Surgeon left in midst of operation

A prominent plastic surgeon has been reprimanded and indefinitely suspended by Beth Israel Deaconess Medical Center after he left a patient in the middle of an operation to perform surgery down the street at another hospital. Dr. Joseph Upton, who specializes in complex hand surgeries, has voluntarily agreed to stop practicing medicine until at least May 4 while state regulators investigate whether he has double-booked operations on other occasions.

Beth Israel officials said Upton left an adult male patient during a scheduled break in a lengthy operation on March 17 and returned before the procedure was scheduled to resume. However, they said he failed to properly notify the operating room team that he was leaving and didn't arrange for another attending surgeon to take his place in case there were complications during the break.

''Though no harm to the patient occurred and the surgery was completed on schedule, the medical center leadership took this breach of policy very seriously and immediately launched its own internal investigation," said a statement issued by Dr. Michael Epstein, chief operating officer of Beth Israel Deaconess. He said Upton has not been allowed to admit new patients or visit existing ones since April 8.

Upton's operating room breach bears a surface similarity to the 2002 case of Dr. David Arndt, whose license was suspended after he left a patient on the operating table to go to the bank to cash a check.

Upton's lawyer, William J. Dailey Jr., bristled at any comparison. He said Upton left Beth Israel only to operate on a child at Children's Hospital Boston. ''There was no personal gain to Dr. Upton, none whatsoever," Dailey said. ''It was solely an effort to assist a child and a child's family that was in need."

Neither patient was harmed, he added.

Children's Hospital spokeswoman Michelle Davis also stood by Upton, saying, ''He's been on staff here since 1977, and he's a very accomplished physician."

However, the incident was serious enough to prompt Beth Israel to report it to the Board of Registration in Medicine, which regulates doctors. The board persuaded Upton to give up his medical license until at least May 4, the date of the next scheduled board meeting, so that investigators can look at his broader practices.

''There was no allegation of harm or substandard care," acknowledged board director Nancy Achin Audesse, ''but it's important to know [that] when the ethical and professional conduct of a physician is impugned and when that conduct undermines public confidence in the profession, that conduct will result in discipline."

During nearly 30 years as a surgeon, Upton has won fame for carrying out complex, sometimes groundbreaking operations. In 1983, he led a team that reattached the arm of a man injured in a car accident. In 1997, he carried out a nerve transplant on a 1-year-old girl at Children's Hospital, the youngest nerve recipient ever at the time. He also worked with tissue-engineering pioneer Dr. Joseph Vacanti to implant a lab-grown rib cage in a teenage boy born without cartilage or bones on one side.

On March 17, according to Beth Israel officials, Upton was leading a team carrying out reconstructive hand surgery that took so many hours that they planned multiple breaks of 45 to 60 minutes each, so that they could restore blood circulation to prevent tissue damage. During a break, Upton left for Children's Hospital down the street on Longwood Avenue where he had agreed to perform surgery on a child before the family left for a vacation.

At Beth Israel, Upton left medical residents, doctors still completing their training, in charge of the operating room while he was away, which Beth Israel officials said is a violation of the hospital's policy that an attending surgeon must be ''immediately available" to the patient throughout an operation.

Initially, the chief of surgery orally reprimanded Upton and told him his future work would be carefully monitored. However, the department of surgery then suspended him for two weeks, starting April 8, and forwarded the complaint to the Medical Executive Committee, which oversees quality control at the hospital. On April 20, the executive committee continued Upton's suspension indefinitely.

In addition, the hospital notified the Beth Israel patient of what had happened and filed a report with the Department of Public Health, which has now launched its own investigation into whether Beth Israel put the patient at risk.

Scott Allen can be reached by email at allen@globe.com.