the Kingsway Animal Clinic, in Brandon, Florida. Dr. Titus observed what was determined to be serum seepage coming through the bandages on the dog's front paws, and noticed a "foul odor" similar to rotten meat coming from the paws. At that time, the dog's temperature was elevated to 104 degrees from a normal range of 100-102 degrees. Dr. Titus attempted to remove the bandages; however, because of the dog's severe pain, Dr. Titus was required to anesthetize the Armstrong dog in order to remove the bandages. Dr. Titus observed that the dog's front paws were swollen more than twice the normal size, and found serum leakage and serum blisters over the paws. Serum is a bodily fluid typically found at sites of inflammation. Dr. Titus also noticed a dehissing, or coming apart, of some sutures. Dr. Titus cleansed the surgical areas with antiseptics and antibiotics, and then rebandaged the paws. Dr. Titus sprayed an alum solution on the bandages to deter the dog from chewing on them. Dr. Titus also prescribed a systemic antibiotic (tetracycline) to fight any infection which might have been present, and also Tylenol 3 for pain. Dr. Titus sent the dog home with instructions to keep the dog as comfortable as possible, and to bring the dog back in two days to again cleanse the paws and rebandage them. On January 18, 1995, Mrs. Armstrong brought the dog back to Dr. Titus. The dog still was in severe pain, and the dog's temperature remained elevated at 104 degrees. Dr. Titus again was required to anesthetize the dog to remove the bandages. Dr. Titus observed more serum seepage, and cleansed the surgical areas, rebandaged the paws, and sent the dog home with the same instructions regarding care and medication. On January 20, 1995, Mrs. Armstrong called Dr. Titus to inform him that the dog was still having difficulty walking. Dr. Titus advised Mrs. Armstrong to continue the same care and medication procedures for a few more days, and then to bring the dog back. On January 23, 1995, Dr. Titus again examined the dog. The dog's temperature was 101 degrees. Dr. Titus cleansed and again rebandaged the dog's paws. At that time the swelling was greatly diminished, and no serum leakage was observed. The paws appeared to be healing, and Dr. Titus discontinued the antibiotics and pain medication. Mrs. Armstrong was informed when to take the bandages off, and to return to Dr. Titus only if the dog showed severe pain. Dr. Titus expressed no opinion as to whether the surgery on the Armstrong dog was performed in accordance with the standard of care acceptable in the practice of veterinary medicine. On January 27, 1995, Mrs. Armstrong called Dr. Titus to inform him that the dog was doing well, and was able to run. The Armstrong dog has now recovered from the surgery; however, the declawing procedure on the dog's front paws has not stopped the digging problem. Mr. and Mrs. Armstrong have kept the dog. Dr. Gary W. Ellison, Associate Professor at the College of Veterinary Medicine of the University of Florida, was qualified as an expert witness for Petitioner. Dr. Ellison testified that an onychectomy is not a common veterinary procedure. Unlike the declawing of an animal with retractable claws, such as a cat, declawing of an animal with nonretractible is a more complicated and difficult procedure and, in Dr. Ellison's opinion, should not be performed unless there is a medical necessity. Dr. Ellison, after reviewing the records, and hearing the testimony in this case, concluded that Respondent did not comply with the minimum standard of care and treatment in performing an onychectomy on the Armstrong dog. Specifically, Dr. Ellison testified that Respondent failed to properly consult with the owner, failed to recommend alternatives to the procedure, and should not have performed the onychectomy except for medically necessary reasons. Dr. Ellison further opined that Respondent was not prepared to do the surgery, which he considered improperly done, resulting in abnormal swelling, bleeding and infection of the paws. Dr. Ellison, however, acknowledged that General Small Animal Surgery, edited by Ira M. Gourley and Philip Vaseur, is an accepted treatise used in the practice of veterinary medicine, and that this treatise states that onychectomy is indicated to prevent digging and property damage. Dr. Ellison also acknowledged that the medication prescribed by Respondent for the Armstrong dog was acceptable under the circumstances, and that it is not unexpected for an onychectomy to produce swelling, bleeding and potential infection. Dr. Richard Goldston, a veterinarian qualified as an expert witness for Respondent, testified that in his opinion performing an onychectomy on a healthy dog was not an acceptable procedure unless there was no alternative and the dog would be euthanized. Dr. Goldston also recognized that accepted treatises state that an onychectomy is indicated to prevent digging. Dr. Goldston further testified that even a properly performed onychectomy produces inflammation and swelling, and that there would be a likelihood of infection. According to Dr. Goldston, normal post-operative recovery is two or three weeks, and a recovery period of less than two weeks would be considered successful. The recovery period of the Armstrong dog was acceptable. Another veterinarian, Dr. Edward Dunham, testified that in his twenty- five years of practice, he had performed an onychectomy on three occasions, and that while the procedure was not common, the procedure did not violate the ethical standards of the practice of veterinary medicine. Dr. Dunham further testified that he would not perform an onychectomy again.
Recommendation Based on the foregoing findings of fact and conclusions of law, it is RECOMMENDED that: As to Count I, that Respondent's license be SUSPENDED for six months, that Respondent's probation be continued for five (5) years, with additional requirements for direct supervision. It is further recommended that Counts II and III be DISMISSED. RECOMMENDED in Tallahassee, Leon County, Florida, this 30th day of June, 1995. RICHARD HIXSON 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 30th day of June, 1995. APPENDIX As to Petitioner's Proposed Findings of Fact 1. - 30. Accepted and incorporated. Rejected as irrelevant. - 54. Accepted and incorporated. 55. - 61. Accepted and incorporated. Accepted, but Dr. Ellison further acknowledged that there is no prohibition on the procedure. Accepted, but Dr. Ellison further testified there is no prohibition on the procedure. Accepted, but Dr. Goldston and Dr. Dunham further testified that they had performed declawing operations, and that there is no prohibition on performing the procedure. As to Respondent's Proposed Findings of Fact 1. - 7. Accepted and incorporated. Accepted, except for second sentence which is rejected as irrelevant. - 11. Accepted and incorporated. Accepted as to the number of hours. Accepted and incorporated. Accepted to the extent that on one occasion Dr. Adey gave Respondent an assignment. Accepted as to dates cancelled, rejected as to reasonableness of effort. Rejected as not supported by the evidence. Accepted and incorporated. Accepted and incorporated. Accepted, except for second sentence. and 21. Accepted and incorporated. Rejected. - 28. Accepted and incorporated. Accepted, except date is October 25, 1994. Rejected, the initial inquiry was regarding the surgery and fee. Accepted and incorporated. Accepted to the extent that Mrs. Armstrong elected not to pursue nail filing. and 34. Rejected. 35. - 38. Accepted. Accepted except Dr. Ellison testified that the resultant swelling was abnormal. Rejected. - 44. Accepted. Accepted, except as noted in finding 39. and 47. Accepted. Accepted, to the extent that there are other publications on onychectomies. - 53. Accepted. Accepted, except that Dr. Dunham testified he does not now perform the procedure. Accepted, except that infection is a possibility, not an expectation. Accepted, except as to date. Rejected. See Finding 30. Accepted. Accepted. See Finding 32. and 61. Rejected. 62. - 65. Accepted. See Finding 39. Accepted. Accepted, except that Dr. Piniero left before the surgery concluded. Rejected. - 73. Accepted. See Finding 45. and 76. Accepted. See Finding 48. - 82. Accepted. See Finding 54. See Finding 55. Accepted, to the extent that Dr. Piniero responded in a letter to DBPR that Respondent was qualified. Accepted. COPIES FURNISHED: Susan E. Lindgard, Esquire James E. Manning, Esquire Department of Business and Professional Regulation 1940 North Monroe Street Tallahassee, Florida 32399-0792 Edward M. Brennan, Esquire 100 South Ashley Drive, Suite 1600 Post Office Box 3429 Tampa, Florida 33601-3429 Dr. Marianne T. Keim 800 West Kennedy Boulevard Tampa, Florida 33606 Lynda L. Goodgame General Counsel Northwood Centre 1940 North Monroe Street Tallahassee, FL 32399-0792 Susan Foster Board of Veterinary Medicine 1940 North Monroe Street Tallahassee, FL 32399-0792
The Issue The issues requiring adjudication in this cause concern whether the Respondent's license as a veterinarian in the State of Florida should be revoked, suspended or other discipline imposed for alleged violations of Chapter 474, Florida Statutes. Those violations involve alleged cruelty to animals treated by the Respondent and whether his treatment and behavior toward those animals amounted to fraud, deceit, negligence, incompetence or misconduct in the practice of veterinary medicine. Also at issue are charges in the Complaint concerning whether the Respondent violated the enumerated sections of Chapter 474, Florida Statutes, involving being convicted or found guilty, regardless of adjudication, of a crime which directly relates to the practice of veterinary medicine. It must also be determined whether the Respondent, with regard to some of the animals treated and named in the Complaint, failed to maintain his veterinary medical records in accordance with the related and enumerated subsections of Chapter 474, Florida Statutes, and the related rule. Finally, if the charges, or any of them, are substantiated, the question of a recommended penalty must be addressed.
