Down the hall in room 64 was Woods other patient, an elderly woman awaiting her own complex surgery, a spinal fusion that would also require precise work spanning much of the day. Though often called simultaneous surgeries, they do not, of course, involve the attending surgeon working directly on two patients at once. Blue Distinction Centers are healthcare facilities recognized for their expertise in delivering specialty care. See some of our current research publications. Jenks had publicly accused his surgical team of botching the surgery, failing to smooth a sharp place on his spine that sliced me open after the surgery and, he believes, ended his career. Learn more about our surgical optimization program, which will help you plan and prepare for your upcoming procedure. Indeed, he said in an interview that he asked Wood before the surgery whether he would be the one to perform the procedure, and the doctor said he would. When the 70-year-old woman returned a week later for another operation by Dr. Wood, she was again one of two simultaneous spine cases that overlapped for more than eight hours, despite the concerns of a senior anesthesiologist, according to e-mails and finalized operating schedules obtained by the Globe. He instructed Shervin to tell the family to find him the next morning and request a consult. to analyze our web traffic. James P. Rathmell, M.D., Susan A. Vassallo, M.D. Veteran spine surgeon specializing in complete range of adult spinal disorders. Mortality Following Surgical Management of Vancouver B Periprosthetic Fractures. Bhattacharyya was part of Mass. Extensive e-mail correspondence, obtained from Mass. Pereira struck the ground and felt a sharp pain on her left side. General officials also said the account from Burke, Shervin, and Vassallo is wrong and gravely so, but the hospital said it could not offer a detailed response because we would be violating federal law and our own patient privacy protections which we consider a fundamental patient right.. Wood, chief of MGHs orthopedic spine service at the time and a nationally renowned practitioner in his specialty, is a confident, veteran surgeon. No one knew it at the time, but it was, for Burke and MGH, the triggering moment in a seven-year conflict. With new Gene and Cell Therapy institute, MGB is staking its claim in The family wanted a second opinion. He completed his undergraduate studies from the College of the Holy Cross, and earned his medical degree from Boston University School of Medicine. He called Mengs sudden plight, a devastating sort of picture., In 2013, Wood stepped down from his post as chief of spine surgery because he never felt completely comfortable in his abilities to communicate with and lead the division, RubashHarry E. Rubash, M.D.Chief of orthopedic surgery said in a written statement to the Globe. MGH officials say their revised policy on concurrency stacks up well against their national peers. Congratulations on this new journey in your professional career. MGH says it has been reviewing the safety of concurrent surgery for some time. Harvard Combined Orthopaedic Residency Program See video animations for common spine conditions and treatments. Thats the most appropriate utilization of this concurrent surgery not having two cases going exactly at the same time and the surgeon bouncing back and forth between the two, said Kirk. But what had come of it? Rather, such cases are handled in successive stages, with the surgeon devoting himself to a section of one patients case, then moving on to the other. His name is Andrew Freiberg, M.D. Speaking generally, Warner wrote, The suggestion that I am not managing all my patients care while they are in the operating room is both untrue and malicious.. It didnt take long for the conversation to become tense. The fact that surgeons are allowed to run two rooms simultaneously is known by physicians, administrators, compliance officers, booking clerks, nurses, residents, and others, Burke wrote in March 2012 to Dr. Keith Lillemoe, head of surgery at MGH, in an e-mail obtained by the Globe. We treat every orthopaedic condition of the young and old: hip and knee arthritis, sports injuries, spinal deformities, hand, shoulder and foot disorders, trauma, and musculoskeletal tumors. But the investigation continues. The existing rules, outlined in a 2002 hospital memo, did little more than require surgeons to be present for the key portions of the case, leaving it to the surgeons to decide what that meant. Hospital officials have declined to share the document, even with state regulators, citing attorney-client privilege and promises of confidentiality to staffers interviewed. He told the Globe that the second part of the operation, which lasted five hours and involved removing hardware from her spine, was not difficult. BostonMA, 02114. In addition to providing the consent form, MGH says its surgeons are expected to verbally discuss with the patient the plan for the surgery and potential risks, though there is no requirement that patients be told their surgeon is overseeing two cases at once. MGH officials dispute the validity and importance of almost every complaint, saying many are based on inaccurate information, turf fights, or