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Cancer Patients Must Provide DOH Approval for Seizures and Muscle Spasms, or May Be Unqualified for Low-THC Medical Marijuana

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by the Florida Bar in Health Law

Barnhart v. Dep’t of Health, Div. Admin. Hearings, Case No. 15-1271RP (Final Order April 10, 2015).

Following is a summary of a recent Division of Administrative Hearings case summary, taken from The Florida Bar Administrative Law Section Newsletter, Vol. 36, No. 4 (June 2015).

FACTS: On February 6, 2015, the Department of Health (“DOH”) published a notice of proposed rule-making setting forth the text of six proposed rules to implement the Compassionate Medical Cannabis Act of 2014 (“the Act”). The Act provides in part that certain physicians treating patients suffering from cancer or a condition that chronically produces seizures or severe muscle spasms may order low-THC cannabis for those patients’ treatment.

The Petitioner filed a Petition asserting that one of the proposed rules (64-4.002) is an invalid exercise of delegated legislative authority.  In support thereof, the Petitioner alleged that she is a four-year-old Florida resident diagnosed with an inoperable brain tumor, and she treats her condition with medical cannabis extracts. The Petitioner further alleged that she plans to register with the Office of Compassionate Use Registry to become a “qualified patient” for the medical use of low THC cannabis.

The Petition also contained allegations regarding the harm that would result without an adopted rule. For instance, the Petition alleged there is a “desperate need for access to low THC cannabis” and that expedited rule promulgation was necessary because the “selected applicants will be responsible for ensuring access to ordered medication, with greater risk of public injury if there is no access to medicine.” The Petition also asserted that potential applicants eligible to become dispensing organizations would be harmed by the proposed rule’s “overly burdensome” application, scoring, and selection process.

OUTCOME: After affording Petitioner leave to file an amended Petition, the ALJ dismissed the Petition due to a lack of standing when Petitioner chose not to file an amended Petition.

The ALJ concluded the Petitioner’s allegations failed to demonstrate that she could become a “qualified patient” and thus potentially eligible for a physician’s order to receive low-THC cannabis.

The ALJ noted that while the Petitioner alleges that she has an inoperable brain tumor, she does not allege that her “condition falls within the narrow parameters of the Act, that is, that Petitioner has cancer or that Petitioner’s medical condition chronically causes seizures or muscle spasms.” Moreover, even if Petitioner had sufficiently alleged that she could be a “qualified patient,” the allegations were insufficient to show that Petitioner would suffer a real or sufficiently immediate injury in fact resulting from application of the proposed rule.

However, the ALJ rejected DOH’s argument that a “qualified patient” could never have standing to challenge proposed rule 64-4.002. While noting that the proposed rule only addresses the application requirements, scoring, and selection process for dispensing organizations, the ALJ concluded that qualified patient status, “when adequately alleged, might, hypothetically, be sufficient as part of the predicate for standing to challenge rules implementing the Act.”

Editor’s Notes on Case Summary:

This case demonstrates a common situation for many Florida residents who suffer from conditions like cancer: denial of medical marijuana. The Compassionate Medical Cannabis Act of 2014 states that in order to qualify for the cannabis, the patient must produce symptoms of seizure and persistent muscle spasms. If the patient is younger than 18 years of age, a second physician must concur the initial physician’s determination. In this case, 4-year-old Dahlia Barnhart, who suffers from a brain tumor, failed to demonstrate that her condition produces seizures and spasms, and therefore was denied low-THC. In court documents, you must allege that you are eligible for the physician’s order.

Comments?

Do you think that 4-year-old Dahlia Barnhart qualifies for medical marijuana? Do you have a chronic condition that was denied medical marijuana? Please leave any thoughtful comments below.

Contact Experienced Health Law Attorneys for Medical Marijuana Concerns.

The Health Law Firm attorneys can assist health care providers and facilities, such as doctors, pharmacists and pharmacies, wanting to participate in the medical marijuana industry. We can properly draft and complete the applications for registration, permitting and/or licensing, while complying with Florida law. We can also represent doctors, pharmacies and pharmacists facing proceedings brought by state regulators or agencies.

To contact the Health Law Firm please call (407) 331-6620 or (850) 439-1001 and visit our website at www.TheHealthLawFirm.com.

