STATE OF FLORIDA DEPARTMENT OF HEALTH DEPARTMENT OF HEALTH, PETITIONER, v. CASE NUMBER 2017-02602 JACOBO NOEL LAMA, M.D., RESPONDENT. ADMINISTRATIVE COMPLAINT Petitioner Department of Health hereby files this Administrative Complaint before the Board of Medicine against Respondent Jacobo Noel Lama, M.D., and 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 ME 64989. 3. Respondent's address of record is 105 South Dixie Highway, Haines City, Florida 33844.
4. On or about July 11, 2012, Patient H.I., a then-50-year-old female, presented to Respondent complaining of a small bump on the upper aspect of her right breast. Respondent noted on exam that Patient H.I. had 5-10 mm "cystic lesions" on both breasts and did not order any further evaluation of this condition. 5. On or about January 23, 2013, Patient H.I. presented to Respondent for a check-up. Respondent did not perform an examination of the patient's breasts or order any further evaluation. 6. On or about April 4, 2013, Patient H.I. presented to Respondent for evaluation of upper respiratory symptoms. Respondent did not perform an examination of the patient's breasts or order any further evaluation. 7. On or about April 23, 2013, Patient H.I. presented to Respondent for a Pap smear. Respondent performed a breast examination and noted a 2 cm mass in Patient right breast. Respondent did not order any further evaluation of the mass. 8. On or about October 16, 2013, Patient H.I. presented to Respondent complaining of nipple discharge and breast pain. Respondent noted that Patient H.I. had a 3-4 cm mass in her right breast and purulent DOH v. Jacobo M. Lama, M.D.; Case # 2017-02602 2
discharge from her right nipple. Respondent diagnosed Patient H.I. with mastitis and prescribed antibiotics for this condition. 9. On or about October 31, 2013, Patient H.I. presented to Respondent for a follow-up visit. Respondent noted a 3-4 cm mass in Patient H.I.'s right breast but did not order any further evaluation of this mass. 10. On or about November 26, 2013, Patient H.I. presented to Respondent to follow up on her Pap test results. Respondent noted a mass in Patient H.I.'s right breast but did not order any further evaluation of this mass. 11. On or about January 13, 2014, Patient H.I. presented to Respondent for a follow-up visit. Respondent ordered a screening mammogram. 12. On or about March 6, 2014, Patient H.I. presented to Respondent, and Respondent did not perform a breast examination. 13. On or about May 6, 2014, Patient H.I. underwent a screening mammogram as ordered by Respondent. The mammogram report noted skin thickening, calcifications, and nipple retraction of the right breast. 14. On or about May 20, 2014, Patient H.I. presented to Respondent's practice for a follow-up visit with a nurse practitioner. The DOH v. Jacobo M. Lama, M.D.; Case # 2017-02602 3
nurse practitioner noted skin retraction and a mass in Patient right breast. The nurse practitioner ordered a breast ultrasound for Patient H.I. 15. On or about May 22, 2014, Patient H.I. underwent a breast ultrasound. The ultrasound report stated that the results were highly suggestive of malignancy. 16. On or about June 3, 2014, Patient H.I. presented to Respondent to review the breast ultrasound results. Respondent referred Patient H.I. to a surgeon and an oncologist for further evaluation. 17. In June of 2014, Patient H.I. was diagnosed with infiltrating ductal carcinoma with likely bone metastasis. Patient H.I. died as a result of metastatic breast cancer on or about May 12, 2015. 18. At all times material to this complaint, the standard of care required Respondent to have done one or more of the following for Patient H.I.: a. Refer Patient H.I. for surgical biopsy after he observed a breast lesion on July 11, 2012; b. Refer Patient H.I. for surgical biopsy at her January 23, 2013 appointment, given her prior history of a breast lesion; DOH v. Jacobo M. Lama, M.D.; Case # 2017-02602 4
