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Medical Malpractice Case Prepares for Trial; Boca Radiologist Admits to Witness Tampering, Says She Would Do it Again, According to Freedland, Glassman, Farmer & Sheller
WESTON, Fla.--(BUSINESS WIRE)--March 15, 2004--A radiologist who faces a medical malpractice lawsuit not only admitted to anonymously mailing a key witness in the case an article advocating the blacklisting of physicians who testify against their colleagues, but said she would do it again, according to a recent deposition, Case Number: 02-20-668-CA15 (Miami-Dade).
The two remaining defendants in the lawsuit, Carol Adami, M.D., and colleague Vincent Mazzeo M.D., are accused of negligence for misreading a screening mammogram for Plaintiff Marsha Gilarmo, 45, a Palm Beach County resident and mother of three minor children.
Gilarmo's lawyers allege that doctors failed to detect obvious radiographic findings of cancer that resulted in Gilarmo suffering a nine-month delay in the diagnosis and treatment of her cancer. A confidential settlement with another doctor in the case as well as Boca Raton Community Hospital has been reached.
According to the deposition, Adami admitted to sending the article to a key witness in the case, Dr. G.W. Eklund, a world-renowned authority in the field of mammography for whom a standard mammographic technique is named. Rather than signing her own name and address on the envelope, Adami wrote the name and address of the director of her employer, Boca Radiology Group. She eventually admitted to sending the article herself only after the Court threatened to force all of the radiologists employed by Boca Radiology Group to submit fingerprint, handwriting and DNA samples.
In her deposition, Adami denied any wrongdoing or engaging in intimidation tactics by sending the letter, claiming that she sent the letter only because she believed the expert was applying an unfair standard of care. However, Adami was unable to provide an explanation as to why she did not mail the article in question to other medical experts.
"Adami's actions were specifically directed to Dr. Eklund, and were a blatant attempt to dissuade Eklund from testifying at the upcoming trial," said Plaintiffs' counsel, Mark Glassman of Freedland, Glassman, Farmer & Sheller." If her intentions were so honorable, then why did she forge another person's name on the envelope?"
Adami was a no show at a recent hearing in which Judge Gill Freeman ruled her actions were inappropriate. Judge Freeman ruled evidence of Adami's conduct and the article in question are admissible at trial in Plaintiffs' case in chief, and the Court is considering a special instruction advising the jury how they may interpret Adami's actions. Additionally, Adami will be held responsible for attorney's fees and costs related to work performed during the witness tampering investigation.
Meanwhile, the true victim in the case, Gilarmo, suffers with a very aggressive form of breast cancer that has spread to her lymph nodes. She recently suffered a second recurrence of cancer, which resulted in hospitalization and life prolonging surgery.
"The negligence of Adami and Mazzeo will cost Marsha Gilarmo her life," said Glassman. "The Gilarmos are eager for their day in Court."
Trial is set for May 2004 in Miami-Dade County....
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Follow-up stories on Adami:
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The following is a Record Searchlight/Redding.com news chronicle ...
DOCTORS under investigation April 30, 2003
First wave of lawsuits filed RMC, doctors, Tenet targeted by 82 patients
A Redding law firm has filed the first of many expected lawsuits on behalf of large groups of clients who claim Tenet Healthcare Inc., Redding Medical Center and several Redding doctors performed unnecessary heart procedures for profit.
Feb. 26, 2003
Lawsuit overload likely: 850 plaintiffs target doctors, Redding hospital and Tenet
Shasta County Superior Court officials are bracing themselves for a litigation overload. Lawsuits naming about 850 plaintiffs could be filed starting next week against two heart doctors, Redding Medical Center and its Santa Barbara-based parent corporation, attorneys and court officials said Tuesday.
Feb. 18, 2003
Officials for RMC, Tenet, Moon insist story not balanced
A "60 Minutes" news magazine report on Redding Medical Center, its parent corporation and former chief cardiologist Chae Hyun Moon was one-sided and unfair, spokesmen for the three said Monday.
Feb. 8, 2003
Dr. Realyvasquez takes leave Cardiac surgeon wants to focus on legal issues
Redding Medical Center cardiac surgery chief Fidel Realyvasquez Jr., one of two Redding doctors targeted by a federal Medicare fraud investigation, is taking a 90-day leave of absence, his attorney said Friday.
Feb. 4, 2003
Moon reaches decision; he will suspend practice
After a weekend of deliberation, Redding cardiologist Chae Hyun Moon decided to suspend his practice after all, a spokesman for his attorneys said Monday.
Jan. 31, 2003
Moon may change mind on suspending practice
Redding cardiologist Chae Hyun Moon, who had announced he would suspend his practice Saturday and had purchased newspaper ads to thank his patients, may be having second thoughts.
Jan. 30, 2003
Doctor suspends practice Insurance carriers refuse to renew Moon's coverage
Dogged by investigations and lawsuits and unable to renew his malpractice insurance, Redding cardiologist Chae Hyun Moon will suspend his practice Saturday.
Jan. 28, 2003
Redding heart doctor considers retirement
Chae Hyun Moon, one of two Redding doctors under investigation for suspected Medicare fraud, may retire as early as this week, a spokesman for Moon's attorneys said Monday.
