A year ago, we discussed a bizarre case where a colonoscopy patient (identified only as “DB”) is suing over abusive comments made about him by his doctors . . . while he was under anesthesia. “DB” had failed to turn off his cellphone which continued to record comments of the doctors ridiculing him, his body, and his character. While the alleged defamation did not leave the operating room (that is until his lawsuit), he alleged that it was still defamation and Dr. Tiffany Ingham and others for $1.35 million in damages for defamation, infliction of emotional distress and illegally disclosing his health records. Well, after a three-day trial, a Fairfax County jury ordered the anesthesiologist and her practice to pay him $500,000.
On the tape, Dr. Tiffany Ingham is recorded addressing his unconscious body: “And really, after five minutes of talking to you in pre-op I wanted to punch you in the face and man you up a little bit.” She also reportedly called him a “big wimp” and a “retard.” In addition about ridiculing his alma mater of Mary Washington College, she is quoted as saying more menacing things about firing a gun up his rectum and suggesting that they falsely note on his chart that he had hemorrhoids.
The staff is portrayed as exhibiting all of the decorum and professionalism of an Animal House fraternity with Ingham as the resident Bluto. Some members reportedly jokes about a rash on DB’s penis and how he looks like he has syphilis. Ingham, who comes off particularly badly, is quoted as saying “It’s probably tuberculosis in the penis, so you’ll be all right.” They all discussed avoiding DB after the surgery. As discussed earlier, defamation does not require contemporary knowledge and indeed it is often discovered later by the victim. Moreover, it only requires publication to other individuals, not widespread disclosure or publication.
The jury appears to have rejected any argument that this was merely juvenile humor or even opinion. Clearly they are expressing their opinion as to his being a “wimp” or “retard.” Dr. Ingham, 42, could not be reached for comment and she no longer appears to work out of the Aisthesis anesthesia practice in Bethesda, Md. State licensing records indicate she has moved to Florida. The gastroenterologist who performed the colonoscopy, Soloman Shah, 48, was dismissed from the case, but he is shown engaging in the juvenile comments.
The jury awarded the man $100,000 for defamation — $50,000 each for the comments about the man having syphilis and tuberculosis — and $200,000 for medical malpractice, as well as the $200,000 in punitive damages.
i need help
i see that a guy in VA sued after his colonoscopy….
i got a worse story in NYS and need help.
I recorded my event too …
sense aug 2013 finding difficulty in receiving reasonable medical care. I got blacklisted and can document this…
last week i had a procedure done that i was very apprehensive about … so i recorded the event… i got horrible treatment in my after “care”. the doctor made fun of me during the procedure where i was sedated.
i was harmed by the comments
mycrownofthorns.org my blog
Medscape has just reported on this case
http://www.medscape.com/viewarticle/847131?nlid=83409_1382&src=wnl_edit_medn_surg&uac=140058BT&spon=14&impID=753026&faf=1
In this New England Journal of Medicine commentary, “Is Academic Medicine for Sale?”, Dr. Marcia Angell describes (in a very moderate critique) how US doctors are indoctrinated in the primacy of synthetic drugs as treatments for diseases from the very beginning of their medical educations:
“When the boundaries between industry and academic medicine become as blurred as they now are, the business goals of industry influence the mission of the medical schools in multiple ways. In terms of education, medical students and house officers, under the constant tutelage of industry representatives, learn to rely on drugs and devices more than they probably should. As the critics of medicine so often charge, young physicians learn that for every problem, there is a pill (and a drug company representative to explain it). [emphasis added]
“They also become accustomed to receiving gifts and favors from an industry that uses these courtesies to influence their continuing education. The academic medical centers, in allowing themselves to become research outposts for industry, contribute to the overemphasis on drugs and devices. [emphasis added] Finally, there is the issue of conflicts of commitment. Faculty members who do extensive work for industry may be distracted from their commitment to the school’s educational mission.
“All of this is not to gainsay the importance of the spectacular advances in therapy and diagnosis made possible by new drugs and devices. Nor is it to deny the value of cooperation between academia and industry. But that cooperation should be at arm’s length, with both sides maintaining their own standards and ethical norms. The incentives of the marketplace should not become woven into the fabric of academic medicine. We need to remember that for-profit businesses are pledged to increase the value of their investors’ stock. That is a very different goal from the mission of medical schools.“ [emphasis added]
http://www.mindfully.org/Health/Academic-Medicine-Sale18may00.htm
Dr. Angell seems to be unaware of the history of the establishment by the Rockefeller Foundation of the modern allopathic medical education system as a means of creating a market for petro-chemically based drugs, the original and ongoing “mission of medical schools.”