misunderstandings in a busy hospital. The prognostic value of preoperative participation in activities of daily living on postoperative outcomes following lumbar discectomy. Then, on Aug. 12, MGHs president, Peter Slavin, made it official. For several hours after anesthesiologists put Meng to sleep around 8 a.m., Wood tended to him and to the woman down the hall. These residents and fellows can relieve senior doctors of routine tasks, like stitching up patients and more, as their training progresses, allowing surgeons to move from one operating room to the next, where others have already prepared the patient. And he is an exceptionally busy practitioner, having performed more than 10,000 knee and hip operations since completing his orthopedics residency in 1984. I doubt that there is a person in this room who would want a family member or themselves to be treated by a surgeon running between two rooms, Burke said he told the group. The French womans case contributed to Shervins difficulties at MGH, where she was placed on probation in 2007 for alleged shortcomings. Learn about career opportunities, search for positions and apply for a job. This summer, Wood said he would leave Boston to become a professor of orthopedic surgery at Stanford University in his native California, starting in November. General. MGH, in a statement, said the vascular surgeon did not plan to do two procedures at once, but responded appropriately to an unexpected emergency.. He also has received numerous faculty teaching awards in his previous academic positions. General leadership, they were dispelled on a bitterly cold morning in February this year in a hospital hallway. Our spine team sees patients at these locations: Mass General - Boston55 Fruit StreetYawkey Center for Outpatient Care, Suite 3ABoston, MA 02114, Orthopaedics at Mass General Waltham52 Second AvenueBuilding 52, 1st Floor, Suite 1150Waltham, MA 02451, Newton-Wellesley Spine Center159 Wells AvenueNewton, MA 02459, Mass General/North Shore Center for Outpatient Care102-104 Endicott StreetDanvers, MA 01923, BW / Mass General Health Care Center20 Patriot PlaceFoxborough, MA 01923. Let us help you navigate your in-person or virtual visit to Mass General. He is an internationally recognized expert on the cellular and molecular mechanisms of bone regeneration and repair, locally applied antibiotics and minimally invasive fracture surgery. We are committed to providing expert caresafely and effectively. Burke and a small but determined cohort of anesthesiologists and other Mass. We use cookies and other tools to enhance your experience on our website and Tony Meng came to MGH suffering from neck pain and tingling in his arms and fingers. In one of the few scientific studies of simultaneous surgeries, a University of Virginia researcher found no increase in complications in operations that overlapped by up to 45 minutes. Surgeons would face more requirements and more limits. They discovered his spinal cord had somehow bent at an acute angle and was protruding through a hole in the dura, the tough membrane that encases the spinal cord where Wood had first operated the morning before. collected, please refer to our Privacy Policy. Im busy, Bhattacharyya told Vassallo, according to her court testimony. Sunder. Bitter internal debates about concurrent surgeries have erupted in recent years at medical institutions in Chicago, Milwaukee, Nashville, and Syracuse, and have led to litigation. After about 20 minutes, SkatesRonald SkatesTrustee of Mass. RubashHarry E. Rubash, M.D.Chief of orthopedic surgery said in a recent interview that he never pressured his staff to do concurrent procedures. Can they really do two overlapping operations equally well? The department, after a one-day inspection this past February during which investigators examined records and interviewed four ranking staff members, but not Burke, issued a report saying it had found nothing wrong. And what must patients be told about their care, and when? We use cookies and other tools to enhance your experience on our website and Wood later testified that he performed this particular procedure only once or twice a year, working in a delicate space where the difference between recovery and ruin is sometimes a scalpels width. PDF Harvard Orthopedic Trauma Fellowship Massachusetts General Hospital Tony Meng had no idea he was sharing Wood with another patient that morning. to analyze our web traffic. Dr. Elhassan spoke with WCVB about his innovative approach to restoring function and range-of-motion in a patient long-suffering from chronic shoulder pain . We allow cases to have a staggered start, he said in an interview. Im just a concerned doc worried about poor patient care and potential damage to the hospitals reputation.. While Wood was checking on the fellows work in OR 64, the crisis continued with Meng. Other luminaries in orthopaedic surgery have headed the Department over the years, including Drs. Our multi-disciplinary spine team uses non-operative therapies and advanced surgical techniques to treat all spine conditions and disorders like spinal deformities & injuries, scoliosis and spinal stenosis. The hospital only allows certain types of procedures to run concurrently and