Dear Family and Friends,
I just wanted to write the story of what has happened to me over the past two weeks. As many of you know, I had a hearing with the hospital where I work on Wednesday and Thursday, June 5 and 6, and it was possible that it would go to June 12 as well. It did go on to the June 12 date as well. Each night it would start at 5 p.m. and go to 11 p.m.. It was a hearing with a panel of three physicians who are staff members of the hospital, who would judge me based on testimony given at the hearing as to whether a suspension of my privileges that occurred on October 30, 2017 was warranted. Even though the suspension happened on October 30, this was the first time I was able to defend myself and try to overturn the suspension. It was also to defend myself from a recommendation by the Executive committee of the hospital on November 16, 2018 as to whether they should revoke my privileges at the hospital. These actions were taken by the hospital because of complications of surgery that happened over a three month period from August to October.
For reference, up to the day I was suspended, I had done 396 gynecologic surgeries at this hospital. 310 of those were major gynecologic surgeries. 80 were minor surgeries. The expert witnesses that testified at my hearing by comparison do 120 cases or less per year. In 16 months, I did 396 cases. Also, for anyone who knows about surgery, there are risks. With the surgeries I do, there are risks of bleeding, infection, damage to internal organs, anesthesia and even death. In the three cases out of the 396 I did in question, there was one case of bowel damage, three cases of kidney tube damage and one case of excess bleeding. While these are serious complications, they are the known complications of the surgeries I do, and they had not happened before these three surgeries. I recognized these complications immediately, and we fixed them. So while I thought that as a surgeon when you do surgery, and you have complications, you find them and fix them. At this hospital, they took the view that as a surgeon, if you have complications, a few in three months, you should be removed and your career destroyed because of these complications. And that is what ensued. They suspended me, investigated me over two weeks and as part of the the investigation, they asked anyone who had any kind of complaint about me at the hospital what their problem with me was, most of it not related to my clinical skills, but mostly heresay about my personality, and they then threw it all together and recommended getting rid of me. The problem is, if they revoke my privieges at this hospital, other hospitals and insurance companies and state licensing boards may not want to take me or insure me or license me. So, if what they were doing to me is upheld, it could ruin my career as a doctor.
So, I requested the hearing in December and the first hearing date was March 11 and 12. That was changed because the hearing panel initially had someone on it that had already prejudicial information about me. When we got another panel member assigned, the hearing was put off three more months to June 5 and 6 and possibly the 12.
I found a lawyer named Louis Szura, who was a specialist in medical staff issues in November. We have been asking for details of why they were doing this to me, as they alluded to other issues besides these three surgeries. Over the past six months, they have slowly trickled information to us, without many specifics about clinical concerns and complaints about me from random people. Then finally, a week before the hearing, they gave us their actual evidence--not the full story but as much of it as we would get before the hearing. Unlike a real trial or other legal meeting, the hospital can do this to a doctor, without any evidence or disclosed issues and a federal law makes them immune to any repercussions. They also have a very low standard for doing this: reasonable cause. So they can do this, they don’t have to tell you why until the hearing is happening and the burden of proof of what they are saying is extremely low.
The weight of this hanging over Larisa and me has been horrible. When it all first happened, I had no comprehension of what was happening or what this meant. Then as I have been educated by my lawyer, the immense gravity of it has been unbelievable. I am only 52, I did not start being a doctor till I was 33, and I need to keep working. I have put two kids through college, I have one still in college and one on a mission in California. We haven't been able to sleep, I have no interest in eating, I wake up stressed, I go to bed stressed, I actually began seeing a therapist because I was so overwhelmed. Poor Larisa has no family that is involved in her life, she has a few friends who call, but aside from me and the kids, she is very alone. We haven't wanted to tell everyone around here about it because we don’t know what will happen, it is the local hospital and we are still living here. I can’t leave to get another job, because this is unresolved, I am on leave from work because they want to see the outcome of the hearing, I can’t work part-time because this is happening. We are literally prisoners of our situation and this hospital.
