Like traveling medicine hucksters of old, doctors who run into trouble today can hopscotch from state to state, staying ahead of regulators.

Instead of snake oil, some peddle opioids. Others have sex with patients, bungle surgeries, misdiagnose conditions or are implicated in patient deaths.

Even after being caught in one state, they can practice free and clear in another; many hold a fistful of medical licenses.

Stories about individual doctors avoiding discipline in a second state have been reported before. An investigation by the Milwaukee Journal Sentinel and MedPage Today shows how widespread the problem is: At least 500 physicians who have been publicly disciplined, chastised or barred from practicing by one state medical board have been allowed to practice elsewhere with a clean license.

And their patients are kept in the dark — even as more become victims — thanks to an antiquated system shrouded in secrecy.

In Colorado, Gary Weiss’ care of a multiple sclerosis patient prompted four doctors to complain to the state medical board when the patient died in 2011. The board and Weiss agreed that he was "permanently inactivating" his license in 2014, meaning he could never get it back.

But in Florida, where Weiss has a long-standing practice, officials applied no restrictions despite malpractice lawsuits from seven other patients in two states, all accusing him of misdiagnosing them with multiple sclerosis.

Plastic surgeon John Siebert had sex with a patient in New York, got his license suspended for three years and was permanently ordered to have a chaperone in the room with any female patients. But he operates free of medical board restrictions in Wisconsin. In fact, he was appointed to an endowed chair at the University of Wisconsin-Madison, funded in part by billionaire Diane Hendricks, a patient and a major political contributor to Gov. Scott Walker.

Look up Jay Riseman on the website of the Division of Professional Registration in Missouri, where he practices as a hospice doctor: It lists no disciplinary history, no red flags.

But in Illinois, where a medical board official once called him an “imminent danger to the public,” the families of three patients who died remain haunted by what he did. Riseman continues to practice, despite having prescribed massive amounts of pre-surgery laxatives to infants and failing to act in the case of an older woman with a blood infection.

Among the more than 500 doctors identified by the Journal Sentinel and MedPage Today, the single biggest reason for board action was medical errors or oversights. One fifth of the cases were a result of putting patients in harm’s way.

All have slipped through a system that makes it difficult for patients, employers and even regulators in other states to find out about their troubling pasts.

The list represents a fraction of the nation’s roughly 200,000 physicians who hold licenses in more than one state, but likely far underestimates the scope of the problem. Most medical errors are never noticed, much less reported, said Julia Hallisy, founder of the Empowered Patient Coalition, a California-based patient advocacy group.

"The numbers you're showing are not anywhere near the real numbers,” she said. “If something goes wrong in a surgery, or you get an infection, or your 80-year-old mother is given the wrong medicine, you may never know that came from this doctor, their impairment, their lack of skill.

“People who want to make the case that we have bigger fish to fry: this is bigger than we know."

A 30-year-old federal database, the National Practitioner Data Bank, was supposed to keep state medical boards and hospitals apprised of doctor transgressions around the country.

But it has never been available to the public, provides only portions of troubled medical backgrounds and even state medical boards rarely turn to it.

Some officials weren’t aware of the misconduct of doctors licensed in their state until it was brought to their attention by reporters.

In an age of transparency and big data, consumers can tap into a wealth of information online to make choices about everything from choosing a restaurant to hiring a painter.

But patients will have a difficult time finding out how many times their doctor has been sued for malpractice, slapped with a disciplinary action or hit with the loss of hospital privileges.

They may not even be able to find out if their doctor has been charged with a crime.

“The data bank should be open to the public,” said Robert Oshel, former director of research at the National Practitioner Data Bank. “The advantages far outweigh the disadvantages. It’s something that ought to be done.”

In the meantime, some states don’t take action, even when others do.

More than three years after Weiss gave up his Colorado license, officials in Florida this month approved a “letter of concern” that would not restrict his license.

While regulators in New York said plastic surgeon Siebert showed a “moral unfitness to practice,” Wisconsin officials considered the case against him to be “minor.”

Tom Ryan, executive director of the Wisconsin medical examining board, would not answer questions about whether he or the board, all appointed by Walker, knew that a Siebert patient and Walker donor had endowed a university chair for the doctor.

“To suggest that the board made decisions based on anything other than evidence would be pure conjecture,” spokeswoman Nicole Anspach said in an email.

Despite more than a dozen malpractice lawsuits, officials in Kansas eventually gave Riseman a license that allows him to perform surgeries -- though they made him promise not to actually do any.

Asked to explain the decision, Kathleen Lippert, executive director of the Kansas State Board of Healing Art, wrote in an email: “There is little or nothing to add.”

Not so, say the families left in his wake.

One doctor, three deaths

Gayle Simpson Bowman remembers the days when her young son and daughter were doted on by their grandmother, Frances Simpson.

Family photo Frances Simpson, 68, who died of a blood infection while in the care of Jay Riseman.

Family photo Frances Simpson, 68, who died of a blood infection while in the care of Jay Riseman.

Simpson was like a third parent. She got the children ready for school each morning and spent summer days playing with them.

One year, she created a “sunflower house” in her backyard. The sunflowers formed a room, and she and the children would hold private tea parties at a table and chairs tucked inside.

“She was so smart and so kind,” Bowman said. “She loved my kids so much.”

In 1998, Simpson, 68, underwent elective colon surgery; she was expected to fully recover.

Then Riseman got involved in her care, overseeing her recovery.

According to court records, he failed to remove and relocate a catheter even after test results showed signs that a staph infection had spread to her blood. He further failed to act when she showed symptoms of sepsis, including severe vomiting, disorientation and fever.

Simpson died a few days later.

