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Days after Burke performed the follow-up operation on Pereira, he said, he approached RubashHarry E. Rubash, M.D.Chief of orthopedic surgery in the surgeons lounge on the fourth floor of the Gray Building to discuss what had happened. Locally, most teaching hospitals allow minor overlap of cases, but only a few permit doctors to run two surgical cases simultaneously over an extended period. Orthopaedic Surgery - Massachusetts General Hospital Schedule a same day virtual visit when you experience a sports injury. Upon returning after World War II in 1947, Dr. Barr succeeded Dr. Marius N. Smith-Peterson as the chief of orthopedic surgery at the Massachusetts General Hospital, having become a member of the staff in 1930. Dr. Freiberg earned his undergraduate degree from Northwestern University, and he graduated from the University of Cincinnati College of Medicine. The patient was then wheeled into the operating room and given anesthesia, while the surgical team, including Dalal, waited for Vrahas. Or more directly: Does a patient have a right to know that he could be sharing his surgeons focus and skills with the patient down the hall? Eighteen minutes later, Dr. Wood started another case down the hall a cervical corpectomy on Tony Meng. This story was reported by Globe Spotlight Team reporters Jenn Abelson, Jonathan Saltzman, Liz Kowalczyk and editor Scott Allen. Dr. Wood said he believed the cause of the worrisome neurological responses could be compression on the spinal cord from the back side. Other fields looked at that model as they got busier.. Specialties. The surgeon was paged three times but failed to respond, Dr. Susan Vassallo, an anesthesiologist for the case, later testified. Leader of orthopedics research program at the National Institutes of Health. What we learned from Donald Stern is that what were hearing from our OR leadership was reflective of reality.. To me that is what we were hoping to accomplish. Sometimes patients find out just moments before the surgery, or even after the fact, that their doctor had a second concurrent procedure. Clash in the name of care - A Boston Globe Spotlight Team Report Dublin, N.H. : William L. Bauhan, 1996. Fax: 617-726-8214. AustenW. Seeking to complete the procedure and possibly relieve the nerve symptoms, Wood then operated for several more hours on the back of Mengs neck. 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. Step away from the bed, VassalloSusan A. Vassallo, M.D.Anesthesiologist said she insisted. 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. Read about safe practices when taking pain medication and non-drug pain relief methods. MGHs rules satisfied those federal regulationsMedicare rules are designed in part to keep the government, which pays teaching hospitals to train residents and fellows, from overpaying for patient care. The family wanted a second opinion. Free Vascularized Fibula Graft with Femoral Allograft Sleeve for Lumbar Spine Defects After Spondylectomy of Malignant Tumors, Modified En Bloc Spondylectomy for Tumors of the Thoracic and Lumbar Spine. After Skates left, Torchiana pulled Burke aside and said it was wrong to involve a trustee in this matter. He knew it was probably a breach of protocol, but he divulged his worries to Ronald Skates, a friend and former computer company executive. My eighth annual Chief's Report for the Orthopaedic Journal at Harvard Medical School will highlight a tremendous year of growth and productivity in the Department. Giants of Orthopaedic Surgery: Richard J. Smith MD - PMC From that moment, battling concurrent surgery became Burkes cause and the gap between him and the hospital he loved now poisoned ground would only grow. Burke said Bhattacharyya had lost the right to take care of the patient by being inattentive during the initial operation. mleelman@partners.org. Explore fellowships, residencies, internships and other educational opportunities. The morning after their conversation, Skates reached out to Dr. David Torchiana, head of the physicians organization and now chief executive of Partners, who promised to look into the matter, according to e-mails obtained by the Globe. 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. But change came to his door. Wood made roughly six trips between the rooms over a span of three hours that morning, moving so seamlessly that one of the anesthesiologists later said in a sworn deposition he didnt even know Wood had a second patient. Burke is a zealot on the issue and makes no apology for it. 