Healthcare News & Insights

Nurse faces 10 years in prison for reporting doc’s malpractice

doctor-facing-problem

A nurse who reported a doctor’s unorthodox-at-best techniques now finds herself facing criminal charges of misusing official information.

Last June, Anne Mitchell and Vickilyn Galle, two nurses at Winkler County Memorial Hospital in Texas, sent an anonymous letter to the Texas Medical Board detailing their concerns about Dr. Rolando Arafiles’ treatment of patients.

Mitchell and Galle each have more than 20 years of nursing experience and their duties included quality improvement issues. Mitchell also served as the hospital’s compliance officer.

The letter they sent to the board included relevant file numbers, but no patient names. They cited six specific problematic cases, among them: Arafiles had performed an unsuccessful skin graft in the ER without surgical privileges. In another case, Arafiles sutured a rubber tip to a patient’s crushed finger — a technique that the Dept. of State Health Services later deemed inappropriate care. The nurses also claimed that Arafiles had e-mailed patients, encouraging them to purchase an herbal supplement he sold on the side.

The nurses stated in the letter that they weren’t signing it because hospital administrators had already been alerted to the problems, had not acted, and the nurses feared retribution if their actions were discovered.

Harassment or Whistle-blowing?

Their fears appear to have been well-founded.

After Arafiles heard about the report from the medical board, he told the county sheriff — a personal friend who credits the doctor with saving his life after a heart attack — that he felt the report amounted to harassment.

In response, the sheriff got a search warrant, seized computers at the hospital, and eventually discovered that Mitchell and Galle were responsible. They were fired in June 2009.

Shortly afterward, the county prosecutor brought charges against the women for “misusing official information.” Eventually, charges against Galle were dropped, but Mitchell’s trial started this week. A third nurse who had reported Arafiles in her own letter to the medical board after resigning from the hospital was not charged.

Mitchell and Galle have countersued in federal court, alleging vindictive prosecution and a denial of First Amendment rights by the hospital, sheriff, prosecutor and Arafiles.

Public opinion seems to be with the nurses. The Texas Medical Board’s executive director warned prosecutors this trial could scare other clinicians from reporting malpractice. Several nurses’ associations have raised money for Mitchell’s legal fees. And most legal experts believe Mitchell’s actions fall under the state whistle-blower protection laws.

We’ll keep you posted on this case as it develops.

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Comments

  1. Randy McMaster says:

    I work in IS in the healthcare industry, and I find it almost unbelievable that this is even going to trial. We are incouraged, even implored, to report any and all types of failures in this industry, especially related to patient care or safety. If she followed proper PHI guidelines, then there should be no “misuse” of information.
    Please let Ms Mitchell know I am with her and applaud her convictions.

  2. I found myself in a simular situation at the hospital I work at (Stevens Hospital, Edmonds, WA). I once turned in an RN that was taking patients meds instead of giving them. I had a lot of proof but because she had friends in upper managment, the issue was ignored. As a result I am look down upon by some of managment. I can tell you, I will never do anything like that again. Next time I will just ingnor any wrong doings I may wittness.

  3. This case smells like small town good-old-boys club environment. It also gives the health care industry a black eye when substandard care like this is given a green light by the people entrusted by the public to contol it. Maybe the best reporting route would have been Medicare or CMS as it’s now called. They practically have an open season for whistle blowers to expose this kind of care. They hold the hospitals accountable with participation in the Medicare program over issues like this. Without being able to care of medicare patients, most hospitals could not exist since 40% to 50% of their business is Medicare patients. Any facility that fires the person they put in charge of Quality improvement over the technicality of the so called mis-use of “official information” when the real issue is the substandare care of their patients maybe should be out of business anyway. I know I would not want to be treated there. I hope Ms. Mitchell has a good attorney who moves this case to Federal court as it certainly has implications the physician violating Medicare participation regulations. They would be very interested in reviewing his cases. Add to that, once a person like this feels they have leverage or “protection” in these kind of matters, it is sure they will give substandard care to others.

