20-000971PL Department Of Health, Board Of Osteopathic Medicine vs. Adam Patrick Hall, D.O. Status: Closed Recommended Order on Thursday, October 15, 2020.

Summary: Ohio Bd. permanently revoked R?s inactive certificate to practice osteopathic medicine after history of trouble ending in felony convictions for scheme to submit stored urine samples to evade monitoring and cover up trip. License should be revoked.

S TATEMENT OF T HE I SSU ES

The issues in this case are whether Respondent 's license or authority to

practice osteopathic medicine was acted against by the licensing authority of

another jurisdiction , in violation of section 45 9.015(1)(b), Florida Statutes

(2016) 1 ; and, if so, what penalty should be imposed.

P RELIMINARY S TATEMENT

On August 9, 2018, the Department of Health ( Department or Petitioner)

filed a Second Amended Administrative Complaint (Complaint) before the

Board of Osteopathic Medicine (Board) against Adam Patrick Hall, D.O.

(Respondent). The Complaint alleged that on or about December 14, 2016,

the State Medical Board of Ohio (Ohio Board) permanently revoked

Respondent's license to practice osteopathic medicine a nd surgery in the

State of Ohio , in violation of section 459.015(1)(b) . R espondent elected a

disputed - fact hearing and on February 20, 2020, the case was transmitted to

DOAH for assignment of an administrative law judge to conduct the

requested hearing.

Th e he aring was initially set for May 4, 2020, but was rescheduled twice

following joint motions for continuance that raised complications in hearing

preparation due to the coronavirus pandemic . Th e hearing format was also

c hanged from video teleconference a t two fixed hearing locations to Zoom

c onference at Petitioner's request, which was not opposed by Respondent.

Prior to the hearing, the parties filed an Amended Joint Pre - hearing

Stipulation in which they stipulated to a number of facts. The relevant

sti pulated facts have been incorporated in the findings below.

1 References herein to substantive statutes and rules are to the 2016 versions, unless

otherwise provided.

At the final hearing, Respondent testified both for Petitioner in its case

and on his own behalf in his case . Petitioner's Exhibits A through C and E

through M were admitted without objection . Pet itioner's Exhibit D was

admitted over Respondent's hearsay objection , but subject to the restrictions

on using hearsay in section 120.57(1)(c) , Florida Statutes, and Florida

Administrative Code Rule 28 - 106.213 ( 3). Respondent's Exhibits E and F were

admitte d into evidence. 2

At the conclusion of the hearing, the parties were informed of the ten - day

deadline provided by rule for filing proposed recommended orders (PROs)

after the final hearing transcript is filed with DOAH. Petitioner asked for an

extended 3 0 - day deadline , with Respondent 's agree ment , which was allowed. 3

The final hearing Transcript was filed on August 17, 2020. Petitioner and

Respondent timely filed their PROs on September 16, 2020, and both PROs

have been considered in the preparation of t his Recommended Order.

F INDINGS OF F ACT

1. The Department is the state agency charged with regulati ng the

practice of osteopathic medicine and prosecuting disciplinary actions on the

Board's behalf , pursuant to section 20.43 and chapters 456 and 459, Flo rida

Statutes.

2 Respondent's Exhibits A through D were also initially offered into evidence and admitted.

However, during the hearing, the parties noted that Respondent's Exhibits A through D

duplicated Petitioner's Exhibits A, B, J, and M, except that Petitioner's versions of these

exhibits contained redactions. After the hearing, the parties filed a joint motion to allow

Re spondent to adopt Petitioner's Exhibits A, B, J, and M and withdraw Respondent's

Exhibits A through D. The joint motion was granted. Accordingly, the record does not include

Respondent's withdrawn Exhibits A through D.

3 By agreeing to an extended deadlin e of more than ten days after the filing of the transcript

for filing PROs , the parties waived the 30 - day time period for issuing the Recommended

Order. See Fla. Admin. Code R. 28 - 106.216.

2 . Respondent is licensed to pr actice osteopathic medicine in Florida ,

having been issued license number OS 10315 on or about March 4 , 2008.

Although Respondent has been licensed to practice osteopathic medicine in

F lorida since 2008, includ ing at all times relevant to the Complaint, he

testified that he did not practice osteopathic medicine in Florida until

sometime after December 14, 2016.

3 . Currently, Respondent does not hold any other active licenses to

practice osteop athic medicine in o ther states. Previously, he held licenses in

Ohio, Missouri, and Kansas .

4. The factual allegation in the Complaint that is the predicate for the

charge against Respondent is as follows:

On or about December 14, 2016, the State Medical

Board of Ohio issued an Entry of Order

permanently revoking the license of Respondent to practice osteopathic medicine and surgery in the State of Ohio. (C omplaint at 2, ¶ 5).

5. The parties stipulated that t he Ohio Board is the licensing authority of

the practice of osteopa thic medicine in the state of Ohio . T he parties also

stipulated to the following:

On December 14, 2016, in case number 16 - C R F -

0055 and in accordance with chapter 119, Ohio Revised Code, the State Medical Board of Ohio entered an order which permanently rev oked

Respondent's certificate to practice osteopathic medicine and surgery in Ohio . (Am ended J t. Pre -

hrg . S tip. Part E (Stipulated Facts), ¶ 10) .

6. Respondent disputed the Complaint's allegation quoted above ,

notwithstanding the stipulation s , based on th e argument that the word

"license" in the Complaint is different from the word "certificate" in the

stipulation. Respondent attempted to argue that the "certificate" that was

permanently revoked was not a form of authority to practice osteopathic

medicine and surgery.

7. Respondent offered various possibilities, such as that the permanently

revoked "certificate" must have been the "training certificate" that he

believed he was given in 2004 to participate in a training program before

licensure, or that it w as some other kind of "certificate." R espondent's

argument i s not credible , is inconsistent with the words following

"certificate" — "to practice osteopathic medicine and surgery" — and is wholly

unsupported by the evidence.

Ohio L icensure H istory

8 . In late D ecember 2003, Respondent applied for osteopathic medical

licensure in Ohio via an application for a Certificate to Practice Osteopathic M edicine and Surgery (Ohio Application) submitted to the Ohio Board.

4 The

application was not deemed officially received for processing until

January 29, 2004, because Respondent 's initial submission was not

accompanied by the required $335.00 fee and he did not pay the fee until

January 29, 2004. See P et . Ex. 1, Bates p. 28 , 3, and 18.

9 . The Ohio Application f orm asked w hether the applicant was, or

intended to be, in an accredited training program in Ohio. R espondent

answered that he intended to be in an accredited training program . He

identified the training program as Doctor's Hospital/Anesthesiology in

Columbus, Ohio, with a planned start date of June 30, 2004.

