final order no. doh-18-0116- -mqa arill2018...state of florida final order no. doh-18-0116- s -mqa...

STATE OF FLORIDA

Final Order No. DOH-18-0116- S -MQA

FILED DATE ArilL2018 Department of Health

uty Agency Clerk

BOARD OF OSTEOPATHIC MEDICINE

DEPARTMENT OF HEALTH,

Petitioner,

vs. Case No.: 2013-10663 License No.: OS 5165

MARK G. KANTZLER, D.O.,

Respondent,

FINAL ORDER

This matter came before the Board of Osteopathic Medicine (Board) at a duly-

noticed public meeting on November 17, 2017, in Jacksonville, Florida, to consider the

Respondent's offer to voluntarily relinquish his license to practice osteopathic medicine

in the State of Florida. A copy of the Respondent's Voluntary Relinquishment of License

is attached hereto as Exhibit "A." Said written offer of relinquishment specifically

provides that Respondent understands that acceptance of the Voluntary Relinquishment

shall be construed as disciplinary action against Respondent's license and Respondent

agrees never again to apply for licensure as an osteopathic physician in the State of

Florida.

Upon consideration of the written offer of voluntary relinquishment, the charges

set forth in the Amended Administrative Complaint filed in this matter on July 13, 2015,

attached hereto as Exhibit "B," and the other documents of record, and being otherwise

advised in the premises,

IT IS HEREBY ORDERED that the voluntary relinquishment of the license of

Mark G. Kantzler, D.O. to practice osteopathic medicine in the State of Florida is

accepted and shall constitute discipline upon his record.

This Final Order shall become effective upon filing with the Clerk for the

Department of Health.

(14 DONE AND ORDERED this day of Watt& , 2013?.'

BOARD OF OSTEOPATHIC MEDICINE

Kama Monroe, J.D., Executive Director on behalf of Michelle Mendez, D.O., Chair

CERTIFICATE OF SERVICE

I HEREBY CERTIFY that a true and correct copy of the foregoing has been

furnished by U.S. Mail to Mark G. Kantzler, D.O., P.O. Box 1619, Largo, FL 3379-

1619; and by email to Donna C. McNulty, Senior Assistant Attorney General, at

[email protected]; and Matthew Witters, Assistant General

Counsel, at [email protected]; this I Li day of , 201?

Deputy Agency Clerk

2

Accredited Health Department blic Health Accreditation Board

Florida Department of Health Division of Medical Quality Assurance 4052 Bald Cypress Way, Bin C-00 • Tallahassee, FL 32399 PHONE: (850) 245-4224 • FAX (850) 414-8209

Mission: To protect, promote & improve the health of all people in Florida through integrated state, county & community efforts.

Rick Scott Governor

Celeste Philip, MD, MPH Surgeon General and Secretary HEALTH

Vision: To be the Healthiest State in the Nation

INTEROFFICE MEMORANDUM

DATE: January 9, 2018

TO: Adrienne Rodgers, J.D., Bureau Chief Bureau of Health Care Practitioner Regulation

FROM: Kama Monroe, J.D., Executive Director Boards of Acupuncture, Massage Therapy, Osteopathic Medicine, Speech-Language Pathology & Audiology and the Council of Licensed Midwifery

SUBJECT: Delegation of Authority

This is to advise that while I am out of the office January 9, 2017, William Spooner has delegated authority to serve as Acting Executive Director for the Boards of Acupuncture, Massage Therapy, Osteopathic Medicine, Speech-Language Pathology & Audiology and the Council of Licensed Midwifery. Mr. Spooner can be reached at 850-245-4586.

KM/dg

STATE OF FLORIDA DEPARTMENT OF HEALTH

FILED DEPARTMENT OF HEALTH

DEPUTY CLERK CLERK Amber Greene

DATE SEP 2 1 2017

0

DEPARTMENT OF HEALTH, Petitioner,

DOH Case No.: 2013-10663

V.

MARK G. KANTZLER, D.O.„

Respondent I

VOLUNTARY RELINQUISHMENT OF LICENSE

Respondent, MARK G. KANTZLER, D.O. license no. 5165, hereby

voluntarily relinquishes Respondent's license to practice osteopathic medicine In

the State of Florida and states as follows:

1. Respondent's purpose In executing this Voluntary Relinquishment is

to avoid further administrative action with respect to this cause. Respondent

understands that acceptance by the Board of Osteopathic Medicine (hereinafter

the Board) of this Voluntary Relinquishment shall be construed as disciplinary

action against Respondent's license pursuant to Section 4561072(1)(t), Florida

Statutes.

