The Issue Whether the Respondent, a licensed massage therapist, should be disciplined under section 480.046(1)(p), Florida Statutes (2016),1/ for sexual misconduct in the practice of massage therapy; and, if so, the appropriate discipline.
Findings Of Fact The Petitioner licenses and regulates the practice of massage therapy in Florida, including discipline of licensees who are in violation of the governing statutes and rules. The Respondent holds massage therapy license MA 80154. In March 2017, the Respondent was employed as a massage therapist at Hand and Stone Massage and Facial Spa in Brandon, Florida. On March 29, 2017, Y.B., went to Hand and Stone to use a gift card for a free massage that had been given to him by his fiancée. The Respondent approached and introduced himself to Y.B., and asked if he could help him. Y.B. told him why he was there, and the Respondent led him back to a therapy room. In the therapy room, Y.B. asked the Respondent to focus on his upper body, arms, and fingers. The Respondent had him undress and lay down on the massage table face down, covered only by a sheet. The massage proceeded without incident at first. Then, the Respondent asked for permission to massage Y.B.’s legs. Y.B. granted permission. As the massage proceeded, Y.B. closed his eyes and relaxed. When the Respondent finished massaging the back of Y.B.’s legs, he asked Y.B. to roll over onto his back. As the massage proceeded, Y.B. again closed his eyes and relaxed. After massaging Y.B.’s upper body, arms, and fingers, the Respondent asked, “May I?” Thinking the Respondent was asking if he had permission to massage the front of his legs, Y.B. said, “yes, do what you have to do.” Before Y.B. knew what was happening, the Respondent grasped Y.B.’s penis in his hand and put it in his mouth. Startled and shocked, Y.B. opened his eyes, sat up, and made the Respondent stop, saying “Whoa, whoa, whoa, what do you think you’re doing? I’m not gay.” At that point, the Respondent stopped and brought Y.B. water and a towel. What the Respondent did was very upsetting to Y.B. He was so upset and angry that he was distracted while being checked out by another employee of Hand and Stone. He unwittingly presented his gift card and answered questions. He discovered later that he not only had paid for the massage but also had given the Respondent a tip. Y.B. continued to be bothered by what happened and returned to Hand and Stone the next day to confront the Respondent and have him explain the reason for what he had done the day before. During this confrontation, the Respondent admitted to his misconduct and tried to apologize, saying “I thought we had a connection.” Y.B. continues to be affected by what the Respondent did to him. He received counseling through his employer. He still is less affectionate than he used to be, even towards his family. To this day, he still becomes anxious when reminded of the incident.
Recommendation Based on the foregoing Findings of Fact and Conclusions of Law, it is RECOMMENDED that the Board of Massage Therapy enter a final order finding the Respondent guilty as charged; revoking his license; and fining him $2,500. DONE AND ENTERED this 23rd day of January, 2018, in Tallahassee, Leon County, Florida. S J. LAWRENCE JOHNSTON Administrative Law Judge Division of Administrative Hearings The DeSoto Building 1230 Apalachee Parkway Tallahassee, Florida 32399-3060 (850) 488-9675 Fax Filing (850) 921-6847 www.doah.state.fl.us Filed with the Clerk of the Division of Administrative Hearings this 23rd day of January, 2018.
The Issue Did Respondent, Jianping Liu, L.M.T. (Ms. Liu), induce patients N.D. and J.H. to engage in sexual activity or engage in sexual activity outside the scope of practice or the scope of generally accepted examination or treatment? Did Ms. Liu massage patient N.D. at a location not licensed as a massage establishment and without exemption? Did sexual misconduct occur in Respondent, Queen Spa, Inc.’s (Queen Spa), massage establishment? Did Queen Spa’s backpage.com and anyitem.org advertisements induce or attempt to induce, or engage or attempt to engage, clients in unlawful sexual misconduct? Did Queen Spa fail to include its license number in its backpage.com and anyitem.com advertisements?
