COMMONWEALTH of VIRGINIA Department of Health Professions John Hasty Board of Medicine 6606 West Broad Street Director of the Department 4th Floor Richmond, Virginia 23230-1717 Warren w. Koontz. M.o. - Februal'y 3, 1995 (804)662-9908 Executive Dhedor of the Board FAX (304) 652.9943 Charles J. Crosby, DC. 13556 Dornoch Drive . - - Orlando, Florida 32825 10 410 268 RE: License No. 0102?036881 - Dear Dr. Crosby: This letter is of?cial noti?cation that an informal conference of the Virginia Boa-rd of Medicine I ("Board") will be held on March 16, 1995 at 3:00: pm. at the Department of Health Professions, 6606 West Broad Street, 4th. Floor, Richmond, Virginia. The conference will be conditcted pursuant to Sections 54.1~ 2919 and 9~6. 14:11 of the-Code of Virginia (1950'), as amended An informal conference committee ("Committee"), composed of three members. of the Board, will inquire into allegations that you may have violated certain laws governing the practice of osteopathy in Virginia. Speci?cally, you may-have and (3), asifurther de?ned in section and (13) cf the Code of Virginia (1950-), as amended, in that: 1. On November 4, 1987, at Southjside Community Hospital, Fannville, Virginia, you performed arthroscopic surgery on Patient A to repair a degeneratiye lateral meniscus tear of the left A Motion for Judgement in a malpractice suit which was ?led by "Patient A in the Circuit Court of Prince William County, Virginia alleged in part that: On November 4, 1988, you to appropriately perform the arthroscopic procedure; you performed the armrescopic pure in a dangerous manner; you failed to employ appropriate safeguards to prevent burns at the portal sites; you failed to warn Patient A that she might sustain burns; you failed. to use appropriate and safe equipment, mediCations and techniques to perform the surgery; you failed-to take appropriate steps to prevent serious injury to the patient; and, you performed the arthroscopic procedure lacking the requisite training, experience and quali?cations. A Medical Malpractice Payment Report (?MMPR?)indicated that this suit settled on or about September 12, 1990, with a monetary payment being made to the patient. wow" a . ?Wu a . mam-mm? - tum?nun," Notice to Charles I. Crosby, D.O. February 8, 1995 Page 2 2. On March 16, 1989, Patient was treated by you through the emergency room of Southside Community Hospital for a fracture and dislocation of the left elbow, a fracture of the right elbow, a displaced fracture of the right tibia, right .perineal- palsy and a pulsel-ess right foot. A Notice of Claim for Medical Malpractice dated June 27, 1989, was mailed to you by Patient which alleged in part that: You negligently failed to diagnose and? treat a severed .popliteal artery and vein; you performed a pelvic examination without the patient?s consent or knowledge and without medical indication; you negligently failed to detect a three month pregnancy; you failed to transmit that information to St. Mary?s Hospital where the patient was transferred; you repaired the right tibial plateau fracture leaving it in an unstable condition upon transfer; you performed an unjusti?ed resection of the radial head of the left elbow without trying to preserve 'its integrity by attempting some other treatment; you failed .to transfer the'medical charts to St. Mary's Hospital, and you failed to adequame stabilize the patients nerve and vascular 3. - On November 28, 1987, Patient was treated by you through the emergency room of Southside Community Hospital for an accidental self4in?icted gunshot wound to. the right-hand. You may be negligent in your medical treatment and management'Ofth-is patient, in that you surgically closed the wound in the right hand without irrigating or deb?'ding it, and you failed to prescribe an antibiotic medication to minimize st?surgfical infection. Based upon this tteatment, the patient experienced pain, swelling and infection, thereby requiring an additidnal surgery on November 29, 1987, and outpatient treatment by the College of Virginia Orthic Service. A WPR indicates that a malpractice suit was ?led, and that this case settled on .or about December 27, 1990, with a monetary payment being made to the patient. 4. On September 21, 1987, Patient was treated by you through the emergency room of Southside Community Hospital for a fracture of the radius and ulna of the left arm. A Motion for Judgement in a suit which was ?led- by Patient in the Circuit Court of Prince Edward County, Virginia in 1988 alleged in part that: On September 21, 1987, you failed to properly treat the fractures of the patients left radius and ulna; you failed to properly treat the fractures of the ulna and radius instead of performing an open reduction; and, on October 5, 1987, during a subsequent surgery, you severed the deep branch of the radial nerve in the patient?s forearm. This suit settled prior to trial with a monetary payment being made to the ?patient. Notice to Charles J. Crosby, D.O. February 8, 1995 Page 3 5. On September 4, 1987, Patient was treated by you through the emergency room of Southside Community. Hospital for injuries to the left hand, including fractures and lacerations to all ?ve digits. A Notice of Claim of Medical. Malpractice dated on or about'September 1, 1988, which was mailed to you by Patient alleged in part that: You failed to preperly evaluate the severity .of the injury; you failed to advise the patient of available treatment'and specialists to treat the injury to preserve the ?ngers and restore their function; you willfully failed to warn and inform the patient of the risks inherent in permitting you to attempt debridement, irrigation and reconstruction .proCedures; you willfully amputated the index, middle and right ?nger without. obtaining the consent of Patient you willfully committed a battery upon. the patient by amputating the ?ngers; you willfully misrepresented that you were quali?ed to treat the patient; you failed to refer the patient to appropriate specialists, and you failed to properly perform the debridement, irrigation reconstruction procedures on the left hand. This suit settled prior to a trial with a monetary payment being. made to the patient. In order to protect the privacy. of your patients,- they have been referred to by letter only. Please see Attachment I of this notice for the identity of the-individuals'referenced above. You may. be represented by an attorney at the infermal cenference. The following actions may be taken by this Committee: 1. If a majority of the Committee is of the opinion that a suspension or. revocation of your license may be justi?ed, the Committee shall present-to theBoa'rd in writing its-?ndings, and the Board may proceed with a formal hearing; 2. The Committee may notify you in writing that you are fully'exonerat'ed of any charge that might affect your right to practice in Virginia; 3. The Committee may reprimand or censure you; or 4. The Committee may place you on probation for such time as it may designate and direct that during such period you furnish the Committee or its chairman, at such intervals as the Committee may direct, evidence that you are not practicing in- violation of the provisions of Chapter 29, Title 54.1 of the Code, which governs the practice of medicine in Virginia. I Should you fail to appear at the informal conference the Board may proceed to a formal administrative hearing in order to impose sanctions. Please inferm this of?ce whether you intend to appear at the conference at least ten (10) days prior to the scheduled date above. Also please provide the Board with a telephone number where you may be reached. Notice to Charles I. Crosby, D.O. February 8, 1995 Page 4 Enclosed you will ?nd copies of the relevant sections of I the Administrative Process Act, which governs proceedings of this nature, as well as laws relating to the practice of medicine and'the other healing arts in Virginia. If you have quest-ions concerning this notice, please contact Karen W. Perrine, Deputy Executive Director, Discipline at (804) 662-9929. Sincerely, @moo/J/Z?ri?f" Executive Director Virginia Board of Medicine cc: Thomas A. Wash, M.D., President John W. Hasty, Director, DBpartme-nt of Health Professions Frank W. Pedrotty, Assistant Attorney General Michael L. Goodman, Esquire Karen T. McCaffrey, Senior legal-Assistant Informal Conference Committee Division of Enforcement .- Enclosure: Virginia Code Sections: 54.1-2914 54.1-291-5 54.1-2919 Attachment I Map COMMONWEALTH of VIRGINIA Department of Health Professions Bernard L. Henderson. Jr. Board of Medicine 6606 West Broad Street Director of the Department 4th Floor August 12, 1993 Richmond. Virginia 23230-1717 Hilary H. Connor. MD. (804) 662-9908 Executive Director of the Board - FAX (804) 562.9943 Charles J. Crosby, D.O. 13556 Domoch Drive CEBTIFIED: M. ML Orlando, Florida 32825 292 457 936 RE: License No. 0102-0368-81 Dear Dr. Crosby: This letter is of?cial noti?cation that an informal conference of the Virginia Board of Medicine . ("Board") will be held on Thursday, September 16, 1993 at 11:30 am. at the Deparunent of Health Professions, 6606 West Broad Street, 4th Floor, Richmond, Virginia. The conference will be conducted - pursuant to Sections 54.1-29-19 and of the Code of Virginia (1950), as amended An informal conference committee ("Committee"), composed of three members of the Board, will inquire into allegations that you may have violated certain laws governing the practice of medicine .in Virgin- i ia. Speci?cally, you may have violated Section 54.1 and (3), as further? de?ned in Section 54.1~ and (13) of the Code of Virginia (1950), as amended, in that: 1. On November 4, 1987, at. Scuthside Community Hospital, Farmvi-lle, Virginia, you performed arthroscopic surger on Patient A to repair a degenerative lateral meniscus tear of the left knee. A Motion for Judgement in a medical malpractice suit which was ?led by Patient A in the Circuit Court of Prince William County, Virginia alleged in part that: On November 4, 1988, you failed to appropriately perform the arthroscopic procedure; you performed the arthroscopic procedure in a dangerous manner, you failed to employ appropriate safeguards to prevent the patient from sustaining burns at the portal sites; you failed to warn patient A that she might sustain burns; you failed to use appropriate and safe - equipment, medications and techniques in the performance of the Surgery; you failed to take appropriate steps to prevent serious injury to the patient, and you performed the arthroscopic procedure lacking the requisite training, experience and quali?cations. A Medical Malpractice Payment Report indicated that this suit settled on or about September 12, I 1990, with a monetary payment being made to the patient. Notice to Charles J. Crosby, D.O. August 12, 1993 Page 2 2. On March 16, 1989, Patient was treated by you through the emergency room of Southside Community Hospital, Farmville, Virginia for a fracture and dislocation of the? left elbow, a fracture of the right elbow, a displaced fracture of the right tibia, right perineal palsy and a pulseless right foot. A Notice of Claim for Medical Malprac?ce dated June 27, 1989, was mailed to you-by Patient which alleged in part that: You negligently failed to diagnose and treat a severed popliteal artery and vein; you performed a pelvic examination without the patient's consent or knowledge and without medical indication; you negligently failed to detect a three month pregnancy; you failed to transmit that information to St. Mary's Hospital where the patient was transferred; you repaired the right tibial plateau fracture leaving it in an unstable condition upon transfer; you performed an unjusti?ed resection of the radial head of the left elbow without trying to preserve its integrity by attempting some other treatment; you failed to transfer the appropriate medical charts .to St. Mary's Hospital, and your failed to adequately stabilize the patients nerve and vascular 3. On November 28, 1987, Patient was treated by you through the emergency room of Southside Community Hospital, Fannville, Virginia for an accidental self-in?icted .gunshOt wound to the right hand. You may be negligent in your medical treatment and management of thispatient, in that you surgically closed the wound in the right hand without irrigating or debriding. it, and you failed-to prescribe an antibiotic medication to minimize post-surgical infection. Based upon this treatment, the patient experienced pain, swelling and infection, thereby requiring an additional surgery on November 29, 1987, and outpatient treatment by the Medical College of Virginia Orthopedic Service. A Medical Malpractice Payment Report indicates that a malpractice suit was ?led, and that'this case settled on or about December 27, 1990, with a monetary payment being made to the patient. 4. On September 21, 1987, Patient was treated by you through the emergency room of - Southside Community Hospital, Farmville, Virginia for a of the radius and ulna of the left arm. A Motion for Judgement in a Medical MalpraCtice suit which Was ?led by Patient in the Circuit Court of Prince Edward County, Virginia in 1988 alleged in part that: On September 21, 1987, you failed to properly treat the fractures of the patients left radius and ulna; you failed to properly treat the ?actu-res of the ulna and radius instead of performing an open reduction, and on October 5, 1987, during a subsequent surgery, you severed the deep branch of the radial nerve in the patient's forearm. This suit settled prior to trial with a monetary payment being made to the patient. Notice to Charles J. Crosby, D.0. August 12, 1993 Page 3 5. On September 4, 1987 Patient was treated-by you through. the. emergency room of Southside Community Hospital, Fannville, Virginia for injuries to the left hand, including fractures-and lacerations to all ?ve digits. A Notice of Claim of Medical Malpractice dated on or about September 1, 1988, which was mailed to you by Patient alleged in part that: You failed to properly evaluate the severity of the injury; you failed to advise the patient of available treatment and specialists to treat the injury to preserve the ?ngers and restore their function; you will?illy failed to warn and inform the patient of the risks inherent in permitting you to attempt debridement, irrigation and reconstruction procedures; you willfully amputated the index, middle and right ?nger without obtaining. the consent of Patient you willfully committed a battery upon the patient by amputating the ?ngers; you will?rlly misrepresented that you werequali?ed- to treat the patient; you failed to refer the patient to appropriate specialists, and you failed. to properly perform the debridement,? irrigation and reconstruction procedures on the left hand. This suit settled prior to atrial with a monetary payment being made to the patient In order to protect the privacy of your patients, they have-been referred to by letter only. Please see Attachment I of this notice for the identity of the individuals referenced above. You may be represented by an attorney at the informal conference. The folloWing actions may be taken by this 1. If a-majority of the Committee is of the opinion that a suspension or revocation of your license may be justi?ed, the Committee shall present to the BOard in writing its ?ndings, and the Board may proceed - with a formal hearing; 2. The Committee may notify you in writing that you are ?rlly exonerated of any charge that .. might affect your right to practice in Virginia; 3. The Committee may reprimand or censure you; or 4. The Committee may place you on probation for such time as it may designate and direct that 3 during such period you furnish the Committee or its chairman, at such intervals as the Committee may direct, evidence that you are not practicing in violation of the provisions of Chapter 29, Title 54.1 of the Code, which governs the practice of medicine in Virginia. Should you fail to appear at the informal conference the Board may proceed to a formal-administrative hearing in order to impose sanctions. Please inform this Of?Ce whether you intend to appear at the conference at least ten (10) days prior to the scheduled date above. Also please provide the Board with a - telephone number where you may be reached. Notice to Charles J. Crosby, D.0. August 12, 1993 Page 4 Enclosed you will ?nd copies of the relevant sections of the Administrative Process Act, which governs proceedings of this nature, as well as laws relating to the practice of medicine and the other healing arts in Virginia. If you have questions concerning this notice, please contact Karen W. Penine, Deputy Executive Director, Discipline. Sincerely, Executive Director Virginia Board of Medicine 12N21NOTICES cc: Catherine S. Casey, MD, President Bernard L. Henderson, Jr., Director, Department of Health Professions Frank W. Pedrotty, Assistant Attorney General Clyde W. Mathews, Jr., Director, Administrative Proceedings Michael L. Goodman, Esquire Karen T. McCaf-frey, Senior Legal Assistant Informal Conference Committee Division of Investigations Wayne J. Farrar, Director of Public Information - Enclosure: Virginia Code Sections: 54.1-2914 54.1-2915 54.1-2919 96. 14:1 1 Attachment I Map COMMONWEALTH of VIRGINIA Department of Health Professions Bernard L. Henderson, Jr. Board of Medicine 8606 West Broad Street Dirocluo?lthe Department 4th Floor - Richmond. Virginia 23230-1717 Hilary H. Connor,M.D. February 15? 1994 (804)662-9908 Executive Director or the Board FAX (804) 662-9943 Michael L. Goodman, Esquire Wright, Robinson, McCammon Osthimer Tatum FIRST CLASS MAIL 411 East Franklin Street, 4th Floor 292 458 03.3 Richmond, Virginia 23219-2205 RE: Charles J. Crosby, D.O. Dear Mr. Goodman: The Board-convened on. Thursday, Febmary 10, 1994, to consider the consent order providing for the voluntary sunender of Dr. Crosby?s license osteopathy in Virginia, inlie'u-of administrative proceedings. The Board voted to "reject the consent order" and to schedule Dr. Crosby for an informal conference. He will: be noti?ed at least '30 "days in advance of his meeting? with the Board's conunittee. - Sincerely Hilary Executive Director Virginia Board of Medicine 141.1 cc: Catherine S. Casey, M.D., President Clyde W. Mathews, In, DepotyDiroctor for Administrative Proceedings Frank W. Pedrotty, Assistant Attorney General Karen T. McCaffrey, Senior Legal AssiStant Division of Investigations . Charles J. Crosby, D.0. .. . . . COMMONWEALTH of VIRGINIA Department of Health Professions John Hasty Board of-Medicine 6606- West Broad Street Director of the Depend-Ian 4th Floor Richmond. Virginia 23230-1717 Warren w. Koontz. MD. Mam? 27? 1995 (304)662-9903 Executive Director of the Board FAX (304) 632.9943 Charles J. Crosby, DC. 13556 Dornoch Drive CERTIFIED M. ALL Orlando, Florida 32825 2 100 410292 RE: License No. 0102?036881 Dear Dr. Crosby: The Committee, after thoroughly evidence and testimony presented, voted {to dismiss the allegations. Therefore, the cases pending before the. Board - will be closed. Please contact Karen W. Perrine, Deputy Executive Director, Discipline-at (804) 66249929, if you have anyquestions regarding this matter. Sincerely, Warren W. Koontz M.D. Executive Director Virginia Board of Medicine cc: Thomas A. Wash, M.D., President John W. Hasty, Director, Department of Health Professions James Banning, Acting Director for Administrative Proceedings Clyde W. Mathews, Jr., Assistant Attorney General Michael L. Goodman, Esqui-r Karen T. McCaffrey, Senior Legal Assistant Division: of ?lgnforcement (9 1 09889191 ?0 1020/91 -00 159193-00490) VIRGINIA: BEFORE THE DEPARTMENT OF HEALTH PROFESSIONS IN RE: CHARLES JULIAN CROSBY, D.O. License N0.: 0102?036881 ORDER In accordance with Section 54.1?2409 ofthe Code ofVirginia (1950), as amended, 1, Robert A. Nebiker, Director ofthe Virginia Department of Health Professions, received and acted upon evidence that the license of Charles Julian Crosby, D.O., to practice osteopathic medicine in the State of Florida was suspended by Order of Emergency Suspension of License entered July 1, 2004. A certi?ed copy of the Order of Emergency Suspension of License (with attachments) is attached to this Order and is marked as Commonwealth's Exhibit No. 1. WHEREFORE, by the authority vested in the Director ofthe Department ofHealth Professions pursuant to Section 54.1?2409 ofthe Code, it is hereby ORDERED that the privilege of Charles Julian Crosby, D.O., to renew his license to practice osteopathic medicine in the Commonwealth of Virginia be, and hereby is, SUSPENDED. Upon entry of this Order, the license of Charles Julian Crosby, D.O., will be recorded as suspended and no longer current. Should Dr. Crosby seek reinstatement of his license pursuant to Section 54.1?2409 of the Code, he shall be responsible for any fees that may be required for the reinstatement and renewal ofhis license prior to issuance ofhis license to resume practice. Pursuant to Section 22-4023 ofthe Code, the signed original ofthis Order shall remain in the custody of the Department of Health Professions as a public record and shall be made available for public inspection and copying upon request. 