Drug doc faced claim

Malpractice lawsuit: Doctor with
cocaine-possession charge
dismissal was impaired
during patient’s care

By David Baker
Posted Sunday, May 29, 2011

A doctor who was the center of controversy after a drug-possession charge was dropped hours after a police officer allegedly found pieces of crack cocaine in and near his car was later accused in a civil wrongful-death lawsuit of being impaired while treating a patient at St. Peter's Hospital in Albany.

But the lawsuit, like virtually every other malpractice case filed against Capital Region medical providers over the past 12 years, was not reported by the media.

The doctor, Darroch Moores, was in the news in 2001 after he was pulled over in Albany’s Arbor Hill neighborhood for allegedly running a red light. The officer stated that he saw something being thrown out a window of Moores’ SUV, and found a small rock of crack cocaine in the vehicle’s ashtray and two pieces on the ground near the car.

The doctor claimed that while he was stopped at a red light, a teenager jumped into the back seat and tried to sell him the crack.

Moores initially was charged with possession of an illegal drug, but the next day an assistant district attorney agreed to drop the misdemeanor charge. The doctor instead pleaded guilty to running a red light and agreed to a fine of $100.

Moores, a surgeon, practiced at both St. Peter’s Hospital and Albany Medical Center Hospital and also had a private practice. He took a leave of absence and entered an in-patient physician-impaired program. As a condition of keeping his medical license, he was ordered to submit to random drug testing after the state Board for Professional Medical Conduct alleged that he was a “habitual user of … narcotics, barbiturates, amphetamines, hallucinogens or other drugs having similar effects,” an allegation Moores did not deny in a consent order.

Moores returned to work at St. Peter’s Hospital nine months after his arrest, in January 2002. But the lawsuit alleges that in October of that year, Moores and another doctor, Bradley Champagne, caused injuries that led to the death of 57-year-old Kathleen Baker of Cohoes, in part by damaging Baker’s spleen during a surgery, requiring its removal.

“The Defendant Moores was negligent for being under the influence of narcotics and/or alcohol at the time care and treatment was rendered to the decedent,” the lawsuit says. “The defendants’ negligence and medical malpractice was a proximate cause and substantial cause of decedent’s injuries and death, on December 11, 2004, and damages and deprived her of a substantial opportunity to recover from her condition.”

The dropped drug charge prompted a wave of controversy in the media, with representatives of minority groups accusing the DA’s office of racially motivated favoritism. But a search of the archives of the area’s newspapers produced no indication that the lawsuit alleging that Moores was later impaired while treating a patient was reported.

The lawsuit also named as a defendant St. Peter’s Hospital. Documents publicly available at the Albany County Clerk’s office do not indicate how the claim, filed by Kathleen Baker’s husband, Bryce, ended. But an entry on the court system’s Web page dated August 27, 2007 – just 17 months after the case was filed – says: “Disposed. Settled before trial.”

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COMMENT

With dead and injured
patients, no news is the news

Some might think that the story above about a lawsuit in which a doctor who was alleged to have be impaired by drugs while treating a patient is not news because it was filed several years ago.

But it is significant because, despite the publicity surrounding the arrest of Dr. Darroch Moores in 2001 and his subsequent treatment for an admitted drug addiction, no story about the lawsuit apparently ever appeared in the newspapers.

The likely reason is that by then the area’s newspapers had long stopped printing stories about any lawsuits alleging malpractice against Capital District medical providers, providers who were – and still are – providing those newspapers with a steady stream of advertising revenue. So the lawsuit documents filed on behalf of the estate of Kathleen Baker in 2006 probably weren’t even read. Why bother, when the reporter checking for stories at the county clerk’s office already knew that his or her newspaper wasn’t printing stories about such suits?

Last week, after the discovery of the lawsuit against Moores, an e-mail that very briefly described the allegation against the doctor and his history was sent to two people at the Times Union: Editor Rex Smith and investigative reporter Brendan Lyons. This was before anything about the suit had been posted on this Web site, and that was deliberate; with nothing new on the site there had been no visitors for a couple of days.

But within an hour of those e-mails going out, there was a series of hits on the site. Someone now knew that a significant story was coming and wanted to see if it had been posted on this page.

But they found nothing, which was also deliberate, and prompts visions of either Smith or someone else at the Times Union making urgent calls in an effort to find out how big a story the paper had ignored.

