A regular patient, irregular pain, death<\/p>\n
Unless otherwise noted, what follows comes from the Florida Department of Health administrative complaint filed June 30, 2025.<\/p>\n
Hernandez had been the primary care physician<\/a> for a patient identified as R.C. for 18 months when the patient came to Sanitas Medical Center Kendall on Sept. 16, 2022.<\/p>\n R.C., who weighed in at 209 pounds, told Hernandez he had \u201cback pain at a level seven out of 10, and limited range of movement, without limping.\u201d<\/p>\n Hernandez ordered a plain film x-ray of R.C.\u2019s back and a testicular ultrasound. But, without doing a musculoskelatal back exam or a testicular exam, Hernandez \u201cassessed R.C. with having unspecified lower back pain, obesity, and testicular swelling, and recommended a follow-up in three months.\u201d<\/p>\n R.C. was back a month later, Oct. 12, 2022, for a follow-up and to go over lab results, however Hernandez \u201cdid not discuss previous back imaging or testicular ultrasound.\u201d R.C. was without pain, the complaint said, and without the eight pounds he\u2019d lost in the 26 days since seeing Hernandez in September.<\/p>\n READ MORE: A South Florida psychiatrist asked two patients to take off clothes, state says<\/a><\/p>\n At R.C.\u2019s next appointment, Nov. 28, 2022, he still weighed 201 pounds but \u201ccomplained of left hip pain at a level of six out of 10.\u201d He placed his hip pain at only two out of 10 on Dec. 29, 2022, but his weight had plunged to 176 pounds.<\/p>\n R.C. had lost another three pounds by Jan. 4, 2023, down to 173, and rated his lower back pain \u201cat a level of 10 of 10 with limited range of movement.\u201d<\/p>\n Hernandez, the complaint said, \u201cperformed physical examinations of R.C., which included a musculoskeletal back exam, ordered annual lab testing, and prescribed diclofenac and gabapentin, but did not discuss R.C.\u2019s weight loss.\u201d<\/p>\n At this point, R.C. had lost 28 pounds in 37 days.<\/p>\n Diclofenac, the Mayo Clinic says, is \u201cused to treat mild-to-moderate pain, and helps to relieve symptoms of arthritis<\/a> (eg, osteoarthritis or rheumatoid arthritis), such as inflammation, swelling, stiffness, and joint pain.\u201d<\/p>\n The Cleveland Clinic says gabapentin is prescribed \u201cto prevent and control partial seizures<\/a>, relieve postherpetic neuralgia after shingles and moderate-to-severe restless legs syndrome.\u201d<\/p>\n Despite R.C.\u2019s lab results showing anemia with a \u201csignificant drop\u201d in hemoglobin levels on Jan. 19, 2023, and his weight still at 173 pounds, the complaint said. Hernandez \u201cprescribed gabapentin and iron supplements to R.C. on or about January 19, 2023, but did not discuss R.C.\u2019s significant weight loss, and did not adequately order consultation or investigation of R.C.\u2019s anemia to determine the underlying cause.\u201d<\/p>\n R.C. went to the Jackson South Medical Center emergency room on Feb. 6 with a distended abdomen and general weakness added to more weight loss and lower back pain. His hemoglobin had dropped even further, necessitating a blood transfusion.<\/p>\n \u201cAbdominal imaging of R.C. on Feb. 6 or Feb. 7, 2023, showed signs of renal carcinoma with metastatic lesions to the lungs and liver,\u201d the complaint said. After a transfer to Jackson Memorial Hospital on Feb. 7, more imaging showed \u201ca large centrally necrotic renal mass consistent with renal cell carcinoma, numerous metastatic pulmonary nodules throughout both lungs, and suspected metastatic disease of the liver.\u201d<\/p>\n Doctors removed a 16-inch cancerous mass, but \u201cdespite the surgical intervention, R.C. could not recover, and he died on Feb. 25, 2023, due to metastatic renal cell carcinoma and septic shock.\u201d<\/p>\n The complaint faulted Hernandez for \u201cfailing to perform a musculoskeletal back exam when R.C. first complained of significant back pain; failing to discuss and\/or investigate the cause of R.C.\u2019s significant short-term weight loss; and by failing to adequately investigate the potential underlying cause of R.C.\u2019s anemia.\u201d<\/p>\n