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. But he did say that Sterns findings affirm his confidence in the soundness of MGH practices. Harvard Combined Orthopaedic Residency Program Several anesthesiologists and surgeons, as well as a doctor who served on the committee that assigned OR time, told the Globe that, under Rubash, the orthopedics department increasingly allowed surgeons to schedule two surgeries at once. Rubash announced the departure with mixed emotions, saying Wood built an outstanding spine service. Burke raised his concerns about overlapping surgery. Instructor or Assistant Professor of Medicine (Division of Endocrinology, Diabetes and Hypertension) Brigham and Women's Hospital Date Posted: 11/18/2022. John Henry, the principal owner of the Red Sox and the owner of The Boston Globe, was a trustee of the hospital from 2005 to 2014. Orthopaedic Journal at Harvard Medical School - annual publication A new research institute at Mass General Brigham seeking to rethink the traditional biotech research model and create a new role for the state's largest healthcare system in the industry. Warner noted he always performs the key components of surgery and that fellows occasionally do non-critical activities such as positioning and making the initial incision. Dr. Christopher M. Bono is a board-certified, fellowship-trained adult spine surgeon in the Orthopaedic Spine Center at Massachusetts General Hospital. That resident worked on the 2008 hip surgery case that first raised concerns for Burke about double-booking. I will spotlight the many significant contributions by the orthopaedic staff at the Massachusetts General Hospital (MGH). Save my name, email, and website in this browser for the next time I comment. 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. Burke says he told her it might be unethical to take over another doctors case but, in his mind, the needs of a patient in distress trumped that concern. Concurrent surgery is also relatively common in trauma, cardiac, brain, and vascular operations. In September 2022, Mass Generals Orthopaedic Trauma Service was chosen to host the inaugural class of the Orthopaedic Trauma Associations Roy Sanders Traveling Fellows. When I am in an OR and focusing on three square inches, bombs can be going off around me, and I am focused on three square inches.. Copyright 2007-2023. It had been a concurrent procedure performed weeks earlier by another MGH surgeon. Burke and a small but determined cohort of anesthesiologists and other Mass. 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. Do you really think it reasonable to do these two cases by the same primary surgeon? PDF Harvard Orthopedic Trauma Fellowship Massachusetts General Hospital Generals busy orthopedic trauma service, and on this day, he was very busy indeed. 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. The three doctors say Lillemoe was blunt about some of the hospitals double-booking practices. 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. 617-724-8636 Request an appointment. They make my skin crawl, Lillemoe said, according to anesthesiologist Lisa Wollman, an account supported by Burke and Sunder. He arrived stressing the need to reduce surgical complications generally and walked into the debate over the safety of double-booking. 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. They in a sense have traded in their New England Journal of Medicine for the Wall Street Journal., Dr. Kirkham Wood, a graduate of Albany Medical College who later trained under a spinal deformity specialist in Minnesota, took on some of the most ambitious concurrent surgeries, a challenge, he acknowledged in court testimony, that was strenuous.. 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. Is this how we are planning the future? We bring together the clinical professionals with the most appropriate skills to deliver your care. Rubash succeeded in boosting the volume of orthopedic surgeries by more than 20 percent and revenue by more than 48 percent between 1999 and 2003, according to the Harvard Business School case study. Jon has a tendency of counting operating time versus actual case time. 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. She told Burke her understanding was that the patient might have to wait days for surgical relief. He studied mechanical engineering at MIT, graduating in 1975, but realized that he would rather treat patients than work with things. Zimmer Gets a Chief Medical Officer For the First Time. Dr. Freiberg, an expert in adult reconstructive surgery with an emphasis on hip and knee arthroplasty, says he wasn't looking for a change. As chief, he was instrumental in the creation of the Orthopedic Research Laboratories. Assistant or Associate Professor of Medicine (Division of Population Sciences) Dana Farber Cancer Institute/Brigham and Women's Hospital Date Posted: 11/17/2022. MGH officials assert that Burke violated hospital rules and possibly federal privacy laws by supplying the Globe with copies of some internal records. When I have access to the dynamic schedule upon arrival to MVH, I will check the times for accuracy. 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. Wood announced plans to leave for Stanford University this fall. He is the inaugural recipient of the Stepping Strong Distinguished Chair in Orthopaedic Surgery while serving as the founding director of the Gillian Reny Stepping Strong Center for Trauma Innovation. Rubash helped introduce an incentive system that paid doctors more if they generated more profits. They are the eyes and ears for patients in their most vulnerable state, carefully watching vital signs for any disturbance. The Meng case reverberated deeply for BurkeDennis William Burke, M.D.Orthopedic surgeon. What can patients rightly expect of their doctors? Then the chief stood up and left, Burke recalled. A hole in the front side of the protective membrane allowed Mengs spine to bend and protrude, potentially causing his paralysis. 