94-003567 Board Of Veterinary Medicine vs. Harold L. Mcgee Status: Closed Recommended Order on Friday, September 1, 1995.

Summary: Veterinarian kept inadequate medical records. Negligence not established.

STATE OF FLORIDA

DIVISION OF ADMINISTRATIVE HEARINGS

DEPARTMENT OF BUSINESS AND )

PROFESSIONAL REGULATION, BOARD )

OF VETERINARY MEDICINE, )

)

Petitioner, )

)

vs. ) CASE NO. 94-3567

)

HAROLD L. McGEE, D.V.M., )

)

Respondent. )

___________________________________)

RECOMMENDED ORDER

Pursuant to notice, the Division of Administrative Hearings, by its duly

designated Hearing Officer, Claude B. Arrington, held a formal hearing in the

above-styled case on November 17, 1994, in Miami, Florida.

APPEARANCES

For Petitioner: Susan E. Lindgard, Esquire

Department of Business and

Professional Regulation

1940 North Monroe Street

Northwood Centre, Suite 60

Tallahassee, Florida 32399-0792

For Respondent: Roderick L. McGee, Esquire

Gregory J. Prusak, Esquire

Ligman, Martin & Evans

230 Catalonia Avenue

Coral Gables, Florida 33134

STATEMENT OF THE ISSUES

Whether the Respondent, a veterinarian, committed the offenses set forth in

the Administrative Complaint and the penalties, if any, that should be imposed.

PRELIMINARY STATEMENT

On April 15, 1994, the Petitioner filed an Administrative Complaint against

the Respondent that contained certain factual allegations as to his treatment of

a cat named Cathy and as to the medical records he kept for that cat. Based on

those allegations, Petitioner charged Respondent with four separate violations

of statute or rule governing the practice of veterinary medicine.

Count One alleged that Respondent violated Section 474.214(1)(o), Florida

Statutes, by "being negligent or incompetent or committing misconduct related to

the practice of veterinary medicine." The Administrative Complaint alleged that

the following acts establish this violation: failure to remove both horns of

the uterus when he spayed the cat, failure to note the cat's temperature or body

weight for the period May 21-26, 1992, and failure to perform lab work to

determine the cause of the cat's illness following the surgery.

Count Two alleged that Respondent violated Section 474.214(1)(ee), Florida

Statutes, "for failing to keep contemporaneous written medical records as

required by rule of the Board." The Administrative Complaint alleged in Count

Two that the medical records kept for the cat between May 21-26, 1992, do not

contain sufficient information "to justify the diagnosis or determination of

health status or to warrant the treatment administered" as required by Rule

61G18-18.002(1), Florida Administrative Code.

Count Three also alleged that Respondent violated Section 474.214(1)(ee),

Florida Statutes, "by failing to keep contemporaneous written medical records as

required by rule of the Board." The factual allegation underpinning Count Three

is the alleged failure of the Respondent to appropriately document his physical

examinations of the cat during the period May 21-26, 1992.

Count Four alleged that Respondent violated Section 474.214(1)(r), Florida

Statutes, "by being guilty of incompetence or negligence by failing to practice

veterinary medicine with that level of care, skill, and treatment which is

recognized by a reasonably prudent veterinarian as being accepted under similar

conditions and circumstances." This conclusory allegation contains no new

factual allegations.

Respondent timely denied the material allegations of the Administrative

Complaint, the matter was referred to the Division of Administrative Hearings,

and this proceeding followed.

At the formal hearing, the Department presented the testimony of James

Bogdansky, D.V.M., Hugh Fitzpatrick, and Gary Ellison, D.V.M. Dr. Bogdansky is

a veterinarian who performed an autopsy on the cat Cathy. Mr. Fitzpatrick is an

investigator employed by the Department. Dr. Ellison was accepted as an expert

witness in the field of veterinary medicine. Petitioner presented two exhibits,

both of which were accepted into evidence. At the request of the Petitioner,

official recognition was taken of Chapter 474, Florida Statutes, and of Chapter

61G, Florida Administrative Code.

Respondent testified on his own behalf and presented the additional

testimony of Virginia Schoubreck and James L. Diluzio, D.V.M.. Ms. Schoubreck

was, at the times pertinent to this proceeding, Respondent's assistant and

office manager. Dr. Diluzio was accepted as an expert witness in the field of

veterinary medicine.

