03-004248 Robert B. Nemerofsky vs. Department Of Health Status: Closed Recommended Order on Thursday, April 29, 2004.

Summary: Petitioner`s application for a license by endorsement to practice medicine should be denied because of numerous misrepresentations and concealments of material facts.

STATE OF FLORIDA

DIVISION OF ADMINISTRATIVE HEARINGS

ROBERT B. NEMEROFSKY, )

)

Petitioner, )

)

vs. ) Case No. 03 - 4248

)

DEPARTMENT OF HEALTH, BOARD OF )

MEDICINE )

)

Respondent. )

)

RECOMMENDED ORDER

Pursuant to notice, a final hearing was conducted in this

case on January 16, 2004, at the Miami - Dade County Courthouse in

Miami, Florida, before Michael M. Parrish, an Administrative Law

Judge of the Division of Administrative Hearings .

APPEARANCES

For Petitioner: Monica Felder - Rodriguez, Esquire

Dresnick & Rodriguez

Suntrust Plaza, Suite 701

201 Alhambra Circle

Coral Gables, Florida 33134

For Respondent: Rosanna Catalano, Esquire

Office of the Attorney General

The Capi tol, Plaza Level 01

Tallahassee, Florida 32399 - 1050

STATEMENT OF THE ISSUE

The issue in this case is whether Petitioner's application

for a license by endorsement to practice medicine in the State

of Florida should be granted or denied.

PRELIMINARY ST ATEMENT

Petitioner filed an application with the Board of Medicine

(Board) seeking to be licensed by endorsement to practice

medicine in Florida. On October 17, 2003, the Board issued a

Notice of Intent to Deny Licensure, in which the Board notified

Peti tioner of its intent to deny his application. Petitioner

filed a timely request for an evidentiary hearing, and in due

course the matter was referred to the Division of Administrative

Hearings. A final hearing was held in this case on January 16,

2004. At the final hearing, Petitioner testified on his own

behalf, but did not call any additional witnesses to testify at

the final hearing. Petitioner also offered two exhibits that

were received in evidence; a certificate of post - graduate

training marked as “Petitioner Exhibit 1,” and a residency

agreement marked as “Petitioner Exhibit 2.”

Respondent presented the testimony of Chandra Prine,

Licensure Administrator for the Board. Two depositions were

filed in lieu of live testimony. Dr. James Tyburski’s

de position was filed as Joint Exhibit 1 and Dr. Mark Granick’s

deposition was filed as Joint Exhibit 5. Petitioner’s complete

licensure file with the Board was received in evidence as Joint

Exhibit 2. Requests for Admissions served by both parties were

mov ed into evidence as Joint Exhibit 3, and responses to both

sets of Requests for Admissions were received in evidence as

Joint Exhibit 4. At the conclusion of the final hearing, the

parties requested and were granted ten days from the date of the

filing of the transcript within which to file their proposed

recommended orders.

Following an unusual and unfortunate delay on the part of

one of the court reporters, the complete transcript of the final

hearing was not filed with the Division of Administrative

He arings until March 31, 2004. Both parties filed timely

Proposed Recommended Orders containing proposed findings of fact

and conclusions of law. The parties' proposals have been

carefully considered during the preparation of this Recommended

Order.

FINDIN GS OF FACT

1. Petitioner is a medical doctor. Petitioner graduated

medical school from the University of Miami in Miami, Florida,

in May 1994.

2. Petitioner signed an application for medical licensure

by endorsement with the Board on January 9, 2003. O n or about

January 16, 2003, the Department of Health received Petitioner’s

application for medical licensure by endorsement. Following

receipt and review of the subject application, Petitioner was

required to provide some additional information to the Bo ard.

Petitioner was eventually required to appear before the

Credentials Committee of the Board to answer questions about his

application. On October 17, 2003, the Board issued a Notice of

Intent to Deny Licensure, in which the Board notified Petitioner

of its intent to deny his application. That notice read as

follows, in pertinent part:

This matter came before the Credentials

Committee of the Florida Board of Medicine

at a duly - noticed public meeting on

September 13, 2003 in Tampa, Florida[,] and

the full Board on October 3 - 4, 2003, in Ft.

