Final Order No. DOH-18-1185- 5 -MQA

DEPARTMENT OF HEALTH,

STATE OF FLORIDA BOARD OF MEDICINE

Petitioner,

vs. DOH CASE NO.: 2012-07498 LICENSE NO.: ME0076692

SHLOMO PASCAL, M.D.,

Respondent.

FINAL ORDER

THIS CAUSE came before the BOARD OF MEDICINE (Board)

pursuant to Sections 120.569 and 120.57(4), Florida Statutes, on

June 8, 2018, in Tampa, Florida, for the purpose of considering

a Settlement Agreement (attached hereto as Exhibit A) entered

into between the parties in this cause. Upon consideration of

the Settlement Agreement, the documents submitted in support

thereof, the arguments of the parties, and being otherwise full

advised in the premises, the Board rejected the Settlement

Agreement and offered a Counter Settlement Agreement which

Respondent was given 7 days to accept. By email dated June 21,

2018, counsel for Respondent timely accepted the Board's Counter

Settlement Agreement on behalf of the Respondent. The Counter

Settlement Agreement incorporates the original Settlement

Agreement with the following amendments:

1. The letter of concern set forth in Paragraph 1 of the

Stipulated Disposition shall be deleted.

2. The costs set forth in Paragraph 3 of the Stipulated

Disposition shall be set at $17,251.30.

3. The Respondent shall be and hereby is Reprimanded by

the Board.

IT IS HEREBY ORDERED AND ADJUDGED that the Settlement

Agreement as submitted be and is hereby approved and adopted in

toto and incorporated herein by reference with the amendments

set forth above. Accordingly, the parties shall adhere to and

abide by all the terms and conditions of the Settlement

Agreement as amended.

This Final Order shall take effect upon being filed with

the Clerk of the Department of Health.

DONE AND ORDERED this :4L7 /4-- day of

2018.

BOARD OF MEDICINE

Claudia Kemp, J.D.,V Executive Director For Jorge J. Lopez, M.D., Chair

CERTIFICATE OF SERVICE

I HEREBY CERTIFY that a true and correct copy of the

foregoing Final Order has been provided by U.S. Mail to SHLOMO

PASCAL, M.D., 1711 NW 123rd Avenue, Pembroke Pines, Florida

33026; to Alex D. Barker, Esquire, Adams, Coogler, Watson &

Merkel, 1555 Palm Beach Lakes Boulevard, Suite 1600, West Palm

Beach, Florida 33401-2329; by email to Allison Dudley, Assistant

General Counsel, Department of Health, at

Allison.Dudley@flhealth.gov; and by email to Edward A.

Tellechea, Chief Assistant Attorney General, at

Ed.Tellechea@myfloridalegal.com this day of

, 2018.

Deputy Agency Clerk

STATE OF FLORIDA DEPARTMENT OF HEALTH

DEPARTMENT OF HEALTH, •

PETITIONER,

v.

SHLOMO PASCAL, M.D.,

RESPONDENT.

CASE NO. 2012-07498

3810

SETTLEMENT AGREEMENT

Shlomo Pascal, M.D., referred to as the "Respondent," and the Department of

Health, referred to as "Department," stipulate and agree to the following Agreement and

to the entry of a Final Order of the Board of Medicine, referred to as "Board,"

incorporating the Stipulated Facts and Stipulated Disposition in this matter.

Petitioner is the state agency charged with regulating the practice of medicine

pursuant to section 20.43, Florida Statutes, and chapter 456, Florida• Statutes, and

chapter 458, Florida Statutes.

STIPULATED FACTS

1. At all times material hereto, Respondent was a licensed physician in the

State of Florida having been issued license number ME 76692.

2. The Department charged Respondent with an Administrative Complaint that

was filed and properly served upon Respondent alleging violations of chapter 458, Florida

S

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Statutes, and the rules adopted pursuant thereto. A true and correct copy of the

Administrative Complaint is attached hereto as Exhibit A.

3. For purposes of these proceedings, Respondent neither admits nor denies

the allegations of fact contained in the Administrative Complaint.

STIPULATED CONCLUSIONS OF LAW

1. Respondent admits that, in his/her capacity as a licensed physician, he/she

is subject to the provisions of chapters 456 and 458, Florida Statutes, and the jurisdiction

of the Department and the Board.

2. Respondent admits that the facts alleged in the Administrative Complaint,

if proven, would constitute violations of chapter 458, Florida Statutes.

3. Respondent agrees that the Stipulated Disposition in this case Is fair,

appropriate and acceptable to Respondent.

STIPULATED DISPOSITION

1. Letter of Concern( - The Board shall issue a Letter of Concern against

Respondent's license.

2. Em - The Board shall impose an administrative fine of nventyThousand

Dollars ($20,000) against Respondent's license which Respondent shall pay to:

Payments, Department of Health, Compliance Management Unit, Bin C-76, P.O. Box 6320,

Tallahassee, FL 32314-6320, within one hundred twenty (120) days from the date of

filing of the Final Order accepting this Agreement ("Final Order). All fines shall be

Paid by cashier's check or money order. Any change in the terms of payment of

DOH v. Sblomo Pascal, M.D., Case Number 2012-07498 Medical Settlement Agreement 2

any fine imposed by the Board must be approved in advance by the Probation

Committee of the Board.

RESPONDENT ACKNOWLEDGES THAT THE TIMELY PAYMENT OF THE

FINE IS HIS/HER LEGAL OBLIGATION AND RESPONSIBILITY AND

RESPONDENT AGREES TO CEASE PRACTICING IF THE FINE IS NOT PAID AS

AGREED IN THIS SETTLEMENT AGREEMENT. SPECIFICALLY, IF RESPONDENT

HAS NOT RECEIVED WRITTEN CONFIRMATION WITHIN 1.35 DAYS OF THE

DATE OF FILING OF THE FINAL ORDER THAT THE FULL AMOUNT OF THE FINE

HAS BEEN RECEIVED BY THE BOARD OFFICE, RESPONDENT AGREES TO CEASE

PRACTICE UNTIL RESPONDENT RECEIVES SUCH WRITTEN CONFIRMATION

FROM THE BOARD.

3. Reimbursement of Costs - Pursuant to Section 456.072, Florida Statutes,

Respondent agrees to pay the Department for the Department's costs incurred in the

investigation and prosecution of this case ("Department costs"). Such costs exclude the

costs of obtaining supervision or monitoring of the practice, the cost of quality assurance

reviews, any other costs Respondent incurs to comply with the Final Order, and the

Board's administrative costs directly associated with Respondent's probation, if any.

