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. 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. At MGH, the acrimony has threatened careers and relationships and potentially much more, a drama that escalated with two steps almost unimaginable in the rigorously professional world of medicine, not to mention the life of a great hospital. Explore fellowships, residencies, internships and other educational opportunities. From my understanding, the delay was not 2.5 hours. SlavinPeter L. Slavin, M.D.MGH president, in a hand-delivered Aug. 12 letter, accused Burke of improperly providing hundreds of the surgeons own medical records to the Globe, violating hospital rules and, potentially, federal privacy law, even though the records Burke shared had names and other identifying details blacked out. OR 21 and OR 30. She told Burke her understanding was that the patient might have to wait days for surgical relief. In addition to his leadership role in trauma, he spent 14 years serving as an active member of the Orthopaedic Spine Service at BWH and initiated a weekly multidisciplinary spinal oncology meeting. General proved particularly receptive to the time-saving potential of concurrent surgeries. https://www.ncbi.nlm.nih.gov/pubmed/?term=Mitchel+b+harris, Mass General Hosts Orthopaedic Trauma Associations Inaugural Traveling Fellows, Mass General orthopaedic surgeons ranked among Top Doctors in Boston, MD, University of Illinois College of Medicine at Chicago, Residency, Dartmouth Hitchcock Medical Center, Residency, Sunnybrook & Women's College Health Sciences Centre, Fellowship, University of Toronto, Sunnybrook Health Science Center, Orthopaedic Surgery, American Board of Orthopaedic Surgery, Great-West Healthcare (formally One Health Plan), Outcomes of the Management of Spinal Disorders: Operative and Nonoperative, Outcomes of Geriatric Spinal Fracture Management, Stem Cell Augmentation of Fracture Healing. Ultimately, Smith agreed to the patients request and the woman calmed down. The board last month filed documents in two of Woods malpractice suits, saying that its investigation of the surgeon was open and ongoing. A state spokeswoman told the Globe, We are unable to provide a definitive timeline for completion due to the complexity of the investigation.. Rubash, in written statements, said there was no connection between the Meng case and the leadership change. Burke sent a blistering e-mail to top hospital leaders, reviewing his long-running efforts to rein in the practice. After other surgeons cut open a patients chest, DeBakey would come in, put the patient on a special blood-circulating machine, and then bypass blocked coronary arteries with blood vessels taken from the patients body. Search for condition information or for a specific treatment program. Then, on Aug. 12, MGHs president, Peter Slavin, made it official. Copyright 2007-2023. He and his wife even loaned Shervin $375,000 to help her pay off debts and launch her own practice. Do you really think it reasonable to do these two cases by the same primary surgeon? 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. Dr. Cheryl Schosky CRNA, Your email address will not be published. No one knew it at the time, but it was, for Burke and MGH, the triggering moment in a seven-year conflict. We allow cases to have a staggered start, he said in an interview. Burke sided with Shervin, testifying against the hospital. RubashHarry E. Rubash, M.D.Chief of orthopedic surgery said in a recent interview that he never pressured his staff to do concurrent procedures. What we learned from Donald Stern is that what were hearing from our OR leadership was reflective of reality.. 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. Meng awoke from the surgery unable to move his arms or legs. ShervinNina ShervinOrthopedic surgery resident later testified that while he was gone, she helped mix the cement for the hip implant, but felt uncomfortable going further on her own. Refer a Patient We are dedicated to working with our referring physicians. Though often called simultaneous surgeries, they do not, of course, involve the attending surgeon working directly on two patients at once. They shared with the Globe a 2015 letter from the executive director of the American College of Surgeons who reviewed the guidelines at MGHs request and deemed them an example of best practice and certainly exceed national standards.. Orthopaedic Trauma Service55 Fruit StreetYawkey Building for Outpatient CareSuite 3C collected, please refer to our Privacy Policy. For more information about these cookies and the data collected, please refer to our Privacy Policy. The orthopedic surgery department at Mass. Step away from the bed, VassalloSusan A. Vassallo, M.D.Anesthesiologist said she insisted. At 7:42 a.m., Dr. Kirkham Wood began a