Doctors being pushed to use electronic medical records

Payment rewards, penalties tied to 2015 deadline

August 16, 2010 | By Bob LaMendola

Sun Sentinel

Patient histories, growth charts, immunization logs and X-rays bulge from racks of color-coded

file folders lining the walls at Pediatrics by the Sea in Delray Beach, where Dr. Karen Kuhns and

a partner see 4,000 patients.

But the two doctors have just ordered a new computer system to begin a paperless future, as the

federal government is pushing the nation’s doctors and hospitals to do.

New federal standards unveiled last month require doctors to start using electronic medical

records routinely, including logging patients’ diagnoses and visits, ordering prescriptions,

monitoring for drug interactions and making records accessible to other medical providers.

Advocates say meeting the “meaningful use” standards will save lives, prevent errors, reduce

waste and save money.

To make it happen, Congress is wielding carrots and sticks. Doctors who use electronic record

according to the standards by 2015 can collect as much as $64,000 each in federal stimulus funds

to help them buy hardware and software. Those who don’t comply by that date will see their

Medicare or Medicaid payments trimmed by one percent per year.

Only about 20 percent of South Florida medical providers use electronic records now, experts

said, and while many doctors are already making the change, some fear that older family

physicians may one day close their practices rather than spend the money and time to go digital.

“There is some opposition,” said Lisa K. Rawlins, executive director of the South Florida

Regional Extension Center, a new nonprofit group that has an $8.5 million federal grant to help

the local medical community make the transition.

“We have a lot of challenges ahead of us. Our goal is to help 1,500 doctors” of the 10,000 active

in South Florida, she said.

Health care experts have estimated the cost of not having electronic medical records at nearly

$78 billion a year. That includes the costs of sending lab results between hospitals and outside

laboratories, needlessly duplicating medical procedures and shuttling paper charts among

doctors.

Just eliminating phone calls between doctors and pharmacists would save at least $2 billion each

year, according to a 2005 study funded by the nonprofit research group Center for Information

Technology Leadership.

Instant access to information also could save lives. The first day Orlando Health hospital system

launched its electronic records in 2001, a woman age 82 was rushed into the ER unconscious

after a car accident. Before starting to treat her, doctors entered her name into their computer and

found she was on the highest dose of blood thinners from an operation the week before.

“If we hadn’t had that software, we surely would have killed this woman,” said Becky Cherney,

president of the Florida Health Care Coalition in Orlando, who has held seminars for South

Florida doctors about the switch to electronic records.

Cherney’s group has spent a decade linking local hospitals and doctors to a Central Florida

database of millions of patients, the kind needed for emergency rooms to quickly learn about

patients who had never been to that hospital. The database is due to come online this fall for a

one-year pilot study.

Rawlins’ group is working to create a similar system linking hospitals and doctors in its turf,

which runs from Broward County to Key West but may soon expand to Palm Beach County and

several counties to the north.

A patient database could greatly benefit public health, too, said Alan Spitzer, a neonatal

researcher at Pediatrix Medical Group in Sunrise. Keeping track of how many children are

injured in accidents such as pool drownings or head injuries can alert doctors to troubling trends

in real time.

But the cost of purchasing and maintaining the systems is steep, and health care providers said

the stimulus grants will not always offset the full cost.

Kuhns and her partner will probably break even, or better. They chose to buy a simple $6,000

system of laptops or tablet computers for entering data, which then gets stored by an online

service costing several hundred dollars a month.

In contrast, Delray Beach family physician Dr. James Byrnes said he went bigger last year,

buying a powerful in-house system of portable computers and a server for $38,000, plus $22,000

in staff training and $1,000 a month for data storage. His maximum grant would be $44,000.

“For four or five years, it’s going to cost me money. But in the long run it’s worth it,” Byrnes

said. “I can document better with my records. It’s better for the patients. I can get paid better

[because] I can prove what I did. And for the health system into the future, it’s definitely a good

idea.”

Hospitals can expect to collect tens of millions each in stimulus funds to help pay for their record

systems, Rawlins said. Some hospitals have said that may only cover part of their costs.

Not everyone is on board with the changes.

Some primary-care physicians worry that electronic records will create more work – such as

filling out a questionnaire about each patient and clicking boxes on computer forms — and take

away time that should be spent face to face with the patient.

“Once you learn it, it might be faster. But not at the beginning,” Kuhns said.

“A lot of the doctors are being dragged into it against their will,” said Hollywood surgeon Dr.

Arthur Palamara, who supports electronic records but says the systems are “not ready for prime

time.”

Some physicians have voiced concerns over whether the systems can protect patients’ privacy.

Others worry that the systems they buy today will be outdated in a few years and will have to be

replaced, or that the data services endorsed by the government may not survive.

Still, doctors are embracing the change.

“This is a big undertaking for a small office like ours,” Kuhns said, “but it’s the right way to go.”

Make doctor visits by smart phone or web cam

September 10, 2010 | By Bob LaMendola

Sun Sentinel

Your smart phone is now a doctor’s office. And before long, you may be checking your blood

pressure, heart rate and throat at home while the physician watches online.

Last month, a Boca Raton company launched a service that lets you consult one of its physicians

via smart phone or web cam if you can’t see your regular doctor. It’s just one of many new ways

you can take charge of your health with technology, by seeing your medical records online,

creating your own medical chart, and communicating more thoroughly with the doctor.

Driving the trend is the federal government, which is pushing medicine to abandon paper records

and go electronic. Experts say E-records are saving money for you and the nation by reducing

duplicate tests and wasteful treatments, as well as preventing needless errors.

E-record systems urge doctors to order drugs recommended for your condition, remind them and

you it’s time for preventive screenings, and eliminate lost medical files. At home, you can look

up your cholesterol scores and refill prescriptions.

Most importantly, electronic records someday will give any doctor instant access to your full

medical file at critical moments.

No one knows better than Lisa Rawlins, executive director of South Florida Regional Extension

Center. Her agency has an $8.5 million federal grant to create an electronic records network

linking local hospitals and as many local doctors as possible.

But she also knows about the issue first-hand. Rawlins in 2005 was diagnosed in Jacksonville

with a benign brain tumor. To get a second opinion, she copied her medical chart into a

keychain-sized computer memory device, and took it to a Boston specialist. He found a rare form

of cancer in her head and neck.

Her hometown doctors called the cancer untreatable and gave her three to 12 months to live.

Back she went to Boston, where she received an intense type of radiation that beat the cancer.

“If I didn’t do all that, I would be dead today,” Rawlins said.