About the Author: George F. Indest III, J.D., M.P.A., LL.M., is Board Certified by The Florida Bar in Health Law. He is the President and Managing Partner of The Health Law Firm, which has a national practice. Its main office is in the Orlando, Florida, area. www.TheHealthLawFirm.com The Health Law Firm, 1101 Douglas Ave., Altamonte Springs, FL 32714, Phone (407) 331-6620.

KeyWords: license, defense attorney, health law, health care attorney, health care lawyer, health investigation, medical license, Department of Health, DOH, health attorney, medical marijuana lawyer, medical cannabis, cannabis, marijuana, Compassionate Medical Cannabis Act, THC, medical THC, health conditions, cancer, cancer patients, brain tumor, petitions, Florida, Office of Compassionate Use, ALJ, administrative law judge, physicians, Florida marijuana, administrative hearing, petition for rule challenge

“The Health Law Firm” is a registered fictitious business name of and a registered service mark of The Health Law Firm, P.A., a Florida professional service corporation, since 1999.
Copyright © 2017 The Health Law Firm. All rights reserved.

New Medical-Marijuana Amendment to be Reviewed for Inclusion on Ballot

Attorney George F. Indest III Headshot By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law

A new medical-marijuana amendment will be reviewed by the Department of State. The second push in Florida has more than 100,000 signatures in favor to date. The petitions were given to the state on Wednesday by an organization called United for Care.

This Year’s Version Addresses Loopholes.

Critics have said legal marijuana would result in dispensaries on street corners, minors obtaining joints and giving drug dealers a legal supply. This year’s version of the amendment will address all of these issues. It will allow the state to ban felons who are working as care-givers from purchasing for qualified patients.

The New Version Gives New Definition for ‘Qualified Patient.’

Additionally, the amendment tightens the definition of “qualified patient.” A patient must have one of a list of serious diseases like cancer and HIV/AIDS or a disease of “the same kind or class.” Last year, the version allowed doctors to prescribe marijuana for any condition they believed the benefits outweighed the risk.

The Department of State Must Review in 30 Days.

The Department of State has 30 days to review the 100,000 signatures. It does this in order to make sure at least 68,317 of the signatures are valid. Then, the state Supreme Court will determine if the proposal is constitutional and focuses on one subject. Ben Pollara, campaign manager at United for Care, says they expect to have the review date by mid-August.

To read a past blog on the 2015 policy, click here.

Comments?

Did you sign the petition? Do you agree with the stricter policies? Please leave any thoughtful comments below.

Contact Experienced Health Law Attorneys for Medical Marijuana Concerns.

The Health Law Firm attorneys can assist health care providers and facilities, such as doctors, pharmacists and pharmacies, wanting to participate in the medical marijuana industry. We can properly draft and complete the applications for registration, permitting and/or licensing, while complying with Florida law. We can also represent doctors, pharmacies and pharmacists facing proceedings brought by state regulators or agencies.

To contact the Health Law Firm, please call (407) 331-6620 and visit our website at www.TheHealthLawFirm.com.

Source:

Sweeney, Dan. “New medical-post amendment advances.” Orlando Sentinel. (July 23, 2015). Print.

About the Author: George F. Indest III, J.D., M.P.A., LL.M., is Board Certified by The Florida Bar in Health Law. He is the President and Managing Partner of The Health Law Firm, which has a national practice. Its main office is in the Orlando, Florida area.  www.TheHealthLawFirm.com The Health Law Firm, 1101 Douglas Ave., Altamonte Springs, FL 32714, Phone (407) 331-6620.

KeyWords: United for Care, defense attorney, health law, health care attorney, health care lawyer, health investigation, medical license, Department of State, health attorney, medical marijuana lawyer, medical cannabis, cannabis, marijuana, THC, medical THC, health conditions, cancer, cancer patients, medical marijuana petitions, petitions, Florida, Florida marijuana, petition for rule challenge

“The Health Law Firm” is a registered fictitious business name of and a registered service mark of The Health Law Firm, P.A., a Florida professional service corporation, since 1999.
Copyright © 2017 The Health Law Firm. All rights reserved.

