The Issue The issue to be determined is whether Respondent violated sections 456.072(1)(v), Florida Statutes (2012-2013), and 458.331(1)(c), Florida Statutes (2014), as alleged in the Second Amended Administrative Complaint, and if so, what penalty should be imposed for his conduct.
Findings Of Fact The Department is the state agency charged with regulating the practice of medicine pursuant to section 20.43 and chapters 456 and 458, Florida Statutes. The Board of Medicine is the professional licensing board charged with final agency action with respect to physicians licensed pursuant to chapter 458. At all times relevant to these proceedings, Respondent has been a licensed physician in the State of Florida, and holds license number ME 50948. Respondent worked as a family practitioner at the Capital Regional Medical Southwood Office (Southwood) in Tallahassee, Florida, from sometime in 2010 to February 2014. Patient M.M. From August 2011 through February 2014, Respondent provided medical care to patient M.M. During a portion of that time, Lourdes Mosely was a physician assistant at Southwood. Ms. Mosely also treated M.M. until Ms. Mosely’s departure from the practice in July 2013. Respondent treated M.M. for chronic pain related to her back and hip, as well as other issues. She had back surgery in 1999 and had pain related to her back since that time. Dr. Williams prescribed controlled substances for her chronic pain, which required that she be seen every four weeks. When seen by Ms. Mosely, M.M. also reported gynecological issues, including painful intercourse. However, she did not discuss those issues with Respondent. M.M. initially saw Dr. Williams when she came to Southwood for treatment, but did not feel especially comfortable with him, so preferred to see Ms. Mosely. She did so until Ms. Mosely left the practice, at which time she returned to seeing Dr. Williams. M.M. saw Dr. Williams approximately six times after Ms. Mosely left the practice. During one of the initial visits following Ms. Mosely’s departure, M.M. testified that Respondent acted inappropriately in that Respondent suggested to M.M. that, in order to address her pain with intercourse, she watch an adult video and insert her fingers into her vagina. M.M. testified that he also suggested that M.M.’s husband could participate and that M.M. could perform oral sex on her husband and allow him to ejaculate into her mouth. She also testified that during a different visit, Dr. Williams suggested that she hang a strap apparatus from the ceiling to elevate her legs during sexual intercourse. Both the suggestions about masturbation and oral sex and the suggestion regarding the strap apparatus were unsolicited and were not given in response to any questions about painful intercourse, as this was a subject M.M. did not discuss with Dr. Williams. M.M. continued to see Dr. Williams because Tallahassee does not have a significant supply of pain management physicians, and she needed medications for her chronic pain. However, she started having her mother, who was also Dr. Williams’ patient, accompany her on her visits to Dr. Williams, and her mother attended all but one of her remaining visits. At some of the visits when her mother accompanied her, toward the end of the visit, Dr. Williams would direct M.M.’s mother to step out of the room. It was after she left the examining room that he would make comments M.M. felt were out of line. At one other visit toward the end of M.M.’s appointments at Southwood, M.M. testified that as she was preparing to leave the examining room, Dr. William slapped her on the buttocks and suggested that she “twerk” for him. M.M. considered all of Respondent’s actions described above to be humiliating, inappropriate, and unprofessional, and felt that Respondent had crossed a line with her. She called the receptionist and complained about Respondent’s conduct, and testified that Ms. Jenkins, the medical office coordinator, told her that Dr. Williams was a chauvinist and Ms. Jenkins could not really say anything to him. While M.M. could not recall when she called Ms. Jenkins, Ms. Jenkins testified that she received a complaint from M.M. after Dr. Williams left the practice in February 2014. Respondent admits that the conduct, if it occurred, would constitute sexual misconduct. He denies that it occurred, however. Instead, he contends that M.M. is not to be believed because her memory of the incidents is not clear and because her claim is based somehow on a desire to get revenge against him for not continuing to prescribe pain management medications. The undersigned finds M.M.’s account of the incidents in the Second Amended Administrative Complaint to be sufficiently clear to support the ultimate finding that Respondent committed the conduct about which she complains. It is true that M.M. could not identify the specific dates upon which the incidents occurred, and she candidly admitted that she could not recall the specific dates. However, her testimony was clear and consistent about what happened, and the time-frame in which it happened. She visited the