Respondent agrees that the amount of Department costs to be paid in this case is

Sixteen Thousand Thirty-Two Dollars and Nine Cents 0161032.04 hut shall

not exceed Eighteen Thousand Thirty-nitro Dollars and Nine Cents

($18,032.09) Respondent will pay such Department costs to: Payments, Department

of Health, Compliance Management Unit, Bin C-76, P.O. Box 6320, Tallahassee, FL

DOH v. Wino Pascal, M.D., Cbse Number 2012-07498 Medical Settlement Agreement 3

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32314-6320, within one hundred twenty (120) days from the date of filing of the Final

Order. All costs shall be mid by cashier' check or money order. Any change in

the terms of payment of costs imposed by the Board must be approved in advance

by the Probation Committee of the Board.

RESPONDENT ACKNOWLEDGES THAT THE TIMELY PAYMENT OF THE

COSTS IS• HIS/HER LEGAL OBLIGATION AND RESPONSIBILITY AND

RESPONDENT AGREES TO CEASE PRACTICING IF THE COSTS ARE NOT PAID

AS AGREED IN THIS SETTLEMENT AGREEMENT. SPECIFICALLY, IF

RESPONDENT HAS NOT RECEIVED WRITTEN CONFIRMATION WITHIN 135

DAYS OF THE DATE OF FILING OF THE FINAL ORDER.THAT THE FULL AMOUNT

OF THE COSTS NOTED ABOVE HAS BEEN RECEIVED BY THE BOARD OFFICE,

RESPONDENT AGREES TO CEASE PRACTICE UNTIL RESPONDENT RECEIVES

SUCH WRITTEN CONFIRMATION FROM THE BOARD.

4. Quality Assurance Consultation/Risk Management Assessment -

Within sixty (60) days of the date of filing of the Final Order, Respondent shall engage

an independent, certified licensed risk manager who will review Respondent's current

practice. Specifically, the independent consultant shall review the office procedures

employed at Respondent's practice and prepare a report addressing Respondent's

practice which shall indude recommended quality assurance improvements of

Respondent's practice ("quality assurance report"). Within six (6) months from the filing

of the Final Order, Respondent will submit the quality assurance report to the Board's

Probation Committee as well as documentation that demonstrates Respondent's

0031 v. Shlomo Pascal, M.D., C3se Number 2012-07498 Medical Settlement Agreement 4

3814

compliance with the recommended improvements. Such documentation shall consist of a

follow-up report completed by the independent consultant or a licensed risk manager that

verifies Reipondents compliance. Respondent shall bear the cost of the initial

consultation and any necessary or appropriate follow-up consultation

5. Probation Language - Effective on the date of the filing of the Final

Order, Respondent's license to practice medicine shall be placed on probation for a period

of six (6) months. The purpose of probation is not to prevent Respondent from practicing

medicine. Rather, probation is a supervised educational experience designed by the Board

to make Respondent aware of certain obligations to Respondent's patients and the

profession and to ensure Respondent's continued compliance with the high standards of

the profession through Interaction with another physician in the appropriate field of

expertise. To this end, during the period of probation, Respondent shall comply with the

obligations and restrictions set forth in this Paragraph.

(a) Indirect Supervision - Respondent shall practice only under the

Indirect supervision of a Board-approved physician, hereinafter referred to as the

"Monitor," whose responsibilities are set by the Board. Indirect supervision does not

require that the Monitor practice on the same premises as Respondent; however, the

Monitor shall practice within a reasonable geographic proximity to Respondent, which

shall be within 20 miles unless otherwise provided by the Board, and shall be readily

available for consultation. The Monitor shall be Board Certified, and actively engaged, in

Respondent's specialty area unless otherwise provided by the Board. Respondent shall

DOH v. Shiomo Pascal, M.D., Case Number 2012-07498 Medical Settlement Agreement S

3815

allow the Monitor access to Respondent's medical records, calendar, patient logs or other

documents necessary for the Monitor to perform the duties set forth in this Paragraph.

• (b) Restriction - Respondent shall not practice medicine without an

approved Monitor/Supervisor, as specified in this Agreement, unless otherwise ordered

by the Board.

(c) Eligibility of Monitor/Supervisor - The Monitor/Supervisor must be a

licensee under chapter 458, Florida Statutes, in good standing and without restriction or

limitation on his/her license. In addition, the Board may reject any proposed

Monitor/Supervisor on the basis that he/she has previously been subject to any

disciplinary action against his/her medical license in this or any other jurisdiction, is

currently under investigation, or is the subject of a pending disciplinary action. The Board

may also reject any proposed Monitor/Supervisor for good cause shown.

(d) Temporary Approval Of Monitor/Supervisor - The Board confers

authority on the Chairman of the Probation Committee to temporarily approve

Respondent's Monitor/Supervisor. To obtain temporary approval, Respondent shall

submit to the Chairman of the Probation Committee the name and curriculum vitae of the

proposed monitor/supervisor at the time this agreement is considered by the Board.

Once a Final Order adopting the Agreement is filed, Respondent shall not

practice medicine without an approved Monitor/Supervisor. Temporary

approval shall only remain in effect until the next meeting of the Probation

Committee.

DOH v. Silo= Paso* M.D., Case Number 2012-07498 Medical Settlement Agreement 6

(e) Formal Approval Of Monitor/Supervisor - Prior to the consideration

of the Monitor/Supervisor by the Probation Committee, Respondent shall provide a copy

of the Administrative Complaint and Final Order In this case to the Monitor/Supervisor.

Respondent shall submit a copy of the proposed Monitor/Supervisor's current curriculum

vita and a description of his/her current practice to the Board office no later than fourteen

(14) days before Respondent's first scheduled probation appearance. Respondent shall

ensure that the Monitor/Supervisor is present with Respondent at Respondent's first

appearance before the Probation Committee. It shall be Respondent's responsibility

to ensure the appearance of the Monitor/Supervisor as directed. If the

Monitor/Supervisor fails to appear as required, this shall constitute a violation of this

Settlement Agreement and shall subject Respondent to disciplinary action.

(f) Change In Monitor/Supervisor - In the event that the

Monitor/Supervisor is unable or unwilling to fulfill the responsibilities of a

Monitor/Supervisor as described above, Respondent shall immediately advise the

Probation Committee of this fact and submit the name of a temporary Monitor/Supervisor

for consideration. Respondent shall not practice pending approval of the

temporary Monitor/Supervisor by the Chairman of the Probation Committee.

