Final Order No.

DOH-17-0602RUMQA

FILED DATE
MAR 2 8 2017
Depart Health
STATE OF FLORIDA
By.
DEPARTMENT OF HEALTH eoutv Aaencv Clerk

In Re: The Emergency Restriction of the license of

Marius Talos Prodan, R.N.
License Number RN 9255440
Case Number 2016-21524

ORDER OF EMERGENCY RESTRICTION OF LICENSE

Celeste Phillip, M.D., M.P.H., State Surgeon General, ORDERS the

emergency restriction of the license of Marius Talos Prodan, R.N., (Mr. Talos

Prodan) to practice as a registered nurse. Mr. Talos Prodan holds license

number RN 9255440. His address of record is 5506 18th Street West,

Bradenton, Florida 34207. The following Findings of Fact and Conclusions

of Law support the emergency restriction of Mr. Talos Prodan's license to

practice as a registered nurse in the State of Florida.

FINDINGS OF FACT

1. The Department of Health (Department) is the state agency

charged with regulating the practice of nursing pursuant to Chapters 20,

456, and 464, Florida Statutes (2016). Section 456.073(8), Florida Statutes

(2016), authorizes the Surgeon General to summarily restrict Mr. Talos

Prodan's license to practice as a registered nurse in the State of Florida, in

accordance with Section 120.60(6), Florida Statutes (2016).

 In Re: The Emergency Restriction of the license of
Marius Talos Prodan, R.N.
License Number RN 9255440
Case Number 2016-21524

2. At all times material to this Order, Mr. Talos Prodan was licensed

to practice as a registered nurse in the State of Florida, pursuant to Chapter

464, Florida Statutes.

3. On or about August 26, 2016, Mr. Talos Prodan ingested a small

bag of heroine after his children were taken into custody by Child Protective

Services.

4. After ingesting the heroin, Mr. Talos Prodan drove his vehicle to

meet a friend. When Mr. Talos Prodan exited his vehicle, a witness observed

him act strangely, then collapse, and become unconscious.

5. Emergency Medical Services technicians conducted lifesaving

efforts on Mr. Talos Prodan and administered two doses of NarCan2 to him.

6. A Manatee County Sheriff's Office Child Protective Investigator

familiar with Mr. Talos Prodan reported that he has a history of drug abuse.

7. On February 2, 2017, Dr. Scott Permesly, M.D., a physician

specializing in addiction medicine, evaluated Mr. Talos Prodan pursuant to

Department order.

' According to Section 893.03(1), Florida Statutes (2016), heroin is a Schedule I controlled substance that
has a high potential for abuse and has no currently accepted medical use in treatment in the United
States. Its use under medical supervision does not meet accepted safety standards.
2 NarCan can be administered to patients in emergency situations to counter the effects of opiate induced

overdoses.

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 In Re: The Emergency Restriction of the license of
Marius Talos Prodan, R.N.
License Number RN 9255440
Case Number 2016-21524

8. Mr. Talos Prodan denied any recent use of prescription pain

medication.

9. Dr. Permesly conducted a urine drug screen on Mr. Talos Prodan.

10. A Medical Review Officer subsequently confirmed that Mr. Talos

Prodan's urine drug screen was positive for hydrocodone3, norhydrocodone4,

and hydromorphone5.

11. Dr. Permesly diagnosed Mr. Talos Prodan with Opioid6 Abuse

Disorder.

12. Dr. Permesly opined that the Mr. Talos Prodan is unable to

practice nursing with reasonable skill and safety to patients.

13. Dr. Permesly recommended Mr. Talos Prodan report to a

program for impaired practitioners7 and enter substance abuse treatment

3 Hydrocodone is commonly prescribed to treat pain. According to Section 893.03(2), Florida Statutes

(2016), hydrocodone is a Schedule II controlled substance that has a high potential for abuse and has a
currently accepted but severely restricted medical use in treatment in the United States. Abuse of
hydrocodone may lead to severe psychological or physical dependence.
4 Norhydrocodone is a metabolite of hydrocodone.
5 Hydromorphone is commonly prescribed to treat pain. According to Section 893.03(2), Florida Statutes

(2016), hydromorphone is a Schedule II controlled substance that has a high potential for abuse and has
a currently accepted but severely restricted medical use in treatment in the United States. Abuse of
hydromorphone may lead to severe psychological or physical dependence.
6 0piate, or opioid, drugs have similar actions as the drug opium and are typically prescribed to treat pain.

Opioid drugs are synthetically manufactured, while opiate drugs are naturally occurring, but the terms
opioid and opiate are often used interchangeably. Opioid drugs are addictive and subject to abuse.
7 Dr. Permesly's report references PRN, the Professionals Resource Network, which is the Department

contracted consultant for impaired practitioners in several other professions, other than nursing.
Intervention Project for Nurses (IPN) is the impaired practitioner program for the Board of Nursing,
pursuant to Section 456.076, Florida Statutes (2016). IPN monitors the evaluation, care, and treatment
of impaired nurses. IPN oversees random drug screens and provides for the exchange of information
between treatment providers, evaluators, and the Department for the protection of the public.

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 In Re: The Emergency Restriction of the license of
Marius Talos Prodan, R.N.
License Number RN 9255440
Case Number 2016-21524

and a monitoring contract which restricts him from administering opiate

medications.

