Dr. Christopher Betz, who works at Starling Physicians, failed to follow the pre-incision protocol and failed to independently verify which knee was the site of the operation prior a procedure that took place at Bristol Hospital on Sept. 14, 2018, according to state Department of Public Health (DPH) documents.

The error wasn’t reported by DPH’s Facility Licensing and Investigations Section (FLIS) to its Practitioner Licensing and Investigations Unit, which investigates complaints against physicians, for the board until July 19, 2019 after Bristol Hospital was the subject of an unannounced inspection by federal health authorities, documents said. Bristol Health reported the medical error as an adverse event on Sept. 21, 2018 to FLIS.

According to a corrective plan based on the federal inspection, Betz also failed to document that he had operated on the wrong knee and failed to note that after he did discover the error, he gave the patient a cortisone shot in the knee that was originally slated for surgery.

Betz has since taken a course in preventing medical errors and near misses in surgery, DPH officials said. Under the discipline approved by the board Tuesday, Betz was fined $5,000 and his license to practice medicine was reprimanded.

In other action, the board temporarily suspended the medical license of Derek Donovan, a physician assistant, after a DPH investigation revealed he had used alcohol and marijuana excessively in the past few years, documents said.

Donovan is also accused of falsifying medical records and intentionally making false written statements provided to DPH staff from June to December 2021, documents said. Donovan also has had an emotional disorder or mental illness since April 2021, DPH officials said.

If the board had not granted the summary suspension, Donovan would have been allowed to continue to practice until a formal consent order with discipline was granted. A panel of three board members will hold a hearing on the allegations on Feb. 25. Following the hearing, the DPH will work with Donovan to determine a resolution that will likely include discipline, officials said.

This story was updated from a previous version to add context on reporting by Bristol Health to DPH.

Another physician was also disciplined by the board for failing to act on test results.

Dr. Syed Hadi and Dr. Waile Ramadan both treated a man who was brought to the Bristol Hospital Emergency Department on Jan. 7, 2019 with a high fever and other symptoms of a bacterial infection but never prescribed antibiotics, according to state Department of Public Health (DPH) investigators.

The man died of sepsis two days later, documents said. The case was the subject of a malpractice lawsuit filed against the physicians, Starling Physicians and Bristol Hospital which was settled in 2021.  DPH opened an investigation of the case after an inspection found violations at the hospital in 2019, documents said.

The physicians failed to meet the standard of care by not reviewing test results including a positive culture for bacteria, not communicating with other hospital staff and not properly diagnosing the patient, a consent order said.

Hadi and Ramadan both received a $5,000 fine from the board. Both physicians have completed coursework in infection control including the diagnosis and treatment of sepsis, communication with other health care providers and documentation standards, documents said.

The board also issued a fine and a permanent restriction on the prescription registration of Dr. Alfred Ranieri, of Medical Associates of New Haven, who prescribed controlled substances several times to two patients without properly determining or documenting the need, documents said.

Ranieri voluntarily gave up his controlled substance registration in July 2020, documents said. The DPH opened an investigation into the allegations in November 2019 after receiving a complaint from the state Department of Consumer Protection Drug Control Division, investigators said.

Under the terms of the discipline approved by the board, Ranieri must pay a $5,000 fine, his drug registration is permanently restricted from prescribing nearly all controlled substances and his Connecticut medical license is reprimanded.

The board also reprimanded the license of a Hartford Healthcare primary care physician who failed to treat a patient’s back pain and irregular urine analysis in 2018, DPH documents said.

Dr. Othman El-Alami treated the patient over the course of two decades but failed to maintain adequate records, failed to act on radiographic and urinalysis test results and failed to adequately treat the patient’s back pain, a DPH investigation found.

El-Alami’s medical license was reprimanded and placed on probation for six months while he completed coursework in proper clinical documentation as part of the discipline issued by the board.