Findings Of Fact Section 20.43 and chapters 456 and 464, Florida Statutes, charge the Department with licensing and regulation of massage therapy. At all times material to the allegations in the Administrative Complaint, Ms. Liu was a licensed massage therapist in the State of Florida. She holds license MA 68834. At all times material to the allegations in the Administrative Complaint, Queen Spa was a licensed massage therapy establishment in the State of Florida. It holds license MM 32567 registered at 10915 Bonita Beach Road, Unit 1121, Bonita Springs, Florida 34135, and license MM 32546 registered at 51 9th Street South, Naples, Florida 34102. Patient N.D. was a criminal investigation detective for the narcotics and vice division of Lee County Sheriff’s Office. On March 27, 2014, N.D., as part of an undercover investigation, scheduled an appointment for a massage at Ms. Liu’s home, 9951 Utah Street, Bonita Springs, Florida 34135. During the massage, Ms. Liu touched N.D.’s penis and asked if he wanted it massaged. N.D. offered an additional $50.00 tip and Ms. Liu began masturbating his penis. Ms. Liu was charged with prostitution. On April 30, 2014, Ms. Liu entered into a deferred prosecution agreement with the Lee County State Attorney’s Office. Ms. Liu’s home on Utah Street has a home occupational license issued by the city for a massage therapy administration office. It is not a licensed massage establishment. J.H. is a police officer in the crime suppression unit for the City of Naples, Florida. On May 9, 2014, the Naples Police Department began investigating Ms. Liu’s massage parlor. On July 24, 2014, J.H., as part of an undercover investigation, scheduled a massage appointment with Ms. Liu at the Queen Spa in Naples. After the massage, J.H. gave Ms. Liu a $20.00 tip and she gave him a separate business card. She explained this card was for “special customers” and had a different phone number than her regular card. J.H. scheduled a second massage for July 29, 2014. At some point near the end of that massage, J.H. asked if Ms. Liu offered special or extra services. Ms. Liu replied by asking if he was trouble or a cop. J.H. asked how much it would cost, but Ms. Liu did not take additional payment. Ms. Liu then began masturbating J.H.’s penis until he ejaculated. Ms. Liu contends that penis manipulation is part of a “full body” massage. But she testified during the hearing that this was an additional service to the full body massage. Further, she testified that she only conducted each “extra service,” because J.H. and N.D. requested it. This establishes that masturbation was not part of the massage. It was a sexual service. Testimony of the expert witness Jennifer Mason also proves this fact. Backpage.com is a classified advertising website that contains listings explicitly for prostitution. The adult entertainment section of backpage.com is linked to the majority of the Naples police investigations into prostitution. Ms. Liu posted ads for Queen Spa on backpage.com and anyitem.org. The backpage.com ad titled “erotic pleasure” was listed in the adult services section. The anyitem.org ad titled “erotic pleasure” was listed in the escort section. Ms. Liu contends the postings did not advertise sexual services and that the application on her phone mistranslated the word erotic from Mandarin to English. However, the character of backpage.com and posting the advertisements as adult services, rather than as massage services, supports the conclusion the postings advertised sexual activities. The backpage.com and anyitem.com advertisements did not include the license number of Queen Spa. Touching of the genitalia is not within the scope of a full body massage. Stimulation of the genital area is considered sexual misconduct. It is not part of an ethical massage. There is no therapeutic value to massaging a client’s penis. Sexual innuendo or stimulation is a problem in massage therapy. The industry has worked to remove it from the practice to create a safe and therapeutic environment. Training of massage therapists requires them to “decline, leave the room, terminate the massage” when sexual stimulation is requested by a patient. When discussing “extra services,” Ms. Liu told J.H. about her friend who got into trouble after performing certain acts and that the friend had lost her license; “no license, no job”. Ms. Liu engaged in sexual misconduct with J.H. just three months after she signed a deferred prosecution agreement disposing of the Lee County charges.