Last year, after moving to Broward County, part of her jawbone died as a result of the radiation.

A new CT scan showed she needed surgery. She saw three surgeons; each asked for another CT

that would have exposed her to more radiation. She talked them out of it by showing the results

of the new scan on her portable memory stick.

“Having the records was the key thing for me,” Rawlins said. “The entity that suffers the most

from the lack of communication and duplication due to [paper] records is the patient. The doctors

don’t. People should be paying attention to electronic medical records.”

E-records are far from perfect. Very few health providers have them yet. Many experts worry

about security and privacy, and the new systems have spawned new types of mistakes.

In the meantime, the technology keeps changing. Here are the latest:

InteractiveMD of Boca Raton last month launched a service in Florida that lets members visit the

doctor via smart phones or computers. A few others do this, too, and big players like General

Electric, Intel and Cisco are developing systems, so expect to hear more.

You need only a web cam and standard broadband or 4G wireless connection, said company

spokesman Alex Price. A company staff doctor talks to you and reads your online medical chart

to diagnose you, then either suggests a treatment, prescribes a drug, sends you to the ER or

insists you see your regular doctor.

Jump in cases of RSV leave children wheezing

Babies, chronically ill most at risk from lung virus

November 21, 2011 | By Bob LaMendola

Sun Sentinel

An outbreak of a little-known but potentially serious lung infection called RSV is clogging the

lungs and airways of South Florida babies and young children.

Emergency rooms, pediatricians and the federal Centers for Disease Control and Prevention

report a surge of respiratory syncytial (sin-SISH-uhl) virus in recent weeks. CDC tracking shows

that 25 percent of RSV lab tests were positive in Florida in the week of Nov. 12, an unusually

high figure indicating an outbreak.

No one counts RSV cases, but the CDC estimates that 1.5 million children need medical

attention for RSV each year and up to 125,000 are hospitalized.

In healthy children and adults, RSV acts like a simple cold, doctors said. But in vulnerable

babies and adults with weak immunity, RSV can clog the airways with mucus and damage the

lungs. There's no vaccine or cure.

"Right now I have three patients in my emergency room who are RSV positive. That's just in the

past three hours," said Dr. Guillermo Salazar, an emergency physician at tax-assisted Joe

DiMaggio Children's Hospital in Hollywood.

Most of the nation gets RSV from November through March, but the tropical southern half of

Florida is the exception, with cases peaking in winter but continuing virtually year-round.

RSV spreads from person to person in droplets from sneezes, coughs and saliva. Children in day

care are prime carriers of RSV, but adults and older children also can infect little ones, said Dr.

Margaret Gorensek, a pediatric infectious disease specialist in Fort Lauderdale.

Premature babies, who often are born with underdeveloped lungs, are most vulnerable.

"Some of these preemies are cute and chubby, and people want to touch them. They shouldn't do

that," said Dr. Ana Hernandez-Puga, medical director of primary care at Children's Diagnostic

and Treatment Center in Fort Lauderdale. "They're already fighting to develop appropriately, and

now they have to fight this bug that can take over their lungs."

Babies with RSV typically wheeze as with asthma, and breathe two or three times as fast as

normal. They may breathe so fast they can't eat, which makes them dehydrated and weak, Puga

said. Or, they may try to eat, throw up and breathe it in, further damaging their lungs.

Kristen and Pavan Kapur, the parents of twins in Boynton Beach, watched RSV take their year-

old daughter Kya in March, after an eight-week fight. A leukemia patient, little Kya had a weak

immune system that couldn't overwhelm the virus.

"In the hospital, I was just holding her in my arms, and she was just breathing and breathing and

struggling and struggling for air," said Kristen Kapur, 31. "It's a very nasty, nasty virus."

What are parents of vulnerable babies to do? Doctors recommend:

Wash hands and face frequently, because the best approach is prevention. Family members

and visitors should wash upon entering the house.

Keep babies away from people with symptoms. Don't let visitors snuggle or touch vulnerable

children.

Preventive treatment with a drug called palivizumab can boost the immune systems of

vulnerable babies before they get sick. Ask the doctor if your child qualifies.

Puga said private insurers and Florida Medicaid now stop covering palivizumab after spring,

because of the nationwide seasonal nature of the virus – even though Florida has cases year-

round. Doctors fear vulnerable babies may not get the drug when they need it most.

Florida health insurers to rebate estimated $113 M

April 13, 2012 | By Bob LaMendola

Sun Sentinel

Floridians who buy health insurance without the help of an employer can expect estimated

rebates of $143 to $949 in August because of the federal health care overhaul.

About 157,000 individuals and families qualify. In addition, an estimated $65 million in health

insurance rebates are in line to be split among workers covered at 352,000 small business, the

Sun Sentinel found by analyzing reports filed this month by 15 of the largest insurers in Florida.

Don’t expect cash back if you get health coverage from an employer of more than 50 workers.

Few of their insurers will owe rebates, and many companies are self-insured and not affected by

the health law, insurance experts said.

“This is important for consumers,” said Richard Polangin, health care policy coordinator with the

advocacy organization Florida Public Interest Research Group. “They already pay extremely

high prices for health insurance.”

Individuals don’t need to do a thing to obtain their money. Insurers must notify them by Aug. 1 if

they are due a refund and pay that month.

The rebates can be paid with a check or a credit toward next year’s premium. Rebates on group

policies go to the employer, which must promise in writing to pass the money to employees or

use it to benefit their health coverage.

The rebates stem from a rule in the health care overhaul law that said, starting last year, insurers

had to spend at least 80 percent of their premiums on medical costs. The rest can go to

administrative costs and profits. If insurers spend too much on overhead, they must refund the

difference to policyholders.

The Sun Sentinel calculated rebate estimates from 2011 year-end financial reports that the 15

health insurers filed this month with the National Association of Insurance Commissioners.

Insurers cautioned that the figures were preliminary and may change in a final report to the

federal government on June 1.

The analysis of the 15 Florida insurers showed that 11 would owe rebates of $48 million on

individual policies. Topping the list was national giant Humana at $16 million, Connecticut

General at $7.7 million, Time Insurance at $6.9 million and Coventry Health at $5.3 million.

Humana officials declined to comment.

Three of the companies also would owe small employers, including Florida Blue (formerly Blue

Cross and Blue Shield of Florida) at $39 million and United Healthcare at $17.7 million.

“More money should go for health care costs and less should be siphoned off. It makes our

health care system more efficient. It limits excess profits to investors,” Polangin said. “If some

insurance companies can comply and have been for quite some time, why can’t the others? They

have to get rid of their excess costs.”

