The Sarasota physicians are disciplined by peers. 

The Florida Board of Medicine disciplined two Sarasota doctors at its December meeting.

Dr. Eric F. Gestrich was fined $5,000 and received a letter of concern in connection with the case of a patient who died after surgery at Manatee Memorial Hospital in 2001.

The 51-year-old woman had been been in his care since 1992, according to the administrative complaint filed by Florida Department of Health attorneys that outlines the case.

Gestrich, then in private practice, began treating her in September 1996 for clotting and inflammation of the deep veins of her left leg.

He prescribed Coumadin, a blood thinner that reduces the formation of clots, but discontinued it three months later.

He treated her for the same problem in 1999 and 2001 but did not prescribe anticoagulants.

In December 2001, the patient went to Manatee Memorial's emergency room with abdominal pain and nausea. Doctors diagnosed her with clotting in the veins that drain blood from the intestines.

When her condition deteriorated, doctors performed surgery but she did not recover. The cause of death was intestinal tissue death due to clotting for unknown reasons, the documents said.

Health Department attorneys said Gestrich violated Florida quality of care standards by not ordering prescription anticoagulant therapy and by failing to order tests or a consultation with a hematologist after the 1999 episode.

In a recording of the Dec. 1 board hearing, released last week, Gestrich said he was "overly cautious" in prescribing Coumadin, an anticoagulant, because of an experience with another patient.

At the hearing, Gestrich accepted a proposed settlement agreement that called for the fine and a letter of concern.

It also requires him to pay up to $2,185 of the Health Department's legal costs, perform 50 hours of community service and take a continuing education course on blood coagulation.

The letter of concern is a mid-level action, less severe than a letter of reprimand. All of the measures are common in discipline cases.

Board members had little comment in the six-minute hearing. They altered the subject matter of the continuing education course.

Health Department records show Gestrich has three malpractice settlements of $100,000 or more in 1997, 1999 and 2001. The records do not indicate whether any were related to the discipline case.

Gestrich did not return a call seeking comment.

Sarasota Memorial Hospital, which now employs Gestrich to cover cases throughout the hospital, said it was aware of the lawsuits and discipline case.

Two committees of doctors reviewed his record before the hiring, and one conducted a personal interview because of his record. Both were satisfied that Gestrich would provide quality care, a hospital spokeswoman said.

At the same hearing, the board also fined cardiologist Dr. John J. Altieri and placed him on probation for actions against his medical license in another state.

Altieri had moved from Florida to New York to better deal with a chemical dependency problem, his attorney Jon M. Pellett told the board.

In September 2005, Altieri reported a one-time chemical dependency relapse to the New York State Medical Board, which in turn censured him and placed him on probation.

Under Florida law, actions against a doctor's medical license in another state are grounds for discipline here.

But in his 20-minute hearing, most board members were sympathetic.

Dr. Robert Cline, a Fort Lauderdale surgeon, said Altieri was stuck in a "double-jeopardy" situation.

"He's doing all the right things," Cline said.

Dr. Laurie Davies, an anesthesiologist and University of Florida professor, questioned whether Altieri was trying to avoid more stringent restrictions in New York.

Altieri had always planned to return to Florida and was not trying to avoid New York's ruling, Pellett said.

In a later interview, Pellett said New York's restrictions did not change after Altieri reported the relapse, so he had no reason to leave that state.

Pellett said the board recognized Altieri's honesty in reporting the relapse.

"If he had not been honest, it was doubtful New York would have learned of it," he said. "Everything that has happened was because he was up-front and honest."

Altieri already was under supervision by Florida's program for impaired health professionals. The board placed him on probation while he remained in the program but allowed him to petition for an early end to the probation.

It reduced Altieri's fine from the proposed $2,500 to $1,000 and ordered him to pay the state's legal costs, up to $1,250.

It also required indirect monitoring, meaning Altieri meets monthly with a doctor who reports to the board. He also must report quarterly to the board's probation committee.

State records show Altieri has no malpractice settlements or other disciplinary actions.

No Southwest Florida doctors appeared before the board in January or December.

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