For an historical look at how modern allopathic medical schools came into being and how they have come to dominate medicine in the US, see the very informative mini-documentary, “Rockefeller Medicine”:
To Ken Rogers.
This is very interesting indeed.
In the UK, the Police have recorded a crime against the GMC and a Hospital Trust of perverting the course of justice following evidence I submitted to them. The Crown Prosecution Service is currently making a decision on whether there is a 50% chance of a conviction, and if so, a criminal prosecution will take place.
This situation appears to be historic – but so far remains unreported.
Other doctors have begun to make contact expressing plans that they want to take similar action.
So maybe this is a way forward to ensure probity and justice for doctors, whose only real concern is to promote patient safety above their own.
This could be a first step for the profession in regaining the respect and support of the public who have been mercilessly exploited by self centred healthcare systems, which have become more important than the patient.
From the information you have provided this would appear to be a transatlantic problem, and the situation is unsustainable.
Professor Ninian Peckitt
1, June 28, 2015 at 3:22 pm
“The political control of medicine is now a fact of life and doctors who challenge this have a shortened career.”
There are countless doctors who have challenged the political control of medicine by the medical-industrial cartel and who continue to have or have retired from successful practices and teaching posts in which they have conducted themselves by their own lights, based on their research and clinical experience.
Here are only a few of the more well-known, off the top of my head: Andrew Weil, M.D.; David Brownstein, M.D.; Mark Hyman, M.D.; Joseph Mercola, D.O.; Julian Whittaker, M.D.; Stanislaw Burzynski, M.D., Ph.D.; Matthias Rath, M.D.; Nicholas Gonzalez, M.D.; Uffe Ravnskov, M.D., Ph.D.; Elmer Cranton, M.D.; Russell Blaylock, M.D.; Marcia Angell, M.D.; Suzanne Humphreys, M.D.; Duane Graveline, M.D., M.P.H.; Stephen Sinatra, M.D.; Kilmer McCully, M.D.; Dwight Lundell, M.D.; Robert S. Mendelsohn, M.D.; and Nancy Turner Banks, M.D.
Knowledge is power, and as more and more medical professionals and lay people acquire knowledge of the true benefits, risks, and costs of drugs, radiation, and surgery vs disease prevention and natural treatment modalities, more and more of them will seek and provide safer and more effective health-supporting measures such as those already being provided by naturopaths, chiropractors, homeopaths, and nutritionists, not to mention the incorporation into medical practices of the important advances in knowledge provided by psychoneuroimmunology (PNI) and energy medicine.
The dominance of the arrogant, contemptuous-of-the-laity, know-it-all allopathic practitioner who learned all she/he knows (or at least all she/he can remember) and all she/he needs to know from his/her pharmaceutical-industry-subsidized medical school education is being steadily and unceremoniously undermined by the Internet and other means of medical and health information sharing.
Those who do not take primary responsibility for their own health and who do not question allopathic medical authority and its disease management model are at grave risk of becoming one of the statistics cited by Dr. Starfield (http://www.jhsph.edu/sebin/s/k/2000_JAMA_Starfield.pdf) and by the authors of Death by Medicine:
“ABSTRACT
“A definitive review and close reading of medical peer-review journals, and government health statistics shows that American medicine frequently causes more harm than good. The number of people having in-hospital, adverse drug reactions (ADR) to prescribed medicine is 2.2 million.1 Dr. Richard Besser, of the CDC, in 1995, said the number of unnecessary antibiotics prescribed annually for viral infections was 20 million. Dr. Besser, in 2003, now refers to tens of millions of unnecessary antibiotics.2, 2a The number of unnecessary medical and surgical procedures performed annually is 7.5 million.3 The number of people exposed to unnecessary hospitalization annually is 8.9 million.4 The total number of iatrogenic deaths shown in the following table is 783,936. It is evident that the American medical system is the leading cause of death and injury in the United States. The 2001 heart disease annual death rate is 699,697; the annual cancer death rate, 553,251.5″ [emphasis added]
http://www.wnho.net/deathbymedicine.htm
To Squeeky Fromm Girl Reporter http://www.zompist.com/libertos.html
This is all good stuff, but it will take me time to grasp the basics….