Findings Of Fact The Petitioner, DEPARTMENT OF PROFESSIONAL REGULATION ("Department"), is an agency of the State of Florida charged with regulating the practice of veterinary medicine pursuant to Section 20.30, Florida Statutes, Chapter 455, Florida Statutes, and Chapter 474, Florida Statutes. The Respondent, is a licensed veterinarian in the State of Florida, holding license number VM0000710. The Respondent maintains his practice at 820 Creighton Road, Pensacola, Florida 32504. The Respondent is the owner and managing veterinarian of Creighton-Davis Animal Hospital located at that address. Counts One through Three of the Administrative Complaint relate to the allegations that the Respondent intentionally, cruelly and repeatedly struck a dog named "Peaches" belonging to Cynthia Barrera, which had been brought to him for veterinary care. It is alleged that on or about October 9, 1986, after the alleged cruel treatment, the dog was found dead in the Respondent's clinic by a staff member. It is alleged that he told the owner of the dog that the dog had "escaped", knowing that story to be untrue. A former staff member employed by the Respondent, Tina Lyttle, submitted an affidavit to the Santa Rosa County Animal Protection Officer, Ms. Betty Simms, from which sprang the charges concerning the dog named "Peaches". She and the Respondent were the only ones present in the examining room on the date in question. "Peaches" had been brought in by its owner to be shaved; and, because the dog had a propensity to bite, he was required to be sedated for the procedure. Tina Lyttle maintained that the Respondent dragged the dog into the room by its leash, slung it up on the examining table, and ran the leash down through the drain hole at one end of the table to hold the dog's head down close to the surface of the table, to restrain the dog. She contends that the Respondent told her to hold the dog's hindquarters and hold a vein so that he could inject the anesthesia. He kept missing the vein and tried in both back and front legs to locate a vein into which he could inject the anesthesia. Tina Lyttle contends that the dog began growling, and the Respondent became enraged and began striking the dog on the back-legs, hips and rib cage and snatched the dog by the hair and slung him off the table which resulted in the dog being hung by the neck with his head and muzzle on the table and his body suspended in the air. She maintains that the Respondent then struck the dog on the muzzle with his fist and that the dog became unconscious due to choking as a result of this alleged handling. She also states that the Respondent was silent during this alleged episode. She then contended that the Respondent and she had an argument about his treatment of the dog and that she "stormed" out of the clinic to the kennel area. The Respondent, a short while later, went out and discussed the matter with her and attempted to placate her and get her to come back and assist him further. She came back inside, saw that the dog was already anesthetized and unconscious and, ultimately, shaved the dog at the Respondent's instruction. She left work that day and missed work the next day. She came back two days later and inquired of the Respondent and staff members about the dog. She alleges that some days later, staff member, Pat Guinn informed her that the dog had died at the Respondent's facility. Pat Guinn claimed in her testimony, that she found the dog dead in his pen and that the Respondent instructed her to put him in a bag and that she delivered the body of the dog to the Respondent and Ms. Vetitoe, another client of the Respondent. She testified that the Respondent directed her to put the body of the dog in Ms. Vetitoe's truck, or else the Respondent put the dog in Ms. Vetitoe's truck, (her testimony is inconsistent here) for the purpose of Ms. Vetitoe removing the dog from the premises and burying it. The Respondent describes the incident involving "Peaches" in quite a different light. The Respondent acknowledges that the dog was there to be shaved and otherwise cared for at the request of its owner, Ms. Berrera. He and Tina Lyttle were holding the dog on the table, as described. That is, the dog's head was cinched down close to the table by placing the leash through the drain hole in the table. This is accepted, proper veterinary practice in order to help restrain the dog and prevent the dog from injuring the veterinarian or his staff. As the Respondent was attempting to locate a vein whereby he could inject the anesthesia, during which time Tina Lyttle was holding the dog's hindquarters, the dog became belligerent, growling and suddenly bit the Respondent on his left forearm. The bite was a severe one going all the way through the upper part of the Respondent's forearm. The Respondent was in extreme pain and bleeding and struck at the dog, attempting to get him to release his hold. The dog's jaws were locked on the Respondent's forearm and ultimately, the Respondent acknowledges that he had to pry the dog's jaws open with a screwdriver to get him to release, all of which caused the Respondent extreme pain and blood loss. During this episode, Tina Lyttle became angry at the Respondent, shouted at him and remonstrated with him for hitting the dog and stormed out of the clinic. Another staff member assisted the Respondent in sedating the dog and preparing him to be shaved. The Respondent proceeded even though he had to stop and render first aid for his wounded forearm. Later he went outside and attempted to calm Ms. Lyttle down and finally got her to go back to work, although during their discussion she assaulted him by throwing him against the kennel building in a rage. Although the Respondent testified unequivocally that the episode occurred in this manner and that, indeed, the dog had bitten all the way through his forearm, both witnesses for the Petitioner, Tina Lyttle and Pat Guinn, denied that the biting incident occurred. The Respondent's version of events is corroborated, however, by Lt. Loria of the U.S. Marine Corps., who was a client of the Respondent and had just brought his dog in for care. The Respondent had noticed Lt. Loria on the premises and asked him to come to the examining room so that he could show him what had occurred. Lt. Loria observed, immediately after the injury to the Respondent's forearm, the wound caused by the dog, who was still in the room. This observation was made with the Respondent spontaneously telling Lt. Loria in no uncertain terms about the manner in which the dog had bitten him. Lt. Loria observed the wound in the Respondent's forearm and indicated that a pencil or fountain pen could have been stuck through the fang wounds. Lt. Loria testified by deposition in this proceeding and corroborated the Respondent's version. The Respondent had a noticeable scar from the wound on his arm and demonstrated it at hearing. It was observable during the investigatory process as well. The circumstances surrounding the death of the dog, described by Tina Lyttle and Pat Guinn, are also disputed by the Respondent and Ms. Vetitoe. Tina Lyttle maintained that she was informed by staff member, Pat Guinn, several days after the incident, that the dog had died on the premises; and then Pat Guinn testified concerning the manner in which she alleged that the Respondent, herself and Ms. Vetitoe arranged for the burial of the dog. The Respondent describes this incident differently. The Respondent stated that on the day after the biting altercation with the dog, he went to the dog's cage and observed that he needed exercise and needed to get out to relieve himself. Consequently, he snapped a leash on the dog and lead him through the clinic to exercise him outdoors. As he neared the patient waiting room, the dog got the leash in his mouth and bit through it, thus, getting loose. As luck would have it, a patient came in the front door of the clinic just at that moment and the dog rushed outside before the Respondent could stop him and escaped off the premises. The Respondent rushed outside, went into the field adjacent to the clinic looking for the dog and called him, to no avail. He then returned to the clinic in order to get into his truck and ride around in the neighborhood in an attempt to apprehend the dog. He maintains that he then met Carla Fowler, another staff member, who was returning from lunch nearby, told her of the dog's escape and enlisted her help in looking for the dog, instructing her to get into her car and also ride around the area in an attempt to locate the dog. The Respondent was never successful in finding the dog and ultimately bought the owner another dog of the same type, color and description and replaced the animal at his own expense. The owner and her children were satisfied with this arrangement and made no complaint concerning the Respondent's treatment of the dog or the unfortunate loss of "Peaches" and his replacement with another dog. The testimony