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Iowa Supreme Court Ruling Limits Public Knowledge of Charges Against Docs

— Medical board violated state law in publishing allegations against heart surgeon, court rules

MedpageToday
The State Supreme Court building in Des Moines, IA

The Iowa Board of Medicine will no longer be permitted to publicize information about any allegations made against a doctor upon filing formal disciplinary charges, the Iowa Supreme Court unanimously ruled.

The justices stated that the members of the board violated a -- which details how licensing boards should handle investigations -- in 2013 when they published details about made against Domenico Calcaterra, MD, a heart surgeon formerly at the University of Iowa.

A summary of the allegations that was published on the Iowa Board of Medicine's website showed that Calcaterra had been accused of engaging in disruptive and unprofessional behavior during his training and practice; among the charges made against him was an accusation that he shoved another physician during a 2010 surgery.

A year later, the board and Calcaterra reached a settlement, with Calcaterra agreeing to pay a $5,000 civil penalty.

"The Board posted the settlement to its website. It also issued another press release that not only disclosed the settlement but also reiterated the factual allegations against Dr. Calcaterra, although those allegations had not been admitted to or even recited in the settlement," Justice Edward Mansfield wrote in the .

In the years that followed, Calcaterra argued that the publications of the allegations made against him were having a detrimental impact on his medical career, and asked the board to remove them from its website. When they refused to officially respond, Calcaterra filed a petition in 2018 for judicial review. The Polk County District Court ultimately forced the board to issue a declaratory order in response to Calcaterra's request. The answer was no, the opinion stated, as the board had "long provided that statements of charges are public records."

After Calcaterra amended his petition, however, the court found that the law clearly prohibited any disclosure of investigative information unless those details were first disclosed in the findings of the statement of fact section of a final written decision in a disciplinary proceeding.

"We do not believe that the statute is ambiguous," Mansfield wrote in the opinion. "Investigative information cannot be released to the public prior to a final decision in a disciplinary proceeding."

Calcaterra no longer has a license to practice medicine in Iowa; his profile shows that he has recently practiced cardiothoracic surgery in Minnesota and Florida.

Kent Nebel, JD, executive director of the Iowa Board of Medicine, called the situation "disturbing," the Des Moines Register .

"When the board finds that there's a dangerous physician out there and wants to make the public aware of those dangers, they're limited on what they can put into those public documents," Nebel said at a recent meeting.

Since the decision, any public disciplinary actions filed against a doctor have not included details about the accusations. For example, according to the report, Nebel said that a charge might say that a doctor is accused of issuing improper prescriptions, but will not include specific information about the medications prescribed or how many patients were involved. The board may release these details after the charge has been settled or when a formal decision has been made, a process that often takes years.

Iowa's assistant attorney general, Anagha Dixit, JD, who works with the board, said that the ruling also applies to state licensing boards that oversee other healthcare professionals, such as nurses, pharmacists, dentists, and chiropractors.

Nebel hopes to seek clarification from legislators about whether regulators can offer the public certain details of allegations made when disciplinary charges are filed against a doctor or other licensee.

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    Kara Grant joined the Enterprise & Investigative Reporting team at ֱ in February 2021. She covers psychiatry, mental health, and medical education.