DEPARTMENT OF HEALTH, Petitioner, STATE OF FLORIDA DEPARTMENT OF HEALTH v. CASE NO. 2016-09658 RAQUEL C. SKIDMORE, M.D., Respondent. ADMINISTRATIVE COMPLAINT Petitioner Department of Health files this Administrative Complaint before the Board of Medicine against Respondent Raquel C. Skidmore, 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 Statutes; 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 ACN 244. Respondent is certified pursuant to a Rear Admiral Leroy Collins, Jr. Temporary Certification to practice medicine only in areas of critical need approved pursuant to Section 458.315, Florida Statutes (2016).
3. Respondent's address of record is 756 Harrison Avenue, Panama City, Florida 32401. 4. On or about and between June 2016 and August 2016, Respondent relocated her practice to 105 Jazz Drive, Panama City, Florida 32405. 5. Respondent failed to timely provide the updated address and location information of Respondent's practice to the Department of Health. 6. Respondent failed to timely update her Department of Health practitioner profile with her primary practice address. 7. On or about September 28, 2015, Patient R.S., a 64 year-old male, presented to Respondent at Gulf Coast Holistic and Primary Care in Panama City, Florida. 8. Patient R.S. had a history of hypertension, gastroesophageal reflux disease (GERD), depression and renal cell carcinoma. 9. On or about September 28, 2015, Respondent provided acupuncture to Patient R.S. 10. On or about October 19, 2015, Patient R.S. presented to Respondent. DOH v. Raquel C, Skidmore, M.D.; DOH Case Number 2016-09658 2
11. Patient R.S. disclosed to Respondent that he felt increasingly fatigued and had been doing research regarding the benefits of medical marijuana. 12. Respondent noted in Patient R.S.'s medical record for October 19, 2015, that his previous medical records had not been received and Patient R.S. had not performed the lab tests ordered by Respondent on September 28, 2015. 13. Respondent documented her plan to "...recommend medicinal marijuana after receiving previous records." 14. On or about January 15, 2016, Patient R.S.. presented to Respondent for treatment. 15. On or about January 25, 2016, Respondent issued a prescription to Patient R.S. for a maximum of 2 grams of cannabis per day. 16. According to Section 893.03(1), Florida Statutes (2015), cannabis, or marijuana, is a Schedule I controlled substance that has a high potential for abuse and had no accepted medical use in treatment in Florida at the time relevant to this Complaint. The term does not include "Low-THC cannabis" as defined in Section 381.986, Florida Statutes (2015), if acquired, manufactured, ordered, possessed, sold, purchased, transferred, delivered, DOH Case Number 2016-09658
distributed, used, or dispensed in accordance with Section 381.986, Florida Statutes (2015). 17. The cannabis Respondent prescribed for Patient R.S. was not "Low-THC cannabis" as defined and approved in Section 381.986, Florida Statutes (2015). 18. Respondent, and/or her agent(s), charged Patient R.S. $250.00 for the prescription for cannabis. 19. At the time Respondent issued the prescription to Patient R.S., she had not completed an 8-hour course or subsequent examination offered by the Florida Medical Association or the Florida Osteopathic Medical Association, as required by Section 381.986, Florida Statutes (2015). 20. At the time Respondent issued the prescription to Patient R.S., she was not authorized or qualified to order "Low-THC cannabis" or any other type of cannabis in the state of Florida. 21. At the time Respondent issued the prescription to Patient R.S., she had not registered as the ordering licensee for Patient R.S. in the compassionate use registry maintained by the Department. 22. Respondent's treatment plan for Patient R.S., did not include the route of administration or planned duration for the substance she prescribed to Patient R.S. DOH Case Number 2016-09658 4
