The Connecticut Medical Examining Board on Tuesday rejected a settlement with a doctor who health inspectors say punctured a patient's spleen during a radiological procedure at New Milford Hospital last October and sent the patient home. The patient came back to the hospital's emergency room four hours later and died. "This case troubles me more than most," C. Steven Wolf, MD, an examining board member, said of Dr. Michael E. Waldman's actions. "He knows immediately he punctured the spleen, yet he doesn't tell the patient or the family. There is a wanton disregard for patient safety here." Waldman, 46, of Brookfield, was investigated by inspectors with the state Department of Public Health. He was recommended for discipline and faced possible license revocation and a fine. In a consent order worked out between health department lawyers and Waldman on Aug. 4, the department proposed a period of probation and monitoring by a consulting radiologist. But the medical examining board at its monthly meeting Tuesday rejected the consent order. "It's insufficient," said Robert A. Green, MD, a board member. "This is completely ignoring a life-threatening situation. He should have admitted the patient to the hospital for observation."