Jan. 09, 2003
Blue Shield pulls contracts: Health firm terminates pact with doctors
Blue Shield of California, one of the state's largest health plans, has canceled its contracts with Redding heart specialists Chae Hyun Moon and Fidel Realyvasquez Jr., a spokeswoman confirmed Wednesday.
Dec. 05, 2002
State to probe hospitals: Assembly committee leader likens Tenet, HCA to Enron
SACRAMENTO Spurred by reports of massive price hikes and fraud allegations surrounding the nation's two largest hospital chains, the chairman of the state Assembly Health Committee announced Wednesday that his committee will begin an extensive probe of its own next month.
Nov. 28, 2002
Suits target doctor's partners: Moon, RMC, Tenet also are named in cases
Two partners of a Redding cardiac surgeon being investigated by the FBI for possible health care fraud are named in separate civil lawsuits that also target Redding cardiologist Chae Hyun Moon, Redding Medical Center and Tenet Healthcare Inc.
Nov. 25, 2002
Tenet's drug prices soar Study: Hospital firm charges more than rivals
LOS ANGELES Hospitals operated by Tenet Healthcare Corp. charged more than eight times their actual cost for drugs and more than twice as much as other hospitals nationwide according to a study commissioned by the California Nurses Association.
Nov. 17, 2002
Rally champions two doctors: Patients sing praises of embattled physicians
Don Ericson describes the FBI investigation of two Redding heart doctors as a witch hunt.
Nov. 15, 2002
Documents reveal source of complaints: Redding residents aided FBI in investigation of 2 doctors
Three more of those interviewed by the FBI in its probe of two Redding heart specialists have been identified through documents filed in the state's failed attempt to suspend the doctors' licenses.
Nov. 14, 2002
Doctors to keep working Judge refuses to suspend Realyvasquez and Moon
After rejecting the bulk of the evidence as hearsay bordering on rumors, a Shasta County Superior Court judge on Wednesday shot down a state medical board attempt to suspend the licenses of two Redding heart specialists.
Nov. 14, 2002
Supporters cite dedication, talent of heart physicians
Holding homemade signs and chanting "Save our doctors they save us," more than 200 supporters of two Redding heart specialists rallied Wednesday outside the Shasta County courthouse.
Nov. 12, 2002
Judge may rule on 2 Redding doctors' licenses
A Shasta County Superior Court judge may rule today on whether to temporarily suspend the licenses of two Redding heart specialists being investigated by the FBI.
Nov. 11, 2002
RMC whistle-blower's road to priesthood unusual
The Rev. John Corapi has been a multimillionaire real estate broker, a cocaine addict, a homeless man and a priest. Now, he's a whistle-blower.
Nov. 9, 2002
RMC duo called 'threat': Board asks judge to suspend cardiologists' medical licenses
Calling the federal fraud case against two Redding heart specialists the most egregious he has ever seen, a consultant to the state medical board warned that the doctors pose "a threat to patients" and that their licenses should be suspended.
Nov. 8, 2002
2 executives quit troubled RMC parent: Tenet's billing policy investigated; 2 Redding heart doctors probed
Troubled Tent Healthcare Corp., parent of Redding Medical Center, announced Thursday that its chief operating officer and chief financial officer are leaving the company in the wake of a federal pricing policy probe.
Nov. 7, 2002
Board targets 2 doctors: Order is sought to halt duo from heart operations
California's medical board is asking the state attorney general's office to seek a temporary restraining order that would halt the practices of two Redding heart specialists whose offices were raided last week by the FBI.
Nov. 5, 2002
Priest files first lawsuit in case; more litigation likely
One lawsuit has been filed and more could follow later this week as patients of two Redding doctors under investigation by the FBI seek legal aid.
Nov. 5, 2002
RMC parent dispatches team to check programs
A team of internal experts from Tenet Healthcare Corp. arrived Monday at Redding Medical Center to begin reviewing cardiology and related programs at the hospital, a Tenet spokesman said.
Nov. 2, 2002
Tenet Healthcare reeling: Investigation of cardiologists creates fallout
In the wake of a federal investigation into two Redding Medical Center cardiac specialists, officers of the hospital's parent Tenet Healthcare Corp. scrambled Friday to assure stockholders that problems are confined to Redding.
Nov. 2, 2002
Rally supports two doctors; some ex-patients skeptical
Shouting and chanting, more than 100 Redding Medical Center employees, hospital patients and citizens gathered for a candlelight rally Friday night in support of two doctors under investigation by the FBI.
Nov. 1, 2002
FBI reviews doctors' files: Affidavit suggests unnecessary heart procedures performed
FBI officials spent a second day at Redding Medical Center on Thursday copying records related to an ongoing investigation of cardiac specialists Dr. Chae Hyun Moon and Dr. Fidel Realyvasquez Jr.
Nov. 1, 2002
Documents reveal investigation into case began earlier this year
Documents that led to the search warrants being executed at Redding Medical Center and two doctors' offices provide detailed information about the federal investigation that prompted the probe.
