Later On

A blog written for those whose interests more or less match mine.

A celebrated surgeon, a trail of secrets and death

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A stunning report of how a hospital betrayed its trust for the sake of money — a Catholic hospital. (Catholic organizations have often shown a pattern of betrayal and greed.) The report by Rebecca Ostriker, Deirdre Fernandes, Liz Kowalczyk, Jonathan Saltzman, and Spotlight editor Patricia Wen appears in the Boston Globe. That link might encounter a paywall, but the report is also available here (though without some animations). It begins:

MANCHESTER, N.H. – From the day he first stepped into the hospital, Dr. Yvon Baribeau had the makings of a star.

In the operating rooms at Catholic Medical Center, where he started working three decades ago, he was a forceful presence — tall, self-assured, ambitious, tireless, a cardiac specialist who relished the toughest cases and was gifted, peers noted, with “natural” hands that moved swiftly and smoothly through long hours of surgery.

He was also the kind of bold new player who might help a community hospital become something more. CMC executives soon marketed him to the public as an innovative, accomplished cardiac surgeon.

His face appeared in advertisements and news articles promoting the 330-bed hospital and its flagship heart institute. In one newspaper ad, a smiling Baribeau in surgical scrubs is described as a pioneer in minimally invasive heart surgery.

“Benefit from the experience,” it reads.

Baribeau, born and trained in Canada, became one of the hospital’s busiest and best-paid surgeons, ultimately earning more than $1 million a year. The hospital sometimes received more than $200,000 from a single Baribeau case and built one of the biggest heart centers in New England north of Boston.

Even after Baribeau abruptly retired at age 63 in 2019, hospital officials continued to describe him only in glowing terms.

“Dr. Baribeau was absolutely among those folks that were revered,” Alex Walker, the CEO of the hospital, said in a recent interview.

But a Boston Globe Spotlight Team investigation has found that the reality could not have been further from the carefully crafted public image — and that the executives who treated him as a star, and promoted him to the public, knew the truth and its consequences.

The facts are blunt and chilling: Baribeau has one of the worst surgical malpractice records among all physicians in the United States.

He has settled 21 medical malpractice claims tied to his work at CMC, including 14 in which he is accused of contributing to a patient’s death. There is no US physician with more settlements involving surgical deaths in the last two decades, and no physician in New Hampshire with more settlements of any kind, than Baribeau, according to an analysis of a national physicians’ database that goes back to 1990.

Even cardiac surgeons at Boston’s academic medical centers, which take on many of the most challenging cases, come nowhere near Baribeau’s statistics. A Globe analysis of 125 current, retired, and other non-practicing cardiac surgeons affiliated with the city’s top teaching hospitals found that only 12 had malpractice settlements, and of those 12, none had more than two, state records show. Ten of those 12 doctors had just one settlement to this point in their careers.

A national study in 2016 painted a similar picture, finding that heart surgeons and other surgical specialists typically face only one or two malpractice claims in their careers.

Baribeau’s 21 settlements do not capture the grievances of all the families of patients treated by him. About a half-dozen other patients or their families have criticized his medical care, including two who filed lawsuits but later dropped them.

Meanwhile, for years, the public had virtually no way to know of his troubled history. To this day, the website of the New Hampshire medical board, which licenses physicians in the state, shows Baribeau with a spotless record.

Hospital executives were well aware for years how dangerous he had become. They knew because they had been repeatedly warned by surgeons and other medical professionals at Catholic Medical Center that Baribeau’s errors were harming, even killing, patients. It was an extraordinary staff uprising in a field that puts a premium on professional deference and chain of command. One former CMC cardiologist even filed a federal whistle-blower suit detailing the disastrous outcomes of a dozen of Baribeau’s cases.

And yet for years hospital management resisted reining in one of their leading rainmakers.

This case out of a little-known community hospital in New England reveals painful truths that apply far beyond its halls and operating rooms and point to some common realities in today’s health care world: Medical consumers — patients in need — are often kept in the dark about the performance history of their physicians, even when that history is grim. And hospital officials can in some cases evade accountability for years, even when confronted repeatedly by alarmed medical staff, as happened in this case. It is one hard edge of a helping profession.

Baribeau’s alleged malpractice in this Manchester hospital ran the gamut from surgical mistakes so basic they surprised other doctors to not showing up when some patients were in crisis. And every time, according to physicians’ accounts, a human life hung in the balance:

A retired Army officer, for instance, died after alleged surgical errors by Baribeau caused so much blood loss that she needed transfusions equal to nearly five times her blood volume.

A construction contractor passed away after Baribeau, while on call that night, did not come to the hospital for hours despite repeated phone requests to deal with this life-threatening situation.

And a garage owner whose sternum Baribeau allegedly sawed off-center at the start of an open-heart procedure suffered severe complications and spent months in the ICU.

Baribeau has also been accused of keeping some patients with little or no hope for recovery on life support for at least 30 days after surgery — perhaps, it is suspected, to improve his surgical metrics and avoid having the death blamed on his work.

Baribeau kept alive one patient even though his chest cavity had turned “black and necrotic,” said a doctor who witnessed this. . .

Continue reading. — Second part of the report is blogged here.

One hospital in New Hampshire — it gives new meaning to the state motto, “Live Free or Die.”

Written by Leisureguy

8 September 2022 at 9:55 am

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