of Ms. Vetitoe corroborates this version of events related by the Respondent. Ms. Vetitoe, by Pat Guinn's own admission, was present when the alleged disposal arrangement, related by Pat Guinn, was made. Ms. Vetitoe owns some thirty-four (34) dogs herself. She has been a client of the Respondent for many years. She testified that on no occasion has she ever buried a dog. She is an ardent animal lover and when her dogs expire, she has them cremated and their remains placed in urns. She testified that it was absolutely untrue that the Respondent or Pat Guinn had requested her help or assisted her in disposing of the dog. Her testimony is unequivocal that that episode never occurred and that she had never seen the dog "Peaches" which Pat Guinn and Tina Lyttle alleged to have died on the premises. Finally, in this regard, the testimony of Carla Fowler also corroborates the Respondent's and Ms. Vetitoe's testimony regarding the events surrounding the dog's demise. Carla Fowler acknowledged that when she was returning from lunch nearby, she saw the Respondent running through the field adjacent to the clinic looking for the dog. When he came back to the vicinity of the clinic, he told her that he was looking for "Peaches" and that the dog had escaped. She stated that he enlisted her help in finding the dog. The Respondent's, Ms. Vetitoe's and Lt. Loria's versions of the events surrounding the care, treatment and death of the dog "Peaches" are accepted. The testimony of Tina Lyttle and Pat Guinn concerning this incident is rejected in its entirety as incredible for the reasons related above and which will be treated more definitively, infra. Paragraphs 15 through 24 of the Administrative Complaint, including, from paragraphs 19 through 24, Counts Four, Five and Six, relate to an alleged incident involving a dog named "Star", belonging to Wanda Bruner. The dog was brought to the Respondent's clinic for veterinary care apparently consisting of a general examination, a flea dip and bath. It is alleged in paragraphs 15 and 16 of the Complaint that on or about September 5, 1986, the Respondent intentionally, cruelly and repeatedly struck the dog "Star" with his hands and bit the dog and that he intentionally and cruelly struck the dog on the head with a hose nozzle. Carla Fowler was the employee who assisted the Respondent in examining and caring for "Star" on the dates in question. The Respondent had placed the dog on the examining table at the outset of the episode of September 5, 1986, apparently for purposes of examination. Carla Fowler relates that the dog was "real nervous" and "I don't know if it was jerking or something, and Dr. Monroe hit it on the head and then on the rib cage and the dog got even more nervous. And then Dr. Monroe stooped down and bit the dog on the nose. And then the dog urinated all over the table". Ms. Fowler then testified that the Respondent told her to remove the dog from the room or words to that effect and then told her the next day to bring the dog in so they could give it a bath. He asked her to assist him in giving the dog a bath because he was afraid the dog would put up fight, in her words. She testified that the dog was trying to squirm along the side of the tub and the Respondent, who had a water hose in his hand, hit the dog on top of the head with the water hose nozzle, broke the head open, causing bleeding. She became upset with the Respondent's action, according to her testimony, and also testified that her husband walked in the door when the incident happened. Although her husband testified that he observed the incident where the Respondent is alleged to have struck the dog on the head with the hose nozzle, it is found that that incident did not occur and that he was not in a position to have observed it. Photographs and the evidence, consisting of the Respondent's Exhibits 1 and 2, coupled with the Respondent's testimony, are accepted as more credible and establish that the Respondent and Ms. Fowler were standing between the door and the bathtub bathing the dog in such a position that anyone coming in the back door, such as Ms. Fowler's husband, would have been unable to observe the alleged incident. The testimony of Ms. Fowler and her husband, as well as that of Pat Guinn, (itself, internally inconsistent in that, in her deposition, she stated that she observed the "hose striking incident" and in her testimony at hearing, admitted that she had not observed it), is rejected as incredible and unworthy of belief. The testimony of the Respondent is accepted. In this regard, the Hearing Officer is mindful of the testimony of Wanda Bruner, "Star"'s owner, who established that, indeed, stitches were observed by her in the head of the dog and that the Respondent told her that he had removed a cyst and stitched up the small incision involved. The testimony of the Respondent concerning this incident, as corroborated or explained by the testimony of Wanda Bruner, is accepted; and it is found that no acts of cruelty were perpetrated by the Respondent against the dog named "Star". Paragraphs 25 through 28 of the Administrative Complaint concern the dog named "Chipper" owned by Lorraine Purcell. Ms. Purcell brought the dog to the Respondent on approximately April 18, 1986 for a checkup and general examination. The Respondent determined that the dog's anal glands were infected, and he recommended to Ms. Purcell that surgery be performed to remove the anal glands. Ms. Purcell agreed to this procedure, and the Respondent performed the surgery removing the anal glands and stitching up the incisions. Some two or three days later, Ms. Purcell telephoned the Respondent's office concerning the release of her dog and was informed that the dog had suffered complications attendant to his "bothering" or chewing the stitches and that the dog needed to remain a few more days. She agreed to this and contacted the Respondent's office at least once more concerning when she should retrieve her dog. The Respondent conversed with her directly on April 23, 1986 and told her that he had had to re-operate on the dog because the dog had chewed or bothered his stitches such that surgical repair of the resulting wound was necessary on the dog's left side, that is, the left side of the anal opening. Upon learning that the dog had a large open hole or wound on the left side of his anus, Ms. Purcell became upset with the Respondent, came to the office and removed the dog from his care against his recommendation and sometime shortly thereafter, took the dog to another veterinarian, Dr. Clinton Chew. Dr. Chew described the large, open wound on the left side of the dog's anus as involving damage to the sphincter muscle with the effect that the dog was unable to control its bowel movements, and therefore, was dripping feces uncontrollably. Dr. Chew was unable to determine if the wound was caused by the dog's self-mutilation of the earlier incision but stated that it could have been the result of self-mutilation. He did not know how long the dog was in its owner's care after it had been removed from the care of the Respondent before being brought to him, but felt that it was approximately a day. He ventured no opinion about whether any self-mutilation could have occurred after the dog was removed from the Respondent's care and before being brought to him. Dr. Chew advised Ms. Purcell that two courses of treatment were available; healing by granulation, that is, the natural healing process for closing up the hole as small as possible before surgery; or immediate surgical intervention to try to close the open wound. Upon his advice, Ms. Purcell elected to allow some time for the natural healing process to close up the hole as small as possible with a view toward trying surgery at a later time if that was still necessary. After leaving the dog in Dr. Chew's care for some days, with the healing process started, Ms. Purcell or her husband retrieved the dog from his care and brought the dog home. The dog suffered at home because he was incontinent and dripping fecal material, such that he became very bothered by flies and could not come into the house as he formerly had. Because the dog was miserable and Ms. Purcell and her husband felt that his quality of life had severely deteriorated and because they were constantly having to clean up after the dog, she and her husband decided to have the dog put to sleep. Mr. Purcell, therefore, brought the dog back to Dr. Chew and upon their own initiative, instructed Dr. Chew to have the dog put to sleep. Dr. Chew testified that that was not his recommendation and that the Purcells had not instructed him to try to effect further repair of the wound surgically. In fact, by June 26, 1986, when the dog was brought in to be put to sleep, the natural healing process had substantially closed the hole although the dog was still incontinent because of the destruction to the sphincter muscle. In any event, without attempting further