Nov. 1, 2002
Tenet Healthcare stock plummets amid sell-off
Trading on Redding Medical Center parent Tenet Healthcare Corp. stock was halted Thursday before finishing at $28.75 per share, its lowest closing value of the year.
Oct. 31, 2002
Two doctors investigated: FBI searches hospital for evidence on surgeries
The FBI is investigating whether cardiac specialists Dr. Chae Hyun Moon and Dr. Fidel Realyvasquez Jr. fraudulently performed unnecessary surgeries on patients at Redding Medical Center, agents said.
©2002 - 2004 Record Searchlight - Redding.com, The E.W. Scripps Co. All rights reserved.
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Patients in Peril: How Virginia's medical system lets dangerous doctors continue to practice
Illustration by Sam Hundley / The Virginian-Pilot.
By LIZ SZABO, The Virginian-Pilot
© January 19, 2003
More than 250 doctors are licensed by the Virginia medical board despite records of serious mistakes or misconduct, a review of board actions since 1990 shows.
They work in every corner of the state, in virtually every specialty. Their ranks include sex offenders, swindlers, tax evaders, felons, former drug dealers and even a convicted murderer. Some have been rejected by a string of hospitals or insurance companies.
Among those still licensed:
- A Norfolk physician who injected cancer patients with medicine made with tiny amounts of their own feces.
- An Abingdon surgeon who accidentally cut out most of a woman's bladder and lost another patient just hours after a hysterectomy.
- A Winchester ear, nose and throat specialist who fondled six young boys during office visits.
- An Army doctor imprisoned for sexual battery of two underage girls during examinations.
- A Norfolk doctor imprisoned for murdering his wife with a .22-caliber rifle.
An analysis of the National Practitioner Data Bank, which tracks physicians, found at least 70 Virginia doctors who have been disciplined five or more times by state and federal authorities, hospitals or professional societies. Only 28 of them lost their licenses.
The Board of Medicine's executive director, Dr. William L. Harp, said state law forbids him or any board member from discussing individual cases or decisions.
Robert Nebiker, director of the Virginia Department of Health Professions, which includes the Board of Medicine, said he does not feel comfortable ``second guessing'' past decisions without reviewing all the evidence.
He said the board takes its responsibility for policing doctors seriously and revokes licenses only after careful consideration.
``A lot of money goes into making a health-care professional, and there aren't enough of them to go around,'' Nebiker said. ``So when you kill one off, you are potentially losing a scarce resource.''
The Virginia Board of Medicine, a state body whose 18 members are appointed to four-year terms by the governor, licenses more than 25,000 physicians and osteopaths. It can vote to reprimand doctors, fine them, place them on probation, suspend them or revoke their licenses.
Nebiker noted that the worst examples of physician misconduct represent a small fraction of the total number of cases that the board reviews.
Although patient advocates stress that the vast majority of doctors are capable and honest, they compare impaired or unethical practitioners to drunken drivers -- few in number but a threat to many people.
The General Assembly this month is considering a bill introduced by Del. Winsome E. Sears of Norfolk and another by Gov. Mark R. Warner that address how the state medical board operates.
``We're trying to rein in the bad doctors, but at the same time you have to rein in the Board of Medicine and the hospitals,'' said Sears, a Republican. ``This is about saving lives.''
Sears, who became interested in the issue last year after reading a report in The Virginian-Pilot about an incompetent Virginia Beach surgeon, said there have been wide-ranging problems with doctor discipline for years.
``It's not just about one doctor,'' she said. ``It's a whole host of people.''
In 1999, an audit by the Joint Legislative Audit and Review Commission, the watchdog arm of the General Assembly, concluded that ``the Board of Medicine does not adequately protect the public from substandard care by physicians.''
For too long, critics say, the medical system has focused on protecting careers rather than consumers.
``The patient should always be put first,'' said Dr. AlanLevinstone, an internist on the ethics committee at Inova Fair Oaks Hospital in Northern Virginia. ``It's not just the Board of Medicine. It's the politicians and the people in Virginia who have not demanded a better system.''
Board rarely revokes licenses for incompetence
Goettert case
Dr. Judith Goettert of Abingdon
Practice area: Family practice and gynecology
Medical school: University of Health Sciences, College of Osteopathic Medicine, Kansas City, Mo.
Year completed: 1984
Virginia law makes it difficult for the Board of Medicine to revoke a physician's license.
Nurses, dentists and others can lose their licenses for ``simple'' negligence, such as a single careless act. But doctors must be found guilty of ``gross'' negligence, such as a pattern of several serious mistakes.
A dozen patients suffered serious complications and another died after surgery by Dr. Judith Goettert, according to a board order, a formal document in which medical officials record their legal findings and disciplinary actions.
The October 2000 order catalogs Goettert's mistakes:
- Accidentally removing most of a woman's bladder.
- Operating on a pregnant woman after ``overlooking'' her pregnancy test.
- Accidentally tying off a woman's ureter, the tube that carries urine from the kidney to the bladder.
- Perforating the uteruses of three patients.
- Dropping a uterus on the floor during a hysterectomy, then contaminating her gloves and sterile instruments by picking up the organ and placing it on a table, according to a hospital incident report. When meeting with the medical board, Goettert later said that she caught the uterus in her lap.