“My mom was a great woman who died a painful and avoidable death,” Bowman said. “The hardest part is to know that he still is practicing medicine. I don’t know how that can happen in this world.”

Wrist-slap discipline has followed Riseman throughout his career, as he has moved from state to state. He racked up more than a dozen malpractice lawsuits. According to the lawsuits and state medical boards, Riseman:

Sliced into one patient’s bile duct and misread another’s breast biopsy.

Neglected to tell patients he wasn’t a pediatric surgeon and performed unnecessary surgeries on infants.

Prescribed massive amounts of a powerful laxative for babies on whom he was set to perform colon surgery.

Molly Hobbie, of Springfield, Ill., recalls confronting Riseman about the laxative he ordered for her infant daughter, Megan, prior to a planned surgery in 1999.

Jay Riseman Over 20 years, a trail of patients who were harmed or died followed Jay Riseman as he moved among states that took different approaches to sanctions. Here is a look at his case: Riseman fails to remove and relocate a catheter in Frances Simpson, a 68-year-old Illinois woman in his care who developed a staph infection that had spread to her blood. He also fails to act even when she shows symptoms of sepsis. Simpson dies.



View lawsuit Prior to a planned surgery, Riseman orders a bowel preparation for 1-year-old Megan Hobbie of Illinois. The dose, which was administered with a nose tube, was twice that recommended for an adult. Only about a third of the laxative was given. Still, the baby was admitted to the hospital because of dehydration caused by the laxative.



View complaint Morgan Brooks, a two-month-old from Illinois, dies after being given a massive amount of the same pre-surgery laxative that was ordered by Riseman. The cause of the girl’s death was cardiac arrest.



View complaint The Illinois Department of Financial and Professional Regulation temporarily suspends Riseman’s license, citing his “incapacity or incompetence” in pediatric surgery and failure to properly perform a biopsy. The state eventually decides to put his license on probation for “not less than five years.”



View order The Illinois medical board files a complaint saying Riseman had violated his probation terms. Another doctor agreed to be a consulting physician for Riseman in May 2002, and Riseman moved his practice to another city in April 2003. “Surgical procedures performed by the respondent after this time were in violation of the terms and conditions of probation,” an attorney writes. She then lists procedures Riseman performed without adequate supervision from 2002 through 2004.



View document Riseman is granted a medical license in Missouri, despite the problems in Illinois. Riseman’s application for licensure in Colorado is denied.



View document Kansas approves Riseman’s application for a medical license, but the state prohibits him from practicing surgery, citing his 13 malpractice cases since 1993.



View document After twice asking Kansas regulators to lift the limitation on practicing surgery, the state agrees – so long as Riseman agrees not to actually perform any surgeries.



View document The Illinois medical board files a complaint against Riseman for not fully answering a question on its annual renewal form. When asked whether he had faced any discipline or been denied a license in another state, Riseman did not disclose his Colorado denial or his limitation in Kansas. His is fined and reprimanded.



View document Riseman’s Illinois medical license expires. Riseman registers as a partner in an Illinois medical marijuana dispensary. The license says he has never been disciplined in Illinois. Riseman begins doing hospice and palliative medicine at St. Luke’s Hospital in Kansas City, where he remains today. In response to questions, the hospital releases a statement noting that Riseman has been awarded 2017 Distinguished Physician of the Year from the Missouri Hospice and Palliative Care Association. “We are grateful for his expertise as he serves our patients, their families, and our community,” the statement says, in part. Show More



Jay Riseman Over 20 years, a trail of patients who were harmed or died followed Jay Riseman as he moved among states that took different approaches to sanctions. Here is a look at his case: Riseman fails to remove and relocate a catheter in Frances Simpson, a 68-year-old Illinois woman in his care who developed a staph infection that had spread to her blood. He also fails to act even when she shows symptoms of sepsis. Simpson dies.



View lawsuit Prior to a planned surgery, Riseman orders a bowel preparation for 1-year-old Megan Hobbie of Illinois. The dose, which was administered with a nose tube, was twice that recommended for an adult. Only about a third of the laxative was given. Still, the baby was admitted to the hospital because of dehydration caused by the laxative.



View complaint Morgan Brooks, a two-month-old from Illinois, dies after being given a massive amount of the same pre-surgery laxative that was ordered by Riseman. The cause of the girl’s death was cardiac arrest.



View complaint The Illinois Department of Financial and Professional Regulation temporarily suspends Riseman’s license, citing his “incapacity or incompetence” in pediatric surgery and failure to properly perform a biopsy. The state eventually decides to put his license on probation for “not less than five years.”



View order The Illinois medical board files a complaint saying Riseman had violated his probation terms. Another doctor agreed to be a consulting physician for Riseman in May 2002, and Riseman moved his practice to another city in April 2003. “Surgical procedures performed by the respondent after this time were in violation of the terms and conditions of probation,” an attorney writes. She then lists procedures Riseman performed without adequate supervision from 2002 through 2004.



View document Riseman is granted a medical license in Missouri, despite the problems in Illinois. Riseman’s application for licensure in Colorado is denied.



View document Kansas approves Riseman’s application for a medical license, but the state prohibits him from practicing surgery, citing his 13 malpractice cases since 1993.



View document After twice asking Kansas regulators to lift the limitation on practicing surgery, the state agrees – so long as Riseman agrees not to actually perform any surgeries.



View document The Illinois medical board files a complaint against Riseman for not fully answering a question on its annual renewal form. When asked whether he had faced any discipline or been denied a license in another state, Riseman did not disclose his Colorado denial or his limitation in Kansas. His is fined and reprimanded.