A transcript of the proceedings was filed on March 3, 1995. Thereafter,

Respondent's attorney filed a motion to strike the transcript which asserted in

general terms that the transcript filed March 3, 1995, was replete with errors.

On April 10, 1995, a revised transcript was filed. Respondent's attorney

asserted, again in general terms, that there were errors in the revised

transcript. The parties were instructed to confer in an attempt to specifically

identify any errors in the revised transcript. Roderick L. McGee, who was

representing Respondent at that juncture, did not cooperate in that effort.

Thereafter, each party was given the opportunity to submit separate errata

sheets to specifically identify each portion of the transcript filed April 10,

1995, that the party considered to contain an error. The Petitioner timely

filed an errata sheet, but the Respondent did not. After the deadline for

identifying any alleged errors had passed, an order was entered that accepted

the transcript filed April 10, 1995, as corrected by the Petitioner's errata

sheet filed June 2, 1995. The order also set the deadline of July 7, 1995, for

the filing of proposed recommended orders. Thereafter, that deadline was

extended to July 31, 1995, after Roderick L. McGee, the attorney in the firm of

Ligman, Martin, and Evans, who had represented the Respondent became unavailable

to represent him further. Gregory J. Prusak, Esquire, another attorney in the

firm of Ligman, Martin, and Evans, was substituted as the attorney of record for

the Respondent.

Because the time for filing post-hearing submissions was, at the request of

the parties, set for more than ten days following the filing of the transcript,

the requirement that a recommended order be rendered within thirty days after

the filing of the transcript was waived. Rule 60Q-2.031, Florida Administrative

Code. Rulings on the Petitioner's proposed findings of fact may be found in the

Appendix to this Recommended Order. Respondent did not file a proposed

recommended order.

FINDINGS OF FACT

1. The parties stipulated that the following factual allegations contained

in the Administrative Complaint were admitted by the Respondent and were not at

issue at the formal hearing. The following findings of fact are based on that

stipulation.

A. Petitioner is the state agency charged

with regulating the practice of veterinary

medicine pursuant to Section 20.165, Chapter

455, and Chapter 474, Florida Statutes.

B. Respondent is a licensed veterinarian

having been issued license number VM 0000231.

C. Respondent's last know address is DBA (sic)

Miami Veterinary Hospital, 3520 N.W. 36th Street,

Miami, Florida 33142.

D. On or about May 19, 1992, J.F. presented

his kitten, aged approximately seven months,

to Respondent for shots, a spay, and boarding.

E. On or about May 19, 1992, Respondent noted

in the kitten's [medical] records that all of

its vital statistics were "ok" or normal.

F. On or about May 20, 1992, Respondent spayed

the kitten. 1/

G. On or about May 21, 1992, Respondent noted

in the kitten's records that it had diarrhea and

no appetite. 2/

H. On or about May 22-24, 1992, Respondent noted

in the kitten's records that it was treated with

antibiotics, fluids, vitamins, and given intensive

care (sic) with hand-feeding.

I. On or about May 25, 1992, Respondent noted in

the kitten's records that its condition was greatly

improved.

J. On or about May 26, 1992, Respondent noted in

the kittens's records that its condition was normal.

K. On or about May 27, 1992, the kitten died. 3/

L. "Spay" is a layman's term which may refer to

an ovariohysterectomy.

M. Respondent failed to perform any lab work on

the kitten when it became ill during the period

after the surgery and until its death.

N. Rule 61G18-18.002(1), Florida Administrative

Code, provides that medical records shall contain

all clinical information pertaining to the patient

with sufficient information to justify the diagnosis

or determination of health status and warrant any

treatment recommended or administered.

2. Respondent had been practicing veterinary medicine in Florida for 48

years at the time of the formal hearing. Respondent testified, credibly, that

he has performed a minimum of 10,000 spays during the course of his practice.

3. At the times pertinent to this proceeding, Respondent was the owner and

sole practicing veterinarian at Miami Veterinary Hospital in Miami, Florida.

4. On May 19, 1992, James Forney presented his cat named Cathy to

Respondent's clinic to be boarded for one week. During that week, the

Respondent was to spay Cathy and give her any appropriate shots. "Spay" is a

layman's term that may refer to an ovariohysterectomy. The term

ovariohysterectomy is generally understood by veterinarians to be a procedure

during which the ovaries and both horns of the uterus are removed.