Lauderdale, Florida. The applicant appeared

before the Credentials Committee on

September 13, 2003, and presented testimony

regarding the application file.

The application file shows:

The applicant lied befor e the Committee

and lied on the licensure application as to

the following:

a. the applicant took a leave of absence

during his training;

b. the applicant was placed on probation

at 3 schools;

c. the applicant did not finish his

training in the nor mal time frame; and,

d. the applicant answered #15 b, c, d and

#31 incorrectly on the application.

The applicant is guilty of violating

Section 458.331(1)(gg), Florida Statutes,

for misrepresenting or concealing multiple

material facts at any time dur ing any phase

of a licensing or disciplinary process or

procedure. Based on the foregoing, the

Board may refuse to certify an applicant for

licensure, or restrict the practice of the

licensee, or impose a penalty, pursuant to

Sections 458.3331(2) and 456. 072(2), Florida

Statutes.

It is therefore ORDERED that the

application for licensure be DENIED.

3. Petitioner attended the following four postgraduate

training programs (residency programs): Medical College of

Pennsylvania; Sinai Hospital 1 ; Wayne Sta te University/Detroit

Medical Center; and University of Medicine and Dentistry of New

Jersey (“UMDNJ”). Petitioner’s dates of attendance in those

four residency programs were as follows:

a) Medical College of Pennsylvania from

July 1, 1994 to June 30, 19 95.

b) Sinai Hospital from July 1, 1995 to

June 30, 1999.

c) Wayne State University/Detroit Medical

from July 1, 1999 to June 30, 2001.

d) UMDNJ from July 1, 2001 to June 30,

2003.

4. Question number 15a on the application for medical

licensure by en dorsement asks, “Have you ever been dropped,

suspended, placed on probation, expelled or requested to resign

from a postgraduate training program?” Petitioner answered

“yes” to question number 15a and submitted a written

supplemental answer which stated, “I was placed on probation

regarding the expectations of running a University service in a

manner that kept attending physicians informed of patients’

clinical changes in July of 2000. Specific goals were given to

me that I immediately fulfilled and was t aken off probation in

September of 2000 and remained in good academic standing until

the time of my graduation.” On his application for licensure,

Petitioner only admitted to being on probation at one residency

program, Wayne State University/Detroit Medi cal Center.

5. During the processing of the subject application, an

employee of the Department of Health, Wendy Alls, advised

Petitioner as follows by e - mail: “We are in receipt of your

response to the inquiry from Wayne State University [Sinai

Hospital ], regarding your Residency from 7/95 to 6/99. It

indicates that you were placed on probation and received

negative reports. It also stated that limitations were placed

upon you due to academic incompetence. Please respond.”

6. On May 6, 2003, Petitio ner submitted an e - mail response

to Wendy Alls regarding his probation at Wayne State University

[Sinai Hospital] which stated: “It is true that I did receive

negative reports during my residency training from 7/95 to 6/99

for my work ethic. However, I w as never formally placed on

probation as per the guidelines of the Wayne State University.

I, as well as the Graduate Medical Education Office, must

receive formal written notification identifying the areas of

deficiency and the duration of the probation period. Written

notification must be submitted to both the GME office and myself

after successful completion of the probation period. This was

never done. In addition, no limitations or restriction were

ever placed upon me due to academic incompetence o r for any

other reason for that matter.” Petitioner did not admit this on

his initial application to the Florida Board of Medicine.

7. Sinai Hospital submitted a Training Evaluation Form to

the Board and stated on the form that Petitioner was on academi c

probation during his residency from 1996 to 1997.

8. Sinai Hospital submitted a report to the Federation

Credentials Verification Service (“FCVS”) 2 and stated on the

report that Petitioner was on academic probation during his

residency from 1996 to 199 7.

9. Sinai Hospital reported that Petitioner was placed on

probation during his residency in response to faculty concerns

regarding both academics and behavior.