Recommendation Based on the foregoing Findings of Fact and Conclusions of Law, it is RECOMMENDED that Petitioner, Department of Health, Board of Massage Therapy, enter a final order: finding that Respondent, Jianping Liu, L.M.T., violated sections 480.0485 and 480.046(1)(o), Florida Statutes; revoking her license; requiring the payment of an administrative fines in the amount of $2,750.00; and awarding costs for the investigation and prosecution of this case to the Department. Based on the foregoing Findings of Fact and Conclusions of Law, it is also RECOMMENDED that Petitioner, Department of Health, Board of Massage Therapy, enter a final order: finding that Respondent, Queen Spa, Inc., violated sections 480.046(1)(e) and 480.0465, Florida Statutes, and Florida Administrative Code Rule 64B7-26.010; revoking its license; requiring the payment of an administrative fine in the amount of $4,000.00; and awarding costs for the investigation and prosecution of this case to the Department. DONE AND ENTERED this 2nd day of October, 2015, in Tallahassee, Leon County, Florida. S JOHN D. C. NEWTON, II 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 2nd day of October, 2015.
The Issue Whether Respondent's license to practice massage in the state of Florida should be disciplined under the facts and circumstances of this case.
Findings Of Fact Upon consideration of the oral and documentary evidence adduced at the hearing, the following relevant findings of fact are made: The Petitioner is the state agency charged with regulating the practice of massage in the state of Florida. At all times material to this proceeding, Respondent was a licensed massage therapist in the state of Florida, holding license number MA 0007149. At all times material to this proceeding, Frank Calta's Health Connection (Health Connection) was not licensed as a massage establishment in the state of Florida. At all times material to this proceeding, Respondent did hold a license for a massage establishment in the state of Florida. In October 1989, the Respondent filed a licensure application with Department of Professional Regulation, Board of Medicine, Dietetics and Nutrition Practice Council (Council) for licensure as a Nutritional Counselor. In answering a request for all work experience as a Nutritional Counselor in the application, Respondent listed the Health Connection as an employer from "11/87 to present" (October 1989) and as to the position held, listed "massage therapist". Respondent's answers to questions in the application were under oath wherein he declared under penalty of perjury that his statements were true and correct. As part of this application to the Council, Respondent submitted a notarized statement by Frank Calta of the Health Connection indicating that Respondent had worked as a massage therapist at the Health Connection from "September 5, 1987 to the present" (September 11, 1989). The testimony of both Respondent and Frank Calta at the hearing established that Respondent was not employed by the Health Connection as such in that he was not paid a salary by the Health Connection or that he worked regular hours for the Health Connection. However, this same testimony established that Respondent did perform massages for Frank Calta and members of the Health Connection in between sets of exercises and at the end of the exercises. These massages were conducted at either the Health Connection located at the 4626 Busch Boulevard, Tampa, Florida address or the Florida Avenue Tampa, Florida address during the period from September 5, 1987 through September 11, 1989. The Respondent was compensated for these massages by the individual members or by Frank Calta through the use of the Health Connection. Other than the individual members of the Health Connection, the Respondent did not solicit business from the "general public" as such. It was Respondent's contention that these massages were performed at sports events. However, there was no evidence that the individual members or Frank Calta were involved in any type of sport competition at the time of the massages by the Respondent, but only exercising to keep their bodies in shape. There was sufficient competent substantial evidence to establish facts to show that Respondent was practicing "massage" as that term is defined in Section 480.033(3), Florida Statutes, in an unlicensed "establishment" as that term is defined in Section 480.083(7), Florida Statutes, during the period from September 5, 1987 through September 11, 1989. There was no evidence presented to show that Respondent's license as a massage therapist had ever been disciplined or that any disciplinary action, other than the instant case, had been taken against the Respondent.
