STATE OF FLORIDA AGENCY FOR HEALTH CARE ADMINISTRATION
Lawton Chiles, GovernorDouglas M, Cook, Director January 31, 1997
4210 Pow's and MIA’S Memorial Drive
St. Cloud, Florida 34772-8142
Agency for Health Care Administration .
Jose Proenza-Sanfiel Case Number: 97-00006
Dear Mr. Proenza-Sanfiel:
Enclosed please find an Emergency Suspension Order which has bean filed against you by
the Agency for Health Care Administration. You should immediately cease the practice of nursing in the State of Florida, Enclosed alsofind an Explanation of Rights form.
If you have any questions, please do not hesitate to contact me at (904) 487-9662.
Enclosures: As noted above
Office of the General Counsel’s Office
Chief Attorney Allied Health (904) 487-9662
OFFICE OF THE GENERAL COUNSEL - MQA - ALLIED HEALTH
Overnight 1580 Waldo Palmer Lane, Tallahassee, Florida 32308
2727 Mahan Drive, Tallahassee Florida 31323
Post Office Box 14229 Tallahassee Florida 11311-1310
Telephone 904-487-9662 Fax 904-414-1991
STATE OF FLORIDA AGENCY FOR HEALTH CARE ADMINISTRATION
The Emergency Suspension of the License of
Jose N. Proenza-Sanfiel, RN
License Number RN’ 2523562
Case Number(s): 97-00006
ORDER OF EMERGENCY SUSPENSION OF THE LICENSE
DOUGLAS M. COOK, Director of the Agency for Health Care Administration hereby
ORDERS the Emergency Suspension of the license to practice nursing of JOSE N. PROENZA-
SANFIEL (hereinafter referred to as PROENZA-SANFIEL), PROENZA·SANFIEL, holds License
number RN 2523862 and his last known address is 4210 Pow's and Mia's Memorial Drive, St.
Cloud, Florida 34772-8142. The Emergency Suspension of PROENZA-Sanfiel’s license to
practice nursing is supported by the Following findings of fact and conclusions of law.
FINDINGS OF FACT
1. Section 4$5.225(8), Florida Statues, empowers theDirector of the Agency for Health Care Administration to summarily suspend Proenza-Sanfiel license to practice nursing in the State of Florida in accordance with Section 120.60(6), Florida Statutes (Supp. 1996). Section 120.60(6), Florida Statutes (Supp. 1996), authorizes the Agency to summarily suspend, restrict or limit a license.
2. PROENZA-SANFIEL has at all times pertinent to this Order been a duly Licensed registered nurse pursuant toChapter 464, Florida Statutes, having been issued Incense number RN 2523862 on or about August 26, 1991.
3. As a licensed registered nurse, PROENZA-SANFIEL is governed byChapters 455 and 464, Florida Statutes, and Rule 59S, Florida Administrative Code.
Final Order No. AHCA-97-0114 Date 1/31/97Agency for Health Care Administration
R.S Power, Agency Clerk
4. Section 455 241, Florida Statutes, regarding confidentiality of patient records, states in part
(2) Except as otherwise provided in Section 440.1242), such records may nor be furnished to, and the medical condition of a patient may not be discussed with, any parson other than the patient or the patient’s legal representative or other heath care providers involved in the care of treatment of the patient. except upon written authorization of the patient.
5. At a date unknown, PROENZA-SANFIEL obtained possession of a computer with a database that contained confidential patient names, addresses, dates of admission, types of addiction, treatments, or psychiatric disorders for individuals treated as Charter Behavioral Health System Orlando (hereinafter referred to as Charter).
6. Charter is a sixty (60) bed, full service, psychiatric treatment hospital where patients are examined, diagnosed and/or treated for drug, alcohol and/or mantel health issues.
7. At all times material hereto, Charter has not authorized the release of nor placed in PROENZA-SANFIEL’S possession, the computer and/or databases which identifier confidential patient information.