I think like a doctor and that’s not always a good thing if you are discussing deeper issues…. especially with clever lawyers. But when their guard is down it gives me the opportunity to shoot, metaphorically speaking.
I think the message is that if you can keep things simple there’s a good chance it will work. Let common sense prevail. Its when you start tinkering that things get complicated to the point it is unmanageable.
Its up to you as a country to identify when you have reached this point.
A lawyer once came to see me to ask me if I could collate scientific publications in an expert capacity with respect to known pathology and health risks of a certain product, which now has health warnings.
I advised the lawyer that the client should settle as the evidence was overwhelming that the product in question caused disease and death.
“We shall never settle” he said to me…. “regardless of judgments – no compensation will ever be paid”.
So I’m glad I’m a doctor, I would find that way of thinking very hard to live with…..
And the sting in the tail?
He was an American Lawyer.
@Ninian
Well, the walls must have ears, because I was just talking about you on another website! Nothing bad, nor your name, just your position on gun stuff. Anyway, you are right about many of the things you said above. The “libertarianism” on the right and left is behind a lot of it. You might enjoy this, which examines the right wing type of libertarianism:
http://www.zompist.com/libertos.html
Squeeky Fromm
Girl Reporter
Ken Rogers Climate in Hospitals :
You have accurately identified what is happening in a clear and informative manner.
“Contempt, like sewage, flows downhill.” is a perfect analogy.
But the “Profits-over-People” mind set is not just associated with Healthcare but with Society in General.
It has become the Engine on which the “Free World” runs, or splutters.
True Freedom for the Masses can only come with Collective Responsibility and that seems to be lacking.
Freedom of the Individual does not necessarily equate with Collective Freedom and the ability for minority/pressure groups to use the Courts rather than Congress is not a reflection of democracy. It is not what America is about but it is what America has become.
The political control of medicine is now a fact of life and doctors who challenge this have a shortened career.
So if the country wants to return to a good and safe medical system, it needs to support its doctors and to do this there has to be some regeneration of mutual trust and respect. In an aggressive confrontational system this cannot possibly occur. Trust and respect are qualities that require to be earned and therefore do not appear in the Bill of Rights. Doctors must play their part in setting an example for others to follow.
We have seen clearly on this blog what individual patients and their doctors want for themselves.
It is an expression of “Me” and not “Us”.
“The Great Game” is being replayed and this time it is about making money for Insurers, Doctors, Lawyers and the Patients who sue. The losers are the sick. That is why the system is failing the country and this will become unsustainable.
For a system to work it has to be about everyone, not the privileged few.
And that also applies to the Constitution and Bill of Rights.
In my last post, I placed an “End italics” signifier after “Big Pharma marketing,” but for some reason, it didn’t “take.”
I also tried to italicize only “status quo” in the last paragraph, but the first failure to end italics seems to have carried over into that paragraph.
I’m sorry for any difficulty in reading and understanding the post this typographical error may have caused.
@ MmeRose
1, June 27, 2015 at 11:03 pm
“I think that the climate in hospitals has changed a great deal. Common courtesy is very hard to find, and the administrators have completely taken over the hospitals, making it clear to physicians that the administrators, as top of the chain of command, must be obeyed. Their contempt for medical staff (doctors and nurses) is made obvious and the overall atmosphere is one of frustration (or bitterness); I am sorry to say that, in this culture, the patients are the victims.”
Although I certainly agree that the Medicine-is-a-Business paradigm of disease management pervades US hospitals (and most US medical practices), I hope you aren’t now defending Dr. Ingham’s behavior by asserting that in American hospital (as in military) culture “Contempt, like sewage, flows downhill.”
If you are, you’re well on your way down the slippery slope (pun intended) of “I was only following orders.”
In medicine, as in any service endeavor, when the profits-over-people mindset prevails, the recipients of the service in question will obviously be victimized to one degree or another by the priorities assigned and the choices made.
And inasmuch as US medical education and practice are in thrall to the epitome of the profits-over-people model, the pharmaceutical industry, you obtain outcomes like the deaths of 106,000 people in US hospitals annually from adverse reactions to FDA-approved drugs that are taken as prescribed.
