645 So. 2d 117 | Fla. Dist. Ct. App. | 1994
Lead Opinion
Appellant, Kleyn B. Russell, appeals a final order of the Department of Business and Professional Regulation, Board of Dentistry (Board). Finding no error in the Board’s denial of appellant’s motion to set aside a previously entered final order, we affirm.
Appellant was a licensed dentist practicing in Crystal Beach, Florida. During May through August 1990, he was asked by a laser surgeon, Dr. Massad, to administer trigeminal facial nerve blocks to a patient Mas-sad was treating for port wine stains (heman-giomas) about the face. The purpose of the nerve blocks was to alleviate discomfort during laser surgery. The patient, B.M., was three years old and weighed 34 pounds at the time of the treatment.
Three facial nerve blocks were administered by appellant on three different occasions. Shortly after the third nerve block was administered, the child experienced respiratory distress and seizures, lapsed into cardiac arrest, and was transported to a local hospital by ambulance. Tragically, B.M. died three days later, on August 25, 1990, due to anoxic encephalopathy as a result of cardiac arrest which was triggered by lidocaine toxicity. In layman’s terms, the child received an overdose of nerve block and, as a result, sustained a cardiac arrest which deprived her brain of oxygen.
An administrative complaint was filed against the appellant, alleging that he failed to meet the minimum standard of care by failing to comprehend that special calculations are required when giving anesthetics to children, and by administering, on three occasions, an amount of anesthesia which exceeded the maximum dosage recommended by the manufacturer. The administrative complaint also alleged a failure to maintain adequate written records, a violation of section 466.028(l)(m), Florida Statutes.
The cause was referred to the Division of Administrative Hearings for an administrative hearing, following which, the hearing officer issued a recommended order finding, by clear and convincing evidence, that appel
With limited exceptions not material to the outcome of this case, the Board adopted the findings of fact and conclusions of law made in the recommended order, but rejected the recommended penalty and entered a final order revoking appellant’s license. No appeal was taken from that order. Specifically, the Board found that there was “competent substantial evidence to support the Hearing Officer’s determination that on the three specified dates” Respondent administered the anesthetic “in an amount that exceeded the manufacturer’s maximum recommended dosage.” The Board also expressly found competent substantial evidence to support the Hearing Officer’s determination that Russell “failed to recognize that special calculations were required when administering local anesthetic to children.” The Board did not reject the Hearing Officer’s conclusion that Russell had admitted his failure to comprehend the correct amount of anesthetic that could safely be administered. The Board merely rephrased this paragraph to make it clear that the admission was not made at the time he was physically in the process of administering the anesthetic. The Board also found competent substantial evidence to support the determinations that Russell failed to maintain appropriate records and failed to properly diagnose and treat B.M. after she began to exhibit signs of the respiratory depression which resulted in her death.
Several months later, appellant moved to set aside the final order or, in the alternative, for a new hearing on the ground of newly-discovered evidence, i.e., evidence regarding a manufacturer’s recall of certain batches of ASTRA Xylocaine. After hearing arguments of counsel, the Board issued a final order denying the Motion to Set Aside. The Board determined that it was without jurisdiction to revisit appellant’s case and noted that it found appellant’s arguments unpersuasive.
It is true that there are some cases in which an agency may exercise its inherent authority to reopen a closed case when there is a change in circumstances or a demonstrated public need or interest. See, e.g., Mann v. Dep’t of Professional Regulation, Bd. of Dentistry, 585 So.2d 1059 (Fla. 1st DCA 1991). This, however, is clearly not such a case. Therefore, the Board correctly determined that it lacked jurisdiction to revisit this decision, in the absence of a material change in circumstances or demonstrated public need.
In Peoples Gas System, Inc. v. Mason, 187 So.2d 335 (Fla.1966), the supreme court observed that Florida “is among those jurisdictions holding that such agencies do have inherent power to reconsider final orders which are still under their control. However, the decisions of this court clearly say that this inherent authority to modify is a limited one.” Id. at 338 (citation omitted). The Peoples Gas court noted that a modification attempted four years after entry of a final order was inappropriate. Id. at 339. The court suggested further that the PSC’s inherent authority to modify a final order should be exercised only upon a change of circumstances or upon a demonstrated public need or interest. Id. The principles announced in Peoples Gas were reaffirmed in Austin Tupler Trucking, Inc. v. Hawkins, 377 So.2d 679 (Fla.1979). See also Richter v. Florida Power Corp., 366 So.2d 798, 800 (Fla. 2d DCA 1979) (Florida case law recognizes the rule that an administrative agency may alter a final decision under “extraordinary circumstances”). Richter was recently cited with approval in Mann v. Department of Professional Regulation, Board of Dentistry, 585 So.2d 1059 (Fla. 1st DCA 1991).
Appellant has failed to demonstrate in his motion to set aside the “extraordinary circumstances” which are a prerequisite for revisiting a closed case. The motion to set aside final order was based upon alleged new evidence that the child’s death may have resulted from a manufacturing problem
Accordingly, we affirm the Board’s final order denying appellant’s Motion to Set aside the Final Order.
. The invoice submitted by appellant shows the receipt of ASTRA Xylocaine on Aug. 8, 1990; obviously, this shipment of anesthesia could not have been used for the May 15 and July 11 treatments of B.M. There is no record indication that the anesthesia used in May and July, whether it was Xylocaine or Octocaine, was defective.
Dissenting Opinion
dissenting.
The majority correctly states that the Board determined it was without jurisdiction to revisit appellant’s case pursuant to appellant’s motion to set aside, or to rehear his case based on newly-discovered evidence. Although the Board allowed appellant’s counsel to proffer for the record the testimony of two expert witnesses, Drs. Eugene Patterson and Stanley Malamed, the Board gave no consideration to the proffered evidence in weighing the decision whether to re-open appellant’s case. It appears that the Board considered only the arguments of counsel, and, as noted by the majority, found them “unpersuasive.” In fact, the Board unceremoniously walked out of the hearing room during the proffered testimony of the two doctors.
The majority’s decision to deny relief in this case is grounded upon its conclusion that appellant “has failed to demonstrate in his motion to set aside the ‘extraordinary circumstances’ which are a prerequisite for revisiting a closed case.” My view is that: (1) the presence or absence of “extraordinary circumstances” is a determination to be made initially by the Board after due consideration under established principles of law and procedure; and, (2) the facts alleged, as amplified by the proffered testimony, demonstrate at least preliminarily a basis for relief.
If for no other reason, appellant is entitled to have his case reopened for reconsideration of the sanction imposed by the Board. It should be recalled that the hearing officer recommended appellant’s suspension for 5 years, while the Board rejected the recommended penalty and revoked appellant’s license. It defies common sense to assume that the unfortunate death of the patient was not a critical factor in the Board’s decision to increase the recommended penalty from suspension to revocation. Yet the newly-discovered evidence, rejected out-of-hand by the Board, raised serious questions concerning the defective anesthetic as the cause of death, rather than appellant’s lack of care or skill.
In conclusion, I would reverse the order appealed and remand to the Board for a hearing, with directions to reconsider its sanctions against appellant.