COUNT I 23. Petitioner re-alleges and incorporates by reference paragraphs 1 through 22 as if fully set forth herein. 24. Section 458.331(1)(v), Florida Statutes (2015), subjects a licensee to discipline for practicing or offering to practice beyond the scope permitted by law or accepting and performing professional responsibilities which the licensee knows or has reason to know that he or she is not competent to perform. 25. Respondent violated Section 458.331(1)(v), Florida Statutes (2015), in one or more of the following ways: a. By providing a prescription for cannabis to Patient R.S.; and/or b. By offering Patient R.S. the opportunity to obtain cannabis; 26. Based on the foregoing, Respondent violated Section 458.331(1)(v), Florida Statutes (2015). COUNT II 27. Petitioner re-alleges and incorporates by reference paragraphs 1 through 22 as if fully set forth herein. DOH Case Number 2016-09658 5
28. Section 458.331(1)(q), Florida Statutes (2015), subjects a licensee to discipline for prescribing a legend drug, including any controlled substance, other than in the course of the physician's professional practice. It shall be legally presumed that prescribing controlled substances inappropriately or in excessive or inappropriate quantities is not in the course of the physician's professional practice, without regard to his or her intent. 29. At the time Respondent issued the prescription to Patient R.S., Section 381.986, Florida Statutes (2015), controlled the regulation of cannabis or marijuana for medical purposes in the state of Florida. Only low- THC cannabis was permitted pursuant to Section 381.986, Florida Statutes (2015), and Respondent was not yet authorized to order cannabis for patients. 30. Respondent violated Section 458.331(1)(q), Florida Statutes (2015), by prescribing cannabis, a controlled substance, outside of the course of her professional practice. 31. Based on the foregoing, Respondent violated Section 458.331(1)(q), Florida Statutes (2015). COUNT III 32. Petitioner re-alleges and incorporates by reference paragraphs 1 through 22 as if fully set forth herein, DOH Case Number 2016-09658 6
33. Section 458.331(1)(k), Florida Statutes (2015), subjects a licensee to discipline for making deceptive, untrue, or fraudulent representations in or related to the practice of medicine or employing a trick or scheme in the practice of medicine. 34. Respondent violated Section 458.331(1)(k), Florida Statutes (2015), in one or more of the following ways: a. By representing to Patient R.S. that she could provide a lawful prescription for cannabis to Patient R.S.; b. By providing a prescription for cannabis to Patient R.S.; c. By offering Patient R.S. the opportunity to obtain cannabis; and/or d. By employing a trick or scheme to gain financially from providing Patient R.S. an unlawful prescription for cannabis. 35. Based on the foregoing, Respondent violated Section 458.331(1)(k), Florida Statutes (2015). COUNT IV 36. Petitioner re-alleges and incorporates by reference paragraphs 1 through 22 as if fully set forth herein. DOH Case Number 2016-09658 7
37. Section 456.072(1)(a), Florida Statutes (2015), subjects a licensee to discipline for making misleading, deceptive, or fraudulent representations in or related to the practice of the licensee's profession. 38. Respondent violated Section 456.072(1)(a), Florida Statutes (2015), in one or more of the following ways: a. By representing to Patient R.S. that she could provide a lawful prescription for cannabis to Patient R.S.; b. By providing a prescription for cannabis to Patient R.S.; and/or c. By offering Patient R.S. the opportunity to obtain cannabis. 39. Based on the foregoing, Respondent violated Section 456.072(1)(a), Florida Statutes (2015). COUNT V 40. Petitioner re-alleges and incorporates by reference paragraphs 1 through 22 as if fully set forth herein. 41. Section 456.072(1)(n), Florida Statutes (2015), subjects a licensee to discipline for exercising influence on the patient or client for the purpose of financial gain of the licensee or a third party. 42. Respondent violated Section 456.072(1)(n), Florida Statutes (2015), by exercising influence on Patient R.S. for the purpose.of financial gain for herself and/or a third-party, including but not limited to Gulf Coast DOH Case Number 2016-09658 8