Recommendation Based upon the foregoing Findings of Fact, Conclusions of Law, and the penalty guidelines set out in Rule 21L-30.002, Florida Administrative Code, it is, accordingly, RECOMMENDED: That the Board enter a Final Order finding Respondent guilty of violating Section 480.036(1)(n), Florida Statutes, and for that violation issue the Respondent a letter of reprimand and assess an administrative fine of $250.00. DONE and ENTERED this 3rd day of February, 1992, in Tallahassee, Florida. WILLIAM R. CAVE Hearing Officer Division of Administrative Hearings The DeSoto Building 1230 Apalachee Parkway Tallahassee, FL 32399-1550 (904) 488-9675 Filed with the Clerk of the Division of Administrative Hearings this 3rd day of February, 1992. APPENDIX TO RECOMMENDED ORDER IN CASE NO. 91-2613 The following constitutes my specific rulings pursuant to Section 120.59(2), Florida Statutes, on all of the Proposed Findings of Fact submitted by the parties in the case. Rulings on Proposed Finding of Fact Submitted by the Petitioner 1. - 4. Adopted in substance as modified in the Recommended Order in Findings of Fact 1, 2, 3, and 4, respectively. 5. - 7. Adopted in substance as modified in the Recommended Order in Finding of Fact 5. 8. - 9. Adopted in substance as modified in the Recommended Order in Finding of Fact 6. Neither relevant nor material to this proceeding other than as to Respondent's credibility as a witness. - 13. Adopted in substance as modified in the Recommended Order in Finding of Fact 7 and 9. 14. Rejected as not supported by competent substantial evidence in the record but in any event, is neither material nor relevant to this proceeding other than as to the extent of the disciplinary action taken. Rulings on Proposed Findings of Fact Submitted by the Respondent 1. Respondent has submitted what is titled Proposed Finding of Facts. However, it more of a conclusion of law or legal argument than finding of fact. As to the facts set out in paragraph 5 (unnumbered) see Finding of Fact 7. COPIES FURNISHED: Lois B. Lepp, Esquire Department of Professional Regulation 1940 N. Monroe Street, Suite 60 Tallahassee, FL 32399-0792 Aaron Benjamin 8319 Cross Timbers Drive East Jacksonville, FL 32244 Anna Polk, Executive Director Board of Massage 1940 N. Monroe Street Tallahassee, FL 32399-0792 Jack McRay, General Counsel Department of Professional Regulation 1940 N. Monroe Street Tallahassee, FL 32399-0792
The Issue This is a license discipline proceeding in which the Petitioner seeks to take disciplinary action against the Respondent on the basis of allegations in a three-count Administrative Complaint. The Administrative Complaint alleges violations of Paragraph (f), (h), and (i) of Section 480.046(1), Florida Statutes.
Findings Of Fact At all times material to this case, the Respondent has been licensed to practice massage therapy, having been issued license number MA0006547. At all times material to this case, the Respondent has also held a massage establishment license, having been issued establishment license number MM000556833. In or around September of 1993, a Mr. J. V. T. 1/ read a newspaper article to the effect that the Respondent had successfully treated children suffering from attention deficit disorder by using vitamins and health supplements in lieu of drugs such as Ritalin. At that time Mr. J. V. T. had a minor son, D. T., who was suffering from attention deficit disorder and was taking Ritalin pursuant to a prescription written by the son's pediatrician. Shortly after reading the newspaper article, Mr. J. V. T. took his son to see the Respondent for the purpose of determining whether his son's condition could be treated without Ritalin. Mr. J. V. T. and his son saw the Respondent at a facility named Advanced Health Center. At that location Mr. J. V. T. saw a massage therapy license for the Respondent. Mr. J. V. T. is not certain that was the only license. The purpose of Mr. J. V. T.'s visit was to obtain nutritional counseling with regard to his son's attention deficit disorder. He did not ask the Respondent to perform a massage on his son. In or around January of 1994, the Respondent recommended that J. V. T.'s son undergo a blood test. The blood test was performed by someone else at another facility. Eventually, someone gave Mr. J. V. T. a videotape that was described to him as being a video tape of his son's blood test. Shortly thereafter, Mr. J. V. T. met with the Respondent to discuss the results of the blood test. The Respondent told Mr. J. V. T. that the blood test showed that Mr. J. V. T.'s son had tape worms and that the tape worms were consuming large quantities of the nutrition and health supplements the son had been taking. The Respondent recommended some treatments to counteract the tapeworms. Mr. J. V. T. lacked confidence in what he was being told by the Respondent and discussed the matter with his son's pediatrician. Based on his discussion with the pediatrician, Mr. J. V. T. did not seek any further services from the Respondent. Mr. J. V. T. paid the Respondent for the services provided by the Respondent. Mr. J. V. T. does not believe that his son received any benefit from the services provided by the Respondent. When questioned by Mr. J. V. T., the Respondent stated that he was self taught and that he was not a doctor.
