Hoover v. The Agency For Health Care Administration

676 So.2d 1380 (1996)

Purchase the Printed Copy at bsmsphd.com

Nature of the Case

To access this section all you need to do is click here and register.

Facts

D filed an administrative complaint alleging that P (1) inappropriately and excessively prescribed various Schedule II controlled substances to seven of her patients and (2) provided care of those patients that fell below that level of care, skill, and treatment which is recognized by a reasonably prudent similar physician as being acceptable under similar conditions and circumstances. All seven of the patients had been treated by P for intractable pain arising from various non-cancerous diseases or ailments. P requested a formal hearing. D presented the testimony of its investigator; several pharmacists and two agency expert physicians. P testified and presented the testimony of two pharmacists and her expert physician. D’s experts had not examined any of the patients or their medical records. The sole basis for the opinions of the agency physicians was computer printouts from the pharmacies where P's patients had filled their prescriptions. These printouts indicated only the quantity of each drug-filled for each patient, occasionally referring to a simplified diagnosis. Both of these expert physicians practiced internal medicine and neither specialized in the care of chronic pain. They did not treat but referred their chronic pain patients to pain management clinics. They testified that without being provided with copies of the medical records for those patients they could not evaluate P's diagnoses of what alternative modalities were attempted or what testing was done to support the use of the medication chosen by P to treat those patients.' D's physicians testified at the hearing that P had prescribed excessive, perhaps lethal amounts of narcotics, and had practiced below the standard of care. P testified in great detail concerning the condition of each of the patients, her diagnoses and courses of treatment, alternatives attempted, the patients' need for medication, the uniformly improved function of the patients with the amount of medication prescribed, and her frequency of writing prescriptions to allow her close monitoring of the patients. P presented corroborating physician testimony regarding the appropriateness of the particular medications and the amounts prescribed and her office-setting response to the patients' requests for relief from intractable pain. The hearing officer found that D had failed to meet its burden of proof on all charges. D filed exceptions. The Board accepted all of D’s exceptions and imposed penalties on P. P appealed.