Thursday, July 07, 2005

Update: Dr. Michael Rosin is an "immediate, serious danger to public health," according to court records


At 4:02 PM, Blogger jewishwhistleblower said...

see also:


Judges won't lift Rosin surgery ban

SARASOTA COUNTY -- Appeals judges on Wednesday denied Dr. Michael Rosin's request to lift a state order that bars him from performing surgery.

Rosin, a popular Sarasota dermatologist who is accused of falsely diagnosing skin cancer in dozens of patients, has been prohibited from performing surgery since June 14.

The doctor's attorneys argued that the emergency order should be postponed while the judges consider quashing or altering it.

But the appeals judges instead ruled on the side of the state Department of Health, which said Rosin is an "immediate, serious danger to public health," according to court records.

A lawyer for the state wrote that it was Rosin's greed that led him to make false diagnoses, do unnecessary surgery and submit false Medicare claims to receive at least $3 million in illegal reimbursements.

He was indicted on federal health-care fraud charges in April, and faces up to life in prison if convicted.

It could be several months before judges in the First District Court of Appeal come to a final decision about the state's emergency order, which also restricts Rosin from diagnosing cancer in any patients. It could be a year before the Board of Medicine decides whether to take more discipline on the doctor.


Patients asking: Why the wait? Deciding Dr. Michael Rosin's professional fate will take a year


SARASOTA -- The FBI says Dr. Michael A. Rosin defrauded Medicare of $3 million, and the state's top health official has declared him a danger to the public.

Rosin is accused of performing unnecessary surgery on dozens of patients, including one elderly man who thought he was going to die based on Rosin's cancer diagnoses.

The doctor has been restricted from performing surgery. But he's going to have a lot of chances to defend his ability to practice medicine starting as early as this week, when appeals judges may decide whether to stay the order while they review the case.

This is the beginning of what promises to be a yearlong back-and-forth between Rosin and state health officials. It may end in a trial separate from the one in federal court.

Rosin's patients are already asking themselves why it's taking so long to decide his fate.

Some of them started complaining about Rosin a year ago, which prompted the FBI investigation.

"I think they worry about the doctors more than they worry about the patients," said Ellen Murray, a former patient who went to federal authorities about Rosin.

But those who have been through the process before say it will get a lot more frustrating before the state will take any action against the doctor's license.

"The whole process is much slower than we ever dreamed," said Don Ayer, whose daughter, Julie Rubenzer, went into a coma and later died after breast augmentation surgery performed by another Sarasota doctor.

Dr. Kurt Dangl's license was eventually revoked -- 18 months after Rubenzer's surgery.

"If somebody's going to expect a revocation, be prepared for the long haul," Ayer said.

A few weeks ago, the Florida secretary of health decided Rosin's continued practice was an "immediate and serious" danger to the public.

The secretary, Dr. John O. Agwunobi, issued an emergency order restricting Rosin from making skin cancer diagnoses and performing surgery.

"We try and move it as fast as possible, but we also have to substantiate the allegations," said the Florida Department of Health's press secretary, Lindsay Hodges, of the emergency order.

It was among the most dramatic actions the state takes against a doctor, and one of the rarest.

Up to 90 percent of DOH complaints against medical doctors are investigated and dismissed after review by the state's in-house physicians and legal staff, said Dr. Rafael Miguel, a University of South Florida professor and former vice chairman of the Board of Medicine. The state seeks formal discipline on few of the remaining cases.

Since the beginning of last year, less than 30 emergency restrictions and suspensions were handed to Florida medical doctors accused of serious misconduct, records show.

"When Dr. Agwunobi signs the emergency order, he literally asks himself, 'Am I saving a life by signing this?'" Hodges said. "If the answer to that question is 'yes,' he signs it without hesitation."

Even then, the health department is bound by state law to take the "least restrictive" action, Hodges said.

In appealing the emergency order last week, Rosin's attorneys called it "overbroad," saying that the public could be protected by simply requiring that Rosin have his biopsy slides confirmed by another doctor before performing surgery.

Rosin's lawyers say he's already got another doctor reviewing his diagnoses, and confirming that they were right.

"We're sure that the Florida Department of Health will be interested to learn that fact," said Theresa Van Vliet, one of Rosin's attorneys.

"It certainly does seem to undercut any argument that the surgeries he's performing now are anything but proper and necessary."

If the state seeks more formal action against Rosin's license, the dermatologist will then have a choice of entering into a consent agreement or taking his case to an administrative hearing.

Bruce D. Lamb, Rosin's attorney in the Department of Health case, said Rosin would likely want an administrative hearing, which will resemble a trial.

Dangl's administrative hearing came more than a year after the plastic surgeon performed surgery on Rubenzer in 2003. A few months after the January hearing, the Board of Medicine took a judge's recommendation and revoked his license.

For Rubenzer's father, it was a long ordeal.