5. On or about May 20, 1992, Respondent spayed Cathy. Respondent placed

the cat under anesthesia and made a small incision, which he referred to as a

"bottle hole incision". Through this small incision, he removed the ovaries and

a portion of both uterine horns. He did not remove the stumps of either uterine

horn and he did not remove the uterus. The cat died on May 27, 1992.

6. Dr. James Bogdansky performed an autopsy of Cathy on May 28, 1992,

during which he made contemporaneous records of his examination. Dr. Bogdansky

observed that Cathy's uterus and portions of both uterine horns were present.

The ovaries were not present.

7. There was a dispute in the evidence as to whether the Respondent was

negligent by failing to remove all portions of both horns of the uterus when he

spayed the cat. The testimony of Dr. Ellison and that of Dr. Diluzio

established that the preferred medical practice in performing an

ovariohysterectomy is to completely remove through an appropriately placed and

sized incision the ovaries, all portions of both horns of the uterus, and the

uterus. Dr. Ellison testified that there is no medical benefit to leaving

portions of both uterine horns and the uterus and that the chance of a rare,

life-threatening infection (pyometritis) increases when the horns of the uterus

are not removed. 4/ Dr. Ellison further testified that the portions of the

uterine horns not removed may become wrapped around the bladder, causing

adhesions or strictures on the bladder. 5/ Dr. Ellison was of the opinion that

Respondent was negligent in failing to remove both uterine horns and the uterus.

6/

8. From the testimony of the Respondent and Dr. Diluzio, it is found that

veterinarians in South Florida commonly make a small incision which permits the

removal of the ovaries and thereby sterilizes the animal, but does not permit

the removal of the two horns of the uterus in their entirety. The practitioner

has to exercise clinical judgment to determine how much of the horns of the

uterus will be left. The main benefit of using a smaller incision is that the

animal suffers less trauma from the surgery.

9. Dr. Diluzio agreed that the method described by Dr. Ellison was the

preferred method of performing an ovariohysterectomy. Dr. Diluzio's main

concern was that a subsequently treating veterinarian may assume that the

Respondent had removed both uterine horns and the uterus, which could lead to a

misdiagnosis in the event the cat ever had a uterine infection. Notwithstanding

his concern and the concerns expressed by Dr. Ellison, Dr. Diluzio did not

believe that the method used by the Respondent was below an accepted standard of

care. Dr. Diluzio's opinion is buttressed by evidence as to procedures being

followed by practitioners such as the Respondent.

10. It is concluded that the Petitioner did not establish that the

procedure Respondent followed in spaying Cathy was below an accepted standard of

care. In reaching that conclusion, the undersigned is persuaded by the

testimony of Dr. Diluzio that the procedure followed by Respondent in spaying

the cat, Cathy, is not an uncommon procedure. Since there was no evidence that

he used poor clinical judgment in the procedure he followed, it is found that

Petitioner failed to establish that Respondent was negligent or incompetent by

his spay of the cat, Cathy.

11. Petitioner asserts that the Respondent failed to adequately look for a

working diagnosis of the cause of the cat's illness following surgery. The

Respondent was not asked what his diagnosis was for the postoperative illness.

From Dr. Diluzio's testimony based on the antibiotics and other treatment

administered, it appears that the working diagnosis was infection of unknown

etiology. Respondent did not perform any lab work on the cat in the

postoperative period to determine the cause of the illness. Instead, Respondent

treated the cat symptomatically. The spay occurred on or about May 20, 1992.

The medical records noted that the cat had no appetite on May 21, 1992. The

scanty medical records note that the cat began to improve on May 25, 1992. The

cat's physical condition between the onset of the improvement and the date of

improvement is not reflected by the medical records. The evidence established

that Respondent closely monitored the cat's condition following the surgery and

that he administered treatment to the cat. Except for Dr. Ellison's question as

to why the steroid prednisone was administered, Dr. Ellison and Dr. Diluzio

found no fault with the treatment actually administered by Respondent. Dr.

