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    Bill helps unlicensed to fit artificial limbs

    Practitioners say the state should extend a licensing deadline. A concerned mom says no.


    © St. Petersburg Times, published March 6, 2001

    TALLAHASSEE -- David Garcia has twice failed a test required for practitioners who fit people with custom-made artificial limbs. Now state lawmakers are considering a bill that would alter a deadline to help Garcia and 40 other practitioners get state licenses and keep their jobs.

    "I'm fighting for what I think is right. I think my years in my profession, they should be taken into account," said Garcia, 44, who has 23 years of experience.

    That doesn't satisfy Lisa Golzbein, who says Garcia made shoddy artificial legs for her 7-year-old daughter that were too painful to wear.

    "Is it unfair that certain people were caught with their pants down and didn't get licensed in time? Yeah, that's very, very unfair. But you know what? Seven years ago, when they told me my daughter needed her legs amputated, that was unfair, too," Golzbein told the House Committee on Health Regulation last month.

    When lawmakers convene today, they will consider big, statewide issues like tax cuts, teacher shortages and growth management. But among the roughly 1,110 bills filed so far this session, a few would help a special someone, or two or three, who have persuaded state lawmakers to push their cause.

    Someone like Garcia, who persuaded state Rep. Matt Meadows, a Lauderhill Democrat, and Sen. Alex Diaz de la Portilla, a Miami Republican, to help him try to weaken a law that regulates people who make and fit artificial limbs and braces.

    "A lot of folks have said (Garcia) has done quality work for them and I didn't want him to lose . . . his ability to continue to practice," Meadows said.

    Four years ago, after a statewide grand jury reported widespread fraud and abuse by unregulated prosthetists and orthotists, the Legislature began to require applicants to pass a state-approved exam.

    Practitioners who had been certified by one of two national organizations by March 1, 1998, were exempted from the state-approved test. Lawmakers later extended the deadline to July 1, 1999.

    Garcia, president of Aceway Prosthetic and Orthotic Corp. in Lauderdale Lakes, has been tested and certified by one of the national groups, the Board for Orthotist/Prosthetist Certification, but he missed the deadlines. He twice failed the state-approved test, which he agrees is far more rigorous than the test he did pass.

    Yet it is unfair, Garcia says, that an arbitrary deadline prevented him from being grandfathered into the law. He wants the Legislature to waive the tougher test requirement for him and a small group of practitioners who have failed to pass it.

    "There are quite a few members of my profession which are licensed . . . who took the (Board for Orthotic/Prosthetist Certification) test a little bit before me. Are they more qualified than I am? . . . I don't think so," Garcia told the House committee last month.

    Golzbein, 31, a registered nurse in Pembroke Pines, said Garcia improperly fit her daughter Taylor with an $8,000 pair of artificial legs that pinched her inner thighs and did not provide the proper suction to prevent them from falling off.

    She said she didn't ask Garcia to fix the legs because she no longer trusted him. Garcia said he would have addressed Golzbein's complaints if she had brought them to him.

    Taylor was born without a tibia, a leg bone, in either leg. When she was 9 months old, doctors said they had to amputate and replace her legs with artificial limbs if she was ever to walk.

    While wearing another pair of legs made by another unlicensed prosthetist, one leg did break off while Taylor was climbing a flight of stairs. Her mother caught her before she fell.

    Prosthetists at Shriners Hospital for Children in Tampa have since made artificial legs for Taylor at no charge, enabling her to attend first grade with less pain.

    For practitioners who design and fit custom-made limbs and braces, experience alone isn't enough, said Ron Gingras, director of orthotics and prosthetics at Shriners. They need a comprehensive medical understanding of how the body works, as measured by the state exam, lest they cause long-term damage to a child's growing bones or life-threatening infections in adults, said Gingras, a former president of the Florida Association of Orthotists and Prosthetists, which opposes Garcia's push to weaken the licensure law.

    "I don't understand how a (state representative) could support a guy who's not passing the exam," Gingras said.

    After the association objected to Meadows' bill, he agreed to a proposed amendment that would require Garcia and the others to pass the state-approved test. But they would have until July 1, 2003 to do it and would be allowed to practice in the meantime.

    "It would not lower the standards in any way," Meadows said.

    That's not enough for Garcia, who says the two-year extension "is like giving an aspirin when you have cancer." He thinks the state-approved test, administered by the American Board for Certification in Orthotics and Prosthetics, was designed to be so difficult it would drive small operators like him out of business.

    If the Legislature refuses to accommodate Garcia, his application for licensure will expire in November, according to the state Department of Health. Practicing without a license is a third-degree felony under Florida law.

    A House committee is scheduled to vote on the bill and the proposed amendment today, after which it must clear two more committees before it can be voted on by the full chamber. It has not yet been slated to be heard in the Senate.

    Golzbein, who may return to Tallahassee to testify again, said she enjoyed her first trip "immensely."

    "It amazed me to realize what opportunities are available to you," she said. "It amazed me that Garcia could go up there and talk to all these people and get them to be on his side."

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