Furthermore, Respondent shall make arrangements with his/her temporary

Monitor/Supervisor to appear before the Probation Committee at its next regularly

scheduled meeting. Respondent shall only practice under the auspices of the temporary

Monitor/Supervisor (after approval by the Chairman) until the next regularly scheduled

DOB v. Shloma Pascal, M.D., Case Number 2012-07498 Medical Settlement Agreement 7

3816

meeting of the Probation Committee at which the formal approval of Respondent's new

Monitor/Supervisor shall be addressed.

(g) Responsibilities of Respondent — In addition to .the other

responsibilities set forth in this Agreement, Respondent shall be solely responsible for

ensuring that:

(1) The Monitor/Supervisor submits monthly reports as required

by this Agreement or directed by the Board;

(2) Respondent submits monthly reports as required by this

Agreement or directed by the Board;

(3) The Monitor/Supervisor appears before the Probation

Committee as required by this Agreement or directed by the Board; and

(4) Respondent appears before the Probation Committee as

required by this Agreement or directed by the Board.

(5) Respondent shall pay all costs associated with probation.

Respondent understands and agrees that if either the approved

Monitor/Supervisor or the Respondent fails to appear before the Probation

Committee as required, Respondent shall immediately cease practicing

medicine until such time as both the approved Monitor/Supervisor (or

approved alternate) and the Respondent appear before the Probation

Committee.

(h) Respon5ibilities of the Monitor/Supervisor - The Monitor/Supervisor

shall:

DOH v. Shiamo Pascal, M.D., Case Number 2012-07498 Med(cal SettlementAgreement a

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(1) Review 25 percent of Respondent's active patient records at

least once every month for the purpose of ascertaining compliance with chapters

456 and 458, Florida Statutes. The Monitor shall go to Respondent's office once

every month and shall review Respondent's calendar or patient log and shall select

the records to be reviewed.

(2) Review 25 percent of Respondent's patient records for

patients treated for bipolar disorder, depression, and anxiety; In this regard,

Respondent shall maintain a log documenting all such patients.

(3) Consult with Respondent on all cases involving substance

abuse.

(4) Maintain contact with Respondent on a frequency of at least

once per month. In the event that Respondent does not timely contact the

Monitor, the Monitor shall immediately report this fact in writing to the Probation

Committee.

(5) Submit reports to the Probation Committee on a monthly

basis, in affidavit form, which shall include:

a. A brief statement of why Respondent is on probation;

b. A description of Respondent's practice (type and composition);

c. A statement addressing Respondent's compliance with the terms of probation;

d. A brief description of the Monitor/Supervisor's relationship with Respondent;

DOH v. Shama Pascal, M.D., Case Number 2012-07498 Medical Settlement Agreement 9

3819

e. A statement advising the Probation Committee of any problems that have arisen; and

f. A summary of the dates the Monitor/Supervisor went to Respondent's office, the number of records reviewed, the overall quality of the records ,reviewed, and the dates Respondent contacted the Monitor/Supervisor pursuant to Subparagraph (h)(4), above.

(6) Report immediately to the Board any violations by Respondent

of chapters 456 or 458, Florida Statutes, and the rules promulgated thereto.

(i) Resppnctents RequirectAppearance Before probation Committee -

Respondent shall appear before the Probation Committee at the first meeting of said

Committee following commencement of the probation, at the last meeting of the

Committee preceding scheduled termination of the probation, and at such other times

as directed by the Committee. Respondent shall be noticed by the Board staff of the

date, time and place of the Committee meeting at which Respondents appearance is

required. Failure of Respondent to appear as directed, and/or failure of

Respondent to comply with any of the terms of this Agreement, shall be

considered a violation of the terms of this Agreement, and shall subject

Respondent to disciplinary action.

(j) Monitor/Supervisor's Required Appearance - Respondent's

Monitor/Supervisor shall appear before the Probation Committee at the first meeting of

said Committee following commencement of the probation, and at such other times as

directed by the Committee. It shall be Respondent's responsibility to ensure the

appearance of Respondent's monitor to appear as directed. If the approved

Monitor/Supervisor fails to appear as directed by the Probation Committee,

DOH v. Shlump Pascal, M.D., Case Number 2012-07498 Medical SettlementAgreement 10

Respondent shall immediately cease practicing medicine until such time as the

approved Monitor/Supervisor or alternate approved monitor appears before

the Probation Committee.

(k) Reporting by Respondent - Respondent shall submit monthly reports,

in affidavit form, the contents of which may be further specified by the Board, but which

shall include:

(1) A brief statement of why Respondent is on probation;

(2) A description of practice location;

(3) A description of current practice (type and composition);

(4) A brief statement of compliance with probationary terms;

(5) A description of the relationship with the Monitor/Supervisor;

(6) A statement advising the Board of any problems that have

arisen; and

(7) A statement addressing compliance with any restrictions or

requirements imposed.

Tolling Provisions - In the event Respondent physically leaves the

State of Florida for a period of thirty (30) days or more or otherwise does not engage

full-time in the active practice of medicine in the State of Florida, then certain provisions

of Respondent's probation (and only those provisions of the probation) shall be tolled as

enumerated below and shall remain in a tolled status until Respondent returns to active

practice in the State of Florida:

(1) The time period of probation shall be tolled;

DOH v. Worm Pascal, M.D., Case Number 2012-07498 Medical Settlement Agreement 11

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(2) The provisions regarding direct and indirect supervision and

required reports from the monitor/supervisor shall be tolled;

(3) The provisions regarding preparation of investigative reports

detailing compliance with this Settlement Agreement shall be tolled; and

(4) Any provisions regarding community service shall be tolled.

(m) Active Practice - In the event that Respondent leaves the active

practice of medicine for a period of one year or more, the Board may require Respondent

to appear before the Board and demonstrate his ability to practice medidne with skill and

safety to patients prior to resuming the practice of medicine in this State.

STANDARD PROWSIONS

1. Appearance - Respondent is required to appear before the Board at the

meeting of the Board where this Agreement is considered.

2. No Force or Effect until Final Order - It is expressly understood that

this Agreement is subject to the approval of the Board and the Department. In this

regard, the foregoing paragraphs (and only the foregoing paragraphs) shall have no force

and effect unless the Board enters a Final Order incorporating the terms of this

Agreement.

