Lisa Zenzen Baker, 1961-2003


Sunday, April 27, 2008

A paid assessment


Diabetes doctor’s
opinion is for sale

By David Baker
Posted Sunday, April 27, 2008

Matthew Leinung is not only a doctor at Albany Medical Center Hospital.

He also apparently is a genius.

Dr. Leinung has been enlisted by the attorneys for Samaritan Hospital to say that Samaritan was not in any way responsible for Lisa Baker’s horrific death.

And using only the records from 2003, he is able to say, four years later, exactly what happened before Lisa, an insulin-dependent diabetic, collapsed into a coma with a blood sugar reading recorded in Samaritan own records as 2 mg/dL.

And that Samaritan Hospital is in no way responsible for her collapse and subsequent death.

Dr. Leinung has an answer for everything, even if it defies accepted treatment and all logic.
Not following a physician’s direct order? Not a problem, according to Dr. Leinung. That’s not a deviation from the ‘standard of care.’

And not giving Lisa a complex carbohydrate – bread or some crackers – after her blood sugar had dipped just below normal a few hours before she collapsed and she had been given orange juice and an intravenous shot of glucose, both of which would push the sugar level up very quickly but not keep it up very long?

Just fine, according to Dr. Leinung, even though that is exactly what was called for in the hospital’s own hypoglycemia protocol, a protocol a consulting physician had specifically ordered that evening to be used if Lisa became hypoglycemic.

Someone should tell the American Diabetes Association about this alleged change. Appearing on its Web page, ( ) in an article titled “Standards of Medical Care in Diabetes—2008” is the following paragraph (emphasis added):

* Glucose (15–20 g) is the preferred treatment for the conscious individual with hypoglycemia, although any form of carbohydrate that contains glucose may be used. If glucose 15 min after treatment shows continued hypoglycemia, the treatment should be repeated. Once glucose returns to normal, the individual should consume a meal or snack to prevent recurrence of hypoglycemia.

But following the treatment recommended by the ADA and required by the hospital’s own written instructions is no longer the standard of care, according to Dr. Leinung. He doesn’t say when following up orange juice with a longer-lasting meal as the standard treatment for hypoglycemia was modified, or who suggested such a dangerous change and why.

The ‘standard of care,’ it seems, is whatever the defendant provider did during the incident that resulted in a lawsuit.

And that glucose meter reading of 2 mg/dL taken after Lisa later was found not breathing?
The meter was wrong. At low levels, Dr. Leinung insists, such meters are inaccurate.
The true glucose level, he claims, was closer to 80 mg/dL.

How convenient! The real level was not anywhere near the dangerous reading the meter showed – even though hospital staff immediately treated Lisa for severe hypoglycemia – but instead was within the safe range for glucose.

The problem with making outrageous claims like these that that it makes all the defendants’ denials and explanations worthless. They deny everything, so none of their denials carry any weigh or credibility.

And Dr. Leinung’s opinion – for which he was likely paid a handsome sum – raises another question: If Lisa did have a cardiac arrhythmia – an irregularity in her heartbeat – that caused her collapse, and if the meter was known to be that inaccurate – why didn’t the hospital’s management discuss it with me and explain it at the time? Why did they instead act as if they had something to hide, slamming the door in my face when I asked for information, and then removing documents from Lisa’s chart. Is that how people who believe their conduct was appropriate would act?

No, of course it isn’t. They acted as if they were guilty, as if they knew exactly what had happened and their only concern was avoiding the consequences. This response, not surprisingly, very quickly destroys trust and credibility.

And they wonder why there are lawsuits?

Dr. Leinung is making his claims as an expert in this case. The original purpose of experts in lawsuits was to explain to judges and juries complicated medical, financial or other technical matters that a lay person would not understand.

But that function has been corrupted over time so that now very often parties to a lawsuit simply find – and pay – someone who is prepared to say just what the lawyer wants said. The case then becomes a battle between two or more ‘experts,’ each of whom will usually say just the opposite of what the ‘experts’ on the other side are claiming.

Which means, of course, that each time one of them is completely wrong.

Insurance companies – thanks to those sky high malpractice premiums – can afford to retain experts who will say just what they want.

That doesn’t necessarily mean the defendants are right; it just means that they can usually afford the more impressive “experts.”

People like Matthew Leniung, who, for a nice check, will evidently will say just about anything another provider wants to hear.