final order - healthgrades · doh case no.: 2015-07097 license no.: me0110623 ilan...
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Final Order No. DOH-17-1571- S -MQA
FILED DATE - AUG 2 5 2017 Departmen alth
By:
STATE OF FLORIDA BOARD OF MEDICINE
DEPARTMENT OF HEALTH,
Petitioner,
vs. DOH CASE NO.: 2015-07097 LICENSE NO.: ME0110623
ILAN RZADKOWOLSKY-RAOLI, 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
August 4, 2017, in Miami, 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 fully advised in the premises,
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 following
clarification:
The costs set forth in Paragraph 3 of the Stipulated
Disposition shall be set at $2,930.43.
day of
the Clerk of the Department of Health.
7'C314 DONE AND ORDERED this
Accordingly, the parties shall adhere to and abide by all
the terms and conditions of the Settlement Agreement as
clarified above.
This Final Order shall take effect upon being filed with
2017.
BOARD OF MEDICINE
Clau is Kemp, J.D., Executive Director For Magdalena Averhoff, 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 ILAN
RZADKOWOLSKY-RAOLI, M.D., 4208 Braganza Avenue, Miami, Florida
33133; to Marc Ganz, Esquire, 75 Valencia Avenue, Coral Gables,
Florida 33134; by email to Allison Dudley, Assistant General
Counsel, Department of Health, at [email protected];
and by email to Edward A. Tellechea, Chief Assistant Attorney
e0,it_6e,10.,
13981
03/23/2017 14:56 flOO 0.002/010
STATE OF manna DEPARTMENT OF HEALTH
orsimumarr OP HEALTH,
Petitioner,
DON Cosa No. 2015-07091
IRAN RESENRIWOLERY-RAOLI„
Reftiondent
MOMENT ArBREONNT
Man Rzadkowolsky-Raeli, KM, refened to as the 'Respondent," and the
Department of Health, referred to as Teparbnent; stipulate and agree to the IbilOwing
Agreement and to the entry of a Final Order of the Board of Medld net referred to as
"Board" incorporating the Stipulated Facts and Stipulated Disposition in this matter,
Petilioner Is the Vale agency charged with (+Vatting the portico of avaltim
pursuant to Section 20.43, Hada Statutes, and Chapter 455, Rends Statutes, and
Chapter 458, Florida Statutes.
pripui,ATErtmas
1. At all times nufterlal heel, Respondent was. a lionised piiyalden in the
State Of Florida having been bassi Valle number ME 110623.
2. The Department charged Respondent Wit en Adinhilstrative complaint that
was filed and prep* served upon Respondent aliajng violations of Chapter 458, Sunda
Statutes, and the: rules adopted pursuant thereto. A true and correct copy of the
Adairdsbaft e tampliart attached bade as Bright A.
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0312312017 14:56 P.0031010
3. For moms ttf these proceedings, Respondent neither admits nor denies
the allegatiors of fact (whined hr the Administrative Complaint.
VIA,IATED-CPUMINIONSoF 'Alt
1. Respandert admits Met, In Miler capacity as a licensed physician, riefshe
Is subject In prctvisions of Charters 456 end 458, Florida Statutes, and thejurisdldto n
of the Department and Mettle.
2. Respondent nitres if got the 'fact! alleged In The NkranislYetive CemPleillts
rowan, would onstItute violation's of Chapter 458, Rorida.Statutes.
3. Respondent agrees that the Stipulated Dispostlion in this c:ase .1s fair,
appropriate and acceptable to Rffipandent.
• firlikiLATEDDISPASETIO
L Q1° -- The Beard shall -issue a Letter of Concern against
Rependenrs license.
