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Judge advises penalties for doctor

The physician had been fined previously for the same thing on another patient: beginning an operation on the wrong knee.

By BARBARA BEHRENDT
Published January 23, 2006


BEVERLY HILLS - An administrative law judge has recommended a $10,000 fine and other sanctions be levied against a Beverly Hills orthopedic surgeon for beginning an incision on the wrong knee of a patient in 2004.

According to the order Judge Charles C. Adams issued Friday, surgeon Walter I. Choung of Nature Coast Orthopaedics violated Florida statutes by his mistake and should pay the fine, be placed on probation for one year, and should perform 100 hours of community service.

Adams also recommended Choung undergo quality assurance consultation and a review of practice methods by a qualified risk manager. The physician, who had been fined previously for beginning an operation on the wrong knee of a different patient, should also establish necessary changes to avoid a third wrong-site surgery.

The recommendation also asks for Choung to pay for the cost of the investigation and prosecution and that he be required to present a one-hour lecture to his peers at a facility where he practices on the perils of wrong-site surgery and how to avoid them.

Neither Choung nor his attorney, Bruce Lamb, could be reached for comment. The recommendation by Adams now returns to the state's Department of Health for final action.

The Florida Department of Health charged Choung with a violation of the law for performing a "wrong-site, incorrect and medically unnecessary procedure" when he made an incision on the left knee of a 25-year-old male patient referred to in records only as "D.M." The patient had been admitted for surgery in February 2004 to repair a tear in the anterior cruciate ligament of his right knee.

The mistake came on the heels of a 1998 case in which Choung began to operate on the right knee of a 69-year-old woman who had come into the hospital for surgery on her left knee. He was fined $5,000 and ordered to take five hours of courses in risk management.

In the more recent case, the Board of Medicine and Choung had tried to reach a settlement, but Choung took the case to the state's Division of Administrative Hearings for a ruling. The hearing was in early November.

Ephraim D. Livingston, assistant general counsel for the Florida Department of Health, argued that Choung had made the same mistake before and "did not take a few simple steps to avoid this violation of the medical practice act," according to his proposed recommendation to the judge.

Livingston's recommendation was a fine of $20,000 and a suspension from his practice of one month, two years' probation and a review of 25 percent of Choung's patient records among other penalties.

Choung's lawyer said the physician immediately reported his mistake and participated in the drawing up of a new procedure at Seven Rivers Regional Medical Center to avoid future mistakes. Suspending him would harm his practice and would harm Seven Rivers because he is on emergency call for the facility, Lamb argued.

Citing more egregious cases of wrong-site surgeries and the penalties those physicians received, Lamb recommended Choung receive a $20,000 fine, pay the costs of the case, receive a reprimand, perform 200 hours of community service and other penalties.

In determining the penalties he would recommend, Adams wrote that the injury to the patient was slight, the mistake was the second occurence, and Choung was cooperative after he made the mistake.