737mm a Robert A. Nebiker, Director Department of Health Professions ENTERED: at l, COMMONWEALTH oi Robe? A- Neb?ker Department ofHeal?r Professions Director TEL (804) 662-9900 6603 West Broad Street, 5th Floor FAX (804) 662_9943 Richmond, Virginia 23230?1712 TDD (804) 6624,19? CERTIFICATION OF DUPLICATE RECORDS 1, Robert A. Nebiker, Director of the Department of Health Professions, hereby certify that the attached Order of Emergency Suspension of License (with attachments) entered July 1, 2004, regarding Charles Julian Crosby, D.O., are true copies of the records received from the State of Florida Department of Health. Date: all 2437/ Robert A. Nebiker Beard ofAudiology Speech - Language Pathology - Board of Dentistry - Board of Funeral Directors Embaimers -Board of Medicine -Board of Nursing Board of Nursing Home Administrators Board of Optometry Board of Pharmacy - Board of Counseling Board of Physical Therapy - Board of - Board of Social Work Board of Veterinary Medicine Board of Health Professions Final Order No. DOPE-040752- FLLED DATE [a ?Na Department of Health . STATE OF FLORIDA Dem DEPARTMENT OF HEALTH In Re: Emergency Suspension of the License of Charles Crosby, D.O. License No. 05 7061 Case Number 2004-12359 ORDER OF EMERGENCY SUPENSION OF LICENSE John O. Agwunobi, M.D., M.B.A., M.P.H., Secretary of the Department of Health, hereby ORDERS the emergency suspension of the license of Charles Crosby, D.O., Crosby?) to practice osteopathic medicine. Dr. Crosby holds license number OS 7061. His last known address is 13556 Dornoch Drive, Orlando, Florida 32828. The following Findings of Fact and Conclusions of Law support the Emergency Suspension of Dr. Crosby's license to practice osteopathic medicine. FINDINGS OF FACT 1. The Department of Health (?Department?) is the state department charged with regulating the practice of osteOpathic medicine pursuant to Chapters 20, 456, and 459, Florida Statutes. Section 456.073, Florida Statutes, authorizes the Secretary of the Department to summarily su3pend Dr. Crosby?s license to practice as an osteopathic . physician in the State of Florida, in accordance with Section Florida Statutes. 2. At all times material to this Order, Dr. Crosby was licensed to practice osteopathic medicine in the State of Florida. 3. At all times material to this Order, Dr. Crosby was a solo practitioner sharing a suite of of?ces with three other physicians. In Re: Emergency Suspension of the License of 1 Charles Crosby, 0.0. license No. OS 7061 Case Number 2004?12359 EXHIBIT z' a. 3 4. In about March 2002, Dr. Crosby treated Patient C, the wife of one of the physicians with whom he shared of?ce space. Patient C's physical complaint was of neck and upper thoracic pain. The following is an excerpt from Dr. Crosby?s statement concerning the treatment that he provided to Patient C: Ribs 1 and 2 were corrected in the following manner. . . . She had removed her blouse and bra. . . . When she was again seated with her right arm draped over my knee while I was standing behind. [sic]. . I stroked her right nipple with my ?ngertips, which immediately allowed the ribs to slip back in place reestablishing the normal motion pattern. The same maneuver was performed on the opposite side. I also kissed her on her cheek. . . . A hand on each breast gave feed back that normal motion had been established. 5. In about March 2002, about one week after the above-described treatment, Patient called Dr. Crosby?s of?ce to complain that his touching of her breasts during treatment had been inappropriate. She also stated that she was uncomfortable with Dr. Crosby?s manipulations on a prior visit when he touched her breasts, despite her request that about March 28, 2002, Dr. Crosby contacted the Professional Resource Network to report that he might be impaired because he had an unusual interest in chest and breast work. 7. PRN is the impaired practitioners program for the Board of Osteopathic Medicine (?the Board?), pursuant to Section 456.076, Florida Statutes. PRN is an independent program that monitors the evaluation, care, and treatment of impaired healthcare professionals, including osteopathic physicians. PRN provides for the exchange of information between treatment providers and the Department for the protection of the public. In Re: Emergency Suspension of the License of 2 Charles Crosby, 0.0. License No. 05 7061 Case Number 2004-12359 8. On or about May 7, 2002, Barbara A. Stein, M.D., (?Dru Stein?) a licensed Department?approved performed a PRN?facilitated examination of Dr. Crosby. During the evaluation, Dr. Crosby described two techniques of treatment that he had developed for the treatment of ?retroareolar somatic dysfunction.? Both treatments involved manipulating the breast and nipple of female patients. Dr. Stein reported that Dr. Crosby ?vacillated? throughout the exam about whether he might be obtaining some sexual grati?cation from his ?novel? osteopathic techniques. Dr. Crosby expressed concerns that he might have a ?breast fetish.? Dr. Stein Opined that Dr. Crosby?s preoccupation with the manipulation of women's breasts strongly suggested that he could be suffering from frotteurism. 9. Frottuerism is a mental disorder characterized by intense sexually arousing fantasies, sexual urges, or-behaviors involving touching or rubbing against the body of a non-consenting person. 10. On or about May 8, 2002, Dr. Stein, as part of her evaluation, contacted Dr. Crosby?s physician associates with whom he shared a suite of of?ces. According to these physicians, Dr. Crosby would sometimes pat female of?ce staff on their buttocks or grab their thighs for no apparent reason. A secretary had recently quit because Dr. Crosby had patted her buttocks and because other patients had sent letters to the of?ce complaining that they felt uncomfortable during Dr. Crosby?s manipulations. One of the physicians reported that he had witnessed Dr. Crosby?s hands ?lingering? on a female patients hips and sliding brie?y onto her buttocks during a manipulation. One of the physicians had observed Dr. Crosby reach across the examination table during an In Re: 2219;? of the License of 3 License No. 05 7061 Case Number 2004?1235? exam and stroke a female physician?s hair for no apparent reason. Dr. Stein also learned that Dr. Crosby would occasionally treat patients in his home. 11. On or about May 15, 2002, based on her evaluation, Dr. Stein diagnosed Dr. Crosby as suffering from paraphilia Frotteurism?provisional and recurrent depressive disorder. Dr. Stein also diagnosed Dr. Crosby as suffering from a narcissistic personality disorder, which was manifested by his sense of entitlement and interpersonal exploitation. According to Dr. Stein, Dr. Crosby?s personality disorder contributed to his paraphilia. She concluded that Dr. Crosby had a serious impairment in occupational functioning and that he was not safe to practice. Dr. Stein recommended that Dr. Crosby required the following: (1) neurological testing to rule out any other cause for Dr. Crosby?s behavior; (2) a ?ve?year PRN contract for problems, assuming no impairment is indicated by the neurological testing; (3) immediate intensive outpatient professional misconduct treatment; (4) ongoing individual therapy for at least two years; (5) group therapy for the term of the PRN contract; (6) if a request to return to practice is made, reevaluation of whether Dr. Crosby is safe to practice; (7) if he is returned to practice, quarterly patient survey and physician surveillance forms; (8) courses on professional boundaries; (9) if he is returned to practice, licensed female chaperone in the room at all times with female patients; and (10) further investigation into Dr. Crosby?s residency program, other state medical boards and past employers to help determine the extent of his problems. In Re: Emergency Suspension of the License of 4 Charles Crosby, 0.0. License No. 05 7061 Case Number 2004?12359 12. On or about May 15, 2002, James 8. Ball, M.D., performed a contrast enhanced magnetic resonance imaging test on Dr. Crosby to rule out any organic basis for his behavior. No abnormality of Dr. Crosby?s brain was demonstrated by the test. 13. On or about June 3, 2002, Dr. Crosby entered inpatient treatment at the Behavioral Medicine Institute of Atlanta 14. On or about June 14, 2002, Tracey L. Irvin, MD, Irvin?) prepared a summary of the BMI evaluation of Dr. Crosby. The summary described Dr. Crosby as having developed a special technique of manipulating?women's breasts to treat pain in other areas of their body. Dr. Irvin Opined that this practice has not been accepted in the medical community as a standard of care. Dr. Irvin further opined that Dr. Crosby's special interest in breasts is consistent with a breast fetish. During his evaluation, in addition to admitting that he touched women's buttocks for sexual grati?cation, Dr. Crosby also admitted to kissing patients. Dr. Crosby acknowledged that he was frequently sexually aroused when he touched patients. Dr. Irvin reported that Dr. Crosby had ?great dif?culty? appreciating the wrongfulness of his actions. Dr. Irvin diagnosed Dr. Crosby as suffering from fetishism, frotteurism, major depression in full remission, and narcissistic personality disorder. The BMI treatment team recommended intensive, inpatient, cognitive-behavioral treatment for eight weeks, followed by individual ?maintenance? therapy. BMI also recommended that when Dr. Crosby was allowed to return to practice, he should be required to see all patients, male and female, with a chaperone and that he should also be required to ensure the privacy of his patients by having a closed examination room. BMI recommended the use of staff In Re: Emergency Suspension of the Licerse of 5 Charles Crosby, 13.0. Ucense No. 05 7061 Case Number 2004-12359 surveillance forms, patient satisfaction forms, and a polygraph every six (6) months to determine whether Dr. Crosby touched patients or staff for sexual reasons. 