not the kind that Tony Meng had. One recurring complaint was that patients lingered under anesthesia for long periods, as the operating room staff waited for the attending surgeon to arrive from work on another concurrent case. He had lost all muscle responses in his arms and legs, and doctors still did not know why. Burke wasnt alone in his doubts about double-booking. Mass. We use cookies and other tools to enhance your experience on our website and He felt he had failed in his long-running effort to sway his colleagues. He was also an Associate Professor of Orthopedic Surgery at Harvard Medical School. Orthopaedic Spine Service 617-724-8636 Contact Information Orthopaedic Spine Service Phone: 617-724-8636 Fax: 617-726-7587 Request an appointment Our spine team sees patients at these locations: Mass General - Boston 55 Fruit Street Yawkey Center for Outpatient Care, Suite 3A Boston, MA 02114 Orthopaedics at Mass General Waltham 52 Second Avenue Dr. Lillemoe, a genial native of a small town in South Dakota, came to Mass. Watch the full documentary and learn more about concurrent surgeries at the homepage for Globe coverage of the issue. He was happy to put himself in the care of Wood, a doctor who was recruited by MGH as chief of its orthopedic spine service in 2004 and who would draw many plaudits from patients. Then, he would turn Meng over onto his abdomen and operate some more. He arrived stressing the need to reduce surgical complications generally and walked into the debate over the safety of double-booking. After earning his medical degree from the University of Illinois College of Medicine in 1984, Dr. Harris completed his residency in Orthopaedic Surgery at Dartmouth-Hitchcock Medical Center in 1989. Clinical and Research Pioneers Molded Massachusetts General Hospital's Orthopedic Surgery History. I do not have one regret over coming forward. Jon has a tendency of counting operating time versus actual case time. , -----, This event will be livestreamed. I have ccd Sue on this since she was the anesthesiologist. Double-booking his first two cases enabled Wood to conduct three major operations on the day of Mengs surgery, logging a collective 21 hours as attending surgeon. To document his case, Burke blacked out identifying information about patients and gave the records to the Spotlight Team saying, Dont take my word for it.. Dr. Kirkham Wood performed an 11-hour operation on Meng in August 2012, a procedure that carried known risks, including possible paralysis, but also the potential for relief from pain and other symptoms. He had become the sounding board and champion for those at MGH who shared his concerns about concurrent surgeries. In June, he sat down with members of US Attorney Carmen Ortizs health care fraud unit at their request and outlined his concerns about double-booking, according to several individuals briefed on the meeting. Zinner explained the philosophy that drives the limits on concurrent surgery at his hospital. It would be almost nine years before he learned, in January, that during the nine-hour case Wood had left him for a time in the hands of a fellow while he operated on a second patient with what Wood later testified was an infected spine. Vivek Babaria, DO, RMSK has joined DISC Sports & Spine Center as its first osteopathic physician. , -----, Wyndham Hotel - Beacon Hill See discharge instructions for the Orthopaedic Spine Service. Previously, Dr. Harris served as the chief of the Orthopaedic Trauma Service at Brigham and Women's Hospital (BWH). Director, Spine Oncology & Co-Director, Stephen L. Harris Chordoma Center. Our orthopedic surgery team includes renowned surgeons who are highly skilled and experienced in their specialty area. Theyre engaged in all these activities which her action or inaction absolutely pales in comparison to.. That resident worked on the 2008 hip surgery case that first raised concerns for Burke about double-booking. Dublin, N.H. : William L. Bauhan, 1996. - A primary care provider (or PCP) is a doctor or in some cases, a nurse practitioner or physician assistant, who sees patients for everyday medical issues, such as colds and annual wellness visits. Thats when, Vassallo said, she did something for the first time in 25 years of medicine: She went looking for the surgeon. Wood, in later testimony, described the hole in the dura as large and that he couldnt pinpoint when it had torn open or what was the cause. Brigham and Women's Hospital . Fax: 617-726-8214. Burke wanted to study mechanical engineering, as Austen had. Malcom Smith, M.D.Chief of MGH orthopedic trauma, in a written statement, said it would be unethical and illegal under federal privacy laws to respond to anything about the case specifically. Stern, with a Partners attorney usually by his side, conducted dozens of confidential interviews over several months to look into allegations of patient harm, billing problems, and what double-booking critics considered a culture of intimidation at the hospital. Generals chief surgeon, Dr. Keith Lillemoe, had to admit to Burke that even he had not seen it. Trustee of Mass. He knew it was probably a breach of protocol, but he divulged his worries to Ronald Skates, a friend and former computer company