After expressing frustration, the Florida Board of Medicine on Friday accepted a settlement that allows a controversial surgeon to continue in practice without interruption.
Orthopedic surgeon Alfred Bonati, who attracts patients from all over the country to Bonati Spine Institute north of Tampa, had been charged with mishandling four cases, leaving patients with permanent disabilities.
But experts disagreed whether Bonati, who did not attend the hearing in Deerfield Beach, was at fault. Some said the disabilities came from complications that are a known risk of spine surgery, no matter who the surgeon is.
That left the Department of Health without sufficient evidence to prove its case at a formal hearing by “clear and convincing evidence,” Florida’s legal requirement in professional discipline cases.
“We strongly urge you to accept this settlement,” said DOH prosecutor Carol Gregg said Friday. “These are frankly the best terms the department could achieve under the circumstances.”
Gregg said several experts who were critical of Bonati when they first reviewed the cases reversed their opinions during depositions.
Board member Nina diPietro said the settlement – which included a reprimand and $25,000 fine –should have, at a minimum, probation with supervision. “I don’t think it (the settlement) does anything for the citizens of Florida,” she said.
The vote was close: 6 to 5. Among those voting to accept the settlement was Dr. Zach Zachariah, who was one of the Board Members sued by Dr. Bonati in 2002, the last time he faced charges by the medical board.
“We actually tried to revoke” his license, Zachariah said Friday. “He had the most high-powered lawyers in Florida. They waged war on the Department (of Health).”
Bonati dropped his 2002 suit against the board and then-DOH Secretary John Agwunobi after the state agreed to settle Bonati’s case with a $50,000 donation to charity and a payment of more than $100,000 in costs. The settlement did not require Bonati to admit wrongdoing.
Friday’s hearing in Deerfield Beach was the fourth time the Florida Board of Medicine addressed charges against Bonati in 21 years. He has been reprimanded, ordered to pay fines, serve probation, and take courses. But his Pasco County operation continued.
Zachariah agreed with some of his colleagues that Bonati should not be practicing, but noted that the state would not win if the surgeon contested the charges at a hearing. Plus, Bonati would probably sue the board again.
Board member Dr. Merle Stringer said that the records show Bonati “has a very poor understanding” of how to deal with spine problems.
In addition to the reprimand and fine, the settlement that the board accepted requires that Bonati complete several courses, including ones on how to handle complications of spine surgery, record-keeping and legal requirements for doctors.
It also requires Bonati to give a one-hour lecture or seminar on preventing wrong-site surgeries. One of the complaints charged that he operated on the wrong disc, but experts disagreed on that.
Bonati, around 75, did not attend the hearing. Cynthia Tunnicliff, one of his attorneys, said afterward that he was pleased with the outcome.
"Dr. Bonati is a pioneer in spinal surgery and has liberated tens of thousands of people from life crippling back pain,' she wrote in an e-mail. "He is pleased with the Board of Medicine's experts, who collectively concluded there was no wrongdoing in these extremely rare instances of ongoing back pain."
For more details on the state complaints, see Spine Doctor's Saga Continues.
Carol Gentry is a special correspondent with WUSF in Tampa. Health News Florida receives support from the Corporation for Public Broadcasting.
