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Promised review wasn’t done in UNM breast cancer surgeon’s lawsuit

Copyright © 2016 Albuquerque Journal

University of New Mexico Health Sciences officials promised an independent, external review in response to allegations that breast cancer surgeries performed by the HSC chief of surgery were substandard, but the Health Sciences Center never furnished enough information for the outside reviewer to render an opinion.

That is the essence of a letter made public after California medical school officials told the Journal last week that they never conducted the case review.

WALLACE: Claimed she was forced out of her job

WALLACE: Claimed she was forced out of her job

A UNM Health Sciences Center spokesman reported in early June that an “external review” occurred after allegations arose in a now-settled whistleblower lawsuit filed by breast cancer surgeon Anne Marie Wallace.

Wallace claimed she was forced out after complaining about surgeries performed by her supervisor, Dr. John Russell, who has headed the surgery department since 2006.

The Journal reported June 26 that UNMHSC settled Wallace’s lawsuit for $775,000, including attorney fees, but both sides signed a confidentiality deal that prevents them from making public statements about the case.

UNM Health Sciences officials had told the Journal in advance of the story published June 26 that they were prohibited by a state law governing medical peer review from divulging the findings of the outside review.

The university did, however, release a letter dated February 2013 letter in which the review was requested.

That letter, from a UNMHSC attorney, asked a breast cancer surgeon from Loma Linda (Calif.) University School of Medicine to review and advise UNM Health Sciences Center about the outcome of data from surgeries performed by Russell.

The letter had blank signature lines where the Loma Linda surgeon and medical school dean were asked to sign.

On June 16, UNM Health Sciences spokesman Billy Sparks sent the following email statement to the Journal : “I understand that the Custodian of Public Records has supplied the Albuquerque Journal with a copy of the retention letter under which an external review was conducted.”

Sparks added that there was no charge to UNMHSC for the review.

But last week, in response to an earlier query from the Journal, the dean at Loma Linda University School of Medicine issued a statement saying the California-based university never performed the review.

HADLEY: Not enough information for the review

HADLEY: Not enough information for the review

“We were asked to review, but ultimately did not due to insufficient information provided to review,” Dr. Roger Hadley said in a statement issued by a Loma Linda University spokeswoman. There was no elaboration.

Insufficient data

Asked about Hadley’s statement, Sparks last Tuesday provided the Journal with a previously undisclosed one-page letter from Loma Linda’s chief of surgical oncology, Dr. Carlos Garberoglio.

Garberoglio’s letter, dated April 5, 2013, said he had been asked to review a data table of patient outcomes for 2008-09 involving UNMHSC breast cancer surgeries.

GARBEROGLIO: "No conclusion" made

GARBEROGLIO: “No conclusion” made

“I analyzed this data multiple times and it has become obvious that any conclusion with the present data would be inaccurate,” Garberoglio told UNM lawyer Scot Sauder in the letter.

Garberoglio, who has expertise in breast cancer care, told UNMHSC that he also showed the data table supplied by UNM to the Loma Linda Chief Patient Safety Officer, as well as the director of Loma Linda’s Breast Health Center. He said both concurred “that no conclusion can be made from this data.”

To make a “fair” conclusion, Garberoglio’s wrote, “will require a review of at least 100 consecutive charts (breast) while looking at specific metrics that can possibly lead to an accurate conclusion.” He said Hadley, the Loma Linda dean, agreed with his decision.

A portion of Garberoglio’s letter was redacted before UNMHSC emailed it to the Journal last week.

A heavily redacted copy of what appears to be the data table referred to by Garberoglio was included in the materials provided to the Journal through its public records request.

Asked why Garberoglio’s letter wasn’t included in those materials and was initially withheld by UNM’s records custodian, Sparks said the letter from Loma Linda University was covered by the medical peer review law.

“However, upon further review by the Office of University Counsel, the legal staff determined that a redacted version could be released without placing the University in the position of violating the Review Organization Immunity Act.”

As to why UNMHSC didn’t follow up by furnishing the 100 consecutive charts, Sparks said Thursday that Loma Linda “declined to perform a more extensive review and therefore no additional records were provided to them.”

Whistleblower suit

Wallace, who now works at a VA Medical Center in Cheyenne, Wyo., sued UNM Health Sciences, naming Russell and a top surgical oncology supervisor as defendants.

She contended in a 2011 lawsuit that her career was damaged after she reported that Russell frequently deviated from accepted standard of care in his breast surgeries and that his patients experienced higher-than-usual rates of complications after his surgeries. She alleged her concerns were ignored by administrators who engaged in “systematic retaliation.”

Russell and UNMHSC officials denied those allegations. Health Sciences Center officials said Wallace wasn’t forced out but resigned because she wouldn’t be a “team player” and take “on-call” duty during off-hours at University Hospital.

After her lawsuit was filed, UNM Health Sciences Chancellor Dr. Paul Roth in April 2011 told the Journal that an external review was pending, even though in-house review of Russell’s cases showed no substandard surgeries. Such a review was typical when “serious career-threatening allegations are made by a peer” and to ensure objectivity because Russell is in a leadership position, Sparks said in an email to the Journal at the time.

Roth defended Russell as having “extraordinary skills and dedication” that have “saved lives and lifted the standard of our institution to new heights.”

UNM attorney Sauder made the same point in his letter to Loma Linda in February 2013.

“Our leadership determined that because Dr. Russell is the Chair of the Department of Surgery, and all of our potential internal reviewers ostensibly work for him, that it would be advisable to go out outside the UNM Health Sciences Center for this review,” Sauder wrote.

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