8. On or about January 23, 1997, PROENZA-SANFIEL contacted multiple news media sources and divulged his access to and the content of the confidential patient information from Charter
9. PROENZA-SANFIEL advised media sources that he purchased the computer from Osceola Opportunity Center at a cost of twenty dollars ($20.00).
12. PROENZA·SANFIEL allowed news stations, WESH-TELEVISION, INC. NBC), a/k/a WESH-TV NEWS CHANNEL 2 (hereinafter Channel 2) and NEW CITY COMMUNICATIONS OF FLORIDA INC. (CBS), a/Ma WCPX TV 6 (hereinafter Channel 6), access to said confidential patient information.
13. On January 23, 2997, Greg Fox, Channel 2 news, aired a report in Orlando, Florida, and its adjacent viewing area wherein a computer screen was shown to the general viewing public via videotape played over the air, Said news report advised the viewing public that an unnamed nurse purchased a computer from Osceola Opportunity Center, a local thrift store, for twenty dollars (S30.00). Also reported was the assertion that upon the nurse’s access to tile computer’s hard drive, the names of "psychiatric patients" were readily identifiable as well As their admission dates, types of addiction, treatments, and psychiatric disorders.
14. The news report additionally advised the viewing public that Charter maintains that they did not donate the computer to the thrift store, Moreover, the thrift store indicated they had no records of any purchase of a computer by the nurse al any time.
15. On January 23, 1997, Nicole Smith Channel 6 news, aired a report in Orlando, Florida and its adjacent viewing area, wherein a computer screen was shown to the general viewing public via videotape played over the air. The news reporter interviewed an unidentified former patient of Charter who was tremendously distraught over the fact that his prior admission to the hospital was not kept confidential and thus exposed to the public at large.
16. The news media access, facilitated by the nurse, caused an unknown number of patients to be contacted by the news media.
17. For all times material hereto, the unnamed nurse who appeared on both newscasts is PROENZA-SANFIEL.
18, On January 23, 1997, representatives for the Agency for Health Care Administration (hereinafter referred to as Agency) spoke with PROENZA-SANFIEL regarding his possession of the confidential records located on the computer’s hard drive. The Agency representatives requested PROENZA-SANFIEL to return the confidential patient records to either Charter or the Agency. PROENZA-SANFIEL refused.
20. On January 24, 1997, an Agency investigator for the Orlando Bureau of investigative Services office made contact with PROENZA-SANFIEL PROENZA-SANFIEL, verified he was the unnamed nurse that was the subject of the aforementioned news media broadcasts. The Agency investigator requested PROENZA-SANFIEL, to relinquish the computer hard drive and/or all tangible or intangible records of patients from Charter to the Agency for Health Care Administration PROENZA-SANFIEL advised that he was in Miami and would relinquish nothing until he spoke with his attorney.
21. PROENZA-SANFIEL during his conversation with the Agency investigator, advised that he would not disclose his employment location in Miami and upon learning of the Agency investigation against his license stated that any more threats of action against his license will result in the records either being given back to Charter or that he would put a, large magnet on top of the computer to erase the records.
22. PROENZA-SANFIEL additionally advised the agency investigator that he was a "former Marine" and "an activist’’ and that he "doesn’t take threats lightly" and that he "was prepared to fight."
23. Upon termination of the conversation by PROENZA·SANFIEL and the Agency investigator, the confidential patient records remained in the possession of PROENZA-SANFIEL.
24. Kim Everett, Vice President of Risk Management for Charter, spoke with PROENZA- SANFIEL on or about January 24, 1997, As a result of said conversation, Ms. Everett executed an affidavit which states in part:
A. Sanfiel stated that he had patient information from Charter Hospital of Orlando on a computer he had purchased, that he was angry because the "government was trying to take away his license," and that the patient information was his property and he could do with it what he wanted.