c. Refer Patient H.I. for surgical biopsy at her April 4, 2013 appointment, given her prior history of a breast lesion; d. Refer Patient H.I. for surgical biopsy after he observed a 2 cm mass in her right breast on April 23, 2013; e. Refer Patient H.I. for surgical biopsy after he observed a 3-4 cm mass and nipple discharge in her right breast on October 16, 2013; f. Refer Patient H.I. for surgical biopsy after he observed a 3-4 cm mass in her right breast on October 31, 2013; g. Refer Patient H.I. for surgical biopsy after he observed a mass in her right breast on November 26, 2013; h. Refer Patient H.I. for surgical biopsy after he observed a mass in her right breast on January 13, 2014; and/or i. Refer Patient H.I. for surgical biopsy at her March 6, 2014 appointment, given her prior history of a breast mass. 19. Section 458.331(1)(t), Florida Statutes (2012-2013), provides that committing medical malpractice as defined in Section 456.50, Florida Statutes, constitutes grounds for disciplinary action by the Board of Medicine. The Board shall give great weight to the provisions of Section 766.102, DOH v. Jacobo M. Lama, M.D.; Case # 2017-02602 5
Florida Statutes (2012-2013), when enforcing Section 458.331(1)(t), Florida Statutes (2012-2013). Medical Malpractice is defined in Section 456.50, Florida Statutes (2012-2013), as the failure to practice medicine in accordance with the level of care, skill, and treatment recognized in general law related to health care licensure. Section 766.102, Florida Statutes (2012-2013)1 provides that the prevailing professional standard of care for a given health care provider shall be that level of care, skill, and treatment which, in light of all relevant surrounding circumstances, is recognized as acceptable and appropriate by reasonably prudent similar health care providers. 20. Respondent failed to practice medicine with that level of care, skill and treatment which, in light of all relevant surrounding circumstances, is recognized as acceptable and appropriate by reasonably prudent similar health care providers in violation of Section 458.331(1)(t), Florida Statutes (2012-2013), in the care and treatment of Patient H.I. in one or more of the following ways: a. By failing to refer Patient H.I. for a surgical biopsy at her July 11, 2012 appointment; b. By failing to refer Patient H.I. for a surgical biopsy at her January 23, 2013 appointment; DOH v. Jacob() M. Lama, M.D.; Case # 2017-02602 6
c. By failing to refer Patient H.I. for a surgical biopsy at her April 4, 2013 appointment; d. By failing to refer Patient H.I. for surgical biopsy after he observed a 2 cm mass in her right breast on April 23, 2013; e. By failing to refer Patient H.I. for surgical biopsy after he observed a 3-4 cm mass and nipple discharge in her right breast on October 16, 2013; f. By failing to refer Patient H.I. for surgical biopsy after he observed a 3-4 cm mass in her right breast on October 31, 2013; and/or g. By failing to refer Patient H.I. for surgical biopsy after he observed a mass in her right breast on November 26, 2013; h. By failing to refer Patient H.I. for surgical biopsy after he observed a mass in her right breast on January 13, 2014; and/or i. By failing to refer Patient H.I. for surgical biopsy at her March 6, 2014 appointment. DOH v. Jacob() M. Lama, M.D.; Case # 2017-02602 7
21. Based on the foregoing, Respondent has violated Section 458.331(1)(t), Florida Statutes (2012-2013), by committing medical malpractice. WHEREFORE, the Petitioner respectfully requests that the Board of Medicine enter an order imposing one or more of the following penalties: permanent revocation or suspension of 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. (Signatures appears on next page) DOH v. Jacobo M. Lama, M.D.; Case # 2017-02602 8
SIGNED this 23rd day of April, 2018. Celeste Philip, MD, MPH Surgeon General and Secretary of Health FILED DEPARTMENT OF HEALTH DEPUTY CLERK CLERK DATE VirfL S2A113 2018 Carymn/ Alberta- Corynn Alberto Assistant General Counsel Florida Bar Number 68814 Florida Department of Health Office of the General Counsel 4052 Bald Cypress Way, Bin C-65 Tallahassee, Florida 32399-3265 Telephone: (850) 558-9843 Facsimile: (850) 245-4684 Email: Corynn.Alberto@flhealth.gov PCP Date: April 20, 2018 PCP Members: Stephanie Haridopolos, M.D.; Brigitte Goersch DOH v. Jacobo M. Lama, M.D.; Case # 2017-02602 9
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 within 21 days from the day Respondent received the 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 the Administrative Complaint must conform to Rule 28-106.2015(5), Florida Administrative Code. Please be advised that mediation under Section 120.573, Florida Statutes, is not available for administrative disputes involving this agency action. 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 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 any other discipline imposed. DOH v. Jacobo M. Lama, M.D.; Case # 2017-02602 10