repair surgically, the dog was put to sleep on or about that date. Neither Dr. Chew nor any other witness established what the appropriate, professional veterinary standard of care in this situation might be. In any event, Dr. Chew testified that the portion of the incision which was not damaged, that is, on the dog's right side, was properly done. He was thus unable to say that the surgery was improperly or incompetently done or that it was unnecessary, nor did any other witness. Paragraphs 29 through 34 of the Administrative Complaint concern an incident allegedly occurring on October 30, 1986 when the Respondent attempted emergency veterinary care for a dog named "Dusty" belonging to Mr. Gary Ethridge. Dusty was brought in earlier on the morning in question very ill, dehydrated and cold. Pat Guinn or others on the Respondent's staff called him at home and told him that the dog had been brought in, and he told them that he would come into the office "in a little while" to see about him. They did not tell him that the dog was an emergency case. When he finally arrived at his office around 9:45 a.m. or 10:00 a.m., he realized that it was an emergency case and that the dog was in serious condition. He then attempted to perform a transfusion and used his German short-haired pointer, "Shadow", as the donor dog. As he had both dogs lying on the table, attempting to use his transfusion equipment, he had his face close to Shadow's head. He told his own dog, Shadow, to be still or be quiet in a loud voice which startled the dog and the dog whirled around and bit the Respondent on the nose, severely lacerating his nose, causing it to bleed copiously. Pat Guinn was the attending staff member at this procedure. The Respondent had Pat Guinn hold something to his nose to staunch the blood flow while he continued to attempt to render care to the severely-ill Dusty. Ultimately, because he was in extreme pain and losing blood from the wound in his nose, he was unable to complete the procedure and instructed Pat Guinn to take Dusty to Dr. Andress, a nearby veterinarian, to secure his care while the Respondent went to the emergency room to have his wound treated. This procedure was followed, but unfortunately the dog expired shortly after arriving at Dr. Andress' office. Pat Guinn testified that the dog "Dusty" came into the office early on that morning very ill and very cold. At about 8:15 a.m. to 8:30 a.m., she called the Respondent and told him of the dog's arrival. She maintains that she told him that morning over the telephone that it was a grave emergency. In any event, she testified that she and Carla Fowler put the dog on the table and placed warm water bottles around him and covered him up, awaiting the Respondent's arrival. She testified that the Respondent did not get to the clinic until 10:30 a.m. and got mad at her when he saw the condition of the dog, saying that it was an emergency and that they should have called him. She claims to have reminded the Respondent that she had told him that it was an emergency when she called him early that morning, shortly after 8:00 a.m. In any event, she testified that the Respondent, in attempting to establish the transfusion, became agitated and bit his dog, "Shadow", on the ear, whereupon Shadow bit him on the nose. Pat Guinn is not worthy of belief. Ms. Vetitoe, a confirmed animal lover, observed the procedure being performed on "Dusty", with the dog "Shadow" as the donor dog, and observed what transpired when the Respondent was bitten on the nose by Shadow. She corroborated the Respondent's own testimony upon which the above Findings of Fact are based to the effect that Shadow bit him on the nose, but he never bit any dog. Pat Guinn was a disgruntled employee. She was fired in February of 1987 by the Respondent and shortly thereafter, executed the affidavit upon which this prosecution was, in part, based. She testified that the Respondent had held a gun on her and threatened her on three different occasions and threatened to kill her and her children. She maintains that she told the Deputy Sheriff, Officer DeLeon, of this when she called him to report these incidents, as he put it, "Just for the record". In fact, Officer DeLeon testified that she had never reported the Respondent threatening her with a gun, holding a gun on her or pointing a gun at her. She also acknowledged in her testimony and in a deposition that she had been treated for stress and for a "nervous breakdown". Even Carla Fowler, another witness for the Petitioner, acknowledged that Pat Guinn had been known to exaggerate the truth. I find Pat Guinn's testimony too inconsistent, false and influenced by her hostility toward the Respondent, due to her discharge and, doubtless, to other altercations with him, to justify accepting it as probative of any facts in dispute. Paragraphs 35 through 37 of the Administrative Complaint charge that the Respondent inflicted cruelty intentionally and repeatedly on a cat named "Leo," belonging to Judith Gahimer, which had been brought to the Respondent for veterinary care. The cat "Leo" suffered from a hematoma in one ear caused by an injury (blood blister). The Respondent performed a "zepp" procedure which involves slitting the hematoma area and inserting a stainless steel ring so that the ring can move and prevent the wound from closing up, thus, enabling it to drain properly while it is healing. This is an accepted procedure for this type of injury, as acknowledged by Dr. Cordell, the Petitioner's expert witness. In this particular animal, however, for some reason, the incision did not heal properly. This was possibly because the cat kept irritating the incision. In any event, the cat had to be brought back to the Respondent on a number of occasions for cleansing of the wound and otherwise caring for it. On one of these occasions, Tina Lyttle assisted the Respondent in caring for the cat. The cat was on the examining table, and Tina Lyttle was assisting in restraining the cat while the Respondent treated it. Tina Lyttle stated that the cat became irritated and growled and hissed at the Respondent. She testified that she then observed the Respondent hit the cat approximately three times on the head with his hemostats and no- where else on the cat's body. Judith Gahimer, the cat's owner, believed that the cat's hips had been injured because the cat walked with a limp at some point after the Respondent was through treating him and was unable to jump anymore. She believed the cat's hip to be fractured. It was not demonstrated, however, even by the testimony of Tina Lyttle; that any permanent injury to the cat occurred during the Respondent's care. In fact, in her own testimony, Tina Lyttle, herself, was holding the cat with her hands in the area of his hips and shoulders to restrain him on the examining table. Any permanent injury to the cat was not caused by the Respondent. The cat's owner was unable to offer any definitive explanation for how the cat may have been injured or when. The Respondent vehemently denies striking the cat, as described by Tina Lyttle. I accept the testimony of the Respondent over that of Tina Lyttle concerning the "Leo" complaint. Shortly after the "Peaches" incident, Tina Lyttle was discharged by the Respondent as a result of a verbal and physical altercation he had with her. The Respondent offered to rehire her if she apologized for her behavior. The totality of the evidence of record reveals, however, that she harbors a great deal of resentment against the Respondent. Her bias against him is definitely demonstrated by the fact, as established by other prosecution witnesses, that she was the person who orchestrated the gathering of complaint affidavits against the Respondent, contacting Betty Simms of the Santa Rosa County Humane Society (after the Escambia County Humane Society refused to pursue the matters involved in this Administrative Complaint) and was the prime movant in getting Ms. Simms and the Santa Rosa County Humane Society to institute both the criminal and administrative proceedings against the Respondent. Her testimony is not credible nor worthy of belief. Paragraphs 38, 39 and 40 of the Administrative Complaint concern a spaniel by the name of "Beau". These paragraphs, which include Count Eight of the Administrative Complaint, allege that the Respondent, on a date unknown, was observed striking and biting "Beau". The incident involving "Beau" purportedly involved the Respondent treating the dog by cleaning his ears. The Respondent's assistant at the time, Peggy Maggard, helped with this procedure. Ms. Maggard testified that she was holding the dog on the examining table while the Respondent was cleaning his ears, which were apparently rather sensitive. She testified that the dog tried to pull away when his ears were being examined and that the Respondent hit the dog on top of the head and then struck him on top of the head again with his fist. He became angry, according to