"You get discouraged," Ayer said. "You start to think that nothing is occurring. The fact of the matter is, it actually is."

How doctors are disciplined

Here is a step-by-step explanation of the Department of Health complaint process:

Step 1: The complaint

It can be initiated by "virtually anyone in the state," says Dr. Rafael Miguel, a USF professor and former vice chairman of the Board of Medicine. Complaints can come from patients, employees or medical malpractice lawsuits.

Step 2: The investigation

A letter is sent to the doctor to notify him of the investigation. An investigator will conduct interviews. The doctor has a chance to contest the complaint. The investigation is then reviewed by in-house physicians and lawyers. Between 80 and 90 percent of complaints get stopped here, said Miguel.

In rare cases, the state's team of doctors and lawyers will recommend an emergency order to suspend or restrict a doctor's license. Calling his continued practice an immediate public danger, the secretary of health prohibited Dr. Michael A. Rosin from making cancer diagnoses and performing surgery. Rosin is contesting the emergency order in appeals court.

Step 3: The probable cause panel

This is made up of two physicians and one layperson. The panel determines whether there's a reason for the state to seek formal discipline against a doctor. Of more than 1,700 medical doctor complaint cases that made it to a probable cause panel in a recent year, the state decided not to seek discipline in more than 85 percent of them, records show.

Step 4: Administrative complaint

This is the official notice that the state is seeking formal discipline against a doctor. It will outline all charges against the doctor. Possible penalties include a confidential letter of guidance or a public letter of concern, fines, community service, probation, suspension or revocation of their license.

Step 5: One of two things happens next ...

Administrative hearing. It looks like a trial and it feels like a trial. Lawyers for the doctor and the state go in front of a judge, who in turn makes a recommendation to the Board of Medicine.

Or ...

Consent agreement. It is a form of settlement between the state and the doctor. Finding a hearing too costly, more than 90 percent of doctors opt for the consent agreement, said Miami Beach attorney Sean M. Ellsworth. The agreement is then forwarded on to the Board of Medicine, which can accept or reject it.

-- Compiled by Mike Saewitz


Rosin wants state's ban lifted

SARASOTA -- Lawyers for Dr. Michael A. Rosin are petitioning appeals judges to overturn a Department of Health order prohibiting the dermatologist from diagnosing skin cancer and performing surgery.

In court papers filed Thursday, the lawyers say that the state's order is "overbroad" and is meant to "punish" Rosin rather than protect the public.

They argue that his patients will be protected if the state requires Rosin to get his biopsies reviewed by an independent doctor before performing surgery.

The state has accused Rosin of gross malpractice, keeping inadequate records and demonstrating a "flagrant disregard" for his duties as a doctor, according to the June 14 emergency order.

"Nothing short of the immediate restriction of Dr. Rosin's license will protect the public," reads the order, which was signed by the secretary of the Department of Health, Dr. John Agwunobi.

The order came a few months after Rosin was arrested and indicted on charges of routinely lying about skin cancer diagnoses and performing unnecessary surgery.

At least one of his former patients says the state was right to restrict Rosin's practice.

"The state has received all the evidence from the FBI," said Ellen Murray, who went to federal authorities about Rosin. "They thought very deliberately and justified that they were right in what they did. They don't do these things lightly."

The state has until next week to respond to Rosin's lawyers.

Court documents filed by Rosin's attorney provide a glimpse into the doctor's possible defense.

Bruce D. Lamb of Tampa wrote that the accusations arose from a former employee with a "bias" against Rosin.

Defending the unusually high number of surgeries the doctor performed, Lamb wrote that many of Rosin's patients were diagnosed by another doctor with skin cancer and referred specifically to Rosin for surgery.

"Thus, it is not surprising that a high percentage of patients seen by Dr. Rosin would be found to be suffering from cancer," said Lamb, who also noted that Rosin treated the most common forms of skin cancer.

Rosin's lawyers argued that the state went too far in issuing the emergency order restricting Rosin's practice, and never demonstrated that his continued practice was a public danger.

Federal authorities have been investigating Rosin since early 2004, when Murray and the doctor's former office manager, Carolyn Ferrara, filed a whistle- istle-blower lawsuit in federal court.

Murray and other patients have said that Rosin performed skin cancer surgery on every patient who visited his Hillview Street office. Ferrara told authorities she had long suspected that Rosin was performing unnecessary surgeries, submitting the claims to Medicare and defrauding the federal government of millions of dollars.

If Rosin is convicted, the two women could gain up to a quarter of the $9 million in damages the government is seeking.

In the court documents, Rosin's attorneys accuse Ferrara of being biased against the doctor and committing identity theft against him. The lawyers also say that Ferrara has an outstanding arrest warrant on a worthless-check charge.

"He's going to throw accusations around about everybody," Ferrara said Thursday. "Absolutely everybody. I'm really not worried about it at all."


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