Final Order No.

DOH-15-0420-E8DMQA

STATE OF FLORIDA
DEPARTMENT OF HEALTH

FILED DATE
-MAR 1 6
Department
ealth

2015D

ty Agency Clerk

In Re: Emergency Restriction of the License of

Tina Mobley Dobbs, R.N.
License No.: RN 3280152
Case Number: 2015-00052
ORDER OF EMERGENCY RESTRICTION OF LICENSE
John H. Armstrong, MD, FACS, State Surgeon General and Secretary of
Health, ORDERS the emergency restriction of the license of Tina Mobley Dobbs,
R.N., (Ms. Dobbs) to practice as a registered nurse in the State of Florida. Ms.
Dobbs holds license number RN 3280152. Her address of record is 6256 Adams
Road, Macclenny, Florida 32063.

The following Findings of Fact and

Conclusions of Law support the emergency restriction of Ms. Dobbs' 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. Section 456.073(8), Florida Statutes (2014), authorizes the
State Surgeon General to summarily restrict Ms. Dobbs' license to practice as a
registered nurse in the State of Florida, in accordance with Section 120.60(6),
Florida Statutes (2014).
2.

At all times material to this Order, Ms. Dobbs was licensed as a

In Re: Emergency Restriction of the License of

Tina Mobley Dobbs, R.N.
License No.: RN 3280152
Case Number: 2015-00052

registered nurse in the State of Florida, pursuant to Chapter 464, Florida

Statutes.
3.

On or about November 10, 2014, at approximately midnight, Baker

County Sheriff's Deputy J.H. observed Ms. Dobbs having difficulty maintaining
her vehicle inside the lane of travel. Deputy J.H. initiated a traffic stop and
made contact with Ms. Dobbs.
4.

Ms. Dobbs told Deputy J.H. that she did not have her purse and left

her license at home. Ms. Dobbs stated that she just woke up and was on her
way home.
5.

Deputy J.H. learned that Ms. Dobbs had a suspended license and

arrested Ms. Dobbs for knowingly driving with a suspended license. Ms. Dobbs'
vehicle was towed and an inventory search of the vehicle yielded two pill bottles
inside Ms. Dobbs' purse. The bottles belonged to Ms. Dobbs' husband and
contained hydrochlorothiazideland promethazine.2
6.

Deputy J.H. also found two straws and a pill grinder inside Ms.

Dobbs' purse. Sargeant S.B. located a vial of 5mg morphine sulfate and a
needle underneath the passenger seat of Ms. Dobbs' vehicle.

1 Hydrochlorothiazide

is a diuretic and is used to treat fluid retention, and high blood pressure.
Promethazine acts as an antihistamine and is typically used to treat allergy symptoms. Promethazine is also
used as a sedative or sleep aid. The promethazine bottle found in Ms. Dobbs' purse was empty.

In Re: Emergency Restriction of the License of

Tina Mobley Dobbs, R.N.
License No.: RN 3280152
Case Number: 2015-00052

7.

Morphine is prescribed to treat pain.

According to Section

893.03(2), Florida Statutes (2014), morphine 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
morphine may lead to severe psychological or physical dependence.
8.

When questioned about the morphine sulfate, Ms. Dobbs stated

"the morphine was an accident."

9.

On or about November 10, 2014, Ms. Dobbs was charged with

Driving while License Suspended or Revoked in violation of Section 322.34,

Florida Statutes (2014); Possession of Legend Drugs in violation of Section
499.03, Florida Statutes (2014); Possession of Drugs Without Prescription in
violation of Section 893.13(1)(f), Florida Statutes (2014); and Drug
Paraphernalia Use or Possession in violation of Section 893.147(1), Florida
Statutes (2014), in Baker County Case Number 02-2014-CF-000551-CFAXMX.
The charges are pending resolution.
10.

On or about January 7, 2015, Ms. Dobbs spoke to a Department

investigator regarding her arrest.

In Re: Emergency Restriction of the License of

Tina Mobley Dobbs, R.N.
License No.: RN 3280152
Case Number: 2015-00052

11.

Ms. Dobbs indicated that she did not know how the morphine bottle

got into her vehicle. Ms. Dobbs speculated that she may have carried the bottle
out of her workplace in her pocket and it may have fallen into the vehicle.
12.