View document Riseman’s Illinois medical license expires. Riseman registers as a partner in an Illinois medical marijuana dispensary. The license says he has never been disciplined in Illinois. Riseman begins doing hospice and palliative medicine at St. Luke’s Hospital in Kansas City, where he remains today. In response to questions, the hospital releases a statement noting that Riseman has been awarded 2017 Distinguished Physician of the Year from the Missouri Hospice and Palliative Care Association. “We are grateful for his expertise as he serves our patients, their families, and our community,” the statement says, in part. Show More



Hobbie and a home health care nurse tried to give the drug to her daughter, but the girl began vomiting and would only take about one-third the amount Riseman prescribed -- still twice the dose recommended for an adult. After the surgery, Hobbie confronted him with the package that showed her daughter had been prescribed far too much.

“I threw a fit with Dr. Riseman,” she said. “It fell on deaf ears.”

She said she has no doubt her daughter would have died had she been given the full amount.

A week later, Riseman prescribed a similar amount for a smaller and younger baby girl, 2-month-old Morgan Brooks. The dose was more than twice what is allowed for an adult and about 10 times what should be given to a child five to nine years old.

The dose was so out of line that a pediatric nurse at first refused to administer it. But Riseman wrote a new order — for it to be given over eight hours.

The baby died.

“It’s something you don’t ever get over,” said Tonya Brooks, who lives in Decatur, Ill., and says she thinks about her daughter every day.

Riseman never apologized for what he did, she said.

Family photo Two-month-old Morgan Brooks with her brother, Matthew.

Family photo Two-month-old Morgan Brooks with her brother, Matthew.

“I have chosen to not follow what he does. Only because, if I did, it would drive me crazy in the long run,” she said. “My baby was going to be fine, but no, he took that away from us.”

In April 2002, the Illinois Department of Financial and Professional Regulation put Riseman on indefinite probation, allowing him to perform surgery only after consulting with an approved surgeon. The order was based on the cases involving the babies and other allegations of malpractice.

One year later, he moved his practice to Harrisburg, Ill., and performed at least 14 surgeries without supervision, according to a 2004 complaint from the Department of Professional Regulations.

Even though he had ignored the requirement, the board lifted his indefinite probation in 2007, five years after it was put in place.

Riseman started to pursue a career in another state.

He obtained a license in Missouri in 2008 and practices there today.

In May 2009, Colorado denied Riseman’s attempt to get licensed in the state. Nearby Kansas issued him a license later that year.

While he was granted the Kansas license, the state’s Board of Healing Arts noted his problems in Illinois and prohibited him from performing surgery of any kind.

Over the next two years, Riseman asked the Kansas board to reconsider his limitation three times. The first two times, he was denied.

In 2011, Riseman tried a new tactic: He promised not to perform any surgeries in Kansas if the limitation was lifted.

It worked.

“Licensee has satisfied the Board's requirement to protect the public by and through Licensee's assurance that he will not practice surgery in the state of Kansas,” the board wrote. “... the Board hereby grants Licensee's request to terminate the practice limitation against practicing surgical procedures imposed on Licensee.”

Riseman declined to be interviewed or respond to questions for this article.

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Laurel Gifford, a spokeswoman for St. Luke’s Hospital in Kansas City, where he now works, said Riseman has created a career he can be proud of: “From his perspective, he had a hard time, and he's moved on.”

She also released a statement that said, in part, “During the past eight years Dr. Riseman has served his patients, their families and his staff with clinical excellence, patience, and insight. His commitment to the field of hospice and palliative care has enriched the lives of many he has touched with his thoughtful care and attention.”

That he was practicing at all came as a shock to Hobbie, the mother of the baby who survived.

“That is just unbelievable to me,” she said. “The man has a God complex in that he is right and he is not going to listen to what anybody else says.”

Lack of data, transparency

Faced with a lack of publicly available data, the Journal Sentinel and MedPage Today worked with TruthMD, a private company that compiles doctor dossiers drawn from thousands of sources — including civil and criminal courts, state medical boards and the U.S. Food and Drug Administration. The data goes back 15 years and includes about 1 million doctors.

The company provided an initial summary of doctors who had been in trouble in one state since 2011, but continued to hold clean licenses elsewhere.

From there, reporters verified the cases, investigated individual examples and obtained thousands of pages of documents from criminal and civil courts around the country, as well as state medical boards, the FDA and other sources.

The lack of a single source for backgrounding doctors led to firms such as TruthMD, LexisNexis and PreCheck stepping in to provide data.

Gerardo Vitale Gemma Cunningham, founder and CEO of TruthMd, with Charles Rosen, TruthMD co-founder and medical director and professor of orthopedic surgery at the University of California-Irvine.

Gerardo Vitale Gemma Cunningham, founder and CEO of TruthMd, with Charles Rosen, TruthMD co-founder and medical director and professor of orthopedic surgery at the University of California-Irvine.

TruthMD founder and CEO, Gemma Cunningham, said she believes that 95% of doctors are ethical and caring.

"It's such a small percentage who have lost their integrity,” she said. “But when you look at the impact, it’s huge.”

A 2016 paper in the New England Journal of Medicine found that 1% of doctors were responsible for 32% of paid malpractice claims.

Doctors who had licenses in multiple states before being rebuked accounted for most of those practicing freely in one state after being disciplined in another. But in about 20% of the cases, doctors sought new licenses after getting in trouble.

“It’s a highly flawed system,” said Robert Wachter, chairman of medicine at the University of California, San Francisco, School of Medicine. “It has created a patchwork of accountability. It takes something pretty bad to get in trouble with your state licensing board.”

Two states, two results

In 2014, Weiss agreed to an order that barred him from ever getting his Colorado medical license back. He was accused of failing to diagnose a brain infection in a 63-year-old woman he had put on an expensive multiple sclerosis drug — a drug known to cause such infections.