So based on very limited information from the hospital, slowly trickled out over time, Louis and I have worked to come up with a defense for me. In addition, after alleging problems with the first three cases out of 396, they scrounged around and found two other surgeries that had no complications, but that the hospital did not think I had predicted the future and outcome of the surgeries well enough and so they threw those on the pile as well. Every day, morning noon and night I have been worrying about this, going over the details in my mind of all the surgeries, all the complaints and everything terrible I could imagine because while the hospital has taken this action, they did not want to give us the information required to respond to their allegations. We finally got a more complete picture the Thursday before the following Wednesday hearing, though still not complete.
Now to preface the next part of this story, we have been going to the temple once, twice and sometimes three times a week because I am off work. Every day, I listen to the Book of Mormon for about 1:15 hours. I pray so many times a day, it feels like I am just always talking to God. In light of what we have been going through, the Book of Mormon has come to mean something completely different to me. As one, who is in the fight of my life, the entire Book of Mormon is about the deliverance of God’s people from the adversary; the plan of salvation, Lehi from his murderous sons, the Children of Isreal from their enemies, Nephi from his brothers, Nephi and Sam from their brothers beating them, Nephi and Lehi from Laman and Lemuel and the sons of Ishmael, the Nephites from the Lamanites over and over, the people of Alma from the Lamanites and Amulon, the righteous waiting for Christ in 3 Nephi from those who want to kill them for waiting for Jesus and on and on and on. As I was reading and listening, I felt these stories were all for me. Then I read 3 Nephi 22:
1 And then shall that which is written come to pass: Sing, O barren, thou that didst not bear; break forth into singing, and cry aloud, thou that didst not travail with child; for more are the children of the cdesolate than the children of the married wife, saith the Lord.
2 Enlarge the place of thy tent, and let them stretch forth the curtains of thy habitations; spare not, lengthen thy cords and strengthen thy astakes;
3 For thou shalt break forth on the right hand and on the left, and thy seed shall ainherit the bGentiles and make the desolate cities to be inhabited.
4 Fear not, for thou shalt not be ashamed; neither be thou confounded, for thou shalt not be put to ashame; for thou shalt forget the bshame of thy youth, and shalt not remember the creproach of thy youth, and shalt not remember the reproach of thy widowhood any more.
5 For thy maker, thy ahusband, the Lord of Hosts is his name; and thy Redeemer, the Holy One of Israel—the God of the whole earth shall he be called.
6 For the Lord hath called thee aas a woman forsaken and grieved in spirit, and a wife of youth, when thou wast refused, saith thy God.
7 For a small moment have I aforsaken thee, but with great mercies will I gather thee.
8 In a little wrath I hid my face from thee for a moment, but with everlasting akindness will I have bmercy on thee, saith the Lord thy Redeemer.
9 For athis, the bwaters of Noah unto me, for as I have sworn that the waters of Noah should no more go over the earth, so have I sworn that I would not be wroth with thee.
10 For the amountains shall depart and the hills be removed, but my bkindness shall not cdepart from thee, neither shall the covenant of my peace be removed, saith the Lord that hath mercy on thee.
11 O thou afflicted, tossed with tempest, and not comforted! Behold, I will lay thy astones with fair colors, and lay thy foundations with sapphires.
12 And I will make thy windows of agates, and thy gates of carbuncles, and all thy borders of pleasant stones.
13 And aall thy children shall be taught of the Lord; and great shall be the bpeace of thy children.
14 In arighteousness shalt thou be established; thou shalt be far from oppression for thou shalt not fear, and from terror for it shall not come near thee.
15 Behold, they shall surely gather together aagainst thee, not by me; whosoever shall gather together against thee shall fall for thy sake.
16 Behold, I have created the smith that bloweth the coals in the fire, and that bringeth forth an instrument for his work; and I have created the waster to destroy.
17 No weapon that is formed against thee shall prosper; and every tongue that shall revile against thee in judgment thou shalt condemn. This is the heritage of the aservants of the Lord, and their righteousness is of me, saith the Lord.
This chapter meant so much to me. It felt like it was written for me at this time. And it came to mean so much more, but I will explain that later.
