In a final order issued late last month, the Florida Board of Medicine not only fined but imposed other obligations on a physician accused of medical malpractice in the death of a patient who underwent complex heart surgery, according to a story in the Miami Herald.
The order followed an administrative complaint filed last year by the state Department of Health against John Crafts Sciarra, MD, a Miami anesthesiologist. In that complaint, the department laid out the circumstances surrounding its allegations against Sciarra.
On or about January 18, 2018, a patient described as "P.S." was admitted to Jackson Memorial Hospital for treatment of triple vessel coronary artery disease.
That same day, P.S.'s doctors performed a coronary artery bypass graft (CABG) "without complications." As the patient was being transferred from the operating room table to a bed, his ventilation machine was inadvertently disconnected from its power source.
As the anesthesiologist on duty that day, Sciarra was responsible for proper postsurgical ventilation. Thus, the complaint faulted him not only for failing to prevent the initial interruption in breathing assistance but also for its "prolonged" cessation. (The Department of Health estimated this period to be from 2 to 9 minutes.)
The result for the patient was catastrophic: He developed severe bradycardia, "followed by a full ventricular fibrillation cardiac arrest." When cardiopulmonary resuscitation failed to restore P.S.'s "spontaneous circulation," his doctors reopened his chest, massaged his heart, and placed him on a cardiopulmonary pump. During the massage, the patient's right ventricle was punctured.
PS was taken to the intensive care unit on life support. He was pronounced dead on January 23, 2019. Court documents indicate that he lived for slightly more than a year after the CABG surgery.
The complaint found that in failing to properly perform his duties, Sciarra had violated certain statutory standards of care. The health department therefore recommended that he be penalized in one or several ways. The most serious would be the permanent revocation or suspension of his license.
In its final order, the Board of Medicine didn't dispute any of the facts of the case. It did cite, however, several mitigating circumstances that justified reducing somewhat the penalties proposed in the health department's complaint.
Among other things, the board noted that not all of the events laid out in the administrative complaint were within Sciarra's control and that the patient's death was caused at least in part by a "system error." The board added that Sciarra willingly cooperated with its investigation.
Given these mitigating circumstances, the board agreed that the following penalties were appropriate:
The issuing of a letter of concern
The requirement that Sciarra complete three CME hours in risk management
A fine of $5,920.45, payable within 30 days of the final order
The board placed no additional penalties on the anesthesiologist, nor did it impose any restrictions on his ability to practice medicine in the state of Florida.
The content contained in this article is for informational purposes only and does not constitute legal advice. Reliance on any information provided in this article is solely at your own risk.
Wayne J. Guglielmo, MA, is an independent journalist based in Mahwah, New Jersey.
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Cite this: Wayne J. Guglielmo. Anesthesiologist Is Punished for Standard of Care Lapses - Medscape - May 24, 2022.