10 . On January 30, 2004, the Ohio Board sent Respondent its

"Acknowledgement of Application for Certificate to Practice Medicine and

Surgery or Osteopathic Medicine and Surgery " (Acknowledgement), notifying

Respo ndent that his application for a certificate to practice osteopathic

medicine and surgery was received b y the Board on January 29, 2004. The

Acknowledgement also notified Respondent that he was authorized to

4 Respondent's entire licensure file, certified as complete by th e Ohio Board, is in evidence,

with Bates page numbers added in red. It is apparent that the pages representing

Respondent's application for licensure to practice osteopathic medicine and surgery are not in order, perhaps because his initial submission in l ate December 2003 was incomplete and

supplemented with various revised answers and additional documentation between 2004 and early 2005.

participate in the training program identified i n his application: "Please be

advised that you are hereby authorized to begin participation in the training

program to which you have been appointed … while your application is being

processed. " (P et . Ex. 1, Bates p. 18) .

11. Respondent claimed that the Ac knowledgement notified him that he

was granted a "training certificate" so he could participate in the residency

program while h is application for a license to practice osteopathic medicine

and surgery was being processed. The Acknowledgement says no such thing .

Respondent's argum ent to the contrary is rejected. No evidence was offered to

prove that a training certificate was ever issued to Respondent.

12. R espondent's "training certificate" argument was part of his broader

attempt to argue that in Ohio, t he terms "certificate" and "license" refer to

distinct items, and that a "license" is the form of authority to practice

osteopathic medicine and surgery. Here too, Respondent's argument is contradicted by the record evidence and by Ohio law .

13. Beginning with Respondent's initial submission, date - stamped by the

Ohio Board on December 23, 200 3 , it is clear that the specific phrase used to

describe the form of authority to practice osteopathic medicine and surgery in

Ohio was a "certificate to practice oste opathic medicine and surgery, "

although the umbrella term "l icense" was frequently used interchangeably

with "certificate . "

5 The interchangeable use of "license" and "certificate,"

prefacing the phrase "to practice osteopathic medicine and surgery," is

rep lete throughout Respondent's Ohio licensure file. The interchangeable use

of these terms is evident perhaps nowhere more clearly than in the Ohio

Board's form "Affidavit and Release of Applicant [ - ] Medicine or Osteopathic

5 Pursuant to the Ohio Administrative Procedure Act, just as under the Florida

Administrative Procedure Act, "license" is an umbrella term defined to mean "any license,

permit, certificate, commission, or charter issued by any agency." § 119.01(b), Ohio Rev.

Code; compare § 120.52(10), Fla. Stat. (defining "license" as "a franchise, permit,

certification, registration, ch arger, or similar form of authorization required by law[.]").

Medicine" 6 executed by Respondent and submitted as part of the Ohio

Application bearing t he Ohio Board's "received" stamp dated Dece mber 26,

2003. By the executed affidavit, Respondent certified under oath :

that I am the person named in this application for

a license to practice medicine or osteopathic medicine in the State of Ohio … and that all

documents, forms or copies thereof furnished or to be furnished with respect to my application are strictly true in every respect. … I further understand that the issuance of a certificate to

prac tice medicine or osteopathic medicine in Ohio

will be considered based on the truth of the

statements and documents containe d herein or to

be furnished[.] (P et . Ex. 1, Bates p. 26, emphasis

added) .

1 4 . Respondent's Ohio Application contained multiple def iciencies and

required several rounds of requests for o mitted information/documentation

followed by submissions that attempted to respond to the requests. T his

process, documented in Respondent's complete Ohio licensure file in evidence,

spanned from early 200 4 through early 200 5 .

1 5 . On April 13, 2005, the Ohio Board gave Respondent notice that it

intended to determine whether to refuse to grant his certificate to practice

osteopathic medicine and surgery , for reasons set forth in a detailed three -

page let ter. T he gist of the reasons was that Respondent allegedly made false,

fraudulent, deceptive, or misleading statements to the Acting Director of Medical Education for Respondent's residency program in Missouri

pertaining to Respondent's failure to appear o r respond to pages when he was

on call. Respondent was informed of his right to a hearing .

1 6 . Respondent requested a hearing, which was held before a hearing

examiner for the Ohio Board on August 24, 2005. The hearing e xaminer's

report and recommendation in evidence set s forth a summary of the evidence

6 The title of this form is on two lines : t he first line is "Affidavit and Release of Applicant" ;

t he second line , immediately below the first, is "Medicine or Osteopathic Medicine." The dash

ha s been inserted to denote separation between the two lines of the title, for clarity.

(including Respondent's testimony at the hearing) , findings of fact, and

conclusions of law. (Pet. Ex. B, Bates p. 71 - 80).

1 7 . The findings were that Respondent had failed to report to work when

he was sche duled to be the r esident on call , and failed to respond to several

pages from the emergency department . He met with the Acting Director, and

after the meeting, a determination was made to terminate Respondent from

the residency program for "grievous dereli ction of duty and subsequent

imminent risk to quality patient care." (P et . Ex. B, Ba t es p. 77). Respondent

appealed the termination. Shortly thereafter, upon questioning by the Acting

Director, Respondent falsely reported that he had been at the hospital, on

duty that night , and received no pages. Respondent said that he had been in

the hospital library and had used the computer. The Acting Director asked

Respondent t hree times if he had used the computer at the library, and

Respondent said yes. But the Act ing Director verified with library staff that

the computers had remained inactive during the time in question. Caught in

the lie, Respondent ultimately admitted to the Acting Director that he had

failed to report to duty . Instead, he had taken cold medicin e and slept the

entire night at home. Respondent "admitted that he had used very poor

judgment and had been dishonest." (P et . Ex. B , Bates p . 77). Respondent 's

termination from the residency program was upheld on appeal.

1 8 . The hearing examiner con cluded that R espondent's conduct violated

section 4731.22( B )(5), Ohio Revised C ode (making false, fraudulent,

dece ptive, or mislea ding statements in relation to the practice of osteopathic

medicine and surgery ) , but did not demonstrate a current failure to prove

good moral character. The hearing examiner elaborated on these conclusions:

Dr. Hall issued a series of deceitful and self - serving

misstatements during the course of his practice.

Such conduct would justify permanent denial of his

certificate to pra ctice in this state. Nevertheless,

Dr. Hall admitted his misconduct and deceit within

a short time of their occurrence. Moreover, Dr. Hall

was forthcoming in his application for licensure in

Ohio . Therefore the evidence suggests that Dr. Hall

has learned f rom his mistakes and will be more

cautious and forthcoming in the future. (P et . Ex. B,

Bates p. 78 , emphasis added ).

19 . Based on the hearing examiner's findings and conclusions, her

proposed order was that Respondent's application "for a certificate to p ractice

o steopathic medicine and surgery " in Ohio be granted, "provided that he

otherwise meets all statutory and regulatory requirements." If so, the

"certificate" should be issued on the effective date of the o rder. However, the

"certificate" should be i mmediately suspended for 30 days , then reinstated

subject to a number of probationary terms for a period of at least two years .

The hearing examiner's proposed order concluded with a provision addressing

when the order would become effective: "This Order s hall become effective

thirty days after mailing of notification of approval by the Board." (P et . Ex. B ,

Bates p. 78 - 80 , emphasis added ).

20 . At a meeting of the Ohio Board on December 14, 2005, the hearing

examiner's proposed findings of fact, conclusions, and order were approved.