executive. By the time Bhattacharyya returned to implant the hip, they say, he had completed work on the critical parts of the ankle case, and the earlier operation in room 22 was also over. His name is Andrew Freiberg, M.D. Then, moving to the other OR, Wood cut into Mengs neck to expose the spine for the procedure, known as a cervical corpectomy. In August, MGH revoked Burkes operating privileges, ending his 35-year career at the hospital that in 2009 gave him a coveted award as one of its best clinicians. Our education portal was built to answer our patient's most common questions. They hired the regions former top federal prosecutor to examine Burkes claims, interviewing 60 staffers across the hospital. All Rights Reserved. Anne wanted relief from her severe arthritis. Other fields looked at that model as they got busier.. Surgeons at Mass General are allowed to run two operating rooms at the same time, as long as they are present for the critical parts of each surgery and are immediately available if a problem arises in either procedure, or have a backup immediately available. While he was a medical student at Loyola University outside Chicago, orthopedic surgery appealed to him because it combined medicine and mechanics. Orthopaedic Surgery - Brigham and Women's Hospital It had to be done, Burke told the Globe. Ron is so worked up that he doesnt know whether to go to the Boston Globe or the FBI about this stuff, Torchiana told Burke, according to Burkes notes, which he gave to the Globe. General in May 2011 after a distinguished career as a pancreatic cancer surgeon and surgeon-in-chief at Indiana University Hospital. I was called a whistle-blower and crusader by some not true, Burke said he told Stern. He and I together recognized the need for new leadership to bring stronger management.. And the attending surgeon, once the work is underway, is committed to managing two cases. named new co-directors of the HSS Women's Sports Medicine Center. Rubash, in an interview, said concurrent surgery did not become more common during his tenure. Some tests may be necessary at that time, including x-rays, CT scans and MRIs. . At Mass General, the brightest minds in medicine collaborate on behalf of our patients to bridge innovation science with state-of-the-art clinical medicine. AustenW. In other words, not following the policy has lead to an appropriate punishment. By the time Bhattacharyya scrubbed back into Pereiras operation, Shervin was concerned the cement was too hard. For the doctor to get informed consent, you have to tell the patient anything thats material about their surgery, and material is defined as what might cause a patient to change his or her mind, to say, I dont want surgery, said Annas, director of the Center for Health Law, Ethics & Human Rights at BUs School of Public Health. Doctors could not be the attending surgeon for three rooms simultaneously, something already prohibited by Medicare rules. The fourth of five children raised by a South Boston pharmacist and a homemaker, Burke began working part time for MGH while still at the Boston Latin School, giving hearing tests at what was called the Bunker Hill Health Center in Charlestown. Is it right, some MGH medical staff asked, for surgeons to divide their attention between two operating rooms especially when the patients dont know? to analyze our web traffic. We offer diagnostic and treatment options for common and complex medical conditions. About Mitchel B Harris - Mass General Brigham These individuals come from medical device or pharmaceutical companies that have chief medical officers, so they said, We need one too., This position has three major components. But Vrahas had at least one other operation going on at the same time, and a resident performed the procedure instead, Dalal said in an interview. Dr. With more than 25 years of experience in academic orthopaedic surgery, Mitchel B. Harris, MD, has been named chief of the Department of Orthopaedics at Massachusetts General Hospital, effective October 1, 2017. Our Orthopedics Team Jessica P. Aidlen, MD Chief of Spine Surgery Specialty:Spine Surgery Location: Ambulatory Care Center 159 Wells Ave, Newton, MA Phone: (617) 831-7082 Kyle Alpaugh, MD Specialty:Joint Replacement Location: Kaplan Joint Center, 2014 Washington St, In addition, the Brigham says it requires that the backup doctor be identified to the patient and listed on consent forms. Rubash helped introduce an incentive system that paid doctors more if they generated more profits. Former US attorney Donald Sterns 2012 report remains private, its conclusions known only at the institutions highest levels. The orthopedic surgery department at Mass. Other authorities see real utility in the practice. Read the draft version. Thats when he bumped into Dr. W. Gerald Austen, the 85-year-old retired chief of surgery and a founder of Partners HealthCare, the parent company of MGH. We offer diagnostic and treatment options for common and complex medical conditions. I am surprised to find this out from the schedule. As the internal controversy stirred by Burke and others escalated, Dr. Peter Dunn, medical director of the hospitals OR, began looking for ways to improve the departments performance, including