Gary Weiss After facing problems and permanently agreeing never to re-apply for a license in Colorado, neurologist Gary Weiss continued to practice in Florida, despite facing a series of malpractice lawsuits from the two states. Here is a look at his case: A 63-year-old Colorado woman whose multiple sclerosis had been treated by neurologist Gary Weiss dies of a viral brain infection that is known to be caused by the MS drug that he had put her on. Four neurologists at the University of Colorado School of Medicine who had been involved in treating the woman after Weiss, send a letter of complaint about him to the Colorado medical board, saying Weiss’s actions “were far below the standard of care for neurologists.”



View lawsuit A panel of the Colorado Medical Board reviews the Weiss case and determines that a formal complaint against the doctor is warranted. Weiss stops practicing in Colorado and focuses on Florida, where he had also been practicing for years. Weiss says he had to leave his Vail, Col., practice because of personal health issues that prevent him from living at high altitude. Weiss and the Colorado board agree that he is “permanently inactivating” his Colorado license after a formal complaint was issued in March.



View complaint

View order Anthony Scarsella, a Florida resident, files a malpractice lawsuit against Weiss alleging that he failed to accurately read an MRI resulting in an aneurysm bursting in his brain and causing disability. Weiss’s insurance company settles the case for $250,000.



View lawsuit Based on the Colorado case, Weiss agrees to permanently relinquish his medical license in Illinois, which had expired in 2002.



View agreement Five Colorado patients file separate lawsuits in federal court, alleging that Weiss had misdiagnosed them as having multiple sclerosis. Weiss says the lawsuits are “opportunistic” and “totally unfounded.”



View lawsuit Two Florida patients malpractice lawsuits, alleging that Weiss misdiagnosed them has having multiple sclerosis. Weiss says the lawsuits are “copycats with no more hope of prevailing than those in Colorado.”



View Beaty complaint

View Tolliver complaint Florida reaches an agreement with Weiss in which it will issue a letter of concern, a $5,000 fine, and a requirement that he take continuing medical education courses. The agreement does not stop him from practicing.



View agreement In a sworn affidavit, John Corboy, a University of Colorado MS specialist, says Weiss misdiagnosed “many, many people (in Colorado) with MS.” Corboy said patient records also revealed that Weiss ordered “excessive amounts of MRIs, which were taken at the facility he owned and that he was prescribing unnecessary medications, both for financial gain.”



View affidavit In an email to the Journal Sentinel, Weiss said he and Corboy have a “history. It is safe to say that he does not like me. For him to say I ever ordered a single MRI or treatment for financial gain is outrageous and flaty wrong.” Corboy is one of the four doctors who filed the 2011 complaint against Weiss. The attorney for Vivian Gallegos, one of the Colorado patients who had sued Weiss, agrees to dismiss the lawsuit against him. It can’t be re-filed.



View dismissal Show More



Gary Weiss After facing problems and permanently agreeing never to re-apply for a license in Colorado, neurologist Gary Weiss continued to practice in Florida, despite facing a series of malpractice lawsuits from the two states. Here is a look at his case: A 63-year-old Colorado woman whose multiple sclerosis had been treated by neurologist Gary Weiss dies of a viral brain infection that is known to be caused by the MS drug that he had put her on. Four neurologists at the University of Colorado School of Medicine who had been involved in treating the woman after Weiss, send a letter of complaint about him to the Colorado medical board, saying Weiss’s actions “were far below the standard of care for neurologists.”



View lawsuit A panel of the Colorado Medical Board reviews the Weiss case and determines that a formal complaint against the doctor is warranted. Weiss stops practicing in Colorado and focuses on Florida, where he had also been practicing for years. Weiss says he had to leave his Vail, Col., practice because of personal health issues that prevent him from living at high altitude. Weiss and the Colorado board agree that he is “permanently inactivating” his Colorado license after a formal complaint was issued in March.



View complaint

View order Anthony Scarsella, a Florida resident, files a malpractice lawsuit against Weiss alleging that he failed to accurately read an MRI resulting in an aneurysm bursting in his brain and causing disability. Weiss’s insurance company settles the case for $250,000.



View lawsuit Based on the Colorado case, Weiss agrees to permanently relinquish his medical license in Illinois, which had expired in 2002.



View agreement Five Colorado patients file separate lawsuits in federal court, alleging that Weiss had misdiagnosed them as having multiple sclerosis. Weiss says the lawsuits are “opportunistic” and “totally unfounded.”



View lawsuit Two Florida patients malpractice lawsuits, alleging that Weiss misdiagnosed them has having multiple sclerosis. Weiss says the lawsuits are “copycats with no more hope of prevailing than those in Colorado.”



View Beaty complaint

View Tolliver complaint Florida reaches an agreement with Weiss in which it will issue a letter of concern, a $5,000 fine, and a requirement that he take continuing medical education courses. The agreement does not stop him from practicing.



View agreement In a sworn affidavit, John Corboy, a University of Colorado MS specialist, says Weiss misdiagnosed “many, many people (in Colorado) with MS.” Corboy said patient records also revealed that Weiss ordered “excessive amounts of MRIs, which were taken at the facility he owned and that he was prescribing unnecessary medications, both for financial gain.”



View affidavit In an email to the Journal Sentinel, Weiss said he and Corboy have a “history. It is safe to say that he does not like me. For him to say I ever ordered a single MRI or treatment for financial gain is outrageous and flaty wrong.” Corboy is one of the four doctors who filed the 2011 complaint against Weiss. The attorney for Vivian Gallegos, one of the Colorado patients who had sued Weiss, agrees to dismiss the lawsuit against him. It can’t be re-filed.



View dismissal Show More



Over the months the infection went undetected, Weiss continued to treat the woman with the drug as she deteriorated, according to a 2011 complaint filed with the state’s medical board by four neurologists from the University of Colorado School of Medicine.