A letter dated December 14, 2005, notifying Respondent that the Ohio Board

had approved the hearing examiner's recommendations, bears a notation that

it was mailed December 16, 2005.

2 1 . Respondent was required to update certai n components of his

licensure application . B y letter dated December 29, 2005, Respondent was

given notice as "a follow - up to your application for Ohio licensure " that he had

to update his resume of activities from July 2004 forward; updat e the listing

of l icensure activity in other states; and execute another notarized Affidavit

and Release of Applicant . (P et . Ex. A, B ates p. 89 , emphasis added ).

Respondent executed another Affidavit and Release on January 13, 2006; the

form appears unchanged from the one h e signed in 2003, continuing to u se

the terms "certificate" and "license" to practice osteopathic medicine and

surgery interchangeably (P et . Ex. A, Bates p. 25). Other updates to his

application also were submitted on or shortly after January 13, 2006 ,

inc luding a letter from Doctors Hospital verifying that Respondent was in the

anesthesia residency program, having begun February 2, 2004, and was

anticipated to complete the program February 1, 2007.

2 2 . T he submission of the required update items on or shor tly after

January 13, 2006, resulte d in Respondent's certificate (a/k/a license) to

practice o steopathic medicine and surgery being issued on January 17, 2006,

two days after it otherwise co uld have been consistent with the provisions of

the hea ring examin er's proposed order.

2 3 . Also in accordance with the hearing examiner's proposed order,

approved by the Ohio Board, Respondent's certificate to practice osteopathic

medicine and surgery was immediately suspended for 30 days, which

included the day that t he certificate was issued. T he 30 - day suspension ran

from January 17, 2006, through F ebruary 15, 2006. Respondent was

permitted to practice osteopathic medicine pursuant to his certificate beginning February 16, 2006, subject to the terms of probation for at least two years.

2 4 . Less than six months after Respondent's first suspension was over ,

Respondent self - reported to the Ohio Board that he was terminated from the

anesthesia residency program for diverting a drug he had prescribed to a

patient for his o wn use. O ne month after the self - report, on August 30, 2006,

Respondent signed a Step I Consent Agreement (Step I Agreement) with the

Ohio Board. The Step I Agreement included the following sti p ulations and

admissions:

E. Dr. Hall admits that the Board ord ered him to

submit to a three - day examination at The Woods at

Parkside [Parkside], a Board - approved treatment

provider in Columbus Ohio, on or about July 31,

2006, based upon his self - report that he was

terminated from his anesthesia residency program

with Doctors Hospital in Columbus, Ohio, because

he diverted for self - use Celestone, a corticosteroid,

that he prescribed for a patient; and that he had

diverted Kenalog, another corticosteroid, in the past. Dr. Hall further admits that during this

examination , he was diagnosed with substance

abuse and Bipolar Disorder with mixed anxiety and

that he entered Parkside for further treatment, including 28 - day residential treatment.

F. Dr. Hall further admits that due to his substance abuse he currently is impaired in his ability to

practice osteopathic medicine and surgery according to acceptable and prevailing standards of

care because of habitual or excessive use or abuse

of drugs, alcohol, or other substances that impair ability to practice and an inability to p ractice

according to acceptable and prevailing standards of care by reason of mental illness or physical illness,

including, but not limited to, physical deterioration

that adversely affects cognitive, motor, or perceptive skills, due to his Bipolar Disord er with mixed anxiety. (P et . Ex. B, Bates p. 57).

2 5 . The Step I Agreement provided that, b ased on the stipulations and

admissions, Respondent's certificate to practice osteopathic medicine and

surgery was suspended indefinitely . A series of requirements and conditions

were imposed, which had to be met before the Ohio Board would "consider

reinstatement of Dr. Hall's certificate to practice osteopathic medicine and

surgery." (P et . Ex. B, Bates p. 60). The St ep I A gree ment took effect

September 13, 2006, w hen signed on behalf of the Ohio Board . (P et . Ex. B ,

Bates p. 63).

2 6 . Six months later, o n March 14, 2007, Respondent and the Ohio Board

entered into the Step II Consent Agreement (Step II Agreement) . Pursuant to

the Step II Agreement, t he indefinite sus pension was lifted and Respondent's

certificate to practice osteopathic medicine and su rgery was conditionally

reinstated under new probationary terms set forth in the Step II Agreement .

2 7 . The Step II Agreement contained additional stipulations and

admi ssions agreed to by Respondent, including:

C. Dr. Hall is applying for reinstatement of his

license to practice osteopathic medicine and surgery in the state of Ohio, which was indefinitely

suspended pursuant to the terms of the [ Step I

Agreement].

* * *

E. Dr. Hall admits that he initially entered

inpatient treatment for cortical steroid abuse, at the Woods at Parkside [Parkside], a Board -

approved treatment provider in Columbus, Ohio, on

or about July 31, 2006, that he transitioned to out -

patient tre atment on or about August 28, 2006, and

that he was subsequently discharged, treatment

complete, on or about September 5, 2006. Dr. Hall further admits that in addition to his abuse of

corticosteroids, in the past he also self - medicated

with Elavil and Ult ram, and excessively consumed

alcohol to the point of having blackout events.

Dr. Hall further admits that during his treatment

at Parkside, he received an additional diagnosis of Bi p olar Disorder for which he was prescribed

medication.

* * *

G. … Dr . Hall states … that Victoria Sanelli, M.D.,

a psychiatrist who was approved by the Board to provide an assessment of Dr. Hall, evaluated

Dr. Hall and submitted a report to the Board … in

which she stated that Dr. Hall's diagnoses include steroid dependenc e in early sustained remission, and that although Dr. Hall has been recently diagnosed with possible Bipolar Disorder, it was

Dr. Sanelli's opinion as an addiction psychiatrist

that it is extreme l y difficult to assign an Axis I

diagnosis to someone who has recently been

involved in substance abuse. … Dr. Sanelli further opined that Dr. Hall has a Mood Disorder, which

may be depressed mood or Bipolar Disorder, and

that Dr. Hall's ability to practice osteopathic medicine and surgery has been assessed, and he is capable of practicing according to acceptable and

prevailing standards of care so long as certain

treatment and monitoring requirements are in place.

2 8 . The Step II A greement provided that reinstatement of Respondent's

license would be subject to a pr obationary term of at least five years from

March 14, 2007 , with numerous conditions and limitations imposed ,

including the treatment and monitoring requirements deemed necessary to

ensure Respondent remained capable of practicing according to acceptable

s tandards of care . The terms of Respondent's probation included random drug

and alcohol tests, evaluations, restrictions on travel outside the state , use of a

monitoring physician to monitor Respondent's practice of osteopathic

medicine and surgery, and sub mission of quarterly reports to the Ohio Board

in which Respondent attested under oath to full compliance with all conditions of the Step II Agreement.

