If you looked up Dr. Marvin Sponaugle last month on Connecticut’s electronic licensing website, you’d have found no sign he was disciplined in the past.
But in Florida, where Sponaugle is also licensed to practice medicine, authorities previously raised serious questions about his patient care.
The Florida Department of Health served Sponaugle with two administrative complaints in 2018 and 2021 alleging medical malpractice and, in the second case, failure to keep legible medical records justifying the course of treatment of one of his patients.
In that matter, a patient came to his facility, the Sponaugle Wellness Institute, in August 2016 for treatment of numerous symptoms, including postural orthostatic tachycardia syndrome, a condition that can cause dizziness and fatigue.
Sponaugle practices integrative medicine, which blends conventional therapies with safe alternatives. According to the Florida complaint, Sponaugle gave the woman numerous diagnoses, including “industrial toxicity,” excessive exposure to black mold and pancreatitis.
But Sponaugle failed to document clear reasoning for the diagnoses, the complaint alleges, despite the patient's complex symptoms and medical history, and crafted a treatment plan without documenting clear reasoning for how it would address her symptoms. The complaint also accuses Sponaugle of failing to reevaluate that plan when his patient’s symptoms didn't improve.
That patient later developed severe pancreatitis and died in a Florida hospital in November 2016, according to the complaint.
Sponaugle denies any liability in the patient's death. He did not respond to multiple requests from Connecticut Public for comment. During a hearing in October 2022 before the Florida Board of Medicine, his lawyer told authorities that the state’s allegations are “highly disputed.”
“There is an abundance of blame that can go around in regard to what happened at the hospital there,” the lawyer, Bruce Lamb, said at the hearing. “There were complications in her treatment."
Sponaugle ultimately reached a settlement with the board. Under that agreement, the board fined Sponaugle $15,000 and placed him on probation for a period of two years.
But months after the settlement went into effect, Sponaugle’s licensing records in Connecticut showed no sign of that disciplinary history in Florida. Patients who looked up his medical license here would have seen a spotless record.
Missing information
Sponaugle’s case isn’t the only one of its kind. An investigation by The Accountability Project found that information about disciplinary action or felony charges was missing from the profiles of more than a dozen doctors who are eligible to practice in the state.
Connecticut Public searched licensing records from more than 20 states, and found doctors eligible to practice in Connecticut who had their licenses suspended or revoked, signed consent orders and received public reprimands in other jurisdictions.
Among them: a Tennessee physician charged with illegally prescribing medication; a Virginia doctor who gave expired drugs to patients; and a teleradiologist who misinterpreted a 68-year-old woman’s CT scan. She later died.
Some matters dated back more than four years. And in each case, Connecticut’s online records showed those doctors had never been disciplined elsewhere.
Omitting that disciplinary information leaves gaps for medical boards trying to assess each doctor’s professional history, said Dr. Robert Steinbrook, health research group director for the consumer advocacy group Public Citizen. It also hampers patients, who rely on official government records to make informed decisions about medical care, Steinbrook said.
“Patients are not going to learn about it and be able to make decisions about which physicians to see based on complete information,” he said.
Connecticut’s response
Under Connecticut law, the Department of Public Health (DPH) is required to create public profiles for each physician and surgeon licensed to practice in the state. Those profiles must include records of disciplinary action taken by authorities in Connecticut, as well as a listing of other jurisdictions where the doctor is licensed to practice, and notations indicating whether the doctor has been sanctioned in another place.
Chris Andresen is chief of the Practitioner Licensing and Investigations Section at DPH, which is tasked with investigating complaints and evaluating out-of-state discipline. In an interview this month, Andresen acknowledged some state records were incomplete.
“Ideally, they would be updated real time,” Andresen said. “But that's not what's happening right now.”
In a subsequent statement issued to Connecticut Public, DPH said it routinely reviews disciplinary reports from other states to determine if they warrant corresponding disciplinary action in Connecticut, with a focus on prioritizing issues that might jeopardize the health and safety of residents.
But DPH acknowledged it had failed to update some physician profiles. It said the task of automatically forwarding all out-of-state discipline reports to the unit that updates those records was “inadvertently lost in the mix of reassigning tasks following a series of staffing changes.”
“The Department has corrected that workflow issue so that going forward profiles will be updated in a timely fashion,” it said. “At the same time, the Department is comparing past reports of out of state physician discipline with the information recorded in profiles and updating the information accordingly.”
Speaking earlier this month, Andresen said Connecticut typically relies on doctors self-reporting their disciplinary history when they first apply for a license, or when they renew that license each year.
Under state law, doctors also must report any new sanctions within 60 days, but that requirement isn’t typically enforced.
Connecticut also gets notifications from a national database. But with limited staff, DPH investigators prioritize acting on cases that directly affect patient care, and for which the physician’s conduct would also merit a sanction under Connecticut law, Andresen said.
“We're not gonna go after the jaywalker when we’ve got a drunk driver swerving down the street coming in the same direction,” he said.
Keeping patients informed
Some other states take a more proactive approach. For example, Sponaugle is also licensed in Colorado. That state’s medical board learned about the issues in Florida and issued Sponaugle a letter of admonition in December 2022.
Steinbrook, from the consumer advocacy group, said states can improve by more frequently querying information from that national database, the National Practitioner Data Bank.
“Congress, of course, could enact legislation requiring this,” Steinbrook said. “Unfortunately, they have not done that. So the onus is on the states to find information that is readily available to them.”
Connecticut has also faced critiques in the past for the length of time it takes to handle misconduct cases.
A pair of consecutive state audits looking back at the period from mid-2014 through mid-2017 documented long delays in the time DPH took to investigate some complaints against health care professionals, and called on DPH to seek more resources.
At the time, DPH cited several issues that contributed to delays, including a higher volume of complaints, and difficulty finding independent practitioners to act as consultants.
Lawmakers also increased the department's workload by expanding a mandate to report impairment by practitioners to 40 different licensed professions, rather than solely physicians and physician assistants.
A more recent audit covering the periods of 2018 and 2019 found those concerns regarding investigative delays had been resolved.
The Connecticut Medical Examining Board, which doles out discipline, also has more limited powers than similar authorities in other states. It isn’t an independent body and doesn’t have its own powers to investigate complaints. Rather, DPH recommends whether the board should revoke or suspend a license, and the board makes the final decision.
DPH officials have themselves pointed to limited resources as a constraint. Investigators vet as many as 1,500 complaints a year pertaining to doctors and several other types of licensed professionals, ranging from nurses to hairdressers and veterinarians.
In North Carolina, health officials enhanced the state’s public-facing website several years ago to provide more transparency about health care workers in the face of mounting public concern.
Among its initiatives, the state now posts primary source documents it gathers about disciplinary actions taken by medical boards in other states, making those records easier to find.
The goal is to make sure patients are well informed, said Jean Fisher Brinkley, communications director for the North Carolina Medical Board.
“I can't emphasize enough how important it is for somebody to go into any kind of relationship with a medical provider with their eyes open,” she said.