Holistic and Primary Care, Inc., by providing an ulawful prescription for cannabis to Patient R.S. for remuneration. 43. Based on the foregoing, Respondent violated Section 456.072(1)(n), Florida Statutes (2015). COUNT VI 44. Petitioner re-alleges and incorporates by reference paragraphs 1 through 22 as if fully set forth herein. 45. Section 458.331(1)(g), Florida Statutes (2015), subjects a licensee to discipline for failing to perform any statutory or legal obligation placed upon a licensed physician. 46. At the time Respondent issued the prescription to Patient R.S., Section 381.986, Florida Statutes (2015), controlled the regulation of cannabis or marijuana for medical purposes in the state of Florida. 47. Respondent violated Section 458.331(1)(g), Florida Statutes (2015), by violating Section 381.986, Florida Statutes (2015), in one or more of the following ways: a. By failing to submit a lawful order for "Low-THC cannabis" to Patient R.S.; b. By failing to complete an 8 hour course and subsequent examination offered by the Florida Medical Association or the DOH Case Number 2016-09658 9
Florida Osteopathic Medical Association prior to prescribing cannabis to Patient R.S.; c. By failing to be authorized or qualified to order "Low-THC cannabis" or any other type of cannabis in the state of Florida, at the time she prescribed cannabis to Patient R.S.; d. By failing to register as the ordering licensee for Patient R.S. in the compassionate use registry maintained by the Department; and/or e. By failing to include a route of administration or planned duration for the substance she prescribed to Patient R.S. 48. Based on the foregoing, Respondent violated Section 458.331(1)(g), Florida Statutes (2015). COUNT WI 49. Petitioner re-alleges and incorporates by reference paragraphs 1 through 22 as if fully set forth herein. 50. Section 456.072(1)(w), Florida Statutes (2015), subjects a licensee to discipline for failing to comply with the requirements for profiling and credentialing, including, but not limited to, failing to provide initial information and failing to timely provide updated information. DOH Case Number 2016-09658 10
51. Respondent violated Section 456.072(1)(w), Florida Statutes (2015), by failing to timely update her Department of Health practitioner profile with her primary practice address. 52. Based on the foregoing, Respondent violated Section 456.072(1)(w), Florida Statutes (2015). WHEREFORE, Petitioner respectfully requests that the Board of 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. SIGNED this 30th day of May, 2017. Celeste Philip, M.D., M.P.H. Surgeon General and Secretary ouise Wilhite-St Laurent Deputy General Counsel Florida Bar No. 91244 DOH-Prosecution Services Unit 4052 Bald Cypress Way-Bin C-65 (850) 245-4444, Ext. 8331 (850) 245-4684 fax E-Mail: Louise.StLaurent@flhealth.gov DOH Case Number 2016-09658 11
FILED DEPARTMENT OF HEALTH DEPUTY CLERK CLERK Amber Gr eene DATE MAY 3 0 2017 PCP: May 26, 2017 PCP Members: Georges EI-Bahri, Nicholas Romanello Seela Ramesh, M.D.; DOH Case Number 2016-09658 12
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 qualified 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. A request or petition for an administrative hearing must be in writing and must be received by the Department of Health within 21 days from the day Respondent received this Administrative Complaint, pursuant to Rule 28-106.111(2), Florida Administrative Code. If Respondent fails to request a hearing within 21 days of receipt of this Administrative Complaint, Respondent waives the right to request a hearing on the facts alleged in this Administrative Complaint pursuant to Rule 28-106.111(4), Florida Administrative Code. Any request for an administrative proceeding to challenge or contest the material facts or charges contained in this Administrative Complaint must conform to Rule 28-106.2015(5), Florida Administrative Code. Mediation under Section 120.573, Florida Statutes, is not available to resolve this Administrative Complaint. 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 456.072(4), Florida Statutes, the Board of Medicine shall assess costs related to the investigation and prosecution of a disciplinary matter, which may include attorney hours and costs, on Respondent in addition to any other discipline imposed. DON v. Raquel C. Skidmore, M.D.; DOH Case Number 2016-0965S 13