When Dr. Jeffrey Piccirillo moved to the small college town of Grinnell, Iowa, the Joliet surgeon had been sued multiple times over allegations of malpractice, personal injury and negligence. In 2003, less than a year earlier, he had filed for bankruptcy.
Things didn't go much better for Piccirillo in Iowa. Within a few years, he was battling another lawsuit, this time from a knee surgery patient alleging that he failed to properly diagnose a fracture and prevent it from worsening, according to court records.
Then the Iowa Board of Medicine charged Piccirillo with "professional incompetency." Eventually, he signed an agreement with the board that placed his license on indefinite probation and prohibited him from practicing surgery in Iowa. A similar agreement with Illinois followed.
Now Piccirillo, 48, has started over again as one of Illinois' and Iowa's few "Lyme-literate" doctors — physicians who are willing to treat the dubious diagnosis of chronic Lyme disease.
Lyme disease is real. The bacterial infection, chiefly transmitted by deer ticks, can cause rashes, swollen joints and inflamed nerves, and usually is curable with a round of antibiotics.
But some doctors are telling patients with common medical problems such as back pain, poor concentration and fatigue that their ailments stem from a chronic form of Lyme disease that can evade standard laboratory testing and treatment. To fight what they say is a persistent infection, the doctors often order months or years of antibiotics, which can cost patients tens of thousands of dollars, often out-of-pocket.
Both the Infectious Diseases Society of America and the American Academy of Neurology have concluded there's little evidence this form of Lyme disease exists. These professional medical organizations also say there is strong evidence from clinical trials that long courses of multiple antibiotics are pointless and even dangerous.
In a lengthy statement to the Tribune, Piccirillo wrote that he is a "Lyme disease survivor" and that he is dedicating himself to the care of Lyme patients. He said he is treating dozens of patients each week, many for Lyme.
"Lyme disease is personal to me," he wrote. "It's my forte, my passion."
His past problems are irrelevant to his current work, Piccirillo wrote.
"The matters you address are prior to the beginning of my practice," he wrote. "I have trained hard in the area of Lyme disease to provide the type of care I hope to perfect over time. … I aspire to be a better care provider than I ever was in my previous work."
In an online forum for patients where Piccirillo is referred to as "Dr. P," one patient posted a link to the Iowa board's action against him and said the doctor had explained it to her without prompting.
"Once you learn the reason, I think you will feel as confident in his care as I do," the patient wrote on the Road Back Foundation message board. She reported taking two antibiotics and a medication that treats protozoans.
After receiving his doctor of osteopathy degree from the Philadelphia College of Osteopathic Medicine in 1989, Piccirillo started practicing as an orthopedic surgeon in Joliet in the 1990s.
By 2002, he was earning more than $500,000 a year and living in a nearly 8,000-square-foot home, according to court records. After he declared bankruptcy in 2003, assets listed in court filings included a Hummer, a Jeep, a Porsche and a 39-foot boat valued at about $100,000.
In an email, Piccirillo said he went bankrupt because of the failure of a Joliet restaurant in which he had invested.
Among the lawsuits referenced in his bankruptcy filings was that of Susan Sweet, a patient who sued the surgeon in 2004. Sweet alleged that Piccirillo failed to give her antibiotics before or after he operated on her broken ankle in 2002 and that she developed an ongoing infection that was improperly treated.
Sweet's mobility was never the same after the surgery, according to sister Lori Phillips. Because Sweet was unable to stand to cook, the sisters were forced to close a Joliet catering business they ran together, Phillips said. Sweet developed other health problems, she said, and died at 56 of a heart attack last year.
Court records show that the case was voluntarily dismissed, but as part of Piccirillo's bankruptcy process, Sweet was awarded $2,695.95 on a $1 million claim.
Piccirillo wrote in an email that Sweet's case never went to trial. "I have no clue where the $1 M dollar number comes from," he wrote.
Court records show that Sweet was among 15 patients or their families who have sued Piccirillo; six cases were filed in 2003 and 2004 alone. Most of the cases filed against Piccirillo were dismissed. One case went to trial, and the jury found in his favor, according to Piccirillo.
