discharge correctly, his attorney Jack. D. Garamella wrote in a Dec. 14, 2010, response to allegations against the doctor, sent to the DPH.

"The patient was completely asymptomatic when discharged," Mr. Garamella wrote.

Dr. Waldman also believed the hospital's radiology department "was fully capable of performing the monitoring tasks. There was a nurse present at all times checking the patient," Mr. Garamella writes.

Medical investigators interviewed two nurses about the incident: Kamala Basdeo, RN, and Linda Zaleta, RN. It was found monitoring of Mr. D'Amato was passed from Ms. Basdeo to Ms. Zaleta at shift change.

Ms. Zaleta told the investigator she was not told about a possible injury to Mr. D'Amato's spleen at shift change, according to the investigator's June 2, 2010, survey notes worksheet.

Ms. Zaleta, in turn, "left to assist with another procedure and a radiology technician monitored (Mr. D'Amato's) vital signs." Ms. Zaleta then returned to discharge Mr. D'Amato, the investigator's summary continues.

Since this incident, New Milford Hospital has put in place a strict protocol requiring imaging studies prior to any thoracentesis procedure. Dr. Waldman helped develop the protocol, according to the April 7, 2011, investigative report.

The hospital now also requires the transfer of a patient to the emergency department in the event of complications that require urgent medical treatment, the investigative report states.

Dr. Waldman had reached a settlement with DPH attorneys over the April 2010 incident. He was to be placed on supervised probation for a year, according to proposed consent order documents.

Dr. Waldman did not admit to allegations of negligence in the incident but agreed not to contest the DPH investigator's findings.

The state Medical Examining Board rejected that settlement on Aug. 16, requiring a stronger sanction, its meeting minutes reveal.

A hearing into the case is possible, if Dr. Waldman's and DPH lawyers do not reach an agreement acceptable to the board, DPH spokesman Diana Lejardi said last month.

Mr. D'Amato's widow, Diane D'Amato, has hired an attorney, John Houlihan Jr., of RisiCassi & Davis, who is reviewing DPH and New Milford Hospital documents to determine what action to take.