3. Continuing Medical Education - Unless otherwise provided in this

Agreement Respondent shall first submit a written request to the Probation Committee

for approval prior to performance of said CME course(s). Respondent shall submit

documentation to the Board's Probation Committee of having completed a CME course in

the form of certified copies of the receipts, vouchers, certificates, or other papers, such

DOH v. Worn° Pascal, M.D., Case Number 2012-07498 Medical Settlement Agreement 12

as physician's recognition awards, documenting completion of this medical course within

one (1) year of the filing of the Final Order in this matter. All such documentation shall

be sent to the Board's Probation Committee, regardless of whether some or any of such

documentation was provided previously during the course of any audit or discussion with

counsel for the Department. CME hours required by this Agreement shall be in addition

to those hours required for renewal of licensure. Unless otherwise approved by the

Board's Probation Committee, such CME course(s) shall consist of a formal, live lecture

format

4. Addresset - Respondent must provide current residence and practice

addresses to the Board. Respondent shall notify the Board in writing within ten (10) days

of any changes of said addresses

5. Future Conduct In the future, Respondent shall not violate Chapter 456,

458 or 893, Florida Statutes, or the rules promulgated pursuant thereto, or any other

state or federal law, rule, or regulation relating to the practice or the ability to practice

medicine to include, but not limited to, all statutory requirements related to practitioner

profile and licensure renewal updates. Prior to signing this agreement, the Respondent

shall read Chapters 456, 458 and 893 and the Rules of the Board of Medicine, at Chapter

6488, Florida Administrative Code.

6. Violation of Terms - It is expressly understood that a violation of the

terms of this Agreement shall be considered a violation of a Final Order of the Board, for

which disciplinary action may be initiated pursuant to Chapters 456 and 458, Florida

Statutes.

DOH v. Shiomo Pascal, M.D., Case Number 2012-07498 Medical Settlement Agreement 13

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7. Purpose of Agreement - Respondent, for the purpose of avoiding further

administrative action with respect to this cause, executes this Agreement. In this regard,

Respondent authorizes the Board to review and examine all investigative file materials

concerning Respondent prior to or in conjunction with consideratioh of the Agreement.

Respondent agrees to support this Agreement at the time it is presented to the Board

and shall offer no evidence, testimony or argument that disputes or contravenes any

stipulated fact or conclusion of law. Furthermore, should this Agreement not be accepted

by the Board, it is agreed that presentation to and consideration of this Agreement and

other documents and matters by the Board shall not unfairly or illegally prejudice the

Board or any of its members from further participation, consideration or resolution of

these proceedings.

8. No Preclusion Of Additional Proceedings - Respondent and the

Department fully understand that this Agreement and subsequent Final Order will in no

way preclude additional proceedings by the Board and/or the Department against

Respondent for acts or omissions not specifically set forth in the Administrative Complaint

attached as Exhibit A.

9. Waiver Of Attorney's Fees And Casts - Upon the Board's adoption of

this Agreement, the parties hereby agree that with the exception of Department costs

noted above, the parties will bear their own attorney's fees and costs resulting from

prosecution or defense of this matter. Respondent waives the right to seek any attorney's

fees or costs from the Department and the Board in connection with this matter.

DOH v. Shiamo Pascal, M.D., Case Number 2012-07498 Medical Settlement Agreement 14

10. Waiver of Further Procedural Stens - Upon the Board's adoption of this

Agreement, Respondent expressly waives all further procedural steps and expressly

waives all rights to seek judicial review of or to otherwise challenge or contest the validity

of the Agreement and the Final Order of the Board incorporating said Agreement.

[Signatures appear on the following page.]

DOH v. Shiomo Pascal, M.D., Case Number 2012-07498 Medical Settlement Agreement

IS

3824

SIGNED this at., day of 2018,

NO ARY RAMC

3825

p . 02

Shlamo Pascal, M.D.

STATE OF FLORIDA

COUNTY OF ecoularei

BEFORE ME personally appearedkan whose

identity Is known to me or who produced Lic.cos (type of identification) and who, under oath, acknowledges that his/her signature appears above.

2018. SWORN TO and subscribed before me this 97142_ day of .F Lary

My Commission Expires:

APPROVED this day of 201$.

Celeste Philip, M.D., M.P.H. Surgeon General & Secretary

By: Natalia S. Thomas Assistant General Counsel Department of Health

00ii v. Siblomp Pascal, M.07 Com Number 2412,07490 MedZsiSenlement Agreement 16

3826

STATE OF FLORIDA DIVISION OF ADMINISTRATIVE HEARINGS

FILED DEPARTMENT OF HEALTH

DEPUTY CLERIC CLERK Bri•Otgeil- Cocute5, DATE: o f

DEPARTMENT OF HEALTH,

• Petitioner,

v.

SHLOMO PASCAL, M.D.,

Respondent.

DOH CASE NUMBER 2012-07498

NOTICE OF SCRIVENER'S ERROR

Petitioner, Department of Health, by and through the

undersigned counsel, files this Notice of Scrivener's Error and states:

1. On or about Jarivary 27, 2014, Petitioner filed an Administrative

Complaint in the above-styled matter.

2. Thereafter, Petitioner discovered that a typographical error

appears in the Administrative Complaint as follows:

a. Paragraph 2 states the following:

At all times material to this Complaint, Respondent was a licensed medical doctor within the state of Florida, having been issued license number ME 36792.

b. Paragraph 2 should read:

At all times material to this Complaint, Respondent was a licensed medical doctor within the state of Florida, having been Issued license number ME 76692.

1

correcting the license number.

3. The correction of this error is of no prejudice to Respondent as

the Complaint references the applicable statutes with sufficient specificity

to put Respondent on notice as to the nature of the violations alleged.

4. This Notice shall take effect upon service to the parties.

Respectfully submitted,

Diane K. Kieslin Assistant General sel Florida Bar #233285 DOH Prosecution Services Unit 4052 Bald Cypress Way, Bin C-65 Tallahassee, Florida 32399-3265 (850) 245-4444 ext. 8127 Telephone (850) 245-4684 — Facsimile E-Mail: dianeskiesling@fihealth.gov

CERTIFICATE OF SERVICE

I HEREBY CERTIFY that a true and correct copy of the foregoing Notice of Scrivener's Error was sent by email, Attorney for Respondent, Alex Barker, 1555 Palm Beach Lakes Blvd., 16th Floor, West Palm Beach, Florida 33401, email: abarker@adamscoogler.com, this 10th day of February, 2014.

3827

Diane K. Kiesling Assistant General Cou

2

STATE OF FLORIDA DEPARTMENT OF HEALTH

DEPARTMENT OF HEALTH,

PETITIONER,

v. CASE NO.: 2012-07498

SHLOMO PASCAL, M.D.,

RESPONDENT.

