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A New York hospital suspended two doctors recently, charging they operated on the wrong side of a man’s brain because the CT scan was placed backward on a viewing screen. Another surgeon accused of wrong-site surgery received what the state health department calls too light a sentence.
The Long Island College Hospital in Brooklyn and the New York State Health Department both report they are investigating the brain surgery incident. The patient survived the experience, undergoing another procedure the following day to remove a potentially fatal blood clot.
The hospital released a statement: "Well-established hospital policies were clearly violated. The incident was reported promptly to the appropriate regulatory agencies, and the hospital will cooperate fully with their investigation." The hospital reports Rene Kotzen, MD, and Mike Chou, MD, were suspended the day after the alleged mix-up.
In another New York case, the state health department announced recently it will "vigorously" appeal the failure by a hearing committee for the New York State Board for Professional Medical Conduct to revoke the medical license of Ehud Arbit, MD, a neurosurgeon at Staten Island University Hospital. The committee found that he committed gross misconduct.
"The State Health Department vehemently disagrees with the hearing committee’s decision, and will aggressively appeal the penalty to the administrative review board," according to a statement released by State Health Commissioner Antonia Novello, MD, MPH, DrPH. "This, the second disciplinary action against Dr. Arbit in only four years for an egregious act of medical negligence, demonstrates convincingly why he must get no more second chances. Dr. Arbit has shown a history and pattern of careless practice that has placed patients at unacceptable risk and which warrants nothing less than the revocation of his license."
The committee members determined Arbit was guilty of gross negligence for an act of misconduct they termed "egregious," but ordered that his medical license merely be suspended, with such suspension limited to the time he has already spent out of practice since signing an Order of Conditions with the state health department in February 2000. The committee also ordered Arbit be placed on probation for three years. The terms of probation require Dr. Arbit to limit his practice of surgery to a health care facility licensed under Article 28 of New York State Public Health Law, to have a practice monitor during his period of probation, and to complete a course in medical record keeping.
"The duty of the Health Department is to protect patients. The terms of probation determined by the committee are in no way sufficient to protect patients in light of Dr. Arbit’s demonstrated inability to learn from his past mistakes," Novello says. "This department must, and will, do whatever is necessary to protect patients from doctors who are repeatedly and flagrantly careless and inattentive in the practice of medicine."
The health department says the most recent misconduct finding stemmed from an operation in which Arbit operated on the wrong part of a patient’s spine. As a result, the patient had to undergo another surgery. The hearing committee members called Arbit’s action "the equivalent of operating on the wrong limb or organ" and stated that "either Respondent [Arbit] had no idea what level he was supposed to operate on, or he operated on the wrong level. Either scenario is egregious."
The committee added that the "Respondent’s conduct as to [10 other] patients shows a pattern of poor documentation and inattention to details of good clinical practice," noting that the "Respondent was disciplined by the New York State Board for Professional Medical Conduct four years ago. In that case, Respondent never adequately examined the patient’s chart, MRIs, or even the patient before surgery. One would expect that the experience of four years ago would have sufficiently chastened Respondent to ensure utmost caution, documentation, and patient attention to prevent a reoccurrence of misconduct. Apparently, that was not the case for the November 1998 surgery on Patient H."
In 1995, Arbit operated on the wrong side of a patient’s brain during surgery at Sloan Kettering Memorial Cancer Center. He subsequently received a censure and reprimand, one-year probation including practice monitoring, and a $10,000 fine after signing a Consent Order in which he agreed not to contest the department’s charges.
In the current disciplinary action brought against Arbit, specifications of misconduct involving the 10 other patients were not sustained. Panel members were divided regarding misconduct specifications stemming from an operation in which Arbit again was accused of operating on the wrong side of a patient’s brain produced a split ruling. Two members of the hearing committee voted not to sustain the charges. The dissenting panel member found the testimony of a physician assistant who was present during the operation to be compelling, and voted to sustain the allegation that Arbit surgically explored the patient’s left cerebellum area, although the tumor was on the right side of the patient’s brain.
Novello vows to appeal the committee’s decision on the appropriate penalty, saying the only appropriate action is to revoke Arbit’s license.