OHIO STATE BOARD OF PHARMACY

77 South High Street, Room 1702; Columbus, OH 43215-6126

-Equal Opportunity Employer and Service Provider-

FAX: 6141752-4836 E-MAIL: exec@bop.state.oh.us TEL: 614/466-4143 URL: http://www.pharmacy.ohiogov 50 Tfl7TDD: Use the Ohio Relay Service: 1-800/750-07

NOTICE OF OPPORTUNITY FOR HEARING

January 18, 2013

Samuel Kyle Gothke 11230 Stiles Rd. Whitehouse, OH, 43571 Re: Ohio Registered Intern License No. 06-00-962 7

Dear Mr. Gothke: YOU ARE HEREBY NOTIFIED that, in accordance with the provisions of Chapters 11 9. and 4729. of the Ohio Revised Code, the Ohio State Board of Pharmacy will determine whether or not to take action against your license. Prior to any such action, you are entitled to a hearing before the State Board of Pharmacy on the basis of the following allegations: (1) (2) Records of the State Board of Pharmacy indicate that you were originally licensed as an Intern in the State of Ohio on September 24, 201 0. You were, on or about January 7, 2008, charged with possession of marijuana in This case was relation to an incident where you consumed marijuana brownies. dismissed without prejudice in February of 2008. Such behavior, and underlying factual situation, if proven, indicates that you are not of good moral character and habits within the meaning of Rule 4729-5-04 of the Ohio Administrative Code and thus, not meeting the requirements of the Board within the meaning of Section 4729.11 of the Ohio Revised Code: further, that you are abusing liquor and/or impaired physically or mentally to such a degree as to render you unfit to practice pharmacy within the meaning of Section 4729.16 of the Ohio Revised Code. You were, on or about October 6, 2009, convicted of operating a vehicle while intoxicated in Hancock County, Ohio. At approximately 1:00 a.m., after drinking with your friends, you decided to drive home and crashed your vehicle. The Findlay Police Department investigated the accident and administered a SAC test which showed that you had a blood alcohol level of .134. Such conviction, and underlying factual situation, if proven, indicates that you are not of good moral character and habits within the meaning of Rule 4729-5-04 of the Ohio Administrative Code and thus, not meeting the requirements of the Board within the meaning of Section 4729.11 of the Ohio Revised Code; further, that you are abusing liquor and/or

(3)

Gothke, Samuel, lnetrn Page 2 Notice of Opportunity practice impaired physically or mentally to such a degree as to render you unfit to pharmacy within the meaning of Section 4729.16 of the Ohio Revised Code. (4) while You were, on or about August 26, 2011, convicted of operating a vehicle a bar, you decided to drive to intoxicated in Hancock County, Ohio. After drinking at the the Findlay Reservoir and were stopped at a DUI checkpoint at 2:35 a.m. At uently You were subseq checkpoint, you refused to take a breathalyzer test. the Hancock County Jail, 1 7 days with WORC sentenced to 3 days confinement at obtain a program referral, your license was suspended and you were required to conviction, and underlying mental evaluation as well as an alcohol evaluation. Such and factual situation, if proven indicates that you are not of good moral character and habits within the meaning of Rule 4729-5-04 of the Ohio Administrative Code n thus, not meeting the requirements of the Board within the meaning of Sectio , that you are abusing liquor and/or 4729.11 of the Ohio Revised Code; further e impaired physically or mentally to such a degree as to render you unfit to practic pharmacywithin the meaning of Section 4729.16 of the Ohio Revised Code.

take action For these reasons, the State Board of Pharmacy will determine whether to pursuant to Section 4729.16 of the Ohio Revised Code. states that: YOU ARE HEREBY ADVISED that Rule 4729-5-04 of the Ohio Administrative Code, the The board of pharmacy may consider as evidence of a person not meeting 4729.08, division (B) of section requirements provided in division (B) of section a 4729.09, and sections 4729.11 and 4729.12 of the Revised Code, and may deny ce of a person admission to the licensure examination, or may deny the issuan a certificate of registration or an identification card to practice pharmacy as : pharmacist or intern in Ohio if such person (A) (B) (C) (D) (E) (F) Has been convicted of a felony; Has been convicted of violating any state or federal pharmacy or drug law; Is not of good moral character and habits; Is addicted to or abusing liquor or drugs; Has been disciplined by the Ohio state board of pharmacy pursuant to section 4729.16 of the Revised Code; or Has been disciplined by any board of pharmacy.

