Copyright © 2012 Albuquerque Journal
There was a time when Dr. Christian Schlicht was “untouchable.”
According to a former colleague, Schlicht used fraudulent credentials to operate on patients even though he wasn’t a surgeon and injected Plexiglas-like cement into patients’ spines in a procedure that turned out to be neither safe nor effective.
When an operating room nurse at Gerald Champion Regional Medical Center in Alamogordo reported to a supervisor that Schlicht’s back surgeries had gone too far, she was told “in no uncertain terms … to leave things the way they are.”
And after a health insurance company balked at paying for his procedures and questioned his qualifications, records show, officials at the nonprofit hospital took Schlicht’s side and threatened to sue the insurer.
Two years later, former patients began to file lawsuits contending the spinal procedures left them with debilitating injury and pain. Some have partial paralysis; others have lost bladder and bowel functions, court records allege.
The patient claims, which grew to about 80 over the past year, forced the hospital to seek bankruptcy court protection last summer. Now, a partial settlement in the litigation has been reached totalling more than $33 million.
The German-born Schlicht is an anesthesiologist and pain management specialist.
But despite the red flags, the hospital allowed him to perform the money-making surgical procedures at a pace that led to the need for a second set of instruments because the first was worn out.
Then the day came in late 2008 when Schlicht had a conversation with Dr. Frank Bryant, the only other physician performing spine surgeries at the hospital.
“He … confided in me that some of his neurosurgery training was falsified,” Bryant recalled during a deposition earlier this year. “I wanted to just die right there in the room. I didn’t know what to do.”
Bryant, an orthopedic surgeon, sometimes performed spine operations with Schlicht. His deposition offers new light on the medical malpractice allegations reported last year in stories by the Journal.
Bryant, who was a defendant in the lawsuits along with Schlicht, said during his deposition that he thought Schlicht was a legitimate neurosurgeon but now says he was misled.
Bryant denied any wrongdoing in court records. He declined, through his attorney, to comment for this story. Bankruptcy court records show claims against Bryant were settled for $11.5 million earlier this year. That’s part of the overall $33 million settlement amount.
According to his deposition, Bryant said he always gave Schlicht the “benefit of the doubt,” but now believes Schlicht performed surgeries he wasn’t qualified to perform, billed for procedures incorrectly and gave false statements about his training and qualifications.
“I believe there are other issues, that are either unethical, illegal or fraudulent that he committed,” Bryant added.
As for the bone cement procedure, Bryant said, “In retrospect, it was the wrong thing to do. But at the time, being misled, I felt it was OK.”
Moved to Japan
The man at the center of the litigation has put thousands of miles between himself and the New Mexico legal controversy.
Last summer, Schlicht was hired as a senior flight surgeon at a U.S. Air Force base in Japan. He is still on assignment as a lieutenant colonel, according to an Air Force spokesman.
Prior to that, he worked in Colorado, where he still has a license to practice medicine. Schlicht’s osteopathic medical license in New Mexico has lapsed.
Citing his Fifth Amendment right against self-incrimination, Schlicht refused to answer most questions during a deposition in New Mexico in June 2011.
But his attorneys in court records say he committed no wrongdoing and that any post-operative problems patients have were unavoidable medical complications.
Meanwhile, Bryant was recently reprimanded by the state Medical Board in connection with the cement injections but still retains his New Mexico medical license.
He had worked at Gerald Champion since 1996, served as chief of staff from 2006 to 2007, but closed his practice in February 2011, according to his deposition.
Several months ago, Bryant testified that his plan was to join the U.S. Army Medical Corps.
His attorney, Robert M. Doughty II, of Alamogordo, told the Journal last week in a letter that Bryant was in the process of leaving the state and establishing a practice elsewhere.
It was like “Play-Doh,” Bryant recalled during his deposition last March.
Bryant said he knew the cement was approved for use to treat fractures in the spine, but discovered that Schlicht was injecting it into disk spaces.
The bone glue would be heated, then the physician would use an injector device to fill the space where the patient’s disk material used to be.
The cement was supposed to harden and act as a cushion. But the patients’ lawsuits allege that the glue sometimes seeped elsewhere in the spine or broke off into pieces after hardening.
Schlicht touted the procedure as a less invasive alternative to spine fusion and presented German “papers” to Bryant to prove the procedure was effective.
“I can’t read German,” Bryant added.
Schlicht told Bryant “how great the patients were doing and how he never had complications.”
“I believed him. I mean he sounded pretty credible,” Bryant said.