B. I explained to Sanfiel that the patient information was not his property and asked him to return it to the Charter Hospital Of Orlando. In response to that, Sanfiel said that he felt he should he compensated for the information, but that he wes not trying to extort money or "anything like that." I told Sanfiel that the company would be willing to reimburse him for what he paid for the computer in exchange for his delivery of the computer and all of the patient information to Charter Hospital of Orlando, but that it would pay nothing more than that.
C. Sanfiel denied that he had released any of the patient information to the news media. When 1 pointed Met to him that I understood at news station in Orlando, Florida had shown some of the patient information on a news broadcast, Sanfiel said he was aware of that because he had asked them to blur the last names of the individuals.
D. Sanfiel said at some point in our conversation that the information belonged to the patients and that "maybe I [Sanfiel] should sell it back to them". I told him that I strongly encouraged him not to do that and that he should contact his lawyer before doing anything like that. He asked again for compensation for the patient information. I told him again that the company would be willing to compensate him for what he paid for the computer in exchange for delivery of the computer and all the patient information to Charter Hospital of Orlando but nothing more.
E. Sanfiel finally said that he would just let the lawyers work it out. The call terminated at that point.
25, As; a result of PROENZA-SANFIEL’S refusal to return the patient records of Charter, and the exposure of same: to unauthorized sources by PROENZA-SANFIEL, Charter filed the injunctive relief in the Circuit Court of the Ninth Judicial Circuit, Orange County, Motioned. On January 27, 1987, the Honorable John H. Adams, SR,, Circuit Court Judge, issued an Order Granting Plaintiff’s Motion for Temporary Injunction wherein the Court made the following Finding of Fact:
1. Patient confidential information subject to restraint from disclosure under Section 349.459(9), Florida statutes, is in the custody of persons not authorized to possess this information,
2. That portions of such information have born disclosed to third parties including the broadcast media
26. Furthermore, said court granted an expedited emergency request by Charter to allow a deposition of PROENZA-SANFIEL on Thursday, January 30, 1997.
27. In a news report published in the January 29, 1997 Orlando Sentinel. PROENZA- Sanfiel quoted as stating that he will defy the court order issued by the circuit court and that he wants to be paid by Charter for the patient records in the amount of twenty thousand dollars (($20,000)).
28. Dr, Roger Goetz, Director of the Physician’s Recovery Network (hereinafter referred to as PRN), is a consultant for the Agency far Health Care Administration
29. PRN is an independent program far monitoring of impaired professionals. Impairment includes, but is not limited to, physical, mental. alcohol or drug abuse. PRN requires individuals to be evaluated, enter treatment, if appropriate, submit to random drug screens, and provide for exchange of information among the treatment programs, PRN, and the Agency far Health Care Administration for the protection of the public.
30. Dr. Goetz, based upon an advisement of the aforementioned facts, opined that the unauthorized release of names of patients who have received psychiatric treatment is a violation of reasonable practice standards and professional ethics of a licensed health care professionals.
Furthermore, public exposure of patient information through media outlets is harmful to the patient, is due and abusive treatment of those who seek help, such has the potential to cause unnecessary disruption to patient care.
31. Additionally, Dr. Goetz further opined that the behavior of PROENZA-SANFIEL, IS outlined above, mandates an immediate physical and mental examination,,
32. As a result of the aforementioned fret, and PROENZA-Sanfiel’s obligation to conform to the dictates of his professional practice, which includes maintaining the security of confidential information as it relates to any patient, PROENZA-Sanfiel’s continued practice of nursing presents an immediate danger to the public health, safety and welfare,
CONCLUSIONS OF LAW
1 . The Director of the Agency for Health Care Administration has jurisdiction over this matter pursuant to Section 455.225(8). Florida Statutes and Section 120.60(6), Florida Statutes (Supp.1996).
2. Based upon the foregoing Findings of fact, the Director concluded that JOSE Proenza-SANFIEL, registered nurse, poses an immediate end serious danger to the health Safety and welfare of the public.
