A plastic surgeon who had previously been fined $29,000 for sloppy record-keeping and rusty and dirty equipment at his Westport clinic was fined $10,000 on Tuesday by the state Medical Examining Board in connection with a 2009 rhinoplasty procedure.
Dr. Joel B. Singer also had his medical license placed on probation for two years. Under the memorandum of decision approved by the board, Singer must hire a licensed physician to monitor his practice and take courses in medical ethics, informed consent and medical record keeping.
Singer’s lawyer, Mary Alice Moore Leonhardt of Hartford, had strongly objected in writing to the penalty, calling it “harsh,” “draconian” and inconsistent with recent penalties the board had imposed on other doctors.
“The material facts of whether [Singer] can practice with skill and safety are not in issue and have never been an issue,” Leonhardt wrote.
A hearing panel had also recommended that Singer’s license be suspended for 60 days, but after some discussion, the board voted 8-5 to approve the fine, probation and monitoring without any suspension of Singer’s license.
Last August, Singer closed his Center for Ambulatory Surgery, ending a string of disciplinary actions against the clinic. At the time, Singer said he had treated more than 8,000 patients in Connecticut and New York and “countless patients have been very pleased with the outcome of their procedures.”
He said he developed one of the first in-office surgical facilities in the state and was the first plastic surgeon in Connecticut to perform liposuction.
In the latest case, Singer failed to obtain a patient’s consent that another surgeon, Dr. Leo Otake, would participate in the operation on her nose on April 27, 2009, the memorandum states. The woman reported that Singer told her Otake would be “observing” the procedure.
When she obtained her medical file later, she learned that Otake had performed the surgery, the memorandum states. Otake signed an operative report that listed him as the surgeon, the memorandum states. Singer testified that Otake was listed as the surgeon due to a possible computer error, but the memorandum said that claim was “not believable” because Singer had admitted in his Aug. 31, 2012 statement that “Dr. Otake performed aspects of the surgery.”
Leonhardt wrote that Otake admitted he made a mistake when he named himself as the surgeon on the report.
The woman was not happy with the surgery and Singer and Otake operated to fix her nose on July 30, 2010, state records show. On July 7, 2010, Otake had written prescriptions for narcotics for the patient using Singer’s company’s prescription pad even though he did not have a contractual or consultant relationship with Singer, the memorandum states. Otake testified that he had considered buying Singer’s practice but that never happened, the memorandum said.
Singer failed to provide any documentation that Otake had examined the patient before prescribing the drugs or that the patient had ever consented to have Otake treat her, the memorandum said. Such actions fall below the standard of care and constitute negligent conduct, the memorandum said.
In objecting to the decision, Leonhardt wrote that the medical board’s panel lacked the expertise to determine whether Singer violated the standard of care and that the board’s plastic surgery expert’s opinions were “speculative” because he had never worked in an outpatient setting.
Singer, a 1966 graduate of Yale University’s medical school, has faced sanctions from the state dating back nearly 15 years.
In a July 1999 consent order, Singer agreed to one year’s probation for inserting breast implants of different sizes into a patient.
In a May 2007 consent order, the state fined him $5,000 for a case of “incompetence/negligence” involving a patient who failed to heal properly after breast reduction surgery.
In 2011, his Westport clinic was fined for $4,000 and Singer was fined $25,000 for several violations at the clinic, including having unqualified nurses, slipshod record keeping, improper sterilization procedures and unsanitary conditions.
In an unrelated case Tuesday, the board also fined Dr. Michael Bar, who works at the Bennett Cancer Center in Stamford, $1,000 for mistakenly prescribing a blood thinner, instead of a steroid, to a patient he had been treating for a bleeding disorder for several years, DPH records show.
The patient went to a hospital emergency room a few days later for bleeding. The patient’s primary care group complained to DPH, which launched an investigation in December 2013. Following the incident and before the investigation, Bar and his partners instituted more safeguards when prescribing blood thinners, records show.
In agreeing to the consent order with the state, Bar did not contest DPH’s findings.
In another case Tuesday, the medical board approved a consent order that prevents Dr. Barry Lobovits of Pittsfield, Massachusetts from practicing medicine in Connecticut unless he provides the state Department of Public Health with 90 days’ notice.
In 2014, Massachusetts officials had imposed a five-year probation on Lobovits. Officials there determined that in 2002, Lobovits had provided substandard care to 25 patients with chronic illnesses. In 2005, Lobovits continued to prescribe a powerful painkiller to a patient even though the doctor knew the patient had become dependent on the drug and was taking up to five times the recommended dose, Massachusetts records show. Between 2008 and 2010, Lobovits also crossed a professional boundary by giving the same patient $15,000, the records show.
Lobovits does not currently practice medicine in Connecticut.