complex spine procedure on a 70-year-old woman in OR 64, according to medical records and legal documents. The most extensive analysis of concurrent surgery was presented last year when a surgical resident at the University of Virginia Health System released a study not yet published that found no difference in short-term outcomes for patients and only minimal increases in surgery length when cardiothoracic surgeries overlapped by up to 45 minutes under closely monitored conditions. His ties to MGH go back to childhood. Are perioperative allogeneic blood transfusions associated with 90-days infection after operative treatment for bone metastases? When something goes wrong as statistically it will in a small percentage of cases the surgeons failure to disclose double-booking can seem to patients inexplicable and intolerable. The conflict went on for years. Did you approve this? , but offered little direction on which procedures are appropriate for double-booking, what are the key or critical parts, and how much overlap of cases is safe and ethical. Search for condition information or for a specific treatment program. Still, the Spotlight Team found that the 2012 Meng case reignited an extraordinary, long-running controversy at one of the nations top-rated hospitals over the propriety and safety of a fairly common but little studied practice that goes to the heart of a doctors obligation to his unconscious patient. For more information about these cookies and the data Wollman, Burke, and Sunder, in separate interviews, all also said Lillemoe cautioned that it would be draconian to ban surgeons from double-booking altogether. Pereira struck the ground and felt a sharp pain on her left side. The Globe declined the hospitals request to return the documents for a review of Burkes redactions. Hi, I am looking at Mondays schedule and I see Dr. Wood booked in two rooms. What will you tell this quadriplegic man and his family when they ask if his paralysis could have been prevented by having his surgeon be attentive only to him during his surgery? Burke wrote in an e-mail copied to senior leaders at MGH and Partners. from the University of Pittsburgh in 1991. Richard M. Pino, M.D., Wilton Levine, M.D., Peter Dunn, M.D. Blue Distinction Centers are healthcare facilities recognized for their expertise in delivering specialty care. To schedule an appointment with one of our 40 expert orthopaedic surgeons at any of our six locations in the greater Boston area, please call 617-732-5322, or fill out an online appointment request form. A hole in the front side of the protective membrane allowed Mengs spine to bend and protrude, potentially causing his paralysis. If this results in my career at the MGH ending, so be it, he told the Globe months before his firing. But change came to his door. It had to be done, Burke told the Globe. We havent found a single case where the concurrency has caused harm, so I dont think patients should be alarmed about it, Dr. Peter Slavin, Mass. To me that is what we were hoping to accomplish. The end of his cases occasionally overlapped with the start of other cases, but it averaged just a few minutes. Read about safe practices when taking pain medication and non-drug pain relief methods. After Warner rushed through the door several minutes later, a vascular surgeon was called to repair the tear and ultimately the operation was aborted. Copyright 2007-2023. Meet our team Conditions & Treatments 617-724-8636 Contact Information Phone: 617-724-8636 Request an appointment 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. Is this how we are planning the future?. and Andrew Pao, M.D. Dr. Bono obtained his medical degree (MD) from the State University of New York (SUNY) Health Science Center at Brooklyn (now called SUNY Downstate Medical Center). and he is the renown orthopedic surgeon who has led the hip and knee service at Massachusetts General Hospital (MGH) in Boston for over 20 years. She later sued the hospital for alleged gender discrimination, an accusation ultimately rejected by a federal court jury after almost five weeks of testimony from MGH doctors and leaders, including Rubash. It examined Mass. I always felt like the [treatment] plan was built for me, and it was like a three-legged stool: It was an ongoing conversation between myself, the physical therapist and the doctor. Schedule a same day virtual visit when you experience a sports injury. Specialties. As chief, he was instrumental in the creation of the Orthopedic Research Laboratories. The reason he was upset, Burke said, was that he simply couldnt swallow the idea that the young doctor was faulted, while the attending physician, managing two and, briefly, three cases at once, went unscathed. Other authorities see real utility in the practice. He also has received numerous faculty teaching awards in his previous academic positions. 