Recommendation On the basis of the foregoing Findings of Fact and Conclusions of Law, it is RECOMMENDED that a Final Order be issued in this case dismissing all charges against the Respondent. DONE AND ENTERED this 22nd day of August, 1997, in Tallahassee, Leon County, Florida. MICHAEL M. PARRISH Administrative Law Judge Division of Administrative Hearings The DeSoto Building 1230 Apalachee Parkway Tallahassee, Florida 32399-3060 (904) 488-9675 SUNCOM 278-9675 Fax Filing (904) 921-6847 Filed with the Clerk of the Division of Administrative Hearings this 22nd day of August, 1997.
Findings Of Fact Petitioner took the March 1994 massage examination in order to become a licensed massage therapist. She scored a 69. She needed 70 to pass. Each question was worth one point. Prior to the hearing, Petitioner challenged 15 of the questions. At the beginning of the hearing, she reduced her challenge to five questions, later reducing it, during the hearing, to four questions. Question three states: "A physiological function which cause edema is a/an." The answer for which Petitioner gave credit was "D. Obstruction in lymphatic flow." Respondent answered "C. Increase in capillary colloidal osmotic pressure." In Healing Massage Techniques: Holistic, Classic, and Emerging Methods by Frances M. Tappan (Appleton & Lange 2d edition 1988), the text identifies at page 30 four physiologic mechanisms favoring edema, including "decreased capillary colloidal osmotic pressure" and "obstruction of lymphatic flow." Petitioner failed to prove that an increase in capillary colloidal osmotic pressure could also predispose someone to edema. She did not understand the meaning of "colloidal" and evidently did not understand the area well enough to challenge the text. Question 47 asks: "For clients who have difficulty relaxing, which strokes can be used on the entire muscle or limb and to encourage relaxation?" Respondent gave credit for "D. Shaking vibration." Petitioner answered "B. Cupping tapotement." In Healing Massage Techniques: A Study of Eastern and Western Methods by Frances M. Tappan (Reston Publishing Co. 1980), the text mentions at page 66 that vibration is often used for a soothing effect. As demonstrated by one of Respondent's witnesses, and confirmed in the text, the vibration is very gentle. Tapotement is used for stimulation, not soothing. Question 58 states: "To loosen superficial scar tissue, you should use". Respondent gave credit for answer "A. Deep circular friction movements." Petitioner answered "B. Light effleurage." In Manual of Hydrotherapy and Massage (Pacific Press Publishing Association 1964), the text states that "[f]riction is a deep circular movement." Petitioner testified that in Sweden, where she learned massage, the stroke is called "effleurage." The problem for Petitioner is that her answer is "light" effleurage. Regardless of the name of the stroke, the touch required for loosening up scar tissue is not light. 16. Question 86 states: "A license to operate a massage establishment can be transferred to another location." Respondent gave credit for the answer, "C. Under NO circumstances." Petitioner answered "D. When a massage therapist moves." As provided by Section 480.043(7), Florida Statutes, a license for operation of a massage establishment, as opposed to the license of a massage therapist, may be not transferred to a different location. The challenged questions and credited answers are reliable and valid. They are supported by good authority. The questions present enough information for the student to supply the correct answer. The challenged questions and credited answers are not arbitrary, capricious, or devoid of logic.
Recommendation It is hereby RECOMMENDED that the Board of Massage enter a final order dismissing Petitioner's exam challenge. ENTERED on March 24, 1995, in Tallahassee, Florida. ROBERT E. MEALE 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 on March 24, 1995. COPIES FURNISHED: Sylvie Salter, pro so 2944 West Bay Drive, Suite 207 Belleair Bluffs, FL 32399-0750 William M. Woodyard Assistant General Counsel Department of Business and Professional Regulation 1940 N. Monroe St. Tallahassee, FL 32399-0750 Linda Goodgame, General Counsel Department of Professional Regulation 1940 North Monroe Street Tallahassee, FL 32399-0792
The Issue Should discipline be imposed by the Department of Health, Board of Massage Therapy (the Petitioner), against Stanley Carroll's (the Respondent) license as a massage therapist for alleged violations of Sections 480.046(1)(o) and 480.0485, Florida Statutes?