The other thing we would do to keep our minds and spirits intact is that we would go to the temple. It was a saving grace for us and me especially. I literally could not think of anything else at times for the past seven months other than what we were going through and the problems I was having with the hospital. Then, we would walk through the doors of the temple and it was like a curtain would come down on my misery and despair and I could not think of any of the hopeless thoughts I had. I have to say, at times, the only time I would feel like a normal person was when I would go to the temple.
We got assigned to work in the Bishop’s storehouse as well during this time and that was a great distraction and chance to serve. We both did our callings and attended church but for me the Book of Mormon, the temple, and prayer were saving graces from the Lord.
Another great blessing from Heavenly Father during this time, were priesthood blessings both Larisa and I received. When this first occurred, I asked for some of my friends at the temple to give me a blessing. During that blessing, I was told:“You will know what to say to take care of this”beside other things. In a blessing later on in the seven-month time period:“When you are called upon to speak about this, you will speak in a way that is humble, you will speak in a way that is not arrogant, but in a way that will change the perspective of those you speak to, on the world around them.” Just the night before the hearing: “You will state your position, with your head held high, and regardless of the outcome of hearing, you will be able to keep your held high and be firm in your position”.
But the hearing was still coming up, and I dreaded it. People would say terrible things about me, an expert would testify against my medical skills and judgement, and there would be an opposing lawyer who I knew was being paid to take me out. And, by reputation from Louis and a friend of his, this opposing lawyer was an angry, mean man. He was purposely hard to get along with, he made our preparation for the hearing very difficult, and I anticipated he would be doing everything he could to nail me to the wall. And, the outcome of this whole thing would possibly be the death knell of my career.
So, the week before the hearing we got the evidence book from them and it was bad. They had the expert’s review of me and though he has little data to support his assessment, he said terrible things about me. Then, we found out that when they looked into me at the hospital, they had three doctors go around the hospital and ask anyone who did not like me, what their complaints were, and they put it into a report of heresay and opinion but though it was only people’s opinions, it was not good. And by this time, after so much time had passed, any of the people who had supported me initially were too afraid to come to the hearing.
I cannot tell you how worried and afraid I was. The idea of going to the hearing for 12 hours listening to people say whatever they wanted about me that was bad was frightening. I could not imagine it would actually go to the 12th, but that idea was frightening as well. The other thing that was stressful was that all the time I was spending with the lawyer getting ready was very expensive, and though he was careful, the hours were ticking up.
So, Wednesday, June 5, comes. I went to the hospital where I had no friends, went to the conference room by the cafeteria and was confronted with the reality. Me and my lawyer and his partner, the panel of three doctors and the hearing officer, and the opposing lawyer, his partner, their medical expert and the head of the Executive committee. Wednesday night and half of Thursday, for 9 hours I sat on two different nights and listened to 5 doctors, some of whom had been my comrades when I was working, bad mouth me and say all the things every detractor I had at the hospital had told them. Two of these witnesses against me had spent two weeks going around the hospital digging up any dirt on my from people, and even though these people were not willing to come themselves, they were more than happy to criticize me. One of the witnesses, the head of the Executive committee, testified that he had invited me to come to the meeting where they had decided to revoke my privileges and that I had not come because I was out of town. This was a complete lie. In fact, my lawyer showed the hearing panel an email where he, the head of the committee had said I could “submit a statement”. But though all of their evidence was based on opinion and heresay, the burden of proof is low, and they had lots of people willing to throw me under the bus, basically because I was all by myself, I was new to the system and some of them did not like me.
That went on for nine hours. A few of the hours were their medical expert giving his opinion of my work. It turns out, he did not look at the context of my surgeries, he did not check the numbers of cases I had done or was doing monthly. He did not look up any papers or data to support his views, he just went off his own personal ideas to say that my complications were evidence I should lose my privileges. When my lawyer asked him how many cases of surgery like me he was doing, did he do, he did not answer and said when he did surgery that way the most, he was doing ten cases a month. While at this hospital I was doing 25-30 a month. And, at the time of his testimony he was doing much less than that. One of his criticisms was that he said I should have known the most likely outcome of a certain case was that the person had cancer and that I should have referred her. What he was saying I should have anticipated was something that happens 1/100,000 people, where I thought she had something that was 1/1,000 people. When asked what the normal complication rates for what I did was, he actually said 0.5-3 percent, and my complication rate is less than 2 percent. But, when he made his assessment of me, he did not bother to look up my case list, which was easily acquired to actually get a clear picture of me as a surgeon. He did not bother to look up the incidence of the findings I found on one of my surgeries, but instead just made very critical summary judgement of me without doing a google search.
