By The New York Times

A Tampa surgeon who has been widely vilified and ridiculed for mistakenly amputating the wrong leg of a patient on Feb. 20 sought this week to regain both his license to practice medicine and a measure of his once-solid reputation.

In a three-day hearing before the state official who will make recommendations on his professional future, the surgeon, Dr. Rolando R. Sanchez, and his lawyer, Michael Blazicek, publicly presented their side of the story for the first time.

They said that a series of errors by other hospital personnel and the severely diseased condition of both legs led Dr. Sanchez to believe that he was operating on the correct leg.

The blackboard to which surgeons refer in the operating room at University Community Hospital in Tampa listed the wrong leg for amputation, as did the operating room schedule and the hospital computer system, testimony revealed. By the time Dr. Sanchez entered the operating room, the wrong leg had been sterilized and draped for surgery.

Some doctors who appeared as witnesses said that the leg Dr. Sanchez removed was in such poor shape that it would probably have been amputated in the future.

"It is my opinion that 50 — no, probably 90 percent — of the surgeons in this state would have made the same mistake that Dr. Sanchez made," said Dr. Joseph Diaco, an expert witness for the defense who is a surgeon and teacher at the University of South Florida. Even a witness for the state suggested it was a mistake anyone could have made.

But Steven A. Rothenburg, the lawyer pressing the case against Dr. Sanchez for the Florida Agency for Health Care Administration, said that the surgeon should have checked other paperwork, including the patient's consent form and medical history, both of which were available in the operating room.

"Isn't it true," he asked Dr. Diaco, "that Dr. Sanchez had the last clear chance before he picked up that knife and cut into that tissue" to make certain the correct leg was being removed?

Dr. Diaco said it was true.

Dr. Sanchez testified that he learned of his error from a nurse as he was still cutting through the leg of the patient, Willie King, 52. After reviewing the patient's file, she had started to shake and cry. But by that point, he said, there was no turning back. "I tried to recover from the sinking feeling I had," he testified, as his eyes grew moist and his voice trailed off.

In July, the state's health agency suspended the medical license of Dr. Sanchez, who will be 51 this month, claiming he presented an "immediate and serious danger to the health, safety and welfare of the public."

That order was issued after another patient of Dr. Sanchez, whom he had treated at another Tampa hospital, Town and Country, said that she had not given him permission to amputate a toe during a procedure to remove diseased tissue from her right foot.

Until this year, the state had received no complaints about Dr. Sanchez.

Mr. Blazicek said that Dr. Sanchez accepted that he should be disciplined for amputating the wrong leg but insists that he had done nothing wrong in the second case. Dr. Sanchez testified that he had not intended to remove the toe of the patient, Mildred Shuler, but that the diseased bone "popped" while he was removing deadened tissue, leaving the toe hanging by a tendon.

Had he done nothing, he said, a bare bone would have been sticking out, making the patient susceptible to further serious infection. Other medical witnesses for the defense supported Dr. Sanchez's assertions.

Another surgeon later amputated Ms. Shuler's right lower leg, which was the treatment Dr. Sanchez had initially recommended. The patient had refused the treatment.

Throughout the hearing, family, friends, colleagues and patients of the doctor wore buttons proclaiming, "I support Dr. Sanchez," and they said he had been unfairly depicted as a sloppy surgeon.

"I would say it's safe to say 99.9 percent of our members support Dr. Sanchez," said Dr. Fred Reddy, a surgeon who is the immediate past president of the Hillsborough County Medical Association, which includes Tampa doctors. "He's an excellent surgeon who made one mistake."

Dr. Reddy said the state had been slow to go after doctors who had as many as 50 malpractice suits against them. He said that intense press attention was responsible for the state's swift and unduly harsh actions against Dr. Sanchez.

Dr. Sanchez, a native of Tampa, received his medical degree from the New York University School of Medicine in 1975. From 1975 to 1981, he worked as an intern, chief surgical resident, and a fellow in vascular surgery at the New York University Hospital, Bellevue, according to his resume. From 1982 to 1987, he was an assistant professor of surgery and emergency medicine at the Albert Einstein College of Medicine in the Bronx as well as the coordinator of hyperbaric medicine at the Bronx Municipal Hospital Center. He returned to Tampa in 1988 to establish a private practice.

There was no organized support at the hearing for disciplining the doctor. The hearing officer will make a recommendation in the case to the Florida Board of Medicine, a panel of 12 doctors and three non-medical members appointed by the Governor. Dr. Sanchez could face a fine as well as the permanent revocation of his license.

Mr. King, whose diseased leg was removed at another hospital, received a $1.2 million settlement in the case from University Community Hospital and Dr. Sanchez.

He told reporters he did not know how Dr. Sanchez should be disciplined and said he did not hold the surgeon alone responsible for what happened to him. "There's a problem there somewhere that needs to be corrected," he said, "and I don't know what it is, and I don't know how to go about it."

Photograph

Dr. Rolando R. Sanchez, who faced a disciplinary hearing in Florida for mistakenly amputating the wrong leg of a patient. (Associated Press)