office once monthly because of her pain management medications, and Ms. Mosely left the practice in July 2013. She was equally clear that the first incidence of inappropriate conduct occurred in one of the first visits following Ms. Mosely’s departure, and that she had her mother accompany her after that point to reduce the possibility of the opportunity for such comments. Moreover, Respondent’s claim that M.M. somehow made up these allegations because Dr. Williams would no longer be prescribing pain management medications, something M.M. adamantly denied, is simply not credible. While M.M. had complained to the office manager, she did not complain directly to the Department of Health. Rather, she was contacted by a Department of Health investigator in April 2014, a few months after Dr. Williams was no longer at Southwood. Had M.M. fabricated the story as Dr. Williams claims, it would have made more sense for her to have acted on the complaint independently, as opposed to simply responding to an inquiry by the Department. Dr. Williams’ actions with respect to M.M. violated the trust that a patient places in his or her physician and constitute sexual activity outside of the scope of the professional practice of medicine. Patient B.G. Between approximately September 2012 and February 2014, patient B.G. was treated at the Southwood office. She was, like M.M., treated by Ms. Mosely until Ms. Mosely’s departure. She was treated at Southwood for a variety of medical conditions which included treatment for chronic pain after a knee replacement surgery that was unsuccessful, and for a herniated disc. At the time of the events in question, B.G. was approximately 63 years old. B.G. saw Dr. Williams, as opposed to Ms. Mosely, in June 2013. At this visit, B.G. testified that when Dr. Williams came to the examining room, he told her that he thought he would see an older woman, and that she looked younger than he expected. He then asked her about her sex life, which stunned her. B.G. replied that her husband was older, but that their sex life was fine. Respondent then told her that she needed a “sugar daddy,” and he would be willing to fill that role for her. B.G. understood this comment to have a sexual connotation, and replied that she had never cheated on her husband and did not intend to do so. B.G. also testified that Dr. Williams referenced an adult website titled adamandeve.com for purchasing sex toys. Dr. Williams’ remarks to B.G. were unsolicited and not associated with any medical problem for which B.G. was consulting with him. She felt his comments were out of line. She did have to return to the Southwood office and see Respondent after the incident because of some serious health conditions she suffered subsequent to the June 2013 visit. However, the incident caused her to lose confidence in Respondent and she began to look for another primary care physician. She also no longer wishes to have a male physician because she no longer feels comfortable doing so. Respondent admits that the conduct, if it occurred, would constitute sexual misconduct. As with M.M., Dr. Williams believes that B.G. was motivated to make up this story because she was no longer able to obtain pain management medications from him. Dr. Williams’ claim is not credible.1/ Since B.G. stopped seeing Dr. Williams, her new primary care physician has reduced the amount of pain medication she takes to approximately half of what she was taking when Dr. Williams prescribed controlled substances to her. Dr. Williams’ actions with respect to B.G. violated the trust that a patient places in his or her physician and constitute sexual activity outside of the scope of the professional practice of medicine. Patient S.D.H. Patient S.D.H. was treated at Southwood for a variety of conditions from approximately May 2011 through January 2014. Her husband, B.H., was also a patient of Dr. Williams. Both S.D.H. and B.H. were treated for chronic pain and both were prescribed narcotics. S.D.H., who is Caucasian, did not see Dr. Williams for gynecological issues. Normally, S.D.H.’s husband would come with her when she came in for her doctor appointments with Respondent. However, in or about November or December 2013, S.D.H. testified that there was one visit where her husband did not accompany her. S.D.H.’s medical records indicate that she had appointments with Dr. Williams on December 4, 2013, and January 3, 2014.2/ According to S.D.H., at the relevant appointment, Dr. Williams commented on her appearance, telling her that she used to be a “fine little thing” when she first became his patient, making smacking noises with his mouth. S.D.H. testified that he went on to tell her that she was trying to change herself to “please a man,” comments which S.D.H. understood to refer to her prior breast augmentation, her weight gain, and her marriage to her husband. S.D.H. testified that Respondent asked her whether she had ever been with a black man, and if she knew what “they said about black men,” and gyrated his hips in a thrusting manner. S.D.H. believed this question and accompanying physical movement