Ms. Maggard, and jerked the dog away from her and bit the dog on the nose, severely enough to leave a gash, causing the gash to bleed. Ms. Maggard testified that at this point she grabbed the Respondent by the throat and admonished him not to treat the dog so. She claims that the bite by the Respondent to the dog's nose caused a gash in approximately the pattern of the Respondent's teeth, or approximately one and a quarter inches wide, causing the wound to bleed and that the blows to the top of the head left a noticeable lump on top of the head which a person examining the dog would be able to feel. She testified that the dog's owner would be able to readily notice both injuries. The dog's owner, Henry Savelle, had used the Respondent for "Beau"'s care and treatment for a number of years, always finding the care and treatment rendered to his dog to be appropriate. Mr. Savelle retrieved his dog from the Respondent's care approximately the next day following the purported incident. He noticed no injuries whatever to the dog. He would have been able to notice such injuries inasmuch as he is frequently in close contact with his dog. The alleged incident concerning the dog "Beau" is supposed to have occurred, according to Peggy Maggard, in 1983, approximately six years before this proceeding. Ms. Maggard did not report this incident until May 14, 1987, some four and one- half years after it occurred. She did not report it until she conferred with Betty Simms, the Santa Rosa County Humane Society member and Animal Control Officer and only did this after learning that others who had worked for the Respondent had made complaints to Ms. Simms. The witness testified that she could not recall how she learned that others had made complaints and purported not to recall whether she had talked to other complainants about the Respondent and the care and treatment he had rendered to the various animals involved in those complaints. It is singular to observe, however, that she was purportedly able to recall clearly all of the events surrounding the incident allegedly occurring with the dog "Beau," even though it allegedly occurred some four and one-half years earlier than the events she purportedly cannot recall concerning how she came to learn of the complaints against the Respondent, the investigation by Animal Control Officer Simms, why she came to make her report in May of 1987, nor whether she conferred with the other complainants before or after making her report concerning "Beau". She did state, however, that upon reporting the "Beau" incident to Betty Simms, the Animal Control Officer, she already knew that others had made complaints, meaning the other former employees of the Respondent. Peggy Maggard, like the other former employees of who made complaints which engendered this prosecution, had had disagreements and altercations with the Respondent which resulted in her being discharged twice from his employ. The Respondent, for unexplained reasons, as in the case of some of the other employees, rehired her after discharging her for the first time. In any event, it is apparent, from the totality of the circumstances concerning the manner in which Ms. Maggard described this alleged incident and the manner in which it came to the attention of the Petitioner through the reporting of it, much belatedly, by Ms. Maggard, after she learned of the efforts by former employees to report incidents concerning the Respondent, that Ms. Maggard harbors a significant amount of resentment against the Respondent. She is a disgruntled former employee. This leads the Hearing Officer to the conclusion, considering circumstances of her employment, history, the purported nature of the "Beau" incident, and the apparent contact that the various former employees, including Ms. Maggard, had with each other concerning the reporting of these incidents, and the manner of reporting them, that Ms. Maggard fabricated this incident It is simply incredible that the Respondent would have bitten the dog on the nose, and Ms. Maggard was certainly not a convincing witness capable of establishing that fact. Perhaps the Respondent said it best when he testified, without contradiction that, at the behest of the Department, he had taken a battery of psychiatric tests and had "passed with flying colors". It is singular to note in reviewing the totality of testimony and evidence in this proceeding that the Respondent is the only witness who was subjected to and passed such psychiatric examinations. The Respondent vehemently denied that this incident occurred. His testimony is credible and accepted. The incident did not occur. The "medical records complaint" concerns paragraphs 41 through 47 of the Administrative Complaint. In this regard, it is alleged that on or about July 23, 1987, the Respondent was contacted by the Petitioner, through its investigator, Mr. Clum, and requested to provide treatment records for the animals, "Peaches, "Chipper", "Babe" and "Geoff", pets he had allegedly treated. The Respondent was presented with a "authorization" to release the records of each of the above- named animals, and is charged with failing or refusing to release those records to the Department's investigator, Mr. Clum, in alleged violation of Rule 21X-18.02, Florida Administrative Code. Indeed, the Respondent did fail to give the investigator those records. In this connection, the record evidence reveals that Tina Lyttle, in approximately February of 1987, was working at the clinic on a Sunday when the Respondent was not present. This was after the point in time when Tina Lyttle had assembled the various affidavits from employees or former employees and reported the alleged incidents to Ms. Simms. On this Sunday occasion, Ms. Lyttle called Ms. Simms; and at her behest, Ms. Simms went to the Respondent's office to make observations, take photographs and to examine the Respondent's records, which Tina Lytt1e allowed her to do. The two examined the Respondent's medical records without the Respondent's or the pet owners' authorizations. They also photographed certain records. Thereafter, on July 23, 1987, when the Respondent was asked by investigator Clum to provide the records of the four above-named animals, the Respondent attempted to do so. He went to his file cabinet where such records are kept and could not find the records. In fact, the record jackets concerning each of these animals were still in his file drawer; but the record materials contained therein were missing. The failure to supply these records to the Department's investigator was not shown to be the fault of the Respondent. He did not fail or refuse to provide the requested records. He tried to provide them. It was simply impossible because they had been removed from his files. Paragraphs 44 through 47 of the Administrative Complaint concern treatment records which the Respondent did provide at the Petitioner's request for the animals named "Leo", "Max", "Beau", and an unnamed mixed collie owned by Kimberly Rowe. It is charged in essence that the records furnished by the Respondent as to these animals failed to contain all of the information required by Rule 21X-18.02, Florida Administrative Code. During the course of the hearing, the Petitioner voluntarily dismissed the complaint as to the dog named "Max" and the unnamed mixed collie, leaving at issue the question of the adequacy of the records concerning the cat named "Leo" and the dog named "Beau". The Petitioner presented, as its expert witness in the field of veterinary medicine and practice, Dr. Joe Wilson Cordell, Jr. of Tallahassee, Florida. Dr. Cordell has been a veterinarian for some 17 years and was accepted as an expert in the practice of veterinary medicine. Dr. Cordell reviewed the medical records on the two named animals consisting of the Petitioner's Exhibits 84 and 85. With regard to the records concerning these two animals, Dr. Cordell did not opine that the treatment or care furnished was inadequate or did not accord with appropriate, professional veterinary medicine standards. He did observe that to some extent the records were incomplete in showing exactly what surgical procedure or other procedure might have been done, whether or not physical examinations were performed, prior to administering anesthetic, what type of anesthetic was used and the route of administration. Certain items, such as body temperature, physical examination findings, medications used, route of administration of the medications, and adequate descriptions of procedures involved were lacking from the records or, to some extent, were illegible. The ear procedure record concerning the dog "Beau," for June 23, 1983, does not contain a diagnosis. Dr. Cordell established that a diagnosis is required for such a medical record. In summary, Dr. Cordell could not tell from examining the records exactly what procedure was done regarding the ear treatment involved as to one of the animals nor were adequate record entries