2. Respondent agrees not to reapply for licensure pursuant to

Chapter 459 in the State of Florida.

z'd 8999-00V-LZI. Jelueo isolams sseiewm dZZ:ROL 1, deS Exhibit A

3. Respondent agrees to voluntarily cease practicing osteopathic

medicine in Florida immediately upon executing this Voluntary

Relinquishment Respondent further agrees to refrain from the practice of

osteopathic medicine In Florida until such time as this Voluntary

Relinquishment is presented to the Board and the Board issues a written final

order in this matter.

4. In order to expedite the consideration and resolution of this

action by the Board in a public meeting, Respondent, being fully advised of

the consequences of so doing, hereby waives the statutory privilege of

confidentiality of Section 456.073(10), Florida Statutes, and waives a

determination of probable cause by the Probable Cause Panel, or the

Department when appropriate, pursuant to Section 456.073(4), Florida

Statutes, regarding the complaint, the investigative report of the Department

of Health, and all other information obtained pursuant to the Department's

investigation of the above-styled action. By signing this waiver, Respondent

understands that the record and the complaint become public record and

remain public record and that information is immediately accessible to the

public. Section 456.073(10), Florida Statutes.

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5. Upon the Board's acceptance of this Voluntary Relinquishment,

Respondent agrees to waive all rights to seek judicial review of, or to

otherwise challenge orcontest the validity of, this Voluntary Relinquishment

and of the Final Order of the Board incorporating this Voluntary

Relinquishment.

6. Petitioner and Respondent hereby agree that upon the Board's

acceptance of this Voluntary Relinquishment, each party shall bear its own

attorney's fees and costs related to the prosecution or defense of this matter.

7. Respondent authorizes the Board to review and examine all

Investigative file materials concerning Respondent in connection with the

Board's consideration of this Voluntary Relinquishment Respondent agrees

that consideration of this Voluntary Relinquishment and other related

materials by the Board shall not prejudice or preclude the Board or any of its

members, from further participation, consideration, or resolution of these

proceedings if the terms of this Voluntary Relinquishment are not accepted by

the Board.

DATED this 21 I

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NOTARY PUBLIC

STATE OF Florida COUNTY OF: - 1 Nato.% Before me, personally appeared 016.*,_ 1.4 arkele whose identity is known to me by krserck type of identification) and who, under oath, ad4ovvledges that his signature appears above. Sworn to and subscribed before me this day of

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STATE OF FLORIDA DEPARTMENT OF HEALTH

FILED DEPARTMENT OF HEALTH

DEPUTY CLERK

CLERK anget Sandeee DATE JUL 1 3 2015

Exhibit B

DEPARTMENT OF HEALTH,

PETITIONER,

V.

MARK G. KANTZLER, D.O.,

RESPONDENT.

CASE NO.: 2013-10663

AMENDED ADMINISTRATIVE COMPLAINT

COMES NOW, Petitioner, Department of Health, by and through its

undersigned counsel, and files this Amended Administrative Complaint

before the Board of Osteopathic Medicine against the Respondent, Mark G.

Kantzler, D.O., and in support thereof alleges:

1. Petitioner is the state agency charged with regulating the

practice of osteopathic medicine pursuant to Section 20.43, Florida

Statutes; Chapter 456, Florida Statutes; and Chapter 459, Florida Statutes.

2. At all times material to this Amended Administrative Complaint,

Respondent was a licensed osteopathic physician within the State of

Florida, having been issued license number OS 5165.

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3. Respondent's address of record is P.O. Box 1619, Largo, Florida

33779.


Respondent was the registered medical director of the "Advanced Wellness

Center", located at 2033 Wood Street, Number 210, Sarasota, Florida

34237.


the "Advanced Wellness Center" was a "clinic" as licensed in Chapter

400.9905, Florida Statutes (2012).

6. Patient M.M. was a 69 year old female with oxygen dependent

Chronic Obstructive Pulmonary Disease (COPD)„ emphysema and lung

cancer in remission.

7. On or about June 11, 2013, patient M.M. consulted Advanced

Wellness Center regarding stem cell treatment for her COPD.

8. Respondent failed to adequately explain that the intravenous

administration of adipose derived stem cells has no medical or scientific

value to treat COPD.

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DOH V. Mark G. Kantzler, D.O. Case No. 2013-10663

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9. Respondent failed to adequately explain that the intravenous

administration of adipose derived stem cells had no proper medical

foundation for success.

10. Respondent failed to adequately explain that the procedure was

not accepted as a proven treatment in the State of Florida.

11. On or about June 17, 2013, Respondent performed a stem cell

procedure by removing fatty adipose tissue from patient M.M. through

liposuction, spinning the tissue to ostensibly isolate stem cells, and re-

injecting the solution into patient M.M. intravenously (IV).

12. During the administration of the IV Respondent and a

Chiropractor, J.L., noticed and attempted to manually separate a red clump

with their hands.

13. During the administration of the IV, patient .'s head began

to sway back and forth and she lost consciousness.

