But Dr. Jon J.P. Warner, the attending surgeon overseeing Price, was not in the room, they said. If this results in my career at the MGH ending, so be it, he told the Globe months before his firing. It is allowed in some form at many prestigious hospitals, limited or banned at many others. The patient did suffer acute blood loss that necessitated transfusions, according to the anesthesia report on the case. Long afterward he learned that Wood had a second spinal surgery going at the same time as his. Previously, Dr. Harris served as the chief of the Orthopaedic Trauma Service at Brigham and Women's Hospital (BWH). Surgeons are encouraged and expected to tell patients when theyll be absent for part of the surgery, an MGH spokeswoman said, but they are not explicitly required to do so. Nothing in the medical record indicates that Mengs sudden paralysis a known risk of the surgery had anything to do with Woods decision to juggle his care with another patients for about seven hours. Dr. Joseph Schwab, Chief of the Orthopaedic Spine Center at Massachusetts General Hospital and Director of SORG, is featured in a new video from the Department of Orthopaedic Surgery at MGH. And thats why we brought in Donald Stern to investigate the situation., Slavin then concluded: He found no basis to support Dr. Burkes concerns.. Overall, patients at MGH share their surgeon for some part of the case 15 percent of the time, figures provided by the hospital show. Thats the most appropriate utilization of this concurrent surgery not having two cases going exactly at the same time and the surgeon bouncing back and forth between the two, said Kirk. General employees complained about at least 44 alleged problems involving concurrent surgeries, and raised concerns to their superiors and colleagues, sometimes through official channels, other times in court testimony or ordinary e-mails about what they considered substandard patient care or medical practice between 2005 and 2015, the Spotlight Team found. Let us help you navigate your in-person or virtual visit to Mass General. As chief, he was instrumental in the creation of the Orthopedic Research Laboratories. He had taken comfort, he said, knowing that her surgeon wasnt occupied with anyones care but hers. Wood was known among his peers for taking on some of the most challenging cases, sometimes as the surgeon of last resort for suffering patients who had been turned down by other doctors. Get the latest news, explore events and connect with Mass General. What we learned from Donald Stern is that what were hearing from our OR leadership was reflective of reality.. To learn more about concurrent surgeries, visit our home for Globe coverage of the issue. Burke would soon find out exactly what Austen, who declined to comment, had warned of. Dunn quickly learned how little scientific research there was about concurrent surgery to guide him. I am disappointed that you felt the need to take this to an outside authority as I am confident that changes internally are in place that could deal with the problems. If there are issues or concerns, please let me and or Harry know. Veteran spine surgeon specializing in complete range of adult spinal disorders. Some tests may be necessary at that time, including x-rays, CT scans and MRIs. Burke wanted to study mechanical engineering, as Austen had. Is this how we are planning the future? The orthopedics department also has one of the highest rates of concurrent surgery at Mass. It is unfortunate, the hospital said in a written statement, that a well-respected surgeon would cause a massive violation of patient confidentiality policies by copying hundreds of patient records and sharing them with the Boston Globe.. The General Hospital Corporation. Since 1927, when a small aluminum splint company opened its doors in Warsaw, Indianas medical alley, Zimmer Biomet has relied on thousands of stellar physician advisors and mentors to help make it the leading supplier of hip and knee arthroplasty systems in the world. Schedule a same day virtual visit when you experience a sports injury. More broadly, MGH officials say their analysis of hundreds of orthopedic cases from 2013 and 2014 found no significant difference in complication rates between overlapping and non-overlapping cases. I was concerned at that time that there was a major disconnect between the views of a very prominent and capable orthopedic surgeon here and what we were hearing from our OR leadership, said Slavin, the hospital president. MRI results came in after midnight and confirmed that something was very wrong. Meet our team Conditions & Treatments 617-724-8636 Contact Information Phone: 617-724-8636 Request an appointment Get the latest news, explore events and connect with Mass General. He never came back until the surgery was finished, said Dalal, who worked mostly on orthopedic cases at MGH from 2001 until he retired in 2013. I just simply did not know what to do with this kind of situation., Vrahas, in a written statement, said he does not recall any such situation and that Dalal never raised concerns about any incident like this with me either at the time or at any time despite our close professional association., MGH said, Dr. BostonMA, 02114, Wyndham Hotel - Beacon Hill Dennis BurkeDennis William Burke, M.D.Orthopedic surgeon is a big burly presence with flashing eyes under bushy eyebrows, a man of obvious personal force, intellectual aspiration, and famously deft hands. is new director of Scoliosis