A Florida doctor without his hearing aid couldn’t hear his colonoscopy patient scream
A pair of colonoscopies that included a screaming patient and a surgical tech without a medical license handling scope insertion put a Tampa doctor on probation last week by the state’s Board of Medicine.
Dr. Ishwari Prasad also was fined $7,500, must pay $6,301 in Florida Department of Health case costs and has to take a five-hour continuing medical education course in laws, rules and ethics before Aug. 7, 2025. But the probation provides the meat of Prasad’s punishment.
Prasad, who has been licensed in Florida since October 1990, can’t perform any gastroenterology procedures solo until he’s either:
▪ Evaluated by the University of Florida’s Florida Comprehensive Assessment and Remedial Education Services Program (Florida CARES); UC San Diego PACE program; or Center for Personalized Education for Professionals as far as his competency. Or...
▪ Does at least 10 gastroenterology procedures “under the supervision of a physician ... actively engaged in the performance of gastroenterology procedures, board-certified by the American Board of Internal Medicine...” among other qualities. Five of the procedures must be colonoscopies, and the 10 procedures must be spread over at least five days. The supervisor will make a recommendation to the probation committee on whether Prasad can go back to working alone.
Dr. John Delgado has been approved as the supervisor.
Prasad has never been disciplined by the Board of Medicine previously, but state records show some insurance payouts to patients of $250,000 in 2017 to the estate of a patient, who alleged a mistake caused a year-long delay in diagnosing colon cancer; $115,000 in 2008 to a patient who suffered “a spontaneous perforation of a diverticula in the third portion of the duodenum” and died after a long hospital stay; and $250,000 in 2004 to a patient who “sustained a colon perforation following the colonoscopy.”
Prasad’s current problems started on June 5, 2023, at the Ambulatory Surgery Center, 4500 E. Fletcher Ave. in the Tampa area.
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The doctor won’t hear you now
According to the Florida Department of Health administrative complaint, Prasad uses hearing aids, but wasn’t wearing them during the two colonoscopies he was in charge of that day.
“During one or both procedures, the surgical team was unable to effectively communicate” with Prasad, the complaint said.
During the first colonoscopy, the complaint said, Prasad “improperly delegated” to a surgical tech, someone without a medical license, at least one of the following tasks: scope insertion, scope manipulation, manipulating the snare over polyps or tissue or removing polyps or tissue.
During the second colonoscopy, the complaint said, Prasad “began inserting the scope before the patient was fully sedated. The patient began yelling.
Prasad “did not immediately stop the procedure when it became apparent that the patient was not fully sedated. [Prasad] failed to realize that the patient was not fully sedated due to [Prasad’s] failure to wear” his hearing aids.
Last September’s emergency restriction order (ERO) that banned Prasad from surgeries and procedures until this matter was settled contained more detail about the second colonoscopy.
“(The patient) 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 (the patient) continued to scream.”
A problem with the patient’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 (the patient’s) rectum while (the patient) 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 (the patient) and shouted ‘I know!’ to the administrator, yet continued to manipulate the scope.”
This story was originally published August 14, 2024 at 3:04 PM.