10. While at Sinai Hospital, Petitioner was informed of

the issues he needed to improve during his probationary period.

These issues included, but are not limited to the following:

Petitioner’s tardiness, sleeping during conferences,

unavailability when on call, failing to follow hierarchy, and

inability to carry his share of the workload.

11. Petitioner admitted at the formal hearing he was told

that he was on probation at Sinai Hospital. During his

appearance before the Credentials Committee on September 13,

2003, Petitioner testified under oath, that he did not disclose

the fact he was on probation at Sinai Hospital because he was

never informed that he “was ever placed on probation.”

12. A letter dated November 4, 1999, from Dr. Andrew Saxe

(who was then the general surgery residency program director at

Sinai Hospital) states that Pe titioner was on “probationary

status” at Sinai Hospital during his residency from 1996 to

1997. Dr. Andrew Saxe also noted Petitioner’s probationary

status in a memo dated April 28, 1999, which Petitioner himself

signed.

13. Petitioner signed a memo dat ed December 18, 1996,

stating that he was on “probationary status” at Sinai Hospital

during his residency. Petitioner also signed a memo dated

April 16, 1997, stating that he was “off probationary status” at

Sinai Hospital during his residency.

14. Wayn e State University/Detroit Medical Center

submitted a Training Evaluation Form to the Board and stated on

the form that Petitioner was on academic probation during his

residency from 1999 to 2000.

15. Petitioner failed to fully disclose all of the reason s

why he was placed on probation at Wayne State University/Detroit

Medical Center. Wayne State University/Detroit Medical Center

submitted a report to the FCVS and stated on the report that

Petitioner was on academic probation during his residency for

fou r months beginning in September 2000. The report stated that

the probation was based on evaluations which cited “inadequate

performances in clinical application of knowledge especially

recognitions of own capabilities and limitations. There were

also con cerns over attention to details and work habits.”

16. Petitioner’s supplemental answer to question 15a does

not fully disclose his deficiencies in clinical knowledge and

work habits at Wayne State University/Detroit Medical Center.

17. At all times mat erial to this case, Dr. Mark Granick

has been the director of the plastic surgery program at UMDNJ.

UMDNJ submitted a Training Evaluation Form to the Florida Board

of Medicine and stated on the form that Petitioner was on

academic probation during his res idency “due to poor in - service

exam scores.”

18. After UMDNJ submitted the Training Evaluation Form,

Petitioner contacted Dr. Mark Granick to discuss his probation

at UMDNJ and the “program’s specifications in defining

probation.” Dr. Mark Granick was p rompted to send a second

Training Evaluation Form to the Board, changing the substance of

the first submitted Training Evaluation Form. The second

Training Evaluation Form to the Board was submitted along with a

letter from Dr. Mark Granick dated February 14, 2003, which

stated he made an error in filling out the original form.

19. When Dr. Mark Granick drafted Petitioner’s Fourth -

Quarter Report on May 31, 2002, he was “documenting the reasons

why I wanted him on a period of supervision, which I thought of

as probation at that point in time.”

20. Petitioner’s Fourth - Quarter Report dated May 31, 2002,

was in fact signed by Petitioner. The Fourth - Quarter Report

documented that Petitioner was “deficient on multiple occasions”

with regard to Patient Care; Petitioner had a “poor acquisition

of a central knowledge base in Plastic Surgery”; Petitioner’s

tardiness needed to “stop”; Petitioner demonstrated “immaturity”

in interpersonal skills; and, Petitioner had “been acting in an

unprofessional manner.”

21. Petitioner signed a memo dated January 8, 2003,

stating that he was placed on “probation” at UMDNJ during his

residency due to “poor performance on the in - service examination

and overall perception of weakness in academic level.”

22. Dr. Mark Granick te stified that when he used the term

“probation” in the January 8, 2003, memo, the word was

consistent with his own thinking, and not consistent with

university definitions. Dr. Mark Granick stated that Petitioner

indicated to him during their meetings at U MDNJ that Petitioner

understood he was on “probation” at UMDNJ.

