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, Harvard Combined Orthopaedic Residency Program For more information about these cookies and the data (Lillemoe later said he had misspoken.). 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. The first is the education of surgeons, residents, fellows, and even the sales force. That doctor worked in the orthopedic trauma service where, MGH says, overlapping surgeries can be more common, and sometimes necessary, as doctors respond to clusters of urgent and emergent cases. MGH officials declined to comment directly on the Meng case, saying federal patient privacy laws forbid their doing so. Warner had a second procedure running simultaneously and was scrubbed into room 20. General, where X-rays revealed she had fractured her left hip. He can rattle off relatives who have been treated at MGH and says he wouldnt dream of going anywhere else. Rather, such cases are handled in successive stages, with the surgeon devoting himself to a section of one patients case, then moving on to the other. Such indirect supervision, where the attending is not present, is allowed under certain circumstances at teaching hospitals. Director, Harvard Combined Orthopaedic Residency Program . Generals busy orthopedic trauma service, and on this day, he was very busy indeed. See discharge instructions for the Orthopaedic Spine Service. 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. Harris is a widely respected and beloved teacher. SunderNeelakantan Sunder, M.D.Anesthesiologist would later retire, in part because he was fed up with the battle over double-booking. Learn about the many ways you can get involved and support Mass General. 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. I think its a fact that most patients would be uncomfortable with their doctor doing two operations simultaneously.. So when things went awry in some operating rooms with double-booked doctors, it was often anesthesiologists writing e-mails to hospital administrators and sharing information with Burke, whom they knew was willing to take their concerns to the top. He removed a damaged disc from the womans lower back and plugged it with bone; it would be the last surgery he did on her that day, though he checked on her twice and gave instructions to her medical team. Save my name, email, and website in this browser for the next time I comment. Both men, wearing scrubs, sat at a formica-covered table in the middle of the room, according to Burkes recollection of the encounter. Rubash announced the departure with mixed emotions, saying Wood built an outstanding spine service. 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. More broadly, MGH officials say their analysis of hundreds of orthopedic cases from 2013 and 2014 found no significant difference in complication rates between overlapping and non-overlapping cases. His chosen path would lead him back to MGH for his residency and the heart of his 35-year career. Dear Dr Freiburg, I would like to know your thoughts on Titanium and/or metal allergy in total joint prothesis rejection/inflammation. Check appointments, communicate with your provider and pay bills online 24/7. Any senior resident who could hold a knife could have done it, Phan said. Dr. Allan Kirk, the head of surgery at Duke University School of Medicine, coauthored an article this year on concurrent surgery in the Annals of Surgery, a journal edited by MGHs chief of surgery, Dr. Keith Lillemoe. This event will be livestreamed. In June 2012, Lillemoe unveiled the much anticipated guidelinesThe final policy formally adopted in October 2012 had some changes from a draft shared in spring 2012. Our orthopedic surgery team includes renowned surgeons who are highly skilled and experienced in their specialty area. We want to get you back to doing the things you love. 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. Michael Kelly, M.D. 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. Burke sent a blistering e-mail to top hospital leaders, reviewing his long-running efforts to rein in the practice. Congratulations on this new journey in your professional career. He completed his undergraduate studies from the College of the Holy Cross, and earned his medical degree from Boston University School of Medicine. He threatened me verbally, and he threatened he was going to have me fired, and what was I doing to his girl, Rubash said. When Dr. Neelakantan Sunder, team leader for orthopedic anesthesia, raised questions about Wood booking two rooms for major spine surgery in 2010 two years before the Meng case Dr. Peter Dunn, medical director of the hospitals OR, reassured him in an e-mail obtained by the Globe that Wood has the fellow manpower to do this., Sunder, who could be prickly about what he considered matters of patient safety, replied: Do you really think it reasonable to do these two cases by the same primary surgeon? Copyright 2007-2023. For more information about these cookies and the data We want to get you back to doing the things you love. Learn about career opportunities, search for positions and apply for a job. Thats the most appropriate utilization of this concurrent surgery not having two cases going exactly at the same time and the surgeon bouncing back and forth between the two, said Kirk. 