One of the doctor's patients, Sharon Raye Santolla, died just hours after surgery.
In 1999, Goettert settled a civil lawsuit filed by relatives of Santolla, who died after a hysterectomy at Russell County Medical Center in Lebanon, Va. Goettert agreed to pay the woman's family $225,000.
``People like this should not be allowed to practice medicine,'' said Charles Inlander, president of a national consumer group called the People's Medical Society. ``It certainly isn't very reassuring to people like you and me. There should be no room for this in medicine.''
In 2000, the medical board placed Goettert on probation and allowed her to continue practicing, with the exception of obstetric and gynecology surgery.
Last year, Goettert told the board that she had given up obstetric and gynecological surgery, no longer had hospital privileges and planned to see patients only in her office. She said she was pursuing not only conventional medicine but homeopathy, a widely disputed type of treatment in which minute quantities of natural substances are administered to improve the body's defense against disease.
Goettert declined to be interviewed for this story.
On Aug. 6, 2002, the board ended her probation and restored her license to ``full and unrestricted status.''
Sen. Janet Howell of Reston said such stories demonstrate the need for change.
``It has been clear for some time now that Virginia is protecting physicians more than patients,'' said Howell, a Democrat. ``The upshot has been true horror stories of patients suffering from actions of physicians. . . . It always seemed that the department bent over backward to defend the doctor.''
Doctors can practice even after ''gross'' carelessness:
The Dunkwu case
Dr. Anthony A. Dunkwu of Alexandria
Practice area: Obstetrics and gynecology
Medical school: University of Florida College Of Medicine, Gainesville Fla.
Year completed: 1973
Even doctors whose records meet the ``gross negligence'' standard are sometimes allowed to keep practicing.
Dr. Anthony A. Dunkwu of Alexandria received only a public reprimand -- the mildest type of sanction -- after botching an abortion.
Dunkwu scheduled the procedure in March 2000 after estimating that his patient was about 10 weeks pregnant.
Although he performed a pelvic examination, he did not order a sonogram, according to a board order. Medical experts say sonograms are not required in the first trimester, although Hampton Roads abortion providers say they perform them routinely. Experts say the procedures are recommended in the second trimester.
Dunkwu began the procedure in his office using a local anesthetic.
The abortion quickly went wrong.
The board order states that Dunkwu believed he might have perforated the woman's uterus and stopped the procedure. A member of his staff took the patient to Inova Alexandria Hospital so that he could complete the abortion under general anesthesia.
Dunkwu examined the woman again. This time, he estimated her pregnancy at 12 to 13 weeks. According to the board order, ``Dunkwu could feel a separate mass, which he identified as a fibroid,'' a common type of benign uterine tumor.
He cut open the woman's abdomen and, according to the board order, discovered that the ``mass'' he had mistaken for a tumor was actually the uterus. He cut open the woman's uterus and removed a lifeless male fetus weighing about 2.7 pounds. Dunkwu estimated that it was 20 to 22 weeks old.
In fact, the fetus was 30 weeks old. Babies delivered prematurely at that age and size usually survive.
Alexandria Hospital placed Dunkwu's clinical privileges on probation for 29 days, the board order shows.
Punishments that last 30 days or longer generally have to be reported to the National Practitioner Data Bank, a registry created by Congress in 1990. Only about 40 percent of hospitals have ever filed a report.
In 2001, when Dunkwu faced the Board of Medicine, he admitted to making ``an unintentional mistake.'' He also noted that he had begun routinely performing sonograms for more of his patients considering abortion, according to the board order.
An informal board committee found Dunkwu to have been ``grossly careless,'' according to the board order, and reprimanded him.
Dunkwu did not return telephone calls for this story.
Some state officials have questioned the medical board's decision.
``In cases like this, the public is not being protected at all,'' said Del. Robert G. Marshall, a Manassas Republican. ``We are elected to be guardians of the public good. If we are not going to pay attention when the public is not being protected, then we bear responsibility and we should pay.''
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Sex abuse of children fails to trigger revocation
The Timberlake case
Dr. Byron B. Timberlake of Winchester
Practice area: Otolaryngology (ear, nose and throat)
Medical school: Ohio State University College of Medicine and Public Health, Columbus, Ohio
Year completed: 1964
Virginia's medical board is not limited to disciplining doctors for incompetence. Only 3 percent of investigations involve medical care alone, according to the 1999 state audit.
The board also can act in cases of unprofessional conduct. For example, doctors can lose their licenses for selling drugs or assaulting patients.
A review of the cases of more than 600 doctors and thousands of pages of records, however, found that the agency allows more than 40 doctors to practice medicine despite offenses such as sleeping with patients, seducing teenage girls or sexually harassing co-workers. About 90 doctors hold licenses in spite of substance abuse or improperly prescribing drugs.
According to board orders:
- Dr. Daniel M. Calhoun Jr. struck a surgical patient at Riverside Regional Medical Center in Newport News in 1992. In 1994, he struck a surgical patient, swore and knocked surgical instruments to the floor.
- Dr. Fang S. Horng, a Luray surgeon, fathered a child with a patient.
