TAMPA — What was he thinking?
That was the big question last month after authorities accused Dr. David J. Ciesla of removing a bullet from the body of a murder suspect to keep as a souvenir.
On Monday, the chief of Tampa General Hospital's trauma center resolved his court case but didn't clear up the mystery.
He pleaded no contest to misdemeanor charges, agreeing to serve two years of probation and perform 100 hours of community service as part of a plea deal.
His attorney said Ciesla, 42, was sorry, but they both refused to take questions from reporters.
Investigative documents released Monday helped fill the void.
The most revealing account of what occurred in the operating room on April 21 came from Dr. Sergio Alvarez, then a first-year resident in the plastic surgery department at the University of South Florida.
Alvarez assisted Ciesla during the surgery. They were looking for a bullet that appeared to be lodged in the abdomen of a fugitive who had been shot twice by a deputy U.S. marshal trying to take him into custody.
"There it is," Ciesla said during the operation.
Alvarez saw the bullet on top of the man's liver.
"There's the bullet," Alvarez agreed.
Ciesla immediately said, "No it's not."
"Yes it is," Alvarez said.
Ciesla looked up from the patient and toward Alvarez.
"You didn't see a bullet," Ciesla said, according to the records.
Alvarez told investigators he did not say anything else about the bullet during the procedure, hesitant to further challenge the attending physician.
About an hour into the surgery, Ciesla was relieved by another doctor so he could attend a conference call. As the other doctor turned from the operating table to wash up, Alvarez said he heard Ciesla say, "I almost forgot."
Ciesla reached in the fugitive's body and removed the bullet.
"This is what we do with bullets," Ciesla said, according to Alvarez, before placing the bullet inside the rubber glove on his right hand.
Alvarez watched as Ciesla went to speak with two Florida Department of Law Enforcement agents, who were waiting 5 to 7 feet away inside the operating room to take the bullets into evidence. Ciesla told them the bullets were still stuck in the suspect's body.
But he put the slug in his pocket before leaving the room, Alvarez said.
Alvarez reported the incident to his supervisors.
"I felt uncomfortable from the moment it occurred," he told investigators.
Ciesla returned the bullet on April 28 after being confronted by university officials. He apologized to an FDLE agent for being "indirect" with him and said he didn't mean to interfere with the investigation.
The Hillsborough State Attorney's Office charged Ciesla in July with providing false information to law enforcement during an investigation and obstructing or opposing an officer without violence.
On Monday, County Judge Cheryl Thomas withheld adjudication, meaning Ciesla won't have a conviction on his record. He will be eligible for an early termination of his probation after one year if all the requirements have been met.
Attorney John Fitzgibbons spoke with reporters afterward, his client standing silently by.
"He is sorry for any problems that were caused by his conduct,'' Fitzgibbons said. "Now it's time to move on."
He said it hasn't been decided what kind of community service the doctor will perform.
Fitzgibbons said Ciesla appreciated the support he has received from the medical community. Court records show that Ronald Hytoff, president and CEO of Tampa General, praised Ciesla as "an invaluable asset" in a letter to prosecutors.
Ciesla still could be disciplined by the state or his employer.
As of Monday, his medical license was clear and active, according to the Florida Department of Health.
USF health spokeswoman Anne DeLotto Baier said the doctor remains a full-time employee at the university. He also serves as division director of trauma/critical care for the medical school.
"We are still undergoing our internal review," she said. "Until that's done, we will have no further comment."
Colleen Jenkins can be reached at firstname.lastname@example.org or (813) 226-3337.