A former Sharp Grossmont physician has sued the hospital saying its officials harassed him and forced him to resign after he criticized dozens of practices he claims endangered mothers and newborns.
[one_half][box type=”shadow this-matters”]Poor management practices and hostility in medical settings can lead to serious patient safety lapses and medical mistakes. Secret video surveillance of surgeries may violate patient privacy and provoke lawsuits.[/box][/one_half]
In his 48-page complaint filed in San Diego Superior Court, Grossmont’s former chief of anesthesiology Dr. Patrick Sullivan also alleges that Sharp administrators in January 2016 reinstalled secret video cameras to record patients, doctors and others during surgeries without their consent.
Embedding of cameras within operating room monitors resembled a yearlong sting operation Grossmont conducted in 2012-2013, Sullivan said in an interview.
Sharp spokesman John Cihomsky said the hospital had not reinitiated video surveillance.
“New laptops were installed in the ORs in support of SurgiNet, a perioperative and anesthesia information system,” he wrote in an email. “Like all new laptops, they came with built-in cameras; however, software was never installed on those laptops to activate the cameras. No surveillance occurred.”
Sullivan’s lawsuit says that in January 2016, before the 2012-2013 video operation became public, he “discovered that Sharp placed cameras in the rims of computer monitors in all three of the Women’s Center operating rooms, in all 12 of the main operating rooms, and in all six of the SGSC (Sharp Grossmont Surgical Center) operating rooms. Dr. Sullivan believed that Sharp was once again secretly recording patients in the operating rooms.”
Sullivan’s lawsuit primarily claims the 524-bed hospital refused to eliminate dozens of safety problems, including severe understaffing of nurses, management’s frequent failure to order enough medications necessary to reduce pain and sedate patients, management’s dissemination of damaging rumors about him and its allowance of disruptive hostility in the workplace.
As an obstetric anesthesiologist, Sullivan’s job is to make sure women giving birth or having gynecologic surgeries are safely anesthetized and sedated.
In an email, Cihomsky said the hospital wouldn’t comment directly on specific allegations because Sullivan had filed a lawsuit.
“What we can say is that Dr. Sullivan voluntarily resigned his membership on Sharp Grossmont’s medical staff in January 2016. As noted in his complaint, Dr. Sullivan has numerous criticisms of others.”
Cihomsky denied the hospital forced Sullivan to resign because he complained. “Sharp Grossmont did not retaliate against Dr. Sullivan because of concerns he raised about hospital operations,” he wrote.
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Resigned under threat
Sullivan, 52, who had a 22-year career at Sharp, said he resigned one day after receiving an email “from the hospital attorney saying that if you resign now, an 805 to the medical board will not be filed.”
An 805 refers to the state regulation that requires hospitals to report certain disciplinary actions taken against physicians with staff privileges, and usually prompts a medical board investigation that can threaten a doctor’s license to practice in California.
Sullivan said in his lawsuit and in interviews that he frequently complained to managers about conditions that could cause “significant risk of patient harm” and “significant risk to patient safety.”
But those complaints “would go into a black hole. You would never hear about it again. Or you’d get platitudes saying they’ll fix the problem, but the problem would never be fixed,” he said during an interview.
In the years before he left, Sullivan said he was so distrustful of patient care practices at Sharp Grossmont he refused to let his own family members go there for care.
“I intervened so that my mother-in-law would go to (Scripps) Mercy because of these things that were going on at Grossmont,” he said.
Sullivan declined to attribute any specific bad outcome during an obstetric procedure to any specific practices, but he said some babies may have been deprived of oxygen longer than necessary because of delayed C-sections.
Sullivan said he doesn’t know whether the questionable practices he alleges have continued at Sharp Grossmont because many of the administrators who established those policies have left. However, he said his wife, orthopedic surgeon and former Grossmont chief of staff Dr. Rina Jain, now takes most of her patients to other hospitals.
Nursing staff, anesthesia shortages
The numerous safety issues identified in Sullivan’s complaint include:
• Installation of pharmaceutical dispensing cabinets that would unnecessarily lock up in the middle of a surgery, delaying physicians’ and nurses’ access to necessary drugs to sedate women who needed emergency C-sections within minutes. To unlock, someone would have to know the password for that particular cabinet.
“Seconds count and delays caused by a locked cart could result in death or significant harm to the mother and baby,” the lawsuit said.
• Inadequate stocking of medications in the labor and delivery surgical carts “causing the physicians to run out of supplies in the middle of the night.”
• Hiring of inexperienced nurses and understaffing of nurses “particularly on the night shift, such that someday a bad baby case would be the result,” and refusal to pay nurses “double time pay,” that compounded the understaffing problem.
On the night of June 15, 2015, Sullivan said he personally witnessed “only one nurse instead of two in the PACU (post-anesthesia care unit) when a patient and her baby were recovering,” a cancellation of a midnight induction due to understaffing, nurses “rushing from patient to patient,” and C-section “decision to incision” time greater than 30 minutes, in violation of standards, and many other staffing issues. “Nurses were afraid to speak up for fear they would be fired,” the lawsuit said.
• Workplace hostility that led to “a culture of fear, backstabbing and endless harassment” that violated leadership standards set by The Joint Commission, the lawsuit said. Sullivan claims management spread false stories about him, such as that he inappropriately touched a nurse, that damaged his reputation.
• Unsafe practices that allowed an anesthesia gas canister to be replaced with one containing a different type of anesthesia gas in the midst of a surgical case without informing the anesthesiologist. Sullivan explained that use of the wrong gas can cause breathing problems in some obese patients and impair their ability to safely wake up from surgery. He said he caught one such example just in time.
“Immediately before I was about to put the patient to sleep, I stepped out for a few minutes and when I came back, there was a different anesthesia gas canister that had been put there, after we’d done the machine check.”
He added, “It’s like changing a part of an airplane right before the pilot, who has done his preflight check, but before the plane takes off.”
Reinstalled video cameras
Sullivan said that just before he resigned, he and other doctors noticed monitors throughout the hospital were embedded with cameras.
He said during an interview he has no proof the cameras were recording patients, but he said it’s logical to think so because similar cameras were installed when the hospital approved secret recording in its Women’s Center operating rooms in 2012 and 2013.
The hospital acknowledged the 2012-2013 video surveillance operation, saying it was intended to determine why sedative drugs were missing from anesthesia carts. It apologized after a thumb drive containing dozens of video clips of recognizable women undergoing surgery was released to an attorney and subsequently, to others, and has notified an undetermined number of women patients whose images were identifiable in those clips.
In 2012 or 2013, one anesthesiologist, Dr. Adam Dorin, was identified on camera putting the drugs in his shirt pocket but was never disciplined because he successfully argued those critically needed sedatives were nationally in short supply and he needed them for other patients. Other doctors, including Sullivan, came to Dorin’s defense during a medical executive committee hearing and in interviews. They said they all took drugs from those carts to stock up for quick use when a patient in labor needed an emergency C-section, because the anesthesia carts were frequently lacking.
An accusation filed by the Medical Board of California alleging that Dorin lied about taking those drugs was dropped last year. Dorin resigned from Sharp Grossmont in 2013 and now practices in Palmdale.
Cihomsky said in his statement this week that he could not comment on the patients’ lawsuits.
Sullivan’s complaint does not specify a damage amount, but Sullivan’s attorney, Lawrance Bohm of Sacramento, said it should include compensation for “damage to his reputation” and “emotional strain.”
Sullivan said he’s been having a hard time finding work since he left Grossmont, but is assisting several days a week at an ambulatory surgery center.