9 Investigates

Mistakes made by mid-level medical providers led to catastrophic results for patients

ORLANDO, Fla. — When you go to the doctor's office, how often are you really seeing a physician?

To keep costs down and due to the rising need for health care services in Florida, you may often end up seeing a physician assistant or an advanced practice registered nurse. Both are allowed to treat patients and prescribe medicine under the supervision of a doctor.

Though the vast majority provide quality care, and poor outcomes are rare, in instances where care plans are not overseen by a physician, results can be catastrophic.


A debilitating injury that led to depression and suicidal thoughts eventually led father of four Eddie Messer to seek help from a psychiatrist.

"We thought we were seeing a doctor," Angela Messer said.  "The doctor was like, I'm going to prescribe you so many different kinds of pills, it was a lot."

Angela Messer says her husband planned to ask for a different treatment plan after a family cruise, but Eddie never made it off the ship.

A lawsuit filed on behalf of Eddie's estate shows after severe drowsiness on board, Eddie was found in the stateroom unresponsive.  An autopsy showed his cause of death as "multiple drug intoxication."

According to the filing, Messer's treatment plan, which was put together by an APRN, was not approved by the supervising physician; never signed off on by that physician until weeks following Messer's death.

"We put so much trust in someone, thinking that we're doing the right thing by getting him help, for it to end up like this," Angela Messer said.

9 Investigates searched Florida Department of Health records and found at least five mid-level providers lost their ability to practice over the last two years simply for failing to approve treatment plans with doctors.

"A lot of people just assume the person here is in scrubs, they have a white coat on, they must be a doctor," Attorney Jack Cook said.  "So I think there needs to be something in place that makes this more clear."

Another case recently filed in Orange County involves a 10-year-old boy with a broken arm, which was improperly set by an APRN causing a permanent injury.

Another, in litigation right now, involves a 53-year-old man who can no longer walk after he claims he was never seen by an orthopedic surgeon who was listed in his medical records. Instead, the suit claims he was seen by a PA.

"Therein lies where the standards of care has to be questioned, as to whether or not a mid-level provider can treat a patient like this," Cook said.

As our reporting confirmed, these catastrophic outcomes are extremely rare.  The Florida Academy of Physician Assistants reiterated such in a statement provided to 9 Investigates: "Physician Assistants (PAs) are essential to expanding access to healthcare for millions of Floridians. Numerous studies confirm the high-quality care that PAs provide. Isolated cases do not reflect the entirety of the profession."

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Karla Ray

Karla Ray, WFTV.com

Karla Ray anchors Eyewitness News This Morning on Saturday and Sundays, and is an investigative reporter for the 9 Investigates unit.

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