Last year, when officials tried to predict the rebates, estimates were much larger. The U.S.

Department of Health and Human Services pegged Florida’s figure at $174 million for individual

policies alone. But insurers took steps in 2011 to avoid rebates, by lowering premiums and co-

payments and reducing overhead, HHS officials said.

“We’re more than happy with that,” said HHS spokesman Brian Chiglinsky. “Consumers are

getting more value for their dollar, whether it’s rebates or lower premiums and costs.”

For example, Golden Rule Insurance, a subsidiary of United Healthcare, had been forecast last

year to owe $33 million on Florida individual policies. The company’s new figures indicate no

refunds. The company declined to comment.

But insurance agents were skeptical, saying the impact has been small.

“I haven’t seen it. The trend on premium increases was a little smaller than in the past but not by

very much,” said W. Adam Clatsoff, president of Adcahb Medical Coverages, an 11-office

agency based in Coral Springs.

Clatsoff, a member of the state’s Florida Health Insurance Advisory Board, said he doubts the

rebates and health care law would help consumers much because it does little to control health

care costs.

America’s Health Insurance Plans, the industry’s trade group, estimates that despite the rebates,

the costs of the health care overhaul would raise health insurance premiums by 2 percent this

year.

Doctor’s license revoked for pain pill deaths

December 3, 2010 | By Bob LaMendola

Chicago Tribune, Sun Sentinel

A Lake Worth pediatrician awaiting trial on homicide charges for trafficking pain pills had his

license revoked Friday by state regulators, their latest act in a yearlong get-tough campaign

against pill mills.

Dr. Sergio Rodriguez had kept his license even though he has been in jail since his arrest in July

2008 for prescribing narcotic pills to an undercover officer. In March, he was indicted for

homicide stemming from the overdose deaths of three patients. He has pleaded not guilty.

The Florida Board of Medicine, a doctor-dominated group that has been criticized as being too

soft on their peers, started suspending and revoking the licenses of pain doctors on a regular

basis in summer 2009. Rodriguez, 54, was the latest.

“Outstanding. I’m glad they finally dealt with him, but it took so long,” said Rachael Arrants, a

Palm Beach Gardens mother whose adult son died from an overdose of pills prescribed by

Rodriguez in December 2007.

“Before, they didn’t seem to do too much or pay too much attention, but all the attention on pain

clinics has changed things,” Arrants said. “Things are moving in a positive direction.”

Florida pain clinics, especially in Broward and Palm Beach counties, have attracted national

attention for being the Southeast’s single biggest supplier of narcotic pills. Prescription drug

overdoses claim seven to nine lives a day in Florida.

Palm Beach County police have said Rodriguez ran an egregious pill operation. Police said seven

of his patients died from overdoses of pills he issued. Arrants’ son, Tommy Nunn, was one of the

seven but not among the three from the homicide case.

Four times, he gave scripts for more than 200 pills a month – a potentially lethal amount – to a

policewoman posing as a pain patient, with no physical exam or proof of an injury, state health

officials said in a complaint against him. Adult addicts mingled with children and parents in his

West Palm Beach office, Children’s Plus Health Center.

He broke the rules by “repeatedly prescribing potentially fatal combinations” of drugs, the

complaint said, putting patients “at an inordinate risk of death.”

The homicide charges stemmed from the 2008 overdose deaths of three men in their 20s,

including Robert Peterkin, a fisherman who drove to the doctor’s office every month from Palm

Bay in Brevard County.

Rodriguez is due in court Dec. 17 for a status report on his upcoming murder trial, a

spokeswoman for Palm Beach County prosecutors said.

In a separate case, the medical board indefinitely suspended the license of Oakland Park

anesthesiologist John R. Habib, who has been in jail since he was arrested in March for selling

crystal methamphetamine to an undercover police officer.

Habib can apply to get his license back but not until he resolves his criminal case and undergoes

an addiction therapy program for physicians, said one of his attorneys, Keith Pierro.

On a related matter, a medical board panel decided not to take emergency action to initiate a

strict set of pain clinic rules that have been delayed by legislative action.

Legislators last month passed a law saying rules with substantial impact on small business cannot

take effect until lawmakers give approval. The medical board could have declared the pill mill

problem to be an emergency and put the rules into effect, but the panel found no grounds to do

so.

The decision angered a Fort Lauderdale pain clinic activist. Maureen Kielian, whose son

survived a pain pill overdose, said a state report Thursday tallying nine prescription overdose

deaths per day proves the need.

“The death rate continues to grow,” Kielian said. “The community is being devastated.”

The delayed rules that were supposed to start Nov. 28 would have forced pain clinics to examine

every patient, counsel them on addiction risks and do random drug tests. The state can’t enforce

them but can enforce a new law started Oct. 1 forcing pain clinics to be inspected and to sell no

more than three days worth of drugs to patients paying by cash.

Florida’s doctor, medical provider discipline system not tough enough, critics say

May 17, 2010 | By Bob LaMendola

Sun Sentinel

Raven Morgan can’t believe a nurse who knowingly exposed patients to the risk of infections

such as HIV/AIDS can still work in Florida.

Morgan’s boyfriend, John Krug, was one of 1,851 patients on whom nurse Qui Lan

acknowledged reusing intravenous supplies, potentially exposing them to contact with other

patients’ blood. None of Lan’s patients who have been tested are known to have contracted a

disease as a result.

The Fort Lauderdale nurse can practice, although it’s unclear whether she is.

“She still has a license? I don’t believe it. That makes me sick,” said Morgan, a former nurse in

New Jersey who now lives in Boca Raton.

Count Morgan among the patients, malpractice attorneys and consumer advocates who say

Florida’s system for policing the state’s 66,000 doctors and 840,000 other medical professionals

is feeble and ineffective.

Consumer group Public Citizen last month ranked Florida the eighth most-lenient in the nation

for disciplining doctors. The ranking stems from the number of serious actions per 1,000 doctors

last year, when the state revoked the licenses of 94 and suspended 18 others. The toughest state

disciplined doctors at rates three times as high. The trend has been true for a decade, the group

said.

Critics contend the state does not act fast enough or toughly enough against the small share of

practitioners accused of substandard care, negligence, crimes or improper behavior. Too often,

they say, the state lets professionals such as Lan continue practicing while officials probe

allegations of crimes or serious violations and injuries.

Regulators dismiss 90 percent of complaints that patients or others file against practitioners,

more than 95 percent of those against doctors. When action is taken, the state rarely imposes

serious punishments, such as revoking or suspending licenses.