If so, the first such call would probably have been to the newspaper’s partners in secrecy at St. Peter’s Hospital – which had been mentioned in the e-mail. But the hospital would be unlikely to have a copy of the lawsuit, so the next step would be to contact one of the law firms that represents defendants in medical malpractice cases. After all, they also benefit from the fact that information about these lawsuits is kept from the public; If people were able to read about all these cases as they were filed, the hospitals would be much more likely to settle claims where there was obvious liability – meaning far fewer billable hours for the lawyers.

So now, for the first time, the story is available to anyone, without a time-consuming trip to a county clerk’s office. And there are many more to follow.

So far, this page has not been promoted, as lawsuits are gradually added. But by late summer details of most lawsuits filed in Albany and Rensselaer counties will be posted here. At that point, aggressive steps will be taken to make the population of the area aware of this site.

The area’s hospitals have spent a fortune over the past 12 years to keep these stories off the pages of newspapers. They are becoming available now only because Northeast Health refused to admit what its own records show; that in 2003 its negligence caused the death of Lisa Baker.

In 2004 Northeast Health was paid $74,000 for treating Lisa for the horrific injuries it inflicted on her. That was before a change in the law that would have stopped it from getting the money. Now, as a result of Northeast’s negligence, arrogance and greed, it and all the other hospitals in the area are about to have their callous disregard for patient safety exposed for all to see.

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Penalties are rare

Fines against hospitals
for errors few and small

Capital District hospitals have faced dozens of lawsuits alleging wrongful death and serious injury – and settled many of those claims. But they almost never get fined by the state; no hospital has been fined more than once since 2002, and none of them since 2008.

The following information is taken from the Department of Health’s Web page www.hospitals.nyhealth.gov. It covers the years 2002-2010.


Seton Health System - St. Mary’s Campus. 2003. Fine: $10,000, based on the occurrence of a wrong-sided surgery. The patient was admitted for drainage/thoracentesis of a right pleural effusion. A needle was inserted on the patient's left side. The patient experienced hemorrhage and death.

Albany Medical Center, South Clinical Campus. 2008. Fine: $6,000, based on the findings that a pediatric patient was admitted for a left side inguinal hernia. A right side inguinal hernia repair was performed. Further review of records identified multiple instances where the facility was out of compliance with internal policy and state guidelines for performing surgery involving laterality.

Samaritan Hospital. 2003. Fine: $2,000, based on an occurrence where a patient with severe lower back pain was diagnosed with right lateral disc herniation. A left-sided laminectomy was performed.

St. Peters Hospital. 2003. Fine: $2,000, based on the investigation of an occurrence involving the surgical repair of a hernia. Although the patient had a left inguinal hernia, an incision was made on the right side. Following incision, the mistake was identified, the site closed and the left-sided procedure completed.

Albany Memorial Hospital. No fines.

Ellis Hospital. No fines.

Ellis Hospital/McClellan Campus. No fines.

Bellevue Women’s Hospital. No fines

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Back to Capital district health claims page

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– David Baker

IV not flushed

Health Department cites hospital
in blood-thinner overdose death

By David Baker
Posted Sunday May 15, 2011

An anesthesiologist and then, an hour later, a nurse at Samaritan Hospital failed to flush out an IV, causing a patient to twice receive a large dose of the blood thinner heparin, according to documents obtained from the Department of Health under the state’s Freedom of Information Law.

The patient, Joseph Bartoski, died the next day. As was first reported here in July 2010, a lawsuit filed by his widow, Dorothy, is pending in state Supreme Court.

This, according to the Health Department’s findings, is what happened:

In June of 2009 Bartoski, who had end-stage renal disease, underwent surgery at Samaritan Hospital to repair a venitral hernia. While preparing for the surgery, an anesthesiologist determined that an IV needle that has been placed into the patient’s hand was not acceptable and decided to administer drugs via a dialysis catheter already in place.

However, he failed to flush out a port on the catheter to remove about 10,000 units of the blood thinner heparin which had been placed in the port to prevent blood from clotting in the device.

Flushing out a catheter is required by the hospital’s protocol, which states: “Due to high concentration of Heparin in the catheter lumens, 5 ml must be aspirated and discarded each time a lumen is accessed.”

During the surgery, Bartoski began bleeding from the nose, mouth and the surgery incision.

He was then moved to a recovery room, where a nurse again failed to flush another port on the catheter before administering another fluid, causing Bartoski to receive another 10,000 units of heparin.