2. fimg - The Ward shalt impose an aditinistrafte fine of Vivo Thosisind
Me Mewled Doan, antiNg Center$24,500.60jagainst Ftespondenes license which
Respenderd shall pay to; Paymerds. Department of fiealth, Compliance Management
Unit, Bin C-76, P.O. Box 6320tIlallabassee, FL 32314-6320, wain thirty (30) days from
the date of tiUng of the final Order accepting Ns Agreement ffinal order% mgmla
gbillaisIditheibiescbsclubrimnneY trderr Any change In the tetras of
payment of any fine Imposed by the Board ninathe atiormied..ie erivansgmjiba
priduitiesteninlittee firths Reed
OM v. Ilan lbagicaegskraark PLI)Orter, Case Number 20154707
13983
0312312017 14:56 FAX) P.0041010
RESPONDENT ACKNOWLEDGES THAT THE TIMELY PA r* OF THE
FINE NIS/HER LEGAL OBLIGATION AND RESPONSIBILITY AND
RESPONDENT AGREES TO CEASE. PRACTICING IF THE FINE IS NOT PAID AS
AIMED IN MS semisoft,' ABREENENT. SPIECMCALLY, IF RESPONDENT
HAS NOT RIKINIVIS) WRITTEN cortniowlammilit *MAYS OF 114i WE
OF FILING OF TILE FINAL ORDER THAT THE FULL AMOUNT OP THE PIE HAS
IMO =NORD BY THE BOARD OFFICE, RESPONDENT AGREES TO CEASE
PRACTICE UNTIL RESPONDENT RECEIVES SUCH WRITTEN CONFIRMATION
FAMINE BOARD.
3. Relmhbanneset0e^ Posuant toSecilon 456.072, Stabitts,
Respondent agrees to pow the Department for the Department's as 'named in the
kwasegetion and prosecution of Ins cue rDepartment costs`). such costs oclude the
awls of obtaining supervision or monitoring of the practicer the east of quay assurance
'glee % aiN velar mots Ralvorgient incurs la comply vAth the Final Order, and The
Board% administrative cobs directly associated valth Respcsidets prohaliondf
Respondent agrees that the amount of Department costs to be paid in this case is Tire
Mormand *Da liffaximsd Ilswessiy-Str DiolIant and litlify42140 Cents
02,405,34 Is a t shall sat armed Fear Thou-- •d The Noilefred SeresgroCk
Daiwa poi Thildreirs °rots ~WO RespotzlentirIll pay such Deriartmant
ante to: ItYmeetk DOPOltolentor He" Co toe MarelfIlment Unit, urn C-76, P.O.
Box 6320, Tallahassee, FL 3231.46320, to In dirty (30) days from the date of filing of
the Mal Order. AllIMEARMARIiRilliBLOISWBABAZIMeink& Any
0011v. lan Maitaroollirltaol, RA, 14mq Oen Number MOW
13984
03123/2017 14:57 P.0051010
dew in the terms (*payment of costs imposed by the Board must J woorowstio
thallitillantaCOMMUtealikatillt
RESPONDENT ACIttiowumwas THAT THE TIMMY PAYMENT OP THE
COSS IS HIS/HER MAL OBLIGATION AND RESPONSE/MTV AND
AusspoNDONT AGREES TO CRAW PRACTICDIG IP THE COSTS ARE NOT PAID
AS AGREED IN 11415 sErrialerr ASIEENENT. SPECIFICALLY, IF
RESPONDENT HAS NOT RECEIVED =MEN CONFIRMATION WITHIN M
DAYS OP THE DATE OF IFILING OF THE FINAL ORDER THAT THE FULL AMOUNT
OPINE tOSIS NOTED ABOVE HAS BEEN UMW BY THE BOARD oFFmm,
ingivomona AGREES TO CEASE PRACTICE innwil. RESPONDENT nouns
suai WRITTEN CONRIU4ATDMI FROMM BOARD.
4. .tkmtbiggsfiggaioLltdg likl6ggemor — Respondent
shall complete this requirement and document such cranpfetion cumin one (1) year from
if* *tell* 'Mad Order tiled. Repundent ehell MN* Mita requirement In one
elf the two folios!** Iwo*
(a) Respondent shall complete five (5) hours of 64E in "Risk
Management' after first obtaining written advance approval from the Board's Probation
Come:ea of sudi proposed Wreak and shall submit documentation of such completion/
In the fermrorcertilled-ceplesofihe -receipts, voudersicarlifirates, neer ofkirdproof
of colon, to the Board'a Probation Committee; or
(b) Respondent shall complete (5) five hours of a4E in risk management
by attending one MI day or eight (B) hours, whichever is more, of disciplinary hearings
obit v.ain itaikaxdighlimolt, MD., N.D, Case titeaba- MiErtgeg7 4
13985
03/2312017 14:57 P.0061010
ate regularmeeling of the Board of Medldne. in order to receive such credit, Respondent
must sign in with the Benda Director of the Board before the meeting day begins,
Respondent must remain In continuous attendence during the full clay or eight (8) hours
of dieciplinery hearings, whichever Is more, and Respondent must sign out with the
fosscutive Director of the Board at the end of the meeting day or et such other trader
Bine as affirairfavely at by the Board. Respondent may not receive dedt
In risk management for attending the clisdplinary hearings portion of a Board meeting
unbars the Respondent is Wending the derdplinary hearings portion for the sole purpose
of obtaining the 01Eaeditin dsk management. in other words, Respondent may not
receive
aura dedt If appearing et the Board meeting Ibr any other puipos4 such as
pending action against Respondent's =dick Oconee.