15. On or about June .20, 2002, as part of his treatment at BMI, Dr. Crosby entered into a Comprehension Contract in which he listed his sexually inapprOpriate behavior. These included: touching patients' breass in a way they found offensive (example, stroking their nipples); examining patients without a chaperone watching from inside the room; kissing patients and staff; using the back of his hand to touch women on the buttocks without their prior consent; and using crass and sexual remarks that others found offensive. 16. On or about July 29, 2002, Dr. Irvin reported that after eight (8) weeks of treatment, Dr. Crosby still struggled with insight into his behavior and that during his last week at the facility, Dr. Crosby reverted back to the way he acted when he ?rst arrived at BMI. Based on this behavior, Dr. Irvin opined that Dr. Crosby was not safe to practice and recommended two (2) additional weeks of treatment. 17. On about August 16, 2002, Dr. Crosby successfully completed treatment at BMI. 18. On or about August 23, 2002, Dr. Irvin prepared a summary of Dr. Crosby?s treatment and presented the BMI treatment team?s conclusions and recommendations. BMI recommended weekly or bi-weekly individual ?maintenance? therapy with Allen Grleco, Grieco"). BMI also recommended the following practice restrictions should Dr. Crosby be returned to practice: 1) no breast exams (including breast manipulations); 2) no kissing patients; 3) no seeing patients in his home; 4) no pelvic In Re: ofme license of 6 License No. 05 7061 Case Number 2004-12359 exams; 5) a chaperone must be present in the room when examining female patients; 6) the examination room must be completely closed for patient privacy; 7) Dr. Crosby must not employ his patients; and 8) Dr. Crosby must not provide osteopathic treatment to his staff. 19. On or about September 16, 2002, Dr. Irvin opined that Dr. Crosby was not safe to practice because he demonstrated a ?tenuous grasp on the extent of his inappropriate sexual behavior." Dr. Crosby?s treatment team at BMI recommended: 1) that Dr. Crosby not be returned to work for three (3) months; 2) that Dr. Crosby should undergo individual therapy; and 3) that, prior to returning to practice, Dr. Crosby should re?evaluated. 20. In about September 2002, PRN drafted a Sexual Boundary Wola?o?on Contract for Dr. Crosby based on the recommendations of Drs. Stein and Irvin. Dr Crosby was also informed that he needed to sign a voluntary restriction of practice with the Department. Dr. Crosby?s PRN contract included his agreement not to return to practice without approval from PRN and the Board, re?evaiuation in three (3) months, bi-weekly individual therapy, weekly group therapy, and a polygraph test every six (6) months. The contract contained additional conditions in the event Dr. Crosby returned to work. Speci?cally, it provided that if Dr. Crosby returned to work he was not to see female patients without a chaperone and that he was not to see patients in a room that was not completely closed for patient privacy. 21. In about January 2003, Dr. Crosby executed the PRN contract described above. As set forth above, Dr. Crosby?s PRN contract provided that he was not to In Re: Emergency Suspension of the License of 7 Charles Crosby, 0-0. license No. 05 7061 Case Number 2004-12359 return to work until approved by PRN and the Board and that he was required to enter into arrestriction of practice agreement with the Department. However, Dr. Crosby failed to do any of these things. 22. In about June 2003, Dr. Crosby attended a trade show in Norfolk, Virginia, where he was marketing a medical device that was his own invention. At the trade show, a woman Dr. Crosby had known for ?some time? asked Dr. Crosby for an ?adjustment.? In a ?somewhat? private area on the trade show ?oor he proceeded to I adjust her neck. Then, according to Dr. Crosby, ?all the treatment I had went out the window.? He proceeded to manipulate the woman?s ribs and breasts. 23. On or about June 26, 2003, Dr. Grieco, Dr. Crosby?s PRN?approved therapist, contacted PRN and informed PRN of Dr. Crosby's relapse that had occurred in Norfolk. 24. On or about June 26, 2003, Joe Trim, LMHC, Trim?) Dr. Crosby?s group therapist, informed PRN of Dr. Crosby?s relapse described above. Mr. Trim reported that Dr. Crosby blamed the incident in Norfolk on aluminum because he had started using a deodorant containing aluminum. Mr. Trim also reported that Dr. Crosby did not equate the treatment he performed on the woman in Norfolk with ?practicing.? Further, in discussing his relapse, Dr. Crosby told his therapy group that he was not refrained from practicing. 25. On or about July 1, 2003, Dr. Irvin of BMI informed PRN that based on Dr. Crosby?s relapse behavior, he ?will not ever? have enough control to see patients and should be restricted to no patient care. In Re: Emergency Suspension of the License of 8 Charles Crosby, 0.0. Ucense No. 05 7051 26. On or about August 27, 2003, based on the above relapse, Dr. Crosby?s treatment team at BMI recommended to PRN that Dr. Crosby?s license be restricted to no patient care. 27. On or about September 10, 2003, and October 1, 2003, PRN contacted or attempted to contact counsel of record for Dr. Crosby concerning the need for Dr. Crosby to sign a restriction of practice agreement with the Department. 28. On or about January 29, 2004, PRN sent a letter to Dr. Crosby?s attorney giving Dr. Crosby ten (10) business days to execute a restriction of practice before PRN referred the case to the Department and requested an emergency suspension of Dr. Crosby's license. 29. On or about February 12, 2004, Dr. Grieco informed PRN that Dr. Crosby should be refrained from practice. 30. On or about March 17, 2004, after Dr. Crosby and his attorney failed to respond to request that Dr. Crosby execute a restriction of practice, Raymond M. Pomm, M.D., Pomm?) Medical Director of PRN, reported Dr. Crosby to the Department for non-compliance with PRN recommendations. In his letter, Dr. Pomm opined that Dr. Crosby was unsafe to practice his profession with reasonable skill and safety and that his return to practice would be an immediate threat to the public health, safety, and welfare. Dr. Pomm stated that his opinion was based on the seriousness of the patient and staff sexual boundary violations, the impressions of PRN, BMI and Dr. Grieco that Dr. Crosby was unsafe to practice, and ?nally, Dr. Crosby?s failure to sign a voluntary restriction of practice. Dr. Pomm explained that the voluntary restriction was In Re: of the License of 9 License No. 05 7061 Case Numbe- 2004-12359 necessary because PRN was unable to monitor whether or not Dr. Crosby returned to work without approval. 31. On or about April 1, 2004, the Department noti?ed Dr. Crosby of its investigation in this matter. 32. Section Florida Statutes (2003), subjects a licensee to discipline, including suspension, for being unable to practice osteOpathic medicine with reasonable skill and safety to patients by reason of illness or use of alcohol, drugs, narcotics, chemicals, or any other type of material or as a result of any mental or physical condition. 33. As described above, Drs. Stein, Grieco, Pomm, and Irvin have each opined that Dr. Crosby is unsafe to practice as a result of his mental disorders. 34. Section Florida Statutes (2001 2002), subjects a licensee to discipline, including suspension, for exercising in?uence within a patient-physician relationship for purposes of engaging a patient in sexual activity. A patient is presumed to be incapable of giving free, full, and informed consent to sexual activity with his or her physician. 35. As described above, Dr. Crosby exercised his in?uence within patient- physician relationships in order to engage in sexual activities with the patients, including manipulating and touching the buttoclc; of patients, manipulating the breasts of patients, and stroking the nipples of patients. 36. Section Florida SEtutes (2001 2002), subjects a licensee to discipline, including suspension, for violating any provision of Chapters 459 or 456, or In Re: Emergency Suspension of the License of 10 Charles Crosby, 0.0. ernse No. OS 7061 Case Number 2004-1359 any rules adOpted pursuant thereto. Section 459.0141, Florida Statutes (2001 2002), prohibits sexual misconduct in the practice of osteopathic medicine. It de?nes ?sexual misconduct in the practice of osteopathic medicine? to mean a violation of the osteopathic physician-patient relationship through which the osteopathic physician uses the relationship to induce or attempt to induce the patient to engage, or to engage 0r attempt to engage the patient, in sexual activity outside the scope of the practice or the scope of generally accepted examination or treatment of the patient. 37. As described above, Dr. Crosby used the physician-patient relationship to induce or attempt to induce patients to engage, or to engage or attempt to engage the patients in sexual activity outside the scope of generally accepted examination or treatment of patients by manipulating and stroking female patients? buttocks, breasts, and nipples. 38. Section Florida Statutes, authorizes the Department to suspend an osteopathic physician?s license if the Department ?nds that the osteopathic physician presents an immediate serious danger to the public health, safety, or welfare. 39. Dr. Crosby?s demonstrated pattern of inappropriate sexual conduct and his relapse related to paraphilia-frotteurism present an immediate serious danger to the health, safety, and welfare of the public. 40. Dr. Crosby has shown a ?agrant disregard for the duties and responsibilities imposed upon osteopathic physicians practicing in the State of Florida and for the health and welfare of his patients. Dr. Crosby?s repeated acts of inappropriate sexual conduct in the physician-patient relationship constitute a breach of the trust and In Re: Emergency Suspension of the license of 11 Charis Crosby, 0.0. license No. 08 7061 Case Number 2004-12359 con?dence that the Legislature placed in him by allowing him to practice osteOpathic medicine in the State of Florida. 