A Florida doctor doing cancer surgery cut in the wrong place. Here’s his punishment

Cutting the wrong thing during a surgery to remove a melanoma will cost a Sarasota doctor $12,495 and the time it takes to do an online course and put together a Power Point presentation.

That’s the settlement Dr. Raymond Knisley reached with the Florida Department of Health without officially admitting or denying his mistake during a 2018 cancer surgery on a patient’s jaw. Online records say this is Knisley’s first piece of discipline since becoming licensed in Florida in January 2014.

As described in the administrative complaint, Knisley’s 88-year-old patient had a papule in his right malar cheek had been diagnosed as squamous cell carcinoma “in situ.” The American Cancer Society says that means it’s still on the first layer of skin. A Medscape.com article by Rutgers University professor Dr. Talib Najjar, a member of the American Society of Clinical Pathology, says that can be treated without surgery.

The elderly man also had a papule in his right superior preauricular cheek. The pathology report identified that as invasive melanoma, which The Skin Cancer Foundation says means “it’s penetrated beneath the top layer of skin into the next layer of skin.”

On Dec. 11, 2018, the patient showed up to have the melanoma removed from the right superior preauricular cheek. Knisley’s operative note said he’d operated on the right superior preauricular cheek.

But, the state says, Knisley actually removed the non-invasive carcinoma in the right malar cheek.

The punitive actions from the Florida Board of Osteopathic Medicine involve:

Money — Knisley must pay a $5,000 fine and $7,496 reimbursement of costs to the Department of Health for the costs in investigating and prosecuting this case..

Return to class — Knisley has to take a five-hour course in risk management that includes wrong site procedures. The course can be taken online.

Power Point — He has to put together a Power Point presentation on “lessons learned from wrong-site surgery in dermatological outpatient settings” and submit it to the Board chair.

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