M141111MMMSAMIAM

Petitioner, Department of health, by and, through undersigned

counsel, files this Administrative Complaint before the Board of Medicine

against Respondent; Shiomo Pascal, M.D., and In support thereof alleges:

1. Petitioner is the state department charged with regulating the

practice of Medicine pursuant to Section 20.43, Florida Statutes; Chapter

456, Florida Statutes; and Chapter 458, Florida Statutes.

2. At - all times material to this Complaint, Respondent was a

licensed medical doctor within the state of Florida, having been issued

license number ME 36792.

3. Respondent's address of record Is 1701 Northwest 123'd

Avenue, Pembroke Pines, Florida 33026.

4. Respondent is not board certified, but specializes in Psychiatry.

3828

5. Respondent provided treatment to Patient R.H. (RH), a then 25

year-old male, from August 9, 2009, until September 14, 2011.

6. The original set of medical rearrds provided by Respondent

were virtually illegible; therefore, through counsel, Respondent provided a

"second" set of medical records that purported to be a set that was

"transcribed" with his assistance to simply put his writing into legible form.

In fact the second set of medical records appears to contain additional

notes and materials and deletes other material.

7. Respondent first saw RH on August 1, 2009, and noted that RH

was receiving Xanax from his primary care physician. The patient reported

a history from 2003-2008 of substance abuse on Ecstacy, Cocaine, Heroin,

LSD, and Ketamine. He also reported current daily use of marijuana.

Respondent prescribed Remeron 15 mg, an antidepressant, Buspar 15 mg

BID, and Ambien 10 mg QHS, a sedative.

8. Xanax is the brand name for aiprazolam and is prescribed to

treat anxiety. According to Section 893.03(4), Florida Statutes, aiprazolam

is a Schedule IV controlled substance that has a low potential for abuse

relative to the substances in Schedule III and has a currently accepted

medical use in treatment in the United States. Abuse of alprazolam may

DOH v. Mom° Pascal, M.D. 2 DOEI Cnchlo. 2012-07498

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lead to limited physical or psychological dependence relative to the

substances in Schedule III.

9. Respondent initially diagnosed RH with Major Depressive

Disorder, Generatired Anxiety Disorder, and Post Traumatic Stress Disorder. -

10. Respondent next saw RH on September 2, 2009. In the notes

from that visit there is no documentation of the continuation of Remeron.

Respondent added Xanax 1mg, Seroquel XL 150 mg, Lamictal and

Straterra, both with no strength specified. For several of these

medications there was no slated dosage. Respondent did not reference

the fact that on RH's first visit he was receiving Xanax from his primary

care physician or that RH had reported prior substance abuse. Respondent

did inaccurately mark the space that said that no changes in medications

had been made.

11. The next progress note was on October 6, 2009, at which time

Respondent noted that RH was clinically depressed,- but he prescribed no

antidepressant. Instead, Respondent prescribed Tranxene 7.5 mg TID, a

sedative, for no presenting symptoms. Additionally RH's Buspar was

increased to 15 mg QD, with no documented justification.

12. Respondent next saw RH on November 4, 2009, at which time

he documented that RHt insight was impaired and his mood was DOTI Y. &Ikon Pascal,. M.D. DOH enallo. 201207498

depressed. The medications listed were Seroquel XR 400 QD and Valuim

10 mg TID, even though neither is appropriate for those complaints. The

notes do not address what other medications RH was on, even though

prior notes list several drugs that he had been prescribed. One cannot

discern whether RH is on both Xanax and Valium, in which case he would

be on two benzodiazapines, which does not meet the standard of care.

13. Valium Is the brand name for diazepam and is prescribed to

treat anxiety. According to Section 893.03(4), Florida Statutes, diazepam

is a Schedule IV controlled substance that has a low potential for abuse

relative to the substances in Schedule III and • has a currently accepted

medical use in treatment in the United States. Abuse of diazepam may

lead to limited physical or psychological dependence relative to the

substances in Schedule M.

14. On December 4, 2009, RH reported that he had a problem and

was currently in a 30 day treatment program. Respondent prescnbed

Pexeva 20 mg QAM, an antidepressant, but does mention discussing risk of

Valium. The notes inaccurately state that no new medications were given;

however, the actual medications prescribed cannot be determined.

15. On December 19, 2009, the progress notes stated ghat RH is

doing well since he has been on Xanax; however RH had. been on Xanax

DOH v. Shionso Paws/. MD. 4 AOff Cac No. 2012.07498

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since his initial visit. Additionally, the progress notes since that initial visit

do not document that Xanax had been prescribed by Respondent.

Respondent documented his diagnosis as Generalized Anxiety.Disorder and

Severe Headaches, but he did not seek any neurology consultdoes not

identify what medications Respondent was talking about and the progress

notes do not list RH'S current medications.

16. The patient's next visit was on January 23, 2010. The

diagnosis was changed_ to BPD • (probably meaning Bipolar Disorder,

although more commonly the abbreviation for Borderline Personality

Disorder), Generalized Anxiety Disorder, and ADHD. The records contain

no supportive information or discussion as to why any of these diagnoses

were listed and the medications that had been previously prescribed are

not consistent with these diagnoses. The notes also describe RH as

"angry", but there is no follow up for that symptom. Respondent

prescribed Sbateria and gave samples with no indication of Why. Finally,

there was no documentation of consent or reason for prescription of

Seroquel. •

17. Respondent next saw RH on February 27, 2010. Respondent

documented changes tothe prescriptions dramatically and the "tronscribed"

notes do not match the original notes. In the original noteS, notations at

DOH v. Mateo Nola; M.D. 5 DOB Ow Xo. 201247458

3833

the bottom of the page indicate the words "Xanax" In two places with

dosages and they are crossed through. Those notes are not on the

"transcribed' notes. Further; accepting that the transcribed notes are

accurate, Respondent added a prescription for Lithium 300 mg po BID,

. Klonopin 1 mg TID, Seroquel XR 400 mg QHS. Seroquel XR 400 Qty is a

antipsychotic at a high dosage level. The notes also stated to discontinue

Valium, but at a different place prescribed Valium 10 mg (a heavy sedative

level) with no frequency indicated. Additionally In the bottom margin, a

prescription for Klonopin is noted for 20 mg TID, twice the dosage from

that stated earlier in the notes. Finally, in the top margin, a prescription

for Adderal [Adderall] 20 mg po QAM is noted and a prescription for

Kapuay twice daily is noted.

