A Palm Beach County doctor has lost his medical license earlier this month after his third Florida discipline issue, this one involving a new mother who bled to death after a difficult delivery in 2017.
Dr. Berto Lopez, administrative hearing judge Robert Cohen said, erred in several ways, most prominently going home while the new mother remained in critical condition at West Palm Beach’s Good Samaritan Hospital.
“...[Lopez] leaving the hospital at a time when he believe everything to be under control and the time had come for him to go home, clean up and go to sleep for the night was where his failure to complete his care for his patient, led, ultimately, to her untimely death,” Cohen wrote. “Had he returned to the hospital after cleaning up, he might have saved his patient. Perhaps, his patient still would not have survived, but we will never know that because [Lopez] left her to go home.”
Lopez, 62, said he needed to change his scrubs. The woman was the second new mother to die after heavy bleeding under Lopez’s care.
Still, Cohen recommended only license suspension and a ban on doing surgery or delivering babies, two things Lopez already had said he would no longer do.
The Board of Medicine rejected that recommendation and revoked the license Lopez has held since 1987. Online records say the Board has dealt with Lopez before.
Fines and not-so-fine care
▪ 2004: Lopez paid a $10,000 fine, $3,310 in administrative costs, did 200 hours of community service and 15 hours of continuing medical education (CME) in medical record keeping.
As described in the Florida Department of Health administrative complaint, two ultrasounds found no heartbeat in a woman’s 15-week fetus. On Oct. 31, 2002, Lopez did a uterine dilatation and curettage (commonly called a D&C), described as “a surgical abortion done during the first 12 weeks of pregnancy to remove the contents of the uterus.”
On Dec. 1, the patient “passed bloody tissue.” Lopez “described the bloody tissue the next day as a female fetus with normal head, neck, abdomen, legs and back.”
The complaint says Lopez fell short of the minimum standard of care by not completely evacuating the uterus; not following up with a pathology report that “showed no fetal tissue identified”; and not recommending another D&C.
▪ 2014: Lopez paid a $22,500 fine; $6,254 in administrative costs; could no longer do surgery except under the supervision of a board certified OB/GYN doctor; had to do 10 hours of CME in treating cesarean section complications; five hours of CME in risk management; five hours of CME in emergency obstetrics; and another five hours of CME in risk management or sit through eight hours of Board of Medicine disciplinary hearings.
This administrative complaint accused Lopez of 12 errors of care in a woman at the 36-week point of her pregnancy and six errors of care in a woman on whom he performed a cesarean section, both at Wellington Regional Center and involving postpartum hemorrhaging.
Though the complaint didn’t say so, the account of the administrative hearing on the most current case says one of these women died under similar circumstances.
“When asked about the 2014 case, Dr. Lopez was evasive and defensive,” Cohen wrote. “He claimed he did not recall why his license was restricted. Then, when asked several times whether the 2014 case resulted in a patient’s death, he refused to answer directly until prompted by the administrative law judge.”
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Fourth big mistake, second death
The administrative complaint on the case that lost Lopez his license says he delivered a baby from mother “O.C.” by scheduled inducement at 8:03 a.m. on July 17, 2017, at Good Samaritan. While trying to repair a laceration, Lopez’s records say he couldn’t see O.C.’s cervix clearly because of the bleeding and, the administrative hearing testimony says, a lighting problem.
Still, Lopez didn’t take O.C. from the delivery room to an operating room, where testimony from both Lopez and the state’s experts said different positioning and lighting would’ve alleviated these problems. Lopez said he needed to wait for an operating room to be ready, but the assisting nurse testified there’s always an operating room at the ready on the Labor and Delivery floor for just such an emergency.
At 9:40 p.m., O.C. was taken to the operating room in an “unresponsive state” and Lopez performed a supracervical hysterectomy, which removes only the uterus, rather than a total abdominal hysterectomy, which removes the uterus and cervix.
The latter, the administrative complaint said, was “the more appropriate procedure considering Patient O.C.’s cervical lacerations. Following the surgery, blood was observed flowing from the incision in Patient O.C.’s abdomen. [Lopez] declined to re-open Patient O.C. and instead ordered the application of pressure dressings to treat the bleeding.”
Lopez left Good Samaritan at 11:39 p.m. He testified that a leg of his scrubs, as well as a sock and a shoe were contaminated with blood and there were no clean scrubs available at Good Samaritan. Even Lopez’s own expert medical witness said he wouldn’t have left the patient or gotten into his own car with blood-covered scrubs.
Each side’s expert medical witness said he’s never known of having to go home to get clean scrubs. Lopez left O.C. with a nurse, an anesthesiologist and an ICU doctor available only via telemedicine. Neither doctor was a trained surgeon with knowledge of O.C.
O.C. died at 3 a.m.
“When asked whether he felt at all responsible for O.C.’s death, Dr. Lopez placed the blame on the ICU staff and the hospital system,” Cohen wrote.
Palm Beach County court records say O.C.’s husband filed a lawsuit against Lopez and reached a settlement in July 2019. A March filing says Lopez has fallen behind on the payments.