41. Dr. Crosby?s acts manifest such a pattern of, and propensity for, mental illness and sexual misconduct that his continued practice as an osteopathic physician poses an immediate serious danger to the health, safety, and welfare of the citizens of the State of Florida. Nothing short of the immediate suspension of Dr. Crosby?s license will ensure the protection of the public from this danger. CONCLUSIONS OF LAW 1. The Secretary of the Department of Health has jurisdiction over this matter pursuant to Sections and 456.073, Florida Statutes, and Chapter 459, Florida Statutes, as set forth above. 2. Based on the foregoing Findings of Fact, the Secretary concludes that Dr. Crosby has violated Section Florida Statutes (2003), by being unable to practice osteOpathic medicine with reasonable skill and safety to patients by reason of illness or use of alcohol, drugs, narcotics, chemicals, or any other type of material or as a result of any mental or physical condition. 3. Based on the foregoing Findings of Fact, the Secretary concludes that Dr. Crosby has violated Section Florida Statutes (2001 2002), by exercising in?uence within a patient-physician relationship for purposes of engaging a patient in sexual activity. 4. Based on the foregoing Findings of Fact, the Secretary concludes that Dr. Crosby has violated Section 459.0141, Florida Statutes (2001 2002), thereby violating In Re: Emergency Suspension of the License of 12 Charles Crosby, DD. License No. 03 7061 Case Number 2004-12359 Section Florida Statutes (2001 81 2002) by using the physician-patient relationship to engage or attempt to engage in sexual activity outside the scope of generally accepted examination or treatment of a patient for his own sexual grati?cation. 5. Based on the foregoing, the Secretary ?nds that Dr. Crosby?s continued practice as a licensed osteopathic physician constitutes an immediate serious danger to the health, safety, and welfare of the public and that this summary procedure is fair under the circumstances to adequately protect the public. WHEREFORE, in accordance with Section Florida Statutes, it is THEREUPON ORDERED THAT: 1. The license of Charles Crosby, D.O., license number OS 7061, is hereby immediately suspended. 2. A proceeding seeking formal suspension or discipline of the license of Charles Crosby, D.O., to practice osteopathic medicine will be instituted and acted upon in compliance with Sections 120.569 and Florida Statutes. DONE and ORDERED this day of Jul-1? . 2004. 43244? WAgWunobi, M.D., M.B.A., M.P.H. Secremry, Department of Health PREPARED BY: Catherine Bedell 405027 Assistant General Counsel DOH, Prosecution Services unit 4052 Bald Cypress Way, Bin Tallahassee, Florida 32399-3265 (850) 414-8126-Telephone (850) 414?1989?Telefax In Re: Emergency Suspension of the License of 13 Ci'larles Crosby, 0.0. License No. OS 7061 Case Number 2004-12359 NOTICE OF RIGHT TO JUDICIAL REVIEW Pursuant to Section and 120.68, Florida Statutes, the Departrnent?s ?ndings of immediate danger, necessity, and procedural fairness shall be judicially reviewable. Review proceedings are governed by the Florida Rules of Appellate Procedure. Such proceedings are commenced by ?ling one copy of a Petition for Review, in accordance with Florida Rule of Appellate Procedure 9.100, with the Department of Health and a second copy of the petition accompanied by a ?ling fee prescribed by law with the District Court of Appeal within thirty (30) days of the date this Order is ?led. In Re: Emergency Suspension of the license of 14 Charis Crosby, 13.0. Liceme No. 05 7051 Case Number 2004-1259 STATE OF FLORIDA DEPARTMENT OF HEALTH DEPARTMENT OF HEALTH, v, CASE NO. 2004-12359 CHARLES CROSBY, RESPONDENT. ADMINISTRATIVE COMPLAINT COMES NOW Petitioner, Department of Health, by and through its undersigned counsel, and files this Administrative Complaint before the Board of Osteopathic Medicine against Respondent, Charles Crosby, DO, and in support thereof alleges: 1. Petitioner is the state agency charged with regulating the practice of osteopathic medicine pursuant to Section 20.43, Florida Statutes, and Chapters 456 and 459, Florida Statutes. 2. At all times material to this Complaint, Respondent was a licensed osteopathic physician within the state of Florida, having been issued license number 05 7061 on July 13, 1995. 3. Respondent?s last known address of record is 13556 Dornoch Drive, Orlando, Florida 32828. 4. On or about March 28, 2002, Respondent contacted the Professional Resource Network to report that he might be impaired because he had an unusual interest in chest and breast work. *rl'lilZ?il T?f? 5. PRN is the impaired practitioners program for the Board of Osteopathic Medicine (?the Board?), pursuant to Section 456.076, Florida Statutes. PRN is an independent program that monitors the evaluation, care, and treatment of impaired healthcare professionals, including osteopathic physicians. PRN provides for the exchange of information between treatment providers and the Department for the protection of the public. 6. On or about May 7, 2002, Barbara A. Stein, MD, Stein?) a licensed Department?approved performed a PRN-facilitated examination of Respondent. 7. On or about May 15, 2002, based on her evaluation, Dr. Stein diagnosed Respondent as suffering from paraphilia Frotteurism?provisional and recurrent depressive disorder. 8. Frottuerism is a mental disorder characterized by intense sexually arousing fantasies, sexual urges, or behaviors involving touching or rubbing against the body of a nonwconsenting person. 9. Dr. Stein also diagnosed Respondent as suffering from a narcissistic personality disorder, which was manifested by his sense of entitlement and interpersonal exploitation. 10. Dr. Stein concluded that Respondent had a serious impairment in occupational functioning and that he was not safe to practice, and made the following recommendations: (1) neurological testing to rule out any other cause for Respondent?s behavior; (2) a ?ve-year contract for problems, assuming no impairment is indicated by the neurological testing; (3) immediate intensive outpatient professional misconduct treatment; (4) ongoing individual therapy for at least two years; (5) group therapy for the term of the PRN contract; (6) if a request to return to practice is made; re-evaluation of whether Respondent is safe to practice; (7) if he is returned to practice; quarterly patient survey and physician surveillance forms; (8) courses on professional boundaries; (9) if he is returned to practice, licensed female chaperone in the room at all times with female patients; and (10) further investigation into Respondent?s residency program; other state medical boards and past employers to help determine the extent of his problems. 11. On or about May 15; 2002, James B. Ball; M.D., performed a contrast enhanced magnetic resonance imaging test on Respondent to rule out any organic basis for his behavior. No abnormality of Respondents brain was demonstrated by the test. 12. On or about June 3; 2002; Respondent entered inpatient treatment at the Behavioral Medicine Institute of Atlanta 13. On or about June 14; 2002; Tracey L. Irvin; Irvin?) prepared a summary of the BMI evaluation of Respondent; describing Respondent as having developed a special technique of manipulating women?s breasts to treat pain in other areas of their body. 14. Dr. Irvin opined that this practice has not been accepted in the medical community as a standard of care. 15. Dr. Irvin further opined that Respondent?s special interest in breasts is consistent with a breast fetish. 16. Dr. Irvin reported that Respondent had ?great dif?culty? appreciating the wrongfulness of his actions. 4) 17. Dr. Irvin diagnosed Respondent as suffering from fetishism, frotteurism, major depression in full remission, and narcissistic personality disorder. 18. The BMI treatment team recommended intensive, inpatient, cognitive? behavioral treatment for eight weeks, followed by individual ?maintenance? therapy. 19. BMI also recommended that when Respondent was allowed to return to practice, he should be required to see all patients, male and female, with a chaperone and that he should also be required to ensure the privacy of his patients by having a closed examination room. 20. BMI recommended the use of staff surveillance forms, patient satisfaction forms, and a polygraph every six (6) months to determine whether Respondent touched patients or staff for sexual reasons. 21. On or about June 20, 2002, as part of his treatment at BMI, Respondent entered into a Comprehension Contract in which be listed his sexually inappropriate behavior, which included touching patients? breasts in a way they found offensive (example, stroking their nipples); examining patients without a chaperone watching from inside the room; kissing patients and staff; using the back of his hand to touch women on the buttocks without their prior consent; and using crass and sexual remarks that others found offensive. 22. On or about July 29, 2002, Dr. Irvin reported that after eight (8) weeks of treatment, Respondent still struggled with insight into his behavior and that, during his last week at the facility, Respondent had reverted back to the way he acted when he ?rst arrived at BMI. 23. Based on this behavior, Dr. Irvin opined that Respondent was not safe to practice and recommended two (2) additional weeks of treatment. 24. On about August 16, 2002, Respondent successfully completed treatment at BMI. 25. On or about August 23, 2002, Dr. Irvin prepared a summary of Respondent?s treatment and presented the BMI treatment team?s conclusions and recommendations. 26. BMI recommended that Respondent participate in weekly or bi?weekly individual ?maintenance? therapy with Allen Grieco, Grieco?). 27. BMI also recommended the following practice restrictions should Respondent return to practice: 1) no breast exams (including breast manipulations); 2) no kissing patients; 3) no seeing patients in his home; 4) no peIVic exams; 5) a chaperone must be present in the room when examining female patients; 6) the examination room must be completely closed for patient privacy; 7) Respondent must not employ his patients; and 8) Respondent must not provide osteopathic treatment to his staff. 28. On or about September 16, 2002, Dr. Irvin Opined that Respondent was not safe to practice because he demonstrated a ?tenuous grasp on the extent of his inappropriate sexual behavior.? 