23. Dr. Mark Granick testified that in his mind he

considered it “probation” when he put Petitioner under direct

supervision, gave Petitioner academic support, and advised

Petitioner of the areas in which he needed to improve. Although

the period of academic supervision imposed on Petitioner did not

qualify as probation at the university level, it did constitute

“probation” in the mind of Dr. Mark Granick and was understood

to be “probation” by the Petitioner himself.

24. Petitioner misrepresented to the Board the

circumstances which caused him to be placed on probation at

Wayne State University/Detroit Medical Center. He also

misrepresented his understanding of his probationary status at

both Sinai Hospital and UMDNJ.

25. Question number 15c on the subject application asks:

“Did you take a leave of absence during a postgraduate

training?” Petitioner answered “no” to question number 15c on

the application. But Wayne State University/De troit Medical

Center documents show that Petitioner took a month - long leave of

absence. Petitioner asserts that his month - long leave of

absence from Wayne State University/Detroit Medical Center was

not a “leave of absence” because he used a combination o f sick

time and vacation time. However, Petitioner signed a Family

Medical Leave Act Certification asking for a leave of absence

due to his being “unable to perform work of any kind” while

training at Wayne State University/Detroit Medical Center.

Petiti oner requested a leave of absence for one month from his

training program at Wayne State University/Detroit Medical

Center in March of 2001.

26. While on leave in March 2001, Petitioner was

hospitalized for benzodiazepine poisoning, pace maker insertion,

and possible seizure disorder secondary to cardiac rhythm

disturbance. After Petitioner’s hospitalization, Petitioner

needed to have a letter clearing him to resume unrestricted

activity. During this period of time Petitioner was also told

that he shoul d avoid driving motor vehicles.

27. Once questioned by the Credentials Committee,

Petitioner admitted to taking a leave of absence in 2001 while

training at Wayne State University/Detroit Medical Center.

Prior to being questioned by the Credentials Comm ittee,

Petitioner concealed from the Florida Board of Medicine that he

took a leave of absence while at Wayne State University/Detroit

Medical Center.

28. Question number 31 on the subject application asks “In

the last five years, have you been treated f or or had a

recurrence of a diagnosed physical impairment?” Petitioner

answered “no” to question number 31 on the application.

However, after questioning by the Credentials Committee,

Petitioner admitted he had a pacemaker. After his

hospitalization, Pe titioner had to be cleared by his doctors to

return to his duties as a resident. Despite Petitioner’s own

definition of “physical impairment,” he concealed his

hospitalization, pacemaker, and possible seizure disorder from

the Board.

29. Question number 15b on the subject application asks

“Was attendance in a postgraduate training program for a period

other than the established time frame?” Petitioner answered

“no” to question number 15b on the application.

30. Petitioner attended the General Surgery postgraduate

training program at Medical College of Pennsylvania for one year

from July 1, 1994, to June 30, 1995.

31. Petitioner attended the general surgery postgraduate

training program at Sinai Hospital for four years from July 1,

1995, to June 30, 1 999.

32. Petitioner attended the general surgery postgraduate

training program at Wayne State University/Detroit Medical

Center for two years from July 1, 1999, to June 30, 2001.

33. As indicated by the foregoing, Petitioner spent seven

years attending general surgery postgraduate training programs.

Physicians applying for licensure by endorsement in Florida are

required to show that they have completed an “approved residency

program” in a “slotted” position. The Accreditation Council for

Graduate Med ical Education (“ACGME”) accredits postgraduate

training programs, sets the standards for training programs, and

determines the number of “slotted” positions a program has.

34. The Board considers an “approved residency program” to

be one that has been a ccredited by the ACGME. The Board relies

on the ACGME in making determinations for licensure. The Board

relies on the information provided in the ACGME directory when

processing applications. The ACGME established time frame for

completing a general sur gery postgraduate training program is

five years . The ACGME - established time frame for completing the

postgraduate training program in general surgery at Medical

College of Pennsylvania, Sinai Hospital, and Wayne State

University/Detroit Medical Center wa s five years when Petitioner

attended these programs. Thus, a five - year general surgery

residency was considered standard by ACGME, the Medical College

of Pennsylvania, Sinai Hospital, Wayne State University/Detroit

Medical Center, medical educators, and residents like

Petitioner.

