St. Petersburg Times (Florida)
August 10, 1992
3 Pinellas doctors disciplined
By Carol Gentry
Don’t you just hate it when doctors say your pain is all in your head?
Clearwater psychiatrist Luis Herrero has learned to be cautious about making that assumption.
A 41-year-old woman he diagnosed with “psychogenic pain disorder” actually had stomach cancer.
Eventually, doctors figured that out, but not before she spent some time in a psychiatric ward.
Herrero’s was one of several cases involving Pinellas County physicians that came before the Florida Board of Medicine in Tallahassee this past weekend.
Others involved Dr. Si H. Azar, a cardiologist in St. Petersburg Beach, and Betty Jo Carter Bertoncini of St. Petersburg.
In addition, Dr. Carlos Solorzano was disciplined for a surgery in Clearwater that left a patient blind in one eye.
Here are the details:
Luis Herrero
The patient, identified in state records only by her initials, N.R., sought help in June 1988 for severe stomach pains. Her weight had dropped by 30 pounds.
Gastroenterologist Fred Lieberman performed a scope procedure at Morton Plant Hospital, according to state records, but could find nothing wrong.
So Lieberman sent N.R. to the psychiatrist. Herrero talked to her, found her sad she recently had lost her job and decided her pain must be originating in her mind, records show. He suggested a tranquilizer and psychotherapy.
About two weeks later, N.R. showed up at the Morton Plant emergency room, vomiting and in pain. Because of Herrero’s diagnosis, she was sent to the psychiatric ward.
After watching N.R. awhile and talking with her, psychiatrist Ali Keskiner decided something must be physically wrong. He called in gastroenterologist Eric Weston.
Weston recommended exploratory surgery, which Dr. William Maistrellis performed. He found the cancer and removed a large part of the stomach.
N.R. underwent chemotherapy, but the records don’t indicate whether she survived.
When he appeared before the Board of Medicine on Friday, Herrero said he feels terrible about his mistake.
“She suffered physically. She suffered emotionally. . It’s a tragedy,” he said.
Board members sympathized. They said the error was understandable.
Prosecutors from the Department of Professional Regulation had asked for a reprimand and $ 5,000 fine. But the board cut the fine to $ 1,000 and will file a “letter of concern.”
Si H. Azar
Jim Veith, one of Azar’s patients, was terribly short of breath.
His feet were swollen. He had high blood pressure. And his chest hurt so much some days that he could get to his office at the General Electric plant in Largo only by pulling himself across the parking lot from car to car.
It should have been obvious to Azar that Veith’s heart was ready to go at any moment, the Board of Medicine said, yet Azar didn’t do much to prevent it.
If he had, board members concluded, Veith might not have died at 59.
It has been more than five years since Veith’s fatal heart attack. It took that long for the case to make its way to the medical board.
Azar told the board Friday that Veith was doomed, that nothing could have saved him. Conservative treatment in such cases is appropriate, he said.
But earlier testimony from Dr. John C. Dormois of Hudson disputes that.
Dormois, who was the state’s expert witness in the case, said Veith needed heart tests that could detect roadblocks in the coronary arteries cardiac catheterization or angiography.
Once the roadblock was found, Dormois said, Veith would have been a candidate for bypass surgery or angioplasty, in which the artery is opened with a balloon-tipped wand.
Though Azar is a cardiologist, he said he does not perform invasive heart tests. And there was no cardiac catheterization lab at either of the two hospitals where he had privileges, he said.
To board members, that was no excuse. They said Azar should have sent the patient where he could get the proper care.
The board placed Azar on three years’ probation and ordered him to take courses to improve his diagnostic skills.
Azar vowed to appeal the penalty.
He said, “I provided the highest standard of care to my patient.”
Betty Jo Carter
Bertoncini
Fresh from federal prison, where she served 14 months for Medicare fraud, Bertoncini is ready to resume her private practice.
She has begun by working as a volunteer at the St. Petersburg Free Clinic, 863 Third Ave. N.
According to state records, Bertoncini was one of four people arrested in connection with a scheme operating in Tampa from January 1988 to November 1990.
She and three other doctors were given kickbacks from a firm called Osmomedic in return for signing prescriptions for expensive medical equipment, records show.
The devices were TENS (Transcutaneous Electrical Nerve Stimulation) units, which use electrical pulses to block pain signals. Medicare was paying Osmomedic $ 484 for each unit, records show, while the units cost Osmomedic only $ 70 apiece.
Bertoncini told the Board of Medicine on Saturday that even though a federal jury found her guilty in August 1990, she actually was duped by the owner of Osmomedic, Oswaldo Mora. Bertoncini is appealing her conviction.
“I really don’t know what was going on,” she said.
Dr. James Burt, a board member, had no patience with that argument. What she did, he said, “hurts our entire profession. It’s a great concern to me when I hear about this kind of sham operation.”
The board accepted a negotiated agreement that calls for a reprimand, a $ 3,000 fine, three years’ probation under indirect supervision, and 150 hours of community service for each year of probation.
Carlos Solorzano
Solorzano, a Tampa eye surgeon, had done a certain type of cataract operation only once, when he attempted it on a 78-year-old woman at Clearwater Community Hospital in June 1989.
His microscope lights burned out during the surgery, records show, but he pressed on.
By the time it was over, the lens capsule had ruptured, and fragments had fallen into the inner core of the eye. The retina detached.
Dr. Jonathan Mines of Clearwater attempted rescue surgery at Morton Plant Hospital, but it was no use. The woman, identified in records by her initials, M.O., lost sight in that eye.
The state Department of Professional Regulation charged that Solorzano should not have attempted an operation for which he was not properly trained. Further, the agency charged, he should have stopped when his microscope malfunctioned.
On Friday, the Board of Medicine accepted a negotiated agreement imposing a $ 5,000 fine, a letter of concern, 45 hours of continuing education courses and 50 hours of community service.