Professional Documents
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DOH-16-0536-RD -MQA
MAR 1
FILED DATE - M
Department of Health
STATE OF FLORIDA
DEPARTMENT OF HEALTH
0 2016
ty Agency Clerk
4.
Due to the concern that Ms. Webb was impaired, Cooper Family
Medical relieved Ms. Webb of her shift duties and requested that A.K. drive Ms.
Webb home. A.K. reported that Ms. Webb dozed off several times on the way
home, attributed her behavior to an over-the-counter cough syrup, and made
nonsensical statements.
7.
Upon Ms. Webb's return to work, C.C., D.O., the medical director
of Cooper Family Medical, informed Ms. Webb that her recent behavior was
unacceptable and would not be tolerated again. Ms. Webb explained that she
was sick and took over-the-counter cough syrup before work on November 5,
2015.
8.
On or about November 30, 2015, Ms. Webb presented for her shift
2
A.K. observed that Ms. Webb had slurred speech, an unsteady gait,
16.
Ms. Webb denied that she was impaired while working at Cooper
Family Medical. Ms. Webb admitted she may have 'nodded off' a few times on
the way home from work. Ms. Webb further explained that the office computer
was difficult to login to.
17.
Ms. Webb explained that her physician had recently prescribed her
trazodonel and alprazolam2 around the time of the November 5, 2015, incident
at Cooper Family Medical. Ms. Webb disclosed that she was also prescribed
Tramado1.3
18.
Medical, Ms. Webb alleged that she was sick and out from work for two or
three days. Ms. Webb explained that she took antibiotics, cough suppressant
and steroids.
19.
2015. Ms. Webb speculated that Cooper Family Medical was trying to find a
1 Trazodone
Regarding the November 5, 2015, incident, Dr. D.B. noted that Ms.
As part of the evaluation, Ms. Webb underwent hair and urine drug
Ms. Webb's drug and alcohol hair screen was positive for the
connection with the evaluation, Dr. D.B. opined that the drug screens revealed
that Ms. Webb had used oxycodone in the previous ninety days. However, Ms.
Webb was not prescribed oxycodone.
24.
Dr. D.B. opined that Ms. Webb lacks insight regarding the nature
of her substance use. Dr. D.B. opined that Ms. Webb has diminished problem
solving ability, diminished judgment, diminished ability to cope with stressful
situations, and diminished decision-making abilities in a crisis.
Oxycodone is commonly prescribed to treat pain. According to Section 893.03(2), Florida Statutes (2015),
oxycodone is a Schedule II controlled substance that has a high potential for abuse and has a currently
accepted but severely restricted medical use in treatment in the United States. Abuse of oxycodone may
lead to severe psychological or physical dependence.
25.
Dr. D.B. diagnosed Ms. Webb with opioid abuse, rule out
Dr. D.B. opined that Ms. Webb is not currently able to practice as
Intervention Project for Nurses (IPN)5 and undergo day treatment, due to Ms.
Webb's severity of intoxication at work, the presence of oxycodone in her hair
drug screen without justification, and the low level of insight Ms. Webb has
regarding her problems.
28.
Dr. D.B. opined that after treatment and with monitoring, Ms.
As of the date of this Order, Ms. Webb has not complied with Dr.
D.B.'s recommendations.
30.
5 IPN is the impaired practitioner program for the Board of Nursing, pursuant to Section 456.076, Florida
Statutes (2015). IPN monitors the evaluation, care, and treatment of impaired nurses. IPN oversees
random drug screens and provides for the exchange of information between treatment providers, evaluators,
and the Department for the protection of the public.
situations regarding their patients, and must be able to quickly observe and
assess potentially life-threatening symptoms or conditions which may befall
their patients.
31.
present fit for work and free from mind-altering substances so that they may
have lucid thought processes and sound perceptive and decision-making
abilities while caring for patients.
32.
presently able to practice nursing with reasonable skill and safety to patients
due to her opioid abuse with possible dependence. The independent medical
expert concluded that Ms. Webb's presentation to work while intoxicated and
denial of her opioid use without a valid prescription indicates her impairment
is likely to continue without treatment and monitoring. Based on that
assessment, there is no lesser restriction than the terms outlined in this Order
that will adequately protect the public.
33.
nurse while impaired by her above diagnoses constitutes such a threat to the
public health, safety, or welfare that the safety of Ms. Webb's patients cannot
be assured.
7
CONCLUSIONS OF LAW
Based on the foregoing Findings of Fact, the State Surgeon General
concludes as follows:
1.
by being unable to practice nursing with reasonable skill and safety to patients
due to her presenting to work intoxicated and diagnosis of opioid abuse, rule
out dependence and insomnia disorder.
4.
5.
day of
Aka.
2016.
H. Armstrong, M.WF.A.C.S.,
ate Surgeon General &
Secretary of Health
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