Ms. Dobbs told the investigator that she did not take narcotics any

longer because she was 8 weeks pregnant. Ms. Dobbs reported that she was
prescribed narcotic medication after a brain surgery in July 2014.
13.

Ms. Dobbs stated to the investigator that the pill grinder was for

prescribed medications. Ms. Dobbs said that she has difficulty swallowing and
must crush the pills to take them.
14.

On or about March 3, 2015, E.S., M.D., evaluated Ms. Dobbs

pursuant to Department order.

15.

Ms. Dobbs admitted to Dr. E.S. that she abuses opiates3 and is

dependent on them. Ms. Dobbs stated that she began using opiates as a
teenager and continued using opiates since that time, with the exception of a
brief period of abstinence lasting approximately one week.
16.

Ms. Dobbs reported experimenting with other illegal drugs including

marijuana and cocaine.

Opiate, 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.
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In Re: Emergency Restriction of the License of

Tina Mobley Dobbs, R.N.
License No.: RN 3280152
Case Number: 2015-00052

17.

Marijuana or cannabis, contains the psychoactive ingredients

tetrahydrocannabinols (THC), a metabolite of cannabinoids. According to

Section 893.03(1), Florida Statutes (2014), THC is a Schedule I controlled
substance that has a high potential for abuse and had no accepted medical use
in treatment in Florida at the relevant time period.
18.

According to Section 893.03(2), Florida Statutes (2014), cocaine 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 cocaine may lead to severe psychological or physical
dependence.
19.

Ms. Dobbs told Dr. E.S. that she takes up to 15 tablets of Percocet

per day. Occasionally, Ms. Dobbs will use so much Percocet that she must
grind the pills and snort them through a straw to avoid the gastrointestinal
upset resulting from the acetaminophen contained in the drug.
20.

Percocet is the brand name for an opioid-class drug that contains

oxycodone and acetaminophen, and is prescribed to treat pain. According to

Section 893.03(2), Florida Statutes (2014), oxycodone is Schedule II controlled
substance that has a high potential for abuse and has a currently accepted but

In Re: Emergency Restriction of the License of

Tina Mobley Dobbs, R.N.
License No.: RN 3280152
Case Number: 2015-00052

severely restricted medical use in treatment in the United States. Abuse of

oxycodone may lead to severe psychological or physical dependence.
21.

Ms. Dobbs reported to Dr. E.S. that she had a miscarriage at the

end of January 2015. Ms. Dobbs blamed the miscarriage on running out of
opioids after her arrest.
22.

Ms. Dobbs reported an Arnold Chiari malformation"' in her cervical

vertebrae causing severe migraine headaches.

This condition went

undiagnosed for approximately nine years and caused Ms. Dobbs severe pain.
Ms. Dobbs had surgery on July 11, 2014, in order to alleviate her symptoms.
23.

Ms. Dobbs receives Percocet to help with the pain caused by her

condition. Ms. Dobbs told Dr. E.S. that her need for opioids became so severe
that she previously diverted opioids from her workplace on two occasions.
24.

Ms. Dobbs detailed experiencing depressive symptoms including

irritability, racing thoughts, anxiety and difficulty sleeping.

25.

Ms. Dobbs told Dr. E.S. that she drank more than three alcoholic

drinks per day in the three to four days preceding her evaluation with Dr. E.S.
Dr. E.S. opined that Ms. Dobbs' behavior demonstrates her need to resort to
mind altering substances in order to deal with stress.
4 A congenital malformation of the cervical vertebrae known to cause numbness, vision problems, muscle
weakness, paresthesis and chronic persistent headaches.

In Re: Emergency Restriction of the License of

Tina Mobley Dobbs, R.N.
License No.: RN 3280152
Case Number: 2015-00052

26.

Dr. E.S. noted that Ms. Dobbs used illegal narcotic analgesics for

years for a legitimate purpose, to alleviate the pain resulting from the Arnold
Chiari malformation.

Ms. Dobbs subsequently became addicted to the

medications.
27.

Dr. E.S. opined that Ms. Dobbs also exhibits symptoms of bipolar

disorder that potentially contributes to her substance abuse.

28.

Dr. E.S. diagnosed Ms. Dobbs with moderate to severe opioid use

disorder, alcohol use disorder and unspecified bipolar disorder.

29.

Dr. E.S. opined that Ms. Dobbs is unable to practice as a registered

nurse with reasonable skill and safety to patients.

