A few weeks before a new lawsuit surfaced against Hudson back surgeon Alfred O. Bonati, the state filed its own complaint alleging malpractice.
A complaint filed March 26 by the state Department of Health prosecution services unit alleges that a series of operations left a 55-year-old man in worse shape than before he went in for neck and back pain in 2004.
The complaint asks the Florida Board of Medicine to enter an order with possible penalties ranging from remedial education to probation to revocation of Bonati's license.
The man, identified only by the initials M.T., had four surgeries over four months.
"Not only did these procedures fail to alleviate M.T.'s pain, his pain worsened," the complaint said. Afterward, he consulted with an orthopedic surgeon in Michigan and had two surgeries to address the problems, the complaint said.
The complaint alleged that in M.T.'s case, Bonati "failed to practice medicine with the level of care, skill and treatment, which, in light of all relevant surrounding circumstances, is recognized as acceptable and appropriate by reasonably prudent similar health care providers" in one or more of the following ways:
• Misdiagnosing M.T.'s pain.
• Failing to accurately interpret diagnostic scans of M.T.'s upper spine.
• Erroneously concluding that M.T. had a bulging disc in a certain spot.
• Failing to have a surgical plan that would resolve the issues and not cause further injury or aggravate pre-existing conditions.
• Failing to consider the possibility of injury in repeatedly re-exploring three previous surgeries.
• Using inadequate surgical technique during a procedure in which no evidence of the surgery showed up on the postoperative MRI the next day.
• Failing to plan an efficient and reasonable means to resolving the patient's pain.
The complaint also alleged that Bonati performed a procedure on the wrong area of the patient, and failed to keep "legible medical records that justify the course of treatment for the patient."
State Health Department spokeswoman Eulinda Smith said probable cause had been established in the complaint, which allowed it to be released. Complaints become public 10 days after probable cause is found.
Bonati's longtime friend and public relations adviser, Bob Brillante, said Bonati could not reveal the patient's name because of confidentiality laws but said the complaint stemmed from a lawsuit filed by a longtime nemesis, West Palm Beach attorney Gary Roberts.
Roberts has represented numerous Bonati patients and in 1996 won a $3.5 million verdict on behalf of a Hernando County woman. But a federal magistrate overturned the award, saying it was excessive and not supported by evidence.
"We welcome any review of this case and of any action of the Bonati Institute," Brillante said. "We're proud of what we're doing. We welcome an audience."
Bonati's spokespeople have said he and his staff have successfully performed 35,000 operations during the course of his practice. His website includes testimonials from patients praising his work.
A review of St. Petersburg Times files show a patient named Michael Thompson sued Bonati in 2007, making similar claims as in the Department of Health complaint.
That suit claimed, "Bonati and the other Defendant physicians and participants, intentionally or negligently exaggerated or misdiagnosed Michael L. Thompson's pathology in order to attempt to justify a course of expensive and aggressive surgical treatment and other new surgical care which was not medically indicated."
It was unclear from court records whether that case had been resolved. An order in 2008 indicated it had been placed in arbitration.
This isn't the first time the state has filed an administrative complaint against Bonati.
In 2001, it filed a 63-count claim of wrongdoing involving a dozen patients in the early 1990s. The case was settled in 2002, with Bonati agreeing to give $50,000 to a program for the medically needy and reimburse the state $116,000 for the cost of prosecution. He was placed on probation for two years and agreed to be monitored by another surgeon, who later signed off on his work.
In 2001, clients who sued reached an agreement to share in an $8 million settlement after Bonati filed for bankruptcy.
And in February, an arbitration panel awarded nearly $12 million to a couple who claimed a series of unnecessary operations at the Bonati Institute left the husband unable to walk.
Times researcher Shirl Kennedy contributed to this report. Lisa Buie can be reached at firstname.lastname@example.org or (813) 909-4604.