PALM BEACH COUNTY, Fla. — A former Florida doctor, who was found liable for $100 million last week in a medical malpractice case centered on an infant's botched circumcision, has been linked to numerous mishandled procedures that include six patient deaths.

A Palm Beach County jury awarded the infant’s parents $100 million on Aug. 27 after the family accused former Dr. Berto Lopez of severing the child’s penis during a circumcision in 2021. Lopez, who had a 33-year career as an OB-GYN in Palm Beach County, performed the procedure 10 days after the Florida Board of Medicine voted to revoke his medical license.

During the trial, jurors heard from expert witnesses and the child's family, and saw graphic photos of the circumcision. Attorney Gary Cohen, who represented the family, described the procedure that reduced the infant’s penis to a "bleeding, scabby mess."

But that's not the only procedure Lopez reportedly mishandled. Court and official records reviewed by The Palm Beach Post, part of the USA TODAY Network, tied Lopez to at least 14 serious injuries to women and children, including six deaths.

Lopez had been named in four disciplinary cases and nine malpractice actions, including lawsuits over the deaths of two infants, an injury to another, and an 18-year-old mother who died in the 1990s. The average OB-GYN faces two or three lawsuits during a career.

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The case of Onystei Castillo-Lopez, a 40-year-old mother who in July 2017 after giving birth to her second child, led to Lopez's license revocation. Lopez had left the hospital to change his scrubs while Castillo-Lopez was wheeled into surgery.

Castillo-Lopez bled to death after she suffered tears in her cervix while giving birth. According to an administrative complaint, the Florida Department of Health said Lopez attempted to repair the cervix in a hospital suite instead of an operating room.

Lopez then failed to perform the required procedure — a complete hysterectomy, according to the complaint. Castillo-Lopez died of postpartum hemorrhage.

Castillo-Lopez's death came three months after several other deaths and injuries prompted the state Board of Medicine to restrict the doctor's license. Lopez failed to inform the mother and her husband about the restriction.

Lopez has yet to pay the settlement amount he owes Castillo-Lopez's husband.

How could Berto Lopez have practiced after board revoked license?

Lopez's license was revoked on Feb. 5, 2021, in the case of the death of Castillo-Lopez, but it didn't take effect immediately. The order taking away his license was filed on Feb. 22.

In the meantime, he was free to practice. On Feb. 15, the parents of a baby boy — identified as Baby G.L. — met Lopez at his office for the circumcision and agreed to Lopez's request for a $250 cash payment.

The former doctor did not tell the infant's parents about his license revocation when preparing to perform the circumcision, according to Cohen. "If he did, they would have run out that door so fast it would have broken," Cohen said during the trial.

The mother waited outside while Lopez cut off a third of the baby's penis, severing his urethra. Lopez told the father, who stood beside him, not to worry and that the bleeding was normal.

Lopez sent the family home with gauze after he sutured the wound and tried to stop the bleeding for about 45 minutes. The parents brought their baby to an emergency room the following day and were sent immediately to a pediatric urologist, who was "visibly shocked" after seeing the wound, the child's father testified.

The parents sued Lopez in January 2022 after learning that Lopez performed the procedure after the state Board of Medicine voted on his license revocation.

Who were the other injured and dead patients?

In a 2021 investigation, The Palm Beach Post traced multiple malpractice allegations throughout Lopez's career, including the deaths of six patients due to botched procedures. 

Early in his career, Lopez worked for the Palm Beach County Health Care District, the county health safety net for underserved people. Some of the patients who died or suffered catastrophic injuries were on Medicaid, the health care insurance that helps people with limited income and resources.

Here are some of the cases:

• Crystal Diane Hicks, infant. Lopez, in a deposition, said he was accused of not performing a timely C-section, causing her death in 1988.
• Earl Buchanan, infant. Records available show the settlement of a lawsuit filed against Lopez in 1992 for his death.
• Nakia Gilmore, 18, died following a 1994 procedure during childbirth. Records do not indicate the cause of death. 
• Samuel Mercedes, infant. A neural tube defect was not diagnosed and the baby suffered severe birth defects, according to 1994 court documents.
• Michelle Hirt, 31. Lopez failed to fully remove her dead fetus in 2002, ignoring a pathology report, according to the Florida Health Department. Hirt said she gave birth to the remains in a friend's bathroom.
• The small intestine of Joyce Rivers, 56, was punctured during an outpatient procedure to remove her ovary in July 2012, and she died of complications, according to the Palm Beach County Medical Examiner's Office. 
• Ashley Perez, a 29-year-old mother, died in April 2014 from internal bleeding following a C-section and tubal ligation in which an ovarian stitch gave way, according to Florida Health Department (DOH) documents.  
• Dominic Shelton, a baby boy, suffered severe brain damage, leading to cerebral palsy after a delayed cesarean section in April 2011, a lawsuit says.  
• Matthew Dixson, a baby boy, was born with a broken arm and permanent nerve damage in November 2011 because a C-section wasn't performed, a lawsuit says.
• Joann Catlett, 47, was incapacitated for six months after a hysterectomy during which her ureter, the duct that carries urine from the kidney to the bladder, was cut. She sued and won a settlement.   
• A woman that the state identifies only asL.R., age 32, suffered a postpartum hemorrhage in July 2014 after a tubal ligation, DOH documents say. She lost 6 liters of blood but lived.
• Baby R.R.R. lost his penis in a circumcision in May 2017, a lawsuit says. The suit was settled.

Contributing: Hannah Phillips and John Pacenti, Palm Beach Post

Holly Baltz is the investigations editor at The Palm Beach Post. You can reach her at [email protected].