KELLI A. BURTON, R.N., PETITIONER,
v.
STATE OF FLORIDA, DEPARTMENT OF HEALTH, RESPONDENT

Fla. 1st DCA | 2013-07-24
No. 1D13-2009
VAN NORTWICK, J., concurs, and OSTERHAUS, J., dissents.
116 So. 3d 1285 Florida District Court of Appeal, First District (2013) Positive Treatment
Cited by 3 cases

AI-generated. These summaries, headnotes, and key points are machine-generated and may contain errors or omissions. Always verify against the full opinion text below. Not legal advice.

Synopsis

Kelli Burton, a registered nurse and newly licensed osteopathic physician, challenged the Department of Health's emergency suspension of her nursing license without a hearing. The court held that while emergency suspensions are permissible, the Department must demonstrate that less restrictive alternatives would be insufficient, and quashed the order because the Department failed to explain why alternatives like drug testing or supervision were inadequate.


Holding

The emergency suspension order must be quashed because, although the Department has authority to issue emergency suspensions pending full proceedings, it must meet strict requirements by showing the suspension is necessary and narrowly tailored. The Department failed to explain why less harsh remedies would be insufficient, and therefore did not meet its high burden for emergency action.


Headnotes

[1] An agency seeking to suspend a professional license through emergency proceedings without a hearing must demonstrate that the suspension is necessary and narrowly tailore…

[2] An emergency suspension order is improper if the agency fails to detail why less restrictive alternatives, such as drug testing or supervision, would be insufficient to p…

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Key Quotes

“While the Department is entitled to emergently suspend a nursing license pending full proceedings, because it does so without a hearing it must meet strict requirements.”

Establishes that emergency suspensions are permissible but require a high burden of proof

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Facts & Procedural History

Dr. Kelli Burton held a nursing license and had recently received her medical degree in osteopathic medicine. The Department of Health issued an emerg…

The full statement of facts, procedural history, and disposition for this case are member content.

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Opinion of the Court
CLARK, J.

CLARK, J.

Dr. Kelli A. Burton, R.N.,1 petitions this Court for review of non-final agency action. She contends the Department of Health (the Department) exceeded its authority when it, by emergency order, suspended her license to practice nursing through summary proceedings and without a hearing. We have jurisdiction under sections 120.60(6) and 120.68(1), Florida Statutes, and Rule 9.100(c)(3), Florida Rules of Appellate Procedure. We agree with Dr. Burton and quash the Department’s emergency suspension order (ESO).

While the Department is entitled to emergently suspend a nursing license pending full proceedings, because it does so without a hearing it must meet strict requirements. See Nath v. State Dep’t of Health, 100 So.3d 1273, 1276 (Fla. 1st DCA 2012). Among those requirements, the Department must show the ESO to be necessary and narrowly tailored; i.e., “why less harsh remedies ... would have been insufficient to stop the harm alleged.” Id. (internal quotations omitted) (quoting Preferred RV, Inc. v. Dep’t of Highway Safety & Motor Vehicles, 869 So.2d 713, 714 (Fla. 1st DCA 2004)).

Here, instead, the Department chose suspension of Dr. Burton’s nursing license — without detailing why a host of other options at its disposal would be insufficient. By way of example, the Department could have ordered her to submit to drug testing if she desired to practice pending final resolution; or, it could have ordered her to have clearance from the Intervention Project for Nurses. The Department thus failed to provide for the least restrictive and narrow option available to it; the emergency suspension must therefore be quashed. See Nath, 100 So.3d at 1276 (quashing emergency suspension of acupuncturist accused of sexual misconduct with two patients; emergency order could have provided for supervised patient sessions); Machiela v. State, Dep’t of Health, Bd. of Optometry, 995 So.2d 1168, 1169 (Fla. 4th DCA 2008) (quashing emergency suspension of optometrist who pled guilty to indecent exposure, for exposing himself to minor patients during eye examinations, as optometrist entitled to *1287“less restrictive, but equally effective, means to protect the public”; e.g., parental supervision of exams).

Ultimately, the Department may well be able to restrict, suspend, or revoke Dr. Burton’s license — after a full hearing, affording her an opportunity to be heard and defend herself against the Department’s contentions. We make no comment as to this subject. But, summary, emergency suspension pending this final resolution is different, and requires the Department meet a high burden. Bio-Med Plus, Inc. v. State, Dep’t of Health, 915 So.2d 669 (Fla. 1st DCA 2005). Here, the Department has not.

Accordingly, we GRANT the petition for review, and QUASH the Emergency Suspension Order.

VAN NORTWICK, J., concurs, and OSTERHAUS, J., dissents.

OSTERHAUS, J.,

dissenting.

I think the Department of Health has adequately stated the facts and reasons underlying its emergency suspension of Petitioner’s nursing license and its conclusion that she presents an immediate danger to public health, safety, and welfare. So I would deny her petition.