S. ' jesiszonengag — Within sbc (6) months Mowing the tiling date of a
Final Order, Respondent shall present a one (1) hour lecture/seminar on "Wrong Ste
Surgeriee;" inducing. Infonmaion on""Wrong Patient Procedures; to medical Off at an
approved medial fisility Rap:indent shall submit a vetten 'plan to the Board's
Probation 0:immitee for aPgroval prior to Peritirmance of said lecture/seminar- Within
dc months of the date of Ming Whir Final Order, Respondent shall obtain a letter from
the Risk Manager of the approved medical facility inclicetkvg that the lectumiserniner has
-been awnpleted and submit-0mb tatter tertheBoard's Probationflommittee.
• srpomu) one
1. Nionringa . Respondert is requirat to appear babe the Board at the
meeting of the Board where Mid Agreement Is considered.
ECM& latlianikumftRaILM.1414D. Cow Miter 201547CW
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03J2312017 14:57 P.0071010
2. po row grilffed: up* 13pad °Are - it Is orpressly 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
end -effect unless the Beard -sews a -Finel -Order Incorporable; tie terms of this
Agreeing*.
3. Cimilteskei lefts! Alucattrre - Unless otherwise prcNIded in this
Agreeing* Responds* shalt first submit a votten request to the Probation Committee
ibr applying firlOr to performanre Of said CME tourse(s). Respondent shall submit
documentation to theSeercilLitobation Committee afhaving comptebed a CME mires in
the form of certleed copies of the. receipts, vouchers, certificates, or other papers, such
as physicianrs recognition awards, documenting completion of this medkel course wain
one (1) year of the Mk* of the Final Order In this meter. Alt soh doarmentation shalt
be sir& to die entre initiation Cormattee , regardiess of whether some army of such
docterwarrialion was providedprevlousty daring the course auto/auditor discussion with
o:ituesel for the Department. CME hours required by this Agreement shell be in addition
In those hours recpired i'or renewal of licensure. Unless otherwise approved by the
Board's Probation CommiLige, such. CME course(s) shalt-consist of a formal, fine lecture
tares.
4. Adikeinee - Respondent must provide current residence and practice
address's to the Board. Respondent shall notify the Board In writing within ten (10) days
of any charges of said addresses
tan ItakRowddrItaak Pm, Ptax, Cua Mitrher 2111,(1707
13987
03/2312017 14:58
(FAX) P.0081010
S. EglinZembEt - tithe future, Respondent shall not virilatethapter 436,
458 or MX ficwitia Statutes, or the riles poourigated•pursuant :thenalD, or any•other
atata or federal law, rule, or repletion relating to the practice or the obi* to practice
medicine to include, but not limited In, all stabtory requirements related to practlioner
prefika and Hamm renewal updates. Prier to signing this agreement the Respondent
shall read Clupbsrs 456, 436 and 883 and the Rulestrf the floardof iviedicine, at Chapter
'64B8slioriditAdmintsbalive Cede.
6. violation of Acuis - >t Is etpresely understood that a violation of the
terms of this Agmenert shaft be considered a violation of a Rnal Order of the Board, for
whidt discitinary action, ma', be in ad pursuant to Chapters 4G and 458, Florida
Stables.