14. Patient M.M. continued to exhibit an abnormal physical

response to the treatment.

15. Respondent failed to call 911,

16. Patient M.M.'s husband called 911 paramedics, requesting an

ambulance to transport patient M.M to the hospital.

3 DOH v. Mark G. Kantzler, D,O. Case No, 2013-10663

17. Patient M.M.'s husband gave the phone to the Respondent.

The Respondent stated that he told patient M.M.'s husband to not call 911.

Respondent walked away from the scene,

18. Chiropractor J.L. got on the phone with the 911 operator.

19. J.L. stated, "We've got things under control though... we're in

the middle of a procedure here."

20. J.L. stated to the 911 operator, "we've just requested that he

[patient M.M.'s husband] not call you guys... the patient's actually looking a

lot better. It was just a.... she hasn't slept all week... and... she got

vasovagal... so we... feel that we have it under control here."

21. The 911 operator asked, "And you don't need an ambulance?"

J.L. stated, "No."

22. Patient M.M.'s heart stopped.

23. Paramedics attempted to provide life-saving procedures.

Patient M.M. was declared dead at approximately 6:16 p.m. on June 17,

2013.

24. Respondent was the certifying physician for patient M.M.'s •

death certificate.

25. Respondent did not send patient M.M. to be autopsied.

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DOH V. Mark G. Kantzler, D.O. Case No. 201340663

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26. Respondent listed causes of death to include "cardiopulmonary

arrest" and "COPD/ Emphysema."

27. Respondent did not submit a 15 day Adverse Incident Report to

the Agency for Health Care Administration (AHCA).

28. Respondent's medical records did not contain medical

justification for the intravenous administration of adipose derived stem cells

as a treatment for patient M.K's COPD.

29. Respondent did not explain to patient M.M. the risks associated

with the procedure.

30. Respondent did not obtain informed consent from patient M.M.

31. Respondent's treatment of patient M.M.'s COPD by the

intravenous administration of adipose derived stem cells as a treatment for

COPD had no substantial medical and / or scientific value.

32. Respondent fell below the standard of care by performing an

unproven experimental procedure, by having inadequate training to

perform the procedure, by failing to call 911 and/or by failing to properly

aid the assistance and arrival of paramedics, and by failing to send the

deceased patient M.M. to the medical examiner.

DOH v. Mark G. Kantzler, 0.0. Case No. 2013-10663

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COUNT I

33. Petitioner realleges and incorporates paragraphs one (1)

through thirty-two (32), as if fully set forth herein.

34. Section 459.015(1)(x), Florida Statutes (2012), allows the

Board of Osteopathic Medicine to impose discipline for committing medical

malpractice as defined in Section 456.50, Florida Statutes.

35. "Medical malpractice" is defined in Section 456.50(1)(e), Florida

Statutes (2012), as the "failure to practice medicine in accordance with the

level of care, skill, and treatment recognized in general law related to

health care licensure."

36. For purposes of Section 459.015(1)(x), Florida Statutes (2012),

the Board shall give great weight to the provisions of Section 766.102,

Florida Statutes (2012), which provides:

The prevailing professional standard of care for a given health

care provider shall be that level of care, skill, and treatment

which, in light of all relevant surrounding circumstances, is

recognized as acceptable and appropriate by reasonably

prudent similar health care providers.

6 DOH V. Mark G. KantrJer, D.O. Case No. 2013-10663

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37. Respondent committed medical malpractice in his care of

Patient M.M. in one or more of the following manners:

a. by performing a procedure that had no substantial medical and

scientific value for the treatment of patient M.M.'s COPD;

b. by performing a procedure that had no proper medical

foundation for success;

c. by performing a procedure that was entirely experimental and

not an accepted or proven treatment in the State of Florida;

cl1 by performing a procedure that was dangerous and

unwarranted;

e. by performing a procedure that was medically unnecessary and

dangerous;

f. by performing a procedure that placed the patient at an

inappropriate risk of death and/or serious injury;

g. by injecting or causing the injection of an unknown material

into M.M.'s circulation without any prior objective knowledge of

the material's properties or the risks to the patient;

h. by failing to perform an adequate medical examination;

7 DOH v. Mark G. Kantzier, Case No. 2013-10663

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I. by failing to call 911 at the onset of signs of cardiac arrest;

and/or

j. by failing to send the deceased patient M.M. to the medical

examiner.

38. Based on the foregoing, Respondent violated Section

459.015(1)(x), Florida Statutes (2012), by committing medical malpractice.

COUNT II

39. Petitioner realleges and Incorporates paragraphs one (1)

through thirty-two (32), as if fully set forth herein,

40. Section 459.015(1)(s), Florida Statutes (2012), subjects a

licensee to discipline for performing professional services which have not

been duly authorized by the patient or client or his or her legal

representative except as provided in s. 743.064, s. 766.103, or s. 768.13.