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. The patient was then wheeled into the operating room and given anesthesia, while the surgical team, including Dalal, waited for Vrahas. Wood, in later testimony, described the hole in the dura as large and that he couldnt pinpoint when it had torn open or what was the cause. General orthopedics ranks fourth in reputation among all US hospitals, according to US News and World Report. Orthopedics Today, September 2010 Rowe, Carter R. Lest we Forget : Orthopaedics at the Massachusetts General Hospital and Ward I, 1900-1996. Rubash, in a July 2011 deposition, described Burke as engaging in extreme advocacy, taking his cause to many people in positions of authority and not considering the views of others. Previously, Dr. Harris served as the chief of the Orthopaedic Trauma Service at Brigham and Women's Hospital (BWH). 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. Theres been huge success in doing [concurrent surgeries] in the cardiovascular field, said Dr. Brian Parsley, a Houston orthopedic surgeon and the former president of the American Association of Hip and Knee Surgeons. Can you imagine, Burke wrote to Ann Prestipino, senior vice president of surgical and anesthesia services, in March 2012, the harm that will occur to this institutions reputation if it were to be discovered that this patients surgery was double booked?, Prestipino, in her response, sought to reassure Burke: The policy for working out of two rooms is in the process of revision under the leadership of Dr. Lillemoe, our new Surgeon-in-Chief.. Orthopaedic Journal at Harvard Medical School - annual publication General orthopedics but did not study whether concurrent surgery played a role in the departments success. Wood, chief of MGH's orthopedic spine service at the time and a nationally renowned practitioner in his specialty, is a confident, veteran surgeon. Paulino Pereira NR, Langerhuizen DW, Janssen SJ, Hornicek FJ, Ferrone ML, Harris MB, Schwab JH. Skates, in a subsequent e-mail, told Burke: the situation must be corrected.. It is unfortunate, the hospital said in a written statement, that a well-respected surgeon would cause a massive violation of patient confidentiality policies by copying hundreds of patient records and sharing them with the Boston Globe.. General officials said that Bhattacharyya provided superb care to this patient, and that his other cases had no impact on his treatment of the French patient. This impressive achievement is a testament to the commitment of our clinical team to providing safe, high-quality care while ensuring an exceptional patient experience. Im busy, Bhattacharyya told Vassallo, according to her court testimony. What can patients rightly expect of their doctors? I saw these hypocrites, sanctimonious hypocrites, who were going to string this woman up, he said in an interview. Then the chief stood up and left, Burke recalled. The Brighams chief of surgery, Dr. Michael Zinner, recently said he scolded a new surgeon at his hospital who violated the rule. This was the conference related to a Dr. WarnerJon J.P. Warner, M.D.Chief of MGHs shoulder service case in 2008 involving a patient who suffered a vascular injury. She told Burke her understanding was that the patient might have to wait days for surgical relief. And he is an exceptionally busy practitioner, having performed more than 10,000 knee and hip operations since completing his orthopedics residency in 1984. We use cookies and other tools to enhance your experience on our website and Other luminaries in orthopaedic surgery have headed the Department over the years, including Drs. Leader of orthopedics research program at the National Institutes of Health. 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. The Department of Orthopaedic Surgery at the Massachusetts General Hospital (MGH) is seeking a Chief of the Arthroplasty Service. Former US attorney Donald Sterns 2012 report remains private, its conclusions known only at the institutions highest levels. The fellow, Dr. Philippe Phan, had worked for a year as a general orthopedic surgeon and had begun specialty training at MGH days before. PCPs often are your first point of contact for your general health concerns. Read the final policy. American Academy of Orthopaedic Surgeons: Spinal Cord Blood Supply and Its Surgical Implications, The use of Autologous Free Vascularized Fibula Grafts in Reconstruction of the Mobile Spine Following Tumor Resection: Surgical Technique and Outcomes. to analyze our web traffic. 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. 