With respect for my colleagues’ views, I do not see “a host of other options” for the Department to deal with nurses who have a multi-year history of abusing painkilling opioids and will not accede to drug screening or intervention efforts. Petitioner has shunned accountability. In fact, both of the other options suggested by the majority opinion — conditioning Petitioner’s license on drug testing pending final resolution and ordering her to have clearance from the Intervention Project for Nurses (IPN) — resemble the Department’s basic conclusion to suspend her license, in part, because Petitioner has not cooperated with available testing or monitoring options. The Department concluded that Petitioner “is not monitored by IPN” and that it has no other restriction available to ensure that she is sober.

I think the Department has met the high factual burden for its emergency suspension order by finding specifically that Petitioner:

• abused an addictive opioid drug for many years;
• received the drug through a doctor with whom she once had a romantic relationship and who wrote her multiple prescriptions at a time for many years, often without an exam;
• filled prescriptions for the drug more than 130 times in the 22-month period leading up to a sheriffs department investigation in early 2012 (and admittedly filled these prescriptions at different pharmacies so that she could “avoid detection”);
• likely had the drug in her system while treating patients (along with another sedation-causing drug that Petitioner took twice daily);
• declined every opportunity to provide urine and hair samples to show that she no longer used opioid medications or illicit drugs; and
• has not contacted or availed herself of help from the IPN.

Based on these facts, the Department concluded that an immediate suspension of Petitioner’s nursing license was necessary because she could not practice nursing with reasonable skill, safety, mental alertness, and emotional stability. And that, in her condition, Petitioner was very likely to cause harm to the health, safety, and welfare of patients. Under these circumstances, I see no legal problem with the Department’s decision to suspend her license for the time being.

*1288- It bears emphasizing that Petitioner ultimately retains the opportunity to keep her nursing license after a full proceeding in her case, which must “be promptly instituted and acted upon.” § 120.60(6)(c), Fla. Stat. Emergency suspension is meant only as an interim solution addressing immediate dangers until a full hearing can be completed. I would deny her petition.

Dissent
OSTERHAUS, J.,

OSTERHAUS, J.,

dissenting.

I think the Department of Health has adequately stated the facts and reasons underlying its emergency suspension of Petitioner’s nursing license and its conclusion that she presents an immediate danger to public health, safety, and welfare. So I would deny her petition.

With respect for my colleagues’ views, I do not see “a host of other options” for the Department to deal with nurses who have a multi-year history of abusing painkilling opioids and will not accede to drug screening or intervention efforts. Petitioner has shunned accountability. In fact, both of the other options suggested by the majority opinion — conditioning Petitioner’s license on drug testing pending final resolution and ordering her to have clearance from the Intervention Project for Nurses (IPN) — resemble the Department’s basic conclusion to suspend her license, in part, because Petitioner has not cooperated with available testing or monitoring options. The Department concluded that Petitioner “is not monitored by IPN” and that it has no other restriction available to ensure that she is sober. I think the Department has met the high factual burden for its emergency suspension order by finding specifically that Petitioner:

• abused an addictive opioid drug for many years;

• received the drug through a doctor with whom she once had a romantic relationship and who wrote her multiple prescriptions at a time for many years, often without an exam;

• filled prescriptions for the drug more than 130 times in the 22-month period leading up to a sheriffs department investigation in early 2012 (and admittedly filled these prescriptions at different pharmacies so that she could “avoid detection”);

• likely had the drug in her system while treating patients (along with another sedation-causing drug that Petitioner took twice daily);

• declined every opportunity to provide urine and hair samples to show that she no longer used opioid medications or illicit drugs; and

• has not contacted or availed herself of help from the IPN.

Based on these facts, the Department concluded that an immediate suspension of Petitioner’s nursing license was necessary because she could not practice nursing with reasonable skill, safety, mental alertness, and emotional stability. And that, in her condition, Petitioner was very likely to cause harm to the health, safety, and welfare of patients. Under these circumstances, I see no legal problem with the Department’s decision to suspend her license for the time being. - It bears emphasizing that Petitioner ultimately retains the opportunity to keep her nursing license after a full proceeding in her case, which must “be promptly instituted and acted upon.” § 120.60(6)(c), Fla. Stat. Emergency suspension is meant only as an interim solution addressing immediate dangers until a full hearing can be completed. I would deny her petition.


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Citator

Cited By

  • Slay v. State, 160 So. 3d 954 (Fla. 1st DCA 2015)
    …tion and the restrictions were narrowly tailored as required to fairly address the public safety pending the formal administrative action. See Nath v. State Dep’t of Health, 100 So. 3d 1273, 1276 (Fla. 1st DCA 2012); Burton v. State Dep’t of Health, 116 So. 3d 1285, 1286-87 (Fla. 1st DCA 2013). Therefore, the petition is DENIED. ROBERTS, SWANSON, and BILBREY, JJ., concur.…
  • …ies . . . would have been insufficient to stop the harm alleged.” Nath, 100 So. 3d at 1276 (quoting Preferred RV, Inc. v. Dep’t of Highway Safety & Motor Vehicles, 869 So. 2d 713, 714 (Fla. 1st DCA 2004)). See also Burton v. State Dep’t of Health, 116 So. 3d 1285, 1286 (Fla. 1st DCA 2013). Like the emergency suspension order in Nath, the order here concludes that “no less restrictive means” other than outright suspension would adequately protect the public. While that may well be the case given the allegati…

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