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1 STATE OF FLORIDA DEPARTMENT OF HEALTH DEPARTMENT OF HEALTH, PETITIONER, v. CASE NO ANDREW GUZMAN, M.D., RESPONDENT. ADMINISTRATIVE COMPLAINT Petitioner Department of Health files this Administrative Complaint before the Board of Medicine against Respondent Andrew Guzman, M.D., and alleges: 1. Petitioner is the state agency charged with regulating the practice of Medicine pursuant to Section 20.43, Florida Statutes; Chapter 456, Florida Statutes; and Chapter 458, Florida Statutes. 2. At all times material to this Complaint, Respondent was a licensed medical doctor within the state of Florida, having been issued license number ME Respondent's address of record is 6705 Park Strand Drive, Apollo Beach, Florida,

2 4. On or about August 9, 2016 Patient A.G., a 64-year-old female, was referred to Respondent due to post-menopausal uterine bleeding. 5. An ultrasound was performed, and reflected an endometrial stripe of 15mm, as well as the appearance of either a blood clot or polyp. 6. Respondent discussed options with Patient A.G. and a hysteroscopy with dilation and curettage was scheduled for later that week. 7. On or about August 12, 2016, Patient A.G. presented to Blake Medical Center for the scheduled hysteroscopy with Respondent. 8. Patient A.G. was placed under anesthesia, and placed in dorsal lithotomy position. The hysteroscope was inserted, and noted three polyps, and a two-cm fibroid. 9. Respondent removed the three polyps with polyp forceps. 10. Respondent then set up MyoSure and inserted it in to the uterus to remove the fibroid. 11. After removal of the fibroid, Respondent noted bleeding, and proceeded to apply Monsels solution to the internal bleeding site using a syringe with a blunt plastic tip. DOH v. Andrew Guzman, M.D.; Case Number

3 12. Monsels Solution has a label use of external and/or topical use only. 13. Soon after, the anesthesiologist advised Respondent that Patient A.G. appeared to be experiencing bradycardia. 14. The code team was called, and after resuscitation attempts, Patient A.G. expired. 15. The prevailing standard of professional care requires a physician to not apply Monsels solution in to internal body cavities of a patient. 16. Respondent applied Monsels solution to the inside of the uterus of Patient A.G to stop internal bleeding. 17. Section (1)(t)1, Florida Statutes (2016), subjects a licensee to discipline for committing medical malpractice as defined in Section (1)(g), Florida Statutes. Section (1)(g), Florida Statutes (2016), states that medical malpractice means the failure to practice medicine in accordance with the level of care, skill, and treatment recognized in general law related to health care licensure. Section , Florida Statutes (2016) provides that the prevailing standard of care for a given healthcare provider shall be that level of care, skill, and treatment DOH v. Andrew Guzman, M.D.; Case Number

4 which, in light of all relevant surrounding circumstances, is recognized as acceptable and appropriate by reasonably prudent similar health care providers. 18. On or about August 12, 2016, Respondent fell below the standard of care in the treatment of Patient A.D. by applying Monsels solution internally on or near Patient A.G.'s uterus to stop bleeding. 19. Based on the foregoing, respondent has violated Section (1)(t)1, Florida Statutes (2016), by failing to meet the prevailing standard of care. WHEREFORE, the Petitioner respectfully requests that the Board of Medicine enter an order imposing one or more of the following penalties: permanent revocation or suspension of Respondent's license, 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 Board deems appropriate. (Signatures appear on next page) DOH v. Andrew Guzman, M.D.; Case Number

5 SIGNED this 7th day of May Celeste Philip, MD, MPH Surgeon General and Secretary CLERK DATE FILED DEPARTMENT OF HEALTH DEPUTY CLERK MAY Sdt EdAvowc14/ Virginia Edwards Assistant General Counsel Florida Bar Number DOH-Prosecution Services Unit 4052 Bald Cypress Way-Bin C-65 Tallahassee, Florida Telephone: (850) Facsimile: (850) PCP Date: May 4, 2018 PCP Members: Mark Avila, M.D.; Magda Averhoff, M.D.; Nicholas Romanello DOH v. Andrew Guzman, M.D.; Case Number

6 NOTICE OF RIGHTS Respondent has the right to request a hearing to be conducted in accordance with Section and , 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 (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 (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 (5), Florida Administrative Code. Mediation under Section , 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 (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. DOH v. Andrew Guzman, M.D.; Case Number