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 Although numerous teaching hospitals permit concurrent surgeries, there is no consensus among top doctors about which procedures can safely overlap, and how much overlap is appropriate. But, this is a separate issue. Neelakantan Sunder, M.D., Richard M. Pino, M.D., Wilton Levine, M.D. Rubash, in an interview, said concurrent surgery did not become more common during his tenure. We are committed to providing expert caresafely and effectively. Goolsby and Shubin Stein, M.D. 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 says he is at peace with that. Dr. Kirkham Wood arrived in the operating room at Massachusetts General Hospital before 7 one August morning with a schedule for the day that would give many surgeons pause. Some surgeons might have awakened Meng to make sure he could still move, but Wood later testified he decided the risk that Meng would thrash and hurt himself was too great. Read the final policy. Dr. Freiberg, an expert in adult reconstructive surgery with an emphasis on hip and knee arthroplasty, says he wasnt looking for a change. Second, I will be involved in quality and safety evaluations and health hazard evaluation of medical devices, something I have done for many years outside of industry. Wood said he believed the cause of the worrisome neurological responses could be compression on the spinal cord from the back side. But the investigation continues. 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. 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. Subscribe today for full access to in-depth investigative reporting. Generals busy orthopedic trauma service, and on this day, he was very busy indeed. Save my name, email, and website in this browser for the next time I comment. A multidisciplinary team of clinicians, including surgeons, physiatrists, pain specialists and advanced practitioners, to ensure your treatment is tailored for your needs, Non-operative treatment options and the latest surgical techniques, including minimally invasive procedures, to get you back to your active lifestyle, Director, Spine Oncology & Co-Director, Stephan L. Harris Chordoma Center, Associate Professor of Orthopedic Surgery, Harvard Medical School, Executive Vice Chair, Department of Orthopaedic Surgery, Program Director, Harvard Combined Orthopaedic Residency Program, Professor of Orthopaedic Surgery, Harvard Medical School, Assistant Chief, Orthopaedic Spine Service, Director, MGH/BWH Orthopaedic Spine Surgery Fellowship Program, Assistant Professor of Orthopaedic Surgery, Harvard Medical School, Instructor in Orthopaedic Surgery, Harvard Medical School, Director, Adult Spinal Deformity & Spinal Reconstruction, MGH Orthopaedic Spine Surgery Fellowship Site Director, Adult Spinal Reconstruction Orthopaedic Surgeon, Pediatric Spine & Scoliosis Surgeon, Mass General for Children, Director of Spine Training for the Harvard/Spaulding Sports Medicine Fellowship Program, Instructor in Physical Medicine and Rehabilitation, Harvard Medical School, Nurse Practitioner with Dr. Christopher Bono, Dr. Stuart Hershman & Dr. Joseph Schwab, Physician Assistant with Dr. Frank Pedlow, Inpatient Physician Assistant - Shoulder; Spine, Inpatient Nurse Practitioner - Shoulder; Spine. Is this how we are planning the future? The Department of Orthopaedic Surgery is a world leader in treating the full spectrum of musculoskeletal conditions from sprains and strains your children experience on the athletic field to limb-sparing oncology procedures; from carpel tunnel syndrome to complex spinal reconstruction. In addition to his orthopaedic surgical residency at UM/Jackson, he completed an orthopaedic oncology fellowship at Massachusetts General Hospital and Children's Hospital Boston. After getting a call at his Beacon Hill home, WoodKirkham Wood, M.D.Spine surgeon, chief of spine 2004-2013 said in his deposition that he returned to the hospital to review the images and a few hours later operated again on Meng with two neurosurgeons assisting. Its not fun to deal with this on a daily basis, Sunder said in an interview. Dr. Kirkham WoodKirkham Wood, M.D.Spine surgeon, chief of spine 2004-2013, in a deposition last year, described the scheduling of Tony Mengs surgery to run concurrently with another complex case as a way to make efficient use of his time and expertise; it is the most commonly cited goal of hospitals that have adopted the practice. Soon state regulators were investigating concurrent surgeries done by several orthopedic surgeons, eventually focusing on 31 double-booked surgeries, according to a letter sent in November 2014 by the medical board to the Department of Public Health. Seventy-year-old Monique Pereira had Parkinsons disease, but she lived independently in the