35. Therefore, Petitioner would have had to complete all

his postgraduate training in general surgery within five years

in order to have finished his training within the “established

time frame.” It took Petitioner seven years to complete all of

his postgraduate training in general surgery. Petitioner’s

attendance in his general surgery postgraduate training programs

was for a period other than the normal time frame established by

both ACGME and by the programs he attended.

36. Question number 15d on the subject application asks,

“Were you required to repeat any of your postgraduate training?”

Petitioner answered “no” to question number 15d on the

application.

37. A memo dated December 3, 1997, written by Dr. Andrew

Saxe (general surgery residency programs director at Sinai

Hospital) and placed in Petitioner's training file, included the

observation that "this is a consequence of his being asked to

repeat the current clinical year."

38. In a memo dated April 28, 1999, a lso written by

Dr. Andrew Saxe and also placed in Petitioner’s training file,

Dr. Saxe stated, “in light of prior probation and concerns

regarding clinical competency an additional year of training

would be of service to him.”

39. At final hearing, Petit ioner himself explained that

each postgraduate year (“PGY”) runs from July 1st of one year to

June 30th of the following year. On the Verification of

Postgraduate Medical Education form submitted to FCVS, Sinai

Hospital listed Petitioner as only completin g PGY 2 through

PGY 4 while attending their program. On the Verification of

Postgraduate Medical Education form submitted to FCVS Wayne

State University/Detroit Medical Center listed Petitioner as

completing PGY 4 and PGY 5 in their program.

40. While a ttending his postgraduate training programs,

Petitioner was continuously evaluated, as evidenced in his

training files. A review of Petitioner’s evaluation forms

demonstrates that Petitioner was evaluated as a PGY 2 from July

1995 through June 1997. That means Petitioner was a PGY 2 for

two years . A review of Petitioner’s evaluation forms

demonstrates that Petitioner was evaluated as a PGY 4 from July

1998 through June 2000. That means Petitioner was a PGY 4 for

two years . Therefore, Petitioner repeate d both PGY 2 and PGY 4

levels of training. As demonstrated by Petitioner’s

postgraduate training files, Petitioner’s education levels of

training did not consistently progress through the calendar

years. Petitioner concealed from the Board that he had to

repeat PGY 2 and PGY 4.

41. Over the course of the last year, the Board has

licensed at least 55 applicants who were found to have made one

or more material misrepresentations on their licensure

applications, or in the course of the licensure process. 3

42. Over the course of the last year, the Board has

licensed a number of applicants alleged to have made material

misrepresentations regarding one or more of the issues raised in

this matter. In a few cases that are arguably similar to the

facts present ed in this case, the Board has granted the license

application, but with conditions that required the applicant to

file a new application, to pay a new application fee, and to pay

an administrative fine in the amount of $5,000.00.

CONCLUSIONS OF LAW

43. The Division of Administrative Hearings has

jurisdiction over the subject matter of this proceeding and the

parties thereto, pursuant to Sections 120.569 and 120.57(1),

Florida Statutes.

44. In a case of this nature, the burden of proof is by a

preponder ance of the evidence.

45. Section 458.313, Florida Statutes, lists the

requirements for a physician to become licensed by endorsement.

One of these requirements is that the physician has met the

qualifications for licensure in Section 458.311(1)(b) - (g) or

Section 458.311(1)(b) - (e), and (g) and (3), Florida Statutes.

46. Section 458.311(1)(f), Florida Statutes, requires that

all graduates from U.S. medical schools complete an “approved

residency” of at least one year.