29. Respondent?s treatment team at BMI recommended: 1) that Respondent not be returned to work for three (3) months; 2) that Respondent should undergo individual therapy; and 3) that, prior to returning to practice, Respondent should re? evaluated. 30. In about September 2002, PRN drafted a Sexual Boundary Violation Contract for Respondent based on the recommendations of Drs. Stein and Irvin, and informed Respondent that he needed to sign a voluntary restriction of practice with the Department. 31. Respondent?s PRN contract included his agreement not to return to practice without approval from PRN and the Board, re-evaluation in three (3) months, bi?weekly individual therapy, weekly group therapy, and a polygraph test every six (6) months. 32. The PRN contract contained additional conditions in the event Respondent returned to work. Speci?cally, it provided that if Respondent returned to work he was not to see female patients without a chaperone and that he was not to see patients in a room that was not completely closed for patient privacy. 33. In about January 2003, Respondent executed the PRN contract. 34. In about June 2003, Respondent suffered a relapse in behavior, manipulating the ribs and breasts of a female while attending a trade show in Norfolk, Virginia, where he was marketing a medical device that was his own invention. 35. On or about June 26, 2003, Dr. Grieco, Dr. Respondent?s PRN-approved therapist, contacted PRN and informed PRN of Respondent?s relapse that had occurred in Norfolk. 36. On or about June 26, 2003, Joe Trim, LMHC, Trim") Respondent?s group therapist, informed PRN of Respondent?s relapse. 37. Mr. Trim reported that Respondent blamed the incident in Norfolk on aluminum because he had started using a deodorant containing aluminum. 38. Mr. Trim also reported that Respondent did not equate the treatment he performed on the woman in Norfolk with ?practicing.? Further, in discussing his relapse, Respondent told his therapy group that he was not refrained from practicing. 39. On or about July 1, 2003, Dr. Irvin of BMI informed PRN that based on Respondent?s relapse behavior, he ?will not ever? have enough control to see patients and should be restricted to no patient care. 40. On or about August 27, 2003, based on the above relapse, Respondent?s treatment team at BMI recommended to PRN that Respondent?s license be restricted to no patient care. 41. On or about September 10, 2003, and October 1, 2003, PRN contacted or attempted to contact counsel of record for Respondent concerning the need for Respondent to sign a restriction of practice agreement with the Department. 42. On or about January 29, 2004, PRN sent a letter to Respondent?s attorney giving Respondent ten (10) business days to execute a restriction of practice before PRN referred the case to the Department and requested an emergency suspension of Respondent?s license. 43. On or about February 12, 2004, Dr. Grieco informed PRN that Respondent should be refrained from practice.- 44. On or about March 17, 2004, after Respondent and his attorney failed to respond to request that Respondent execute a restriction of practice, Raymond M. Pomm, MD, Pomm?) Medical Director of PRN, reported Respondent to the Department for non-compliance with PRN recommendations. 45. In his letter to the Department, Dr. Pomm opined that Respondent was unsafe to practice his profession with reasonable skill and safety and that his return to practice would be an immediate threat to the public health, safety, and welfare. 46. Dr. Pomm stated that his opinion was based on the seriousness of the patient and staff sexual boundary violations, the impressions of PRN, BMI and Dr. Grieco that Respondent was unsafe to practice, and ?nally, Respondent's failure to sign a voluntary restriction of practice. 47. Dr. Pomm explained that the voluntary restriction was necessary because PRN was unable to monitor whether or not Respondent returned to work without approval. 48. Section Florida Statutes (2003), provides that being unable to practice osteopathic medicine with reasonable skill and safety to patients by reason of illness or use of alcohol, drugs, narcotics, chemicals, or any other type of material or as a result of any mental or physical condition constitutes grounds for disciplinary action by the Board of Osteopathic Medicine. 49. Respondent is unable practice osteopathic medicine with reasonable skill and safety to patients due to his mental disorders. 50. Based on the foregoing, Respondent has violated Section Florida Statutes (2003), by being unable to practice osteopathic medicine with reasonable skill and safety to patients by reason of illness or use of alcohol, drugs, narcotics, chemicals, or any other type of material or as a result of any mental or physical condition. WHEREFORE, the Petitioner respectfully requests that the Board of Osteopathic Medicine enter an order imposing one or more of the following penalties: 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. dayof . lot/Ky? ,2003; John O. Agwunobi, M.D., M.B.A., M.P.H. Secretary, Department of Health HLED DEPARTMENT OF HEALTH Richard 37 Shoop r? DEPUTY GLER Assistant General Counsel Florida Bar 0389234 -0q DOH, Prosecution Services Unit onerljiin?wn? 4052 Bald Cypress Way, Bin Tallahassee, Florida 32399?3265 Tel.: (850) 414?8126 Fax: (850) 488~1855 Reviewed and approved by: (initials) 1H 01. (date) PCP Date: 3:5, Lg zany PCP Members: ?ancee.ng 00H v. Char/e5 Crosb? 0.0., case no. 2004?12359 NOTICE OF RIGHTS Respondent has the right to request a hearing to be conducted in accordance with Section 120.569 and 120.57, Florida Statutes, to be represented by counsel or other quali?ed representative, to present evidence and argument, to call and cross?examine witnesses and to have subpoena and subpoena duces tecum issued on his or her behalf if a hearing is requested. NOTICE REGARDING ASSESSMENT OF COSTS Respondent is placed on notice that Petitioner has incurred costs related to the investigation and prosecution of this matter. Pursuant to Section 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 00H v. Char/es 00519? D. 0., case no. 2004-12359 10 (If? Final Order No. 4 - - Dennmmuof?e?m By Deputy Agency Clerk STATE OF FLORIDA BOARD OF MEDICINE DEPARTMENT OF HEALTH, Petitioner, CASE NO.: 2004-12359 vs. LICENSE NO. 08007061 CHARLES CROSBY, 13.0., Respondent. FINAL ORDER THIS CAUSE came before the BOARD OF OSTEOPATHIC MEDICINE (Board) pursuant to Sections 120.569 and Florida Statutes, on November 13, 2004, in Orlando, Florida, for the purpose of considering a Consent Agreement (attached hereto as Exhibit A) entered into between the parties in this cause; Upon consideration of the Consent 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 Consent 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 $1,018.80. Accordingly, the parties shall adhere to and abide by all the terms and conditions of the Consent Agreement as clarified above. This Final Order shall take effect upon being filed with the Clerk of the Department of Health. DONE AND ORDERED this 093 day 015W r? 2004. BOARD OF OSTEOPATHIC MEDICINE Pamela King Executive Director CE TI 8 VI I HEREBY CERTIFY that a true and correct copy of the foregoing Final Order has been furnished by U. S. Mail to Charles Crosby, D.O., 13556 Dornoch Drive, Orlando, Florida 32828; to Steven R. Ballinger, Esquire, 888 South Andrews Avenue, Suite 205, Fort Lauderdale, Florida 3316; and by interoffice delivery to and by interoffice delivery to Richard Shoop, Assistant General Counsel, and Dana Baird, Assistant General Counsel, Department of Health, 4052 Bald Cypress Way, Bin Tallahassee, Florida 32399-3265 this day of 2004. ?00 Denim! Agency merit 151 STATE OF FLORIDA BOARD OF OSTEDPATHIC MEDICINE DEPARTMENT OF HEALTH, Petitioner, v. DOH Case Number 2004-12359 CHARLES CROSBY, Respondent. I Chane-.5 Crosby, 110., 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 Osteopathic Medicine, referred to as "Board," incorporating the Stipulated Facts and S?pulated DiSpositlon in this matter. 1. At all times material hereto, Respondent was a licensed ost30pa1hlc physician in the State of Florida having been issued license number 05 7061. 2. Respondent neither admits nor denies the allegations of fact contained in the Administrative Complaint for purposes of time only. 1. Respondent that, in his capacity as a licensed osteopathic physician, he is subject to the provisions of Chapters 456 and 459, Fiorida Statutes, and the jurisdiction of the Department and the Board. 152 2. Respondent admits that the facts set forth in the Administrative Compialnt, if proven, would constitute violations of Chapter 459, Florida Statutes, as alleged In the Administrative Complaint 3. Respondent admits that the Stipuiabed Disposition in this case is fair, and acceptable to Respondent. 1. Respondent shall not in the future violate Chapters 456, 459 and 893, Florida Statutes, or the rules promulgated pursuant thereto. Pn'or to signing this agreement, Respondent will read Chapters 456 and 459, Florida Statutes, and the Rules of the Board of Osteopathic Medicine, at Section 648-15, Florida Adminiso'a?ve Code. 2. mm, Respondent?s license to practice osteopathic medicine shall be suspended until such time as Respondent can appear before the Board and successfully demonstrate that he is able to practice osteopathic medicine with reasonable skill and safety to patients. Such demonstration shall include, but not be limited to, a favorable recommendation from the Professionals Resource Network (PRN). At that time, the Board may conditionally reinstate Respondent?s license to practice osteopathic medicine subject to the imposition of such additionai terms and conditions, including, but not limited to, participation in PRN, probation, resb'iction of practice, and corrective action, as It deems necessary in order to protect the health and safety of the citizens of the State of Florida. 