Ex-Mayo surgeon who let student help operate is cleared
By Christine Giordano and Carol Gentry
10/3/2008 © Florida Health News
ORLANDO -- A surgeon who let an untrained college student play a hands-on role in three breast-cancer operations at the Mayo Clinic last year was cleared of wrongdoing Friday by the Florida Board of Medicine.
Stephen L. Smith, who now is chief of general surgery at Scripps Clinic and an affiliated hospital in LaJolla, Calif., said he didn't know that Mayo-Jacksonville's program for student observers barred them from direct participation. He said he was accustomed to training medical students and residents and didn’t think there was a problem.
The administrative complaint filed by the Department of Health over the incident said the techniques he allowed the college student to do included making an incision, holding retractors, dissecting tissue and stitching up.
While his signature was on a form that included the information, Smith said no one pointed that rule out to him. “I was totally unaware of the new policy,” Smith told the medical board.
Board member Frank Farmer of Daytona Beach said it’s a shame that Smith wound up leaving Florida because of it. “I think this doctor was thrown under the train by the Mayo Clinic,” he said.
In an e-mail exchange, Mayo Clinic-Florida spokesman Kevin Punsky said that as soon as officials there learned of the 2007 incident, they investigated and promptly notified the three patients of the incidents. Mayo temporarily suspended the observership program, but after a thorough review and broadening of the approval process, it was resumed.
Mayo considers the program "part of its mission to train the next generation of physicians and allied health practitioners," Punsky wrote.
In another case involving an unlicensed helper, the board had a different reaction. It rejected a negotiated settlement that included a $10,000 fine for Ocala family practitioner Viterbo Martinez, who had been accused of allowing his wife to collect Pap smear specimens from two women patients at La Familia Medical Clinic on SW 62nd Court in Ocala, without being in the room himself. The collection involves insertion of a wand into the vagina to swab the cervix, the opening to the uterus.
One of the women, who said the procedure was more painful than usual, went to the Marion County Sheriff’s Office. Mayra Martinez Rosario was arrested in late 2006, records show, but went through pretrial intervention and was not jailed or prosecuted.
On Friday, Martinez told the board that his wife had been a physician in another country and was therefore amply qualified to perform the task, even though she lacks a health professional license here. He did not mention which country and declined after the hearing to talk to a reporter from Florida Health News.
Medical board member Laurie K. Davies of Gainesville asked him whether he would want a prostate exam to be done by an unlicensed assistant. “I think every woman here is appalled,” she said.
The board rejected the settlement, which had called for a $10,000 fine, and counter-offered a settlement that would include a reprimand, a fine of $20,000 and several tasks, such as taking courses on supervision and risk management. Martinez has up to seven days to decide whether to accept the settlement. The alternative would mean an evidentiary hearing before an administrative law judge, which can take months or years to prepare for and cost a great deal in attorney and expert witness fees.
--Christine Giordano can be reached at ChristineDianaGiordano@gmail.com; Carol Gentry can be reached at Carol.Gentry@FloridaHealthNews.org.
