Iowa Supreme Court limits what health regulators can tell public about disciplinary charges against doctors
Tony LeysIowa health care regulators can’t tell the public details of what a physician allegedly did wrong when the state files formal disciplinary charges, the Iowa Supreme Court said Friday.
The justices unanimously ruled the Iowa Board of Medicine violated state law when it publicly summarized allegations of misconduct against former University of Iowa heart surgeon Domenico Calcaterra.
The justices cited an Iowa Code section defining the duties of state licensing boards, including how the boards should handle investigations.
“We do not believe the statute is ambiguous," Justice Edward Mansfield wrote in the opinion. "Investigative information cannot be released to the public prior to a final decision in a disciplinary proceeding."
What happened in former Iowa heart surgeon's case?
The ruling stemmed from a 2013 disciplinary case brought against Calcaterra by the Iowa Board of Medicine, which licenses and regulates physicians. The board accused the surgeon of “a pattern of disruptive behavior and/or unethical or unprofessional conduct.” The statement of charges and a news release said the allegations included that Calcaterra had shoved another physician during a surgery in 2010.
Calcaterra denied the allegation. Although he eventually reached a settlement with the board and paid a $5,000 fine, his lawyers contended that under state law, regulators should not have released details until the doctor had the chance to defend himself at a hearing and the board could fully consider the evidence. They said the board's public charges, which were posted online, unfairly limited his employment opportunities.
A Polk County district judge agreed with Calcaterra in April 2020, and the board appealed the judge's decision. The Iowa Supreme Court on Friday affirmed the judge's ruling.
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Kent Nebel, executive director of the Iowa Board of Medicine, called the situation "disturbing."
"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," he told the board in a meeting Friday morning.
What details have been and can be publicly released
Nebel said the board receives about 600 confidential complaints against physicians per year, and files about 25 to 30 public disciplinary actions. Since the 2020 district court ruling, such charges have not included details of what a doctor is accused of. For example, Nebel said, the charge might now say a doctor is accused of improper prescriptions, but it will no longer say how many patients were involved or what medications were prescribed.
Even after the Supreme Court ruling, the board still may release details of allegations once a disciplinary charge has been settled or has gone through a formal hearing and decision — but that process can take years.
Anagha Dixit, an assistant attorney general who works with the board, said the new Supreme Court ruling also applies to other state licensing boards, such as those that oversee nurses, pharmacists, dentists and chiropractors.
Former Iowa heart surgeon's lawyer says releasing details can be harmful, unnecessary
Calcaterra's lawyers said Friday the medical board's practice of releasing details of administrative charges before a hearing was held led to permanent harm based on unproven allegations.
"Frankly, it can ruin a professional career," Trent Nelson, a Des Moines attorney representing Calcaterra, said in an interview.
Nelson acknowledged that patient complaints to the medical board are confidential, and relatively few such complaints result in public charges. But he said unvetted allegations can wind up being published in the charging documents. In Calcaterra's case, he said, the medical board published disputed allegations from years earlier.
"He didn't admit to any of it," Nelson said.
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Nelson disagreed with Nebel's claim that public disclosure of such details is necessary to protect the public. He noted that state regulatory boards have authority to order emergency suspensions if they believe a physician or other professional presents an immediate danger.
Calcaterra no longer has an Iowa medical license. According to his LinkedIn account, he has worked as a surgeon in Minnesota and Florida in recent years.
What's next?
Nebel said the Iowa Board of Medicine plans to ask legislators to clarify the law to say regulators can publicly offer some details of allegations when disciplinary charges are filed against physicians or other licensed professionals.
Jefferson Fink, a lawyer for Calcaterra, said such a proposal was introduced at the Statehouse last spring as House File 764. It drew substantial comment, he said, but never made it out of committee.
Tony Leys covers health care for the Register. Reach him at tleys@registermedia.com or 515-284-8449.