By Carol Gentry
2/9/2009 © Florida Health News
Women have two openings below the belt, which don't look anything alike. What are the odds that a doctor would get them mixed up and do a procedure on the wrong one -- not just once, but twice? What are the odds that such a doctor would keep his medical license?
Welcome to Florida.
***
Dwarka Nath, a digestive-tract specialist who had a busy practice in St. Petersburg for 20 years, appeared before the Florida Board of Medicine on Saturday in Tampa to try to explain how things went so wrong and seek redemption.
For the past year and a half, Nath said, he has been chief of gastroenterology at the Veterans Affairs medical center in Reno, Nev. But he wants to come home to St. Pete, where his wife and children still live.
Being apart is a hardship on his family, Nath said. He has taken courses and corrective action in his practice, he said. He apologized to the board and the citizens of Florida.
The board, which bears responsibility for protecting those same citizens, had seen Nath before. Last August, he was placed on probation after the board heard the following charges from the Department of Health:
- On Jan. 13, 2002, a 65-year-old man with a history of bleeding ulcers was admitted to St. Anthony’s Hospital through the emergency room with symptoms of internal hemorrhage. Nath, who was called in on the case, ordered blood transfusions but failed to act quickly enough, DOH charged. The man, identified only by the initials W.M., vomited blood and died on Jan. 15.
- Almost exactly a year later at the same hospital, DOH charged, Nath set out to do a colonoscopy on 37-year-old Anita Richardson but inserted the scope into the wrong orifice and perforated her colon.
The infection led to abdominal surgery and a colostomy. State insurance records say Richardson and Nath settled a malpractice suit in 2005 for $250,000, the limit of Nath’s coverage for a single case.
When medical board members agreed to a settlement of the disciplinary charges last summer with probation, they didn’t realize they’d be seeing Nath again so soon.
The case presented Saturday involved Nath’s intended colonoscopy of a 93-year-old woman in December 2006. He found a tumor. But when a surgeon went in to remove it, he found the intestines were clean. It turned out the patient had cervical cancer, which meant Nath had scoped the wrong orifice.
The patient, identified only as D.B., was sent to a nursing home after the hysterectomy. A board member asked Nath whether she is still alive. He said he didn’t know.
***
DOH and Nath offered a proposed settlement calling for a reprimand, $20,000 fine and two more years of probation. Some members of the board thought that wasn’t anywhere near enough.
“I’m having a really hard time seeing how somebody could do this once,” said plastic surgeon Jason Rosenberg, a board member from Gainesville. “I’m having an impossible time seeing how somebody could do this twice.”
Board member Donald Mullins, who said he’s in the “homeland security” business, said anyone in his field who made a serious mistake twice would be kicked out.
“You are a danger to the public,” Mullins told Nath. “You should not be allowed to practice in this state.”
Board member Gary Winchester, a family practice doctor from Tallahassee, said his “gut feeling” was to agree with Mullins. But he said if the board revoked Nath’s license, the doctor could appeal to the courts, which would likely overturn the board’s action.
So the board offered Nath a deal that would let him keep his Florida license as long as he has direct supervision by a highly qualified specialist any time he sets out to do a scope procedure.
Nath’s attorney, Gregory Chaires, said the doctor would think about whether to accept the offer or request a formal hearing. Under the rules, he has up to seven days to decide.