a review of the hospitals guidelines for concurrent surgeries. An inveterate tinkerer, he crafts some of his own surgical tools in the barn beside his Milton home. Read the final policy. When Dr. Neelakantan Sunder, team leader for orthopedic anesthesia, raised questions about Wood booking two rooms for major spine surgery in 2010 two years before the Meng case Dr. Peter Dunn, medical director of the hospitals OR, reassured him in an e-mail obtained by the Globe that Wood has the fellow manpower to do this., Sunder, who could be prickly about what he considered matters of patient safety, replied: Do you really think it reasonable to do these two cases by the same primary surgeon? MGH declined to say how much orthopedic surgeons there earn on average. Seventeen days before Nina Shervins call to Dennis Burke, the woman had fallen by the entrance to her sons apartment on tree-lined Commonwealth Avenue in the Back Bay. Candidate must be an arthroplasty fellowship-trained, board-certified orthopaedic surgeon with an exemplary record that exhibits the . and Andrew Pao, M.D. He said he got emotional, especially when he recalled for Stern a time when his wife was a patient at Mass. Learn how your comment data is processed. Joseph H. Schwab, MD, MS. Chief, Orthopaedic Spine Surgery. Meet the Orthopaedic Surgery Team - Lahey Hospital & Medical Center Let me know. Wood was known among his peers for taking on some of the most challenging cases, sometimes as the surgeon of last resort for suffering patients who had been turned down by other doctors. If Burke had any doubts about the price he would pay for openly challenging Mass. Partway through the procedure, Bhattacharyya left Shervin and another resident in room 21 and scrubbed into operating room 25 as the attending for an ankle fracture case that had started two minutes after Pereiras case, according to medical records. Step-by-step guidance: our spine team, spine anatomy, preparing for surgery and more. This event will be livestreamed. I am absolutely thrilled for Dr. Freuberg on his new role. George J. Annas, a prominent patients rights advocate at Boston University, said its a no-brainer that a surgeon should inform a patient that the doctor intends to operate on that person and another patient in the same time frame. Those changes came only after MGH officials took a remarkable step. MRI results came in after midnight and confirmed that something was very wrong. General. It was a battle pitting a star surgeon against a great hospital, MGH. In terms of the grape vine, it is not correct. And physicians could be anywhere on the hospitals expansive campus more than a quarter mile wide and be considered immediately available to their patients. But the Globe, through dozens of interviews and a review of hospital records, court filings, and hundreds of e-mails shared by current and former medical staffers, pieced together a portrait of this remarkable and revealing episode, one which changed surgical practice and procedure at the hospital and resulted in double-booking being raised as an issue in malpractice lawsuits. 5 Blossom St Are perioperative allogeneic blood transfusions associated with 90-days infection after operative treatment for bone metastases? Dr. Joseph Schwab, Chief of the Orthopaedic Spine Center at Massachusetts General Hospital and Director of SORG, is featured in a new video from the Department of Orthopaedic Surgery at MGH. Concurrent surgery is also relatively common in trauma, cardiac, brain, and vascular operations. Then in April 2011, Skates helped arrange a meeting with Burke and Torchiana and the three of them gathered in Torchianas office on the second floor of the Bulfinch Building at 6:30 a.m. Torchiana was not about to simply bow to Burkes demands. The surgeon was paged three times but failed to respond, Dr. Susan Vassallo, an anesthesiologist for the case, later testified. Our hospital is being crucified for something that happens at hospitals across the globe, Wood said. And thats why we brought in Donald Stern to investigate the situation., Slavin then concluded: He found no basis to support Dr. Burkes concerns.. Dr. Hornicek completed his clinical fellowship in orthopaedic oncology at the MGH in 1997 and is a leader in the fields of tissue banking, allograft transplantation, and cell membrane biology. Now, attorneys for three of Woods patients say that double-booking will play a prominent role in their malpractice lawsuits against the surgeon, including one filed by Meng and another by former Red Sox pitcher Bobby Jenks, who blames Wood for what he alleges was a botched back surgery in 2011 that ended his career. He then completed a General Surgery Internship and the Orthopedic Training Program at the University of Michigan Hospitals. That doctor worked in the orthopedic trauma service where, MGH says, overlapping surgeries can be more common, and sometimes necessary, as doctors respond to clusters of urgent and emergent cases. The conflict went on for years. But, this is a separate issue. While a senior resident at the University of Michigan, Dr. Freiberg did a rotation at MGH and he went on to complete the Hip and Implant Fellowship there.
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