An orthopedic surgeon accused of slapping anesthetized patients in the buttocks and making crude comments about them is facing serious ramifications, and so is the hospital that reportedly ignored staff complaints about his behavior.

Michael C. Clarke, MD, is the subject of a CMS investigation, along with St. Joseph's Hospital Health Center in Syracuse, N.Y., according to a report.

Staff members say Dr. Clarke slapped patients so hard on the buttocks that he sometimes left red marks or hand prints. But according to federal investigators, the hospital ignored a staffer's complaint for more than a year. Other staffers say they didn't report the behavior because they thought nothing would be done or they were afraid to jeopardize their jobs.

The hospital's inaction could result in termination from Medicare and Medicaid, which cover most of its patients.

This raises the question: Are your staff members comfortable speaking up if they witness unsavory behavior by a physician? Would you respond immediately if they did?

Dr. Clarke, who moved to neighboring Crouse Hospital in February, is also the target of an investigation into possible criminal conduct, based on the same accusations. He reportedly has claimed that he slapped patients to test the adequacy of their spinal anesthetic, but 11 staff members interviewed by investigators said they'd never seen another physician do that. He's also accused of using sexually explicit language during procedures, sometimes directed at staff members.

Calls by Outpatient Surgery Magazine to Dr. Clarke and to James Lantier, his lawyer, were not returned.

* * * UPDATE on April 17 * * *

Dr. Clarke will not face criminal charges related to the investigation, according to the Onondaga County (N.Y.) District Attorney's office. "None of the witnesses described conduct that could be proven to be sexual in nature," the office said in a news release. "In order to charge a criminal offense it is necessary to have proof of the element of sexual gratification," and to have victims who've come forward, says District Attorney William J. Fitzpatrick. "In this case there is neither." St. Joseph's Hospital may still face sanctions.

Jim Burger