Topeka ? A former Topeka physician has been sentenced to 32 months in prison for the death of a woman he was treating for Lyme disease using an unauthorized method.

Prosecutors and defense attorneys had recommended probation for John Toth after he pleaded no contest in November to a charge of reckless involuntary manslaughter in the 2006 death of Beverly A. Wunder.

But Shawnee County District Judge Jan Leuenberger rejected the suggestion Friday, saying the reasons given to avoid a prison sentence for Toth “pale” next to the damage to Wunder. He also ordered that Toth be jailed immediately.

The sentence stunned Toth and a packed courtroom of family and friends. It was so unexpected that a sheriff’s deputy wasn’t present to take him into custody and it took 10 minutes before one arrived.

Melanie Bezner, Wunder’s daughter and a former patient of Toth’s, said she was surprised by the sentence.

“I’m breathing a sigh of relief because justice has been served for my mother,” Bezner said. “My jaw dropped when he was sentenced.”

Toth, 58, initially was charged with reckless second-degree murder for the death of Wunder, 47, of Topeka, and reckless aggravated battery for his treatment of Bertha “Susie” Groves. But prosecutors dropped the battery charge because Groves did not want Toth prosecuted in her case, and because the doctor agreed to give up his medical license.

Toth treated Wunder and Groves, both Lyme disease patients, by giving them intravenous infusions of a “heavy metal” known as bismuth, which has not been approved for such a use.

Wunder died a year and two days after collapsing in Toth’s office on April 18, 2005, after receiving at least a second infusion of bismuth.

Groves, who had to be hospitalized in serious condition with kidney failure after receiving a similar treatment, said overall Toth’s treatment was beneficial and substantially improved her health.

Defense attorney Mark Bennett and deputy district attorney David Debenham had recommended Toth be placed on probation.

But Leuenberger said Toth hadn’t operated his medical practice with care and had manipulated his patients. He also said Toth didn’t report the names of 18 patients, including Wunder, to state officials for having Lyme disease, as required by law.

Before his sentencing Friday, Toth apologized to Wunder’s family and said he wanted to help her but used poor judgment.

“I am truly remorseful for the pain and loss I’ve caused,” he said.