was an allusion to Respondent’s male anatomy. S.D.H. became visibly upset and asked Respondent what these comments had to do with her. She was also shaken during the testimony at hearing, which was visibly difficult for her. Respondent told her the conversation was just between the two of them as physician-patient, and that he would hate to see her husband’s care suffer should there be a misunderstanding about the conversation. Respondent again remarked about her breasts and reached over, placed his hands underneath her breasts and lifted them upward. S.D.H. did not give Respondent permission to touch her in this manner, and she was sickened and frightened by his actions. S.D.H. grabbed her patient checkout sheet and left the room. S.D.H. reported the incident to the office coordinator, and while there is some dispute as to when she reported the behavior, it is undisputed that she in fact did so. Respondent admits that the conduct, if it occurred, would constitute sexual misconduct. Respondent denied that the events occurred and tried to undermine S.D.H.’s testimony in several ways. First, S.D.H. testified that after this encounter she did not see Dr. Williams for care again. There are medical records for S.D.H. for January 3, 2014, and January 30, 2014. However, the medical record for January 3, 2014, is not electronically signed until April 28, 2014, long after Dr. Williams left the practice. It is plausible that January 3, 2014, is the date that the incident occurred. The note for January 30, 2014, is a telephone encounter as opposed to an office visit. In any event, her testimony is clear, concise, consistent, and credited. Respondent also suggested that S.D.H.’s complaint is motivated by a failed drug test in connection with her controlled substances monitoring contract. S.D.H. testified that in an effort to no longer take controlled substances, both she and her husband went to the Leon County Treatment Center and began methadone treatment. Records for S.D.H. from the Leon County Treatment Center notifying the Southwood office of this treatment are in her medical records. She no longer takes controlled substances. Likewise, Respondent’s suggestion that S.D.H. made up the story in anger over treatment decisions made with respect to her husband is rejected as not credible. Dr. Williams’ actions with respect to S.D.H. violated the trust that a patient places in his or her physician and constitute sexual activity outside of the scope of the professional practice of medicine. Respondent’s nolo plea S.D.H. reported the incident to Carrie Jenkins soon after it happened, but did not immediately report it to anyone else. A few months later, she received a telephone call from an investigator with the Department of Health inquiring about her contacts with Dr. Williams. After “a lot of praying and soul- seeking,” S.D.H. filed a complaint with the Leon County Sheriff’s Office. Based upon her complaint, Dr. Williams was charged with the first-degree misdemeanor of battery on July 24, 2014. Respondent turned himself in on July 29, 2014, and on March 19, 2015, he entered a plea of nolo contendere to the battery charge in State v. Williams, Case No. 2014-MM-221441 (2d Jud. Cir. in and for Leon Cnty.). As a result, adjudication was withheld, and Respondent was sentenced to 12 months’ probation, 310 hours of community service, and no contact with S.D.H. Respondent denied that the incident with S.D.H. occurred. However, Respondent did not present any evidence to explain the circumstances related to the plea. The plea of battery clearly related to the incident taking place in Respondent’s medical office during the context of an office visit. As such, the plea is clearly directly related to the practice or the ability to practice medicine.
Recommendation Based on the foregoing Findings of Fact and Conclusions of Law, it is RECOMMENDED that the Florida Board of Medicine issue a final order finding that Respondent violated sections 456.072(1)(v) and 458.331(1)(c) as alleged in Counts I through IV of the Second Amended Administrative Complaint. It is further recommended that the Board revoke Respondent’s license to practice medicine; impose an administrative fine in the amount of $15,000, and impose costs of investigation and prosecution. DONE AND ENTERED this 4th day of March, 2016, in Tallahassee, Leon County, Florida. S LISA SHEARER NELSON Administrative Law Judge Division of Administrative Hearings The DeSoto Building 1230 Apalachee Parkway Tallahassee, Florida 32399-3060 (850) 488-9675 Fax Filing (850) 921-6847 www.doah.state.fl.us Filed with the Clerk of the Division of Administrative Hearings this 4th day of March, 2016.
The Issue Whether Sandra Ann Lindstrom (“Ms. Lindstrom” or “Respondent”), a licensed physician assistant, prescribed Lorcet, a medication containing a controlled substance (hydrocodone), in violation of the Florida Statutes and the Florida Administrative Code as charged in the Amended Administrative Complaint filed at the Department of Health in DOH Case No. 2006-36542 on October 27, 2014. If so, what is the appropriate discipline?