See, for example, former Editor-in-Chief of The New England Journal of Medicine Dr. Marcia Angell’s book The Truth About the Drug Companies: How They Deceive Us and What To Do About It:
“During her two decades at The New England Journal of Medicine, Dr. Marcia Angell had a front-row seat on the appalling spectacle of the pharmaceutical industry. She watched drug companies stray from their original mission of discovering and manufacturing useful drugs and instead become vast marketing machines with unprecedented control over their own fortunes. She saw them gain nearly limitless influence over medical research, education, and how doctors do their jobs.” [my emphasis]
http://www.barnesandnoble.com/w/the-truth-about-the-drug-companies-marcia-angell/1111502268?ean=9780375760945
In her book, Dissolving Illusions: Disease, Vaccines, and the Forgotten History, nephrologist Suzanne Humphries, M.D., co-authored with Roman Bystrianyk, she chronicles her own experience with hospital culture and the highly injurious contamination of it by Big Pharma marketing.
http://www.dissolvingillusions.com/
In examining and treating patients with kidney failure who had been admitted to her hospital, she began to see that previously kidney-healthy patients had recently received various vaccines. She then observed the same pattern in patients who were vaccinated after being admitted:
“Later, several patients were admitted with normal kidneys and had their health decline within twenty-four hours of vaccination. Even these well-defined and documented cases were denied as vaccine-induced, by most of my colleagues. There was the rare doctor who would confer with me in the dark, or the the nurse who would come and thank me and agree with me when nobody was listening. It was a lonely time and certainly a dark night for my soul.” (p.xiv)
After then doing an extensive research of the medical literature regarding the safety and efficacy of vaccines in general, she writes:
“I came to realize that the guidelines, evidence, and opinions of the [medical] leaders were unsound and NOT leading the herds to authentic health.What was most puzzling to me was how I was treated when I tried to protect my own kidney-failure patients from being vaccinated—especially when they were ill.
“After attempting to get the hospital to defer vaccinating for for pneumonia and influenza until the day of hospital discharge instead of admission, I was told not to interfere with the vaccination protocol. Even more outrageously, I was continuously told that if I wanted credibility for my views, I should conduct my own study to prove that the vaccines were causing kidney failure. The burden of proof was somehow placed on me to obtain Institutional Review Board (IRB) approval and funding and and conduct a statistically significant study that those who doubted my evidence of harm would believe.” (p.xv)
“This was the first time in my career that my opinion regarding kidney failure was not respected. Any other time I suggested that a drug was responsible for kidney damage, the drug was immediately discontinued—no questions asked. But now I was unable to protect my own kidney-failure patients from vaccinations given in the hospital.” (p.xv)
“When I pointed out the connection between vaccines and worsening or new-onset kidney failure to a couple of open-minded colleagues, they understood, started taking vaccine histories, and saw what was happening. Yet they remained silent. Most doctors continue to practice with comfortable indifference. Some see the errors, damage, and limits of their practices, but still walk [in] lockstep with the herd and protect the brotherhood. I don’t know what it will take to resist the dictates of those who rule over them.” (p.xvi)
It will take the ongoing (and increasing) one-on-one and public pressure of their more enlightened professional and lay critics, who don’t have a vested interest in the status quo and who aren’t cowed by the unremitting profits-over-health propaganda of the medical-industrial complex.
I think that the climate in hospitals has changed a great deal. Common courtesy is very hard to find, and the administrators have completely taken over the hospitals, making it clear to physicians that the administrators, as top of the chain of command, must be obeyed. Their contempt for medical staff (doctors and nurses) is made obvious and the overall atmosphere is one of frustration (or bitterness); I am sorry to say that, in this culture, the patients are the victims.
A very few practices of the old type still exist. In those, patients and physicians have a mutually caring and respectful relationship, but, unfortunately, private practices (in which we can spend time with patients when it is needed) are disappearing fast. “Clinical pathways” (cookbook medicine) is now the order of the day, and the employed physician who deviates from the recipe, even if only to take a few extra minutes to answer questions, is soon reprimanded, warned or forced out of the employment.
To Ken Rogers
I come from an era where surgeons were called “Sir” and there was no first name use. Sister was Sister Surname and Nurse was Nurse Surname.
When surgeons called themselves by their surnames on the phone and when a male medical student was asked to leave the ward if he wasn’t wearing a tie or if he had long hair.
I remember as a student in my early 20s being on a ward round and the consultant was cracking jokes in Latin.