Virtually all of the dismissed complaints are dropped during confidential reviews by the Florida

Department of Health and its panels of medical professionals, state records show. Complaints

that advance to public hearings often take years to resolve and typically end in settlements in

which doctors are fined or ordered to take remedial classes, critics say.

“People ask us if they should go after the doctor. We have to be honest,” said Scott Schlesinger,

a Fort Lauderdale malpractice attorney. “From our perspective, the system is virtually non-

existent. Nothing ever comes of it.”

The system is juggling more than 1,300 complaints pending against doctors. Officials said they

had to dismiss dozens of cases in the past year — some involving deaths — because time ran out

under a law that requires the state to bring charges within six years of the initial incident. The

deadline does not apply if the doctor committed a crime, sexual misconduct, illegal drug activity

or obstructed the case.

STATE DEFENDS SYSTEM

State officials and some attorneys defend the system and say the criticisms are overstated. They

say any system can be improved, but contend the state focuses on protecting the public from

professionals who commit the most serious wrongs, and demands remedial training for

professionals who make errors.

“I don’t see the evidence to support (the criticism). We believe we are doing a good job,” said

Lucy Gee, the health department’s director of medical quality assurance.

Gee said the process moves deliberately so it can be thorough. Cases remain secret because laws

aim to keep baseless complaints from becoming public and unfairly tarnishing professionals, she

said.

The state can suspend practitioners on an emergency basis if officials believe they pose a danger

to the public, and they did so 248 times last year. Gee said the department moves carefully to

build cases that can stand up in court. When professionals get arrested, the department

sometimes takes no action and lets police take the lead.

“The boards tend to do a good job distinguishing between a problem doctor and a doctor who

may have made a human error,” said Steve Ballinger, a Weston attorney who defends doctors in

disciplinary cases.

THOUSANDS OF COMPLAINTS FILED

Last year, Floridians and agencies filed almost 11,000 complaints against doctors and about

13,000 against nurses and those practicing in 38 other medical professions. More than half were

thrown out quickly because they raised issues the state has no power over, such as rudeness or

billing, Gee said.

Andy Dezolt’s complaint didn’t make it to a public hearing. The Hollywood retiree, 79, filed a

complaint last summer after his surgeon admitted leaving out two screws during hip replacement

surgery three years ago. Dezolt said he now walks with a limp and has chronic pain.

Dezolt said he sent the state his medical file and X-rays showing the absence of the screws. He

heard nothing more than form letters until he got a letter in January saying the case was

dismissed, with no explanation. The state has a policy of not explaining why confidential cases

are dropped.

“He screwed up my hip. I can’t walk right,” Dezolt said. “They’re not going to do anything to

this doctor. It’s like they’re calling me a liar.”

Gee said she could not comment on dismissed cases.

Critics also complain that even when practitioners get arrested for serious felonies or have a

track record of disciplinary action, the state sometimes lets them keep their licenses while the

case is pending. Some examples:

Dr. Stuart F. Tillman, a Tallahassee anesthesiologist arrested in July and charged with soliciting

sex online from a police officer posing as a girl of 14.

Dr. Joseph M. Hernandez, formerly of Fort Lauderdale, who was arrested in Lake City in

February and charged with trafficking narcotic pain pills and prescribing drugs for monetary

gain. In 2006, records show the state banned him from doing surgery and temporarily suspended

his license because his vision was severely impaired. In 2007, he was fined $5,000 for leaving

part of an IV tube in a patient’s chest.

Dr. John N. Mubang, an internist in the Tampa suburb of Seffner who was arrested and charged

in July 2008 with drug trafficking and prescribing controlled substances for monetary gain.

All three have pleaded not guilty, with trials pending. Hernandez and Mubang are practicing,

according to their offices. Hernandez declined to comment. Mubang and Tillman could not be

reached for comment, despite calls or messages left at their offices.

In another case, the state took six months but suspended the license of Dr. Omar Brito Marin

after finding he performed a liposuction last fall at a Weston medspa where the procedure should

not have been done, leading to the death of a Miramar nurse, 37. Brito gave up his license rather

than contest the action. An autopsy found the woman’s death was caused by a bad reaction to

anesthesia.

Attorneys who represent practitioners said the state does not, and should not, yank a person’s

medical license whenever a patient has a tragic result. Many bad outcomes result from side

effects of treatments and from honest mistakes, said attorney Allen Grossman, a former Board of

Medicine general counsel.

OLD CASES EXPIRE BEFORE INVESTIGATED

Grossman and others said the department’s complaint unit is hampered by a lack of staff and

swamped by complaints. The unit has 132 people to investigate almost 24,000 complaints a year

as well as other duties.

For example, of the 44 cases handled by the medical board at its April meeting, half involved

incidents from 2007 or earlier, one as far back as 2003.

“From what I see, it does not appear there are enough resources for the department to retain and

keep the kind of experience it needs,” Grossman said.

Officials had to start dropping old cases in June. A 2003 law gives the department six years after

an incident to bring charges. At least four dozen cases were dropped initially and 28 more

expired since December, but officials could not say how many had expired in all. The cases

remain secret.

Time ran out on some cases because patients or agencies did not file complaints or report

violations until after it was too late or just before the deadline, said department spokesman Irving

“Doc” Kokol.

Other cases stalled because patients refused to let officials view their files, such as when doctors

are accused of prescribing excessive pain pills to an addict. Investigators must go to court for

subpoenas.

Officials have been trying to resolve old cases to prevent them from expiring. It’s “miraculous,”

Gee said, that investigators now complete initial reviews within six months on 93 percent of

complaints.

But Kevin Smith, a West Palm Beach malpractice attorney who used to defend doctors, said

many cases end because overworked officials drop cases at the first sign of resistance.

Regulators often dropped complaints against his clients as long as he got another doctor to sign a

affidavit saying there was no error, he said.

That way, “the investigator has his butt covered with the affidavit in the file saying the case

should be dismissed. They’ve got so many cases where they have bad guys doing bad things the

other cases just get dropped,” Smith said. “Any close-call cases, (doctors) are getting away

with.”

Liposuction death ends surgeon’s career

August 1, 2013 | By Bob LaMendola

Health News Florida

A Broward County physician who had two young women die from complications of his

“minimally invasive” liposuction gave up his license to the Board of Medicine on Friday.

Dr. Alberto Sant Antonio agreed to surrender his license rather than face state disciplinary action

for multiple errors that led to deaths at his unregistered cosmetic surgery office in Weston, state

records show.