- Dr. Antony Joseph, a Richmond psychiatrist, impregnated a former patient and then told her to ``get rid of it.''
And then there is the case of Dr. Byron B. Timberlake.
Board members concluded that he fondled six boys between the ages of 6 and 13.
The board could have taken Timberlake's license but instead allowed the Winchester ear, nose and throat specialist to continue practicing.
The abuse began nearly a decade before Timberlake appeared at a formal hearing of the medical board in 1985, according to an official board order.
Timberlake saw an adolescent boy 22 times between 1975 and 1977, according to the board order. On nearly every visit, he took the child to an operating room alone. Out of sight of the boy's parents or his staff, he fondled the boy's genitals and, on one occasion, placed his ear on the child's belly below the navel.
Timberlake got another child alone by telling his mother that he planned to check the boy's lungs in a different room.
Board officials ruled that Timberlake's bizarre behavior had nothing to do with a legitimate exam. Officials found that he routinely examined boys' genitals behind closed doors while a nurse or other staff member waited outside.
At his hearing, Timberlake testified that he preferred not to examine children in front of their mothers or chaperones because ``the male adolescent patient would feel awkward and embarrassed.''
Timberlake did not return telephone calls for this story.
He was arrested in December 1983 and charged with committing aggravated sexual battery on a child under 13. A jury found him not guilty in June 1984.
The family of an 11-year-old boy filed a civil suit against Timberlake in 1985. The doctor settled the suit two years later.
In the lawsuit, filed in Winchester Circuit Court, the boy's family charged that the ``conduct of the defendant was of such a nature as to shock the conscience of reasonable men.''
Yet the board was forgiving.
Medical officials found Timberlake ``guilty of fraud or deceit'' and unprofessional conduct, ruling that his treatment of the six children was ``contrary to the standard of ethics,'' according to the board order. He was further found to have practiced medicine ``in such a manner as to make his practice a danger to the health and welfare of his patients.''
Authorities revoked Timberlake's license but immediately ``stayed'' the revocation, placing the doctor on indefinite probation, according to the board order. Officials ordered him not to treat boys under 18 and to see a psychiatrist.
The board commonly issues one sanction and replaces it with another if it believes there are mitigating circumstances, director Nebiker said.
The next year, in 1986, the board allowed Timberlake to begin treating young boys again. Officials required that such visits take place ``in the presence of an appropriate chaperone, preferably a parent,'' according to a board order.
To protect the identity of her son, the mother who sued Timberlake asked that her name not be used. She is still angry that the board allows Timberlake to practice and worries that other parents may not be aware of his history.
``We had such a sound case,'' she said. ``It's just astounding.''
In 1990 -- five years after the board found him guilty -- Timberlake was taken off probation, and his license was ``reinstated with all attendant rights and privileges,'' a board order shows.
There are no restrictions on his ability to see children.
Physicians allowed to use discredited alternative therapies
The Speckhart case
Dr. Vincent J. Speckhart of Norfolk
Practice area: Internal medicine and oncology
Medical school: New York Medical College, Valhalla, N.Y.
Year completed: 1958
Dr. Vincent J. Speckhart's unusual brand of medicine has attracted the attention of state investigators.
At one time, the Norfolk oncologist treated cancer patients with vaccines made with minute quantities of their own urine and feces, a board order shows. He also has used a non-standard, experimental procedure called ``electro-acupuncture of vol,'' in which machines are supposed to measure patients' electrical activity as a way to diagnose disease.
In 1993, the board concluded that some of Speckhart's treatments had no ``accepted therapeutic purpose'' and were ``contrary to sound medical judgment,'' according to an official order.
The board found that Speckhart, who declined to comment, violated Virginia law, conducted his practice unethically and endangered patients, according to the order. He was instructed to stop using the unusual vaccines and to use the acupuncture procedure only as part of formal clinical trials.
The board voted to arrange an audit of Speckhart's practice and placed him on probation, which lasted until 1998.
Speckhart was quoted in The Virginian-Pilot after his 1993 hearing as saying, "I am grateful to the board for its concern, patience and diligence in looking after their patients. I feel vindicated . . . I am a good physician."
The family of Navy Cmdr. Robert A. Rizzi, a 48-year-old cancer patient who died after being treated by Speckhart, filed suit against the physician in Norfolk Circuit Court. In 1996, a jury in 1996 found in the family's favor.
The lawsuit asserted that Rizzi, a Hampton Roads father of three, died as a direct result of Speckhart's ``failure to comply with the applicable standards of care.''
Rizzi's widow said she's shocked that Speckhart is still practicing.
``When you have a family member with cancer, you're pretty desperate,'' said Victoria Rizzi. ``He sure had us fooled.''
>> Story continued:
- Doctors lose licenses not for medical care, but for criminal convictions
- Even convicted felons can practice medicine
- A doctor convicted of felonies directly related to patient care is allowed to keep working
- Even when doctors lose their licenses, it may not be for long
>> Read about those cases
Previous related report: Operating Behind Closed Doors - the Dr. Robert G. Brewer case
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Patients in Peril, Part 2
By LIZ SZABO, The Virginian-Pilot
© January 19, 2003
(... story continued from Part 1)
Doctors lose licenses not for medical care, but for criminal convictions
The Zamzam case
Dr. Salih M. Zamzam of Grundy
Practice areas: Otolaryngology, orthopedic surgery, gynecology
Medical school: American University of Beirut, Lebanon
Year completed: 1967
The Internal Revenue Service accomplished what the Board of Medicine had long refused to do -- keep Dr. Salih M. Zamzam away from patients.