2 9 . Respondent testified that , at the beginning, he complied with the

probationary terms he agreed to . For example, with regard to the travel

restrictions, i n 2007, when Respondent decided on the spur of the moment to

travel to Alabama to visit a friend, he requested and obtained last - minute

permission from the Ohio Board for the trip with the proviso that he continue

t o be subject to random screening s and go to meetings there.

30 . However, in or about September 2008, after the Step II Agreement

had been in place for only a year and a h alf, Respondent decided he could no

longer comply with the agreement he entered into. When his brothers, who lived in Florida, asked him to travel with them to Italy and Lebanon for a

v acation, for which the brothers would pay, Respondent agreed. The brothers

coordinated the travel dates to work with Respondent's schedule . Res pondent

testified that he could not recall how long the trip was, but it was more than

one week and possibly less than two weeks.

3 1 . Even though this long er trip was planned , rather than spontaneous

like the Alabama trip for which Respondent had obtained Ohio Board

approval, this time Respondent did not request approval. This was no

accident. Instead, Re spondent schemed to leave "clean" urine samples and

slips filled out to submit with the samples to the lab, and left them behind

with an employee who kept the samples in a freezer and submitted one or

more samples while Respondent was out of the country. Respondent devised

this scheme to cover up his unauthorized travel , and to give the impression

that the samples were being given contemporaneously with thei r submission

to the lab. Instead, Respondent went unmonitored during his unauthorized

trip abroad. This was a blatant and devious affront to the terms of the Step II

Agreement Respondent promised to abide by.

3 2 . At the hearing, Respondent attempted to exp lain several different

times why he carried out a scheme to circumvent the Step II Agreement's

monitoring requirements and cover up his unauthorized travel :

Because I had no control in my life. I was doing

everything that the board had asked; I had gone to

meeting s , two, three, sometimes four times a week

as required; I was doing random urine drug screens

for almost two years; and I had done everything that was asked, and I felt I had n o control of my

life. I wasn't getting anywhere with this board

program. I felt that they were completely inflexible

and had a total lack of understanding. And I

thought that the suspension — I'm sorry; the impairment diagnosis for basically prednisone,

which is an anti - inflammatory drug, was cruel. …

[W]hen the program in Ohio said that I had an

[impairment], based on the use of drug that in literature is used for inflammatory conditions, it blew my mind. I was still being required to test like

a drug addict for over two years and I was labeled a

drug addict for two - plus years a t that point, and

the board didn't want to listen to my protest or my concerns. And there was just a total lack of understanding on the part of the board. And I — and

I got — I got overwhelmed emotionally. And just

said I had enough of being controlled by some body who didn' t — who didn't have any of my interests at

heart. They only wanted to punish. (Tr. 135 - 136).

* * *

I was put in a vice like a grape and crushed.

(Tr. 142).

* * *

I don't know that I thought it was okay [to

circumvent the Step Two Agr eement] . … At the

time, like I said, I was under the impairment agreement; I was hoping there would be some benefits to asking for help for mental health issues,

and like I said, rolling in the drug portion. But as

time went on, there was no positive affec t on my

life. I couldn't travel to see family. Family is important. Family is who we turn to in times of stress. I couldn't see them without the board's

approval. I couldn't find work because of the scarlet

letter that was on me. I couldn't find work becau se

I didn't finish the residency. You know, I think when we tell patients by the way, we have a

treatment for your problem, but it's going to kill

you, most people would say, well, screw that, I'm not going to do it. And you know, I don't think any

of the downside was anticipated by me. (Tr. 144).

I didn't foresee all of the negative repercussions

that would come through in my life. And I was — I

was adhering to everything they that they asked of

me, meetings, urine drug screens. This — you know,

when you have to do a urine drug screen, you have

to basically strip for them and someone has to look at you. And it's intrusive. And I was doing that. I was more than willing to work within their system, and do back flips and front flips. If they said, you

know, stand on one leg, I would have said yes, sir,

for how long, sir? But at the same time, you could

only get beaten and put into a corner for so long and say what in the hell is this program designed to do except excommunicate people from a

profession? … And so I broke. After a certain

amount of time, I broke. It was too much. I — I know

I did something stupid. I know I did. And I regret it every day of my life. And I look at it and kick

myself and wish I would have never done it. But all

I can say is I'm sorry. … So , you know, that's all I can say. I know I screwed up and I took the

punishment for it, and I'm here today to say, I am

not that person from 12 years ago. (Tr. 14 5 - 146).

* * *

In 2008, like I said, I had been compliant with the board's ruling since '06, since August of '06. I think it was August of '06. And now we're looking at two years later and despite having done everything the

board asked, I'm gettin g — I'm getting nowhere. I'm

just feeling like I'm spinning my wheels and there's

no end in sight t o thi s — to this situation. And so I

threw my hands up. (Tr . 1 49).

3 3 . No evidence was offered to substantiate Respondent's dramatic claims

that t he Ohio Board showed inflexibility, a lack of understanding, or an

unwillingness to consider any protests or co ncerns submitted by Respondent.

No evidence was offered to show that the Ohio Board ever denied a request

by Respondent to travel; the only evidence was that Respondent's single last -

minute request was granted and Respondent was allowed to meet his

monitor ing and treatment requirements while traveling.

3 4 . A s Respondent acknowledged, the Step II Agreement that he signed

was for a minimum of five years , beginning M arch 200 7. Before March 2007,

Respondent was subject to the Step I Agreement, which he also s igned . These

agreements included stipulations and admissions agreed to by Respondent ,

and imposed terms and conditions th at he accepted. Respondent's

characterization at the hearing of the terms he had agreed to as cruel, and

his explanation at the hearing that he could not abide by the Step II

Agreement because he decided he needed to take back control, after less than

one - third of the five - year minimum term had passed , are very troubling

current - day admissions.

3 5 . Respondent attempted to refute his admis sions in the Step I and

Step II Agreements, di sputing the substance abuse characterizations and

claiming that he admitted to them as a means to have his license reinstated .

Without any evidentiary basis to contradict his own admissions in the Step I

and St ep II Agreements, it is sufficient for purposes of this proceeding to

simply point out that Respondent's admissions speak for themselves, an d

Respondent is not painted in a favorable light , whether he admitted to facts

he did not believe as a means to the end of having his suspended license

reinstate d or whether he admitted to facts that were true .

3 6 . Respondent's claims of oppression and torture ( i.e., being put in a vice

like a grape and crushed) to explain the backdrop to the Ohio Board's action

permane ntly revoking his certificate to practice osteopathic medicine cause

concern. Respondent overly dramatize s the simple fact that he chose to enter

into the Step I and Step II A greements , regardless of his rationalizations for

having done so .

37. Also of con cern is that for all of his dramatic expressions at the

hearing, Respondent ignored a troubling series of admissions . In the Step II

Agreement, Respondent admitted to diverting the hospital's prescription

medication that he had prescribed for a patient for his own use , and he also

admitt ed to having diverted other medication for his own use in the past . His

diversion of hospital medication that he p rescribed for a patient for his own

use instead was essentially theft , resulting in his terminat ion from the

h ospital's residency program. Respondent admitted to drug diversion on more

than one occasion, in addition to self - medicating, and th ose admission s w ere

p redicate s for the conditions imposed by the Step II Agreement. At the

hearing, Respondent never addr ess ed this dishonest conduct. That makes

Respondent's attempted explanation for why he could no longer abide by the

Step II Agreement , with three and a half years left to the agreement he

entered into , wholly unsatisfactory. Respondent seemingly has not recog nized

that th ese underlying dishonest dealings in medication played a part in hi s

being "painted with a scarlet letter." Whether he recognized it or not, he

certainly expressed no remorse.