The woman became forgetful and had trouble speaking. She soon had to use a wheelchair and eventually had to go into a nursing home.

“If the (condition) had been diagnosed in a timely fashion and treatment instituted, (her) prognosis would have been improved and (she) would have avoided much suffering,” the doctors wrote to the medical board. It accused Weiss of acting “far below the standard of care for neurologists.”

In his settlement with the Colorado Medical Board, Weiss denied that his treatment of the woman fell below the standard of care.

He also provided to the Journal Sentinel and MedPage Today a letter sent to the Colorado board from a doctor who reviewed the case of the woman who died. That doctor, Ray Lopez of Miami, said the accusations made against Weiss “may well stem from the conflict of cultures between the purely academic and the private practitioner” and that Weiss had offered “an appropriate standard of care.”

Allegations against Weiss didn’t end with the woman’s death in 2011 or the permanent loss of his Colorado license in 2014.

Five other Colorado patients filed malpractice lawsuits, accusing him of misdiagnosing them with multiple sclerosis and treating them with dangerous drugs. According to their lawsuits, five other doctors determined that the patients did not even have the disease, which causes a spectrum of symptoms, including muscle weakness, fatigue, numbness and difficulty with walking and vision.

One case was dismissed this month and will not be re-filed. The other cases still are pending; no final judgments have been made as to Weiss’s fault or liability.

In August, two patients in Florida, where Weiss has practiced since the 1980s, filed malpractice cases with similar allegations.

State medical boards can discipline a doctor based on the actions of another state.

Family photo Anthony Scarsella and his wife, Christy, of Palm Bay, Fla.

Family photo Anthony Scarsella and his wife, Christy, of Palm Bay, Fla.

For instance, after Colorado acted to stop Weiss from renewing his license, Weiss agreed with Illinois regulators in July 2015 to permanently relinquish his license, which had expired in 2002.

Florida did not act until last August, when regulators reached a deal with Weiss in which it would issue a “letter of concern,” a $5,000 fine, and a requirement that he take continuing medical education courses. The agreement does not limit his ability to practice.

The agreement was approved by the Florida Board of Medicine in early February.

“I think it is disgraceful,” said Christy Scarsella, a resident of Palm Bay, Fla., whose husband, Anthony, 48, had gone to Weiss in 2013 with complaints of shoulder and neck pain, headaches and numbness in his hands.

In a malpractice lawsuit, they alleged Weiss performed an MRI, but failed to accurately read it, resulting in an aneurysm bursting in Scarsella’s brain.

The Scarsellas could not discuss details of the case, due to a confidential settlement, but their lawsuit said Anthony Scarsella suffered disability, the loss of the ability to earn money and needed nursing care.

Records from the Florida Office of Insurance Regulation indicate the couple settled the case for $250,000 in 2015.

Christy Scarsella said she plans to file a complaint with the Florida medical board in hopes that she can get Weiss’s license revoked.

“It is an injustice to people who are seeking proficient medical help,” she said.

Doctor faces malpractice lawsuits Brenda Culhane is one of four people in Colorado now suing doctor Gary Weiss, claiming he misdiagnosed them as having multiple sclerosis and put them on potentially dangerous drugs.

Culhane went to Weiss at his Vail office in 2007 because she began experiencing weakness in her upper extremities, according to her lawsuit, filed in August 2016.

After diagnosing her with MS, Weiss put her on the drug Tysabri. The expensive and highly restricted drug, which has to be infused every month, can cause a viral brain infection known as progressive multifocal leukoencephalopathy (PML). Though rare, it usually is fatal or causes severe disability.

Those infusions — more than 100 — continued through 2014, when another doctor, Enrique Alvarez of the University of Colorado, determined Culhane did not have MS.

She said the faulty diagnosis caused depression and anxiety.

"There is no cure for MS, so I was living with the knowledge that eventually I would be completely incapacitated,” she said. “That was a very difficult thing to live with all those years."

In a sworn statement filed as part of a lawsuit, Andrew Solomon, a neurologist and multiple sclerosis specialist at the University of Vermont who reviewed Culhane’s medical records, said Culhane does not and never did have MS.

Solomon said he also reviewed the records of 10 other Colorado patients Weiss had diagnosed with MS.

“To a patient, while Dr. Weiss diagnosed them with MS, while they were put on MS medications with considerable risk for morbidity and even death, and while they received MS treatment for prolonged periods of time, it is my opinion that none of these individuals ever actually had MS,” he said.

Concerns also were raised about Weiss in a sworn affidavit from John Corboy, a University of Colorado MS specialist.

Corboy was one of four University of Colorado neurologists who filed a 2011 complaint against Weiss with the Colorado medical board after a Weiss patient died of a PML infection that is known to be caused by the drug Tysabri, which Weiss put her on.

“Based on my review of medical records, as well as numerous conversations with other neurologists throughout Colorado, Dr. Weiss has misdiagnosed many, many people with MS,” Corboy said in a December 2017 affidavit filed in connection with one of the lawsuits.

Patient records also revealed that Weiss ordered “excessive amounts of MRIs, which were taken at the facility he owned and that he was prescribing unnecessary medications, both for financial gain,” Corboy said.

In an email provided through a spokesman, Weiss said he and Corboy have a “history. It is safe to say that he does not like me. For him to say I ever ordered a single MRI or treatment for financial gain is outrageous and flaty wrong.”

He also questioned whether Culhane changed her mind about the care she got from him after talking to a lawyer or being contacted by the doctor to whom Weiss sold his Colorado medical practice. That doctor sued Weiss over the sale but later dropped the case.

He said the doctor told some of his former patients that they had been misdiagnosed.

