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Patient's death prompts hearing on doctor's care

The state says the doctor should have done more tests. The Board of Medicine will decide any discipline.

By JIM ROSS

© St. Petersburg Times,
published July 1, 2001


INVERNESS -- State authorities have alleged that an Inverness doctor made poor decisions when caring for an elderly patient who later died. The doctor, Douglas Peterson, faces possible disciplinary action from the Board of Medicine.

Peterson sees patients at the Harbor Family and Community Medical Center, 8429 State Road 44 E. A licensed physician since 1980, Peterson holds a clear state license and has not had any final disciplinary action taken against him -- or paid any liability claims exceeding $5,000 -- during the past 10 years, state records show.

Peterson has disputed the state Department of Health's accusations and asked for a state administrative law judge to review the case. A hearing is scheduled for 10 a.m. July 26 at the Citrus County Courthouse.

The Board of Medicine will have final say on any discipline. Peterson's lawyer, Juan Ruiz of Orlando, declined comment for this story.

At issue is the care Peterson provided for a patient identified in state records only as R.B. The woman was 75 in October 1999 when she visited an orthopedist complaining of weakness and multiple falls.

According to a complaint the Department of Health prepared, Peterson had been the woman's treating physician the previous 2 1/2 years. The orthopedist called Peterson, who directed the woman to visit Citrus Memorial Hospital's emergency room.

That same day, Oct. 18, the hospital admitted the woman as a patient, the records said. She had new onset of diabetes and a probable cerebrovascular accident (stroke); she complained of multiple falls, belching and abdominal gas.

Peterson ordered a neurology consultation and a CT scan because the patient had weakness on her left side and the left side of her face was droopy, the state complaint said.

The CT scan was interpreted as normal. But the state said Peterson should have gone further, ordering a stool test or rectal examination so doctors could determine whether she had upper gastrointestinal problems.

What is more, Peterson did not determine whether his patient was in diabetic ketoacidosis -- a process where ketones make the blood acidic -- even though her glucose levels were extremely high and she had ketones in her urine, the complaint said.

State records showed the woman remained in the hospital until Oct. 22, 1999, with Peterson seeing her twice. She was discharged to a rehabilitation facility Oct. 22 but was returned to the hospital shortly afterward that day. She was bleeding in her upper GI tract and had low hemoglobin levels. The woman died.

The Department of Health said a "reasonably prudent physician under similar conditions and circumstances" would have ordered a consultation from a gastrointestinal specialist and ordered a stool test and rectal examination and checked for diabetic ketoacidosis.

The department asked the Board of Medicine to impose discipline ranging from a fine to a revocation or suspension of Peterson's license.

Peterson is a fellow of the American Academy of Family Physicians

- Jim Ross writes about medical issues in Citrus County. Reach him at 860-7302.

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