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. The form now emphasizes that medical care will be provided by a team and says my doctor or an attending designee will be present for the critical parts of the procedure. What began as an internal discussion about safe surgical practice long ago turned personal and bitter, pitting top medical figures against one another. Meng, can you move your arms or legs, or squeeze my fingers or wiggle your toes?, All Meng could do, when the resident asked, was wince.. Malcom Smith, M.D.Chief of MGH orthopedic trauma, in a written statement, said it would be unethical and illegal under federal privacy laws to respond to anything about the case specifically. Explore fellowships, residencies, internships and other educational opportunities. The General Hospital Corporation. Burke, in a later deposition, called Rubashs account a total fabrication.. Shervin had herself tried and failed to put the hip back into place. At 1:49 p.m. the next day, Pereira was wheeled into operating room 21. But change came to his door. 1 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. 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. 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. Faculty and Staff - FARIL MGH - Harvard University Read the draft version. After Skates left, Torchiana pulled Burke aside and said it was wrong to involve a trustee in this matter. The Globe declined the hospitals request to return the documents for a review of Burkes redactions. Learn about career opportunities, search for positions and apply for a job. Now director of Orthopedic Trauma Services at Suburban Hospital in Bethesda, Md. We took those concerns very seriously, Slavin said. Hospital attorneys say Wood acted appropriately and within the acceptable standard of care. Dr. Christopher Bono Director, HCORP The Harvard Combined Orthopaedic Residency Program has existed for more than 100 years, and we are proud of the rich tradition of educating outstanding clinicians and leaders. 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. If I had known, I wouldnt do the surgery.. He had lost all muscle responses in his arms and legs, and doctors still did not know why. About Jon J.P. Warner - Mass General Brigham Rubash helped introduce an incentive system that paid doctors more if they generated more profits. By the time Bhattacharyya scrubbed back into Pereiras operation, Shervin was concerned the cement was too hard. ShervinNina ShervinOrthopedic surgery resident was the one at fault, Rubash shot back, according to Burke. Rubash, in an interview, said concurrent surgery did not become more common during his tenure. Leonard DA, Schoenfeld AJ, Harris MB, Bono CM. Vassallo and Shervin did not respond to repeated requests for comment. I have ccd Sue on this since she was the anesthesiologist. The Meng case reverberated deeply for BurkeDennis William Burke, M.D.Orthopedic surgeon. One fellow will start at Massachusetts General Hospital (MGH) and the other will start at Brigham and Women's Hospital (BWH) and rotate half-way . Providing journalistic work product, particularly during an ongoing project Burke is a zealot on the issue and makes no apology for it. So tightly guarded was the report that, at one point, Mass. Some tests may be necessary at that time, including x-rays, CT scans and MRIs. Then, on Aug. 12, MGHs president, Peter Slavin, made it official. Dr. The question: Is it right or safe for surgeons to run two operations at once? Access to sports medicine experts when you need them most. 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. When word of Mengs paralysis reached him in August 2012, he couldnt sleep, Burke says. Our orthopaedic specialists see patients at many locations, including Boston, Waltham, Danvers, Newton-Wellesley and Foxborough. Can they really do two overlapping operations equally well? is new director of Scoliosis and Spinal Deformities at Rady Childrens Hospital-San Diego. Search for condition information or for a specific treatment program. MGH officials say that hiring Stern who likely commanded $600 to $900 an hour at the time, according to lawyers who practice similar work shows they took Burke seriously, and the report gave them confidence they were on the right track. The hospital said that, in 2014, 10 percent of Burkes surgeries had procedural overlap. Im just a concerned doc worried about poor patient care and potential damage to the hospitals reputation.. They discovered his spinal cord had somehow bent at an acute angle and was protruding through a hole in the dura, the tough membrane that encases the spinal cord where Wood had first operated the morning before. Consider Nicholas Gregory. We bring together the clinical professionals with the most appropriate skills to deliver your care. Candidate must be an arthroplasty fellowship-trained, board-certified orthopaedic surgeon with an exemplary record that exhibits the . I am absolutely thrilled for Dr. Freuberg on his new role. Neither knew it at the time, but a seed had been planted. . The prognostic value of preoperative participation in activities of daily living on postoperative outcomes following lumbar discectomy. Tony Meng didnt dwell much on the risks as he prepared for surgery on that August morning in 2012. The patient was reduced to tears, started to have a full blown panic attack, wrote WollmanLisa T Wollman-Kliman, M.D.Anesthesiologist. The Chief will . 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.

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