153 3. The Respondent agrees to reimburse the Department for any administrative costs incurred In the investigation and preparation of this case, including cosm assessed by the Division of Administrative Hearings, if applicable, and by the Board of Osteopathic Medicine of?ce. The agreed upon Deparb?nent costs to be reimbursed in this case is not to eXiteed one thousand ?ve hundred dollars The cosis in this case are currently eight hundred ninety-six dollars and twelve cents The Respondent shall pay the costs to the Board of Osteopathic Medicine within days of the entry of the Final Order. THE RESPONDENT ACKNOWLEDGES THAT THE TIMELY PAYMENT OF THE COSTS IS HIS LEGAL OBLIGATION AND RESPONSIBILITY AND RESPONDENT AGREES TO CEASE PRACTICING IF THE ARE NOT PAID AS AGREED TO IN THIS CONSENT AGREEMENT, SPECIFICALLY: IF THE RESPONDENT HAS NOT RECEIVED WRITTEN CONFIRMATION THAT THE FULL AMOUNT OF THE COSTS NOTED ABOVE HAS BEEN RECEIVED BY THE BOARD OFFICE WITHIN SIXTY (60) DAYS OF THE ENTRY OF THE FINAL ORDER, THE RESPONDENT AGREES TO CEASE PRACTICE UNTIL SUCH WRITTEN CONFIRMATION IS RECEIVED BY THE RESPONDENT FROM THE BOARD. (SEE EXHIBIT A OF THIS CONSENT AGREEMENT FOR BOARD ADDRESS AND STANDARD TERMS. 4. W: In arriving at this diSposition the parties did not consider any mitigating factors. 5. It is expressly understood that this Agreement is subject to the approval of dwe Board and the Department. In this regard, the foregoing paragraphs (and only the 154 foregoing paragraphs) shall have no force and effect unless the Board enters a ?nal Order incorporating the terms of this Agreement 6. Respondent shall appear before the Board at the meeting of the Board where this Agreement is considered. Respondent, in conjunction with the consideration of this Agreement by the Board, shall respond to questions under oath from the Board, Board Staff or Department Staff. Respondent shall be prepared to explain the circumsiances involved In this matter and what measures have been taken to prevent a recurrence. 7. Should this Agreement be rejected, no statement made in furtherance of this Agreement by the Respondent may be used as direct evidence against the Respondent in any proceeding; however, such statements may be used by the Petitioner for impeachment purposes. 8. Respondent and the Deparbnent fully understand that this joint Agreement and subsequent Final Order incorporating same will in no way preclude additional proceedings by the Board and/or the Department against the Respondent for acts or omissions not speci?cally set forth in the Administrative Complaint. 9. Upon the Board?s adoption of this Agreement, Respondent expressly waives all further procedural steps, and expressly waives all righis 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. 10. Respondent waives the right to seek any attorney's fees or cosis from the Deparb'nent in oonnection with this matter. 155 11. This Agreement is executed by the Respondent for the purpose of avoiding further administrative action with respect to this cause. In this regard, Respondent authorizes the Board to review and examine all investigative ?le materials concerning Respondent prior to or In conjunction with consideration of the Agreement. Furthennore, should this joint Agreement not be accepted by the Board, it is agreed that presentadon 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. SIGNED this 4 day of [9427? .237" 2004. 442/ c??anes Crosbg?o. Before me, personally appeared Charles Crosby, 0.0., whose identity is known to me by (type of identi?cation) and who, under oath, acknowledges that his signature appears above. Sworn to and subsumed before me this day of A 1/9 My Commission Expires: ANN KELLERMAN t-mzm'tm ?lmmam?r .?mmw. . APPROVED this (0 day of . 2004. John O. Agwunobl, M.D., M.B.A., MPH. Sea-etary, Department of Health ?/Mg J. By: Wings 5. genton Deputy General Counsel Prosecution Services Unit 156 157 EXHIBIT A STANDARD TERMS APPLICABLE TO CONSENT AGREEMENT 5 The following are the standard terms applicable to all consent agreements, including supervision and monitoring provisions applicable to licensees on probation. A. EAYMENT OF FINES. Unless othemrise directed by the consent agreement, all ?nes shall be paid by check or money order and sent to the Board address set forth in paragraph E, below. The Board of?ce does not have the authority to change the terms of payment of any ?ne imposed by the Board. B. COMMUNITY BERVICE AND CONTINUING EDUCATION UNIIS. Unless othemise directed by the consent agreement, all community service requirements, continuing education units/courses must be completed, and documentation of such completion submitted to the Board of Osteopathic Medicine at the address set forth below in paragraph E, WITHIN ONE YEAR OF THE DATE OF THE FINAL ORDER. C. wages. addresses on ?ie with the Board. Respondent shali notify the Board within ten (10) days Reapondent must keep current residence and practice of any changes of said addresses. Furthermore, if the Respondents license ls on probation, the Respondent shall notify the Board within ten (10) days in the event that Respondent leaves the active practice of osteopathic medicine in Florida. D. Pursuant to Section 4593159), Florida Statutes, the Respondent shall pay all costs necessary to comply with the terms of this Consent Agreement. Such costs include, but are not limited to, the costs of preparation of Investigative Reports detailing compliance with the terms of the Consent Agreement, obtaining supervision or monitoring of the practice, the cost of quality assurance reviews, and the Board?s administrative costs directly associated with Respondent?s probation. E. Unless otherwise directed by the Board of?ce, all ?nes and costs shall be sent to: Department of Health, Services, P.O. Box 6320, Tallahassee, Florida 32314-6320, Arum: Medical Compliance Of?cer. Unless otherwise directed by the Board of?ce, all other correspondence shall be sent to: Department of Health, Services,i Bin 4052 Bald Cypress Way, Tallahassee, Florida 32399?3251, Attn.: Medical Compliance Of?cer. 158 ELECTION OF FtIGl-n?s OOH 9. modes Cmsoy. 9.0. Case No. 2004-12359 PLEASE SELECT ONLY 1 OF THE 3 OPTIONS ManbianationafRights isattached. Ifyouoo not understand these optione.piease consme n?orneyoroomadthe attorneyiorthe Proeewtion Services Unitatthe addressiphone numbe-r?stedatthe bottomotti?siorm. OPTION 1. Ida not dispute the allegations 0t iactin theAdminisu'ative Complaint. but do wishtobe accorded a hearing. theoomplainttotheBoard. OPTION 2. ldo not dispute the allegations of fact commend In the Administm?ve Complaint and waive my right to object orto be heard. lrequestthat the Boom enters ?nal order pursuant to Section 120.57. Fiorida Statutes. OPTION3. loo disg?ethea?egatione request?tistobeoonsidered a petition tor iom?nai hearing. pmeuant to Sections 120.569t2xe) and Florida Statutes. before an Administ Law Judge appomted by the D'Msion 0! Administrative Hearings I speci?cally dispuos the Iotiowing moi-rpm o! the Administrative Compllint cation I also II - I accept the ten-n5 of the Settlement Stipulation. have signed and am returning the Settlement Stiputatton or I am interested in settling this ease. I do not wish to continue practicing. have signed and returned the voluntary formula-merit of Iioeneme Down. If It has been provided. Reset-dim of which option I have uiectld, I understand that I wit! be given notice ottime. date. end place when this Media?onunderSeotion 129.513, m. (Pious Sign and complete all the Womation below.) Respondents sign Adda-.33: US. No. Phone No. FaxNo. STATEOFFLORI COUNTYOF wheaeEderIItIyisknowntomeby A {typed - methts 5? dayef ?M?fgf' 2004- I ANN L. KELLEFIMM OOMMIBBION a or; TypeorPrinmm - .. .. PLEASE MAIL AHDIOR FAX COMPLETED FORM TO: Rt . p. Mutual-M OOH. Pto?cution Services Unit, 4052 Bald Cyprus Way. Bin 0.55. Tanahass?bmro?e'nwnben {350) 414.3125: FAX {swim-1855: TDD 1-600-955-8771. 159 160 STATE OF FLORIDA DEPARTMW OF DEPARTMENT or PETITIONER, v. CASE NO. 2004?12359 CHARLES CROSBY, RESPONDENT. MIN 12 COMES NOW Petitioner, Department of Health, by and through its undersigned counsel, and ?les this Administrative Complaint before the Board of Dsteopatl'lic Medicine against Respondent, Charles Crosby, 0.0., and in support thereof alleges: 1. Petitioner is the state agency charged 'with regulating the practice of osteopathic medicine pursuant to Section 20.43, Florida Statutes, and Chapters 456 and 459, Florida Statutes. 2. At all times material to this Complaint, Respondent was a licensed osteopamic physician within the state of Florida, having been issued license number OS 7'061 on July 13, 1995. 3. Respondent's last known address of record is 13556 Domoch om, O?ando, Florida 32828. 4. On or about March 28, 2002, Respondent contacted me Professional Resource Network to report that he might be impaired because he had an unusual interst in chest and breast worlc 161 5. PRN is the impaired practitioners program for the Board of Osteopathic Medicine (?the Board"), pursuant to Section 456.076, Florida S?Eltutes. PRN is an independent program that monitors the evaluation, care, and treatment of impaired healthcare professionals, including osteopathic physicians. PRN provides for the exchange of information between treatment providers and the Department for the protection of the public. 6. On or about May 7, 2002, Barbara A. Stein, M.D., (?De Stein?) a iicensed Department-approved performed a examination of Respondent 7. On or about May 15, 2002, based on her evaluation, Dr. Stein diagnosed ReSpondent as suffering from paraphilia Frotteurism?provisionai and recurrent depressive disorder. 8. Frottuerisrn is a mental disorder characterized by intense sexmily arousing fantasies, sexual urges, or behaviors involving touching or rubbing against the body of a non-consenan person. 9. Dr. Stein also diagnosed Respondent as suffering from a narcissistic personality disorder, Which was manifested by his sense of entitlement and interpersonal explanation. 10. Dr. Stein concluded that Respondent had a serious impairment in occupational functioning and that he was not safe to practice, and made the following recommendations: (1) neurological testing to rule out any other cause for Respondent's behavior; a five?year PRN contract for problems, assuming no impairment is indicated by the neurological testing; (3) is} 162 immediate intensive outpatient professional misconduct treatment; (4) ongoing individual therapy for at least two years; (5) group therapy for the term of the PRN contract; (6) if a request to return to practice is made, reevaluation of whether Respondent is safe to practice; (7) If he is returned to practice, quarterly patient survey and physician surveillance forms,- courses on professional boundaries; (9) if he is returned to practice, licensed female chaperone in the room at all times with female patients; and (10) further investigation into Respondent?s residency program, other state medical boards and past employers to heip determine the extent of his problems. 