How times have changed.
The current situation you describe must mirror attitudes in current society and I’m sure my dinosaur like views are now out of place. But I have certainly never seen the type of behaviour you describe although of course I have now heard about it.
Zero tolerance is the answer. But it is somewhat disturbing that you have to tell a doctor their behaviour is inappropriate.
I think it is true that familiarity breeds contempt.
MmeRose
1, June 26, 2015 at 8:51 pm
“Is anyone aware of the reason that the malpractice carrier allowed this to go to a jury trial, rather than settling? I find that extraordinary.”
Perhaps like you, the malpractice carrier didn’t find the behavior all that objectionable, considering it instead just routine OR banter reflecting the good doctors’ contempt for many of their patients, including the one undergoing the colonoscopy. See, for example, their comparison of their patients from Virginia, as opposed to those they’d had in Texas.
1, June 26, 2015 at 9:02 pm
“ ‘Sticks and stones’ as we said as children. I am not certain that childish humor really contributes to death or damage from iatrogenic causes. One hopes that silliness, like emotion, can be separated from the job at hand.” Yes, and one can hope that politicians aren’t influenced by big campaign contributions, either.
Many people, including the jury awarding DB $500,000, didn’t and still don’t buy the “childish humor” defense, and according to a commenter here (Porkchop) who attended the trial, Dr. Ingham’s offered a singularly unconvincing apologia on the witness stand:
“Dr. Ingham’s comments displayed utter contempt for her patient, as did the gastroenterologist’s comments. Her attempt to display remorse and contrition while on the witness stand struck me as unconvincing — I guess that the jury felt that way, as well.”
Are you suggesting, MmeRose, that having a contemptuous attitude toward one’s patients does not affect to one degree or another one’s medical judgment and behavior toward those patients?
If so, the jury members were unable to buy into your denial:
“The sheer volume of crude locker room levity during the procedure supported the plaintiff’s argument that Dr. Ingham was simply not capable of paying full attention to the patient’s vital signs — apparently the jury found that convincing proof of negligence.” (Porkchop1, June 24, 2015 at 10:00 am)
You indicated in your first comment that, “I can assure you that these are by no means the worst comments made in operating rooms, doctors’ lounges and law offices.”
If you don’t attribute, at least in part, to physician hostility, callousness, contempt, and/or indifference to their patients as vulnerable people, the number of iatrogenic injuries and deaths cited in Dr. Starfield’s commentary in JAMA, to what do you attribute those injuries and deaths?
“Sticks and stones” as we said as children. I am not certain that childish humor really contributes to death or damage from iatrogenic causes. One hopes that silliness, like emotion, can be separated from the job at hand.
An example, Ninianpeckitt:
I recall a surgeon removing dressings from a patients’ abdomen, daily, all the time making comments and sounds and facial expressions of disgust. When I finally took him aside and spoke with him about it, he first said “it does not matter, she doesn’t speak English” and then began a vicious personal attack against me (a mere medical student). But I also know many teachers, who make snide comments about their students, lawyers who mock their “ignorant” clients, and others. We live in an unpleasant society, and Drs Ingham’s and Shah’s comments were pretty mild, albeit puerile.
Arranging to be “paged out” of a patient’s room is a very common practice, especially now that most physicians are employed, and have strict time limits imposed on all patient encounters by administration.
Is anyone aware of the reason that the malpractice carrier allowed this to go to a jury trial, rather than settling? I find that extraordinary.
Just to be clear regarding the medical malpractice verdict — it didn’t come out of thin air. In Virginia, in order to succeed on a medical malpractice claim, one must proffer expert testimony concerning the standard of care required of a medical professional, and the expert must explain how that standard was breached in the particular case. Both the plaintiff and the defendant presented expert witnesses. The plaintiff’s expert witness was more convincing to me as an observer of the trial than was the defendants’ expert witness. Obviously, she was more convincing to the jury as well.
Mme. Rose, you are simply wrong about the facts of the case. There was evidence that others people were coming in and out of procedure room during this “banter” — that was sufficient to support the determination that the defamatory comments were published. In addition, there was evidence to support the conclusion that the condition of the patient’s penis was not germane to the medical procedure and thus should not have been discussed at all.
And in my career as a surgeon working in hospital over a 36 year period, in several countries, I have never witnessed language like this coming out of a doctor’s mouth.