“It’s great news and a huge benefit to the people of the state and the community that he’s no

longer going to practice medicine,” said Michael Freedland, a Weston attorney who represented

the family of one Sant Antonio victim. “It’s offensive and scary that someone of his credentials

and his history was allowed to continue seeing patients after what he did.”

In other action Friday, the board voted to indefinitely suspend the license of a Tampa doctor who

promoted himself as a role model for pain treatment, for doling out excessive pain pills. Dr.

David VanDercar, who ran Tampa Pain Clinic, said he has sold it.

Here are details of each case:

Dr. Alberto Sant Antonio

The state investigated the June 2011 death of Freedland’s client, Davie housekeeper and mother

Maria Shortall, 38, who came to the doctor’s Alyne Medical Rejuvenation Institute to have fat

sucked from her back and reinserted to enhance her buttocks. According to a state summary,

Shortall died when Sant Antonio mistakenly injected the fat into a blood vessel, causing an

embolism that blocked the blood flow and stopped her heart.

Another patient died after getting liposuction at the Alyne clinic in February 2010. Miami

mother Kellee Lee-Howard, 32, was found dead at home the day after surgery from “poly-drug

toxicity,” including excessive levels of the anesthetic lidocaine in her blood, an autopsy showed.

The family sued Sant Antonio, claiming he did not measure the sedative and gave too much. The

doctor and clinic paid a confidential settlement to end the case, said the family’s attorney, Philip

Freidin.

Shortall’s family also filed suit against Sant Antonio and Alyne; it is still pending.

Sant Antonio, 60, advertised the cosmetic procedure as “minimally invasive” and minor, but the

state Department of Health found that it was too complex to be done safely in his office, which

was not registered or inspected. The office did not have emergency equipment, lifesaving drugs,

properly trained staff and surgical assistance that the state requires for office surgery locations,

the state complaint says.

In addition, Sant Antonio failed to monitor Shortall’s heart rate and vital signs, and neglected to

quickly call paramedics when her heart stopped, the complaint says. Freedland said Sant Antonio

testified during a deposition that he did not call 911 for seven to 10 minutes after her heart

stopped. Shortall left behind a husband, daughter and son, who were 15 and 12 at the time.

After her death, the state halted Sant Antonio from performing surgery. But he continued seeing

patients at the clinic, which is still open and offering cosmetic surgery under the name Elite

Aesthetic Center. A manager who declined to give his name Wednesday said Sant Antonio had

retired and was unavailable for comment; he said the clinic is now run by his business partner,

physician's assistant Lynne Ulevich. Sant Antonio’s attorney, Ariel Sofro, could not be reached

for comment.

“The state does not do a good job regulating doctors,” Freedland said. “We leave it to physicians

to police themselves, and they do a bad job of it.”

Dr. David VanDercar

The Florida Board of Medicine, which met Friday in Deerfield Beach, found that Dr. David H.

VanDercar prescribed up to 390 narcotic pills each month for about two years to a patient who

was an addict and who fed his habit by robbing drugstores. The doctor never established the

man’s pain was real, did not properly test him for drug abuse and failed to try other ways to ease

his pain, all of which are recommended for pain doctors, the board found.

The patient’s mother, Laurie Eubanks, told the board at a hearing that she blamed the physician

for hooking her son Jeremy, 25, while treating him at Tampa Pain Clinic, which VanDercar ran.

Her son, a UPS driver with back pain, is now serving a 32-year sentence for robbing pharmacies.

“He indiscriminately prescribed drugs to our son with no regard for the outcome,” Eubanks said.

“I cannot fathom almost 400 pills being given at one time. He became an addict. Spending

money to keep my son behind bars for 32 years is not a good way to spend my money.”

VanDercar has been outspoken on pain management issues in recent years when Florida was

besieged by out-of-state drug dealers and addicts flooding pain clinics to obtain large quantities

of narcotic pills, especially oxycodone. The doctor promoted his clinic as an example of one that

properly screens patients and regulates their intake of drugs.

He told the board 20 percent of his patients take more drugs than Eubanks received, with no

problems. Eubanks’ treatment was appropriate, he said.

“I did not see any signs of addiction from him,” VanDercar said.

He said he has sold his pain clinic and withdrawn from practicing medicine in order to undergo

cancer surgery. He said he does not intend to resume practicing medicine.

The state complaint in the case said VanDercar, who saw Eubanks from 2006 to 2008, prescribed

inappropriate amounts of oxycodone, valium and methadone.

State health officials and VanDercar had negotiated a deal to settle the case, with a $15,000 fine,

a reprimand and a ban for life on prescribing controlled substances. Eubanks called the

settlement “a slap on the wrist.”

“Dr. VanDercar will probably retire and feel no penalty. He’s being ordered to pay a fine that is

minimal compared to the money he has made (at the pain clinic),” Eubanks said.

Board member Nabil El Sanadi, a Fort Lauderdale physician, persuaded the board to reject the

settlement, and to vote to suspend VanDercar until he undergoes a state review process. The fine

would be increased to $20,000 and he would be banned from owning or working at a pain clinic.

VanDercar declined to comment on whether he would accept the punishment or file for an

administrative hearing.

VanDercar was one in a series of pain doctors who came up for disciplinary cases. The board

rejected three other settlement deals as too lenient, and voted to impose suspensions as well as

higher fines.

For example, the board voted to suspend Boca Raton physician Steven Lemberg for six months,

fine him $50,000 and ban him from owning or working at a pain clinic. State investigators said

he had doled out hundreds of narcotic pills every month to patients he saw at Coastal Pain

Management clinic.

West Palm Beach gastroenterologist Lawrence Rothenberg would be suspended for six months,

fined $30,000, banned from prescribing controlled substances and put on probation for two

years. He was found to have prescribed large quantities of pain pills to patients at a North Fort

Myers pain clinic, where he worked to make extra money.

Boca Raton neurologist Robert Schiftan would be suspended for six months, fined $40,000,

banned from owning or working at a pain clinic, banned from prescribing controlled substances,

and put on probation for two years. He was found to have prescribed hundreds of pills per month

to at least 10 patients who found him by word of mouth and paid in cash.

Each doctor had the right to accept the punishment or file for an administrative hearing.

“It’s our job to protect the public,” El Sanadi. “We need to suspend these doctors and send the

message that what they are doing is not OK.”

