STATE OF FLORIDA DEPARTMENT OF HEALTH BUREAU OF EMERGENCY MEDICAL SERVICES ADMINISTRATIVE COMPLAINT

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STATE OF FLORIDA DEPARTMENT OF HEALTH BUREAU OF EMERGENCY MEDICAL SERVICES DEPARTMENT OF HEALTH, PETITIONER, v. CASE NO. 2016-08921 ERIC R. ISHAM, PMD., RESPONDENT. ADMINISTRATIVE COMPLAINT COMES NOW, Petitioner, Department of Health, by and through its undersigned counsel, and files this Administrative Complaint against Respondent, Eric R. Isham, PMD., and in support thereof alleges: 1. Petitioner is the state department charged with regulating emergency medical technicians and paramedics pursuant to Section 20.43, Florida Statutes; Chapter 401, Florida Statutes; and Chapter 456, Florida Statutes. 2. At all times material to this Complaint, Respondent was certified as a paramedic within the state of Florida, having been issued certificate number PMD 510548, on or about November 1, 2005. 1

3. At all times relevant to this Complaint, Respondent was employed as a paramedic with Palm Beach County Fire Rescue in West Palm Beach, Florida. 4. On or about February 1, 2015, Respondent was dispatched to the home of Patient S.K., an 85-year-old female, who was experiencing shortness of breath. Respondent found Patient S.K. to be conscious but experiencing significant respiratory distress. The decision was made to transport Patient S.K. to Bethesda Hospital West in Boynton Beach, Florida. 5. En route to the hospital, Patient S.K. stopped breathing and became unresponsive. Respondent attempted to intubate Patient S.K. 6. After the endotracheal tube was placed, Patient S.K.'s condition remained unchanged, and she began vomiting. Respondent removed the endotracheal tube when it filled with fluid. 7. Respondent made a second attempt to intubate Patient S.K. After the second endotracheal tube was placed, Patient S.K.'s condition remained unchanged, and she continued vomiting. 2

8. After the second intubation attempt failed, Respondent left the endotracheal tube in place and placed a Ventimaski on Patient S.K. 9. When hospital staff at Bethesda Hospital West evaluated Patient S.K. upon her arrival, the endotracheal tube was found to be in Patient S.K.'s esophagus. Shortly thereafter, Patient S.K. experienced cardiac arrest. Patient S.K. died four days later. 10. At all times relevant to this Complaint, the minimum prevailing standards of acceptable practice required Respondent to have done one or more of the following: a. Use a bag valve mask2 rather than a Ventimask when intubation attempts failed, as a Ventimask is not effective when a patient is not breathing; b. Remove the endotracheal tube after the second intubation attempt failed; c. Refrain from using a Ventimask while the endotracheal tube was in place; and 1 A Ventimask, also known as an air-entrapment mask, is a mask which is placed over a patient's nose and mouth to deliver a controlled dose of oxygen to a patient who can breathe but requires supplemental oxygen 2 A bag valve mask is a hand-held device which is used to provide ventilation to patients who are not breathing or are not breathing adequately. 3

d. Confirm proper placement of the endotracheal tube. 11. Section 401.411(1)(g), Florida Statutes (2014), provides that engaging in unprofessional conduct, including any departure from or failure to conform to the minimum prevailing standards of acceptable practice, constitutes grounds for discipline against a licensee. 12. Respondent engaged in unprofessional conduct, including departing from or failing to conform to the minimum prevailing standards of acceptable practice in his care of Patient S.K., in one or more of the following ways: a. By using a Ventimask rather than a bag valve mask when intubation attempts failed; b. By leaving the endotracheal tube in place after the second intubation attempt failed; c. By using a Ventimask while the endotracheal tube was still in place; and d. By failing to confirm proper placement of the endotracheal tube. 13. Based upon the foregoing, Respondent violated Section 401.411(1)(g), Florida Statutes (2014). 4

WHEREFORE, Petitioner respectfully requests that the Department enter an order imposing one or more of the following penalties: permanent revocation or suspension of Respondent's certificate, 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 Department deems appropriate. SIGNED this 02 day of Sepk4"t _,,,, 2018. Celeste Philip, M.D., M.P.H. Surgeon General and Secretary CLERK: FILED EPARTMENT OF HEALTH DEPUTY CLERK DATE SEP 2 6 2018, ) Kimberly Marshall Assistant General Counsel Florida Bar Number 123880 Florida Department of Health Office of the General Counsel 4052 Bald Cypress Way, Bin C-65 Tallahassee, Florida 32399-3265 Telephone: (850) 558-9810 Facsimile: (850) 245-4684 Email: Kimberly.Marshall@flhealth.gov PCP Date: 94,, PCP Chairperson: 4;+-:\,e_ LieC6,1 5

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. 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 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. 6