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    Doctor fined for breast surgery error

    But Dr. Charles E. Cox will not be formally reprimanded by the Florida Board of Medicine.

    By WES ALLISON

    © St. Petersburg Times,
    published June 2, 2001


    The head of the Moffitt Cancer Center's breast cancer program was fined $5,000 on Friday for removing a woman's breast when he was supposed to remove only a tumor. The doctor and operating room staff had confused her with another patient.

    The Florida Board of Medicine also ordered Dr. Charles E. Cox, who has been nationally recognized for his patient care and research, to attend five hours of risk management classes and give a one-hour lecture to his colleagues about what happened and how it could have been avoided.

    The board declined, however, to issue a formal reprimand, a stinging rebuke that can affect a doctor's ability to get HMO and insurance contracts.

    Cox acknowledged performing a left mastectomy on the wrong patient, a 66-year-old woman with cancer of the left breast, in November 1998. The woman was scheduled to have a tumor removed, a procedure called a lumpectomy.

    She was mistakenly brought into the operating room when Cox called for the next patient, a woman of similar age who also had cancer of the left breast but was scheduled for a mastectomy.

    Cox, who attended Friday's hearing, acknowledged that he failed to verify he had the right patient before starting the operation. He learned of the mix-up just as he was finishing.

    In an interview Thursday, Cox said he regrets the mistake and was pained by the loss of his patient's trust. The University of South Florida, which is affiliated with Moffitt, paid an undisclosed sum to settle the case, although the patient never sued.

    "This is obviously not something I would want to have had to happen, and it's been extremely difficult, from my perspective, dealing with this every day in the operating room," Cox said Thursday.

    He said he was also disappointed by the breakdown in the system, which allowed the wrong patient to be prepared for surgery.

    Although the incident occurred almost three years ago, it only now came before the board of medicine. Such delays are not uncommon.

    On Friday, at the board's meeting in Fort Lauderdale, board members deliberated briefly before agreeing to accept most of the terms of an agreement that Cox had struck with the state Agency for Health Care Administration, which investigates and prosecutes medical mistakes. But instead of the formal reprimand that had been proposed, the board added the lecture to his peers and the classes in risk management, in which doctors are taught how better to avoid mistakes. He also must pay the state's $928 cost of investigating the case.

    Cox leads the Comprehensive Breast Cancer Program at Moffitt, Florida's only National Cancer Institute-designated center. He said he has performed 2,500 to 3,000 breast surgeries in the past 18 years. This marked his first disciplinary case.

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