Something that was very interesting about the hearing up to this point; my lawyer was completely respectful of their witnesses who based on heresay by my detractors, were saying very damning things. Regardless of how respectfully my lawyer treated them, their witnesses were so angry-looking and defensive. I was told by my lawyer, when giving testimony, I need to be calm, but one of their witnesses specifically looked like she hated me and my lawyer for simply asking for clarification during the entire testimony. Their lawyer was also very antagonistic. At one point he got up from his chair and yelled “I need a two minute break” and he stormed out of the room. I could not believe it. I was being criticized by some people for asking for help at this hospital, and their lawyer was yelling at all of us about a break. I have to say, seeing their witnesses and their lawyer, it was almost like seeing the face of contention. Even though they had unlimited financial, informational and personnel resources, they were so angry.
So, finally on the second night at about 9 p.m., my expert witness, Dr. Robert Starr, gets up to the witness chair. He goes through each case and basically says, while he would not doing everything the way I did, he supported the decisions I made and stated that they were reasonable and the complications were within the range of normal for what we do. He was excellent. Then, their lawyer cross-examined him and debated with him, cut him off, interrupted him and basically treated him with disrespect. After that, two people from my practice said about 20 minutes each in support of me and my demeanor and work and that was the end of that night. It was 11 p.m. and it was my “hearing” and I still had not said anything. All my family and friends had been praying for me for these two nights, and they had been so terrible and for the most part heartbreaking and now the hearing was going till next Wednesday. I had been told and made aware by my lawyer that this whole thing was very unequitable, that I had little chance to win because of the injustice of the system, and now it was going on for another week, and I would be the final witness. I was really worried and scared.
Then, on Saturday morning I woke up and had two distinct impressions: one of the reports by my critics was that I had too much blood loss with my cases. Even though a review of my cases in March 2018 had revealed this was not the case, it was still being said. The impression I had was that I should go through every op report for every surgery I had done, write down the blood loss and figure out how much per case, get the average per case and identify how many had more than 500 ml and how many had more than 1000 ml of blood loss. This took forever, I had my work computer and I had to find each patient on my list of cases, open their record and then open the op report but I did it. I got the numbers, totalled it up and divided by 396 and found the average per case was 145 ml. Then, I found 19 cases of 396 that were more than 500 ml and 5 cases more than 1000 ml. So, based on the idea that someone who has a vaginal birth loses about 500 ml, the 19 cases were the most significant but only about 5% which was not excessive. Then I figured out that the 5 cases that were over 1000 ml might have gotten a transfusion and 1% transfusion rate is completely normal for gynecologic surgery. I had also been criticized for my “tissue handling” by some surgeons who claimed they had worked with me and seen this. I looked up my case list and checked how many of these specific surgeons had worked with me on how many cases. It turned out, these critics of me, had observed my surgical skills one time or less each. So they were criticizing me after working with me on one case each. This was another example of how the case against me was based on opinion and heresay, and I had actual data to prove that these assessments were not correct or based on any information, rather they were based on ideas and attitudes.
A few days after the first two days of the hearing, I had the distinct impression that all the prayers and fasting leading up to the hearing dates had brought this to pass: that I would have more time to get ready and be the final witness. This thought gave me comfort, but I was still dreading the last day of the hearing and worried about being on the stand, especially when I was cross-examined by the opposing lawyer. He was known as a very tough litigator. My lawyer and his partner had been in a hearing with him before, and he was known to badger witnesses, paint them into a corner and having seen him work, I was very worried. I told one of my friends who I spoke to on the Sunday before this final hearing day, I wanted to have faith that I could withstand this scrutiny and examination, but though I trusted Heavenly Father, I was very worried and fearful. He told me, that was normal, and that my faith was not too weak, my faith was expressed in how I was obedient to the Lord and his commandments and how I honored my duty to God.