47. Florida Administrative Code R ule 64B8 - 4.004(1),

provides, in pertinent part:

An approved residency of at least one year

constitutes a course of study and training

in a single program for a period of not less

than twelve calendar months by a person

holding a degree as a medical doctor. The

hospital and the program in which the

medical doctor is participating must be

accredited for the training and teaching of

physicians by the Accreditation Council for

Graduate Medical Education (ACGME) and the

medical doctor must be assigned to one of

the allocated positions or slots approved by

the ACGME. Fellowship training or residency

training in a non - slotted position shall be

considered approved residency training only

in the instance when the fellowship or

residency training has been recognized and

accepted for that applicant toward

completion of requirements for specialty

board certification by a specialty board

listed by the American Board of Medical

Specialties.

48. Section 458.331(1), Florida Statutes, provides, in

pertinent part:

The f ollowing acts constitute grounds for

denial of a license or disciplinary action

as specified in Section 456.072(2):

* * *

(gg) Misrepresenting or concealing a

material fact at any time during any phase

of a licensing or disciplinary process or

proce dure.

49. Petitioner misrepresented and concealed numerous

material facts on his licensure application and in his

subsequent written and oral statements to the Board regarding

questions 15a, b, c, d, and 31 on the subject application for

licensure by en dorsement.

50. Petitioner misrepresented and concealed facts on his

licensure application and in his subsequent written and oral

statements to the Board regarding postgraduate academic

probation, repeated training, leave of absence, physical

impairment, and normal time frame of residency program

completion.

51. The Board uses the licensure application as a basis

for obtaining important and relevant information from the

applicant regarding his background. Therefore, the answers

Petitioner provided on hi s licensure application, and in his

subsequent oral and written statements to the Board are material

facts which affect the Board’s ability to review his application

and assess his qualifications to be a licensed doctor in

Florida.

52. Because Petitioner has misrepresented and concealed a

number of material facts during the course of the application

process, he has violated Section 458.331(1)(gg), Florida

Statutes. Because he has violated Section 458.331(1)(gg),

Florida Statutes, the Board has the statut ory authority, under

Section 456.072(2), Florida Statutes, to enter an order doing

any of the following:

(a) Refusal to certify, or to certify

with restrictions, an application for a

license.

(b) Suspension or permanent revocation of

a license.

( c) Restriction of practice or license,

including, but not limited to, restricting

the licensee from practicing in certain

settings, restricting the licensee to work

only under designated conditions or in

certain settings, restricting the licensee

from per forming or providing designated

clinical and administrative services,

restricting the licensee from practicing

more than a designated number of hours, or

any other restriction found to be necessary

for the protection of the public health,

safety, and welfa re.

(d) Imposition of an administrative fine

not to exceed $10,000 for each count or

separate offense. If the violation is for

fraud or making a false or fraudulent

representation, the board, or the department

if there is no board, must impose a fine o f

$10,000 per count or offense.

(e) Issuance of a reprimand or letter of

concern.

(f) Placement of the licensee on

probation for a period of time and subject

to such conditions as the board, or the

department when there is no board, may

specify. T hose conditions may include, but

are not limited to, requiring the licensee

to undergo treatment, attend continuing

education courses, submit to be reexamined,

work under the supervision of another

licensee, or satisfy any terms which are

reasonably tailor ed to the violations found.

(g) Corrective action.

(h) Imposition of an administrative fine

in accordance with s. 381.0261 for

violations regarding patient rights.

(i) Refund of fees billed and collected

from the patient or a third party on beh alf

of the patient.

(j) Requirement that the practitioner

undergo remedial education.

53. In view of the Board’s orders mentioned in the last

two paragraphs of the findings of fact, above, it would appear

to be consistent with those orders to issue a final order in

this case that granted the license sought by the Petitioner, but

that also imposed on the Petitioner a requirement that he file a

new application, that he pay a new application fee, and that he

pay a substantial administrative fine. Never theless, the

undersigned is inclined to recommend a different disposition of

this matter: specifically, to recommend denial of the

application. This inclination is inspired in large part by the

reasoning that underlies the following language from the last

paragraph of the "Argument" portion of Respondent's Proposed

Recommended Order:

This case is about Petitioner’s ability to

be forthright and truthful. These

characteristics are essential to the

practice of medicine. Patient safety

requires honest doctor s. It is of the

utmost importance that doctors tell patients

the truth about their illnesses/diagnosis so

that cures/treatments can be administered.