3 8 . Respondent's scheme to violate the Step II Agreement and cover up his

violation succeeded, initially , and for several years thereafter. Respondent

made it to the end of his five - year probation, falsely representing under oath

to the Ohio Board in quarterly reports that he complied with the terms the

entire time. Resp ondent's probation was lifted under false presences, based

on the false impression given by Respondent to the Ohio Board that as of

March 14, 2012, he had complied with the Step II Agreement for the five - year

probationary term . F rom then until April 1, 201 3 , Respondent's certificate to

practice was active and unrestricted for the first time since it was issued .

39. Respondent's scheme came to light after Respondent fired an employee

and reported to police that the employee was discovered forging prescriptio ns

to obtain prescription drugs. The employee reciprocated by reporting to the

Ohio Board that Respondent had falsified his urine samples to cover up an

unauthorized jaunt abroad , during which he evaded the required monitoring .

40 . Once again, Respondent's c ertificate to practice osteopathic medicine

in Ohio was immediately and indefinitely suspended by the Ohio Board on

April 1, 201 3 . Criminal charges were brought against Respondent in the fall

of 2014 , based on his scheme to have an employee submit "clean " urine

samples that were kept in a freezer, with slips Respondent filled out ahead of

time , to give the appearance that he was providing those samples while he

was on his overseas trip .

41 . Respondent's Ohio certificate to practice osteopathic medicine wa s still

under indefinite suspension when it came up for biennial renewal in 2014 .

Resp ondent chose not to renew the li cense, so the license became inactive on

October 1, 2014 , but remained under suspension . Respondent did not

surrender his license/certific ate to practice osteopathic medicine in 2014 or at

any time thereafter.

42 . On March 2, 2016, Respondent pled guilty to, and was found guilty of,

two felonies: attempted tampering with evidence , a fourth degree felony; and

possession of criminal tools, a f ifth degree felony.

4 3 . After the felony convictions, on April 13, 2016, the Ohio Board both

vacated the summary suspension of his certificate and initiated the

disciplinary action against Respondent's certificate , d esignated case number

16 - CRF - 0055, notwi thstanding that Respondent's certificate was inactive.

4 4 . The notice mailed to Respondent on April 14, 2016, informed

Respondent that the Ohio Board "intends to determine whether or not to

limit, revoke, permanently revoke, suspend, refuse to register or reinstate

your certificate to practice osteopathic medicine and surgery, or to reprimand

you or place you on probation" for reason s enumerated in the notice . The

reasons included the two felony convictions , Respondent's falsification of his

quarterly repor ts to the Ohio Board attesting to full compliance with the Step

II Agreement , and Respondent's violations of the limits placed on his

certificate to practice pursuant to the terms of the Step II Agreement .

Respondent was informed of his right to a hearing.

4 5 . Respondent asked for a hearing regarding the proposed disciplinary

action against his certificate to practice osteopathic medicine and surgery in

Ohio . Respondent testified at the hearing in this case that he pursued a

hearing before the Ohio Board in the hope that he and his attorneys could

persuade the Ohio Board to reinstate his inactive license. In his view, he had

been punished enough and deserved something less tha n the most draconian

punishment of permanent revocation. He believed that reinstati ng his

license, likely subject to more conditions, was a possible outcome of the

proceeding.

4 6 . Instead, the decision following an evidentiary hearing was to

p ermanently revoke Respondent's certificate to practice osteopathic medicine

and surgery in Ohio . The written decision reflect s that the basis for the

permanent revocation was, in part, Respondent's lack of remorse,

downplaying his past crimes for which he pled guilty, and dishonesty

displayed at the hearing.

4 7 . After setting forth proposed findings of fact and conclusions of law, the

hearing examiner provided a summary to explain why the proposed order

recommended permanent revocation :

Dr. Hall was dismissed from a residency program

at the University of Health Sciences in Independence, Missouri, for sleeping through a shift, then lied about his whereabouts in an effort to regain his position. Before this Board, he

testified that he learned his lesson and had come to

understand the importance of te l ling the truth. Yet

while working at Doctors Hospital in Columbus, Ohio, he created a false patient record in order to

obtain corticosteroids to treat his own pain. Then,

in 2008, Dr. Hall devised and employed a scheme to deceive the Board that he remained in Ohio when

in fact he was abroad, because he feared his

request to travel might be refused. He caused

specimens, provided in different times than he had

indicated, to be submitted for drug testing, as part

of that scheme. He has been under Board supervision his entire tenure in Ohio, up to 2012.

It is ind eed true that several years have passed

since the 2008 conduct at issue in this hearing, and

that there have been no proven instances of misconduct or non - compliance with monitoring for

the five years between 2008 and 2013, when Dr. Hall's license was summ arily suspended, or

since early 2016 when Dr. Hall resumed practice in

Florida. But his career up to that point in 2008 had consisted of a nearly unbroken cha i n of deceitful

conduct , and for four of the five following years,

Dr. Hall had remained under Boa rd supervision on

pain of revocation of his license. So the question now is whether Dr. Hall's pattern of lying "under pressure" was situational, caused by pain,

depression, and perhaps frustration, the causes of

which are largely in his past, or whether t his

conduct reflects an ingrained character trait.

Given his history, if Dr. Hall wished to regain the

Board's "trust" and demonstrate a character trait for truthfulness, it was incumbent upon Dr. Hall to

testify with complete candor in the proceedings

bef ore this Hearing Examiner. This Hearing

Examiner did not, however, find Dr. Hall's testimony to be particularly credible as a general

matter, based on his demeanor and testimony.

Three factors stand out in particular:

Dr. Hall attempted to minimize his de ceit to [the

Acting Director of his Missouri residency

program] … . But the Board's prior finding was

that Dr. Hall's lie was premeditated; …

Dr. Hall repeatedly attempted to minimize the character of his scheme to conceal from the Board his travel outsi de Ohio, and to submit urine

speci mens not given at the times indicated … .

… Dr. Hall repeatedly resorted to pat phrases to describe, and in all likelihood exaggerate, the level of discomfort he experienced … .

The evidence that Dr. Hall's persistent la ck of

candor is merely a result of past causes, no longer at play in his life, is less than convincing.

Accordingly, this Hearing Examiner does not

believe that the record reflects mitigating

circumstances sufficient to support providing a pathway for Dr. Hall to regain licensure by this

Board.

[ 7 ] (P et . Ex. B, Bates p. 27 - 28).

