Doctors who err still get clean bill of health

This one is a blast from the past, but it's still one of the articles I've written that I'm most proud of. I accomplished it as A Chicago Sun-Times intern while attending graduate school in 2001.

Chicago Sun-Times, Jun 24, 2001 by JAMES FULLER

SPRINGFIELD When you're ailing, you hope the doctor will cure you, not scramble your internal organs or prescribe radiation treatment for a cancer you do not have.

And if the doctor does do something horrific, you can sue. The doctor might have to pay for the mistake, and it will become a matter of public record, albeit filed away in a courthouse somewhere.

Yet physicians who hurt patients are rarely if ever punished-or even mildly reprimanded-by the state agency that licenses and monitors doctors, the Illinois Department of Professional Regulation.

The doctors' transgressions, though they may have led to a court judgment or an out-of-court settlement, are not posted on the state Web site, and the agency will refuse to reveal such information even if you call to ask.

"It utterly confounds logic," said Gail Siegel, executive director of the Coalition for Consumer Rights, a watchdog group that identified cases of malpractice for the Sun-Times. "Not only do we have incompetent doctors practicing incompetence on people, but we have a culture of incompetence at the regulatory agency that's supposed to be protecting patients."

When to sanction

An analysis of state, federal and court records showed that 85 doctors in Illinois have been hit with malpractice awards of more than $2 million since 1991. Of those, only seven have been disciplined by the state.

In five of the seven discipline cases, the punishments meted out by the nine-member Medical Disciplinary Board were so mild-a reprimand or probation-that the doctors continued to work without interruption.
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Of the 85 cases, six doctors had multiple settlements or judgments against them. Yet none received as much as a slap on the wrist.

"If that was you or I driving, our licenses would be revoked," said Rep. Mary Flowers (D-Chicago), chairwoman of the legislative House Health Care Availability and Access Committee.

In defense of its policies, DPR points out that juries in malpractice cases operate under far less stringent standards than state regulators. It's easier to win a six-figure malpractice award than to identify clear violations of state law.

"Somebody was in contact with a doctor, something didn't go right, and someone has a . . . substantial problem as a result," said DPR Director Leonard Sherman. "But that doesn't, by any means, (make) a violation of the Medical Practice Act."

The law outlines 43 instances under which the state can recommend sanctions against a doctor's medical license, including the charge of "gross negligence." Ultimately, the semi-autonomous Medical Disciplinary Board makes the call. Since 1991, the board has revoked 68 doctor licenses, suspended 255 others and issued 258 reprimands.

Physicians have been sanctioned for owing back taxes and child support, failing to repay student loans, misdiagnosing ailments and demonstrating incompetence.

But consider the cases in which the state stood silent:

A 55-year-old Joliet woman undergoing surgery in 1992 for a bowel obstruction had her bowel punctured by mistake-an error her physician neglected to tell her about. For 10 days, Arlene Johnson's stool seeped out of her surgical incision at a rate that approached 8 liters per day. Yet Robert Chambers dismissed the secretions as a normal part of the healing process. Subsequent surgeries by other doctors could not correct Chambers' mistake, and Johnson died.

"In my eye, in my family's eye, it was murder," said Johnson's daughter, Cheryl Ryan. "Dr. Chambers just left her to lay there and die. You don't let somebody's bowels ooze into their bodies and think that they are going to heal themselves."

Chambers, now practicing in North Dakota, declined to discuss the case, other than to say: "The state was very aware of what was going on. The state medical board looked at it and did not feel that there was any reason to have concern." He was not disciplined. Johnson's family was awarded $5.2 million in 1995.

Suffering pain in her pelvis, 52-year-old Ruta Ivey of Zion underwent radiation and chemotherapy after Alfonso Mellijor incorrectly diagnosed the return of cervical cancer. Mellijor made the diagnosis without taking a biopsy.

As a result of the treatment, a severe ulcer developed on Ivey's buttocks, and her pelvic pain continued.

Finally, a Wisconsin surgeon, while preparing to amputate her left leg and part of her pelvis, discovered the true source of her pain: two sponges left inside her from an earlier hysterectomy or ulcer surgery. Neither of the earlier surgeries involved Mellijor.

A jury awarded Ivey $6 million in 1995 for Mellijor's botched cancer diagnosis, but the state DPR took no action against him.

Ivey's attorney, James H. Canel, acknowledges that Mellijor had no way of knowing about the sponges. "On the flip side, you say, `Wait a minute, you took this patient and you assumed she had a recurrence of cancer and exposed her to all sorts of bad things, radiation and chemotherapy.' Clearly a jury thought that that was negligent."

While declining to comment on specific cases, the Illinois State Medical Society-the voice of doctors in Springfield-said it favors sanctions against incompetent doctors. At the same time, the group says, it's not uncommon for doctors in high-risk fields to be sued multiple times because they take on cases where the outcomes are far from certain.

"Filing a suit is easy, but proving that there's true malpractice is another story," said Dr. Ronald L. Reucker, the group's president. "Malpractice isn't the same as bad medicine."

Secret findings

Although Illinois law requires insurance companies to report all malpractice judgments to DPR, a 1997 report by Auditor General William Holland showed that most of these cases never were investigated.

When the DPR does investigate a malpractice case, it keeps its findings secret unless the investigation leads to a formal complaint or disciplinary action. These cases are posted on DPR's Web site, www.dpr.state.il.us.

For more details, a consumer may have to check court records in 102 county courthouses, assuming the doctor has practiced only in Illinois. Or pay $200 for access to the National Practitioners Database, which contains information about the malpractice suits filed in a particular state. Or rely on the Jury Verdict Reporter, a publication of Law Bulletin Publishing that provides summaries of some malpractice cases for $645 a year.

Flowers, the state lawmaker from Chicago, pushed legislation last spring requiring DPR to compile physician profiles so people could compare doctors.
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The profile would list criminal charges, disciplinary actions, hospital privilege revocations and medical malpractice awards.

Flowers' bill was never voted on by the full House, in large part because of opposition from the Illinois State Medical Society and, initially, DPR. The agency now is neutral on the issue.

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