Overdone? Radiation doses risky, study says

August 27, 2009 | By Bob LaMendola

Sun Sentinel

A large study including 134,000 patients in the Orlando area found that a small but significant

number of patients received dangerously high doses of radiation from medical imaging tests,

putting them at higher risk for cancer -- sometimes needlessly.

CT scans and the commonly used heart stress tests carrying high doses of radiation were the

biggest sources of exposure, but even low-dose X-rays add to the lifetime exposure to radiation

that can cause tumors, researchers said in the study published in today’s New England Journal of

Medicine.

About 2.1 percent of patients in the study were exposed to more than 20 millisieverts of radiation

yearly, the maximum annual dose recommended for health-care employees, said the lead author,

Dr. Reza Fazel, a cardiologist at Emory University. The study looked at adults younger than 65,

who likely have decades of life left for cancer to develop.

“It sounds small, but when you translate it to the whole adult population, that’s an estimated 4

million people getting high doses of radiation every year,” Fazel said. “That’s not a trivial thing.

These are young people.”

The study adds more fuel to an ongoing debate over whether some doctors overprescribe

imaging tests to guard against patient lawsuits and to make money. Past research has shown that

doctors with ownership in imaging centers order 27 percent to 54 percent more CT scans, MRIs

and stress tests than other doctors do.

The new study examined the records of 952,000 people insured by UnitedHealthcare in five

areas -- Orlando, South Florida, Dallas, Wisconsin and Arizona -- from 2005 through 2007.

Fazel said a surprising 69 percent of the patients got radiation from a medical test, with half of

those younger than 35.

The radiation risks rose in older patients. Among those ages 60 to 64, more than 6.6 percent of

men and 5 percent of women were subjected to high doses. About one-third of those who got

high doses were under age 50.

Studies have shown that many doctors, and virtually all patients, do not understand the long-term

risks from imaging tests and are unconcerned about using them, said Dr. Edward Dauer, a

Lauderdale Lakes radiologist and associate professor at the University of Miami medical school.

Dauer was not involved in the new study.

“We need to still continue with these procedures when they are clinically indicated, but eliminate

the ones that are done for no good reason,” he said.

One example he cited: full-body CT scans marketed as preventive medicine. Another example,

according to Fazel, are doctors doing annual stress tests on healthy diabetics. While the scans

may appear to be a good way to monitor for heart trouble, Fazel said research shows the tests do

not prevent heart attacks or lengthen life.

“We need [more] research to figure out in which situations these imaging studies are helpful and

in which they’re not,” Fazel said.

Mosquitoes carrying Dengue fever can live indoors

July 30, 2010 | By Bob LaMendola

Sun Sentinel

When a Palm Beach County family was plagued by a swarm of little black mosquitoes, county

mosquito chief Ed Bradford knew to look for Aedes aegypti hiding in the house.

“They were in the Waterpik,” Bradford said. “The family hadn’t used it in a while, I guess, and

there was a little water left in it.”

A Broward County family had Aedes in their bottled water system. Another had them in the

overflow tray under a refrigerator water dispenser, said Broward mosquito biologist Evaristo

Miqueli.

Clogged roof gutters. Little-used toilets. Pet dishes. Recycling bins. Waste tires. Plant pots.

Abandoned toys. Foam coffee cups. Stalks of bromeliad plants. Boat covers.

Drain them, flush them or get rid of them.

Anywhere a few ounces of water can collect and stagnate in or outside the house can become the

breeding ground for Aedes aegypti, a strain of mosquito carrying the tropical virus dengue fever

now present in Key West.

At least 46 people since September have fallen ill from the virus they contracted in Key West,

including a Broward County woman. It’s the first extended outbreak of the potentially fatal

disease in the continental U.S. since 1946. So far the cases are mild, resembling a bad flu.

Health officials across South Florida this week stepped up efforts to track Aedes populations –

mostly along the coast at the moment – and to educate people about avoiding mosquito bites.

They warned against worrying too much. Mosquitoes are few due to the dry weather. None

outside Key West have been found carrying dengue fever, and almost all people there bitten by

infected mosquitoes fought off the virus without getting ill. The virus spreads only by mosquito

bites, not human contact.

“There’s no virus right now in Broward,” said Joseph Marhefka, the county mosquito control

director. “We’re just doing this as a preventative.”

But the more tourists who get bitten in Key West, the greater the chance dengue fever will spread

to other areas. And, dengue is often more severe the second time a person gets infected.

Most types of mosquitoes appear after heavy rains and bite at night. Basic steps thwart them:

Apply repellent that contains DEET, stay indoors from dusk to dawn, wear long sleeves and

pants at night, dump standing water and fix holes in your screens.

Those work fine for the common mosquitoes in South Florida: Culex that carries West Nile virus

and St. Louis encephalitis, Anopheles that carries the malaria parasite and some viruses, and

Psorophora that carries West Nile and other diseases.

Then there’s dengue carrier Aedes. They bite during the day, so good luck relying on long pants

and sleeves. Since they live in or near the house, you’d have to wear repellent all day to beat

them. Their proximity to humans makes it harder for county fogging crews to reach them.

What’s more, when it’s dry, Aedes can bloom because people run sprinklers more often and

create puddles in yard containers.

“Some of the protections don’t work against Aedes,” Bradford said.

The best thing you can do is scrutinize your environment and be vigilant about standing water.

Unlike other mosquitoes that can fly 50 miles, Aedes rarely travels more than 300 feet from

where it emerges.

“All they need is a little water,” Miqueli said. “We need to educate the citizens to look around

their own environment and take care of their own situation.”

How the George brothers made millions with pill mills

$40 million in cash, 56 overdosed customers in two years

August 25, 2011| By Bob LaMendola

Sun Sentinel

It was “the Candy Man” who schooled two bad-boy rich kids in 2007 on how to make a fortune.

His advice? Start a pain clinic.

The unnamed physician, nicknamed by cops for his large volume of pill prescriptions, launched

Wellington twins Jeffrey and Christopher George, then 27, to start a pill mill empire that raked in

$40 million in two years in Broward and Palm Beach counties, officials say. On Tuesday, the

Georges and 31 co-conspirators were arrested on charges ranging from murder to racketeering to

fraud.

The brothers had sold 20 million pain pills by the time police and federal agents shut down their

four clinics in March 2010, prosecutors said in a 123-page indictment.

Each clinic made up to $50,000 a day. Employees carried the receipts to the bank in garbage

bags. Their mother – who worked in a clinic and got arrested with her sons – kept about $4.5

million of their spare cash in two safes in the attic of her house on Primrose Lane in Wellington.