Findings Of Fact The Parties The Department of Health is the state agency responsible for regulating the practice of physician assistants in the State of Florida. The regulation is pursuant to both chapter 456 (“Health Professions and Occupations, General Provisions”) and chapter 458 (“Medical Practice”), Florida Statutes. Respondent is licensed as a physician assistant by the Board of Medicine. Her license number is PA 9103823. The license was effective on August 3, 2006, with an expiration date of March 31, 2008. Her license has been continuously renewed since its effective date. See Pet’r’s Ex. A. Ms. Lindstrom is not licensed to practice medicine as a physician. Id. Physician Assistants Physician assistants are governed by section 458.347, a section within the chapter of the Florida Statutes that governs Medical Practice. Physician assistant licensure is provided for in section 458.347(7), and the Board of Medicine is authorized to “impose any of the penalties authorized under ss. 456.072 and 458.331(2) upon a physician assistant if the physician assistant or the supervising physician has been found guilty of or is being investigated for any act that constitutes a violation of this chapter [Ch. 458] or chapter 456.” § 456.347(7)(g), Fla. Stat. A physician assistant’s supervisory physician may delegate authority to conduct aspects of medical practice to a physician assistant under circumstances expressed in the statutes. The limited medical practice that may be delegated to a physician assistant includes certain practices at county health departments. Whether conducting the delegated practice of medicine at a county health department, or not, physician assistants may be delegated authority to prescribe medications provided they are not listed on a formulary created pursuant to section 458.347(7)(f). See § 458.347(7)(d) and (e), Fla. Stat. The formulary must include “controlled substances as defined in chapter 893.” § 458.347(7)(f)1., Fla. Stat. In sum, physicians may not delegate to physician assistants the prescription of medications which are controlled substances as defined in chapter 893, Florida Statutes. The Department’s Investigative Office The Department has an investigative office charged with looking into regulatory complaints. In a typical regulatory investigation, the investigator discloses his identity to any party interviewed, whether the party is the source of the complaint, a witness, or, if amenable to an interview, the licensee who is the subject of the complaint. Aside from interviews, the investigations include record reviews, the obtaining of evidence, and the preparation of an investigative report. In addition to investigating complaints of regulatory violations by licensed health care practitioners, the investigative office looks into cases of unauthorized practice by unlicensed individuals. Investigations of unlicensed activity are conducted by what is known as the “ULA” section of the office. Commonly, ULA investigations are done by investigators who are “undercover,” that is, the investigators hide their identity as investigators and use pseudonyms rather than their actual names. Typically, undercover ULA investigators present at the offices of the subjects of investigation. If the unlicensed subject of the investigation offers to perform services that require a license or engages in practice that requires a license, the Department pursues remedies, including an order that the subject cease and desist from the unlawful, unlicensed activity. Investigations of a licensee for practicing outside the scope of the licensed activity may be viewed as something of a hybrid of a typical regulatory investigation and a ULA investigation. It is regulatory since the subject is a licensee, but it is usually done undercover in the same manner in which a ULA investigation is conducted. One such investigation was conducted by Ryan Heal, an employee of the Department between August and December of 2006. Mr. Heal conducted the investigation undercover using a pseudonym referred to in Department documents as “RJ.” RJ and the 2006 Investigation of JHS Mr. Heal has been a medical malpractice investigator for the Department since November 2000. During the course of his more than 15 years as a Department investigator, Mr. Heal has investigated both regulatory violations and unauthorized practice violations. In 2006, allegations reached the Department that prescriptions were being written at Jacksonville Health Systems (“JHS”), a clinic located on Baymeadows Road in Jacksonville, Florida, by a physician assistant without the supervision of a physician. In response, the Department launched an investigation. The investigation was conducted undercover by Mr. Heal using his pseudonym RJ. Commenced in August of 2006, the investigation lasted until the following December. August 10, 2006 On August 10, 2006, Mr. Heal, using his fictitious name, presented at JHS. A woman behind the counter in the reception area accepted a cash payment for the visit. She took RJ’s blood pressure and requested the name of the pharmacy for any medicine prescribed. To the best of Mr. Heal’s recollection, the receptionist recorded some of the information. After the interaction with staff in the reception room, Mr. Heal took a seat and waited to be called back to the examination room. Shortly thereafter, Ms. Lindstrom emerged and asked for RJ. Mr. Heal “stood up and went over to her.” Hr’g Tr. 19. Ms. Lindstrom identified herself by her first name and said, “I’m the provider here.” Id. Ms. Lindstrom accompanied Mr. Heal to the examination room where only she and Mr. Heal were present. After Mr. Heal complained of back pain, Ms. Lindstrom asked where in his back the pain was located and what caused it, but she did not conduct a physical examination. As Mr. Heal testified at hearing, “[t]here was no examination. She never touched my back. Never took vitals or anything.” Hr’g Tr. 20. Ms. Lindstrom suggested that Mr. Heal use a chair with lumbar support, try stretching, lose weight, and have an MRI. Ms. Lindstrom then stated that