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. Please join us in congratulating the 13 Mass General orthopaedic surgeons named Top Doctors by Boston magazine for 2022. The former spine chief testified he carefully positioned both patients, an important step. 50th President of the CSRS, Dr. Babaria Joins DISC Sports & Spine Center, Michael Kelly, M.D. Department of Nursing Leadership - Brigham and Women's Hospital Refer a Patient We are dedicated to working with our referring physicians. Contacted by the Globe, Stern declined comment. 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.. The hospital only allows certain types of procedures to run concurrently and not the kind that Tony Meng had. Wollman, Burke, and Sunder, in separate interviews, all also said Lillemoe cautioned that it would be draconian to ban surgeons from double-booking altogether. MGH officials declined to comment directly on the Meng case, saying federal patient privacy laws forbid their doing so. There is no known connection between the complications and deaths and the double-booking, but none of the patients and family members interviewed had any idea that the surgeons were involved in a second operation at the same time. This year, in response to Spotlight Team questions, the hospital conducted an analysis of hundreds of surgical cases and also reviewed 25 cases of concurrent surgeries where patients suffered complications. Hes as great a person as he is a doctor and Ill miss him at MGH. 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, Mass. After Warner rushed through the door several minutes later, a vascular surgeon was called to repair the tear and ultimately the operation was aborted. Dear Dr Freiburg, I would like to know your thoughts on Titanium and/or metal allergy in total joint prothesis rejection/inflammation. Thanks, Sunder. The prognostic value of preoperative participation in activities of daily living on postoperative outcomes following lumbar discectomy. Subscribe today for full access to in-depth investigative reporting. Chiefs Reports: Massachusetts General Hospital 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. At 1:49 p.m. the next day, Pereira was wheeled into operating room 21. 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. PCPs often are your first point of contact for your general health concerns. ShervinNina ShervinOrthopedic surgery resident was the one at fault, Rubash shot back, according to Burke. Mass General Waltham's Outpatient Surgery Center offers joint replacement as day surgery in our new and convenient facilities at the crossroads of Bostons MetroWest. Burke met twice with Stern in July 2011. General employees complained about at least 44 alleged problems involving concurrent surgeries, and raised concerns to their superiors and colleagues, sometimes through official channels, other times in court testimony or ordinary e-mails about what they considered substandard patient care or medical practice between 2005 and 2015, the Spotlight Team found. The Spotlight Team interviewed four patients who suffered complications and the relatives of two patients who died after double-booked cases between 2006 and 2015. In 1976, Dr. Glickel completed a residency in Orthopedic Surgery at the Harvard Combined Orthopedic Program. Other luminaries in orthopaedic surgery have headed the Department over the years, including Drs. 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. An MRI revealed a condition causing compression of his spinal cord. The risks are real; the benefits can be huge. He began the meeting by reminding the men of the obvious, that Mass. Get the latest news, explore events and connect with Mass General. If you have any questions, contact Megan Leelman at I saw these hypocrites, sanctimonious hypocrites, who were going to string this woman up, he said in an interview. Warner had a second procedure running simultaneously and was scrubbed into room 20. RubashHarry E. Rubash, M.D.Chief of orthopedic surgery said in a recent interview that he never pressured his staff to do concurrent procedures. Double-booking also fit well with the business-like approach that Dr. Harry Rubash brought to Mass. Dr. Bridwell is the Co-Director and Founder of the Pediatric/Adult Spinal Deformity Service. If this results in my career at the MGH ending, so be it, he told the Globe months before his firing. OR 21 and OR 30. Associate Professor of Orthopaedic Surgery, Harvard Medical School. As an anesthesiologist, Dr. Akshay Dalal, watched, Vrahas explained the procedure that would be done on the patients lower leg, and gave him the consent form, which both the patient and Vrahas signed. Massachusetts General Hospital (MGH) in 1899 and served as the first Chief of Orthopaedic Surgery until 1909. Please complete our confidential survey. This event will be livestreamed. General. Hospital leaders would define the critical parts for many surgeries, and identify operations and types of patients whose surgeries should not overlap. While he was a medical student at Loyola University outside Chicago, orthopedic surgery appealed to him because it combined medicine and mechanics. No one knows why it happened to Tony Meng, or how, or even exactly when. 