  4. This is absolutely INSANE!!!

  5. If the Compliance Officer is fired for doing her job, be sure that NO ONE will every report improper behavior ever again at that hospital. Then people will learn that improper medical care is allowed and even condoned there and eventually the scales of justice will be righted when the hospital goes out of business, because patients will be careful to AVOID the hospital, even in emergency situations.

    This is absurd! ! !

    Roger T.

  6. Section 164.512(d) Uses and Disclosures for which an authorization or opportunity to agree or object is not required states:
    A covered entity may dislcose PHI to a health oversight agency for oversight activities authorizaed by law, including audits; civil, administrative, or criminal investigations; inspections; licensure or disciplinary actions; civil, administrative, or criminal proceedings or actions; or other activities necessary for appropriate oversight.
    In other words, the nurse was well within her right to report the horrendous care by this physician to his oversight agency. As the patient advocate it is her duty to protect the patient as part of her licensure. We should be giving her a medal!

  7. These charges cannot be made without a DA who will push them forward. I’m curious to know exactly what was on the affidavit that allowed for the execution of a search warrant at a hospital for harassment? That was either some great work of fiction (move over Robert Ludlum; fiction has reached new heights) or the county judge should consider hanging up his robe. I think someone ought to suture a human brain into Dr. Arafiles’ head.

    (oops… better be careful, someone may supeona the IP address attached to this blog entry and have me charged with using my first amendment rights). To Arafiles: get a life jack$@s.

  8. Just my 2 cents says:

    Obviously all details of the actions of the nurses are not disclosed. I suspect two nurses, each with over 20 years experience, have seen a LOT and most likely overlooked a lot during their nursing tenure. I presume, based on their actions, there were significant activities not in the best interest for patient care and this time they were not overlooking it. I am also confident the physician has helped many and would have some support from satisfied patients such as the supportive county sheriff but no number of rights equates to allow any number of wrongful doings in the medical profession. I have to question why this physician would identify the nurses action as harassment – hello? Professional practices typically doesnt lead to harassment by nurses! I suspect these nurses need all the support they can get for asking someone to look into the physician’s actions. I cannot ascertain if this nurse was presently the compliance nurse or held the position previously. Regardless, it appears by the information offered in this article that her intent is focused on optimum patient care. What more can we ask from nurses nationwide? Dedication to patient care and patient safety SHOULD be number one! Perhaps she blew it with the process, but she kept the patient names out of the loop and probably made every attempt (in her eyes) to process this correctly. It is MOST unfortunate another nurse actually had to resign to keep away from the legal issues. Major kudos to Sawtooth for comments presented. Let’s focus on the SUBSTANDARD care these nurses felt someone should be investigating and the actions of the hospital administrators with previous knowledge of all of this. A peer group of Doctors in a jury may just tell it all regarding the accusations of the whistle blowers. As far as the doc selling nutraceuticals on the side – with the global market expecting to grow to over a $900+ Billion dollar market by 2012 as a result of our families being more focused on healthy lifestyle living, natural supplements, etc.- if the herbal supplement was felt by the MD to actually assist/benefit specific patients and not for just the supplemental income then why not – unless the laws in Texas say they can’t. If my doctor had something in his office that he was not completely focused on the profit end for himself but felt I really should take the supplement and offered it in his office as a convenience to me (and other patients) – why not? I think the laws allow for same, although they do attempt to discourage, but allows for administrative fees, stocking costs, etc. My doctor recently, 30 days ago, recommended Vit D and calcium for osteopenia and I still haven’t purchased it BUT if he had some on the shelves at the office, boy would that have been convenient! What about if I need an ortho brace, crutches, etc. some ortho physicians provide for convenience to their patients – why not herbal supplements? Just because of the amway issues? The majority of physicians are NOT going to refer a product they feel may be harmful but if the product MIGHT just help, why not? Well this is another issue and not really the one at hand. My support goes out to the nurses for “Whistle Blowing” when necessary for patient safety!

    • Carol Katarsky says:

      To “Just my two cents”: In response to your question, Mitchell was the hospital’s compliance officer at the time she sent the letter to the medical board. As far as I can tell, she continued to hold that position until she was fired.