11. On or about May 15, 2002, James 8. Ball, M.D., performed a contrast enhanced magnetic resonance imaging test on Respondent to rule out any organic basis for his behavior. No abnormality of Respondents brain was demonstrated by the tat. 12. On or about June 3, 2002, Respondent entered inpatient treatment at the Behavioral Medicine Institute of Atlanta 13. On or about June 14, ZDUZ, Tracey 1.. Irvin, M.D., (?Din Irvin") prepared a summary of the BMI evaluation of Respondent, describing Respondent as having developed a special technique of manipulating women's breasts to treat pain in other areas of their body. 14. Dr. Irvin opined that this practice has not been accepted in the medical community as a standard of care. 15. Dr. Irvin further opined that Respondent?s special interest in breasts is consistent with a breast fetish. 16. Dr. Irvin reported that Respondent had ?great dif?culty" appreciating the wrongfulness of his actions. a) 163 17. Dr. Irvin diagnosed Respondent as suffering from fetishism, frotteurism. major depression in fuli remission, and narcissistic personality disorder. 18. The BMI treatment team recommended intensive, inpatient, cognitive? behavioral treatment for eight weeks, followed by individual ?mainteziance? therapy. 19. BMI also recommended that when Respondent was allowed to return to practice, he should be required to see all patients, male and female, with a chaperone and that he should alanine required to ensure the p?vaw of his patients by having a closed examination room. 20. BMI recommended the use of staff surveiliance forms, patient satisfadzion forms, and a polygraph every six (6) months to determine whe?d'ler Respondent touched patients or staff for sexuai reasons. 21. On or about June 20, 2002, as part of his treatment at BMI, Respondent entered into a Comprehension Contract in which he listed his sexually inappropriate behavior, which included touching patients? breasts in a way they found offensive (example, stroking their nipples); examining patients without a chaperone watching from inside the room; kissing patients and staff; using the back of his hand to touch women on the buttocks without their prior consent; and using crass and sexual remarks that others found offensive. 22. On or about July 29, 2002, Dr. Irvin reported that after eight (8) weele of treatment, Respondent still struggled with insight into his behavior and that, during his iast Week at the fadiity, Respondent had reverted back to the way he acted when he arrived at BMI. 164 23. Based on this behavior, Dr. Irvin opined that Respondent was not safe to practice and recommended two (2) additional weeks of treatment. 24. On about August 16, 2002, Respondent successfuliy completed treatment at BML 25. On or about August 23, 2002, Dr. Irvin prepared a summary of Respondents treatment and presented the BMI treatment team?s conclusions and recommendations. 26. ENE recommended that Respondent participate in weekly or bi-weekly individual ?maintenance? ?werapy with Alien Grieco, Grieco"). BMI aiso recommended the following practice restrictions should Respondent remrn to practice: 1) no breast exams (including breast manipulations); 2) no kissing patients; 3) no seeing patients in his home; 4) no pelvic exams,- 5) a chaperone must be present in the room when examining female patients; 6) the examination room must be completely closed for patient privacy; 7) Respondent must not employ his patients; and 8) Respondent must not provide osteopathic oea?onent to his staff. 28. On or about September 16, 2002, Dr. Irvin opined that Respondent was not safe to practice because he demolish-cited a ?tenuous grasp on the extent of his inappropriate same] behavior." 29. Respondent's treatment team at BMI recommended: 1) that Respondent not be returned to work for three (3) mon?rs; 2) that Respondent should undergo individual therapy; and 3) that, prior to returning to practice, Respondent should re- evaiuated. 165 30. In about September 2002, PRN drafted a Sexual Boundary Violation Contract for Respondent based on the recommendations of Drs. Stein and Irvin, and informed Reapondent that he needed to sign a voluntary restriction of practice with the Department. 31. Respondent?s PRN contract included his agreement not to return to practice without approval from PRN and the Board, reevaluation in three (3) months, individual therapy, weekly group therapy, and a polygraph test every six (6) months. 32. The PRN contract contained additional conditions in the event Respondent returned to work. Speci?cally, it provided that if Respondent returned to work he was not to see female patients without a chaperone and that he was not to see patients in a room that was not completely closed for patient privacy. 33. In about January 20GB, Respondent executed the PRN contract. 34. In about June 20(13, Respondent su?ered a relapse in behavior, manipulating the ribs and breasts of a female whlie attending a trade show in Norfolk, Virginia, where he was marketing a medical device that was his own invention. 35. On or about June 26, 2003, Dr. Gn?eco, Dr. Respondent's PRN-appmved therapist, contacted PRN and infomed PRN of Respondent?s reiapse that had occurred, in Norfolk. 36. On or about June 26, 20b3, Joe Trim, LMHC, (?Mn Trim") Respondent?s group therapist, informed PRN of Respondent's relapse. 37. Mr. Trim reported that Respondent blamed the incident in Norfolk on aluminum because he had started using a deodorant containing aluminum. 166 38. Mr. Trim also reported that Respondent did not equate the treatment he performed on the woman in Norfolk with ?practicing.? Further, in discussing his relapse, Respondent told his therapy group that he was not refrained from practicing. 39. On or about July 1, 2003, Dr. Irvin of BMI informed PRN that based on Respondent?s relapse behavior, he ?will not ever" have enough control to see patients and should be restricted to no patient care. 40. On or about August 27, 2003, based on the above relapse, Respondents treatrn'ent team at BMI recommended to PRN that Respondent's license be restrictai to no patient care. 41. On or about September 10, 2003, and October 1, 2003, PRN contacted or attempted to contact counsel of record for Respondent concerning the need for Respondent to sign a restriction of practice agreement the Department 42. On or about January 29, 2004, PRN sent a letter to Respondent's attorney giving Respondent ten (10) business days to execute a restriction of practice before PRN referred the case to the Department and requested an emergency suspension of Respondent?s license. 43. On or about February 12, 2004, Dr. Grieco informed PRN that Respondent should be refrained from practice. 44. On or about March 17, 2004, after Respondent and his attorney failed to respond to request that Respondent execute a restriction of practice, Raymond M. Pomm, M.D., (?Dix Pomm") Medical Director of PRN, reported Respondent to the Department for non-compliance with PRN recommendations. ml 167 45. In his ietter to the Department, Dr. Pornrn opined that Respondent was unsafe to practice his profession with reasonable skill and safety and that his return to practice would be an immediate threat to the public health, safety, and welfare. 46. Dr. Pomm stated that his opinion was based on the seriousness of the patient and staff sexual boundary violations, the Impressions of PRN, BMI and Dr. Grieco that Respondent was unsafe to practice, and ?nally, Respondents Eilure to sign a voluntary restriction of practice. 47. Dr. Pomrn explained that the voluntary restriction was necessary because PRN was unable to monitor whether or not Respondent returned to work without approval. 48. Section Florida Statutes (2003), provldes that being unable to practice osteopathic medicine with reasonable skill and safety to patients by reason of Illness or use of alcohol, drugs, narcotics, chemicals, or any other type pf material or as a resort of any mental or physical condition constimtes grounds for disciplinary action by the Board of Osteopathic Medicine. 49. Respondent is unabie practice osteopad'iic medicine with reasonabie and safety to panents due to his mental disorders. 50. Based on the foregoing, Respondent has yioiated Section Florida Statutes (2003), by being unable to practice osteopathic medicine with reasonable skill and safety to patients by reason of illness or use of alcohol, drugs, narcotics, chemicals, or any other type of material or as a resuit of any menial or physical condition. 168 WHEREFORE, the Petitioner respectfully requests that the Board of Osteopathic Medicine enter an order imposing one or more of the following penalties: permanent revocation or suspension of Respondent?s license, restriction of practice, imposition of an administrative ?ne, 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 day of . 20012:. John O. Agwunobi, M.D., M.B.A., M.P.H. Secreiary, Department of Health DEPARTMENT OF Richard Shoop 7? DEPUTY Assistant General Counsel Florida Bar 0389234 DATE i?I .. 0'4 DOH, Prosecution Services Unit 4052 Bald Cypress Way, Bin C-ES Tallahassee, Florida 32399-3265 Tel.: (350) 414-8126 Fax: (850) 488-1855 Reviewed and approved by: . (initials) PCP Date: {3 my PCP 00H Obades Crosby, 0.0., case no. 2004-12359 169 NOTICE OF !5 Respondent has the right to rednest a hearing to be conducted in accordance with Section 129.569 and 120.57,. Florida Statutes, to be represented by counsel or other quali?ed representative, to present evidence and argument, to call and cross-examine witnesses and to have subpoena and subpoena duces tecum issued on his or her behalf if a hearing is requested. NOTICE REGARDING ASSESSMENT OF COSTS Respondent is placed on notice that Petitioner-has incurred costs related to the investigation and prosecution of this matter. Pursuant to Section Florida Statutes, the Board shall assess costs related to the investigation and prosecution of a disciplinaryIr matter, which may include attorney hours and costs, on the Respondent in addition to any other discipline imposed 00H v. 0531195 00st D. 0., case no. 2004-12359