Zamzam had been investigated repeatedly throughout the 1990s. For years, the board chose not to suspend his license, even after concluding that he may have contributed to a patient's death.
The Grundy, Va., surgeon was finally removed from practice in 1997 when he was incarcerated after his conviction for felony tax evasion.
Yet charges about his ethics and competence date to 1990.
That's when Zamzam groped three female patients under the pretext of legitimate medical exams, according to an official board notice that spelled out the charges against him. In one of the cases, prosecutors charged, Zamzam pulled a woman's pants down to her knees and, while standing behind her, reached under her clothes to grope her breast and pressed his penis against her buttocks.
In 1993, Zamzam -- whose practice ranged from gynecology to orthopedic surgery to ear, nose and throat operations -- signed a consent order, which is somewhat like a no-contest plea. The board placed his license on indefinite probation.
In its final order, however, the board deleted all of the graphic details of Zamzam's behavior toward the three women. Instead, it recorded only that he ``acted unprofessionally and in a sexually inappropriate manner.''
The terms of Zamzam's probation required him to use a female chaperone when treating women and to comply with other restrictions.
In the same consent order, the board found that Zamzam had improperly prescribed Methadone -- used as a substitute for heroin when treating addicts -- along with a barbiturate called Butalbital.
``This treatment was without accepted therapeutic purpose and injurious'' to the patient, who died two days later of ``multiple drug poisoning,'' the board order states.
Two years later, board prosecutors accused Zamzam of performing a mastectomy on a woman's right breast based partly on the results of a mammogram without performing a biopsy to verify that the woman really had cancer, according to an official notice. Fewer than 30 percent of women with suspicious mammograms actually have the disease.
The woman was cancer-free, and Zamzam had needlessly cut off a healthy breast, the notice states.
In 1995, the board issued an order faulting Zamzam in his administration of drugs but postponed a decision about the mastectomy. Board officials voted to allow an audit committee to review the case and decided that Zamzam should remain on probation.
In a recent telephone interview, Zamzam said he offered to perform the mastectomy in part because the woman was small-chested and a biopsy would have ``deformed'' her breast. The woman already had lost one breast to cancer.
``I said, `If you let me do the mastectomy, you don't have to worry about further follow-ups or breast exams every year,' '' Zamzam said. ``The board won't listen to the facts. This lady was sort of money hungry. She would have been happy to have had cancer so she could collect money from the insurance company.''
Authorities in New York, where Zamzam also held a license, were far more severe than their Virginia counterparts.
When one medical board disciplines a doctor, officials in other states where he or she holds a license typically sanction the practitioner as well. Based on Virginia's findings, a hearing committee in New York voted to revoke Zamzam's license, ruling that ``the serious nature of the offenses and the absence of mitigating factors made revocation the only appropriate sanction.''
Virginia's board finally suspended Zamzam's license in 1997, after the doctor was convicted of tax evasion in U.S. District Court in the Western District of Virginia.
Zamzam said he served two years in jail because of the conviction. He blamed his tax problems on his accountant, who has since died.
Zamzam petitioned the board for reinstatement in 1999. By then, a board order states, he was on supervised release from prison.
The board -- which had finally made a decision on the mastectomy case, finding Zamzam negligent -- rejected his request.
Zamzam applied for reinstatement most recently in 2000.
The board turned him down.
He said he hasn't given up hope, however. He plans to take a standardized competency exam for practicing doctors to prove his fitness to Virginia officials.
``If they really cared for the public and the patients, they would almost immediately reinstate my license,'' Zamzam said. ``Almost every day I get 20 calls from patients asking me, `When are you coming back?' ''
Even convicted felons can practice medicine
The Schorr case
Dr. Julian B. Schorr of Scarsdale, N.Y., formerly of Norfolk
Practice areas: Pediatrics, blood banking, hematology, oncology, sports medicine
Medical school: Columbia University College of Physicians and Surgeons, New York, N.Y.
Year fellowship completed: 1951
Current Virginia law allows doctors whose licenses have been revoked to apply for reinstatement after only one year.
In some cases, that leniency allows even those convicted of violent crimes to quickly return to practice.
A review of public board documents turned up more than 30 convicted felons licensed by the state of Virginia.
State law requires health officials to suspend the license of any doctor convicted of a felony, Nebiker said. But Virginia also demands that the board give the doctor a fair hearing at its next meeting, where the practitioner can ask to be reinstated.
``Obviously, when anyone is convicted of a felony it's serious, and it indicates conduct that you may not want in someone providing you health care,'' Nebiker said. ``I could certainly understand why someone might be concerned about it.''
The majority of felons licensed by the Virginia medical board committed nonviolent offenses such as tax evasion.
Dr. Julian B. Schorr's license was revoked in 1979 after a Norfolk Circuit Court jury convicted him of second-degree murder.