Weiss also said that making an MS diagnosis is a difficult, subjective process and that early treatment of suspected cases is important to prevent symptoms years later.

“The fact that a patient is doing well today may mean that the treatment worked or it may mean that he or she was one of the fortunate 30% who looked like they have MS, but don’t,” he said. “No one knows. “In any case, if a patient is healthy, I’m happy.”

— John Fauber Show More

In an email provided by a spokesman, Weiss said the payment to the Scarsellas was made only because of an insurance company’s business decision to settle the case -- a decision he disagreed with.

Weiss said the Colorado malpractice lawsuits are “opportunistic” and “totally unfounded” and the Florida lawsuits are “copycats with no more hope of prevailing than those in Colorado.”

“I refuse to settle any of the cases for even a penny,” he said.

Weiss said he only agreed to give up his license in Colorado, which expired earlier that year, because he had developed his own health issues that made it impossible for him to live in a high-altitude setting.

That led him to focus on Florida, where he also had a practice, he said.

“Even in the unlikely event that I did not prevail in a hearing on the Colorado complaint, it was not the kind of issue that would have led to significant discipline or loss of my license,” he said. He termed the action in Florida “a very low-level ‘letter of concern’ triggered by my giving up my Colorado license.”

In fact, the Colorado board said that if the allegations regarding the MS patient who died were proven at a hearing it would amount to a “prima facie case of unprofessional conduct.”

Wide variation among states

The Journal Sentinel and MedPage Today surveyed 62 boards across the country that regulate physicians at the state level. In some cases, there are two boards in a state — one for medical doctors and another for osteopathic physicians, who focus on the musculoskeletal system. Governors appoint some or all members of 56 of them.

Each board can have wildly different rules. A 2016 study in the British Medical Journal found annual average rates of discipline ranged from 1.9 actions per 1,000 doctors in Massachusetts to 10.3 in Delaware. In other words, Delaware disciplines doctors at over five times the rate of Massachusetts. The rate in Wisconsin was 4.4.

There are also huge differences in the amount and quality of information each board makes available about doctors to the public.

Consider Julie Sullivan of Oceanside, Calif. That state’s licensing website shows a clean record. No hospital disciplinary actions. No action taken by other states. No court orders or anything else that might raise eyebrows.

It does not mention the problems listed on the Texas Medical Board’s website, stemming from her care of a patient who complained of headaches and extreme sensitivity to light. Despite the patient’s prior similar symptoms and history of aneurysms, Sullivan did not perform a specialized eye exam, and discharged him with a diagnosis of a severe headache, according to records from the Texas Medical Board.

Less than six hours later, the man went to an emergency room where a CT exam showed a cyst in his brain. He was in an ambulance on the way to another hospital when he suffered cardiac arrest and died.

The California site also doesn’t mention that a health insurance company had trouble getting information from Sullivan about the encounter, for which it issued her a corrective action plan. That’s only available on the Texas site.

Sullivan declined to comment for this piece. A spokesman for the Medical Board of California said the site does not include Sullivan’s record in Texas because the incidents there preceded her licensure in California.

When it comes to problems, there are many sources of information, but each only covers a portion of a doctor’s background: discipline by a medical board; discipline from other states; malpractice claims and payouts; loss of hospital privileges; criminal convictions; Medicaid/Medicare exclusions and fraud charges; and actions by the federal regulators, such as the U.S. Food and Drug Administration and the Drug Enforcement Agency.

Medical boards across the U.S. Click a state to see information about its medical board, including who appoints its members, how often it disciplines doctors and what information it posts online. Highlight states based on What boards post online Discipline rate Clear Board discipline Discipline by other state boards Felony convictions Medicare/Medicaid exclusions and fraud cases Loss of hospital privileges Malpractice claims and/or payments DEA actions The board . The board is composed of What do they post online? Board discipline Loss of hospital privileges Discipline by other state boards Malpractice claims and/or payments Felony convictions Actions by DEA and FDA Medicare/Medicaid exclusions and fraud cases Close

No state’s website consistently reports all of the pieces of the puzzle.

According to a Journal Sentinel/MedPage Today analysis, only five states include at least six of the seven categories — Florida, Kansas, Maryland, Massachusetts and North Carolina. Five other states regularly reported five: California, Georgia, Indiana, New York and Tennessee.

The majority report only their own disciplinary actions.

“Should all state medical boards list all of these elements? Absolutely,” said Sidney Wolfe, a physician and director of the patient advocacy group Public Citizen. “A background check on a doctor you have, or one you’re thinking of going to, may have more of an effect on your health than anything else.”

Even when state medical boards make this information available, they often rely on physicians to report their own transgressions. At license renewal time, doctors are asked a series of questions about whether they’ve been disciplined by other states, had run-ins with the law or paid malpractice claims.

The federal National Practitioner Data Bank allows state boards to keep tabs on their doctors who hold licenses in other states. Boards rarely take advantage of the system, though.

The Federation of State Medical Boards has its own system for tracking state actions and credentials, but doesn’t have all the same information as the data bank.

Insurance companies say they have their own protections.

All doctors are reviewed through a credentialing process when added to a network, said Armando Deltoro an official with America’s Health Insurance Plans, an industry group. Most insurance plans re-screen their members again every three years, sooner if they become aware of a problem with a doctor’s record, he said.

He said he could not provide the number of doctors who had been excluded after screenings.

Hiring doctors can be a “buyer beware” situation for hospitals, said William Golden, medical services director for the Arkansas Department of Medical Services.

“Medical boards tend to believe in the power of redemption and letting people make a living.”

From New York to Wisconsin

Consider Siebert, the UW-Madison plastic surgeon.