Bryant said Schlicht “indicated to me that the technique was learned in Germany and that it was basically utilized and improved and or perfected at the VA in Albuquerque.”
Schlicht worked at the Veteran Affairs hospital in Albuquerque as a anesthesiologist from 1997 to 2006.
Schlicht tended to be somewhat secretive — not the type to have someone over for a couple of beers, Bryant said.
But Schlicht invited Bryant to his house one evening and showed him a bookcase in his study that was about 6 feet tall, and 3 to 4 feet wide.
It “was just full of X-rays, and these X-rays were all from (patients) at the VA,” Bryant said, explaining that Schlicht had kept the films to show before and after views of patients who received the cement injections. The X-rays showed the patients’ names and medical record numbers, Bryant said.
“He wanted to establish some credibility in the sense of … ‘Hey, look, there’s a hundred films or hundred cases I’ve done. Look how I can achieve this correction. These patients are all doing great.’ ”
VA officials won’t say whether the agency’s internal review of Schlicht’s patient cases, started last fall, found evidence that patients had received the cement injections.
“As with any review, we are constantly seeking ways to improve our processes to ensure that high quality care is provided to our veterans,” said spokeswoman Sonja Brown last week.
As for patient X-rays, Brown said, “We are unable to verify any of the facts about the validity of that doctor’s testimony, nor can we verify the contentions of Dr. Schlicht.”
Physicians were permitted to remove X-rays from the hospital, she said, but were supposed to return them.
Questions and threats
The bone cement procedures weren’t a secret, Bryant said.
Bryant and Schlicht had talks with the CEO of the hospital to discuss buying injection equipment that the two doctors had designed for the spinal procedure.
And the hospital’s board of directors listened to a presentation about the cement treatment in 2008, he said.
But Schlicht’s training and credentials were called into question in September 2007 by Molina Healthcare, which had reviewed a case involving a patient it insured who reported post-operative loss of motor and sensory functions, immobility and incontinence.
Molina informed Gerald Champion officials that the surgery involved appeared to be outside Schlicht’s scope of practice, according to Bryant’s deposition.
“It appears the operating room did not stop the provider from performing this surgery,” Molina also stated in a letter, which came up during Bryant’s deposition.
Molina concluded that there was a “gross flagrant violation of acceptable medical practice or service standard” and asked for a plan to ensure patient safety.
The hospital administration responded by threatening to start “aggressive legal and regulatory action” against the health insurance company, contending that “Molina appears to have consistently violated Dr. Schlicht’s rights and now has additionally openly damaged the hospital.”
Just days before leaving the job in November 2008, Schlicht performed an extensive spine surgery on a patient, embedding spacers, rods and screws into the patient’s vertebrae.
Bryant, who said he “inherited” the patient and had to perform a second operation to remove the hardware, said he had “no idea” why Schlicht undertook such a surgery.
The patient was left with excruciating pain and a severely atrophied right leg, according to his lawsuit.
Blowing the whistle
A hospital medical staff officer, whose department is supposed to verify a physician’s credentials, told Bryant “probably sometime in 2008” that Schlicht was “untouchable.”
“Who told her that?” Bryant was asked at the deposition.
“It came from the administration,” Bryant said, adding that he could tell the medical staff officer was very uncomfortable talking about it.
“It had to do with the type of procedures Dr. Schlicht was involved in,” Bryant stated.
Bryant said an operating room nurse approached him on more than one occasion to report her concerns that Schlicht was performing surgeries he wasn’t authorized to do or shouldn’t have been doing, Bryant said.
The nurse complained to her supervisor, but to no avail, Bryant said.
The nurse “told me that she had in fact reported that to the administration and was told in no uncertain terms … to leave things the way they are.”
Bryant was asked about Schlicht’s operation on one patient in which he went in from the front of the patient’s neck and moved aside the esophagus and trachea to inject the cement into the patient’s spine.
“He definitely had no business doing some of these procedures,” Bryant said.
Highly paid doctor
Bryant said Schlicht told him he left the VA hospital to make more money.
At Gerald Champion, he was one of the highest-paid physicians on staff, earning more than $450,000 in 2007.
His department became one of the busiest at the hospital by September 2007. The volume of procedures performed by Bryant and Schlicht was so large, a second set of spine instruments was requested, Bryant confirmed.
Why Schlicht resigned is still unclear, but Bryant said Schlicht mentioned having a dispute with the hospital over bonus pay.
In a performance evaluation that same month, a top hospital official gave Schlicht “excellent” ratings in quality of work, competency and job knowledge.
— This article appeared on page A1 of the Albuquerque Journal