made regarding the results of physical examinations. He acknowledged, however, that the records probably meant a great deal more to the Respondent than they did to him inasmuch as he was unaware of the Respondent's manner of making notes. He observed that the Respondent's notes probably meant more to him than they would to anyone who examined them. Such medical records and notes are for the purpose of assuring continuity of treatment and to refresh the doctor's recollection of the status and condition of an animal which he may been treating and keeping records on for a number of years. The Respondent testified that he felt that he was making records in the manner taught at the veterinary school at Auburn where he was trained and at which his brother, who advised him concerning record-keeping, is a professor. Further, the Respondent, in an effort to improve his record keeping, prior to this prosecution, installed a $23,000.00 computer hardware and software system to help him to assure better and more adequate record-keeping. The observations of Dr. Cordell concerning the record-keeping as to the animals named "Leo" and "Beau" are accepted to the extent that they demonstrate the inadequacies in recording the observations, results of examinations, treatment details and diagnoses related to those two animals. Neither Dr. Cordell nor any other witness established, however, what the professional veterinary medicine practice standards are as to any illnesses or conditions presented and resulting treatment performed as to any of the animals referenced in the Administrative Complaint. There has been no demonstration that any care and treatment performed by the Respondent has failed to accord with any professional veterinary medicine practice standards. Thus, as to any of the animals referenced in the Administrative Complaint, there has been no showing of incompetency or misconduct in the practice of veterinary medicine nor has there been any demonstration of fraud, deceit or negligence in the practice of veterinary medicine. Concerning the so-called "General Complaint" appearing at paragraph 48 of the Administrative Complaint, the Respondent is charged with practicing veterinary medicine in a way that inflicted unnecessary pain and suffering on animals entrusted to his care and treatment which, in turn, is alleged to be misconduct in the practice of veterinary medicine, as well as being beneath the minimal standard of care required of veterinarians in the State of Florida. Once again, it is found that no minimal standard of care required of veterinarians in Florida has been established of record in this proceeding. In accordance with the above Findings of Fact, it has not been established that any unnecessary pain and suffering was inflicted on any of the animals entrusted to the Respondent's care and treatment. Finally, it is true that the Respondent entered a plea of nolo contendere to two counts of the offense of cruelty to animals, as shown by the Petitioner's Exhibit 83, the order of the circuit judge entered on July 6, 1987. The Respondent established, however, that after paying a $15,000.00 fee to his attorney, Leo Thomas, in that criminal proceeding, and vehemently insisting on a jury trial because he felt that he had not committed any misconduct, he bowed to the advice of Attorney Thomas to the effect that if he proceeded with litigating the criminal matter, it would ruin his veterinary practice due to adverse publicity. Consequently, the Respondent established that that plea was merely "a plea of convenience" and was not made because the Respondent felt or tacitly admitted any guilt of the charges involved. In fact, the circuit judge did not adjudicate him guilty and stated affirmatively in his order that he did not feel that the alleged course of conduct involved required that he should be adjudged guilty. That order does not establish any conviction or adjudication of guilt but rather, was a result of a "plea of convenience". In summary, none of the violations alleged in the Administrative Complaint, other than the minor record keeping violations established by Dr. Cordell, have been proven in this proceeding. In reading the conflicting testimony, the Respondent's testimony and that of Ms. Vetitoe and Lt. Loria is accepted over that of the Petitioner's complaining witnesses because they are more credible and worthy of belief. The testimony of most of the Petitioner's witnesses, consisting of the former employees of the Respondent, is tainted and colored by bias and resentment against the Respondent, caused by past disagreements between him and those witnesses which, in the instance of each of them, culminated in their discharge from his employ, in some cases, multiple times. Tina Lyttle, for instance, had a number of verbal and physical altercations with the Respondent, at one point, in connection with the "Peaches incident", slamming the Respondent against the wall of the kennel or outdoor building when he went outside to attempt to calm her down from her misplaced anger resulting from the "Peaches incident". It was Tina Lyttle who conferred with the other complaining witnesses, orchestrated the complaints and secured the affidavits as to the alleged instances of animal cruelty and the infliction of unnecessary pain and suffering which, were given over to Ms. Simms, the Animal Control Officer, who then proceeded to instigate both the criminal prosecution and this administrative prosecution. There is sufficient evidence of record to infer that these witnesses, who had worked for the Respondent, conferred with each other at various times in orchestrating their complaints against the Respondent, and that each of them had sufficient grounds for bias and resentment against the Respondent as disgruntled employees so as to support a finding and conclusion that these former employees fabricated the essential specifics of the story of the Respondent's alleged cruelty and improper treatment of the animals in question. This finding is supported in this record by the inconsistencies in the testimony, at various times, of some of these witnesses. Pat Guinn, for instance, in her deposition, taken prior to this proceeding, indicated that she observed the Respondent strike the dog "Star" on the head with the hose nozzle. In her testimony at hearing, she recanted and stated that she had not seen that incident. Her testimony is also inconsistent about the manner in which "Peaches" death was reported and the manner in which the dog's body was allegedly disposed of. Her testimony is simply incredible in the face of the testimony of Ms. Vetitoe, an avowed animal lover, who testified that she never buries a dog but rather, cremates all of the dogs she has ever had to die in her custody, placing the remains in urns. Her testimony concerning the Respondent threatening her with a gun on three different occasions was belied by that of Officer DeLeon, who certainly had no motive for fabrication of his testimony when he indicated that no report of her being threatened with a gun was ever made to him. He testified that she reported an alleged threat against her by the Respondent, "Just for the record". In his experience as a law enforcement officer, he testified that it is highly unusual for an employee to report such an altercation with her employer, "Just for the record". The testimony of Carla Fowler is inconsistent with that of Guinn and Lyttle concerning the question of Peaches death or disappearance. Like the other witnesses, it is found to have been guided by her resentment against the Respondent more than any righteous indignation and genuine concern for the animals in question, as evidenced by the fact, established by Ms. Vetitoe's testimony that she, herself, had had a verbal altercation with Carla Fowler. When Ms. Vetitoe brought her own dog to be cared for by Carla Fowler, she warned Ms. Fowler that the dog had a propensity bite. Ms. Fowler, supposedly an animal lover herself, responded to Ms. Vetitoe by saying that if the dog bit her, she would "knock the m f hell out of the dog", a remark and attitude which upset Ms. Vetitoe, a dog fancier and client of long standing. In summary, the testimony of these former employee witnesses is fraught with internal inconsistencies and inconsistencies with the testimony of each other. Their testimony is simply not credible and worthy of belief and is found to have been fabricated with regard to the essential details concerning alleged cruelty to the animals in question. The testimony of witness Gahimer, the owner of the cat "Leo" is rejected. She did not establish that the alleged hip injury to the cat, if it occurred, was caused by the Respondent. The testimony of Tina Lyttle herself shows that no injury to the cat's hip area could have occurred during that treatment episode. The Respondent established that the Gahimer complaint was motivated by a billing dispute with the Respondent. No other pet owner had any complaints.
