After a 35-year career as a cancer surgeon and teacher of laparoscopic surgery, a pulmonologist at my home hospital, Sequoia Hospital, was promoted to Quality Assurance Director. This QA Director misinterpreted her QA computer output and wrongly informed my colleagues for over two years that a computer print-out showed that I had a 20% takeback rate. The administration investigated me for “increased complications, infections and takebacks to the OR” when their data and my own counts showed this was untrue. They refused to share with me their “data” despite my repeated asking.

 

The QA Director ignored her QA computer print-outs from the National Surgical Quality Improvement Project (NSQIP) data showing my accurate total complication rate of 6.3%, infection rate of 3%, and takeback rate of 3%. She ignored the hospital electronic medical record data showing my total complication rate was 7%. She ignored the hospital’s count of 28 total complications and count of 628 total cases: 5%. (5 divided by 628 = 5%)

 

Every surgeon has complications. It is important to practice in a way that minimizes them, identifies them early, addresses them properly and then learn from them. They will always happen, and they should be rare. Many surgical publications detail acceptable complication rates, and I had published 13 studies from my laparoscopic work with over 2,300 patients, demonstrating that my rates were consistent with those of other gynecologic cancer surgeons.

 

The QA Director was advised by the American College of Surgeons NSQIP staff to compare my data with other Gynecologic Oncology publications, but she testified under oath that she declined to do this. Rather, she told over 30 colleagues in the administration and Medical Executive Committee for two years, and 16 times under oath, that my take back rate was 20%. This caused good colleagues of many years to have to vote to expel me from the hospital. (I would too, if it were true.)

 

It was only during the appeal process that I received their data records, and found out that the QA Director had been misinterpreting a hospital bed census statistic for an actual takeback rate and that all their quality data and counts showed that my rates of complication, infections and takebacks were safe, the same as all publications from gynecologists. It was too late.

 

Being expelled from a hospital automatically triggers a review by the Medical Board. The hospital sent four cases out of 628 procedures I had done over 44 months. The Medical Board did not review the hospitals truthfulness or accuracy; it only reviewed these four cases.

• In one case, I wish I had retained a patient and repeated her blood count, as it might have been low then, even though all her vital signs were normal. She developed internal bleeding later and returned for laparoscopic repair.

• In another case, a patient had qualified for discharge and developed internal bleeding on her 3-hour drive home and had to return for laparoscopic repair.

• A nurse misread a scheduling form when she should have read the patient’s signed consent, mistakenly indicating that a patient's ovaries were to be removed. The patient had not changed her mind, and we should have preserved her ovaries. The hospital was fined $45,000 for this mistake, but the hospital blamed me.

• I planned the removal of a cancer recurrence adjacent to the Aorta Artery, coordinating with a vascular surgeon for potential vessel repair. The procedure went as intended, and the patient has since been cured; however, the hospital inaccurately labeled it a “near miss.”

 

I was promptly offered probation for these four cases, but I was unable to operate locally or maintain my practice. My lawyer advised that closing my office would be acceptable, overlooking the fact that MBC probation required ongoing medical practice.

 

With no office or hospital to operate in, I faced significant challenges.

 

After incurring nearly $300,000 in legal fees and at the age of 66, with retirement on the horizon, I ultimately surrendered my medical license to the MBC, requesting they acknowledge the merits of merely issuing a letter of reprimand. Unfortunately, this information was omitted from the final MBC report circulated to all doctors in California.

 

My last surgical procedure took place in May 2020.

 

After teaching 19 laparoscopic surgery courses, and nearly annually at the Society for Gynecologic Oncologists or American Association for Gynecologic Laparoscopy, I was unable to teach anymore.

 

As it stands now, I am not practicing surgery, only tennis.

 

But trust me, I was better at surgery.