The George boys spent their riches on six-bedroom houses, a shopping plaza, four-figure Rolex

and Patek Phillippe watches, boats and fast cars, such as Jeff George’s yellow Lamborghini

Murcielago.

Federal agents are moving to seize it all as well as $3.1 million left in their business accounts,

but concede tens of millions are missing. Before their arrests, the twins had talked about stashing

cash in Belize, the indictment says.

“They were swimming in money. Obscene,” said one federal official who asked not to be named

because he is involved in the case.

Money and death: Prosecutors said they traced 56 drug overdose deaths to George clinics.

Their chain of pain centers quickly became a blueprint that others copied to turn South Florida

into a regional epicenter for the illicit trade in narcotic prescription drugs, prosecutors said.

The keys: Take only cash and credit cards to avoid state regulation of clinics that accept

insurance. Cater to drug dealers from Kentucky and states with high rates of pain drug abuse.

Sell each customer hundreds of pills a month. Pay doctors by the patient to encourage big

volume.

Other clinics were following some of these tenets, but investigators say the Georges put them all

together.

Before they met the Candy Man, the sons of prominent builder John Paul George had been in

trouble. Jeff George was put on probation for dealing in stolen property, battery and resisting

arrest with violence. Chris George was sentenced to eight months in jail in 2003 for possession

with intent to deliver prescription drugs and steroids.

In 2006, Jeff George started selling steroids illegally via the Internet and muscle magazines

through his South Beach Rejuvenation telemarketing firm, the indictment said.

He met the Candy Man and an unnamed clinic owner and learned about the profits to be made

from selling pain pills, especially the cheap generic oxycodone, the indictment said. The center

attracted throngs of rowdy, out-of-state addicts. The police began investigating. When the heat

got too high, the Georges would move to different locations. At their peak, they had four clinics

selling pills from West Palm Beach to Hallandale, officials say.

The Georges hired friends and family. The money was so great that employees could make

$1,000 or more per week in “tips” from pill buyers eager to cut in line to see a doctor, the

indictment said, and one clinic manager, Derik Nolan, made employees pay him a cut of the

bribes to keep their jobs.

The brothers hired doctors through ads on Craig’s List. On a wiretapped phone call, Chris

George told a manager he had hired Jupiter physician Augusto Lizarazo, 70, even though he

spoke with a heavy accent and had no experience with pain pills.

“You know what, people don’t care as long as he’s writing the scripts,” Chris George said.

The doctors spent no more than a few minutes with each customer before writing prescriptions,

the indictment said. The brothers gave them stamp pads so they could easily mark each script

with identical dosages. They had staffers forge prescriptions so customers could get falsified

MRIs to document their injuries.

To control the operation from top to bottom, officials said, the Georges set up one of their steroid

telemarketers in a mobile MRI business that operated behind a strip club. It made $2 million.

Chris George financed two clinic staffers to start a pharmacy in Boca Raton and another in

Orlando to fill their prescriptions and disguise the volume of pills being sold, the indictment said.

Pills also financed two phony time-share companies that took $4.7 million from victims.

The brothers knew patients had died. In January 2010, the indictment said, Chris George

complained on his cell phone to a manager about a new patient who had overdosed.

“Now I got this lawful [sic] death lawsuit for a patient that [Dr.] Jacob [Dreszer] killed… This f--

-ing idiot came in one time and f---ing died. First visit,” Chris George said. “He couldn’t handle

pain management.”

In late 2009, two Tennessee women were killed and a man critically injured as they drove away

from a George clinic in Fort Lauderdale. Their car was hit by a train and oxycodone pills were

strewn all over the scene, leading Chris George to berate the victims during a cell phone call. “You got to be an idiot to get hit by a train,” he told a manager.

“They showed a callous disregard for their patients, including not caring whether they lived or

died,” said Wifredo Ferrer, U.S. Attorney for South Florida.

Officials said the brothers used violence in their business.

They threatened operators of other clinics. They had staffers vandalize buildings and cars of

competitors or people who opposed them.

The brothers and aides kidnapped and handcuffed a man they thought had stolen $50,000 from

them, the indictment said. They threw him on the ground, and while trying to get him to talk, Jeff

George fired a bullet next to his head, the indictment said.

When the indictment was released Tuesday, Chris George was in jail on charges of illegally

having two shotguns and a handgun at his house in violation of his past felony conviction. He’s

being held without bond.

All those arrested this week are pleading not guilty and have not commented. In the past, the

brothers’ lawyers have said they were running a legitimate business for patients truly in pain,

with commonly used dosages prescribed by licensed doctors.

“They made a profit,” attorney James Eisenberg said last year. “They used that profit to buy a

house. That’s what we all do.”

Authorities say this week’s arrests on top of three other major busts, tougher state laws and

continued police heat have slowed South Florida’s pain clinics – but not stopped them.

“I think we’re making significant advances,” said Palm Beach State Attorney Michael

McAuliffe. “I don’t think we’re quite to the end of the story yet.”

Some OB-GYNs in South Florida Turn Away Obese Women

May 17, 2011| By Bob LaMendola

Sun Sentinel

In a nation with 93 million obese people, a few ob-gyn doctors in South Florida now refuse to

see otherwise healthy women solely because they are overweight.

Fifteen obstetrics-gynecology practices out of 105 polled by the Sun Sentinel said they have set

weight cut-offs for new patients starting at 200 pounds or based on measures of obesity — and

turn down women who are heavier.

Some of the doctors said the main reason was their exam tables or other equipment can’t handle

people over a certain weight. But at least six said they were trying to avoid obese patients

because they have a higher risk of complications.

“People don’t realize the risk we’re taking by taking care of these patients,” said Dr. Albert

Triana, whose two-physician practice in South Miami declines patients classified as obese.

“There’s more risk of something going wrong and more risk of getting sued. Everything is more

complicated with an obese patient in GYN surgeries and in [pregnancies].”

Plantation ob-gyn partners Jeffrey Solomon and Isabel Otero-Echandi turn down any woman

weighing more than 250 pounds.

Solomon and Otero don’t want to begin seeing heavy women and then have to send them to

specialists if they later develop problems, said their office manager, who asked not to be named.

The two doctors, like several of the others with weight cutoffs, declined to comment.

“This is not a high-risk practice,” the office manager said. “They are not experts in obesity.”

Turning down overweight people is not illegal for doctors, but the policy worried leaders of

Physician groups, medical ethics experts and advocates for the obese, all of whom said it violates

the spirit of the medical profession.