she would prescribe medication to treat the pain: Lorcet, Flexeril, and Motrin. With the visit in the examination room concluded, Ms. Lindstrom took Mr. Heal back to the receptionist. The meeting in the examination room and his first visit to the JHS offices being over, Mr. Heal departed the JHS facility. He did not return until the following October. October 31, 2006 Mr. Heal returned to the JHS facility on October 31, 2006. The process during the second visit was similar to the one followed during the visit the previous August. He presented as “RJ.” A staff member took his blood pressure in the reception area and he paid her $90 in cash. Mr. Heal sat down and waited to be called. Again, Ms. Lindstrom appeared in the reception area and took him to the examination room in the back. The visit was shorter than it had been in August. Ms. Lindstrom asked if his pain had improved and if an MRI had been done. With the intention of calling in his prescriptions, Ms. Lindstrom showed Mr. Heal a list of five pharmacies from which to choose. Mr. Heal, however, took a tack that was different from Ms. Lindstrom’s intention and from his first visit: I explained to her that I did not have reliable transportation and asked [for] . . . handwritten prescriptions . . . so that I could take them to whatever pharmacy was convenient . . . . She agreed that she could write them that time, but that on the next visit, I would have to arrange for proper transportation to get to the pharmacy or wherever they needed to be called into. Hr’g Tr. 23. Ms. Lindstrom wrote out three prescriptions: Two of them were for “Flexeril 10mg (ten) #30 (thirty)” and “Ibprofen (sic) [Ibuprofen] 800mg #120 (one twenty).” Pet’r’s Ex. B. The third prescription was for “Lorcet 10/650 #90 (Ninety).” Id. Ms. Lindstrom explained to Mr. Heal that he should use one of the five pharmacies on her list because “several [of the Clinic’s patients] had been kicked out of pharmacies . . . [that] were refusing to fill the prescriptions.” Hr’g Tr. 25. Ms. Lindstrom also “mentioned that a couple of her patients had been arrested for forging prescriptions.” Hr’g Tr. 25-6. At no time during his visit to JHS on October 31, 2006, did Mr. Heal see a physician. No one entered the examination room where Ms. Lindstrom met with Mr. Heal that day. Nor did Ms. Lindstrom leave the examination room while Mr. Heal was present in the room. Like the first visit the previous August, Ms. Lindstrom recommended that Mr. Heal have an MRI. She explained that results from an MRI were needed “in case the DEA wanted to look at the file, to show that [she and JHS] were actually treating [Mr. Heal] for something.” Hr’g Tr. 28. December 1, 2006 Little more than a month later on December 1, Mr. Heal made a third visit to JHS. The reception process was the same. The receptionist took his blood pressure, he paid $90 in cash, and waited in the reception area for Ms. Lindstrom to call him back. While waiting, he was informed that the number of pharmacies that would accept JHS prescriptions had been drastically reduced. Only one pharmacy would now accept JHS prescriptions: a pharmacy called New Horizon. Subsequent to the third visit, Mr. Heal presented to the pharmacy identified as New Horizon. In the company of law enforcement and with its supervision, Mr. Heal had the prescriptions filled for three medications: Flexeril, Ibuprofen at a prescription-strength dosage, and Lorcet. Supervising Physician and Other Claims At hearing under oath, Ms. Lindstrom admitted that she treated Mr. Heal once at the JHS facility and admitted that she prescribed Flexeril and Ibuprofen for him. She claimed under oath that the supervising physician for the 2006 visit in which she prescribed the two medications was James Hendrick, M.D. The Department produced documentation in the Department’s official business records that shows that Dr. Hendrick cancelled his Professional Liability Insurance Policy effective October 1, 2005, the year before Ms. Lindstrom claims to have seen Mr. Heal at the JHS facility under Dr. Hendrick’s supervision. The reason for the cancellation of the policy is listed on the letter from the insurer to the Department as “Retired.” Pet’r’s Ex. F, letter dated October 17, 2005, from FPIC, First Professionals Insurance Company. Department records also include an “Address Change” form that contains a section entitled “Financial Responsibility” dated November 21, 2005, the year before the incidents in this case. No boxes are checked in the section that shows “Financial Responsibility Coverage.” Under a section on the form entitled, “Category II: Financial Responsibility Exemptions,” Dr. Hendrick checked a box that indicated he was “retired or maintain[ed] part-time practice,” id., at least as of late November 2005, 11 months or more before the October 31, 2006, visit by Mr. Heal. Ms. Lindstrom made other claims with regard to RJ’s visit that she asserted occurred on October 3, 2006, rather than October 31, 2006, as charged. Among them was that she left the examination room after completing the prescriptions for Flexeril and Ibuprofen and partially completing a third prescription by inserting all the information, including her signature, except for the medicine to be prescribed and how often it should be taken. Ms. Lindstrom claimed that she intended to write a prescription for Lodine, but failed to write down “Lodine” on the third prescription form because she was distracted by a discussion with Mr. Heal about the need for RJ to have an MRI. She says she left the room to make arrangements for an MRI and when she returned, RJ was gone, together with the two filled out prescriptions, the third incomplete prescription, and her prescription pad. Ms. Lindstrom’s testimony about the theft of the pad and other details about the event, including when it occurred, is not credible. In contrast, Mr. Heal’s testimony about the visits he made to the JHS facility, seeing Ms. Lindstrom, and her prescription of Lorcet, is credited as truthful. Lorcet Lorcet contains hydrocodone, which is a controlled substance.
