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Wed November 9, 2011
Part 1: Malpractice Investigation Has Unintended Consequence
KANSAS CITY, Mo. – Patients put a certain trust in doctors, that they'll provide the best medical care possible. But what happens when that trust is broken? The Kansas City Star recently used a federal database of physician reports to examine just that: how doctors with a history of alleged malpractice are monitored in the region. But what the newspaper discovered had an unintended consequence, affecting public access to nationwide data on doctors. In the first of a two-part series, KCUR's Elana Gordon tells us how the story of one family set the stage for what ensued.
It's been nearly five years since Claire Chase's mom died. But Chase has yet to put the circumstances around her mom's passing to rest. In 2007, her otherwise healthy mom, at age 77, suffered a subdural hematoma. She went in for a fairly routine emergency surgery to get fluid drained from her brain and relieve some of the pressure.
It was a Monday.
"You know really by Tuesday, we'd lost her because she never really was able to speak or anything after that," says Chase.
Chase says only after consulting other doctors and then obtaining medical records, did she learn there'd been a mistake during surgery...one that the neurosurgeon had ignored.
"He'd let her die to cover up his mistake," says Chase. "And that goes beyond the mistake that was covered up in the operating room."
Chase filed a complaint with the state medical board. She filed a civil lawsuit, too. In court records, Dr. Robert Tenny denied any wrongdoing. But turns out, Chase wasn't the first to file suit.
"My brother's a physician, my son's a physician. Doctors get sued for malpractice. The average is one lawsuit for every 20 years. Dr. Tenny had in the neighborhood of 15 to 16 medical malpractice suits over the last 20 years," says Chase.
Chase says she only learned of this after the fact, by sifting through public court records from the Johnson county courthouse.
Patient-safety advocates view this kind of history of alleged malpractice as possible red flag. But the agency charged with monitoring doctors in the state, the Kansas Board of Healing Arts, has yet to discipline Tenny.
During its investigation this summer, the Kansas City Star found that Tenny's situation wasn't rare. Longtime medical reporter, Alan Bavley, reviewed Tenny's cases and crunched numbers from a publicly available file within the National Practitioner Data Bank.
The data bank was created about twenty years ago. It contains statistical information on malpractice, state disciplinary actions, and hospital suspensions for thousands of doctors and health professionals nationwide. Medical boards and hospitals have access to confidential records that contain physician names, to help them decide whether to grant licenses and staffing privileges. But the public component of the database, which Bavley reviewed, doesn't have any identifying physician information - just ID numbers to go with reports.
Bavley used the files to see that Chase's experience was part of a larger trend. He looked at how many doctors in Kansas and Missouri had a clean license but had ten or more malpractice payouts since 1990.
"Which is a substantial number," says Bavley.
He found there were 21 doctors like this.
Bavley did something else, too. With the help of public court records, he identified Dr. Tenny in the anonymous public databank. Bavley says doing so shed more light on physician oversight trends in the region and revealed more details about Dr. Tenny's history.
Other journalists, researchers, and patient-safety groups across the country have - like Bavley - used the databank to examine trends in physician oversight and - like Bavley - matched specific doctors to the public databank. The St. Louis Post dispatch did so last year, as part of an investigation into what the paper describes as Missouri's "lax and secretive" system for physician oversight. The report led to a new state law that makes more physician information available to the public, and gives the state licensing board greater authority to suspend licenses of "incompetent" doctors.
But Bavley's story had an unexpected response. HHS took down the practitioner database's public file from its website.
"I'm dismayed," says Bavley. "This is a useful tool, reporters have used this many times and done it in the public's good."
Bavley wasn't the only one who felt this way.
In Part two, we'll learn more about HHS's decision, the complexities of malpractice, and the strong reactions that followed the restriction of the databank.
Funding for health care coverage on KCUR has been provided by the Health Care Foundation of Greater Kansas City.
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