7 The hearing examiner's observation regarding whether mitigating circumstances supported

providing a pathway for Respondent to regain licensure confirms Respondent's te stimony

that the reason he invested time and resources in this hearing was in the hope that the Ohio

Board would consider mit igating circumstances, with the possibility of having his license

reinstated subject to conditions. This would have been similar to the approach of the Step I

and Step II Agreements, whereby in Step I, Respondent's certificate to practice was suspended, and would be considered for reinstatement only after Respondent complied with

a series of requirements , followed by Step II, which wa s treated as an application for

reinstatement , and was granted subject to limitations and conditions. This time, Respondent

failed to convince the hearing examiner or the Ohio B oard to allow another similar pathway.

48 . T he Ohio Board entered an Order on December 14, 2016, attaching

and incorporating the hearing examiner's report and r ecommendation and

o rdering as follows : "The certificate of A dam Patrick Hall, D.O., to practice

osteopathic medicine and surgery in the State of Ohio shall be permanently

revoked." (P et . Ex. B, Bates p. 3).

49 . Just as Respondent's candor was found lacking in the Ohio proceeding,

s o, too, at the hearing in this cas e, Respondent was not credible , based on his

demeanor and testimony . Instead, he was evasive, dramatizing his personal

tribulations to which he attributed his past mistakes, while downplaying the extent and significance of his past wrongdoing.

5 0 . Several months after the Ohio Board permanent ly revoked

Respondent's certificate to practice osteopathic medicine, Respondent's

counsel, who ha d represented him since the Ohio pro ceedings in 2016 , and

worked with local Ohio counsel in the 2016 disciplinary procee ding, wrote the

following on his behalf as a "self - report" to the Department on April 3, 2017 :

Please be advised that Adam Hall is represented by

Chapman Law Group before the Florida

Department of Health ("Department") and Board of Osteopathic Medicine (" Board"). … In November

2016, Dr. Hall submitted his response to the Department's Administrative Complaint. Subsequently, the Ohio Board of Osteopathic Medicine took action against his license .

To wit, on December 15, 2016, by an order of the Board, Dr. Halls' [sic] Osteopathic medical license

was permanently revoked . Such an order was based

on convictions in the Court of Common Pleas of Lawrence County, Ohio in which Dr. Hall pled guilty to Attempted Tampering of Evidence, a fourth degree felony and Poss ession of Criminal

Tools, a fifth degree felony. …

Dr. Hall knows that pursuant to Florida Statute, his Ohio Board action constitutes grounds for disciplinary action , as specified in s. 456.072(2). To

wit s. 456.015 [sic; 459.015(1)(b)] reads that:

Having a license or the authority to

practice osteopathic medicine revoked,

suspended, or otherwise acted against,

including the denial of licensure, by the

licensing authority of any jurisdiction ,

including its agencies or subdivisions. The licensing authority' s acceptance of a

physician's relinquishment of license, stipulation, consent order, or other settlement offered in response to or in anticipation of the filing of administrative charges against the physician shall be

construed as action against the physic ian's license.

Chapman Law Group respectfully submits that no action is needed on the part of either the

Department or Board, because Dr. Hall reported

this incident to the Department as required by law.

(P et . Ex. E, emphasis added).

The letter was submi tted on Respondent's behalf by attorneys Steven D.

Brownlee and Ronald W. Chapman for the firm .

Other Relevant Facts

51 . Respondent had a license to practice osteopathic medicine in Missouri

at one time. He testified that " Missouri followed the action of O hio, and I lost

my license to practice in Missouri." (Tr. 148). Respondent did not provide

specific details regarding the basis for the Missouri action to take away

Respondent's license to practice in Missouri.

52 . Respondent had a license to practice os teopathic medicine in Kansas

at one time. Respondent did not provide details regarding what happened to

the Kansas license he held at one time.

53 . Respondent's Ohio licensure file contains a Kansas license verification

form submitted as part of Respondent 's application for a license (certificate)

to practice osteopathic medicine and surgery in Ohio. The Kansas license

v erification form dated April 15, 2004, reports that Respondent's "original

license date" was April 26, 2003 ; and the "expiration date" was September 30,

2003. The license status was reported as "cancelled." (P et . Ex. A , Bates p. 31).

No other evidence was offered regarding Respondent's Kansas licensure

history, the reason for the short duration of his license, or why his license

was "cancelle d."

54 . As previously noted, Respondent has also been licensed to practice

osteopathic medicine in Florida since 2008. However, he testified that he did

not begin practicing in Florida until after the Ohio proceedings concluded with the Ohio Board's o rder of permanent revocat ion. There is no evidence of

any blemishes on his track record practicing in Florida, but the tenure has

been relatively short — three and a half years at the time of the hearing .

8

55 . Respondent is married, with three children. At the t ime of his hearing

in Ohio that resulted in permanent revocation of his certificate to practice

osteopathic medicine, his now - wife was his fiancé e and they had a one -

month - old child. Respondent testified that his wife is a lawyer . He credited

her with comi ng up with the argument that the permanent revocation of his

"certificate" to practice osteopathic medicine in Ohio was arguably s omething

different than a permanent revocation of a "license" to practice osteopathic medicine in Ohio. Respondent noted that she raised this question before the

Ohio disciplinary hearing, but the argument was not pursued there.

C ONCLUSIONS OF L AW

56 . DOAH has jurisdiction over the subject matter of this proceeding and

the parties thereto . §§ 120.569 and 120.57(1), F la. Stat. (2019).

57 . By its Complaint, Petitioner charged Respondent with violating

section 459.015(1)(b), which provid es :

8 Respondent's PRO offered the followi ng proposed finding: "Respondent has been practicing

in Florida since 2008 and has never had his Florida licensed disciplined. (Tr. 136 - 137)." R esp .

PRO at 7, ¶ 31. That proposed finding is contrary to the evidence. The testimony on the cited

pages was tha t Respondent has been licensed (not practicing) in Florida since 2008, with no

other disciplinary complaints besides this one. Earlier in the hearing, Respondent testified

that he has not been practicing in Florida since 2008; he said that he did not start practicing

in Florida until 2016, after his Ohio certificate was revoked. (Tr. 16).

(1) The following acts constitute grounds for denial

of a license or disciplinary action, as specified in

s. 456.072(2):

* * *

(b) H avi ng a license or the authority to practice

osteopathic medicine revoked, suspended, or otherwise acted against, including the denial of licensure, by the licensing authority of any jurisdiction, including its agencies or subdivisions.

The licensing authorit y's acceptance of a physician's

relinquishment of license, stipulation, consent order, or other settlement offered in response to or in anticipation of the filing of administrative charges against the physician shall be construed as action against the phys ician's license.

58 . A proceeding to suspend or revoke a license, or to impose other

discipline upon a licensee, is penal in nature. State ex rel. Vining v. Fla. Real

Estate Comm'n , 281 So. 2d 487, 491 (Fla. 1973). Petitioner therefore bears

the burden of proving the charges against Respondent by clear and

convincing evidence, as the parties acknowledged at the outset of the hearing.

Fox v. Dep't of Health , 994 So. 2d 416, 418 (Fla. 1st DCA 2008) (citing Dep't of

Banking & Fin. v. Osborne Stern & Co. , 670 So. 2d 932 (Fla. 1996)).

