What started with back pain ended with a death and a Miami doctor on probation
A Miami doctor was put on professional probation after, the state said, failing to investigate a regular patient’s serious back pain, 25-pound weight drop and anemia before the patient’s 16-inch cancerous mass was discovered.
In addition to the one-year probation, the state Board of Medicine’s final order fined Dr. Reinaldo Hernandez Loy $7,500 and assessed $13,839 in reimbursement of Florida Department of Health case costs.
During the probation, the final order said, Hernandez must practice under the “indirect supervision” — within 20 miles — of a “board-certified family physician, with experience in cosmetic procedures.” He must also take a five-hour continuing medical education course in risk management and a three-hour course in “primary care including cancer recognition, diagnosis, or treatment.”
Hernandez didn’t respond to the Miami Herald’s attempts to reach him. According to the settlement agreement with the terms of his probation, he “neither admits nor denies the allegations of fact contained in the administrative complaint.”
This is the first professional punitive action against Hernandez since he became licensed in Florida on May 2, 2013.
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A regular patient, irregular pain, death
Unless otherwise noted, what follows comes from the Florida Department of Health administrative complaint filed June 30, 2025.
Hernandez had been the primary care physician for a patient identified as R.C. for 18 months when the patient came to Sanitas Medical Center Kendall on Sept. 16, 2022.
R.C., who weighed in at 209 pounds, told Hernandez he had “back pain at a level seven out of 10, and limited range of movement, without limping.”
Hernandez ordered a plain film x-ray of R.C.’s back and a testicular ultrasound. But, without doing a musculoskelatal back exam or a testicular exam, Hernandez “assessed R.C. with having unspecified lower back pain, obesity, and testicular swelling, and recommended a follow-up in three months.”
R.C. was back a month later, Oct. 12, 2022, for a follow-up and to go over lab results, however Hernandez “did not discuss previous back imaging or testicular ultrasound.” R.C. was without pain, the complaint said, and without the eight pounds he’d lost in the 26 days since seeing Hernandez in September.
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At R.C.’s next appointment, Nov. 28, 2022, he still weighed 201 pounds but “complained of left hip pain at a level of six out of 10.” He placed his hip pain at only two out of 10 on Dec. 29, 2022, but his weight had plunged to 176 pounds.
R.C. had lost another three pounds by Jan. 4, 2023, down to 173, and rated his lower back pain “at a level of 10 of 10 with limited range of movement.”
Hernandez, the complaint said, “performed physical examinations of R.C., which included a musculoskeletal back exam, ordered annual lab testing, and prescribed diclofenac and gabapentin, but did not discuss R.C.’s weight loss.”
At this point, R.C. had lost 28 pounds in 37 days.
Diclofenac, the Mayo Clinic says, is “used to treat mild-to-moderate pain, and helps to relieve symptoms of arthritis (eg, osteoarthritis or rheumatoid arthritis), such as inflammation, swelling, stiffness, and joint pain.”
The Cleveland Clinic says gabapentin is prescribed “to prevent and control partial seizures, relieve postherpetic neuralgia after shingles and moderate-to-severe restless legs syndrome.”
Despite R.C.’s lab results showing anemia with a “significant drop” in hemoglobin levels on Jan. 19, 2023, and his weight still at 173 pounds, the complaint said. Hernandez “prescribed gabapentin and iron supplements to R.C. on or about January 19, 2023, but did not discuss R.C.’s significant weight loss, and did not adequately order consultation or investigation of R.C.’s anemia to determine the underlying cause.”
R.C. went to the Jackson South Medical Center emergency room on Feb. 6 with a distended abdomen and general weakness added to more weight loss and lower back pain. His hemoglobin had dropped even further, necessitating a blood transfusion.
“Abdominal imaging of R.C. on Feb. 6 or Feb. 7, 2023, showed signs of renal carcinoma with metastatic lesions to the lungs and liver,” the complaint said. After a transfer to Jackson Memorial Hospital on Feb. 7, more imaging showed “a large centrally necrotic renal mass consistent with renal cell carcinoma, numerous metastatic pulmonary nodules throughout both lungs, and suspected metastatic disease of the liver.”
Doctors removed a 16-inch cancerous mass, but “despite the surgical intervention, R.C. could not recover, and he died on Feb. 25, 2023, due to metastatic renal cell carcinoma and septic shock.”
The complaint faulted Hernandez for “failing to perform a musculoskeletal back exam when R.C. first complained of significant back pain; failing to discuss and/or investigate the cause of R.C.’s significant short-term weight loss; and by failing to adequately investigate the potential underlying cause of R.C.’s anemia.”