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. We do not allow an attending to be in two rooms at a time. Phone: 617-726-9111 By getting involved in Pereiras case, Burke had embarrassed the trauma service, Rubash said. Watch the video to hear Dr. Schwab discuss the importance of the multidisciplinary care that orthopaedic oncology patients receive . Your email address will not be published. Sunder. Dr. Mark Price, a fellow in the orthopedics department, had accidentally sliced a blood vessel during a complex shoulder operation in late 2008, and the patient was quickly losing blood, according to Dr. Neelakantan Sunder, an anesthesiologist, and Jane Hardiman, a certified nurse anesthetist, who were working on the case and present in the room. Are we allowing 2 rooms for major spine surgery? Is it right that their patients may have no idea? 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. Mortality Following Surgical Management of Vancouver B Periprosthetic Fractures. Certainly, at a hospital where 37,000 surgeries are performed each year, concurrent operations make up a small minority. Leonard DA, Schoenfeld AJ, Harris MB, Bono CM. This is why we are one of the best in the US. Then, he would turn Meng over onto his abdomen and operate some more. Copyright 2007-2023. I was called a whistle-blower and crusader by some not true, Burke said he told Stern. He said he got emotional, especially when he recalled for Stern a time when his wife was a patient at Mass. Dr. Hornicek is an excellent teacher and surgeon and plans to continue his basic science efforts in a new laboratory. I was brought here to build a fabulous academic department, which we are, Rubash said. I am taking this summary action to restore the integrity of Hospital standards, operations, and patient care.. They also privately question the motives of some who made them. Dr. Cheryl Schosky CRNA, Your email address will not be published. Let us help you navigate your in-person or virtual visit to Mass General. 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. 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. We have the best compensation plan around, said shoulder surgeon Dr. Jon J.P. Warner in a department-approved Harvard Business School case study last revised in 2005. Indeed, the issues go far beyond Mass. Jeanine Wiener-Kronish, M.D., Jean Kwo, M.D. Brandon E. Earp, MD - Brigham and Women's Hospital We don't rush your visits. He said he had reached a breaking point, that he felt he had no choice now but to contact state regulators the Board of Registration in Medicine and the Department of Public Health. The family called for an ambulance and headed to the emergency room at Mass. Now director of Orthopedic Trauma Services at Suburban Hospital in Bethesda, Md. The Chief will . And it isnt over yet. Meet Dr. Joseph Schwab - SORG Orthopaedic Research Group 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. 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. at a meeting of the orthopedic surgeons. When people in medicine trace the origin of overlapping surgery, one name invariably comes up: Dr. Michael DeBakey. 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. Dont lose hope, because we may have a solution, says Bassem Elhassan, MD, co-chief of the Shoulder Service. Some even wonder at his motives, believing he is driven by outrage at the hospital for placing a Burke protege on academic probation and not hiring her. On Aug. 10, Burkes lawyer got a call from an attorney for the hospital bearing hard news: Mass. As Burke recalls it, Shervin sobbed into the phone, asking what she should do. Im just a concerned doc worried about poor patient care and potential damage to the hospitals reputation.. 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). 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. See some of our current research publications. Our Team | Newton-Wellesley Hospital Copyright 2007-2023. Burke and Austen had known each other since the early 1970s. So when he crossed paths with a trustee for the Massachusetts General Physicians Organization in early November 2010, the surgeon couldnt help himself. Among his many accolades, Dr. Harris received the BWH Hippocrates Society Humanitarian Award and both held the chair position and served as a mentor for the AAOSs Leadership Fellows Committee. He routinely does not account for sometimes two hours of a patient anesthetized waiting for him when he is operating in two rooms and the frequent need for PM incentives to cover his rooms because of surgical delays covering two ORs. He received the coveted Golden Apple Award, presented to the Harvard Orthopaedic faculty member identified by the residents as the teacher/mentor of the year.