Schorr was sentenced to eight years in prison after shooting his wife twice in the chest with a .22-caliber rifle in their Edgewater home. Schorr admitted to the January 1978 shooting but claimed he fired in self-defense after his wife attacked him with a knife during an argument.
The couple had played a prominent role in the community. Schorr, who had directed the Tidewater Regional Red Cross Blood Program, was also a professor at Eastern Virginia Medical School and sometimes served as a consultant for medical cases around the world.
Board members voted to revoke Schorr's license shortly after his conviction.
At the hearing, some doctors said they were sensitive to criticism that -- even then -- the board was too lenient with physicians. Dr. Eugene O.S. Stevenson of Fairfax was quoted in The Virginian-Pilot at the time as saying that the board should send a message that it was committed to rooting out bad doctors.
``We have child molesters, murderers and frauds whose licenses have not been revoked,'' Stevenson said. ``This is one of the reasons that this board has received criticism for not taking strong positive action.''
Schorr served two years in prison. Nine years after his wife's murder, however, the board voted to reinstate his license and place him on probation.
In 1990, the state board voted to end Schorr's probation and reinstate him without restriction.
In an interview, Schorr said he now works part time practicing sports medicine in Scarsdale, N.Y., an affluent Manhattan suburb, and also serves as a pediatrician for a foster-care agency in Irvington, N.Y. He said the board made the right decision.
``The crime I committed was a domestic crime which has an almost zero rate of recidivism, and it was not connected to my medical career,'' Schorr said. ``I paid my penalty to the community. I was a good physician.''
A doctor convicted of felonies directly related to patient care is allowed to keep working
The Talbot case
Dr. Asa Talbot, Jolivert, Haiti
Surgery: Head and neck, allergy, ophthalmology, otolaryngology, plastic surgery within the head and neck, facial plastic surgery, general practice, pediatrics, allergy
Medical school: Indiana University School of Medicine, Indianapolis
Year completed: 1965
Unlike Timberlake and Zamzam, who were never found guilty in a criminal court of harming patients, Dr. Asa Talbot was convicted of sexually abusing those in his care during exams.
In 1988, Talbot was convicted by a U.S. District Court in Tennessee of one count of aggravated sexual battery and another count of sexual battery, according to court records.
Talbot pleaded guilty to fondling two underage girls from May to June 1985 while serving as an Army medical officer at Fort Campbell, Ky., according to a board order. Talbot fondled a 17-year-old girl during an examination after a tonsillectomy. He also groped the pubic area of an 11-year-old girl during an ear, nose and throat examination.
This wasn't the first time Talbot had been accused of sexual misconduct.
A board order reports that he was accused of kissing a patient as she came out of anesthesia in 1977 while he was in private practice in Harrisonburg. Talbot denied the allegations, which were never proven.
In 1979, executives at Rockingham Memorial Hospital in Harrisonburg found that Talbot conducted himself ``in an inappropriate and unprofessional manner'' with two female patients, according to the board order. The hospital placed his privileges on probation for a year and required him to have a chaperone when examining women or girls.
Talbot was reprimanded by the commanding officer at Fort Campbell for his behavior toward three female subordinates in 1984 and 1985, according to the board order. He repeatedly made offensive sexual comments to the women, solicited sexual favors, and kissed and fondled them.
After his conviction, Talbot was dismissed from the Army with a ``less than honorable'' discharge, according to the board order.
The Virginia Board of Medicine revoked Talbot's license in 1988, then restored it two years later and ordered him to undergo counseling and fulfill other requirements. A board order shows that Talbot's probation ended in 1994.
Today, Talbot works in Jolivert, Haiti, at Missions of Love Inc., a religious charity.
Dr. Robert Johnson, the mission's president, said he's aware of Talbot's conviction. Talbot uses a chaperone when treating children, Johnson said.
``We count him to be a real asset to our mission,'' Johnson said. ``He has a very special place in his heart for Haitians, especially the children.''
Even when doctors lose their licenses, it may not be for long
The Tanksley case
Dr. Marion H. Tanksley, Fulton, Texas, formerly of Saluda, Va.
Practice areas: Osteopathic medicine
Medical school: Des Moines University, Osteopathic Medical Center, Des Moines, Iowa
Year completed: 1968
The Virginia Board of Medicine heard the case of Dr. Marion H. Tanksley only after a military court-martial had found him guilty of several serious crimes.
While the Navy's sanction was permanent, the Virginia board reversed itself after only five months.
In March 1995, Tanksley, a Navy captain, was court-martialed and convicted of taking indecent liberties with a minor, according to a board order. The child was his 6-year-old daughter.
Tanksley, an osteopathic physician, was convicted of two other felonies, including lying on official military documents and obstructing justice. A seven-member Navy panel found that he intimidated witnesses and lied about prior charges that he had driven drunk, physically abused his wife and sexually abused his daughters, had his medical privileges suspended and had been sued for malpractice, a board order shows.
Tanksley, now 65, had served as the administrative director of the Oceana Branch Medical Clinic. He spent eight months before trial in the brig at the Norfolk Naval Station and 19 more in the federal penitentiary at Fort Leavenworth. He was dismissed from the Navy.
