The Iowa Board of Medicine regulates the state’s medical profession as part of the Iowa Department of Inspections, Appeals and Licensing. (Photo by Getty Images, board seal courtesy the State of Iowa)
The Iowa Board of Medicine has dismissed charges of professional incompetence that it previously filed against a heart surgeon who practiced in Sioux City.
Citing “the incredibly difficult nature of this decision,” the board said it could not reach a consensus on allegations that Dr. Giovanni Ciuffo performed unnecessary heart surgeries on patients who were at too great a risk of dying from the procedures.
On April 28, 2023, the board charged Ciuffo with professional incompetence, engaging in a practice that is harmful or detrimental to the public, and knowingly making misleading or untrue representations in the practice of medicine.
At the time, the factual basis for those charges was kept secret in keeping with an Iowa Supreme Court ruling that says the basis for disciplinary charges against licensees is not to be made public until a case is finalized.
Newly disclosed board records show that in Ciuffo’s case, the board eventually narrowed the undisclosed factual basis for the charges to allege that Ciuffo had performed unnecessary surgical procedures, demonstrated a pattern of poor patient selection, and chose to operate on patients who had a prohibitive risk for surgery.
He was also accused of demonstrating a pattern of giving patients “unrealistic expectations” prior to their surgery and with failing to obtain informed consent prior to surgery.
Earlier this year, Ciuffo sought a continuance in the board proceedings against him, arguing in part that the board had not turned over to him all of the relevant information in the case during the “discovery” phase of the proceedings, in which each side shares information with the other. When the board refused to reschedule the hearing, Ciuffo took the matter to court.
In June, Polk County District Court Judge Coleman McAllister found that the board, in denying Ciuffo’s request for a continuance, had given no indication it had even considered Ciuffo’s argument there was good cause for such a continuance.
The judge issued a stay in the proceedings, preventing the board from moving forward with its scheduled hearing at least until it issued a ruling showing it had considered Ciuffo’s specific arguments for a continuance.
Attorney objects to anonymous, ‘ludicrous’ claims
The board then reconsidered the request for a continuance and denied it again, which meant that the state’s case against him — which included 30,000 pages of documents within the board’s investigative file — proceeded toward a hearing scheduled for late October.
That triggered another round of objections by Ciuffo’s attorney, Mike Sellers, who argued that because Ciuffo does not, and has not practiced, in Iowa for several years there was “no public interest in forcing this matter to a hearing when serious matters of improper planned introduction of improper evidence have been assured by the state.”
Sellers also argued Ciuffo’s “license and his career are on the line in these proceedings. The state has repeatedly declared its intent to introduce anonymous complaints that contain ludicrous opinion comments by unknown persons, rambling videos of prior informal investigative interviews years ago, and declared its plan to introduce inadmissible evidence.”
Board records indicate that Ciuffo’s disciplinary hearing took place over three days late last month. According to the board, the state offered expert opinions from two experienced cardiothoracic surgeons who reviewed medical records in eight cases and concluded Ciuffo failed to meet the standard of care in three of those cases because the patients were at too great of a risk of an adverse outcome to allow surgery.
The board says Ciuffo then presented the expert opinion of what it describes as “numerous cardiothoracic surgeons with similar or greater experience than the state’s experts,” each of whom suggested Ciuffo acted appropriately.
Ciuffo also testified as to the substantive conversation he had with the patients or their families in obtaining their consent for surgery, provided corroborating evidence from previous patients as to his explanations of the risks involved.
Board records show that at the conclusion of the hearing, the board members were divided, and a majority of them failed to find the state had met its burden of proof.
With respect to performing surgeries on patients with a “prohibitive risk of surgery,” the board said it failed to reach a consensus with the exception of one patient who had a 73% chance of dying from the procedure, but an even greater risk of dying without it. The board concluded the “alternative (to surgery) for this patient was passing away … in the near future.”
The board concluded that even if Ciuffo had failed to meet the standard of care in that particular case, the “misjudgment” didn’t warrant the filing of charges.
Civil case naming Ciuffo was dismissed by court
“At most,” the board said in dismissing the charges against Ciuffo, “a majority of the board shared a concern about Dr. Ciuffo offering (one patient) a surgery given the exceptional risk of the heart surgery with little prospect of any meaningful recovery.” The board added that such “an isolated incident, where the facts show the decision was made in good faith with informed consent” did not amount to a serious deviation from the standard care.
In May 2022, the Iowa Capital Dispatch reported that Ciuffo was referenced in a federal civil lawsuit that alleged he had provided substandard care for patients and manipulated patient-outcome data at MercyOne Siouxland Medical Center. Through his attorney, Ciuffo said then that the allegations made against him in that lawsuit were “outrageous and completely false.”
The claims were part of a lawsuit filed by Cynthia Tener, a registered nurse, against her former employer, MercyOne. Tener, who was the Siouxland Medical Center’s director of the cardiovascular service line, alleged she faced retaliation after raising concerns regarding Ciuffo’s conduct and his treatment of patients – an allegation that Mercy denied.
Ciuffo was accused of keeping patients alive via ventilators, heart pumps and feeding tubes for at least 30 days after surgery to improve his ratings in the Society of Thoracic Surgeons’ database – a charge Ciuffo’s attorney said was demonstrably false. Tener’s lawsuit was dismissed two months after it was filed, with the judge in the case noting the False Claims Act, under which she sued, allows for claims related to fraud, not malpractice.
Ciuffo now practices in Las Vegas, Nevada, according to board records.