More Than 7,000 Patients of Oklahoma Dentist Are Being Asked to Get Tested for HIV and Hepatitis

4 Indest-2009-3By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law

The unsanitary practices of an Oklahoma dentist may have exposed more than 7,000 patients to HIV and hepatitis, according to a number of media sources and the Oklahoma Department of Health (DOH). Currently officials with the Oklahoma DOH are contacting all of the dentist’s patients since 2007, and urging them to get tested for blood-borne diseases. Since the news broke on March 28, 2013, the dentist has voluntarily closed his two offices and surrendered his dental license for 30 days.

Click here to read a copy of the letter from Oklahoma DOH warning the dentist’s patients to get tested.

We want to point out that these are just allegations made against the dentist at this point in time and have not been proven by the state.

Dentist Accused of Being a “Menace to the Public” in Complaint.

According to the complaint filed with the Oklahoma Board of Dentistry, the dentist is allegedly facing 17 allegations from The Board due to the violations against his practice.

Alleged charges against the dentist include:

1.  A patient testing positive for HIV and hepatitis C;

2.  The dental practice being unsafe, unsanitary and lacking of sterilization checks;

3.  Committing gross negligence related to decisions related to the dental health care of patients;

4.  Practicing dentistry without the proper display of licenses and certifications;

5.  Violation of provisions of the State Dental Practice Act by failing to keep a suitable record of dangerous drugs;

6.  Unlawful practices in authorizing dental assistants to practice dentistry; and

7.  Having open vials of medications and unsanitary dental materials in an unclean environment.

Click here to read the complaint.

Dentist Admitted to Not Handling Sterilization and Drugs Procedures.

According to the complaint, a device in the dentist’s office used to sterilize dental instruments wasn’t working properly. An inspector also found two separate sets of instruments. Each set was cleaned differently, one set of instruments was for patients known to have infectious diseases, and one set was for those not believed to have such diseases. Oklahoma DOH officials said the proper approach is for all instruments to be handled as if they contain viruses and infectious diseases.

According to an article in The New York Times, the dentist allegedly told officials during one inspection of his office that his staff handled all sterilization and drug procedures. Click here to read the entire article from The New York Times.

Dentist Faces Hearing at State Board of Dentistry.

According to the Oklahoma DOH, the dentist has been a state-licensed dentist since 1974, and an oral surgeon since 1977. He faces the possibility of having his license revoked, after a hearing on April 19, 2013, at the state Board of Dentistry in Oklahoma. This investigation is ongoing.

Contact Health Law Attorneys Experienced with Department of Health Investigations of Dentists.

The attorneys of The Health Law Firm provide legal representation to dentists in Department of Health (DOH) investigations, Drug Enforcement Administration (DEA) investigations, FBI investigations and other types of investigations of health professionals and providers.

To contact The Health Law Firm, please call (407) 331-6620 or (850) 439-1001 and visit our website at http://www.TheHealthLawFirm.com.

Comments?

What do you think of this dentist’s story? Are you curious as to how the practice got so bad? Please leave any thoughtful comments below.

Sources:

Oklahoma Board of Dentistry State of Oklahoma v. Wayne Scott Harrington, D.M.D. Case Number 13-005. Statement of Complaint. (March 28, 2013). From: http://www.thehealthlawfirm.com/uploads/OK%20Dentist%20Complaint.pdf

Ball, Brandi. “Tulsa County Dentist May Have Exposed 7,000 Patients to HIV, Hepatitis.” News on 6. (March 28, 2013). From: http://www.newson6.com/story/21820518/tulsa-county-dentist-may-have-exposed-patients-to-hiv-hepatitis

Oklahoma State Department of Health. “Tulsa Health Department, Oklahoma State Department of Health and Oklahoma Board of Dentistry Investigate Tulsa Dentist.” (March 28, 2013). From: http://bit.ly/ZwRhRT

Fernandez, Manny. “Tests Start for Patients of Dentist in Inquiry.” The New York Times. (March 29, 2013). From: http://www.nytimes.com/2013/03/30/health/dental-patients-in-oklahoma-warned-of-disease-risk.html

About the Author: George F. Indest III, J.D., M.P.A., LL.M., is Board Certified by The Florida Bar in Health Law.  He is the President and Managing Partner of The Health Law Firm, which has a national practice.  Its main office is in the Orlando, Florida, area.  www.TheHealthLawFirm.com  The Health Law Firm, 1101 Douglas Ave., Altamonte Springs, FL 32714, Phone:  (407) 331-6620.