Piccirillo said he has been served notice of lawsuits only seven times. "I suspect lawsuits can be filed but never served on the opposing party," he said. He said his insurance company settled twice.
Three years after Piccirillo moved to Iowa in 2004, Joyce Haines, of Grinnell, filed suit against him. One of her physicians filed an affidavit alleging Piccirillo had broken Haines' leg during knee-replacement surgery, failed to tell her not to put weight on that leg and later told her it had healed when it had not.
The case was settled for an undisclosed sum, Piccirillo said.
In 2008, the Iowa Board of Medicine charged Piccirillo with a "failure to provide appropriate care and treatment to numerous patients," according to a news release.
The board alleged that he "failed to demonstrate necessary surgical skills, failed to demonstrate necessary clinical judgment, failed to provide proper surgical treatment … and failed to provide appropriate preoperative and postoperative care to patients."
A 2009 agreement between Piccirillo and the Iowa Medical Board placed Piccirillo's license on indefinite probation and ordered him to pay a $5,000 civil penalty.
The agreement also required him to submit to psychiatric care and mental health counseling. The board concluded that after a mental health assessment, Piccirillo was "safe to practice medicine subject to appropriate mental health counseling and board monitoring."
Citing him for "professional incompetence and practice harmful or detrimental to the public in his orthopedic surgery practice," the agreement also prohibited him from performing surgery under his Iowa medical license.
A few months later, he signed a similar agreement with Illinois.
In an email, Piccirillo said the Iowa board's action was spurred by a complaint from a hospital employee, not a patient. The Iowa agreement allows Piccirillo to petition to terminate the probation.
"Probation is probation," he wrote in his statement. "It serves a protective and reconstituting purpose when allowed to run its course; it doesn't end one's life or one's productivity, but it also most certainly does not keep others from trying to do so, or from trying to exact an additional pound of flesh."
Piccirillo wrote that he believes he contracted Lyme disease in January 2006 while doing missionary work in Haiti. While he was a surgeon, he wrote, he was suffering from the ravages of Lyme disease — "ravages which took away my first love as a physician but made me a better doctor as a result."
He likened his past as a surgeon to Michael Jordan's unremarkable tenure as a baseball player, saying his new work was a better fit and something he excels at.
"I don't profess to be free of flaws, I'm no Michael Jordan, of course, but I'm just as focused at being the very best every bit as much as he was and still is today in his endeavors," Piccirillo wrote.
Piccirillo said he trained as a Lyme doctor with the International Lyme and Associated Diseases Society, a group that promotes the diagnosis and treatment of chronic Lyme disease. He has treated Lyme patients for about 21/2 years, according to news reports.
The society's treatment guidelines support treating patients diagnosed with chronic Lyme with long courses of antibiotics, sometimes administered intravenously and sometimes multiple drugs at once.
Piccirillo's statement said he uses a treatment protocol he attributes to his training from the society and his personal experience with Lyme. Referring to the standard treatment for Lyme infections, a short course of antibiotics, he asked why mainstream medicine would want to "accommodate the Lyme bacteria by letting it sip on two or three weeks of antibiotics after it has permeated the inter-recesses of every component of the body, including the brain, in its chronic form?"
Infectious disease physicians dispute Piccirillo's description of Lyme. Clinical trials found little or no benefit from long-term antibiotics along with serious — potentially fatal — risks. In one study, one-fourth of the patients suffered severe problems linked to the treatment, including blood clots, infection and the loss of a gallbladder.
Some doctors who treat Lyme disease patients with long-term antibiotics and other unproven regimens have been disciplined by medical boards, the Tribune reported in December.
In some of those cases, patients crowded board hearings to support their "Lyme-literate" doctors. And in Piccirillo's case, some patients also seem willing to look past his trouble with medical regulators.
"I think it's our gain," one person wrote on a message board in September. "I am most happy to be seeing him in 2 weeks!"