Welcome to the latest edition of Investigative Roundup, highlighting some of the best investigative reporting on healthcare each week.
Paralyzed Patient, Whistleblower Surgeon
Omar Spencer, paralyzed from downstream complications of his pancreas-kidney transplant, is at the center of a lawsuit filed by one of the surgeons who operated on him, .
John Renz, MD, is suing the State University of New York (SUNY) and SUNY Downstate Medical Center for firing him after he raised concerns about patient safety and deaths in the organ transplant program. Among those issues: deaths and failures being misreported, and some deaths resulting from not prescribing immunosuppressive drugs.
His colleague Rainer Gruessner, MD, formerly surgery department chair at SUNY Downstate who was demoted after raising those concerns internally -- and who also operated on Spencer -- (he still has his faculty position, though).
Amid their complaints, in July 2019, the United Network for Organ Sharing (UNOS) recommended that SUNY Downstate voluntarily inactivate its transplant program.
Spencer is now paralyzed from the waist down and wondered how his transplant led to this. He said the first time he got details about what went wrong were via Renz's lawsuit.
Though the initial transplant surgery went fine, a third check-up in January 2019 revealed worrisome blood test results, and Spencer fell outside the hospital and had to be admitted. He had additional surgeries and part of his new pancreas was removed. Renz's lawsuit also talks about a surgeon abandoning Spencer in the operating room during that post-transplant surgery.
"If I had known that I would be paralyzed, Downstate would not be my first-choice hospital," Spencer told the Journal.
Uncredentialed Child Abuse Doc
She was regarded as an expert in child abuse, but Elizabeth Woods, MD, hadn't done the three-year fellowship to become a child abuse pediatrician and never passed the requisite board exam, .
Instead, Woods, who works at Mary Bridge Children's Hospital in Tacoma, Washington, said her expertise came from her work on child abuse while serving in the Army and other first-hand experience.
Despite her lack of training, Washington state child welfare officials have given Woods "remarkable influence" when it comes to taking children from parents or pursuing criminal charges, the news outlets reported.
In one case, Woods accused Megan Carter of medical child abuse of her 5-year-old daughter Ellie, who had been born premature at 24 weeks and required intensive treatment over the course of her young life. Based on Woods' report, Child Protective Services took Ellie and her 8-year-old brother.
Carter was separated from her children for more than a year, and she and her husband spent more than $300,000 on their defense. At the trial last April, Woods was the state's star witness, testifying that Carter used Ellie's health problems for her own gain. But a judge concluded most of Woods' testimony was "without supporting factual basis" and dismissed some of her conclusions as "not plausible" and "speculation at best," NBC News and KING 5 TV reported.
At a court hearing last May, Woods testified that most child abuse pediatricians in the U.S. have no better credentials than she does, and that specific training in the discipline began only 3 years ago. In fact, the news outlets found, "more than 375 child abuse pediatricians [are] certified by the American Board of Pediatrics," and fellowship programs began nearly 15 years ago. In Washington state, at least three other doctors have the board certification that Woods lacks.
Nevertheless, officials at Mary Bridge defended Woods, citing her "specialized training and significant experience," while declining to answer questions about the absent board certification or her misstatements about fellowship programs.
Therapy Sessions Used Against Young Detainees
Details garnered during mandatory therapy sessions are being used against juvenile asylum seekers in the U.S., violating patient confidentiality norms, .
In April 2018, the Office of Refugee Resettlement (ORR), which provides therapy sessions to all juveniles in detention, signed a formal agreement with Immigration and Customs Enforcement (ICE) to share details about kids in its care.
The Post reported on a handful of cases where details from therapy sessions were used against young asylum seekers, either to move them to more secure detention facilities or to argue for their deportation. The report focused on a young Honduran refugee, Kevin Euceda, who was held for a time in one of the government's highest-security facilities and whose requests for asylum were denied based on things he'd once told a therapist in confidence.
That includes his history of physical abuse, being in a gang, selling drugs, and "witnessing torturing and killing, including dismembering of body parts," according to a therapist report. He has now been held for more than two years as ICE has twice appealed judges' decisions to grant asylum.
Shelter therapists interviewed by the Post said they're aware of the policy and they try to protect patient privacy by using two sets of notes or leaving things out of their reports, but they also acknowledge making promises about confidentiality that they can't keep, the Post reported.
While the strategy is legal, professional organizations say it's a serious breach of patient confidentiality. The urging ORR to stop disclosing to ICE immediately, and calling on ICE to release any immigrants who had their asylum requests denied as a result of those conversations. The also called for the practice to stop.
"For this administration to weaponize these therapy sessions by ordering that the psychotherapy notes be passed to ICE is appalling," the psychological association's statement said. "These children have already experienced some unimaginable traumas. Plus, these are scared minors who may not understand that speaking truthfully to therapists about gangs and drugs – possibly the reasons they left home – would be used against them."