Bartoski was given a dose of the drug Protamine in an attempt to reverse the effect of the heparin. However he continued to bleed and a further dose was given.

But the Department found that the effort was insufficient.

“Expert review felt that although Protamine was the drug of choice, the amount given was not adequate and medication was not given in a timely manner,” according to an investigation report.

The nurse is identified as Doreen Fitzgerald. A report of an interview with Fitzgerald says she: “Knew when pt arrived in PACU that he was going bad. Drs present yelling orders. Knew the policy but also knew the patient needed meds or he would die. Doesn’t know why she didn’t aspirate. Has been a nurse 29 yrs. No problems.”

The anesthesiologist was not cited by name in these documents, which deal only with the hospital and its nursing and medical staff. But the lawsuit filed by Bartoski’s widow names as defendants Dr. Ike A. Boka, and Empire Anesthesia Medical Consulting LLP. And in a note in an investigation report, a box is checked that says Boka was directly involved in the patient’s care and that during an interview, “Dr. Boka indicated that he was familiar with hemodialysis caths but was not familiar with the policy to aspirate prior to instilling solutions.”

After the Department completed its investigation, the records and findings were sent to IPRO – the Island Peer Review Organization – with a request for opinions on the care given to Bartoski. One of the questions asked was if an anesthesiologist should have been aware that heparin is placed in a catheter between infusions.

IPRO’s answer is not available to be reported here because its entire response is redacted from the records obtained from the Department. However, in a report of the investigation, a paragraph headed ‘Investigative Summary’ says: “Unanimous opinion was that standard of care was not met. Allegations were substantiated.”

Samaritan Hospital was then ordered to submit a ‘plan of correction,’ which it did in March 2010. But that, too, is redacted in its entirety.

There is no indication in the records provided that a fine or any other penalty was imposed on the hospital.

Meanwhile, Samaritan Hospital and Dr. Boka are continuing to fight the lawsuit, denying any responsibility for Bartoski’s death.
***

UPDATE: The Bartoski lawsuit was settled on the first day of trial for $350,000.  The case was totally ignored by the area's newspapers.

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COMMENT: Ignoring instructions seems routine. Read the editorial HERE

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COMMENT

Ignoring instructions appears to be
a routine event at Northeast Health

By David Baker
Posted Sunday May 15, 2011

Once again, it is alleged that staff or agents at Northeast Health failed to follow the organization’s own care instructions. And, once again, a patient is dead.

This time, it isn’t just an allegation in a lawsuit. This time, the state Health Department and an outside review organization have concluded that a nurse and an anesthesiologist each failed to flush a blood thinner out of an IV catheter before using it to administer another medication, as is required by the hospital's protocol.

And according to documents obtained from the Department under the state’s Freedom of Information Law, both the nurse and the anesthesiologist admitted to investigators that they failed to flush the IV.

As a result, the Department says, in less than two hours the patient received two separate large doses of the blood thinner heparin, causing him to lose blood and die a few hours later from the resulting cardiac arrest.

In addition, a medication that might have reversed the effect of the blood-thinning agent was given too little and too late.

But despite that finding, the hospital and the anesthesiologist are both fighting a lawsuit brought by the patient’s widow.

The widow is 87 years old. If ever there was a case when an immediate admission of liability and an offer of a settlement was appropriate, this is it.

But that’s not how Northeast Health operates. Rather, its policy for the past 12 years has been to use its lawyers to fight every claim, while pouring hundreds of thousands of advertising dollars into the coffers of the area’s newspapers, which – just coincidentally, of course – have conveniently ignored dozens of lawsuits alleging that Northeast Health is responsible for the deaths of several patients, and of causing or failing to prevent serious injury to others.

Now the management of Northeast Health is about to get control of two more hospitals, one of which has also generated a long list of unreported lawsuits. But those lawsuits and all new ones will no longer be kept out of public view by a compliant media. Now they will be easily accessible to anyone with a computer and an Internet connection.

***

The Health Department’s actions in the Joseph Bartoski case are in sharp contrast to its response to a complaint over the care given to Lisa Baker in 2003.

Longtime readers of the Answers For Lisa blog may recall that although Samaritan Hospital’s own records showed that nursing staff had failed to follow the hospital’s printed Hypoglycemia Protocol, and in doing so had ignored a doctor’s written order to apply the protocol, the Department and an IPRO reviewer both insisted that the standard of care had been met

Lisa, an insulin-dependent diabetic, died three weeks after she was found in her hospital bed with a blood-glucose level near zero.