7. Etsitlateiniatilibillint -‘ResuondOok tett* feirPose of avokiing further
administrative action with respect to this muse, execuhs this Agreement In this regard,
Respondent authorizes the Board to review and examine all inveritigative file materiels
ooncool111811Moodent Orlorto or In cortunction wig cons 1n of the Agreementr
Respondent ;gees to stood Ifts Agreement at Ore time It Is ,pt to the Board
and shall Offer no evidences testimony or argument that, disputes or exatTavenee any
stipulated
test or condusi on 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 ant matters # the Board shall -not unftdrly "Ur illegaity prejudice the
Board or any of its members *Om further penlidpation, considenalion or eesciutton of
Mese pmceedings.
bOthimRRodfnkwitir4loolf, ILD.,14.0. Oise Number =WOW 7
13988
03/2312017 14:58
fit* P.0091010
8. No Predualoti OF ltHoneI pita:alga - Respondent and the
Deparbnent fully andertitandlhatthitt Agteement inld are Thai 'Order will in no,
• way pledude addltfonei pm:efts by the Roan, andidr the Department against
Revondentior acts estomissionsnotspeelftadly set lb,* in the Adninistrative Complaid
oached as &M it A.
9.MiltfalritiabliKhAtt Colds - Upon the Board's adopt on of
this Agreement, the votes -hereby agreeit tat-with the -exbention.of Depanmenttotts
noted above, the pattio WV bear their OW1/ attotney's lees and costs 'resulting from
. prosecution or defense of this maths. Responder* waives the righttosegic anyattorrosys
fees or costs from the *I-Apartment and Board! connector*, with this maths..
10. widearesTortiler:PrgoaderaliBteiss - Uponthe Bdcvd's adoption of this
Agreementr Respondmt expressly waives -alt *other preeedural -steps -and qty
waives all fights to sealoudichil today. of or to otherwise challenge or contort the validity
of the Itreesnentand.the Final Order of the Board incorporiting said Agreement.
gignafriereppearotrtheiblowirapigal-
• 91033111090-4 Florida 491100,3101 7707
My Comm fil$310 30.20"
MY Commission EttiNer
13989
03123/2017 14:59
its` k day.
P.0101010
' STATE OPTUMID A ,
_MIRY OF
BEFORE ME personally -appeared 1201 vihose Identity Is imam to me or who prodiicedsrick tives<1.1#1,f0 (type of Idendflestien)-end whoeimdereotheadeerwiedgeithathisiher allinftre'aPPeNd above.
SW011,1 10 and subsailied. it afont me this day of elfro, s72.0131 2017.
APP ft 6 darof Jgoe.
Celesbanillp-elviDi WH • Siiitiedri Gemnid and Seintary
Assistant General Counsel . Depaitinat or Heath
iii v. DIM bakvailitivita*, Mika NA. Cos *Mbar Magna
2011
9.
13974
STATE OF FLORIDA DEPARTMENT OF HEALTH
DEPARTMENT OF HEALTH,
PETITIONER,
V. CASE NO. 2015-07097
ILAN RZADKOWOLSKY-RAOLI, M.D.,
RESPONDENT. /
ADMINISTRATIVE COMPLAINT
Petitioner Department of Health files this Administrative Complaint
before the Board of Medicine against Respondent Ilan Rzadkowolsky-Raoli,
M.D., and in support thereof alleges:
1. Petitioner is the state agency charged with regulating the
practice of medicine pursuant to Section 20.43, Florida Statutes; Chapter
456, Florida Statues; and Chapter 458, Florida Statutes.
2. At all times material to this Complaint, Respondent was a
licensed physician within the State of Florida, having been issued license
number ME 110623.
DOH v. Ilan Rzadkowolsky-Raoli, M.D. 1 Case Number 2015-07097
13975
3. Respondent's address of record is 4208 Braganza Avenue,
Coconut Grove, Florida 33133.
4. On or about December 23, 2014, Patients MD1 and MD2, both
eighty-nine year old females, presented to the radiology department at
Palmetto General Hospital.
5. Patient MD1 presented for a carotid ultrasound.
6. Patient MD2 presented for a PICC line insertion.
7. Patients MD1 and MD2 had the same first and last name and
were born the same year, but were born on different dates.
8. After undergoing a carotid ultrasound, Patient MD1 was
erroneously transported to the special procedures unit for a PICC line
insertion.
9. Respondent injected MD1 with lidocaine in preparation of
performing the PICC line insertion.
10. Respondent began to insert the PICC line guidewire, but
stopped when the accompanying nurse recognized that MD1 was not the
correct patient.