and Spinal Deformities at Rady Childrens Hospital-San Diego. Mass. At MGH, that raised eyebrows and hackles. General is a teaching hospital where residents have graduated responsibility for the burdens of surgery and that concurrent surgery is an acceptable practice at other institutions, according to notes Burke took of the meeting. mleelman@partners.org. A knowledge portal for all patient guides, rehab protocols, exercises & stretches and more. At MGH, the acrimony has threatened careers and relationships and potentially much more, a drama that escalated with two steps almost unimaginable in the rigorously professional world of medicine, not to mention the life of a great hospital. Jon has a tendency of counting operating time versus actual case time. When word of Mengs paralysis reached him in August 2012, he couldnt sleep, Burke says. ShervinNina ShervinOrthopedic surgery resident later testified that while he was gone, she helped mix the cement for the hip implant, but felt uncomfortable going further on her own. would threaten the independence of the Globes editorial process, the newspapers attorney Jonathan Albano wrote in an e-mail to a hospital lawyer. General orthopedics but did not study whether concurrent surgery played a role in the departments success. Warner had a second procedure running simultaneously and was scrubbed into room 20. And he is an exceptionally busy practitioner, having performed more than 10,000 knee and hip operations since completing his orthopedics residency in 1984. Our spine team sees patients at these locations: Mass General - Boston55 Fruit StreetYawkey Center for Outpatient Care, Suite 3ABoston, MA 02114, Orthopaedics at Mass General Waltham52 Second AvenueBuilding 52, 1st Floor, Suite 1150Waltham, MA 02451, Newton-Wellesley Spine Center159 Wells AvenueNewton, MA 02459, Mass General/North Shore Center for Outpatient Care102-104 Endicott StreetDanvers, MA 01923, BW / Mass General Health Care Center20 Patriot PlaceFoxborough, MA 01923. There is no known connection between the complications and deaths and the double-booking, but none of the patients and family members interviewed had any idea that the surgeons were involved in a second operation at the same time. Theyre engaged in all these activities which her action or inaction absolutely pales in comparison to.. At Mass General, the brightest minds in medicine collaborate on behalf of our patients to bridge innovation science with state-of-the-art clinical medicine. Surgeons at Mass General are allowed to run two operating rooms at the same time, as long as they are present for the critical parts of each surgery and are immediately available if a problem arises in either procedure, or have a backup immediately available. The most extensive analysis of concurrent surgery was presented last year when a surgical resident at the University of Virginia Health System released a study not yet published that found no difference in short-term outcomes for patients and only minimal increases in surgery length when cardiothoracic surgeries overlapped by up to 45 minutes under closely monitored conditions. Hospital attorneys, however, strongly defended Wood in court documents filed in Mengs malpractice suit, saying he broke no rules and acted appropriately within the accepted standard of care. At 1:49 p.m. the next day, Pereira was wheeled into operating room 21. Earlier this year, an anesthesia resident filed a safety report after a patient in March lay anesthetized on the operating table for more than an hour while the surgical team waited for the vascular surgeon to arrive from a concurrent operation. 4 and he is the renown orthopedic surgeon who has led the hip and knee service at Massachusetts General Hospital (MGH) in Boston for over 20 years. Is this how we are planning the future?. But change came to his door. Clinical and Research Pioneers Molded Massachusetts General Hospital's Orthopedic Surgery History. As Burke recalls it, Shervin sobbed into the phone, asking what she should do. Copyright 2007-2023. I was brought here to build a fabulous academic department, which we are, Rubash said. Watch the full documentary and learn more about concurrent surgeries at the homepage for Globe coverage of the issue. He was recently promoted to full professor at Harvard Medical School. Both men, wearing scrubs, sat at a formica-covered table in the middle of the room, according to Burkes recollection of the encounter. Muscle transfer technique brings pain relief to patients. Some surgeons might have awakened Meng to make sure he could still move, but Wood later testified he decided the risk that Meng would thrash and hurt himself was too great. Burke and his allies remain unpersuaded, and believe MGH is in a state of denial or something worse particularly when it comes to the critical matter of patient consent. Cases with procedural overlap, involving at least one patient with an open incision while the second case is underway, account for 3 percent of the total about 1,000 cases a year. Can they really do two overlapping operations equally well? He recalled Burke coming into his office in late 2009 and launching a fusillade of threats. MGH officials dispute the validity and importance of almost every complaint, saying many are based on inaccurate information, turf fights, or misunderstandings in a busy hospital. This is an example of one of his concurrent surgeries, according to finalized operating room schedules. They shared with the Globe a 2015 