30.

Dr. E.S. recommended that Ms. Dobbs engage in a psychiatric

evaluation after a documented period of abstinence from all substances aside

from an appropriate mood-stabilizing medication, to confirm the bipolar disorder
diagnosis. Dr. E.S. also recommended that Ms. Dobbs engage in monitoring
with the Intervention Project for Nurses (IPN).
31.

IPN is the impaired practitioner program for the Board of Nursing,

pursuant to Section 456.076, Florida Statutes (2014). IPN monitors the

evaluation, care and treatment of impaired nurses. IPN oversees random drug

In Re: Emergency Restriction of the License of

Tina Mobley Dobbs, R.N.
License No.: RN 3280152
Case Number: 2015-00052

screens and provides for the exchange of information between treatment

providers, evaluators and the Department for the protection of the public.
32.

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 must
also possess good judgment, be able to recognize abnormal signs or symptoms
of patients, and provide emergency care when needed. Because Ms. Dobbs is
impaired by the use of opioids, alcohol and bipolar disorder, and may not be
capable of administering medications to, or caring for, patients in a manner that
is correct and safe, Ms. Dobbs' continued unrestricted practice as a registered
nurse presents an immediate serious danger to the health, welfare and safety
of the public.
33.

An independent medical expert has determined that Ms. Dobbs is

unable to practice nursing with reasonable skill and safety. Based on that
opinion, Ms. Dobbs' continued opioid use disorder, alcohol use disorder, bipolar
disorder, and the expert's recommendations, there are no less-restrictive means
than the terms outlined in this Order that will adequately protect the public.

In Re: Emergency Restriction of the License of

Tina Mobley Dobbs, R.N.
License No.: RN 3280152
Case Number: 2015-00052

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 (2014), and

Chapter 464, Florida Statutes (2014), as set forth above.
2.

Section 464.018(1)(j), Florida Statutes (2014), authorizes the Board

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

Ms. Dobbs violated Section 464.018(1)(j), Florida Statutes (2014),

by being unable to practice nursing with reasonable skill and safety to patients
due to one or more of the following:
a. Moderate to severe opioid use disorder;
b. Alcohol use disorder; and
c. Bipolar disorder.
4.

Section 120.60(6), Florida Statutes (2014), authorizes the State

Surgeon General to summarily restrict a registered nurse's license upon a

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In Re: Emergency Restriction of the License of

Tina Mobley Dobbs, R.N.
License No.: RN 3280152
Case Number: 2015-00052

finding that the registered nurse presents an immediate, serious danger to the
public health, safety or welfare.
5.

Ms. Dobbs' continued unrestricted practice as a registered nurse

constitutes an immediate, serious danger to the health, safety, or welfare of the

citizens of the State of Florida, and this summary procedure is fair under the
circumstances to adequately protect the public.
WHEREFORE, in accordance with Section 120.60(6), Florida Statutes
(2014), it is ORDERED THAT:
1.

The license of Ms. Dobbs to practice as a registered nurse, license

number RN 3280152, is immediately restricted to prohibit Ms. Dobbs from

practicing as a registered nurse until the Intervention Project for Nurses, or an
IPN-approved evaluator, notifies the Department that Ms. Dobbs is safe to
resume practice as a registered nurse.
2.

A proceeding seeking formal discipline of the license of Tina Mobley

Dobbs, R.N., to practice as a registered nurse in the State of Florida will be

promptly instituted and acted upon in compliance with Sections 120.569 and
120.60(6), Florida Statutes (2014).

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In Re: Emergency Restriction of the License of

Tina Mobley Dobbs, R.N.
License No.: RN 3280152
Case Number: 2015-00052

DONE and ORDERED this

11/ 12-

day of March, 2015.

Jo H. Armstrong, MD ACS
State Surgeon General and
Secretary of Health

PREPARED BY:
Louise Wilhite-St Laurent
Assistant General Counsel
DOH Prosecution Services Unit
4052 Bald Cypress Way, Bin C-65
Tallahassee, FL 32399-3265
Florida Bar Number 91244
(P) 850/245-4444, ext. 8331
(F) 850/245-4662
(E) Louise.StLaurentflhealth.gov

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In Re: Emergency Restriction of the License of

Tina Mobley Dobbs, R.N.
License No.: RN 3280152
Case Number: 2015-00052

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.

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