  9. Just my 2 cents says:

    I’d like to see CNN check into this – I am very curious to whether the nurses had good intentions and simply whistle blowing to protect the health care of patients or if there is some substance to the accusation of harassment by the Physician. I just simply cannot see several nurses harassing a physician but I can see nurses standing up to a physician to protect the patient. If the doc was in the wrong here, I do hope the hospital has to face consequences also for overlooking something like this!

  10. Judy Buckley says:

    Wonder if this hospital is accredited under the Joint Commission on Accreditation for Hospitals? I also applaud this nurse for having the courage to stand up and report this. The doctor sounds like he has a sense of entitlement the size of Montana – not least because of his support by the sheriff. Talk about conflice of interest. The doc and the sheriff and the hospital officials need to be taken down a peg. Obviously, this kind of retaliation discourages reporting of future events. I hope the court finds in favor of this nurse and that she and the second nurse win their countersuit.

  11. Sounds like the Sheriff needs to be investigated. This is an outrage! I can only imagine what the nurses did turn a blind eye too up to this point. The hospital should stand by them since this doc has had problems before. What’s next for the rest of us? We are taught to be patient advocates and where does it get us?

  12. I am enraged that this even happened in the first place. Absolutely unbelievable that nurses, who took an oath to be patient advocates would even be considered on charges of this nature. Nurses are first and foremost there for patient safety and patient rights. Sounds to me like there is a lot that needs to be investigated in regards to the sheriff as well as the hospital itself. I find it highly interesting that the third nurse who also reported things to the medical board never received anything. Sounds to me like the hospital itself is a little more than sneaky and underhanded. Maybe it is time for a federal investigation into the practices as a whole there. Nurses as a whole do overlook a lot of things that should be considered as shody practice…. the hospital should be so lucky to have a nursing staff who cares enough to report a Doctor who gives them a less than sparkling reputation!!!! Appauling!!!!!!!!!!!!!!!!!!!!!

  13. Karen Grinmanis, MS/Ed, RN says:

    This really is absurd. There was no “misuse” of protected information. The names of patients were removed and the substandard care delivered was reported as it should have been.
    According to the ANA Code of Ethics for Nurses, “The nurse promotes, advocates for, and strives to protect the health, safety, and rights of the patient, and “The nurse participates in establishing, maintaining, and improving healthcare environments and conditions of employment conducive to the provision of quality health care and consistent with the values of the profession through individual and collective action.”
    Both of these nurses acted within the scope of the profession by reporting this MD. As far as loosing their employment as a result maybe not a bad thing, why continue employment at a facility that allows substandard care to be delivered? Wonder if Medicare or Medicaid paid for this substandard care?

  14. I live in San Diego, California and have been a nurse almost 15yrs. I am sad to say that retaliation towards nurses who speak out against patient safety issues and discriminatory practices is a regular occurrence in 3 health-care/biomedical systems.

    It is a no win situation for nurses-if you speak out you are black balled and labeled as “not being a team player, difficult”; if you ignore the unsafe and illegal practices you keep your job (most likely given a job promotion) but risk loosing your license, being sued, a patient being seriously harmed (or die) and compromising your morale values.

    How can I continue to do what I love-Nursing-but protect myself legally?
    Last comment: I applaud these two nurses. Their selfless acts are protecting and saving patients.

  15. Lisa Vieira says:

    I would like to follow the case. please post any updates.

  16. This has already come back as not guilty. The jury ruled quickly. This article didn’t mention it, but the sheriff was also in business with Dr. Arafiles. He was not in this as some sort of life debt. As always, follow the money. It was a homeopathic supplement business. I might guess that prescribing his own products over those for standard practice played some part in the initial charges, but I don’t know for sure. There again, I advise investigators to follow the money.

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  1. […] compliance officer at Winkler County Memorial Hospital, was charged by the county prosecutor after the doctor she reported for suspected malpractice said he felt “harassed” by her allegations. She had previously anonymously reported Dr. […]

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