When Ron Wolff, a disabled Army veteran, walked into the examining room at the VA Hospital in Miami three years ago, he says he found it unsettling that nurse practitioner Andres Irizarry began talking about how he enjoyed going to sadomasochism conventions.

As he later stated in sworn testimony, Wolff says the nurse ordered him to drop his pants and began fondling him in a way that felt distinctly sexual, not medical.

Robert Pelier, Irizarry's attorney, says Wolff's accusation is ``absolutely untrue.''

For almost three years, Wolff tried to complain about the incident, first to the U.S. Department of Veterans Affairs, then to the Florida Department of Health.

His case is another example of how the healthcare system, particularly in Florida, seems sometimes to move extremely slowly in investigating its professionals.

A spokeswoman for the state Health Department told The Miami Herald that investigators ''must follow due process against a practitioner.'' The system is designed to protect doctors' reputations until disciplinary action is taken.

In April, Public Citizen reported Florida ranked No. 31 among the states for serious actions per 1,000 physicians.

Fourteen months ago, The Miami Herald reported that a hospital had removed heart surgeon Alex Zakharia from its staff after ''numerous patient deaths'' and that Zakharia had admitted he suffered from worsening memory loss. The surgeon's disciplinary case is still slowly moving through the state system. He retains a clear/active license.

In the VA case, attorney Pelier said his client didn't want to talk to The Herald, but had cooperated fully with the investigation and had an excellent job record at the VA. Pelier said the VA has told him of no other accusations.

However, a VA investigation, which began more than two years after Wolff first complained, found that at least two other patients and an intern had made similar complaints about Irizarry, going back to the early 1990s.

The VA now says it was a mistake that The Miami Herald obtained the VA investigative report. Written in July, the report concluded there had been ''a long-standing pattern of inappropriate behavior to vulnerable individuals by Mr. Andres Irizarry dating back to at least 1991.'' It recommended the hospital consider some kind of disciplinary action.

Wolff obtained that report from the VA after repeated requests, and he gave a copy to The Herald.

Susan Ward, spokeswoman for the Miami VA, said: ''The investigation is still ongoing,'' and that's why it hadn't been shown to Irizarry's lawyer.

The spokeswoman said Irizarry continues to be employed by the hospital, but he ``has been taken out of patient care while the administration is looking at the recommendations the panel made. Appropriate steps were taken.''

''Why didn't the VA do anything before?'' asks Tonia Werner, a forensic psychiatrist at the University of Florida who specializes in legal issues involving behavior, including sexual abuse. ``Why are there four reports and he's still there?''

Irizarry retains a clear/active license in Florida as an advanced nurse practitioner.

Wolff says he complained to the state several months ago but an investigator didn't see him until Wednesday.

Raised in Iowa, Wolff joined the Army when he was 17. He has been in the VA system for years, with a life-threatening illness that he asks not be revealed, plus high blood pressure, diabetes, heart arrhythmia and anxiety and panic disorders.

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