STATE OF FLORIDA DEPARTMENT OF HEALTH. The Emergency Restriction of the License of Ignacio J. Calvo, M.D. License No: ME Case No:

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1 STATE OF FLORIDA DEPARTMENT OF HEALTH Final Order No. DOH ILED DATE - JUN 1 Depart j Health F8R MQA 018 In Re: Ignacio J. Calvo, M.D. License No: ME Case No: ORDER OF EMERGENCY RESTRICTION OF LICENSE Celeste Philip, M.D., M.P.H., State Surgeon General, ORDERS the emergency restriction of the license of Ignacio J. Calvo, M.D., (Dr. Calvo) to practice medicine in the State of Florida. Dr. Calvo holds license number ME His address of record is 2451 Brickell Ave., Apt. PH-H, Miami, Florida The following Findings of Fact and Conclusions of Law support the emergency restriction of Dr. Calvo's license to practice medicine in the State of Florida. FINDINGS OF FACT 1. The Department of Health (Department) is the state agency charged with regulating the practice of medicine, pursuant to Chapters 20, 456, and 458, Florida Statutes (2017). Section (8), Florida Statutes (2017), authorizes the State Surgeon General to summarily restrict Dr. Calvo's license to practice as a physician in the state of Florida, in accordance with Section (6), Florida Statutes (2017).

2 2. At all times material to this Order, Dr. Calvo was licensed to practice medicine in the State of Florida, pursuant to Chapter 458, Florida Statutes (2017), holding license number ME At all times material to this Order, Dr. Calvo had staff privileges at the following institutions: a. Hialeah Hospital, located in Hialeah, Florida; b. Coral Gables Hospital, located in Coral Gables, Florida; c. Columbia Kendall Medical Center, located in Miami, Florida; d. University of Miami Hospital, located in Miami, Florida; and e. Palm Springs General Hospital, located in Hialeah, Florida. 4. On June 16, 2017, Dr. Calvo was arrested and charged with ten (10) counts of computer pornography, one (1) count of transmitting child pornography, and four (4) counts of possession of material depicting sexual performance by a child in Miami-Dade County case number CF XX. 5. The allegations against Dr. Calvo in the aforementioned criminal case are that he transmitted graphic sexual content depicting both male and Page 2 of 12

3 female infants and children engaging in oral, vaginal, and anal sex, and bondage, with and without adults and other infants and children. 6. During the pendency of his criminal case, Dr. Calvo was ordered to undergo a psychological evaluation to assess his competency to stand trial. 7. Pursuant to Section , Florida Statutes (2017), a defendant is incompetent to proceed, if the defendant does not have sufficient present ability to consult with her or his lawyer with a reasonable degree of rational understanding or if the defendant has no rational, as well as factual, understanding of the proceedings against her or him. 8. On July 7, 2017, Michael J. Scott, Psy.D. (Dr. Scott), a psychologist specializing in neuropsychology, evaluated Dr. CaIvo. 9. Dr. Scott diagnosed Dr. Calvo with Major Neurocognitive Disorder/Dementia (due to multiple etiologies) and Persistent Depressive Disorder. I In considering the issue of competence to proceed, an examining expert shall first consider and specifically include in his or her report the defendant's capacity to: (a) Appreciate the charges or allegations against the defendant. (b) Appreciate the range and nature of possible penalties, if applicable, that may be imposed in the proceedings against the defendant. (c) Understand the adversarial nature of the legal process. (d) Disclose to counsel facts pertinent to the proceedings at issue. (e) Manifest appropriate courtroom behavior. (f) Testify relevantly. Page 3 of 12

4 10. Dr. Scott opined that Dr. Calvo's symptoms are consistent with Alzheimer's Dementia and a vascular dementia. 11. Dr. Scott opined that Dr. Calvo suffered from severe, persistent, and pervasive deficits in executive functioning, memory, language functioning, sustained attention, and other aspects of daily living. 12. During the evaluation, Dr. Calvo's wife indicated that Dr. Calvo frequently required things to be repeated or asked the same thing over and over, Dr. Calvo had frequent problems remembering appointments, family occasions and holidays, and sometimes got lost while walking or driving in familiar places. 13. Dr. Scott opined that cognitive deficits such as Dr. Calvo's are not typically reversible and usually worsen over time. 14. On July 11, 2017, Gonzalo F. Yanez, M.D. (Dr. Yanez), a physician specializing in psychiatry and neurology, evaluated Dr. Calvo. 15. Dr. Calvo reported to Dr. Yanez with complaints of a progressive memory deficit, insomnia, progressive ataxia, and dizziness. Page 4 of 12

5 Ignacio S. CaIvo, M.D. 16. Dr. Yanez performed a Mini Mental examination and opined that the results were indicative Alzheimer's Dementia. Accordingly, Dr. Yanez ordered an MRI of Dr. CaIva's brain. 17. On July 20, 2017, Dr. CaIvo had a follow up evaluation with Dr. Yanez. Dr. Yanez determined that Dr. CaIvo had atrophy of the cerebellum, old cerebrovascular accidents, small vessel disease (Mini Strokes), and hippocampal atrophy. 18. Dr. Yanez diagnosed Dr. CaIvo with Alzheimer's Dementia and Mini Strokes. 19. Dr. Yanez determined that Dr. Calvo's mental status "wax[ed] and wane[d]" and that his condition was progressive in nature. Dr. Yanez indicated that there is no treatment for Dr. Calvo's conditions. 20. On September 22, 2017, Manuel E. Alvarez, Ph.D. (Dr. Alvarez), a licensed clinical psychologist, evaluated Dr. CaIvo pursuant to a Court-order. 21. During the evaluation, Dr. CaIvo complained of depression, memory impairment, episodic spatial disorientation, problems with attention and concentration, and stated he had suicidal ideations and threatened to shoot himself previously. Page 5 of 12