south of France and had recently flown to visit her son, Stephane, and his partner who ran a French bistro nearby on Newbury Street. Surgeons are encouraged and expected to tell patients when theyll be absent for part of the surgery, an MGH spokeswoman said, but they are not explicitly required to do so. A 43-year-old former Anheuser-Busch sales manager from Peabody, Gregory has suffered from incontinence and sexual dysfunction since Dr. Wood performed spine surgery on him in October 2006. Membrane protecting spinal cord. Burke and Austen had known each other since the early 1970s. General is a teaching hospital where residents have graduated responsibility for the burdens of surgery and that concurrent surgery is an acceptable practice at other institutions, according to notes Burke took of the meeting. He would need all of his talent and confidence this day, and then some, as he planned to tackle two complicated spinal surgeries over the next many hours two patients, two operating rooms, moving back and forth from one to the other, focusing on the challenging tasks that demanded his special skills, leaving the other work to a general surgeon, who assisted briefly, and two surgeons in training. Assistant or Associate Professor of Medicine (Division of Population Sciences) Dana Farber Cancer Institute/Brigham and Women's Hospital Date Posted: 11/17/2022. Please complete our confidential survey. Hospital attorneys say Wood acted appropriately and within the acceptable standard of care. MGH says it has been reviewing the safety of concurrent surgery for some time. In the spring of 2012, two anesthesiologists and Burke met with Lillemoe to discuss their ongoing concerns about patients waiting under anesthesia for their surgeon and not knowing that their cases are double-booked. Burke said Bhattacharyya had lost the right to take care of the patient by being inattentive during the initial operation. He studied mechanical engineering at MIT, graduating in 1975, but realized that he would rather treat patients than work with things. Woods cases were scheduled to start within minutes of each other. Madelyn "Maddy" Pearson, DNP, RN, NEA-BC, is chief nursing officer and senior vice president of patient care services at Brigham and Women's Hospital. Mark Vrahas is a nationally respected trauma surgeon and under his leadership, MGH created an orthopedic trauma team system that has been emulated across the country.. Surgeons would face more requirements and more limits. Indeed, the issues go far beyond Mass. Drs. Massachusetts General Hospital (MGH) in 1899 and served as the first Chief of Orthopaedic Surgery until 1909. For patients, however, it can come as an unsettling surprise especially when things go wrong. Burke wasnt alone in his doubts about double-booking. 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. The former spine chief testified he carefully positioned both patients, an important step. Your email address will not be published. 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 joined DunnPeter Dunn, M.D.Medical director of the OR in developing the hospitals revised policy on the practice, hoping the new guidelines would become, as Lillemoe later described them, among the most comprehensive and well-defined in the country. He also began communicating with Burke in often-sympathetic sounding language that made Burke hopeful that he had found an ally. I see things that are not right and thats not the way we practiced medicine for a long time.. My only hope is that out of all of this, some good happens. He is appealing his ouster, a process that could ultimately put the matter before MGHs board of trustees. Search for condition information or for a specific treatment program. Consider Nicholas Gregory. Nine percent of all orthopedic surgeries fall into this category triple the overall hospital average, according to data provided by MGH. We are committed to providing expert caresafely and effectively. Learn about career opportunities, search for positions and apply for a job. General staffers, offers a behind the scenes look at the heated battle inside one of the nations top-rated hospitals, involving some of the most prominent names in Boston medicine. The General Hospital Corporation. As Burke recalls it, Shervin sobbed into the phone, asking what she should do. Get the latest news, explore events and connect with Mass General. Boston Medical Center spine surgeon Dr. Tony Tannoury occasionally runs two operating rooms, overlapping his cases by several hours in what the hospital describes as a tightly monitored program that enables him to do his operations more safely and during daytime hours. His stature and roster of well-known patients would prove no protection against what was coming. Let us help you navigate your in-person or virtual visit to Mass General.