18. Adderall is the brand name for a drug that contains

amphetamine, commonly prescribed to treat attention deficit disorder.

A

According to Section 893.03(2), Florida Statutes, amphetamine Is a

Schedule II controlled substance that has a high potential for abuse and

has a currently accepted but severely restricted medical use in treatment in

the United States. Abuse of amphetamine may lead to severe

psychological or physical dependence.

DOR v. Staten* Pascal, ALD. 6 DOH Cate No. 2012.07498

‘,A

19. Klonopin is the brand name for donazepam and is prescribed

to treat anxiety. According to Section 893.03(4), Florida Statutes,

donaiepam is a Schedule IV controlled substance that has a low potential

for abuse relative to the substances in Schedule III and has a currently

accepted medical use in treatment in the United States. Abuse of

clonaz.epam_ may lead to limited physical or psychological dependence

relative to the substances in Schedule III.

20. On March 22, 2010, Respondent saw RH and the transcribed

notes are confusing. Notes stated an order to discontinue

benzodiazepines; however, in the next line Respondent prescribed Xanax 1

mg po QID. Xanax is a benzodiazepine. Respondent also prescribed

Prozac 20 mg QAM.

21. The patient's next visit was June 22, 2010; however the notes

for that date are confusing. The transcribed noted indicate Ariderall 30 mg

BID, an amphetamine, was prescribed. Doxepin SO mg QHS, an

antidepressant, was prescribed by another physician and • Respondent

noted that he placed a call to that physician, without noting the results.

Respondent increased the Doxepin to 100 mg QHS. The transcribed note

also indicated that Respondent prescribed Oleptro 100 mg 11/2 pID and 1

QHS. However, the progress notes statd that no new meilications were

nag v. Waco Pascal. M.D. 7 DOH Casettio. 2012477498

3834

prescribed. Clearly that indication is erroneous. The original notes do not

appear to coincide with these second notes. The original notes appear to

contain the word Paxil in the margin and not Oteptro anywhere.

22. Respondent next saw RH on lily 19, 2010, when RH arrived 50

minutes late and was described as "bizarre." No notation of medication

changes was made.

23. The next visit was August 23, 2010, however the notes were

inadequate and incomplete. Respondent added Fanapt, an antipsychotic

medication, for use as a mood stabilize; and described giving risks of

Xanax and Remeron. There was no informed Consent for Fanapt. There

was no indication of Xanax on the medication list. Further Adderall 30 mg

BID was prescribed. The notes state that no new medication was given,

which is clearly erroneous.

24. Respondent next .saw RH on September 20, 2010, when

Topornax 20 mg BID, an anticorwulsant, was prescribed. However there

was no Indication in the notes as to why this medication was prescribed.

The note also documented the Kionopin was discontinued, but the last

documented prescription for Klonopin was February 27, 2010. Finally there

was no documentation of what happened with the prescription of Fanapt.

DOR v. Shlomo Pasta. M.D. 8 DOH CaseNo. 2012.07498

3835

25. On October 20, 2010, when Respondent next saw RH,

Respondent prescribed Xanax 2 mg TID (double the prior dose), Retneron

45 mg sol tab, and Seroquel XR 50 mg. There is no documentation of what

happened to the Fariapt or the Topamax; there is no rationale given for the

changes; there is no informed consent; and there is no explanation for why

the notes say there no new medications.

26. Respondent saw RH on November 19, 2010, and, again the

notes cannot be reconciled. The only medications listed for RH were

Adderail 30 mg QAM and Xanax 2 mg TID, which are both controlled,

addictive substances. While the notes state that RH does "much better on

current meds," there is no documentation to support that statement.

Respondent added Doxepin 200 mg with no indication as to why and the

dosage given is higher that the usual starting dose. Respondent simply

failed to document RH's medications, justifications for them or for any

changes, and the doses given.

27. On December 14, 2010, Respondent saw RH for a diagnosis of

Bipolar Disorder. There is no explanation of why the diagnoses of Major

Depressive Disorder, ADHD, and General Anxiety Disorder are no longer

being listed or treated. Serowe' XR discontinued even though jt was last

prescribed in OdtDber. Respondent started RH on Saphris 10 mg BID, but

DOE v. Mb= Pascal. max 9 DOR CascNo. 2012437498

3836

gave no indication or rationale for the medication or why he stopped the

antipsychotics or whether other medications were being administered

currently from prior visits.

28. At the next visit on January 21, 2011, Respondent's notes

documented that RH reported difficulty sleeping. Respondent prescribed

Prosom 2 mg po QD, a sedative. The half life of Prosom Is 24 hours,

therefore the standard of care would require that It be prescribed for HS

dosing (one time per day). Additionally, there was no documentation of

whether RH was still taking Xanax or any other sedatives concurrently with

Prosom or whether the Xanax prescribed In November had been

discontinued.

29. Respondent next saw RH on February 21, 2011, and noted a

diagnosis of Generalized Anxiety Disorder. He did not document whether

this is in addition to Bipolar Disorder or to the exclusion of the previous

diagnoses. The patient continued to report problems sleeping and

Respondent prescribed Lunesta, a sedative, without documenting what

action he was taking regarding the Prosom. He also documented

wremazepam stopped", but he had never started Temazepam. The original

note actually appears to say rpm, not "stopped."

DOH v. Sk..4crao E !SSD. I0 DON Case Nix 2012-07498

3837

30. The patient next saw Respondent on March 21, 2011, at which

time Respondent diagnosed Generalized Anxiety Disorder, Bipolar Disorder

and Major Depressive Disorder. Difficulty sleeping is again documented

and medications listed are Xanax and Neurontin, an anticonvulsant. No

explanation is documented for the Neurontin prescription. The Adderall is

continued, but there is no explanation as to why a stimulant is continued if

the patient is having difficulty sleeping. Additionally, Seroquel XL 40 mg

was prescribed even though Respondent had repeatedly started and

stopped the medication without any indications of the reasons for starting

and stopping the medication.

31. At the April 21, 2011, visit, Respondent wrote prescriptions for

Rozeren 8 mg and Restoril, a sedative, although there is no way to

comprehend from the notes why those medications were prescribed.

Additionally, there was no documentation as to what happened to all the

prior prescribed medications: Temazepam, Seroquel XL, Neurontin,

Adderall, Doxepin, and Prosom.

32. Respondent next saw RH on May 17, 2011, and prescribed

Xanax and Neurontin, both having sedative effects. Respondent restarted

RH on Saphris. None of the previously prescribed medications are

addressed.

