BAKERSFIELD, Calif. (KGET) -- A Bakersfield urologist has been accused of gross negligence and incompetence in connection with the 2022 death of a patient during surgery, according to a report filed with the state medical board. The allegations against Dr. David Horovitz could lead to the revocation or suspension of his license. The accusation was filed Friday by Reji Varghese, executive director of the Medical Board of California. The board will consider the allegations at a future hearing. A message left for Horovitz on Tuesday was not immediately returned. On Feb. 18, 2022, Horovitz performed surgery on a 63-year-old man at Mercy Hospital to remove a cancerous growth from a kidney. During surgery, which was performed robotically, "a vascular structure was inadvertently injured" -- and Horovitz could not find the source, according to the accusation. He took several steps to try to control the bleeding, but it worsened, the document says. He called for help from vascular surgeons, according to the accusation. While waiting, Horovotiz fired a stapler at what he believed was the patient's main renal artery -- the vessel supplying blood to the kidney, the document says. He hit the aorta, according to the accusation, cutting off blood flow to the lower extremities. The filing says "an entire section of the aorta was missing." "Vascular surgeons were unable to repair the aorta despite multiple grafts," according to the accusation. "Patient 1 died after approximately 12 hours of surgery." The accusation says firing a stapler without clearly identifying the renal artery was an "extreme departure" from the standard of care, adding surgeons must be aware of other structures in the area -- including the aorta --to avoid injury. "A stapler should never be fired when anatomy is obscured by bleeding," the filing says. The accusation says Horovitz instead should have continued holding pressure until the vascular surgeons arrived -- or converted from robotic to open surgery. But Horovitz didn't know how to proceed to open surgery without a "skilled bedside assistant" to provide pressure, the filing says. A second person wasn't necessary, the accusation says. Horovitz could have used the robotic arm to provide pressure -- something he didn't know, according to the accusation. "Due to (Horovitz's) unfamiliarity with the conversion to open algorithm, a series of missteps occurred that resulted in disaster," the accusation says.