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As Allegations Swirl, Baylor Plano Rejects Baldrige Award

 |  By cclark@healthleadersmedia.com  
   February 27, 2014

Hospital officials say they have declined a prestigious national quality award because of a lawsuit alleging that a neurosurgeon they employed was incompetent and caused patient injuries and at least one death.

There may be no greater prestige for a hospital than winning the Malcolm Baldrige National Quality award. And there may be no greater shame than to be compelled to give it up.

So it goes for Baylor Regional Medical Center at Plano, a 112-bed facility 20 miles northeast of Dallas.

When the Baldrige committee announced in November that Baylor Plano would be the 102nd company—and the 18th healthcare system—to garner the top honor in the program's 26-year history, proud staff wasted no time in getting the word out.

They hoisted bright blue banners outside the hospital and surely made a place for the gleaming trophy they'd bring back from ceremonies in April. A marketing campaign to publicize the prize would recognize the accomplishments of a relatively small community hospital.

In Washington, U.S. Rep. Sam Johnson, (R-TX), touted Baylor Plano's "innovative practices and visionary leadership," before Congress and said the organization's "dedication to training the best and brightest goes unmatched." The Baldrige program is administered by the National Institute of Standards and Technology, which is an agency of the U.S. Commerce Department.

But all that pomp and pride evaporated a week ago. Now, on the federal website where Baylor Plano's quality achievements were once extolled, there is only this.

'An Imminent Peril to the Public Health'

Hospital officials said they were declining the award because of a lawsuit  and media coverage over allegations surrounding their hiring and promotion of Christopher Duntsch, a neurosurgeon and spine specialist whose license is now revoked.

Last June, in a temporary suspension, the Texas Medical Board found that Duntsch was "an imminent peril to the public health, safety or welfare," because of widespread violations of standard of care that severely harmed four patients. Additionally, it found that Duntsch was "unable to practice medicine with reasonable skill and safety due to impairment from drugs or alcohol."

In legal filings, plaintiffs claim that Duntsch used cocaine and alcohol before he operated, performed unnecessary surgeries, abandoned at least one patient postoperatively, and refused to take a drug test when repeatedly asked to do so. Under his care, one patient died, according to the complaint.

All hospitals have bad doctors. The legal case against Duntsch, however, turns on the concern that the hospital ignored behavioral problems in someone in a hard-to-fill position expected to bring in lots of revenue in order to justify a $600,000 annual salary with bonuses.

The lawsuit claims that Baylor Plano covered up Duntsch's problems and failed to engage appropriate peer review processes or report Duntsch to the National Practitioner Data Bank as required... According to the lawsuit, hospital leaders told doctors to refer their back pain patients to Duntsch even while they were increasingly aware of patients harmed under his care

Baylor Plano denies the allegations.

In December, six months after suspending Duntsch's medical license, the Texas Medical Board permanently revoked it. The revocation order notes, however, that the medical panel "did not find evidence that the Respondent was under the influence of drugs or alcohol during any of the procedures in question."

Attention Shifts from Awards to Lawsuits
Baylor Plano said in a statement that although it is proud to have been named a Baldrige winner, "the hospital's leadership is making the difficult decision at this time to withdraw from the process."

Winning the Baldrige requires a time commitment to share stories of success with other organizations across the country, the statement said. But "right now, Baylor Plano is working to address allegations made against it by plaintiff's attorneys in lawsuits and in the media… "So at this time, out of respect for the Baldrige Award and to not give any misleading allegations an elevated public platform, Baylor Plano is announcing this decision."

In response, Robert (Bob) Fangmeyer, deputy director of the Baldrige Performance Excellence Program, issued a brief statement saying in part: "We appreciate the difficulty of this decision for Baylor Plano and encourage the organization to reapply for the Baldrige Award in the future."

Baldrige Committee Was Gathering Information
At least one media report reports Fangmeyer as saying this month that Baldrige examiners were looking into the lawsuit and its implications,  It's unclear, and Baldrige officials declined to tell me when I asked, if those remarks persuaded Baylor Plano to withdraw because of the seriousness of the accusations involving Duntsch.

Baylor Plano spokeswoman Nikki Mitchell insists that the hospital volunteered to relinquish the Baldrige. It's not unusual for any doctor or hospital, even a Baldrige winner, to be sued, she acknowledges.

"But it is unusual for there to be so much media attention around a lawsuit, and for a city of our size, it is what it is." And while she declined to comment on the lawsuit, she urged reporters covering the story not to take the lawsuit's claims as truth, "as a lot of reporters have assumed."

Malice for Patients Alleged
An attorney for two of the plaintiffs, Kay Van Wey of Dallas, said in an interview Wednesday that the case against Baylor Plano is about a lack of credentialing integrity.

She is trying to make the case under Texas law that Baylor Plano's failure to stop Duntsch through its credentialing process and peer review, constitutes malice, or "the intent to harm."

"This is a very big deal, especially because of the sheer number of people who were harmed in such a short period of time," she says.

"The problem we have here in Texas, and I'm sure other states have it as well, is that we've given hospitals free reign over credentialing decisions. And this case demonstrates very clearly how vitally important to patients health credentialing is.

"This wasn't just about Baylor. After (Baylor Plano) allowed (Duntsch) to resign and gave him a favorable recommendation, that allowed him to go to hospital number 2, and then number 3, and then 4, and kill and maim other patients."

On Feb. 13, Van Wey filed an 86-page complaint against Baylor Plano in the U.S. District Court for the Northern District of Texas detailing horrifying behaviors colleagues witnessed in Duntsch at the hospital.

'The Worst Surgeon They Had Ever Seen'
"Baylor Plano employees and other staff participating in surgeries with (Duntsch) witnessed a startling lack of surgical skill by Duntsch resulting in high blood loss, malpositioning of hardware, misuse of hardware, and other complications. Other doctors described Dr. Duntsch as 'dangerous' and 'the worst surgeon they had ever seen,' "the complaint says.

"Meanwhile the Baylor [Plano] defendants continued to actively promote Dr. Duntsch and encourage other physicians associated with the Baylor system to refer their patients to Dr. Duntsch… and pay for a marketing professional to promote Dr. Duntsch and his neurosurgery practice."

Baylor Plano's leadership at one point told Duntsch he could no longer operate and took him off of cases because of his behavioral issues and competence, but "inexplicably" the next day he was back in the operating room, the lawsuit claims.

Finally, the hospital in 2012 helped Duntsch, to move on, sending a letter of recommendation to Dallas Medical Center, which hired him to perform neurosurgery there.

"Therefore Dr. Duntsch was allowed to operate on even more unsuspecting victims at other hospitals and outpatient surgical centers throughout the metroplex,"

Dallas Medical Center revoked Duntsch's hospital privileges in July 2012.

If there is anything good to come out of this embarrassing disaster I hope it is this: Hospital and physician leaders need to take peer review processes much more seriously than is alleged they did in this case. And they need to report behavioral issues to the National Practitioner Data Bank so that dangerous doctors can be stopped before they hurt or kill.

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