If a physician makes a mistake, patients

need doctors to be forthright and to admit

to the mistake so tha t it can be corrected

in a timely manner. If a course of

treatment or surgery is unsuccessful,

patients should be able to expect a

physician to tell them right away so that

alternative treatment options can be

explored quickly. A physician’s self -

concept should not get in the way of

practicing medicine nor should it get in the

way of the licensure process. Full

disclosure during the licensure process is

essential for Board members to make informed

decisions based on an applicant’s totality

of experiences . Petitioner’s initial

concealment and subsequent failure to answer

Board inquiries truthfully were material

misrepresentations which impeded the Board’s

review of his application. The Board is not

looking for “perfect” physicians. They are

looking for competent doctors who

demonstrate that they can acknowledge

mistakes, rise above adversity, and conquer

challenges both in life and in professional

practice.

54. The first sentence of the foregoing argument was

accompanied by a footnote reading as fol lows:

In Chames v. Department of Professional

Regulation, Board of Medicine , DOAH Case

No. 86 - 1438 (Recommended Order issued

April 14, 1987), the ALJ stated as follows:

In a field as sensitive as the medical

profession, even a talented practitioner

must n ot be in the practice of medicine

regardless of his technical

qualifications, and clinical and

diagnostic skills, if he cannot be

called upon to tell the truth when

required. Regardless of how qualified a

physician might be, such an individual

may well at any time be subject to

unknown stresses or pressures which

would cause him to be less than

forthcoming to the detriment of his

patients. It is just this eventuality

that the review process of the Board was

designed to prevent.

55. Because truthfulne ss, honesty, and candor are so

essential to the proper practice of medicine, it does not appear

to the undersigned that misrepresentations and concealments of

material facts can be adequately addressed by administrative

fines, new applications, and new app lication fees. The

consequences of medical mendacity appear to be too serious to be

appropriately addressed by anything less than denial of the

application.

RECOMMENDATION

Based on the foregoing Findings of Fact and Conclusions of

Law, it is RECOMMENDED that the Board of Medicine enter a final

order denying Petitioner’s application for medical licensure by

endorsement.

DONE AND ENTERED this 29th day of April, 2004, in

Tallahassee, Leon County, Florida.

S

MICHAEL M. PARRISH

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 He arings

this 29th day of April, 2004.

ENDNOTES

1/ Sinai Hospital was affiliated with Wayne State University

during Petitioner’s attendance there.

2/ The FCVS is an organization which verifies the medical

education and post - graduate training of physicia ns by resort to

primary sources of information.

3/ The findings of fact in this paragraph and in the paragraph

which follows are based on the contents of 55 orders of the

Board of Medicine of which official recognition was taken during

the course of the final hearing in this case.

COPIES FURNISHED:

Rosanna Catalano, Esquire

Edward A. Tellechea, Esquire

Office of the Attorney General

The Capitol, Plaza Level 01

Tallahassee, Florida 32399 - 1050

Monica L. Felder - Rodriguez, Esquire

Dresnick & Rodriguez, P.A.

SunTrust Plaza, Suite 701

201 Alhambra Circle

Coral Gables, Florida 33134

Larry McPherson, Executive Director

Board of Medicine

Department of Health

4052 Bald Cypress Way

Tallahassee, Florida 32399 - 1701

Dr. John O. Agwunobi, Secretary

Department o f Health

4052 Bald Cypress Way, Bin A00

Tallahassee, Florida 32399 - 1701

R. S. Power, Agency Clerk

Department of Health

4052 Bald Cypress Way, Bin A02

Tallahassee, Florida 32399 - 1701

William W. Large, General Counsel

Department of Health

4052 Bald Cypre ss Way, Bin A02

Tallahassee, Florida 32399 - 1701

NOTICE OF RIGHT TO SUBMIT EXCEPTIONS

All parties have the right to submit written exceptions within

15 days from the date of this Recommended Order. Any exceptions

to this Recommended Order should be fil ed with the agency that

will issue the Final Order in this case.

2 4