DOH v. Ilan Rzadkoviolsky-Raoli, M.D. 2 Case Number 2015-07097
13976
11. Respondent did not create or maintain documentation of
properly performing, a timeout procedure.
Count I
12. Petitioner realleges and incorporates by reference paragraphs
one (1) through eleven (11) as if fully set forth herein.
13. Section 456.072(1)(bb), Florida Statutes (2014), provides that
performing or attempting to perform health care services on the wrong
patient, a wrong-site procedure, a wrong procedure, or an unauthorized
procedure or a procedure that is medically unnecessary or otherwise
unrelated to the patient's diagnosis or medical condition constitutes
grounds for disciplinary action by the Board of Medicine. For the purposes
of this paragraph, performing or attempting to perform health care services
includes the preparation of the patient.
14. Respondent performed or attempted to perform health care
services on the wrong patient by injecting Patient MD1 with lidocaine in
preparation of performing a PICC line insertion and/or by beginning to
insert a guidewire into Patient MD1.
DOH v. Dan Rzadkowolsky-Raoli, M.D. 3 Case Number 2015-07097
13977
15. Based on the foregoing, Respondent violated Section
456.072(1)(bb), Florida Statutes (2014).
Count II 16. Petitioner realleges and incorporates by reference paragraphs
one (1) through eleven (11) as if fully set forth herein.
17. Section 458.331(1)(nn), Florida Statutes (2014), provides that
violating any provision of Chapters 458 or 456, or any rules adopted
pursuant thereto constitutes grounds for disciplinary action by the Board of
Medicine.
18. Rule 64B8-9.007(2)(b), Florida Administrative Code, requires
that:
Except in life-threatening emergencies requiring immediate
resuscitative measures, once the patient has been prepared for
the elective surgery/procedure and the team has been gathered
and immediately prior to the initiation of any procedure, the
team will pause and the physician(s) or physician assistant(s)
performing the procedure will verbally confirm the patient's
identification, the intended procedure and the correct
surgical/procedure site. The operating physician shall not make
DOH v. Ilan Rzadkowolsky-Raoli, M.D. 4 Case Number 2015-07097
13978
any incision or perform any surgery or procedure prior to
performing this required confirmation. If the surgery/procedure
is performed in a facility licensed pursuant to Chapter 395, F.S.,
or a level II or III surgery/procedure is performed in an office
surgery setting, the physician(s) or physician assistant(s)
performing the procedure and another Florida licensed health
care practitioner shall verbally and simultaneously confirm the
patient's identification, the intended procedure and the correct
surgical/procedure site prior to making any incision or initiating
the procedure. The medical record shall specifically reflect
when this confirmation procedure was completed and which
personnel on the team confirmed each item.
19. Respondent did not create or maintain documentation of
properly performing, a timeout procedure.
20. Based on the foregoing, Respondent violated Section
458.331(1)(nn), Florida Statutes (2014), by violating rule 6488-9.007,
Florida Administrative Code.
WHEREFORE, the Petitioner respectfully requests that the Board of
Medicine enter an order imposing one or more of the following penalties:
DOH v. Ilan Rzadkowolsky-Raoll, M.D. 5 Case Number 2015-07097
13979
permanent revocation or suspension of Respondent's license, restriction of
practice, imposition of an administrative fine, issuance of a reprimand,
placement of the Respondent on probation, corrective action, refund of
fees billed or collected, remedial education and/or any other relief that the
Board deems appropriate.
SIGNED this 23rd day of January, 2017.
Celeste Philip, MD, MPH Surgeon General and Secretary
FILED DEPARTMENT OF HEALTH
DEPUTY CLERK CLERK Aniel Sanders
DATE JAN 2 4 2017
(1 dad nate Chad Dunn Assistant General Counsel Florida Bar No. 111963 DOH-Prosecution Services Unit 4052 Bald Cypress Way-Bin C-65 Tallahassee, Florida 32399-3265 (850) 245-4444, Ext. 8224 (850) 245-4684 fax E-Mail: [email protected]
CD/In
PCP Date: January 20, 2016 PCP Members: Dr. Georges El-Bahri, M.D., Dr. Sarvam Terkonda, and Ms. Brigitte Goersch
DOH v. Ilan Rzadkowolsky-Raoll, M.D. 6 Case Number 2015-07097