Findings Of Fact Facts Established by the Answer This is an action to impose administrative penalties and assess costs related to the investigation and prosecution of the allegations against Respondent pursuant to Sections 456.072, 480.046(1)(o) and 480.0485, Florida Statutes. This tribunal has jurisdiction pursuant to Sections 120.569 and 120.57, Florida Statutes (2003). Venue shall be determined pursuant to Florida Administrative Code Rule 28-106.207. Effective July 1, 1997, Petitioner is the state agency charged with regulating the practice of massage therapy pursuant to Section 20.43, Florida Statutes, and Chapter 480, Florida Statutes. At all times material hereto, Respondent has been licensed as a massage therapist, having been issued license number MA 20209 on September 12, 1995. Respondent's last known address is 5135 San Juan Avenue, Jacksonville, Florida 32210-3137. O.C. was a patient of Respondent during the year 2000. Facts Established by Responses to Request for Admissions Respondent Stanley Carroll possesses Florida massage therapist license number MA 20209. Respondent was issued Florida massage therapist license number MA 20209 on September 12, 1995. Respondent practices massage therapy at the "Hands that Care," 5135 San Juan Avenue, Jacksonville, Florida 32210. Respondent began providing massage therapy to O.C. in late July 2000 or early August 2000. O.C. was referred to Respondent by K.C. O.C. saw Respondent approximately ten times during the year 2000. During massage therapy sessions with Respondent, O.C. would be covered by only a sheet. Respondent would move the sheet that covered O.C. during massage therapy sessions so that Respondent would not be completely covered during massage therapy sessions. When Respondent would massage O.C.'s pectoral muscles, Respondent would fold the sheet covering O.C. down to expose her breasts. During some massage therapy sessions, Respondent would massage O.C.'s left hip and left upper thigh in an attempt to return feeling to those areas that was lost due to the removal of a lymph node when O.C. was a child. When Respondent would massage O.C.'s left hip and left upper thigh, Respondent would move the sheet covering O.C. and expose O.C.'s pubic area. When Respondent would massage O.C.'s left hip and left upper thigh, Respondent would place one of his hands next to her pubic area. Respondent called O.C. and invited her to his massage establishment for a $30.00 massage, which is half of Respondent's normal fee (at that time). After O.C. was dressed, Respondent walked O.C. to her car (in her last visit to Respondent). Respondent told a Department of Health investigator that he did touch "delicate areas" on O.C.'s body. On May 24, 1999, the Florida Department of Health filed an Amended Administrative Complaint against Respondent in discipline case number 98-12083 and his massage therapist license, alleging that Respondent violated Subsection 480.046(1)(c) of the Florida Statutes by being convicted of battery on patient M.J. for inappropriately touching M.J.'s breasts and nipples. Respondent disputed the material facts as alleged in Amended Administrative Complaint 98-12083. In DOAH case number 99-3719, Administrative Law Judge, (ALJ) Suzanne F. Hood found that Respondent violated Subsection 480.046(1)(c) of the Florida Statutes by being convicted of misdemeanor battery for intentionally touching M.J. against her will and that this battery would have not have occurred, but for Respondent and M.J.'s massage therapy session. The Board of Massage Therapy rendered a Final Order in disciplinary case number 98-12083 in which it adopted the findings of fact and conclusions of law of Administrative Law Judge Suzanne F. Hood in DOAH case number 99-3719. The Board of Massage Therapy's Final Order in disciplinary case 98-12083 imposed an administrative fine in the amount of $500.00 and investigative costs in the amount of $1,452.05. Additional Facts O.C. was first seen by Respondent on August 1, 2000. At that time, a questionnaire was completed by O.C., Respondent's Exhibit numbered two. O.C. indicated in her response to the questionnaire that this was the first experience O.C. had with massage therapy. By report, in the questionnaire, the medical history referred to PMS/painful menstruation. Other than the questionnaire which was filled out on the initial visit, no other documentation was established concerning the therapy. That questionnaire, in addition to commenting on the medical history by report, described the fact that O.C. rarely exercised and spent a lot of time in her day standing while at work. Respondent's Exhibit numbered two, the questionnaire, has a statement at its end where it says "I have had the massage treatment and protocol explained to me. I understand that areas will be massaged. With this information I give my permission for a massage, I know I may stop the massage at any time for whatever reason. (pain, discomfort or just being uncomfortable with the massage.)" What