But the IPRO reviewer dismissed all the evidence of negligence in two short paragraphs, stating, without any explanation, that the care given to Lisa “appeared to be appropriate.”

Seven months later, another patient with diabetes, Alec MacKenzie, died in Samaritan in shockingly similar circumstances. This time, the Department found the almost identical care to be lacking and issued a statement of deficiencies – leaving unanswered to this day the question of why it was so intent on brushing Lisa’s case under the rug.

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Back to www.capitaldistricthealthclaims.com

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Another missed diagnosis

Lawsuit alleges Albany
hospital caused leg injury

By David Baker
Posted May 1, 2011

A woman who went to Albany Memorial Hospital after falling from a stepladder has filed a lawsuit in which she alleges that she has been left with permanent injuries after nurses failed to follow a doctor’s orders to check for a dangerous build up of pressure in her leg.

This, according to legal papers, is what happened:

An emergency room physician found two fractures in Karen Rogers’ right leg. In an emergency department report, the physician noted that the patient should be evaluated for compartment syndrome, a condition in which fluids are trapped in tissues that surround muscles.

Without immediate treatment, compartment syndrome can cause serious injury to muscles, nerves and blood vessels.

The next day Rogers underwent surgery for the two fractures, after which the surgeon issued orders for the pain medication Demerol, and for an elastic stocking and a compression boot to be placed on the left leg, the one that had not been broken.

But, according to the suit, the stocking and the boot were put on the right, injured leg.

Later that day, Rogers complained of pain in the leg. Contacted by telephone by nursing staff, Jessica Newson, a physician’s assistant in the orthopedic surgeon’s office, ordered the same dose of Demerol switched from intermuscular shots to an IV. But less than an hour later Rogers told an nurse that the pain was increasing to “20 out of 10.” After a nurse again contacted the surgeon’s service, Newson, without examining Rogers, ordered a different IV medication, Dilaudid.

But Rogers continued to be in what she descried as “unbearable pain.” According to the complaint, she then was told that no further pain medications were authorized and “she would have to make do with the pain medication that had already been prescribed.”

Extreme pain that is not alleviated by medication is a prime symptom of compartment syndrome, according to a listing on the Internet site WebMD.

By the early hours of the next day, Rogers began losing sensation, first in the toes, then in the foot and later in the calf. The calf also was swollen and began to feel cold.

Swelling and loss of feeling is another symptom of compartment syndrome, according to numerous Internet medical sites.

But according to the lawsuit, the hospital staff took no action in response to the symptoms.

“Despite the Plaintiff’s continuing complaints of extreme pain that were disproportionate to her condition, and which were not relieved by the administration of seven total doses of three different narcotic pain medications, and other signs and symptoms of compartment syndrome, the nurses of Defendant, Albany Memorial, did not contact … anyone from the orthopedic group, or any other physician to evaluate the Plaintiff,” the suit says.

The lawsuit also says that the surgeon had ordered nursing staff to perform neurovascular checks every hour, and that Memorial Hospital’s own protocol for a patient such as Rogers calls for the checks to be done every four hours, but that no check was done on Rogers between 11 p.m. and 8 o’clock the following morning.

The alleged failure to perform the checks as require by the hospital’s own protocol – “Care Pathway #55” – resulted in the state Health Department issuing a ‘statement of deficiencies’ against the hospital, according to the lawsuit.

At 9 a.m., the surgeon who had treated Rogers the day before examined her and immediately performed surgery to open four compartments and relieve the pressure. This surgery required four incisions, each about 8 inches long.

The incisions were left open until further surgery was done to close them. Also, necrotic – dead – tissue – was removed and later a skin graft operation was performed

Rogers also had lost blood and needed a transfusion.

“The Plaintiff is now permanently left with grotesque scarring, deformity, tissue loss, muscle loss, atrophy, loss of sensation, numbness , tingling, burning, pain, loss of motor function, nerve damage, vascular compromise, constant swelling and edema, the need to wear a compression stocking, destabilization of the right extremity, bone loss, decreased coordination and agility, and a diminished physical capacity, along with further physical compromise and related emotional distress as a result of the compartment syndrome and the delay in diagnosing that condition,” the suit says.

The lawsuit seeks an unspecified amount in damages.