Ellison was of the opinion that Respondent was negligent in failing to perform

basic blood tests, including a complete blood count, because such tests may have

determined the cause of the cat's illness or indicated the proper course of

treatment. Blood tests could also have helped determine whether the cat was

hemorrhaging internally. Dr. Diluzio was of the opinion that it was acceptable

practice to treat the cat symptomatically for the first few days after surgery

without ordering lab work. Dr. Diluzio opined that since the cat appeared to

improve between the onset of the illness and its death, lab work was not

necessary in this case. Because of these conflicting opinions, both of which

are supported by logical rationale, it is concluded that the Petitioner failed

to establish that Respondent exceeded his clinical judgement or that he

practiced below an accepted standard of care in his postoperative treatment of

this cat by treating the cat symptomatically instead of ordering lab tests.

12. On May 19, 1992, Respondent began a medical record for Cathy on a form

that contained an area for identifying information as to the owner and as to the

animal. The form also had spaces to record the findings of a physical

examination, a description of any abnormal symptoms, any diagnosis made, any

treatment administered, and any appropriate remarks.

13. On May 21, 1992, continuing through May 24, 1992, Respondent noted in

Cathy's records that she was treated with antibiotics, fluids, vitamins, and

given intensive care with hand-feeding.

14. The medical records should have reflected the Respondent's working

diagnosis for the cat's illness so as to justify the treatment administered.

The records do not contain a working diagnosis for the cat's illness and failed

to justify the treatment administered.

15. The medical records should have reflected the dosages of antibiotics

given to the cat. The records do not record the dosages of antibiotics given to

Cathy.

16. The medical records should have stated the reason(s) the cat was given

one cc. of the steroid prednisone (referred to in the records as "pred"). There

were no medical records kept that justified the administration of this steroid.

17. The medical records should have reflected the findings of his physical

examinations following the surgery. The medical records kept by Respondent did

not reflect the findings of his physical examinations of the cat during that

period. He failed to document the physical examinations he made after the cat's

operation. He did not record the cat's weight, its daily temperature, or the

dosages of the antibiotics administered.

18. Petitioner established that the postoperative care given the cat was

not adequately documented by Respondent's medical records.

19. Respondent had never, prior to this proceeding, been the subject of a

disciplinary action by the Department. During the course of his practice,

Respondent served four years on the Board of Veterinary Medicine for the State

of Florida, has served as the president of the South Florida Veterinary

Association and as the treasurer of the state association.

CONCLUSIONS OF LAW

20. The Division of Administrative Hearings has jurisdiction of the

parties to and the subject matter of this proceeding. Section 120.57(1),

Florida Statutes.

21. Petitioner has the burden of proving by clear and convincing evidence

the allegations against Respondent. See Ferris v. Turlington, 510 So. 2d 292

(Fla. 1987); Evans Packing Co. v. Department of Agriculture and Consumer

Services, 550 So.2d 112 (Fla. 1st DCA 1989). Evans Packing, supra, 550 So. 2d

112, 116, fn. 5, provides the following pertinent to the clear and convincing

evidence standard:

That standard has been described as follows:

[C]lear 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 evidence must be

precise 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 the

firm belief of (sic) conviction, without hesitancy,

as to the truth of the allegations sought to be

established. Slomowitz v. Walker, 429 So.2d 797,

800 (Fla. 4th DCA 1983).

22. Chapter 474, Florida Statutes, regulates the practice of veterinary

medicine in the State of Florida.

23. Section 474.214, Florida Statutes, authorizes the Petitioner to

discipline the licensure of a veterinarian and sets forth the following grounds

pertinent to this proceeding:

(1) The following acts shall constitute the

grounds for which the disciplinary actions in

subsection (2) may be taken:

* * *

(o) Fraud, deceit, negligence, incompetency,

or misconduct, in or related to the practice

of veterinary medicine.

* * *

(r) Being guilty of incompetence or negligence

by failing to practice medicine with that level

of care, skill, and treatment which is recognized

by a reasonably prudent veterinarian as being

acceptable under similar conditions and circum-

stances.

* * *

(ee) Failing to keep contemporaneously written

medical records as required by rule of the board.

24. Rule 61G18-18.002, Florida Administrative Code, has been duly adopted

by the Petitioner and requires veterinarians to keep medical records for each

patient. The rule provides, in pertinent part, as follows:

(1) There must be an individual medical record

maintained on every patient examined or administered

to by the veterinarian . . . The medical record

shall contain all clinical information to justify

the diagnosis or determination of health status

and warrant any treatment recommended or administered.

