Neurosurgeon suspended six months after patient dies following nerve blocks injections

An Ontario neurosurgeon with a long disciplinary history in the United States is facing a six-month suspension after the death of a patient following the administration of nerve blocks.Dr. Stefan Joseph Konasiewicz had been treating the patient, a 70-year-old man with a history of neck and shoulder pain, since 2015. The treatment plan included a series of injections for pain management.But on Oct. 31, 2024, the patient collapsed after Dr. Konasiewicz administered a series of nerve blocks to treat pain. The patient, who also had a history of cardiac issues at the time of his death, could not be revived and ultimately died, despite receiving CPR. The Office of the Chief Coroner had expressed concerns about Dr. Konasiewicz’s practice and said the patient had experience an inadvertent intrathecal injection of local anesthetics. An investigation from the College of Physicians and Surgeons of Ontario (CPSO) found that Dr. Konasiewicz’s technique for fluoroscopic-guided cervical facet had improper needle placements that “posed significant risks to patient safety.” “Specifically, there were multiple instances where Dr. Konasiewicz directed needles toward the spinal canal (not the intended target) without confirming their final position using required lateral views or ensuring adequate imaging quality,” the Ontario Physicians and Surgeons Discipline Tribunal said in its summary of the college’s investigation.The college’s investigator also expressed concerns about the use of alcohol neurotomy in the cervical spine without image guidance, the use of nerve blockers not indicated for chronic pain management and the fact that multiple injections were performed in a single session without properly balancing the risks and benefits. Ultimately, the college’s investigator concluded the care “did not meet the standard of practice of the profession and displayed a lack of knowledge, skill and judgment.”On Jan. 31, 2025, after receiving information about the patient’s death, the college’s Inquiries, Complaints and Reports Committee imposed practice restrictions on Dr. Kozakiewicz’s certificate of registration, prohibiting him from performing “any neuraxial, paravertebral, plexus and facet joint injections and/or nerve blocks for adult chronic pain,” and “injections along or near the spinal column.”But despite these restrictions, the college received a letter from a patient on May 5, 2025, expressing concerns that he had breached these conditions by performing injections along or near her spinal column.In his defence, Dr. Konasiewicz said he had interpreted the practice conditions differently, but did not dispute that he had performed the injections.This isn’t Dr. Konasiewicz’s first run-in with the college’s disciplinary committee. After a separate investigation into his practice in 2022, Dr. Konasiewicz had previously signed an undertaking to complete a 12-month clinical supervision of his practice followed by a reassessment. But upon reassessment, the college’s assessor found that Dr. Konasiewicz’s “failed to maintain the standard of practice” in 12 of the 15 patient charges reviewed, highlighting issues such as inadequate record keeping and failing to change treatment plans even when the evidence showed the treatment was ineffective.As a result of the patient death, the breach of practice conditions and the findings of the reassessment, the tribunal imposed a six-month suspension and issued a reprimand as part of a joint submission between Dr. Konasiewicz and the college, along with a minimum of 12 months of clinical supervision that involves the direct observations of a minimum of 200 procedures.Dr. Konasiewicz has also been ordered to complete a course from the International Pain & Spine Intervention Society as well as an ethics course. In addition, he will be responsible for paying $6,000 to cover part of the costs of the investigation.“Ultimately, we are satisfied that the proposed order is not so unhinged from the circumstances that implementing it would bring the administration of the College’s professional discipline system into disrepute,” the tribunal wrote.A long disciplinary history Dr. Konasiewicz was also one of the subjects of a 2018 investigation from the Toronto Star that looked into doctors with extensive disciplinary history practicing with impunity in Canada.The newspaper’s reporting found that in Minnesota, where he was licenced to practice between 1997 and 2009, Dr. Konasiewicz faced reprimands from the Minnesota Board of Medical Practice after several cases where surgical mistakes were followed by debilitating injuries and even deaths. The Duluth News Tribune also reported in 2011 that Dr. Konasiewicz had settled five malpractice cases for US$3.2 million.The Star also reported that in 2011, the Wisconsin Medical Examining Board reprimanded him after reviewing the Minnesota cases. Dr. Konasiewicz subsequently moved to Texas, but in 2013, the Texas Medical Board ordered him to take continuing medical education courses in record keeping and risk management upon reviewing two of the Minnesota Cases.Dr. Konasiewicz continues to hold an active licence in Texas, according to his profile on the CPSO website.

Neurosurgeon suspended six months after patient dies following nerve blocks injections

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