by Ron A. Virmani, M.D.
On September 1, 1995, Presbyterian hospital called me to their imposing corporate Board Room in Charlotte, NC and dropped a bomb on me. They said they were summarily suspending my hospital privileges at 4 pm that day!
Suspension from a hospital is a kiss of death for any physician! I knew that I would never be able to deliver any more babies nor take care of women who needed gynecologic surgery. I could not stop myself from crying.
I knew that they had been reviewing my charts for several months now. But I had no idea that they would not even give me a chance to present my side of the story with regard to any of those charts before taking such Draconian action. This was truly a stab in the back.
"We do not have to tell you what the charts are." Said then CEO of Presbyterian hospital Mr. Paul Betzold and chief of ob-gyn Dr. Ronald Brown. They simply stated that I had 24 "problematic" charts, as determined by the peer review committee.
I had received my M.D. from New Jersey Medical School in 1985 and finished my ob-gyn residency from Temple University hospital in 1989. I had come to Charlotte in 1990 and become a member of Presbyterian hospital medical staff as an ob-gyn physician.
On December 1994, I had a surgical mishap. Inadvertently, I punctured the external iliac artery in a patient during laparoscopy. This was unfortunate but a known complication of such a procedure. I immediately proceeded to laparotomy and summoned Dr. John Hollenbeck (general surgeon) and Dr. Scott Andrews (cardiovascular surgeon) to assist me. We repaired the injury and the patient went home after a few days stay in the hospital. My malpractice insurance company as well as several independent reviewers determined that I met the standard of care in this case. However, citing business reasons, the insurance company later decided to settle the lawsuit for 300K.
Following the incident, Presbyterian hospital went on a fishing expedition of my charts from over a two year period. Most of these charts had been filed in the hospital archives as having had no problems with them. Anyway, a departmental "peer review" committee headed by Dr. James Hardy somehow managed to label 24 of them "problematic" out of my 102 charts reviewed.
Did Dr. Hardy have more experience than I as an ob-gyn? No, we both finished medical school and residency in same years. The difference is that he is a good old Southern boy trained at Chapel Hill while I am India born, with my residency from Philadelphia. He was later promoted to the position of the chief of the ob-gyn department.
Although I repeatedly asked the hospital for an independent external review of my charts, the hospital did not grant that simple request. The Medical Board of North Carolina asked an experienced ob-gyn physician from Charlotte, Dr. Kenneth Chambers to review my cases. He as well as several other reviewers found my charts to be within the standard of care.
According to a letter circulated by Dr. Jared Schwartz in October 1998 among the hospital's medical staff, I was the first physician to be suspended in 20 years at Presbyterian hospital!
Was it just a coincidence that I was the first ob-gyn physician of Indian origin at Presbyterian hospital?
I decided to do a little research starting with the local courts. I found out the following facts, which are true to the best of my knowledge.
Dr. W. Wortman injured a patient's bladder while performing laparoscopy. The jury found him negligent and awarded the Plaintiff $100,000. (92-CVS-16674)
Dr. Kenneth Baker performed a laparscopic surgery in October 1993 at Union Memorial Hospital. An injury to the intestine was not recognized at this time. Patient presented later with abdominal abscess and died. (Union County 95 CVS 01325) Dr. Baker performed another laparoscopy in November 1994 at which time a bowel perforation was not recognized. She died of sepsis. (Union County, 96 CVS 00992) Presbyterian hospital had no problem subsequently giving Dr. Baker privileges in ob-gyn department.
Dr. Whitesides performed a laser laparoscopy on a patient in 1995 (99- CVS-5141). The patient complained of abdominal pain on December 2 and 3, the physician prescribed stool softener. On December 4, she fell down and the husband had to carry her. An exploratory laparotomy and hemicolectomy was done. Suit also named Nalle clinic.
Dr. C. Ellington performed a laser laparoscopy in September 1991 on a patient and perforated her small bowel. She underwent multiple subsequent surgeries and became unable to eat and drink. She was placed on TPN (intravenous nutrition). The suit also named Bradford Clinic and PHAC. (94-CVS-11679)
Dr. John Tidwell performed a laparoscopy on a patient who died from overwhelming sepsis six days later. (97-CVS-1707) Dr. Tidwell also failed to respond to nurse's pages for another patient in labor in August 1989. The infant suffered severe physical and neurological injuries. (92-CVS-11209)
Dr. A J Lewis failed to manage fetal distress during labor in 1992, the parties named (Dr. Lewis and Mintview ob-gyn) settled for $5M in May 1995.
Drs. M. Torres and K Stephens were performing a hysterectomy at Presbyterian hospital, while managing a labor patient at Carolinas Medical Center in September 1995. They failed to respond to fetal distress in time. The baby was born with zero apgars and died 16 hours after birth.(96-CVS-9576)
Dr. W. McDonald failed to assess fetal distress in February 1987. The result was severe physical and neurological injuries. (96-CVS-7927).
Dr. Alice Teague delayed performing a c/section after unsuccessful vacuum extraction of a baby with much fundal pressure. The baby was born with birth asphyxia and skull fracture. The jury awarded Plaintiff 23.2 million. The hospital settled separately for $6M. (95-CVS-13212)
These cases are only the tip of the iceberg of adverse events involving Presbyterian physicians. I know of no disciplinary action against these physicians by the hospital. They kept on practicing at Presbyterian hospital. Some are still there. In fact, some of them sat in my judgment.
First, I filed a state court case for breach of the by-laws. The hospital adroitly dodged the intent of the court order. When I filed a discrimination case in the federal court, the hospital attorneys dragged the case for several years during which the original judge died. A new judge was assigned.
However, out of nowhere, Judge Mullen, apparently sympathetic to the hospital, appeared and grabbed the case. He stopped it from going to trial citing convoluted technical grounds and not its merits. So much for spending eleven long years in the courts and a million dollars in legal fees! My career has been destroyed for ever. I have been thrown to the sidelines to wither away. Nobody, not even the media, gives a damn. I will never get justice in this country because of my national origin. Even though North Carolina Medical Board found my cases meeting the standard of care and said they would help me, they never did.
In this state and the country, an undercurrent of racism exists in the medical field. Bad physicians of the politically correct persuasion are allowed to practice based on their political clout. Good physicians, who are not part of the "good old boys club" and not approved by the club, are disciplined and thrown to dogs. The "peer review" system is used by the physicians to protect their own and destroy the disenfranchised. This does not bode well for the health care of the citizens of this country.
RON A. VIRMANI, M.D.
Board Certified Obstetrician and Gynecologist
4626 Charlestown Manor Drive
Charlotte NC 28211