Lisa Zenzen Baker, 1961-2003


Saturday, November 02, 2013

Missed red flags

Withheld or ignored information
preceded a doctor’s malpractice

Credentialing documents raise questions about the
process of granting hospital privileges to doctors

By David Baker
Posted Monday, November 4, 2013
934 words

Three doctors at Albany Medical Center indicated in response to a request by St. Mary’s Hospital in Troy, N.Y. for a reference for former gynecologist Akiva Abraham that they knew of no disciplinary action against, him, even though Abraham had been placed on probation by Albany Medical Center Hospital for making a false entry in a medical chart.

One of those doctors was Myron Gordon, who was chairman of the OB/GYN department at Albany Medical Center during Abraham’s residency there in the mid 1990s.

One of the questions on the form filled out and returned by Gordon asks: “Are you aware of any instances in which the applicant ever had privileges revoked, suspended, reduced or denied or any circumstances in which disciplinary measures were directed or contemplated against the applicant at your facility or any other medical facility?”

Gordon checked “No.”

Another question on the form was: “Has the applicant been involved in any professional misconduct proceedings?” Again, Gordon checked  “No.”

Two other doctors then at Albany Medical Center, Donald Swartz and Robert Lobel  – who Abraham had listed as references – also indicted that they knew of no disciplinary actions against Abraham.

But despite these responses, St. Mary Hospital did know when it decided to hire Abraham he had been disciplined.  In a letter dated June 1998 to then St. Mary’s president and CEO Edward G. Murphy, Dr. Anthony Levatino, who was assistant residency program director at Albany Medical College, wrote: “Dr. Abraham was placed on probation at one time during his residency for entering information on a medical record that was not verified by personal observation.”

However, other legal documents say that Abraham wrote in a medical record that he had examined a patient when another physician had done the examination.

Abraham’s application to St. Mary’s and the responses from the doctors are among confidential documents that were a part of the hospital’s credentialing process.

Abraham was fired by St. Mary’s Hospital for writing in a medical chart that he had done a full examination of a patient when he had not done so.

Another reason given for his termination was a false statement on his application.  In response to the question “Have you ever been denied membership or renewal thereof, or subject to disciplinary action in any medical organization?” Abraham checked a box marked “No.”

Abraham was appointed to the staff at St. Mary’s in June 1998.  In January 2000, he was fired.  As is reported in the previous post on this page, he then filed a lawsuit against the hospital, claiming $1.5 million for breach of his employment contract.  The suit was dismissed on a motion for summary judgment in January 2004.

At the time he was fired from St. Mary’s Hospital, Abraham also had privileges at nearby Samaritan Hospital.  These privileges were last renewed in 2002.  In 2006, Samaritan Hospital was named in a lawsuit in which in was alleged that in 2004 Abraham performed an unnecessary and unauthorized surgery on a patient without her knowledge that left her with a disfigured breast. The suit also alleged that the hospital was negligent when it granted and renewed Abraham’s privileges. In its defense of that lawsuit, Samaritan Hospital claimed it had carried out all the required checks on Abraham, which included verifying information provided by him, and had found no reason not to renew his privileges.

But other documents suggest a less then rigorous check.  During Abraham’s lawsuit, St. Mary’s Hospital served a subpoena on Samaritan for a copy of its credentialing file on Abraham.  It produced a response from a Samaritan Hospital lawyer, objecting to the disclosure of the file.

The subpoena, which made Samaritan Hospital aware of Abraham’s lawsuit relating to his termination, was served in August 2001, several months before Samaritan renewed Abraham’s privileges.  An examination of publicly available legal documents would have revealed that Abraham had been accused of falsifying medical records at two different hospitals.

Also, at the time of each renewal of Abraham’s privileges, the hospital was a co-defendant with Abraham in an active lawsuit in which Abraham was alleged to have injured a woman during childbirth, and from 2001, in another lawsuit naming him and the hospital over the death of a woman during childbirth that was settled in 2004 for $1.4 million.

Samaritan Hospital’s credentialing file on Abraham is protected from disclosure by state law so it cannot be determined if Abraham acknowledged the existence of these lawsuits, his firing by St. Mary’s or the disciplinary action imposed by Albany Medical Center in any of his applications to Samaritan for privileges. But in a legal document in the negligent-credentialing case, lawyer William C. Firth with Thuillez, Ford, Gold, Butler and Young, which was representing Samaritan, stated that the hospital had checked with all the facilities where Abraham had privileges and those checks “…failed to unveil any issues concerning his medical care and treatment.”  Regarding any pending lawsuits, Firth wrote that “Dr. Abraham provided the required information.”  The lawyer also stated that during the time Abraham had privileges at Samaritan, “…his privileges were not restricted or suspended by any other facility.”

He was fired for misconduct by St. Mary's Hospital during that time.

In August 2012, Samaritan settled the claim alleging Abraham’s unnecessary breast surgery for an undisclosed sum.  By then Abraham – who had no malpractice insurance for his defense and no lawyer – was serving a 4- to 12-year prison sentence for insurance fraud stemming from a fire that destroyed a commercial building he had purchased with a bogus mortgage.  His appeal of that conviction was denied by a mid-level appeals court.  A decision on his further appeal to the state’s highest court, the Court of Appeals, is expected in mid December.