“If I had that policy, I wouldn’t have a practice. I’d lose half my patients,” said Dr. Maureen

Whelihan, a West Palm Beach ob-gyn. “We never turn down anyone. We would see them, and if

we had to, we would refer them to a specialist.”

Leaders of eight local, state and national medical associations said they had never heard of

doctors turning away patients solely because of weight. Several said obese people with no other

health issues do not need special treatment.

“No doctor should be unable to treat patients just because they are heavy,” said Dr. Bruce

Zafran, a Coral Springs ob-gyn.

So far, the weight cutoffs have been enacted only by South Florida ob-gyns, who have long

complained of high numbers of lawsuits after difficult births and high rates for medical-

malpractice insurance. More than half go without coverage.

Ob-gyns for years have declined to see pregnant women who are overweight, typically sending

them to specialists. It’s new for them to turn down overweight women who are not pregnant,

physician groups said.

Several ob-gyn offices said their ultrasound machines do not give good images of internal

anatomy in obese women, making it harder to diagnose some medical problems.

The Plantation office manager said weight limits are not uncommon at offices owned, like hers,

by the Coconut Grove medical services company VitalMD.

VitalMD treasurer Kerry Kuhn, an ob-gyn in Coral Springs, said he was unaware of his doctors

setting weight limits, adding the company has nothing to do with doctor decisions.

“This is individual choice by a doctor,” Kuhn said. “Doctors know who they want to treat.”

Physicians, like any business, can decline service to whomever they choose for any reason —

including personality conflicts — as long as it’s not discriminatory. The American Medical

Association advises doctors that they cannot reject patients because of race, gender, sexual

orientation or infectious diseases.

Doctors also are allowed to drop patients, if they believe they lack the medical skills to properly

treat them. They must send notices and refer them to other doctors.

But decisions about patients typically are made after assessing the individual’s condition during

an exam, not by ruling out an entire group, said Dr. Robert Yelverton, a board member of the

Florida Obstetric and Gynecologic Society. He said he would discourage physicians from

excluding the obese.

“Do I think it’s a good policy? No,” Yelverton said. “Overweight people need doctors. I don’t

know where a patient in that situation would go if every practice had that policy.”

The AMA and the ob-gyn group declined to comment on doctors setting weight limits. A

spokesman for the Obesity Action Coalition in Tampa said the restrictions sound like

discrimination.

“This completely goes against the principles of being a doctor,” James Zervios said. “Health care

professionals are there to help individuals improve their quality of health, not stigmatize them

according to their weight.”

Florida Wants to Ban ‘Legal Weed’

Sept. 16, 2010 | By Bob LaMendola

Sun Sentinel

Florida officials want to ban so-called “legal weed,” packs of herbs treated with chemicals that

mimic the high of marijuana and have sent a rising number of smokers to emergency rooms.

The herbs are sold as incense in head shops and hookah bars under brand names such as K2 and

Spice. They’ve become popular in the past year among teens and young adults who want legal

substitutes for pot.

Doctors said some legal weed smokers have been stricken by short-lived yet potentially serious

side effects, such as racing heartbeat, high blood pressure, agitation, panic attacks, severe

vomiting and occasionally fevers as high as 106.

“We’ve seen a couple really bad things,” said Richard Weisman, director of the Florida Poison

Information Center at the University of Miami. “If you had asked about this at this time last year,

we wouldn’t have known what you were talking about.”

The Miami poison center logged about 50 cases of side effects from legal weed, none before

May. Florida’s other centers in Tampa and Jacksonville reported a few cases each. Nationally,

1,259 cases have been reported so far this year compared to 14 last year, said the American

Association of Poison Control Centers.

Although no one’s tracking the severity of illnesses caused by legal weed in Florida, a check of

news reports shows a 17-year-old girl was found unresponsive on the ground and hospitalized in

June near Tallahassee after smoking K2. Officials in Iowa contend that K2 may have contributed

to a teen’s suicide.

Florida’s drug control director, Bruce Grant, said he and the state Drug Policy Advisory Council

will ask the Legislature next year to add synthetic marijuana products to the state’s list of illegal

drugs — as at least 11 other states have done.

“They are psychoactive and intoxicating, and they are a risk if you use them and drive,” Grant

said. “Law enforcement knows this is an issue, but their hands are tied.”

Those who sell and smoke legal weed say authorities are overreacting to rare problems with

products they call generally harmless.

“We’ve heard nothing bad about it whatsoever,” said Jay Work, who sells Spice at Grateful J’s

Deadhead Shops in Margate and Boca Raton. “It’s an incense. It’s labeled as not for human

consumption. What people do with it after they leave, I don’t know. It’s like inhaling [cleaning

spray] for your computer. People abuse a lot of things. You can’t ban everything.”

Carlos, a Tamarac student who asked that his full name not be used, said he smoked legal weed

items called Mr. Nice Guy and Blaze after he was arrested for pot possession.

“It’s just as good as regular marijuana, and it’s cheaper, too, and it’s legal,” said Carlos, who was

sent by a drug court to the Starting Place treatment center in Plantation. “I like it a lot. I can

control it, and I can moderate it. I would like it to stay legal.”

The weed products abound on the Internet, along with at least one online petition urging

government officials not to ban it.

Legal herbs for smoking have been around for decades, but a new generation came out a few

years ago using synthetic cannabinoids called JWH 018, CP 4797 and HU-210, developed in labs

to imitate THC, the active ingredient in pot.

Makers spray the chemicals on herbs and sell them under brand names such as Zohai, Jamaican

Gold Bud, Orange Krush, Black Magic, Serenity Now, California Dreams, Armageddon, King

Krypto, Spike 99 and Bombay Blue. Officials worry because there’s no control over what’s

really in the products.

K2 and Spice are the most common. They caught on in Europe, then spread to the United States.

They’re not cheap. K2 sells for $30 to $35 for a three-gram packet, or $170 an ounce.

A few South Florida head shops stopped selling K2 after incidents earlier in the year led to bans

in Kansas, Kentucky, North Dakota and eight other states. The U.S. Drug Enforcement

Administration calls K2 a “drug of concern” but has not banned it.

Because few blood tests can detect legal weed, it is catching on with people trying to kick

addictions to other drugs, said Kevin Bandy, adolescent outpatient coordinator at the Hanley

Center treatment program in West Palm Beach. The Starting Place has the same problem, Chief

Executive Joel Kaufman said.

“I have seen this drug be a complicating factor for people trying to get clean, trying to get sober,”

Bandy said. “It will be hard to control. If they ban one of these, they’ll just change the name and

keep going.”