So, the day came, June 12. I arrived at 4:45 and sat down in the board room. At 5 p.m., I was called to sit in the witness chair and I was sworn in. For the next five hours, I was questioned by my lawyer regarding all I had done at this hospital, how hard I had worked and tried to get along, and I told my story. It came out beautifully. I had thought about what I felt and would say for the past seven months, I had discussed it with Louis, but I did not know if any of that would help me be ready for being questioned about it in this terribly antagonistic setting. I spoke clearly, calmly and directly to the panel the entire five hours. I made every point I had thought about and been inspired to speak about. It came out believably and when I was emotional, the panel members were emotional. While I was speaking even the hearing officer, paid for by the hospital, was nodding along with my answers and the story. The panel was with me the entire time. When the first two hours were over, it had seemed like a moment. I could not even believe when the end came. The last two questions were: How had this affected you? The opposing lawyer opposed this and said; “How this has affected Dr. Kennedy is irrelevant,” and that was supported by the hearing officer. The last question was “What is your next step?” and I just said that my reputation here has been ruined and I just want to work somewhere, but if this goes against me, I may not be able to work anywhere else as a physician ever again. Then that part was over and the next part was the cross-examination by their lawyer.
We took a break and then came back to me. He had the opportunity to grill me for as long as he wanted to, and he asked me a few questions for about 30 minutes. He was fumbling around for papers, he was making points about me that did not even make me feel bad. One of his points, I actually laughed about quietly, because it was kind of ridiculous. Then it was over.
Finally, the two lawyers had their time to make their closing statements. Their lawyer gave his for about 15 minutes and during it he looked down, he fumbled for his words. I had the thought after seeing his closing statement and perceiving his cross-examination, that I was dealing with a muzzled dog. I had been so worried about this final moment, and the terrible beast had a muzzle on it and it could not do any significant damage. “No weapon that is formed against thee shall prosper; and every tongue that shall revile against thee in judgment thou shalt condemn. This is the heritage of the aservants of the Lord, and their righteousness…”
Then came Louis’ time to give his closing statement. His statement was about 20 minutes long, it was completely written out and memorized and he looked at the panel the entire time. It was amazing! It shredded the entire case by the hospital, and it was said with energy and emotion and precision. It was based on clear data, strong points and drove home the fact that this was not a choice between a good doctor and a bad doctor, it person they had just listened to for five hours testifying on behalf of his skills and character. What really told the story of Louis’ closing argument was the face and actions of the head of the Executive committee. The entire time he was frustrated, he was shaking his head and he was writing down questions or comments, and at one point he looked at me as if for support, and I just stared him down and he looked away. I thought, “Your time to comment and speak and criticize is over,” and you can’t say anything more. Their lawyer didn’t even look at him.
I am a witness, that for the past seven months, the Lord prepared me to face this inquisition, and He was with me in the hearing. I told my story, I think it took care of what was happening to me, I said things in a humble but convincing way, I held my head up high even through the worst criticism I have ever heard in my life, and I stated my position calmly and firmly. I know God was speaking through me, I hardly remember what I said and yet when I think of it, I know it was what needed to be said. The panel members when I was done could ask questions and when they did, they were either gentle with me or actually supportive of me.
Because this situation is so unfair, I cannot say how it will go. I may have been in a hopeless situation seven months ago when this first occurred. I offered to leave before the hearing, but they said they would report me as if they had revoked my privileges. Because this would have been almost as bad, and based on the blessings I had receive and the messages from the Lord I had received, I felt like I needed to go through with this. I wish I knew the outcome but now the transcript needs to be produced, the lawyers prepare a 20 page brief and then the panel makes its determination over 30 days.
Thank you all for your prayers and your fasting and your faith. It has bouyed up Larisa and me throughout this entire time, and we will need it over the next two months. I cannot see how, with all the Lord has done for me to get me through the hearing, that I will lose, but I accept the Lord’s will and I love Him no matter what. I do hope I win so I can move on and work. I am too young to retire and I am a good doctor. I also hope to give you all a good report, that the “glory of God might be made manifest”.
Larisa and I send our love to you all.
With love,
John Kennedy
Comments
Post a Comment