State board opts not to discipline Greenwich anesthesiologist

The state Medical Examining Board on Tuesday imposed no disciplinary action against a Greenwich Hospital anesthesiologist who in 2010 administered a nerve block on the wrong arm of a patient who was about to undergo a wrist arthroscopy.

Though a board hearing panel had concluded that the state had proven misconduct on the part of Dr. Paul Sygall, the board voted to change the word “misconduct” to “error” and imposed no disciplinary action.

State records show the hearing panel considered Sygall’s “stellar professional record,” in which he had performed 10,000 procedures, and his credible testimony at a hearing and concluded that he posed “no threat to public health and safety.”

DPH records showed the error occurred because a nurse had changed equipment to the opposite side of the patient while Sygall was out of the room. Sygall administered the nerve block on the wrong side, noticed the error right away, stopped the procedure and kept the patient overnight for observation, DPH records show.

In recent years, the board has fined or reprimanded other physicians for similar errors. For example, in June 2011, the board approved a consent order fining Dr. David Heimbinder of Glastonbury $5,000 for administering a nerve block in the wrong shoulder of a patient in 2009.

While the public may view that as inconsistent, chairwoman Anne C. Doremus said, the board has to weigh the evidence in each case separately. In some cases, physicians such as Heimbinder have agreed to a fine through a consent order that is negotiated with DPH while Sygall chose the hearing route, she said.

“In my 12 years on the board, we have generally considered critically what the hearing panels have concluded,’’ she said. “I think the process is fair.”

In other business, the board imposed a six-month probation on Dr. David Wilterdink, who has a family medicine practice in Danielson, for giving a patient early refills for Ativan and Fioricet without an adequate review of the patient’s medical record or without adequate record-keeping.

Ativan is prescribed for anxiety and Fioricet is used to treat tension headaches. Wilterdink’s patient, who also was his employee, was being treated for chronic headaches, the consent order accepted by the board states.

Under the order, Wilterdink agreed to take course work in prescribing practices and documentation, and to have a consultant monitor his practice during the probation.

The board also declined to revisit a 1997 ruling governing the use of lasers for hair removal. James J. Schultz, a New Britain lawyer representing Iyad “Ed” Shaham, owner of Laser55 in West Hartford, had asked for a new ruling because, he said, technology has evolved in the past 16 years to allow the use of low-level, diffuse laser treatment for fat reduction.

Laser55 uses that treatment, which Schultz wrote is “less extreme and risky” to patients than other procedures. The “cold laser” warms fat cells by 3 to 5 degrees, “tricking” them into acting as if they had been warmed through exercise such as jogging, Schultz said.

Dr. Henry Jacobs, a medical board member, said there have been no studies that conclude that using lasers to reduce fat works, but he added that it wasn’t the medical board’s job to step in at Shaham’s request.

“This is a scientific device that no one has concluded does much of anything,’’ he said. “I don’t think this is medicine.”

This story was reported under a partnership with the Connecticut Health I-Team (www.c-hit.org).

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