59 . As stated by the Florida Supreme Court:

Clear and convincing evidence requires that the

evidence must be found to be credible; the facts to which the witnesses testify must be distinctly remembered; the testimony must be preci se and

explicit and the witnesses must be lacking in confusion as to the facts in issue. The evidence must

be of such weight that it produces in the mind of the trier of fact a firm belief or conviction, without hesitancy, as to the truth of the allegation s sought

to be established.

In re Henson , 913 So. 2d 579, 590 (Fla. 2005) (quoting Slomowitz v. Walker ,

492 So. 2d 797, 800 (Fla. 4th DCA 1983)). This burden of proof may be met

where the evidence is in conflict; however, "it seems to preclude evidence th at

is ambiguous." Westinghouse Elec. Corp. v. Shuler Bros. , Inc. , 590 So. 2d 986,

988 (Fla. 1st DCA 1991).

60 . Disciplinary statutes and rules "must be construed strictly, in favor of

the one against whom the penalty would be imposed." Griffis v. Fish &

W ildlife Conser. Comm'n , 57 So. 3d 929, 931 (Fla. 1st DCA 2011); Munch v.

Dep't of Prof'l Reg., Div. of Real Estate , 592 So. 2d 1136, 1143 (Fla. 1st DCA

1992); McClung v. Crim. Just. Stds. & Training Comm'n , 458 So. 2d 887, 888

(Fla. 5th DCA 1984).

61 . Res pondent may not be found guilty of an offense that was not charged

in the Complaint. See, e.g. , Trevisani v. Dep't of Health , 908 So. 2d 1108 (Fla.

1st DCA 2005) (administrative complaint charged physician with a failure to create medical records; proof of a failure to retain medical records cannot

support a finding of guilt). Furthermore, due process prohibits the

Department from taking disciplinary action against a licensee based on

matters not specifically alleged in the charging instrument, unless those

matters have been tried by consent. See Delk v. Dep't of Prof'l Reg. , 595 So.

2d 966, 967 (Fla. 5th DCA 1992).

62 . In this case, the Department proved by clear and convincing evidence

that Respondent violated section 459.015(1)(b) when his l icense to pra ctice

osteopathic medicine was permanent ly revoked by the licensing authority in

Ohio in December 2016 . Indeed, th is proof was largely provided by the

following stipulation of fact:

On December 14, 2016, in case number 16 - CRF -

0055 and in accordance with ch apter 119, Ohio

Revised Code, the State Medical Board of Ohio

entered an order which permanently revoked

Respondent's certificate to practice osteopathic medicine and surgery in Ohio. (Amended J t. Pre -

hrg. Stip . , Part E ( Stipulated Fact s), ¶ 10).

63 . Desp ite this stipulation, Respondent argued that he could not have

had his license to practice osteopathic medi cine permanent ly revoked because

he had let his license to practice osteopathic medicine lapse while it was

suspended in 2014 .

64 . Respondent argued that the "certificate to practice osteopathic

medicine and surgery" that was permanently revoked was something different than a license to practice osteopathic medicine and surgery. Respondent sought to make something out of the fact that the words

"certi ficate" and "license" are different. Respondent attempted to

manufacture uncertainty by arguing that perhaps the Ohio Board only

revoked his training certificate, or some other kind of certificate, even though

the Ohio Board's Order permanently revoked Res pondent's certificate "to

practice osteopathic medicine and surgery," and not a training certificate or

any other kind of certificate. Respondent cannot so easily evade the language

of the Ohio Board's O rder or the parties' stipulation , to which he is boun d .

6 5 . Respondent's attempted word game is contrived and disingenuous.

Like Florida's Administrative Procedure Act, the Ohio Administrative

Procedure Act defines "license" as an umbrella term that mean s "any license,

permit, certificate, commission, or ch arter issued by any agency." § 119.01(B),

Ohio Rev. Code; compare § 120.52(10), Fla. Stat. (defining "license" as "a

franchise, permit, certification, registration, charter, or similar form of authorization required by law[.]"). Thus, as a matter of law, in the context

presented, the words "certificate" and "license" are interchangeable.

6 6 . Where Respondent's argument goes wrong is by focusing exclusively

on the word "certificate," ignoring completely the words t hat follow in the

Ohio Board's O rder and in the parties' stipulation — "to practice osteopathic

medicine and surgery." The Ohio Board permanently revoked Respondent's

certificate (i.e., his license) to practice osteopathic medicine and surgery.

6 7 . Respondent's argument is also refuted by an entire l icensure file full of

documents demonstrating, as found above, that the form of authority to

practice osteopathic medicine and surgery is referred to as either and both a

"license" and "certificate." Those terms were used interchangeably by the

Ohio Board and by Respondent himself in their communications.

6 8 . R espondent argues in this proceeding that his license (a/k/a certificate)

to practice osteopathic medicine c ould not be permanently revoked under

Ohio law because it was inactive. However , he did not make that argument in

the proceedings leading up to the permanent revocation O rder, nor did he

appeal that O rder to argue that the Ohio Board lacked authority to

permanent ly revoke his license to practice osteopathic medicine and surgery.

6 9 . Indeed, such an argument could not have been fairly made under Ohio

law , which is very clear on this point . The statute authorizing disciplinary

actions under which the Ohio Board expressly acted to revoke Respondent's license to practice osteopathic medicine and surg ery provides :

Failure by an individual to renew a license or

certificate to practice in accordance with this

chapter … shall not remove or limit the board's

jurisdiction to take any disciplinary action under

this section against the individual.

§ 4731.22 ( M)(3), Ohio Rev. Code.

9

70 . T aking a different tack , Respondent's PRO argued that because

Respondent's license in Ohio was inactive, it was essentially a worthless

piece of paper that was permanently revoked by the Ohio Board . From there,

Respondent assert s that it was not the Florida Legislature's intent "to

discipline physicians for revocation of a worthless piece of paper. It is to

protect the public. T here is no danger presented to the public by a physician

having disciplinary action taken against him i n a jurisdiction where he had

no authority to practice in the first place." ( R esp . PRO at 13 ) .

9 For ease of reference, the above quote is from the current version available through

Westlaw and other legal research tools. However, researching prior versions of the s tatute on

Westlaw shows that essentially the same provision ha s been in section 4731.22(M)(3)

throughout th e entire time that Respondent had a certificate to practice osteopathic medicine

in Ohio .

7 1 . Respondent's policy argument has been rejected in Florida cases

considering whether Florida professional boards have a legitimate interest in

taking discipli nary action a gainst non - practicing physician s with inactive

license s . T he response to this policy argument is as follows :

[T]o suggest that physicians should be able to

immunize themselves from prosecution by simply

going inactive suggests a form of self - regulation of

the medical profession which was obviously rejected by the Legislature when it chose to enact Chapter 458, Florida Statutes. To permit a licensee

to indefinitely hide behind an inactive status while evidence is lost, witnesses disappear and m emory is

eradicated serves no useful public purpose.