O.C. hoped to gain from the massage therapy was relaxation, given the stress levels she experienced at the time. All the massage therapy which Respondent provided was at his location referred to as "Hands That Care," 5135 San Juan Avenue, Jacksonville, Florida. There were 10 sessions involved with the therapy, which commenced around 7:30 p.m. on each occasion. At these visits, Respondent and O.C. would be alone in the room where the therapy was provided. At the therapy sessions, O.C. would be completely undressed with a drape over her when she was on the massage table receiving therapy. That drape was a sheet with which she covered herself. She tried to ensure that the private or sensitive areas of her body were covered with the sheet. The sheet was sufficient to cover her exposed body. Nonetheless, the client felt a draft at times around her genital area, and her breasts were exposed during certain forms of massage. This was referred to as frontal massage. That massage involved the pectoral area of her body. O.C. did not feel that there was a problem with her pectoral area being massaged. When O.C. first went for a massage, she and Respondent discussed clothing options for the course of the massage. Respondent told her that there were different options, among them that she could completely disrobe and there would not be any restriction, taken to mean any restriction in the performance of the massage. He told her that she could wear her panties if that made her feel comfortable. She chose to completely disrobe. On an estimated two or three times, O.C. describes that Respondent's ". . . hand might have swept across my nipple, but (she) tried to disregard it and hoped that it was an accident." When O.C. described the "swipe" across her nipple, she meant the actual touching of the nipple. She was not persuaded that the touching was intentional. She hoped that it was not and, at the time, did not believe that it was. O.C. had not consented to any type of lymphatic drainage breast massage or any type of breast massage from Respondent. Her request was for "relaxation massage." On the last visit with Respondent, which took place sometime in 2001, presumably the earlier part of that year, O.C. experienced a problem with Respondent in which he engaged in inappropriate conduct. On that occasion when O.C. entered the room, the room was dimly lit, as it had been on her other visits, and music was provided. The massage session began with a frontal massage, with O.C. on her back draped. The massage period took approximately two hours. O.C. was relaxed with her eyes closed. In the last massage period, one of the areas being addressed was the scar tissue on the inside of O.C.'s upper left thigh. This area is roughly portrayed on the drawing which was admitted as Respondent's Exhibit numbered three. That scar was the result of surgery, in which nerve damage was suffered by O.C. Respondent was trying to break down the tissue associated with the scar to bring about some correction in the condition. Respondent explained to O.C. that massage therapy can help nerve damage. During the last visit when Respondent was working on the scar that was left when the lymph node was removed, the massage did not feel pleasant, in that some sensation in the area was still being experienced by O.C., notwithstanding related areas of numbness. At some point while Respondent was working on the scar tissue, the draping was not covering the area to include her genitalia. At this juncture, Respondent put his hand on O.C.'s genitalia, the clitoris, and began rubbing the clitoris for a period of a minute or less. The touching involved the clitoris itself and the area around it. After that Respondent pulled O.C. up from the table. The sheet was not covering her at the time and as Respondent was pulling O.C. up his hand was still in the clitoris area. O.C. was shocked by Respondent's conduct and did not know how to handle the situation. She had not given Respondent permission to touch, rub, or massage the genital area, to include her clitoris. O.C. never experienced pain in her genital area and never asked Respondent to touch the clitoris or the area around the clitoris or to massage in those places. O.C. had never requested fertility massage or an approach known as the Wurn technique. After helping O.C. up from the table, Respondent asked O.C. to get dressed and to meet him outside. When Respondent left the room, O.C. left the table and went to the dressing room and dressed herself. She met Respondent outside the office area of the building. At this time Respondent asked O.C. if he had ever touched her inappropriately. O.C. simply shook her head in acknowledgement of his comment. She was embarrassed. Respondent also made a comment to the effect that younger people are more susceptible to certain touches than older persons. Respondent encouraged O.C. to come back for more massage therapy and assured her that he would work with her schedule and that if money to pay for the therapy