State sanctions 2 Fort Myers doctors

The Florida Board of Medicine has accepted disciplinary measures against two Fort Myers physicians, one for failure to provide proper medical care and the second for initiating the wrong surgical procedure for a patient's pain relief.

Dr. Jane Daniel, an obstetrician/gynecologist, has agreed to pay a $10,000 fine and reimburse the state Department of Health $5,000 for investigating a case in which Daniel didn't order appropriate tests or follow-up care for a 20-year-old pregnant woman who went to the emergency room at HealthPark Medical Center in south Lee County with severe abdominal pain on Feb. 15, 2004.

A nurse was unable to detect a fetal heart rate. The doctor ordered an ultrasound and diagnosed fetal death at 33-week gestation rather than diagnosing a hidden rupture of the placenta. The patient was sent to a birthing suite and the doctor left the hospital without leaving orders for intensive cardiac monitoring or for a blood coagulation profile, according to state Department of Health records.

The doctor returned the next morning and considered a rupture of the placenta, ordered blood tests and had the patient transferred to a high-risk perinatal unit. The doctor ordered blood transfusions and delivered by Caesarean section a stillborn infant that afternoon. The patient developed massive bleeding and a total hysterectomy was performed, records show.

The state's administrative complaint said Daniel breached standards of care by leaving the hospital soon after the patient arrived without ordering additional monitoring and a coagulation test, and that the doctor should have induced labor much earlier.

Daniel also will perform 50 hours of community service under the settlement agreement accepted by the medical board at its meeting earlier this month in Orlando. Daniel couldn't be reached for comment.

The second case involved Dr. James Weiner, an anesthesiologist, who will pay a $1,000 fine and reimburse the state $12,000 for the cost of investigating a case involving a 59-year-old man who had been under Weiner's care for chronic lower back pain.

The patient went to Weiner's practice in Fort Myers on Jan. 29, 2004, and agreed to undergo radio frequency ablation of specific nerves to alleviate pain.

The procedure was scheduled for Feb. 19, 2004, at the Center for Digestive Health and Pain Management in Fort Myers and upon arriving, the patient was presented with a consent agreement for an epidural catheter procedure to break up scar tissue. The patient signed the consent form for the wrong procedure, state records show.

Weiner initiated the wrong procedure and realized something wasn't correct, stopped and asked for his own records for the patient to be brought to him. He informed the patient he had initiated the wrong procedure and stopped.

Weiner opted to have an administrative hearing held this past January with a finding that the center does its own patient charts and wrote down the wrong procedure. Ultimately, the state said Weiner initiated the wrong procedure even though the patient had signed the consent form for it. The administrative judge recommended the $1,000 fine and 25 hours of community service.

"Our position is the surgery center scheduled, rather than his office, the wrong procedure that he did not order," said Weiner's attorney, Sean Ellsworth of Miami Beach.