3. Based on the foregoing Findings of Fact, the Director concludes that PROENZA-Sanfiel’s actions are in violation of the following statutory provisions:
a) Section 464.018(1)(1), Florida Statutes, by knowingly violating any provision of this chapter, a rule of the board or the department, or a lawful order of tire board or department previously
entered in a disciplinary proceeding or failing to comply with a lawful issued subpoena of the department. Specifically, Rule 598-8.005(1)(0); Florida Administrative Code, by being guilty of unprofessional conduct which shall include, but not be limited to: 3, Misappropriating supplies, equipment or drugs; or 5. Violating the confidentiality of information or knowledge concerning a patient; or 12. Acts of negligence, gross negligence, either by omission or commission; or 13. Failure to conform to the minimal standards of acceptable, prevailing Nursing practice regardless of whether or not actual injury to a patient was sustained,
b) Section 455.227(1)(k), Florida Statutes by failing to perform any statutory or legal obligation placed upon a licensee, to wit: Section 455.2412~ Florida statutes which states, ’’Except as otherwise provided in Section 440, 13(2), such [patient] records may not be furnished to, and the medical condition of a patient may not be discussed with, any person other than the patient or the patient’s legal representative or other health can! providers involved in the care or treatment of the patient, except upon written authorization of the patient".
c) Section 455.227(l)(q), Florida Statutes, by violating any provision of this chapter, the applicable professional practice act, a rule of the department or agency or the board, or a lawful order of the department or agency or the board, or fail to comply with a lawfully issued subpoena of the department or agency, to wit: Section 455.241(2), Florida Statutes and Rule S9S-8.005(l)(e), ]Florida Administrative Code.
4. The Director finds that Proenza-Sanfiel continued ability to practice nursing constitutes an immediate and serious danger to the health, safety and welfare of the public, and that this summary procedure is fair under the circumstances to adequately protect the public.
WHEREFORE, in accordance with Section 120.54(4), and Section 120,60(6), Florida Statutes (Supp. 1996), it is THEREUPON ORDERED THAT:
1. The license of Jose PROENZA-SANFIEL, license number RN 2523862 is hereby immediately suspended and he is hereby prohibited from practicing nursing as defined in Chapter 464, Florida Statutes.
2. A proceeding seeking formal suspension or evacuation of the license to practice nursing of PROENZA-SANFIEL will be promptly instituted And acted upon in compliance with Section 120.60(6), Florida Statutes (Supp. 1996), and this Order shall be tiled in accordance with Section 120.54(4), Florida Statutes(Supp. 1996)
DONE and ORDERED this 30 day of January 1997
Douglas M Cook director
NOTICE OF RIGHT TO JUDICIAL REVIEW
Pursuant to Section 120.54(4)(a), Florida Statutes (Supp. 19%), the agency’s finding of immediate danger, necessity, and procedural Hearings shall be judicially reviewable. Review proceedings are governed by the Florida Rules of Appellate Procedure. Such proceedings an commenced by filing one copy of a Petition for Review in accordance with Rule 9.100, Florida Rules of Appellate Procedure, with the Agency for Health Care Administration and a second copy Of the petition accompanied by a filing fee prescribed by law with the District Court of Appeal within thirty(30) days of the date of this Order is filed.
CERTIFICATE OF SERVICE
I HEREBY CERTIFY that a true and correct copy of the forgoing ORDER OF
EMERGENCY SUSPENSION OF THE LICENSE has been Initiated by Request for Hand
Delivery and by Certified U.S. Mail to, Jose Proenza-Sanfiel, 4110 Pow's and Mia's Memorial 1997.