letter from the executive director of the American College of Surgeons who reviewed the guidelines at MGHs request and deemed them an example of best practice and certainly exceed national standards.. James P. Rathmell, M.D., Susan A. Vassallo, M.D. Dr. Kirkham Wood performed an 11-hour operation on Meng in August 2012, a procedure that carried known risks, including possible paralysis, but also the potential for relief from pain and other symptoms. So much so that he also did both of my brothers hips. In court papers, a medical expert hired by Jenks disputed the hospital account, noting that Wood was listed as the surgeon in charge of a second case that completely overlapped Jenkss. Most recently, he served at MGH as the Interim Department Chair of the Department of Orthopedic Surgery and Chief of the Center for Hip and Knee Replacement. We have the best compensation plan around, said shoulder surgeon Dr. Jon J.P. Warner in a department-approved Harvard Business School case study last revised in 2005. We have remained at the forefront of medicine by fostering a culture of collaboration, pushing the boundaries of medical research, educating the brightest medical minds and maintaining an unwavering commitment to the diverse communities we serve. Please join us in congratulating the 13 Mass General orthopaedic surgeons named Top Doctors by Boston magazine for 2022. Had he known Dr. Wood might schedule a second surgery overlapping his, he said, I would have gone somewhere else.. He can rattle off relatives who have been treated at MGH and says he wouldnt dream of going anywhere else. We took those concerns very seriously, Slavin said. Did you approve this? The prognostic value of preoperative participation in activities of daily living on postoperative outcomes following lumbar discectomy. Introduction. In addition to his orthopaedic surgical residency at UM/Jackson, he completed an orthopaedic oncology fellowship at Massachusetts General Hospital and Children's Hospital Boston. Orthopedic surgeons are also among the leaders when it comes to the less common but more controversial cases involving at least one patient with an open incision while the second case is underway. Now, attorneys for three of Woods patients say that double-booking will play a prominent role in their malpractice lawsuits against the surgeon, including one filed by Meng and another by former Red Sox pitcher Bobby Jenks, who blames Wood for what he alleges was a botched back surgery in 2011 that ended his career. Pereira did not respond to requests to allow the hospital to comment on her case. And since I know a lot of surgeon-colleagues they are honest with their opinions and dont hold back., Orthopedic surgeons as a group tend to think of their careers in a linear fashion, i.e., I am going to do this for X number of years and then retire or do something different. I am 55 and some people would say, What are you doing? Dr. Allan Kirk, the head of surgery at Duke University School of Medicine, coauthored an article this year on concurrent surgery in the Annals of Surgery, a journal edited by MGHs chief of surgery, Dr. Keith Lillemoe. Rather, such cases are handled in successive stages, with the surgeon devoting himself to a section of one patients case, then moving on to the other. Peter Dunn, M.D.,Richard M. Pino, M.D., Wilton Levine, M.D. Burke spoke up at the end of LillemoesKeith D. Lillemoe, M.D.Chief of surgery talk and pointed out what he viewed as the policys shortcomings: Surgeons were still not explicitly required to tell patients when they had simultaneous cases. When the Globe informed MGH officials that Burke had rebutted their charge by providing the records, the hospital began an investigation into whether Burke had violated federal law requiring that patient information be kept confidential. In other words, not following the policy has lead to an appropriate punishment. Refer a Patient We are dedicated to working with our referring physicians. He also has received numerous faculty teaching awards in his previous academic positions. SmithR. The surgeon was paged three times but failed to respond, Dr. Susan Vassallo, an anesthesiologist for the case, later testified. We use cookies and other tools to enhance your experience on our website and My eighth annual Chief's Report for the Orthopaedic Journal at Harvard Medical School will highlight a tremendous year of growth and productivity in the Department. In June 2012, Lillemoe unveiled the much anticipated guidelinesThe final policy formally adopted in October 2012 had some changes from a draft shared in spring 2012. triathlete and orthopaedic surgery patient, If you have any questions, contact Megan Leelman at, Anesthesia, Critical Care & Pain Medicine, Billing, Insurance & Financial Assistance, Mass General Sports Medicine Physicians Head to Red Sox Spring Training, Family Nurse Practitioner Colleen McGauley, FNP-BC, Delivers Orthopedics Presentation at Statewide Conference, Orhun Muratoglu, PhD, Inducted into the National Academy of Inventors' Fellows Program, Sports Medicine Physician Kelly McInnis, DO, Receives 2023 Moyer Award, 31st Annual Smith Day & 8th Annual Jupiter International Forum. Not the man, in other words, one would expect to become the hospitals bitter antagonist. The only person seemingly unaware of this practice is the patient.. At 7:42 a.m., Dr. Kirkham Wood began a complex spine procedure on a 70-year-old woman in OR 64, according to medical records and legal documents. [ Contact MGH Archives for use] Partners HealthCare Pathology RubashHarry E. Rubash, M.D.Chief of orthopedic surgery said in a recent interview that he never pressured his staff to do concurrent procedures. He died in 2008 at the age of 99. Sunder and Hardiman said they scrambled to put in arterial and intravenous lines and transfused the patient with several pints of blood. He studied mechanical engineering at MIT, graduating in 1975, but realized that he would rather treat patients than work with things. Burke only made it through point 12 before the meeting ended. from the University of Pittsburgh in 1991. Phone: 617-726-9111 For more information about these cookies and the data We want to get you back to doing the things you love. Burkes looming departure does not, however, mean an end to the controversy. Dr. Bono obtained his medical degree (MD) from the State University of New York (SUNY) Health Science Center at Brooklyn (now called SUNY Downstate Medical Center). The board last month filed documents in two of Woods malpractice suits, saying that its investigation of the surgeon was open and ongoing. A state spokeswoman told the Globe, We are unable to provide a definitive timeline for completion due to the complexity of the investigation.. When I am in an OR and focusing on three square inches, bombs can be going off around me, and I am focused on three square inches.. Great skill and stamina would be required for the long hours of medical ballet ahead, as Wood timed his moves between the two ORs to match the ordinary progress of each procedure and both patients needs. Now director of Orthopedic Trauma Services at Suburban Hospital in Bethesda, Md. Extensive e-mail correspondence, obtained from Mass. Our spine team sees patients at these locations: Mass General - Boston55 Fruit StreetYawkey Center for Outpatient Care, Suite 3ABoston, MA 02114, Orthopaedics at Mass General Waltham52 Second AvenueBuilding 52, 1st Floor, Suite 1150Waltham, MA 02451, Newton-Wellesley Spine Center159 Wells AvenueNewton, MA 02459, Mass General/North Shore Center for Outpatient Care102-104 Endicott StreetDanvers, MA 01923, BW / Mass General Health Care Center20 Patriot PlaceFoxborough, MA 01923. We have remained at the forefront of medicine by fostering a culture of collaboration, pushing the boundaries of medical research, educating the brightest medical minds and maintaining an unwavering commitment to the diverse communities we serve. Congratulations on this new journey in your professional career. And what must patients be told about their care, and when? See some of our current research publications. During a recent interview at her home in Montpellier, France, she said she was angry to find out that Bhattacharyya was tending to other patients at the same time as her. If you have any questions, contact Megan Leelman at General Physicians Organization interrupted Torchiana and asked if Burke could share his views. Those changes came only after MGH officials took a remarkable step. Consider Nicholas Gregory. Pereira struck the ground and felt a sharp pain on her left side. Kirk said that double-booked operations can increase efficiency if done correctly, with brief overlaps at the start and end of cases. John Henry, the principal owner of the Red Sox and the owner of The Boston Globe, was a trustee of the hospital from 2005 to 2014. at a meeting of the orthopedic surgeons. He says he is at peace with that. George Dyer, M.D. Rubash, according to a hospital spokeswoman, says the meeting with Burke never took place. The General Hospital Corporation. Some doctors, Wood among them, consider disclosure of double-booking a case-by-case call. Our multi-disciplinary Spine team uses non-operative therapies and advanced surgical techniques to treat all spine conditions and disorders. We bring together the clinical professionals with the most appropriate skills to deliver your care. Vicky wanted to get back to her active life. Now, decades later, Austen had learned that Burke was speaking out against the institution they both held dear. I doubt that there is a person in this room who would want a family member or themselves to be treated by a surgeon running between two rooms, Burke said he told the group. Copyright 2007-2023. Your actions have been extraordinarily disruptive to the orthopaedic surgery department, Slavin wrote Burke. The Meng case reverberated deeply for BurkeDennis William Burke, M.D.Orthopedic surgeon. Dr. Kwon has varied clinical interests including sports-related injuries, arthritis, deformity correction, total ankle replacement, cartilage, ligament and tendon disorders and trauma. The risks are real; the benefits can be huge. Boston Medical Center spine surgeon Dr. Tony Tannoury occasionally runs two operating rooms, overlapping his cases by several hours in what the hospital describes as a tightly monitored program that enables him to do his operations more safely and during daytime hours. The General Hospital Corporation. He completed his undergraduate studies from the College of the Holy Cross, and earned his medical degree from Boston University School of Medicine. We have remained at the forefront of medicine by fostering a culture of collaboration, pushing the boundaries of medical research, educating the brightest medical minds and maintaining an unwavering commitment to the diverse communities we serve. General officials acknowledged Burkes surgical skill, but in March they suggested he was a hypocrite for condemning