At the court-martial, military prosecutors argued that Tanksley's crimes began years earlier.
Tanksley's ex-wife, Loni Kemp, said he terrorized her and kept her from speaking out about his abuse of their daughters. Kemp said Tanksley has four daughters with her and a fifth daughter with a later wife.
Tanksley's two older daughters had run away from home as teenagers, according to a decision by the U.S. Court of Appeals for the Armed Forces. One of those daughters testified during the appeal that Tanksley began molesting her in the bathtub in the 1960s, when she was 3 or 4 years old, and raping her when she was 9 or 10. The abuse continued, she testified, until she ran away from home at age 17 in 1978.
This daughter contacted Virginia authorities in 1993 after learning that Tanksley had taken a shower with her 6-year-old half-sister, according to documents from the appeal.
In September 1996, the Board of Medicine automatically suspended Tanksley's license based on his felony conviction, as required by state law.
At a formal administrative hearing five months later, the board found Tanksley guilty of unprofessional conduct. In particular, he was found to have practiced medicine unethically and endangered his patients, the board order shows.
The board voted to stay his earlier suspension and forbid Tanksley from practicing medicine until he complied with a number of terms, including taking a test of medical knowledge and being examined by a psychiatrist.
Just a few months after that, in October 1997, the board placed Tanksley on indefinite probation. The board's order allowed him to resume practicing medicine as long as the medical board's executive director approved of the setting.
Tanksley's ex-wife said she was shocked by the board's leniency.
Kemp said she's frustrated that the board was not swayed by her repeated appeals. State officials, she said, seemed more interested in protecting Tanksley's livelihood than anything else.
``If they are going to let him keep his license, then I just wouldn't trust anyone with a medical license in Virginia,'' Kemp said. ``And that's unfair to all the good doctors out there.''
The Navy upheld Tanksley's conviction and denied his appeal in September 2000.
North Carolina's medical board reprimanded him in 1999. In 2000, Florida revoked his license. Tanksley is included on sex offender registries in Georgia and Virginia. The Virginia Sex Offender Registry lists Tanksley's last known address as Fulton, Texas.
Tanksley's attorney, Allen P. Fancher of Virginia Beach, said the doctor is now living in China, where he is teaching English. When contacted by e-mail, Tanksley said, ``I have always felt that the Virginia Board of Medicine was very fair in all aspects of my situation. I hope that the medical board will continue giving physicians the same professional fair play that was given to me.''
Today, his license is active, ``with all attendant rights and privileges.''
Nothing in the board's order forbids him from treating women or little girls.
Computer-assisted reporting specialist David Gulliver contributed to this report. Reach Liz Szabo at 446-2286 or lszabo@pilotonline.com
More information:
- About the Virginia Board of Medicine
- Bills proposed to reform the board:
Patients in Peril: Proposed reforms to Va. Board of Medicine
The Virginian-Pilot
© January 19, 2003
Legislation introduced by Gov. Mark Warner and Del. Winsome E. Sears, R-Norfolk, aims to reform the Virginia Board of Medicine and increase its power to protect patients.
Both bills would:
- Permit the medical board to act after a single case of negligence. Current law bars the board from revoking a license unless it can prove a pattern of negligence.
- Allow regulators to issue a ``confidential'' letter of concern -- which would be kept secret and would not be available to the public -- in lieu of disciplinary action in cases where there is little or no injury to a patient. The letters could prescribe remedial action such as counseling or additional education.
- Increase penalties and set mandatory minimum fines for hospitals and doctors who fail to report cases of negligence.
- Require increased reporting by hospitals of negligence.
- Increase public disclosure of some state disciplinary actions.
- Require a three-year waiting period -- increased from the current wait of one year -- before a physician can apply for reinstatement of his or her license.
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Board of Medicine
The Virginian-Pilot]
© January 19, 2003 There is a 7/11 ratio, which means doctors outnumber consumer advocates [neutral parties
What it is: The 18 members of this state body are appointed to four-year terms by the governor. Eleven members are medical doctors, three are other health professionals, and four are members of the public. The board licenses medical doctors, osteopaths, chiropractors, podiatrists and certain other health practitioners. The board disciplines practitioners and creates regulations for the practice of health care. Its meetings are open to the public.
What can it do? The board has a range of ways to discipline health professionals, such as reprimanding them, fining them, placing them on probation, suspending them, revoking their licenses, denying them the right to renew a license and accepting the surrender of a license. Most disciplinary actions are reported to the National Practitioner Data Bank, a registry created by Congress to help track physicians across the country. Prospective employers and hospitals check this registry when considering whether to grant doctors privileges. If doctors hold medical licenses in other states, those states may choose to act on the Virginia agency's findings and issue their own penalties.
Suspension and revocation: Doctors whose licenses are suspended or revoked may not practice medicine unless the board votes to reinstate them.
Probation: Doctors on probation often are permitted to practice but must fulfill certain conditions, such as taking additional medical classes or undergoing counseling. A doctor who fails to fulfill the terms of probation could lose his or her license.
Reprimand/Censure: Doctors who are reprimanded or
EXAMPLES OF THE LACK THEREOF