EXPLANATION OF RIGHTS AND PROCEDURES
An Order of Emergency suspension her been entered against your license to practice nursing In hearing that order, the Director of the Agency health Can Administration has determined that the immediate and serious damage to the public health Safety or your continued practice presents and welfare. You have a right to seek to judicial review of this order in order to challenge the procedural fairness of the issuance of this order, the necessity for the order and the agency’s finding of immediate described ‘In the Natl. of Right to Judicial
danger. You may Seek; judicial review in the manner in the Order of Emergency Suspension. See Section 120.54(9), Florida Statues. I review contained This order is a final summary order, but it is net a final order in this case. By law, this agency ,and promptly institute formal suspension or revocation to take final anal disciplinary action against your license to practice your profession. Sec section 120.60(8), Florida statutes therefore, this agency has or will in the near future file so Administrative Complaint against your license to institute the formal suspension or revocation proceedings.
Because this Order of Emergency Suspension her been issued, you have a right to a prompt hearing on the Administrative Complaint Against your license. See Section 120.60(8), Florida Statutes If you dispute material facts alleged in the Administrative Complaint, then you may request a prompt formal hearing, pursuant to Section 120,57(1) Florida Statute 5180888 before a hearing officer who will be appointed by the Division of Administrative Hearings, whose address L the DeSoto Building, 1230 Apalachee parkway, Tallahassee, Florida 32399-1550. You may 01880 your request by faring.
telegraphing or mailing your request far a prompt Formal Hearing to the Counsel for the Agency, as listed on the Order of Emergency Suspension, at Agency for Health CM Administration, 2727 Mahan Drive, Palmer Building, Tallahassee, Florida 32308, Our Fax number is 904-414-1991 The Agency will then immediately refer the matter to the Attention of Administrative Hearings, and will arrange a telephone conference between the Agency, the Hearing Offer, and you or your attorney, to act the formal hearing, date.
If you do not dispute any material facts as alleged in the Administrative Complaint, then you may request a prompt informal hearing, pursuant to Section 120.S7(2), Florida statutes, before the appropriate Regulatory board, or, Where no board exists, before the Director. You may send your request by telegraph, fax or mail as noted above to the Counsel for the Agency as listed on the order of Emergency Suspension.
If you have any questions about your rights, please do not hesitate to contact the Counsel for the Department as listed on the Order of Emergency Suspension. Please do not contact the Director of the Agency directly about this order at this time.
Woooeee…!!! There sure are enough charges here. It does not matter none that I had spoken to a representative of the ( AHCA ) and explained exactly what had happened and how I had come about the computer. It does not matter to them Either that I did identify my self fully even giving them my beeper Number it does not matter to them Either that I had given the computer voluntarily already to a Judge. He dared to say no to us and we will teach him a lesson and the same to any other punny Nurse that dares to rock the boat. Just how dare Jose try to protect the patients and the Taxpayers coffer. We are sure that from all of this something will stick. ( it is amazing when you are on the right not matter what they trow at you it will slide off. Please note that after all of this, there is only one charge standing here and further review will show that even that will fall on the way side with proper representation then after that it will be my turn at the Bat.
In the mid time this is what happened to their protégé.
This is the part that shows you care a little extra. Please take the time and go to some of these areas and let them know how you feel, and what they can do to help. Thanks so much. Also, contact any other person you wish. It is a free country still. SPECIALLY in my place!!
E-Mail Address for Nursing Organizations
Email Address for US Senate………………
E-Mail Address for US House of Representatives
Is a BEARof a job but if you like you can also reach the whole Nation trough the air ways via Radio and TV Links
We the people can make changes.!!
And if you E-Mail this Journalists will help us all.
And if you E-Mail this Journalists will help us all.
************* NOTE OF INTEREST *********************
I have been caring for the American Way of life for a while now.... you can see the other part of me on the other Web Site that I also maintain. That Web-Site deal's with the POW/MIA Issue Please visit it and get involved there are still men left behind and they need your help also. Visit " THE REAPER'S EDGE A POW's SCREAMED ECHO IN CYBERSPACE "
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.Contacting Jose via E-ail..Mailto:email@example.com
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