6 22. Dr. Calvo had difficulty maintaining attention to questions asked by Dr. Alvarez and Dr. Calvo required significant reframing of questions and perseverance to arrive at answers to most of Dr. Alvarez's questions. 23. Dr. Alvarez opined that Dr. Calvo is incompetent to stand trial based upon a combination of his Alzheimer's Dementia and unspecified depressive disorder. 24. Dr. Alvarez stated that based upon the MRI evidence of brain atrophy, "the likelihood of significant improvement, even with aggressive treatment, is unlikely." Dr. Alvarez noted that Dr. Calvo's mental status can vary significantly at any given point. 25. On November 16, 2017, the Court declared Dr. Calvo incompetent to stand trial. 26. On December 18, 2017, the Court ordered that Dr. Calvo remains incompetent to stand trial, ordered him to undergo psychiatric treatment, and ordered his case manager to provide written monthly reports to the Court regarding Dr. Calvo's progress. 27. At present Dr. Calvo has not been declared competent to stand trial. Page 6 of 12

7 28. In the course of their practice, doctors must possess good judgment; be alert, attentive, and able to recognize abnormal signs or symptoms of patients; and provide emergency medical care when needed. Dr. Calvo has been found incompetent to proceed in a criminal case by reason of his diagnoses of Major Neurocognitive Disorder/Dementia (due to multiple etiologies), Persistent Depressive Disorder, and Mini Strokes. Dr. Calvo suffers from "severe, persistent, and pervasive deficits in executive functioning, memory, language functioning, sustained attention, and other aspects of daily living" and has a well-documented, vacillating mental status. All three evaluating mental health professionals concurred in their opinions that Dr. Calvo's conditions are expected to worsen over time. Accordingly, Dr. Calvo's unrestricted practice of medicine presents an immediate, serious danger to the health, welfare, and safety of the public. Due to the progressive nature of his diagnoses, the danger to the public is likely to continue. Accordingly, there are no less-restrictive means than the terms outlined in this Order that will adequately protect the public. Page 7 of 12

8 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, (8), Florida Statutes (2017), and Chapter 458, Florida Statutes (2017). 2. Section (1)(s), Florida Statutes (2017), subjects a physician to discipline, including restriction, for "being unable to practice medicine with reasonable skill and safety to patients by reason of illness or use of alcohol, drugs, narcotics, chemicals, or any other type of material or as a result of any mental or physical condition." 3. Dr. Calvo violated Section (1)(s), Florida Statutes (2017), by being unable to practice medicine with reasonable skill and safety due to his Major Neurocognitive Disorder/Dementia (due to multiple etiologies), Persistent Depressive Disorder, and/or Mini Strokes. 4. Section (6), Florida Statutes (2017), authorizes the State Surgeon General to restrict a physician's license if the Department finds that Page 8 of 12

9 the physician presents an immediate, serious danger to the public health, safety, or welfare. 5. Dr. Calvo's continued unrestricted practice of medicine constitutes an immediate, serious danger to the health, safety, and welfare of the public, and this summary procedure is fair under the circumstances to adequately protect the public. WHEREFORE, in accordance with Section (6), Florida Statutes (2017), it is ORDERED THAT: 1. The license of, license number ME 55079, is hereby immediately restricted to prohibit him from practicing medicine until a Professionals Resource Network (PRN)2-approved neuropsychological evaluator notifies the Department that, is safe to resume practice as a medical doctor. 2. A proceeding seeking formal discipline of the license of Ignacio C. Calvo, M.D., to practice medicine will be promptly instituted and acted upon in compliance with Sections and (6), Florida Statutes (2017). [Signature page follows] 2 PRN is a Department-contracted consultant for matters dealing with impaired healthcare practitioners Page 9 of 12

10 Case Number DONE and ORDERED this (6 day of dl,{afl PREPARED BY: Ross D. Vickers, Esq. Florida Bar No Assistant General Counsel Prosecution Services Unit 4052 Bald Cypress Way, Bin C-65 Tallahassee, Florida (P) (F) (E) Celeste Philip, M.D., M.P.H. Surgeon General and Secretary Page 10 of 12

11 Case Number NOTICE OF RIGHT TO JUDICIAL REVIEW Pursuant to Sections (6) and , Florida Statutes (2017), this Order is judicially reviewable. Review proceedings are governed by the Florida Rules of Appellate Procedure. Proceedings are commenced by filing a Petition for Review, in accordance with Florida Rule of Appellate Procedure 9.100, with the District Court of Appeal, accompanied by a filing fee prescribed by law, and a copy of the Petition with the Agency Clerk of the Department within 30 days of the date this Order is filed. Page 11 of 12