How do your surgeons act when cases are running behind schedule and their OR isn't ready? Probably not nearly as violently as a Florida urological surgeon who allegedly "pitched a fit" when he learned that his OR would not be ready for another 20 minutes. Jorge Leal, MD, became so enraged that he broke a telephone, shattered the glass on a copy machine, shoved a metal cart into the doors of the operating suite so hard that it damaged one of them and threw jellybeans down the hallway, court records show. He then allegedly became verbally abusive toward the OR staff members, who later announced that they "were fearful of working with him in the future."

This outburst happened long ago, in 2001, when hospital administrators reported that Dr. Leal's privileges had been suspended after a violent outburst on what a judge, invoking a classic children's book, called "a terrible, horrible, no good, very bad day."

Now, nearly a decade later, Dr. Leal has lost an attempt to have an unflattering hospital discipline report removed from the National Practitioner Data Bank. Dr. Leal, based in Merritt Island, sued the federal government in 2008 to have the report removed from the database because he claimed it was inaccurate and would harm his reputation personally and professionally. But the U.S. Court of Appeals, 11th District, in Atlanta, Ga., affirmed in late September a lower court's ruling that a disciplinary report filed by Cape Canaveral Hospital in Cocoa Beach, Fla., was accurate and should remain in the Department of Health and Human Services' database.

Dr. Leal and his lawyer did not respond to a request for comment. In court documents, Dr. Leal disputes the hospital account of what happened. He says the phone broke when he tripped on the cord, and he cracked the glass on the copier when he closed lid with "some force." He simply moved the cart that was blocking the OR door, Dr. Leal claims. As for the jellybeans, a few "may have fallen on the floor when he tried to throw away flavors that he did not like," according to court documents.

After the incident, the hospital suspended Dr. Leal's privileges for 60 days and reported the outburst and the suspension to the National Practitioner Data Bank, as required by the Health Care Quality Improvement Act. The database, which was created to prevent physicians from moving from state to state in order hide from past misconduct, is not public information. It can only be accessed by hospitals, state licensing boards, professional societies and government agencies.

The hospital had no comment for this article, said spokesman Elliot Cohen. "Because of ongoing issues between our organization and Dr. Leal, it is not appropriate to comment on his case at this time."

In his opinion, Judge Carnes wrote that a hospital is no place for disruptive behavior. "When a physician becomes enraged and lashes out at other members of the medical staff, patient welfare is endangered. That kind of behavior intimidates other health care workers, discouraging the kind of open communication and close cooperation that is essential to providing the best care to patients."

Kent Steinriede

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