Boedy v. Dep't of Prof ' l Reg. , 433 S o. 2d 544 (Fla. 1st DCA 1983).

10

7 2 . Finally, Respondent's argument that section 459.015(1)(b) r equires

that the action taken in another jurisdiction must be against an active license

to practice osteopathic medicine is refuted by the statute itself, which

imposes no such requirement. Indeed, section 459.015(1)(b) authorizes

disciplinary action when another jurisdiction 's action against one's authority

to practice oste opathic medicine is by " denial of licensure . " This co nclusively

demonstrates that an active current license is not a required element of this

statute. O ne can have " a license or the authority to practice osteopathic

medicine revoked, suspended, or otherwis e acted against, including the

denial of licensure, by the licensing authority of any jurisdiction " without

holding an active license to practice osteopathic medicine.

73 . As applied to the circumstances here, it is plain that the Ohio Board

pursued action against Respondent's authority to practice osteopathic

medicine in Ohio to impos e the emphatic sanction of permanent revocation.

10 In Boedy , the court also considered whether the Florida B oard of Medicine had jurisdiction

to take disciplinary action against a physician with an inactive license, and concluded that it

did have jurisdiction. Here, there is no question that the Ohio Board had jurisdiction to take disciplinary action against Res pondent after he chose to let his license lapse, because that

authority is expressly provided in the disciplinary action statute, section 4731.22(M)(3), Ohio

Revised Code.

T he Ohio Board exercised its authority to impose severe dis ciplinary

consequences for Respondent's violations. The Ohio Board had every right to

do so, and Respondent accepted the consequences by not appealing the o rder

of permanent revocation. The Ohio Board's permanent revocation of

Respondent's certificate to practice osteopathic medicine in Ohio is grounds to

discipline Respo ndent under section 459.015(1)(b).

Appropriate Penalty

7 4 . Florida Administrative Code Rule 64B 15 - 19.002 sets forth disciplin ary

guidelines and directs that the Board "shall impose a penalty within the range corresponding to" specific violations. Rule 64 B15 - 19.002(2) provides the

penalty range for a violation of section 459.015(1)(b). For a first offense, as

here, the low end of the penalty range is:

Imposition of discipline comparable to discipline

that would have been imposed in Florida if the substant ive violation occurred in Florida to

suspension or denial of the license until the license

is unencumbered in the jurisdiction in which disciplinary action was original taken, and an

administrative fine ranging from $1,000.00 to

$5,000.00. (emphasis added) .

The high end of the penalty range for a first offense is:

Imposition of discipline comparable to discipline

that would have been imposed in Florida if the

substantive violation occurred in Florida to revocation or denial of the license until the licens e

is unencumbered in the jurisdiction in which

disciplinary action was originally taken, and an administrative fine ranging from $5,000.00 to

$10,000.00. (emphasis added).

75 . The disciplinary action taken by the Ohio Board was predicated on

violati ng con ditions of limitation placed by the Ohio Board on Respondent's

certificate to practice (via the Step II Agreement); submitting false,

fraudulent, and deceptive statements to the Ohio Board relati ng to the

practice of osteopathic medicine (quarterly reports falsely attesting to full

compliance with the Step II A greement) ; and committing felonies to evad e

the Step II Agreement's terms and monitoring requirements . These violations

found by the Ohio Board were comparable to at least the following grounds

for di scipline : section 459.015(1)(c) (being found guilty of a crime directly

related to the practice or ability to practice osteopathic medicine) ; and section

459.015(1)(bb) (violation of an order) or section 459.015(1)( pp) (violation of a

provision of chapter 456 or 459, or rules adopted pursuant to those chapters) .

76 . Discipline that would have been imposed in Florida if these

substantive violations occurred here most likely would have been license

revocation , considering the context in which the violations o ccurred, as laid

out in the Ohio Board hearing examiner's report and recommendation .

77 . Using the alternative measure in the penalty guidelines for a first

offense also supports revocation as the appropriate penalty .

78 . I n addition to revocation, the pe nalty guidelines rule dictates a fine

ranging from $1,000.00 to $10,000.00.

79 . Rule 64B15 - 19.003 allows for consideration of aggravating or

mitigating circumstances that are proved by clear and convincing evidence , to

deviate from the penalty guidelines . Mitigating factors relevant to this case

are: (2) The length of time since the violations; (3) The number of times the

licensee has been previously disciplined by the Board ; and (7) The effect of

the penalty upon the licensee's livelihood. Relevant aggrava ting factors

include: (9) The actual knowledge of the licensee pertaining to the violation;

(10) Attempts by the licensee to correct or stop violations or refusal by the

licensee to correct or stop violations; and (11) Related violations against the

licens ee in another state .

80 . The undersigned concludes that c onsider ation of the aggravating and

mitigating factors with regard to the appropriate penalty against

Respondent's license does not support deviation from the penalty range to

impose a sanction less than revocation. If anything, the aggravating

circumstances outwei gh the mitigating circumstances.

81. However, with revocation as the undersigned's recommended penalty,

consideration of the impact on the licensee's livelihood mitigates against also

impos ing a monetary fine as the p enalty guidelines rule provides, and to that

extent, a deviation is warranted. That is particularly so because there is no

discretion in requiring an assessment of the costs in investigating and

prosecuting this action. § 456. 07 2(4) , Fla. Stat .

R ECOMMENDATION

Based on the foregoing Findings of Fact and Conclusions of Law, it is

R ECOMMENDED that the Department of Health, Board of Osteopathic

Medicine , enter a final order revoking Respondent, Adam Patrick Hall,

D.O.'s , license t o practice osteopathic medicine and assessing costs against

him for the investigation and prosecution of this matter.

D ONE A ND E NTERED this 15th day of October , 2020 , in Tallahassee, Leon

County, Florida.

E LIZABETH W. M CARTHUR

Administrative Law Judge

D ivision 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 15th day of O ctober , 2020 .

C OPIES F URNISHED :

Michael Jovane Williams, Esquire

Department of Health

4052 Bald Cypress Way , Bin C - 65

Tallahassee, Florida 32399

(eServed)

Ronald W. Chapman, Esquire

Chapman Law Group

6841 Energy Court

Sarasota, Florida 34240

(eServe d)

Lauren Ashley Leikam, Esquire

Chapman Law Group

6841 Energy Court

Sarasota, Florida 34240

(eServed)

Jamal Burk, Esquire

Department of Health

Prosecution Services Unit

4052 Bald Cypress Way , Bin C - 65

Tallahassee, Florida 32399 - 3265

(eServed)

Kama Mo nroe, Exec utive Director

Board of Osteopathic Medicine

Department of Health

Bin C - 06

4052 Bald Cypress Way

Tallahassee, Florida 32399 - 3257

(eServed)

Louise St. Laurent, Gen eral Counsel

Department of Health

Bin C - 65

4052 Bald Cypress Way

Tallahassee, Flor ida 32399 - 3265

(eServed)

N OTICE OF R IGHT T O S UBMIT E XCEPTIONS

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 filed with the agency that will issue the Final Order in this

case.