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Medical board revises in-office surgery rules

It's the fourth time in seven months the state board has revised restrictions on in-office surgical procedures.

The Florida Board of Medicine continued to tinker with restrictions on in-office surgical procedures Saturday, revising its standards for the fourth time in seven months.

The board amended a hotly debated rule that called for in-office surgeons to provide at least two caretakers certified in advanced cardiac life support to monitor patients recovering from surgery. It ruled an in-office surgeon can opt to allow a patient who is otherwise able to be discharged to remain under the watch of only one certified caretaker.

The board also revised language to clarify that a patient must be transferred to a hospital if he needs care beyond a surgeon's required 24-hour watch.

The changes are the latest step in a process that follows more than a year of research and hearings following published reports of deaths and injuries stemming from office procedures.

It was not immediately clear when the latest regulations would go into effect. Two medical groups with opposing agendas have challenged the restrictions made by the board.

The Florida Society of Anesthesiologists and the Florida League of Health Systems Inc. are set to go before an administrative judge next month to argue against the proposed rules.

The judge will decide whether the board's rules fall within the scope of its authority, board attorney Allen Grossman said.

"It's going to go to an administrative hearing and an administrative law judge will decide what's going to happen," said Zachariah P. Zachariah, a board member who has opposed the changes.

The Florida Medical Association and the Florida Association of Nurse Anesthetists have filed to intervene on behalf of the board.

"Hopefully we can utilize the time between now and (September) to try and resolve it," Grossman said. "If we can't, then we come together and start moving forward on the litigation process."

An investigation by the Sun-Sentinel of Fort Lauderdale found at least 34 people had died since 1986 during in-office procedures in Florida, including 13 in the past two years.

A push to change regulations resulted, with the board approving proposed revisions in January, adopting refined changes in April, amending them in June and again Saturday.