was an issue, then he would work with her on that subject as well. She shook her head as if to agree. She left and never came back. The experience which O.C. had with Respondent on her last visit left her very embarrassed beyond the event. She had not had massage therapy before her experience with Respondent and did not know what to expect, but realized that his placing his hands on her clitoris or the area around the clitoris was not appropriate. The Respondent describes the massage performed on O.C. as a full body massage. This involves the neck, back, legs, feet, hands and head. The therapy is a mix between deep tissue and what Respondent considers Swedish Massage. Ordinarily, the patient is uncovered in the specific areas that are being worked on. Respondent asks permission before performing massage in the delicate areas such as around the breast. It is assumed that is what transpired with patient O.C. Respondent's involvement with O.C. in massaging an area related to her breast was addressing her pectoral muscles. Respondent did not deny the possibility that he touched O.C.'s nipple. He explained, "I don't recall swooping across the breast. If I touched any, it would have been when your pushing breast up and the breast tissue slipping and I would move my hand down to adjust for that. . ." Respondent stated that he had no intention to touch the nipple. Upon the facts presented it is not found that Respondent intended to touch her nipple, unlike the experience with the clitoris and clitoral area. Respondent acknowledges that the drape covering O.C. when he helped her to sit up on the massage table fell down to her waist when he last saw her. Respondent acknowledges that the deliberate touching of the nipples or the area of the clitoris or vaginal area is inappropriate conduct for a massage therapist. EXPERT OPINION TESTIMONY Jennifer Mason has been licensed in Florida as a massage therapist for 10 years. No discipline has ever been imposed against her license. She is an anatomy instructor at the CORE Institute of Massage Therapy in Tallahassee, Florida, where she instructs in musculoskelatal anatomy. Ms. Mason has instructed hundreds of students at Core Institute, and she has given hundreds of massages as a licensed therapist. She is expert in the field of massage therapy and was received as an expert for offering opinions concerning the practice of massage therapy. Ms. Mason practices a form of massage therapy that is similar in technique to that employed by Respondent in this case. From what Ms. Mason explained, the size and manner of draping employed by Respondent in the O.C. case and the amount of clothing worn by the patient are not at odds when taking into account what Ms. Mason believes is appropriate. Ms. Mason established that the massage therapist would never engage in the touching, rubbing, or massaging of a female patient's nipples. She does not believe that touching the nipples would be appropriate even if its accidental. Under the facts in this case, her belief that accidental touching would be inappropriate is not accepted. Ms. Mason established that it is inappropriate for a massage therapist to rub or touch a female patient's genital area, including the clitoris. Kenneth C. Oram has been licensed as a massage therapist in Florida and is an expert in the field of neuromuscular massage therapy. He has no disciplinary history in Florida in his field. He believes that a therapist could inadvertently touch the patient's nipple. He does not ascribe fault to that form of touching. His opinion in that sense is accepted given the facts in this case. Mr. Oram agrees with Ms. Mason that intentional touching of the nipples and genital area, to include the clitoris, is sexual misconduct. Those opinions are accepted. His opinion is that touching the genital area when assisting a patient from the massage table, such as was the case with O.C. is inappropriate. That opinion is accepted. Prior Disciplinary Action In Department of Health, Petitioner v. Stanley Michael Carroll, Respondent, before the State of Florida Board of Massage Therapy, Case No. 98-1208A3, Respondent was required to pay an administrative fine of $500.00 for violating Subsection 480.047(1)(c), Florida Statutes, as more particularly described in the Answers to Request for Admissions reported in these facts.
Recommendation Upon consideration of the facts found and conclusions of law reached, it is RECOMMENDED: That a Final Order be entered finding Respondent in violation of Section 480.0485, Florida Statutes (2000), and revoking his massage therapist license. DONE AND ENTERED this 20th day of May, 2004, in Tallahassee, Leon County, Florida. S CHARLES C. ADAMS Administrative Law Judge Division of Administrative Hearings The DeSoto Building 1230 Apalachee Parkway Tallahassee, Florida 32399-3060 (850) 488-9675 SUNCOM 278-9675 Fax Filing (850) 921-6847 www.doah.state.fl.us Filed with the Clerk of the Division of Administrative Hearings this 20th day of May, 2004.