* * *

(3) Medical records shall be contemporaneously

written and include the date of each service

performed. They shall contain the following

information:

Name of owner or agent.

Patient identification.

Record of any vaccinations administered.

Complaint or reason for provision of services.

History.

Physical examination.

Any present illness or injury noted.

Provisional diagnosis or health status

determination.

25. Count One of the Administrative Complaint alleged that Respondent

violated Section 474.214(1)(o), Florida Statutes, by "being negligent or

incompetent or committing misconduct related to the practice of veterinary

medicine." The Administrative Complaint alleges that the following acts

establish this violation: failure to remove both horns of the uterus, failure

to note the cat's temperature or body weight for the period May 21-26, 1992, and

failure to perform lab work to determine the cause of the cat's illness

following the surgery. As discussed in the findings of fact portion of this

Recommended Order, the Petitioner failed to establish that the Respondent acted

below an accepted standard of care in making a small incision and in leaving a

portion of the horns of the uterus. The Petitioner did not establish, clearly

and convincingly, that the standard of care dictates that the horns of the

uterus be removed. Petitioner established by clear and convincing evidence that

Respondent failed to note the temperature and body weight of the cat during the

period May 21-26, 1992, and that he failed to note the dosages of the

antibiotics administered. That failure, however, should be considered a failure

to keep adequate medical records as required by Section 474.214(1)(ee), Florida

Statutes. There was no evidence that the Respondent did not weigh the cat or

take its temperature or that he failed to properly administer medications to the

cat postoperatively. Petitioner also failed to establish that Respondent

exceeded his clinical judgment in his postoperative care of the cat.

26. Count Two and Count Three alleged that Respondent violated Section

474.214(1)(ee), Florida Statutes, "for failing to keep contemporaneous written

medical records as required by rule of the Board." This allegation is based on

the medical records kept by the Respondent between the time of the spay and the

time of the cat's death. Petitioner established by clear and convincing

evidence by establishing that the medical records do not contain a diagnosis of

the cat's postoperative illness so as to justify the course of treatment, do not

contain sufficient information as to the cat's physical examination, do not

contain sufficient information as to the doses of antibiotics administered, and

do not contain sufficient documentation to justify the use of a steroid.

Petitioner has asserted these violations in two separate counts. The factual

allegations that underpin both Count Two and Count Three were established by

clear and convincing evidence.

27. Count Four alleged that Respondent violated Section 474.214(1)(r),

Florida Statutes, "by being guilty of incompetence or negligence by failing to

practice veterinary medicine with that level of care, skill, and treatment which

is recognized by a reasonably prudent veterinarian as being accepted under

similar conditions and circumstances." As discussed above, the evidence fails

to establish that Respondent was negligent by using the "keyhole" procedure to

spay the cat or in his postoperative care of the cat. The only violations

established in this proceeding pertained to medical records. Consequently, it

is concluded that Petitioner failed to establish a violation by clear and

convincing evidence that Respondent violated the provisions of Section

474.214(1)(r), Florida Statutes, as alleged in Count Four.

28. Rule 61G18-30.001(ee), Florida Administrative Code, provides that the

recommended penalty for a violation of Section 474.214(1)(ee), Florida Statutes,

consists of the issuance of a reprimand, the imposition of probation for six

months, and the assessment of investigative costs. In considering the penalty

to imposed in this proceeding, the undersigned has considered the foregoing

guidelines, that there was no evidence as to the costs of investigation, and

that Respondent has practiced veterinary medicine in the State of Florida for 48

years with distinction and without any prior disciplinary action being brought

against him.

RECOMMENDATION

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

RECOMMENDED that the Petitioner enter a final order that adopts the

findings of fact and conclusions of law contained herein. Based on those

findings and conclusions, it is recommended that Petitioner find Respondent not

guilty of the violations alleged in Counts One and Four of the Administrative

Complaint, and guilty of the violations alleged in Counts Two and Three of the

Administrative Complaint. For the violations of Counts Two and Three, it is

recommended that the Petitioner issue Respondent a formal reprimand and place

his licensure on probation for a period of six months.