Between 2000 and 2008, he performed multiple surgeries at New York University Medical Center on a woman with whom he had a sexual relationship between 2006 and 2008. An investigation began in 2009 and New York disciplined Siebert for the relationship in 2013.

His “inappropriate intimate relationship” with a patient was determined to be professional misconduct and his license in New York was suspended for three years. The board stayed the suspension, put Siebert on probation and ordered him to have a chaperone whenever he saw a female patient. It is a condition that stays with him for as long as he is licensed in New York.

John Siebert Plastic surgeon John Siebert faced sanctions in New York after having sex with a patient. In Wisconsin, regulators did not follow suit. Here is a look at his case: Plastic surgeon John Siebert begins what is later termed a two-year “inappropriate intimate relationship” in New York with a married patient on whom he had performed multiple surgeries. The woman’s husband later files a complaint with the New York state medical board. Siebert tells New York state investigators that he bought a cell phone for the patient he was having sex with because her husband was becoming suspicious. Siebert says he resigned from New York University Medical Center because he wanted to work full-time at the University of Wisconsin-Madison. Siebert tells an investigator with the New York State Department of Health that he had resigned from Lenox Hill Hospital in New York, which has an academic residency affiliation with NYU, four months earlier “in lieu of being fired.” The University of Wisconsin hires Siebert on a full-time basis. Siebert works as a plastic surgeon and a professor in the medical school. The New York State Board of Professional Medical Conduct says Siebert’s affair with the female patient showed a “moral unfitness to practice.” It issues an order suspending his medical license for three years, though the suspension is stayed and he is put on probation. The state also issues a permanent requirement that a chaperone be present whenever he sees a female patient in that state. Siebert agrees to the order.



View charges

View order Billionaire businesswoman Diane Hendricks, a Siebert patient who also is one of the biggest political supporters of Wisconsin Gov. Scott Walker, puts up $1.75 million to fund two endowed chairs at UW, including one for Siebert. Hendricks told the Journal Sentinel she never talked to Walker about Siebert. After a review, an advisor to the Wisconsin Medical Examining Board, which is appointed by Walker, and a staff attorney, decide no action should be taken against Siebert, saying that while the New York case may have been a “minor or technical violation,” it was not seriously harmful to the public.



View memo In an email to the Journal Sentinel, Siebert says the incident in New York was a mistake. “I have accepted responsibility and followed all requirements. I am proud I’ve been given the opportunity to move ahead and provide the care that I was trained to give.” Show More



John Siebert Plastic surgeon John Siebert faced sanctions in New York after having sex with a patient. In Wisconsin, regulators did not follow suit. Here is a look at his case: Plastic surgeon John Siebert begins what is later termed a two-year “inappropriate intimate relationship” in New York with a married patient on whom he had performed multiple surgeries. The woman’s husband later files a complaint with the New York state medical board. Siebert tells New York state investigators that he bought a cell phone for the patient he was having sex with because her husband was becoming suspicious. Siebert says he resigned from New York University Medical Center because he wanted to work full-time at the University of Wisconsin-Madison. Siebert tells an investigator with the New York State Department of Health that he had resigned from Lenox Hill Hospital in New York, which has an academic residency affiliation with NYU, four months earlier “in lieu of being fired.” The University of Wisconsin hires Siebert on a full-time basis. Siebert works as a plastic surgeon and a professor in the medical school. The New York State Board of Professional Medical Conduct says Siebert’s affair with the female patient showed a “moral unfitness to practice.” It issues an order suspending his medical license for three years, though the suspension is stayed and he is put on probation. The state also issues a permanent requirement that a chaperone be present whenever he sees a female patient in that state. Siebert agrees to the order.



View charges

View order Billionaire businesswoman Diane Hendricks, a Siebert patient who also is one of the biggest political supporters of Wisconsin Gov. Scott Walker, puts up $1.75 million to fund two endowed chairs at UW, including one for Siebert. Hendricks told the Journal Sentinel she never talked to Walker about Siebert. After a review, an advisor to the Wisconsin Medical Examining Board, which is appointed by Walker, and a staff attorney, decide no action should be taken against Siebert, saying that while the New York case may have been a “minor or technical violation,” it was not seriously harmful to the public.



View memo In an email to the Journal Sentinel, Siebert says the incident in New York was a mistake. “I have accepted responsibility and followed all requirements. I am proud I’ve been given the opportunity to move ahead and provide the care that I was trained to give.” Show More



In 2011, Siebert became a full-time employee at UW-Madison, where he had been working part time.

After New York imposed the chaperone requirement in 2013, UW-Madison worked out its own such requirement with Siebert, but unlike New York’s, which is permanent, the UW requirement can be reopened in the future. And the requirement only applies to Siebert’s work for the university; it does not apply to any work he might do on the side or should he leave the university system and continue practicing in Wisconsin.

After New York’s disciplinary action, the Wisconsin medical board looked into the case and decided to put no restrictions on his license. Its review included an interview with Siebert and documents from UW-Madison and the New York medical board.

While New York said Siebert showed a “moral unfitness to practice,” Wisconsin officials described his sex with a patient as “a minor or technical violation,” that was “not seriously harmful to the public.”

A month earlier, it was announced that Wisconsin billionaire Hendricks, who was treated by Siebert in 2014, had put up $1.75 million to help fund two endowed chairs at the University of Wisconsin, including one now held by Siebert.

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Siebert was paid $841,000 by University of Wisconsin-related entities in the most recent fiscal year. About $73,000 of that is base salary, with the rest coming from the UW Medical Foundation, which includes income from his practice as a doctor and surgeon.

With a net worth of $4.9 billion, Hendricks, 70, is the second-richest woman in America, according to Forbes magazine. She has been a major contributor to Scott Walker, who appoints all 13 members of Wisconsin’s medical board. She gave $500,000 to Walker's 2012 recall campaign and $5 million toward his 2016 presidential run.

