Contraindications: Dr. Bahram Tafreshi Moshiri, State by State

Health care reporters know how rarely hospitals suspend a doctor's privileges. Those rights are granted and revoked by other doctors, and doctors are loathe to set a precedent by saying a botched surgery or missed diagnosis should bar a doctor for life.

That's why it was a big deal when the Reston Hospital Center in Virginia took away Dr. Bahram Tafreshi Moshiri's right to practice there in November 2001.

Moshiri, a board-certified thoracic surgeon, had paid a family $1,000 in 1999 after a one of his patients developed a blood clot following a varicose vein surgery and died. That same year, he paid $10,000 to a patient after leaving a sponge next to the patient's spleen. More settlements followed, for paralyzed vocal cords, leaky sutures and a leg that had to be amputated. The final tally was nearly $1 million. Yet no one reported any of this to the Virginia medical board. Not the courts. Not the malpractice attorneys. And not Moshiri, who was the one by law who had the responsibility to do so.

In fact, it wasn't until July 2006 that Moshiri's troubles started to catch up with him. He had fibbed a year prior on a questionnaire while trying to get a medical license in Ohio. He was asked "Have you ever been warned, censured, disciplined...had privileges suspended or terminated, been put on probation, or been requested to withdraw from or resign privileges from any hospital...for reasons other than failure to maintain records on a timely basis, or failure to attend staff or section meetings?" He answered, "No." While the board was reviewing his application, they found out he had lied and asked him to withdraw his application, which he did.

This is how screwy she state of doctor discipline is. Moshiri had to leave the state where he made his medical mistakes before he was held accountable for those mistakes. Ohio's action prompted the Virginia medical board to finally take a hard look at him and it determined that he had not properly reported all of those malpractice settlements. He agreed to surrender his license there in July 2008. The state medical board in California, where he also had a license, followed suit, rather promptly, this January.

None of the other hospitals where he worked - Arlington Hospital, Inova Fairfax Hospital, Potomac Hospital, Virginia Hospital Center - appear to have had any issues with his track record. One could argue that they, like the medical boards, did not know. But how about a little background work? Is it so difficult to find out that a doctor has racked up nearly $1 million in malpractice settlements?

Moshiri may have been hit with a few more lawsuits and settlements along the way, either in California or Ohio. He also was licensed in Kentucky, and it looks like that state simply allowed his license to lapse with no action.

It would be interesting to see if there are any more missing sponges or missing limbs out there in the court files. Doctors sometimes settle these cases at the very mention of a lawsuit just to keep the information away from the medical boards. That, of course, makes it much harder to track down but, as I have found when reporting on other doctors with complicated legal histories, patients who have been hurt tend to find out about each other. Find that patient with the offended spleen and that might open the door to Moshiri's closet of skeletons.