41. Prior to administering the adipose derived stem cells

intravenously into patient M.M., Respondent failed to adequately explain to

patient M.M. one or more of the following:

a. That the intravenous administration of adipose derived stem

cells has no medical or scientific value to treat COPD;

DOH v. Mark G. Kantzler, 0.0. Case No. 2013-10663

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b. That the intravenous administration of adipose derived stern

cells had no proper medical foundation for success; and/or

C. That the procedure was not accepted as a proven treatment in.

the State of Florida.

42. Respondent failed to obtain proper informed consent from

patient M.M., by failing to make proper disclosures, indicating that patient

M.M. was sufficiently educated on the risks, benefits, and alternatives to

the proposed treatment of intravenous administration of adipose derived

stem cells for the treatment of COPD.

43. Based on the foregoing Respondent violated Section

459.015(1)(s), Florida Statutes (2012).

COU NT III



45. Section 456.072(1)(bb), Florida Statutes (2012), provides that

performing or attempting to perform health care services on the wrong

patient, a wrong-site procedure, a. wrong procedure, or an unauthorized

procedure or a procedure that is medically unnecessary or otherwise

9 DOH v. Mark G. Kantzler, 0.0. Case No. 2013-10663

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unrelated to the patient's diagnosis or medical condition is grounds for

disciplinary action.

46. Respondent performed a wrong procedure, an unauthorized

procedure, a medically unnecessary procedure or a procedure unrelated to

patient's diagnosis or medical condition by intravenously administering

adipose derived stems cells into patient M.M. to treat COPD.


456.072(1)(bb), Florida Statutes (2012).

COUNT IV



• 49. Section 459.015(1)(g), Florida Statutes (2012), provides that

failing to perform any statutory or legal obligation placed upon a licensed

osteopathic physician is grounds for discipline.

50. Section 400.9935(1), Florida Statutes (2012), states that each

clinic shall appoint a medical director or clinic director who shall agree In

writing to accept legal responsibility for certain activities.

51. Section 400.9935(1)(f), Florida Statutes (2012), lists that one

such responsibility is to ensure compliance with the recordkeeping, office

10 DON v. Mark G. Kantzler, D.O. Case No. 2013-10663

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surgery, and adverse incident reporting requirements of chapter 456, the

respective practice acts, and rules adopted under this part and part 11 of

chapter 408.

52. Section 459.026(1), Florida Statutes (2012), provides that any

adverse incident that occurs on or .after January 1, 2000, in any office

maintained by an osteopathic physician for the practice of osteopathic

medicine which is not licensed under chapter 395 must be reported to the

department in accordance with the provisions of this section.

53. Section 459.026(3), Florida Statutes (2012), provides that the

required notification to the department must be submitted in writing by

certified mail and postmarked within 15 days after the occurrence of the

adverse incident.

54. Section 459.026(4)(a), Florida Statutes (2012), provides that

"adverse incident" includes "the death of a patient."

55. As the acting medical director of Advanced Wellness Center,

Respondent was required to submit an adverse incident report within

fifteen days of the death of patient M.M.

56. Respondent failed to submit an adverse incident report within

fifteen days of the death of patient M.M.

11 DOH v. Mark G. Kantzler, D.O. Case No. 2013-10663

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459.015(1)(g), Florida Statutes (2012), by violating Section 459.026(1),

Florida Statutes (2012).

COUNT V



59. Section 459.015(1)(o), Florida Statutes (2012), provides that

failing to keep legible, as defined by department rule in consultation with

the board, medical records that identify the licensed osteopathic physician

or the osteopathic physician extender and supervising osteopathic

physidan by name and professional title who is or are responsible for

rendering, ordering, supervising, or billing for each diagnostic or treatment

procedure and that justify the course of treatment of the patient, including,

but not limited to, patient histories; examination results; test results;

records of drugs prescribed, dispensed, or administered; and reports of

consultations and hospitalizations is grounds for discipline.

60. Respondent failed to keep legible records that justified the

course of treatment of patient M.M.

12 DOH v. Mark G. Kantzler, D.O. Case No. 2013-10663

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459.015(1)(o), Florida Statutes (2012).

WHEREFORE, the Petitioner respectfully requests that the Board of

Osteopathic 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.

SIGNED this day of 2015.

John H. Armstrong, MD, FACS State Surge, General and Secretary of Health

Lucas L. May Assistant General Counsel DOH Prosecution Services Unit 4052 Bald Cypress Way, Bin C-65 Tallahassee, Florida 32399-3265 Florida Bar No.: 0102747 (850) 245 - 4444 (850) 245 - 4662 Facsimile [email protected]

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13 DOH v. Mark G. Kantzier, D.O. Case No. 2013-10663

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