Recommendation Based on the foregoing Findings of Fact and Conclusions of Law, it is RECOMMENDED that the Board of Medicine enter a final order: Finding that Respondent Sandra A. Lindstrom, P.A., violated section 458.331(1)(nn), Florida Statutes (2006), by violating Florida Administrative Code Rule 64B8-30.008 (2006), as charged in the Amended Administrative Complaint; Imposing a $2,500 fine; and Revoking Respondent’s license as a physician assistant. DONE AND ENTERED this 30th day of March, 2016, in Tallahassee, Leon County, Florida. S DAVID M. MALONEY Administrative Law Judge Division of Administrative Hearings The DeSoto Building 1230 Apalachee Parkway Tallahassee, Florida 32399-3060 (850) 488-9675 Fax Filing (850) 921-6847 www.doah.state.fl.us Filed with the Clerk of the Division of Administrative Hearings this 30th day of March, 2016. COPIES FURNISHED: Sandra Ann Lindstrom 6726 Pomeroy Circle Orlando, Florida 32810 Yolonda Y. Green, Esquire Maciej Lewandowski, Esquire Department of Health 4052 Bald Cypress Way, Bin C65 Tallahassee, Florida 32399-3265 (eServed) Andre Ourso, Executive Director Board of Medicine Department of Health 4052 Bald Cypress Way, Bin C03 Tallahassee, Florida 32399-3253 (eServed) Nichole C. Geary, General Counsel Department of Health 4052 Bald Cypress Way, Bin A02 Tallahassee, Florida 32399-1701 (eServed)
The Issue Whether Respondent, a medical doctor, in his treatment of Patient M.A., failed to keep legible medical records in violation of section 458.331(1)(m), Florida Statutes (2007); prescribed or administered inappropriate or excessive quantities of controlled substances in violation of section 458.331(1)(q), Florida Statutes (2007); committed medical malpractice by practicing below the standard of care in violation of section 458.331(1)(t), Florida Statutes (2007); failed to perform a statutory or legal obligation placed upon a licensed physician in violation of section 458.331(1)(g), Florida Statutes (2007); and violated any provision of chapter 458 or chapter 456, or any rules adopted pursuant thereto in violation of section 458.331(1)(nn), Florida Statutes (2007), as Petitioner alleges in the Third Amended Administrative Complaint; if so, whether (and what) disciplinary measures should be imposed.
Recommendation Based on the foregoing Findings of Fact and Conclusions of Law, it is RECOMMENDED that the Board of Medicine enter a final order: Finding that Paul M. Goldberg, M.D., violated sections 458.331(1)(g) and (nn), Florida Statutes, as charged in Counts IV and V of the Complaint; Dismissing Counts I-III of the Complaint; Imposing $20,000 in administrative fines; issuing a reprimand against Dr. Goldberg's medical license; requiring Dr. Goldberg to complete the "Laws and Rules" Course; suspending Dr. Goldberg's medical license until such time as Dr. Goldberg undergoes a "UF CARES" evaluation; and placing Dr. Goldberg's license on probation for three years under indirect supervision with 100 percent chart review of cosmetic surgery patients and 25 percent chart review of all other patients. DONE AND ENTERED this 4th day of March, 2015, in Tallahassee, Leon County, Florida. S TODD P. RESAVAGE Administrative Law Judge Division of Administrative Hearings The DeSoto Building 1230 Apalachee Parkway Tallahassee, Florida 32399-3060 (850) 488-9675 Fax Filing (850) 921-6847 www.doah.state.fl.us Filed with the Clerk of the Division of Administrative Hearings this 4th day of March, 2015.