DONE AND ENTERED this 1st day of September, 1995, in Tallahassee, Leon

County, Florida.

___________________________________

CLAUDE B. ARRINGTON

Hearing Officer

Division of Administrative Hearings

The DeSoto Building

1230 Apalachee Parkway

Tallahassee, Florida 32399-1550

[phone]

Filed with the Clerk of the

Division of Administrative Hearings

this 1st day of September, 1995.

ENDNOTES

1/ Paragraph 6 of the Administrative Complaint alleged that "[O]n or about May

20, 1992, Respondent spayed the kitten." Respondent admitted this allegation

and the parties stipulated that the fact was not at issue. At hearing, the

Respondent's assistant, Ms. Schoubreck, testified that the cat was spayed on a

Saturday. If her testimony is accurate, the spay occurred on Saturday, May 23,

1992. May 20, 1992, fell on a Wednesday. The date of the surgery is further

called into question by the Respondent's medical record, which appears to record

the spay as being on May 19, 1992. The finding that the spay occurred on or

about May 20, 1992, is based on the stipulation of the parties that the

allegations set forth in paragraph 6 of the Administrative Complaint were not at

issue.

2/ Petitioner Exhibit 1 is the form on which Respondent kept the cat's medical

records. There is no entry on that form reflecting that the cat had diarrhea

while under Respondent's care.

3/ The cause of death of the cat was not established. Respondent is not

accused of causing the death of this cat.

4/ That this infection is rare in cats is underscored by the testimony of Dr.

Ellison, Dr. Diluzio, and the Respondent as to their experiences with this

illness. Dr. Ellison has been a faculty member at the University of Florida

since 1983 where he teaches and does clinical surgery and research. Dr. Ellison

has only seen three cases of pyometritis in cats during his career. Dr.

Diluzio, who has practiced in Florida since 1967, and Respondent, who has

practiced for 48 years in Florida, have never encountered a case of pyometritis

in a cat.

5/ Respondent testified, credibly, that the portions of the horns of the uterus

left in this cat were immature and subject to atrophy following surgery. Based

on that testimony, it is concluded that Dr. Ellison's testimony as to

theoretical damage to the bladder does not provide sufficient rationale to

support a conclusion that the procedure followed by Respondent was below an

accepted standard of care.

6/ The Administrative Complaint does not charge Respondent with failing to

remove the uterus.

APPENDIX TO RECOMMENDED ORDER, CASE NO. 94-3567

The following rulings are made as to the proposed findings of fact

submitted by the Petitioner.

1. The proposed findings of fact in paragraphs 1, 2, 3, 4, 5, 6, 7, 8, 9,

11, 12, 13, 14, 15, 17, 18, 19, 20, 22, 23, 24, 26, 27, and 28 are adopted in

material part by the Recommended Order.

2. The proposed findings of fact in paragraphs 10 and 16 are subordinate

to the findings made.

3. The proposed findings of fact in paragraph 21 are adopted in part by

the Recommended Order, but are rejected to the extent that the course of

treatment if found to be within the clinical judgment of the practitioner.

4. The proposed findings of fact in paragraph 25 are adopted as being the

opinion of Dr. Ellison.

COPIES FURNISHED:

Susan E. Lindgard, Esquire

Department of Business and

Professional Regulation

1940 North Monroe Street, Suite 60

Tallahassee, Florida 32399-0792

Roderick L. McGee, Esquire

LIGMAN, MARTIN & EVANS

230 Catalonia Avenue

Coral Gables, Florida 33134

Susan Foster, Executive Director

Board of Veterinary Medicine

Department of Business and

Professional Regulation

1940 North Monroe Street

Tallahassee, Florida 32399-0787

Lynda L. Goodgame, General Counsel

Department of Business and

Professional Regulation

1940 North Monroe Street

Tallahassee, Florida 32399-0792

NOTICE OF RIGHT TO SUBMIT EXCEPTIONS

All parties have the right to submit written exceptions to this recommended

order. All agencies allow each party at least ten days in which to submit

written exceptions. Some agencies allow a larger period within which to submit

written exceptions. You should contact the agency that will issue the final

order in this case concerning agency rules on the deadline for filing exceptions

to this recommended order. Any exceptions to this recommended order should be

filed with the agency that will issue the final order in this case.