14. As of the date of this Order, Mr. Talos Prodan has failed to

comply with Dr. Permesly's recommendations.

15. In the course of their practice, registered nurses have access to

medications, including controlled substances, which have a high likelihood

for abuse and harm. Registered nurses must dispense and administer such

drugs in a manner that is safe and effective for the patient. Registered

nurses are also entrusted with the lives of patients. Registered nurses must

possess good judgment, be able to recognize abnormal signs or symptoms

of patients, and provide emergency care when needed. As such, physical

and mental stability are essential traits that registered nurses must possess

in order to competently practice their profession. Even the smallest error in

judgment could be fatal. It is crucial that the judgment and critical thinking

skills of a registered nurse are not impaired in high pressure situations.

16. An independent medical expert evaluated Mr. Talos Prodan and

diagnosed him with Opioid Abuse Disorder. Mr. Talos Prodan's diagnosis,

positive urine drug screen, and failure to enter substance abuse treatment

with the IPN indicates a significant likelihood that Mr. Talos Prodan will cause

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 In Re: The Emergency Restriction of the license of
Marius Talos Prodan, R.N.
License Number RN 9255440
Case Number 2016-21524

harm to patients in the future. Because Mr. Talos Prodan is impaired by his

Opioid Abuse Disorder, he may not be capable of administering medications

to, or caring for, patients in a manner that is correct and safe. Mr. Talos

Prodan's continued unrestricted practice as a registered nurse presents a risk

of immediate, serious danger to the health, welfare, and safety of the public.

As a result, nothing short of the immediate restriction of Mr. Talos Prodan's

license to practice as a registered nurse will adequately protect the public.

17. Because of Mr. Talos Prodan's failure to enter substance abuse

treatment, the danger is likely to continue and there are no less-restrictive

means than the terms outlined in this Order that will adequately protect the

public.

CONCLUSIONS OF LAW

Based on the foregoing findings of fact, the State Surgeon General

concludes as follows:

1. The State Surgeon General has jurisdiction over this matter

pursuant to Sections 20.43 and 456.073(8), Florida Statutes (2016), and

Chapter 464, Florida Statutes (2016).

2. Section 464.018(1)0), Florida Statutes (2016), authorizes the

Board of Nursing to impose discipline, including restriction, against a licensee

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 In Re: The Emergency Restriction of the license of
Marius Talus Prodan, R.N.
License Number RN 9255440
Case Number 2016-21524

for being unable to practice nursing with reasonable skill and safety to

patients by reason of illness or use of alcohol, drugs, narcotics or chemicals

or any other type of material or as a result of any mental or physical

condition.

3. Mr. Talus Prodan violated section 464.018(1)(j), Florida Statutes

(2016), by being unable to practice nursing with reasonable skill and safety

to patients due to Opioid Abuse Disorder.

4. Section 120.60(6), Florida Statutes (2016), authorizes the

Department to summarily restrict a registered nurse's license if the

Department finds that that the registered nurse presents an immediate,

serious danger to the public health, safety, or welfare.

5. Mr. Talus Prodan's continued unrestricted practice as a

registered nurse constitutes an immediate, serious danger to the health,

safety, or welfare of the public and this summary procedure is fair under the

circumstances to adequately protect the public.

WHEREFORE, in accordance with Section 120.60(6), Florida Statutes

(2016), it is ORDERED THAT:

1. The license of Marius Talus Prodan, R.N., license number RN

9255440, is immediately restricted to prevent Mr. Talus Prodan from

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 In Re: The Emergency Restriction of the license of
Marius Talos Prodan, R.N.
License Number RN 9255440
Case Number 2016-21524
practicing as a registered nurse until IPN or an IPN-approved evaluator

notifies the Department that Mr. Talos Prodan is safe to return to the practice

of nursing.

2. A proceeding seeking formal discipline of the license of Marius

Talos Prodan, R.N., to practice as a registered nurse will be promptly

instituted and acted upon in compliance with Sections 120.569 and

120.60(6), Florida Statutes (2016).

DONE and ORDERED this (>2-3- day of MarCin 2017.

di ) IP
Celeste Phillip, M.D., M.P.H.
Surgeon General and Secretary

COUNSEL FOR DEPARTMENT:

Keith Humphrey
Assistant General Counsel
DOH Prosecution Services Unit
4052 Bald Cypress Way, Bin C-65
Tallahassee, Florida 32399-3265
Florida Bar Number 93767
Telephone: (850) 245 4444 ext. 8222
Facsimile: (850) 245 4662
Email: Keith.Humphrey@flhealth.gov

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 In Re: The Emergency Restriction of the license of
Marius Talos Prodan, R.N.
License Number RN 9255440
Case Number 2016-21524

NOTICE OF RIGHT TO JUDICIAL REVIEW

Pursuant to Sections 120.60(6) and 120.68, Florida Statutes, the

Department's findings of immediate danger, necessity, and procedural

fairness shall be judicially reviewable. Review proceedings are governed by

the Florida Rules of Appellate Procedure. Such proceedings are commenced

by filing a Petition for Review, in accordance with Florida Rule of Appellate

Procedure 9.100, and accompanied by a filing fee prescribed by law with the

District Court of Appeal, and providing a copy of that Petition to the

Department of Health within thirty (30) days of the date this Order is filed.