Florida doctor didn’t wear his hearing aid — and didn’t hear patient scream, state says
Investigators from two state agencies say they saw a Tampa gastroenterologist cause a colonoscopy patient rectal pain that had a patient screaming and let a surgical technician do things during a colonoscopy that only a doctor should.
That’s in the Sept. 21 emergency restriction order (ERO) that bans Dr. Ishwari Prasad from procedures or surgeries.
The Florida Department of Health filed an administrative complaint on Oct. 10 on against Prasad, which starts a process that could end in Board of Medicine discipline.
Prasad “is hearing impaired and uses assistive hearing devices to be able to effectively communicate with his surgical team and patients,” the complaint said. “During one or both procedures, [Prasad] was not wearing his assistive hearing device to help him hear. During one or both procedures, the surgical team was unable to effectively communicate with [Prasad].”
Prasad’s attorney, Chris Schulte of Weekley Schulte Valdes Murman Tonelli, says his client “vehemently denies the allegations” in the restriction order and the complaint.
“In that regard, he has filed Motion to Stay the emergency restriction while his request for an expedited review of the emergency restriction is pending,” Schulte wrote via email. “He will defend his actions, his care, and his practice in the pending DOH proceedings.”
The motion to stay is pending before a District Court of Appeals.
Prasad has been licensed in Florida since Oct. 23, 1990, with no previous disciplinary action taken against him. A 2015 Hillsborough County malpractice case accusing Prasad of negligence in a patient’s death from cancer ended with a settlement in which the doctor’s insurance paid $250,000.
“Based on the interviews with Dr. Prasad’s coworkers, his inability to safely perform procedures and surgeries is a result of a mental or physical condition,” the Emergency Restriction Order said. “Therefore, Dr. Prasad should be restricted from performing procedures and surgeries until it is determined that he is able to safely practice.”
That determination will be made by an evaluator from the Professional’s Resource Network (PRN), which the Department of Health uses for consultation for “impaired practitioners, including practitioners who have mental and physical conditions that could affect their ability to safely practice their profession.”
Unqualified insertion during a colonoscopy?
While visiting the Ambulatory Surgery Center in Tampa on June 5, Agency for Health Care Administration and the Florida Department of Health employees saw two colonoscopies by Prasad. A surgical tech with initials “M.D.” assisted Prasad, who allegedly wasn’t wearing his hearing aids.
“M.D., a surgical tech, began the procedure by inserting the scope into (Patient 1’s) rectum,” the ERO said. “Dr. Prasad placed his hand on the instrument, but M.D. was primarily moving the scope.”
Both the insertion and moving the scope after insertion, the ERO said, were beyond M.D.’s license and training as a surgical tech. So was moving a snare during a polyp hunt, which the ERO said M.D. also did during this colonoscopy and the one with Patient 2.
“During the procedure, Dr. Prasad ordered M.D. to place a clip on (Patient 1’s) colon,” the ERO said. “M.D. advised that she was unable to place the clip because there was already a clip in that location and the two would overlap.”
The ERO said Prasad repeatedly shouted “What?” in the procedure room in response to people speaking to him.
This included the surgery center’s administrator, the ERO said, while another colonoscopy patient screamed in pain.
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Shouting and screaming?
When Prasad and M.D. the surgical tech walked into the procedure room for Patient 2’s colonoscopy, the ERO said, the patient was awake and engaging in conversation. Prasad and M.D. started the insertion. But, the ERO said, Patient 2 wasn’t fully sedated.
“(Patient 2) began to yell and shouted that he was in pain and could still feel everything,” the ERO said. “Dr. Prasad continued to move the scope while (Patient 2) continued to scream.”
A problem with Patient 2’s IV line prevented him from being as sedated as he should have been. The ERO said Prasad was told to wait until the problem was fixed.
“Dr. Prasad continued to insert the scope despite being told to wait and began to thrust the scope into (Patient 2’s) rectum while (Patient 2) shouted in pain,” the ERO said.
“The administrator for the Ambulatory Surgery Center was also in the procedure room and advised Dr. Prasad that he needed to wait,” the ERO continued. “Dr. Prasad leaned over (Patient 2) and shouted “I know!” to the administrator, yet continued to manipulate the scope.”
After the colonoscopy, Patient 2, the ERO said, “recalled that the colonoscopy was horrible and that he was in significant pain.”
The ERO said M.D. told investigators afterward “during colonoscopies with Dr. Prasad, she pushes the scope, holds the scope, cuts polyps, puts clips on and removes and pulls out specimens,” the ERO said. “M.D. indicated that she performs all of these functions because Dr. Prasad is unable to perform them himself.”
