Saturday, February 6, 2010

I wonder what Dr. J will think of this

The New York Times reports on nurses fired for doing the right thing
It occurred to Anne Mitchell as she was writing the letter that she might lose her job, which is why she chose not to sign it. But it was beyond her conception that she would be indicted and threatened with 10 years in prison for doing what she knew a nurse must: inform state regulators that a doctor at her rural hospital was practicing bad medicine.

...But in what may be an unprecedented prosecution, Mrs. Mitchell is scheduled to stand trial in state court on Monday for “misuse of official information,” a third-degree felony in Texas.

The prosecutor said he would show that Mrs. Mitchell had a history of making "inflammatory" statements about Dr. Rolando G. Arafiles Jr. and intended to damage his reputation when she reported him last April to the Texas Medical Board, which licenses and disciplines doctors.

Mrs. Mitchell counters that as an administrative nurse, she had a professional obligation to protect patients from what she saw as a pattern of improper prescribing and surgical procedures — including a failed skin graft that Dr. Arafiles performed in the emergency room, without surgical privileges. He also sutured a rubber tip to a patient’s crushed finger for protection, an unconventional remedy that was later flagged as inappropriate by the Texas Department of State Health Services.
Commentary on this case seems like something tailor-made for North Carolina's Dr. J.


Dr. Mary Johnson said...

The case is old news in the medical blogosphere, and I've already blogged on it - at Housecalls and Kevin MD's and Respectful Insolence.

And/so you don't have to wonder.

I'll probably do a post on it later today.

As I told you in my e-mail this morning, retaliation against whistle-blowing nurses and doctors is a huge problem in this country (especially in Texas) and is shielded by some very badly-written Federal laws.

The really sad thing about "citizen journalism" in these parts is that GSO had the tools in place to lead the pack with a very similar story (i.e. mine . . . a case that amounts to a "reverse Nifong") . . . in short, the blogosphere had a chance to BE "relevant".

But my story steps on the mighty name of Cone.

Anonymous said...

The woman is not even a real nurse, she is an admin nurse, those who type and checks medicare eligibility.

The rubber suture was a temporary fix. THe doctor is US licensed, had previously practiced in other US hospitals, FOR YEARS.

People are calling him now a quack because of the ramblings of a typist nurse who writes ghost letters so someone who worked all his life be deduced to a 'quack'.

She wants someone to lose his license, something the guy worked for all his life. Now that she was outed, she is now playing hero - claiming she just wants to save the world.

How can you be a hero if you are out to destroy someone's reputation and livelihood?

The guy has saved lots of lives, hasnt lost one. Yet the woman is out to destroy him. Now is that heroism to you?

Dr. Mary Johnson said...

Interesting comment. I might give it more credence if you had the guts to sign your name to your own "ghost-letter".

I'm no lover of the suits. But I'm sure all the hospital VP's and CEO's out there - who got their start as nurses - will be thrilled to hear that in the eyes of this physician's supporters, they are barely more than "typists".

Medical peer review (which this was) is a protected activity by Federal law. Anonymous complaints are accepted - even by the N.C. Medical Board. And those who report and act within those parameters are supposed to be protected - if they acted in good faith. Peer review materials (and deliberations) are inadmissable in Court. That's what makes this so ludicrous.

(Of course, in my case, the pesky black & white of Federal law did not stop Bob Morrison or Steven Eblin from releasing documents I authored and submitted in good faith to Peer and Medical Board review to discovery.)

The trouble with peer review is that good faith is NOT defined and that due process can often get lost in the shuffle of bad faith applications of the process.

I find it ironic that a local small town sheriff was all over this case (a the behest of the doctor) - but in twelve years here in N.C., and even with clear-cut evidence of criminal behavior, I cannot get law enforcment to look in my general direction.

Dave Ribar said...

Dear Anon:

Nurses have to have the ability to report these kinds of problems to the appropriate medical authorities. Indeed, they are required to do so.

Much of the problems to the doctor's reputation appear to be due to procedures and actions that were deemed inappropriate by medical authorities and administrators. They may also be due to the alleged retaliation that the nurses have suffered.

Dr. Mary Johnson said...

Dave, you are correct. Nurses and doctors are REQUIRED BY LAW TO REPORT.

It's the law that I foolishly relied upon for protection so long ago. Alas, North Carolina does not defend the duties it requires.

Moreover, in five years in this blogosphere, for all of their noble blather on transparency & accountability, I've not been able to get a journalist to care about that . . . and now I have a GSO cyberstalker dropping nasty comments on my blog almost every day (I am saving them and plan to give them to the DA).

If the authorities have taken action against this Texas doctor based, at least in part, on the complaints of the nurses (and it seems that they have), then it's fairly clear that this is a malicious prosecution.

The nurses have legal recourse, but first they have to survive this criminal trial, and then turn to civil court. It's an incredibly expensive proposition. Lawyers cost money. And most lawyers won't touch a civil case like this . . . the billable hours might be swell, but the likelihood of getting paid for those hours is not very good.

The average lay person whose legal training comes from watching too much Law & Order doesn't get that.

Part of the problem is that the medical authorities/boards don't really have the jurisdiction to intervene and stop stuff like this. What's more, in this state, they've not done anything to get it.

In short, they've totally sold out their own people.

And that will be the basis of the civil case I hope to file later this year.

Of course we can see how turning to civil court worked out the first time, can't we?

Dave Ribar said...


Thanks for your comment. As you may have read, criminal charges against one of the nurses were dropped (a small consolation for charges that never should have been filed in the first place). Charges against the other nurse still stand.

To its credit (and unlike your unfortunate experience), the Texas Medical Board issued strongly worded letters to the local Sheriff, condemning the prosecution. The nurses, in turn, have filed a civil suit.

Dr. Mary Johnson said...

Dave, I think I've more than established that the North Carolina Medical Board is a fairly tepid/useles bunch.

People have to die before they take notice. And they have to be sued in order to move.

Anne Mitchell was just found not guilty.

I think her civil suit should go well;)