## Facts

- Dr. Katherine A. Hoover, a board-certified internist, treated seven patients suffering from intractable non-cancer pain.
- She prescribed various Schedule II controlled substances as part of pain-management treatment.
- The licensing agency filed an administrative complaint alleging (1) inappropriate and excessive prescribing of Schedule II substances and (2) substandard care, citing Fla. Stat. § 458.331(1)(q) and (t).
- At a formal administrative hearing, the agency’s case relied significantly on two physician experts who did not examine any patient or review any patient medical records; their opinions were based solely on pharmacy printouts reflecting prescriptions filled.
- Dr. Hoover testified in detail about each patient’s diagnoses, treatment history, monitoring, and medical rationale; she presented supporting testimony from pharmacists and an expert physician.
- The hearing officer found the agency failed to meet its burden of proof and recommended dismissal.
- The Board of Medicine rejected and amended key factual findings, found statutory violations, and imposed discipline including a reprimand, fine, continuing education, and probation with licensure restrictions.

## Issues

1. Whether the Board of Medicine could reject and replace the hearing officer’s factual findings concerning Dr. Hoover’s prescribing practices when those findings were supported by competent substantial evidence.
2. Whether the Board’s final order improperly reweighed evidence and credibility determinations reserved to the hearing officer in a medical-discipline case.

## Decision

- The Third District Court of Appeal reversed the Board of Medicine’s final order.
- The court held the Board improperly supplanted the hearing officer’s supported findings by substituting its own evaluation of the evidence.
- The court concluded the hearing officer’s findings were supported by competent substantial evidence, and the Board lacked a lawful basis to alter them to impose discipline.

## Legal Principles

- In Florida administrative proceedings, an agency or professional licensing board must give substantial deference to a hearing officer’s findings of fact.
- A board may reject a hearing officer’s factual findings only if they are not supported by competent substantial evidence.
- A board may not reweigh evidence or substitute its judgment on credibility and evidentiary weight, particularly where technical medical testimony and treatment context are central to the dispute.
- Expert opinions grounded solely on pharmacy dispensing printouts, without patient examination or review of medical records, may provide an inadequate evidentiary basis to overturn a hearing officer’s clinically contextual fact findings.

## Conclusion

The appellate court reversed physician discipline because the Board of Medicine unlawfully replaced a hearing officer’s supported factual findings with its own view of the evidence, despite the requirement that factual changes be justified by competent substantial evidence and not by reweighing testimony or credibility.


Hoover v. Agency for Health Care Admin., 676 So. 2d 1380 (Fla. 3d DCA 1996)