Pittsburgh Post-Gazette series

What happens to doctors who report negligent colleagues?

During the week of October 26, 2003, the Pittsburgh Post-Gazette reported on a number of physicians whose careers have been destroyed because they had the nerve to report medical errors and negligence of their colleagues. Among the physicians are:

- A Corpus Christi, Texas family practitioner who criticized Humana Health Care for requiring that its own doctors treat patients who are admitted to its hospital instead of allowing patients to have their own doctors treat them. As a result of his criticism, the family practitioner was dropped from the Humana plan, claiming as its reason a malpractice claim that the physician had settled years before. The physician got a lawyer, sued Humana and was awarded almost $20 million.

- An Anadarko, Oklahoma physician who reported a colleague's abandonment of a patient to hospital administrators. The hospital took no action on the report, so the physician reported it to state and federal authorities, who threatened to suspend the hospital's license. The hospital then denied the physician admitting privileges. It took him seven years to get his privileges restored.

- An Encino, California OB/GYN specialist reported substandard treatment to hospital administrators, including one case of a surgeon removing the wrong fallopian tube. The physician also agreed to testify as an expert witness on behalf of a family of a patient suing the hospital for malpractice. The hospital suspended his privileges without so much as a hearing, claiming that he had a history of disruptive, threatening and non-cooperative behavior.

- A Reno, Nevada psychiatrist who reported to governmental authorities that the hospital and some personnel were guilty of substandard care. The psychiatrist reported that the hospital was discharging mentally ill patients when their insurance ran out, whether they were ready for discharge or not. The hospital's peer review committee ordered the psychiatrist himself to undergo psychiatric tests, removed him from the hospital staff and reported him to the National Practitioners' Database for having been involuntarily removed. The psychiatrist sued and, eventually, after going all the way to the Nevada Supreme Court, won reinstatement to the hospital staff.

- A Philadelphia, Pennsylvania neurologist reported a colleague for leaving the operating room in the middle of a surgery and allowing residents to place electrodes directly on the brains of epileptic patients. One of the patients died and another went into a coma. The hospital responded by removing her from the hospital staff

- A Portland, Oregon surgeon who was removed from his position as head of the liver transplant program at the University of Oregon Health Sciences Center after he reported an unusually high death rate among a colleague's patients. Over a seven month period, six of the colleague's eleven patients died. When the physician reported this to hospital administrators, he was rebuked for "a lack of collegiality." After another patient died, the colleague agreed not to perform any more liver transplants. However, being right did not save the head of the program from losing his job. He did sue the hospital, and a jury awarded him $500,000 in damages, but he is still out of work.

- A Cleveland, Ohio physician who was recruited in 1998 by University Hospitals to head the cardiothoracic surgery and lung transplantation program. The physician had previously worked at the Columbia University lung transplant program in NYC and the Cleveland Clinic program when Case Western University offered him the opportunity to run his own program. When he took over the heart surgery program, he found a disturbingly high death rate among patients, and he began pressing hospital officials to make changes. Among the cases he reported to hospital administrators was that of a 60 year old cardiac surgery patient who died after a heart monitor had been turned off; a heart bypass patient who ended up requiring a heart transplant after a surgical mistake; a patient scheduled for surgery on a Monday who died when his surgeon failed to come in over the weekend despite reports from hospital staff that the patient was bleeding internally; a patient who died following a heart valve replacement surgery that took 24 hours to complete and involved transfusion of 120 pints of blood; and a 46 year old woman who died of untreated post-surgical bleeding. Things were so bad that at one point the hospital had to suspend its heart transplant program because four consecutive patients died. However, it was the surgeon who reported the problems and pressed for changes who lost his job.

For the entire report, entitled The Cost of Courage, visit the Pittsburgh Post-Gazette website.