DOH v. Salem Pascal, M.D. DOii CiteNa. 2012-07499

3838

33. On June 16, 2011, Respondent documented a visit with RH in

which RH complained of "consistent panic attacks." Despite this,

Respondent continued the prescription for Adderali 20 mg QD.

Respondent also prescribed Seroquel XL increased from 200 to 300 mgs

and discontinued the Saphis. He continued the Xanax 2 mg TID and the

Restoril 30 mg QHS. Respondent ordered no laboratory testing to

determine if RH was using the drugs as prescribed or using other drugs,

legal or illegal, which Respondent did not know about

34. On July 13, 2011, Respondent saw RH and documented at the

bottom of the page that he had discussed the risks of Lamictal; however,

there was no documentation that RH had ever been prescribed Lamictal.

Respondent diagnosed Generalize Anxiety Disorder, Bipolar Disorder and

Major Depressive Disorder. In the note, RH was prescribed Xanax 2 mg

T1D and Latuda 40 mg QHS was added. Both are antipsythotics; however

there is no documentation of the Indication for the prescriptions. The note

also documented Seroquel XL 200 mg plus 300 mg, with no explanation.

Further at the top of the note it states that RH is on both Xanax and

Restonl with no further indications, both of which are heavy sedatives.

35. At the visit on August 16, 2011, it cannot be 4etermined

whether the prescriptions of Xanax 2 mg TID and Remeron 45 mg QHS are

DOH v. Sbiomo Puce. M.D. 12 DOB Cue No. 2012.074911

3839

3840

in addition to all or some of the other medications or if all or some of the

other medications were discontinued.

36. The last visit with RH Is documented on September 4, 2011.

Respondent prescribed Trifeptal 300 mg BID, an anticonvulsant, Mellaril 50

mg QD, an antipsychotic, Xanax 2 mg TID, Viibryd 40 mg QD, an

antidepressant, Trileptal 300 mg BID (which is a repeat of the previous

prescription of the same date), and Mellaril 25 mg QD (which may be in

addition to or instead of the 50 mg dosage of the same date). No

indication was documented for any of these medications or changes in

medications.

37. The standard of care requires an indication of why certain

diagnoses are given throughout the records. Respondent made diagnoses

that included at various times Generalize Anxiety Disorder, Bipolar Disorder,

Major Depressive Disorder, and ADHD, • with no indication of why the

kk

diagnoses were given. There was no evidence in the record that RH met

the criteria for any of these disorders and there was no documentation of

the exact symptoms RH was complaining of to support the diagnoses.

Respondent noted no thought process behind the diagnoses. Therefore

Respondent failed to meet the standard of care in diagnosing RH,

DOH v. Sidatuo Pucal,M.D. 13 DOEf Csso Ka. 201247498 -

38. The standard of care requires that the rationale for treatment

and medication be given. Respondent gave no indications for the

treatment or lack of treatment and gave no indications for the medications

prescribed or the manner in which they were prescribed. Throughout

Respondent's treatment of RH, he documented at almost every visit that

no changes in medication had been made. This notation was inaccurate.

Further, despite Rigs self-reported history of poly-substance abuse,

Respondent prescribed multiple controlled substances, some concurrently

and without any rationale. Respondent failed to meet the standard of care

by failing to provide any indications for the treatment given or not given or

for the medications prescribed or, the manner in which they were

prescribed.

39. Based on RN's history of substance abuse, prescribing Adderall,

a Schedule II controlled amphetamine stimulant, along with three sedative

drugs throughout the day is below the standard of care. Clinically

prescribing amphetamine concurrently with a sedative to treat a diagnosis

of Generalized Anxiety Disorder would only exacerbate the illness.

Additionally, the medications prescribed do not rationally address the

diagnosis of Major Depressive Disorder because the Resporldent only

DOH v. Mono Pa sal. 14 DOH C0042. 201247498

3841

3842

•••• •-••••••••• ..... •

sporadically prescribed antidepressant medications. These prescribing

practices were below the standard of care.

40. The standard of care requires that Respondent pertbim a

complete. Initial assessment. Respondent documented no initial

assessment

41. The standard of care requires that Respondent refer RH for

additional evaluation and therapeutic assessment once it because apparent

that RH was deteriorating despite seeing Respondent Failure to do so is

below the standard of care.

42. The standard of care requires the Respondent order periodic

laboratory testing, including illicit substances, to determine whether there

was any additional possible explanation for RH's condition. Respondent

failed to meet the standard of care by ordering laboratory testing.

43. The standard of care requires that the patient's complaints and

symptoms be adequately evaluated, but there is no evidence that

Respondent met this standard of care when' his treatment is taken as a

whole.

COUNT ONE

44. Petitioner realleges and incorporates paragraphs, one . (1)

through forty-three (43) as if fully set forth herein. Deli v. Shia= Nara; MD. 15 10011 Caw No. 21/124114511

45. Section 458.331(1)(t)1., Florida Statutes (2009-2011), subjects

a medical doctor to discipline by the Board of Medicine for committing

medical malpractice as defined in Section 456.50. Section 456.50, Florida

Statutes (2009-2011), defines medical malpractice as the failure to practice

medicine in accordance with the level of care, skill, and treatment

recognized in general law related to health care ilcensure.

46. The level of care, skill, and treatment recognized in general law

related to health care lioansure means the standard of care specified in

Section 766.102. Section 766.102(1), Florida Statutes (2009-2011),

defines the standard of care to mean " . . The prevailing professional

standard of care for a given health care provider shall be that level of care,

skill, and treatment which, in light of all relevant surrounding

drcumstances, is recognized as acceptable and appropriate by reasonably

prudent similar health care providers. . .

47. Respondent fell below the standard of care in one or more of

the following ways:

a. By diagnosing at various limes Generalized Anxiety Disorder,

Bipolar Disorder, Major Depressive Disorder, and ADHD with

no indications of why the diagnoses were given and without

the criteria for those diagnoses;

3843

DOH v. Odom Pascal. MED. 16 DOn Ciaa No. 201247448

b. By falling to have any rationale for the treatment and

medications given;

c. By failing to give any indications for the treatment or lack of

treatment and any indications for the medications prescribed

or the manner in which they were prescribed;

d. By prescribing Adderall, a Schedule II controlled

amphetamine stimulant; along with three sedative drugs

throughout the day;

e. By prescribing amphetamine concurrently with a sedative to

treat.a diagnosis of Generalized Anxiety Disorder;

f. By falling to rationally address the diagnosis of Major

Depressive Disorder because of sporadically prescribing

antidepressant medications; •

g. By failing to perform a complete initial assessment;

h. By failing to refer RH for additional evaluation and

therapeutic assessment once it became apparent that RH

was deteriorating despite seeing Respondent;

i. By failing to order periodic-laboratory testing, including for

Illicit substances, to determine whether there, was any

additional possible explanation for RH's conditkon;

noses Memo Pascal, MD. 17 DOH Coo lin. 201247498

3844

3845

j. By failing to adequately evaluate RH's complaints and

symptoms.

