Disciplinary Actions against Jeffrey Piccirillo, D.O.
Stephen Barrett, M.D.
In June 2013, Jeffrey Piccirillo, D.O. who has practiced surgery and general medicine in Grinnell, Iowa, entered a settlement with Iowa Board of Medicine under which:
- He was placed on indefinite probation subject to Board monitoring.
- He may practice medicine only in a board-approved setting.
- Before seeking approval of a practice setting, he must successfully complete a Board-approved sexual misconduct evaluation, comprehensive clinical competency evaluation and professional ethics program.
- He is prohibited from treating Lyme disease.
- He must pay a $10,000 civil penalty.
The agreement settled charges (shown below), filed in 2012, that he had:
- Diagnosed patients with Lyme disease despite the fact that they did not meet standard diagnostic criteria.
- Treated these patients with long-term intravenous antibiotics even though such treatment is not recognized as medically appropriate.
- Engaged in an inappropriate sexual relationship with a female patient.
This is the second time Piccirillo has been severely disciplined. In 2008, the board charged that in his practice of orthopedic surgery, he had failed to (a) demonstrate necessary surgical skills, (b) demonstrate necessary clinical judgment, (c) provide proper surgical treatment, (d) maintain appropriate medical records, and (e) provide appropriate preoperative and post-operative care to patients. He settled these charges in 2009 with an agreement under which he was fined $5,000, prohibited from doing surgery, and placed on indefinite probation subject to counseling and monitoring of his medical practice and his mental health.
Piccirillo also practiced in Illinois. In August 2013, based on the Iowa action, the Illinois Department of Financial & Professional Regulation suspended Piccirillo's Illinois medical license. The South Bend Tribune has reported that he blamed his surgical difficulty on severe hand tremors that attributed to chrnic Lyme disease and that in 2008, he became a "Lyme specialist." The Chicago Tribune has posted additional background information.
BEFORE THE IOWA BOARD OF MEDICINE
IN THE MATTER OF THE STATEMENT OF CHARGES
AGAINST JEFFREY L. PICCIRILLO, D.O., RESPONDENT
FILE Nos. 03-11-157,03-11-400 & 03-11-502
STATEMENT OF CHARGES
COMES NOW the Iowa Board of Medicine on September 21,2012, and files this Statement of Charges pursuant to Iowa Code section 17 A.12(2). Respondent was issued Iowa medical license no. 3594 on September 1, 2004. Respondent's Iowa medical license is active and will next expire on October 1,2012.
A. TIME, PLACE AND NATURE OF HEARING
1. Hearing. A disciplinary contested case hearing shall be held on December 7, 2012, before the Board. The hearing shall begin at 8:00 a.m. and shall be located in the conference room at the Board office at 400 SW 8th Street, Suite C, Des Moines, Iowa.
2. Answer. Within twenty (20) days of the date you are served this Statement of Charges you are required by 653 IAC 24.2(5)(d) to file an Answer. In that Answer, you should state whether you will require a continuance of the date and time of the hearing.
3. Presiding Officer. The Board shall serve as presiding officer, but the Board may request an Administrative Law Judge make initial rulings on prehearing matters, and be present to assist and advise the board at hearing.
4. Prehearing Conference. A prehearing conference will be held by telephone on October 10, 2012, at 9:00 a.m., before an Administrative Law Judge from the Iowa Department of Inspections and Appeals (ALJ). Please contact Kent M. Nebel, J.D., Legal Director, Iowa Board of Medicine, at 515-281-7088 with the telephone number at which you or your legal counsel can be reached. Board rules on prehearing conferences may be found at 653 Iowa Administrative Code 25.15.
5. Hearing Procedures. The procedural rules governing the conduct of the hearing are found at 653 IAC 25. At hearing, you will be allowed the opportunity to respond to the charges against you, to produce evidence on your behalf, cross-examine witnesses, and examine any documents introduced at hearing. You may appear personally or be represented by counsel at your own expense. If you need to request an alternative time or date for hearing, you must review the requirements in 653 IAC 25.16. The hearing may be open or closed to the public at the discretion of the Respondent.
6. Prosecution. The office of the Attorney General is responsible for representing the public interest (the State) in this proceeding. Pleadings shall be filed with the Board and copies should be provided to counsel for the State at the following address: Julie Bussanmas, Assistant Attorney General, Iowa Attorney General's Office, 2nd Floor, Hoover State Office Building, Des Moines, Iowa 50319.
7. Communications. You may not contact board members by phone, letter, facsimile, e-mail, or in person about this matter. Board members may only receive information about the case when all parties have notice and an opportunity to participate, such as at the hearing or in pleadings you file with the Board office and serve upon all parties in the case. You should direct any questions to Kent M. Nebel, J.D., Legal Director at 515- 281-7088 or to Assistant Attorney General Julie Bussanmas at 515-281-5637.
B. LEGAL AUTHORITY AND JURISDICTION
8. Jurisdiction. The Board has jurisdiction in this matter pursuant to Iowa Code chapters 17A, 147, 148, and 272C.
9. Legal Authority: If any of the allegations against you are founded, the Board has authority to take disciplinary action against you under Iowa Code chapters 17 A, 147, 148, and 272C and 653 IAC 25.
10. Default. If you fail to appear at the hearing, the Board may enter a default decision or proceed with the hearing and render a decision in your absence, in accordance with Iowa Code section 17 A.l2(3) and 653 IAC 25.20.