In a telephone interview, Hendricks said she never discussed Siebert with the governor. She said she was aware of “a blemish” on his record before she funded the UW endowed chair.

“To me it was insignificant,” she said, adding: “He is a wonderful physician.”

A spokeswoman for the board said the Walker administration is not involved in reviewing complaints against doctors.

In an email response to questions, Siebert said the incident in New York “was a mistake that I made and for which I have accepted responsibility and followed all requirements. I am proud I’ve been given the opportunity to move ahead and provide the care that I was trained to give.”

In a statement, UW spokeswoman Lisa Brunette said Siebert was hired because he is “one of the most gifted surgeons in the nation, perhaps the world,” noting that he is a leader in treatment of a rare deformity, Parry-Romberg Syndrome, involving soft tissues in the face.

However, just before he was hired by UW, Siebert told New York state investigators, who were looking into his affair with a patient, that he had recently resigned “in lieu of being fired” from Lenox Hill Hospital. The hospital has an academic residency affiliation with NYU.

Siebert said that while he recalls making the comment, he was not going to be fired.

“It was meant to be sardonic in light of a difficult situation,” he said in an email.

Few checks made by states

Congress created the National Practitioner Data Bank in 1986, saying it would improve healthcare quality and reduce fraud and abuse.

The database was designed as a central tool for recording malpractice payments, state disciplinary actions, restrictions from health plans or hospitals and other limits on any health care professional — doctors, nurses, dentists, physical therapists and others.

Inside a medical board hearing The Florida Board of Medicine met this month on the case of Gary Weiss, a neurologist who in Colorado agreed to forever give up his right to practice after allegations that his care of a patient who died was “far below the standard of care for neurologists.”

When it did, it only got a partial view of Weiss’ legal record.

At a hearing on the proposed settlement, one Florida board member said the Colorado discipline “seems unusually harsh. Is there something that’s going on?”

Another board member raised a concern about a doctor barred from practicing in one state being allowed to practice in Florida:

“Are we okay having someone having a license in Florida that cannot hold a license in another state, where they were banned from practicing medicine and they cannot hold a license there?”

Another board member said there was plenty of evidence that Weiss was not a danger to the public in Florida.

Then, another board member asked Weiss if he had any other malpractice cases.

Weiss acknowledged a case in Florida that he had settled.

Then, he added, “But I had no malpractice cases.”

However, court records indicate that at the time of the board meeting Weiss had been sued seven times since he left Colorado, including five malpractice cases brought by former patients in Colorado and two by Florida patients. (Since then, one of the Colorado cases has been dismissed as part of an agreement by the attorneys.)

Through a spokesman, Weiss said he was referring to “adjudicated or settled” lawsuits.

Brad Dalton, a spokesman for the Florida medical board, said information about other malpractice cases against Weiss was not included in materials reviewed by board members, "as that was not part of the complaint against Dr. Weiss in this particular case."

— John Fauber Show More

"The intent was to help make sure that physicians were not able to go from state to state without any past history of activity being known,” said David Loewenstein, who oversees the data bank.

He acknowledged the listings don’t provide a full picture of a doctor’s history.

"We by no means hold ourselves out to be the all-encompassing definition of good and bad practitioners,” he said. “We're a data point, to be used along with others.”

The bank now has more than 1.3 million records of “adverse actions” going back to 1990. The resource is open to hospitals, insurers, and state medical boards. In 2016, the data bank logged 7.5 million searches from those groups, with state medical boards accounting for a small share.

The same legislation that created the tool shrouded it in secrecy. Public versions of the database don’t include doctor’s names or other identifying information.

That makes it impossible to determine what happened in several cases where reporters asked officials why doctors with license problems in other states were allowed to practice in their state without issue.

In each case, officials said it was the first time they heard of the misdeed.

Oshel, who formerly oversaw the data bank, said it’s likely the information was in the data bank. Most state boards report actions as required by law, he said.

“It was very unusual to get queries from a state board,” he said. “There were states that maybe didn't submit any queries at all, or one or two.”

Though doctor searches cost only about $3 each, most states, he said, performed only 10 to 20 searches every year.

States can even sign up for automatic updates from the data bank, which will run doctor names every 24 hours and report any new actions.

Of the 64 state medical boards, only 13 subscribe.

John Fauber is a reporter for the Milwaukee Journal Sentinel. Matt Wynn and Kristina Fiore are reporters with MedPage Today.

This story was reported as a joint project of the Journal Sentinel and MedPage Today, which provides a clinical perspective for physicians on breaking medical news at medpagetoday.com.

How we reported this story

To pursue this investigation, reporters at the Milwaukee Journal Sentinel and MedPage Today worked with TruthMD, a Los Angeles-area company that collects information on doctors from thousands of sources.

The company provided records of doctors who had faced a public board action in one state between 2011 and 2017, and no action in at least one other state where they were licensed.

More than 500 such cases were identified. Each one was checked with the state medical board that took the initial action against the doctor. The reporters also verified that the other board took no public action of its own.

Additionally, reporters obtained thousands of pages of medical board records, court filings, Medicare records, and federal actions on specific cases. In the analysis, reporters excluded cases where the initial action was dismissed or found baseless. In some cases, a board took action well after another state issued a public notice. Cases were included if there was a gap of at least a year between the first state’s action and the follow-up in a second state.

To identify cases where a doctor applied for a license in a new state after an investigation started in another, reporters flagged cases where the physician pursued a license after the action that eventually resulted in discipline.

Reporters also interviewed dozens of people, including families of those alleged to have been harmed, state medical board officials and experts in the field of doctor discipline, as well as individual doctors accused of wrongdoing.