Recommendation Having considered the foregoing Findings of Fact, Conclusions of Law, the evidence of record, the pleadings and arguments of the parties, and the candor and demeanor of the witnesses, it is, therefore, RECOMMENDED that a Final Order be entered by the Board of Veterinary Medicine dismissing the entire Administrative Complaint, with the exception of the charges in paragraphs 44 and 45 concerning the records of the cat "Leo" and the dog "Beau", and that it find that the Respondent has violated Section 474.214(1)(f), Florida Statutes, derivatively, by violating Rule 21X-18.02, Florida Administrative Code, concerning those two animals. Because of the circumstances surrounding this violation, as delineated above, it is recommended that a private reprimand be accorded the Respondent for this violation. DONE and ENTERED this 1st day of December, 1989, in Tallahassee, Leon County, Florida. P. MICHAEL RUFF 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 1st day of December, 1989.
The Issue Whether Respondent's B license to practice veterinary medicine in the State of Florida should be suspended, revoked, or otherwise disciplined for the reasons set forth in the Administrative Complaints filed in the above-styled consolidated cases.
Findings Of Fact Petitioner, DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION, is the agency of the State of Florida vested with statutory authority for instituting disciplinary proceedings to enforce the provisions of Chapter 474, Florida Statutes, governing the practice of veterinary medicine. Respondent, MARIANNE T. KEIM, D.V.M., is, and at all times material hereto has been, a licensed veterinarian in the State of Florida, holding license number VM 0005113. Findings as to Case No. 95-324 On May 31, 1994, Mrs. Julie Panatela presented her six-month old female canine named Godly to Respondent's clinic in Tampa, Florida, for the purpose of having a spay procedure performed. Godly is a mixed-breed dog of primarily golden retriever parentage. Mrs. Panatela left Godly at Respondent's clinic at approximately 8:30 a.m. At that time Godly was in good health, and had no prior surgical procedures. On June 1, 1994, Respondent performed a spay procedure on Godly. Respondent was assisted during the surgery by Lori Burden, a veterinary assistant employed by Respondent. There were no gauze sponges present in the dog's abdomen when Respondent opened the body to perform the spay procedure. A canine spay procedure, an ovariohysterectomy, is the surgical removal of the dog's uterus and both ovaries. The procedure requires the dog to be placed under a general anesthesia. A sterile prep scrub is done. An incision is made in the abdomen below the umbilicus. In removing an ovary, clamps are placed on the ovarian pedicle to compress the tissue so that ligatures, i.e. sutures, may be tightly applied to the area. The purpose of this procedure is to close the blood supply so that the ovary may be removed. Similarly a clamp and ligatures are applied to the uterine body so that the organ may be removed. After removal of the uterus and ovaries, the abdomen is closed, usually in three layers. First the ventral midline, linea alba, is closed, then the subcutaneous layer, and finally the skin. There is little bleeding associated with this procedure. While there may be some seepage, only a few tablespoons of fluid is normal. Prudent veterinary practice requires the counting of sponges during a surgical procedure. Respondent has performed hundreds of canine spay procedures. It is Respondent's normal practice to always hold sponges in her fingers during surgery, and not to place sponges unattached inside an animal's body. As a routine practice Respondent's employed assistants are instructed to count sponges during any surgical procedure. On June 1, 1994, Lori Burden was the veterinary assistant responsible for counting sponges during the spay procedure Respondent performed on Godly. Six sponges were used during the procedure, four while inside the dog, and two during closing. Ms. Burden believed the sponge count to be accurate, and that all sponges were accounted for, and properly disposed of after Respondent completed the spay procedure. On the afternoon of June 1, 1994, Mrs. Panchal's husband, Raja Panatela, picked Godly up from Respondent's clinic and took the dog home. The Panchals observed that Godly was very lethargic, unusually inactive, and had difficulty going to the bathroom. Additionally, the Panchals observed about a quarter of a cup of pinkish fluid draining from the incision site. Goldie's condition continued to deteriorate that evening. More fluid was draining from the incision, and the dog was increasingly listless. The Panchals became extremely concerned about Goldie's worsening condition, and on the next day, June 2, 1994, Mr. Panatela returned with Godly to Respondent's clinic. Mr. Panatela reported to Respondent his observations, and expressed his concerns regarding Goldie's condition. Respondent examined the incision and stated to Mr. Panatela that it looked fine. Respondent did not diagnose any significant problems with Godly, and placed a belly wrap around the dog's abdomen to absorb any seepage. Mr. Panatela returned home with Godly. During the evening Goldie's condition continued to worsen. The dog remained listless and more fluid was discharging from the incision. The next morning, June 3, 1994, Mrs. Panatela discussed the dog's condition with her neighbor. Later that morning, at her neighbor's suggestion, the Panchals presented Godly to G. Brooks Buck, D.V.M., a veterinarian operating a clinic in Valrico, Florida. The Panchals informed Dr. Buck that Godly had been spayed on June 1, 1994, and that since the procedure was performed the dog had been abnormally listless, had difficulty going to the bathroom, and that significant amounts of fluid were discharging from the incision site. The Panchals did not inform Dr. Buck at this time that Respondent had performed the spay procedure on Godly. Dr. Buck's initial observation of the incision site revealed no problems, and the skin incision appeared well sutured; however, when Dr. Buck picked Godly up to place her on the floor a large amount of fluid, approximately one-half cup, discharged from the incision site. Dr. Buck then became very concerned, and recommended to the Panchals that the incision be reopened so that he could determine the cause of the fluid discharge. The Panchals agreed, and on June 3, 1994, Dr. Buck reopened the incision. During his surgery, Dr. Buck found no signs that the subcutaneous tissue layer had been sutured. Dr. Buck further observed that two-thirds of the caudal layer incision through the abdominal wall had been sutured with chromic catgut and steel; however, the final third of the caudal layer incision showed no sign of having been sutured. Dr. Buck observed fluid leaking through the unsutured portion of the caudal incision into the abdominal cavity. Inside the abdominal cavity Dr. Buck observed that the omentum appeared red and irritated, as did the peritoneal wall. Dr. Buck also observed a wad-like mass within the abdominal cavity which, upon closer inspection, he discovered to be a surgical sponge that had become surrounded by the omentum. Dr. Buck cut the retained sponge from the omentum and removed the sponge from the dog's abdomen. After removing the retained sponge, Dr. Buck further observed that the ovarian and uterine stumps were irritated, and that the right ovarian stump was leaking blood from a nicked artery. Dr. Buck sutured the ovarian and uterine stumps, as well as all three layers of incision, and discharged Godly. Godly recovered from Dr. Buck's surgery without further complications, and on June 13, 1994, Dr. Buck removed the sutures. Godly is now in good health. It is standard veterinary practice to count sponges before and after surgery. It is standard