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Tampa General Hospital doctor accused of keeping bullet from detectives after operating on fugitive

TAMPA — The surgeon wanted a souvenir.

A homicide suspect lay on his operating table, shot twice by a deputy U.S. marshal. Two law enforcement agents waited nearby to collect the bullets as evidence.

But as colleagues looked on, Dr. David J. Ciesla, medical director of the trauma center at Tampa General Hospital, plucked a bullet from the suspect's liver and hid it under his rubber glove, authorities say.

Afterward, he told the Florida Department of Law Enforcement special agents that he was unable to retrieve either of the slugs because of their location in the man's body.

"He's a doctor, so we take that to be the truth," said Bob Ura, the FDLE special agent supervisor in Tampa.

Ciesla, 42, apparently didn't count on one of the other doctors in the operating room — a surgeon he was supposed to be teaching, Ura said — telling supervisors otherwise.

Seven days after the April 21 surgery, with an attorney by his side, Ciesla returned the bullet to FDLE agents, Ura said. But that didn't keep him from getting charged Wednesday with providing false information to law enforcement during an investigation and obstructing or opposing an officer without violence, both misdemeanor offenses.

Ciesla, hired by the University of South Florida on Jan. 1, 2008, also serves as division director of trauma/critical care for the medical school and as a medical consultant to the state's trauma system.

He provides training for Special Operations Command medics preparing for service in Iraq and Afghanistan.

As of Thursday, when the FDLE announced the charges, he had not been removed from those positions. Reached by phone, Ciesla referred questions to USF administrators.

"It's not a resolved situation, so I really don't have much to say about it," the doctor said. "I can't really comment on anything that's going on."

His attorney, John Fitzgibbons, could not be reached.

USF officials said the medical school and hospital have worked closely with law enforcement on the case.

"We are very saddened by this incident," a joint statement read. "It is our understanding that Dr. Ciesla indicated that he had made a mistake and had apologized for his error. Dr. Ciesla is an extremely talented surgeon and in the 18 months he has practiced here has become an invaluable asset to the Tampa Bay community."

University and hospital officials characterized the situation as an isolated incident for a doctor with no obvious blemishes in his history. Ciesla has a clear and active license in Florida, and records indicate no problems with his licenses in Colorado and Washington, D.C., where he previously practiced.

USF spokesman Michael Hoad noted that no final court judgment has been made. The university has started a disciplinary process, which will not be public until concluded, he said.

Complaints against doctors are vetted by the Florida Department of Health, which determines probable cause of wrong-doing. Such complaints are confidential, said department spokeswoman Eulinda Smith, noting that disciplinary actions are imposed by the Board of Medicine if a complaint is found to be legally sufficient.

How unusual — and ethical — is it for a surgeon to take a bullet from a patient as a personal keepsake?

"Never had this kind of question asked to me, to be candid with you," said Bob Harvey, noting he never pondered the legality of such an allegation in his role as executive director of the Florida Committee on Trauma of the American College of Surgeons.

He noted that Ciesla, while fairly new to Tampa, is highly respected as a trauma surgeon.

Tampa General has "one of the largest trauma centers in the state, and you don't get that job by being average," he said. "I don't imagine Tampa General Hospital would have him running their trauma center if he wasn't considered a top-notch trauma surgeon."

Bill Allen, director of the bioethics program at the University of Florida College of Medicine, said physicians have an ethical obligation to be honest and truthful.

"The part of this issue and this case that is serious is lying to law enforcement," he said. "The keeping the bullet is odd in some ways, but not nearly as serious an ethical issue."

It would not be unheard of, he noted, for a trauma surgeon to keep a relic from an especially unusual case, perhaps as a teaching tool. But bullets are standard fare in trauma units, making this situation seem particularly odd.

Ciesla performed surgery April 21 on Thomas Ford McCoy Jr., a 42-year-old man who had been accused earlier that month of killing a Coca-Cola employee who was stocking a vending machine in the Florida Panhandle.

McCoy was shot by a deputy U.S. marshal outside a Tampa hotel. Officials said he pulled a gun on members of the marshals' fugitive task force as they tried to arrest him on an outstanding warrant. The shooting was later determined to be a justified use of deadly force, Ura said.

Two FDLE agents who were investigating the marshal shooting waited outside the operating room for four hours before Ciesla told them he was unable to remove the bullets, Ura said. Using "doctor speak," Ura said, Ciesla told them that one bullet was lodged in McCoy's liver, the other near his spine.

The same day, Dr. Sergio Alvarez, a second-year plastic surgery resident who witnessed the surgery, reported to his supervisor at USF that Ciesla had one of the bullets. Subsequent interviews with other medical personnel supported Alvarez's claim, Ura said.

He did not respond to an interview request by the St. Petersburg Times.

After being confronted by university officials, Ciesla admitted he took the bullet, Ura said.

DNA tests showed that the bullet still had McCoy's tissue on it, Ura said. The other bullet remains in McCoy's body.

Ciesla didn't provide much of an explanation, Ura said, but interviews with witnesses led investigators to believe that Ciesla "intended to keep the bullet as a type of souvenir."

Ura said agents never imagined their shooting investigation would take this turn.

"I think now he realizes the gravity of the situation," Ura said. "I think it's probably fair to say that at the time, he didn't realize the ramifications of his actions. It's a very, very bizarre case."

Times researcher John Martin and staff writer Rebecca Catalanello contributed to this report. Colleen Jenkins can be reached at cjenkins@sptimes.com or (813) 226-3337.

Correction: Dr. Sergio Alvarez is a plastic surgery resident in his second year at the University of South Florida. USF provided incorrect information to the Times on his affiliation late Thursday.

Tampa General Hospital doctor accused of keeping bullet from detectives after operating on fugitive 07/16/09 [Last modified: Thursday, July 23, 2009 4:43pm]
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