C. SECTIONS OF STATUTES AND RULES INVOLVED
11. Professional Incompetency: Respondent is charged with professional incompetency pursuant to Iowa Code sections 147.55(2), 148.6(2)(g) and (i), and 272C.lO(2), and 653 IAC 23.l(2)(c), (d), (e), and (f) by demonstrating one or more of the following:
- A substantial lack of knowledge or ability to discharge professional obligations within the scope of the physician's or surgeon's practice;
- A substantial deviation from the standards of learning or skill ordinarily possessed and applied by other physicians or surgeons in the state of Iowa acting in the same or similar circumstances;
- A failure by a physician or surgeon to exercise in a substantial respect that degree of care which is ordinarily exercised by the average physician or surgeon in the state of Iowa acting in the same or similar circumstances; and
- A willful or repeated departure from, or the failure to conform to, the minimal standard of acceptable and prevailing practice of medicine and surgery in the state of Iowa.
12. Practice Harmful or Detrimental to the Public: Respondent is charged under Iowa Code section 147.55(3) and 272C.lO(3) and 653 IAC 23.1(3) with engaging in practice harmful or detrimental to the public.
13. Sexual Misconduct: Respondent is charged pursuant to Iowa Code section 148.6(2)(i) and 653 IAC 23.1(10), 23.l(5) and 13.7(4)(a)-(d) with engaging in sexual misconduct in violation of the laws and rules governing the practice of medicine in Iowa including, but not limited to, the following:
- In the course of providing medical care, a physician shall not engage in contact, touching, or comments of a sexual nature with a patient or with the patient's parent or guardian if the patient is a minor.
- A physician shall not engage in any sexual conduct with a patient when that conduct occurs concurrent with the physician-patient relationship, regardless of whether the patient consents to that conduct.
- A physician shall not engage in any sexual conduct with a former patient unless the physician-patient relationship was completely terminated before the sexual conduct occurred. In considering whether that relationship was completely terminated, the board will consider the duration of the physician-patient relationship, the nature of the medical services provided, the lapse of time since the physician-patient relationship ended, the degree of dependence in the physician-patient relationship, and the extent to which the physician used or exploited the trust, knowledge, emotions, or influence derived from the physician-patient relationship.
14. Unethical or Unprofessional Conduct: Respondent is charged pursuant to Iowa Code sections 147.55(3) and 272C.I0(3) and 653 IAC 23.1(4) with engaging in unethical or unprofessional conduct. Engaging in unethical or unprofessional conduct includes, but is not limited to, the committing by a licensee of an act contrary to honesty, justice or good morals, whether the same is committed in the course of the licensee's practice or otherwise and whether committed within this state or elsewhere; or a violation of the standards and principles of medical ethics.
D. STATEMENT OF MATTERS ASSERTED
15. Respondent is an Iowa-licensed physician who formerly practiced orthopedic surgery in Grinnell, Iowa. Respondent currently practices general medicine in Grinnell, Iowa, and Lake in the Hills, Illinois.
16. On January 28, 2008, the Board filed formal disciplinary charges against Respondent alleging that he demonstrated a pattern of professional incompetency and practice harmful or detrimental to the public in his orthopedic surgery practice.
l7. On February 12, 2009, Respondent entered into a Settlement Agreement with the Board to resolve the pending disciplinary charges. Under the terms to the Settlement Agreement, Respondent was: prohibited from practicing surgery under his Iowa medical license; required to complete a Board-approved mental health assessment; placed on indefinite probation subject to Board monitoring; ordered to pay a $5,000 Civil Penalty and issued a Citation and Warning.
18. Professional Incompetency: The Board alleges that Respondent violated the laws and rules governing the practice of medicine including, but not limited to, the following:
- Respondent diagnosed and treated patients for Lyme disease despite the fact that they did not meet the criteria for the laboratory diagnosis of Lyme disease recognized by the Centers for Disease Control and Prevention (CDC).
- Respondent diagnosed and treated patients for Lyme disease despite the fact that his medical records did not support the laboratory diagnosis of Lyme disease recognized by the CDC.
- Respondent diagnosed and treated patients for Lyme disease without performing appropriate diagnostic testing.
- Respondent diagnosed and treated patients for Lyme disease following the use of diagnostic testing that is not recognized by the CDC.
- Respondent treated patients for Lyme disease with long-term intravenous antibiotics despite the fact that such treatment is not recognized by the CDC or the medical literature and such treatment does not conform to the minimal standard of acceptable and prevailing practice of medicine and surgery in the state of Iowa.
- Respondent treated patients for Lyme disease with long-term intravenous antibiotics despite the fact that serious adverse effects of such treatment have been documented.
- Respondent failed to report all of the patients he diagnosed with Lyme disease to the Iowa Department of Public Health in violation of the laws and rules governing the practice of medicine in Iowa. (See 641 IAC 1).
- Respondent failed to maintain appropriate medical records. Respondent's medical records do not adequately reflect his physical findings for individual patients and/or his medical decision making.
19. Sexual Misconduct and/or Unprofessional Conduct: The Board alleges that Respondent engaged in sexual misconduct and/or unprofessional conduct in violation of the laws and rules governing the practice of medicine in Iowa including, but not limited to, the following:
- Respondent engaged in a sexual relationship with a female patient.
- Respondent reportedly forced the female patient to perform a sexual act.
- Respondent sent sexually explicit photographs to the female patient.
- Respondent shared other patients' protected health care information with the female patient.
20. Settlement. This matter may be resolved by settlement agreement. The procedural rules governing the Board's settlement process are found at 653 IAC 25. If you are interested in pursuing settlement of this matter, please contact Kent M. Nebel, J.D., Legal Director at 515-281-7088.
F. PROBABLE CAUSE FINDING
21. On September 21, 2012, the Iowa Board of Medicine found probable cause to file this Statement of Charges.
Colleen K. Stockdale, M.D., M.S.,
Chairwoman Iowa Board of Medicine
400 SW 8th Street, Suite C
Des Moines, Iowa 50309-4686
This page was revised on September 21, 2013.