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Board and surgeon are close to truce

The Florida Board of Medicine's protracted battle with Hudson physician Alfred Bonati may be at an end.

A 16-hour conference produced a settlement that, if approved, will resolve the state's 62-count complaint against Bonati _ the most recent of five complaints brought against the orthopedic surgeon by the medical board.

Under the proposed agreement, the state will drop its claim that Bonati improperly tested, treated or billed 14 patients from 1991 to 1994. In return, Bonati must:

+ Submit to a review of his cases by a spine surgery professor from Pennsylvania for up to two years.

+ Have his bills audited by an expert in the medical procedure codes used to get payment for treatments.

+ Donate $50,000 to a private, nonprofit organization that helps those who are medically underserved in Florida.

+ Reimburse the Board of Medicine up to $116,000 for the cost of prosecuting its case.

+ Drop his federal suit, which accused the agency of trying to drive Bonati out of business with repeated, unjustified prosecutions.

The proposed settlement also notes that, should Bonati violate any of the provisions, the state can yank his license, according to Department of Health spokesman Bill Parizek.

The Board of Medicine will vote on the settlement at its Dec. 7 meeting in Tampa.

Since the board asked for mediation, Bonati's attorney Cynthia Tunnicliff said she doesn't know of any reason the agency would reject the settlement.

But Bonati's history with the board is rocky. In June 2000, the state had negotiated a resolution to a similar complaint against Bonati, but the medical board's chairman called it a "lousy settlement." The board voted it down and continued its disciplinary actions against Bonati.

Bonati uses lasers and his own patented tools to perform a less invasive method of back surgery than used by most doctors. His arthroscopic spine surgery has won praise from many of the thousands of patients who visit his glass-walled Bonati Institute in Hudson.

But it has also brought him continued confrontations with the Board of Medicine over his unusual techniques and a string of malpractice lawsuits. In those lawsuits, patients accused him of misdiagnosing their pain and performing serial back surgeries that weakened their spines and created the risk of future problems. Because of those lawsuits, Bonati and his corporations filed bankruptcy. The suits were resolved as part of a bankruptcy settlement last year.

If the Board of Medicine adopts the proposed resolution of its most recent complaint, Bonati's practice will be reviewed by Dr. Alexander Vaccaro, professor of orthopedic surgery and co-chief of the Spine Division at the Rothman Institute, which is affiliated with Thomas Jefferson University Hospital in Philadelphia. Vaccaro helped mediate the settlement.

The agreement says Vaccaro will meet with Bonati monthly for three months to review some of Bonati's cases, both before and after surgery, to ensure that "the appropriate course of treatment is followed." Vaccaro can elect to continue his reviews and follow the cases for up to two years, the settlement says.

Tunnicliff said Vaccaro already had "scrubbed with" Bonati and observed his surgical techniques.

"I just think Dr. Bonati is doing very, very, innovative good medicine and I think Dr. Vaccaro will tell you that," she said.

Bonati "has some very happy patients that he has helped tremendously."

Neither Bonati nor Vaccaro immediately returned telephone messages from the Times.

_ Times researcher Caryn Baird contributed to this report.