A search of the archives of the Times Union produced no indication that the lawsuit was reported by the paper.

Representing Rogers is the Albany law firm Lynch, Schwab.

The defendants are represented by D’Agostinio, Krackeler, McGuire & Cardona of Menands; Thuillez, Ford, Butler & Young; Napierski, Vandenburgh, Napierski & O’Connor; and Thorn, Gershonm, Tymann, Bonnani, all of Albany.

UPDATE:  The case was settled in January 2013, four years after it was filed and five weeks before a scheduled trial.

*****

COMMENT: 

Once again, nursing staff ignore instructions http://bit.ly/1EaHB58

**

Pattern repeats

COMMENT

Why do Northeast Health
nurses keep ignoring orders?

By David Baker
Posted May 1, 2011

Once again Northeast Health is accused of causing serious injury.

And once again the lawsuit describes a disturbingly similar picture: Nursing staff who ignore both a doctor’s orders and the hospital’s own printed protocol for handling the patient’s condition.

It happened in the case of Lisa Baker, when, according to Samaritan Hospital’s own records, nurses ignored a doctor’s written order to follow the hospital’s printed protocol for treating hypoglycemia.

Lisa lapsed into a coma after – according to Samaritan own records – her blood glucose level dropped to almost zero.

She died three weeks later, and her death certificate lists ‘profound hypoglycemia’ as one of the causes of her death.

Seven months later, Alec MacKenzie died in Samaritan Hospital. And again, the resulting lawsuit – eventually settled with a payout – alleged that nurses failed to follow a doctor’s instructions to use the hypoglycemia protocol.

Now yet another lawsuit alleges that nurses at Albany Memorial Hospital – also operated by Northeast Health – ignored a doctor’s order to check a patient for a condition that at best can cause serious injury and at worst can lead to death.

This patient survived. But according to legal papers, she has been left with permanent physical incapacity and disfigurements which could have been avoided if the condition had been monitored as ordered.

So why does this keep happening? Why do Northeast’s nurses keep ignoring orders?

It’s a disturbing thought, but it is beginning to look like it is the organization’s policy that rather than employing and appropriately training competent staff, it instead chooses to do everything it can to avoid responsibly for the tragic results of its ongoing callous indifference to patient safety.

First, it has on retainer dozens of lawyers who do everything possible to obstruct and delay every claim of negligence and malpractice. Cases drag on for years, as these lawyers throw every possible obstacle in the path of those who want to know what happened to a person who died or was injured in the hospital’s care.

And second, although allegations in lawsuits usually are set out in publicly available documents, Northeast Health and the operators of other Capital District hospitals have been able to keep these details out of the newspapers. That’s because for the past 12 years the area’s news outlets have willing abandoned journalist integrity and ignored dozens of malpractice lawsuits – while running hundreds of thousand of dollars worth of advertising for those same hospitals.

As far back as 2004, Rex Smith, the editor of the Times Union, was asked in writing for an explanation for what appears to be legal bribery.

There was no response.

The only time there was any sort of reaction from the newspaper was in 2007 when I wrote to Smith informing him that I intended to subpoena him to testify in a deposition in a lawsuit against attorney Steve Coffey.

The response was immediate: Within hours, a lawyer in the Hearst Corporation’s office in New York City called to tell me in no uncertain terms that the newspaper would vigorously fight any attempt to obtain Smith’s testimony.

Think about all that the next time you read a TU story about the newspaper going to court to get information, or an editorial lamenting the buying of influence in politics, or Smith, in his self-serving column, blathering about the media's duty to inform the public without fear or favor.

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No comment

No only does the Albany Times Union suppress news about malpractice lawsuits. Now it is suppressing readers’ comments about its censorship, too.

Last week, its medical reporter, Cathleen Crowley, tweeted about a new way to search the newspaper’s archives. A link in the tweet led to a page on Crowley’s blog, which, like most posts, had a comment box below a notice saying that comments will be posted only after they have been have been approved.
So in that box I submitted the following:

I frequently search the Times Union archives - each time I go to a county clerk's office and make a copy of a medical-malpractice lawsuit filed against a TU advertiser. But each time I find that no story appeared in the TU.

That's why I launched www.capitaldistricthealthclaims.com, to make easily accessible information that for the past 12 years the Times Union has routinely suppressed.

But my comment never appeared. Not only that, but the next day the entire post had been removed from the blog.

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Back to www.capitaldistricthealthclaims.com

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