veterinary practice in a canine spay procedure to suture the subcutaneous layer of incision. It is standard veterinary practice in a canine spay procedure to completely suture the linea alba incision. Excessive discharge of fluid after a canine spay procedure indicates an abnormality. It is standard veterinary practice to recognize that excessive fluid discharge after a canine spay procedure indicates an abnormality and requires treatment. Findings as to Case No. 95-327 On Wednesday, July 27, 1994, Mrs. Nan Sherwood presented her cat, Mollie, to Respondent's clinic. Mrs. Sherwood informed the clinic staff that Mollie was acting unusually shy and had no appetite. At this time Mrs. Sherwood did not see or speak with Respondent. Mrs. Sherwood left Mollie at Respondent's clinic for treatment. Mrs. Sherwood was very concerned about Mollie's condition. When Mrs. Sherwood had not received any information from Respondent, she returned to Respondent's clinic on Friday, July 29, 1994. Mrs. Sherwood saw Mollie, observed that the cat's condition had worsened, and requested to speak to Respondent. A clinic staff technician told Mrs. Sherwood that Respondent would contact her later. Respondent did not, however, contact Mrs. Sherwood. When Mrs. Sherwood did not hear from Respondent, she placed a call to Respondent's emergency telephone number on the evening of July 29, 1994. Mrs. Sherwood did not hear from Respondent that evening. The next morning, Saturday, July 30, 1994, Respondent telephoned Mrs. Sherwood and informed her that the cat was being administered fluids, that diagnostic tests on Mollie were being conducted, and stated that she would call Mrs. Sherwood again on Sunday, July 31, 1994, between 11:00 a.m. and 1:00 p.m. On Saturday night, July 30, 1994, Respondent returned to her clinic and examined Mollie. At approximately 11:30 p.m., while Respondent was examining Mollie on the examination table, the cat died. The cause of death was advanced kidney disease and diabetes. The medical therapy administered by Respondent to Mrs. Sherwood's cat, Mollie, met acceptable standards of veterinary practice. After the cat's death, Respondent had the cat's body placed in the freezer at her clinic along with other animal remains scheduled for cremation. Due to a personal emergency, Respondent did not place a call to Mrs. Sherwood until after 3:00 p.m. on Sunday, July 31, 1994. At this time Mrs. Sherwood was in the shower, and her husband, Robert Sherwood, answered the telephone. Respondent informed Mr. Sherwood that the cat had died. Mr. Sherwood was very concerned that Respondent had been unresponsive to his wife and had failed to inform them in a timelier manner that the cat had died. Respondent asked Mr. Sherwood about the disposal of the cat's remains, and Mr. Sherwood informed Respondent that his wife would contact her later. Mr. Sherwood did not authorize cremation of the cat's remains. On Monday, August 1, 1994, Mrs. Sherwood spoke by telephone with Respondent. Mrs. Sherwood was interested in understanding the cause of her cat's death and why Respondent had not notified her earlier regarding the cat's death. Respondent told Mrs. Sherwood about her personal problems which had occurred on the weekend. Mrs. Sherwood was not satisfied with this explanation, but told Respondent she would come by for Mollie's body. Mrs. Sherwood did not authorize cremation of Mollie's body. On Wednesday, August 3, 1994, Mrs. Sherwood again spoke with Respondent by telephone. Mrs. Sherwood told Respondent she was coming to Respondent's clinic to pick up Mollie's body. At this time Respondent told Mrs. Sherwood that the cat's body had probably been taken on Tuesday for cremation, and that Mrs. Sherwood could come later to pick up the ashes. At this point Mrs. Sherwood became extremely upset because she had not authorized cremation of Mollie's remains. Mrs. Sherwood then called the offices of Petitioner to inform the Department of the circumstances surrounding Respondent's actions in regard to the death of Mollie. That same day, August 3, 1994, Mrs. Sherwood went to the Petitioner's office in Brandon, Florida, met with Diane Gusset, an agency investigator, and filed a statement detailing these events. Mrs. Sherwood also signed a form for Ms. Gusset authorizing the release of Mollie's records, as well as Mollie's remains, if still on the clinic premises. On Thursday, August 4, 1994, at approximately 10:00 a.m., Ms. Gusset, accompanied by Dennis Force, also an agency investigator, went to Respondent's clinic for the purpose of retrieving the records of Mrs. Sherwood's cat, and the cat's remains if on the premises. Upon arrival at the clinic, Investigator Force identified himself and Ms. Gusset to Respondent's staff as officials of the Department and requested access to the clinic. The staff went to inform Respondent about the presence of the Department investigators. During this time, the Department investigators proceeded into the clinic. Ms. Gusset entered the surgery area where Respondent was performing surgery. Ms. Gusset asked for the Sherwood records, but Respondent informed her the records were not on the premises. While inside the clinic, the investigators observed that the kennels had not been recently cleaned, and dogs in the outside kennels needed water. The investigators also saw eight containers of medication which appeared out of date; however, the medication containers contained small amounts of medicine, and there is no evidence that Respondent administered out-of-date medication. One container of hydrogen peroxide which appeared out of date was actually a reusable container. Ms. Gusset and Mr. Force also discovered the remains of Mrs. Sherwood's cat, Mollie, in the freezer at Respondent's clinic. By this time Respondent had contacted her attorney who requested Ms. Gusset and Mr. Force leave the clinic premises. After consulting with the Department's attorney, the investigators left the clinic. Respondent's clinic staff regularly cleans the premises. On the morning of August 4, 1994, when the Department investigators arrived, the clinic staff was in the process of, but had not yet completed, the cleaning of the kennel area. Respondent has instituted procedures in her clinic to monitor the dispensing of medications, and to update the effective dates of medications administered. There is no evidence Respondent administered outdated medication.
Recommendation Based on the foregoing Findings of Fact and Conclusions of Law, it is recommended that the Board of Veterinary Medicine enter a final order in DOAH Case No. 95-0324 suspending Respondent's license to practice veterinary medicine for a period of six months, placing Respondent on probation for a period of two years under supervised practice, imposing a fine of $1000, and requiring Respondent to attend additional continuing education courses in organizational skills, and veterinary medical therapy. It is further recommended that the Board of Veterinary Medicine enter a final order in DOAH Case No. 95-0327 dismissing the Administrative Complaint. RECOMMENDED this 17th day of January, 1997, in Tallahassee, Florida. Hearings Hearings RICHARD HIXSON Administrative Law Judge Division of Administrative 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 this 17th day of January, 1997. COPIES FURNISHED: Miriam S. Wilkinson, Esquire James Manning, Esquire Department of Business and Professional Regulation 1940 North Monroe Street Tallahassee, Florida 32399-0792 Michael J. Kinney, Esquire KINNEY, FERNANDEZ and BOIRE, P.A. Post Office Box 18055 Tampa, Florida 33679 Lynda L. Goodgame, General Counsel Department of Business and Professional Regulation 1940 North Monroe Street Tallahassee, Florida 32399-0792 Susan Foster, Executive Director Board of Veterinary Medicine Department of Business and Professional Regulation 1940 North Monroe Street Tallahassee, Florida 32399-0792
