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Medical Board Penalizes Doctor

Posted on: Thursday, 18 August 2005, 21:00 CDT

Aug. 18--A Fresno anesthesiologist has been disciplined by the California Medical Board in connection with a patient's death four years ago.

Dr. Jacob Samuel had his medical license revoked and then immediately reinstated after he agreed to disciplinary action by an administrative law judge last month. The discipline includes a three-year probation that places restrictions on his ability to practice medicine.

Samuel could not be reached to comment. James M. Nelson, his Walnut Creek-based attorney, did not return telephone calls.

The discipline comes more than a year after the medical board filed a formal accusation of wrongdoing against Samuel related to the death of a 38-year-old woman. The accusation was filed by the California Attorney General's Office, which acts as the prosecuting arm of the medical board. He was accused of incompetence and gross negligence.

According to the seven-page accusation, Samuel was the anesthesiologist assisting in the woman's gastric bypass surgery -- a popular weight-reduction procedure -- on Sept. 28, 2001. The patient is identified only by the initials B.D.

Samuel is blamed for several fatal errors. The woman suffered cardiac arrest and "severe anoxic brain insult," according to documents. Anoxic brain injury occurs when there is a complete lack of oxygen.

"Following the induction of general anesthesia and endotracheal intubation, the respondent [Samuel] noted immediate difficulty in ventilating B.D.," documents state. The patient's oxygen saturation level fell to a dangerously low level.

Samuel attempted to correct the problem and administered medication, but the patient's difficulties persisted.

The accusation questions why Samuel "did not inform the surgeon of the patient's respiratory system compromise and did not attempt to cancel the surgery."

The patient's oxygen levels failed to improve during surgery. Samuel later installed a valve to correct the problem, but it was done incorrectly. Her condition worsened even after another anesthesiologist tried to assist. She had to be resuscitated.

She died Oct. 2, 2001.

The accusation states Samuel should have spent more time trying to isolate the cause of the patient's deterioration and that he should have requested assistance earlier. "[Samuel] demonstrated a lack of knowledge in his understanding of the severity of his patient's condition and how to proceed in more carefully clarifying the nature of her problems."

The accusation also states Samuel should have recommended the patient's surgery be canceled.

Samuel waived his right to a hearing before an administrative law judge by admitting to the allegations and agreeing to the discipline.

Candis Cohen, spokeswoman for the medical board, said it is not unusual for accusations to be settled without a hearing.

"About 75 percent of cases are resolved by a formal stipulation or where the physician agrees to some type of discipline," she said.

In order to retain his license, Samuel is required to enroll in a training program for physicians that will assess and evaluate his specialty skills. At the end of the program, he will have to pass an examination. He also must be monitored by another practicing physician in the same specialty until he has been involved in the treatment "of 10 morbidly obese patients."

Samuel must inform the chief executive officer at every hospital or organization where he works or has privileges of the accusation and the judge's decision. He also is prohibited from supervising physician assistants.

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Copyright (c) 2005, The Fresno Bee, Calif.

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Source: The Fresno Bee

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