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    Neurosurgeon fined for 'wrong-side' mistake

    By WES ALLISON

    © St. Petersburg Times, published December 3, 2000


    TAMPA -- Drilling a hole in the wrong side of a patient's head is one thing. Failing to be contrite about it, the Florida Board of Medicine made clear Saturday, is quite another.

    The Board of Medicine fined a St. Petersburg neurosurgeon $5,000 for boring a burr hole into the wrong side of a 66-year-old woman's head as part of a biopsy of a brain tumor.

    The doctor, Jeffrey Walker, realized the mistake before he reached her brain and continued the operation on the correct side.

    The incident occurred in March 1998 at Northside Hospital. During his short hearing before the board in Tampa Saturday afternoon, members of the board gave Walker credit for properly reporting the mistake and for being candid about it with the patient's family, and said there's no doubt Walker is a well-trained and accomplished brain surgeon.

    But then Walker blamed the nurse for shaving, cleaning and draping cloth around the patient's left, rather than right, side, which he said led to his error. "The nurse made a mistake and I failed to notice the mistake," Walker told the board. "The nurse, of course, no longer works there."

    "This doctor is very impressed with himself," snapped Dr. Zachariah P. Zachariah, a cardiologist from Fort Lauderdale. "He thinks he's so fantastic that checking the patient before he makes a burr hole is beneath him."

    Zachariah suggested Walker needed to be taught a lesson and should be required to perform 30 or 40 hours of community service.

    "This is one of the most arrogant guys I've seen in an long time," he said. "This guy needs to eat some humble pie."

    Dr. John W. Glotfelty, a taciturn ophthalmologist from Lakeland, sounded equally irritated at Walker's assertion that no harm was done.

    "Maybe we can go around the table and have everyone take a turn shaving your head," he said. Wrong-side surgery "has been a problem for the Board of Medicine for some time. Apparently $5,000 may not be enough money to get his attention."

    Walker, a well-known Tampa Bay-area neurosurgeon, told the board that he has performed more than 4,000 procedures. He has practiced in the area since 1985 and has not been disciplined before.

    Dr. Gaston J. Acosta-Rua, a board member from Jacksonville, tried to calm his colleagues and urged them to accept the state's recommended punishment: the fine, plus administrative costs of $928.24; a letter of concern from the board; and five hours of continuing medical education in risk management. The sanction is typical for that sort of offense.

    Walker may be arrogant, but "so are we all," said Acosta-Rua, also a neurosurgeon. "Maybe I am getting old and I am not so arrogant. Maybe you will not be so arrogant."

    The board agreed, 6-3. Walker left, not saying a word.

    Also Saturday, the board fined a Tampa internist, Dr. Atul R. Shaw, $2,500 for failing to timely diagnose and treat a bleeding duodenal ulcer and colon cancer in an 80-year-old woman. Instead, he treated her for anemia. By the time the cancer was discovered, the tumor was large, and little could be done for her. She died in September 1993, and the board found that Shaw's action contributed to her death.

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