doctors who run two rooms when he does it himself. The Spotlight Team wants to hear about your experience with double-booked surgeries, as a patient, family member or medical staffer. Explore fellowships, residencies, internships and other educational opportunities. Learn about the many ways you can get involved and support Mass General. The Globe declined the hospitals request to return the documents for a review of Burkes redactions. I think its a fact that most patients would be uncomfortable with their doctor doing two operations simultaneously.. Contact us to learn more about our services or to make an appointment with one of our orthopaedic specialists. For the doctor to get informed consent, you have to tell the patient anything thats material about their surgery, and material is defined as what might cause a patient to change his or her mind, to say, I dont want surgery, said Annas, director of the Center for Health Law, Ethics & Human Rights at BUs School of Public Health. Double-booked surgery patients often didnt at the time, and sometimes still do not. Then, on Aug. 12, MGHs president, Peter Slavin, made it official. I am taking this summary action to restore the integrity of Hospital standards, operations, and patient care.. Former US attorney Donald Sterns 2012 report remains private, its conclusions known only at the institutions highest levels. Previously, Dr. Harris served as the chief of the Orthopaedic Trauma Service at Brigham and Womens Hospital (BWH). He repaired a hip replacement gone bad for me in 2010 and Ive loved knowing him all these years. She said she finally found the doctor in room 25 doing the ankle procedure and asked him to come assist Shervin. Double-booking his first two cases enabled Wood to conduct three major operations on the day of Mengs surgery, logging a collective 21 hours as attending surgeon. Double-booking also fit well with the business-like approach that Dr. Harry Rubash brought to Mass. Gitajn IL, Heng M, Weaver MJ, Casemyr N, May C, Vrahas MS, Harris MB. Candidate must be an arthroplasty fellowship-trained, board-certified orthopaedic surgeon with an exemplary record that exhibits the . Instructor or Assistant Professor of Medicine (Division of Endocrinology, Diabetes and Hypertension) Brigham and Women's Hospital Date Posted: 11/18/2022. Hospital officials have declined to share the document, even with state regulators, citing attorney-client privilege and promises of confidentiality to staffers interviewed. In addition to providing the consent form, MGH says its surgeons are expected to verbally discuss with the patient the plan for the surgery and potential risks, though there is no requirement that patients be told their surgeon is overseeing two cases at once. - A primary care provider (or PCP) is a doctor or in some cases, a nurse practitioner or physician assistant, who sees patients for everyday medical issues, such as colds and annual wellness visits. The Harvard Orthopaedic Journal is an annual publication of the Harvard Combined Orthopaedic Residency Program which includes Massachusetts General Hospital, The Children's Hospital, Beth Israel Deaconess Medical Center, and Brigham and Women's Hospital. MGHs charges for Woods services that day totaled about $73,000, according to copies of the bills provided to the Globe by Mengs attorneys at the Boston law firm Lubin & Meyer. Orthopedics in some ways is well suited to the practice, proponents say, because many procedures unfold in fairly predictable fashion, allowing surgeons to plan their movements with reasonable precision. But change came to his door. For patients, however, it can come as an unsettling surprise especially when things go wrong. He removed a damaged disc from the womans lower back and plugged it with bone; it would be the last surgery he did on her that day, though he checked on her twice and gave instructions to her medical team. Andrew Rogers, MD, FRCSC is the Director of Hip Preservation at Newton-Wellesley Hospital and is a Team Physician for Boston College Athletics. Hospital policy specifies that the patient be told generally of the involvement of the attending surgeon in the operation, but there is no written requirement to disclose whether the doctor will be responsible for a second overlapping operation. Burke and Austen had known each other since the early 1970s. Partway through the procedure, Bhattacharyya left Shervin and another resident in room 21 and scrubbed into operating room 25 as the attending for an ankle fracture case that had started two minutes after Pereiras case, according to medical records. To schedule an appointment with one of our 40 expert orthopaedic surgeons at any of our six locations in the greater Boston area, please call 617-732-5322, or fill out an online appointment request form. In June, he sat down with members of US Attorney Carmen Ortizs health care fraud unit at their request and outlined his concerns about double-booking, according to several individuals briefed on the meeting. Produced by Russell Goldenberg, Gabriel Florit, Elaina Natario, Scott LaPierre, Emily Z. Fortier, David Butler. If thats the case, I feel deceived, Meng, who has not returned to his job as a financial analyst since the 2012 operation, said in an interview. Ron is so worked up that he doesnt know whether to go to the Boston Globe or the FBI about this stuff, Torchiana told Burke, according to Burkes notes, which he gave to the Globe.
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