pertinent YOU ARE FURTHER ADVISED that Section 4729.1 6 of the Ohio Revised Code states in part that: (A) The state board of pharmacy, after notice and hearing in accordance with Chapter 11 9. of the Revised Code, may revoke, suspend, limit, place on probation, or refuse to grant or renew an identification card, or may impose a monetary penalty or forfeiture not to exceed in severity any fine designated under the Revised Code

Gothke, Samuel, lnetrn Page 3 Notice of Opportunity d Code for a similar offense, or in the case of a violation of a section of the Revise more than five that does not bear a penalty, a monetary penalty or forfeiture of not hundred dollars, if the board finds a pharmacist or pharmacy intern: (1) Guilty of a felony or gross immorality;

(2) Guilty of dishonesty or unprofessional conduct in the practice of pharmacy; ally or (3) Addicted to or abusing liquor or drugs or impaired physic or pharmacy intern mentally to such a degree as to render the pharmacist unfit to practice pharmacy; (4) Has been convicted of a misdemeanor related to, or committed in, the practice of pharmacy; ting to (5) Guilty of willfully violating, conspiring to violate, attemp this violate, or aiding and abetting the violation of any of the provisions of of the Revised Code, Chapter 2925. or chapter, sections 371 5.52 to 371 5.72 3719. of the Revised Code, or any rule adopted by the board under those provisions; pharmacy (6) Guilty of permitting anyone other than a pharmacist or intern to practice pharmacy; s (7) Guilty of knowingly lending the pharmacists or pharmacy intern ional name to an illegal practitioner of pharmacy or having profess connection with an illegal practitioner of pharmacy; the (8) Guilty of dividing or agreeing to divide remuneration made in not limited to, practice of pharmacy with any other individual, including, but any licensed health professional authorized to prescribe drugs or any owner, , manager, or employee of a health care facility, residential care facility or nursing home; (9) Has violated the terms of a consult agreement entered into pursuant to section 4729.39 of the Revised Code; (10) Has committed fraud, misrepresentation, or deception in applying for or securing a license or identification card issued by the board under this chapter or under Chapter 371 5. or 3719. of the Revised Code. d Code, (E) If, pursuant to an adjudication under Chapter 11 9. of the Revise is the board has reasonable cause to believe that a pharmacist or pharmacy intern the pharmacist or pharmacy physically or mentally impaired, the board may require intern to submit to a physical or mental examination, or both.

Gothke, Samuel, Inetrn Page 4 Notice of Opportunity YOU ARE FURTHER NOTIFIED, in accordance with the provisions of Chapters 11 9. and 4729. of the Ohio Revised Code, that you are entitled to a hearing before the Ohio State Board of Pharmacy, if you request such a hearing within thirty (30) days of the time of the mailing of this notice. IF YOU DESIRE A HEARING, such request shall be mailed to the State Board of Pharmacy, 77 South High Street, Room 1702, Columbus, Ohio 43215-6126. YOUR REQUEST MUST BE IN WRITING, AND MUST BE RECEIVED IN THE OFFICE OF THE OHIO STATE BOARD OF PHARMACY ON OR PRIOR TO THE THIRTIETH (30TH) DAY FOLLOWING THE MAILING DATE OF THIS NOTICE. You may appear at such hearing in person, by your attorney, or by such other representative as is permitted to practice before the agency, or you may present your position, arguments or contentions in writing; and, at this hearing, you may also present evidence and examine any witnesses appearing for and against you. YOU ARE FURTHER ADVISED that if there is no request for such a hearing received by the Board on or prior to the thirtieth (30t1) day following the mailing of this notice, the Ohio State Board of Pharmacy, upon consideration of the aforementioned allegations against you, may take action without such a hearing. BY ORDER OF THE STATE BOARD OF PHARMACY

Kyl W. arker, M.B.A., R.Ph. ye Director Exe

KWP/bte REGISTERED MAIL/Return Receipt RE 946 606 255 US Sean M. CuIIey, Assistant Attorney General

C: