A Laconia Clinic doctor of internal medicine was reprimanded and fined $3,000 for mistreating a patient with a cancerous skin lesion and a patient with Lyme disease.

Dr. Roger N. Gutner signed a settlement with the state Board of Medicine after an investigation and waived his right to a full hearing.

Gutner is a staff doctor at the Laconia Clinic and has been licensed to practice medicine in New Hampshire since August 2003.

He is board certified in internal medicine and joined the clinic in September 2003, according to the clinic’s website.

Laconia Clinic is a clinical department of Lakes Region General Hospital, spokeswoman Natalie Rudzinsky said. Any disciplinary action by the clinic or the hospital would be kept confidential, she said.

According to the settlement, in which Gutner neither admitted nor denied wrongdoing, he engaged in alleged professional misconduct with two patients.

After removing a black lesion from the first patient’s shoulder, Gutner failed to send it to pathology because he thought it was benign, or noncancerous, and the patient died a year later of melanoma, a skin cancer.

The Board of Medicine document said it was unclear whether the patient’s death resulted from the delay in diagnosis of cancer.

A second patient was treated for a headache, but Gutner failed to recognize side effects to the patient’s nervous system of the medicine he prescribed. Also, the doctor used a less than adequate dose of an antibiotic for a possible Lyme disease diagnosis in the same patient, the settlement said.

Attorney Michael Pignatelli of the Rath, Young and Pignatelli law firm, represented Gutner. Gutner signed the settlement June 15.

Gutner must complete refresher courses in prescribing medicine and diagnosing cancer.

dpaiste@unionleader.com