48. Based on the foregoing, Respondent has violated Section

458.331(1)(t)1., Florida Statutes (2009-2011), by committing medical

malpractice.

COUNT TWO

49. Petitioner realleges and incorporates paragraphs one (1)

through forty-three (43) as if fully set forth herein.

50. Section 458.331(1Xm), Florida Statutes (2009-2011), subjects

a medical doctor to discipline by the Board of Medicine for failing to keep

legible, as defined by department rule in consultation with the board,

medical records . . . that justify the course of treatment of the patient,

inducting, but not limited to, patient histories; examination results; test

results; records of drugs prescribed, dispensed, or administered; and

reports of consultations and hospitalizations.

51. Respondent failed to keep legible medical records that justified

the course of treatment, in one or more of the following ways:

a. By keeping' such Illegible medical records that they

needed "transcribing";

DOH v. alma Pascal, MD. 18 DOH Caw tro. 2012-07498

b. By failing to document the indications of why the

diagnoses were given;

c. By failing to document that RH met the criteria for any of

these disorders diagnosed because there was no documentation of

RH's exact complaints or symptoms;

d. By failing to document his thought process behind the

diagnoses;

e. By failing to document the rationale for treatment and

medication given;

f. By failing to document the Indications for the treatment

or lack of treatment and indications for the medications prescribed or

the manner in which they wemprescribed;

g. By falling in perform a complete initial assessment;

h. By failing to document Rigs symptoms and complaints.

52. Based on the foregoing, Respondent has violated Section

458.331(1)(m), Florida Statutes (2009-2011), for falling to keep legible, as

defined by department rule in consultation with the board, medical records

. . that justify the course of treatment of the patient, including, but not

limited to, patient histories; examination results; test results; records of

DOH. Womb Foca, MD. 19 DOB Cue No. 20120749B

3846

drugs prescribed, dispensed, or administered; and reports of consultations

and hospitalizations.

COUNT THREE

53. Petitioner reaileges and incorporates paragraphs one (1)

through forty-three (43) as If fully set forth herein.

54, Section 458.331(1)(nn), Florida Statutes (2009-2011), subjects

a medical doctor to discipline by the Board of Medicine for violating any

provision of Chapter 458 or Chapter 456, or any rules adopted pursuant

thereto.

55. Rule 64138-9.003(2) and (3), Florida Administrative Code (FAC),

provide as follows:

(2) A licensed physician shall maintain patient medical records in English, in a legible manner and with sufficient detail to dearly demonstrate why the course of treatment was undertaken. (3) The medical record shall contain sufficient information to identify the patient, support the diagnosis, Justify the treatment and document the course and results of treatment accurately, by including, at a minimum, patient histories; examination results; test results; records of drugs prescribed, dispensed, or administered; reports of consultations and hospitalizations; and copies of records or reports or other documentation obtained from other health care practitioners at the request of the physician and relied upon by the physician in determining the appropriate treatment of the patient

Don v. Shim* Pitted, MD. Mal Cue No. 2012-07498 2°

3847

56. Respondent failed to comply with Rule 64B8-9.003(2) and (3),

FAC, in one or more of the following ways:

a. By failing to maintain legible patient medical records;

b. By failing to maintain patient medical records that

support the diagnoses;

c. By failing ID maintain patient records that justify the

treatment;

d. By failing to document the course and results of

treatment accurately;

e. By falling to maintain patient medical records that

accurately record drugs prescribed, dispensed, or administered.

57. Based on the foregoing, Respondent has violated Section

458.331(1)(nn), Florida Statutes (2009-2011), by violating Rule 64B8-

9.003(2) and (3), Florida Administrative Code (FAC)

WHEREFORE, the Petitioner respectfully requests that the Board of

Medicine enter an order Imposing one or more of the following penalties:

permanent revocation or suspension of Respondentt license, restriction of

practice, Imposition of an administrative fine, issuance of a reprimand,

placement of the Respondent on probation, corrective ac tion„mfund of

DOH% Salaam Pasc4, M.D. 21 DOEICaseNo. 101247498

3848

fees billed or collected, remedial education and/or any other relief that the

Board deems appropriate.

[Signatures appear an the following pageJ

3849

DOH v. Sidocao Paws; M.D. 22 DOH Con Na. 2012-07498

SIGNED this eV day of 2014.

3850

FILED

John H. Armstrong, MD, RCS, FCCP State Surgeon General & Secretary of Health, State of Florida

lane K. iGesling Assistant General Florida Bar # 233285 DOH-Prosecution Services Unit 4052 Bald Cypress Way-Bin C-65 Express Mall-2585 Merchants Row, Ste. 105 Tallahassee, Florida 32399-3265 (850) 245-4444, Ext. 8127 (850) 245-4684. fax E-Mail: diane.kiesling@flhealth.gov

DKK

PCP Date: January 24, 2014

tok PCP Members: Dr. El-Bahri, Dr. On; Ms. Tootle

DOH v. Shlomo Pascal, M.D., Case No, 2012-07498

DOH v. SiTamo Popealv M.D. DOH Cue No. 201247498

001-I v. Shtomo Pascal, M.D., Case No. 2012-07498

NOTICE OF RIGHTS

Respondent has the right to request a hearing to be conducted in accordance with Section 120.569 and 120.57, Florida Statute* to be represented by counsel or other qualified representative, to present evidence and argument, to call and cross-examine witnesses and to have subpoena and subpoena duces tecum Issued an his or her behalf if a hearing is requested.

NOTICE REGARDING ASSESSMENT OF COSTS

Respondent is placed on notice that Petitioner has incurred casts related to the investigation and prosecution of this matter. Pursuant to Section 456.072(4), Florida Statutes, the Board shall assess .costs related to the investigation and prosecution of a disciplinary matter, which may include attorney hours and costs, on the Respondent in addition to any other discipline imposed.

3851

DOH v. Malmo Poscal, MA% 24 DOH esso No. 201247498