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Youth Death Rallies Anti-Vaxers; Insurers Hire After Malpractice; Bad Doc Ignored?

— This past week in healthcare investigations

Ƶ MedicalToday
INVESTIGATIVE ROUNDUP over an image of two people looking at computer screens.

Welcome to the latest edition of Investigative Roundup, highlighting some of the best investigative reporting on healthcare each week.

Young Man's Tragic Death Caught the Attention of Vaccine Opponents

When a 24-year-old man from Elmira, New York passed away in October 2021, his family and a hospital medical examiner concluded his death was tied to the COVID vaccine, .

The medical examiner wrote the cause of death for George Watts, Jr., was "COVID-19 vaccine-related myocarditis," the Times noted. (Multiple studies have shown myocarditis can develop in some people, especially young men, who receive the vaccine.)

However, shortly thereafter, news of the young man's death "ricocheted around the internet, transforming the family's tragedy into a powerful anecdote inside anti-vaccine communities," the Times wrote.

But as claims spread online, many medical experts raised questions, the Times added. "Myocarditis could have been the culprit, they said, but it was difficult to conclude that the vaccine was the cause -- especially without further examination of George Jr.'s body," the outlet wrote. "That is now impossible. His body was cremated."

The CDC has, however, received specimens from the young man's autopsy and is finalizing a pathology report, the Times reported, citing the New York State Department of Health.

In the meantime, some doctors have said that what stood out from the autopsy was what happened in the rest of the young man's body, saying it raised additional questions about his cause of death, the Times reported. Other findings included a very enlarged spleen, kidney damage, late-stage pneumonia, chronic inflammation in the brain, and a prostate gland that was partially necrotic.

Ultimately, the report being prepared by the CDC "could shed more light on George Jr.'s death," the Times wrote. "If they agree with the medical examiner, George Jr.'s death could become the first that the department has tied to vaccine-related myocarditis in the United States. If they disagree, it could offer more clarity about what happened to George Jr."

Docs with History of Malpractice Flock to Insurance Industry

The insurance industry has welcomed with open arms physicians with histories of large malpractice settlements, giving them jobs as medical directors, .

Though insurers hold that medical directors "steer patients away from unnecessary or risky care and expensive treatments for which there are less costly, equally effective alternatives," patients and their physicians often claim they "routinely, and wrongly, deny payment for critical lifesaving treatments because they are expensive," the outlets wrote.

Additionally, beyond requirements by many states for medical directors to be licensed physicians, insurers are generally left to determine which professionals are fit for the position, ProPublica and The Capitol Forum noted.

Reporting by the outlets identified a dozen insurance company doctors with a history of multiple malpractice payments, a single payment in excess of $1 million, or a disciplinary action by a state medical board.

Examples of malpractice cases settled by the physicians include one with 11 patients, some of whom allege they were left incontinent after urology surgeries, ProPublica and The Capitol Forum reported. In another case, a 27-year-old mother of two died less than a year after her cancer was finally discovered. (It is said that cancerous cells were previously not identified on a pathology slide.)

"None of this would have been easily visible to patients seeking approvals for care," the outlets wrote, "or payment from insurers who relied on these medical directors."

Arizona Doc Kept License Despite a Generation of Misconduct Claims

In Arizona, a physician was allowed to keep his license despite a series of sexual misconduct allegations that spanned a generation, .

Michael Ridge, MD, is now in his 70s and had practiced in Casa Grande for decades, specializing in internal medicine and pediatrics, before recently retiring, the Republic noted. He has denied the allegations against him.

The physician beat criminal sexual misconduct charges more than 20 years ago and settled a related lawsuit, and also emerged from Arizona Medical Board scrutiny "at least 11 times for a variety of issues and kept his license," the Republic reported.

"In the court of public opinion, and in criminal court, Ridge got the benefit of the doubt," the outlet wrote. "Claims that Ridge abused his patients were judged by a changing cast of medical board members, but their reactions were similar. In those cases of he-said-vs-she-said, the board didn't side with the women, despite similar claims spanning decades and the #MeToo global reckoning about the handling of sexual misconduct."

Why the state medical board didn't take more action is "difficult to pin down," the Republic reported. Investigations are not public.

In the Republic's reporting on the matter, the outlet noted that questions to current board members largely went unanswered. However, Patricia McSorley, JD, the board's executive director, told the outlet in part in an email that the board is busy, but that investigations are not compromised by the workload. McSorley added that hands are tied in some cases -- for instance, the board cannot take anonymous complaints or investigate misbehavior more than 4 years old.

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    Jennifer Henderson joined Ƶ as an enterprise and investigative writer in Jan. 2021. She has covered the healthcare industry in NYC, life sciences and the business of law, among other areas.