The Health Law Firm” is a registered fictitious business name of George F. Indest III, P.A. – The Health Law Firm, a Florida professional service corporation, since 1999.Copyright © 1996-2012 The Health Law Firm. All rights reserved.

Administrative Final Orders Must State Findings of Fact Based on the Evidence Presented

Attorney George F. Indest III HeadshotBy George F. Indest III, J.D., M.P.A., LL.M., Board Certified by the Florida Bar in Health Law

Following is a summary of a recent appellate case on an issue relevant to health law:

Borges v. Dep’t of Health, 143 So. 3d 1185 (Fla. 3d DCA 2014).
Gustavo Borges (Borges) appealed a final order of the Florida Board of Dentistry that revoked his license to practice dentistry based on a conviction of the knowing receipt of child pornography under a federal statute.

At hearing, eight lay witnesses and four expert witnesses testified. In the recommended order’s discussion of the evidence presented, which was the basis for the Board’s final order, the administrative law judge (ALJ) discussed the testimony of only one witness-Borges-after concluding that a statement by Borges constituted a concession that established that his conviction was related to his ability to practice dentistry. No other testimony was discussed in the order, or even acknowledged.

On appeal, the appellate court concluded that the ALJ’s recommended order adopted by the Board did not comply with one of the requirements of section 120.57, Florida Statutes-that an ALJ’s order must contain “express findings of fact.” The court was quick to point out that, while the findings of fact did not have to address the testimony of every witness (i.e., all twelve here), the order must at least address the factual controversies at issue to the extent they are relevant to the disposition, or address why the testimony is irrelevant. Having failed to do so in this case, the appellate court reversed and remanded.

The case summary above was originally published in the Administrative Law Section Newsletter, Vol. 34, No. 2 (Dec. 2014), a publication of The Administrative Law Section of The Florida Bar.

Editor’s Comments on Case Summary.

This case demonstrates an important concept in administrative law. This is, an administrative law judge is required to discuss the evidence presented at the hearing and make specific findings of fact based on that evidence. Failing to do this in the recommended order (RO) can lead to reversal by an appellate court.


Comments?

Do you think the appellate court should have reversed? Do you think it was important to discuss all testimonies in this case? Please leave any thoughtful comments below.


Contact Health Law Attorneys Experienced in Handling Licensure Matters.

If you have been arrested, it is strongly recommended that you retain an experienced healthcare attorney who can advise you as to the effects a potential outcome could have on your license.

The attorneys of The Health Law Firm routinely represent physicians, pharmacists, nurses, and other healthcare practitioners in licensure matters. We frequently consult with criminal defense attorneys regarding defense strategies tailored to minimizing criminal sanctions while preserving the practitioner’s license.

To contact The Health Law Firm, please call (407) 331-6620 or (850) 439-1001 and visit our website at www.TheHealthLawFirm.com.


About the Author
: George F. Indest III, J.D., M.P.A., LL.M., is Board Certified by The Florida Bar in Health Law. He is the President and Managing Partner of The Health Law Firm, which has a national practice. Its main office is in the Orlando, Florida, area. www.TheHealthLawFirm.com The Health Law Firm, 1101 Douglas Ave., Altamonte Springs, FL 32714, Phone (407) 331-6620.

KeyWords: Criminal law, license, defense attorney, health law, health care attorney, health care lawyer, health investigation, medical license, conviction, desntist, dentist criminal charges, Department of Health, DOH, professional license, federal statutes, license disciplined, license revoked, health attorney, finding of guilt, adjudication withheld, diversion program, DOH conviction, adjudication, discipline, criminal trial, defense lawyer, ALJ, administrative law judge, administrative law, appellate court, administrative orders, Florida Board of Dentistry, Board of Dentistry, dentistry, statutes, testimony

“The Health Law Firm” is a registered fictitious business name of George F. Indest III, P.A. – The Health Law Firm, a Florida professional service corporation, since 1999.
Copyright © 1996-2015 The Health Law Firm. All rights reserved.