Board of Medicine To Review Case of Lakeland Doctor

LAKELAND | An 82-year-old man was in Lakeland Regional Medical Center's emergency department after pulling out his feeding tube.

A doctor replaced the tube, but an X-ray performed the same day indicated the feeding tube didn't appear to be in the stomach. A radiologist's interpretation also expressed doubt about the placement.

A CT scan showed the tube was inside the cavity between the layers of a membrane lining the abdomen, according to a Department of Health complaint.

The next day, April 12, 2006, a note in the patient's chart said the tube wasn't positioned right. A follow-up report also indicated it was unlikely the feeding tube was in the right place, the state said.

Dr. Eliezer Moshe Izsak, a board-certified Lakeland gastroenterologist, was called in for consultation that afternoon. He examined the patient and did a clinical test.

Results of that test seemed to indicate the feeding tube was appropriately placed, the state said.

Determining it was, Izsak told the staff to start feeding the man through the tube. About 9:30 p.m., Izsak was notified that the patient was having severe abdominal pain after the tube was restarted.

He told the nurse to stop tube feeding and to send the patient for an internal scan. That scan said the tube wasn't within the stomach.

The patient, identified by the initials W.C., died April 13, 2006.

On Friday, Izsak is scheduled to appear before the Florida Board of Medicine to see whether its members accept a proposed settlement worked out between him and the Department of Health. The settlement proposes discipline without Izsak's admitting or denying allegations against him in a complaint the state issued Dec. 7, 2007.

The complaint accuses Izsak of failing to adequately access or follow up previous work-ups of the patient and notes indicating the tube was in the wrong place. It said he didn't meet the required standard of care by not doing a more conclusive diagnostic exam.

Izsak, who retired this summer, couldn't be reached for comment. There's no state record of previous discipline against him.

If the board approves the settlement, which it isn't required to do, Izsak would pay a $10,000 fine, do 50 hours of community service and attend five hours of medical education in identifying this type of complication. The board would put a letter of concern in his file. He would be required to pay the state's investigative costs.

[ Robin Williams Adams can be reached at robin.adams@theledger.com or 863-802-7558. Read her blog at robinsrx.theledger.com. ]