Health Law

?Jumping Jelly Beans? and Surgeon?s ?very bad day? lead to Summary Suspension and NPDB Report.

By Greg Piche'

?Pitching a fit?  in a hospital operating room can land a  surgeon in the National Practitioner Data Bank. In Leal, M.D. v. Secretary, U.S. Dept. of HHS issued on September 22, 1010, the Eleventh Circuit Court of Appeals affirmed the decision of the trial court upholding the determination by the Secretary of HHS that Dr. Leal?s 60 day suspension for disruptive conduct was accurately reported and required to be reported to the data bank. When notified that there would be a delay in the start time for a urological surgery case, Dr. Leal broke a telephone, shattered the glass on a copier, shoved a metal cart into the OR doors causing damage, through jelly beans down the hallway, through a patient chart on the floor and verbally abused a nurse. In his review petition to the Secretary he suggested that he had merely been clumsy, a portrayal the Court was reluctant to accept from a urological surgeon.

The Court of Appeals obviously had some fun with this case giving it a chance to refer to Judith Viorst?s book, A Terrible, Horrible, No Good, Very Bad Day,  to describe Dr. Leal?s puerile behavior leading to his suspension.  Dr. Leal?s objections to the Secretary?s determination seemed ill considered  and petulant as well. He suggested that in order to be reportable that his behavior must have created an immanent threat to patient harm.  That is an inherently loosing argument.  Surgery is a team event requiring the coordination and collaboration of physicians, technicians and nurses who need to cooperate with each other and anticipate each other?s needs for the benefit of the patient. As the court noted, obnoxious behavior by a physician can lead to disruption of the ideal level of functioning of the team.  ?When a physician becomes enraged and lashed out at other members of the medical staff, patient welfare is endangered.?

Full post as published by Healthcare Law Blog on September 30, 2010 (boomark / email).